RESUMO
INTRODUCTION: Experience accumulated over the last decades suggests nonoperative management (NOM) of civilian gunshot liver injuries can be safely applied in selected cases. This study aims to compare the outcomes of selective NOM versus operative management (OM) of patients sustaining gunshot wounds (GSW) to the liver. METHODS: A registry-based retrospective cohort analysis was performed for the period of 2008 to 2016 in a Brazilian trauma referral. Patients aged 16-80 years sustaining civilian GSW to right-sided abdominal quadrants and liver injury were included. Baseline data, vital signs, grade of liver injury, associated injuries, injury severity scores, blood transfusion requirements, liver- and non-liver-related complications, length-of-stay (LOS), and mortality were retrieved from individual registries. RESULTS: A total of 54 patients were eligible for analysis, of which 37 underwent NOM and 17 underwent OM. The median age was 25 years and all were male. No statistically significant differences were observed between groups regarding patients' demographics, injury scores, grade of liver injury and associated lesions. NOM patients tended to sustain higher-grade injuries (86.5% vs 64.7%; p = 0.08), and failure of conservative management was recorded in two (5.4%) cases. The rate of complications was 48% with no between-group statistically significant difference. Blood transfusion requirements were significantly higher in the OM group (58.8% vs 21.6%; p = 0.012). The median LOS was seven days. No deaths were recorded. CONCLUSION: Patients with liver GSW who are haemodynamically stable and without peritonitis are candidates for NOM. In this study, NOM was safe and effective even in high-grade injuries.
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The goal of this study is to analyze the floristic patterns and the structure of disturbed and undisturbed upland forests, in Permanent Preservation Areas (PPAs) along the Moju river, in the Brazilian state of Pará. Trees with a diameter equal to or larger than 10cm at 1.30m from the ground (DBH) ≥ 10cm were analyzed for the upper stratum. For the middle stratum, individuals with DBH between 4.99 and 9.99cm were sampled. Forty-five families and 221 species were found in disturbed forests, and 43 families and 208 species in undisturbed forests. Floristic similarity was high between strata and between forest types, with values above 50%. Similarity was highest between middle strata. The most species-abundant families in undisturbed forests were Fabaceae, Sapotaceae, Chrysobalanaceae and Myrtaceae; the species with the highest density there were Eschweilera grandiflora, Licania sclerophylla and Zygia cauliflora. In disturbed forests, the dominant families were Fabaceae, Sapotaceae, Lecythidaceae and Melastomataceae. The Shannon-Wiener diversity index was 3.21 for undisturbed forests and 2.85 for disturbed forests. Non-metric multidimensional scaling (MDS) analysis did not group the forests by their floristic composition in both upper and middle strata. Overall, the PPA forests along the Moju river, even if disturbed, did not show major floristic changes but substantially change their structural characteristics.(AU)
Este estudo teve como objetivo analisar os padrões florísticos e a estrutura de florestas ripárias perturbadas e não perturbadas inseridas em Áreas de Preservação Permanente ao longo do rio Moju, Pará. A análise do estrato superior foi realizada em árvores com diâmetro a 1,30 m do solo (DAP) ≥ 10 cm. No estrato médio, amostrou-se os indivíduos com DAP entre 4,99 e 9,99 cm DAP. Nas florestas perturbadas foram encontradas 45 famílias e 221 espécies e nas florestas não perturbadas, 43 famílias e 208 espécies. A similaridade florística foi elevada entre os estratos e entre os tipos de florestas, alcançando valores maiores de que 50%. A maior semelhança foi encontrada entre os estratos médios. As famílias mais abundantes em espécies nas florestas não perturbadas foram Fabaceae, Sapotaceae, Chrysobalanaceae e Myrtaceae. As espécies com maiores densidades foram Eschweilera grandiflora, Licania sclerophylla e Zygia cauliflora. Nas florestas perturbadas, as famílias dominantes foram Fabaceae, Sapotaceae, Lecythidaceae e Melastomataceae. A diversidade (Shannon) nas florestas não perturbadas foi de 3,21, e nas florestas perturbadas, alcançaram 2,85. A ordenação feita pelo escalonamento multidimensional MDS, não agrupou as florestas por sua composição florística, tanto no estrato superior como no médio. Em geral, as florestas perturbadas das APPs do rio Moju, mesmo se perturbadas, não evidenciam grandes mudanças florísticas, mas apresentam alterações nas suas características estruturais.(AU)
Assuntos
Animais , Flora/classificação , Florestas , Conservação dos Recursos Naturais , Fabaceae , Sapotaceae , Chrysobalanaceae , Myrtaceae , BrasilRESUMO
Abstract The goal of this study is to analyze the floristic patterns and the structure of disturbed and undisturbed upland forests, in Permanent Preservation Areas (PPAs) along the Moju river, in the Brazilian state of Pará. Trees with a diameter equal to or larger than 10cm at 1.30m from the ground (DBH) ≥10cm were analyzed for the upper stratum. For the middle stratum, individuals with DBH between 4.99 and 9.99cm were sampled. Forty-five families and 221 species were found in disturbed forests, and 43 families and 208 species in undisturbed forests. Floristic similarity was high between strata and between forest types, with values above 50%. Similarity was highest between middle strata. The most species-abundant families in undisturbed forests were Fabaceae, Sapotaceae, Chrysobalanaceae and Myrtaceae; the species with the highest density there were Eschweilera grandiflora, Licania sclerophylla and Zygia cauliflora. In disturbed forests, the dominant families were Fabaceae, Sapotaceae, Lecythidaceae and Melastomataceae. The Shannon-Wiener diversity index was 3.21 for undisturbed forests and 2.85 for disturbed forests. Non-metric multidimensional scaling (MDS) analysis did not group the forests by their floristic composition in both upper and middle strata. Overall, the PPA forests along the Moju river, even if disturbed, did not show major floristic changes but substantially change their structural characteristics.
Resumo Este estudo teve como objetivo analisar os padrões florísticos e a estrutura de florestas ripárias perturbadas e não perturbadas inseridas em Áreas de Preservação Permanente ao longo do rio Moju, Pará. A análise do estrato superior foi realizada em árvores com diâmetro a 1,30 m do solo (DAP) ≥10 cm. No estrato médio, amostrou-se os indivíduos com DAP entre 4,99 e 9,99 cm DAP. Nas florestas perturbadas foram encontradas 45 famílias e 221 espécies e nas florestas não perturbadas, 43 famílias e 208 espécies. A similaridade florística foi elevada entre os estratos e entre os tipos de florestas, alcançando valores maiores de que 50%. A maior semelhança foi encontrada entre os estratos médios. As famílias mais abundantes em espécies nas florestas não perturbadas foram Fabaceae, Sapotaceae, Chrysobalanaceae e Myrtaceae. As espécies com maiores densidades foram Eschweilera grandiflora, Licania sclerophylla e Zygia cauliflora. Nas florestas perturbadas, as famílias dominantes foram Fabaceae, Sapotaceae, Lecythidaceae e Melastomataceae. A diversidade (Shannon) nas florestas não perturbadas foi de 3,21, e nas florestas perturbadas, alcançaram 2,85. A ordenação feita pelo escalonamento multidimensional MDS, não agrupou as florestas por sua composição florística, tanto no estrato superior como no médio. Em geral, as florestas perturbadas das APPs do rio Moju, mesmo se perturbadas, não evidenciam grandes mudanças florísticas, mas apresentam alterações nas suas características estruturais.
Assuntos
Árvores , Florestas , Conservação dos Recursos Naturais , Biodiversidade , Brasil , RiosRESUMO
The goal of this study is to analyze the floristic patterns and the structure of disturbed and undisturbed upland forests, in Permanent Preservation Areas (PPAs) along the Moju river, in the Brazilian state of Pará. Trees with a diameter equal to or larger than 10cm at 1.30m from the ground (DBH) ≥10cm were analyzed for the upper stratum. For the middle stratum, individuals with DBH between 4.99 and 9.99cm were sampled. Forty-five families and 221 species were found in disturbed forests, and 43 families and 208 species in undisturbed forests. Floristic similarity was high between strata and between forest types, with values above 50%. Similarity was highest between middle strata. The most species-abundant families in undisturbed forests were Fabaceae, Sapotaceae, Chrysobalanaceae and Myrtaceae; the species with the highest density there were Eschweilera grandiflora, Licania sclerophylla and Zygia cauliflora. In disturbed forests, the dominant families were Fabaceae, Sapotaceae, Lecythidaceae and Melastomataceae. The Shannon-Wiener diversity index was 3.21 for undisturbed forests and 2.85 for disturbed forests. Non-metric multidimensional scaling (MDS) analysis did not group the forests by their floristic composition in both upper and middle strata. Overall, the PPA forests along the Moju river, even if disturbed, did not show major floristic changes but substantially change their structural characteristics.
Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Florestas , Árvores , Brasil , RiosRESUMO
BACKGROUND AND PURPOSE: Caffeine (a non-selective adenosine receptor antagonist) prevents memory deficits in aging and Alzheimer's disease, an effect mimicked by adenosine A2 A receptor, but not A1 receptor, antagonists. Hence, we investigated the effects of adenosine receptor agonists and antagonists on memory performance and scopolamine-induced memory impairment in mice. EXPERIMENTAL APPROACH: We determined whether A2 A receptors are necessary for the emergence of memory impairments induced by scopolamine and whether A2 A receptor activation triggers memory deficits in naïve mice, using three tests to assess short-term memory, namely the object recognition task, inhibitory avoidance and modified Y-maze. KEY RESULTS: Scopolamine (1.0 mg·kg(-1) , i.p.) impaired short-term memory performance in all three tests and this scopolamine-induced amnesia was prevented by the A2 A receptor antagonist (SCH 58261, 0.1-1.0 mg·kg(-1) , i.p.) and by the A1 receptor antagonist (DPCPX, 0.2-5.0 mg·kg(-1) , i.p.), except in the modified Y-maze where only SCH58261 was effective. Both antagonists were devoid of effects on memory or locomotion in naïve rats. Notably, the activation of A2 A receptors with CGS 21680 (0.1-0.5 mg·kg(-1) , i.p.) before the training session was sufficient to trigger memory impairment in the three tests in naïve mice, and this effect was prevented by SCH 58261 (1.0 mg·kg(-1) , i.p.). Furthermore, i.c.v. administration of CGS 21680 (50 nmol) also impaired recognition memory in the object recognition task. CONCLUSIONS AND IMPLICATIONS: These results show that A2 A receptors are necessary and sufficient to trigger memory impairment and further suggest that A1 receptors might also be selectively engaged to control the cholinergic-driven memory impairment.
Assuntos
Transtornos da Memória/fisiopatologia , Memória de Curto Prazo/fisiologia , Agonistas do Receptor Purinérgico P1/farmacologia , Antagonistas de Receptores Purinérgicos P1/farmacologia , Receptor A2A de Adenosina/fisiologia , Adenosina/administração & dosagem , Adenosina/análogos & derivados , Adenosina/antagonistas & inibidores , Adenosina/farmacologia , Animais , Aprendizagem da Esquiva/efeitos dos fármacos , Relação Dose-Resposta a Droga , Infusões Intraventriculares , Locomoção/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Transtornos da Memória/induzido quimicamente , Memória de Curto Prazo/efeitos dos fármacos , Camundongos , Fenetilaminas/administração & dosagem , Fenetilaminas/antagonistas & inibidores , Fenetilaminas/farmacologia , Pirimidinas/farmacologia , Receptor A1 de Adenosina/fisiologia , Reconhecimento Psicológico/efeitos dos fármacos , Escopolamina/antagonistas & inibidores , Escopolamina/farmacologia , Triazóis/farmacologia , Xantinas/farmacologiaRESUMO
Interleukin (IL) 10 and interferon-gamma (IFN-) levels in induced sputum supernatants of 21 tuberculosis (TB) patients at diagnosis and during chemotherapy were correlated to recurrence rates. IL-10 decreased until day 60 of treatment (T60), and between T60 and T180 it increased again in 7 cases (Pattern 1) and further decreased in 14 cases (Pattern 2). Follow-up of 69 months was performed in 20/21 cases; 6 had recurrence of TB, of which 5/7 (71%) had Pattern 1 and 1/13 (7.7%) Pattern 2 (OR 30.0, 95%CI 2.19411.3, P 0.0072). This was not observed for IFN-. High IL-10 levels at the end of treatment may function as a risk factor for TB recurrence.
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Antituberculosos/uso terapêutico , Interferon gama/imunologia , Interleucina-10/imunologia , Tuberculose/imunologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Recidiva , Fatores de Risco , Escarro/imunologia , Tuberculose/tratamento farmacológico , Adulto JovemRESUMO
We tested the effect of bone marrow cell (BMC) transplantation in either preventing or reversing cirrhosis on an experimental model of chronic liver disease. Female Wistar rats were fed a liquid alcohol diet and received intraperitoneal injections of carbon tetrachloride (CCl4) over 15 weeks. Ten animals (cell-treated group) received five injections of BMCs during the cirrhosis induction protocol (on the 4th, 6th, 8th, 10th, and 12th weeks) and four animals received the cells after liver injury was established through tail vein. Nine animals (nontreated group) were submitted to the previously described protocols; however, they received vehicle injections. Analyses were performed to verify whether the infusion of cells was effective in preventing the development of cirrhosis in our model of induction, and if the cells could reverse cirrhosis once it was established. Hepatic architecture and fibrotic septa were analyzed in liver slices stained with hematoxilin & eosin and Sirius red, respectively. Fibrosis quantification was measured by Sirius red histomorphometry. Indirect immunofluorescence was performed to detect the amount of tissue transglutaminase 2. Blood analyses were performed to assess liver injury and function by the assessment of alanine aminotransferase and albumin. Ultrasound was performed to analyze the portal vein caliber and presence of ascitis. Cirrhosis features (regenerative nodules and fibrous septa) were observed in histopathology after 15 weeks of continuous hepatic injury in nontreated and cell-treated groups. Collagen content, immunofluorescence analysis, and biochemical and ultrasound parameters were similar in nontreated and cell-treated groups; however, both groups showed significant differences compared to a normal control group. Cell infusions with bone marrow-derived cells seem to be ineffective in improving morphofunctional parameters of the liver when applied to chronic cases either during or after establishment of the hepatic lesion.
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Transplante de Medula Óssea/métodos , Cirrose Hepática Experimental/cirurgia , Fígado/cirurgia , Albuminas/análise , Albuminas/metabolismo , Animais , Compostos Azo , Tetracloreto de Carbono/toxicidade , Depressores do Sistema Nervoso Central/toxicidade , Colágeno/análise , Colágeno/metabolismo , Corantes , Modelos Animais de Doenças , Enzimas/análise , Enzimas/metabolismo , Amarelo de Eosina-(YS) , Etanol/toxicidade , Feminino , Hematoxilina , Hepatócitos/efeitos dos fármacos , Hepatócitos/patologia , Fígado/diagnóstico por imagem , Fígado/patologia , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/patologia , Cirrose Hepática/cirurgia , Cirrose Hepática Experimental/patologia , Cirrose Hepática Experimental/fisiopatologia , Veia Porta/diagnóstico por imagem , Veia Porta/patologia , Veia Porta/fisiopatologia , Proteína 2 Glutamina gama-Glutamiltransferase , Ratos , Ratos Wistar , Resultado do Tratamento , UltrassonografiaRESUMO
Costimulatory and antigen-presenting molecules are essential to the initiation of T cell immunity to mycobacteria. The present study analyzed by immunocytochemistry, using monoclonal antibodies and alkaline phosphatase-anti-alkaline phosphatase method, the frequency of costimulatory (CD86, CD40, CD40L, CD28, and CD152) and antigen-presenting (MHC class II and CD1) molecules expression on human lung cells recovered by sputum induction from tuberculosis (TB) patients (N = 22) and non-TB controls (N = 17). TB cases showed a statistically significant lower percentage of HLA-DR+ cells than control subjects (21.9 ± 4.2 vs 50.0 ± 7.2 percent, P < 0.001), even though similar proportions of TB cases (18/22) and control subjects (16/17, P = 0.36) had HLA-DR-positive-stained cells. In addition, fewer TB cases (10/22) compared to control subjects (16/17) possessed CD86-expressing cells (P = 0.04; OR: 0.05; 95 percentCI = 0.00-0.51), and TB cases expressed a lower percentage of CD86+ cells (P = 0.04). Moreover, TB patients with clinically limited disease (£1 lobe) on chest X-ray exhibited a lower percentage of CD86-bearing cells compared to patients with more extensive lung disease (>1 lobe) (P = 0.02). The lower expression by lung cells from TB patients of HLA-DR and CD86, molecules involved in antigen presentation and activation of T cells, may minimize T cell recognition of Mycobacterium tuberculosis, fostering an immune dysfunctional state and active TB.
Assuntos
Adulto , Feminino , Humanos , Masculino , Células Apresentadoras de Antígenos/imunologia , Antígenos CD/imunologia , Antígenos HLA-DR/imunologia , Antígenos de Histocompatibilidade Classe II/imunologia , Linfócitos T/imunologia , Tuberculose Pulmonar/imunologia , Fosfatase Alcalina/imunologia , Anticorpos Monoclonais/imunologia , Células Apresentadoras de Antígenos/metabolismo , Antígenos CD/metabolismo , Estudos de Casos e Controles , Antígenos HLA-DR/metabolismo , Antígenos de Histocompatibilidade Classe II/metabolismo , Imunidade Celular , Imuno-Histoquímica , Ativação Linfocitária/imunologia , Mycobacterium tuberculosis/imunologia , Escarro/microbiologiaRESUMO
Costimulatory and antigen-presenting molecules are essential to the initiation of T cell immunity to mycobacteria. The present study analyzed by immunocytochemistry, using monoclonal antibodies and alkaline phosphatase-anti-alkaline phosphatase method, the frequency of costimulatory (CD86, CD40, CD40L, CD28, and CD152) and antigen-presenting (MHC class II and CD1) molecules expression on human lung cells recovered by sputum induction from tuberculosis (TB) patients (N = 22) and non-TB controls (N = 17). TB cases showed a statistically significant lower percentage of HLA-DR+ cells than control subjects (21.9 +/- 4.2 vs 50.0 +/- 7.2%, P < 0.001), even though similar proportions of TB cases (18/22) and control subjects (16/17, P = 0.36) had HLA-DR-positive-stained cells. In addition, fewer TB cases (10/22) compared to control subjects (16/17) possessed CD86-expressing cells (P = 0.04; OR: 0.05; 95%CI = 0.00-0.51), and TB cases expressed a lower percentage of CD86+ cells (P = 0.04). Moreover, TB patients with clinically limited disease ( pound1 lobe) on chest X-ray exhibited a lower percentage of CD86-bearing cells compared to patients with more extensive lung disease (>1 lobe) (P = 0.02). The lower expression by lung cells from TB patients of HLA-DR and CD86, molecules involved in antigen presentation and activation of T cells, may minimize T cell recognition of Mycobacterium tuberculosis, fostering an immune dysfunctional state and active TB.