Influencia del Estado Metabólico Preoperatorio sobre los Cambios en el Gasto Energético en Reposo después del Transplante Hepático en Adultos

Introduction: The resting energy expenditure (REE) evolution after liver transplantation is not fully understood. Objective: To assess longitudinally the REE evolution in adults undergoing liver transplantation, in association with other nutritional measurements that characterize the metabolic profile. Methods: A single-center cohort of consecutive end-stage liver disease patients with indication for liver transplantation was recruited. REE, subjective global assessment (SGA), handgrip strength and body composition measurements were assessed before transplantation (T0) and at median nine (T1) and 36 (T2) days after transplantation. Mixed effects regression models were used for analysis. Results: Fifty-six patients with a mean age of 53.7 (8.5) years were included; 87.5% were males. In T0, 41% of patients were normometabolic, 37.5% were hypometabolic and 21.4% were hypermetabolic. After transplantation, the mean REE decreased progressively in patients initially hypermetabolic and the opposite occurred in those initially hypometabolic. The REE evolution was positively associated with body weight (β = 9.6, p < 0.001) and energy intake (β= 13.6, p = 0.005) in the whole sample; it was positively associated with body weight (β= 7.1, p = 0.018) and percentage of energy intake from lipids (β= 18.9, p = 0.003) in initially hypometabolic patients, and positively associated with body weight (β= 14.1, p < 0.001) and negatively associated with SGA-undernourishment (β = -171, p = 0.007) in initially normometabolic patients. Conclusion: Different REE evolutions after liver transplantation are associated with the preoperative metabolic status. In patients initially hypometabolic, the REE evolution is positively associated with body weight and percentage of energy intake from lipids, and in those initially normometabolic, it is positively associated with body weight and negatively associated with SGA-undernourishment.info:eu-repo/semantics/publishedVersio

Keratocystic odontogenic tumor overexpresses invadopodia-related proteins, suggesting invadopodia formation

OBJECTIVE: Keratocystic odontogenic tumor (KOT) is an odontogenic neoplasm that shows aggressive clinical behavior and local invasiveness. Invadopodia are actin-rich cellular protrusions exhibiting proteolytic pericellular activity, thereby inducing focal invasion in neoplastic cells and increasing neoplasms aggressiveness. Thus, this study aimed to evaluate immunoexpression of invadopodia-related proteins, cortactin, MT1-MMP, Tks4, and Tks5, in KOT. STUDY DESIGN: Immunohistochemistry of 16 cases of KOT, eight cases of calcifying cystic odontogenic tumor (CCOT), and eight samples of the oral mucosa (OM) was carried out to assess the expression of the above described invadopodia-related proteins in the basal and suprabasal layer. RESULTS: KOT samples showed higher and significant immunoexpression of cortactin, MT1-MMP, TKs4, and TKs5 compared with the CCOT and OM samples. Significant expression of all these proteins was observed in the basal layer compared with the suprabasal layer in KOT. CONCLUSIONS: Overexpression of cortactin, MT1-MMP, TKs4, and TKs5 was observed in KOT compared with samples of CCOT and OM. These proteins were also overexpressed in the basal over the suprabasal layer of KOT samples. Taken together, these results suggest the participation of invadopodia-related proteins on the pathogenesis of this lesion

Transtorno do Espectro Autista: Direitos Fundamentais

A obra apresenta evidências sobre os direitos fundamentais sobre o Transtorno do Espectro Autista, uma condição neurológica que afeta o desenvolvimento do cérebro, afetando principalmente a comunicação social, a interação social e o comportamento. É uma condição que se manifesta de maneira variada em diferentes pessoas, e é considerada um espectro porque engloba uma ampla gama de sintomas e níveis de gravidade. Embora não haja cura para o TEA, intervenções e terapias podem ajudar a melhorar a qualidade de vida das pessoas com autismo. Alguns tratamentos comuns incluem terapia comportamental, terapia ocupacional, fonoaudiologia e educação especializada. O apoio e a compreensão da família, amigos, pais e da comunidade também desempenham um papel crucial no suporte às pessoas com TEA. É importante ressaltar que cada pessoa com TEA é única, e suas necessidades e habilidades variam. O objetivo principal é fornecer o suporte necessário para ajudar as pessoas com TEA a desenvolver todo o seu potencial e viver uma vida plena e inclusiva.The book presents evidence on the fundamental rights of Autism Spectrum Disorder, a neurological condition that affects the development of the brain, mainly affecting social communication, social interaction and behavior. It is a condition that manifests itself in different ways in different people, and is considered a spectrum because it encompasses a wide range of symptoms and levels of severity. Although there is no cure for ASD, interventions and therapies can help improve the quality of life of people with autism. Some common treatments include behavioral therapy, occupational therapy, speech therapy and specialized education. The support and understanding of family, friends, parents and the community also play a crucial role in supporting people with ASD. It is important to emphasize that each person with ASD is unique, and their needs and abilities vary. The main goal is to provide the necessary support to help people with ASD develop their full potential and live a full and inclusive life

GESTÃO HOSPITALAR: GERENCIAMENTO EM HOTELARIA HOSPITALAR E EQUIPE MULTIPROFISSIONAL

O capital humano era visto como fonte geradora de lucros para as organizações. Diante da competitividade, transformação do cenário, cobranças por melhores resultados, e diversidades de profissão no mundo das organizações de saúde, as exigências e perfil profissional vem mudando, as pessoas são percebidas como peça fundamental e indispensável para sucesso das organizações, tornando mais evidente que nesta diversidade requer gestores que seja resiliente e com habilidades de relacionamento interpessoal para formar equipes qualificadas e eficientes. Para tanto, objetiva-se formar equipe multiprofissional especializada em cuidados paliativos e implementar o conceito de hotelaria hospitalar. Trata-se de uma pesquisa qualitativa, bibliográfica, retirado de artigos científicos e sites relevantes sobre a temática e nas bases de dados Google acadêmico, Scielo e Biblioteca Virtual em Saúde (BVS), apreciados no mês de julho e agosto 2022 com as seguintes palavras-chaves: gestão de pessoas, hotelaria hospitalar e equipe multiprofissional. Como resultados, observa-se que as organizações e os gestores vêm desenvolvendo um olhar mais holístico, integral e mais humano para com seus colaboradores em busca de reter bons profissionais e consolidar equipes multiprofissionais integradas e eficazes, com serviço em saúde e de hotelaria hospitalar mais humanizado com menor custo e melhores resultados. O planejamento financeiro deve ter como foco oferecer o melhor atendimento hospitalar com os recursos disponíveis, ou seja, com uma relação custo-benefício, prestando um serviço humanizado de qualidade com segurança e de referência para seus clientes e ambiente seguro para seus colaboradores.Human capital was seen as a source of profit for organizations. Faced with the competitiveness, transformation of the scenario, demands for better results, and diversity of professions in the world of health organizations, the requirements and professional profile have been changing, people are perceived as a fundamental and indispensable part for the success of organizations, making it more evident that this diversity requires managers who are resilient and with interpersonal skills to form qualified and efficient teams. Therefore, the objective is to form a multidisciplinary team specialized in palliative care and implement the concept of hospital hospitality. This is qualitative, bibliographical research, taken from scientific articles and relevant websites on the subject and in the Google Academic, Scielo and Virtual Health Library (BVS) databases, analyzed in July and August 2022 with the following keywords: people management, hospital hospitality and multidisciplinary team. As a result, it is observed that organizations and managers have been developing a more holistic, integral and more humane look towards their employees in order to retain good professionals and consolidate integrated and effective multidisciplinary teams, with a more humanized health and hospital hospitality service with lower costs and better results. Financial planning should focus on offering the best hospital care with available resources, that is, with a cost-effective relationship, providing a humanized quality service with safety and reference for its customers and a safe environment for its employees

Role of HIF-1α and CASPASE-3 in cystogenesis of odontogenic cysts and tumors

OBJECTIVES: Odontogenic cysts and tumors are the most relevant lesions that affect the gnathic bones. These lesions have in common the formation of cystic areas and this common feature may suggest involvement of similar mechanisms. The hypoxia inducible factor 1 alpha (HIF-1α), a responsive protein to hypoxia and caspase-3, an irreversible apoptosis marker, may contribute to cyst formation. Thus, this study aimed to investigate the immunoexpression of these proteins in odontogenic cysts and tumors. MATERIAL AND METHODS: Twenty cases of ameloblastoma, keratocystic odontogenic tumor (KOT) (n = 20), radicular cyst (RC) (n = 18), dentigerous cyst (DC) (n = 11), calcifying cystic odontogenic tumor (n = 8), and dental follicle (DF) (n = 10) were used to investigate HIF-1α and caspase-3 expression in sequential serial cuts by immunohistochemistry. RESULTS: HIF-1α was overexpressed in RC, DC, and ameloblastoma when compared with DF. The basal and sometimes the lower suprabasal layer showed no or very low expression in DC, KOT, and ameloblastoma, the last also showing strong expression in solid epithelial areas and initial cystic formation regions. Caspase-3 was found to be overexpressed in all lesions, with the highest expression in odontogenic cysts compared to tumors. HIF-1α and caspase-3 were localized in similar areas of the same lesions, especially in the epithelium surrounding cystic formations. CONCLUSIONS: This study showed distinct immunoexpression of HIF-1α and caspase-3 in odontogenic cyst and tumors, with higher expression observed in odontogenic cysts. CLINICAL RELEVANCE: These findings suggest a possible correlation between hypoxia, apoptosis, and cystogenesis, leading to understand the mechanisms responsible to cystic formation in odontogenic lesions

Evaluation of cystamine-modified hyaluronic acid/chitosan polyplex as retinal gene vector

A successful gene therapy approach can prevent or treat congenital and acquired diseases. However, there is still no ideal non-viral vector for gene delivery in a safe and timely manner. In this report the anionic polymer hyaluronic acid (HA) was investigated as a potential vector for gene therapy. Due to its intrinsic characteristics it constitutes an excellent candidate to deliver therapeutic genes, pending the modification of its surface charge

The Genome of Anopheles darlingi, the main neotropical Malaria vector

Anopheles darlingi is the principal neotropical malaria vector, responsible for more than a million cases of malaria per year on the American continent. Anopheles darlingi diverged from the African and Asian malaria vectors ∼100 million years ago (mya) and successfully adapted to the New World environment. Here we present an annotated reference A. darlingi genome, sequenced from a wild population of males and females collected in the Brazilian Amazon. A total of 10 481 predicted protein-coding genes were annotated, 72% of which have their closest counterpart in Anopheles gambiae and 21% have highest similarity with other mosquito species. In spite of a long period of divergent evolution, conserved gene synteny was observed between A. darlingi and A. gambiae. More than 10 million single nucleotide polymorphisms and short indels with potential use as genetic markers were identified. Transposable elements correspond to 2.3% of the A. darlingi genome. Genes associated with hematophagy, immunity and insecticide resistance, directly involved in vector–human and vector–parasite interactions, were identified and discussed. This study represents the first effort to sequence the genome of a neotropical malaria vector, and opens a new window through which we can contemplate the evolutionary history of anopheline mosquitoes. It also provides valuable information that may lead to novel strategies to reduce malaria transmission on the South American continent. The A. darlingi genome is accessible a