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1.
Artículo en Inglés | MEDLINE | ID: mdl-38505951

RESUMEN

BACKGROUND: PTEN is primarily known as a tumour suppressor gene. However, research describes higher rates of difficulties including intellectual disability and difficulties relating to autism spectrum conditions (ASCs) in people with germline PTEN mutations. Other psychological characteristics/experiences are less often reported and are explored in this study. METHODS: The parents of 20 children with PTEN mutations completed an online survey exploring adaptive behaviour, ASC-associated behaviours, anxiety, mood, hypermobility, behaviours that challenge, sensory experiences, quality of life and parental wellbeing. Published normative data and data from groups of individuals with other genetic neurodevelopmental conditions were used to contextualise findings. RESULTS: Overall levels of adaptive behaviour were below the 'typical' range, and no marked relative differences were noted between domains. Higher levels of ASC-related difficulties, including sensory experiences, were found in comparison with 'typically developing' children, with a possible peak in restrictive/repetitive behaviour; ASC and sensory processing atypicality also strongly correlated with reported joint hypermobility. A relative preservation of social motivation was noted. Anxiety levels were found to be elevated overall (and to relate to sensory processing and joint hypermobility), with the exception of social anxiety, which was comparable with normative data. Self-injurious behaviour was common. CONCLUSIONS: Results suggest a wide range of possible difficulties in children with PTEN mutations, including elevated anxiety. Despite elevated ASC phenomenology, social motivation may remain relatively strong. Firm conclusions are restricted by a small sample size and potential recruitment bias, and future research is required to further explore the relationships between such characteristics.

2.
Braz J Biol ; 83: e277437, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38422256

RESUMEN

The use of residues from coffee production to obtain biochar is a sustainable approach, which aims to minimize the environmental impact of these materials. In this study, the effect of adding coffee straw biochar on the physiological quality of lettuce and sorghum seeds was investigated. Thus, the objective of this work was to study the effect of adding different concentrations of coffee biochar in the substrate composition on the physiological quality of lettuce (Lactuca sativa) and sorghum (Sorghum bicolor) seeds. The experimental design used was completely randomized, with five concentrations of biochar (0; 7.5; 15; 30 and 60%), conducted with four replications of 25 seeds. The use of biochar in the concentrations studied does not provide an increase in the average germination percentage and vigor of lettuce and sorghum seeds. The increase in the concentration of biochar caused less seed vigor, suggesting a toxic effect. For seed germination, there was no significant difference between lettuce and sorghum species, regardless of treatment. For the germination speed index, sorghum seeds have higher means, except for the treatment with the addition of 15% coffee straw biochar. Lettuce seeds have higher shoot length averages, except for treatment with 100% commercial substrate. The sorghum seeds have higher mean root length and dry mass than lettuce, regardless of the treatment.


Asunto(s)
Carbón Orgánico , Germinación , Sorghum , Café , Grano Comestible , Lactuca , Semillas/fisiología
3.
Braz J Biol ; 83: e277798, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38126645

RESUMEN

In the cropping systems that integrate the corn crop, the insertion of Crotalaria ochroleuca G. Don is predominantly intercropped. In this context, there is a need to observe herbicides that present selectivity for this sunn hemp species. The objective of this study was to evaluate the selectivity of pre and post-emergent herbicides on C. ochroleuca. Two field experiments were conducted in randomized blocks with four replications, involving the pre-emergence and post-emergence application of different herbicide treatments. For the pre-emergent ones, amicarbazone, atrazine and flumioxazin provided phytotoxicity higher than 90% and, consequently, low plant biomass. On the other hand, acetochlor and s-metolachlor did not cause phytotoxicity and did not affect the dry mass of crotalaria. In post-emergence, atrazine + mesotrione showed phytotoxicity >95%, followed by nicosulfuron and 2.4-D with phytotoxicity between 50-60%, whereas tembotrione did not cause injury to the plants. Thus, it was found that among the pre-emergent, acetochlor and s-metolachlor were selective, and for the emerging powders, only tembotrione was the most selective for all parameters analyzed.


Asunto(s)
Atrazina , Crotalaria , Herbicidas , Herbicidas/toxicidad , Zea mays
4.
Endocr Connect ; 12(3)2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-37931414

RESUMEN

Background: Although differentiated thyroid carcinoma (DTC) is the most frequent endocrine pediatric cancer, it is rare in childhood and adolescence. While tumor persistence and recurrence are not uncommon, mortality remains extremely low. Complications of treatment are however reported in up to 48% of the survivors. Due to the rarity of the disease, current treatment guidelines are predominantly based on the results of small observational retrospective studies and extrapolations from results in adult patients. In order to develop more personalized treatment and follow-up strategies (aiming to reduce complication rates), there is an unmet need for uniform international prospective data collection and clinical trials. Methods and analysis: The European pediatric thyroid carcinoma registry aims to collect clinical data for all patients ≤18 years of age with a confirmed diagnosis of DTC who have been diagnosed, assessed, or treated at a participating site. This registry will be a component of the wider European Registries for Rare Endocrine Conditions project which has close links to Endo-ERN, the European Reference Network for Rare Endocrine Conditions. A multidisciplinary expert working group was formed to develop a minimal dataset comprising information regarding demographic data, diagnosis, treatment, and outcome. We constructed an umbrella-type registry, with a detailed basic dataset. In the future, this may provide the opportunity for research teams to integrate clinical research questions. Ethics and dissemination: Written informed consent will be obtained from all participants and/or their parents/guardians. Summaries and descriptive analyses of the registry will be disseminated via conference presentations and peer-reviewed publications.

5.
Rev Esp Anestesiol Reanim (Engl Ed) ; 70(10): 602-607, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37669702

RESUMEN

Whole lung lavage (WLL) is the first-line treatment for pulmonary alveolar proteinosis. We hypothesized that lung ultrasound (LUS) would guide flooding during treatment in a 15-year-old boy. WLL of each lung consisted of instillation of saline followed by kinesiotherapy and fluid drainage. In the first WLL, the lung was repeatedly flooded until the lavage fluid was clear on macroscopic examination. During this process, LUS was used to visualise lung aeration. In the second WLL, we used LUS signs to guide the lavage volume. The appearance of the fluid bronchogram sign showed that saline infusion could be stopped earlier than in the first lavage. In conclusion, LUS helped monitor the different stages of controlled lung de-aeration during WLL and reduce the total amount of saline used. This technique will also reduce the risk of WLL-related complications.


Asunto(s)
Proteinosis Alveolar Pulmonar , Masculino , Humanos , Niño , Adolescente , Proteinosis Alveolar Pulmonar/diagnóstico por imagen , Proteinosis Alveolar Pulmonar/terapia , Lavado Broncoalveolar/métodos , Pulmón/diagnóstico por imagen , Ultrasonografía
6.
Appl Ergon ; 106: 103902, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36162274

RESUMEN

Medical events can affect space crew health and compromise the success of deep space missions. To successfully manage such events, crew members must be sufficiently prepared to manage certain medical conditions for which they are not technically trained. Extended Reality (XR) can provide an immersive, realistic user experience that, when integrated with augmented clinical tools (ACT), can improve training outcomes and provide real-time guidance during non-routine tasks, diagnostic, and therapeutic procedures. The goal of this study was to develop a framework to guide XR platform development using astronaut medical training and guidance as the domain for illustration. We conducted a mixed-methods study-using video conference meetings (45 subject-matter experts), Delphi panel surveys, and a web-based card sorting application-to develop a standard taxonomy of essential XR capabilities. We augmented this by identifying additional models and taxonomies from related fields. Together, this "taxonomy of taxonomies," and the essential XR capabilities identified, serve as an initial framework to structure the development of XR-based medical training and guidance for use during deep space exploration missions. We provide a schematic approach, illustrated with a use case, for how this framework and materials generated through this study might be employed.


Asunto(s)
Vuelo Espacial , Humanos , Programas Informáticos
7.
Clin Mol Allergy ; 20(1): 11, 2022 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-36104791

RESUMEN

BACKGROUND: Allergy to Apis dorsata (Giant Asian Honeybee) venom is the commonest insect allergy in Sri Lanka and South East Asia. However, laboratory diagnosis is difficult as the pure venom and diagnostic reagents are not commercially available. OBJECTIVE: This study assessed the use of four recombinant allergens of A. mellifera venom and the passive basophil activation test in the diagnosis of A. dorsata venom anaphylaxis. METHODS: Serum IgE levels to four recombinant allergens of A. mellifera, rApi m 1, 2, 5 and 10 were assessed and compared with serum IgE to the crude venom of A. mellifera or V. vulgaris by Phadia ImmunoCAP, in patients who developed anaphylaxis to A. dorsata stings. Basophil activation in response to venom of A. dorsata or V. affinis was assessed using a passive basophil activation test. Association of the severity of the reaction with basophil activation was compared. RESULTS: rApi m 1 and 10 combinedly had significant correlation (r = 0.722; p < 0.001) with the crude venom of A. mellifera (Western honeybee) and a higher positivity rate of 90% (27/30). Whereas, IgE reactivity to rApi m 2 or 5 had significant correlation (p = 0.02 and p = 0.005 respectively) with V. vulgaris crude venom. All 30 (100%) were positive to A. dorsata venom in passive BAT; 70% (21/30) had over 80% activation, 96.7% (29/30) had over 60% activation and 100% had over 50% activation. Percentage activation of basophils in patients who had mild or moderate reactions (n = 20) was significantly low (p = 0.02) from that of patients who had severe reactions (n = 10). CONCLUSIONS: rApi m 1 and 10 when combined was sensitive for the diagnosis of A. dorsata allergy. This combination had the lowest cross-reactivity rate with Vespula vulgaris. The passive BAT is highly sensitive in A. dorsata allergy. The basophil reactivity was significantly higher in severe anaphylaxis compared to mild/moderate anaphylaxis. This finding should be further explored in further studies.

8.
Artículo en Inglés | MEDLINE | ID: mdl-35937956

RESUMEN

The cardiac surgery operating room is a high-risk and complex environment in which multiple experts work as a team to provide safe and excellent care to patients. During the cardiopulmonary bypass phase of cardiac surgery, critical decisions need to be made and the perfusionists play a crucial role in assessing available information and taking a certain course of action. In this paper, we report the findings of a simulation-based study using machine learning to build predictive models of perfusionists' decision-making during critical situations in the operating room (OR). Performing 30-fold cross-validation across 30 random seeds, our machine learning approach was able to achieve an accuracy of 78.2% (95% confidence interval: 77.8% to 78.6%) in predicting perfusionists' actions, having access to only 148 simulations. The findings from this study may inform future development of computerised clinical decision support tools to be embedded into the OR, improving patient safety and surgical outcomes.

10.
Heliyon ; 8(1): e08808, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35128100

RESUMEN

Given the importance of the financial markets in the global context, data analysis and new statistical approach are always welcome, especially if we are referring to G-20 group (the world's richest countries). As we know, the pandemic outbreak of COVID-19 has affected the global economy, and its impact seems to be inevitable (as it was in 2020). From the perspective of what was raised above, this paper aims to analyze the stock market efficiency in 21 indexes of G-20. We are going to do our analysis with intraday scale (of hour), from May 2019 to May 2020. In order to be successful in this analysis, we applied the DFA and the DCCA methods, to identify or not two points:i)Are G-20 stock market efficient in their weak form?ii)With open/close values, it is possible to identify some type of memory in G-20 group? The answer to these points will be given throughout this paper. For this purpose, the entire analysis will be divided into two different time-scale: Period I, time-scale less than five days and Period II, with time-scale greater than ten days. In the pandemic times of COVID-19, our results show that taking into account the DFA method, for time-scale shorter than 5 days, the stock markets tend to be efficient, whereas for time-scale longer than 10 days, the stock market tend to be inefficient. But, with DCCA method for cross-correlation analysis, the results for open/close indexes show different types of behaviors for each stock market index separately.

11.
Rev Neurol ; 74(5): 170-173, 2022 03 01.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35211951

RESUMEN

INTRODUCTION: PURA syndrome is a rare autosomal dominant condition caused by de novo pathogenic variants in PURA gene and characterized by a multisystemic phenotype that includes global neurodevelopmental delay, early hypotonia, absence of speech, feeding difficulties, hypersomnolence, epilepsy and movement disorders. CASE REPORT: We report a 9-year-old girl with hypotonia and feeding difficulties with failure to thrive since the neonatal period. At the age of 3 years motor and intellectual delay were evident, she had a wide-based gait, no speech and an exaggerated acoustic startle response. She developed hand-mouthing stereotypies and epilepsy at 6 years old. The 24 hours continuous electroencephalogram monitoring revealed global slow activity and frequent epileptiform activity in left temporal and centrotemporal areas. The brain MRI revealed delayed myelination. At 6 years old the clinical exome sequencing identified a heterozygous pathogenic variant in the PURA gene, c.153delA p.(Leu54CysfsTer24). CONCLUSION: PURA syndrome has clinical features similar to other neurological disorders but the association with some clinical features, not as common in other neurological entities, like never being able to speak but being able to follow simple orders and exaggerated acoustic startle response, should raise the suspicion of PURA syndrome and genetic analysis must be performed to confirm the diagnosis and provide early multidisciplinary intervention.


TITLE: Síndrome PURA en una niña con retraso grave del desarrollo: un diagnóstico desafiante.Introducción. El síndrome PURA es una condición autosómica dominante poco común causada por variantes patogénicas de novo en el gen PURA y que se caracteriza por un fenotipo multisistémico que incluye retraso del neurodesarrollo global, hipotonía temprana, ausencia de habla, dificultades para alimentarse, hipersomnolencia, epilepsia y trastornos del movimiento. Caso clínico. Presentamos una niña de 9 años con hipotonía y dificultades para alimentarse con retraso del crecimiento desde el período neonatal. A la edad de 3 años era evidente el retraso motor e intelectual, tenía una marcha de base amplia, no hablaba y una respuesta de sobresalto acústico exagerada. Desarrolló estereotipias de mano-boca y epilepsia a los 6 años. La monitorización electroencefalográfica continua de 24 horas reveló una actividad lenta global y una actividad epileptiforme frecuente en las áreas temporal izquierda y centrotemporal. La resonancia magnética del cerebro reveló un retraso en la mielinización. A los 6 años, la secuenciación clínica del exoma identificó una variante patógena heterocigótica en el gen PURA, c.153delA p. (Leu54CysfsTer24). Conclusión. El síndrome PURA tiene características clínicas similares a otros trastornos neurológicos, pero la asociación con algunas características clínicas, no tan comunes en otras entidades neurológicas, como no poder hablar, pero poder seguir órdenes simples, y una respuesta de sobresalto acústico exagerado, deben ser factores de sospecha de síndrome PURA y servir para realizar un análisis genético para confirmar el diagnóstico y proporcionar una intervención multidisciplinar precoz.


Asunto(s)
Epilepsia , Discapacidad Intelectual , Niño , Proteínas de Unión al ADN/genética , Discapacidades del Desarrollo/diagnóstico , Discapacidades del Desarrollo/genética , Epilepsia/genética , Femenino , Humanos , Discapacidad Intelectual/genética , Reflejo de Sobresalto , Factores de Transcripción/genética
12.
Rev Esp Anestesiol Reanim (Engl Ed) ; 68(9): 531-536, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34836583

RESUMEN

INTRODUCTION: Epidural analgesia is considered the preferred analgesic choice during labour. Post dural puncture headache (PDPH) is considered a potential complication of this analgesic technique and is a frequently hypothesis for any headache occurring after delivery. It is essential that anaesthetists and obstetricians are familiar with other possible differential diagnosis for postpartum headache (PPH). CASE DESCRIPTION: 37-year-old female presented after delivery with intense occipital pulsatile headache associated with neck radiation, nausea and vomiting, hemodynamically stable and normal neurologic physical examination. Abnormalities in thyroid hormone levels were found. CT-scan findings suggested pituitary apoplexy. DISCUSSION: There are many differential diagnoses for PPH and some are rarely considered, such as pituitary apoplexy. It is essential to differentiate signs and symptoms of each diagnosis, since many of them overlap. CONCLUSION: Not all postpartum headaches are PDPH and the first suspected diagnosis may not always be accurate.


Asunto(s)
Analgesia Epidural , Anestesia Epidural , Cefalea Pospunción de la Duramadre , Analgesia Epidural/efectos adversos , Anestesia Epidural/efectos adversos , Femenino , Cefalea/diagnóstico , Humanos , Cefalea Pospunción de la Duramadre/diagnóstico , Periodo Posparto
13.
Rev Esp Anestesiol Reanim ; 68(7): 408-413, 2021.
Artículo en Español | MEDLINE | ID: mdl-34629562

RESUMEN

INTRODUCTION: Regional anesthesia techniques were recently introduced to provide analgesia for breast surgery. These techniques are rarely used as the primary anesthesia due to the complexity of breast innervation, with numerous structures that can potentially be disrupted during breast surgery. CASE REPORT: A female patient in her sixties diagnosed with invasive ductal carcinoma on her left breast was scheduled for a simple mastectomy. After anesthetic evaluation, identification of high risk perioperative cardiovascular complications, it was proposed to perform the surgery only with regional anesthesia. A combination of pectoral nerve block (Pecs II), pecto-intercostal fascial block (PIFB) and supraclavicular nerve block ultrasound-guided were successfully performed. CONCLUSION: This is the first case reporting a novel approach in a patient with severe cardiopulmonary disease who underwent breast surgery in a COVID-19 era.

14.
Artículo en Inglés | MEDLINE | ID: mdl-34509278

RESUMEN

INTRODUCTION: Regional anesthesia techniques were recently introduced to provide analgesia for breast surgery. These techniques are rarely used as the primary anesthesia due to the complexity of breast innervation, with numerous structures that can potentially be disrupted during breast surgery. CASE REPORT: A female patient in her sixties diagnosed with invasive ductal carcinoma on her left breast was scheduled for a simple mastectomy. After anesthetic evaluation, identification of high risk perioperative cardiovascular complications, it was proposed to perform the surgery only with regional anesthesia. A combination of pectoral nerve block (Pecs II), pecto-intercostal fascial block (PIFB) and supraclavicular nerve block ultrasound-guided were successfully performed. CONCLUSION: This is the first case reporting a novel approach in a patient with severe cardiopulmonary disease who underwent breast surgery in a COVID-19 era.


Asunto(s)
Anestésicos , Neoplasias de la Mama , COVID-19 , Bloqueo Nervioso , Ultrasonografía Intervencional , Neoplasias de la Mama/cirugía , Femenino , Humanos , Mastectomía , Mastectomía Simple , Persona de Mediana Edad , SARS-CoV-2 , Volumen Sistólico , Función Ventricular Izquierda
15.
Ultrasound Obstet Gynecol ; 58(4): 597-602, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34090308

RESUMEN

OBJECTIVE: 22q11.2 deletion is more common than trisomies 18 and 13 combined, yet no routine approach to prenatal screening for this microdeletion has been established. This study evaluated the clinical sensitivity and specificity of a targeted cell-free DNA (cfDNA) test to screen for fetal 22q11.2 deletion in a large cohort, using blinded analysis of prospectively enrolled pregnancies and stored clinical samples. METHODS: In order to ensure that the analysis included a meaningful number of cases with fetal 22q11.2 deletion, maternal plasma samples were obtained by prospective, multicenter enrolment of pregnancies with a fetal cardiac abnormality and from stored clinical samples from a research sample bank. Fetal genetic status, as evaluated by microarray analysis, karyotyping with fluorescence in-situ hybridization or a comparable test, was available for all cases. Samples were processed as described previously for the Harmony prenatal test, with the addition of DANSR (Digital Analysis of Selected Regions) assays targeting the 3.0-Mb region of 22q11.2 associated with 22q11.2 deletion syndrome. Operators were blinded to fetal genetic status. Sensitivity and specificity of the cfDNA test for 22q11.2 deletion were calculated based on concordance between the cfDNA result and fetal genotype. RESULTS: The final study group consisted of 735 clinical samples, including 358 from prospectively enrolled pregnancies and 377 stored clinical samples. Of 46 maternal plasma samples from pregnancies with a 22q11.2 deletion, ranging in size from 1.25 to 3.25 Mb, 32 had a cfDNA result indicating a high probability of 22q11.2 deletion (sensitivity, 69.6% (95% CI, 55.2-80.9%)). All 689 maternal plasma samples without a 22q11.2 deletion were classified correctly by the cfDNA test as having no evidence of a 22q11.2 deletion (specificity, 100% (95% CI, 99.5-100%)). CONCLUSIONS: The results of this large-scale prospective clinical evaluation of the sensitivity and specificity of a targeted cfDNA test for fetal 22q11.2 deletion demonstrate that this test can detect the common and smaller, nested 22q11.2 deletions with a low (0-0.5%) false-positive rate. Although the positive predictive value (PPV) observed in this study population was 100%, the expected PPV in the general pregnant population is estimated to be 12.2% at 99.5% specificity and 41.1% at 99.9% specificity. The use of this cfDNA test to screen for 22q11.2 deletion could enhance identification of pregnancies at risk for 22q11.2 deletion syndrome without significantly increasing the likelihood of maternal anxiety and unnecessary invasive procedures related to a false-positive result. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.


Asunto(s)
Ácidos Nucleicos Libres de Células/sangre , Síndrome de DiGeorge/diagnóstico , Pruebas de Detección del Suero Materno/estadística & datos numéricos , Adulto , Síndrome de DiGeorge/embriología , Femenino , Genotipo , Humanos , Hibridación Fluorescente in Situ , Cariotipificación , Análisis por Micromatrices , Valor Predictivo de las Pruebas , Embarazo , Estudios Prospectivos , Sensibilidad y Especificidad , Método Simple Ciego
16.
J Appl Microbiol ; 131(4): 1942-1957, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33709536

RESUMEN

AIMS: In-vitro/In-vivo evaluation of cholesterol-lowering probiotic strain Lactobacillus paracasei DTA81 and the possible connection with the gut microbiota modulation. METHODS AND RESULTS: In the present study, strain DTA81 has been evaluated for the possible influence on blood lipid and glucose concentrations, modulation of the immune system, gastrointestinal survivability and modulation of gut microbiota in BALB/c mice receiving a high-fat diet. After 6 weeks of treatment, a significant reduction of total cholesterol and fasting blood sugar (FBS) among animals treated with L. paracasei DTA81 has been recorded. Comparison of colon tissue levels of different cytokines revealed a significant reduction of the inflammatory cytokine interleukin-6. The comparison of gut microbiota using the 16S rRNA approach indicated that the treatment with L. paracasei DTA81 significantly increased the taxa Bacteroidetes and Coprococcus. Moreover, the genome of DTA81 was sequenced for the in-silico assessment, and the analysis indicated the presence of cholesterol assimilation-related genes as well as the absence of negative traits such as transmissible antibiotic resistance genes, plasmids and prophage regions. CONCLUSION: The outcome of this study revealed the in-vitro and in-vivo properties of L. paracasei DTA81 and the possible mechanism between consumption of this strain, the abundance of Bacteriodetes/Coprococcus taxa, immunomodulatory activity and the subsequent reduction of cholesterol/FBS in BALB/c mice. SIGNIFICANCE AND IMPACT OF THE STUDY: Lactobacillus paracasei DTA81 as a non-pharmacological potential probiotic supplement can influence metabolic homeostasis in individuals, particularly those adopting high-fat diets, and it can contribute to reduce coronary heart disease.


Asunto(s)
Microbioma Gastrointestinal , Lacticaseibacillus paracasei , Probióticos , Animales , Colesterol , Dieta Alta en Grasa , Ratones , Ratones Endogámicos BALB C , ARN Ribosómico 16S/genética
17.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33516566

RESUMEN

INTRODUCTION: Epidural analgesia is considered the preferred analgesic choice during labour. Post dural puncture headache (PDPH) is considered a potential complication of this analgesic technique and is a frequently hypothesis for any headache occurring after delivery. It is essential that anaesthetists and obstetricians are familiar with other possible differential diagnosis for postpartum headache (PPH). CASE DESCRIPTION: 37-year-old female presented after delivery with intense occipital pulsatile headache associated with neck radiation, nausea and vomiting, hemodynamically stable and normal neurologic physical examination. Abnormalities in thyroid hormone levels were found. CT-scan findings suggested pituitary apoplexy. DISCUSSION: There are many differential diagnoses for PPH and some are rarely considered, such as pituitary apoplexy. It is essential to differentiate signs and symptoms of each diagnosis, since many of them overlap. CONCLUSION: Not all postpartum headaches are PDPH and the first suspected diagnosis may not always be accurate.

18.
Health Educ Res ; 35(5): 396-406, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32772070

RESUMEN

Effective obesity interventions in adolescent populations have been identified as an immediate priority action to stem the increasing prevalence of adult obesity. The purpose of this meta-analysis was to make a quantitative analysis of the impact of school-based interventions on body mass index during adolescence. Studies were retrieved from PubMed, Scopus, Science Direct and Web of Science databases. Results were pooled using a random-effects model with 95% confidence interval considered statistically significant. Of the 18 798 possible relevant articles identified, 12 articles were included in this meta-analysis. The global result showed a low magnitude effect, though it was statistically significant (N = 14 428), global e.s. = -0.055, P = 0.004 (95% CI = -0.092, -0.017). Heterogeneity was low among the studies (I2 = 9.017%). The funnel plot showed no evidence of publication bias. The rank-correlation test of Begg (P = 0.45641) and Egger's regression (P = 0.19459) confirmed the absence of bias. This meta-analysis reported a significant effect favoring the interventions; however, future research are needed since the reported the evidence was of low magnitude, with the studies following a substantial range of approaches and mostly had a modest methodological quality.


Asunto(s)
Instituciones Académicas , Adolescente , Índice de Masa Corporal , Humanos , Prevalencia
19.
Transl Psychiatry ; 10(1): 107, 2020 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-32313006

RESUMEN

A pivotal aim of psychiatric and neurological research is to promote the translation of the findings into clinical practice to improve diagnostic and prognostic assessment of individual patients. Structural neuroimaging holds much promise, with neuroanatomical measures accounting for up to 40% of the variance in clinical outcome. Building on these findings, a number of imaging-based clinical tools have been developed to make diagnostic and prognostic inferences about individual patients from their structural Magnetic Resonance Imaging scans. This systematic review describes and compares the technical characteristics of the available tools, with the aim to assess their translational potential into real-world clinical settings. The results reveal that a total of eight tools. All of these were specifically developed for neurological disorders, and as such are not suitable for application to psychiatric disorders. Furthermore, most of the tools were trained and validated in a single dataset, which can result in poor generalizability, or using a small number of individuals, which can cause overoptimistic results. In addition, all of the tools rely on two strategies to detect brain abnormalities in single individuals, one based on univariate comparison, and the other based on multivariate machine-learning algorithms. We discuss current barriers to the adoption of these tools in clinical practice and propose a checklist of pivotal characteristics that should be included in an "ideal" neuroimaging-based clinical tool for brain disorders.


Asunto(s)
Encefalopatías , Encéfalo , Encéfalo/diagnóstico por imagen , Encefalopatías/diagnóstico por imagen , Humanos , Aprendizaje Automático , Imagen por Resonancia Magnética , Neuroimagen
20.
Poult Sci ; 99(4): 2033-2040, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32241488

RESUMEN

Many requirements are necessary to meet the European Union rules to export poultry, including the amount of physiological water and water-protein ratio (WPR) in carcasses. Therefore, the aim of this study was to identify if strain, nutrition, and age affect the amount of collagen and fat and the WPR in cuts and verify whether the latter meets the international export standards. A total of 3,240 male chicks were housed in a completely randomized design in a 3 × 3 × 5 factorial arrangement, which included 3 nutritional densities (regular, medium, and high), 3 strains (021 Embrapa and 2 commercial strains identified as A and B), and 5 ages. Twelve broilers from each treatment (totaling 540 birds) were slaughtered at 28, 35, 42, 49, and 56 D of age to determine collagen and fat levels and WPR (through the calculation of moisture and protein percentage) in broiler breasts and legs using the near-infrared spectroscopy method. The use of feeds with different nutritional densities presented in this study has no effect on the WPR in the breast and legs of broilers slaughtered between 28 and 56 D of age. However, nutritional density influences liveweight and percentage of fat in the breast and legs. Collagen percentage in the legs decreases with increasing nutritional density. The 021 Embrapa strain cuts present a lower WPR than those of other commercial strains. However, the values found for all strains studied are within the limits of the Europe Union and Brazilian legislations. The liveweight, breast weight, leg weight, and leg fat increases linearly with age. Quite the opposite, water protein ratio, breast fat level, and breast collagen level decrease linearly with age. Leg WPR and leg collagen level are not affected by age. Despite the differences found for strains, nutritional densities and age readers should be aware that these factors may interact with each other depending on the response variable studied.


Asunto(s)
Pollos/fisiología , Dieta/veterinaria , Miembro Posterior/química , Carne/análisis , Estado Nutricional , Músculos Pectorales/química , Factores de Edad , Alimentación Animal/análisis , Animales , Proteínas Aviares/análisis , Brasil , Pollos/genética , Colágeno/análisis , Lípidos/análisis , Masculino , Agua/análisis
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