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The development of novel chemically developed and physically defined surfaces and environments for cell culture and screening is important for various biological applications. The Droplet microarray (DMA) platform based on hydrophilic-superhydrophobic patterning enables high-throughput cellular screening in nanoliter volumes and on various biocompatible surfaces. Here we performed phenotypic and transcriptomic analysis of HeLa-CCL2 cells cultured on DMA, with a goal to analyze cellular response on different surfaces and culture volumes down to 3 nL, compared with conventional cell culture platforms. Our results indicate that cells cultured on four tested substrates: nanostructured nonpolymer, rough and smooth variants of poly(2-hydroxyethyl methacrylate-co-ethylene dimethacrylate) polymer and poly(thioether) dendrimer are compatible with cells grown in Petri dish. Cells cultured on nanostructured nonpolymer coating exhibited the closet transcriptomic resemblance to that of cells grown in Petri dish. Analysis of cells cultured in 100, 9, and 3 nL media droplets on DMA indicated that all but cells grown in 3 nL volumes had unperturbed viability with minimal alterations in the transcriptome compared with 96-well plate. Our findings demonstrate the applicability of DMA for cell-based assays and highlight the possibility of establishing regular cell culture on various biomaterial-coated substrates and in nanoliter volumes, along with routinely used cell culture platforms.
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The process of drug discovery includes individual synthesis and characterization of drug candidates, followed by a biological screening, which is separated from synthesis in space and time. This approach suffers from low throughput and associated high costs, which in turn lead to inefficiency in the field of drug discovery. Here, we present a miniaturized platform combining combinatorial solid-phase synthesis with high-throughput cell screenings. The method is based on the formation of nanoporous poly(2-hydroxyethyl methacrylate-co-ethylene dimethacrylate) layers patterned with hydrophilic spots separated from each other by superhydrophobic liquid-impermeable barriers. The porous polymer inside the hydrophilic spots is used as a support to conduct solid-phase synthesis. The hydrophilic spots can be then filled with droplets containing either reagents for synthesis or live cells. Upon irradiation with UV light, products of solid-phase synthesis are released from the porous polymer because of the photo-cleavable linkers used and diffuse into separate droplets. The light-induced release of the products allows the control of the release spatially, temporally, and quantitatively. To demonstrate the versatility and usability of the platform for various cell lines, we have successfully implemented peptide synthesis to create an exemplary chemical library and demonstrated high cell viability after the UV-triggered small-molecule release.
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OBJECTIVES: To evaluate the changes in prognostic impression and patient management following PET/CT in patients with vulvar and vaginal carcinoma; and to compare PET/CT findings with those of conventional imaging modalities. METHODS: We summarized prospectively and retrospectively collected data for 50 consecutive patients from our institution that enrolled in the National Oncologic PET Registry and underwent FDG-PET/CT for a suspected or known primary or recurrent vulvar/vaginal cancer. RESULTS: 54/83 (65%) studies included had a diagnosis of vulvar cancer, and the remaining 29/83 (35%), a diagnosis of vaginal cancer. Following FDG-PET/CT, the physician's prognostic impression changed in 51% of cases. A change in patient management, defined as a change to/from a non-interventional strategy (observation or additional imaging), to/from an interventional strategy (biopsy or treatment), was documented in 36% of studies. The electronic records demonstrated that 95% of the management strategies recorded in the physician questionnaires were implemented as planned. MRI and/or CT were performed within one month of the FDG-PET/CT in 20/83 (24%) and 28/83 (34%) cases, respectively. FDG-PET/CT detected nodes suspicious for metastases on 29/83 (35%) studies performed. MRI and CT detected positive nodes on 6 and 11 studies respectively. Distant metastases were identified in 10 cases imaged with FDG-PET and 5 cases that had additional conventional CT imaging. All suspicious lesions seen on CT were positively identified on PET/CT. In 4 cases, an abnormality identified on PET/CT, was not seen on diagnostic CT. CONCLUSIONS: FDG-PET/CT may play an important role in the management of vulvar and vaginal carcinoma.
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Carcinoma/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Neoplasias Vaginais/diagnóstico , Neoplasias Vulvares/diagnóstico , Carcinoma/secundário , Carcinoma/terapia , Gerenciamento Clínico , Feminino , Fluordesoxiglucose F18 , Humanos , Metástase Linfática , Imagem Multimodal , Prognóstico , Estudos Prospectivos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Neoplasias Vaginais/terapia , Neoplasias Vulvares/terapiaRESUMO
Respiratory syncytial virus (RSV) usually causes self-limiting upper respiratory tract infections, but can be associated with severe lower respiratory tract infection disease (LRTID) in infants and in patients with hematologic malignancies. We have analyzed the risk factors and the measures for containment within an outbreak of nosocomial RSV infections in a hematology and SCT unit. A total of 56 patients were affected (53 RSV-A and 3 RSV-B) including 32 transplant patients (16 allogeneic and 16 autologous). Forty (71%) of the 56 patients suffered from LRTID and 14 (35%) of the patients with LRTID subsequently died. However, because of concomitant infections with fungal and bacterial pathogens, the impact of RSV on the fatal outcome was difficult to assess. Multivariate analysis showed that low levels of IgG were significantly associated with fatal outcome (P=0.007), treatment with oral ribavirin represented a protective factor (P=0.02). An extremely protracted viral shedding was observed in this cohort of patients (median=30.5 days, range: 1-162 days), especially pronounced in patients after allogeneic transplantation (P=0.002). Implementation of rigorous isolation and barrier measures, although challenged by long-term viral carriers, was effective in containment of the outbreak.
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Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Adolescente , Adulto , Idoso , Infecção Hospitalar/virologia , Feminino , Alemanha/epidemiologia , Hematologia , Departamentos Hospitalares , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/isolamento & purificação , Estudos Retrospectivos , Fatores de Risco , Transplante de Células-Tronco , Adulto JovemRESUMO
Duke Swamp is a wetland ecosystem that receives (14)C via a groundwater pathway originating from a waste management area on Atomic Energy Canada Limited's Chalk River Laboratories site. This groundwater reaches the surface of the swamp, resulting in relatively high (14)C levels over an area of 146 m(2). The objective of this study was to quantify (14)C concentrations in flora and fauna inhabiting areas of Duke Swamp over the gradient of (14)C activity concentrations in moss to determine whether (14)C specific activities in receptor biota reflect the localized nature of the groundwater source in the swamp. Representative receptor plants and animals, and corresponding air and soil samples were collected at six sites in Duke Swamp with (14)C specific activities in air that ranged from 1140 to 45,900 Bq/kg C. In general, it was found that specific activities of (14)C in biota tissues reflected those measured in environmental media collected from the same sampling site. The findings demonstrate that mosses could be used in monitoring programs to ensure protection of biota in areas with elevated (14)C, negating the need to capture and euthanize higher organisms.
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Biota , Radioisótopos de Carbono/análise , Monitoramento Ambiental , Poluentes Químicos da Água/análise , Áreas AlagadasRESUMO
BACKGROUND/PURPOSE: Different devices are used for the non-invasive measurement of (constitutive) skin pigmentation in (epidemiological) studies. Reproducibility of measurements with the Chromameter (CM, model CR 300, Minolta, Osaka) and the Reflectometer (RM, Courage & Khazaka, Cologne) has not yet been examined in detail and was addressed in a set of four experiments and studies respectively. METHODS: Regarding the CM, the Y value of the Yxy CIE 1931 colour system was utilized, representing lightness in this colour space, while the RM measured reflectance at 660 nm with a small bandwidth of 20 nm. Both devices measure reflectance on a scale from 0 to 100%, however, in different wavelength ranges. Between 3 and 20 repetitions were performed on standard grey scales and different sets of human volunteers, including RM measurements in a large epidemiological field study. RESULTS: While the coefficient of variation (V) increases and the intraclass correlation coefficient decreases from controlled laboratory to field conditions, reproducibility remained in a range considered acceptable, if adequate study conditions were maintained. In a direct comparison on human skin, V of the RM was significantly smaller than that of the CM. CONCLUSION: Both devices can be used confidently in field studies; however, based on considerations of skin optics and in view of slightly lesser variability, the RM may be preferable.
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Colorimetria/instrumentação , Fotometria/instrumentação , Pigmentação da Pele/fisiologia , Adulto , Idoso , Estudos Epidemiológicos , Desenho de Equipamento , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
PURPOSE: To assess the diagnostic accuracy of a new automatic texture-based algorithm (ATBA) in ultrasound imaging of ovarian masses and to compare its performance to subjective assessment by examiners with different levels of ultrasound experience. MATERIALS AND METHODS: A total of 105 ultrasound images from three different groups of ovarian lesions (malignancies, functional cysts, and dermoid cysts) were evaluated using ATBA and by a total of 36 examiners with four different levels of experience (9 junior trainees, 8 senior trainees, 11 senior gynecologists, and 8 experts). Cohen's κ, Youden's indices, and the sensitivity and specificity of ATBA and of each observer were calculated for every subgroup of ovarian lesions. RESULTS: ATBA classified 78 of the 105 masses correctly (κ = 0.62) - results that were significantly better than those of the junior and senior trainees (p = 0.02 and p < 0.01), while differences from the group of level II examiners did not reach statistical significance (p = 0.27). The best diagnostic performance (κ = 0.70) was obtained by the group of expert level III ultrasonographers. The best classification rates overall, including both ATBA and subjective assessments, were achieved in the detection of functional cysts (Youden's indices from 0.73 to 0.85), while the poorest diagnostic performance was obtained for the classification of dermoid cysts (Youden's indices from 0.28 to 0.55). CONCLUSION: ATBA showed a significantly better diagnostic performance than observers with low or medium levels of experience, emphasizing its potential value for training purposes and in providing additional diagnostic assistance for inexperienced observers.
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Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Ovarianas/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Variações Dependentes do Observador , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Ovário/diagnóstico por imagem , Ovário/patologia , Sensibilidade e Especificidade , Adulto JovemRESUMO
OBJECTIVES: When motor imagery (MI) is impaired in stroke patients, it is not clear, whether this is caused by the central lesion with a disruption of networks or this may be due to inactivity/lack of practice following hemiparesis. To answer this question, we investigated MI in two groups of patients: stroke patients and patients with no central lesion, who suffered high-grade tetraparesis caused by myopathy or spinal muscular atrophy. MATERIALS AND METHODS: The first study measured MI in 31 sub-acute and chronic stroke patients with hand paresis. We used self-assessment questionnaires [Kinaesthetic and Visual Imagery Questionnaire (KVIQ), the Vividness of Motor Imagery Questionnaire (VMIQ)] as well as a new chronometric test (mental version and normal/physical version of Box and Block Test). The second study assessed MI in 10 patients without a central lesion, but with severe tetraparesis of peripheral origin. They were incapable of performing the requested task physically. RESULTS: MI in patients was better (i) for the third-person (VMIQ(3.P) ) compared to the first-person perspective (VMIQ(1.P) ), (ii) in patients without sensory impairment compared to those with impaired proprioception, (iii) in patients with light paresis compared to severe paresis and (iv) for the non-affected than the affected hand (KVIQ-10). Patients with severe tetraparesis were able to imagine another person's knee bends, but were not capable of imagining themselves performing knee bends. CONCLUSIONS: MI may be hampered on the affected side in severely paretic patients, particularly in the presence of impaired proprioception. Remarkably, the second study illustrates that motor experiences shape MI. This confirms the close relationship between MI and movement execution. The study advocates the careful use of test batteries for assessment of MI when investigating mental training in clinical trials. Not all patients might benefit to the same extent from MI training. This is possibly contingent on intact proprioception and preserved MI.
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Imagens, Psicoterapia/métodos , Movimento , Paresia/complicações , Doenças do Sistema Nervoso Periférico/complicações , Medula Espinal/fisiopatologia , Acidente Vascular Cerebral , Feminino , Lateralidade Funcional , Mãos/fisiopatologia , Humanos , Cinestesia , Masculino , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , Atividade Motora , Paresia/reabilitação , Doenças do Sistema Nervoso Periférico/reabilitação , Autoavaliação (Psicologia) , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral , Inquéritos e Questionários , Resultado do TratamentoRESUMO
In the past, enormous public and private investments have been made to reduce cancer incidence and mortality. Despite some improvements over the last 10 years, the overall outcome of the "war on cancer" has been disappointing. Among the reasons for this limited success is our inability to determine, whether the therapeutic target is present, and whether the target is reached by the drug. A further important issue is our limited ability to correctly assess response to treatment early after start of therapy which would allow for more individualized treatment approaches. PET and PET/CT with the glucose analogue 2'-[(18)F]-fluoro-2'-deoxy-D-glucose (FDG) are increasingly used to assess response to therapy in patients, and a converging large body of evidence is emerging that suggests that changes in glucose utilization during therapy can be used to predict clinical outcome. In this article we provide an overview of the utility of (18)F-FDG PET/CT imaging for early monitoring of cancer therapy and address current and future challenges for its more widespread adoption. First, we discuss general requirements that any imaging modality must meet to provide valid and valuable treatment response assessment. We will then review the strengths and limitations of CT (RECIST) and PET based response criteria. Finally, we will examine the role of FDG-PET/(CT) imaging for response assessments in solid tumors.
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Fluordesoxiglucose F18 , Imagem Molecular/tendências , Neoplasias/diagnóstico , Neoplasias/terapia , Avaliação de Resultados em Cuidados de Saúde/tendências , Tomografia por Emissão de Pósitrons/tendências , Tomografia Computadorizada por Raios X/tendências , Humanos , Compostos Radiofarmacêuticos , Técnica de Subtração/tendências , Resultado do TratamentoRESUMO
In children with nocturnal bedwetting, the basic diagnostic evaluation to differentiate between monosymptomatic enuresis and organic or functional urinary incontinence is mandatory. When the diagnosis of monosymptomatic enuresis is set, a stepped therapeutic program is available, in which alarm/behavior therapy has a central role. Drug therapy of monosymptomatic enuresis in childhood is an established option and is reserved for certain indications.
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Enurese/etiologia , Adolescente , Terapia Comportamental , Criança , Pré-Escolar , Antagonistas Colinérgicos/uso terapêutico , Terapia Combinada , Desamino Arginina Vasopressina/uso terapêutico , Diagnóstico Diferencial , Enurese/terapia , Terapia Familiar , Feminino , Humanos , Imipramina/uso terapêutico , Masculino , Fatores de RiscoRESUMO
AIMS: To evaluate acute effects of hemodialysis (HD) on the salivary flow rate, pH and biochemical composition before, during and after completion of a dialysis session. MATERIAL AND METHODS: Unstimulated whole saliva (UWS) and chewing-stimulated whole saliva (CH-SWS) were collected in 94 HD patients. Salivary flow rate, pH, concentrations of total protein, albumin, cystatin C, secretory immunoglobulin A (S-IgA) and of sodium, potassium and urea were measured. RESULTS: HD had an acute stimulating effect on the salivary flow rate (UWSbefore = 0.30+/-0.22 ml/min, UWSduring = 0.39+/-0.25 ml/min, p < 0.005). The mean pH of UWS showed a small but significant increase during HD mainly due to an increased watery secretion from the salivary glands. The salivary biochemical constituents changed markedly, but no significant difference in output was found. The electrolyte concentration did not change significantly during dialysis. The level of urea in CH-SWS declined to 40% (Ureabefore = 25.+/-6.4 mmol/l, Ureaduring = 15.3+/-4.5 mmol/1). CONCLUSIONS: This study shows that HD has significant acute effects on both salivary secretion rate and protein concentrations in saliva. We conclude that the observed changes in salivary concentrations and proteins are mainly due to an increased watery secretion from the salivary glands.
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Diálise Renal , Saliva/química , Saliva/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistatina C , Cistatinas/análise , Feminino , Humanos , Concentração de Íons de Hidrogênio , Imunoglobulina A Secretora/análise , Masculino , Pessoa de Meia-Idade , Potássio/análise , Proteínas e Peptídeos Salivares/análise , Sódio/análise , Ureia/análiseRESUMO
OBJECTIVES: To compare oral health, salivary flow rate, xerostomia and thirst in end stage renal disease (ESRD) patients remaining on dialysis treatment and after renal transplantation. DESIGN: Longitudinal observation. SETTING: ESRD patients recruited from dialysis centres in Amsterdam, The Hague and Utrecht, The Netherlands. METHOD: At baseline and after two years, salivary flow rates, xerostomia and thirst were determined in 43 ESRD patients. The number of decayed missing filled teeth/surfaces (DMFT/DMFS) was recorded, and periodontal status assessed. RESULTS: After renal transplantation (n = 20), the salivary flow rate increased significantly from UWS = 0.30 +/- 0.21 ml/min to 0.44 +/- 0.29 ml/min (p <0.001) and the level of xerostomia and thirst decreased. After two years, the percentage of bleeding on probing in dialysis patients (n = 23) decreased from 29.5 +/- 25.4% to 10.3 +/- 12.3%, (p <0.05). No differences in DMFT and DMFS were observed between dialysis and renal transplant patients. CONCLUSIONS: DMFT, dental plaque, gingival bleeding and periodontal indices did not change remarkably after two years, comparing dialysis and renal transplant patients. Renal transplantation enhances salivary flow and decreases symptoms of xerostomia and thirst, and hence enhances the potential to improve the quality of life of affected individuals.
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Falência Renal Crônica/complicações , Xerostomia/etiologia , Análise de Variância , Índice CPO , Feminino , Seguimentos , Humanos , Falência Renal Crônica/terapia , Transplante de Rim , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Diálise Renal , Saliva/metabolismo , Taxa Secretória , Sede , Xerostomia/terapiaRESUMO
BACKGROUND: Central auditory processing disorders (CAPD) are associated with reduced discriminatory abilities of the auditory system. One of these abilities is directional hearing, which is based on the evaluation of interaural signal differences. Since these differences affect also the binaural difference potentials (BDP), these derived evoked potentials could be suitable for the objective detection of disabilities in acoustic localization. METHOD: Auditory brainstem responses (ABR) evoked by monaural and binaural stimulation were recorded in 32 adult normal-hearing volunteers at stimulus levels between 10 and 80 dB nHL and the BDP were derived. Additionally, a test of directional hearing was performed and evaluated. RESULTS: BDP are detectable at all stimulus levels without difficulties, with acceptable examination times and with satisfactory reliability in a routine clinical environment. The electrodes can be positioned at the mastoid (A1 and A2) and vertex (Cz) as for conventional ABR recording. Normal ranges are given for latency and amplitude as well as for their lateral differences. CONCLUSION: The spectrum in directional hearing ability as covered by normal-hearing subjects is not mirrored in the parameters of their BDP. Nevertheless, it cannot be ruled out that a real impairment of directional hearing goes along with significantly altered BDP.
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Eletroencefalografia/métodos , Potenciais Evocados Auditivos/fisiologia , Testes Auditivos/métodos , Localização de Som/fisiologia , Adulto , Ensaios Clínicos como Assunto/tendências , Feminino , Transtornos da Audição/diagnóstico , Transtornos da Audição/fisiopatologia , Humanos , Masculino , Estatística como AssuntoRESUMO
The occurrence of Brachyspira species and Lawsonia intracellularis was investigated by PCR analyses of faeces from 60 children living on European pig farms. In addition, 60 other children were included as controls. Two samples were positive for B. aalborgi but B. pilosicoli and L. intracellularis were not demonstrated.
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Lawsonia (Bactéria)/isolamento & purificação , Spirochaetales/isolamento & purificação , Suínos , Adolescente , Agricultura , Animais , Criança , Estudos Transversais , Europa (Continente) , Fezes/microbiologia , Feminino , Humanos , Lawsonia (Bactéria)/genética , Masculino , Reação em Cadeia da Polimerase , Spirochaetales/genéticaRESUMO
Dust collection by study participants instead of fieldworkers would be a practical and cost-effective alternative in large-scale population studies estimating exposure to indoor allergens and microbial agents. We aimed to compare dust weights and biological agent levels in house dust samples taken by study participants with nylon socks, with those in samples taken by fieldworkers using the sampling nozzle of the Allergology Laboratory Copenhagen (ALK). In homes of 216 children, parents and fieldworkers collected house dust within the same year. Dust samples were analyzed for levels of allergens, endotoxin, (1-->3)-beta-D-glucans and fungal extracellular polysaccharides (EPS). Socks appeared to yield less dust from mattresses at relatively low dust amounts and more dust at high dust amounts than ALK samples. Correlations between the methods ranged from 0.47-0.64 for microbial agents and 0.64-0.87 for mite and pet allergens. Cat allergen levels were two-fold lower and endotoxin levels three-fold higher in socks than in ALK samples. Levels of allergens and microbial agents in sock samples taken by study participants are moderately to highly correlated to levels in ALK samples taken by fieldworkers. Absolute levels may differ, probably because of differences in the method rather than in the person who performed the sampling. Practical Implications Dust collection by participants is a reliable and practical option for allergen and microbial agent exposure assessment. Absolute levels of biological agents are not (always) comparable between studies using different dust collection methods, even when expressed per gram dust, because of potential differences in particle-size constitution of the collected dust.
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Poeira/análise , Monitoramento Ambiental/métodos , Habitação , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Alérgenos/análise , Leitos , Endotoxinas/análise , Exposição Ambiental/análise , Monitoramento Ambiental/instrumentação , Pisos e Cobertura de Pisos , Pessoal de Saúde , Humanos , Pais , Polissacarídeos/análiseRESUMO
BACKGROUND: The prevalence of allergic diseases has increased rapidly in recent decades, particularly in children. For adequate prevention it is important not only to identify risk factors, but also possible protective factors. The aim of this study was to compare the prevalence of allergic diseases and sensitization between farm children, children in anthroposophic families, and reference children, with the aim to identify factors that may protect against allergic disease. METHODS: The study was of cross-sectional design and included 14,893 children, aged 5-13 years, from farm families, anthroposophic families (recruited from Steiner schools) and reference children in Austria, Germany, The Netherlands, Sweden and Switzerland. A detailed questionnaire was completed and allergen-specific IgE was measured in blood. RESULTS: Growing up on a farm was found to have a protective effect against all outcomes studied, both self-reported, such as rhinoconjunctivitis, wheezing, atopic eczema and asthma and sensitization (allergen specific IgE > or = 0.35 kU/l). The adjusted odds ratio (OR) for current rhinoconjunctivitis symptoms was 0.50 (95% confidence interval (CI) 0.38-0.65) and for atopic sensitization 0.53 (95% CI 0.42-0.67) for the farm children compared to their references. The prevalence of allergic symptoms and sensitization was also lower among Steiner school children compared to reference children, but the difference was less pronounced and not as consistent between countries, adjusted OR for current rhinoconjunctivitis symptoms was 0.69 (95% CI 0.56-0.86) and for atopic sensitization 0.73 (95% CI 0.58-0.92). CONCLUSIONS: This study indicates that growing up on a farm, and to a lesser extent leading an anthroposophic life style may confer protection from both sensitization and allergic diseases in childhood.
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Agricultura , Medicina Antroposófica , Hipersensibilidade/prevenção & controle , Estilo de Vida , Adolescente , Criança , Pré-Escolar , Conjuntivite/prevenção & controle , Estudos Transversais , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Razão de Chances , Prevalência , Rinite/prevenção & controleRESUMO
BACKGROUND: Growing up on a farm and an anthroposophic lifestyle are associated with a lower prevalence of allergic diseases in childhood. This might be related to increased inhalatory exposure to microbial agents. OBJECTIVE: To assess the association between microbial agents in house dust and atopic wheeze in farm children, Steiner school children and reference children. METHODS: Levels of bacterial endotoxin, fungal beta(1,3)-glucans and fungal extracellular polysaccharides (EPS) in mattress and living room floor dust were measured in a population of 270 atopic (=Phadiatop-positive) children with self-reported wheezing, including 168 current atopic wheezers, and 441 non-atopic, non-symptomatic controls. These children were selected from a cross-sectional study in five European countries. RESULTS: In the study population as a whole, average levels of mattress dust endotoxin, EPS and glucans were slightly (1.1-1.2-fold; P<0.10) higher in control children than in atopic wheezers. Atopic wheeze was related to mattress levels of endotoxin, EPS and glucans in farm and farm-reference children. However, when adjusting for group (farm vs. farm-reference children), the associations became non-significant whereas the group effect remained. No associations between atopic wheeze and microbial agents were observed in Steiner and Steiner-reference children. For current atopic wheeze, the farm effect became non-significant after adjustment for microbial agent levels. CONCLUSION: Not only bacterial endotoxin but also mould components might offer some protection against atopic wheeze in children. However, the protective effect of being raised on a farm was largely unexplained by the mattress microbial agent levels measured in this study.
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Agricultura , Alérgenos/análise , Poeira/análise , Hipersensibilidade Respiratória/prevenção & controle , Sons Respiratórios/etiologia , Adolescente , Poluição do Ar em Ambientes Fechados/análise , Antígenos de Fungos/análise , Leitos , Criança , Pré-Escolar , Estudos Transversais , Endotoxinas/análise , Europa (Continente)/epidemiologia , Feminino , Habitação , Humanos , Exposição por Inalação/análise , Masculino , Polissacarídeos/análise , Hipersensibilidade Respiratória/epidemiologia , Hipersensibilidade Respiratória/etiologia , Instituições Acadêmicas , beta-Glucanas/análiseRESUMO
BACKGROUND: In most epidemiological surveys the estimated prevalence of asthma is based on questionnaire responses, which may depend on the individual's perception as well as medical consulting habits in a given population. Therefore, measurement of bronchial hyper-responsiveness as a key feature of asthma has been suggested as an objective parameter for asthma. OBJECTIVE: The aim of the present study was to validate questionnaire responses on asthma and wheeze against bronchial response to hypertonic saline (HS) (4.5%) in populations previously shown to have a lower prevalence of asthma and allergies: farmers' children and children from anthroposophic families. METHODS: Children whose parents had completed a written questionnaire in the cross-sectional PARSIFAL-study were drawn from the following four subgroups: 'farm children' (n=183), 'farm reference children' (n=173), 'Steiner schoolchildren' (n=243) and 'Steiner reference children' (n=179). Overall, 319 children with wheeze in the last 12 months and 459 children without wheeze in the last 12 months performed an HS challenge. RESULTS: Odds ratios, sensitivity, specificity, likelihood ratios and measures of association did not differ significantly between the four subgroups. The correlation between the bronchial response to HS and wheeze and asthma questions was moderate and similar for farm children, farm reference children, Steiner schoolchildren and Steiner reference children (kappa for 'wheeze': 0.25, 0.33, 0.31, 0.35, respectively, P=0.754, kappa for 'doctor's diagnosis of asthma': 0.33, 0.19, 0.33, 032, respectively, P=0.499). CONCLUSION: The findings from this study suggest that the reliabilitiy of questionnaire responses on asthma and wheeze is comparable between farmers' children, children raised in families with anthroposophic lifestyle and their respective peers.
Assuntos
Asma/diagnóstico , Sons Respiratórios/diagnóstico , Adolescente , Medicina Antroposófica , Asma/imunologia , Testes de Provocação Brônquica , Criança , Feminino , Volume Expiratório Forçado/imunologia , Humanos , Masculino , Reprodutibilidade dos Testes , Sons Respiratórios/imunologia , Saúde da População Rural , Solução Salina Hipertônica , Sensibilidade e Especificidade , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To determine the limits of accuracy of fusion of optical three-dimensional (3D) imaging and computed tomography (CT) with and without metal artefacts in an experimental setting and to show the application of this hybrid system in 3D orthognathic surgery simulation. METHODS: Ten plaster casts of dental arches were subjected to a CT scan and optical 3D surface imaging. Subsequently, the first molars in the plaster casts were supplied with metal restorations, bilaterally, and new CT scans and optical surface images were assessed. The registration of the surface data of the two imaging modalities of the study models without and with metal restorations was carried out. The mean distance between the two data sets was calculated. From a patient a CT scan of the skull as well as optical 3D images of plaster casts of the dental arches were acquired. Again the two imaging modalities were registered and virtual orthognathic surgery simulation was carried out. RESULTS: The mean distance between the corresponding data points of CT and optical 3D surface images was 0.1262+/-0.0301 mm and 0.2671+/-0.0580 mm, respectively, for the plaster casts without and with metal restorations. The differences between these data were statistically significant (P<0.0005). For the patient case a mean difference of 0.66+/-0.49 mm and 0.56+/-0.48 mm for mandible and maxilla, respectively, was calculated between CT and optical surface data. CONCLUSION: The accuracy of the fusion of 3D CT surface data and optical 3D imaging is significantly reduced by metal artefacts. However, it seems appropriate for virtual orthognathic surgery simulation, as post-operative orthodontics are performed frequently.
Assuntos
Artefatos , Dentição , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Procedimentos Cirúrgicos Ortognáticos , Planejamento de Assistência ao Paciente , Tomografia Computadorizada Espiral/métodos , Adulto , Ligas Dentárias/química , Arco Dental/patologia , Arco Dental/cirurgia , Restauração Dentária Permanente , Feminino , Humanos , Mandíbula/patologia , Mandíbula/cirurgia , Maxila/patologia , Maxila/cirurgia , Modelos Dentários , Mordida Aberta/cirurgia , Óptica e Fotônica , Prognatismo/cirurgia , Intensificação de Imagem Radiográfica , Interface Usuário-ComputadorRESUMO
It has been the aim of the present study, to introduce the combination of computed tomography and optical 3D imaging to exophthalmometry and to compare the resulting data to the classic Hertel method. Twenty patients without orbital pathology and 12 patients were included in the study, who were subjected to a preoperative computed tomography. Optical 3D images of the facial surface were assessed and Hertel exophthalmometry was carried out to determine protrusion. In patients with zygomatic fractures the assessment of optical 3D images and Hertel values was repeated 5 days after surgery. Preoperative axial CT slices and postoperative optical contours through the globes were superimposed and the change in protrusion was determined. The protrusion values assessed either by CT, Hertel exophthalmometry or optical 3D imaging for patients without orbital pathology did not show any statistically significant differences between each other. For zygomatic fractures, Hertel exophthalmometry revealed more pronounced protrusion data in four of five cases of a posterolaterally dislocated lateral orbital rim and a higher degree of enophthalmos in cases without dislocation of the lateral orbital rim than it could be proved in the CT slices. The differences between optical measurements and CT data were minimal in patients with zygomatic fractures. The combination of computed tomography as baseline measurement and optical 3D imaging for the follow-up examinations reveal more realistic data in cases of zygomatic fractures than Hertel measurements and should be preferred.