IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100562

Cristiane Tavares , Cláudia Maia Memória , Luiz Guilherme Villares da Costa , Vinícius Caldeira Quintão , Alberto Azoubel Antunes , Deborah Teodoro , Maria José Carvalho Carmona

{"title":"Effect of melatonin on postoperative cognitive function in elderly patients submitted to transurethral resection of the prostate under spinal anesthesia","authors":"Cristiane Tavares , Cláudia Maia Memória , Luiz Guilherme Villares da Costa , Vinícius Caldeira Quintão , Alberto Azoubel Antunes , Deborah Teodoro , Maria José Carvalho Carmona","doi":"10.1016/j.clinsp.2024.100562","DOIUrl":"10.1016/j.clinsp.2024.100562","url":null,"abstract":"<div><h3>Background</h3><div>Hospitalization for Transurethral Prostate Resection (TURP) involves circadian rhythm disturbance – a possible cause of Postoperative Neurocognitive Disorder (POCD) in elderly patients. This study investigated whether melatonin ameliorated this effect.</div></div><div><h3>Methods</h3><div>A double-blind, randomized clinical trial used a battery of neuropsychological tests to evaluate cognitive performance of 118 patients aged ≥ 60, before TURP with spinal anesthesia, and at 21- and 180-days PO. Patients received 10 mg of melatonin, or a placebo, on the night before surgery and 1-, 2- and 3-days PO. Delayed neurocognitive recovery in the two groups at 21 days PO was compared using the Chi-Squared test; individual performances in each test at each date were compared using the General Mixed Model. Results with p < 0.05 were considered significant.</div></div><div><h3>Results</h3><div>Pre-surgery, both groups had significant cognitive deficits. Delayed cognitive recovery at 21 days PO was the same in both. There were no cases of POCD at 180 days. The melatonin group performed better in the delayed-recall FOME, which assesses memory, and in the Digit Span test, which assesses attention and cognitive flexibility. Unexpectedly, global neurocognitive performance was improved at 180 PO in both groups.</div></div><div><h3>Conclusions</h3><div>Melatonin had no statistical effect on POCD, but a selective beneficial effect was observed in two cognitive areas. The high prevalence of preoperative cognitive impairment may be related to the lower urinary tract symptoms which were reasons for the surgery; the unexpected improvement of cognitive performance in all patients at 180 days PO may reflect alleviation of these symptoms.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100562"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Do not expect an endoluminal complete response to identify a pathologic complete response in rectal cancer!

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100587

Alexandre Gheller , Guilherme Inácio Bertoldo de Melo e Patriarca da Silva Neiva , Mario Nóbrega de Araújo Neto , Fernando Gonçalves Lyrio , Dunya Bachour Basílio , Marília Cristina Roda da Costa , Douglas Vieira Mourão , Paulo Gonçalves de Oliveira , João Batista de Sousa

{"title":"Do not expect an endoluminal complete response to identify a pathologic complete response in rectal cancer!","authors":"Alexandre Gheller , Guilherme Inácio Bertoldo de Melo e Patriarca da Silva Neiva , Mario Nóbrega de Araújo Neto , Fernando Gonçalves Lyrio , Dunya Bachour Basílio , Marília Cristina Roda da Costa , Douglas Vieira Mourão , Paulo Gonçalves de Oliveira , João Batista de Sousa","doi":"10.1016/j.clinsp.2025.100587","DOIUrl":"10.1016/j.clinsp.2025.100587","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the relationship between endoluminal and pathologic complete response after chemoradiotherapy for rectal cancer and identify predictors of a pathologic complete response.</div></div><div><h3>Method</h3><div>The anatomic pathology reports of 102 consecutive patients with rectal cancer who underwent neoadjuvant chemoradiotherapy followed by proctectomy between 2013 and 2017 were reviewed for the presence or absence of endoluminal complete response. The presence of endoluminal complete response was compared with the anatomopathological stage. The residual lesion area was compared with the final pathologic stage to identify predictors of complete response.</div></div><div><h3>Results</h3><div>Of 102 patients, 20 (19.6 %) achieved a pathologic complete response (ypT0N0). Of these, 9 (45 %) did not achieve an endoluminal complete response. The presence of endoluminal complete response had a sensitivity of 55.00 %, specificity of 96.34 %, and accuracy of 88.24 % to identify ypT0N0. The presence of endoluminal complete response, residual lesion area ≤ 4 cm<sup>2</sup>, and tumor located in the mid-rectum were associated with pathologic complete response (ypT0N0).</div></div><div><h3>Conclusion</h3><div>Almost half of the patients who had a pathologic complete response did not achieve an endoluminal complete response. Tumors located in the mid-rectum with a residual size of ≤ 4 cm<sup>2</sup> and the presence of endoluminal complete response were significantly associated with the achievement of ypT0N0.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100587"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Aseptic thoracic spondylodiscitis (pseudo discitis) in a septuagenarian without predisposing factors

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100571

Ana C. Fiorini , Carla Alexandra Scorza , Fulvio Alexandre Scorza , Josef Finsterer

引用次数: 0

Evaluation of single-dose umbilical cord blood-derived mononuclear cell injection immediately and 7 days after spinal cord trauma in mice

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100579

Alex Oliveira de Araujo , Gustavo Bispo dos Santos , Raphael Martus Marcon , Maria Helena Alves Nicola , Marcela Saldanha Pereira , Fernando Barbosa Sanchez , Thiego Pedro Freitas Araujo , Alexandre Fogaça Cristante

{"title":"Evaluation of single-dose umbilical cord blood-derived mononuclear cell injection immediately and 7 days after spinal cord trauma in mice","authors":"Alex Oliveira de Araujo , Gustavo Bispo dos Santos , Raphael Martus Marcon , Maria Helena Alves Nicola , Marcela Saldanha Pereira , Fernando Barbosa Sanchez , Thiego Pedro Freitas Araujo , Alexandre Fogaça Cristante","doi":"10.1016/j.clinsp.2025.100579","DOIUrl":"10.1016/j.clinsp.2025.100579","url":null,"abstract":"<div><h3>Study design</h3><div>Experimental study utilizing a standardized Balb C mouse model.</div></div><div><h3>Objectives</h3><div>Evaluate histological changes and motor function recovery in the acute and subacute phases of Spinal Cord Injury (SCI) in mice using human Umbilical cord blood-derived mononuclear cells.</div></div><div><h3>Methods</h3><div>Forty mice were divided into five groups, with two receiving human Umbilical cord blood-derived mononuclear cells immediately after SCI and after 7 days, and three control groups. Motor assessment utilized BMS, MFS, and horizontal plane scales over six weeks. Necropsy evaluated macroscopic and histological spinal cord changes.</div></div><div><h3>Results</h3><div>Histologically, Umbilical cord blood-derived mononuclear cells-treated groups exhibited significant reductions in necrosis, hemorrhage, and degeneration compared to controls. Motor recovery showed partial improvement across all groups, with no statistically significant differences in scales between intervention and control groups.</div></div><div><h3>Conclusions</h3><div>In the acute phases of SCI, Umbilical cord blood-derived mononuclear cells applied directly to Balb C mice lesions demonstrated histological improvement but played a limited role in functional enhancement. The study highlights distinctions in the treatment's efficacy, potentially related to these cells' diverse differentiation capacities and intrinsic properties.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100579"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CircRBM33 competitively binds miR-15a-5p to mediate EZH1 expression to ameliorate sepsis-induced acute lung injury CircRBM33竞争性结合miR-15a-5p介导EZH1表达，以改善败血症诱导的急性肺损伤。

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100550

Jinquan Lin , Qiongying Wei , Zhipeng Fang

{"title":"CircRBM33 competitively binds miR-15a-5p to mediate EZH1 expression to ameliorate sepsis-induced acute lung injury","authors":"Jinquan Lin , Qiongying Wei , Zhipeng Fang","doi":"10.1016/j.clinsp.2024.100550","DOIUrl":"10.1016/j.clinsp.2024.100550","url":null,"abstract":"<div><h3>Background</h3><div>The study was to investigate circRBM33 in septic acute lung injury (ALI).</div></div><div><h3>Methods</h3><div>Treatment of Murine Lung Epithelial-12 cells (MLE-12) cells was performed using 10 ng/mL Lipopolysaccharide (LPS). circRBM33, miR-15a-5p, and Enhancer of zeste homolog 1 (EZH1) were ascertained through RT-qPCR or Western blot analysis. The viability of MLE-12 cells was measured using the MTT assay, and their rate of apoptosis was ascertained through flow cytometry. B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X (Bax) were determined using Western blot analysis. Oxidative stress levels were assessed with ELISA kits, and levels of malondialdehyde(MDA) content, Superoxide Dismutase (SOD) activity, and glutathione (GSH) were detected. Dual luciferase reporter gene and RIP assays verified the targeting link between miR-15a-5p and circRBM33 or EZH1. The role of circRBM33 in ALI <em>in vivo</em> was determined by performing cecum ligation-perforation (CLP) surgery. HE staining, W/D pulmonary edema, and histological damage scores were taken to assess the extent of lung tissue damage. ELISA was performed to determine proinflammatory factors in lung tissue and cells.</div></div><div><h3>Results</h3><div>CircRBM33 downregulation ameliorated ALI-induced edema, apoptotic, and inflammatory reactions in mouse lung tissues. In addition, apoptosis and inflammation mediated by LPS in MLE-12 cells were ameliorated by circRBM33 downregulation, whereas miR-15a-5p knockdown or EZH1 elevation eliminated the action of silencing circRBM33. circRBM33 mediated EZH1 expression by competitive adsorption of miR-15a-5p.</div></div><div><h3>Conclusion</h3><div>CircRBM33 improves ALI in septic mice by targeting the miR-15a-5p/EZH1 axis.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100550"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New, late-onset relapsing-remitting multiple sclerosis in a woman in her 60s after SARS-CoV-2 vaccination 一名60多岁妇女在接种SARS-CoV-2疫苗后出现新的晚发型复发缓解型多发性硬化症。

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100556

Carla Alexandra Scorza , Fulvio Alexandre Scorza , Josef Finsterer

引用次数: 0

Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway 焦糖皂苷通过调节PI3K/AKT/mTOR通路改善七氟醚麻醉诱导的大鼠认知功能障碍和神经元凋亡。

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100560

Lijuan Lin , Chenhui Zhu , Bing Yan , Pinxian Yu , Liu Yang , Wei Huang , Junren Chen

{"title":"Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway","authors":"Lijuan Lin , Chenhui Zhu , Bing Yan , Pinxian Yu , Liu Yang , Wei Huang , Junren Chen","doi":"10.1016/j.clinsp.2024.100560","DOIUrl":"10.1016/j.clinsp.2024.100560","url":null,"abstract":"<div><h3>Background</h3><div>Sevoflurane (Sev) is an inhalational anesthetic for surgical procedures where it can trigger cognitive dysfunction and neuronal apoptosis. Gyosaponin (GpS) was studied for its effects on brain morphology and cognitive behaviors in Sev-anesthetized rats.</div></div><div><h3>Methods</h3><div>Male Sprague-Dawley rats were induced by 3 % Sev anesthesia, and 25 mg/kg and 100 mg/kg GpS were injected into the rats by tail vein. The in vitro model of Sev anesthesia was constructed by treating primary rat hippocampal neurons with 4.1 % Sev in the presence of GpS (5, 10, and 20 μM). The neuroprotective effects of GpS against Sev-induced cognitive deficits in rats were evaluated using the open field and Morris water maze tests. The apoptosis of hippocampal neurons was observed using HE staining and TUNEL assay. Apoptosis-related proteins and proteins related to the PI3K/Akt/mTOR pathway were determined via Western blot. Also, pro-inflammatory factors were measured via ELISA.</div></div><div><h3>Results</h3><div>GpS diminished the Sev-triggered apoptosis in neurons and Cleaved caspase-3, BAX, TNF-α, IL-6, lessened oxidative stress damage, and stimulated the PI3K/Akt/mTOR pathway. GpS therapy markedly enhanced learning and memory abilities in rats suffering from Sev-related cognitive impairments.</div></div><div><h3>Conclusion</h3><div>GpS ameliorates Sev-induced neurotoxicity and cognitive dysfunction by modulating the PI3K/Akt/mTOR pathway and alleviating neuronal apoptosis and oxidative stress.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100560"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of adipose-derived mesenchymal stem cells on the viability of the transverse rectus abdominis myocutaneous flap in rats

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100590

André Luiz Pires de Freitas , Sang Won Han , Priscila Keiko Matsumoto Martin , Lydia Masako Ferreira

{"title":"Effect of adipose-derived mesenchymal stem cells on the viability of the transverse rectus abdominis myocutaneous flap in rats","authors":"André Luiz Pires de Freitas , Sang Won Han , Priscila Keiko Matsumoto Martin , Lydia Masako Ferreira","doi":"10.1016/j.clinsp.2025.100590","DOIUrl":"10.1016/j.clinsp.2025.100590","url":null,"abstract":"<div><h3>Introduction</h3><div>The Transverse Rectus Abdominis Myocutaneous (TRAM) flap is used for breast reconstruction, but involves the risk of necrosis. Adipose tissue-derived mesenchymal Stem Cells (ADSCs) can be used to stimulate neovascularization and reduce the risk of TRAM flap necrosis.</div></div><div><h3>Aim</h3><div>Determine the effect of ADSCs on TRAM flap viability in rats.</div></div><div><h3>Methods</h3><div>Twenty-four Wistar-EPM rats were distributed into three groups (<em>n</em> = 8). A right caudal pedicled TRAM flap was performed in all the animals and was the only procedure performed in Group TRAM. The additional procedures of intradermal injection of α-MEM culture medium and intradermal injection of α-MEM containing ADSCs labeled with a fluorescent marker were performed in Groups α-MEM and α-MEM-SC, respectively. The percentage of flap necrosis was determined, and the level of neovascularization and distribution of stem cells in the TRAM flap was assessed using immunohistochemical analysis and fluorescence microscopy, respectively.</div></div><div><h3>Results</h3><div>The percentage of necrosis observed in Group α-MEM-SC was lower than that observed in Groups TRAM and α-MEM, namely 23.36 % vs. 50.42 % and 53.57 %, respectively (<em>p</em> < 0.05). In Zone IV of the flap, the number of vessels was greater in Group α-MEM-SC than in the other groups (<em>p</em> < 0.05). Multiple stem cells were observed in the four zones of the flap in Group α-MEM-SC. No stem cells were observed in Groups TRAM or α-MEM.</div></div><div><h3>Conclusion</h3><div>ADSCs increased TRAM flap viability and the number of vessels in Zone IV of the flap in rats.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100590"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis 气管造口术后获得性气管或喉气管狭窄患者的临床及吞咽特征。

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100552

Carina Escudero , Fernanda Chiarion Sassi , Ana Paula Ritto , Paulo Francisco Guerreiro Cardoso , Claudia Regina Furquim de Andrade

{"title":"Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis","authors":"Carina Escudero , Fernanda Chiarion Sassi , Ana Paula Ritto , Paulo Francisco Guerreiro Cardoso , Claudia Regina Furquim de Andrade","doi":"10.1016/j.clinsp.2024.100552","DOIUrl":"10.1016/j.clinsp.2024.100552","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical and swallowing profiles of patients with post-intubation tracheal or laryngotracheal stenosis requiring tracheostomy prior to surgical or corrective airway interventions.</div></div><div><h3>Methods</h3><div>A retrospective cohort clinical study. Patients who met the inclusion criteria underwent a swallowing evaluation, as well as imaging studies of the neck and chest. At 6 and 12-months after the initial assessment, all patients participated in follow-up speech pathology consultations to evaluate the current state of swallowing and the progress of airway stenosis treatment.</div></div><div><h3>Results</h3><div>Twenty-five patients with a median tracheostomy duration of 30.52 months were assessed. The study found a female predominance (68%) and a high prevalence of subglottic stenosis (44%). Most patients required intubation due to severe acute respiratory failure and airway protection due to a decreased level of consciousness. Imaging revealed additional airway abnormalities, including laryngotracheobronchitis and laryngeal edema. Swallowing assessments showed that 20% had significant dysphagia. After one year, only two patients were successfully decannulated, while others remained tracheostomy dependent.</div></div><div><h3>Conclusion</h3><div>The study underscores the need for personalized, multidisciplinary care for these patients. It finds that while treatments like reconstructive surgeries and the Montgomery T-tube can be effective, complications such as clinical instability and dysphagia can worsen outcomes and extend the need for tracheostomy.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100552"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updated report of Blastocystis spp. in a teaching hospital of Brazil: A 6-year retrospective experience 巴西一家教学医院囊虫病的最新报告：6年回顾性经验。

IF 2.2 4区医学

Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100543

Gessica Baptista de Melo , Marcelo Alves Ferreira , Vera Lucia Pagliusi Castilho , Elenice Messias do Nascimento Gonçalves , Ronaldo Cesar Borges Gryschek , Fabiana Martins de Paula

引用次数: 0

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