Altered Antioxidant-Oxidant Status in the Aqueous Humor and Peripheral Blood of Patients with Retinitis Pigmentosa

Retinitis Pigmentosa is a common form of hereditary retinal degeneration constituting the largest Mendelian genetic cause of blindness in the developed world. It has been widely suggested that oxidative stress possibly contributes to its pathogenesis. We measured the levels of total antioxidant capacity, free nitrotyrosine, thiobarbituric acid reactive substances (TBARS) formation, extracellular superoxide dismutase (SOD3) activity, protein, metabolites of the nitric oxide/cyclic GMP pathway, heme oxygenase-I and inducible nitric oxide synthase expression in aqueous humor or/and peripheral blood from fifty-six patients with retinitis pigmentosa and sixty subjects without systemic or ocular oxidative stress-related disease. Multivariate analysis of covariance revealed that retinitis pigmentosa alters ocular antioxidant defence machinery and the redox status in blood. Patients with retinitis pigmentosa present low total antioxidant capacity including reduced SOD3 activity and protein concentration in aqueous humor. Patients also show reduced SOD3 activity, increased TBARS formation and upregulation of the nitric oxide/cyclic GMP pathway in peripheral blood. Together these findings confirmed the hypothesis that patients with retinitis pigmentosa present reduced ocular antioxidant status. Moreover, these patients show changes in some oxidative-nitrosative markers in the peripheral blood. Further studies are needed to clarify the relationship between these peripheral markers and retinitis pigmentosa

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The impact of obesity on surgery in gynecological oncology: a review.

Surgery represents a mainstay in the treatment of gynecological cancers. It is a common belief that operating on obese patients causes more peri- and postoperative complications than operating on nonobese patients. The surgical outcome in gynecological oncology can be evaluated by comparing intra- and postoperative complications, extent of lymphadenectomy, negativity of the specimens' margins, and percentage of optimal debulking between obese and nonobese patients affected by malignancies at the same stage. In this review, we analyze how obesity affects the feasibility of a correct oncologic procedure in case of cervical, endometrial, and ovarian cancer. We also describe the techniques that have been suggested in the literature to improve the surgical outcome on obese patients

Desenvolvimento de fotocatodos ? base de ?xidos mistos de Bi e Al, Zn ou Sr para produ??o de hidrog?nio a partir da clivagem fotoeletroqu?mica da ?gua

A busca por fontes alternativas de energia, tem sido a for?a motriz de muitas linhas de pesquisas por todo o mundo. Nesta tese de doutorado ? feito um estudo em cima de propriedades fotoeletroqu?micas de materiais ? base de bismuto, para obten??o de outros com potencial aplica??o na produ??o de H2, que ? tido como uma fonte de combust?vel renov?vel e limpo. Atualmente os materiais mais utilizados como fotocatodos na produ??o de H2 s?o em sua grande maioria constitu?dos por cobre (Cu), que apresentam pequena energia de bandgap (Valores entre 1,5 - 1,8 eV), banda de condu??o (BC) com potencial mais negativo que o potencial de redu??o de H+/ H2 (Valor pr?ximo de -0,41eV), al?m de ser constitu?do de materiais de f?cil obten??o. Por?m ele ? inst?vel por sofrer fotocorros?o em solu??o aquosa, ocasionado pela redu??o de cobre, limitando sua atividade. Alternativo aos materiais a base de cobre, nessa tese ? descrito a obten??o de tr?s materiais ? base de ?xidos de bismuto, alum?nio, zinco ou estr?ncio. O material obtido Al2Bi24O35 / Al2Bi48O75 apresentou densidade de corrente de -5,09 mA.cm-2, efici?ncia de convers?o dos f?tons incidentes (IPCE) de 3,5% em 360nm e efici?ncia faradaica de 96% na produ??o de H2. O material SrBi4O7 apresentou uma densidade de corrente de - 1,92 mA.cm-2 , efici?ncia de convers?o dos f?tons incidentes (IPCE) de 4% em 500nm e efici?ncia faradaica de 91% para produ??o de H2. O ZnBi38O60 apresentou densidade de corrente de -1,3 mA.cm-2 efici?ncia de convers?o do f?ton incidente (IPCE) de 6,4% com pico m?ximo no comprimento de onda de 400nm e efici?ncia faradaica de 100% de convers?o da corrente em H2. Todos os materiais obtidos nesta tese se mostraram uma alternativa de fotocatodos para substituir os materiais constitu?dos de Cobre.Tese (Doutorado) ? Programa de P?s-Gradua??o Multic?ntrico em Qu?mica de Minas Gerais, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2020.A search for alternative sources of energy has been the driving force behind many lines of research around the world. In this article, a study is made on the photoelectrochemical properties of bismuth-based materials, to detect others with a potential application of hydrogen production H2, which is used as a clean and renewable fuel source. Currently, the materials most used as photocathodes in the production of H2 are mostly made up of copper (Cu), which have a small bandgap energy (values between 1.5 - 1.8 eV), conduction band (BC ) with more negative potential than H + / H2 reduction potential (value close to -0.41eV), in addition to being made of easy-to-use materials. However, it is unstable because it undergoes photocorrosion in the aqueous solution, caused by the reduction of copper, limiting its activity. Alternative to copper-based materials, it is described as testing three materials based on bismuth, aluminum, zinc or strontium oxides. The material obtained Al2Bi24O35 / Al2Bi48O75 showed a current variation of -5.09 mA.cm-2, incident photon conversion efficiency (IPCE) of 3.5% in 360nm and faradaic efficiency of 96% in H2 production. SrBi4O7 material shows a current density of - 1.92 mA.cm-2, incident photon conversion efficiency (IPCE) of 4% at 500nm and faradaic efficiency of 91% for H2 production. The ZnBi38O60 has a current variation of -1.3 mA.cm-2 of incident photon conversion efficiency (IPCE) of 6.4% with a maximum peak at 400 nm wavelength and faradaic efficiency of 100% current variation in H2 production. All materials selected in this list show a photocathode alternative to replace materials made up of Copper

Laparoscopic pelvic and paraaortic lymphadenectomy in gynecologic oncology.

In the early 1990s, different authors independently developed techniques for pelvic and paraaortic lymph node sampling. Since then, laparoscopic lymphadenectomy has been demonstrated to yield the same number of nodes when compared with the laparotomic approach. Only one microscopically involved lymph node was lost at laparoscopic lymphadenectomy when a laparotomic control followed immediately after. It seems bleeding, which is the most serious perioperative complication, is more common during laparoscopic lymphadenectomy than during laparotomy; however, the incidence will decrease with experience of the surgeon. The laparoscopic procedure does not seem to influence negatively the survival of patients with early stage endometrial and cervical cancer. There does not seem to be a significant reduction in overall hospital charges for laparoscopic surgery in oncology, but patients who undergo laparoscopic surgery recover significantly sooner than those who undergo laparotomy

Uterine sarcoma occurring in a premenopausal patient after uterine arteryembolization: a case report and review of the literature.

Objective: We report a case of uterine leiomyosarcoma occurring after uterine artery embolization and review the previously published cases. We estimate the incidence of sarcoma after UAE, the mean diagnostic delay in young women undergoing this procedure and review the potential and limits of preoperative procedures in diagnosing uterine sarcomas. Case report: A 35-year-old woman had an early failure after UAE. She underwent surgery 13 months after the procedure. Final pathologic report was consistent with uterine leiomyosarcoma. Conclusion: Incidence of uterine sarcomas after UAE is low, probably similar to that of misdiagnosed leiomyosarcomas in women undergoing surgery for presumed symptomatic leiomyomas. Therefore a relation between the procedure and the malignancy seems to be very unlikely. Diagnostic delay in menstruated women younger than 50 undergoing UAE for presumed symptomatic leiomyoma ranges between 13 and 15 months. The safest procedure for women who fail the conservative management of leiomyoma with UAE is surgical, allowing for definitive pathologic exclusion of malignancy

Extensive fever workup produces low yield in determining infectious etiology.

OBJECTIVE: The study was undertaken to evaluate the use of a fever workup in women undergoing benign gynecologic procedures. STUDY DESIGN: A retrospective chart review was performed at Jackson Memorial Hospital between 1994 and 2000. Information was abstracted from hospital and clinic records. Fever criteria was defined as 1 temperature equal to or greater than 101.5, or 2 equal to or greater than 100.4, at least 4 hours apart within a 24-hour period. Patients undergoing additional intraoperative procedures leading to increased febrile morbidity were excluded. Data abstracted included patient demographics, procedure, complications, antibiotic use, and extent of fever workup. Statistical analysis used was 2-sample t tests, Wilcoxon rank test, chi2 test, and multivariate logistic regression. Alpha level = .05. RESULTS: The charts of 505 patients were reviewed, and 147 patients met fever criteria. All patients underwent surgery for benign conditions, abdominal hysterectomy being the most common (90%). The study population was divided into 2 groups: the noninfectious group and infectious group. These groups were determined by wound infection, pelvic abscess, blood or urine culture, ultrasound, and chest roentgen. Both groups were found to be similar with respect to demographics, surgical procedures, and postoperative complications, with the exception of body mass index (28.4 vs 31.7) and length of hospital stay (3.9 vs 5.3). Results from fever workups included positive results blood cultures (9.7%), urine culture (18.8%), and chest roentgens (14%) in this study population. We found no association between positive urine analysis and urine culture. When comparing both groups, a statistically significant difference was found with regard to maximum temperature elevation, number of days febrile, and postoperative day of maximum temperature (P < .05). CONCLUSION: The extensive fever workup was not frequently positive in this study population. Its use and cost-effectiveness should be questioned. Therefore, the fever workup should be tailored to the individual patient