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Endovascular treatment of residual or recurrent intracranial aneurysms after surgical clipping
da Silva Júnior Nilton Rocha,Trivelato Felipe Padovani,Nakiri Guilherme Seizem,Rezende Marco Túlio Salles,de Castro-Afonso Luís Henrique,Abud Thiago Giansante,Vanzin José Ricardo,Manzato Luciano Bambi 대한뇌혈관외과학회 2021 Journal of Cerebrovascular and Endovascular Neuros Vol.23 No.3
Objective Total aneurysm occlusion is crucial for the prevention of rebleeding of a ruptured aneurysm or to avoid rupture of an unruptured lesion. Both surgical and endovascular embolization fail to achieve complete aneurysm occlusion in all the cases. The objective of the study was to establish the safety and efficacy of endovascular treatment for previously clipped residual or recurrent aneurysms. Methods This was an observational, retrospective study of patients harboring incompletely occluded intracranial aneurysms after clipping who underwent endovascular treatment. Patients were treated using 4 different techniques: (1) simple coiling, (2) balloon remodeling, (3) stent-assisted coiling, and (4) flow diversion. Analyses were performed to identify predictors of total aneurysm occlusion, recanalization and complications. Results Between May 2010 and September 2018, 70 patients harboring incompletely occluded intracranial aneurysms after clipping met the inclusion criteria in 5 centers. The mean residual aneurysm size was 7.5 mm. Fifty-nine aneurysms were unruptured. Total aneurysm occlusion was achieved in 75.3% of the aneurysms after 1 year. All aneurysms treated with flow diversion revealed complete occlusion according to control angiography. Recanalization was observed in 14.5%. Permanent morbidity and mortality occurred in 2.9% and 1.4% of the patients, respectively. Conclusions Endovascular treatment of recurrent or residual aneurysms after surgical clipping was safe and efficacious. Flow diversion seems to be associated with better anatomical results. A more rigid study, a larger group of patients, and long-term follow-up are required to provide stronger conclusions about the best approach for residual clipped aneurysms.
Ivair Matias Júnior,Priscila Medeiros,Renato Leonardo de Freita,Hilton Vicente-César,José Raniery Ferreira Junior,Hélio Rubens Machado,Rafael Menezes-Reis 대한척추신경외과학회 2019 Neurospine Vol.16 No.2
Objective: Chronic constriction injury (CCI) of the sciatic nerve is a peripheral nerve injury widely used to induce mononeuropathy. This study used machine learning methods to identify the best gait analysis parameters for evaluating peripheral nerve injuries. Methods: Twenty-eight male Wistar rats (weighing 270±10 g), were used in the present study and divided into the following 4 groups: CCI with 4 ligatures around the sciatic nerve (CCI-4L; n=7), a modified CCI model with 1 ligature (CCI-1L; n=7), a sham group (n=7), and a healthy control group (n=7). All rats underwent gait analysis 7 and 28 days postinjury. The data were evaluated using Kinovea and WeKa software (machine learning and neural networks). Results: In the machine learning analysis of the experimental groups, the pre-swing (PS) angle showed the highest ranking in all 3 analyses (sensitivity, specificity, and area under the receiver operating characteristics curve using the Naive Bayes, k-nearest neighbors, radial basis function classifiers). Initial contact (IC), step length, and stride length also performed well. Between 7 and 28 days after injury, there was an increase in the total course time, step length, stride length, stride speed, and IC, and a reduction in PS and IC-PS. Statistically significant differences were found between the control group and experimental groups for all parameters except speed. Interactions between time after injury and nerve injury type were only observed for IC, PS, and IC-PS. Conclusion: PS angle of the ankle was the best gait parameter for differentiating nonlesions from nerve injuries and different levels of injury.
Antinociceptive Action and Redox Properties of Citronellal, an Essential Oil Present in Lemongrass
Lucindo Quintans-Júnior,Ricardo Fagundes da Rocha,Fernanda Freitas Caregnato,José Claudio Fonseca Moreira,Francilene Amaral da Silva,Adriano Antunes de Souza Araújo,João Paulo Almeida dos Santos,Mônic 한국식품영양과학회 2011 Journal of medicinal food Vol.14 No.6
Citronellal (CT) is a monoterpenoid and the major constituent of the mixture of terpenoids that give the citronella oil its lemon scent. Citronella oil is widely used around the world for various purposes and is mainly obtained from plants of the Cymbopogon genus, which are known as “lemongrass.” Considering these plants have been used worldwide for various medicinal purposes, the interest of researchers to understand the biological activities of monoterpenoids related to the Cymbopogon genus has been increasing. In the present work, we investigated the antinociceptive action and the redox properties of CT. Our results indicate that intraperitoneal injection of CT was effective in reducing nociceptive face-rubbing behavior in both phases of the formalin test, which was also naloxone-sensitive. CT also evoked antinociceptive response in the capsaicin and glutamate tests. The total radical-trapping antioxidant parameter and total antioxidant reactivity assays indicate that CT at doses of 0.1 and 1 mg/mL exerts a significant antioxidant activity, which is probably related to its ability to scavenge superoxide and nitric oxide, but not H_2O_2 or hydroxyl radicals, as evaluated separately by specific in vitro tests. These results show for the first time the antinociceptive potential of CT and indicate that the antioxidant properties of this compound may rely on its mechanism of biological actions because CT-containing natural products are used to treat various diseases related to oxidative stress and reactive species.
Carlos Walter Sobrado Júnior,Carlos de Almeida Obregon,Afonso Henrique da Silva e Sousa Júnior,Lucas Faraco Sobrado,Sérgio Carlos Nahas,Ivan Cecconello 대한대장항문학회 2020 Annals of Coloproctolgy Vol.36 No.4
Purpose: Present an updated classification for symptomatic hemorrhoids, which not only guides the treatment of internal hemorrhoids but also the treatment of external components. In addition, this new classification includes new treatment alternatives created over the last few years. Methods: Throughout the past 7 years, the authors developed a method to classify patients with symptomatic hemorrhoids. This study, besides presenting this classification proposal, also retrospectively analyzed 149 consecutive patients treated between March 2011 and November 2013 and aimed to evaluate the association between the management adopted with Goligher classification and our proposed BPRST classification. Results: Both classifications had a statistically significant association with the adopted management strategies. However, the BPRST classification tended to have fewer management discrepancies when each stage of disease was individually analyzed. Conclusion: Although there is much disagreement about how the classification of hemorrhoidal disease should be updated, it is accepted that some kind of revision is needed. The BPRST method showed a strong association with the management that should be adopted for each stage of the disease. Further studies are needed for its validation, but the current results are encouraging.
José Aginaldo de Sousa Júnior,Márcia Luciana Carregosa Santana,Fabricio Eneas Diniz de Figueiredo,André Luis Faria-e-Silva 대한치과보존학회 2015 Restorative Dentistry & Endodontics Vol.40 No.3
Objectives: This study determined the effect of the air-stream application time and the bonding technique on the dentin bond strength of adhesives with different solvents. Furthermore, the content and volatilization rate of the solvents contained in the adhesives were also evaluated. Materials and Methods:Three adhesive systems with different solvents (Stae, SDI, acetone; XP Bond, Dentsply De Trey, butanol; Ambar, FGM, ethanol) were evaluated. The concentrations and evaporation rates of each adhesive were measured using an analytical balance. After acid-etching and rinsing, medium occlusal dentin surfaces of human molars were kept moist (conventional) or were treated with 10% sodium hypochlorite for deproteinization. After applying adhesives over the dentin, slight air-stream was applied for 10, 30 or 60 sec. Composite cylinders were built up and submitted to shear testing. The data were submitted to ANOVA and Tukey’s test (α = 0.05). Results: Stae showed the highest solvent content and Ambar the lowest. Acetone presented the highest evaporation rate, followed by butanol. Shear bond strengths were significantly affected only by the factors of ‘adhesive’ and ‘bonding technique’ (p < 0.05), while the factor ‘duration of air-stream’ was not significant. Deproteinization of dentin increased the bond strength (p < 0.05). Stae showed the lowest bond strength values (p < 0.05), while no significant difference was observed between XP Bond and Ambar. Conclusions: Despite the differences in content and evaporation rate of the solvents, the duration of air-stream application did not affect the bond strength to dentin irrespective of the bonding technique.
The impact of first-trimester intrauterine hematoma on adverse perinatal outcomes
Alberto Borges Peixoto,Edward Araujo Júnior,Taciana Mara Rodrigues da Cunha Caldas,Caetano Galvão Petrini,Ana Cecília Palma Romero,Luciano Eliziário Borges Júnior,Wellington P. Martins 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.4
Purpose: The aim of this study was to evaluate whether the presence of an intrauterinehematoma (IUH) on an early pregnancy ultrasound scan showing a live fetus was related toadverse perinatal outcomes. Methods: We performed a retrospective cohort study to evaluate pregnant women whounderwent an ultrasound examination in early pregnancy, between 6 weeks 0 days and 10weeks 6 days. We compared the perinatal outcomes between women with and without firsttrimester IUH using the Mann-Whitney and Fisher exact tests. Furthermore, we performed astepwise regression analysis to identify possible predictors of miscarriage among maternalcharacteristics, ultrasound parameters, and IUH. Results: During the study period, data from 783 pregnancies were included, and the incidence ofIUH was 4.5% (35 of 783). We observed a higher proportion of miscarriage following the scan(28.6% vs. 10%, P=0.003) and a larger yolk sac diameter during the scan (4.8 mm vs. 3.8 mm,P<0.001) in the pregnant women with first-trimester IUH. There was no significant differenceregard the prevalence of low birth weight (LBW; P=0.091), very LBW (P=0.370), or extremelyLBW (P=0.600) between cases with IUH and without IUH, the cesarean section rate (68% vs. 81%, P=0.130), preterm delivery (16% vs. 16%, P>0.999), or the incidence of first-trimestervaginal bleeding (31% vs. 20%, P=0.130). Moreover, heart rate (HR) was the only variable thatpredicted miscarriage with statistical significance (P=0.017). Conclusion: Women with first-trimester IUH had a higher risk of miscarriage after the ultrasoundscan. HR was the only variable that predicted miscarriage with statistical significance.
Murilo Henrique Souza Leal,André Ricardo Zeist,Nilson Rodrigues Júnior,André Dutra Silva Júnior,José Henrique Verhalem Arantes,Jair Garcia Neto,Julia Roberta Sanches de Pieri,Amanda Carvalho Perrud 한국작물학회 2021 Journal of crop science and biotechnology Vol.24 No.3
Sweet potato (Ipomoea batatas L.) is a root that allows healthy eating and combats malnutrition. There is a need for more productive sweet potato genotypes displaying good resistance and a favorable appearance and shape. New genotypes that are more productive, resistant to the main soil pests and with good physical characteristics would contribute to meet the needs of producers and the demands of consumers. The aim of this study was to develop and select sweet potato genotypes regarding agronomic and physical root parameters. The new genotypes were obtained through the cross-linking of 22 parents with commercial characteristics. Subsequently, 386 experimental genotypes were conducted in the feld in an experimental design consisting of augmented blocks with intercalated controls. Aspects related to agronomic, physical root characteristics and resistance to Euscepes postfasciatus were explored. Genotypes with higher performance than the controls were identifed for all assessed parameters. The genotypes UZBD-K-09, UZBD-K-56 and UZBD-K-78, with purple fesh roots, UZBD-F-15 and UZBD-F-34, with orange fesh, and UZBD-K-70, with a white fesh were selected.
Maurício Mendes Barbosa,Eduardo Félix Martins Santana,Hérbene José Figuinha Milani1,Julio Elito Júnior,Edward Araujo Júnior,Antônio Fernandes Moron,Luciano Marcondes Machado Nardozza 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.4
ObjectiveTo evaluate the initial maternal and perinatal outcomes of fetoscopic laser photocoagulation for the treatment oftwin-to-twin transfusion syndrome (TTTS) in a referral center in Brazil. MethodsThis prospective observational study analyzed 24 fetoscopic laser photocoagulation procedures at 18.26 weeks ofgestation. TTTS severity was determined using the Quintero classification. Blood vessels that crossed the interamnioticmembrane were nonselectively photocoagulated. The χ2 test and Mann-Whitney U test were used for the statisticalanalysis. ResultsThe mean (±standard deviation) age of pregnant women, gestational age at surgery, surgical time, gestational age atbirth, and newborn weight were 32.2±4.1 years, 20.7±2.9 weeks, 51.8±16.7 minutes, 30.5±4.1 weeks, and 1,531.0±773.1g, respectively. Using the Quintero classification, there was a higher percentage of cases in stage III (54.2%), followedby stages IV (20.8%), II (16.7%), and I (8.3%). Ten (41.7%) donor fetuses died and 14 (58.3%) donor fetuses surviveduntil the end of gestation. Placental insertion location (anterior vs. posterior) did not affect the incidence of iatrogenicseptostomy, surface bleeding, and premature rupture of membranes until the end of gestation. The death rate ofdonor and recipient fetuses before 24th gestational week increased with severity of TTTS. ConclusionThe maternal and perinatal outcomes resulting from the implementation of a new minimally invasive surgicaltechnique are in line with those obtained in major centers worldwide, considering the learning curves andinfrastructures.
Tábata Longo da Silva Machado,Alysson Zanatta,Larissa Gonçalves Braz Santos,Rafaella Ferreira de Araújo Litvin,Lizandra Moura Paravidine Sasaki,Júlio Elito Júnior,Edward Araujo Júnior,Alberto Moreno Z 대한산부인과학회 2019 Obstetrics & Gynecology Science Vol.62 No.6
The objective of this study was to evaluate the feasibility of posterior colpotomy for the surgical treatment oftubal ectopic pregnancy in hemodynamically stable women. We performed a retrospective analysis of medicalrecords obtained over a period of 18 months. Twelve cases were identified, with the following characteristics: meangestational age, 7.7 weeks; mean serum β-human chorionic gonadotropin level, 7,786 mIU/mL; and greater diameterof the mass, 15–69 mm. Treatment was successful in all cases. Salpingectomy was performed in 10 patients (83.3%)and salpingostomy, in 1 patient. The remaining patient only received peritoneal lavage, as the evidence of ectopicabortion with only a slightly dilated uterine tube was found during surgery. The mean surgical time was 42.5 minutes. In the analyzed cases, posterior colpotomy was found to be a feasible alternative method for the surgical treatmentof tubal ectopic pregnancy in hemodynamically stable women.