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BACKGROUND: High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) is a standard treatment for relapsed/refractory lymphoma patients. Yet, the widespread use of BEAM is hindered by carmustine accessibility. This study evaluates the efficacy and safety of PEAM (Cisplatin, Etoposide, Cytarabine, and Melphalan) versus BEAM in auto-HSCT for Hodgkin (HL) and non-Hodgkin lymphoma (NHL) patients. METHODS: We conducted a retrospective single-center study of adult lymphoma patients who received PEAM or BEAM pretransplant conditioning between January 2004 to December 2022, comparing efficacy and safety outcomes. RESULTS: Among 143 patients (median age of 33 years, 58% males), 55 had HL, and 88 had NHL. The overall response rate (ORR) was 86.7% for PEAM and 72.3% for BEAM, and the relapse rate (RR) was lower for PEAM than BEAM (22.9% vs 45.6%). Median time to relapse (TTR) and overall survival (OS) were not reached for either group. PEAM exhibited a shorter time to both neutrophil (NE) and platelet (PE) engraftment compared to BEAM (10 vs 12 days), with a more tolerable gastrointestinal (GI) toxicity profile. CONCLUSIONS: Both BEAM and PEAM showed similar outcomes, demonstrating comparable efficacy in terms of ORR, TTR, and OS for both HL and NHL patients. However, PEAM-conditioning was associated with a shorter time to engraftment and fewer GI adverse events.
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Protocolos de Quimioterapia Combinada Antineoplásica , Carmustina , Cisplatino , Citarabina , Transplante de Células-Tronco Hematopoéticas , Melfalan , Condicionamento Pré-Transplante , Transplante Autólogo , Humanos , Adulto , Masculino , Feminino , Carmustina/administração & dosagem , Carmustina/uso terapêutico , Estudos Retrospectivos , Citarabina/administração & dosagem , Citarabina/uso terapêutico , Melfalan/administração & dosagem , Melfalan/uso terapêutico , Condicionamento Pré-Transplante/métodos , Cisplatino/administração & dosagem , Cisplatino/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Pessoa de Meia-Idade , Adulto Jovem , Doença de Hodgkin/terapia , Doença de Hodgkin/mortalidade , Etoposídeo/administração & dosagem , Linfoma/terapia , Linfoma/mortalidade , Adolescente , Linfoma não Hodgkin/terapia , Linfoma não Hodgkin/mortalidade , Resultado do TratamentoRESUMO
INTRODUCTION AND AIMS: Posttransplantation diabetes mellitus (PTDM) is a serious long-term complication that has a negative impact on graft and patient survival. The purpose of the present study was to describe the incidence of PTDM in a Mexican cohort and evaluate its association with a previous family history of diabetes (FHD). METHODS: A retrospective single-center cohort study was conducted on patients undergoing liver transplantation (LT). The primary outcome was time from LT to PTDM. The diagnosis of PTDM was established using the ADA criteria. A mediation analysis that used adjusted Cox regression models and considered pretransplant prediabetes a mediator was performed, to determine the total effect and direct effect of FHD on PTDM. RESULTS: A total of 152 patients were included, with a median follow-up time of 41 months; 19.2% (nâ¯=â¯29) had pretransplant diabetes. During the follow-up time, 15% of patients developed PTDM (nâ¯=â¯23), with an incidence rate of 4.71 cases/100 person-years. PTDM was significantly higher in patients with FHD, compared with those with no FHD (8.72 cases/100 person-years vs 2.04 cases/100 person-years, respectively; pâ¯=â¯0.001). The adjusted hazard ratio of PTDM for FHD was 4.14 (95% CI 1.60-10.7), pâ¯=â¯0.005) and 3.48 (95% CI 1.35-9.01, pâ¯=â¯0.010), when further controlled for pretransplant prediabetes. CONCLUSION: The occurrence of PTDM was similar to that reported in most international studies. As with type 2 diabetes, family history plays an important role in the development of PTDM, even after accounting for pretransplant prediabetes. Patients with FHD should undergo a stricter metabolic program.
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The overwhelming majority of SARS-CoV-2 epidemiological studies cover a narrow time period, making general knowledge about the COVID-19 pandemic difficult. To assess COVID-19-related host aspects in the overall pandemic, we analyzed COVID-19 cases during the first two years of SARS-CoV-2 circulation in southern Brazil. Herein, 390 patients admitted in 2020-2022 to a Brazilian public referral hospital were allocated into two groups according to the COVID-19 outcome: hospital discharge (n=237) or death (n=153). In the univariate analysis, several variables, including sociodemographic, clinical and laboratory aspects (primary data), were significantly different between the analyzed groups. In multivariate logistic regression, eight of these factors remained associated with the COVID-19 outcome. In particular, we report oxygen supplementation and the need for hemodialysis as predictors of hospital discharge and death from COVID-19, respectively. To the best of our knowledge, none of these findings have been previously reported in the Brazilian or world population. In conclusion, our results contribute to current knowledge by demonstrating that factors described at different times may remain associated with COVID-19 over the pandemic and by identifying novel predictors of COVID-19 outcome.
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COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Brasil/epidemiologia , Pandemias , HospitalizaçãoRESUMO
Traumatic brain injury (TBI) represents a significant public health concern and has been associated with high rates of morbidity and mortality. TBI generates two types of brain damage: primary and secondary. Secondary damage originates a series of pathophysiological processes, which include metabolic crisis, excitotoxicity, and neuroinflammation, which have deleterious consequences for neuronal function. However, neuroprotective mechanisms are also activated. The balance among these tissue responses, and its variations throughout the day determines the fate of the damage tissue. We have demonstrated less behavioral and morphological damage when a rat model of TBI was induced during the light hours of the day. Moreover, here we show that rats subjected to TBI in the dark lost less body weight than those subjected to TBI in the light, despite no change in food intake. Besides, the rats subjected to TBI in the dark had better performance in the beam walking test and presented less histological damage in the corpus callosum and the cingulum bundle, as shown by the Klüver-Barrera staining. Our results suggest that the time of day when the injury occurs is important. Thus, this data should be used to evaluate the pathophysiological processes of TBI events and develop better therapies.
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Armchair graphene nanoribbons, when forming a superlattice, can be classified into different topological phases, with or without edge states. By means of tight-binding and classical molecular dynamics (MD) simulations, we studied the electronic and mechanical properties of some of these superlattices. MD shows that fracture in modulated superlattices is brittle, as for unmodulated ribbons, and occurs at the thinner regions, with staggered superlattices achieving a larger fracture strain than inline superlattices. We found a general mechanism to induce a topological transition with strain, related to the electronic properties of each segment of the superlattice, and by studying the sublattice polarization we were able to characterize the transition and the response of these states to the strain. For the cases studied in detail here, the topological transition occurred at â¼3-5% strain, well below the fracture strain. The topological states of the superlattice - if present - are robust to strain even close to fracture. The topological transition was characterized by means of the sublattice polarization of the states.
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Healthcare services must be guided by biosafety practices and microbial control. This control is highly influenced by humidity, which directly impacts the maintenance of sterility of the materials used in the appointments. High concentration of moisture, in the form of aerosol, splashes and spills, is caused during dental care. During the COVID-19 times the contamination by aerosol and droplets worries greatly. Considering that it could cause harm to the sterility of an autoclaved material, especially in dental environments, the objective was to evaluate the behavior of SMS sterilization packages (Spunbonded / Meltblown / Spunbonded) against microbial penetration in an aqueous vehicle. SMS of three brands were challenged, equally divided into two groups: virgin and processed (subjected to a single autoclaving cycle). Each specimen was aseptically deposited on Macconkey agar. Subsequently, 5 µL of Escherichia coliATCC 25922 saline solution [108CFU mL-1] was deposited in center of the SMS specimen and the dish incubated at36°C/ 48h. Reading was performed by the presence or absence of bacterial growth typical of the species under the SMS, observed on the back of Petri dish. The lowest penetration rate observed was 60% for one of the brands in the virgin condition, and 75% for two brands in the processed condition. Statistical analysis showed an association between bacterial penetration and the evaluated group, this association being valid only in the virgin condition. The different SMS behave similarly in terms of resistance to bacterial penetration after being processed. The data show that moisture can assist in bacterial transport through sterilized SMS. Therefore, SMS packages are not able to prevent bacterial penetration, and possibly other microorganisms, when in aqueous vehicles, offering a potential risk of breaking the aseptic chain. Thus, care must be taken in routines for handling and storage sterile packaging.
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Embalagem de Produtos/instrumentação , Contenção de Riscos Biológicos/instrumentação , Consultórios Odontológicos/organização & administração , Umidade/prevenção & controle , Esterilização/instrumentação , Controle de Infecções/instrumentação , Estudo de Avaliação , Embalagem de Medicamentos/instrumentação , Solução Salina/análise , COVID-19/prevenção & controle , Fenômenos Microbiológicos/imunologiaRESUMO
Maternal exercise has shown beneficial effects on mother and child. Literature confirm progeny's cognition improvement, and upregulation in neurotrophins, antioxidant network, and DNA repair system. Considering that there is a lack of information demonstrating the impact of maternal exercise on offspring's skeletal muscle, we aimed to investigate the mitochondrial and redox effects elicited by maternal swimming. Adult female Wistar rats were divided into three groups: control sedentary, free swimming, and swimming with overload (2% of the body weight). Exercised groups were submitted weekly to five swimming sessions (30 min/day), starting 1 week prior to the mating and lasting to the delivery. Gastrocnemius and soleus muscle from 60-day-old offspring were analyzed. Our results clearly showed a sex-dependent effect. Male soleus showed increased mitochondrial functionality in the overload group. Female muscle from the overload group adapted deeply. Considering the redox status, the female offspring delivered to overload exercised dams presented reduced oxidants levels and protein damage, allied to downregulated antioxidant defenses. We also observed an increase in the mitochondrial function in the gastrocnemius muscle of the female offspring born from overload exercised dams. Soleus from female delivered to the overload exercise group presented reduced mitochondrial activity, as well as reduced reactive species, protein carbonyls, and antioxidant network, when compared to the male. In conclusion, maternal exercise altered the redox status and mitochondrial function in the offspring's skeletal muscle in a sex-dependent way. The clinical implication was not investigated; however, the sexual dimorphism in response to maternal exercise might impact exercise resilience in adulthood.
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Antioxidantes , Condicionamento Físico Animal , Adulto , Filhos Adultos , Animais , Feminino , Humanos , Masculino , Mitocôndrias/metabolismo , Músculo Esquelético/metabolismo , Oxirredução , Condicionamento Físico Animal/fisiologia , Gravidez , Ratos , Ratos WistarRESUMO
This study aimed to evaluate the demographic and healthcare situation of dogs and cats owned by families assisted by the Family Health Strategy (FHS), from Santa Maria/RS, Brazil. This research was a cross-sectional and population-based study developed by applying a questionnaire to residents in the 16 FHS areas of the city. This was the first study addressing pet animal conditions in the FHS area. A total of 414 households were studied, and 88.5% of them had pets (dogs and/or cats), with an average of 2.2 dogs and 0.8 cats per household. Only 18.4% (228/1.241) of the animals were sterilized (dogs, 15.1% [135/891]; cats, 26.7% [93/348]). When considering the number of dogs, households with one resident had fewer dogs than households with two or more residents (p=0.006). The level of education and family income were not associated with the number of animals (p>0.001). However, higher levels of education and family income were associated with the sterilization of dogs, veterinary monitoring, vaccination, and treatment of ectoparasites in dogs and cats (p<0.0001). Additionally, the higher family income was associated with a higher frequency of endoparasite treatment (p<0.05). The study shows a high average number of pets per household in FSH areas compared to the average household population as well as a lack of veterinary care, making it essential to promote responsible custody.
Este estudo teve como objetivo avaliar a situação demográfica e de saúde de cães e gatos pertencentes a famílias assistidas pela Estratégia de Saúde da Família (ESF), de Santa Maria/RS, Brasil. Esta pesquisa foi um estudo transversal baseado na população adscrita, desenvolvido por meio da aplicação de questionário aos residentes das 16 áreas de ESF da cidade. Este foi o primeiro estudo que abordou as condições dos animais de estimação na área de ESF. Foram estudados 414 domicílios, e 88,5% deles tinham animais de estimação (cães e/ou gatos), com uma média de 2,2 cães e 0,8 gatos por domicilio. Apenas 18,4% (228/1,241) dos animais foram esterilizados (cães, 15,1% [135/891]; gatos, 26,7% [93/348]). Ao considerar o número de cães, os lares com um residente tinham menos cães que os lares com dois ou mais residentes (p=0,006). O nível de educação e a renda familiar não estavam associados ao número de animais (p>0,001). Entretanto, níveis mais altos de educação e renda familiar foram associados com a esterilização de cães, monitoramento veterinário, vacinação e tratamento de ectoparasitas em cães e gatos (p<0,0001). Adicionalmente, a maior renda familiar foi associada a uma maior freqüência de tratamento endoparasitário (p<0,05). O estudo mostra um alto número médio de animais de estimação por domicílio nas áreas de ESF em comparação com a população domiciliar média, bem como uma falta de cuidados veterinários, tornando essencial promover a custódia responsável.
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Humanos , Animais , Gatos , Cães , Vínculo Humano-Animal , Enquete Socioeconômica , Criação de Animais Domésticos/métodos , Criação de Animais Domésticos/estatística & dados numéricos , Serviço Social/estatística & dados numéricos , BrasilRESUMO
BACKGROUND: Peer tutoring is a process of accompaniment carried out by a student with certain features and skills, whose objective is to support and guide, academically and emotionally, other students who may require it. AIM: To assess the experience of medical students who played the role of peer tutor. MATERIAL AND METHODS: We carried out semi-structured in-depth interviews, with prior informed consent, to a non-probabilistic and intentional sample of six students who performed the role of peer tutor, during 2017 and 2018. The data analysis followed the scheme of constant comparison and progressive reduction in a manual way, according to the comparative method, guaranteeing scientific rigor, maintaining criteria of credibility, dependence, confirmability, and transferability. RESULTS: The first level identified 234 units of meaning that originated in the third level, two qualitative domains, oriented to the contribution of peer tutors derived from their experience to strengthen both the process of peer tutor training and the management of peer tutoring. CONCLUSIONS: Peer tutoring as a teaching-learning strategy contributes to the development of generic competences and metacognitive skills, generating high levels of personal satisfaction and identification their teaching role.