Deposição de colágeno e formação de sinéquias na prega vocal de suínos após exérese de fragmento de mucosa com laser de CO2 : efeito da mitomicina-C tópica

Orientador: Prof. Dr. Antonio Carlos L. CamposCoorientador: Prof. Dr. João Carlos RepkaCoorientador: Prof. Dr. Jorge Eduardo F. MatiasDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Clínica Cirúrgica. Defesa: Curitiba, 22/12/2004Inclui referências: fls. 50-53Resumo: Introdução:A fonocirurgia a laser de CO2, a partir da alta tecnologia desenvolvida nos últimos anos, tem permitido cirurgias mais precisas e conservadoras. Várias terapias adjuvantes têm sido estudadas na tentativa de modular o processo de cicatrização. Recentemente foi demonstrado que a Mitomicina-C tópica (MTC tópica) reduz a fibrose pós-operatória experimentalmente em diversos modelos animais e no ser humano. Objetivo: Avaliar os efeitos da MTC tópica no processo de cicatrização de pregas vocais de suínos 30 dias após exérese de fragmento de mucosa com laser de CO2 mediante a mensuração da deposição de colágeno e formação de sinéquias. Material e método: Foram estudados 12 suínos jovens (6 machos e 6 fêmeas), separados em 2 grupos: controle (n=6 ) e experimento (n=6 ). Grupo controle, realizada exérese de fragmento de mucosa a laser de CO2 sem o uso da MTC tópica. Grupo experimento: após a exérese de fragmento de mucosa a laser de CO2 foi aplicada MTC tópica. Os procedimentos cirúrgicos a laser de CO2 foram realizado com 2 watts de potência, de forma contínua, no modo focado em superpulso, com microspot de 250?. Após 30 dias os animais foram submetidos à eutanásia e coletadas amostras das pregas vocais para avaliação macroscópica da formação de sinéquias e para análise histológica, a fim de quantificar a deposição de colágeno, mediante coloração de Picrosirius Red, através do programa Pro Image-plus 4.5? acoplado ao microscópio Olympus? BX50. Os resultados foram comparados pelo teste de Wilcoxon, com p?0.05. Resultado: A média da área do colágeno total das pregas vocais do grupo controle foi de 2648,03 ?m2, enquanto a média do colágeno total das pregas vocais, quando utilizada a MTC tópica foi de 2200,30 ?m2, (p = 0,0043). Não houve formação de sinéquias em nenhum animal. Conclusão: A MTC usada topicamente após 30 dias da exérese de fragmento de mucosa da prega vocal a laser de CO2 em suínos diminui, significativamente, a deposição do colágeno total, e não se associa à formação de sinéquias pós cirúrgicas em nenhum dos animais estudados. Palavras-chave: Experimental, Mitomicina-C, Cicatrização, Prega vocal, Suínos, Laser CO2Abstract: Introduction: Laser phonosurgery, due to new technology development over the last years, allowed more conservative and precise surgical procedures. Several adjuvant therapies have been investigated to help modulate the wound healing process. Recently, topical Mitomycin-C.(MTC) has been associated with reduction in post-operative adherences. Objectives: To evaluate the effects of topical MTC on the healing process in vocal folds mucosa of swines after mucosal fragment excision with CO2 laser by measuring collagen deposition and adherence formation in a 30 day period. Material and Method: Twelve larger white pigs were divided into two groups of 6 animals each: control group, where surgical excision was made with CO2 laser without application of topical Mitomycin-C and experimental group, in which MTC was applied after the vocal fold CO2 laser excision. The CO2 laser surgical procedures were performed with 2 watts, in continuous mode and superpulse 250? microspot. After 30 days, by the time of euthanasia, the formation of adherences was evaluated by macroscopic evaluation and the collagen depositions, by Picrosirius Red stain under pollarized light. The histologic examinations were analysed by Pro-Image Plus? 4,5 connected to a Olympus? microscope BX 50. The results were compared using the Wilcoxon test with p? 0,05. Results: The amount of total collagen deposition on the vocal folds in the control groups was 2648,03 ?m2, while the amount of total collagen of vocal folds using MTC was 2200,30 ?2 (p=0,0043). Adherence formation was not observed in any group Conclusion: Topical MTC used after 30 days of parcial excision of swines vocal folds using CO2 laser is associated with a significant decrease in the area of total collagen deposition, without formation of adherences. Key-words: Experiment, Mitomycin-C, Healing, Vocal fold, Swines, CO2 laser

Estudo imunoistoquímico da angiogenese e da fibrogenese na prega vocal de suinos após exerese de fragmento de mucosa utilizando instrumental a frio e laser CO2 /

Orientador: Prof. Dr. Antonio Carlos L. CamposCo-orientador: Prof. Dr. Jorge Eduardo F. MatiasTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Clínica Cirúrgica. Defesa: Curitiba, 2007.Inclui bibliografi

A proposal for using data from antimicrobial prescriptions: the EUREQA experience

This study demonstrates that the use of information from medical prescriptions is essential for understanding the dynamics of community bacterial resistance. The resulting analysis can also influence and help establish more adequate public health policies on the control and optimization of antimicrobial use. The article demonstrates the use of a logical model developed by the EUREQA project for acquisition, classification, interpretation, and analysis of data from prescriptions for oral antimicrobial use.A presente nota pesquisa demonstra que o uso das informações de receituário ou prescrição médica tem fundamental valor para a compreensão das correlações da dinâmica da resistência bacteriana comunitária. Além disso, a análise dos dados gerada pode ajudar a estabelecer medidas e políticas de saúde pública mais adequadas para o controle e a otimização do consumo de antimicrobianos. Para isso, o artigo usa como base o modelo lógico desenvolvido pelo Projeto EUREQA voltado para aquisição, classificação, interpretação e análise das informações relacionadas à prescrição dos antimicrobianos de uso oral.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Instituto Nacional de Pesquisas EspaciaisUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal do Paraná Laboratório de Estatística e GeoinformaçãoUNIFESP, EPMSciEL

A spatial approach for the epidemiology of antibiotic use and resistance in community-based studies: the emergence of urban clusters of Escherichia coli quinolone resistance in Sao Paulo, Brasil

Copyright © Kiffer et al; licensee BioMed Central Ltd. 2011 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background Population antimicrobial use may influence resistance emergence. Resistance is an ecological phenomenon due to potential transmissibility. We investigated spatial and temporal patterns of ciprofloxacin (CIP) population consumption related to E. coli resistance emergence and dissemination in a major Brazilian city. A total of 4,372 urinary tract infection E. coli cases, with 723 CIP resistant, were identified in 2002 from two outpatient centres. Cases were address geocoded in a digital map. Raw CIP consumption data was transformed into usage density in DDDs by CIP selling points influence zones determination. A stochastic model coupled with a Geographical Information System was applied for relating resistance and usage density and for detecting city areas of high/low resistance risk. Results E. coli CIP resistant cluster emergence was detected and significantly related to usage density at a level of 5 to 9 CIP DDDs. There were clustered hot-spots and a significant global spatial variation in the residual resistance risk after allowing for usage density. Conclusions There were clustered hot-spots and a significant global spatial variation in the residual resistance risk after allowing for usage density. The usage density of 5-9 CIP DDDs per 1,000 inhabitants within the same influence zone was the resistance triggering level. This level led to E. coli resistance clustering, proving that individual resistance emergence and dissemination was affected by antimicrobial population consumption

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

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost