Transverse coloplasty pouch and colonic J-pouch for rectal cancer: a comparative study

OBJECTIVES: The introduction of the colonic J-pouch has markedly improved the functional outcome of restorative rectal cancer surgery. However colonic J-pouch surgery can be problematic and may present some late evacuatory problems. To overcome these limitations a novel pouch has been proposed: the transverse coloplasty pouch. The purpose of our study was to compare the functional outcomes of these two different types of pouches--the transverse coloplasty pouch (TCP) and the colonic J-pouch (CJP)--during the first 12 months postoperatively. PATIENTS AND METHODS: A prospective randomized trial was conducted in which a total of 30 patients with mid and low rectal cancer were submitted either to a transverse coloplasty pouch or a colonic J-pouch. Clinical defaecatory function was assessed and anorectal physiological assessment was carried out, pre-operatively and at 3, 6 and 12 months postoperatively, by means of a standard clinical questionnaire and by anorectal manometry. RESULTS: No statistically significant differences were found between the two groups regarding bowel function. The postoperative frequency of daily bowel movements was lower in the TCP group in all the phases of the study (3.9 vs. 4.1 at 3 months; 3.1 vs. 3.4 at 6 months; 2.1 vs. 2.8 at 12 months), the same occurring with fragmentation (33% vs. 40% at 3 months; 26.6%vs. 33.3% at 6 months; 7.1%vs. 14.3% at 12 months). Less urgency was also seen in the TCP group during the first 6 months (20%vs. 26.7%), with identical values at 12 months (14.3% vs. 14.3%). No significant differences were also found concerning incontinence grading and scoring, with TCP patients having less nocturnal leaks. At one year two CJP patients (14.3%) needed the use of enemas to evacuate the pouch and provoke defaecation, a problem never seen in TCP patients. The anorectal manometry data was similar in both types of pouches. The local complication rates were also identical in the two groups (20%); more anastomotic leaks were seen in TCP patients (13.2% vs. 6.6%), without reaching a statistical significance. CONCLUSION: The transverse coloplasty pouch has similar functional results but fewer evacuation problems than the J-Pouch, making it a safe and reliable alternative to the colonic J-pouch

Coping styles within the family system in the chronic phase following acquired brain injury: its relation to families’ and patients’ functioning

OBJECTIVE: To investigate how the functioning of family members and the coping styles they use are related to the psychosocial functioning both of the family members and of the person who has sustained a brain injury. DESIGN: Cross-sectional study. SUBJECTS: Primary caregivers (n = 61) and other family members (n = 15) of 61 patients with brain injury. METHODS: Primary caregivers completed the Utrecht Coping List, the Life Satisfaction Questionnaire 9, and the Caregiver Strain Index. All family members completed the Family Assessment Device. Data for the patients were collected retrospectively. RESULTS: Primary caregivers who had a preference for passive coping styles reported that they experienced a lower level of family functioning, a lower quality of life, and a higher strain. Neither the coping styles nor the psychosocial outcomes of the primary caregivers were significantly associated with patients' self-reported quality of life. Furthermore, there was no correlation between the level of family functioning and a patient's quality of life. CONCLUSION: Coping styles of caregivers are important determinants for their own psychosocial functioning, but not for patients' psychosocial functioning, although causality cannot be inferred. To enhance caregivers' psychosocial functioning, rehabilitation should focus on changing their coping styles into ones that are less passive. Furthermore, distinct or additional interventions may be needed to change the patient's coping style

Injecção intralesional de betametasona nas estenoses benignas do esófago

Intralesional steroid injection has been used in benign oesophageal strictures to improve the results of dilatation. Most studies use triamcinolone, only a few have reported using betamethasone. Objectives: To evaluate the efficacy and safety of the combination of dilatation and intralesional betamethasone injection in benign oesophageal strictures. Methods: Cases of benign oesophageal strictures treated with dilatation and betamethasone injection between January 1st 1998 and December 31st 2004 were retrospectively analysed. Thirty-one patients (21 males, 10 females) were identified, with a mean age of 58.8 years. The most frequent aetiologies of the stenosis were post-surgical (16 patients), peptic (11 cases) and caustic (5 cases). Results: The periodic dilatation index significantly decreased (p=0.002), although there was no statistically significant variation between medium luminal diameter pre and post-treatment. There were no adverse events. Conclusion: Intralesional betamethasone injection is a safe technique which increases efficacy of endoscopic dilatation. However, no conclusions can be drawn from our study due to the small population studied

Identification of therapeutic and diagnostic targets through yeast two hybrid system: molecular biology in medicine

Nas últimas décadas, o desenvolvimento da biologia molecular tem impulsionado a medicina, principalmente na identificação de novos alvos terapêuticos e de diagnóstico. Nas células são as proteínas as principais intervenientes responsáveis pelo funcionamento de todos os processos celulares, desde a síntese de novas moléculas de DNA, à formação de RNA e de novas proteínas, ao transporte de todos os componentes celulares bem como da composição estrutural da própria célula. Também são as proteínas um dos componentes mais relevantes das vias de sinalização entre as células. Estudos apontam para que, normalmente, as proteínas não funcionem sozinhas mas em complexos. Daí a importância de estudar as interações entre proteínas e, por outro lado, encontrar compostos que interfiram com esses complexos para tratamentos farmacológicos. Já existem alguns fármacos com estas características. A tricostatina A, um inibidor duma diacetilase de histonas (DH), atua no complexo Proteína Fosfatase 1-DH, sendo um bom alvo na terapia anti-cancerígena. Em 1989, de um modo revolucionário para a época, Fields e Songs desenvolveram o Yeast Two Hybrid system (YTH). Este método baseia-se na genética da levedura Saccharomyces cerevisiae para detetar interações entre proteínas. Desde a sua descoberta sofreu várias modificações que permitiram a sua aplicação à investigação translacional. Por exemplo, esta técnica permite fazer um rastreio em larga escala para determinar que droga pode interferir com uma determinada interação proteica. Por outro lado, pode também utilizar-se para se determinar que proteínas num determinado tecido (por exemplo, cérebro ou testículo) interagem com a nossa proteína de interesse. Deste modo é possível desvendar funções de novas proteínas, vias de sinalização e funcionamento de tecidos. A grande quantidade de informação produzida por esta abordagem é de eleição para a identificação e validação de alvos de diagnóstico, terapêuticos e mesmo desenvolvimento de novos fármacos. Esta revisão tem como intuito elucidar o funcionamento do Yeast Two Hybrid system e a sua contribuição para a identificação de novos tratamentos farmacológicos

Geometry Optimization for Miniaturized Thermoelectric Generators

Thermoelectric materials capable of converting heat into electrical energy are used in sustainable electric generators, whose efficiency has been normally increased with incorporation of new materials with high figure of merit (ZT) values. Because the performance of these thermoelectric generators (TEGs) also depends on device geometry, in this study we employ the finite element method to determine optimized geometries for highly efficient miniaturized TEGs. We investigated devices with similar fill factors but with different thermoelectric leg geometries (filled and hollow). Our results show that devices with legs of hollow geometry are more efficient than those with filled geometry for the same length and cross-sectional area of thermoelectric legs. This behavior was observed for thermoelectric leg lengths smaller than 0.1 mm, where the leg shape causes a significant difference in temperature distribution along the device. It was found that for reaching highly efficient miniaturized TEGs, one has to consider the leg geometry in addition to the thermal conductivity

O balão intragástrico nas formas graves de obesidade

Introduction: In patients with morbid obesity the intragastric balloon (IGB) can be a “bridge” to surgery or a temporary treatment in patients who are not candidates for surgery. Objective: Evaluate IGB efficacy in morbidly obese patients. Patients and Methods: In 2003/2004 seventeen IGB Bioenterics ® filled with normal saline and methylene blue were placed in 17 patients [11 women, median age was 49.2 (27-69 years); median body mass index was 55.6 (40.2-74.2 Kg/m2)], followed by nutritionists and/or endocrinologists. They had previously tried dietetic and/or pharmacological measures with limited results. Co-morbidities were present in 13 (76.5%). Results: Eight (47%) patients presented nausea/vomiting in the first 24-72h that persisted in 4 (23.5%) leading to dehydration and pre-renal insufficiency and forcing premature removal of the balloon (0.5 to 4 months). In the other patients, the device was removed at 6 months treatment (in 1 patient at 10 months). All patients suffered weight loss (5-70 Kg); median loss-19.6 Kg (p<0.001). No cases of spontaneous deflation/displacement occurred. Six (35.3%) underwent bariatric surgery. Conclusions: The IGB is a useful method for weight loss in morbidly obese patients. Nausea and vomiting are the most common complications. Although desirable, subsequent surgery is not always performed

ULTRASTRUCTURAL AND CYTOCHEMICAL CHARACTERIZATION OF THE OENOCYTOID IN LARVAE OF DIATRAEA SACCHARALIS (LEPIDOPTERA: PYRALIDAE) PARASITIZED BY THE WASP COTESIA FLAVIPES (HYMENOPTERA: BRACONIDAE)

The hemocytes participate in the cellular encapsulation around foreign material implanted into the insect hemocoel. However, the suppression of this reaction by entomopathogens remains largely misunderstood. This study describes the ultrastructural modifications in one type of hemocyte of Diatraea saccharalis larvae, the oenocytoid (OE), along the parasitism by the wasp Cotesia flavipes, using conventional and cytochemical techniques. The OE of parasitized D. saccharalis larvae exhibited areas of cytoplasm rarefaction with intensity proportional to the time of parasitism. There was cell lyse at long-term parasitism, although we did not observe melanization either into the host haemocel or around of parasitoid. The OE of either control or parasitized larvae did not show phenoloxidase activity in the ultrastructural preparations; these absence was related with the morphological modifications caused by the parasitism. The trimetaphosphatase and acid phosphatase activities were not detected in OE of control larvae, but were visualized along the parasitism, reinforcing the role played by the OE in the defense reactions. Key words: Ultrasctructural, oenocytoid, Diatraea saccharali

Improving the electroluminescence of [Zn(salophen)(OH2)] in polyfluorene-based light-emitting diode: the role of energy transfer and charge recombination

Combining two or more different compounds with advantageous properties has been a useful and straightforward strategy in achieving a new class of materials with improved physical properties. This has been especially true for electronic polymers, whose optoelectronic properties can be completely tuned, and even improved, when mixed with other polymeric materials, dye molecules and guest coordination compounds. Here, a light-emitting diode prepared with the conjugated polymer poly[(9,9-dioctylfluorenyl-2,7-diyl)-alt-co-(9,9-di-{5'-pentanyl}-fluorenyl-2,7-diyl)] (PFOFPen) as the host material and aquo[N,N'-bis(salicylidene)-o-phenylenediamine]zinc(II) ([Zn(salophen)(OH2)]) as the guest molecule was studied in terms of its photo and electroluminescence properties. The role of the ZnII coordination compound as a guest in the electroluminescence is discussed as a strategy for the improvement of the electroluminescence performance of coordination compounds using conjugated polymers as matrices. An additional advantage of these composites is that they are solution processable, a low-cost and time efficient alternative to vacuum vapor deposition. Additionally, the photophysical processes involved in both electroluminescence and photoluminescence emissions are discussed because they are markedly different.Combining two or more different compounds with advantageous properties has been a useful and straightforward strategy in achieving a new class of materials with improved physical properties. This has been especially true for electronic polymers, whose opt272295302FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO2013/16245-2470529/2012-1The authors acknowledge FAPESP (2013/16245-2), CNPq (470529/2012-1), National Institute of Organic Electronics (INEO) (MCT/CNPq/FAPESP) and UNICAMP/FAEPEX for financial support and fellowship