cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14317032
title: Predictive factors of lethality and complications of deep fascial space infections of the neck

description: ABSTRACT Objective: to identify predictive factors for lethality and complications of deep fascial space infections of the neck (DFSIN), establishing an early and aggressive treatment in the neck before the progression to descending mediastinitis. Methods: we retrospectively analyzed 133 cases of DFSIN treated at Discipline of Head and Neck Surgery of the Medicine School of Santa Casa de Misericórdia de São Paulo. We accessed demographic characteristics, associated diseases, clinical presentation, laboratorial tests, length of hospital stay, number of involved anatomic neck spaces, intra-operative and microbiology findings. We analyzed these data using logistic regression to predict DFSIN lethality and life threatening complications (mediastinitis, septic shock, pneumonia, pleural empyema, skin necrosis). Results: lethality and complication ratios were 9% and 50.3%, respectively. The logistic regression model showed that patients with septic shock were more likely to have progression to death (p &lt; 0.001) and, the presence of more than two involved neck spaces (p &lt; 0.001) and older individuals (p = 0.017) were more likely to have complicated deep neck infections. Descending necrotizing mediatinitis increased the lethality ratio by 50%, and was associated to necrotizing fasciitis (p=0.012) and pleural empyema (p&lt;0.001). Conclusion: septic shock is a lethal predictive factor and age as well as more than two involved neck spaces are the predictive factors for complications. Necrotizing fasciitis is an important factor for complications and death. Therefore, its surgical treatment must be more aggressive. Descending mediastinitis has a high lethal rate and the successful treatment is based on early diagnosis and aggressive surgical approach.
DOI: 10.6084/m9.figshare.14317031
title: Association between preoperative potential sarcopenia and survival of cancer patients undergoing major surgical procedures

description: ABSTRACT Objective: to evaluate the impact of probable sarcopenia (PS) on the survival of oncological patients submitted to major surgeries. Method: prospective cohort bicentrical study enrolling adult oncological patients submitted to major surgeries at Cancer Hospital and Santa Casa de Misericordia in Cuiabá-MT. The main endpoint was the verification of postoperative death. Demographic and clinical data was collected. PS was defined as the presence of 1) sarcopenia risk assessed by SARC-F questionnaire and 2) low muscle strength measured by dynamometry. The cumulative mortality rate was calculated for patients with either PS or non PS using Kaplan Meier curve. The univariate and multivariate Cox regression model was used to evaluate the association of mortality with various investigated confounding variables. Results: a total of 220 patients with a mean (SD) age of 58.7±14.0 years old, 60.5% males participated of the study. Patients with PS had higher risk to postoperative death (RR=5.35 95%CI 1.95-14.66; p=0,001) and for infectious complications (RR=2.45 95%CI 1.12-5.33; p=0.036). The 60 days mean survival was shorter for patients with PS: 44 (IQR=32-37) vs 58 (IQR=56-59) days (log rank &lt;0,001). The Cox multivariate regression showed that PS was an independent risk factor (HR=5.8 95%CI 1.49-22.58; p=0.011) for mortality. Conclusion: patients bearing PS submitted to major oncological surgery have less probability of short term survival and preoperative PS is an independent risk for postoperative mortality.
DOI: 10.6084/m9.figshare.14317029
title: Development and application of a swine model for training ultrasonography-guided central venous access

description: ABSTRACT Introduction: simulation based teaching is a powerful tool in medical education, allowing hands on practice under a controlled environment and with repeated maneuvers. Central venous access venipuncture is one of the most frequent procedures carried out in the hospital setting, due to its various clinical indications and, when performed with the help of ultrasonography, the risk of adverse events is minimized. Aim: to develop, to describe and to test a porcine model that simulates the central venous access puncture aided by ultrasonography. Method: a low cost porcine model was developed to train medical students and residents on central venous access guided by ultrasonography. Both students and medical residents underwent a theoretical training regarding the model, followed by a hands-on training session. Afterwards, the participants assessed the model by answering a questionnaire. Results: there were 51 participants. The average score regarding the similarity between the model and the human anatomy was 9.15. When the characteristics were separately assessed, the mean scores regarding the similarity of the vessels, anatomic disposition and ultrasonographic characteristics as well as the venipuncture were, respectively, 9.27; 9.31; 9.54 and 8.86. Conclusion: The model was approved and considered appropriate for the training of central venous venipuncture by all the participants. Furthermore, it is a low cost, simple and reproducible model, that presents high similarity with the human anatomy. Therefore, it may be used as an aid to train people on ultrasonography guided central venous access.
DOI: 10.6084/m9.figshare.14317028
title: Undeclared civil war? Urban violence in major city in Brazil

description: ABSTRACT Purpose: Civil violence is responsible for 2.5% of deaths worldwide; it killed more people in the 21st century than the sum of all wars. This study describes violence victims treated at a trauma reference hospital in Salvador, Brazil and analyzes the impact of different types of interpersonal violence. Methods: Interpersonal violence victims admitted between July 2015 and July 2017 were included. The 1,296 patients (mean age: 30.3 years; 90% male) were divided into three groups according to the mechanism of interpersonal violence: 1) beating, 2) firearm injury and 3) stab wound (STW) injury. The groups were compared for the following variables: age, gender, trauma mechanism, Revised Trauma Score (RTS) at admission, need for intensive care unit (ICU) attention, length of hospital stay, need for transfusion of blood products and death. Results: Gunshot wounds (GSW) were the primary mechanism of injury (59%), followed by beating (24%) and STW (17%). Gunshot wound victims had a lower mean RTS upon admission, increased need for blood products and more Intensive Care Unit (ICU) admissions. Beating victims had the longest mean hospital stay (11.6 ± 19.6 days). The GSW group accounted for 77.4% of all deaths. The in-hospital mortality rate was significantly higher in the GSW group (12.7%) than in the beating group (5.4%) and in the STW group (4.9%). Conclusions: Gunshot wound victims are more critical: they require longer ICU stays, more transfusions of blood products and exhibit increased mortality compared with STW and beating victims.
DOI: 10.6084/m9.figshare.14317026
title: Portomesenteric vein thrombosis after bariatric surgery: a case series

description: ABSTRACT Portomesenteric vein thrombosis (PMVT) is a potentially severe complication that can occur after bariatric surgery. PMVT has gained importance because of the increasing number of bariatric surgeries being performed. Objective: to report a rare and severe complication after bariatric surgery, which is difficult to manage. To try to identify common characteristics among the cases and discuss potential causes comparing our data to the available literature. Methods: We describe six cases of PMVT in young women with different presentations. Results: All six cases occurred in young women 29-41 years old with obesity - body mass index - BMI: 36-39) and weighing 105-121 kg. The patients had few comorbidities (all of which were related to metabolic syndrome) and moderate hepatic steatosis with no sign of cirrhosis. Five patients used oral contraceptives until a few days before the operation. One patient tested positive for thrombophilia. Five patients underwent a laparoscopic sleeve gastrectomy and one underwent a gastric bypass with no complications during the operation (median operating time: 61.3 min, range 52-91 min). The mean duration of follow-up after hospitalization was 12.3 months (range: 7-18 months) and to-date only one patient has had no recanalization. Conclusion: The frequency of PMVT appears to be increased in woman and after sleeve gastrectomy. Our findings indicate that patients with abdominal pain weeks after bariatric surgery must be investigated.
DOI: 10.6084/m9.figshare.14317025
title: Analysis of the surgical management of patients with recurrent cervical cancer after radiotherapy and chemotherapy.

description: ABSTRACT Objectives: To analyze the results of morbidity and survival after curative and palliative surgery in recurrent cervical cancer patients who underwent chemoradiation as their primary treatment. Another goal was to assess the factors associated with curative and non-curative procedures. Methods: This was a retrospective cohort consisting of patients undergoing surgery curative and palliative from January 2011 to December 2017 at a high complexity oncology center. Outcome of morbidity was reported according to the Clavien-Dindo classification, and survival analysis was carried out using the Kaplan-Meir method. To assess the factors associated with the procedures, a univariate analysis using the Mann-Whitney U test was performed. Results: Two radical hysterectomies, three pelvic exenterations with curative intent, and five palliatives pelvic exenterations were performed. In the curative group, there were major complications in 40% of the cases, and the median survival time was 16 months. In the palliative group, there were major complications in 60% of the cases, and the median survival time was 5 months. Advanced staging (p-value= 0.02), symptoms (p-value=0.04), tumor size greater than five centimeters (p-value=0.04), and more than three organs involved (p-value=0.003) were factors significantly associated with non-curative surgery. Conclusions: The morbidity rates of this study were higher in palliative group, and the median survival time was lower in the palliative group than the curative group, but this difference in survival was not statistically significant. Advanced stage, symptoms, tumor size and number of organs involved are factors that should be taken into consideration when indicating surgical salvage.
DOI: 10.6084/m9.figshare.14317022
title: Trauma in Curitiba: multifactorial assessment of victims admitted to a university hospital

description: ABSTRACT Objective: to describe the epidemiological profile of trauma patients admitted to a referral hospital in Curitiba (PR). Also, to investigate trauma mechanisms and to evaluate trauma severity scores. Methods: descriptive observational cross-sectional study. Data were collected by applying a questionnaire to victims admitted in the emergency room from December 2016 to February 2018. Results: a total of 1354 trauma victims were included in the study, of which 60% were transported by SIATE and 40% by SAMU. Regarding gender, 70% of the patients were male. The mean age was 39.48 years. About the time and day of the calls, the largest proportion was concentrated on Friday night. In relation to the mechanism of trauma, in patients transported by SIATE, the most frequent in men was motorcycle collision (34.3%), while in women was same-level fall (21.42%). In SAMU, the most frequent mechanism regardless of gender was same-level fall (20.06% and 40.66%, respectively). Analyzing the severity scores, it was observed that 95.5% of the patients were classified as mild by the Glasgow Coma Scale. Conclusion: the profile of trauma victims analyzed in this large study is quite similar to what other national smaller studies have already described: young men victims of traffic accidents. Therefore, the economically active population is the most affected, reflecting in high cost to society.
DOI: 10.6084/m9.figshare.14317020
title: Nutritional impact of bariatric surgery: a comparative study of Roux-en-Y Gastric Bypass and Sleeve gastrectomy between patients from the public and private health systems.

description: ABSTRACT Purpose: To compare the nutritional status follow up of patients who underwent Roux-en-Y gastric bypass (BGYR) and Sleeve gastrectomy (SG) in hospitals of the private and public health systems, in Pernambuco. Methods: This study included patients who underwent bariatric surgery in the public and private health systems, in Pernambuco, from 2008 to 2016. Anthropometric and biochemical (hemoglobin, B12, iron and ferritin) data were evaluated in the preoperative period and at 3, 6 and 12 months after the operation. Results: There were no significant difference between patients seen at the two health systems regarding the levels of hemoglobin, iron, anemia and vitamin B12. Patients who underwent the RYGB, presented with iron deficiency which was significantly lower for those in the private system, but only at the 3 month evaluation. Low levels of ferritin were observed at the 6 month evaluation, and patients in the private health system presented with the highest ferritin deficiency. The rate of surgical success was significantly higher in those patients undergoing the RYGB at the private system. Conclusions: After a 12-month bariatric surgery follow-up, there was no statistically significant difference regarding micronutrient deficiency between patients followed up at the private and public health systems.
DOI: 10.6084/m9.figshare.14317019
title: Bilateral R5-R8 sympathectomy for compensatory hyperhidrosis: complications and patient satisfaction

description: ABSTRACT Objective: The purpose of this study was to assess the quality of life of patients who had undergone bilateral thoracic sympathectomy from R5 to R8 as a treatment for severe and debilitating compensatory hyperhidrosis (CH). Methods: Twelve patients with severe and debilitating compensatory hyperhidrosis underwent extended sympathectomy (R5-R8) from September 2016 to May 2019 at the Hospital das Clínicas, Federal University of Pernambuco, Brazil. Outcomes such as the level of patient satisfaction with the operation, quality of life scores as well as postoperative complications were assessed. Results: There has been a substantial improvement in the quality of life score of 66% of the sample. In all four domains, a statistical significant difference was seen, regarding the relief of compensatory hyperhidrosis symptoms. Conclusions: Extended sympathectomy from R5 to R8 was shown to be quite effective in most cases, leading us to believe that this approach could be a therapeutic option for severe compensatory hyperhidrosis.
DOI: 10.6084/m9.figshare.14317017
title: Metabonomic model for the assessment of type 2 diabetes remission after bariatric/metabolic surgery

description: ABSTRACT Purpose: To evaluate the differences in the metabonomic profile of patients who achieved remisison of Type 2 diabetes mellitus (T2DM) after bariatric surgery in relation to those who presented maintenance or recurrence of this condition after surgery. Methods: Thirthy-three patients with obesity and T2D were submitted to bariatric/metabolic surgery, among which, 22 experienced complete remission of T2D, and 11 did not experience remission in the postoperative period. Blood samples were taken in order to assess the serum profiles through a 1H NMR-based metabonomic study. Results: The metabonomic model for the assessment of T2D recurrence presented an accuracy of 93.9%, sensibility of 81.8%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 91.7%. Conclusion: bariatric surgery provide specific effects on the distribution of metabolites in those patients who achieved remission of T2DM, and this new distribution can be assessed through a metabonomic model.
DOI: 10.6084/m9.figshare.14317016
title: Ultra-early postoperative feeding and its impact on reducing endovenous fluids.

description: ABSTRACT Objective: To investigate the use of “ultra-early” postoperative feeding (oral liquid diet offered in the post-anesthetic recovery room) in patients undergoing common general surgical procedures and to assess the volume of intravenous fluids, as well as the rate of complications and the length of hospital stay. Methods: Prospective, observational study, which assessed the compliance with the “ultra-early” feeding, the reduction of preoperative fasting time, the perioperative venous hydration volume, the length of stay and the operative morbidity. Results: 154 patients with a mean age of 46 ± 15 years were followed. “Ultra-early” feeding was performed in 144 cases (93.5%). Patients who did not receive the “ultra-early” feeding received a significantly greater volume of postoperative intravenous fluids (500mL versus 200mL, p = 0.018). The length of stay was 2.4 ± 2.79 days (conventional feeding) versus 1.45 ± 1.83 days (“ultra-early” feeding), with no statistical difference (p = 0.133). There was no difference in the percentage of general complications (p = 0.291), vomiting (p = 0.696) or surgical infection (p = 0.534). Conclusion: “Ultra-early” feeding had a high adherence by patients undergoing common general surgical procedures, and it was related to decreased infusion of postoperative fluids. Complication rates and the length of stay were similar between groups.
DOI: 10.6084/m9.figshare.14316667
title: Non-biting flying insects as carriers of pathogenic bacteria in a Brazilian hospital

description: IntroductionInsects have been described as mechanical vectors of nosocomial infections.MethodsNon-biting flying insects were collected inside a pediatric ward and neonatal-intensive care unit (ICU) of a Brazilian tertiary hospital.ResultsMost (86.4%) of them were found to carry one or more species of bacteria on their external surfaces. The bacteria isolated were Gram-positive bacilli (68.2%) or cocci (40.9%), and Gram-negative bacilli (18.2%).ConclusionsInsects collected inside a hospital were carrying pathogenic bacteria; therefore, one must consider the possibility they may act as mechanical vectors of infections, in especially for debilitated or immune-compromised patients in the hospital environments where the insects were collected.
DOI: 10.6084/m9.figshare.14316648
title: Survey of sandfly vectors of leishmaniasis in Marambaia Island, municipality of Mangaratiba, State of Rio de Janeiro, Brazil

description: IntroductionThe influx and efflux of military personnel in the possible endemic areas of leishmaniasis provided the impetus for research on the sandflies on Marambaia Island.MethodsSandflies were collected with light traps installed in the 3 ecotypes of 3 areas chosen for their particular landscape aspects.ResultsIn 2009, were collected 32,006 specimens of sandflies belonging to 13 species. The species that showed highest density were Nyssomyia intermedia and Migoneimyia migonei.ConclusionsN. intermedia and M. migonei are the principal vectors of American tegumentary leishmaniasis (ATL) in Brazil; thus, extension studies related to the eco-epidemiology of these species of Marambaia Island are essential.
DOI: 10.6084/m9.figshare.14318335
title: “Yellow Araçá” flour (Psidium cattleyanum cv. Ya-cy) in cereal bars - nutritional and functional potential

description: Abstract Yellow Araçá (Psidium cattleyanum cv. Ya-cy) is a Brazilian native fruit that can be consumed fresh or turned into food products. However, distribution and consumption of fresh fruits are still limited due to faulty post-harvest handling. Thus, the present study aimed to evaluate the nutritional and functional potential of fresh Yellow Araçá fruit, turned into flour, in formulations of cereal bars. Ripe fruits preserved higher nutritional and functional indexes, presenting high antioxidant potential. As observed during the sensory analysis, addition up to 20% of fruit flour into the cereal bar was well accepted by the consumers. The cereal bar showed significant levels of omega-6 (n-6) and omega-9 (n-9), and minerals nutrients such as iron, magnesium, potassium, zinc. Significant levels of phenolic compounds and low levels of sodium and saturated fatty, free from trans fatty acids, were also observed. The cereal bar presented high amount of crude fiber content, indicating a high potential for use as a functional food.
DOI: 10.6084/m9.figshare.14318308.v1
title: CircRNA malignant fibrous histiocytoma amplified Sequence 1 (MFHAS1) reduced inflammatory responses in a Colitis Model via SIRT1/NF-κB

description: Abstract Ulcerative colitis (UC) is a chronic and non-specific inflammatory bowel disease (IBD). Its pathogenesis remains unclear, but its morbidity shows an increasing trend year by year. The pathogenesis of UC may be related to the genetic susceptibility, immune factor and intestinal microflora. In the last few years, an increasing number of studies have examined the relationship between the expression levels of peripheral CircRNA and UC. We aimed to evaluate the efficacy of CircRNA MFHAS1 in colitis and its possible mechanism. The expression of CircRNA MFHAS1 was reduced in colitis, and miR-486-5p expression was also increased in citrobacter rodentium-induced murine colitis. In vitro model, over-expression of CircRNA MFHAS1 reduced inflammatory responses, induced SIRT1 protein expression, and suppressed NF-κB protein expression. However, miR-486-5p CircRNA MFHAS1 suppressed SIRT1 protein expression, and induced NF-κB protein expression in vitro model. The inactivation of SIRT1 reduced the anti-inflammation effects of CircRNA MFHAS1 on inflammatory responses in vitro model. Over-expression of miR-486-5p also reduced the anti-inflammation effects of CircRNA MFHAS1 in vitro model. Our results demonstrated that CircRNA MFHAS1 reduces inflammatory responses in Colitis via SIRT1/NF-κB by miR-486-5p.
DOI: 10.6084/m9.figshare.14318342
title: miR-223-3p suppresses inflammation to protect cardiomyocytes by targeting NLRP3 in acute myocardial infarction patients

description: Abstract microRNA (miRNA) had been found played an important role in occurrence and development of acute myocardial infarction (AMI) disease. In this paper, we found that the circulating miR-223-3p in AMI patients was significantly higher than that in unstable angina (UA) patients and healthy people. Univariate and logistic regression analysis showed the circulating miR-223-3p was a protective factor in the occurrence of AMI. We also found that the circulating miR-223-3p was negatively correlated with the serum CK-MB, cTnI, AST, LDH, TNF-α, IL-6, IL-1β and IL-8. The luciferase reporter gene system confirmed that miR-223-3p targeted inhibition of NLRP3 expression in THP-1 and human peripheral blood mononuclear cell (PBMC), and miR-223-3p was negatively correlated with the expression of NLRP3 in the PBMC of AMI patients. In PBMC of healthy people, miR-146a-mimic could increase the expression of NLRP3, but decreased the level of TNF-α secretion. Moreover, H2C9 cells apoptosis by TNF-α in a dose-dependent. In conclusion, these results suggested that miR-223-3p suppressed inflammation to protect cardiomyocytes by targeting NLRP3 in AMI patients.