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The thermodynamic characteristics, antioxidant potential, and photoprotective benefits of full-spectrum cannabidiol (FS-CBD) against UVB-induced cellular death were examined in this study. In silico analysis of CBD showed antioxidant capacity via proton donation and UV absorption at 209.09, 254.73, and 276.95 nm, according to the HAT and SPLET methodologies. FS-CBD protected against UVB-induced bacterial death for 30 min. FS-CBD protected against UVB-induced cell death by 42% (1.5 µg/mL) and 35% (3.5 µg/mL) in an in vitro keratinocyte cell model. An in vivo acute irradiated CD-1et/et mouse model (UVB-irradiated for 5 min) presented very low photoprotection when FS-CBD was applied cutaneously, as determined by histological analyses. In vivo skin samples showed that FS-CBD regulated inflammatory responses by inhibiting the inflammatory markers TGF-ß1 and NLRP3. The docking analysis showed that the CBD molecule had a high affinity for TGF-ß1 and NLRP3, indicating that protection against inflammation might be mediated by blocking these proinflammatory molecules. This result was corroborated by the docking interactions between CBD and TGF-ß1 and NLRP3, which resulted in a high affinity and inhibition of both proteins The present work suggested a FS-CBD moderate photoprotective agent against UVB light-induced skin damage and that this effect is partially mediated by its anti-inflammatory activity.
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Colleters are secretory structures characteristic of the apices of more than 60 botanical families. In the Myrtaceae, three types of colleters were previously described: petaloid, conical, and euriform. In Argentina, most species of the Myrtaceae family grow in subtropical regions and a few in the temperate-cold zones of Patagonia. We evaluated the vegetative buds of five species of the subfamily Myrtoideae, tribe Myrtea: Amomyrtus luma, Luma apiculata, and Myrceugenia exsucca, native to the temperate rainforests of Patagonia and Myrcianthes pungens and Eugenia moraviana from the riparian forest of northwestern Corrientes, in order to analyze the presence and morphological types and main secretion products of colleters. Optical and scanning electron microscopy was used to identify the presence of colleters in vegetative organs. Histochemical tests were performed to identify the main secretion products in these structures. The colleters are on the inner side of the leaf primordia and cataphylls and on the edge of the petiole, where they replace the stipules. They are classified as homogeneous because they consist of epidermis and internal parenchyma, both formed by cells with similar characteristics. They lack vascularization and originate from the protodermis. The colleters are of the conical type in L. apiculata, M. pungens, and E. moraviana and of the euriform type in A. luma and M. exsucca, the latter being identified by its dorsiventrally flattened shape. Histochemical tests showed the presence of lipids, mucilage, phenolic compounds, and proteins. This is the first time that colleters have been described in the analyzed species; the taxonomical and phylogenetic importance of this structures is discussed in relation to the Myrtaceae family.
Assuntos
Myrtaceae , Humanos , Filogenia , Microscopia Eletrônica de Varredura , Folhas de Planta , PolissacarídeosRESUMO
Bone Regeneration represents a clinical need, related to bone defects such as congenital anomalies, trauma with bone loss, and/or some pathologies such as cysts or tumors This is why a polymeric biomaterial that mimics the osteogenic composition and structure represents a high potential to face this problem. The method of obtaining these materials was first to prepare a stabilized hydrogel by means of physical bonds and then to make use of the lyophilization technique to obtain the 3D porous scaffolds with temperature conditions of -58 °C and pressure of 1 Pa for 16 h. The physicochemical and bioactive properties of the scaffolds were studied. FTIR and TGA results confirm the presence of the initial components in the 3d matrix of the scaffold. The scaffolds exhibited a morphology with pore size and interconnectivity that promote good cell viability. Together, the cell viability and proliferation test, Alamar BlueTM and the differentiation test: alizarin staining, showed the ability of physically stabilized scaffolds to proliferate and differentiate swine dental pulp stem cell (DPSCs) followed by mineralization. Therefore, the Cs-PCL-PVA-HA scaffold stabilized by physical bonds has characteristics that suggest great utility for future complementary in vitro tests and in vivo studies on bone defects. Likewise, this biomaterial was enhanced with the addition of HA, providing a scaffold with osteoconductive properties necessary for good regeneration of bone tissue. Graphical abstract.
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Quitosana , Durapatita , Suínos , Animais , Durapatita/química , Engenharia Tecidual/métodos , Quitosana/química , Álcool de Polivinil , Alicerces Teciduais/química , Polpa Dentária , Osteogênese , Materiais Biocompatíveis/química , Diferenciação Celular , Osso e Ossos , Células-Tronco , Proliferação de CélulasRESUMO
INTRODUCTION: Joint affection is a frequent complication of hemophilia. Virtual reality programs offer the patient a dynamic plan with maximum functional benefit. The objective of this work is to evaluate the effect of a rehabilitation program combined with conventional therapy and virtual reality on joint function, in patients with hemophilic arthropathy and the impact on the gait. MATERIAL AND METHODS: Eleven pediatric patients with hemophilia and history of hemophilic arthropathy grade I or II were evaluated. An 8-week rehabilitation program was carried out with Xbox KinectTM and mechanotherapy. Movement analysis laboratory to evaluate the gait pattern and the Joint Health Scale was performed at the beginning and end of the program. RESULTS: A reduction of 50% (p = 0.000), 68% (p = 0.016) and 48% (p = 0.000) were observed in the Total Joint Health score (STA), Global Gait Score (PMG) and Total Score of the Joint Health Scale (P-HJHS-T) respectively. There is a decrease in the support phase and right stride, and increase in cadence, step length, left stride and swing phase. CONCLUSIONS: The overall improvement of the patients makes us conclude that this pilot study opens a window of opportunity to continue the study of an integral rehabilitation program based on the use of virtual reality in pediatric patients with hemophilic arthropathy.
INTRODUCCIÓN: La afección articular es una complicación frecuente de la hemofilia. Los programas de realidad virtual ofrecen al paciente pediátrico un esquema dinámico con máximo beneficio funcional. El objetivo de este trabajo es evaluar el efecto de un programa de rehabilitación combinado con terapia convencional y realidad virtual sobre la función articular en pacientes con artropatía hemofílica y el impacto sobre el patrón de la marcha. MATERIAL Y MÉTODOS: Se evaluaron 11 pacientes pediátricos con hemofilia A o B y antecedente de artropatía hemofílica en grado I o II. Se sometieron a un programa de rehabilitación de ocho semanas con Xbox KinectTM y mecanoterapia. Se utilizó el laboratorio de análisis de movimiento para evaluar el patrón de marcha y la escala de salud articular al inicio y término del programa. RESULTADOS: Se redujo 50% (p = 0.000), 68% (p = 0.016) y 48% (p = 0.000) el puntaje de la escala de salud total articular (STA), puntaje marcha global (PMG) y puntaje total de la escala de salud articular (P-HJHS-T) respectivamente. Se observó disminución en la fase de apoyo y zancada derecha y aumento en cadencia, longitud de paso, zancada izquierda y fase de balanceo. CONCLUSIONES: La mejoría global de los pacientes nos hace concluir que este estudio piloto abre una ventana de oportunidades para continuar el estudio de un programa integral de rehabilitación con base en el uso de la realidad virtual en pacientes pediátricos con artropatía hemofílica.
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Hemofilia A , Realidade Virtual , Criança , Hemartrose , Hemofilia A/complicações , Humanos , Projetos Piloto , Estudos RetrospectivosRESUMO
BACKGROUND: In October 2008, the Brazilian Ministry of Health authorized listing of downstaged hepatocellular carcinoma (HCC) for liver transplantation, according to a standardized protocol. The aim of this study was to compare the outcome of patients submitted to liver transplantation after downstaging of HCC with the results other standard indications in Brazil. METHODS: We conducted a retrospective analysis of 2,667 adult 1st elective deceased-donor liver transplantations registered at the database of the Transplant Notification Center of the São Paulo State Health Secretariat. These cases are classified into 3 groups: "cirrhosis," including 1,709 patients transplanted because of end-stage liver disease; "Milan-HCC," including 873 HCC patients initially meeting the Milan criteria; and "downstaging" group, including 85 HCC patients submitted to tumor downstaging to the Milan criteria before liver transplantation. RESULTS: One-, 3-, 5-, and 6-year patients survivals were, respectively, 82.7%, 72.0%, 66.1%, and 66.1%, in the "downstaging" group and 76.7%, 68.4%, 63.9%, and 63.5% in the "Milan-HCC" group (P = .483). At the same time intervals, patient survivals were 67.8%, 62.9%, 60.9%, and 60.2% in the "cirrhosis" group. These probabilities were significantly lower than those of both "downstaging" (P = .047) and "Milan-HCC" (P = .001) groups. CONCLUSIONS: Patients submitted to liver transplantation after downstaging of HCC, according to a Brazilian selection protocol, present long-term outcomes similar to HCC patients initially within the Milan criteria and better survival than recipients with end-stage liver disease.
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Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/mortalidade , Adulto , Brasil , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Seleção de Pacientes , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: Biliary atresia (BA) is the most common cause of liver transplantation in children. The earlier the treatment is done, the better the prognosis. The aim is to evaluate the impact of late diagnosis in children with BA, including the histopathological findings and success rate of biliary drainage in patients submitted to hepatic portoenterostomy (HPE). MATERIALS AND METHODS: A retrospective study of cases of BA in the Department of Pediatric Surgery, Federal University of São Paulo (UNIFESP) between 1998-2011. We found 63 cases of BA; of these, 42 underwent HPE and 21 were referred for liver transplantation. Clinic and pathologic data were evaluated. RESULTS: The HPE was performed with a mean age of 86.5 days, with 16.6% having the operation at 60 days or earlier; 59.2% between 61 and 90 days; and 23.8% after 90 days. Successful biliary drainage occurred in 31% of surgeries, Mean days when HPE drained was 69.1 days, and 94.3 days when the surgery did not drain (P = .05). All patients who were successfully drained, did not have grade IV fibrosis on histology. In cases in which surgery was performed after 60 days that had not drained, 25% had grade IV fibrosis on biopsy (P = .0469). CONCLUSION: The age of HPE relates to better prognosis of the disease. It was found that the rate of grade IV fibrosis is higher in no drainage patients. All patients with grade IV fibrosis had no biliary drainage.
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Ductos Biliares Intra-Hepáticos/patologia , Atresia Biliar/patologia , Diagnóstico Tardio/efeitos adversos , Drenagem , Portoenterostomia Hepática , Atresia Biliar/complicações , Atresia Biliar/diagnóstico , Atresia Biliar/cirurgia , Biópsia , Progressão da Doença , Drenagem/métodos , Feminino , Fibrose , Seguimentos , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Simultaneous pancreas/kidney transplants require a long graft survival and the recipient to present with more benefits than risks. We evaluated the risk factors of receptor's death and pancreatic graft loss on 2 occasions (3 and 12 months' postoperatively) in 292 transplants in whom 22 variables were evaluated. Variables were selected, 9 receivers, 8 donors, and 5 variables related to the surgical procedure. All independent variables were compared with the dependent variables of pancreatic graft losses and patient deaths. Those considered significant according to univariate analysis were analyzed by using multiple logistic regression techniques in an attempt to develop a mathematical model capable of predicting both pancreatic graft and patient losses. Lastly, based on the resulting models with all significant variables, scores were created to determine the risk of patient death and pancreatic graft loss. In the adjusted multivariate analysis, the significant variables were donor age, receiver's body mass index, initial pancreas implant, iliac venous drainage, and use of induction therapy related to pancreatic loss within 3 months after transplantation. Independent risk factors regarding the loss of patients within 12 months were body mass index and receptor induction therapy. The variables related to pancreatic graft loss within 3 months were donor age, receiver body mass index, initial use of pancreatic graft, iliac venous drainage, and induction therapy; these variables can be used for creating a risk score. The donor body mass index and the induction therapy were independently related to patient loss within 12 months after the transplant.
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Diabetes Mellitus/cirurgia , Rejeição de Enxerto/epidemiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Transplante de Pâncreas/efeitos adversos , Medição de Risco , Adolescente , Adulto , Brasil/epidemiologia , Diabetes Mellitus/mortalidade , Feminino , Sobrevivência de Enxerto , Humanos , Incidência , Falência Renal Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências , Adulto JovemRESUMO
BACKGROUND: Simultaneous pancreas-kidney transplantation (SPKT) is one of the treatments for insulin-dependent chronic renal failure patients. METHODS: One-year patient and kidney allograft survival rates of 150 patients undergoing SPKT were subjected to Cox regression and Kaplan-Meier analyses. Uni- and multivariate methods identified risk factors involved in allograft and patient survival. RESULTS: One-year patient and kidney allograft survival rates were 82% and 80%, respectively. Delayed graft function (DGF) (P = .001; hazard ratio [HR]5.41) and acute kidney rejection episodes (P = .016; HR 3.36) were related to 1 year patient survival as well as intra-abdominal infection (IAI) rates. (IAI). One-year kidney allograft survival was related to DGF (P = .013; odds ratio [OR] 3.39), acute rejection (P = .001; OR 4.74), and IAI (P = .003, OR 6.29). DGF was related to a time on dialysis >27 months (P = .046; OR 2.59), cold kidney ischemia time >14 hours (P = .027; OR 2.94), donor age >25 years (P = .03; OR 2.82), and donor serum sodium concentration >155 mEq/L (P < .0001; OR 1.09). Female kidney to male recipient in 17% of the cases did not increase the risk of DGF. We observed an important correlation between donor serum sodium and creatinine (P < .0001), which suggested undertreatment of diabetes insipidus secondary to brain death. CONCLUSIONS: DGF, acute rejection, and IAI were the main determinants of survival after SPKT. Improving the care of deceased donors may reduce DGF occurrence.
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Função Retardada do Enxerto/etiologia , Diabetes Mellitus Tipo 1/cirurgia , Nefropatias Diabéticas/cirurgia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Rim/fisiopatologia , Transplante de Pâncreas/efeitos adversos , Adolescente , Adulto , Brasil , Distribuição de Qui-Quadrado , Criança , Função Retardada do Enxerto/mortalidade , Função Retardada do Enxerto/fisiopatologia , Diabetes Mellitus Tipo 1/complicações , Nefropatias Diabéticas/etiologia , Feminino , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Humanos , Estimativa de Kaplan-Meier , Falência Renal Crônica/etiologia , Transplante de Rim/mortalidade , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Transplante de Pâncreas/mortalidade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Transplante Homólogo , Resultado do Tratamento , Adulto JovemRESUMO
UNLABELLED: Ex situ hepatic transection (ESHT) has allowed transplantation of younger and smaller patients than whole liver grafts. Liver transection is a technical challenge due to the prolonged back table time, possible graft lesions, and increased surgical bleeding from the cut surface. We compare the outcomes of whole versus transected liver grafts in pediatric liver transplantation. METHODS: We retrospectively studied 41 pediatric patients who underwent 42 consecutive liver transplants (1 retransplant) from cadaveric donors. The study included all patients <18 years old who were transplanted at our institution from December 2001 to September 2009. Patients were distributed into 2 groups: whole organ (WO; n = 20) and transected liver grafts (TLG; n = 21). The ESHT grafts included 17 splits and 5 reduced size livers. We evaluated the age, weight, blood component transfusions, 1-year survival, laboratory tests at 2nd and 7th days postoperatively, surgical complications, reoperations, rejection episodes, cold ischemia time, biliary reconstruction type, and donor laboratory tests. Data were analyzed using Fisher and Student's t-tests. RESULTS: The mean age was 115 months (range, 7 months to 17.6 years) in the WO group and 43.3 months (range, 5 months to 16.25 years) in the TLG group (P = .0003). Mean weight was 19.8 kg (range, 5.8-67) and 9.7 Kg (range, 5.2-57) in the WO and TLG groups, respectively (P = .0079). Red blood cell transfusion was higher in the TLG group (P = .0479). Laboratory tests showed no difference between the 2 groups considering hepatic lesions or function markers. One-year patient survivals were 90% and 85.8% among the WO and LTG, respectively (P = .588). The overall 1-year survival rate was 88.8%. CONCLUSION: ESHT allowed smaller and younger children to be transplanted. There was an increased necessity of red blood cell transfusions after hepatic transection. There was no impact on liver function or 1-year patient or graft survival after ESHT.
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Transplante de Fígado/estatística & dados numéricos , Adolescente , Transfusão de Componentes Sanguíneos , Perda Sanguínea Cirúrgica , Cadáver , Criança , Pré-Escolar , Contagem de Eritrócitos , Vesícula Biliar/cirurgia , Rejeição de Enxerto/epidemiologia , Hematócrito , Hepatectomia , Humanos , Lactente , Período Intraoperatório , Testes de Função Hepática , Transplante de Fígado/imunologia , Transplante de Fígado/mortalidade , Contagem de Plaquetas , Período Pós-Operatório , Procedimentos de Cirurgia Plástica , Reoperação , Estudos Retrospectivos , Análise de Sobrevida , Doadores de TecidosRESUMO
UNLABELLED: To evaluate the risk factors for pancreas graft loss within 3 months postoperatively among 170 simultaneous pancreas-kidney transplantation (SPKT) we examined 38 variables. METHODS: Twenty-two variables were related to recipients; 12 to donors and 4 to the surgical procedure. In addition the latest follow-up dates as well as the transplant and/or death dates. Independent variables were examined with reference to the dependent pancreatic loss variable, excluding losses owing to deaths. Variables with statistical significance were analyzed to predict early graft loss. RESULTS: Univariate analyses determined the following significant variables: kidney cold ischemia time, older donors, non-white donors, death cause related to vascular disease, wound infection, and length of extended hospitalization. However, multivariate analysis showed that only donor age and kidney cold ischemia time were significant predictors for early pancreatic graft loss. CONCLUSION: Donor age and kidney cold ischemia time were independently related to pancreatic loss after SPKT within 3 months posttransplantation.