Fetal endoscopic tracheal occlusion reduces pulmonary hypertension in severe congenital diaphragmatic hernia.

OBJECTIVE: Fetal endoscopic tracheal occlusion (FETO) is associated with increased perinatal survival and reduced need for extracorporeal membrane oxygenation (ECMO) in fetuses with severe congenital diaphragmatic hernia (CDH). This study evaluates the impact of FETO on the resolution of pulmonary hypertension (PH) in fetuses with isolated CDH. METHODS: We reviewed retrospectively the medical records of all fetuses evaluated for CDH between January 2004 and July 2017 at a single institution. Fetuses with additional major structural or chromosomal abnormalities were excluded. CDH cases were classified retrospectively into mild, moderate and severe groups based on prenatal magnetic resonance imaging indices (observed-to-expected total fetal lung volume and percentage of intrathoracic liver herniation). Presence of PH was determined based on postnatal echocardiograms. Logistic regression analyses were performed to evaluate the relationship between FETO and resolution of PH by 1 year of age while controlling for side of the CDH, use of ECMO, gestational age at diagnosis, gestational age at delivery, fetal gender, sildenafil use at discharge and CDH severity. Resolution of PH by 1 year of age was compared between a cohort of fetuses with severe CDH that underwent FETO and a cohort that did not have the procedure (non-FETO). A subanalysis was performed restricting the analysis to isolated left CDH. Parametric and non-parametric tests were used for comparisons. RESULTS: Of 257 CDH cases evaluated, 72% (n = 184) had no major structural or chromosomal anomalies of which 58% (n = 107) met the study inclusion criteria. The FETO cohort consisted of 19 CDH cases and the non-FETO cohort (n = 88) consisted of 31 (35%) mild, 32 (36%) moderate and 25 (28%) severe CDH cases. All infants with severe CDH, regardless of whether they underwent FETO, had evidence of neonatal PH. FETO (OR, 3.57; 95% CI, 1.05-12.10; P = 0.041) and ECMO (OR, 5.01; 95% CI, 2.10-11.96; P < 0.001) were independent predictors of resolution of PH by 1 year of age. A higher proportion of infants with severe CDH that underwent FETO had resolution of PH by 1 year after birth compared with infants with severe CDH in the non-FETO cohort (69% (11/16) vs 28% (7/25); P = 0.017). Similar results were observed when the analysis was restricted to cases with left-sided CDH (PH resolution in 69% (11/16) vs 28% (5/18); P = 0.032). CONCLUSION: In infants with severe CDH, FETO and ECMO are independently associated with increased resolution of PH by 1 year of age. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Improved evolutionary algorithm for the global optimization of clusters with competing attractive and repulsive interactions.

We propose improvements to our evolutionary algorithm (EA) [J. M. C. Marques and F. B. Pereira, J. Mol. Liq. 210, 51 (2015)] in order to avoid dissociative solutions in the global optimization of clusters with competing attractive and repulsive interactions. The improved EA outperforms the original version of the method for charged colloidal clusters in the size range 3 ≤ N ≤ 25, which is a very stringent test for global optimization algorithms. While the Bernal spiral is the global minimum for clusters in the interval 13 ≤ N ≤ 18, the lowest-energy structure is a peculiar, so-called beaded-necklace, motif for 19 ≤ N ≤ 25. We have also applied the method for larger sizes and unusual quasi-linear and branched clusters arise as low-energy structures.

A Detailed Study on the Low-Energy Structures of Charged Colloidal Clusters.

The target of this investigation is the systematic characterization of the low-energy structures of charged colloidal clusters that may be important to understand the self-assembling process of biomolecules. The aggregation of charged colloidal particles is governed by the attractive short-ranged Morse potential and the Yukawa repulsive tail to describe the long-range charge effect. A global optimization strategy, based on our own evolutionary algorithm, was adopted to discover the low-energy structures of colloidal clusters composed of up to 20 particles. A detailed analysis of the low-energy structures involving charged particles shows that the appearance of the Bernal spiral as the most stable motif occurs, first, at N = 6, but it is favored for larger clusters (N ≥ 13); for 6 ≤ N ≤ 12, there is a competition between the spiral (which is favored for higher charges) and more spherical-like structures. Finally, we study binary clusters composed by two sets of differently charged colloidal particles. Although a great diversity of low-energy structures is observed (especially for aggregates with one of the components in excess), the global minimum is disputed by three structural motifs depending on the composition of the cluster and, in some cases, on the range of the Morse potential.

Structure of floral galls of Byrsonima sericea (Malpighiaceae) induced by Bruggmanniella byrsonimae (Cecidomyiidae, Diptera) and their effects on host plants.

Galls are anomalies in plant development from parasitic origin, and affect cellular differentiation or growth of plants. This parasite-plant interaction occurs in many environments and typically in vegetative organs of plants. The existence of galls in reproductive organs and their effects on the host plant are seldom described in the literature. In this paper, we present a novel study of galls in plants of the neotropical region. Galls of Bruggmmaniella byrsonimae develop in the flower buds of Byrsonima sericea DC. (Malpighiaceae) and affect development of the reproductive organs and the reproductive effort of these plants. The sepals and petals show hypertrophy of parenchyma tissues after differentiation, and the stamens exhibit degeneration of the sporogenic tissue. The gynoecium is not entirely developed; ovary and ovules are often absent. Changes in vascular tissues are also frequent, which may indicate high demand for nutrient resources by the new tissues initiated by the larva. We compared the amount of inflorescences, galls and fruits to evaluate possible effects on host reproduction. The results suggest that the Cecidomyiidae galls in flower organs affect fruit set and the reproductive success of B. sericea.

Cell uptake survey of pegylated nanographene oxide.

Graphene and more specifically, nanographene oxide (GO) has been proposed as a highly efficient antitumoral therapy agent. Nevertheless, its cell uptake kinetics, its influence in different types of cells and the possibility of controlling cellular internalization timing, is still a field that remains unexplored. Herein, different cell types have been cultured in vitro for several incubation periods in the presence of 0.075 mg ml(-1) pegylated GO solutions. GO uptake kinetics revealed differences in the agent's uptake amount and speed as a function of the type of cell involved. Osteoblast-like cells GO uptake is higher and faster without resulting in greater cell membrane damage. Moreover, the dependence on the commonly used PEG nature (number of branches) also influences the viability and cell uptake speed. These facts play an important role in the future definition of timing parameters and selective cell uptake control in order to achieve an effective therapy.

Vascular ultrasound studies for the non-invasive assessment of vascular flow and patency in experimental surgery in the pig.

Vascular ultrasound is a reliable non-invasive tool used for the routine assessment of vascular flow and patency in human recipients. We describe the use at three different time points (immediately, 1 week and 4 weeks postsurgery) of ultrasound studies and its validation by angiographic studies in 37 swine undergoing carotid graft replacement. We calculated predictive values (>92%), sensitivity (>85%) and specificity (>92%) with high results at all time points. Ultrasound appeared as an accessible non-invasive technique, providing rapid, safe, repeatable and reliable results. It is an excellent alternative to angiography, avoiding risks inherent to invasive methods and therefore contributing to animal welfare.

A prospective randomized evaluation of three schedules of mesna administration in patients receiving an ifosfamide-containing chemotherapy regimen: sustained efficiency and simplified administration.

Chemotherapy with oxazaphosphorines, such as ifosfamide, is often limited by unacceptable urotoxicity. Without uroprotection hemorrhagic cystitis becomes dose-limiting. Mesna, a thiol compound, is a drug able to bind the toxic metabolites, forming nontoxic compounds in the urine. A total of 122 patients were enrolled in this study and 228 chemotherapy cycles with an ifosfamide-containing regimen were performed (225 evaluable). Mesna was given at the same total dose as the ifosfamide in all arms. On arm A, mesna was given i. v. in equal doses 15 min before and 4 h and 8 h following the ifosfamide dose. On arm B, mesna was given in three equivalent doses 15 min before (i.v.) and 4 h (i.v.) and 8 h (p.o., double dose) following ifosfamide. On arm C, mesna was given i.v. in two equal doses given 15 min before and 4 h following. The incidence of urotoxicity was very low (lower than 15%) in the three arms, 0% in A, 1.36% in B and 2.70% in C. All three arms were equally efficient. Schedule C was considered superior to the others, since it was equally effective, simpler and more convenient.

Growth and sexual maturation of Brazilian patients with sickle cell diseases.

Growth and sexual maturation was studied of 125 Brazilian patients with sickle cell disease whose ages ranged from 7 months to 42 years. Height and weight were significantly lower when compared with the unaffected population. The height and weight deficit increased in the age range of 11-19 years as compared with patients less than 11 years of age. Age of menarche, breast and pubic hair staging in girls, and genitalia staging and testicular volume measurements in boys indicated a delayed sexual maturation for both sexes. The comparison of adult and young patients, however, demonstrated that although puberty is delayed, a normal sexual maturation is attained later in life by most patients.

[Nutritional assessment of children 0 to 5 years old cared for by the municipal network of urban health of the southern region of Brazil, 1988]. / Diagnóstico nutricional de crianças de zero a cinco anos atendidas pela rede municipal de saúde em área urbana da região sul do Brasil, 1988.

An epidemiological survey was undertaken to fulfil one of the conditions required for the establishment of the Nutritional Surveillance System, on the basis of data from 1988. In this survey an anthropometric examination was employed for the purpose of discovering the prevalence and the kinds of protein energy malnutrition among children under five years of age who had been assisted at Health Centers of the Municipal Health Department of Curitiba, Paraná (Brazil). Of a sample population of 4,213 children it was found (by the Gòmez criterion) that 28.1% had malnutrition 3.6% of this percentage being of second or third degree. By the use of the Seoane-Latham criterion as modified by Batista Filho, 19.7% of the children presented some kind of malnutrition. The distribution of the sample in centiles showed that it contained an excess of children in the first centiles after 6 th months of age as compared with the reference population. This excess was more evident in the 12 to 24-months age group.