This article presents the stem and progenitor cells from subcutaneous adipose tissue,briefly comparing them with their bone marrow counterparts,and discussing their potential for use in regenerative medicine.Subcutane...This article presents the stem and progenitor cells from subcutaneous adipose tissue,briefly comparing them with their bone marrow counterparts,and discussing their potential for use in regenerative medicine.Subcutaneous adipose tissue differs from other mesenchymal stromal/stem cells(MSCs)sources in that it contains a pre-adipocyte population that dwells in the adventitia of robust blood vessels.Pre-adipocytes are present both in the stromal-vascular fraction(SVF;freshly isolated cells)and in the adherent fraction of adipose stromal/stem cells(ASCs;in vitro expanded cells),and have an active role on the chronic inflammation environment established in obesity,likely due their monocyticmacrophage lineage identity.The SVF and ASCs have been explored in cell therapy protocols with relative success,given their paracrine and immunomodulatory effects.Importantly,the widely explored multipotentiality of ASCs has direct application in bone,cartilage and adipose tissue engineering.The aim of this editorial is to reinforce the peculiarities of the stem and progenitor cells from subcutaneous adipose tissue,revealing the spheroids as a recently described biotechnological tool for cell therapy and tissue engineering.Innovative cell culture techniques,in particular 3D scaffold-free cultures such as spheroids,are now available to increase the potential for regeneration and differentiation of mesenchymal lineages.Spheroids are being explored not only as a model for cell differentiation,but also as powerful 3D cell culture tools to maintain the stemness and expand the regenerative and differentiation capacities of mesenchymal cell lineages.展开更多
<strong>Background:</strong> Photodynamic therapy (PDT) is the generation of cytotoxic agents through the dynamic interaction between a photosensitizer excited by light at a specific wavelength. When assoc...<strong>Background:</strong> Photodynamic therapy (PDT) is the generation of cytotoxic agents through the dynamic interaction between a photosensitizer excited by light at a specific wavelength. When associated with phthalocyanines, they are efficient in incorporating target cells and exhibiting high rates of triplet generation. This study aimed to characterize PDT associated with the phototherapeutic agent Phthalomethyl D, developed by the authors, in the process of repair, healing and immune improvement for possible application against SARS-CoV-2. <strong>Methods: </strong>Sixty-nine mice were used, divided into 2 groups: GI, treated with ILIB laser, without a phototherapeutic agent, and subjected to surgery for viral induction;GII, same as GI plus association of Phthalomethyl D. They were divided into subgroups and reevaluated at 7, 14, and 21 days, and then divided into 3 subgroups of 6 animals each, subjected to treatment at 24 h, 48 h, 72 h, 5 and 7 days. <strong>Results:</strong> Both groups had a high rate of partial incision closure and acute inflammatory control. Microscopically, there was a greater amount of amorphous fundamental substance, fibrocytes, fibroblasts, and giant cells and reduction in the number of keratinocytes, in the amount of keratin, and epidermal thickness in GII than in GI. <strong>Conclusions:</strong> PDT with Phthalomethyl D stimulates the processes of healing/repair and immunomodulation during viral infection, initially favoring the inflammatory response and, after 21 days, contributing to the anti-inflammatory response profile, making this approach possible in the treatment of individuals infected with SARS-CoV-2.展开更多
Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive...Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were（1） to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and（2） to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.展开更多
This study aimed to understand the use of low level laser in the regeneration of injured tissues. Also to design our own opinion on the subject, as chemists. Laser is nothing more than a light with very special charac...This study aimed to understand the use of low level laser in the regeneration of injured tissues. Also to design our own opinion on the subject, as chemists. Laser is nothing more than a light with very special characteristics that grant it therapeutic properties. We can observe the existence of three different types of laser, being one of them the therapeutic laser, which is used in substitution for medications or along with them. Another type of laser is the surgical one and, in addition to these, there is a diagnostic type. A great advantage is that, instead of taking the medicine, the patient’s own body can be activated by the laser to produce certain substances that can often replace the drugs. This is a literature review emphasizing the use of low level laser. Thus, the reflections from this study can contribute to the amplification of the production of knowledge that aims at the resignification of the use of laser in therapy. Greater attention was given to two types of laser radiation: He-Ne and As-Ga, both presenting a high therapeutic potential in superficial and deep injures. However, the He-Ne laser excels in superficial lesions, whereas the As-Ga laser does so in deep injures, such as articular, muscular, etc.展开更多
Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications ...Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications arising from cirrhosis. The aim of this paper is to report a case of a patient with liver cirrhosis and the complications of a transjugular intrahepatic portosystemic shunt.</span><b> </b><span style="font-family:Verdana;">Male, elderly, and ex-alcoholic, diagnosed with liver cirrho</span><span style="font-family:Verdana;">sis, ascites, and esophageal varices. He underwent transjugular intrahepatic portosystemic shunt due to portal hypertension and returned to the hospital</span> <span style="font-family:Verdana;">after 24 hours with agitation and mental confusion. He had a bowel move</span><span style="font-family:Verdana;">ment stop, neurological worsening, loss of renal function, hepatic hydrothorax, hepatic encephalopathy, hypernatremia, hypocalcemia, and hypophosphatemia. He underwent a new procedure to occlude the transjugular intrahepatic portosystemic shunt, showing improvement of the mental status and ascites. However, continued with decompensation and hydro-electrolytic disorders. He evolved with worsening of the ventilatory pattern, and neurological and renal function, with a fatal outcome.</span><b> </b><span style="font-family:Verdana;">Esophageal varices due to portal hypertension can be corrected with the transjugular intrahepatic portosystemic shunt. However, complications such as hypernatremia, hepatic hydrothorax, and hepatic encephalopathy may occur. Therefore, there is a need for reintervention to shunt or reduce its caliber. Thus, for patients with advanced age and decompensated cirrhosis, the potential risks and benefits of this procedure should be carefully evaluated due to the risk of complications and death.展开更多
Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters call...Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters called spheroids are the basis for scaffold-free tissue engineering.In this review,we explore the use of spheroids from adult mesenchymal stem/stromal cells as a model in the developmental engineering area in order to mimic the developmental stages of cartilage and bone tissues.Spheroids from adult mesenchymal stromal/stem cells lineages recapitulate crucial events in bone and cartilage formation during embryogenesis,and are capable of spontaneously fusing to other spheroids,making them ideal building blocks for bone and cartilage tissue engineering.Here,we discuss data from ours and other labs on the use of adipose stromal/stem cell spheroids in chondrogenesis and osteogenesis in vitro.Overall,recent studies support the notion that spheroids are ideal"building blocks"for tissue engineering by“bottom-up”approaches,which are based on tissue assembly by advanced techniques such as three-dimensional bioprinting.Further studies on the cellular and molecular mechanisms that orchestrate spheroid fusion are now crucial to support continued development of bottom-up tissue engineering approaches such as three-dimensional bioprinting.展开更多
The objective of this research will be to calculate the feasibility of investing in a solar energy generation project through the development of a methodology that allows the capture of environmental uncertainties by ...The objective of this research will be to calculate the feasibility of investing in a solar energy generation project through the development of a methodology that allows the capture of environmental uncertainties by improving decision making. The article presents a comparative study of the feasibility analysis of investment in a solar mini solar energy for a Shopping, considering a regime of certainty and uncertainty. The assumed stochastic variables were energy tariff and price of solar panels. The trajectories were simulated with the binomial approach that combined resulted in a quadratic diagram. The applied methodology presented the best recommendation and the option to wait was the most valuable. The exchange of the energy obtained from LIGHT by own generation of energy with solar photovoltaic source will be viable for the manager since it observes the behavior of the variables over time and follows the rules of optimal decision.展开更多
<strong>Introduction:</strong> Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in ...<strong>Introduction:</strong> Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. <strong>Objective:</strong> To describe the correlation between depression and functionality of elderly people who live in homes for the aged. <strong>Method:</strong> A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. <strong>Result: </strong>It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). <strong>Conclusion: </strong>Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.展开更多
<i>Cytomegalovirus</i> (CMV) and <i>Pneumocystis jirovecii</i> fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to pre...<i>Cytomegalovirus</i> (CMV) and <i>Pneumocystis jirovecii</i> fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave the immune system vulnerable to these infections. The present report is about a kidney transplanted patient using immunosuppressants who was diagnosed with cytomegalovirus and pneumocystosis requiring admission to the intensive care unit (ICU). Female patient, 57 years old, a kidney transplanted three years ago, with comorbidities, such as systemic arterial hypertension, hypertriglyceridemia and type 2 diabetes mellitus. She was admitted to the hospital in January 2020 with a history of diarrhea, cough, malaise and weight loss of seven kg in a month. She made continuous use of the immunosuppressants tacrolimus<sup>®</sup> and mycophenolate sodium (MFS). After five days of hospitalization, she was transferred to the ICU due to refractory diarrhea, worsening renal function and respiratory pattern, requiring mechanical ventilation. Chest tomography showed changes that led to the diagnostic hypothesis of CMV pneumonia or <i>Pneumocystis jirovecii</i>. Treatment with Ganciclovir<sup>®</sup> and Bactrim<sup>®</sup> was started. The bronchial lavage polymerase chain reaction test confirmed the infectious condition for CMV and <i>Pneumocystis jirovecii</i>. Despite the drug therapy instituted, there was no improvement in the infectious condition. The patient started to present a general and progressive worsening of the clinical picture with loss of renal graft function, respiratory failure, metabolic acidosis, hemodynamic instability and severe distributive shock, evolving to death. In the present report, it was observed that after late kidney transplantation the fragility of the immune system caused by the use of immunosuppressants contributed to the development of a severe infection with CMV and <i>Pneumocystis jirovecii</i>. Adjusting the doses of immunosuppressants to individual needs can be an important measure for maintaining the proper immune system and consequently avoiding late opportunistic infections and death outcomes.展开更多
Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leadin...Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-Hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-Hodgkin’s lymphoma.展开更多
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects mainly women, presents several clinical manifestations and has no known exact cause. The skin is one of the organs that can be affected, with su...Systemic lupus erythematosus (SLE) is an autoimmune disease that affects mainly women, presents several clinical manifestations and has no known exact cause. The skin is one of the organs that can be affected, with subacute cutaneous lupus erythematosus (SCLE) being one of the classifications according to cutaneous lupus erythematosus lesions. SCLE is commonly found in young to middle age women and carries characteristics related to sun exposure. In this report, there is a rare case of a male and elderly patient that presents SCLE subgroup initially asymptomatic, with subsequent appearance of macular skin lesions and vitiligo appearance. This is an important case to alert health professionals that the disease can manifest itself and open its clinical profile even in patients of sex and unusual ages.展开更多
<span style="font-family:Verdana;">Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can pr...<span style="font-family:Verdana;">Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MAC</span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), violet (60</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s) and blue (120</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method showed improvement in signs and symptoms</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">—</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">t</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he sensation of prosthesis stiffness in the lower and medial region, local temperature, and pain in the right breast. The patient was followed up after treatment and currently, she has no complaints. There was also no need for surgical intervention. In the present case report, the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method proved to be effective. Further research is suggested with a cohort of patients with capsular contracture, with randomization and evaluation of a larger number of patients with the referred method.</span></span></span>展开更多
Introduction: Syphilis consists in a systemic infect contagious pathology with a chronic character. The etiological agent consists of an anaerobic spirochete bacterium, Treponema pallidum. Laboratory diagnosis can be ...Introduction: Syphilis consists in a systemic infect contagious pathology with a chronic character. The etiological agent consists of an anaerobic spirochete bacterium, Treponema pallidum. Laboratory diagnosis can be made through a direct investigation of the etiologic agent or non-treponemal (VDRL) and treponemal (FTA-Abs) serological tests. False-negative results are rare. Objectives: The present report presents a rare case of a man with a secondary syphilis syndrome who was initially undiagnosed due to the prozone effect, since he presented VDRL in low titers, and was later confirmed with a new diluted serum sample and VDRL and FTA-Abs, which were positive. Conclusion: A close look should be given to patients who, although the clinical condition is compatible, complementary exams may not be, and clinical cases should be carefully evaluated so that the patient is not treated late.展开更多
Introduction: The involvement of undergraduate student at the beginning of their training in activities based on Primary Health Care (PHC), provides preventive and health promoting actions, and ensures the evaluation ...Introduction: The involvement of undergraduate student at the beginning of their training in activities based on Primary Health Care (PHC), provides preventive and health promoting actions, and ensures the evaluation of the vulnerability of communities and people. Objectives: To analyze the opinion of students and teachers of two medicine higher education institutions on the relevance of Primary Health Care in this course. METHODS: Students and teachers should be effectively enrolled in order for the study to be conducted, being chosen in a random manner and without interferences on the part of the researchers so that the work was as reliable as possible. A cross-sectional study was conducted with interviews structured in questionnaires about what they thought about PHC. To some students and teachers of the medical course of Valen?a and Grande Rio University (UNIGRANRIO). Before receiving the questionnaire, all interviewed signed a Free and Informed Consent Term, which included the objectives and methodology of the work. Results: 310 students and 51 teachers participated in the study, where 91.43% of the students and 100% of the teachers affirmed that primary care plays a fundamental role in medical education. 94.86% of students and 97.91% of teachers, claimed that the discipline allows a greater contact between undergraduates and community. When questioned about the encouragement that teachers give to students to pursue a career in PHC, 57.87% of the students and 70.83% of the professors said they lacked in such a stimulus. Conclusion: PHC is still very neglected by governmental policies, educational institutions and by the own teachers, that often, turn they attention only to tertiary medicine and, as a consequence, a discouragement of this area occur. Therefore, a higher PHC value is necessary, allowing a more humane look at the patient, valuing their feelings, anguishes and their pathological framework.展开更多
Henoch-Schönlein purpura is a vasculitis of small vessels, characterized by tissue deposition of IgA, affecting predominantly the skin, intestine, joints and kidneys. It mainly affects the pediatric age group...Henoch-Schönlein purpura is a vasculitis of small vessels, characterized by tissue deposition of IgA, affecting predominantly the skin, intestine, joints and kidneys. It mainly affects the pediatric age group, especially from 2 to 11 years old. Most often, it is preceded by episode of upper airway infection from days to weeks. The most common clinical manifestations are purpuric cutaneous lesions located in the lower limbs and buttocks, abdominal pain in colic, nausea, vomiting, diarrhea, in addition to arthralgia/arthritis, usually with spontaneous resolution. Renal impairment usually manifests with hematuria and proteinuria, and renal function may also be impaired. The case described refers to a female patient, 86 years old, with a previous history of infection of the upper airways, followed by purpura in the lower limbs and renal impairment: serum creatinine 3.1 mg/dL (N 0.5 - 1.2 mg/dL);glomerular filtration rate 15 ml/min (N > 60 ml/min);urea 118 mg/dL (N önlein purpura in an atypical age group, with significant renal impairment, improvement only with conservative treatment, thus avoiding the use of immunosuppressants and the risks of immunosuppression and toxicity related to such drugs.展开更多
Mesenteric adenitis consists of an important differential diagnosis of potentially serious diseases such as acute appendicitis, since they manifest themselves with a similar clinical picture. Case report: A 17-year-ol...Mesenteric adenitis consists of an important differential diagnosis of potentially serious diseases such as acute appendicitis, since they manifest themselves with a similar clinical picture. Case report: A 17-year-old male patient presented with periumbilical abdominal pain for 2 days, of abrupt onset and moderate intensity, who gave away with a common analgesic, which progressed to the right iliac fossa (RIF) and increased of intensity. He also reported liquid diarrhea, with several episodes a day, without mucus and/or blood, 38°C fever, anorexia and vomiting. He was hospitalized for investigating a possible diagnostic of Acute Appendicitis. In the exams, it was considered mesenteric adenitis, and antibiotic therapy was prescribed. The patient had complete improvement at the end of treatment. Conclusions: Given its importance as a differential diagnosis of numerous pathologies, as well as controversial before the therapeutic and diagnostic conduct, it is essential to report these cases in order to elucidate the specificities of this disease.展开更多
Introduction: Gastrointestinal stromal tumor (GIST) occurrence is uncommon and usually manifested by nonspecific signs and symptoms, which hinders its reasoning as a diagnostic hypothesis. The objective is to report a...Introduction: Gastrointestinal stromal tumor (GIST) occurrence is uncommon and usually manifested by nonspecific signs and symptoms, which hinders its reasoning as a diagnostic hypothesis. The objective is to report a case of female GIST with curative treatment through video-laparoscopy with partial gastrectomy. Case report: A 61-year-old female patient attended the Luiz Gioseffi Jannuzzi School Hospital (HELGJ) emergency room, with a sudden onset of upper gastrointestinal bleeding with hemodynamic instability. After stabilization, she was admitted for diagnostic investigation, showing sub-epithelial lesion of antrum in upper digestive endoscopy (UDE) and solid-cystic mass in the gastric antrum to computed tomography (CT). The conduct was the video laparoscopy surgical approach with partial gastrectomy. The histopathological and immunohistochemical aspects of the surgical specimen showed a gastrointestinal stromal tumor (GIST) in a gastric antrum of low grade of malignancy, positive e-Kit and mycotic index (50 cga) Discussion: Compared to the scarce reports in literature, the case described presented typical epidemiology, but the clinical picture was not the most incident. Conclusions: Given the rarity of this pathology cases, it is essential to report these in order to elucidate the specificities and also to discuss diagnostic and therapeutic methods.展开更多
基金Supported by the Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro(FAPERJ),No.E-26/202.682/2018
文摘This article presents the stem and progenitor cells from subcutaneous adipose tissue,briefly comparing them with their bone marrow counterparts,and discussing their potential for use in regenerative medicine.Subcutaneous adipose tissue differs from other mesenchymal stromal/stem cells(MSCs)sources in that it contains a pre-adipocyte population that dwells in the adventitia of robust blood vessels.Pre-adipocytes are present both in the stromal-vascular fraction(SVF;freshly isolated cells)and in the adherent fraction of adipose stromal/stem cells(ASCs;in vitro expanded cells),and have an active role on the chronic inflammation environment established in obesity,likely due their monocyticmacrophage lineage identity.The SVF and ASCs have been explored in cell therapy protocols with relative success,given their paracrine and immunomodulatory effects.Importantly,the widely explored multipotentiality of ASCs has direct application in bone,cartilage and adipose tissue engineering.The aim of this editorial is to reinforce the peculiarities of the stem and progenitor cells from subcutaneous adipose tissue,revealing the spheroids as a recently described biotechnological tool for cell therapy and tissue engineering.Innovative cell culture techniques,in particular 3D scaffold-free cultures such as spheroids,are now available to increase the potential for regeneration and differentiation of mesenchymal lineages.Spheroids are being explored not only as a model for cell differentiation,but also as powerful 3D cell culture tools to maintain the stemness and expand the regenerative and differentiation capacities of mesenchymal cell lineages.
文摘<strong>Background:</strong> Photodynamic therapy (PDT) is the generation of cytotoxic agents through the dynamic interaction between a photosensitizer excited by light at a specific wavelength. When associated with phthalocyanines, they are efficient in incorporating target cells and exhibiting high rates of triplet generation. This study aimed to characterize PDT associated with the phototherapeutic agent Phthalomethyl D, developed by the authors, in the process of repair, healing and immune improvement for possible application against SARS-CoV-2. <strong>Methods: </strong>Sixty-nine mice were used, divided into 2 groups: GI, treated with ILIB laser, without a phototherapeutic agent, and subjected to surgery for viral induction;GII, same as GI plus association of Phthalomethyl D. They were divided into subgroups and reevaluated at 7, 14, and 21 days, and then divided into 3 subgroups of 6 animals each, subjected to treatment at 24 h, 48 h, 72 h, 5 and 7 days. <strong>Results:</strong> Both groups had a high rate of partial incision closure and acute inflammatory control. Microscopically, there was a greater amount of amorphous fundamental substance, fibrocytes, fibroblasts, and giant cells and reduction in the number of keratinocytes, in the amount of keratin, and epidermal thickness in GII than in GI. <strong>Conclusions:</strong> PDT with Phthalomethyl D stimulates the processes of healing/repair and immunomodulation during viral infection, initially favoring the inflammatory response and, after 21 days, contributing to the anti-inflammatory response profile, making this approach possible in the treatment of individuals infected with SARS-CoV-2.
基金support by Conselho Nacional de Desenvolvimento Científico e Tecnologico(CNPq)Fundacao de AmparoàPesquisa do Estado do Rio de Janeiro(FAPERJ)+1 种基金Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES)Financiadora de Estudos e Projetos(Finep)
文摘Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were（1） to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and（2） to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.
文摘This study aimed to understand the use of low level laser in the regeneration of injured tissues. Also to design our own opinion on the subject, as chemists. Laser is nothing more than a light with very special characteristics that grant it therapeutic properties. We can observe the existence of three different types of laser, being one of them the therapeutic laser, which is used in substitution for medications or along with them. Another type of laser is the surgical one and, in addition to these, there is a diagnostic type. A great advantage is that, instead of taking the medicine, the patient’s own body can be activated by the laser to produce certain substances that can often replace the drugs. This is a literature review emphasizing the use of low level laser. Thus, the reflections from this study can contribute to the amplification of the production of knowledge that aims at the resignification of the use of laser in therapy. Greater attention was given to two types of laser radiation: He-Ne and As-Ga, both presenting a high therapeutic potential in superficial and deep injures. However, the He-Ne laser excels in superficial lesions, whereas the As-Ga laser does so in deep injures, such as articular, muscular, etc.
文摘Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications arising from cirrhosis. The aim of this paper is to report a case of a patient with liver cirrhosis and the complications of a transjugular intrahepatic portosystemic shunt.</span><b> </b><span style="font-family:Verdana;">Male, elderly, and ex-alcoholic, diagnosed with liver cirrho</span><span style="font-family:Verdana;">sis, ascites, and esophageal varices. He underwent transjugular intrahepatic portosystemic shunt due to portal hypertension and returned to the hospital</span> <span style="font-family:Verdana;">after 24 hours with agitation and mental confusion. He had a bowel move</span><span style="font-family:Verdana;">ment stop, neurological worsening, loss of renal function, hepatic hydrothorax, hepatic encephalopathy, hypernatremia, hypocalcemia, and hypophosphatemia. He underwent a new procedure to occlude the transjugular intrahepatic portosystemic shunt, showing improvement of the mental status and ascites. However, continued with decompensation and hydro-electrolytic disorders. He evolved with worsening of the ventilatory pattern, and neurological and renal function, with a fatal outcome.</span><b> </b><span style="font-family:Verdana;">Esophageal varices due to portal hypertension can be corrected with the transjugular intrahepatic portosystemic shunt. However, complications such as hypernatremia, hepatic hydrothorax, and hepatic encephalopathy may occur. Therefore, there is a need for reintervention to shunt or reduce its caliber. Thus, for patients with advanced age and decompensated cirrhosis, the potential risks and benefits of this procedure should be carefully evaluated due to the risk of complications and death.
基金the Coordination for the Improvement of Higher Education Personnel(CAPES),No.88882.366181/2019-01the Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro(FAPERJ),No.E-26/202.682/2018National Council for Scientific and Technological Development(CNPq),No.467513/2014-7
文摘Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters called spheroids are the basis for scaffold-free tissue engineering.In this review,we explore the use of spheroids from adult mesenchymal stem/stromal cells as a model in the developmental engineering area in order to mimic the developmental stages of cartilage and bone tissues.Spheroids from adult mesenchymal stromal/stem cells lineages recapitulate crucial events in bone and cartilage formation during embryogenesis,and are capable of spontaneously fusing to other spheroids,making them ideal building blocks for bone and cartilage tissue engineering.Here,we discuss data from ours and other labs on the use of adipose stromal/stem cell spheroids in chondrogenesis and osteogenesis in vitro.Overall,recent studies support the notion that spheroids are ideal"building blocks"for tissue engineering by“bottom-up”approaches,which are based on tissue assembly by advanced techniques such as three-dimensional bioprinting.Further studies on the cellular and molecular mechanisms that orchestrate spheroid fusion are now crucial to support continued development of bottom-up tissue engineering approaches such as three-dimensional bioprinting.
文摘The objective of this research will be to calculate the feasibility of investing in a solar energy generation project through the development of a methodology that allows the capture of environmental uncertainties by improving decision making. The article presents a comparative study of the feasibility analysis of investment in a solar mini solar energy for a Shopping, considering a regime of certainty and uncertainty. The assumed stochastic variables were energy tariff and price of solar panels. The trajectories were simulated with the binomial approach that combined resulted in a quadratic diagram. The applied methodology presented the best recommendation and the option to wait was the most valuable. The exchange of the energy obtained from LIGHT by own generation of energy with solar photovoltaic source will be viable for the manager since it observes the behavior of the variables over time and follows the rules of optimal decision.
文摘<strong>Introduction:</strong> Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. <strong>Objective:</strong> To describe the correlation between depression and functionality of elderly people who live in homes for the aged. <strong>Method:</strong> A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. <strong>Result: </strong>It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). <strong>Conclusion: </strong>Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.
文摘<i>Cytomegalovirus</i> (CMV) and <i>Pneumocystis jirovecii</i> fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave the immune system vulnerable to these infections. The present report is about a kidney transplanted patient using immunosuppressants who was diagnosed with cytomegalovirus and pneumocystosis requiring admission to the intensive care unit (ICU). Female patient, 57 years old, a kidney transplanted three years ago, with comorbidities, such as systemic arterial hypertension, hypertriglyceridemia and type 2 diabetes mellitus. She was admitted to the hospital in January 2020 with a history of diarrhea, cough, malaise and weight loss of seven kg in a month. She made continuous use of the immunosuppressants tacrolimus<sup>®</sup> and mycophenolate sodium (MFS). After five days of hospitalization, she was transferred to the ICU due to refractory diarrhea, worsening renal function and respiratory pattern, requiring mechanical ventilation. Chest tomography showed changes that led to the diagnostic hypothesis of CMV pneumonia or <i>Pneumocystis jirovecii</i>. Treatment with Ganciclovir<sup>®</sup> and Bactrim<sup>®</sup> was started. The bronchial lavage polymerase chain reaction test confirmed the infectious condition for CMV and <i>Pneumocystis jirovecii</i>. Despite the drug therapy instituted, there was no improvement in the infectious condition. The patient started to present a general and progressive worsening of the clinical picture with loss of renal graft function, respiratory failure, metabolic acidosis, hemodynamic instability and severe distributive shock, evolving to death. In the present report, it was observed that after late kidney transplantation the fragility of the immune system caused by the use of immunosuppressants contributed to the development of a severe infection with CMV and <i>Pneumocystis jirovecii</i>. Adjusting the doses of immunosuppressants to individual needs can be an important measure for maintaining the proper immune system and consequently avoiding late opportunistic infections and death outcomes.
文摘Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-Hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-Hodgkin’s lymphoma.
文摘Systemic lupus erythematosus (SLE) is an autoimmune disease that affects mainly women, presents several clinical manifestations and has no known exact cause. The skin is one of the organs that can be affected, with subacute cutaneous lupus erythematosus (SCLE) being one of the classifications according to cutaneous lupus erythematosus lesions. SCLE is commonly found in young to middle age women and carries characteristics related to sun exposure. In this report, there is a rare case of a male and elderly patient that presents SCLE subgroup initially asymptomatic, with subsequent appearance of macular skin lesions and vitiligo appearance. This is an important case to alert health professionals that the disease can manifest itself and open its clinical profile even in patients of sex and unusual ages.
文摘<span style="font-family:Verdana;">Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MAC</span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), violet (60</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s) and blue (120</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method showed improvement in signs and symptoms</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">—</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">t</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he sensation of prosthesis stiffness in the lower and medial region, local temperature, and pain in the right breast. The patient was followed up after treatment and currently, she has no complaints. There was also no need for surgical intervention. In the present case report, the MAC</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="font-family:Verdana;"><span style="font-family:Verdana;">ò</span></span></sup></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> method proved to be effective. Further research is suggested with a cohort of patients with capsular contracture, with randomization and evaluation of a larger number of patients with the referred method.</span></span></span>
文摘Introduction: Syphilis consists in a systemic infect contagious pathology with a chronic character. The etiological agent consists of an anaerobic spirochete bacterium, Treponema pallidum. Laboratory diagnosis can be made through a direct investigation of the etiologic agent or non-treponemal (VDRL) and treponemal (FTA-Abs) serological tests. False-negative results are rare. Objectives: The present report presents a rare case of a man with a secondary syphilis syndrome who was initially undiagnosed due to the prozone effect, since he presented VDRL in low titers, and was later confirmed with a new diluted serum sample and VDRL and FTA-Abs, which were positive. Conclusion: A close look should be given to patients who, although the clinical condition is compatible, complementary exams may not be, and clinical cases should be carefully evaluated so that the patient is not treated late.
文摘Introduction: The involvement of undergraduate student at the beginning of their training in activities based on Primary Health Care (PHC), provides preventive and health promoting actions, and ensures the evaluation of the vulnerability of communities and people. Objectives: To analyze the opinion of students and teachers of two medicine higher education institutions on the relevance of Primary Health Care in this course. METHODS: Students and teachers should be effectively enrolled in order for the study to be conducted, being chosen in a random manner and without interferences on the part of the researchers so that the work was as reliable as possible. A cross-sectional study was conducted with interviews structured in questionnaires about what they thought about PHC. To some students and teachers of the medical course of Valen?a and Grande Rio University (UNIGRANRIO). Before receiving the questionnaire, all interviewed signed a Free and Informed Consent Term, which included the objectives and methodology of the work. Results: 310 students and 51 teachers participated in the study, where 91.43% of the students and 100% of the teachers affirmed that primary care plays a fundamental role in medical education. 94.86% of students and 97.91% of teachers, claimed that the discipline allows a greater contact between undergraduates and community. When questioned about the encouragement that teachers give to students to pursue a career in PHC, 57.87% of the students and 70.83% of the professors said they lacked in such a stimulus. Conclusion: PHC is still very neglected by governmental policies, educational institutions and by the own teachers, that often, turn they attention only to tertiary medicine and, as a consequence, a discouragement of this area occur. Therefore, a higher PHC value is necessary, allowing a more humane look at the patient, valuing their feelings, anguishes and their pathological framework.
文摘Henoch-Schönlein purpura is a vasculitis of small vessels, characterized by tissue deposition of IgA, affecting predominantly the skin, intestine, joints and kidneys. It mainly affects the pediatric age group, especially from 2 to 11 years old. Most often, it is preceded by episode of upper airway infection from days to weeks. The most common clinical manifestations are purpuric cutaneous lesions located in the lower limbs and buttocks, abdominal pain in colic, nausea, vomiting, diarrhea, in addition to arthralgia/arthritis, usually with spontaneous resolution. Renal impairment usually manifests with hematuria and proteinuria, and renal function may also be impaired. The case described refers to a female patient, 86 years old, with a previous history of infection of the upper airways, followed by purpura in the lower limbs and renal impairment: serum creatinine 3.1 mg/dL (N 0.5 - 1.2 mg/dL);glomerular filtration rate 15 ml/min (N > 60 ml/min);urea 118 mg/dL (N önlein purpura in an atypical age group, with significant renal impairment, improvement only with conservative treatment, thus avoiding the use of immunosuppressants and the risks of immunosuppression and toxicity related to such drugs.
文摘Mesenteric adenitis consists of an important differential diagnosis of potentially serious diseases such as acute appendicitis, since they manifest themselves with a similar clinical picture. Case report: A 17-year-old male patient presented with periumbilical abdominal pain for 2 days, of abrupt onset and moderate intensity, who gave away with a common analgesic, which progressed to the right iliac fossa (RIF) and increased of intensity. He also reported liquid diarrhea, with several episodes a day, without mucus and/or blood, 38°C fever, anorexia and vomiting. He was hospitalized for investigating a possible diagnostic of Acute Appendicitis. In the exams, it was considered mesenteric adenitis, and antibiotic therapy was prescribed. The patient had complete improvement at the end of treatment. Conclusions: Given its importance as a differential diagnosis of numerous pathologies, as well as controversial before the therapeutic and diagnostic conduct, it is essential to report these cases in order to elucidate the specificities of this disease.
文摘Introduction: Gastrointestinal stromal tumor (GIST) occurrence is uncommon and usually manifested by nonspecific signs and symptoms, which hinders its reasoning as a diagnostic hypothesis. The objective is to report a case of female GIST with curative treatment through video-laparoscopy with partial gastrectomy. Case report: A 61-year-old female patient attended the Luiz Gioseffi Jannuzzi School Hospital (HELGJ) emergency room, with a sudden onset of upper gastrointestinal bleeding with hemodynamic instability. After stabilization, she was admitted for diagnostic investigation, showing sub-epithelial lesion of antrum in upper digestive endoscopy (UDE) and solid-cystic mass in the gastric antrum to computed tomography (CT). The conduct was the video laparoscopy surgical approach with partial gastrectomy. The histopathological and immunohistochemical aspects of the surgical specimen showed a gastrointestinal stromal tumor (GIST) in a gastric antrum of low grade of malignancy, positive e-Kit and mycotic index (50 cga) Discussion: Compared to the scarce reports in literature, the case described presented typical epidemiology, but the clinical picture was not the most incident. Conclusions: Given the rarity of this pathology cases, it is essential to report these in order to elucidate the specificities and also to discuss diagnostic and therapeutic methods.
