REVISÃO DOS OUTCOMES CIRÚRGICOS DA CORREÇÃO DE FÍSTULAS AÓRTICAS: A EXPERIÊNCIA DE UM SERVIÇO

Introdução e métodos: A abordagem das fístulas com origem na artéria aorta permanece um desafio em Cirurgia Vascular. O objetivo deste trabalho é rever os outcomes da intervenção cirúrgica em doentes com fístulas com origem na aorta torácica descendente e abdominal através da consulta dos processos clínicos durante um período de 16 anos num Departamento de Cirurgia Vascular. Resultados: Obtiveram-se um total de vinte e dois casos que correspondem a vinte doentes (dois doentes com fístulas primária e secundária consecutivas), com uma média de idades de 66,6 anos. Dezoito doentes eram do sexo masculino e 50% dos casos correspondem a fístulas primárias. A localização da fístula foi aorto-cava em cinco, aorto-duodenal em catorze, aorto-esofágica em três e aorto-jejunal em dois casos. As fístulas primárias abdominais estavam na sua maioria associadas a aneurisma da aorta abdominal. Relativamente às fístulas secundárias, a intervenção cirúrgica prévia foi bypass aorto-bi-femoral em quatro casos e enxertos aórticos em sete. O tempo entre a intervenção até ao diagnóstico de fístula variou entre 2 meses a 19 anos. A apresentação clínica mais comum foi hematemeses em 59% e melenas ou hematoquézias em 32%, com choque hipovolémico em 41% dos casos. Todos os casos foram submetidos a cirurgia convencional, com exceção dos três casos de fístula aorta-esofágica que foram corrigidos por cirurgia endovascular. A 3ª porção do duodeno foi o local mais comum da fístula aorto-entérica e foi necessária cirurgia intestinal em 72,7% dos casos. Nos doentes com fístulas secundárias, foi realizada exérese de prótese em oito casos e, posteriormente, cirurgia de revascularização dos membros inferiores em cinco. A complicação mais frequente no pós-operatório foi isquemia irreversível do membro inferior, com uma taxa de amputação major de 25%. Oito doentes necessitaram de intervenção cirúrgica posterior, nomeadamente trombectomia ou amputação major, exclusão com endoprótese de fístula persistente e cirurgia de Hartmann. A mortalidade foi de 50%, correspondente a quatro casos de fístulas primárias e a sete de secundárias. O tempo médio de internamento foi de 22,4 dias. A sobrevida dos doentes variou entre dois meses a dezasseis anos e entre as causas de mortalidade conhecidas estão fístula secundária após fístula primária da aorta, isquemia intestinal, persistência da fístula apesar de intervenção, pneumonia ou infeção protésica. Conclusão: As fístulas com origem na aorta são uma entidade com uma mortalidade cirúrgica elevada. Os resultados apresentados vão de encontro ao previamente publicado na literatura

THORACOSCOPIC SYMPATHECTOMY IN PATIENTS WITH PALMAR HYPERHIDROSIS: EVALUATION OF QUALITY OF LIFE AFTER SURGERY

When approaching patients with primary palmar hyperhidrosis (PH), refractory to conservative treatment, endoscopic thoracic sympathectomy (ETS) is a safe and effective alternative. Methods and materials: Retrospective study in order to assess the quality of life of patients with PH undergoing ETS, from 1 of January 2009 to 31 of December 2014. The data was collected from the medical registries of each patient and from a clinical interview with the application of the quality of life SF-36 questionnaire. The statistical analysis was preformed using SPSS. Results: In this period, 21 patients were operated, 14 of which answered the questionnaire. It was found that ETS is an effective procedure in 100% of patients, who have a reasonable quality of life as assessed by the SF-36 questionnaire. Most patients have a perception of improved quality of life after ETS. In this study, 85.7% of patients developed compensatory hyperhidrosis (CH). Discussion: In this study we confirmed the benefit associated to ETS, in line with previous studies. However, this study as some limitations such as the subjectivity of the symptoms, the small sample size, the recall bias and the complexity of the SF-36 questionnaire. When referring a patient to ETS, the possibility of CH should be addressed in patient’s decision-making process given its high incidence. Conclusion: The ETS is a safe and effective procedure and is associated with an improved quality of life of individuals with PH

Cytotoxicity assessment of endodontic sealers: metabolic activity, morphology and chromosomal alterations

Introduction: Endodontic treatment aims to eliminate infection of the root canals and fill the dental pulp space, being, the obturation of root canals an important step. The study of the toxicity/biocompatibility of the sealers used to fill the root canals is crucial since they are applied into direct contact with periradicular tissues.There are several types of sealers, categorized according to their main chemical constituents. The aim of this study was to evaluate the cytotoxicity of three root canal sealers, AH Plus, Bio MTA+ and Bio C, on immortalized human gingival fibroblasts. Methods: To study the cytotoxicity of the sealers we performed a Methyltetrazolium (MTT) assay, a study of cell's morphology and a cytogenetic study. Cells were placed in contact with material-conditioned media, for 24 h, at three different concentrations (1, 10 and 100 mg/ml) for the MTT assay. Cell morphology and cytogenetic studies were performed at 100 mg/ml. Cells in normal culture medium were analyzed as control group. Results: MTT assay revealed a cytotoxic effect of Bio MTA+ and Bio C with a growing decrease of metabolic activity with increasing compound concentration, reaching 50% with 100 mg/ml. Regarding the cells morphology, Bio C was the compound that showed a more drastic effect, with a decrease in cell confluence and several morphological changes. AH Plus and Bio MTA+ did not seem to affect the cell confluence, however morphology changes were observed, as compromised cell membranes and loss of cell content. Cytogenetic study was thus far only performed with AH Plus. Since there was a severe decrease of mitotic index after treatment, it was not yet possible to obtain sufficient metaphases, even after several cytogenetic harvesting procedures, but, so far, no relevant structural or numerical changes were observed. Discussion: This preliminary study allowed us to verify that these root canal sealers exhibit some cytotoxicity, depending on the concentration used. Although more studies are still needed, this work could be important to both, help in the selection of the most appropriate compounds for clinical practice and to determine the maximum recommended amounts of each sealer.info:eu-repo/semantics/publishedVersio

Platinum(II) Ring-Fused Chlorins as Near-Infrared Emitting Oxygen Sensors and Photodynamic Agents

Novel near-infrared luminescent compounds based on platinum(II) 4,5,6,7-tetrahydropyrazolo[1,5-a]pyridine-fused chlorins are described. These compounds have high photostability and display light emission, in particular simultaneous fluorescence and phosphorescence emission in solution at room temperature, in the biologically relevant 700-850 nm red and near-infrared (NIR) spectral region, making them excellent materials for biological imaging. The simultaneous presence of fluorescence and phosphorescence emission at room temperature, with the phosphorescence strongly quenched by oxygen whereas fluorescence remains unaffected, allows these compounds to be used as ratiometric oxygen sensors in chemical and biological media. Both steady-state (fluorescence vs phosphorescence intensities) and dynamic (dependence of phosphorescence lifetimes upon oxygen concentration) luminescence approaches can be used. Photocytotoxicity studies against human melanocytic melanoma cells (A375) indicate that these compounds display potential as photosensitizers in photodynamic therapy

Novel fluorinated ring-fused chlorins as promising PDT agents against melanoma and esophagus cancer

Investigation of novel 4,5,6,7-tetrahydropyrazolo[1,5-a]pyridine-fused chlorins, derived from 5,10,15,20-tetrakis(pentafluorophenyl)porphyrin, as PDT agents against melanoma and esophagus cancer is disclosed. Diol and diester fluorinated ring-fused chlorins, including derivatives with 2-(2-hydroxyethoxy)ethanamino groups at the phenyl rings, were obtained via a two-step methodology, combining SNAr and [8π + 2π] cycloaddition reactions. The short-chain PEG groups at the para-position of the phenyl rings together with the diol moiety at the fused pyrazole ring promote a red-shift of the Soret band, a decrease of the fluorescence quantum yield and an increase of the singlet oxygen formation quantum yield, improving the photophysical characteristics required to act as a photosensitizer. Introduction of these hydrophilic groups also improves the incorporation of the sensitizers by the cells reaching cellular uptake values of nearly 50% of the initial dose. The rational design led to a photosensitizer with impressive IC50 values, 13 and 27 nM against human melanoma and esophageal carcinoma cell lines, respectively.The authors thank Coimbra Chemistry Centre (CQC), supported by the Portuguese Agency for Scientific Research, “Fundação para a Ciência e a Tecnologia” (FCT) through project UIDB/00313/2020 and UIDP/QUI/00313/2020, co-funded by COMPETE2020-UE. Center for Innovative Biomedicine and Biotechnology (CIBB) is funded by FCT (UID/NEU/04539/2013) and COMPETE-FEDER (POCI-01-0145-FEDER-007440), through the Strategic Project UIDB/04539/2020 and UIDP/04539/2020. Thanks are also due to CIMAGO (Project 06/2019) and FCT, co-funded by the European Regional Development Fund (FEDER) through Portugal 2020/CENTRO 2020 (CENTRO-01-0145-FEDER-000014/MATIS)

Ring-Fused meso-Tetraarylchlorins as Auspicious PDT Sensitizers: Synthesis, Structural Characterization, Photophysics, and Biological Evaluation

Novel 4,5,6,7-tetrahydropyrazolo[1,5-a]pyridine-fused meso-tetraarylchlorins, with different degrees of hydrophilicity (with methyl ester, hydroxymethyl, and carboxylic acid moieties), have been synthesized and their photophysical characterization as well as in vitro photocytotoxicity assessment against human melanoma and esophageal and bladder carcinomas was carried out. An integrated analysis of the photosensitizers' performance, considering the singlet oxygen generation data, cell internalization, and intracellular localization, allowed to establish relevant structure-photoactivity relationships and the rationalization of the observed photocytotoxicity. In the diacid and monoalcohol series, chlorins derived from meso-tetraphenylporphyrin proved to be the most efficient photodynamic therapy agents, showing IC50 values of 68 and 344 nM against A375 cells, respectively. These compounds were less active against OE19 and HT1376 cells, the diacid chlorin with IC50 values still in the nano-molar range, whereas the monohydroxymethyl-chlorin showed significantly higher IC50 values. The lead di(hydroxymethyl)-substituted meso-tetraphenylchlorin confirmed its remarkable photoactivity with IC50 values below 75 nM against the studied cancer cell lines. Subcellular accumulation of this chlorin in the mitochondria, endoplasmic reticulum, and plasma membrane was demonstrated

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved