Tag: pubmed

Arq Bras Cir Dig. 2022 Jan 5;34(3):e1621. doi: 10.1590/0102-672020210002e1621. eCollection 2022.

ABSTRACT

BACKGROUND: Multimodal therapy with neoadjuvant chemoradiotherapy, followed by esophagectomy has offered better survival results, compared to isolated esophagectomy, in advanced esophageal cancer. In addition, patients who have a complete pathological response to neoadjuvant treatment presented greater overall survival and longer disease-free survival compared to those with incomplete response.

AIM: To compare the results of overall survival and disease-free survival among patients with complete and incomplete response, submitted to neoadjuvant chemoradiotherapy, with two therapeutic regimens, followed by transhiatal esophagectomy.

METHODS: Retrospective study, approved by the Research Ethics Committee, analyzing the medical records of 56 patients with squamous cell carcinoma of the esophagus, divided into two groups, submitted to radiotherapy (5040 cGY) and chemotherapy (5-Fluorouracil + Cisplatin versus Paclitaxel + Carboplatin) neoadjuvants and subsequently to surgical treatment, in the period from 2005 to 2012, patients.

RESULTS: The groups did not differ significantly in terms of gender, race, age, postoperative complications, disease-free survival and overall survival. The 5-year survival rate of patients with incomplete and complete response was 18.92% and 42.10%, respectively (p> 0.05). However, patients who received Paclitaxel + Carboplatin, had better complete pathological responses to neoadjuvant, compared to 5-Fluorouracil + Cisplatin (47.37% versus 21.62% – p = 0.0473, p <0.05).

CONCLUSIONS: There was no statistical difference in overall survival and disease-free survival for patients who had a complete pathological response to neoadjuvant. Patients submitted to the therapeutic regimen with Paclitaxel and Carboplastin, showed a significant difference with better complete pathological response and disease progression. New parameters are indicated to clarify the real value in survival, from the complete pathological response to neoadjuvant, in esophageal cancer.

PMID:35019133 | DOI:10.1590/0102-672020210002e1621

Arq Bras Cir Dig. 2022 Jan 5;34(3):e1606. doi: 10.1590/0102-672020210003e1606. eCollection 2022.

ABSTRACT

RATIONAL: The metabolic response to surgical trauma is enhanced by prolonged preoperative fasting, contributing to increased insulin resistance. This manifestation is more intense on the 1st and 2nd postoperative days and is directly proportional to the size of the operation.

AIM: To compare whether preoperative fasting abbreviation and early postoperative refeeding associated with intraoperative and postoperative fluid restriction interfere in the evolution of patients undergoing gastrojejunal bypass.

METHODS: Eighty patients indicated for Roux-en-Y gastrojejunal bypass were selected. They were randomly divided into two groups: Ringer Lactate (RL) group, who underwent a 6 hours solids fasting, with the administration of 50 g of maltodextrin in 100 ml of mineral water 2 hours before the beginning of anesthesia; and Physiologic Solution (PS) group, who underwent a 12 hours solids and liquids fasting. Anesthesia was standardized for both groups. During the surgical procedure, 1500 ml of ringer lactate solution was administered in the RL and 2500 ml of physiological solution (0.9% sodium chloride) in the PS. In both groups, the occurrence of bronchoaspiration was analyzed during intubation, and the residual gastric volume was measured after opening the abdominal cavity. In the postoperative period in Group RL, patients started a liquid diet 24 hours after the end of the operative procedure; whilst for PS group, fasting was maintained for the first 24 hours, it was prescripted 2000 ml of physiological solution and a restricted liquid diet after 36 hours. Each patient underwent CPK, insulin, sodium, potassium, urea, creatinine, PaCO2, pH and bicarbonate dosage in the immediate postoperative period, and 48 hours later, the exams were repeated.

RESULTS: There were no episodes of bronchoaspiration and gastrojejunal fistulas in either group. In the analysis of the residual gastric volume of the PS and RL groups, the mean volumes were respectively 16.5 and 8.8, which shows statistical significance between the groups. In laboratory tests, there was no difference between groups in sodium; PS group showed a higher level of serum potassium (p=0.029); whilst RL group showed a higher urea and creatinine values; CPK values were even for both; PS group demonstrated a higher insulin level; pH was higher in PS group; sodium bicarbonate showed a significant difference at all times; PaCO2 values in RL group was higher than in PS. In the analysis of the incidence of nausea and flatus, no statistical significance was observed between the groups.

CONCLUSIONS: The abbreviation of preoperative fasting and early postoperative refeeding of Roux-en-Y gastrojejunal bypass with the application of ERAS or ACERTO Project accelerated the patient’s recovery, reducing residual gastric volume and insulin level, and do not predispose to complications.

PMID:35019120 | DOI:10.1590/0102-672020210003e1606

Arq Bras Cir Dig. 2022 Jan 5;34(3):e1615. doi: 10.1590/0102-672020210002e1615. eCollection 2022.

ABSTRACT

BACKGROUND: Obesity and bariatric surgery may be related with mental and oral disorders.

AIM: To evaluate the impact of bariatric surgery on anxiety, initial dental caries lesion and gingival bleeding in obese patients.

METHODS: Eighty-nine patients were divided in two groups: Control Group (CG) – obese patients and Experimental Group (EG) – patients submitted to bariatric surgery. EG was analyzed before and 12 months after bariatric surgery; for the CG, was respected an interval of 12 months between the evaluations. International Caries Detection and Assessment System, Gingival Bleeding Index and Trace-State Anxiety Inventory were used. Medical profile, anthropometrics data, sociodemographic and behavioral variables were considered.

RESULTS: There were no statistically significant differences between groups in evaluation times regarding to initial dental caries lesion and anxiety. However, the number of teeth with initial dental caries lesion (p=0.0033) and gingival bleeding (p<0.0001) increased significantly after bariatric surgery in EG.

CONCLUSION: These results reinforce the need for multi-professional team follow-up, including dental care, for both obese and bariatric patients.

PMID:35019127 | DOI:10.1590/0102-672020210002e1615

Arq Bras Cir Dig. 2022 Jan 5;34(3):e1591. doi: 10.1590/0102-672020210003e1591. eCollection 2022.

ABSTRACT

BACKGROUND: Abdominal obesity or android obesity, that is, the increase in adipose tissue in the abdominal region, is considered a risk factor for several morbidities. Different ways of quantifying it have been proposed, one method is the measurement of the abdominal fat area by computed tomography.

AIM: To establish correspondence between the groups defined by degree of obesity in relation to the total, subcutaneous and visceral fat area.

METHODS: Cross-sectional observational study carried out through the analysis of tomographic examinations. Horos v3.3.5 medical image visualization software was used, with abdominal tomography in a single cut including the L4 vertebral body and the umbilical scar, to obtain the areas of total, visceral and subcutaneous fat.

RESULTS: Of the 40 patients, 10 had grade II obesity, 23 grade III and 7 superobese. The amount of total fat showed an increase in relation to the degree of obesity. Visceral fat did not show significant differences between the degrees of obesity, but the data showed a lower average in the group of obesity grade II. The area of subcutaneous fat, as well as total fat, showed an increase in its measurements, according to the progression of the patients’ BMI, but there was no statistical significance in this difference between the groups of grade II and super-obese individuals.

CONCLUSION: The area of total and subcutaneous fat showed an increase in its measurements according to the progression of the BMI groups, which did not happen with visceral fat.

PMID:35019117 | DOI:10.1590/0102-672020210003e1591

Codas. 2022 Jan 7;34(3):e20210057. doi: 10.1590/2317-1782/20212021057. eCollection 2022.

ABSTRACT

PURPOSE: Develop new lists of monosyllables for conducting logoaudiometric tests in Portuguese, perform content validation, considering ear side and education and check the equivalence between the lists.

METHODS: Were selected 125 monosyllables with different syllabic structures, which were submitted to the content validation process, which included judgment on familiarity, organization of lists, recording of material and auditory recognition. After content validation, the monosyllable lists were subjected to equivalence research, in order to obtain evidence of reliability for the proposed test instrument.

RESULTS: Five lists with 25 monosyllables were elaborated and analyzed for content, of these, four lists were validated. There was no statistically significant difference between the responses obtained in the right and left ears. The education of the subjects did not influence the recognition of words. As for the equivalence search, it was found that two lists were equivalent, one not equivalent, but similar and one list was different from the others, and then excluded.

CONCLUSION: Two monosyllable lists were validated for content and considered equivalent, with the same level of difficulty between them, and one list was considered similar, which can be used as training to apply the test on the audiological battery. The validated lists were not influenced by ear and education.

PMID:35019086 | DOI:10.1590/2317-1782/20212021057

Braz J Biol. 2022 Jan 5;84:e253555. doi: 10.1590/1519-6984.253555. eCollection 2022.

ABSTRACT

The aim of the present study is to assess the effects of selenium nanoparticles on the growth, hematology and nutrients digestibility of Labeorohita fingerlings. Fingerlings were fed with seven isocaloric sunflower meal-based diet supplemented with different concentrations of nanoparticles naming T1 to T7 (0, 0.5, 1, 1.5, 2, 2.5, and 3 mg/kg), with 5% wet body weight while chromic oxide was used as an indigestible marker. After experimentation for 90 days T3 treated group (1mg/kg -1Se-nano level) showed the best result in hematological parameters (WBC’s 7.97 ×103mm-3, RBC’s 2.98 ×106 mm-3 and Platelet count 67), nutrient digestibility (crude protein: 74%, ether extract: 76%, gross energy: 70%) and growth performance (weight gain 13.24 g, weight gain% 198, feed conversion ratio 1.5, survival rate 100%) as compared to the other treatment groups. Specific growth rates were found significantly higher in T5 than in other groups. The present study indicated positive effect of 1 mg/kg Se-nanoparticles on growth advancement, hematological parameters, and nutrients digestibility of L. rohita fingerlings.

PMID:35019098 | DOI:10.1590/1519-6984.253555

Codas. 2022 Jan 7;34(3):e20210019. doi: 10.1590/2317-1782/20212021019. eCollection 2022.

ABSTRACT

PURPOSE: To compare the air-conduction hearing thresholds obtained with different acoustic transducers and verify the users’ preferences regarding them.

METHODS: This is a cross-sectional, analytical, observational study with 26 participants aged 18 to 30 years, with normal hearing and no history of exposure to high sound pressure levels or complaints of tinnitus at the time of the assessment. We surveyed their medical history and performed meatoscopy, pure-tone threshold audiometry, speech audiometry, and acoustic immittance. The auditory thresholds were surveyed twice, each time with a different type of acoustic transducer: insert (E-A-RTONE) and circumaural earphones (HDA200). The assessments were performed in a random order, with 5-minute intervals. In the end, we asked the participants which earphones they found more comfortable in the tests. The data were submitted to nonparametric statistical analysis.

RESULTS: Assessing the medians in the auditory threshold survey, the circumaural earphones obtained better results at 250, 500, 2000, and 6000 Hz, while the insert earphones were better at 3000 and 4000 Hz; there were no statistical differences at 1000 and 8000 Hz. The circumaural was elected the most comfortable earphone.

CONCLUSION: The circumaural earphones had better auditory thresholds at 250, 500, 2000, and 6000 Hz than the insert earphones and were reported by the patients as the most comfortable type of transducer.

PMID:35019084 | DOI:10.1590/2317-1782/20212021019

Codas. 2022 Jan 7;34(3):e20200207. doi: 10.1590/2317-1782/20212020207. eCollection 2022.

ABSTRACT

PURPOSE: To verify the test-retest reliability of the Masking Level Difference in normal hearing female university students.

METHODS: Prospective descriptive study with 78 young female adults without hearing complaints, submitted to the compact disc version of the Masking Level Difference by Auditec of Saint Louis. The threshold was determined by the difference between signal-to-noise ratios at hearing thresholds found in the antiphasic and homophasic conditions. The test was applied by the same examiner in two moments (test and retest) with an interval of seven to 14 days between them. Inferential statistical analysis included comparison of test and retest situations using Student’s t test for paired samples, calculation of the intraclass correlation coefficient and calculation of 95% confidence intervals for signal-to-noise ratios at hearing thresholds found in the antiphasic and homophasic conditions and for masking level difference.

RESULTS: The average signal-to-noise ratio at hearing threshold ​​in the homophasic condition was -12.59 dB and -12.46 dB in the Test and Retest situations, respectively, and -21.54 dB and -21.08 dB in the antiphasic condition. The average value ​​in the final Masking Level Difference result was 8.95 dB in the Test and 8.74 dB in the Retest. Intraclass correlation coefficient values ​​obtained were 0.436, 0.625 and 0.577 for homophasic, antiphasic and Masking Level Difference conditions, respectively.

CONCLUSION: The Masking Level Difference showed moderate test-retest reliability in normal hearing adults female university students.

PMID:35019083 | DOI:10.1590/2317-1782/20212020207

Phytother Res. 2022 Jan 11. doi: 10.1002/ptr.7364. Online ahead of print.

ABSTRACT

Some medicinal herbs and their effective components showed positive effects on the features of the cardiometabolic syndrome (CMS). The aim of the present systematic review and meta-analysis is to examine the effects of silymarin on the components of CMS in adults. Four electronic databases including PubMed/Medline, Scopus, Web of Science, and Embase were systematically searched up to December 31, 2020 to identify all eligible clinical trials. A random-effect model using DerSimonian and Laird method was used to estimate the pooled weighted mean differences (WMDs) and the 95% confidence intervals (95%CIs). Finally, 11 clinical trials met the eligibility criteria. Our results demonstrated that silymarin significantly reduced the levels of fasting blood glucose (WMD: -17.96 mg/dL, 95% CI: -32.91, -3.02;I² : 82.4%, p < 0.001), hemoglobin A1C (WMD: -1.25%, 95% CI: -2.34, 0.16; I² : 92.9%, p ˂ 0.001), total cholesterol (WMD: -17.46 mg/dL, 95% CI: -30.98, -3.95; I² = 62.9%, p = 0.006), triglyceride (WMD: -25.70 mg/dL, 95% CI: -47.23, -4.17; I² :54.3%, p = 0.025), low-density lipoprotein-cholesterol (WMD: -10.53, 95% CI: -19.12, -1.94; I2: 37.5%, p = 0.119) and increased high-density lipoprotein- cholesterol (WMD: 3.36 mg/dL, 95% CI: 0.88, 5.84; I² : 37.4%, p = 0.120) compared to placebo. However, its effects on BMI were not statistically significant. Silymarin can be an effective complementary therapy to improve most features of CMS. However, due to high heterogeneity and limited clinical trials in some parameters, further high-quality clinical trials are needed to confirm its efficacy.

PMID:35016260 | DOI:10.1002/ptr.7364

Br J Pharmacol. 2022 Jan 11. doi: 10.1111/bph.15795. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Acamprosate is an anti-craving drug used for the pharmacotherapy of alcohol use disorder (AUD). However, only some patients achieve optimal therapeutic outcomes. This study was designed to explore differences in metabolomic profiles between patients who maintained sobriety and those who relapsed, and to determine whether those differences might provide insight into variation in acamprosate treatment response phenotypes.

EXPERIMENTAL APPROACH: We previously conducted an acamprosate trial involving 442 AUD patients, and 267 of these subjects presented themselves for the 3-month follow-up. The primary outcome was abstinence. Clinical information, genomic data, and metabolomics data were collected. Baseline plasma samples were assayed using targeted metabolomics.

RESULTS: Baseline plasma arginine, threonine, alpha-aminoadipic-acid, and ethanolamine concentrations were associated with acamprosate treatment outcomes and baseline craving intensity, a measure which has been associated with acamprosate treatment response. We next applied a pharmacometabolomics-informed genome-wide association study (GWAS) strategy to identify genetic variants that might contribute to variations in plasma metabolomic profiles that were associated with craving and/or acamprosate treatment outcome. RNA-seq data for induced pluripotent stem cell-derived forebrain astrocytes showed that a series of genes identified during the metabolomics-informed GWAS were ethanol-responsive. Furthermore, a large number of those genes could also be regulated by acamprosate. Finally, we identified a series of single nucleotide polymorphisms that were associated with acamprosate treatment outcomes.

CONCLUSION AND IMPLICATIONS: These results serve as an important step toward advancing our understanding of disease pathophysiology and drug action responsible for variation in acamprosate response and alcohol craving in AUD patients.

PMID:35016259 | DOI:10.1111/bph.15795