Search Articles
27/May/2021
Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
DOI: 10.6061/clinics/2021/e2610
OBJECTIVES: To compare the early and late predictive values of several critical illness scores (CISs) and biomarkers in sepsis-3 patients with bloodstream infections (BSIs) and to identify the prognostic value of procalcitonin (PCT) for different gram-stain bacteria infections. METHODS: Patients with at least one positive blood culture within 24h of emergency department admission and with a final diagnosis of sepsis/septic shock were enrolled. CISs were calculated based on the first parameters on the day of admission. The receiver operating characteristics […]
Keywords: Procalcitonin; Prognosis; Sepsis; Septic; Shock
Clinical and echocardiographic predictors of left ventricular remodeling following anterior acute myocardial infarction
Caroline Ferreira da Silva Mazeto Pupo da Silveira , Karina Nogueira Dias Secco Malagutte , Bruna Franco Nogueira , Fabrício Moreira Reis , Cássia da Silva Antico Rodrigues , Daniele Andreza Antonelli Rossi , [...]
27/May/2021
Clinical and echocardiographic predictors of left ventricular remodeling following anterior acute myocardial infarction
Caroline Ferreira da Silva Mazeto Pupo da Silveira , Karina Nogueira Dias Secco Malagutte , Bruna Franco Nogueira , Fabrício Moreira Reis , Cássia da Silva Antico Rodrigues , Daniele Andreza Antonelli Rossi , [...]
DOI: 10.6061/clinics/2021/e2732
OBJECTIVES: Coronary artery disease is the primary cause of death and is responsible for a high number of hospitalizations worldwide. Ventricular remodeling is associated with worse prognosis following ST-segment elevation myocardial infarction (STEMI) and is a risk factor for ventricular dysfunction and heart failure. This study aimed to identify the predictors of ventricular remodeling following STEMI. Additionally, we evaluated the clinical, laboratory, and echocardiographic characteristics of patients with anterior wall STEMI who underwent primary percutaneous intervention in the acute phase […]
Keywords: Acute Myocardial Infarction; Echocardiography; Predictors; Ventricular Remodeling
17/May/2021
Continuous peripheral nerve block for in-patients with lower limb ischemic pain
Hermann dos Santos Fernandes , Jorge Luiz Saraiva Ximenes , Paloma Kiyomi Taguchi , Eloisa Bonetti Espada , Áquila Lopes Gouvêa , Joaquim Edson Vieira , [...]
DOI: 10.6061/clinics/2021/e2805
OBJECTIVES: Demonstrate that continuous peripheral nerve block (CPNB) may be an alternative with adequate analgesia and a lower incidence of side effects for ischemic pain due peripheral obstructive arterial disease (POAD). METHODS: Retrospective cohort study with 21 patients with POAD, Fontaine IV graded, with foot pain. Patients were submitted to continuous sciatic nerve block (CSNB), through a perineural catheter. Primary outcomes were pain intensity (by numerical rating scale) and opioid consumption (in oral morphine equivalents). RESULTS: During CSNB, pain scores […]
Keywords: Analgesia; Continuous Peripheral Nerve Block; Nerve Block; Pain management; Peripheral Arterial Disease; Peripheral Vascular Disease; Regional Anesthesia
Multilayer stents affect the final diameter of aortic aneurysms and maintain renal artery patency for a short time in a swine experimental model
Anna Paula Weinhardt Baptista-Strazzi , Ricardo Aun , Igor Rafael Sincos , Allana M. Tobita , Maria Fernanda Cassino Portugal , Vitória Penido de Paula , [...]
11/May/2021
Multilayer stents affect the final diameter of aortic aneurysms and maintain renal artery patency for a short time in a swine experimental model
Anna Paula Weinhardt Baptista-Strazzi , Ricardo Aun , Igor Rafael Sincos , Allana M. Tobita , Maria Fernanda Cassino Portugal , Vitória Penido de Paula , [...]
DOI: 10.6061/clinics/2021/e2812
OBJECTIVES: We sought to analyze the hemodynamic effects of the multilayer flow-modulated stent (MFMS) in Thoracoabdominal aortic aneurysms (TAAAs). METHODS: The hemodynamic effects of MFMS were analyzed in aortic thoracoabdominal aneurysms in experimental swine models. We randomly assigned 18 pigs to the stent or control groups and underwent the creation of an artificial bovine pericardium transrenal aneurysm. In the stent group, an MFMS (Cardiatis, Isnes, Belgium) was immediately implanted. After 4 weeks, we evaluated aneurysm sac thrombosis and renal branch […]
Keywords: Aortic Aneurysm; Endovascular; Experimental; Model; Stent; Thoracic
11/May/2021
Short-term survival in extensive craniofacial resections
Ana Kober N. Leite , Gustavo Fernandes de Alvarenga , Sérgio Gonçalves , Alexandre Bezerra dos Santos , Hugo Sterman Neto , Claudio R. Cernea , [...]
DOI: 10.6061/clinics/2021/e2836
OBJECTIVES: Craniofacial resection (CFR) procedures for craniofacial tumors with cranial extension are often extensive. Although CFRs may yield good oncological results, there are concerns about high perioperative morbidity and mortality. This study aimed to determine risk factors for perioperative mortality after open CFR in terms of deaths occurring during index hospitalizations. METHODS: We conducted a retrospective analysis of CFRs conducted at a tertiary oncology hospital from May 2009 through December 2018. RESULTS: Our analysis included data from the medical records […]
Keywords: Complications; Craniofacial Surgery; Prognosis; Surgery; Survival
06/May/2021
Claudin-1 and Claudin-3 as Molecular Regulators of Myelination in Leukoaraiosis Patients
Yan Chen , Zheng Zheng , Ainong Mei , Huan Huang , Fan Lin
DOI: 10.6061/clinics/2021/e2167
OBJECTIVES: Leukoaraiosis is described as white matter lesions that are associated with cognitive dysfunction, neurodegenerative disorders, etc. Myelin depletion is a salient pathological feature of, and the loss of oligodendrocytes is one of the most robust alterations evident in, white matter degeneration. Recent studies have revealed that claudin proteins are aberrantly expressed in leukoaraiosis and regulate oligodendrocyte activity. However, the roles of claudin-1 and claudin-3 in oligodendrocytes and leukoaraiosis are still not well-defined. METHODS: Quantitative polymerase chain reaction was used […]
Keywords: Apoptosis; Claudin-1; Claudin-3; Leukoaraiosis; Myelination; Oligodendrocyte
06/May/2021
Efficacy and safety of umbilical cord mesenchymal stem cells for the treatment of patients with COVID-19
Fengtao Wei , Dexiao Kong , Tao Li , Ai Li , Yi Tan , Jinfeng Fang , [...]
DOI: 10.6061/clinics/2021/e2604
OBJECTIVES: The coronavirus disease (COVID-19) outbreak has catastrophically threatened public health worldwide and presented great challenges for clinicians. To date, no specific drugs are available against severe acute respiratory syndrome coronavirus 2. Mesenchymal stem cells (MSCs) appear to be a promising cell therapy owing to their potent modulatory effects on reducing and healing inflammation-induced lung and other tissue injuries. The present pilot study aimed to explore the therapeutic potential and safety of MSCs isolated from healthy cord tissues in the […]
Keywords: Coronavirus; COVID-19; Mesenchymal Stem Cells; Stem Cell Therapy
06/May/2021
Risk Factors Associated with Postoperative Infection in Cancer Patients Undergoing Spine Surgery
Mauro Costa Morais Tavares-Júnior , Gabriela Estefania Delgado Cabrera , William Gemio Jacobsen Teixeira , Douglas Kenji Narazaki , Cesar Salge Ghilardi , Raphael Martus Marcon , [...]
DOI: 10.6061/clinics/2021/e2741
OBJECTIVES: To determine the rate of and main risk factors for postoperative infection in cancer patients who underwent spine surgery in the last 5 years in order to determine whether there is an association between postoperative infection and increased mortality during hospitalization. METHODS: All cancer patients who underwent surgical procedures between January 2015 and December 2019 at a single hospital specializing in spine cancer surgery were analyzed. The primary outcome of interest was postoperative infection. Bivariate logistic regression was used […]
Keywords: Postoperative Complication; Risk factors; Spinal Metastasis; Spine Tumor; Surgical site infection
26/Apr/2021
A randomized controlled study on an integrated approach to prevent and treat re-adhesion after transcervical resection of moderate-to-severe intrauterine adhesions
Li-Zhen Pan , Ying Wang , Xian Chen
DOI: 10.6061/clinics/2021/e1987
OBJECTIVES: This study aims to compare the clinical efficacy of an integrated approach to prevent and treat the recurrence of moderate-to-severe intrauterine adhesions (IUA) after hysteroscopic transcervical resection of adhesion (TCRA). METHODS: The study included a total of 70 patients with moderate-to-severe IUAs who underwent TCRA. Patients were randomly divided into two groups: treatment group (n=35) and control group n=35). In the treatment group, patients underwent balloon uterine stent placement and artificial cycle as well as received intrauterine perfusion of […]
Keywords: Danshen injection; Intrauterine Perfusion; Moderate-to-severe Intrauterine Adhesions; Re-adhesion; Transcervical Resection of Adhesion
26/Apr/2021
Overexpression of serum extracellular vesicle microRNA-215-5p is associated with early tumor recurrence and poor prognosis of gastric cancer
Yunfei Zhang , Fengchang Huang , Ning Xu , Jin Wang , Dan Li , Liang Yin
DOI: 10.6061/clinics/2021/e2081
OBJECTIVES: Extracellular vesicle microRNAs (EV-miRNAs) have been demonstrated to be reliable candidate biomarkers for clinical applications. However, the clinical application potential of serum EV-miR-215-5p for gastric cancer (GC) remains poorly understood. The goal of our study was to determine the efficacy of serum EV-miR-215-5p in predicting the prognosis of GC. METHODS: Blood samples were collected from 118 patients with GC, 60 patients with benign gastric disease and BGD and 70 healthy controls. The relative levels of serum EV-miR-215-5p were measured […]
Keywords: Diagnosis; Early Tumor Recurrence; Gastric Cancer; Prognosis; Serum Extracellular Vesicle miR-215-5p
26/Apr/2021
A Modified Flexor Tendon Suture Technique Combining Kessler and Loop Lock Flexor Tendon Sutures
Wenfeng Yang , Jvtao Li , Yuewen Su , Wu Liang , Yuanfei Ren , Yvjin Dong , [...]
DOI: 10.6061/clinics/2021/e2358
OBJECTIVES: In the present study, a novel single knot tenorrhaphy was developed by combining the modified Kessler flexor tendon suture (MK) with the loop lock technique. METHODS: A total of 48 porcine flexor digitorum profundus tendons were collected and randomly divided into six groups. The tendons were transversely cut and then repaired using six different techniques, the MK method, double knot Kessler-loop lock flexor tendon suture (DK), and single knot Kessler-loop lock flexor tendon suture (SK), each in combination with […]
Keywords: Biomechanical Property; Flexor Tendon; Hand Surgery; Kessler-Loop Lock Suture
26/Apr/2021
Melatonin can be, more effective than N-acetylcysteine, protecting acute lung injury induced by intestinal ischemia-reperfusion in rat model
Alberto Andrade Leite , Russel Joseph Reiter , Julio Cezar Mendes Brandão , Thiago Mamoru Sakae , Marcia Marinho , Celia Regina Camargo , [...]
DOI: 10.6061/clinics/2021/e2513
OBJECTIVES: The current study compared the impact of pretreatment with melatonin and N-acetylcysteine (NAC) on the prevention of rat lung damage following intestinal ischemia-reperfusion (iIR). METHODS: Twenty-eight Wistar rats were subjected to intestinal ischemia induced by a 60 min occlusion of the superior mesenteric artery, followed by reperfusion for 120 min. Animals were divided into the following groups (n=7 per group): sham, only abdominal incision; SS+iIR, pretreated with saline solution and iIR; NAC+iIR, pretreated with NAC (20 mg/kg) and iIR; […]
Keywords: Acute respiratory distress syndrome; Experimental Model; Intestinal Ischemia-Reperfusion; Melatonin; NAC
16/Apr/2021
Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes
Juliana Naves Ravanini , Aline Kawassaki Assato , Alda Wakamatsu , Venâncio Avancini Ferreira Alves
DOI: 10.6061/clinics/2021/e2587
OBJECTIVES: Whole genome expression profiles allow the stratification of bladder urothelial carcinoma into basal and luminal subtypes which differ in histological patterns and clinical behavior. Morpho-molecular studies have resulted in the discovery of immunohistochemical markers that might enable discrimination between these two major phenotypes of urothelial carcinoma. METHODS: We used two combinations of immunohistochemical markers, i.e., cytokeratin (CK) 5 with CK20 and CK5 with GATA3, to distinguish subtypes, and investigated their association with clinicopathological features, presence of histological variants, and […]
Keywords: Carcinoma; Cystectomy; Histologic Variants; Immunohistochemistry; Tissue Microarray; Urinary Bladder
16/Apr/2021
Estradiol prevented intestinal ischemia and reperfusion-induced changes in intestinal permeability and motility in male rats
Fernanda Yamamoto Ricardo-da-Silva , Evelyn Thaís Fantozzi , Sara Rodrigues-Garbin , Helori Vanni Domingos , Ricardo Martins Oliveira-Filho , Bernardo Boris Vargaftig , [...]
DOI: 10.6061/clinics/2021/e2683
OBJECTIVES: Ischemia and reperfusion (I/R) in the intestine could lead to severe endothelial injury, compromising intestinal motility. Reportedly, estradiol can control local and systemic inflammation induced by I/R injury. Thus, we investigated the effects of estradiol treatment on local repercussions in an intestinal I/R model. METHODS: Rats were subjected to ischemia via the occlusion of the superior mesenteric artery (45 min) followed by reperfusion (2h). Thirty minutes after ischemia induction (E30), 17β-estradiol (E2) was administered as a single dose (280 […]
Keywords: Estradiol; Gastrointestinal Motility; Inflammation; Intestine; Ischemia-reperfusion injury
16/Apr/2021
Double-Needle Arthrocentesis with Viscosupplementation in Patients with Temporomandibular Joint Disc Displacement without Reduction
Rafael Rossini , Eduardo Grossmann , Rodrigo L. Poluha , Ênio T. Setogutti , Marcos Fabio Dos Santos
DOI: 10.6061/clinics/2021/e2840
OBJECTIVES: Arthrocentesis is the simplest surgical intervention for the temporomandibular joint (TMJ). It can be performed on an outpatient basis at a low cost and with low morbidity. The objective is to release the articular disc by disrupting the adhesion formed between its surfaces and the mandibular fossa through hydraulic pressure generated by irrigation of the upper compartment of the TMJ. Viscosupplementation with hyaluronic acid during or after arthrocentesis improves clinical outcomes, increases mouth opening, and reduces pain levels. The […]
Keywords: Arthrocentesis, Temporomandibular Joint; Magnetic Resonance Imaging; Oral Surgery; Viscosupplementation