Mortalidade, morbidade e categorização de risco para complicações perioperatórias em pacientes com câncer de pulmão

OBJECTIVE:To determine morbidity and mortality rates by risk category in accordance with the American College of Chest Physicians guidelines, to determine what role pulmonary function tests play in this categorization process, and to identify risk factors for perioperative complications (PCs).METHODS:This was a historical cohort study based on preoperative and postoperative data collected for cases of lung cancer diagnosed or suspected between 2001 and 2010.RESULTS:Of the 239 patients evaluated, only 13 (5.4%) were classified as being at high risk of PCs. Predicted postoperative FEV1 (FEV1ppo) was sufficient to define the risk level in 156 patients (65.3%); however, cardiopulmonary exercise testing (CPET) was necessary for identifying those at high risk. Lung resection was performed in 145 patients. Overall morbidity and mortality rates were similar to those reported in other studies. However, morbidity and mortality rates for patients at an acceptable risk of PCs were 31.6% and 4.3%, respectively, whereas those for patients at high risk were 83.3% and 33.3%. Advanced age, COPD, lobe resection, and lower FEV1ppo were correlated with PCs.CONCLUSIONS:Although spirometry was sufficient for risk assessment in the majority of the population studied, CPET played a key role in the identification of high-risk patients, among whom the mortality rate was seven times higher than was that observed for those at an acceptable risk of PCs. The risk factors related to PCs coincided with those reported in previous studies.OBJETIVO:Determinar as taxas de morbidade e mortalidade por categoria de risco conforme as diretrizes do American College of Chest Physicians, verificar como exames funcionais participaram dessa categorização e identificar fatores de risco para complicações perioperatórias (CPOs).MÉTODOS:Estudo de coorte histórica a partir de avaliações pré e pós-operatórias de casos diagnosticados ou suspeitos de câncer de pulmão avaliados entre 2001 e 2010.RESULTADOS:Dos 239 pacientes avaliados, apenas 13 (5,4%) foram considerados como de alto risco para CPOs. O cálculo do VEF1 previsto para o pós-operatório (VEF1ppo) foi suficiente para a estratificação do risco em 156 pacientes (65,3%); entretanto, o teste de exercício cardiopulmonar (TECP) foi necessário para a identificação de alto risco. Foram operados 145 pacientes, e as taxas globais de morbidade e mortalidade encontradas foram semelhantes às de outros estudos. Entretanto, as taxas de morbidade e mortalidade para aqueles com risco aceitável foram de 31,6% e 4,3%, respectivamente, enquanto as taxas para aqueles com alto risco foram de 83,3% e 33,3%. Idade mais avançada, presença da DPOC, ressecção de um ou mais lobos e VEF1ppo mais baixo estiveram relacionados à ocorrência de CPOs.CONCLUSÕES:Embora a espirometria tenha sido suficiente para a determinação de risco na maioria da população estudada, o TECP teve papel fundamental na identificação de pacientes com risco alto, que apresentaram uma taxa de mortalidade sete vezes maior que os de risco aceitável. Os fatores de risco relacionados a CPOs coincidiram aos relatados em outros estudos.Federal University of São Paulo Department of MedicineArnaldo Vieira de Carvalho Cancer InstituteUNIFESP, Department of MedicineSciEL

Liquid-phase microextraction (LPME): fundamentals and applications to the analysis of drugs in biological samples

The analysis of drugs and metabolites in biological fluids usually requires extraction procedures to achieve sample clean-up and analyte preconcentration. Commonly, extraction procedures are performed using liquid-liquid extraction or solid-phase extraction. Nevertheless, these extraction techniques are considered to be time-consuming and require a large amount of organic solvents. On this basis, microextraction techniques have been developed. Among them, liquid-phase microextraction has been standing out. This review describes the liquid-phase microextraction technique based on hollow fibers as a novel and promising alternative in sample preparation prior to chromatographic or electrophoretic analysis. The basic concepts related to this technique and its applicability in extraction of drugs are discussed

Determination of levetiracetam in human plasma by dispersive liquid-liquid microextraction followed by gas chromatography-mass spectrometry

Levetiracetam (LEV) is an antiepileptic drug that is clinically effective in generalized and partial epilepsy syndromes. The use of this drug has been increasing in clinical practice and intra- or -interindividual variability has been exhibited for special population. For this reason, bioanalytical methods are required for drug monitoring in biological matrices. So this work presents a dispersive liquid-liquid microextraction method followed by gas chromatography-mass spectrometry (DLLME-GC-MS) for LEV quantification in human plasma. However, due to the matrix complexity a previous purification step is required. Unlike other pretreatment techniques presented in the literature, for the first time, a procedure employing ultrafiltration tubes Amicon (R) (10 kDa porous size) without organic solvent consumption was developed. GC-MS analyses were carried out using a linear temperature program, capillary fused silica column, and helium as the carrier gas. DLLME optimized parameters were type and volume of extraction and dispersing solvents, salt addition, and vortex agitation time. Under chosen parameters (extraction solvent: chloroform, 130 mu Ldispersing solvent: isopropyl alcohol, 400 mu Lno salt addition and no vortex agitation time), the method was completely validated and all parameters were in agreement with the literature recommendations. LEV was quantified in patient's plasma sample using less than 550 mu L of organic solvent.Sao Paulo Research Foundation (FAPESP) [2012/07210-8]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, 14040-903 Ribeirão Preto, SP, BrazilDepartment of Exact and Earth Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo, 09972-270 Diadema, SP, BrazilDepartament of Chemistry, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, 14040-901 Ribeirão Preto, SP, BrazilDepartment of Clinical Analysis, Toxicology and Food Science, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, 14040-903 Ribeirão Preto, SP, BrazilDepartment of Exact and Earth Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo, 09972-270 Diadema, SP, BrazilFAPESP: 2012/07210-8Web of Scienc

Evaluation of dispersive liquid–liquid microextraction in the stereoselective determination of cetirizine following the fungal biotransformation of hydroxyzine and analysis by capillary electrophoresis

AbstractWe developed a capillary electrophoresis (CE) and dispersive liquid–liquid microextraction (DLLME) method to stereoselectively analyze hydroxyzine (HZ) and cetirizine (CTZ) in liquid culture media. The CE analyses were performed on an uncoated fused-silica capillary; 50mmolL−1 sodium borate buffer (pH 9.0) containing 0.8% (w/v) S-β-CD was used as the background electrolyte. The applied voltage and temperature were +6kV and 15°C, respectively, and the UV detector was set to 214nm. Chloroform (300µL) and ethanol (400µL) were used as the extraction and disperser solvents, respectively, for the DLLME. Following the formation of a cloudy solution, the samples were subjected to vortex agitation at 2000rpm for 30s and to centrifugation at 3000rpm for 5min. The recoveries ranged from 87.4 to 91.7%. The method was linear over a concentration range of 250–12,500ngmL−1 for each HZ enantiomer (r>0.998) and 125–6250ngmL−1 for each CTZ enantiomer (r>0.998). The limits of quantification were 125 and 250ngmL−1 for CTZ and HZ, respectively. Among the six fungi studied, three species were able to convert HZ to CTZ enantioselectively, particularly the fungus Cunninghamella elegans ATCC 10028B, which converted 19% of (S)-HZ to (S)-CTZ with 65% enantiomeric excess

Determination of Levetiracetam in Human Plasma by Dispersive Liquid-Liquid Microextraction Followed by Gas Chromatography-Mass Spectrometry

Levetiracetam (LEV) is an antiepileptic drug that is clinically effective in generalized and partial epilepsy syndromes. The use of this drug has been increasing in clinical practice and intra- or -interindividual variability has been exhibited for special population. For this reason, bioanalytical methods are required for drug monitoring in biological matrices. So this work presents a dispersive liquid-liquid microextraction method followed by gas chromatography-mass spectrometry (DLLME-GC-MS) for LEV quantification in human plasma. However, due to the matrix complexity a previous purification step is required. Unlike other pretreatment techniques presented in the literature, for the first time, a procedure employing ultrafiltration tubes Amicon® (10 kDa porous size) without organic solvent consumption was developed. GC-MS analyses were carried out using a linear temperature program, capillary fused silica column, and helium as the carrier gas. DLLME optimized parameters were type and volume of extraction and dispersing solvents, salt addition, and vortex agitation time. Under chosen parameters (extraction solvent: chloroform, 130 μL; dispersing solvent: isopropyl alcohol, 400 μL; no salt addition and no vortex agitation time), the method was completely validated and all parameters were in agreement with the literature recommendations. LEV was quantified in patient’s plasma sample using less than 550 μL of organic solvent

Conhecimento de neurociências para a comunidade: Neuroanatomia e memória/aprendizado

O Programa Internacional de Avaliação de Estudantes mostrou que os alunos brasileiros apresentam déficit expressivo em leitura, matemática e ciências. A neurociência tem como objeto de estudo o sistema nervoso e descobertas recentes podem impactar a capacidade cognitiva da população. O projeto "Pílulas de Neurociências para um Cérebro Melhor: Ensino de Neuroanatomia e Aprendizado/Memória em Divinópolis-MG” foi desenvolvido com o objetivo de divulgar as neurociências para comunidade. A proposta extensionista foi desenvolvida por discentes da área da saúde da Universidade Federal de São João del-Rei, Campus Centro-Oeste, em Divinópolis-MG. O objetivo do artigo foi relatar a experiência extensionista do projeto de 2016 à 2020. Escolares, estudantes de cursinhos pré-vestibulares, universitários, professores e a população geral participaram de encontros teóricos e práticos em que puderam discutir sobre anatomia e função cerebral, com foco em mecanismos de memória e aprendizado. O impacto da qualidade do sono, da alimentação, da prática de atividade física, da diminuição do estresse e outros foram discutidos em cerca de setenta ações extensionistas em instituições de ensino, praças públicas e eventos acadêmicos. A interdisciplinaridade e a interprofissionalidade nortearam a abordagem dos temas escolhidos nas ações extensionistas. O diálogo com a comunidade gerou impacto na formação do extensionista e, possivelmente, promoveu transformação social ao empoderar a população quanto à escolhas saudáveis para o cérebro. A consciência do papel social do cidadão escolarizado frente aos desafios da educação no país motivou a ação extensionista e permitiu a devolutiva da universidade pública à sociedade. Palavras-chave: Relações Comunidade-Instituição; Anatomia; Neurofisiologia; Educação Knowledge of neurosciences for the community: Teaching of neuroanatomy and memory/learning mechanisms Abstract: The International Student Assessment Program showed that Brazilian students have significant reading, mathematics, and science deficits. Neuroscience has the nervous system as its object of study, and recent discoveries can impact the cognitive capacity of the population. The project "Neuroscience Pills for a Better Brain: Teaching Neuroanatomy and Learning/Memory in Divinópolis-MG" was developed to disseminate neurosciences to the community. The action proposed was developed by students in the health area of ​​the Federal University of São João del-Rei, Campus Centro-Oeste, in Divinópolis, Minas Gerais state, Brazil. The objective of the article was to report the experience of the project from 2016 to 2020. Schoolchildren, pre-university preparatory courses, university students, teachers, and the general population participated in theoretical and practical meetings, and they could discuss brain anatomy and function, focusing on memory and learning mechanisms. The impact of sleep quality, food, physical activity, stress reduction, and other topics was discussed in about seventy extension actions in schools, public squares, and academic events. Interdisciplinarity and interprofessionality guided the approach to the themes chosen in the actions. The dialogue with the community positively impacted academics and possibly promoted social transformation by empowering the population regarding healthy choices about the brain. The awareness of the social role of the educated citizen in the face the challenges of education in the country motivated the action and allowed the return of the public university to society. Keywords: : Community-Institutional Relations; Anatomy; Neurophysiology; Educatio

Portal de Busca Integrada do SIBiUSP: metodologia de implantação

Relata o estudo, a instalação e implantação de ferramenta de descoberta e entrega do Portal de Busca Integrada, para o Sistema Integrado de Bibliotecas da Universidade de São Paulo (SIBiUSP). Esta nova interface denominada Portal de Busca Integrada possibilita uma nova experiência de pesquisa científica ao usuário final pela recuperação de literatura em diferentes fontes de informação

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio