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INTRODUCTION: One of the major concerns with post-acute sequelae of COVID-19 (PASC) is the development of pulmonary fibrosis, for which no approved pharmacological treatment exists. Therefore, the primary aim of this open-label study was to evaluate the safety and the potential clinical efficacy of a prolonged-release pirfenidone formulation (PR-PFD) in patients having PASC-pulmonary fibrosis. METHODS: Patients with PASC-pulmonary fibrosis received PR-PFD 1800 mg/day (1200 mg in the morning after breakfast and 600 mg in the evening after dinner) for three months. Blood samples were taken to confirm the pharmacokinetics of PR-PFD, and adverse events (AEs) were evaluated monthly using a short questionnaire. Symptoms, dyspnea, and pulmonary function tests (spirometry, diffusing capacity for carbon monoxide, plethysmography, and 6-min walk test [6MWT]) were evaluated at baseline, and one and three months after having started the PR-PFD treatment. RESULTS: Seventy subjects with mild to moderate lung restriction were included. The most common AEs were diarrhea (23%), heartburn (23%), and headache (16%), for which no modifications in the drug study were needed. Two patients died within the first 30 days of enrolment, and three opted not to continue the study, events which were not associate with PR-PFD. Pulmonary function testing, 6MWT, dyspnea, symptoms, and CT scan significantly improved after three months of treatment with PR-PFD. CONCLUSION: In patients with PASC pulmonary fibrosis, three months' treatment with PR-PFD was safe and showed therapeutic efficacy. Still, it remains to be seen whether the pulmonary fibrotic process remains stable, becomes progressive or will improve.
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COVID-19 , Fibrose Pulmonar Idiopática , Pneumonia , Humanos , COVID-19/complicações , Progressão da Doença , Dispneia/tratamento farmacológico , Dispneia/etiologia , Fibrose Pulmonar Idiopática/complicações , Fibrose Pulmonar Idiopática/tratamento farmacológico , Fibrose Pulmonar Idiopática/diagnóstico , Fenótipo , Pneumonia/tratamento farmacológico , Piridonas/efeitos adversosRESUMO
SUMMARY: Based on the new concepts of the modified Le Fort III osteotomy (MLFIIIO), Three variations of this technique are implemented: (A) the modified osteotomy Le Fort III Champy (1980) technique to be described with the use of surgical guides, and subciliary approach or an transconjunctival approach. Excellent technique for horizontal advancement no further to 6 mm, without requiring any type of graft.. (B) The modified Le Fort III osteotomy in "Z": to solve horizontal (posterior anterior) problems of more than 6 mm without bone grafting. It is itself a modification of the technique described by Champy. (C) The modified Le Fort III osteotomy ascending: modified the original technique described by Bell and Epker with interpositional grafts, was modified by the called ascendant, making it higher in cases where the patient has an acceptable nasal bridge, but exorbitism the lateral wall of the orbit. Le Fort III osteotomy combined with a Le Fort I osteotomy and a front implant. METHOD: As pointed out in Part I for the modified oblique Le Fort III osteotomy, methods for the design of the osteotomy Le Fort III property will depend on the requirements of individual patients, and this has led us to design specific techniques for the deformity. RESULTS: Patients have a right projection of the middle third, and protection of the eyeball. CONCLUSIONS: The techniques presented for the advancement of the middle third have excellent results with the ability to be tailored to each patient deformity.
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Anthropogenic debris ingestion has been reported for green turtles in all their life stages worldwide. The aim of the present study is to evaluate the marine debris ingestion by green turtles stranded in Uruguayan coast between 2005 and 2013. Debris items were categorized and quantified by frequency of occurrence, relative weight, volume and number of items. A total of 96 dead stranded turtles were analyzed and 70% presented debris in their guts. The majority of debris found were plastic, being hard plastics the most abundant in weight. We found no differences in debris ingestion in stranded turtles a long the Uruguayan coast. However we detected a negative correlation between the presence of debris and turtle's size. Smaller turtles are new recruits to neritic grounds indicating that the early juvenile stage of this species is the most vulnerable to this threat in the Southwestern Atlantic.
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Dieta , Monitoramento Ambiental/métodos , Conteúdo Gastrointestinal/química , Plásticos/análise , Tartarugas/crescimento & desenvolvimento , Poluentes Químicos da Água/análise , Animais , Ingestão de Alimentos , UruguaiRESUMO
Aging increases the vulnerability to stress and risk of developing depression. These changes have been related to a reduction of dehydroepiandrosterone (DHEA) levels, an adrenal steroid with anti-stress effects. Also, adult hippocampal neurogenesis decreases during aging and its alteration or impaired is related to the development of depression. Besides, it has been hypothesized that DHEA increases the formation of new neurons. However, it is unknown whether treatment with DHEA in aging may stimulate the dendrite maturation of newborn neurons and reversing depressive-like signs evoked by chronic stress exposure. Here aged male rats (14 months old) were subjected to a scheme of chronic mild stress (CMS) during six weeks, received a treatment with DHEA from the third week of CMS. Changes in body weight and sucrose preference (SP) were measured once a week. DHEA levels were measured in serum, identification of doublecortin-(DCX)-, BrdU- and BrdU/NeuN-labeled cells was done in the dentate gyrus of the hippocampus. CMS produced a gradual reduction in the body weight, but no changes in the SP were observed. Treatment enhanced levels of DHEA, but lack of recovery on body weight of stressed rats. Aging reduced the number of DCX-, BrdU- and BrdU/NeuN- cells but DHEA just significantly increased the number of DCX-cells in rats under CMS and controls, reaching levels of young non-stressed rats (used here as a reference of an optimal status of health). In rats under CMS, DHEA facilitated dendritic maturation of immature new neurons. Our results reveal that DHEA improves neural plasticity even in conditions of CMS in middle age rats. Thus, this hormone reverted the decrement of DCX-cells caused during normal aging.
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Envelhecimento/efeitos dos fármacos , Desidroepiandrosterona/farmacologia , Dendritos/efeitos dos fármacos , Giro Denteado/efeitos dos fármacos , Psicotrópicos/farmacologia , Estresse Psicológico/tratamento farmacológico , Envelhecimento/fisiologia , Envelhecimento/psicologia , Animais , Antígenos Nucleares/metabolismo , Peso Corporal/efeitos dos fármacos , Bromodesoxiuridina , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , Doença Crônica , Desidroepiandrosterona/sangue , Dendritos/metabolismo , Dendritos/patologia , Giro Denteado/metabolismo , Giro Denteado/patologia , Sacarose Alimentar , Proteínas do Domínio Duplacortina , Proteína Duplacortina , Masculino , Proteínas Associadas aos Microtúbulos/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Neurogênese/efeitos dos fármacos , Neurogênese/fisiologia , Neuropeptídeos/metabolismo , Psicotrópicos/sangue , Distribuição Aleatória , Ratos Wistar , Estresse Psicológico/metabolismo , Estresse Psicológico/patologiaRESUMO
Chrysactinia mexicana A. Gray (Asteraceae) and Turnera diffusa Willd (Turneraceae) are employed in traditional medicine as aphrodisiacs; however, there is no scientific evidence supporting the prosexual properties of C. mexicana. The aim of this study was to determine whether an aqueous extract of C. mexicana (Cm) stimulates rat male sexual behavior in the sexual exhaustion paradigm. Sexually exhausted (SExh) male rats were treated with Cm (80, 160, and 320 mg/kg), an aqueous extract of T. diffusa (Td), or yohimbine. The sexual exhaustion state in the control group was characterized by a low percentage of males exhibiting mounts, intromissions, and ejaculations and no males demonstrating mating behavior after ejaculation. Cm (320 mg/kg), Td, or yohimbine significantly increased the proportion of SExh rats that ejaculated and resumed copulation after ejaculation. In males that exhibited reversal of sexual exhaustion, Cm (320 mg/kg) improved sexual performance by reducing the number of intromissions and shrinking ejaculation latency. The effects of treatments on sexual behavior were not related with alterations in general locomotion. In conclusion, the prosexual effects of Cm, as well as those of Td, are established at a central level, which supports the traditional use of C. mexicana for stimulating sexual activity.
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Introducción: En los últimos años se ha incrementado la evidencia sobre la adquisición de habilidades o conductas críticas para el desempeño escolar, sin que esto sea conclusivo acerca de la efectividad de intervenciones en el aula. El objetivo de este proyecto es identificar la ocurrencia de los elementos que definen la adquisición de habilidades o conductas críticas para el desempeño escolar y describirlas desde las dimensiones de actividades de participación del escolar. Métodos: Estudio observacional-descriptivo con una muestra de 28 preescolares y escolares evaluados entre septiembre del 2008 y marzo del 2009 en una institución prestadora de servicio en Cali, Colombia. El procedimiento fue identificar las capacidades de ejecución de los niños usando el inventario de desarrollo de Battell, para luego describir la repercusión en las actividades de participación del escolar. Resultados: El 61,5% de los niños se identificaron con dificultad en las habilidades motoras; el 56%, en el área personal social, y el 46,2%, en el área adaptativa, áreas fundamentales para la participación en las actividades escolares. Estos niños no han desarrollado la capacidad de controlar los músculos de forma integrativa. Presentaron dificultades en la interacción social y en las habilidades propias a la realización de las actividades diarias. Conclusión: Los resultados encontrados en el estudio sugieren la necesidad de aumentar el estudio sobre la relevancia del desarrollo de habilidades motoras, personal-social y adaptativas. Se requiere conocer y aprender estrategias con la colaboración los profesionales encargados del desarrollo
Introduction: In recent years, evidence regarding acquisition of skills or critic behaviors for school performance has increased though there it is not conclusive in terms of the effectiveness in class participation. The purpose is to define the elements implicated in the acquisition of such skills or critical behaviors and describe them from the perspective of school activities involving participation. Methods: Descriptive, observational study with a sample of 28 pre- school and primary school students during September 2008 and March 2009 at a public institution in the city of Cali, Colombia. The procedure was the identification of child performance capabilities using Battells developmental inventory to describe afterwards the repercussions on students participation in school activities. Results: 61.5% of the children show motor difficulties; 56% exhibit socio and personal difficulties, while 46.2% reveal adaptive difficulties. These areas are fundamental for school participation in the different activities. These children have not developed the ability for an integrated control of their muscles. They also exhibit difficulties regarding social interactions and regarding the skills necessary in the performance of daily activities. Conclusion: The results found in this study suggest the need to enhance the study on the relevance to develop motor, personal-social, and adaptive skills in cooperation with developmental professionals. It is necessary to know and learn strategies in cooperation with the developmental professionals
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Desenvolvimento Infantil , Pré-Escolar , Relações InterpessoaisRESUMO
INTRODUCTION: In recent years, evidence regarding acquisition of skills or critic behaviors for school performance has increased though there it is not conclusive in terms of the effectiveness in class participation. The purpose is to define the elements implicated in the acquisition of such skills or critical behaviors and describe them from the perspective of school activities involving participation. METHODS: Descriptive, observational study with a sample of 28 preschool and primary school students during September 2008 and March 2009 at a public institution in the city of Cali, Colombia. The procedure was the identification of child performance capabilities using Battell's developmental inventory to describe afterwards the repercussions on student's participation in school activities. RESULTS: 61.5% of the children show motor difficulties; 56% exhibit socio and personal difficulties, while 46.2% reveal adaptive difficulties. These areas are fundamental for school participation in the different activities. These children have not developed the ability for an integrated control of their muscles. They also exhibit difficulties regarding social interactions and regarding the skills necessary in the performance of daily activities. CONCLUSION: The results found in this study suggest the need to enhance the study on the relevance to develop motor, personal-social, and adaptive skills in cooperation with developmental professionals. It is necessary to know and learn strategies in cooperation with the developmental professionals.
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INTRODUCTION: We describe the technique and present the preliminary results of the laparoscopic radical cystectomy technique with the extracorporeal creation of a "y" shaped ileal orthotopic neobladder using non-absorbable mechanical suture (Fontana). MATERIALS AND METHOD: We describe the technique step by step and we present a series of 15 patients that underwent this surgery between November 2005 and August 2009, with special emphasis on the duration of the surgery, urinary diversion time, intraoperative and postoperative complications, daytime and night time continence and the frequency of postoperative micturition. RESULTS: The mean follow-up of the series was 24 months (6-32). The mean duration of surgery was 280 (range 210-345) minutes and the mean urinary diversion time was 54.5 (range 40-75) minutes. There were no intraoperative complications and the average hospitalization time was 7 (range 5-15) days. During the follow-up, there were 5 late postoperative complications, 2 cases of urinary infection with good response to antibiotic treatment and 3 uretero-neovesical anastomosis strictures, which were treated with percutaneous balloon dilation, with a good functional result. No lithiasis was found in the neobladder. Complete daytime continence was obtained in 13/14 patients (92.9%) and complete night time continence in 6/14 (42.9%). One patient (6.7%) required clean intermittent self-catheterization as the patient did not micturate spontaneously. CONCLUSIONS: The creation of a "Y" shaped ileal orthotopic neobladder using non-absorbable mechanical suture is a feasible, fast and safe technique and it provides promising functional results. Further follow-up is required to determine its long-term results.
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Cistectomia/métodos , Íleo/cirurgia , Laparoscopia/métodos , Grampeamento Cirúrgico/métodos , Suturas , Derivação Urinária/métodos , Coletores de Urina , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/cirurgia , Seguimentos , Humanos , Complicações Intraoperatórias/epidemiologia , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/cirurgia , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologiaRESUMO
INTRODUCTION AND OBJECTIVES: hemorrhagic cystitis (HC) after pelvic radiotherapy occurs in 2-8% of patients. A variety of treatments have been described, most of them with uncertain results. We assessed the efficacy of hyperbaric oxygen therapy (HBOT) in HC cases. PATIENTS AND METHODS: retrospective analysis of patients with HC after pelvic radiotherapy receiving HBOT at our center between January 2002 and January 2010. Our protocol included 40 sessions of HBOT in a multiplace hyperbaric chamber with 90minutes of 100% oxygen breathing at 2.2 atm. Success was evaluated in terms of total or partial stop of bladder bleeding. Telephone follow-up was updated at the time of submission in all cases. RESULTS: twenty-five patients were treated (21 male, 4 female); the mean age was 66.7 years. Twenty men were irradiated for prostate cancer and one for bladder cancer. Three women had cervix cancer and one endometrial cancer. In all cases previous conservative treatment had failed and HBOT was considered only after other measures failed. All the patients responded to HBOT and none recurred after end of treatment at a mean follow-up of 21.2 months. There were no serious complications. CONCLUSION: HBOT is a highly effective and safe, non-invasive therapy for HC secondary to pelvic radiation; it should be considered as first line alternative in these difficult cases.