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INTRODUCTION: The relationship between epilepsy and music is poorly understood. Musicogenic epilepsy, which involves seizures triggered by music, and epilepsy that triggers or involves musical experiences are rare. Anti-seizure medications (ASMs) may affect cognition and possibly the musical sphere. The relationship between epilepsy, ASMs and music perception is insufficiently investigated in the literature. This study describes the clinical characteristics of patients with epilepsy with advanced musical knowledge, and aims to understand the disease's involvement in the musical sphere. PATIENTS AND METHODS: A qualitative study was conducted in epileptic patients with musical knowledge, investigating their musical perception before and after a diagnosis of epilepsy and after a change of ASM when this was possible. Questionnaires and recordings of music were used to assess musical perception. RESULTS: Fourteen patients had musical knowledge, and the majority of these (50%) had temporal lobe epilepsy. A total of 92.8% of the patients stated that epilepsy or its medications had affected them in the musical sphere. There was no clear relationship between the lateralisation of the epilepsy and musical involvement. 42.9% were professional musicians, and had to give up their profession. The patients prescribed with more than one ASM had greater musical involvement. CONCLUSIONS: Temporal lobe epilepsy appears to have the greatest effect on music perception, and more studies with ASM and music perception are needed to determine its effects.
TITLE: Epilepsia y percepción musical. Una visión a través de 14 pacientes.Introducción. La relación entre la epilepsia y la música es poco comprendida. La epilepsia musicógena, que involucra crisis desencadenadas por la música, y la epilepsia que produce o involucra experiencias musicales son poco comunes. Se sabe que los medicamentos anticrisis (MAC) pueden afectar a la cognición y posiblemente a la esfera musical. La relación entre la epilepsia, los MAC y la percepción musical está insuficientemente investigada en la bibliografía. El objetivo de este estudio es describir las características clínicas de pacientes con epilepsia con conocimientos musicales avanzados e intentar comprender la afectación de la enfermedad a la esfera musical. Pacientes y métodos. Se llevó a cabo un estudio cualitativo en pacientes epilépticos con conocimientos musicales, investigando su percepción musical antes y después del diagnóstico de epilepsia y, cuando fue posible, tras el cambio de MAC. Se utilizaron cuestionarios y grabaciones musicales para evaluar la percepción musical. Resultados. Catorce pacientes tenían conocimientos musicales, la mayoría (50%) con epilepsia del lóbulo temporal. Un 92,8% de los pacientes indicó que la epilepsia o sus medicamentos le habían afectado en la esfera musical. No había una clara relación entre lateralización de la epilepsia y afectación musical. Un 42,9% eran músicos profesionales y tuvieron que dejar la profesión. Los pacientes con más de un MAC pautado tenían mayor afectación musical. Conclusiones. La epilepsia del lóbulo temporal parece ser la que más afecta a la percepción musical, y hacen falta más estudios con MAC y percepción musical para dilucidar sus efectos.
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Percepção Auditiva , Epilepsia , Música , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Epilepsia/psicologia , Epilepsia/tratamento farmacológico , Adulto Jovem , Anticonvulsivantes/uso terapêutico , Pesquisa Qualitativa , Epilepsia do Lobo Temporal/psicologia , Epilepsia do Lobo Temporal/fisiopatologia , Epilepsia do Lobo Temporal/tratamento farmacológicoRESUMO
INTRODUCTION: Epileptic seizures are a common cause of admission in emergency services at hospitals. Performing the correct diagnosis can be difficult, and deciding when and which anti-seizure medication (ASM) to prescribe is critical. Our objective is to detail the characteristics of patients treated in a medium-sized hospital for this reason. PATIENTS AND METHODS: A retrospective observational study was performed, including all the adult patients treated by the emergency service of the Lucus Augusti University Hospital between January 2022 and January 2023 with a diagnosis of epileptic seizure on discharge. The study recorded their demographic variables, history, whether it was their first seizure, the number of seizures, whether an anti-seizure medication was administered and which one, the diagnosis, the tests performed, and whether the patient was referred to the neurology service. RESULTS: A total of 122 patients were diagnosed with epileptic seizures in the emergency service. 50.8% of the patients were women. The mean age was 69.8 years. Neurological assessment was requested for 47.6%. 50.8% presented their first seizure. No diagnosis was performed in 46% of the cases, of which only 10 were evaluated by the neurology service. The most common etiology was vascular. An electroencephalogram was performed on 41.8%. Levetiracetam was practically the only drug administered when the neurology department was not consulted. CONCLUSIONS: Early evaluation of patients with their first seizure in the emergency service by a neurological specialist is crucial for the diagnosis of epilepsy. The same anti-seizure medication is almost always prescribed when no cross-consultation takes place.
TITLE: Crisis en urgencias: una vista a las características clínicas y terapéuticas a través de 122 pacientes.Introducción. Las crisis epilépticas son un motivo frecuente de consulta en los servicios de urgencias hospitalarias. Llegar al diagnóstico correcto puede ser complejo, y es fundamental decidir cuándo y qué medicamento anticrisis (MAC) pautar. Nuestro objetivo es detallar las características de los pacientes que consultaron por este motivo en un hospital mediano. Pacientes y métodos. Estudio observacional retrospectivo de todos los pacientes mayores de edad que consultaron en el servicio de urgencias del Hospital Universitario Lucus Augusti entre enero de 2022 y enero de 2023 con diagnóstico al alta de crisis epiléptica. Se registraron variables demográficas, los antecedentes, si era una primera crisis, el número de éstas, si se inició un MAC y cuál, el diagnóstico, qué pruebas se realizaron y si se interconsultó con la guardia de neurología. Resultados. Se diagnosticó a 122 pacientes de crisis epilépticas en urgencias. El 50,8% eran mujeres. La media de edad fue de 69,8 años. Se solicitó valoración por neurología en un 47,6%. El 50,8% presentó una primera crisis. No se llegó al diagnóstico en un 46% de los casos, de los cuales sólo 10 fueron valorados por neurología. La etiología más frecuente fue la vascular. Se realizó un electroencefalograma en un 41,8%. El levetiracetam fue prácticamente el único fármaco utilizado cuando no se consultó con neurología. Conclusiones. La valoración precoz de los pacientes con una primera crisis en urgencias por un especialista en neurología es determinante para el diagnóstico de epilepsia. Cuando no se interconsulta, casi siempre se pauta el mismo MAC.
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Serviços Médicos de Emergência , Adulto , Humanos , Feminino , Idoso , Masculino , Eletroencefalografia , Hospitalização , Hospitais Universitários , Convulsões/diagnóstico , Convulsões/tratamento farmacológicoRESUMO
PURPOSE: The aim of the present study was to analyse current surgical treatment preferences for anal fistula (AF) and its subtypes and nationwide results in terms of success and complications. METHODS: A retrospective multicentre observational cohort study was conducted. The study period was 1 year (2019), with a follow-up period of at least 1 year. A descriptive analysis of patient characteristics and trends regarding technical options was performed. Univariate and multivariate Cox regression models were used to analyse factors associated with healing and faecal incontinence (FI). RESULTS: Fifty-one hospitals were involved, providing data on 1628 patients with AF. At a median follow-up of 18.3 (9.9-28.3) months, 1231 (75.9%) patients achieved healing, while 390 (24.1%) did not; failure was catalogued as persistence in 279 (17.2.0%) patients and as recurrence in 111 (6.8%). On multivariate analysis, factors associated with healing were fistulotomy (OR 5.5; 95% CI 3.8-7.9; p < 0.001), simple fistula (OR 2.1; 95% CI 1.5-2.8; p < 0.001), single tract (HR 1.9; 95% CI 1.3-2.8; p < 0.001) and number of preparatory surgeries (none vs. 3; HR 1.8; 95% CI 1.2-2.8; p = 0.006). Regarding de novo FI, in the multivariate analysis previous anal surgery (OR 1.5, 95% CI 1.0-2.4, p = 0.037), age (OR 1.02, 95% CI 1.00-1.04, p = 0.002) and being female (OR 1.7, 95% CI 1.1-2.5, p = 0.008) were statistically related. CONCLUSIONS: Anal fistulotomy is the most used procedure for AF, especially for simple AF, with a favourable overall balance between healing and continence impairment. Sphincter-sparing or minimally invasive sphincter-sparing techniques resulted in lower rates of healing. In spite of their intended sphincter-sparing design, a certain degree of FI was observed for several of these techniques.
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Procedimentos Cirúrgicos do Sistema Digestório , Incontinência Fecal , Fístula Retal , Humanos , Feminino , Masculino , Canal Anal/cirurgia , Resultado do Tratamento , Tratamentos com Preservação do Órgão/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Fístula Retal/cirurgia , Fístula Retal/complicações , Incontinência Fecal/cirurgia , Incontinência Fecal/complicaçõesRESUMO
INTRODUCTION: In the evaluation of drug-resistant epilepsy (DRF), a detailed analysis of the semiology is essential to establish a diagnostic hypothesis of the location of the epileptogenic zone. Cross-sign (CS) is a very infrequent complex manual automatism described for the first time in 2008 and rarely reported in the literature. CASE REPORT: We present two cases from our series of patients monitored by videoEEG, one of whom also studied with deep electrodes, in which we describe the location of the discharge while performing the CS. A bibliographic review is also carried out to try to establish a localizing and/or lateralizing value of this sign. CONCLUSION: The sign of the cross is a rare ictal automatism that occurs in patients with temporal lobe epilepsy. The hand used to make the sign of the cross is the dominant one, regardless of the origin of the crises.
TITLE: La señal de la cruz: un automatismo muy poco frecuente en la epilepsia del lóbulo temporal. Descripción de dos casos.Introducción. En la evaluación de la epilepsia farmacorresistente, el análisis detallado de la semiología es fundamental para establecer una hipótesis diagnóstica de la localización de la zona epileptógena. La señal de la cruz es un automatismo manual complejo muy infrecuente descrito por primera vez en 2008 y poco referido en la bibliografía. Caso clínico. Presentamos dos casos con presencia de la señal de la cruz de nuestra serie de pacientes monitorizados mediante videoelectroencefalograma, uno de ellos estudiado también con electrodos profundos, en los que describimos la localización de la descarga en el momento de realizar la señal de la cruz. Se realiza también una revisión bibliográfica para intentar establecer un valor localizador y/o lateralizador de este signo. Conclusión. La señal de la cruz es un raro automatismo ictal que ocurre en pacientes con epilepsia del lóbulo temporal. La mano empleada para la señal de la cruz es la dominante, independientemente del origen de las crisis.
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Epilepsia Resistente a Medicamentos , Epilepsia do Lobo Temporal , Humanos , Automatismo , Eletrodos , MãosRESUMO
In this work nanocomposites based on alginate (Alg) and halloysite as a nanotubular clay (Hy) were developed. Characterization techniques reveal that Hy/Alg nanocomposites are cation exchangers with predominantly negative charge density and good thermal stability. The adsorption equilibrium of Cd(II) in aqueous solution onto Hy/Alg nanocomposites revealed that by increasing the mass of halloysite in the nanocomposite, the adsorption capacity diminished significantly due to the halloysite-alginate interactions. Maximum adsorption capacities of 8, 65, 88, and 132 mg/g of Cd(II) were obtained for samples Hy, Hy/Alg 50%, Hy/Alg 95%, and Alg, respectively. In addition, the adsorption equilibrium of Cd(II) on the Hy/Alg bionanocomposites was affected by the pH and temperature of the solution, demonstrating the presence of electrostatic interactions during adsorption and that this is an exothermic process. The controlling mechanism of adsorption was cation exchange influenced by electrostatic forces. The Cd(II) adsorption rate studies were interpreted by the diffusion-permeation model and reveal that the presence of Hy in the structure of the nanocomposites enhances the permeation coefficient, that is, the adsorption rate was increased. The values of the permeation coefficient varied from 1.95 × 10-7 to 8.50 × 10-7 cm2/s for Hy/Alg 50% and from 1.70 × 10-7 to 3.55 × 10-7 cm2/s for Hy/Alg 95%.
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Alginatos , Nanocompostos , Argila/química , Adsorção , Alginatos/química , Cádmio , Minerais , Cinética , Concentração de Íons de HidrogênioRESUMO
The rapid spread of conspiracy ideas associated with the recent COVID-19 pandemic represents a major threat to the ongoing and coming vaccination programs. Yet, the cognitive factors underlying the pandemic-related conspiracy beliefs are not well described. We hypothesized that such cognitive style is driven by delusion proneness, a trait phenotype associated with formation of delusion-like beliefs that exists on a continuum in the normal population. To probe this hypothesis, we developed a COVID-19 conspiracy questionnaire (CCQ) and assessed 577 subjects online. Their responses clustered into three factors that included Conspiracy, Distrust and Fear/Action as identified using principal component analysis. We then showed that CCQ (in particular the Conspiracy and Distrust factors) related both to general delusion proneness assessed with Peter's Delusion Inventory (PDI) as well as resistance to belief update using a Bias Against Disconfirmatory Evidence (BADE) task. Further, linear regression and pathway analyses suggested a specific contribution of BADE to CCQ not directly explained by PDI. Importantly, the main results remained significant when using a truncated version of the PDI where questions on paranoia were removed (in order to avoid circular evidence), and when adjusting for ADHD- and autistic traits (that are known to be substantially related to delusion proneness). Altogether, our results strongly suggest that pandemic-related conspiracy ideation is associated with delusion proneness trait phenotype.
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COVID-19 , Delusões , Humanos , Pandemias , Transtornos Paranoides/epidemiologia , FenótipoRESUMO
A significant fraction of Brazil's population has been exposed to drought in recent years, a situation that is expected to worsen in frequency and intensity due to climate change. This constitutes a current key environmental health concern, especially in densely urban areas such as several big cities and suburbs. For the first time, a comprehensive assessment of the short-term drought effects on weekly non-external, circulatory, and respiratory mortality was conducted in 13 major Brazilian macro-urban areas across 2000-2019. We applied quasi-Poisson regression models adjusted by temperature to explore the association between drought (defined by the Standardized Precipitation-Evapotranspiration Index) and the different mortality causes by location, sex, and age groups. We next conducted multivariate meta-analytical models separated by cause and population groups to pool individual estimates. Impact measures were expressed as the attributable fractions among the exposed population, from the relative risks (RRs). Overall, a positive association between drought exposure and mortality was evidenced in the total population, with RRs varying from 1.003 [95% CI: 0.999-1.007] to 1.010 [0.996-1.025] for non-external mortality related to moderate and extreme drought conditions, from 1.002 [0.997-1.007] to 1.008 [0.991-1.026] for circulatory mortality, and from 1.004 [0.995-1.013] to 1.013 [0.983-1.044] for respiratory mortality. Females, children, and the elderly population were the most affected groups, for whom a robust positive association was found. The study also revealed high heterogeneity between locations. We suggest that policies and action plans should pay special attention to vulnerable populations to promote efficient measures to reduce vulnerability and risks associated with droughts.
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The Speedy A (spdya) gene is a member of the Speedy/RINGO family, encoding a spdya protein associated with cellular cycle and meiosis in vertebrates. Results from genetic analyses indicated spdya conditional knockout mice are sterile, suggesting that this protein has essential functions in mammalian reproduction. There, however, are no published reports on the localization of spdya mRNA in the germline or in somatic cell lineages within the gonads from mollusks or other invertebrate species. Using a previously obtained transcriptome assembly from the scallop Argopecten purpuratus, an economically important hermaphroditic scallop species from Chile and Peru, there was identification of a complete coding sequence of the spdya mRNA. Phylogenetically spdya protein has sequence conservation homology with other scallops and mollusks. The relative mRNA transcript abundances at different gametogenic stages was assessed using quantitative PCR procedures. Results indicated there was an increase of spdya mRNA transcript abundance in testicular region samples at the late active stage, followed by a decrease in testis of reproductively mature individuals. To gain insight into the cellular localization of ap-spdya transcript within the gonads, specific RNA probes were synthesized for in situ hybridization analyses of gonad histological sections. Results indicated spdya mRNA is located exclusively in early germline (previtellogenic oocytes and spermatogonia) and somatic proliferative tissues of A. purpuratus ovarian and testicular regions. Overall, these results indicate there are putative functions of spdya in the early oogenesis and spermatogenesis of A. purpuratus and will contribute to furthering the understanding of gametogenesis in this species.
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Gametogênese , Pectinidae/metabolismo , RNA Mensageiro/metabolismo , Animais , Gônadas/metabolismoRESUMO
Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.
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This work presents the study of the voltage and oxygen effect on bacterial inactivation in water using a pulsed dielectric barrier discharge (DBD) under atmospheric pressure, where Escherichia coli (E. coli) and Salmonella typhi (S. typhi) bacteria were used as model microorganisms. A cylindrical DBD reactor was developed and tested in applications to assay the efficiency of bacterial inactivation in water on a volume of 500 mL flowing continuously throughout the system assisted with a peristaltic pump at 4.4 ± 0.1 mL/s. The efficiency of the treatment reached a 6-log10 reduction for both E. coli and S. typhi bacteria at 106 CFU/mL of concentration at the end of the first cycle of treatment at a minimum voltage of 12 kV with oxygen bubbling gas, concluding that there was a minimum voltage to produce inactivation of E. coli and S. typhi samples. Bacterial inactivation without the oxygen condition contrasted with the high rate of inactivation with oxygen at relatively low voltage discharges.
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Eletricidade , Escherichia coli , Viabilidade Microbiana , Oxigênio/metabolismo , Salmonella typhiRESUMO
The deep oceans of the Southern Hemisphere are home to several elusive and poorly studied marine megafauna. In the absence of robust observational data for these species, genetic data can aid inferences on population connectivity, demography and ecology. A previous investigation of genetic diversity and population structure in Gray's beaked whale (Mesoplodon grayi) from Western Australia and New Zealand found high levels of mtDNA diversity, no geographic structure and stable demographic history. To further investigate phylogeographic and demographic patterns across their range, we generated complete mitochondrial and partial nuclear genomes of 16 of the individuals previously analysed and included additional samples from South Africa (n = 2) and South Australia (n = 4), greatly expanding the spatial range of genomic data for the species. Gray's beaked whales are highly elusive and rarely observed, and our data represents a unique and geographically broad dataset. We find relatively high levels of diversity in the mitochondrial genome, despite an absence of population structure at the mitochondrial and nuclear level. Demographic analyses suggest these whales existed at stable levels over at least the past 1.1 million years, with an approximately twofold increase in female effective population size approximately 250 thousand years ago, coinciding with a period of increased Southern Ocean productivity, sea surface temperature and a potential expansion of suitable habitat. Our results suggest that Gray's beaked whales are likely to be resilient to near-future ecosystem changes, facilitating their conservation. Our study demonstrates the utility of low-effort shotgun sequencing in providing ecological information on highly elusive species.
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The development of versatile carriers to deliver chemotherapeutic agents to specific targets with establishing drug release kinetics and minimum undesirable side effects is becoming a promising relevant tool in the medical field. Magnetic hybrid nanostructured lipid carriers (NLC) were prepared by incorporation of 1,8-cineole (CN, a monoterpene with antiproliferative properties) and maghemite nanoparticles (MNPs) into a hybrid matrix composed of myristyl myristate coated with chitosan. Hybrid NLC characterized by DLS and TEM confirmed the presence of positively charged spherical nanoparticles of around 250 nm diameter and +10.2 mV of Z-potential. CN encapsulation into the lipid core was greater than 75 % and effectively released in 24 h. Modification of the crystalline structure of nanoparticles after incorporation of CN and MNPs was observed by XRD, DSC, and TGA analyses. Superparamagnetic NLC behavior was verified by recording the magnetization using a vibrating scanning magnetometer. NLC resulted in more cytotoxic than free CN in HepG2 and A549 cell lines. Particularly, viability inhibition of HepG2 and A549 cells was increased from 35 % to 55 % and from 38 % to 61 %, respectively, when 8 mM CN was incorporated into the lipid NPs at 24 h. Green fluorescent-labeled NLC with DIOC18 showed an enhanced cellular uptake with chitosan-coated NLC. Besides, no cytotoxicity of the formulations in normal WI-38 cells was observed, suggesting that the developed hybrid NLC system is a safe and good potential candidate for the selective delivery and potentiation of anticancer drugs.
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Antineoplásicos , Nanopartículas , Nanoestruturas , Antineoplásicos/farmacologia , Portadores de Fármacos , Eucaliptol , Lipídeos , Fenômenos Magnéticos , Tamanho da PartículaRESUMO
We report a 12-year-old diabetic boy with a right-sided parapneumonic effusion and pneumonia who failed initial empirical antibiotics. Prevotella pleuritidis was identified from the pleural fluid using next-generation sequencing-based clinical metagenomics with cultures of pleural fluid and blood resulting negative. The patient responded well to intravenous meropenem followed by oral metronidazole.
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Diabetes Mellitus , Metagenômica , Adolescente , Criança , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Prevotella/genéticaRESUMO
AIMS: We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations. METHODS: Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986-2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression. RESULTS: We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The amplitude of seasonal patterns (i.e. the peak/trough relative risk) also varied from 1.47 (95% confidence interval [CI]: 1.33-1.62) to 1.05 (95% CI: 1.01-1.1) among 12 countries. The subgroup difference in the seasonal pattern also varied over countries. In some countries, larger amplitude was shown for females and for the elderly population (≥65 years of age) than for males and for younger people, respectively. The subperiod difference also varied; some countries showed increasing seasonality while others showed a decrease or little change. Finally, the amplitude was larger for communities with colder climates, higher proportions of elderly people and lower unemployment rates (p-values < 0.05). CONCLUSIONS: Despite the common features of a spring peak and a winter trough, seasonal suicide patterns were largely heterogeneous in shape, amplitude, subgroup differences and temporal changes among different populations, as influenced by climate, demographic and socioeconomic conditions. Our findings may help elucidate the underlying mechanisms of seasonal suicide patterns and aid in improving the design of population-specific suicide prevention programmes based on these patterns.
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Estações do Ano , Suicídio/estatística & dados numéricos , Temperatura Baixa , Feminino , Temperatura Alta , Humanos , Masculino , Periodicidade , Distribuição por Sexo , Fatores Socioeconômicos , Suicídio/psicologiaRESUMO
AIM: To assess clinical healing in patients with perianal Crohn's disease with local intrafistular injection of autologous platelet-rich plasma. METHOD: The pilot study was conducted at a single centre between January 2013 and December 2015. Autologous platelet-rich plasma was prepared in platelet-rich and platelet-poor fractions for local intrafistular injection in patients with proven, established perianal Crohn's disease. Patients were permitted biological therapies, and the Perianal Crohn's Disease Activity Index was recorded. Patients were followed for 48 weeks for clinical signs of healing (complete, partial or non-healing), monitoring fistula drainage, closure and epithelialization. RESULTS: The study included 29 patients (19 males; mean age 38 ± 12.8 years) with four exclusions in the operating room because surgery was not indicated and four lost to follow-up. Five adverse events were recorded, with two requiring the drainage of abscess collections. Of the 21 patients assessable at 24 weeks, there was complete healing, partial healing and non-healing in 7 (33.3%), 8 (38.1%) and 6 (28.6%) patients, respectively. By 48 weeks, there was complete healing, partial healing and non-healing in 6 (40%), 6 (40%) and 3 (20%) patients, respectively, with a reduction in the number of visible external fistula openings at both time points (P = 0.021). By the end of the study, there was a higher trend of healing if biological therapies were continued (85.7% with biologics vs. 75% without, P = 0.527), but there were no statistically significant differences and no differences in the Perianal Crohn's Disease Activity Index. CONCLUSION: Autologous platelet-rich plasma is safe in patients with perianal Crohn's disease, with an acceptable healing rate over a medium-term follow-up, particularly if biological therapies are used concomitantly.
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Doença de Crohn , Plasma Rico em Plaquetas , Fístula Retal , Adulto , Doença de Crohn/complicações , Doença de Crohn/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fístula Retal/etiologia , Fístula Retal/terapia , Resultado do TratamentoRESUMO
The study area is located in the eastern slope of Las Peñas Mountain and its adjacent oriental fluvio-aeolian-plain. Agriculture is the main activity (soybean, maize, wheat, peanuts and alfalfa) with no-tillage farming and intensive use of agrochemicals (pesticides-fertilizers). Glyphosate (N-phosphono-methylglycine) is the most common used herbicide which suffers microbial biodegradation giving aminomethylphosphonic acid (AMPA), its main metabolite. The objective of this work is to evaluate hydrogeological features which influence the presence of glyphosate and AMPA in waters. In the study area, the main flow direction of surface and groundwater is NW-SE. The unsaturated zone thickness decreases in the same direction from 60 to 0 m, so groundwater surges in low areas in the eastern sector. From the total water samples collected, glyphosate was detected in 66% of surface water samples (0.2 to 167.4 µg/L), in 15.8% of the groundwater samples (1.3 to 2 µg/L) and in the harvested precipitation sample (0.2 µg/L). AMPA was found in 33% of surface water and 15.8% of groundwater. The herbicide detection was related to areas with the shallowest water table (< 4 m), low hydraulic conductivity in the aquifer (K = 1.5 m/d), low hydraulic gradient (i = 0.16%) and very low flow velocity (0.02 m/d). The most outstanding result is that the groundwater presents higher values in comparison with the surface water samples, which can be explained by the greater dilution capacity of streams. The detection of glyphosate and AMPA in the unconfined aquifer shows that the application for decades under the prevailing agricultural model exceeds the degradation potential of the soil and the unsaturated zone, causing groundwater contamination.
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Triatomines (Heteroptera: Reduviidae) include around 139 species, widely known as vectors of Chagas disease. Our aim is to review the existing knowledge of the genital morphology and sexual behavior and provide some functional analysis of these traits in triatomines. A complex set of traits comprise genitalia and these are highly variable among species. The components of the phallus and seminal products (secreted by action of testes and two accessory glands) interact to allow successful sperm transfer to the female spermathecae (usually a pair of blind tubes that emerge from the common oviduct). Seminal products may inhibit female physiology and extend mating duration. Mating behavior in triatomines is best characterized as scramble competition. We suggest that males may evaluate female condition prior to copulation, given that female fitness is largely affected by food (blood) source. Although rearing several triatomine species may be difficult and discourage from undertaking studies on this group, any further investigation on sexual behavior and mating interactions may provide data for applicative studies including Chagas disease vectors control.
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Copulação , Triatominae/anatomia & histologia , Triatominae/fisiologia , Animais , Feminino , Genitália Feminina/anatomia & histologia , Genitália Feminina/ultraestrutura , Genitália Masculina/anatomia & histologia , Genitália Masculina/ultraestrutura , Masculino , Microscopia Eletrônica de Varredura , Triatominae/ultraestruturaRESUMO
To gain knowledge of listening effort in adverse situations, it is important to know how the brain processes speech with different signal-to-noise ratios (SNR). To investigate this, we conducted a study with 33 hearing impaired individuals, whose electroencephalographic (EEG) signals were recorded while listening to sentences presented in high and low levels of background noise. To discriminate between these two conditions, features from the 64-channel EEG recordings were extracted using the power spectrum obtained by a Fast Fourier Transform. Features vectors were selected on an individual basis by using the statistical R2 approach. The selected features were then classified by a Support Vector Machine with a nonlinear kernel, and the classification results were validated using a leave-one-out strategy, and presented an average classification accuracy over all 33 subjects of 83% (SD=6.4%). The most discriminative features were selected in the high-beta (19-30 Hz) and gamma (30-45 Hz) bands. These results suggest that specific brain oscillations are involved in addressing background noise during speech stimuli, which may reflect differences in cognitive load between the conditions of low and high background noise.
Assuntos
Encéfalo/fisiologia , Eletroencefalografia , Razão Sinal-Ruído , Percepção da Fala , Idoso , Percepção Auditiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ruído , Fala , Máquina de Vetores de SuporteRESUMO
AIM: Laparoscopic gastric plication (LGP) is a bariatric surgical technique based on the anatomical principles of laparoscopic sleeve gastrectomy (LSG), but its effects on the metabolic profile are still uncertain. The aim of our study is to compare the changes in weight, metabolic parameters and gastric histology following intervention by gastric plication (GP) and sleeve gastrectomy (SG) in an experimental model of obesity. METHODS: To conduct the study, 32 8-week-old male Sprague-Dawley rats (Charles River®) were fattened by means of a cafeteria diet and randomly assigned to the following experimental groups: group 1: GP (n = 12); group 2: SG (n = 12) and group 3: sham (n = 8). RESULTS: Unlike the SG group, the GP group attained the weight of the sham group at the end of the experiment (week 16). The GP group continued to eat more cafeteria diet than the SG group. In addition, the SG group achieved better glycaemic control than the GP group. Significantly higher plasma ghrelin levels were observed at week 16 in the GP group than in the SG group (2.29 ± 0.5 vs 1.07 ± 0.4, p < 0.05), which also occurred for the glucagon plasmatic levels (62.71 ± 36.2 vs 24.63 ± 9.3, p < 0.05). CONCLUSIONS: GP is not as effective as SG and cannot be considered a metabolic surgery due to observed hormonal variations. The animals subjected to a GP continued to have a high appetite for the cafeteria diet unlike the animals submitted to an SG. Hormonal mechanisms possibly related to glucagon and ghrelin may be involved in this metabolic response.
Assuntos
Ingestão de Energia/fisiologia , Gastrectomia/métodos , Obesidade/metabolismo , Obesidade/cirurgia , Estômago/cirurgia , Redução de Peso/fisiologia , Animais , Glicemia/metabolismo , Dieta Hiperlipídica , Modelos Animais de Doenças , Grelina/sangue , Glucagon/sangue , Laparoscopia/métodos , Masculino , Obesidade/etiologia , Obesidade/patologia , Distribuição Aleatória , Ratos , Ratos Sprague-DawleyRESUMO
RESUMEN Introducción: La prevención de la enfermedad y la muerte durante el proceso de reproducción es uno de los pilares fundamentales para el desarrollo de la salud reproductiva, donde el rol de la enfermera juega un papel primordial en el empoderamiento del autocuidado de la mujer en edad fértil. Objetivo: Sistematizar la actuación de enfermería en la prevención y control del riesgo reproductivo preconcepcional. Métodos: Revisión bibliográfica sistemática para realizar análisis crítico reflexivo del contenido de artículos originales y de revisión publicados en español entre 2005 y 2015. La búsqueda fue realizada en las bases de datos Medline EMBASE, Current Contents, Science Citation Index, de enero a marzo de 2016, las palabras clave utilizadas fueron "riesgo preconcepcional", "práctica de enfermería", y "atención de enfermería al riesgo preconcepcional". Tras la identificación de los estudios pre-seleccionados se llevó a cabo la lectura de los títulos, resumen y palabras clave, comprobando la pertinencia con el estudio. Conclusión: Un adecuado conocimiento de la mujer en edad fértil sobre el riesgo preconcepcional permite mantener un estado de salud óptimo para asumir un embarazo con resultados finales satisfactorios. El déficit de conocimientos en la mujer sobre padecimientos o hábitos de riesgo para su salud y para asumir un embarazo satisfactorio, a ello se suma insuficiente trabajo de enfermería en la prevención del riesgo preconcepcional(AU)
ABSTRACT Introduction: Preventing disease and death during the reproduction process is one of the fundamental pillars for the development of reproductive health, in which the nurse plays a key role in empowering the self-care of women at childbearing age. Objective: To systematize the nursing action in prevention and control of preconception reproductive risk. Methods: Systematic bibliographic review to carry out a reflexive critical analysis of the content of original and review articles published in Spanish between 2005 and 2015. The search was carried out in the databases Medline EMBASE, Current Contents, and Science Citation Index, from January to March 2016; the key words used were riesgo preconcepcional [preconception risk], práctica de enfermería [nursing practice], y atención de enfermería al riesgo preconcepcional [nursing care over preconception risk]. After the identification of the pre-selected studies, the titles, summary and key words were read, verifying the relevance with the study. Conclusion: An adequate knowledge of women of childbearing age on preconception risk allows maintaining an optimal state of health to assume a pregnancy with satisfactory final results. The lack of knowledge in women about conditions or habits of risk for their health and for assuming a satisfactory pregnancy, to which insufficient nursing work is added in the prevention of preconception risk(AU)