Laparoscopic Splenectomy Using LigaSure

LigaSure as a vessel sealing system appears to allow safe performance of laparoscopic splenectomy

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants.

 It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants. OBJECTIVE:  To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants. MATERIALS AND METHODS:  Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers. Statistical analysis was performed using IBM SPSS statistics 23. RESULTS:  A total of 494 preterm infants from 410 mothers were enrolled, and 119 (28%) of the 425 babies, still alive at 36 weeks, developed BPD. The association between chronic arterial hypertension, chronic arterial hypertension with superimposed preeclampsia, and gestational hypertension in mothers and BPD in preterm infants was not significant (p = 0.115; p = 0.248; p = 0.060, respectively). The association between preeclampsia-eclampsia and BPD was significant (p = 0.007). The multivariate analysis revealed an association between preeclampsia-eclampsia and BPD (odds ratio [OR] = 4.6; 95% confidence interval [CI] 1.529-13.819; p = 0.007) and a protective effect for BPD when preeclampsia occurred superimposed on chronic arterial hypertension in mothers (OR = 0.077; 95%CI 0.009-0.632; p = 0.017). CONCLUSION:  The results of this study support the association of preeclampsia in mothers with BPD in preterm babies and suggest that chronic hypertension may be protective for preterm babies.info:eu-repo/semantics/publishedVersio

Targeting the tumor microenvironment: An unexplored strategy for mutant KRAS tumors

Current evidence strongly suggests that cancer cells depend on the microenvironment in order to thrive. In fact, signals from the surrounding tumor microenvironment are crucial for cancer cells´ aggressiveness, altering their expression profile and favoring their metastatic potential. As such, targeting the tumor microenvironment to impair cancer progression became an attractive therapeutic option. Interestingly, it has been shown that oncogenic KRAS signaling promotes a pro-tumorigenic microenvironment, and the associated crosstalk alters the expression profile of cancer cells. These findings award KRAS a key role in controlling the interactions between cancer cells and the microenvironment, granting cancer a poor prognosis. Given the lack of effective approaches to target KRAS itself or its downstream effectors in the clinic, exploring such interactions may open new perspectives on possible therapeutic strategies to hinder mutant KRAS tumors. This review highlights those communications and their implications for the development of effective therapies or to provide insights regarding response to existing regimens.This work was supported through FEDER funds through the Operational Programme for Competitiveness Factors (COMPETE 2020), Programa Operacional de Competitividade e Internacionalização (POCI), Programa Operacional Regional do Norte (Norte 2020), European Regional Development Fund (ERDF), and by National Funds through the Portuguese Foundation for Science and Technology (FCT) (PTDC/MED-ONC/31354/2017). PDC is a PhD student from Doctoral Program in Pathology and Molecular Genetics from the Institute of Biomedical Sciences Abel Salazar (ICBAS) and she is funded through a PhD fellowship (SFRH/BD/131156/2017) awarded by Portuguese Foundation for Science and Technology (FCT). FM is a PhD student from Doctoral Programme in Biomedicine from the Faculty of Medicine of the University of Porto and she is funded through NORTE-01-0145-FEDER-000029. ALM is funded through NORTE-01-0145-FEDER-000012. SV is hired by IPATIMUP under norma transitória do DL n.º 57/2016 alterada pela lei n.º 57/2017. This work was supported through FEDER funds through the Operational Programme for Competitiveness Factors (COMPETE 2020), Programa Operacional de Competitividade e Internacionaliza??o (POCI), Programa Operacional Regional do Norte (Norte 2020), European Regional Development Fund (ERDF), and by National Funds through the Portuguese Foundation for Science and Technology (FCT) (PTDC/MED-ONC/31354/2017). PDC is a PhD student from Doctoral Program in Pathology and Molecular Genetics from the Institute of Biomedical Sciences Abel Salazar (ICBAS) and she is funded through a PhD fellowship (SFRH/BD/131156/2017) awarded by Portuguese Foundation for Science and Technology (FCT). FM is a PhD student from Doctoral Programme in Biomedicine from the Faculty of Medicine of the University of Porto and she is funded through NORTE-01-0145-FEDER-000029. ALM is funded through NORTE-01-0145-FEDER-000012. SV is hired by IPATIMUP under norma transitória do DL n.° 57/2016 alterada pela lei n.° 57/2017

Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy : Literature review of aetiopathogenesis, presentation, diagnosis and management

Pseudoaneurysms (PSAs) of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy (LC). Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation (TAE) is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation (85.1%) and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases (88.1%), followed by the cystic artery (7.9%) and a combination of both (4.0%). Most cases were managed with TAE (72.3%), with a 94.5% success rate. The overall mortality rate was 2.0%

Displasia Torácica

Os autores descrevem um caso clínico referente a uma criança que apresentava ao nascer uma marcada desproporção toraco-abdominal,por diminuição do diâmetro torácico. O Recém-nascido (RN) fez um Síndrome de Dificuldade Respiratória (SDR) precoce com necessidade de ventilação mecânica, tendo-se verificado dificuldade na entubação traqueal. Após a extubação manteve crises frequentes de polipneia e cianose. Na sequência da investigação etiológica, verificou-se que tinha uma estenose sub glótica importante. Associando os achados clínicos verificamos tratar-se de um síndrome de Barnes, forma rara de displasia torácica

Iguais ou diferentes? Cuidados de saúde materno-infantil a uma população de imigrantes

Os concelhos de Amadora e Sintra constituem um território de fortes características de identidade na Área Metropolitana de Lisboa que resultam, entre outros aspectos, da elevada densidade populacional (sobretudo Amadora), do marcado crescimento na última década (sobr etudo Sintra, onde a população residente aumentou cerca de 40% entre 1991 e 2001) e, principalmente, da sua diversidade social, cultural e étnica. D e facto, a proporção de imigrantes nestes concelhos atinge um dos v alores mais elevados do país. A equidade na pr estação de cuidados tem sido demonstrada como factor de r edução das disparidades na saúde que determina a morbilidade e a mortalidade decorrentes da assimetria das populações. Na Unidade de Saúde D (Hospital Fernando Fonseca e 9 Centr os de Saúde da Amadora e Sintra), não tinha ainda sido desenvolvida uma investigação científica estruturada sobre os níveis de saúde e o acesso e utilização dos serviços e que sustentem políticas ajustadas às vulnerabilidades deste grupo. Este conhecimento possibilita a reorganização dos serviços de cuidados de saúde e é fundamental para (r e)pensar processos de planeamento e modelos de inter venção que culminem numa integração de sucesso para o século XXI.info:eu-repo/semantics/publishedVersio

Protracted Chemical Peritonitis Following Laparoscopy for Dermoid Cyst: A management dilemma

Dermoid cysts are common benign ovarian tumors arising from totipotent germ cells. We report a rare case of chemical peritonitis and prolonged fever following laparoscopic salpingo-oophorectomy for torsion of a large ovarian dermoid and discuss the management of this patient with prolonged hospital stay, antibiotics and anti-inflammatory use, repeated drainage of the collection as well as re-laparotomy. The occurrence of this rare condition can be extremely distressing for the patient and treating surgeon alike, as the recommendations for management are limited. The management of chemical peritonitis may require one or more surgical procedures along with prolonged anti-inflammatory therapy. Keywords: peritonitis, dermoid cyst, laparoscop

Mapeamento e comparação de acordos de proteção de investimentos internacionais na América latina e central 1990 a 2018

MAPEAMENTO E COMPARAÇÃO DE ACORDOS DE PROTEÇÃO DE INVESTIMENTOS INTERNACIONAIS NA AMÉRICA LATINA E CENTRAL 1990 A 201

Biological effects of soft denture reline materials on L929 cells in vitro.

Soft denture reline materials have been developed to help patients when their oral mucosa is damaged or affected due to ill-fitting dentures or post-implant surgery. Although reports have indicated that these materials leach monomers and other components that do affect their biocompatibility, there is little information on what cell molecules may be implicated in these material/tissue interactions. The biocompatibility of six soft liners (Ufi Gel P, Sofreliner S, Durabase Soft, Trusoft, Softone and Coe Comfort) was evaluated using a mouse fibroblast cell line, L929. Within 2 h of material disc preparation, each of the materials was exposed by direct contact to L929 cells for periods of 24 and 48 h. The effect of this interaction was assessed by alamarBlue assay (for cell survival). The expression of integrin α5β1 and transforming growth factor β1 was also assessed using plate assays such as enzyme-linked immunosorbent assay. Trusoft, Softone and Coe Comfort showed significantly reduced cell survival compared with the other soft lining materials at each incubation period. Furthermore, there were significant differences with these same materials in the expression of both integrin α5β1 and transforming growth factor β1. Soft liner materials may affect cell viability and cellular proteins that have important roles in wound healing and the preservation of cell viability and function in the presence of environmental challenges and stresses