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71.
Barroso Rosmeire Aparecida Navarro Ricardo Tim Carla Roberta de Paula Ramos Lucas de Oliveira Luciane Dias Araki Ângela Toshie Fernandes Karina Gonzales Camara Macedo Daniela Assis Lívia 《Lasers in medical science》2021,36(6):1235-1240
Lasers in Medical Science - Acne vulgaris is the most recurring skin condition in the world, causing great harm to the physical and psychological well-being of many patients. Antimicrobial... 相似文献
72.
Carlos Jiménez Romero Laura Alonso Murillo Paula Rioja Conde Alberto Marcacuzco Quinto Óscar Caso Maestro Anisa Nutu Isabel Pérez Moreiras Iago Justo Alonso 《Cirugía espa?ola》2021,99(6):440-449
IntroductionThere is controversy regarding the ideal pancreaticojejunostomy technique after pancreaticoduodenectomy. Many authors consider the external Wirsung stenting technique to be associated with a low incidence of fistula, morbidity and mortality. We analyse our experience with this technique.Patients and methodsA retrospective analysis of the morbidity and mortality of a series of 80 consecutive patients who had been treated surgically over a 6.5-year period for pancreatic head or periampullary tumors, performing pancreaticoduodenectomy and pancreaticojejunostomy with external Wirsung duct stenting.ResultsMean patient age was 68.3 ± 9 years, and the resectability rate was 78%. The texture of the pancreas was soft in 51.2% of patients and hard in 48.8%. Pylorus-preserving resection was performed in 43.8%. Adenocarcinoma was the most frequent tumor (68.8%), and R0 was confirmed in 70% of patients. Biochemical fistula was observed in 11.2%, pancreatic fistula grade B in 12.5% and C in 2.5%, whereas the abdominal reoperation rate was 10%. Median postoperative hospital stay was 16 days, and postoperative and 90-day mortality was 2.5%. Delayed gastric emptying was observed in 36.3% of patients, de novo diabetes in 12.5%, and exocrine insufficiency in 3. Patient survival rates after 1, 3 and 5 years were 80.2, 53.6 and 19.2%, respectively.ConclusionsAlthough our low rates of postoperative complications and mortality using external Wirsung duct stenting coincides with other more numerous recent series, it is necessary to perform a comparative analysis with other techniques, including more cases, to choose the best reconstruction technique after pancreaticoduodenectomy. 相似文献
73.
Mya L. Roberson Matthew D. Egberg Paula D. Strassle Michael R. Phillips 《Journal of pediatric surgery》2021,56(3):439-445
BackgroundThere is a limited understanding of the impact of pediatric malnutrition indicators on post-operative outcomes.Materials and methodsAll pediatric surgical patients captured in the ACS NSQIP-Pediatric database from 2016 to 2018 were included. Multivariable logistic regression was used to estimate odds of 30-day post-operative infection by malnutrition definition (stunted, wasted, requiring nutritional support, pre-operative hypoalbuminemia).ResultsAmong pediatric surgery patients (n = 282,056), 19% of patients met one definition of malnutrition, 6% met two, 1% met 3, and < 0.1% met all 4. After adjustment, requiring nutritional support (OR 1.47, 95% CI 1.36–1.60), stunting (OR 1.17, 95% CI 1.10–1.25), and hypoalbuminemia (OR 1.17 95% CI 1.04–1.32) were associated with increased odds of post-operative infection while wasting was not. Requiring nutritional support was associated in an increase of 10.17 days (95% CI 9.89–10.44) in time from admission to surgery.ConclusionsThe metric used to define malnutrition changed the association with post-operative outcomes. Nutritional supplementation, stunting, and hypoalbuminemia were associated with poorer postoperative outcomes. These findings have implications for pre-operative patient level counseling, accurate risk stratification, surgical planning, and patient optimization in pediatric surgery.Level of EvidenceIII. 相似文献
74.
Marina Guitton Rodrigues Paula Marcela Vilela Castro Tiago Careli de Almeida Fernanda Ribeiro Danziere Francisco Antonio Sergi Filho Beimar Edmundo Zeballos Sempertegui Juan Rafel Branez Leonardo Toledo Mota Marcelo Perosa de Miranda Regina Gomes dos Santos Tércio Genzini 《Transplantation proceedings》2021,53(2):661-664
ObjectiveThis study aimed to evaluate how cold ischemia time (CIT) interferes with liver graft function in the first 7 days after surgery for Custodiol (HTK) preserved organs.MethodsThis retrospective observational study analyzed the medical records of 38 transplantation patients at Hospital Leforte Liberdade, São Paulo, in 2018. The study population was divided into 2 groups (group A, CIT < 8 hours; group B, CIT > 8 hours). Postoperative parameters—such as international normalized ratio, total bilirubin, aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, gamma glutamyl transferase (GGT), lactate dehydrogenase, lactate, creatinine, red blood cell transfusion, need for hemodialysis, use of vasoactive drugs, endotracheal intubation time, length of stay in the intensive care unit (ICU), and length of hospital stay—were compared.ResultsGroup A (CIT < 8 hours) presented less need for red blood cell transfusions (odds ratio 0.29; confidence interval 0.06-0.98; P = .04), had a shorter hospital stay (P = .024), and had lower levels of total bilirubin (P = .05) and GGT (P = .05) in the first 7 postoperative days. The other variables showed no statistically significant difference.ConclusionIn livers preserved with Custodiol, CIT > 8 hours generated higher levels of total bilirubin and GGT in the postoperative period, in addition to higher hospital costs; greater need for red blood cell transfusions; and longer hospitalization, including longer stays in the ICU. 相似文献
75.
Daniela de Queiroz Moura Ramon Rawache Marília Ferreira Gomes Garcia Nathalia Farias Vasconcelos Priscila Santos Gustavo Rego Coelho Thiago Luis da Paz Santos Duílio Reis da Rocha Filho Sonia Leite da Silva Eliana Regia Barbosa de Almeida Paula F.C.B.C. Fernandes João Batista Cerqueira José Huygens Parente Garcia Claudia Maria Costa de Oliveira 《Transplantation proceedings》2021,53(4):1345-1349
Transplantation of any organ has some inherent risk of disease transmission, such as infection and malignancy. The present study aims to describe 2 cases of choriocarcinoma transmission after kidney and liver transplantation originating from the same patient. The donor was a 17-year-old woman who died of cerebral hemorrhage. Both organ recipients died of metastatic choriocarcinoma few months after the transplantation, within days after starting chemotherapy. Retrospective hCG (human chorionic gonadotropin hormone) analysis in donor's blood stored at the time of donation had a result of 9324 mIU/mL. Despite its rarity, clinicians should be aware of the risk of transplant-related choriocarcinoma from female donors in childbearing age. In some cases, hCG dosage should be performed before donation. 相似文献
76.
Shamsah Kazani David J. Rowlands Ivan Bottoli Julie Milojevic Jose Alcantara Ieuan Jones Kenneth Kulmatycki Surendra Machineni Lidia Mostovy Ian Nicholls Jerry A. Nick Steven M. Rowe Nicholas J. Simmonds Raju Vegesna Jeroen Verheijen Henry Danahay Martin Gosling Phaninatha Sarma Ayalavajjala Robert Strieter 《Journal of cystic fibrosis》2021,20(2):250-256
BackgroundThis is the first-in-human study of icenticaftor, an oral potentiator of the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) channel. Restoration of CFTR activity has shown significant clinical benefits, but more studies are needed to address all CFTR mutations.MethodsSafety, pharmacodynamics/pharmacokinetics of icenticaftor were evaluated in a randomized, double-blind, placebo-controlled study in healthy volunteers. Efficacy was assessed in adult CF patients with ≥1 pre-specified CFTR Class III or IV mutation (150 and 450 mg bid), or homozygous for F508del mutation (450 mg bid). Primary efficacy endpoint was change from baseline in lung clearance index (LCI2.5). Secondary endpoints included %predicted FEV1 and sweat chloride level.ResultsClass IV mutations were present in 22 patients, Class III in 2 (both S549N), and 25 were homozygous for F508del. Icenticaftor was well-tolerated in healthy and CF subjects with no unexpected events or discontinuations in the CF groups. The most frequent study-drug related adverse events in CF patients were nausea (12.2%), headache (10.2%), and fatigue (6.1%). Icenticaftor 450 mg bid for 14 days showed significant improvements in all endpoints versus placebo in patients with Class III and IV mutations; mean %predicted FEV1 increased by 6.46%, LCI2.5 decreased by 1.13 points and sweat chloride decreased by 8.36 mmol/L. No significant efficacy was observed in patients homozygous for a single F508del.ConclusionsIcenticaftor was safe and well-tolerated in healthy volunteers and CF patients, and demonstrated clinically meaningful changes in lung function and sweat chloride level in CF patients with Class III and IV CFTR mutations.ClinicalTrials.gov: NCT02190604 相似文献
77.
Samuel Cibulski Thais Fumaco Teixeira Ana Paula Muterle Varela Matheus Fabião de Lima Gabriela Casanova Yuri Mangueira Nascimento Josean Fechine Tavares Marcelo Sobral da Silva Patrícia Sesterheim Diogo Onofre Souza Paulo Michel Roehe Fernando Silveira 《Vaccine》2021,39(3):571-579
Vaccine adjuvants are compounds that enhance/prolong the immune response to a co-administered antigen. Saponins have been widely used as adjuvants for many years in several vaccines – especially for intracellular pathogens – including the recent and somewhat revolutionary malaria and shingles vaccines. In view of the immunoadjuvant potential of Q. brasiliensis saponins, the present study aimed to characterize the QB-80 saponin-rich fraction and a nanoadjuvant prepared with QB-80 and lipids (IMXQB-80). In addition, the performance of such adjuvants was examined in experimental inactivated vaccines against Zika virus (ZIKV). Analysis of QB-80 by DI-ESI-ToF by negative ion electrospray revealed over 29 saponins that could be assigned to known structures existing in their congener Q. saponaria, including the well-studied QS-21 and QS-7. The QB-80 saponins were a micrOTOF able to self-assembly with lipids in ISCOM-like nanoparticles with diameters of approximately 43 nm, here named IMXQB-80. Toxicity assays revealed that QB-80 saponins did present some haemolytical and cytotoxic potentials; however, these were abrogated in IMXQB-80 nanoparticles. Regarding the adjuvant activity, QB-80 and IMXQB-80 significantly enhanced serum levels of anti-Zika virus IgG and subtypes (IgG1, IgG2b, IgG2c) as well as neutralized antibodies when compared to an unadjuvanted vaccine. Furthermore, the nanoadjuvant IMXQB-80 was as effective as QB-80 in stimulating immune responses, yet requiring fourfold less saponins to induce the equivalent stimuli, and with less toxicity. These findings reveal that the saponin fraction QB-80, and particularly the IMXQB-80 nanoadjuvant, are safe and capable of potentializing immune responses when used as adjuvants in experimental ZIKV vaccines. 相似文献
78.
B Gontijo F A Fantini J A de Paula e Silva J T Barbosa M O Vrandecic M da G Masci 《The Journal of cardiovascular surgery》1990,31(6):815-817
A new technique to correct persistent left superior vena cava (LSVC) drainage into the left atrium is described in a 14-year-old patient with situs inversus, left atrial isomerism common atrium, and mitral valve regurgitation. During surgery, occlusion of the LSVC markedly increased the venous pressure, precluding its ligation. Because of the malposition of the heart and the unusual atrial anatomy, correction with an intra-atrial baffle was not attempted. After correcting the intra-cardiac anomaly, the LSVC was divided and anastomosed to the "right" atrial appendage using a segment of PTFE graft. The postoperative course was uneventful and an angiogram demonstrated excellent performance of the graft. 相似文献
79.
Abdullahi Idris Nasir Lozano Carmen Juárez-Fernández Guillermo Höfle Ursula Simón Carmen Rueda Silvia Martínez Angela Álvarez-Martínez Sandra Eguizábal Paula Martínez-Cámara Beatriz Zarazaga Myriam Torres Carmen 《European journal of clinical microbiology & infectious diseases》2023,42(5):569-581
European Journal of Clinical Microbiology & Infectious Diseases - This study determined the carriage rates and antimicrobial resistance (AMR) genes of enterococci from... 相似文献
80.
Chlorhexidine susceptibility and Eagle effect in planktonic cells and biofilm of nosocomial isolates
Marchi Ana Paula Farrel Côrtes Marina Vásconez Noguera Saidy Rossi Flavia Levin Anna Sara Figueiredo Costa Silvia Perdigão Neto Lauro Vieira 《European journal of clinical microbiology & infectious diseases》2023,42(6):787-792
European Journal of Clinical Microbiology & Infectious Diseases - The aim of this study is to evaluate the chlorhexidine gluconate (CHG) susceptibility in both planktonic cells and biofilm of... 相似文献