Artigos - Cirurgia e Ortopedia - FMB

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INTERACTION BETWEEN FOOD PYRAMID AND GUT MICROBIOTA. A NEW NUTRITIONAL APPROACH
(2023-01-01) Magro, Daniela O.; Rossoni, Carina; Saad-Hossne, Rogerio [UNESP]; Santos, Andrey; Universidade Estadual de Campinas (UNICAMP); Universidade de Lisboa; Universidade Estadual Paulista (UNESP)
The food pyramid is a pre-established nutritional education tool. The integration between the intestinal microbiome, food groups, and SCFA-producing bacteria, which benefit from the ingestion of these foods, has the potential to further improve and innovate healthy eating. The diet-microbiome interaction needs to be incorporated into nutrition science, and the food pyramid might assist in this interaction and nutritional learning. Against this context, this brief communication proposes through the food pyramid, the interactions between the intestinal microbiota, food groups, and SCFAs-producing bacteria.
Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020
(2023-02-28) Martins, Adalberta Lima; Gasparini, Rodrigo Galhardi; Sassaki, Ligia Yukie [UNESP]; Saad-Hossne, Rogerio [UNESP]; Ritter, Alessandra Mileni Versut; Barreto, Tania Biatti; Marcolino, Taciana; Santos, Claudia Yang; State Office for Pharmaceutical Assistance; Specialized Medical Center; Universidade Estadual Paulista (UNESP); IQVIA Brazil; Takeda Pharmaceuticals Brazil
BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database. AIM To describe the intestinal complications (IC) of patients with ulcerative colitis (UC) who started conventional therapies in Brazil´s public Healthcare system. METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10threvision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes (malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate (IR) [per 100 patient-years (PY)] over the available follow-up period were calculated. RESULTS In total, 41229 UC patients were included (median age, 48 years; 65% women) and the median (interquartile range) follow-up period was 3.3 (1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine (87%), sulfasalazine (15%), azathioprine (16%) or methotrexate (1%) with a median duration of 1.9 (0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy (index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%; associated diseases from 0.9% to 1.2% - in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported; and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones. CONCLUSION Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system.
Nerves injuries during rhytidoplasty: How to avoid and surgical reparation
(2021-04-07) Viterbo, Fausto [UNESP]; Universidade Estadual Paulista (UNESP)
Nerve injury in facial aesthetic surgery is not rare. Specially in facial lifting, the injuries may occur in the sensory and motor nerves. In this chapter, we describe the most injured nerves during face-lifting and our approach in terms of clinical and surgical treatment.
Adalimumab Serum Concentrations, Clinical and Endoscopic Disease Activity in Crohn’s Disease: A Cross-Sectional Multicentric Latin American Study
(2023-02-01) de Souza, Letícia Rodrigues; Magro, Daniela Oliveira; Teixeira, Fábio Vieira; Parra, Rogério Serafim; Miranda, Eron Fábio; Féres, Omar; Saad-Hossne, Rogério [UNESP]; Soares Prates Herrerias, Giedre [UNESP]; Nisihara, Renato Mitsunori; Coy, Claudio Saddy Rodrigues; Sassaki, Ligia Yukie [UNESP]; Kotze, Paulo Gustavo; PUCPR; Universidade Estadual de Campinas (UNICAMP); Clínica Gastrosaúde; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Mackenzie Evangelical School of Medicine
Despite some variability in ideal serum Adalimumab (ADA) concentrations, there is increasing evidence that higher concentrations of anti-TNF-α agents can be associated with sustained efficacy, and low or undetectable levels may lead to loss of response. This study aims to correlate serum ADA concentrations with clinical and endoscopic activity in patients with Crohn’s disease (CD). A cross-sectional and multicentric study was performed with patients with CD, who used ADA for at least 24 weeks. Patients were allocated into groups according to the presence of clinical or endoscopic disease activity. Serum ADA concentrations were measured and compared between groups. Overall, 89 patients were included. A total of 27 patients had clinically active CD and 62 were in clinical remission. Forty patients had endoscopic disease activity and 49 were in endoscopic remission. The mean serum ADA concentration was 10.2 μg/mL in patients with clinically active CD and 14.3 μg/mL in patients in clinical remission (p = 0.395). The mean serum ADA concentration in patients with endoscopic activity was 11.3 μg/mL as compared to 14.5 μg/mL in those with endoscopic remission (p = 0.566). There was no difference between serum ADA concentrations regarding clinical or endoscopic activity in CD, as compared to patients in remission.
Grayscale median (GSM) post-processing, posterizing, and color mapping for carotid ultrasound
(2023-01-01) Filho, Pedro Luciano Mellucci [UNESP]; Bertanha, Matheus [UNESP]; Jaldin, Rodrigo Gibin [UNESP]; Yoshida, Winston Bonetti [UNESP]; Sobreira, Marcone Lima [UNESP]; Universidade Estadual Paulista (UNESP)
Factors related to atherosclerotic plaques may indicate instability, such as ulcerations, intraplaque hemorrhages, lipid core, thin or irregular fibrous cap, and inflammation. The grayscale median (GSM) value is one of the most widespread methods of studying atherosclerotic plaques and it is therefore important to comprehensively standardize image post-processing. Post-processing was performed using Photoshop 23.1.1.202. Images were standardized by adjusting the grayscale histogram curves, setting the darkest point of the vascular lumen (blood) to zero and the distal adventitia to 190. Posterization and color mapping were performed. A methodology that presents the current state of the art in an accessible and illustrative way should contribute to the dissemination of GSM analysis. This article describes and illustrates the process step by step.
Earlier surgery is associated to reduced postoperative morbidity in ileocaecal Crohn's disease: Results from SURGICROHN – LATAM study
(2023-05-01) Avellaneda, Nicolás; Coy, Claudio Saddy Rodrigues; Fillmann, Henrique Sarubbi; Saad-Hossne, Rogerio [UNESP]; Muñoz, Juan Pablo; García-Duperly, Rafael; Bellolio, Felipe; Rotholtz, Nicolás; Rossi, Gustavo; Marquez, Juan Ricardo; Cillo, Mariano; Lacerda-Filho, Antonio; Carrie, Augusto; Maruyama, Beatriz Yuki; Fillmann, Lucio Sarubbi; Ferro, Ezequiel; Londoño-Schimmer, Eduardo; Iglesias, Andrés; Harriott, Camila Bras; Campana, Juan Pablo; Estrada, Daniel Londoño; Balachandran, Rogini; Kotze, Paulo Gustavo; Hospital Universitario CEMIC; Aarhus University Hospital; Universidade Estadual de Campinas (UNICAMP); Pontificia Universidad Católica de Rio Grande do Sul; Universidade Estadual Paulista (UNESP); Nueva Proctología; Fundación Santa Fé de Bogotá; Pontíficia Universidad Católica de Chile; Hospital Aleman de Buenos Aires; Hospital Italiano de Buenos Aires; Clínica Las Américas; Hospital Británico de Buenos Aires; Felicio Rocho Hospital; Pontificia Universidade Católica do Paraná (PUCPR)
Background: Early surgical resection is an emerging concept for patients with ileocaecal Crohn's disease (CD). The aim of this study was to compare postoperative outcomes after ileocaecal resections between patients with luminal and complicated CD. Methods: A retrospective analysis of patients operated for ileocaecal CD during an 8-year period in ten tertiary referral academic centres from Latin America was performed. Patients were allocated into 2 groups: those operated for early (luminal) disease (Early Crohn's Disease -ECD-) and for complications of CD (Complicated Crohn's disease -CCD-). A comparative analysis was performed regarding short-term outcomes of surgery, considering overall postoperative complications as main outcome. Results: 337 patients were included in the analysis, 60 (17.80%) in the ECD group. Smoking and exposure to perioperative biologic drugs were more prevalent in CCD group. CCD patients had increased requirement of urgent surgery (26.71 vs. 15%, p = 0.056), longer operative time (164.25 vs. 90.53 min, p< 0.01), lower rates of primary anastomosis (90.23 vs. 100%, p = 0.012), increased rate of overall postoperative complications (33.21 vs. 16.67%, p = 0.013), more reoperations (13.36 vs. 3.33%, p = 0.026), and higher rates of major anastomotic fistulas and hospital stay. On multivariable analysis, smoking (p = 0.001,95%CI: 2.59–32.11), operative time (p = 0.022,95%CI:1–1.02), associated procedures (p = 0.036,95%CI:1.09–15.72) and intraoperative complications (p = 0.021,95%CI:1.45–92.31) were independently related to presenting postoperative complications. Conclusion: Early (luminal) ileocaecal resections were associated to lower rates of overall postoperative complications. Proper timing for surgery, avoiding delays in surgical indication can impact postoperative outcomes.
Epidemiology of inflammatory bowel diseases in the state of Rio Grande do Sul, Brazil
(2022-08-14) Cassol, Ornella Sari; Zabot, Gilmara Pandolfo; Saad-Hossne, Rogerio [UNESP]; Padoin, Alexandre; IMED Medical School; Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS); Coloprocto Canoas Clinic; Hospital Moinhos de Vento (HMV); Universidade Estadual Paulista (UNESP)
BACKGROUND This is the first study on the epidemiology of inflammatory bowel diseases (IBDs) in Rio Grande do Sul (RS), the southernmost state of Brazil with the country’s fifth largest population. Crohn’s disease (CD) and ulcerative colitis (UC) are collectively termed IBDs. They have high incidence and prevalence rates in high-income countries, although in recent years there has been a change in the classic geographical distribution of IBDs, with growing rates in traditionally low-incidence regions. AIM To estimate the incidence and prevalence of IBDs in the RS state, Brazil, between 2014 and 2019. METHODS This is a cross-sectional descriptive observational study. Patients with IBD who had initiated treatment and met the inclusion criteria of the RS state free drug distribution program were included. Data were obtained from registration or renewal records of the RS state specialty pharmacy. The male, female, and total populations were estimated according to mid-year data from the Brazilian Institute of Geography and Statistics, which served as a reference for calculating the incidence and prevalence rates of IBDs during the study period. Results were described using mean, standard deviation, and range. RESULTS We included 1082 patients with IBD, of whom 57.5% were female and 42.5% were male. Patients with CD accounted for 72.45% of the sample, and those with UC accounted for 27.54%. IBD prevalence during the study period was 9.51 per 100000 population, of which 6.89 corresponded to people with CD and 2.62, to people with UC. Incidence rates per 100000 population/year were 2.54 in 2014, 2.61 in 2015, 1.91 in 2016, 0.80 in 2017, 0.83 in 2018, and 0.96 in 2019. The mean IBD incidence rate per 100000 population was 1.61, of which 1.17 corresponded to CD and 0.44, to UC. The mean age was 41 years, and patients were mostly aged 30-40 years. Prevalence by region was higher in the state capital metropolitan area: 12.69 per 100000 population. CONCLUSION Our results demonstrated an IBD prevalence of 9.51% and incidence of 1.61 per 100000 population. The patients were predominantly female, and CD was more prevalent than UC.
Fat grafting: Lipofragmentation X Liposuction
(2019-01-01) Mendes, Flavio Henrique [UNESP]; Viterbo, Fausto [UNESP]; Deffune, Elenice [UNESP]; Domingues, Maria Aparecida Custódio [UNESP]; Golim, Marjorie Assis [UNESP]; Gabas, José Marcos [UNESP]; Rossoni, Renan Roldi [UNESP]; Nunes, Helga Caputo [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction: Aiming to obtain autogenous and injectable lipografts from resected tissues in dermolipectomies, this study proposes a new method for harvesting and processing adipose tissue through a specific fragmenting device. The main objective was to establish a comparative analysis of the quality and viability characteristics of the new lipofragmentation technique and those of the well-known liposuction technique, widely accepted as a viable source of fat grafting. In vivo and in vitro assays were designed to evaluate the biological behavior of the samples to guide new and possible human studies with clinical applications. Methods: A post-bariatric patient who underwent abdominal dermolipectomy had her surgical specimen resected, which was divided into four parts that underwent liposuction and lipofragmentation, with and without prior infiltration. All samples were centrifuged and distributed for assays with assessments involving histological analysis, immunohistochemistry, flow cytometry, cell culture, and xenograft injection on the back of 10 Wistar rats, which was evaluated after six weeks for mass, volume, and histological features. Results: The structural characteristics and biological behaviors of fragmented, dry, and infiltrated fat samples were similar to those of liposuction samples. Conclusions: Fat fragmentation transformed the subcutaneous cellular tissue of dermolipectomies into a new, viable injectable lipograft variant, with biological characteristics similar to those of traditional liposuction. Although still preliminary, our results support further investigations to optimize the technique and improve fat grafting and its possible applications in regenerative medicine.
Major and minor risk factors for postoperative abdominoplasty complications: A case series
(2022-06-01) Daronch, Oona Tomiê; Marcante, Renata Fernanda Ramos; Neto, Aristides Augusto Palhares; Universidade de São Paulo (USP)
Background: Although abdominoplasty is a safe and popular surgery, it is associated with a higher complication rate than other body contouring procedures. Therefore, identifying predictive factors of major and minor complications in patients who have undergone abdominoplasty is necessary to achieve better treatment outcomes after major weight loss. Methods: This retrospective study analyzed the medical records of patients who underwent abdominoplasty between January 2016 and December 2019. The inclusion criteria were patients aged >18 years who underwent abdominoplasty as the only surgical procedure and had adequate follow-up. Other patients were excluded from the study. Statistical evaluation was performed using SPSS 20.0; statistical significance was set at a P-value of <0.05. Results: The study included a total of 152 patients, of whom 146 (96.1%) were women and 6 (3.9%) were men. The mean patient age was 41.1 ± 9.8 years. Comorbidities were reported in 67 patients (44.07%). A direct proportional relationship was observed between the weight of the resected tissue and occurrence of general complications (P=0.01), and the presence of comorbidities increased the occurrence of minor (P=0.04) and major complications (P=0.01). Conclusion: Abdominoplasty is an aesthetic surgical plastic procedure, and its application has increased over the years. Despite its popularity, patient safety requires further attention due to the high risk of complications. It is essential to study all risk factors.
COVID-19 and isolation: Risks and implications in the scenario of new variants
(2022-09-01) Dias, Viviane Maria de Carvalho Hessel; Oliveira, Alexandre Ferreira; Marinho, Ana Karolina Barreto Berselli; Santos Ferreira, Carlos Eduardo dos; Domingues, Carlos Eduardo Ferreira; Fortaleza, Carlos Magno Castelo Branco [UNESP]; Vidal, Claudia Fernanda de Lacerda; Carrilho, Claudia Maria Dantas de Maio; Pinheiro, Debora Otero Britto Passos; de Assis, Denise Brandão; Medeiros, Eduardo Alexandrino; Morejón, Karen Mirna Loro; Weissmann, Leonardo; Michelin, Lessandra; Carneiro, Marcelo; Nogueira, Maria Dolores Santos da Purificação; de Oliveira, Priscila Rosalba Domingos; Buralli, Rafael Junqueira; Stucchi, Raquel Silveira Bello; Lins, Rodrigo Schrage; Costa, Silvia Figueiredo; Chebabo, Alberto; Associação Brasileira dos Profissionais em Controle de Infecções e Epidemiologia Hospitalar; Sociedade Brasileira de Infectologia; Hospital Nossa Senhora das Graças; Hospital Marcelino Champagnat; Sociedade Brasileira de Cirurgia Oncológica; Associação Brasileira de Alergia e Imunologia; Universidade de São Paulo (USP); Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial; Laboratório Clínico ‒ Hospital Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP); Ministério do Trabalho e Previdência; Universidade Estadual Paulista (UNESP); Universidade Federal de Pernambuco (UFPE); Universidade Estadual de Londrina (UEL); Universidade do Estado do Rio de Janeiro (UERJ); Universidade Federal do Estado do Rio de Janeiro (UNIRIO); Divisão de Infecção Hospitalar/Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac/Secretaria de Estado da Saúde de São Paulo; Instituto de Infectologia Emilio Ribas; Universidade de Ribeirão Preto (UNAERP); Universidade de Caxias do Sul (UCS); Hospital Santa Cruz; Agência Nacional de Vigilância Sanitária (ANVISA); Ministério da Saúde; Universidade Estadual de Campinas (UNICAMP); Hospital Naval Marcílio Dias; Universidade Federal do Rio de Janeiro (UFRJ)
With the emergence of new variants of SARS-CoV-2, questions about transmissibility, vaccine efficacy, and impact on mortality are important to support decision-making in public health measures. Modifications related to transmissibility combined with the fact that much of the population has already been partially exposed to infection and/or vaccination, have stimulated recommendations to reduce the isolation period for COVID-19. However, these new guidelines have raised questions about their effectiveness in reducing contamination and minimizing impact in work environments. Therefore, a collaborative task force was developed to review the subject in a non-systematic manner, answering questions about SARS-CoV-2 variants, COVID-19 vaccines, isolation/quarantine periods, testing to end the isolation period, and the use of masks as mitigation procedures. Overall, COVID-19 vaccines are effective in preventing severe illness and death but are less effective in preventing infection in the case of the Omicron variant. Any strategy that is adopted to reduce the isolation period should take into consideration the epidemiological situation of the geographical region, individual clinical characteristics, and mask for source control. The use of tests for isolation withdrawal should be evaluated with caution, due to results depending on various conditions and may not be reliable.
Liquid Biopsy in Lung Cancer: Biomarkers for the Management of Recurrence and Metastasis
(2023-05-01) Souza, Vanessa G. P. [UNESP]; Forder, Aisling; Brockley, Liam J.; Pewarchuk, Michelle E.; Telkar, Nikita; de Araújo, Rachel Paes [UNESP]; Trejo, Jessica; Benard, Katya; Seneda, Ana Laura [UNESP]; Minutentag, Iael W. [UNESP]; Erkan, Melis; Stewart, Greg L.; Hasimoto, Erica N. [UNESP]; Garnis, Cathie; Lam, Wan L.; Martinez, Victor D.; Reis, Patricia P. [UNESP]; British Columbia Cancer Research Institute; Universidade Estadual Paulista (UNESP); British Columbia Children’s Hospital Research Institute; IWK Health Centre; Dalhousie University; Beatrice Hunter Cancer Research Institute; University of British Columbia
Liquid biopsies have emerged as a promising tool for the detection of metastases as well as local and regional recurrence in lung cancer. Liquid biopsy tests involve analyzing a patient’s blood, urine, or other body fluids for the detection of biomarkers, including circulating tumor cells or tumor-derived DNA/RNA that have been shed into the bloodstream. Studies have shown that liquid biopsies can detect lung cancer metastases with high accuracy and sensitivity, even before they are visible on imaging scans. Such tests are valuable for early intervention and personalized treatment, aiming to improve patient outcomes. Liquid biopsies are also minimally invasive compared to traditional tissue biopsies, which require the removal of a sample of the tumor for further analysis. This makes liquid biopsies a more convenient and less risky option for patients, particularly those who are not good candidates for invasive procedures due to other medical conditions. While liquid biopsies for lung cancer metastases and relapse are still being developed and validated, they hold great promise for improving the detection and treatment of this deadly disease. Herein, we summarize available and novel approaches to liquid biopsy tests for lung cancer metastases and recurrence detection and describe their applications in clinical practice.
Extracellular Vesicle-Packaged miR-195-5p Sensitizes Melanoma to Targeted Therapy with Kinase Inhibitors
(2023-05-01) Santos, Nathalia L.; Bustos, Silvina O.; Reis, Patricia P. [UNESP]; Chammas, Roger; Andrade, Luciana N. S.; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
Management of advanced melanoma remains challenging, with most BRAF (B-Raf proto-oncogene, serine/threonine kinase)-mutated metastatic patients relapsing within a few months upon MAPK inhibitors treatment. Modulation of tumor-derived extracellular vesicle (EVs) cargo with enrichment of antitumoral molecules is a promising strategy to impair tumor progression and increase treatment response. Herein, we report that restored expression of miR-195-5p, down-regulated in melanoma favoring drug resistance, increases the release of EVs enriched in the tumor suppressor miRNAs, miR-195-5p, miR-152-3p, and miR-202-3p. Incorporating these EVs by bystander tumor cells resulted in decreased proliferation and viability, accompanied by a reduction in CCND1 and YAP1 mRNA levels. Upon treatment with MAPK inhibitors, miR-195 EVs significantly decreased BCL2-L1 protein levels and increased cell death ratio and treatment efficacy. Additionally, EVs exogenously loaded with miR-195-5p by electroporation reduced tumor volume in vivo and impaired engraftment and growth of xenografts implanted with melanoma cells exposed to MAPK inhibitors. Our study shows that miR-195-5p antitumoral activity can be spread to bystander cells through EVs, improving melanoma response to targeted therapy and revealing a promising EV-based strategy to increase clinical response in patients harboring BRAF mutations.
Social media and scientific knowledge
(2020-01-01) Secanho, Murilo Sgarbi [UNESP]; Santos, Marcelo Hanato [UNESP]; DE CARVALHO SALES PERES, Matheus [UNESP]; DE MENEZES NETO, Balduino Ferreira [UNESP]; Palhares, Aristides Augusto [UNESP]; DE OLIVEIRA NETO, Fausto Viterbo [UNESP]; Universidade Estadual Paulista (UNESP)
HIV-associated lipodystrophy: epidemiological analysis of a Plastic Surgery Service in Brazil
(2023-01-01) Secanho, Murilo Sgarbi [UNESP]; Neto, BALDUINO FERREIRA DE MENEZES [UNESP]; Carvalho, Laísa Brandão [UNESP]; Moragas, Weber Ribolli [UNESP]; Daronch, Oona Tomiê [UNESP]; Marcante, Renata Fernanda Ramos [UNESP]; Neto, Aristides Augusto Palhares [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction: Lipodystrophy is an important complication of HIV and has different clinical manifestations, such as lipoatrophy of the face, buttocks, and limbs and accumulation of fat in the abdominal and cervical regions. Lipodystrophy has aesthetic and psychosocial consequences, stigmatizing and affecting patients’ quality of life. The objective is to evaluate the epidemiology and treatments performed in patients treated at the HIV-related Lipodystrophy Outpatient Clinic at Hospital das Clínicas da Faculdade de Medicina de Botucatu. Method: The study was conducted retrospectively, with port analysis of patients treated between June 2012 and December 2019, at Hospital das Clínicas da Faculdade de Medicina de Botucatu, in Botucatu, SP, Brazil. Results: The medical records of 153 individuals were analyzed, 79 male and 74 female patients. The mean age was 45.6 years. The referrals came from 48 cities in four states. Caucasian patients accounted for 74.5% of the consultations. The complaint of facial lipodystrophy was reported by 52.9% of the patients. The most common invasive procedure was facial filling with polymethylmethacrylate (PMMA) in 62 patients. Gluteal implants were the most common surgery on six occasions. Conclusion: The data found show a higher proportion of female patients with complaints of lipodystrophy when compared to general data of patients with HIV. The white race was predominant, and the main complaint of lipodystrophy was facial atrophy. Facial filling with PMMA was the most common procedure.
Sequence-Based Platforms for Discovering Biomarkers in Liquid Biopsy of Non-Small-Cell Lung Cancer
(2023-04-01) Brockley, Liam J.; Souza, Vanessa G. P. [UNESP]; Forder, Aisling; Pewarchuk, Michelle E.; Erkan, Melis; Telkar, Nikita; Benard, Katya; Trejo, Jessica; Stewart, Matt D.; Stewart, Greg L.; Reis, Patricia P. [UNESP]; Lam, Wan L.; Martinez, Victor D.; British Columbia Cancer Research Institute; Universidade Estadual Paulista (UNESP); IWK Health Centre; Dalhousie University; Beatrice Hunter Cancer Research Institute; British Columbia Children’s Hospital Research Institute
Lung cancer detection and monitoring are hampered by a lack of sensitive biomarkers, which results in diagnosis at late stages and difficulty in tracking response to treatment. Recent developments have established liquid biopsies as promising non-invasive methods for detecting biomarkers in lung cancer patients. With concurrent advances in high-throughput sequencing technologies and bioinformatics tools, new approaches for biomarker discovery have emerged. In this article, we survey established and emerging biomarker discovery methods using nucleic acid materials derived from bodily fluids in the context of lung cancer. We introduce nucleic acid biomarkers extracted from liquid biopsies and outline biological sources and methods of isolation. We discuss next-generation sequencing (NGS) platforms commonly used to identify novel biomarkers and describe how these have been applied to liquid biopsy. We highlight emerging biomarker discovery methods, including applications of long-read sequencing, fragmentomics, whole-genome amplification methods for single-cell analysis, and whole-genome methylation assays. Finally, we discuss advanced bioinformatics tools, describing methods for processing NGS data, as well as recently developed software tailored for liquid biopsy biomarker detection, which holds promise for early diagnosis of lung cancer.
Quantitative analysis validation for sclerotherapy treatment of lower limb telangiectasias
(2023-07-01) Bertanha, Matheus [UNESP]; Mellucci Filho, Pedro Luciano [UNESP]; Genka, Caroline Araujo [UNESP]; de Camargo, Paula Angeleli Bueno [UNESP]; Grillo, Vinicius Tadeu Ramos da Silva [UNESP]; Sertório, Nathalia Dias [UNESP]; Rodrigues, Lenize da Silva [UNESP]; Sobreira, Marcone Lima [UNESP]; Lourenção, Pedro Luiz Toledo de Arruda [UNESP]; Universidade Estadual Paulista (UNESP)
Background: The evaluation of sclerotherapy efficacy for lower limb telangiectasias, which is the standard treatment for such condition, is commonly assisted by scores based on before and after pictures. This method is marked by its subjectivity, which impairs the precision of studies on the subject, making it unfeasible to evaluate and compare different interventions. We hypothesize that a quantitative method for evaluating the effectiveness of sclerotherapy for lower limb telangiectasias may present more reproducible results. Reliable measurement methods and new technologies may become part of the clinical practice in the near future. Methods: Before and after treatment photographs were analyzed using a quantitative method and compared with a validated qualitative method based on improvement scores. Reliability analysis of the methods was performed, applying the intraclass correlation coefficient (ICC) and kappa coefficient with quadratic weights (Fleiss Cohen), for analysis of inter-examiner and intra-examiner agreement in both evaluation methods. Convergent validity was evaluated by applying the Spearman test. To assess the applicability of the quantitative scale, the Mann-Whitney test was used. Results: A better agreement between examiners is shown for the quantitative scale, with a mean kappa of.3986 (.251-.511) for qualitative analysis and a mean kappa of.788 (.655-.918) for quantitative analysis (P <.001 for all examiners). Convergent validity was achieved by correlation coefficients of.572 to.905 (P <.001). The quantitative scale results obtained between the specialists with different degrees of experience did not show statistical difference (seniors: 0.71 [−0.48/1.00] × juniors: 0.73 [−0.34/1.00]; P =.221). Conclusions: Convergent validity between both analyses has been achieved, but quantitative analysis has been shown to be more reliable and can be applied by professionals of any degree of experience. The validation of quantitative analysis is a major milestone for the development of new technology and automated, reliable, applications.
Circulating Extracellular Vesicles microRNAs Are Altered in Women Undergoing Preterm Birth
(2023-03-01) Ramos, Bruna Ribeiro Andrade [UNESP]; Tronco, Júlia Abbade [UNESP]; Carvalho, Márcio [UNESP]; Felix, Tainara Francini [UNESP]; Reis, Patrícia Pintor [UNESP]; Silveira, Juliano Coelho; Silva, Márcia Guimarães [UNESP]; Universidade Estadual Paulista (UNESP); University of Western São Paulo (UNOESTE); Universidade de São Paulo (USP)
Preterm labor (PTL) and preterm premature rupture of membranes (PPROM) lead to high perinatal morbidity/mortality rates worldwide. Small extracellular vesicles (sEV) act in cell communication and contain microRNAs that may contribute to the pathogenesis of these complications. We aimed to compare the expression, in sEV from peripheral blood, of miRNAs between term and preterm pregnancies. This cross-sectional study included women who underwent PTL, PPROM, and term pregnancies, examined at the Botucatu Medical School Hospital, SP, Brazil. sEV were isolated from plasma. Western blot used to detect exosomal protein CD63 and nanoparticle tracking analysis were performed. The expression of 800 miRNAs was assessed by the nCounter Humanv3 miRNA Assay (NanoString). The miRNA expression and relative risk were determined. Samples from 31 women—15 preterm and 16 term—were included. miR-612 expression was increased in the preterm groups. miR-612 has been shown to increase apoptosis in tumor cells and to regulate the nuclear factor κB inflammatory pathway, processes involved in PTL/PPROM pathogenesis. miR-1253, miR-1283, miR378e, and miR-579-3p, all associated with cellular senescence, were downregulated in PPROM compared with term pregnancies. We conclude that miRNAs from circulating sEV are differentially expressed between term and preterm pregnancies and modulate genes in pathways that are relevant to PTL/PPROM pathogenesis.
PTEN in the Context of Myocardial Revascularization: The Iceberg Tip?
(2023-01-01) Garcia, Leonardo Rufino [UNESP]; Garzesi, André Monti [UNESP]; Felicio, Marcello Laneza [UNESP]; Zornoff, Leonardo Antônio Mamede [UNESP]; Universidade Estadual Paulista (UNESP)
Orthotopic Heart Transplantation in a Covid-19 Recipient
(2023-01-01) Garcia, Leonardo Rufino [UNESP]; Garzesi, André Monti [UNESP]; Sinatora, Julia Bazzo [UNESP]; Grotto, Rejane Maria Tommasini [UNESP]; Passaroni, Andréia Cristina [UNESP]; de Campos, Nelson Leonardo Kerdahi Leite [UNESP]; Martins, Antônio Sérgio [UNESP]; Felicio, Marcello Laneza [UNESP]; Brito, Flávio de Souza [UNESP]; Universidade Estadual Paulista (UNESP)
Atherectomy to treat femoropopliteal atherosclerotic disease
(2023-04-01) Neves, Pedro J.; Malgor, Emily A.; Kabeil, Mahmood; Sobreira, Marcone L. [UNESP]; Malgor, Rafael D.; University of Colorado; Universidade Estadual Paulista (UNESP)
Atherectomy as an endovascular modality to treat peripheral arterial disease has gained traction over the past 10 years. Unlike most other available technologies, atherectomy works by physically debulking atherosclerotic plaque via a variety of mechanisms being the femoropopliteal segment the most targeted one. The aims of this review were to detail the types of atherectomy available, existing evidence available for atherectomy use in the femoropopliteal segment as compared to other interventions, critical appraisal of its current use and the possible influences on its indication. Future steps regarding atherectomy usage and data presentation are also described.

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