Radiological treatment of HCC: Interventional radiology at the heart of management

International audience

Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?

International audience

Le diagnostic anténatal modifie-t-il la prise en charge néonatale et le devenir à 1 an des enfants suivis pour atrésie de l’œsophage de type III ?

International audience

Efeito da intensidade luminosa no desenvolvimento larval do camarão-da-amazônia, Macrobrachium amazonicum

The effects of four light intensities (0; 2.8 +/- 0.9; 5,5 +/- 1,8 e 7,8 +/- 2,5 mu mol s(-1) m(-2), about 136.5 +/- 87.5; 273 +/- 43.8 e 390 +/- 125 lux, respectively) on survival, productivity, weight gain and larval development of Macrobrachium amazonicum were investigated. Four treatments with three replicate tanks were evaluated. Newly hatched larvae were held in black tanks (80.2 +/- 0.6 larvae L(-1)) filled with 50-L-brackish water (salinity of 10), in a recirculating system. Tanks were covered with shadow cloth allowing 35% and 70% light, respectively, to reach light intensities of 2.8 +/- 0.9 and 5.5 +/- 1.8 mu mol s(-1) m(-2) at the water surface. Complete absence of light (0 mu mol s(-1) m(-2)) was obtained covering the tanks with opaque black plastic, and full-light condition used no covering (7.8 +/- 2.5 mu mol s(-1) m(-2)). Observations showed that the survival rate was not affected by light intensity. Productivity and weight gain were higher under 7.8 +/- 2.5 mu mol s(-1) m(-2) light intensity than under 0 and 2.8 +/- 0.9 1 mu mol s(-1) m(-2) intensities (P<0.05). The larval development index was similar among the treatments under the different light intensities. However, from stage VII this index was increased slightly in the treatment under 7.8 +/- 2.5 mu mol s(-1) m(-2) light intensity. In conclusion, light intensity affects larval development of M. amazonicum. Values as high as 7.8 mu mol s(-1) m(-2) (about 390 lux) improve the larval performance by enhancing development, productivity and weight gain compared to lower values.

De-escalação da antibioterapia na sépsis grave e choque séptico numa unidade de cuidados intensivos : estudo epidemiológico no serviço de medicina intensiva do Hospital de Santa Maria

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Ratio of hemocomponents in massive transfusion and mortality of trauma patients in a university hospital

Background: Nowadays, there are very few studies about massive transfusion in our country. This situation generates the necessity to the elevation of possible new strategies to diminish mortality and its adverse effects. Material and methods: All massive transfusions were evaluated in a retrospective way from October 2010 to October 2012. All diagnosis groups were recorded and the patients were divided into three groups depending on the ratio between packed red blood cells (PRBC) and fresh frozen plasma (FFP) units (ratios ≤2, >2, and without FFP). Their mortality and/or survival were evaluated 30 days after as well as all the factors associated with the event. Results: A total of 69 patients were included (37 trauma patients, 28 gunshot wounds and 4 with lacerated wounds); the groups (ratios ≤2, >2, and no plasma at all) were distributed as follows: 30, 30 and 9 patients each, with an overall mortality rate of 60.8% within 30 days. A lower survival rate (12%) in the no plasma group (P=.015) was found and systolic blood pressure during transfusion had a mean of 67.7 mmHg (P=.012) in this group. Fresh frozen plasma units were 136 and 249 for >2 and ≤2 ratios respectively (P<.01); 85.5% of all patients developed metabolic acidosis during the transfusion, and the number of days in the hospital after the event had a mean of 24.5 days in all patients. Conclusions: High rates of massive transfusion mortality are still being reported in our ield. The use of transfusion strategies contribute to elevate the survival rate in patients with massive transfusion treatment

Usefulness of clinical observations and blood chemistry values for predicting clinical outcomes in dairy goats with pregnancy toxaemia

Background Pregnancy toxaemia (PT) is a disease that affects pregnant goats during their last month of gestation and is characterized by a high case fatality rate. This study involved 32 does maintained on a commercial dairy goat farm that were diagnosed with PT. A physical examination was performed on and haematology parameters obtained from each doe, at the time of diagnosis. The data from the 24 PT goats that died was compared with the corresponding data from the 8 PT goats that survived. Results Polypnea, swollen limbs, anorexia with absence of ruminal motility, recumbency, nervous signs and drooping ears were the most frequently observed clinical manifestations. Nineteen out of 21 recumbent goats died. Sixteen out of 17 goats with anorexia and absence of ruminal motility died. Mean beta-hydroxybutyric acid (BHBA) values in the goats that died were not significantly different from those in goats that survived. The blood values for pH and pCO2 (p < 0.005) as well as for HCO3 −, BE and K+ (p < 0.001) were significantly lower in the goats that died than in those that survived. Conclusions The clinical signs most indicative of a poor prognosis are anorexia with absence of ruminal motility and recumbency. Among the blood parameters to be considered, hypokalaemia and metabolic acidosis are the most relevant. Goats with PT have a high mortality and their condition can deteriorate very fast. Based on the authors’s experience, a good strategy to minimize the economic losses caused by PT is to focus on the offspring survival rate since an early decision (induction of kidding or caesarian surgery) can increase the number of alive kids.

Experience of a Single Center in NTBC Use in Management of Hereditary Tyrosinemia Type I in Libya

Background: Hereditary Tyrosinemia type I (HTI) is a metabolic disease caused by deficiency of fumarylacetoacetate hydrolase enzyme. Objectives: This study reports beside its clinical and biochemical presentation, the outcome of NTBC [2- (2-nitro-4-trifloro-methylbenzoyl)-1, 3-cyclohexanedion] treatment of the disease and evaluates its biochemical markers in 16 pediatric Libyan patients. Patients and Methods: The diagnosis was based on presence of high tyrosine levels in blood and succinylacetone in urine. Results: The consanguinity rate was 81.2%, the median age at onset, at diagnosis and at starting treatment were 4.5, 8, and 9.5 months respectively. At presentation hepatomegaly, jaundice, rickets and high gamma glutamyl transferase (GGT) were observed in 87.5% of patients. All patients had extremely high alpha fetoprotein (AFP) and high alkaline phosphatase (ALP) levels. Fifteen patients were treated with NTBC, normalization of PT (Prothrombine time) was achieved in average in 14 days. The other biochemical parameters of liver function (transaminases, GGT, ALP, bilirubin and albumin) took longer to improve and several months to be normalized. Survival rate with NTBC was 86.6%. Patients who started treatment in a median of 3 months post onset observed a fast drop of AFP in 90.6% of patients (P = 0.003). Abnormal liver function and rickets were the common presentations, GGT was an early cholestatic sensitive test. ALP was constantly high even in asymptomatic patients. Conclusions: In HT1 a faster dropping of AFP is a marker of good prognosis.

Evaluation of Neurodevelopment and Factors Affecting it in Children With Acyanotic Congenital Cardiac Disease

Background: The rate of congenital heart disease is 0.8% in all live births. The majority of this, however, is acyanotic congenital heart disease. The survival rate of children with cardiac disease has increased with the developments provided in recent years and their lifetime is extended. Objectives: This study aims to evaluate neurodevelopment of children with uncomplicated acyanotic congenital heart disease in preschool period and determine the factors affecting their neurodevelopmental process. Patients and Methods: 132 children with acyanotic congenital heart disease aged 6 - 72 months were involved in the study. Mental development and intelligence levels of patients under 2 years old were assessed by using Bayley Development Scale-III, and Stanford Binet Intelligence test was employed for patients over 2 years old. Denver Developmental Screening Test II was applied to all patients for their personal-social, fine motor, gross motor and language development. Results: The average age of patients (67 girls, 65 boys) included in the study was 35.2 ± 19.6 months. It was determined that there were subnormal mental level in 13 (10%) patients and at least one specific developmental disorder in 33 (25%) patients. Bayley Mental Development Scale score of patients who had received incubator care in perinatal period was found significantly low (88 ± 4.2) compared to those with no incubator care (93.17 ± 8.5) (P = 0.028). Low educational level of father was established to be linked with low mental development scores at the age of 2 and following that age (P < 0.05). Iron deficiency anemia was discovered to be related to low psychometric test scores at every age (P < 0.05). Conclusions: Neurodevelopmental problems in children with acyanotic congenital heart disease were found higher compared to those in society. Mental development and intelligence levels of patients were determined to be closely associated with receiving incubator care, father’s educational level and iron deficiency anemia.

Clinical Studies on conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor in second-line treatment of non-small cell lung cancer

Purpose: To study the effect of conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in the second-line treatment of non-small cell lung cancer (NSCLC). Methods: A total of 316 patients attending Shanghai Pulmonary Hospital affiliated to Tongji University, were divided into two groups: 106 patients were treated with conformal radiotherapy combined with EGFR-TKI (gefitinib, 250 mg/day; or erlotinib, 150 mg/day), while 210 patients were treated with EGFRTKI alone. Some factors, including adverse reactions (AR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and one-year and two-year survival rate, were evaluated. Results: No obvious difference was observed in AR between the two groups (p > 0.05). In the combination therapy group, complete response (CR) was 5 cases, partial response (PR) 43 cases, and stable disease (SD) 47 cases, progressive disease (PD) was 11 cases, response rate (RR) was 45.3 %, and DCR 89.6 %. Median PFS in the combination therapy group and targeted therapy group was 6.5 and 5.0 months, respectively. On the other hand, median OS in the combination therapy group and targeted group was 14.1 and 12.6 months, respectively. One-year survival rate of the combination therapy group and EGFR-TKI group was 60.3 and 50.0 %, respectively, while the two-year survival rate was 26.3 and 19.0 %, respectively. Conclusion: Conformal radiotherapy combined with EGFR-TKI can be used as an effective second-line treatment for NSCLC.

Sexagem histológica e desempenho de Oreochromis niloticus testando diâmetros de ração de acordo com o aparato bucal

Estudou-se o tamanho da boca de larvas de tilápia-do-nilo e testou-se o efeito de diferentes granulometrias da ração sobre o ganho de peso, comprimento e sobrevivência das larvas aos 30 e 60 dias de arraçoamento. Avaliou-se também o método de sexagem por meio de microscopia de luz aos 35 dias de idade. A medida da boca das larvas apresentou valores médios de 918,2±152,9μm aos cinco dias de idade. de acordo com esse dado, testaram-se três granulometrias: 0,25, 0,35 e 0,50mm. Aos 30 e aos 60 dias de arraçoamento, 10% das larvas foram medidas, pesadas e contadas para cálculo da taxa de sobrevivência. O tamanho dos grânulos testados não afetou o desempenho das larvas de tilápia nilótica com alimentação iniciada aos cinco dias pós-eclosão. Quanto à sexagem histológica aos 35 dias de idade, as gônadas apresentaram-se, em sua maioria, indiferenciadas. Recomenda-se que essa análise deva ser realizada de acordo com o tamanho dos animais e não com a idade.

Custos e rentabilidade da produção de juvenis de tilápia-do-nilo em tanques-rede utilizando-se diferentes densidades de estocagem

Neste trabalho foi realizada a análise econômica da produção de juvenis de tilápia-do-nilo em tanques-rede utilizando-se diferentes densidades de estocagem. O experimento foi desenvolvido em área aquícola, em delineamento de blocos casualizados, com quatro densidades de estocagem (100, 200, 300 e 400 peixes m-3), avaliadas com seis repetições, em dois períodos de criação: de março a abril de 2005 (52 dias - peso inicial de 43,08 ± 2,98 g e peso final de 262,14 ± 47,86 g) e de março a abril de 2006 (58 dias - peso inicial de 43,16 ± 5,34 g e peso final 314,24 ± 73,30 g). Foram avaliadas as seguintes variáveis econômicas: custo da ração mais custo do juvenil dividido pela biomassa, em R$ kg-1; porcentagem do custo da ração por quilo de peixe produzido sobre o preço de venda; porcentagem do custo do juvenil por quilo de peixe produzido sobre o preço de venda e; porcentagem dos custos da ração mais do juvenil por quilo de peixe produzido sobre o preço de venda. da menor densidade de estocagem (100) para a maior (400), ocorreu diminuição no ganho de peso diário e elevação do índice de conversão alimentar aparente, mas essa redução não comprometeu a taxa de sobrevivência. Entretanto, o ganho de biomassa aumentou com o adensamento de peixes. As maiores receitas líquidas foram obtidas nas densidades de estocagem de 100 e 200 peixes m-3. Os preços não remuneraram os custos operacionais (efetivo e total) em maiores densidades (300 e 400 peixes m-3). Os melhores resultados para a produção de juvenis de tilápia-do-nilo foram obtidos com densidades de até 200 peixes m-3.

Influence of food restriction on the reproduction and larval performance of matrinxã, Brycon amazonicus (Spix and Agassiz, 1829)

Este estudo avaliou o efeito da restrição alimentar e realimentação na reprodução de fêmeas e no crescimento inicial e sobrevivência de larvas de matrinxã, Brycon amazonicus. Matrizes distribuídas em 8 viveiros (15 peixes/tanque) foram alimentadas diariamente (em 4 tanques - G1) e alimentados em ciclos de 3 dias de alimentação seguidos de 2 dias de restrição (em 4 tanques - G2) por 6 meses antes da desova. Na indução à desova, 57% das fêmeas no G1 e 45% no G2 desovaram. Os pesos médios dos oócitos foram 208,1 g (G1) e 131,6 g (G2), sendo os oócitos G2 menores (1,017 ± 0,003 mm) que os oócitos de G1 (1,048 ± 0,002 mm). As taxas de fertilização (71,9 ± 12,6% e 61,2 ± 13,7%) e de eclosão (61,3 ± 33,9% e 67,5 ± 23,4%) entre os G1 e G2 não diferiram. Larvas foram coletadas na eclosão e às 24, 48 e 72 horas de incubação para medida do crescimento e as restantes transferidas para aquários e amostradas 1, 5, 9 e 15 dias depois. Na transferência, as larvas G1 e G2 tinham pesos similares (1,5 ± 0,15 e 1,46 ± 0,07 mg), mas o comprimento das larvas G2 era maior (6,2 ± 0,13 e 6,7 ± 0,14 mm). Ao 9° dia, quando é recomendada a transferência dos juvenis para tanques externos, os juvenis G2 tinham peso (13,6 ± 0,26 e 18,9 ± 0,07 mg) e comprimento (11,8 ± 0,09 e 14,5 ± 0,04 mm) maiores, mas no 15º dia os juvenis G1 eram maiores em peso (90,2 ± 1,19 e 68,6 ± 0,77 mg) e comprimento (18,8 ± 0,16 e 18,5 ± 0,04 mm). Aos 15 dias, a prole das fêmeas submetidas à restrição alimentar apresentou sobrevivência mais alta que a prole das fêmeas alimentadas diariamente (24,7 ± 2,07% e 19,2 ± 1,91%). A restrição alimentar imposta às fêmeas de matrinxã, apesar de reduzir o número de fêmeas que desovaram e a quantidade de oócitos extrusados, não afetou a fertilização e eclosão das larvas e melhorou a sobrevivência final das larvas.

Parasitology of juvenile mullet (Mugil liza) and effect of formaldehyde on parasites and host

Few studies have been performed with parasites of marine and estuarine fish in southern Brazil. In the present study, unpublished results show the ways of parasitism of juvenile mullet by parasites. The toxicity of formaldehyde and the effectiveness of this chemotherapy in controlling parasites in reared juvenile mullet Mugil liza were also studied. Juvenile mullets (1 +/- 0.26 g; 4.1 +/- 0.4 cm) were exposed to different concentrations of 37% formaldehyde: control group and five formaldehyde concentrations which were tested: T1 (13.5), T2 (21.6), T3 (40.5), T4 (81) and T5 (135) mg L-1 with 8 fish per repetition in triplicate. To verify the drug effectiveness in parasitic control, juvenile mullets were exposed to 1 h prophylactic bath of 37% formaldehyde with a control group and five formaldehyde concentrations: T1 (67.5), T2 (135), T3 (270), T4 (405) and T5 (540) mg L-1, 8 fish per repetition in triplicate. Ligophorus cf. uruguayensis (Monogenoidea: Ancyrocephalidae) and Solostamenides cf. platyorchis (Monogenoidea: Microcotylidae) were identified in the gills. Digenea and Nematoda were observed in the intestines. This is the first occurrence of S. cf. platyorchis in Brazil. During the toxicity test, the LC50-96 h was estimated at 20.77 mg L-1 of formaldehyde. During the 1 h formaldehyde prophylactic bath, all parasites were eliminated in formaldehyde concentrations between 135 and 540 mg L-1. High survival rate was observed in all treatments. Values of prevalence and intensity of infestation observed in this study showed the potential damage caused by Monogenoidea to mullet. Formaldehyde baths with 135 mg L-1 are recommended to control Monogenoidea in mullet and the safe limits for formaldehyde use were presented. Besides, the endoparasites were tolerant to formaldehyde exposure. (C) 2012 Elsevier B.V. All rights reserved.

Superexpressão do gene dehidrina de Arachis duranensis em plantas transgênicas de Arabidopsis thaliana

Dissertação (mestrado)—Universidade de Brasília, Departamento de Botânica, Programa de Pós-Graduação em Botânica, 2016.