RESUMO

PURPOSE: To determine the incidence of VTE and clinical outcomes in a cohort of cancer patients and COVID-19 infection, and to establish possible predictive factors of VTE. METHODS/PATIENTS: A single-center retrospective cohort study was performed to determine the incidence of VTE and mortality in 118 cancer patients with SARS-CoV-2 infection from March to August 2020. We calculated individual Khorana Risk and CATS-MICA scores in order to evaluate their utility to identify risk of VTE or death. Continuous variables were compared using Wilcoxon or Student's T test, and categorical variables were compared using the Chi-Square or Fisher's exact text among patients with and without VTE. A Log-Rank test was performed to detect mortality differences between the groups. RESULTS: A total of 118 patients were included. VTE global incidence was 4.2% (n = 5), and mortality 25.4% (n = 30). Obesity (p = 0.05), recent chemotherapy (p = 0.049) and use of steroids (p = 0.006) were related to higher risk of VTE in the univariate analysis, although they were not confirmed in the multivariate analysis as independent risk factors. Statistically significant differences in all-cause, COVID-19-related and cancer-related mortality according to the Khorana risk score (KRS) were observed. CATS-MICA score (CMS) also showed statistically significant differences in mortality between low- and high-risk patients. Prediction of risk of VTE development with these scores showed a tendency towards significance. CONCLUSIONS: In this cohort, VTE incidence was similar to previously reported in the general population with SARS-CoV-2 infection. KRS was associated with overall and specific-cause mortality, and might be a useful prognostic tool in this setting.

RESUMO

The small airway, present since the origins of humanity and described barely a century ago, has recently been discovered as the anatomical site where inflammation begins in some obstructive lung diseases, such as asthma and Chronic Obstructive Pulmonary Disease (COPD), per se. Small airway dysfuction was identified in up to 91% of asthmatic patients and in a large proportion of COPD patients. In subjects without pathology, small airway represent 98.8% (approximately 4500 ml) of the total lung volume, contributing only between 10-25% of the total lung resistance; however, in subjects with obstruction, it can represent up to 90% of the total resistance. Despite this, its morphological and functional characteristics allow its dysfunction to remain undetected by conventional diagnostic methods, such as spirometry. Hence the importance of this review, which offers an overview of the tools available to assess small airway dysfunction and the possible therapies that act in this silent zone.

La vía aérea pequeña, presente desde los orígenes de la humanidad y descrita hace apenas un siglo, se ha descubierto recientemente como el sitio anatómico donde inicia la inflamación provocada por algunas enfermedades pulmonares obstructivas: asma y enfermedad pulmonar obstructiva crónica (EPOC), per se. Se ha identificado disfunción de la vía aérea pequeña en el 91% de los pacientes asmáticos y en una gran proporción de quienes padecen EPOC. En los pacientes sin enfermedad, la vía aérea pequeña representa el 98.8% (4500 mL) del volumen pulmonar total, y solo aporta del 10 al 25% de la resistencia pulmonar total; sin embargo, en sujetos con obstrucción puede suponer el 90% de la resistencia total. A pesar de esto, sus características morfológicas y funcionales permiten que la disfunción pase inadvertida por métodos diagnósticos convencionales, por ejemplo la espirometría. Con base en lo anterior, el objetivo de este estudio fue revisar el panorama general de los métodos disponibles para evaluar la vía aérea pequeña y los posibles tratamientos asociados con esta zona silente.

RESUMO

This study describes a multistage methodology to detect minute amounts of tetrodotoxin in fishes, a plan that may be broadened to include other marine organisms. This methodology was applied to porcupinefish (Diodon hystrix) collected in Punta Chiquirín, El Salvador. A three-stage approach along with post-acquisition processing was employed, to wit: (a) Sample screening by selected reaction monitoring (HPLC-MS/MS-SRM) analyses to quickly identify possible toxin presence via a LC/MS/MS API 3200 system with a triple quadrupole; (b) HPLC-HRFTMS-full scan analyses using an ion trap-Orbitrap spectrometer combined with an MZmine 2-enhanced dereplication-like workflow to collect high-resolution mass spectra; and (c) HPLC-HRMS2 analyses. This is the first time tetrodotoxin has been reported in D. hystrix specimens collected in El Salvador.

Assuntos

RESUMO

Intracranial germ cell tumors are uncommon brain tumors; germinoma is the most common tumor in children and young adults, and the most common regions affected are pineal gland and suprasellar region. Germinomas of the suprasellar region are accompanied by endocrine alterations, with adipsia being a rare presentation. Here, we present the case of a patient with an extensive intracranial germinoma whose initial presentation was adipsia, without any other endocrinological alteration, with development of severe hypernatremia and unusual manifestations derived from it, such as deep vein thrombosis, myopathy with rhabdomyolysis, and neurological axonal damage.

RESUMO

The aim of this study was to evaluate the biocompatibility of the regeneration of the dentin-pulp complex in a murine model with different treatments with MTA Angelus, NeoMTA, and TheraCal PT. An in vivo controlled experimental study of 15 male Wistar rats forming three study groups, the upper and lower central incisors were selected where pulpotomies were conducted, leaving a central incisor as control at 15, 30, and 45 days. For data analysis, these were expressed as mean ± standard deviation and were examined by Kruskal-Wallis test. Three factors were analyzed as follows: "inflammatory infiltrate; disorganization of pulp tissue, and the formation of reparative dentin". No statistical significance was found between the different groups (p > 0.05). Treatment with these three biomaterials (MTA, TheraCal PT, and Neo MTA) presented an inflammatory infiltrate and slight disorganization of the odontoblast layer in the pulp tissue of a murine model, with normal coronary pulp tissue and the formation of reparative dentin in the three experimental groups. Thus, we are able to conclude that all three are biocompatible materials.

RESUMO

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder characterized by the formation of hamartomas in organ systems such as the brain, skin, kidneys and lungs. Patients with TSC are usually diagnosed early in life. However, in some cases, the diagnosis is delayed until adulthood because various manifestations occur at various times throughout an individual's life. In this regard, we present the case of a female patient diagnosed at the beginning of the seventh decade of life. The patient had a history of seizures and showed clinical findings on the skin (facial angiofibromas, ungual fibromas, 'Confetti-like' skin lesions, shagreen patch), brain (cortical tubers), heart (cardiac rhabdomyomas), kidneys (angiomyolipomas) and a positive genetic test for mutations in TSC2, fulfilling the diagnostic criteria. We compared the differences between manifestations in patients diagnosed during childhood and adulthood. Knowledge of the clinical spectrum of TSC allows early identification.

RESUMO

Invasive fungal infections represent a global health threat. They are associated with high mortality and morbidity rates, partly due to the ineffectiveness of the available antifungal agents. The rampant increase in infections recalcitrant to the current antifungals has worsened this scenario and made the discovery of new and more effective antifungals a pressing health issue. In this study, 65 extracts from marine organisms of the Yucatan Peninsula, Mexico, were screened for antifungal activity against Candida albicans and Candida glabrata, two of the most prevalent fungal species that cause nosocomial invasive fungal infections worldwide. A total of 51 sponges, 13 ascidians and 1 gorgonian were collected from the coral reef and mangrove forest in the Yucatan Peninsula (Mexico) and extracted with organic solvents. Nine crude extracts showed potent antifungal activity, of which four extracts from the sponge species Aiolochroia crassa, Amphimedon compressa, Monanchora arbuscula and Agelas citrina had promising activity against Candida spp. Bioassay-guided fractionation of the M. arbuscula extract revealed the remarkable fungicidal activity of some fractions. Analysis of the chemical composition of one of the most active fractions by UHPLC-HRMS and NMR indicated the presence of mirabilin B and penaresidin B, and their contribution to the observed antifungal activity is discussed. Overall, this work highlights marine organisms of the Yucatan Peninsula as important reservoirs of natural products with promising fungicidal activity, which may greatly advance the treatment of invasive fungal infections, especially those afflicting immunosuppressed patients.

Assuntos

Assuntos

RESUMO

Backyards are family settings adjacent to the house, characterized mainly by being small-scale and diversified productive spaces. The research typologically characterized the backyards and their contribution to family food security in La Concordia municipality, Chiapas, Mexico. The research was descriptive and mixed, quantitative, and qualitative, and semi-structured interviews were applied to 130 families. For the typification, 21 variables were used, and the statistical techniques of Factorial Analysis and Clusters were applied. The cases studied were classified, according to the relevance of their production and contribution to food security, into two general groups: a) a group of backyards that is more productive and contributes to food security, which in turn includes three subtypes of backyards that differ from each other by their profile towards vegetable or poultry production for subsistence, and/or pigs as a form of savings; b) a group of less productive backyards in which other management strategies for food security are assumed and differ from each other by the level of expulsion of labor force and types of families, nuclear or extended. Poultry and plant species for multiple uses was the most frequently characteristic, regardless of the type of backyard.

Os quintais são ambientes familiares adjacentes à casa, caracterizados principalmente por serem espaços produtivos de pequena escala e diversificados. A pesquisa teve como objetivo caracterizar tipologicamente os quintais e sua contribuição para a segurança alimentar familiar no município de La Concordia, Chiapas, México. A pesquisa foi descritiva e mista, quantitativa e qualitativa, na qual foram aplicadas entrevistas semiestruturadas a 130 famílias. Para a tipificação foram utilizadas 21 variáveis e aplicadas as técnicas estatísticas de Análise Fatorial e Clusters. Os casos estudados foram classificados, de acordo com a relevância de sua produção e contribuição para a segurança alimentar, em dois grupos gerais: a) um grupo de quintais mais produtivos e que contribuem para a segurança alimentar, que por sua vez inclui três subtipos de quintais que diferem entre si pelo seu perfil para a produção de hortaliças ou aves para subsistência, e/ou suínos como forma de poupança; b) conjunto de quintais menos produtivos em que se assumem outras estratégias de gestão da segurança alimentar e diferem entre si pelo nível de expulsão de mão de obra e tipos de famílias, nucleares ou extensas. Aves e espécies vegetais de uso múltiplo foi a característica mais encontrada, independente do tipo de quintal.

Assuntos

RESUMO

This study assesses the variability of physicochemical and biochemical parameters, identifies principal pollutant sources, and characterizes water quality in Yuriria reservoir using water quality indexes in combination with multivariate statistical techniques. In situ parameters were measured in 55 reservoir sites including surface and deep points and in 7 associated channels. Moreover, major compounds and biochemical data were determined. Yuriria reservoir had alkaline, bicarbonate-mixed waters, with total dissolved solids (TDS) of 393.83 ± 3.43 mg L-1. Water quality index (WQI) indicated a good class for agricultural irrigation but very poor and poor classes for preservation of aquatic life. The nutrient inputs and the internal nitrogen recycling triggered a hypereutrophic status in the reservoir. The decomposition of residual biomass from aquatic macrophytes contributed to reduce dissolved oxygen (DO) in the hypolimnetic waters (mean DO = 3.86 mg L-1). Statistical analysis revealed that the study area is highly exposed to anthropogenic stress and in a lesser extent to natural processes. Urban and agriculture runoff enhanced the salinization and the generation of solid particles which deteriorated water quality. Chemical oxygen demand (COD), biochemical oxygen demand (BOD), and NO3--N presented a common anthropogenic origin by external (point and diffuse) and internal pollution sources, while a diffuse source (agricultural activities) was reveled for phosphorus. This study is important to be used in systematic monitoring and sustainable co-management programs and for formulating the necessary strategies to remediate the Yuriria reservoir water quality and extrapolate to other reservoirs worldwide.

Assuntos