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Introducción: La cirugía endoscópica nasosinusal (CEN) de cavidades paranasales es un tratamiento ampliamente utilizado para la rinosinusitis crónica, con un impacto significativo en mejorar la calidad de vida de los pacientes. Objetivo: Evaluar el impacto de la CEN en la calidad de vida en pacientes con diagnóstico de rinosinusitis crónica en una cohorte nacional y a largo plazo (1 año). Material y Método: Se realizó un estudio de cohorte prospectiva. Se incluyó 95 pacientes con diagnóstico de RSC operados en el servicio de otorrinolaringología del hospital del Salvador en el período 2017-2021. Se compararon síntomas como obstrucción nasal, rinorrea, descarga posterior, algia facial e hiposmia, además de la encuesta SNOT-22 pre y post cirugía utilizando como medidas la escala visual análoga (EVA) de sintomatología cardinal de RSC y SNOT-22. Resultados: Los resultados mostraron una mejoría significativa en todos los síntomas evaluados. La obstrucción nasal, rinorrea, descarga posterior, hiposmia y algia facial presentaron una disminución estadísticamente significativa después de la CEN. Además, la encuesta de calidad de vida SNOT-22 reveló una mejora significativa en la calidad de vida de los pacientes después de la cirugía. Conclusión: Este estudio sugiere que la CEN podría tener un impacto significativo en la mejora de los síntomas y la calidad de vida de los pacientes con rinosinusitis crónica. Los resultados de esta cohorte nacional respaldan la efectividad de la CEN como tratamiento para esta enfermedad a largo plazo (1 año) y destacan la importancia de considerar esta opción terapéutica en el manejo de la RSC.
Introduction: Functional endoscopic sinus surgery (FESS) is a widely employed treatment for chronic rhinosinusitis (CRS) and has shown significant benefits in enhancing the quality of life for affected patients. Objective: To assess the impact of FESS on the quality of life in patients diagnosed with chronic rhinosinusitis in a national and longterm cohort (1 year). Material and Method: A prospective cohort study was conducted at the otolaryngology service of Hospital del Salvador between 2017 and 2021, involving 95 patients diagnosed with CRS who underwent FESS. Symptoms such as nasal obstruction, rhinorrhea, posterior discharge, facial pain, and hyposmia were evaluated. The visual analog scale (VAS) was used to measure the cardinal symptoms of CRS, and the SNOT-22 survey was administered before and after the surgical procedure. Results: The study demonstrated a significant improvement in all evaluated symptoms following FESS. Nasal obstruction, rhinorrhea, posterior discharge, hyposmia, and facial pain exhibited a statistically significant decrease. Moreover, the SNOT-22 survey revealed a notable enhancement in the quality of life for patients after surgery. Conclusion: The highlights of this national cohort support the impact of FESS in alleviating symptoms and improving the quality of life for patients diagnosed with chronic rhinosinusitis. The findings provide strong evidence supporting the effectiveness of FESS as a treatment option for CRS and emphasize the importance of considering this surgical approach in the management of this condition.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Endoscopia/métodos , Procedimentos Cirúrgicos Nasais/métodos , Rinossinusite/cirurgia , Seios Paranasais/cirurgia , Qualidade de Vida , Chile , Doença Crônica , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Cladophialophora bantiana is a filamentous fungus, known as a dematiaceous fungus because of the presence of melanin. This fungus is of clinical importance because it is neurotropic and causes cerebral phaeohyphomycosis. MATERIAL AND METHODS: The available scientific information on the development of cerebral phaeohyphomycosis caused by Cladophialophora bantiana was analysed by selecting articles from the PubMed, Scopus and Google Scholar databases that describe case reports of fungal infection by C. bantiana in adults, taking into account the analysis of the patients' symptomatology, clinical history and neuroanatomical damage, in addition to considering the mortality of the condition. RESULTS: India and United States were the countries with most case reports, with 32 and 11 cases respectively. Moreover, in terms of neuroanatomical lesions, the majority of patients suffered mixed lesions (29%) and frontal lobe lesions (22%). In accordance with the patients' condition, the pathology has a mortality rate of 62%. CONCLUSIONS: It is concluded that cerebral phaeohyphomycosis has a high mortality rate, there is no standardised treatment and, in most cases, the fungal infection of the brain is mixed and affects several different parts of it. Furthermore, if not diagnosed and treated in time, it can lead to the patients' death.
TITLE: Infección micótica por Cladophialophora bantiana y desarrollo de feohifomicosis cerebral. Revisión sistemática de 58 informes de caso.Introducción. Cladophialophora bantiana es un hongo filamentoso, denominado hongo dematiáceo por la presencia de melanina. Este hongo tiene importancia clínica por ser neurotrópico y causar feohifomicosis cerebral. Material y métodos. Se analizó la información científica disponible sobre el desarrollo de feohifomicosis cerebral provocada por Cladophialophora bantiana, seleccionando artículos de las bases de PubMed, Scopus y Google Scholar, que describen informes de caso sobre infección micótica de C. bantiana en adultos, considerando el análisis de la sintomatología, el historial clínico y los daños neuroanatómicos de los pacientes, además de considerar la mortalidad de la patología. Resultados. La India y Estados Unidos fueron los países con más informes de caso, 32 y 11 casos, respectivamente. Asimismo, en cuanto a las lesiones neuroanatómicas, en su mayoría, los pacientes sufrieron lesiones mixtas (29%) y del lóbulo frontal (22%). De acuerdo con el estado de los pacientes, la patología tiene una mortalidad del 62%. Conclusiones. Se concluye que la feohifomicosis cerebral tiene una alta mortalidad, no existe un tratamiento estandarizado y, en la mayoría de los casos, la infección fúngica del cerebro es mixta y afecta a varias partes del cerebro; además, si no se diagnostica y trata a tiempo, puede ocasionar la muerte de los pacientes.
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Ascomicetos , Abscesso Encefálico , Feoifomicose Cerebral , Micoses , Adulto , Humanos , Antifúngicos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Feoifomicose Cerebral/diagnóstico , Feoifomicose Cerebral/tratamento farmacológico , Micoses/tratamento farmacológico , Relatos de Casos como AssuntoRESUMO
In this work, we focus on understanding the morphology and photocatalytic properties of CeO2 nanocrystals (NCs) synthesized via a microwave-assisted solvothermal method using acetone and ethanol as solvents. Wulff constructions reveal a complete map of available morphologies and a theoretical-experimental match with octahedral nanoparticles obtained through synthesis using ethanol as solvent. NCs synthesized in acetone show a greater contribution of emission peaks in the blue region (â¼450 nm), which may be associated with higher Ce3+ concentration, originating shallow-level defects within the CeO2 lattice while for the samples synthesized in ethanol a strong orange-red emission (â¼595 nm) suggests that oxygen vacancies may originate from deep-level defects within the optical bandgap region. The superior photocatalytic response of CeO2 synthesized in acetone compared to that of CeO2 synthesized in ethanol may be associated with an increase in long-/short-range disorder within the CeO2 structure, causing the Egap value to decrease, facilitating light absorption. Furthermore, surface (100) stabilization in samples synthesized in ethanol may be related to low photocatalytic activity. Photocatalytic degradation was facilitated by the generation of ·OH and ·O2- radicals as corroborated by the trapping experiment. The mechanism of enhanced photocatalytic activity has been proposed suggesting that samples synthesized in acetone tend to have lower e'âh· pair recombination, which is reflected in their higher photocatalytic response.
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RESUMEN Introducción: La neuroprotección farmacológica se utiliza en el período antenatal para ayudar a disminuir el riesgo de parálisis cerebral o disfunciones motoras en el recién nacido (RN). El sulfato de magnesio (MgSO4) es de gran utilidad por los beneficios que proporciona como tocolítico, neuroprotector fetal en prematuros menores a 32 semanas y en el manejo de la preeclampsia. Sin embargo, durante su uso se observaron efectos adversos a dosis dependientes tanto para la madre como para el RN, lo que genera gran importancia para el trabajo del profesional de obstetricia y enfermería. Objetivo: Determinar la frecuencia de reanimación neonatal en prematuros menores de 32 semanas según el uso de neuroprotección con MgSO4. Métodos: Estudio retrospectivo, observacional, realizado en un hospital de Santiago de Chile. Se realizó un muestreo aleatorio simple. Se incluyeron prematuros menores a 32 semanas de edad gestacional con o sin tratamiento de MgSO4 que hayan requerido o no reanimación neonatal. La información fue recogida a partir de fichas clínicas con un instrumento propio. Análisis de los datos por determinación de frecuencias absolutas y relativas de las variables y su comparación directa. Resultados: Del total de los RN que recibieron MgSO4, 61.7 % requirió reanimación neonatal al nacer, de los que no recibieron este neuroprotector, el 52.8 % necesitó reanimación neonatal. Conclusiones: La mayor frecuencia de reanimación neonatal está asociada al uso de la neuroprotección con MgSO4 y ocurre más probablemente en recién nacidos de edad gestacional menor que 32 semanas. Los resultados contribuyen a la toma de decisiones basadas en pruebas.
ABSTRACT Introduction: Diverse drug-related neuroprotections are used during the prenatal period to help reduce the risk of cerebral palsy or motor dysfunctions in the newborn. Magnesium sulfate (MgSO4) is useful as a fetal neuroprotector in prematures with less than 32 weeks, as well as in the management of preeclampsia. Nevertheless, some dose-dependent adverse effects both on the mother and the newborn have been reported. This situation is necessarily of concern to the nursing and obstetrics professional. Objective: To determine the frequency of neonatal reanimation en prematures with less than 32 weeks with MgSO4 neuroprotection. Methods: This is a retrospective and observational study conducted in a hospital in Santiago, Chile. Simple random sampling was used. Prematures with less than 32 weeks of gestational age, with or without MgSO4 treatment and who had or had not required neonatal reanimation, were included in the study. Data were collected from clinical records. Absolute and relative frequencies and their direct comparisons were calculated. Results: From the total of newborns who received MgSO4, 61.7% required neonatal reanimation, while from those who did not receive MgSO4, 52.8% required neonatal reanimation. Conclusions: The higher frequency of neonatal reanimation is associated with the received MgSO4 as a neuroprotection with and occurs more likely in neonates with a gestational age less than 32 weeks. The results contribute to evidence-based decision making.
RESUMO Introdução: A neuroproteção farmacológica é utilizada no período pré-natal para ajudar a reduzir o risco de paralisia cerebral ou disfunções motoras no recém-nascido (RN). O sulfato de magnésio (MgSO4) é muito útil devido aos benefícios que proporciona como tocolítico, neuroprotetor fetal em prematuros com menos de 32 semanas e no tratamento da pré-eclâmpsia. Porém, durante seu uso, foram registrados efeitos adversos em doses dependentes tanto para a mãe quanto para o recém-nascido, o que gera grande importância para o trabalho do profissional obstétrico e de enfermagem. Objetivo: Determinar a frequência de reanimação neonatal em prematuros com menos de 32 semanas de acordo com o uso de neuroproteção com MgSO4. Métodos: Estudo retrospectivo e observacional realizado em um hospital de Santiago de Chile. Foi realizada uma amostragem aleatória simples. Foram incluídos bebês prematuros com menos de 32 semanas de idade gestacional com ou sem tratamento com MgSO4 que exigia ou não a reanimação neonatal. Coletou-se informação de prontuários clínicos com um instrumento proprietário. Análise dos dados através da determinação das frequências absolutas e relativas das variáveis e sua comparação direta. Resultados: Do total dos RN que receberam MgSO4, 61,7% necessitaram de reanimação neonatal ao nascimento, dos que não receberam esse neuroprotetor, 52,8% necessitaram de reanimação neonatal. Conclusões: A frequência de reanimação neonatal foi maior em recém-nascidos com menos de 32 semanas de idade gestacional que receberam neuroproteção com MgSO4, situação semelhante em cada estrato de idade gestacional.
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BACKGROUND: The use of artificial intelligence (AI) algorithms for the diagnosis of skin diseases has shown promise in experimental settings but has not been yet tested in real-life conditions. OBJECTIVE: To assess the diagnostic performance and potential clinical utility of a 174-multiclass AI algorithm in a real-life telemedicine setting. METHODS: Prospective, diagnostic accuracy study including consecutive patients who submitted images for teledermatology evaluation. The treating dermatologist chose a single image to upload to a web application during teleconsultation. A follow-up reader study including nine healthcare providers (3 dermatologists, 3 dermatology residents and 3 general practitioners) was performed. RESULTS: A total of 340 cases from 281 patients met study inclusion criteria. The mean (SD) age of patients was 33.7 (17.5) years; 63% (n = 177) were female. Exposure to the AI algorithm results was considered useful in 11.8% of visits (n = 40) and the teledermatologist correctly modified the real-time diagnosis in 0.6% (n = 2) of cases. The overall top-1 accuracy of the algorithm (41.2%) was lower than that of the dermatologists (60.1%), residents (57.8%) and general practitioners (49.3%) (all comparisons P < 0.05, in the reader study). When the analysis was limited to the diagnoses on which the algorithm had been explicitly trained, the balanced top-1 accuracy of the algorithm (47.6%) was comparable to the dermatologists (49.7%) and residents (47.7%) but superior to the general practitioners (39.7%; P = 0.049). Algorithm performance was associated with patient skin type and image quality. CONCLUSIONS: A 174-disease class AI algorithm appears to be a promising tool in the triage and evaluation of lesions with patient-taken photographs via telemedicine.
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Dermatologia , Dermatopatias , Telemedicina , Adulto , Inteligência Artificial , Feminino , Humanos , Masculino , Redes Neurais de Computação , Estudos Prospectivos , Dermatopatias/diagnósticoRESUMO
Crustaceans are frequently used as bioindicators, and changes in their metabolism at the hepatopancreas (HP) level are often followed in these studies. The HP is the site of digestion, absorption, nutrient storage, and toxic metal detoxification, enabling crabs to survive in metal contaminated regions. Cellular damage and high lipid peroxidation (LPO) levels have been found in crab populations under high cadmium (Cd) concentrations. The aim of this work was to separate and characterize the HP cells of the stone crab Menippe frontalis from the Pacific Ocean, Perú (5° 5' 21â³ S-81° 6' 51â³ W) and to measure the cellular viability and LPO after exposure to the non-essential metal Cd. The HP cells were dissociated by magnetic stirring, with posterior separation by sucrose gradient at concentrations of 10, 20, 30, and 40%. We found the same cell types that were described for other species (e.g., Ucides cordatus, Atlantic Ocean, Brazil). High cellular viability against 1 mmol L-1 of Cd was observed for resorptive (R) cells in 20% sucrose layer (88 ± 8%, *P < 0.05, ANOVA), and blister (B) cells in the 40% sucrose layers (92 ± 7%, *P < 0.05, ANOVA). Cd (1 mmol L-1) caused an increase in LPO levels, suggesting that crabs from polluted areas can be affected by toxic metals, generating a physiological stress. The gradient sucrose methodology can be used for different species and results in a similar separation, viability, and cellular identification. The results are a starting point for toxic metal studies for species distributed across different geographic coordinates.
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Braquiúros/citologia , Cádmio/toxicidade , Separação Celular/métodos , Hepatopâncreas/citologia , Peroxidação de Lipídeos/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Animais , Braquiúros/embriologia , Sobrevivência Celular/efeitos dos fármacos , Embrião não Mamífero/citologiaRESUMO
In this paper we show a very simple route for the incorporation of catalytically active niobium species on the surface of carbon materials, such as graphene oxide, carbon nanotubes and activated carbon. Some existing methods of incorporating a transition metal on a support have involved co-precipitation or wet impregnation, to obtain the corresponding oxides. These methods, however, cause reduction in the specific area of the support and can also form large metal oxide particles with loss of metal exposure. Therefore, here we present a novel way to add catalytically active species on the surfaces of different types of carbon through the formation of interaction complexes between the metal precursor and the functional groups of the carbon matrix. Because of the excellent catalytic properties exhibited by the niobium species we choose the NH4[NbO(C2O4)2(H2O)2]·2H2O salt as the model precursor. The characterization by XPS reveals the presence of the niobium species indicated by the displacement of the peaks between 206-212 eV related to the oxalate species according to the spectrum from pure niobium oxalate. Images obtained by TEM and SEM show the typical morphologies of carbonaceous materials without the niobium oxide formation signal, which indicates the presence of niobium complexes as isolated sites on the carbon surfaces. This new class of materials exhibited excellent properties as catalysts for pollutant oxidation. The presence of Nb promotes the catalytic activation of H2O2 generating hydroxyl radicals in situ, which allows their use in the organic compound oxidation processes. Tests for DBT oxidation indicate that Nb significantly improves the removal of such pollutants in biphasic reactions with removal around 90% under the tested conditions. Theoretical calculations showed that the most favorable adsorption model is an ionic complex presenting a ΔG = -108.7 kcal mol(-1) for the whole adsorption process.
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Membrane pathway for intracellular cadmium (Cd(2+)) accumulation is not fully elucidated in many organisms and has not been studied in crab gill cells. To characterize membrane Cd(2+) transport of anterior and posterior gill cells of Ucides cordatus, a hypo-hyper-regulating crab, a change in intracellular Cd(2+) concentration under various experimental conditions was examined by using FluoZin, a fluorescent probe. The membrane Cd(2+) transport was estimated by the augmentation of FluoZin fluorescence induced by extracellular application of CdCl2 and different inhibitors. Addition of extracellular calcium (Ca(2+)) to the cells affected little the fluorescence of FluoZin, confirming that Cd(2+) was the main ion increasing intracellular fluorescence. Ca(2+) channels blockers (nimodipine and verapamil) decreased Cd(2+) influx as well as vanadate, a Ca(2+)-ATPase blocker. Chelating intracellular Ca(2+) (BAPTA) decreased Cd(2+) influx in gill cells, while increasing intracellular Ca(2+) (caffeine) augmented Cd influx. Cd(2+) and ATP added at different temporal conditions were not effective at increasing intracellular Cd(2+) accumulation. Ouabain (Na(+)/K(+)-ATPase inhibitor) increased Cd(2+) influx probably through a change in intracellular Na and/or a change in cell membrane potential. Routes of Cd(2+) influx, a non-essential metal, through the gill cell plasma membrane of crabs are suggested.
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Braquiúros/metabolismo , Cádmio/metabolismo , Membrana Celular/metabolismo , Poluentes Químicos da Água/metabolismo , Animais , Transporte Biológico/efeitos dos fármacos , Braquiúros/efeitos dos fármacos , Cádmio/toxicidade , Cafeína/farmacologia , Cálcio/metabolismo , Bloqueadores dos Canais de Cálcio/farmacologia , Sobrevivência Celular , Quelantes/farmacologia , Ácido Egtázico/análogos & derivados , Ácido Egtázico/farmacologia , Fluorescência , Corantes Fluorescentes/metabolismo , Brânquias/efeitos dos fármacos , Brânquias/metabolismo , Transporte de Íons/efeitos dos fármacos , Nimodipina/farmacologia , Vanadatos/farmacologia , Verapamil/farmacologia , Poluentes Químicos da Água/toxicidadeRESUMO
Antecedentes: En años recientes la demanda de productos alimenticios percibidos como naturales se ha incrementado de manera importante, los cuales no contienen dentro de sus ingredientes conservantes o aditivos de origen químico o artificial. Al retirar de la fórmula estos conservantes/aditivos artificiales se puede generar en el producto un medio ideal de crecimiento de bacterias alterantes o patógenas. Esto es particularmente cierto en productos cárnicos procesados empacados al vacío, donde su alta actividad acuosa, bajo pH y un largo periodo de almacenamiento a condiciones de refrigeración generan un ambiente ideal para el crecimiento de microorganismos patógenos como Listeria monocytogenes. Por tanto, esto genera la necesidad de nuevas y efectivas tecnologías que permitan su control y eliminación. Los Bio-Conservantes (adición de bacterias vivas a los productos cárnicos) ofrecen una solución ideal a este tipo de problemas directamente relacionados con la seguridad alimentaria, y a la vez satisfacen la demanda por parte de los consumidores de productos saludables. Objetivos: Determinar si el cultivo C. maltaromaticum CB1 puede controlar el crecimiento de una cepa nativa de L. monocytogenes en morcilla y chorizo empacados al vacío (película de baja permeabilidad al oxigeno). Métodos: Tres lotes diferentes de chorizo y morcilla producidos a nivel industrial fueron posteriormente inoculados con una cepa nativa de L. monocytogenes a un nivel de 102 UFC/g junto con el bio-conservante C. maltaromaticum CB1 a un nivel de 103 UFC/g. A los tratamientos denominados como control no se les aplicó el bio-conservante. Después de ser empacados al vacío, los productos fueron almacenados a dos temperaturas diferentes de 4°C (refrigeración) y 8°C (abuso de temperatura) durante 35 días. En intervalos de 7 días se hizo recuentos del crecimiento de la L. monocytogenes utilizando agar Oxford...