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INTRODUCTION: The anatomical variations of the mandibular canal have been described according to the number of additional branches it presents, bifid and trifid. Within the bifids we can also find subtypes of variations such as the retromolar mandibular canal. These anatomical variations can have important clinical implications for the work of dental professionals. METHODS: A systematic search of the literature was carried out in different databases that met the following criteria: articles published between 2000 and 2020, and articles that established a clinical correlation with variations in the mandibular canal. RESULTS: After applying inclusion and exclusion criteria, 32 articles were obtained, in which the variations of the mandibular canal were identified, their prevalence and incidence, which was very varied between the different articles, it was also found that the CBCT was the main technique to identify the anatomical variations of the mandibular canal. Lastly, the anatomical variations of the mandibular canal have a direct clinical correlation with pre-surgical, intra-surgical and postsurgical complications in pathologies that require surgical intervention. CONCLUSIONS: The anatomical variations of the mandibular canal have a high incidence, so knowing them is of vital importance both for clinicians and anatomy professors who provide morphological training. We believe that research should focus on describing and diagnosing the causes of these anatomical variations. That said, there is also a continuous challenge for all health professionals to learn about the different anatomical variations that the human body presents and how these can affect clinical practice.
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Variação Anatômica , Complicações Intraoperatórias/prevenção & controle , Mandíbula/anatomia & histologia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Tomografia Computadorizada de Feixe Cônico , Humanos , Incidência , Complicações Intraoperatórias/etiologia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Complicações Pós-Operatórias/etiologia , Radiografia PanorâmicaRESUMO
PURPOSE: We analyzed the workflow of the blood culture procedure with one blood culture incubator in the microbiology laboratory, in comparison with the workflow with the incubators systems placing outside, and in a microbiology laboratory without 24-h staffing. METHODS: We assessed the elapsed time (ET) and time-to-result (TTR) in the two laboratory workflows during 1 month period in consecutive years. First period with one BACT/ALERT 3D module located in the microbiology laboratory (ML) (access 8 a.m. to 10 p.m.) and second period with three BACT/ALERT VIRTUO modules (one located in ML and two in the core sample laboratory, access 24 h). RESULTS: The mean ET with BACT/ALERT 3D was 7.09 ± 6.15 h and 1.32 ± 3.14 h with BACT/ALERT VIRTUO. During the 8:00 a.m. to 10:00 p.m. shift, the average ETs were 3.54 ± 5.06 vs 1.59 ± 1.29 h for the two time periods, respectively. Since the automated loading of bottles on the BACT/ALERT VIRTUO allows processing of blood cultures during the night shift, there was a significant reduction of time during the 10:00 p.m. to 8:00 a.m. shift, where the average ET was 10.52 ± 5.23 vs 1.00 ± 4.40 h, respectively. The percentage of positivity in the first period was 9.03% and 11.18% in the second (p = 0.0003). The average TTR in the first period was 24.78 ± 15.9 h and 16.85 ± 14.13 h in the second (p < 0.0001). CONCLUSIONS: Easy 24-h access to blood culture incubators resulted in significant improvement in the workflow of blood culture, decreasing ET, and therefore decreasing the time to positivity and the efficiency of recovery.
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Bactérias/crescimento & desenvolvimento , Técnicas Bacteriológicas/instrumentação , Hemocultura/instrumentação , Bactérias/genética , Bactérias/isolamento & purificação , Técnicas Bacteriológicas/métodos , Hemocultura/métodos , Humanos , Incubadoras , Laboratórios , Fatores de Tempo , Fluxo de TrabalhoRESUMO
RESUMEN Objetivo. Evaluar el efecto de dosis crecientes del glucósido cianogénico Linamarina, en la reducción de metano ruminal in vitro. Materiales y Métodos. Se empleó líquido ruminal de dos ovejas fistuladas de la raza Merino Precoz, con el que se inoculó un sustrato fermentativo constituido por heno de alfalfa (Medicago sativa) y grano de avena molido (Avena sativa L.), se adicionó solución buffer y Linamarina (pureza de ≥98%) en dosis crecientes, lo que se llevó a incubación por ocho horas in vitro. El metano se midió cada hora, con un monitor de gases infrarrojo. Resultados. De acuerdo con el incremento de las dosis de Linamarina (0, 6, 13, 20 y 26 mg/L), la concentración de metano disminuyó de forma lineal (p≤0.05) en (9.7, 9.2, 18.1 y 29.4%) respectivamente. Se observó una reducción significativa de metano con la dosis más alta de Linamarina. Conclusión. La Linamarina, en su estado puro, fue eficaz en la reducción de metano durante la fermentación ruminal in vitro. Por lo tanto, este estudio constituye una base para futuros experimentos que incluyan fuentes vegetales de Linamarina y otras variables ruminales, lo que puede conducir a encontrar estrategias para reducir los gases de efecto invernadero.
ABSTRACT Objective. To assess the effect of rising doses of the cyanogenic glucoside Linamarin on the reduction of in vitro rumen methane. Materials and methods. Rumen fluid from two fistulated Merino Precoz sheep, inoculated with a fermentation substrate comprising alfalfa hay (Medicago sativa) and ground oat grain (Avena sativa L.), and added with buffer solution and Linamarin (purity ≥98%) in rising doses, was incubated for eight hours in vitro. Methane was measured each hour with an infrared gas monitor. Results. According Linamarin doses were increased (0, 6, 13, 20 and 26 mg/L), the methane concentration fell in a linear manner (p≤0.05) by (9.7, 9.2, 18.1 and 29.4%), respectively. A significant reduction of methane was seen whit the highest dose of Linamarin. Conclusions. Linamarin, in pure state, was effective to reduce methane during in vitro ruminal fermentation. Therefore, this study constitutes a basis for future experiments including vegetable sources of Linamarin as well as other rumen variables, leading to find a strategy for reducing greenhouse gases.
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Técnicas In Vitro , Aditivos Alimentares , Glucosídeos , Metano , FermentaçãoRESUMO
It is difficult to establish the properties of massive stars that explode as supernovae. The electromagnetic emission during the first minutes to hours after the emergence of the shock from the stellar surface conveys important information about the final evolution and structure of the exploding star. However, the unpredictable nature of supernova events hinders the detection of this brief initial phase. Here we report the serendipitous discovery of a newly born, normal type IIb supernova (SN 2016gkg), which reveals a rapid brightening at optical wavelengths of about 40 magnitudes per day. The very frequent sampling of the observations allowed us to study in detail the outermost structure of the progenitor of the supernova and the physics of the emergence of the shock. We develop hydrodynamical models of the explosion that naturally account for the complete evolution of the supernova over distinct phases regulated by different physical processes. This result suggests that it is appropriate to decouple the treatment of the shock propagation from the unknown mechanism that triggers the explosion.
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PURPOSE: The fusion gene BCR-ABL has an important role to the progression of chronic myeloid leukemia (CML) and several signaling pathways have been characterized as responsible for the terminal blastic phase (BP). However, the initial phase, the chronic phase (CP), is long lasting and there is much yet to be understood about the critical role of BCR-ABL in this phase. This study aims to evaluate transcriptional deregulation in CD34+ hematopoietic cells (CD34+ cells) from patients with untreated newly diagnosed CML compared with CD34+HC from healthy controls. METHODS: Gene expression profiling in CML-CD34 cells and CD34 cells from healthy controls were used for this purpose with emphasis on five main pathways important for enhanced proliferation/survival, enhanced self-renewal and block of myeloid differentiation. RESULTS: We found 835 genes with changed expression levels (fold change ≥ ±2) in CML-CD34 cells compared with CD34 cells. These include genes belonging to PI3K/AKT, WNT/b-catenin, SHH, NOTCH and MAPK signaling pathways. Four of these pathways converge to MYC activation. We also identified five transcripts upregulated in CD34-CML patients named OSBPL9, MEK2, p90RSK, TCF4 and FZD7 that can be potential biomarkers in CD34-CML-CP. CONCLUSION: We show several mRNAs up- or downregulated in CD34-CML during the chronic phase.
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Biomarcadores Tumorais/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Transdução de Sinais/genética , Transcriptoma , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos CD34 , MAP Quinases Reguladas por Sinal Extracelular/genética , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Feminino , Proteínas Hedgehog/genética , Proteínas Hedgehog/metabolismo , Células-Tronco Hematopoéticas/patologia , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/metabolismo , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , Pessoa de Meia-Idade , Fosfatidilinositol 3-Quinases/genética , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Receptores Notch/genética , Receptores Notch/metabolismo , Via de Sinalização Wnt/genética , Adulto JovemRESUMO
Acute GvHD (aGvHD) is a life-threatening complication of hematopoietic stem cell transplantation. Frontline therapy for aGvHD consists of corticosteroid administration. However, â¼25% of the patients have a steroid-refractory disease, a sign of poor prognosis. An alternative therapy for steroid-refractory aGvHD is infusion of mesenchymal stromal cells (MSCs). Herein, we report the results of 46 patients treated with MSC infusion as salvage therapy for steroid-refractory aGvHD III/IV (78% grade IV). Patients received a median cumulative dose of MSCs of 6.81 × 106/kg (range, 0.98-29.78 × 106/kg) in a median of 3 infusions (range, 1-7). Median time between the onset of aGvHD and the first MSC infusion was 25.5 days (range, 6-153). Of the patients, 50% (23/46) presented clinical improvement. Of these, 3 patients (13%) had complete response, 14 (61%) had partial response and 6 (26%) had transient partial response. The estimated probability of survival at 2s year was 17.4%. Only 2 patients (4.3%) presented acute transient side effects (nausea/vomiting and blurred vision) during cell infusion. No patient had late or severe side effects because of MSC infusion. These results suggest that this therapeutic modality is safe and should be considered for steroid-refractory aGvHD, especially in countries where other second-line agents are less available.
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Doença Enxerto-Hospedeiro , Neoplasias Hematológicas , Transplante de Células-Tronco Hematopoéticas , Transplante de Células-Tronco Mesenquimais , Doença Aguda , Adolescente , Adulto , Idoso , Aloenxertos , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Doença Enxerto-Hospedeiro/mortalidade , Doença Enxerto-Hospedeiro/terapia , Neoplasias Hematológicas/mortalidade , Neoplasias Hematológicas/terapia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Esteroides/administração & dosagem , Taxa de SobrevidaRESUMO
Titania hollow spheres were synthesized using silica nanospheres as the template. The core was removed using NaOH solution. They were subsequently impregnated with tungstophosphoric acid (TPA) solutions and annealed at two different temperatures (100 and 500 °C). These materials were characterized by several physicochemical techniques (XRD, BET, SEM, DRS, FT-IR, FT-Raman and 31P MAS-NMR). The 31P MAS-NMR and FT-IR characterization showed that the main species present in the samples was the [PW12O40]3- anion, which was partially transformed into the [P2W21O71]6- anion during the synthesis and drying step. 31P MAS-NMR, and FT-Raman characterization revealed the evidence of a strong interaction between the Keggin anion of TPA and TiO2 surfaces, possibly due to the formation of surface heteropolyacid-TiO2 complexes. The DRS results showed that the absorption threshold onset continuously shifted to the visible region with increased TPA concentration and calcination at 500 °C. The enhanced visible light absorption could be related to the formation of a surface complex TPA Keggin anion-TiO2. The catalytic activity of the materials in the photodegradation of 4-chlorophenol under UV and visible light irradiation increased when the TPA content and the calcination temperature of the samples were raised.
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OBJECTIVES: Evaluate whether poor mobilisers had delayed haematopoietic (neutrophil and platelet) recovery despite receiving similar cell dose as good mobilisers. BACKGROUND: Autologous haematopoietic progenitor cell (HPC) transplantation is indicated to treat some haematological malignancies. This procedure requires HPC mobilisation from bone marrow to peripheral blood. Cell dose is important for a fast haematological recovery. Despite being poor mobilisers, some patients can collect enough cell numbers for transplantation. RESULTS: Fifteen poor mobiliser patients (peak of CD34+ cells ≤10 µL(-1) in peripheral blood) were transplanted at our institution. Haematological recovery (neutrophil ≥ 500 µL(-1) ) in this group was compared to that observed in the group of 16 patients of good mobilisers (peak of CD34+ cells ≥20 µL(-1) in peripheral blood) who received similar cell dose (2·637 ± 0·1744 × 10(6) kg(-1) vs 2·727 ± 0·1746 × 10(6) kg(-1) ; P = 0·7177). The poor mobiliser group had neutrophil and platelet recovery later than the good mobiliser group (on day 12, range 9-14 vs day 10, range 9-22, P = 0·0381 for neutrophil, and on day 22·89 ± 11·16 and 14·08 ± 4·821, P = 0·0193 for platelet). Mortality rates and transfusion requirements were not different between the groups. CONCLUSION: Poor mobilisers have delayed neutrophil and platelet recovery after autologous HPC transplantation despite having received the same cell dose as good mobilisers.
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Neoplasias Hematológicas/mortalidade , Neoplasias Hematológicas/terapia , Mobilização de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas , Adulto , Idoso , Autoenxertos , Intervalo Livre de Doença , Feminino , Neoplasias Hematológicas/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Taxa de SobrevidaRESUMO
El empiema subdural es una complicación intracraneana secundaria a sinusitis bacteriana poco frecuente que ocurre generalmenteen varones entre la segunda y tercera década de la vida. Se presenta el caso de un paciente masculino, de 16 años, sinantecedentes, asintomático. Ingresa por cefalea frontoparietal izquierda intensa, compromiso cualitativo de conciencia, calofríos,fiebre y vómitos, sin focalidad neurológica ni signos meníngeos. Resonancia magnética de cerebro muestra colección líquida subduralinterhemisférica en región frontoparietal izquierda que desplaza línea media y sinusitis aguda frontoetmoidomaxilar ipsilateral.Se realiza craniectomía frontoparietal, drenaje quirúrgico y tratamiento antibiótico triasociado intravenoso. Paciente evolucionacon desaparición de síntomas y sin secuelas neurológicas. La clínica del empiema subdural es inespecífica, encontrándose másfrecuentemente cefalea, vómitos, fiebre y compromiso de conciencia. Las imágenes son esenciales para confirmar el diagnósticoy determinar la necesidad de cirugía. Es una patología, cuyo manejo debe ser médico y quirúrgico, comprendiendo drenaje dela colección y terapia antimicrobiana intravenosa. La duración del tratamiento se ha descrito de 3 a 6 semanas. Es necesario unabordaje multidisciplinario precoz para un buen resultado neurológico y funcional, ya que la morbimortalidad se describe hastaun 40%.
The subdural empyema secondary to sinusitis is a rare intracranial complication, which occurs mostly in males in the secondto third decade. We present a case of a 16 years old male patient, without medical history. He is hospitalized for a frontparietalprogressive headache, associated with decreased of consciousness, chills, fever and vomiting, without neurological deficit andmeningeal signs. The magnetic resonance imaging reveals a subdural interhemispheric liquid collection in the left frontparietal regionwith deviation of midline brain structures and left acute frontethmoidmaxilary sinusitis. Craniotomy and surgical drainage withintravenous antibiotic treatment was made. The symptoms dissapear after this and no neurological sequelae was found. The clinicalmanifestation of subdural empyema are inespecific. The more frecuent symptoms are headache, vomit, fever and decreasedof consciousness. The imaging study is essential to diagnose and evaluate the surgical need. The subdural empyema is pathologywith a medical and surgical management; wich involves collection drainage and intravenous antibiotic therapy. It is been describedthat the treatment duration will be prolonged for 3 to 6 weeks. A multidisciplinary approach is necessary for a better neurologicaland functional outcome, because the mortality rates are described up to 40%.
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Humanos , Masculino , Adolescente , Craniotomia , Drenagem , Empiema Subdural/diagnóstico , Empiema Subdural/epidemiologia , Sinusite Frontal/complicações , Sinusite Frontal/diagnóstico , Sinusite Frontal/terapia , Antibacterianos/administração & dosagem , Espectroscopia de Ressonância Magnética/métodos , CefaleiaRESUMO
La hidatidosis es una zoonosis causada por la fase larval del Echinoccocus. Afecta principalmente a la región mediterránea, Sudamérica, África, Medio-Oriente, Australia y Nueva Zelanda. Afecta principalmente al hígado y al pulmón, aunque puede comprometer cualquier parte del cuerpo ya sea, por inoculación primaria o diseminación secundaria. Se presenta el caso de paciente de 54 años, sexo masculino, con antecedentes de hidatidosis pulmonar izquierda y abdominal subdiafragmática, diagnosticada hace 33 años. Ingresa por cuadro de paraparesia progresiva de extremidades inferiores, disminución de sensibilidad a la altura de T12 y lumbalgia sin otros signos ni síntomas asociados. La Tomografía axial computada mostró lesión tumoral paravertebral izquierda con signos de infiltración y destrucción de costilla y vértebra T12 a nivel de lámina y pediculo izquierdo, junto con lesión de 12 cm paravertebral anterior, con ingreso de quiste a lúmen aórtico, entre T4 y T6. Resonancia nuclear magnética muestra invasión hacia canal medular con signos de compresión. Se realizó laminectomía descompresiva con evacuación de vesículas. La evolución posterior es satisfactoria con recuperación de su paraparesia, logrando la bipedestación a los pocos días. Si bien el compromiso vertebral es raro, este se puede manifestar con dolor y síntomas secundarios a la compresión medular como paraparesia o paraplejia, déficit sensorial, reflejos osteotendíneos alterados, disfunción esfintérica y síndrome de cauda equina. Imágenes como tomografía axial computada y resonancia nuclear magnética, son necesarias para un efectivo diagnóstico y monitorización de la hidatidosis. El tratamiento de elección es la descompresión quirúrgica asociado a antihelmínticos para evitar la recurrencia.
The hydatid disease is a zoonoses caused by Echinoccocuss larvae stage. The most affected regions are Meditarranea, South America, Africa, Mid West, Australia and New Zealand. Mostly infects the liver and the lungs, but any part of the body can be affected, by primary inoculation or dissemination. We present a case of a 54 years old, male patient, with 33 years history of pulmonary and abdominal hydatid disease. He is hospitalized for progressive paraparesia of lower limbs, paresthesia T12 root nerve and low back pain. Without any other symptoms. The CT scan shows a left paravertebral mass with infiltration signs and destruction of T12 vertebra and rib, and a 12 cm anterior paravertebral tumor with aorta invasion. Magnetic resonance imaging shows invasion of the spinal canal. Descompressive laminectomy was made with evacuation of the vesicles. Patient shows a satisfactory evolution, with a complete recovery of paresthesia and be able to walk. The vertebral hydatid disease is rare, but can be manifested by pain and medular compression symptoms, such a paraparesia, paresthesis, altered tendon reflexes, sphincter dysfunction and cauda equina syndrome. Imaging such a CT scan and Magnetic resonance imaging, are necesary for an effective diagnosis and monitoring of the disease. The treatment of choice is the surgical descompression with the use of antihelminthics in order to prevent the recurrence.