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Ciscar A, Ruiz P, Saez E, Vila M, Gomez M, Troyano D, Abadal M, Pereira JA, Badia JM. OC-069 EFECTIVENESS OF PROPHYLACTIC ONLAY MESH FOR PREVENTION OF TROCAR HERNIA: PRELIMINARY RESULTS OF A RANDOMIZED CLINICAL TRIAL. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Trocar site hernia (TSH) incidence is a common complication of laparoscopic surgery. In the literature there is a lack of tools to prevent it. Our aim was to assess the effectiveness and safety of a prophylactic measure to decrease it.
Methods
A multicentric randomized clinical trial was performed in high-risk patients (diabetes mellitus and/or age ≥70 years and/or BMI ≥30 Kg/m2 and/or extended incision for specimen retrieval) who underwent laparoscopic cholecystectomy in an elective or emergency setting. Patients were allocated to prophylactic onlay polypropylene mesh fixation (intervention) or standard trocar closure (control). The main aim was to analyze the efficacy of the intervention, being TSH incidence the primary outcome. Clinical and radiological follow up was atleast 1 year after surgery. Secondary endpoints were technique-related complications.
Results
134 patients were included (70 and 62 to intervention and control arm, respectively). Groups were homogeneous. Mean [SD] age, 64.8 (17.3) years; 80 (60, 6%) women. The cumulative TSH incidence was lower in the intervention group although not reaching significant differences, either when were radiologically (16 [26.7%] vs 17 [37%], p = 0.294) or clinically assessed (9 [17.6%] vs 9 [24.3], p = 0.593). No differences in surgical site infection, hematoma or seroma were detected. Mean follow-up was 736 days (min. 365 – max. 1294).
Conclusions
Our preliminary results points out that the overall TSH incidence is extremely high when properly assessed. A polypropylene onlay mesh would not be an effective measure to decrease the TSH incidence. Radiological evaluation would show more accuracy.
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Affiliation(s)
- A Ciscar
- General Surgery, Hospital de Mataró - Consorci Sanitari del Maresme , Mataró , Spain
| | - P Ruiz
- General Surgery, Hospital de Granollers , Granollers , Spain
| | - E Saez
- General Surgery, Hospital de Sant Boi , Sant Boi de Llobregat , Spain
| | - M Vila
- General Surgery, Hospital de Mataró - Consorci Sanitari del Maresme , Mataró , Spain
| | - M Gomez
- General Surgery, Hospital de Calella , Calella , Spain
| | - D Troyano
- General Surgery, Hospital Esperit Sant , Santa Coloma de Gramenet , Spain
| | - M Abadal
- General Surgery, Hospital de Mataró - Consorci Sanitari del Maresme , Mataró , Spain
| | - J A Pereira
- General Surgery, Hospital Universitari del Mar , Barcelona , Spain
| | - J M Badia
- General Surgery, Hospital de Granollers , Granollers , Spain
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2
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Olona C, Pereira JA, Comas J, Protti GP, Alonso V, Amador S, Bombuy E, Mitru C, Gimeno M, López-Cano M. OC-081 VALIDATION OF THE DATA QUALITY OF THE SPANISH INCISIONAL HERNIA SURGERY REGISTRY (EVEREG). PILOT STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
The Spanish Incisional Hernia Surgery Registry (EVEREG) is promoted by the Abdominal Wall section of the Spanish Association of Surgeons, starting data collection in July 2012 and currently has more than 13,500 cases.
The objective of this study is to validate the data collected through a pilot audit process
Material & Methods
A sample of hospitals participating in the EVEREG registry since 2012 is selected. Patients registered in these centers in the period 2012–2019 are included. A stratified random sampling is carried out, with the inclusion of 10% of registered cases per center with a minimum of 20.
In the 2020–2021 period, a selection of researchers, different from that of the center to be audited, checks the concordance between the registry data and the data collected in the patient's clinical history, either in person or online.
Results
330 patients have been analyzed, out of a total of 2673 registered, in 9 participating centers. The average accuracy has been 95.7% (99.1–79.35%). With 1.5% incorrect data and 2.28% missing data
Conclusions
This is the first validity study of an abdominal wall registry
The accuracy greater than 95% obtained allows us to determine an excellent quality in the data collection of the EVEREG registry. We believe that the confirmation of these data in all the centers participating in the registry would guarantee the quality of the studies carried out and their comparison with other international registries
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Affiliation(s)
- C Olona
- Abdominal Wall Unit. General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - J A Pereira
- General Surgery / MELIS , Parc de Salut Mar, Barcelona , Spain
| | - J Comas
- Complex Abdominal Wall Unit. General Surgery Department, Complex Hospitalari Moisès Broggi , Sant Joan Despí , Spain
| | - G P Protti
- Abdominal Wall Unit. General Surgery Department, Hospital Universitari Arnau de Vilanova , Lleida , Spain
| | - V Alonso
- General Surgery, Hospital Dos de Maig , Barcelona , Spain
| | - S Amador
- General and Digestive Surgery, Hospital General de Granollers , Granollers , Spain
| | - E Bombuy
- General Surgery, Hospital de Mataro , Mataro , Spain
| | - C Mitru
- General Surgery, Hospital Mutua de Terrassa , Terrassa , Spain
| | - M Gimeno
- General Surgery, Parc de Salut Mar , Barcelona , Spain
| | - M López-Cano
- Abdominal Wall Unit. General Surgery Department, Hospital Universitari Vall d'Hebron , Barcelona , Spain
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3
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Pereira JA, Ray A, Rana M, Silva C, Salinas C, Zamorano F, Irani M, Opazo P, Sitaram R, Ruiz S. A real-time fMRI neurofeedback system for the clinical alleviation of depression with a subject-independent classification of brain states: A proof of principle study. Front Hum Neurosci 2022; 16:933559. [PMID: 36092645 PMCID: PMC9452730 DOI: 10.3389/fnhum.2022.933559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Most clinical neurofeedback studies based on functional magnetic resonance imaging use the patient's own neural activity as feedback. The objective of this study was to create a subject-independent brain state classifier as part of a real-time fMRI neurofeedback (rt-fMRI NF) system that can guide patients with depression in achieving a healthy brain state, and then to examine subsequent clinical changes. In a first step, a brain classifier based on a support vector machine (SVM) was trained from the neural information of happy autobiographical imagery and motor imagery blocks received from a healthy female participant during an MRI session. In the second step, 7 right-handed female patients with mild or moderate depressive symptoms were trained to match their own neural activity with the neural activity corresponding to the “happiness emotional brain state” of the healthy participant. The training (4 training sessions over 2 weeks) was carried out using the rt-fMRI NF system guided by the brain-state classifier we had created. Thus, the informative voxels previously obtained in the first step, using SVM classification and Effect Mapping, were used to classify the Blood-Oxygen-Level Dependent (BOLD) activity of the patients and converted into real-time visual feedback during the neurofeedback training runs. Improvements in the classifier accuracy toward the end of the training were observed in all the patients [Session 4–1 Median = 6.563%; Range = 4.10–27.34; Wilcoxon Test (0), 2-tailed p = 0.031]. Clinical improvement also was observed in a blind standardized clinical evaluation [HDRS CE2-1 Median = 7; Range 2 to 15; Wilcoxon Test (0), 2-tailed p = 0.016], and in self-report assessments [BDI-II CE2-1 Median = 8; Range 1–15; Wilcoxon Test (0), 2-tailed p = 0.031]. In addition, the clinical improvement was still present 10 days after the intervention [BDI-II CE3-2_Median = 0; Range −1 to 2; Wilcoxon Test (0), 2-tailed p = 0.50/ HDRS CE3-2 Median = 0; Range −1 to 2; Wilcoxon Test (0), 2-tailed p = 0.625]. Although the number of participants needs to be increased and a control group included to confirm these findings, the results suggest a novel option for neural modulation and clinical alleviation in depression using noninvasive stimulation technologies.
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Affiliation(s)
- Jaime A. Pereira
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratory for Brain-Machine Interfaces and Neuromodulation, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andreas Ray
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Mohit Rana
- Laboratory for Brain-Machine Interfaces and Neuromodulation, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Claudio Silva
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Cesar Salinas
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Francisco Zamorano
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Martin Irani
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricia Opazo
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ranganatha Sitaram
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratory for Brain-Machine Interfaces and Neuromodulation, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, United States
- *Correspondence: Ranganatha Sitaram
| | - Sergio Ruiz
- Departamento de Psiquiatría, Facultad de Medicina, Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratory for Brain-Machine Interfaces and Neuromodulation, Pontificia Universidad Católica de Chile, Santiago, Chile
- Sergio Ruiz
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Jairam AP, López-Cano M, Garcia-Alamino JM, Pereira JA, Timmermans L, Jeekel J, Lange J, Muysoms F. Prevention of incisional hernia after midline laparotomy with prophylactic mesh reinforcement: a meta-analysis and trial sequential analysis. BJS Open 2020; 4:357-368. [PMID: 32057193 PMCID: PMC7260413 DOI: 10.1002/bjs5.50261] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 12/17/2019] [Indexed: 02/04/2023] Open
Abstract
Background Incisional hernia is a frequent complication after abdominal surgery. The aim of this study was to assess the efficacy of prophylactic mesh reinforcement (PMR) after midline laparotomy in reducing the incidence of incisional hernia. Methods A meta‐analysis was conducted following PRISMA guidelines. The primary outcome was the incidence of incisional hernia after follow‐up of at least 12 months. Secondary outcomes were postoperative complications. Only RCTs were included. A random‐effects model was used for the meta‐analysis, and trial sequential analysis was conducted. Results Twelve RCTs were included, comprising 1815 patients. The incidence of incisional hernia was significantly lower after PMR compared with sutured closure (risk ratio (RR) 0·35, 95 per cent c.i. 0·21 to 0·57; P < 0·001). Both onlay (RR 0·26, 0·11 to 0·67; P = 0·005) and retromuscular (RR 0·28, 0·10 to 0·82; P = 0·02) PMR led to a significant reduction in the rate of incisional hernia. The occurrence of seroma was higher in patients who had onlay PMR (RR 2·23, 1·10 to 4·52; P = 0·03). PMR did not result in an increased rate of surgical‐site infection. Conclusion PMR of a midline laparotomy using an onlay or retromuscular technique leads to a significant reduction in the rate of incisional hernia in high‐risk patients. Individual risk factors should be taken into account to select patients who will benefit most. [Correction added on 19 February 2020, after first online publication: J. García Alamino has been amended to J. M. Garcia‐Alamino]
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Affiliation(s)
- A P Jairam
- Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, Netherlands
| | - M López-Cano
- Department of General and Digestive Surgery, Hospital Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Garcia-Alamino
- Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - J A Pereira
- Department of General and Digestive Surgery, Hospital Del Mar, Barcelona, Spain
| | - L Timmermans
- Department of Surgery, Maasstad Ziekenhuis Rotterdam, Rotterdam, Netherlands
| | - J Jeekel
- Department of General Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - J Lange
- Department of General Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - F Muysoms
- Department of Surgery, Maria Middelares Hospital, Ghent, Belgium
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Coelho-Medeiros ME, Bronstein J, Aedo K, Pereira JA, Arraño V, Perez CA, Valenzuela PM, Moore R, Garrido I, Bedregal P. M-CHAT-R/F Validation as a screening tool for early detection in children with autism spectrum disorder. ACTA ACUST UNITED AC 2019; 90:492-499. [PMID: 31859732 DOI: 10.32641/rchped.v90i5.703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/23/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Screening for Autism Spectrum Disorders (ASD) using the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) increases early detection, allowing early interventions and improving prognosis. This tool is part of the management in case of suspected ASD in several clinical guidelines. The objective of this article was to conduct the concurrent and discrimi nant validation and the reliability analysis of M-CHAT-R/F in the Chilean population. PATIENTS AND METHOD This is the second stage of the cross-cultural adaptation of cross-sectional design. M-CHAT- R/F was applied to a sample of 20 children with suspected ASD and 100 randomly selected healthy control children, aged between 16-30 months. Autism Diagnostic Observation Schedule (ADOS-2), considered as reference, was applied to the 20 patients of the clinical sample, to 20 children of the healthy control sample and to those cases of the healthy control sample with M-CHAT-R/F positive. Cronbach alpha was calculated, as well as M-CHAT-R/F and ADOS-2 correlation, sensitivity, and specificity analyses. RESULTS In the healthy sample, M-CHAT-R/F was positive in two patients, with one of them positive and the other one negative for ASD with ADOS-2 test. In the clinical sample, M- CHAT-R/F was positive in all cases, three of them were negative in the ADOS-2 test. The Alfa relia bility of M-CHART-R/T was 0,889, the discriminant sensitivity and specificity were 100% and 98%, and the concurrent ones were 100% and 87.5% respectively. CONCLUSIONS The Chilean M-CHAT- R/F version was reliable, sensitive and specific, similar to the original test, which opens the possibility for its use in clinical samples and for research. Validating M-CHAT-R/F is an ongoing process which must be further developed.
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Affiliation(s)
| | - Jonathan Bronstein
- Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Karina Aedo
- Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Jaime A Pereira
- Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Verónica Arraño
- Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Carolina A Perez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Patricia M Valenzuela
- Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Rosario Moore
- Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Isabel Garrido
- Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Paula Bedregal
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
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Pereira JA, Sepulveda P, Rana M, Montalba C, Tejos C, Torres R, Sitaram R, Ruiz S. Self-Regulation of the Fusiform Face Area in Autism Spectrum: A Feasibility Study With Real-Time fMRI Neurofeedback. Front Hum Neurosci 2019; 13:446. [PMID: 31920602 PMCID: PMC6933482 DOI: 10.3389/fnhum.2019.00446] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/04/2019] [Indexed: 12/27/2022] Open
Abstract
One of the most important and early impairments in autism spectrum disorder (ASD) is the abnormal visual processing of human faces. This deficit has been associated with hypoactivation of the fusiform face area (FFA), one of the main hubs of the face-processing network. Neurofeedback based on real-time fMRI (rtfMRI-NF) is a technique that allows the self-regulation of circumscribed brain regions, leading to specific neural modulation and behavioral changes. The aim of the present study was to train participants with ASD to achieve up-regulation of the FFA using rtfMRI-NF, to investigate the neural effects of FFA up-regulation in ASD. For this purpose, three groups of volunteers with normal I.Q. and fluent language were recruited to participate in a rtfMRI-NF protocol of eight training runs in 2 days. Five subjects with ASD participated as part of the experimental group and received contingent feedback to up-regulate bilateral FFA. Two control groups, each one with three participants with typical development (TD), underwent the same protocol: one group with contingent feedback and the other with sham feedback. Whole-brain and functional connectivity analysis using each fusiform gyrus as independent seeds were carried out. The results show that individuals with TD and ASD can achieve FFA up-regulation with contingent feedback. RtfMRI-NF in ASD produced more numerous and stronger short-range connections among brain areas of the ventral visual stream and an absence of the long-range connections to insula and inferior frontal gyrus, as observed in TD subjects. Recruitment of inferior frontal gyrus was observed in both groups during FAA up-regulation. However, insula and caudate nucleus were only recruited in subjects with TD. These results could be explained from a neurodevelopment perspective as a lack of the normal specialization of visual processing areas, and a compensatory mechanism to process visual information of faces. RtfMRI-NF emerges as a potential tool to study visual processing network in ASD, and to explore its clinical potential.
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Affiliation(s)
- Jaime A. Pereira
- Laboratory for Brain Machine Interfaces and Neuromodulation, Pontifical Catholic University of Chile, Santiago, Chile
- Department of Psychiatry, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - Pradyumna Sepulveda
- Laboratory for Brain Machine Interfaces and Neuromodulation, Pontifical Catholic University of Chile, Santiago, Chile
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Mohit Rana
- Laboratory for Brain Machine Interfaces and Neuromodulation, Pontifical Catholic University of Chile, Santiago, Chile
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Cristian Montalba
- Biomedical Imaging Center, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - Cristian Tejos
- Biomedical Imaging Center, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
- Department of Electrical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile
| | - Rafael Torres
- Department of Psychiatry, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - Ranganatha Sitaram
- Laboratory for Brain Machine Interfaces and Neuromodulation, Pontifical Catholic University of Chile, Santiago, Chile
- Department of Psychiatry, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
- Department of Electrical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Biological and Medical Engineering, Faculty of Engineering, Pontifical Catholic University of Chile, Santiago, Chile
| | - Sergio Ruiz
- Laboratory for Brain Machine Interfaces and Neuromodulation, Pontifical Catholic University of Chile, Santiago, Chile
- Department of Psychiatry, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
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Pereira JA, Bravo-Salva A, Montcusí B, Pérez-Farre S, Fresno de Prado L, López-Cano M. Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters. BMC Surg 2019; 19:103. [PMID: 31391112 PMCID: PMC6686257 DOI: 10.1186/s12893-019-0569-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/29/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Recurrence after incisional hernia repair is one of the major problems related with this operation. Our objective is to analyze the influence of abdominal wall surgery expertise in the results of the open elective repair of incisional hernia. METHODS We have compiled the data of a cohort of patients who received surgery for an incisional hernia from July 2012 to December 2015 in a University Hospital. Data were collected prospectively and registered in the Spanish Register of Incisional Hernia (EVEREG). The short- and long-term complications between the groups of patients operated on by the Abdominal Wall Surgery (AWS) unit and groups operated on by surgeons outside of the specialized abdominal wall group (GS) were compared. RESULTS During the study period, a total of 237 patients were operated on by the open approach (114 AWS; 123 GS). One hundred seventy-five patients completed a median follow-up of 36.6 months [standard deviation (SD) = 6]. Groups were comparable in terms of age, sex, body mass index (BMI), comorbidities, and complexity of hernia. Complications were similar in both groups. Patients in the AWS group presented fewer recurrences (12.0% vs. 28.9%; P = 0.005). The cumulative incidence of recurrence was higher in the GS group [log rank 13.370; P < 0.001; odds ratio (OR) = 37.8; 95% confidence interval (CI) = 30.3-45.4]. In the multivariate analysis, surgery performed by the AWS unit was related to fewer recurrences (OR = 0.19; 95%CI = 0.07-0.58; P < 0.001). CONCLUSION Incisional hernia surgery is associated with better results in terms of recurrence when it is performed in a specialized abdominal wall unit.
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Affiliation(s)
- J A Pereira
- Servicio de Cirugía General y del Aparato Digestivo, Parc de Salut Mar. Hospital del Mar. P, Marítim 23-25, 08003, Barcelona, Spain. .,Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain.
| | - A Bravo-Salva
- Servicio de Cirugía General y del Aparato Digestivo, Parc de Salut Mar. Hospital del Mar. P, Marítim 23-25, 08003, Barcelona, Spain
| | - B Montcusí
- Servicio de Cirugía General y del Aparato Digestivo, Parc de Salut Mar. Hospital del Mar. P, Marítim 23-25, 08003, Barcelona, Spain
| | - S Pérez-Farre
- Servicio de Cirugía General y del Aparato Digestivo, Parc de Salut Mar. Hospital del Mar. P, Marítim 23-25, 08003, Barcelona, Spain
| | - L Fresno de Prado
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain
| | - M López-Cano
- Servicio de Cirugía General y Digestiva, Hospital Vall d'Hebrón, Passeig Vall d'Hebrón 119-129, 08035, Barcelona, Spain.,Departament de Cirurgia. Vall d'Hebrón, Universitat Autònoma de Barcelona, Passeig Vall d'Hebrón 119-129, 08035, Barcelona, Spain
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8
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Fernandes L, Pereira JA, Saraiva JA, Ramalhosa E, Casal S. Phytochemical characterization of Borago officinalis L. and Centaurea cyanus L. during flower development. Food Res Int 2019; 123:771-778. [PMID: 31285027 DOI: 10.1016/j.foodres.2019.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 11/19/2022]
Abstract
The present work details the nutritional and chemical compositions of borage and centaurea, at three flowering stages. Water was the main constituent, followed by total dietary fiber. Both flowers showed statistically different (p < 0.05) nutritional and chemical profiles, although in both, polyunsaturated fatty acids (PUFAs) (mainly linoleic and α-linolenic acids), free sugars (3.9-28.9% dw as fructose, glucose, and sucrose), tocopherols (with the major contribution of α-tocopherol from 1.24 to 2.75 mg/100 g dw), carotenoids (0.2-181.4 mg/100 g dw, mainly as lutein), and organic acids (6.1-14.4 g/100 g dw, mainly malic, succinic, and citric acids) were quantified. Concerning flowering, significant differences (p < 0.05) were found for some components, particularly carotenoids; however, no specific trend was observed in either of the two flower species. Thus, the present study shows that each flower species, as well as their flowering stages, may have different phytochemical and nutritional compositions.
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Affiliation(s)
- L Fernandes
- Centro de Investigação de Montanha (CIMO)/School of Agriculture, Polytechnic Institute of Bragança, Campus de Stª Apolónia, 5300-253 Bragança, Portugal; LAQV@REQUIMTE/Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, Porto University, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; Organic Chemistry, Natural Products and Agrifood (QOPNA) - Chemistry Department, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - J A Pereira
- Centro de Investigação de Montanha (CIMO)/School of Agriculture, Polytechnic Institute of Bragança, Campus de Stª Apolónia, 5300-253 Bragança, Portugal
| | - J A Saraiva
- Organic Chemistry, Natural Products and Agrifood (QOPNA) - Chemistry Department, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - E Ramalhosa
- Centro de Investigação de Montanha (CIMO)/School of Agriculture, Polytechnic Institute of Bragança, Campus de Stª Apolónia, 5300-253 Bragança, Portugal.
| | - S Casal
- LAQV@REQUIMTE/Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, Porto University, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
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Malheiro R, Casal S, Pinheiro L, Baptista P, Pereira JA. Olive cultivar and maturation process on the oviposition preference of Bactrocera oleae (Rossi) (Diptera: Tephritidae). Bull Entomol Res 2019; 109:43-53. [PMID: 29463321 DOI: 10.1017/s0007485318000135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The olive fly, Bactrocera oleae (Rossi) (Diptera: Tephritidae), is a key-pest in the main olives producing areas worldwide, and displays distinct preference to different olive cultivars. The present work intended to study oviposition preference towards three Portuguese cultivars (Cobrançosa, Madural, and Verdeal Transmontana) at different maturation indexes. Multiple oviposition bioassays (multiple-choice and no-choice) were conducted to assess cultivar preference. No-choice bioassays were conducted to assess the influence of different maturation indexes (MI 2; MI 3, and MI 4) in single cultivars. The longevity of olive fly adults according to the cultivar in which its larvae developed was also evaluated through survival assays.Cultivar and maturation are crucial aspects in olive fly preference. Field and laboratory assays revealed a preference towards cv. Verdeal Transmontana olives and a lower susceptibility to cv. Cobrançosa olives. A higher preference was observed for olives at MI 2 and MI 3. The slower maturation process in cv. Verdeal Transmontana (still green while the other cultivars are reddish or at black stage) seems to have an attractive effect on olive fly females, thus increasing its infestation levels. Olive fly adults from both sexes live longer if emerged from pupae developed from cv. Verdeal Transmontana fruits and live less if emerged from cv. Cobrançosa. Therefore, olive cultivar and maturation process are crucial aspects in olive fly preference, also influencing the longevity of adults.
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Affiliation(s)
- R Malheiro
- Centro de Investigação de Montanha (CIMO), ESA, Instituto Politécnico de Bragança,Campus de Santa Apolónia, 5300-253 Bragança,Portugal
| | - S Casal
- REQUIMTE/LAQV/Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia,Universidade do Porto,Porto,Portugal
| | - L Pinheiro
- Centro de Investigação de Montanha (CIMO), ESA, Instituto Politécnico de Bragança,Campus de Santa Apolónia, 5300-253 Bragança,Portugal
| | - P Baptista
- Centro de Investigação de Montanha (CIMO), ESA, Instituto Politécnico de Bragança,Campus de Santa Apolónia, 5300-253 Bragança,Portugal
| | - J A Pereira
- Centro de Investigação de Montanha (CIMO), ESA, Instituto Politécnico de Bragança,Campus de Santa Apolónia, 5300-253 Bragança,Portugal
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10
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Thomas DE, Kaimakliotis HZ, Rice KR, Pereira JA, Johnston P, Moore ML, Reed A, Cregar DM, Franklin C, Loman RL, Koch MO, Bihrle R, Foster RS, Masterson TA, Gardner TA, Sundaram CP, Powell CR, Beck S, Grignon DJ, Cheng L, Albany C, Hahn NM. Commentary on "Prognostic effect of carcinoma in situ in muscle-invasive urothelial carcinoma patients receiving neoadjuvant chemotherapy.". Urol Oncol 2018; 36:345. [PMID: 29880459 DOI: 10.1016/j.urolonc.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 05/07/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Carcinoma in situ (CIS) is a poor prognostic finding in urothelial carcinoma. However, its significance in muscle-invasive urothelial carcinoma (MIUC) treated with neoadjuvant chemotherapy (NAC) is uncertain. We assessed the effect of CIS found in pretreatment transurethral resection of bladder tumor (TURBT) biopsies on the pathologic and clinical outcomes. MATERIALS AND METHODS Subjects with MIUC treated with NAC before cystectomy were identified. The pathologic complete response (pCR) rates stratified by TURBT CIS status were compared. The secondary analyses included tumor response, progression-free survival (PFS), overall survival (OS), and an exploratory post hoc analysis of patients with pathologic CIS only (pTisN0) at cystectomy. RESULTS A total of 137 patients with MIUC were identified. TURBT CIS was noted in 30.7% of the patients. The absence of TURBT CIS was associated with a significantly increased pCR rate (23.2% vs. 9.5%; odds ratio = 4.08; 95% CI: 1.19-13.98; P = 0.025). Stage pTisN0 disease was observed in 19.0% of the TURBT CIS patients. TURBT CIS status did not significantly affect the PFS or OS outcomes. Post hoc analysis of the pTisN0 patients revealed prolonged median PFS (104.5 vs. 139.9 months; P = 0.055) and OS (104.5 vs. 152.3 months; P = 0.091) outcomes similar to those for the pCR patients. CONCLUSION The absence of CIS on pretreatment TURBT in patients with MIUC undergoing NAC was associated with increased pCR rates, with no observed differences in PFS or OS. Isolated CIS at cystectomy was frequently observed, with lengthy PFS and OS durations similar to those for pCR patients. Further studies aimed at understanding the biology and clinical effect of CIS in MIUC are warranted.
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11
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Coelho-Medeiros ME, Bronstein J, Aedo K, Pereira JA, Arraño V, Pérez CA, Valenzuela PM, Moore R, Garrido I, Bedregal P. [Importance of cross-cultural adjustment of M-CHAT R/F in the process of validation as an Autism Test]. Rev Chil Pediatr 2017; 88:822-823. [PMID: 29546936 DOI: 10.4067/s0370-41062017000600822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | | | - Karina Aedo
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
| | | | - Verónica Arraño
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Carolina A Pérez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
| | | | - Rosario Moore
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Isabel Garrido
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Paula Bedregal
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
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12
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Dinis AM, Pereira JA, Benhadi-Marín J, Santos SAP. Feeding preferences and functional responses of Calathus granatensis and Pterostichus globosus (Coleoptera: Carabidae) on pupae of Bactrocera oleae (Diptera: Tephritidae). Bull Entomol Res 2016; 106:701-709. [PMID: 27063655 DOI: 10.1017/s0007485316000213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Carabid beetles are important predators in agricultural landscapes feeding on a range of prey items. However, their role as predators of the olive fruit fly, Bactrocera oleae (Rossi) (Diptera: Tephritidae), one of the most serious pests of olives, is unknown. In this context, the feeding preferences and the functional responses of two carabid beetle species, Calathus granatensis (Vuillefroy) and Pterostichus globosus (Fabricius), were studied under laboratory conditions. Feeding preference assays involved exposing carabid beetles to different ratios of B. oleae pupae and an alternative prey, the Mediterranean fruit fly, Ceratitis capitata (Wiedemann). Both species fed on B. oleae pupae however, C. granatensis always showed a significant preference for that prey whereas P. globosus switched to C. capitata pupae when the offered ratio was below 0.5. The total prey biomass consumed was significantly higher for P. globosus than for C. granatensis. Functional response curves were estimated based on different densities of B. oleae pupae and both carabid beetle species exhibited a type II functional response using Rogers' random-predator equation. P. globosus showed shorter handling time (1.223 ± 0.118 h) on B. oleae pupae than C. granatensis (3.230 ± 0.627 h). Our results suggest that both species can be important in reducing the densities of B. oleae in olive groves, although P. globosus was more efficient than C. granatensis.
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Affiliation(s)
- A M Dinis
- Mountain Research Center, CIMO, School of Agriculture, Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - J A Pereira
- Mountain Research Center, CIMO, School of Agriculture, Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - J Benhadi-Marín
- Mountain Research Center, CIMO, School of Agriculture, Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - S A P Santos
- Mountain Research Center, CIMO, School of Agriculture, Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
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13
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Rejili M, Fernandes T, Dinis AM, Pereira JA, Baptista P, Santos SAP, Lino-Neto T. A PCR-based diagnostic assay for detecting DNA of the olive fruit fly, Bactrocera oleae, in the gut of soil-living arthropods. Bull Entomol Res 2016; 106:695-699. [PMID: 27296773 DOI: 10.1017/s000748531600050x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Bactrocera oleae (Rossi) (Diptera: Tephritidae) is considered the most devastating pest of the olive tree worldwide. In an effort to develop management and biological control strategies against this pest, new molecular tools are urgently needed. In this study, we present the design of B. oleae-specific primers based on mitochondrial DNA sequences of cytochrome oxidase subunit I (COI) gene. Two pairs of B. oleae-specific primers were successfully designed and named as SBo1-F/SBo1-R and SBo2-F/SBo1-R, being able to amplify 108 and 214 bp COI fragments, respectively. The specificity of designed primers was tested by amplifying DNA from phylogenetically related (i.e. Diptera order) and other non-pest insects living in olive groves from the Mediterranean region. When using these primers on a PCR-based diagnostic assay, B. oleae DNA was detected in the gut content of a soil-living insect, Pterostichus globosus (Fabricius) (Coleoptera: Carabidae). The detection of B. oleae DNA in the guts of arthropods was further optimized by adding bovine serum albumin enhancer to the PCR reaction, in order to get a fast, reproducible and sensitive tool for detecting B. oleae remains in the guts of soil-living arthropods. This molecular tool could be useful for understanding pest-predator relationships and establishing future biological control strategies for this pest.
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Affiliation(s)
- M Rejili
- BioSystems and Integrative Sciences Institute (BioISI),Plant Functional Biology Centre,University of Minho,Campus de Gualtar,4710-057 Braga,Portugal
| | - T Fernandes
- BioSystems and Integrative Sciences Institute (BioISI),Plant Functional Biology Centre,University of Minho,Campus de Gualtar,4710-057 Braga,Portugal
| | - A M Dinis
- CIMO/School of Agriculture,Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - J A Pereira
- CIMO/School of Agriculture,Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - P Baptista
- CIMO/School of Agriculture,Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - S A P Santos
- CIMO/School of Agriculture,Polytechnic Institute of Bragança,Campus de Santa Apolónia,5300-253 Bragança,Portugal
| | - T Lino-Neto
- BioSystems and Integrative Sciences Institute (BioISI),Plant Functional Biology Centre,University of Minho,Campus de Gualtar,4710-057 Braga,Portugal
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14
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Brownlee WJ, Anderson NE, Sims J, Pereira JA. Neurological complications of acute multifocal placoid pigment epitheliopathy. J Clin Neurosci 2016; 31:76-80. [PMID: 27183958 DOI: 10.1016/j.jocn.2016.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/13/2016] [Indexed: 10/21/2022]
Abstract
Acute multifocal placoid pigment epitheliopathy (AMPPE) is an autoimmune chorioretinal disease that can be complicated by neurological involvement. There is limited information on this potentially treatable condition in the neurological literature. The objective of this patient series is to describe the neurological complications of AMPPE. We retrospectively identified patients with neurological complications of AMPPE seen at Auckland Hospital between 2008 and 2013 and summarised cases in the literature between 1976 and 2013. We identified five patients with neurological complications of AMPPE at Auckland Hospital and 47 reported patients. These patients demonstrated a spectrum of neurological involvement including isolated headache, stroke or transient ischaemic attack, seizures, venous sinus thrombosis, optic neuritis, sensorineural hearing loss and peripheral vestibular disorder. We propose criteria to define AMPPE with neurological complications. A cerebrospinal fluid (CSF) lymphocytosis in a patient with isolated headache may predict the development of cerebrovascular complications of AMPPE. Patients with cerebrovascular complications of AMPPE have a poor prognosis with high rates of death and neurological disability among survivors. Predictors of poor outcome in those who develop neurological complications of AMPPE are a relapsing course, generalised seizures and multifocal infarction on MRI. All patients with neurological complications of AMPPE, including headache alone, should be investigated with an MRI brain and CSF examination. Patients with focal neurological symptoms should receive intravenous (IV) methylprednisolone followed by a tapering course of oral steroids for at least 3months. Patients with AMPPE and an isolated headache with a CSF pleocytosis should be treated with oral steroids.
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Affiliation(s)
- W J Brownlee
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - N E Anderson
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - J Sims
- Department of Ophthalmology, Auckland City Hospital, Auckland, New Zealand
| | - J A Pereira
- Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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15
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Chaklader M, Das P, Pereira JA, Law A, Chattopadhyay S, Chatterjee R, Mondal A, Law S. 17-AAG mediated targeting of Hsp90 limits tert activity in peritoneal sarcoma related malignant ascites by downregulating cyclin D1 during cell cycle entry. Exp Oncol 2012; 34:90-96. [PMID: 23013759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Peritoneal or retro-peritoneal sarcomatosis related malignant ascites formation is a rare but serious consequence of the locoregional metastatic event. The present work aimed to study the effect of the Hsp90 inhibitor (17-AAG), an ansamycin analog, on cell cycle and DNA replication specific chaperone-clients interaction in the event of peritoneal sarcoma related malignant ascites formation in mouse model at the late stage of malignant growth. METHODS We administered 17-AAG, an Hsp90 inhibitor, divided doses (330 μg/kg b.w./day for first five days then next ten days with166 μg/kg b.w./day) through intra-peritoneal route of inbred Swiss albino mice bearing full grown peritoneal malignant ascites of sarcoma-180. Our study was evaluated by peripheral blood hemogram analysis, malignant ascitic cytology, cell viability test, survival time and mitotic indexing. Furthermore, flowcytometric HSP90, TERT, CyclinD1, PCNA and GM-CSF expression analysis has been considered for special objective of the study. RESULTS Our experimental efforts reduced the aggressive proliferation of malignant ascites by drastic downregulation of TERT and cyclin D1 on the verge of cell cycle entry along with DNA replication processivity factor PCNA by directly modulating their folding machinery - heat shock protein 90. Consequently, we observed that malignant ascitic cells became error prone during the event of karyokinesis and produced micronucleus containing malignant cells with low viability. Peripheral neutrophilia due to over-expression of GM-CSF by the peritoneal malignant ascites were also controlled by the treatment with 17-AAG and overall, the treatment modality improved the median survival time. CONCLUSION Finally we can conclude that 17AAG administration might serve as a prospective pharmacological agent for the management of peritoneal sarcoma related malignant ascites and throws light towards prolonged survival of the patients concerned.
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Affiliation(s)
- M Chaklader
- Stem Cell Research and Application Unit, Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, Kolkata-700073, West Bengal, India
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16
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Martínez-Serrano MA, Pereira JA, Sancho J, Argudo N, López-Cano M, Grande L. Specific improvement measures to reduce complications and mortality after urgent surgery in complicated abdominal wall hernia. Hernia 2011; 16:171-7. [PMID: 21909976 DOI: 10.1007/s10029-011-0875-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 08/04/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE Morbidity and mortality are increased after urgent surgery for complicated abdominal wall hernia. We analysed prospectively early morbidity and mortality after implementing specific management measures in patients undergoing urgent hernia repair. METHODS The study population included 244 patients with complicated abdominal wall hernia requiring surgical repair on an emergency basis over 1-year period. Patients were managed according to a protocol that included specific actions to be implemented in the pre-, intra- and postoperative periods. Outcomes of these patients were compared with those of 402 undergoing similar operations before development of the protocol. RESULTS Patients in whom acute complication was the first hernia symptom had higher mortality (7.2% vs 2.5%; P = 0.07) and were consulted later than 24 h (49.4% vs 36%; P = 0.044). Patients consulting later than 24 h had higher mortality (8.1% vs 1.4%, P = 0.017). Femoral hernias exhibited specific characteristics and were associated with higher mortality (13% vs 1.6%; P = 0.001). Overall, both groups had similar mortality (4.5% vs 4.1%; P = 0.8); complications (38.8% vs 37.7%; P = 0.2), and bowel resection rates (12.2% vs 11.5%; P = 0.8). Excluding the group of femoral hernias, the measures achieved a lower rate of severe complications (21.2% vs 10.3%; P = 0.04) and a decrease in mortality (2.9% vs 0.6%; P = 0.05) after bowel resection. CONCLUSIONS Specific measures for improvement of management and prevention of complications and mortality were effective in patients without femoral hernia. To reduce mortality, the best applicable measure is early detection and to prioritize the scheduled operation of femoral hernias and those affecting high risk patients. The implementation of preventive and educational programs in high risk patients is essential.
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Affiliation(s)
- M A Martínez-Serrano
- Department of General and Digestive Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain.
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17
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Chaklader M, Das P, Pereira JA, Chatterjee S, Basak P, Law A, Banerjee T, Chauhan S, Law S. Telomerase reverse transcriptase (TERT) expression and role of vincristine sulfate in mouse model of malignancy related peritoneal ascites: an experimental metastatic condition. Exp Oncol 2011; 33:83-89. [PMID: 21716204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To evaluate the efficacy of intraperitoneal vincristine administration into ascitic sarcoma-180 bearing mice as a model of human malignant ascites regarding various peritoneal/retroperitoneal sarcomatosis, and to evaluate the flowcytometric telomerase reverse transcriptase expression for the diagnostic and prognostic purposes. METHODS Present study included disease induction by intraperitoneal homologous ascitic sarcoma-180 transplantation followed by in vivo intraperitoneal drug administration to study mitotic index, flowcytometric cell cycle and telomerase reverse transcriptase expression pattern, erythrosin-B dye exclusion study for malignant cell viability assessment. Besides, in vitro malignant ascite culture in presence and absence of vincristine sulfate and survival study were also taken into consideration. RESULTS Intraperitoneal vincristine administration (concentration 0.5 mg/kg body weight) significantly diminished the mitotic index in diseased subjects in comparison to untreated control subjects. Treated group of animals showed increased life span and median survival time. Cell viability assessment during the course of drug administration also revealed gradual depression on cell viability over time. Flowcytometric cell cycle analysis showed a good prognostic feature of chemotherapeutic administration schedule by representing high G2/M phase blocked cells along with reduced telomerase reverse transcriptase positive cells in treated animals. CONCLUSION We conclude that long term administration of vincristine sulfate in small doses could be a good pharmacological intervention in case of malignant peritoneal ascites due to sarcomatosis as it indirectly reduced the level of telomerase reverse transcriptase expression in malignant cells by directly regulating cell cycle and simultaneously increased the life expectancy of the diseased subjects.
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Affiliation(s)
- M Chaklader
- Stem Cell Research and Application Unit, Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, Kolkata-700073, West Bengal, India
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18
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Barreira JCM, Ferreira ICFR, Oliveira MBPP, Pereira JA. Antioxidant potential of chestnut (Castanea sativa L.) and almond (Prunus dulcis L.) by-products. FOOD SCI TECHNOL INT 2010; 16:209-16. [PMID: 21339136 DOI: 10.1177/1082013209353983] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The antioxidant properties of almond green husks (Cvs. Duro Italiano, Ferraduel, Ferranhês, Ferrastar and Orelha de Mula), chestnut skins and chestnut leaves (Cvs. Aveleira, Boa Ventura, Judia and Longal) were evaluated through several chemical and biochemical assays in order to provide a novel strategy to stimulate the application of waste products as new suppliers of useful bioactive compounds, namely antioxidants. All the assayed by-products revealed good antioxidant properties, with very low EC(50) values (lower than 380 μg/mL), particularly for lipid peroxidation inhibition (lower than 140 μg/mL). The total phenols and flavonoids contents were also determined. The correlation between these bioactive compounds and DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging activity, reducing power, inhibition of β-carotene bleaching and inhibition of lipid peroxidation in pig brain tissue through formation of thiobarbituric acid reactive substances, was also obtained. Although, all the assayed by-products proved to have a high potential of application in new antioxidants formulations, chestnut skins and leaves demonstrated better results.
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Affiliation(s)
- J C M Barreira
- CIMO/Escola Superior Agrária, Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5301-855 Bragança, Portugal
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19
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Duarte S, Bento J, Pena A, Lino CM, Delerue-Matos C, Oliva-Teles T, Morais S, Correia M, Oliveira MBPP, Alves MR, Pereira JA. Monitoring of ochratoxin A exposure of the Portuguese population through a nationwide urine survey--Winter 2007. Sci Total Environ 2010; 408:1195-1198. [PMID: 20018347 DOI: 10.1016/j.scitotenv.2009.11.048] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Revised: 11/09/2009] [Accepted: 11/20/2009] [Indexed: 05/28/2023]
Abstract
Ochratoxin A (OTA) is a mycotoxin produced by a variety of fungi, such as Penicillium verrucosum and Aspergillium spp., which has been found to have a wide number of potentially deadly toxic effects, and can enter the human organism through a variety of means. It then finds its way into the bloodstream and, after a lengthy process, is eventually excreted through the urine. It can thus be detected in its original form not only in blood samples but also in this biological medium. As such, and in an attempt to evaluate the exposure of the Portuguese population to this mycotoxin, morning urine samples were collected during the Winter of 2007, from each of five geographically distinct Portuguese locations--Bragança, Porto, Coimbra, Alentejo, and Algarve--and subjected to extraction by immunoaffinity columns and to OTA quantification through liquid chromatography coupled with fluorescence detection. Prevalent incidence was higher than 95% with Coimbra being the exception (incidence of 73.3%). In nearly all locations, the OTA content of most samples was found to be above the limit of quantification (LOQ) of 0.008 ng/ml. Indeed, excluding Coimbra, with an OTA content level of 0.014 ng/ml, all regions featured content values over 0.021 ng/ml.
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Affiliation(s)
- S Duarte
- Group of Health Surveillance, Center of Pharmaceutical Studies, University of Coimbra, Health Sciences Campus, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
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20
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Sancho JJ, Pascual-Damieta M, Pereira JA, Carrera MJ, Fontané J, Sitges-Serra A. Risk factors for transient vocal cord palsy after thyroidectomy. Br J Surg 2008; 95:961-7. [DOI: 10.1002/bjs.6173] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Transient recurrent laryngeal nerve palsy affects to 5–10 per cent of patients after extracapsular thyroidectomy. This prospective study assessed the impact of surgical injury and extralaryngeal branching of the inferior laryngeal nerve (ILN) on vocal cord dysfunction (VCD).
Methods
Total thyroidectomy or lobectomy was performed in 188 patients, with 302 ILNs at risk. The anatomy of the ILN and degree of injury to the nerve, based on the Laryngeal Nerve Injury Score (LNIS), were recorded. Fibreoptic laryngoscopy was performed a mean(s.d.) of 10·6(4·1) days after thyroidectomy.
Results
Some 37·4 per cent of ILNs showed extralaryngeal branching. In all, 10·9 per cent of patients developed VCD; 4·3 per cent had paresis and 6·6 per cent paralysis. All paretic and all but one paralytic cords recovered fully after 61(17) days. VCD was more frequently associated with branched than non-branched ILNs (15·8 versus 8·1 per cent; P = 0·022). Injuries were more common in branched nerves (mean(s.e.m.) total LNIS 0·94(0·08) versus 0·51(0·05); P < 0·001). Branched nerves were more likely to be associated with VCD (odds ratio 2·2 (95 per cent confidence interval 1·1 to 4·5)).
Conclusion
Branched ILNs suffer more surgical injuries and are twice as likely to be associated with VCD.
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Affiliation(s)
- J J Sancho
- Endocrine Surgery Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain
| | - M Pascual-Damieta
- Endocrine Surgery Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain
| | - J A Pereira
- Endocrine Surgery Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain
- Life Sciences Department, Universitat Pompeu Fabra, Hospital del Mar, Barcelona, Spain
| | - M J Carrera
- Endocrine and Metabolism Department, Hospital del Mar, Barcelona, Spain
| | - J Fontané
- Department of Otorhinolaryngology, Hospital del Mar, Barcelona, Spain
| | - A Sitges-Serra
- Endocrine Surgery Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain
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Pereira JA, Claro BM, Pareja JC, Chaim EA, Astiarraga BD, Saad MJA, Muscelli E. Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery. Int J Obes (Lond) 2003; 27:463-8. [PMID: 12698955 DOI: 10.1038/sj.ijo.0802269] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the impact of important weight loss on insulin inhibition of its own secretion during experimentally induced hyperinsulinemia under euglycemic conditions. DESIGN Longitudinal, clinical intervention study--bariatric surgery (vertical banded gastroplasty--gastric bypass--Capella technique), re-evaluation after 4 and 14 months. SUBJECTS Nine obese patients class III (BMI=54.6+/-2.6 kg/m2) and nine lean subjects (BMI=22.7+/-0.7 kg/m2). MEASUREMENTS Euglycemic hyperinsulinemic clamp (insulin infusion: 40 mU/min m2), C-peptide plasma levels, electrical bioimpedance methodology, and oral glucose tolerance test (OGTT). RESULTS BMI was reduced in the follow-up: 44.5+/-2.2 and 33.9+/-1.5 kg/m2 at 4 and 14 months. Insulin-induced glucose uptake was markedly reduced in obese patients (19.5+/-1.9 micromol/min kg FFM) and improved with weight loss, but in the third study, it was still lower than that observed in controls (35.9+/-4.0 vs 52.9+/-2.2 micromol/min kg FFM). Insulin-induced inhibition of its own secretion was blunted in obese patients (19.9+/-5.7%, relative to fasting values), and completely reversed to values similar to that of lean ones in the second and third studies (-60.8+/-4.2 and -54.0+/-6.1%, respectively). CONCLUSION Weight loss in severe obesity improved insulin-induced glucose uptake, and completely normalized the insulin inhibition on its own secretion.
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Affiliation(s)
- J A Pereira
- Departmento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estudual de Campinas (UNICAMP), São Paulo, Brazil
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Pereira JA, Casal S, Bento A, Oliveira MBPP. Influence of olive storage period on oil quality of three Portuguese cultivars of Olea europea, Cobrançosa, Madural, and Verdeal Transmontana. J Agric Food Chem 2002; 50:6335-6340. [PMID: 12381113 DOI: 10.1021/jf011661y] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Olives (Olea europaea cv. Cobrançosa, Madural, and Verdeal Transmontana) used for oil production were stored, in plastic containers, at 5 +/- 2 degrees C (70% relative humidity) for three different periods before oil extraction: 0, 7, and 14 days (T(0), T(7), and T(14), respectively). In the crop year 1997/1998 this procedure was done only for cv. Cobrançosa and in 1998/1999 for the three cultivars. After storage, the oils were extracted from the fruits, and the acidity, peroxide value, coefficients of specific extinction at 232 and 270 nm, stability, color, p-anisidine value, fatty acids, and tocopherols compositions were determined. The results confirm that storage of fruits produces losses in the olive oil quality. Acidity and stability to oxidation indicate a progressive deterioration of oil quality as fruit is stored. The storage time affects the total tocopherols contents, namely, alpha-tocopherol, which clearly decreased during fruit storage. The oil quality of the Verdeal Transmontana cultivar deteriorated more rapidly than that of Cobrançosa and Madural cultivars. This study also shows that cv. Cobrançosa, the main cultivar in the region, is a good choice in terms of final olive oil quality.
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Affiliation(s)
- J A Pereira
- CEQUP/Serviço de Bromatologia, Faculdade de Farmácia da Universidade do Porto, Rua Aníbal Cunha 164, 4050-047 Porto, Portugal
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Abstract
Seventy-one plastic surgeons and therapists, of varying levels of seniority and experience, were asked to examine a resin cast of an adult male hand and use estimation to measure the angles of the metacarpophalangeal and interphalangeal joints of each digit. Visual estimation by all subjects was inaccurate by a mean of approximately 25% (median percentage error 22, range 1-100). Consultants were the most accurate, whilst physiotherapists were the least. Regular goniometer users were no more accurate. However, hand surgery experience correlated with accuracy, as did a stated interest in hand surgery. Although visual accuracy improves with experience, it is still an inaccurate technique. We, therefore, recommend that goniometers should be used for measuring angles in hand surgery patients.
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Affiliation(s)
- V Rose
- Department of Plastic and Reconstructive Surgery, The Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex, RH19 3DZ, UK.
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Abstract
Cauliflower ear is a serious deformity of the auricle induced by single or repeated injury to the external ear. Few papers deal with surgical techniques for correcting this deformity. We describe the use of ipsilateral excess cartilage to restore the helical rim.
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Affiliation(s)
- F Schonauer
- Plastic Surgery, University of Naples Federico II, Naples, Italy
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25
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Etchebehere EC, Cendes F, Lopes-Cendes I, Pereira JA, Lima MC, Sansana CR, Silva CA, Camargo MF, Santos AO, Ramos CD, Camargo EE. Brain single-photon emission computed tomography and magnetic resonance imaging in Machado-Joseph disease. Arch Neurol 2001; 58:1257-63. [PMID: 11493166 DOI: 10.1001/archneur.58.8.1257] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Machado-Joseph disease (MJD) is one of the most frequently encountered spinocerebellar ataxias. However, few reports on brain single-photon emission computed tomographic (SPECT) imaging (BSI) with hexylmethylpropylene amineoxine labled with technetium Tc 99m and magnetic resonance imaging (MRI) have been performed for the evaluation of patients with MJD. OBJECTIVES To investigate possible abnormalities with BSI and MRI in patients with MJD and to correlate these findings with the duration of symptoms; cerebellar, extrapyramidal, and pyramidal syndromes; and the molecular characteristics of the MJD mutation. PATIENTS AND METHODS Twelve patients (8 males and 4 females [mean age, 39 years]) with genetically proven MJD were studied. The patients underwent BSI and MRI on the same day. Brain SPECT imaging was performed after an intravenous injection of 99mTc-hexylmethylpropylene amineoxine. The transaxial, coronal, and sagittal BSIs obtained were submitted to visual and semiquantitative analyses. Magnetic resonance imaging was obtained in a 2-T system with coronal, sagittal, transaxial, and 3-dimensional (volumetric) acquisitions. The volumes of the cerebellar hemispheres and vermis were calculated. Control groups for BSI (22 female and 20 male subjects [mean age, 33 years]) and MRI (13 female and 4 male subjects [mean age, 32.2 years]) were included for comparison. RESULTS Correlation was observed between the perfusion abnormalities identified by visual analysis in the BSI with the structural abnormalities observed on MRI in the parietal lobes and vermis. Brain SPECT imaging identified (by visual analysis) more perfusion abnormalities in the inferior portion of the frontal lobes, mesial and lateral portions of the temporal lobes, basal ganglia, and cerebellar hemispheres. Magnetic resonance imaging identified more abnormalities in the pons and superior portions of the frontal lobes. Olivary atrophy was identified by MRI. Semiquantitative analysis showed a statistically significant difference of perfusion in the inferior and superior portions of the frontal lobes, lateral portion of the temporal lobes, parietal lobes, left basal ganglia, cerebellar hemispheres, and vermis when compared with the control group. A significant difference was noted between the vermis and cerebellar volumes on MRI when compared with the control group. A significant relationship was observed between the perfusion of the left parietal lobe (P =.05) and extrapyramidal syndrome. There was a tendency toward an inverse relationship between the duration of symptoms and the perfusion of the cerebellar hemispheres (rho = -0.37; P =.24) and volume of the vermis (rho = -0.30; P =.34); between the length of the expanded (CAG)n repeat and the perfusion of the left parietal lobe (rho = -0.32; P =.36), vermis (rho = -0.28; P =.43), and pons (rho = -0.28; P =.42). A direct association was observed between the length of the expanded (CAG)n repeat and the perfusion of the lateral portion of the right temporal lobe (rho = 0.67; P =.03). CONCLUSIONS Brain SPECT imaging and MRI were capable of identifying subclinical abnormalities in individuals with MJD. These findings may be helpful for a better understanding of the pathophysiology of this disease.
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Affiliation(s)
- E C Etchebehere
- Department of Radiology, Campinas State University, UNICAMP, Caixa Postal 6142, 13081-970 Campinas, Brazil.
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Muscelli E, Pereira JA, Lazarin MA, da Silva CA, Pareja JC, Saad MJ. Lack of insulin inhibition on insulin secretion in non-diabetic morbidly obese patients. Int J Obes (Lond) 2001; 25:798-804. [PMID: 11439292 DOI: 10.1038/sj.ijo.0801607] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2000] [Revised: 12/07/2000] [Accepted: 01/03/2001] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Insulin inhibition of insulin secretion has been described in normal lean subjects. In this study, we examined whether this phenomenon also occurs in the morbidly obese who often have severe peripheral insulin resistance. SUBJECTS Twelve obese patients, normotolerant to glucose (8 F/4 M, body mass index (BMI)=54.8+/-2.5 kg/m(2), 39 y) and 16 lean control subjects (10 F/6 M, BMI=22.0+/-0.5 kg/m(2), 31 y). DESIGN AND MEASUREMENTS An experimental study using various parameters, including an euglycemic hyperinsulinemic clamp (280 pmol/min/m(2) of body surface), an oral glucose tolerance test (OGTT), electrical bioimpedance and indirect calorimetry. RESULTS The obese subjects were insulin resistant (M=19.8+/-1.6 vs 48.7+/-2.6 micromol/min kg FFM, P<0.0001) and hyperinsulinemic in the fasted state and after glucose ingestion. Fasting plasma C-peptide levels (obese 1425+/-131 pmol/l vs lean 550+/-63 pmol/l; P<0.0001) decreased less during the clamp in the obese groups (-16.9+/-6.9% vs -43.0+/-5.6% relative to fasting values; P=0.007). In the lean group, the C-peptide decrease during the clamp (percentage variation) was related to insulin sensitivity, M/FFM (r=0.56, P=0.03), even after adjustment for the clamp glucose variation. CONCLUSION We conclude that, in lean subjects, insulin inhibits its own secretion, and this may be related to insulin sensibility. This response is blunted in morbidly obese patients and may have a role in the pathogenesis of fasting hyperinsulinemia in these patients.
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Affiliation(s)
- E Muscelli
- Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), 13081-970, Campinas, São Paulo, Brazil.
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Pereira JA, Belcher HJ. A comparison of metacarpophalangeal joint silastic arthroplasty with or without crossed intrinsic transfer. J Hand Surg Br 2001; 26:229-34. [PMID: 11386773 DOI: 10.1054/jhsb.2001.0574] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Forty-three hands in 36 adults undergoing Silastic interposition arthroplasty of the index, middle, ring and little finger metacarpophalangeal joints for rheumatoid arthritis were randomly allocated to undergo replacement with or without crossed intrinsic transfer. The patients were reviewed at a median of 17 (range, 7-50) months after surgery. The demographic characteristics and pre-operative clinical measurements of the two groups were indistinguishable. Both groups showed improvement in ulnar drift and an altered arc, but no change in total range of motion at the metacarpophalangeal joints. Grip strength and pulp to pulp pinch were significantly and comparably improved in both groups. There was no difference in pain scores or perceived function between the treatment groups. It is concluded that crossed intrinsic transfer does not significantly affect the outcome of Silastic interposition arthroplasty of the metacarpophalangeal joints in rheumatoid patients.
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Affiliation(s)
- J A Pereira
- Department of Plastic Surgery, The Queen Victoria Hospital, East Grinstead, West Sussex, UK
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Abstract
We describe a technique for extraction of lipomata using gynaecological polyp forceps, via incisions placed in aesthetically better sites than directly over the lesion. Although this can also be achieved by liposuction, we have found that this alternative technique is valuable in those cases where liposuction has failed due to the fibrous nature of the lesion, or where equipment is not available.
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Affiliation(s)
- J A Pereira
- Department of Plastic Surgery, The Queen Victoria Hospital, East Grinstead, UK
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Nduka CC, Pereira JA, Belcher HJ. A simple technique to avoid inadvertent damage to monofilament core suture material during flexor-tendon repair. Br J Plast Surg 2001; 54:80-1. [PMID: 11121328 DOI: 10.1054/bjps.2000.3450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Etchebehere EC, Caron M, Pereira JA, Lima MC, Santos AO, Ramos CD, Barros FB, Sanches A, Santos-Jesus R, Belangero W, Camargo EE. Activation of the growth plates on three-phase bone scintigraphy: the explanation for the overgrowth of fractured femurs. Eur J Nucl Med 2001; 28:72-80. [PMID: 11202455 DOI: 10.1007/s002590000395] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children with an uncomplicated femoral fracture, treated with superimposition of fragments and intentional shortening, usually develop overgrowth of the fractured femur and the ipsilateral tibia which may compensate for the initial shortening and enable the limb in question to reach a length similar to that on the normal side. The overgrowth is evaluated clinically and by scanography. The increased metabolic activity of the growth plates that support this overgrowth has not been documented by any laboratory method. In order to evaluate the metabolic activity of the growth plates, 18 patients (11 males, seven females; mean age 6.1 years) with fractures of the femur were studied at three different time intervals (2-5 months, 6-12 months and 18-24 months). Three-phase bone scintigraphy was performed in all patients. Ten children (five males, five females; mean age 7.5 years) who had had bone imaging for other reasons were used as the control group. Visual analysis of the flow and equilibrium phases was performed for the distal femoral and proximal tibial growth plates. Visual and semi-quantitative analyses of the delayed images were performed for the distal femoral and proximal and distal tibial growth plates. Semi-quantitative analyses yielded the following activity ratios: (a) the distal femoral growth plate of the fractured femur to the contralateral one (FR); (b) the proximal growth plate of the tibia on the side of the fractured femur to the contralateral one (TpR); (c) the distal growth plate of the tibia on the side of the fractured femur to the contralateral one (TdR); and (d) in the control group, the distal growth plates of both femora (FCG) and the proximal (TCGp) and distal (TCGd) growth plates of the tibiae. Visual analysis of the blood flow, equilibrium and delayed images showed increased activity in the distal femoral growth plates during the first and second time intervals, but not during the third. No significant activity changes were found in the proximal and distal tibial growth plates during any of the phases analysed. The mean and standard deviation for FR in the three time intervals were: FRI=1.22+/-0.27, FRII=1.17+/-0.16 and FRIII=1.09+/-0.20. FR values were significantly higher than in the control group (FCG=0.99+/-0.03) (P=0.033). The mean and standard deviation for TpR in the three time intervals were: TpRI=1.08+/-0.18, TpRII=0.94+/-0.09 and TpRIII=0.96+/-0.20. TpR values were not significantly different from those in the control group (TCGp=1.00+/-0.05). However, TpRI was significantly higher than TpRII (P=0.043). The mean and standard deviation for TdR in the three time intervals were: TdRI=1.10+/-0.41, TdRII=1.05+/-0.15 and TdRIII=1.13+/-0.36. TdR values were not significantly higher than in the control group (TCGd=1.00+/-0.04) (P=0.777). These results support the concept that three-phase bone imaging is able to quantify and determine that activation occurs in the distal femoral and proximal tibial growth plates of fractured femora. This phenomenon may explain the overgrowth observed in this injured bone structure.
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Affiliation(s)
- F D Mendes
- Departamento de Psicologia, Universidade Católica de Goiás, Goi ania, Brasil.
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Pereira JA, da Silveira EF. Cluster and velocity effects on yields and kinetic energy distributions of Li+ desorbed from LiF. Phys Rev Lett 2000; 84:5904-5907. [PMID: 10991084 DOI: 10.1103/physrevlett.84.5904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/1999] [Indexed: 05/23/2023]
Abstract
MeV N+ and N2+ ions were used to induce Li+ desorption from LiF. The contributions due to elastic atomic collisions and electronic excitation processes to the sputtering yield could be unambiguously separated. In the case of N2+ ions, a Li+ yield enhancement, i.e., Y(N2+)>2Y(N+), was found only for the electronic process. The maximum sputtering yield was observed in a projectile velocity range where the projectile electronic energy loss still increases. These results are simultaneously explained using the radial distribution of the deposited energy rather than the electronic energy loss.
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Affiliation(s)
- J A Pereira
- Departamento de Física, Pontifícia Universidade Católica, CP 38071, Rio de Janeiro 22952-970, Brazil
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Pereira JA. Inequality in infant mortality in Portugal, 1971-1991. Dev Health Econ Public Policy 2000; 6:75-93. [PMID: 10662410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Barros JC, Pinheiro SR, Bozza M, Gueiros-Filho FJ, Bello AR, Lopes UG, Pereira JA. Evidences of gentamicin resistance amplification in Klebsiella pneumoniae isolated from faeces of hospitalized newborns. Mem Inst Oswaldo Cruz 1999; 94:795-802. [PMID: 10585658 DOI: 10.1590/s0074-02761999000600016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The intestinal microbiota, a barrier to the establishment of pathogenic bacteria, is also an important reservoir of opportunistic pathogens. It plays a key role in the process of resistance-genes dissemination, commonly carried by specialized genetic elements, like plasmids, phages, and conjugative transposons. We obtained from strains of enterobacteria, isolated from faeces of newborns in a university hospital nursery, indication of phenotypical gentamicin resistance amplification (frequencies of 10(-3) to 10(-5), compatible with transposition frequencies). Southern blotting assays showed strong hybridization signals for both plasmidial and chromosomal regions in DNA extracted from variants selected at high gentamicin concentrations, using as a probe a labeled cloned insert containing aminoglycoside modifying enzyme (AME) gene sequence originated from a plasmid of a Klebsiella pneumoniae strain previously isolated in the same hospital. Further, we found indications of inactivation to other resistance genes in variants selected under similar conditions, as well as, indications of co-amplification of other AME markers (amikacin). Since the intestinal environment is a scenario of selective processes due to the therapeutic and prophylactic use of antimicrobial agents, the processes of amplification of low level antimicrobial resistance (not usually detected or sought by common methods used for antibiotic resistance surveillance) might compromise the effectiveness of antibiotic chemotherapy.
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Affiliation(s)
- J C Barros
- Departamento de Patologia e Laboratórios, Faculdade de Ciências Médicas, UERJ, Rio de Janeiro, RJ, 20551-030, Brasil
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Pereira JA, Schonauer F, Belcher HJ. A simple technique for applying local splintage to the fingers. J Hand Surg Br 1999; 24:610-1. [PMID: 10597944 DOI: 10.1054/jhsb.1999.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report a simple method of splinting the interphalangeal joints that we have employed as our standard technique without complication.
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Affiliation(s)
- J A Pereira
- Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital, East Grinstead, West Sussex, UK.
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Habets PE, Franco D, Ruijter JM, Sargeant AJ, Pereira JA, Moorman AF. RNA content differs in slow and fast muscle fibers: implications for interpretation of changes in muscle gene expression. J Histochem Cytochem 1999; 47:995-1004. [PMID: 10424883 DOI: 10.1177/002215549904700803] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Quantification of a specific muscle mRNA per total RNA (e.g., by Northern blot analysis) plays a crucial role in assessment of developmental, experimental, or pathological changes in gene expression. However, total RNA content per gram of a particular fiber type may differ as well. We have tested this possibility in the distinct fiber types of adult rat skeletal muscle. Sections of single fibers were hybridized against 28S rRNA as a marker for RNA content. Quantification of the hybridization showed that the 28S rRNA content decreases in the order I>IIA>IIX>IIB, where Type I fibers show a five- to sixfold higher expression level compared to Type IIB fibers. Results were verified with an independent biochemical determination of total RNA content performed on pools of histochemically defined freeze-dried single fibers. In addition, the proportion of myosin heavy chain (MHC) mRNA per microgram of total RNA was similar in slow and fast fibers, as demonstrated by Northern blot analysis. Consequently, Type I fibers contain five- to sixfold more MHC mRNA per microgram of tissue than IIB fibers. These differences are not reflected in the total fiber protein content. This study implies that proper assessment of mRNA levels in skeletal muscle requires evaluation of total RNA levels according to fiber type composition.
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Affiliation(s)
- P E Habets
- Department of Anatomy and Embryology, University of Amsterdam, Amsterdam, The Netherlands
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Brierly RD, Pereira JA, Arnstein PM. Use of a vertical rectus abdominis myocutaneous flap in bilateral groin dissection for recurrent carcinoma of the penis. Urol Int 1999; 61:243-6. [PMID: 10364759 DOI: 10.1159/000030339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We present a 42-year-old man requiring bilateral groin dissection for recurrent squamous cell carcinoma of the penis. Tissue cover was obtained using a pedicled vertical rectus abdominis myocutaneous flap. This case is made interesting by the use of a unilateral flap to cover a large bilateral lower abdominal tissue defect, enabling minimal weakening of the abdominal wall, primary skin closure, and allowing early mobilization and hospital discharge.
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Affiliation(s)
- R D Brierly
- Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, UK
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38
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Vieira LA, Castro EA, Duarte JL, Pinheiro SR, Suassuna I, Pereira JA. [Newborn intestinal colonization by multidrug resistant enterobacteria in a neonatal unit]. J Pediatr (Rio J) 1999; 75:83-90. [PMID: 14685546 DOI: 10.2223/jped.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE: To evaluate the occurrence of intestinal colonization in newborns by multidrug-resistant enterobacteria strains (MDRES) during hospital stay after birth. We used selective media in an attempt to determine the relationship between isolation of these strains and some of the presumed colonization risk factors. METHOD: A sequencial inclusion study of 30 newborns was carried out in the neonatal unit of the HUPE, State University Hospital, a general 600-bed tertiary care hospital. We obtained clinical and epidemiological information from medical records and collected a fecal sample from each newborn, which was plated in gentamicin (8mg/ml) medium and potassium tellurite (25mg/ml) medium. The isolated strains were biochemically identified and also submitted to tests of antimicrobial susceptibility. Nine MDRES were submitted to an assay for plasmid conjugational transfer. RESULTS: We isolated 56 distinct MDRES from 14 among 30 newborns (46.7%). Klebsiella pneumoniae was the most common bacterial species (38/56 (68%). We found statistical association between individual MDRES isolation and presence of 3 or 4 of the following colonization risk factors considered: antimicrobial use, low weight (<2.500g), more than 6 days of hospitalization and artificial milk feeding (p< 0.02). We could detect plasmid resistance transfer by bacterial conjugation for 8 among 9 MDRES. CONCLUSION: The seletive cultura media were useful to detect the high frequence of newborns colonized by MDRES in association with well established infection risk factors. We emphasize the importance of reinforcing control rules aiming at preventing intestinal colonization viewed as a risk of nosocomial infection.
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Affiliation(s)
- L A Vieira
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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Abstract
Leeches are commonly used in the postoperative course of plastic surgical operations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. It is known that leeches can carry Aeromonas hydrophila infection, and a second or third generation cephalosporin antibiotic has traditionally been given as prophylaxis against infection. We report a new observation that leeches can carry Serratia marcescens and give rise to clinically significant infection. The implication for prophylaxis and treatment of leech-associated cellulitis is discussed.
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Affiliation(s)
- J A Pereira
- Department of Plastic and Reconstructive Surgery, St George's Hospital, London, UK
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Martínez-Ródenas F, Pereira JA, Jiménez W, Gubern JM, Sitges-Serra A. Circulating bile is the main factor responsible for atrial natriuretic peptide release in experimental obstructive jaundice. Br J Surg 1998; 85:480-4. [PMID: 9607527 DOI: 10.1046/j.1365-2168.1998.00661.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Biliary obstruction in the rabbit causes increased release of atrial natriuretic peptide (ANP). Circulating bile, raised biliary pressure or absence of bile in the duodenum may be implicated in this hepatocardiac syndrome. METHODS An experimental model was developed to elucidate the mechanism linking obstructive jaundice and increased plasma ANP. Hepatic and renal function, biliary tree pressure and ANP plasma concentrations were investigated in conscious rabbits 4 and 24 h after common bile duct ligation, biliovenous shunting or external drainage via a biliary fistula. RESULTS Bilirubin concentration increased after bile duct ligation and creation of a biliovenous shunt. Plasma creatinine increased abruptly in rabbits with a biliovenous shunt. At 4 h, the ANP increase in animals with a biliovenous shunt was ninefold that observed after bile duct obstruction while no change was noted after external biliary diversion (mean 350 versus 45 versus 9 fmol/l; P < 0.01). Relief of biliary tree obstruction was associated with a return of ANP levels towards basal normal values. CONCLUSION Raised plasma ANP in obstructive jaundice is not the result of an increased biliary pressure per se or absence of bile in the proximal duodenum but of the passage of bile components to the circulation.
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Affiliation(s)
- F Martínez-Ródenas
- Department of Surgery, Hospital Universitari del Mar, Institut Municipal d'Investigacions Mèdiques, Barcelona, Spain
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41
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Pereira JA. [Mental health and general practice in Macao]. ACTA MEDICA PORT 1997; 10:345-9. [PMID: 9312978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of this study was to evaluate the prevalence of mental health disturbances and similar complaints within the general practice of Macao. From 1993 to 1995, 0.5% or 2-3 in each 1000 inhabitants per year, consulted their general practitioner (GP), with at least one of these complaints or symptoms. This also means that 1% of all the enrolled people in all the health centres (P.H.C.) were observed at least once a year, with health problems of this order. At the same time, 1% of all the general practitioner's consultations had been codified (ICHPPC-2 defined) with at least one of the selected 20 codes, defining mental problems (V and VI chapter). In spite of this we consider these values lower than the reality, concerning the peoples' cultural and social environment. One of the most important reasons may be the deficient training of PHC doctors on this subject. To improve the quality of the mental health care in general practice we suggest complementary training and a continuous supervision of a consulting psychiatrist. Each health centre or each small group of health centres should have one nominated psychiatrist to answer promptly to all the mental problems and help requested by GPs.
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Abstract
Twenty-seven patients, with eight femoral and 20 tibial fractures, were treated with the Marchetti/Vincenzi flexible intramedullary nail between March 1993 and May 1994 in a District General Hospital. Clinical and radiological reviews were performed on all patients except for one who died. There was a high complication rate in both groups (63.5 per cent femoral and 43 per cent tibial). Particularly common was coronal mal-alignment. Other complications included non-union, external rotation, and fracture shortening with proximal migration of the nail. These data suggest that flexible intramedullary nails do not give adequate stability to either femoral or tibial fractures. We believe they should not be used in the lower limb without external support or delayed weight bearing.
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Affiliation(s)
- D G Hargreaves
- Department of Orthopaedics and Trauma, Central Middlesex Hospital, London, UK
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43
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Evans DM, Chevretton EB, Cole RP, Pereira JA, Morrison GA. Through-flow revascularization of the tongue using a radial forearm free flap. Br J Plast Surg 1994; 47:419-21. [PMID: 7952808 DOI: 10.1016/0007-1226(94)90070-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Surgery for invasive squamous cell carcinoma involving the tongue base usually necessitates a total glossectomy because complete tumour resection requires sacrifice of both lingual arteries leaving a non-viable anterior tongue. A case is presented in which both lingual arteries were sacrificed to achieve complete tumour excision and the remaining anterior two-thirds of the tongue were successfully revascularized by through-flow from a radial forearm free flap which was used for pharyngeal reconstruction. This technique offers hope of preservation of the tongue when radical surgery would otherwise lead to its removal.
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Affiliation(s)
- D M Evans
- Department of Plastic Surgery, St Thomas' Hospital, London, UK
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Pereira JA, Torregrosa MA, Martínez-Ródenas F, Clària J, Pallarés L, Gubern JM, Ruano-Gil D, Sitges-Serra A. Increased cardiac endocrine activity after common bile duct ligation in the rabbit. Atrial endocrine cells in obstructive jaundice. Ann Surg 1994; 219:73-8. [PMID: 8297180 PMCID: PMC1243093 DOI: 10.1097/00000658-199401000-00012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE This study investigated the pathogenesis of water and sodium metabolism derangements in obstructive jaundice. SUMMARY BACKGROUND DATA Obstructive jaundice is associated with hypodipsia, depletion of extracellular water, alterations of the water and sodium regulating hormones, and an increased incidence of renal failure. Plasma atrial natriuretic factor (ANF) increases after common bile duct ligation in the rabbit. The present study was designed to investigate ANF-secreting cardiac atrial cells in this animal model. METHODS Plasma ANF and the percentage of atrial cells staining for ANF were determined in jaundiced and sham-operated rabbits at 24 (group OJ-24, n = 11; group SO-24, n = 5) and 72 hours (group OJ-72, n = 11; group SO-72, n = 5) after surgery. The atrial ANF content was also determined. RESULTS Plasma ANF was higher in jaundiced animals than in controls both at 24 (63 +/- 44 fmol/mL vs. 17 +/- 10 fmol/mL, p < 0.02) and at 72 hours (73 +/- 49 fmol/mL vs. 12 +/- 11 fmol/mL). In the two OJ groups, the percentage of positive ANF cells per 200-power field in the right atrial appendage was higher than in the SO groups both at 24 (62 +/- 11% vs. 31 +/- 12%, p < 0.003) and at 72 hours (56 +/- 18% vs. 31 +/- 12%, p < 0.01). Similar results were obtained in the right auricular wall. The percentage of positive ANF cells was significantly higher in the left atrium in which significant differences between the OJ and SO groups were also noted. The right atrial ANF content was higher in the OJ than in SO groups (437 +/- 323 pmol/mg of protein vs. 83 +/- 44 pmol/mg of protein). CONCLUSIONS Cardiac endocrine activity is increased in experimental obstructive jaundice. ANF may be involved in the pathogenesis of the renal and water and sodium metabolic disturbances present in this disease.
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Affiliation(s)
- J A Pereira
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
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45
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Strecht J, Amaral I, Pereira JA, Sanches J, Gargaté A. [Imaging of aortic aneurysms and dissections. Part 2. Aortic dissections]. ACTA MEDICA PORT 1993; 6:385-92. [PMID: 8279276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The authors review the main imaging findings of aneurysms and dissections of the aorta. Based on the experience and imaging techniques available in their institution (Conventional Radiology, Sonography and Computed Tomography), they try to make a decision tree of radiologic procedures in ambulatory and emergency patients. Nowadays, in the majority of situations, these techniques allow the Radiologist to make the correct diagnosis, detect the complications and evaluate the patients in the pre and post-surgical phases. Other imaging techniques not available in their institution, such as Magnetic Resonance Imaging and Aortography, will be mentioned in view of their usefulness in some specific situations.
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Affiliation(s)
- J Strecht
- Serviço de Imagiologia do Hospital de S. Francisco Xavier, Lisboa
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46
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Amaral I, Strecht J, Pereira JA, Sanches J, Gargaté A. [Imaging of aneurysms and dissections of the aorta. Part 1--Aneurysms of the abdominal aorta]. ACTA MEDICA PORT 1993; 6:319-25. [PMID: 8379351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The authors review the main imaging findings of aneurysms and dissections of the aorta. Based on the experience and imaging techniques available in their institution (Conventional Radiology, Sonography and Computed Tomography), they try to make a decision tree of radiologic procedures in ambulatory and emergency patients. Nowadays, in the majority of situations, these techniques allow the Radiologist to make the correct diagnosis, detect the complications and evaluate the patients in the pre and post-surgical phases. Other imaging techniques not available in their institution, such as Magnetic Resonance Imaging and Aortography, will be mentioned in view of their usefulness in some specific situations.
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Affiliation(s)
- I Amaral
- Serviço de Imagiologia do Hospital de S. Francisco Xavier, Lisboa
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47
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Melo SA, de Castro EA, Pereira JA, Suassuna I. Use of a selective medium with potassium tellurite to follow intestinal colonization of hospitalized patients by drug-resistant Enterobacteriaceae. Mem Inst Oswaldo Cruz 1993; 88:135-40. [PMID: 8246748 DOI: 10.1590/s0074-02761993000100021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Nosocomial infections are a relevant factor in complicating the recovery of patients interned for even minor causes. In a attempt to determine their origin it is crucial to consider that their origin is of an endogenous nature. Looking for an accessible expression of intestinal colonization we analyzed fecal samples from 3 separate groups of hospital patients collected after different lengths of time. For practical reasons one group was studied prospectively and two other groups (patients hospitalized for up to 7 days and patients hospitalized for more than 7 days) were compared to one another. We looked for the emergence of tellurite resistance among Enterobacteriaceae using a selective medium, MacConkey potassium tellurite (MCPT). The frequency of prospectively studied patients with tellurite resistant strains was significantly greater after 7 days of hospitalization. For the two other groups, patients with more than 7 days of hospitalization showed a significant increase of bacterial species and of strains with new antimicrobial resistance markers. High molecular weight plasmids were detected in some of these strains. These data show that the MCPT medium is a useful tool for the investigation of bowel colonization in hospitalized patients by drug-resistant Enterobacteriaceae.
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Affiliation(s)
- S A Melo
- Departamento de Patologia, Faculdade de Ciências Médicas-UERJ, Rio de Janeiro, Brasil
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48
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Abstract
Pharmacological treatment of patients with enterocutaneous fistulas aims at reducing output, increasing the chance of spontaneous closure and reducing the time of fistula closure. Our initial experience with octreotide suggests that this drug effectively reduces output of established enterocutaneous fistulas when compared with a placebo in patients on parenteral nutrition. Output reduction was independent of the basal output. Likewise, this somatostatin analogue was shown to accelerate fistula closure in a series of 27 patients treated with the drug after having received parenteral nutrition for a mean of 25 days. When compared with a historical series, the rate of spontaneous fistula closure was not modified by octreotide.
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Affiliation(s)
- A Sitges-Serra
- Department of Surgery, Hospital Universitari de Mar, Universitat Autònoma de Barcelona, Spain
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49
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Kloetzel K, Pereira JA. [Human hydatidosis in Rio Grande do Sul (brazil): an estimate of its significance for the public health of the country]. Rev Inst Med Trop Sao Paulo 1992; 34:549-55. [PMID: 1342124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
By means of data collected through personal visits to hospitals and clinics in the 24 counties of Rio Grande do Sul held to be endemic for Echinococcus granulosus an assessment of the importance of this disease is attempted. (Barring new developments, these data reflect the situation in the country as a whole). The surgical incidence for 1990 was found to be 5.5 cases per 100 thousand inhabitants, far less than the rates for the neighboring countries. As concerns prevalence, in the absence of adequate population surveys the authors were forced to rely upon radiologic and echographic evidence available at various clinics throughout the area. The provisional prevalence rate thus adopted is 0.8 per thousand for lung cysts and 5.5 per thousand for abdominal cysts. According to the testimony of a group of local senior surgeons it appears that human hydatidosis is declining in Brazil. Such a conclusion gains further credibility on examination of the age distribution in the recent case series, as well as current investigations in veterinary medicine.
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Affiliation(s)
- K Kloetzel
- Universidade Federal de Pelotas, Faculdade de Medicina, Departamento de Medicina Social, RS, Brasil
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50
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Valverde J, Martínez-Ródenas F, Pereira JA, Carulla X, Jiménez W, Gubern JM, Sitges-Serra A. Rapid increase in plasma levels of atrial natriuretic peptide after common bile duct ligation in the rabbit. Ann Surg 1992; 216:554-9. [PMID: 1444646 PMCID: PMC1242672 DOI: 10.1097/00000658-199211000-00005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Previous studies have shown that common bile duct ligation in the rabbit is followed by a reduction of the extracellular water compartment. To further elucidate the mechanisms leading to volume depletion in this model, water and sodium balances and changes in plasma concentrations of atrial natriuretic peptide (ANP), vasopressin (ADH), plasma renin activity (PRA) and aldosterone (Ald) were investigated during the first 4 days after common bile duct ligation (group OJ,) or sham operation (group SO). Water and chow intakes were lower in group OJ (148 +/- 30 versus 226 +/- 40 mL/4 days; p = 0.004 and 12 +/- 9 versus 171 +/- 40 g/4 days; p = 0.0001). There were no differences in urine output. Sodium urinary losses were marginally higher in group OJ (12.4 +/- 7 versus 6.7 +/- 5 mEq/4 days; p = 0.06). Water balance was lower in group OJ (-50 +/- 56 versus 101 +/- 71 mL/4 days; p = 0.0001). At 24 hours, plasma ANP (41 +/- 7 versus 10.7 +/- 1 fmol/mL, p = 0.0001), ADH (21.8 +/- 7 versus 12.3 +/- 6 pg/mL, p = 0.008) and Ald (14.5 +/- 5 versus 3.7 +/- 3 ng/dL, p = 0.001) were higher in group OJ. These alterations persisted 72 hours after bile duct ligation, when a concomitant increase in PRA (10.7 +/- 5 versus 3 +/- 1.6 ng/dL, p = 0.006) was also observed. A group of pair-fed pair-watered sham-operated controls (group SO2, n = 13) showed a metabolic profile similar to group OJ but a low ANP concentration. Multiple venous sampling in five rabbits 24 hours after bile duct ligation showed the highest plasma levels of ANP in the aorta and infrarenal vena cava. These results suggest that common bile duct ligation in the rabbit is followed by marked hypodipsia and hypophagia, possibly mediated by ANP, leading to isotonic volume depletion and secondary activation of the water and sodium retaining hormones.
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Affiliation(s)
- J Valverde
- Department of Surgery, Hospital Universitari del Mar, Autonomous University of Barcelona, Spain
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