Laparoscopic Nephrectomy in Pediatric age

Objectivos: Numerosas séries têm sido publicadas documentando a experiência em nefrectomias por via transperitoneal e retroperitoneal. Este artigo pretende documentar as primeiras 10 nefrectomias e nefroureterectomias laparoscópicas via transperitoneal realizadas no Hospital D. Estefânia. Material e Métodos: Revisão retrospectiva de cinco nefrectomias e cinco nefroureterectomias laparoscópicas realizadas no período de Fevereiro a Setembro de 2010 em crianças com idades compreendidas entre os 2 e os 18 anos. Todos os doentes foram referenciados por complicações de rins não funcionantes. Os procedimentos, via transperitoneal, foram unilaterais, com recurso a 3 portas. Foi igualmente efectuada a análise da duração da cirurgia, taxa de conversão, tempo de internamento e complicações associadas à técnica. Resultados: Todos os rins foram removidos com sucesso por via laparoscópica, sem necessidade de conversão em nenhum dos casos. O tempo operatório médio foi de 103 minutos. Cinco doentes tiveram alta ao 2º dia de pós-operatório, três doentes ao 3º dia de pós-operatório e dois doentes, pela complexidade médico-cirúrgica inerente tiveram internamentos mais prolongados. Não se verificaram complicaçõesno per- ou pós-operatório, com retoma precoce da actividade normal em todos os doentes. Conclusão: A nefrectomia laparoscópica na criança parece ser uma alternativa viável e segura à cirurgia aberta. Consideramos necessário a aquisição de mais experiência para reduzir os tempos operatórios e definir a sua verdadeira eficácia. A experiência adquirida com outros procedimentos laparoscópicos transperitoneais foi determinante na opção por esta via (versus retroperitoneal)

Antioxidant capacities of flavones and benefits in oxidative-stress related diseases

Flavonoids, a group of secondary metabolites widely distributed in the plant kingdom, have been acknowledged for their interesting medicinal properties. Among them, natural flavones, as well as some of their synthetic derivatives, have been shown to exhibit several biological activities, including antioxidant, anti-inflammatory, antitumor, anti-allergic, neuroprotective, cardioprotective and antimicrobial. The antioxidant properties of flavones allow them to demonstrate potential application as preventive and attenuating agents in oxidative stress, i.e., a biological condition that is closely associated to aging process and several diseases. Some flavones interfere in distinct oxidative-stress related events by directly reducing the levels of intracellular free radicals (hydroxyl, superoxide and nitric oxide) and/or of reactive species (e.g. hydrogen peroxide, peroxynitrite and hypochlorous acid) thus preventing their amplification and the consequent damage of other biomolecules such as lipids, proteins and DNA. Flavones can also hinder the activity of central free radical-producing enzymes, such as xanthine oxidase and nicotinamide adenine dinucleotide phosphate oxidase (NADPH-oxidase) or inducible nitric oxide synthase (iNOS) and can even modulate the intracellular levels of pro-oxidant and/or antioxidant enzymes. The evaluation of flavones antioxidant ability has been extensively determined in chemical or biological in vitro models, but in vivo therapy with individual flavones or with flavones-enriched extracts has also been reported. The present manuscript revises relevant studies focusing the preventive effects of flavones on stress-related diseases, namely the neurological and cardiovascular diseases, and diabetes and its associated complications

A Case of Late-Diagnosed Ovotesticular Disorder of Sex Development

We report acase of!ovotesticular disorder of sex development!(DSD) with ambiguous genitalia, 46XX presenting the clinical, laboratory, imaging and operative findings and highlighting the pertinent features of this case. Results of hormonal, genetic testing and histopathology findings are reviewed. Diagnosis of true hermaphroditism is well defined and the condition can be recognized even prenatally. Conservative gonadal surgery is the procedure of choice after the diagnosis of true hermaphroditism, if the risk of a gonadal malignancy is low. Continued follow-up is necessary because of the multiple psychological, gynecological and urological problems encountered postpubertally by these patients

Mediterranean diet: a precious tool for fighting inflammatory diseases

Epidemiological studies indicate that populations who consume foods rich in specific polyphenols have lower incidence of inflammatory diseases. In turn, Mediterranean diet, claimed for its several health benefits, provides a wide range of foods which are particularly enriched sources of polyphenols, some of which known for their anti-inflammatory properties. In this context, various herbs, vegetables and fruits, as well as fruit derivative products, such as wine and virgin olive oil, are believed to have an important role preventing and/or ameliorating inflammatory conditions through diet. Additionally, they are strong candidates for anti-inflammatory drugs. In general, the anti-inflammatory properties of polyphenols involve the modulation of pro-inflammatory gene expression including cyclooxygenase, lipoxygenase, nitric oxide synthases and several pivotal cytokines such as TNF-α, interleukin-1 (IL-1) and interleukin-6 (IL-6), mainly by acting through nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling. Since inflammation is a phenomenon present in many chronic diseases including cancer, diabetes, obesity, and cardiovascular disease, the modulation of the aforementioned markers by polyphenols may positively contribute for the prevention and/or amelioration of these diseases. The present chapter focus various edible Mediterranean typical foods known for their anti-inflammatory properties, as well as the main pheno-lic constituents associated to the protection process and their underlying mechanisms of action

Use of CPAP to Reduce Arterial Stiffness in Moderate-to-Severe Obstructive Sleep Apnoea, Without Excessive Daytime Sleepiness (STIFFSLEEP): an Observational Cohort Study Protocol

INTRODUCTION: Sleepiness is a cardinal symptom in obstructive sleep apnoea (OSA) but most patients have unspecific symptoms. Arterial stiffness, evaluated by pulse wave velocity (PWV), is related to atherosclerosis and cardiovascular (CV) risk. Arterial stiffness was reported to be higher in patients with OSA, improving after treatment with continuous positive airway pressure (CPAP). This study aims to assess whether the same effect occurs in patients with OSA and without sleepiness. METHODS AND ANALYSIS: This observational study assesses the CV effect of CPAP therapy on a cohort of patients with moderate-to-severe OSA; the effect on the subcohorts of sleepy and non-sleepy patients will be compared. A systematic and consecutive sample of patients advised CPAP therapy will be recruited from a single outpatient sleep clinic (Centro Hospitalar de Lisboa Central-CHLC, Portugal). Eligible patients are male, younger than 65 years, with confirmed moderate-to-severe OSA and apnoea-hypopnea index (AHI) above 15/hour. Other sleep disorders, diabetes or any CV disease other than hypertension are exclusion criteria. Clinical evaluation at baseline includes Epworth Sleepiness Scale (ESS), and sleepiness is defined as ESS above 10. OSA will be confirmed by polygraphic study (cardiorespiratory, level 3). Participants are advised to undertake an assessment of carotid-femoral PWV (cf-PWV) and 24 hours evaluation of ambulatory blood pressure monitoring (ABPM), at baseline and after 4 months of CPAP therapy. Compliance and effectiveness of CPAP will be assessed. The main outcome is the variation of cf-PWV over time

Tecnologias Embrapa para a cultura da mamoneira.

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Complexity of the Ruminococcus flavefaciens FD-1 cellulosome reflects an expansion of family-related protein-protein interactions

This work was supported in part by the European Union, Area NMP.2013.1.1–2: Self-assembly of naturally occurring nanosystems: CellulosomePlus Project number: 604530, and by the EU Seventh Framework Programme (FP7 2007–2013) under the WallTraC project (Grant Agreement no 263916), and BioStruct-X (grant agreement no 283570). This paper reflects the author’s views only. The European Community is not liable for any use that may be made of the information contained herein. CMGAF is also supported by Fundação para a Ciência e a Tecnologia (Lisbon, Portugal) through grants PTDC/BIA-PRO/103980/2008 and EXPL/BIA-MIC/1176/2012. EAB is also funded by a grant (No. 1349/13) from the Israel Science Foundation (ISF), Jerusalem, Israel and by a grant (No. 2013284) from the U.S.-Israel Binational Science Foundation (BSF). E.A.B. is the incumbent of The Maynard I. and Elaine Wishner Chair of Bio-organic Chemistry.Peer reviewedPublisher PD