New Paradigms in Endometriosis Surgery of the Distal Ureter

It is estimated that 2% of endometriosis cases involve the urinary tract and that the ureter is involved in up to 30% of these cases, or 0.6% of all endometriosis cases. Increasingly, the standardization and systematization of surgical treatment of endometriosis require the surgeon to have knowledge of the surgical spaces and the ureteral and surrounding pelvic anatomy in order to carry out a cytoreductive surgery that is as possible. A thorough workup is essential for the differentiation of intrinsic or extrinsic endometriosis of the ureter. The use of the resonance imaging preoperatively and ureteroscopy intraoperatively is now considered indispensable. The decision and choice of the best technique will be guided by the diagnosis (intrinsic or extrinsic), the location of the lesions, the length of the involved segment (greater or less than 3 cm), vitality of the ureter stumps, and anastomosis without tension. The main alternatives are ureterolysis and dilatation with balloon catheter which is performed for extrinsic endometriosis more than 85% of the time and ureterectomy for intrinsic endometriosis. To perform the reconstruction, the techniques with end-to-end anastomosis with the distal ureter stump or uretero-vesical reimplantation are used. Increasingly, with better knowledge of the distal ureter anatomy, easier access through laparoscopy and in contradiction to the current recommendations, we are verifying that the end-to-end anastomosis has become the preferred option or procedure of choice for ureteral reconstruction, with ureterovesical reimplantation the second option

Direito, tecnologia e telecomunicações

Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à Lei de Direitos Autorais, não disponibilizamos a obra na íntegra.Localização na estante: 34:004 D598ttCoordenado por: Rodrigo Freitas Palma, Camila Nogueira de Resende Lopes Ribeiro e Fernanda da Rocha Teixeira

Variação na carga de treinamento de força: Ainda há muito para se explicar

Studies have shown that periodic variations in the strength training configuration are more efficient for promoting muscle strength in comparison to training that does not vary over time. Although the evidences point the superiority of the varied training, it’s not clear how the processes that influence the force production are affected when training is performed using variation through the time. The present study aims to discuss the central and peripheral mechanisms that influence the process of force production and to generate insights for new investigations that aim to compare the strength development between the varied and non-varied strength training programs.Estudios han demostrado que las variaciones periódicas en la carga del entrenamiento de son más efectivas para promover la fuerza muscular en comparación con el entrenamiento que no varía la carga con el tiempo. Esta variación se produce al manipular las variables de un programa de entrenamiento, como la intensidad, el volumen, la velocidad de las acciones musculares y el orden de los ejercicios. Aunque la evidencia apunta a la superioridad del entrenamiento variado, no está claro cómo los procesos que influyen en la producción de fuerza se ven afectados cuando el entrenamiento se realiza con cargas variables. Conocer los mecanismos desencadenados por la variación de la carga puede conducir a un entrenamiento más específico hacia los objetivos deseados. Nuestro objetivo es discutir los mecanismos centrales y periféricos que influyen en el proceso de producción de fuerza y generar conocimientos para nuevas investigaciones que tienen como objetivo comparar el desarrollo de la fuerza entre los programas de entrenamiento de fuerza variados y no variados.Estudos demonstraram que as variações periódicas na carga de treinamento de força são mais eficientes para promover força muscular em comparação a treinamentos que não variam a carga ao longo do tempo. Essa variação ocorre pela manipulação das variáveis de um programa de treinamento, como a intensidade, volume, velocidade das ações musculares e ordem dos exercícios. Embora as evidências apontem a superioridade do treinamento variado, não está claro como os processos que influenciam a produção de força são afetados quando o treinamento é realizado com variação de carga. Conhecer os mecanismos desencadeados pela variação da carga ao longo do tempo pode levar a treinamentos mais específicos aos objetivos desejados. Assim, objetivamos discutir os mecanismos centrais e periféricos que influenciam o processo de produção de força e gerar insights para novas investigações que visem comparar o desenvolvimento da força entre os variados e não variados programas de treinamento de força

Treatment-Resistant Hypertension: An Update in Device Therapy

Resistant hypertension (RH) is a clinical condition in which the hypertensive patient has become resistant to drug therapy and is often associated with increased cardiovascular morbidity and mortality. Several signaling pathways have been studied and related to the development and progression of RH: modulation of sympathetic activity by leptin and aldosterone, primary aldosteronism, arterial stiffness, endothelial dysfunction, and variations in the renin-angiotensin-aldosterone system (RAAS)

Blocking of Connexin-Mediated Communication Promotes Neuroprotection during Acute Degeneration Induced by Mechanical Trauma

Accruing evidence indicates that connexin (Cx) channels in the gap junctions (GJ) are involved in neurodegeneration after injury. However, studies using KO animal models endowed apparently contradictory results in relation to the role of coupling in neuroprotection. We analyzed the role of Cx-mediated communication in a focal lesion induced by mechanical trauma of the retina, a model that allows spatial and temporal definition of the lesion with high reproducibility, permitting visualization of the focus, penumbra and adjacent areas. Cx36 and Cx43 exhibited distinct gene expression and protein levels throughout the neurodegeneration progress. Cx36 was observed close to TUNEL-positive nuclei, revealing the presence of this protein surrounding apoptotic cells. The functional role of cell coupling was assessed employing GJ blockers and openers combined with lactate dehydrogenase (LDH) assay, a direct method for evaluating cell death/viability. Carbenoxolone (CBX), a broad-spectrum GJ blocker, reduced LDH release after 4 hours, whereas quinine, a Cx36-channel specific blocker, decreased LDH release as early as 1 hour after lesion. Furthermore, analysis of dying cell distribution confirmed that the use of GJ blockers reduced apoptosis spread. Accordingly, blockade of GJ communication during neurodegeneration with quinine, but not CBX, caused downregulation of initial and effector caspases. To summarize, we observed specific changes in Cx gene expression and protein distribution during the progress of retinal degeneration, indicating the participation of these elements in acute neurodegeneration processes. More importantly, our results revealed that direct control of GJ channels permeability may take part in reliable neuroprotection strategies aimed to rapid, fast treatment of mechanical trauma in the retina.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Universidade Federal do ABC (UFABC)Universidade Federal do ABC (UFABC)Universidade de Sao Paulo (USP)Universidade de Sao Paulo (USP

TOXICIDADE DE AGENTES CLAREADORES SOBRE STREPTOCOCCUS MUTANS

Embora os agentes de clareamento dental venham sendo utilizados extensivamente, efeitos biológicos adversos sobre estruturas do organismo e bactérias têm sido reportados. Objetivo deste estudo foi avaliar a toxicidade in vitro de agentes clareadores [peróxido de carbamida 16% (PC) e peróxido de hidrogênio 35% (PH)] sobre Streptococcus mutans crescido em fase planctônica e biofilme em dois tempos de exposição continuada. Os resultados foram submetidos aos testes Kruskal-Wallis e U de Mann-Whitney (p<0,05). Os grupos PH, PC, e seus excipientes demonstraram efeito bactericida para as células em fase planctônicas, nos dois tempos. PC e PH apresentaram efeito bactericida em biofilme.. Os tratamentos com excipientes apresentaram redução tempo-dependente na viabilidade de células crescidas em biofilme para todos os períodos de tempo. Os agentes clareadores e seus excipientes apresentaram toxicidade para Streptococcus mutans crescido em fase planctônica e em biofilme, nos dois tempos investigados.  

Gene delivery to Nile tilapia cells for transgenesis and the role of PI3K-c2α in angiogenesis

Microinjection is commonly performed to achieve fish transgenesis; however, due to difficulties associated with this technique, new strategies are being developed. Here we evaluate the potential of lentiviral particles to genetically modify Nile tilapia cells to achieve transgenesis using three different approaches: spermatogonial stem cell (SSC) genetic modification and transplantation (SC), in vivo transduction of gametes (GT), and fertilised egg transduction (ET). The SC protocol using larvae generates animals with sustained production of modified sperm (80% of animals with 77% maximum sperm fluorescence [MSF]), but is a time-consuming protocol (sexual maturity in Nile tilapia is achieved at 6 months of age). GT is a faster technique, but the modified gamete production is temporary (70% of animals with 52% MSF). ET is an easier way to obtain mosaic transgenic animals compared to microinjection of eggs, but non-site-directed integration in the fish genome can be a problem. In this study, PI3Kc2α gene disruption impaired development during the embryo stage and caused premature death. The manipulator should choose a technique based on the time available for transgenic obtainment and if this generation is required to be continuous or not. © The Author(s) 2017

Decoding resistant hypertension signalling pathways

Resistant hypertension (RH) is a clinical condition in which the hypertensive patient has become resistant to drug therapy and is often associated with increased cardiovascular morbidity and mortality. Several signalling pathways have been studied and related to the development and progression of RH: modulation of sympathetic activity by leptin and aldosterone, primary aldosteronism, arterial stiffness, endothelial dysfunction and variations in the renin–angiotensin–aldosterone system (RAAS). miRNAs comprise a family of small non-coding RNAs that participate in the regulation of gene expression at post-transcriptional level. miRNAs are involved in the development of both cardiovascular damage and hypertension. Little is known of the molecular mechanisms that lead to development and progression of this condition. This review aims to cover the potential roles of miRNAs in the mechanisms associated with the development and consequences of RH, and explore the current state of the art of diagnostic and therapeutic tools based on miRNA approaches

INFLUÊNCIA DAS CARACTERÍSTICAS FÍSICAS NA DETERMINAÇÃO DE PARÂMETROS HIDRÁULICOS DE RESÍDUOS SÓLIDOS URBANOS

Nos projetos de aterros sanitários brasileiros são utilizados parâmetros de resíduos advindos de países europeus e da América do Norte. Entretanto, os resíduos possuem características diferenciadas conforme a renda da população, hábitos culturais, clima, entre outros. A fim de melhorar os procedimentos relativos à disposição dos resíduos sólidos urbanos (RSU) em aterros sanitários, faz-se necessário a determinação de parâmetros de acordo com a realidade brasileira. Neste contexto, objetivou-se neste trabalho avaliar a influência da composição gravimétrica e do peso específico (γ) no valor da condutividade hidráulica (k) e da capacidade de campo (θ) de resíduos sólidos urbanos (RSU). Amostras de RSU foram coletadas na usina de triagem e compostagem (UTC) da cidade de Nazareno e também de restaurantes da cidade de Lavras, no estado de Minas Gerais, no Brasil. O artigo apresenta detalhes do equipamento desenvolvido, bem como da metodologia usada e os resultados encontrados. As conclusões apontam que o equipamento mostrou-se adequado para os procedimentos adotados. Além disso, pode-se concluir que houve uma diminuição da condutividade hidráulica e um aumento da capacidade de campo para as amostras de RSU com maior peso específico. Porém, não foram observadas variações significativas desses parâmetros em relação à composição gravimétrica, provavelmente devido ao tipo e qualidade dos materiais utilizados

Severe cardiac insufficiency secondary to cardiotoxicity with clinical and morpho-functional improvement after optimised clinical treatment: case report

Many therapies used for cancer (pathology whose cases are progressively increasing in the world) such as chemotherapy and radiotherapy have numerous adverse effects, with cardiotoxicity being one of the most important. This can be defined from the detection, by an imaging method, of a reduction of at least 10% in the left ventricular ejection fraction (LVEF), bringing it to a value below 53%. Anthracyclines (such as Doxorubicin), Trastuzumab, and Taxanes (Docetaxel) are among the most associated chemotherapeutics. To emphasize the importance of optimized treatment for heart failure and to review the main updates on the theme of cardiotoxicity. Case report and bibliographic review on the latest updates to the management of cardiotoxicity and associated heart failure. When correctly identifying the main risk factors associated with chemotherapy and the individual to develop myocardial injury, it is possible to perform the monitoring by means of two main predictors: the myocardial tension strength and the biomarkers. In this sense, changes associated with these predictors may allow early intervention through appropriate treatment and, with the advancement of research, even prevention, mainly using the association of Carvedilol with Enalapril. Continuous monitoring and early initiation of drug therapy for heart failure are clearly associated with a lower degree of myocardial injury and a lower rate of complications. In addition, there is still an increasingly promising possibility in relation to preventive drug therapy, however, there is still a lack of studies on this topic