Integration of genomic and ecological methods inform management of an undescribed, yet highly exploited, sardine species.

Assessing genetic diversity within species is key for conservation strategies in the context of human-induced biotic changes. This is important in marine systems, where many species remain undescribed while being overfished, and conflicts between resource-users and conservation agencies are common. Combining niche modelling with population genomics can contribute to resolving those conflicts by identifying management units and understanding how past climatic cycles resulted in current patterns of genetic diversity. We addressed these issues on an undescribed but already overexploited species of sardine of the genus Harengula. We find that the species distribution is determined by salinity and depth, with a continuous distribution along the Brazilian mainland and two disconnected oceanic archipelagos. Genomic data indicate that such biogeographic barriers are associated with two divergent intraspecific lineages. Changes in habitat availability during the last glacial cycle led to different demographic histories among stocks. One coastal population experienced a 3.6-fold expansion, whereas an island-associated population contracted 3-fold, relative to the size of the ancestral population. Our results indicate that the island population should be managed separately from the coastal population, and that a Marine Protected Area covering part of the island population distribution can support the viability of this lineage.

Comparison of 20-gauge Procore® and 22-gauge Acquire® needles for EUS-FNB of solid pancreatic masses: an observational study.

Background and Aims: Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) has been proposed to obtain high-quality tissue samples for pancreatic tumors. We performed an observational study to compare EUS-FNB with a 20-gauge Procore® needle versus a 22-gauge Acquire® needle. Our primary endpoint was the quantity of the obtained tissue, as defined by the mean cumulative length of tissue core biopsies per needle pass. Methods: Sixty-eight EUS-FNB were consecutively performed on patients with a pancreatic mass. The choice of needle depended on availability at the time of admission: 34 punctures were performed with each needle. Histological material was studied in a blinded manner with respect to the needle, and the cumulative length of tissue core biopsies per needle pass was determined. Intraobserver and interobserver variability of this criterion was then evaluated. Results: There were no between-group differences. Histological diagnosis was achieved and core biopsy specimens were obtained in 28 out of 34 patients (82%) in the 20-gauge Procore® group and in 33 out of 34 patients (97%) in the 22-gauge Acquire® group (p = .1). The mean cumulative length of tissue core biopsies per needle pass was significantly higher with the 22-gauge Acquire® needle with 8.2 ± 4.2 mm versus 4.2 ± 3.8 mm for the 20-gauge Procore® needle (p < .01). No intra and inter-observer variability of this criterion was observed. Conclusions: Our results suggest significant differences, with a mean cumulative length of tissue core biopsies per needle pass significantly higher with the 22-gauge Acquire® needle. This simple criterion seems reliable and reproducible.

Low-level laser therapy improves bone formation: stereology findings for osteoporosis in rat model.

Low-level laser therapy (LLLT) benefits bone metabolism, but its use needs to be standardized. We evaluated the effects of LLLT on bone defects in calvaria of ovariectomized rats. Stereology was used to calculate tissue repair volume (V tr ), density of trabecular bone volume (Vv t ), total volume of newly formed trabecular bone (Vtot), and the area occupied by collagen fibers (A C ). Fifty-four Wistar rats were submitted to bilateral ovariectomy, and bone defects were created in calvaria after 150 days. The animals were divided into nine groups (n = 6), and 24 h after defects, the treatment started with a 780-nm low-intensity GaAlAs laser: G1, G2, and G3 received 3 sessions of 0, 20, and 30 J/cm(2) respectively; G4, G5, and G6 received 6 sessions of 0, 20, and 30 J/cm(2), respectively; and G7, G8, and G9 received 12 sessions of 0, 20, and 30 J/cm(2), respectively. A normal distribution was found for all of the data. The test used to verify the normality was the Kolmogorov-Smirnov (KS, p > 0.05). The one-way ANOVA followed by Tukey's post hoc test was used for data processing. A difference of p < 0.05 was considered statistically significant. Groups G2 and G1 showed significance for V tr , Vv t , Vtot, and (A C ). Results were significant for (Vv t ) and (Vtot) between G3 and G1. There were no significant results between G5 and G4 as well as between G8 and G7. Groups G6 and G4 results showed statistical difference for V tr , Vv t , Vtot, and (A C ). Groups G9 and G7 showed significance for V tr , Vv t , Vtot, and (A C ). In conclusion, there was new bone formation in the groups that received 20 and 30 J/cm(2) when compared to control groups, but over time, the dose of 30 J/cm(2) showed better stereological parameters when compared to 20 J/cm(2).

Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study.

BACKGROUND AND AIMS: Few studies have been conducted addressing the safety of thiopurine treatment in pregnant women with inflammatory bowel disease (IBD). The aim of this study was to evaluate the pregnancy outcome of women with IBD who have been exposed to thiopurines. METHODS: 215 pregnancies in 204 women were registered and documented in the CESAME cohort between May 2004 and October 2007. Physicians documented the following information from the women: last menstrual date, delivery term, details of pregnancy outcome, prematurity, birth weight and height, congenital abnormalities, medication history during each trimester, smoking history and alcohol ingestion. Data were compared between three groups: women exposed to thiopurines (group A), women receiving a drug other than thiopurines (group B) and women not receiving any medication (group C). RESULTS: Mean age at pregnancy was 28.3 years. 75.7% of the women had Crohn's disease and 21.8% had ulcerative colitis, with a mean disease duration of 6.8 years at inclusion. Of the 215 pregnancies, there were 138 births (142 newborns), and the mean birth weight was 3135 g. There were 86 pregnancies in group A, 84 in group B and 45 in group C. Interrupted pregnancies occurred in 36% of patients enrolled in group A, 33% of patients enrolled in group B, and 40% of patients enrolled in group C; congenital abnormalities arose in 3.6% of group A cases and 7.1% of group B cases. No significant differences were found between the three groups in overall pregnancy outcome. CONCLUSIONS: The results obtained from this cohort indicate that thiopurine use during pregnancy is not associated with increased risks, including congenital abnormalities.

Influence of Apical Diameter on Filling Material Extrusion during Retreatment - A Micro-CT and CBCT evaluation.

AIM: To investigate whether foraminal widening performed at primary treatment has an effect on the amount of apically extruded obturator material during retreatment and to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting extruded obturator material. METHODS: Forty palatal roots of maxillary molars were selected based on micro-CT and divided into two groups (n=20): with foraminal widening (WE) and without foraminal widening (NE). To standardize the apical foramen, all specimens were instrumented to the foramen using the Protaper Next system, up to instrument X3. The WE group was instrumented to the foramen up to instrument X5, and the NE group was instrumented 1 mm lower. The canals were obturated 1 mm below the apical foramen with gutta-percha and AH Plus and stored for 7 days at 37 °C and 95% humidity. Roots were fixed in microtubes filled with 1.5% agar gel. The obturation material was removed with Reciproc R50. Scans of the teeth and agar were performed using micro-CT and CBCT. Comparison between groups and between methods was performed using Mann-Withney test (p ≤0.05). RESULTS: No statistical difference was found when comparing the extruded material between groups using micro-CT (p = 0.589) or CBCT (p = 0.953). CBCT measured a greater volume of extruded material than micro- CT (p = 0.0004). CONCLUSION: Foraminal widening had no effect on the extrusion of filling material during retreatment. The CBCT favored the evaluation of apically extruded filling material.

Antibacterial Efficacy of Triple Antibiotic Medication With Macrogol (3Mix-MP), Traditional Triple Antibiotic Paste, Calcium Hydroxide, and Ethanol Extract of Propolis: An Intratubular Dentin Ex Vivo Confocal Laser Scanning Microscopic Study.

INTRODUCTION: This study aimed to assess the effectiveness of antibacterial activity of medications used in regenerative endodontic treatment. METHODS: Sixty-seven dentin cylinders of single-rooted teeth were contaminated with a culture of Enterococcus faecalis (ATCC 29212; American Type Culture Collection, Manassas, VA) for 5 days. Samples were divided into 1 control group and the following experimental groups according to the medication applied: traditional triple antibiotic paste (TAP), clindamycin-modified TAP (mTAP), triple antibiotic medication with macrogol (3Mix-MP), clindamycin-modified 3Mix-MP (m3Mix-MP), calcium hydroxide (CH), and ethanol extract of propolis (EEP). After 14 days, the medications were removed, and the samples were submitted to confocal laser scanning microscopic analysis to quantify the percentage of viable bacteria. The distribution of data was confirmed by the Shapiro-Wilk test. The Kruskal-Wallis and Dunn tests were used for intergroup comparisons, and the Wilcoxon test was used for comparison between superficial and deep antibacterial efficacy for the same medication. The level of significance was set at P < .05. RESULTS: 3Mix-MP and m3Mix-MP presented significantly higher antibacterial efficacy compared with the other tested medications (P < .05), except for mTAP. mTAP was more effective than TAP (P < .05). The antibacterial efficacy of EEP and CH did not differ significantly from TAP and mTAP (P > .05). All medications showed effective antibacterial action compared with the control group (P < .05). CONCLUSIONS: 3Mix-MP and m3Mix-MP, which present extremely high concentrations of antibiotics (1500 mg/mL), were not more effective than mTAP at the concentration recommended by the American Association of Endodontists (5 mg/mL). Moreover, CH and EEP were as effective as TAP and mTAP.

No one-size-fits-all solution to clean GBIF.

Species occurrence records provide the basis for many biodiversity studies. They derive from georeferenced specimens deposited in natural history collections and visual observations, such as those obtained through various mobile applications. Given the rapid increase in availability of such data, the control of quality and accuracy constitutes a particular concern. Automatic filtering is a scalable and reproducible means to identify potentially problematic records and tailor datasets from public databases such as the Global Biodiversity Information Facility (GBIF; http://www.gbif.org), for biodiversity analyses. However, it is unclear how much data may be lost by filtering, whether the same filters should be applied across all taxonomic groups, and what the effect of filtering is on common downstream analyses. Here, we evaluate the effect of 13 recently proposed filters on the inference of species richness patterns and automated conservation assessments for 18 Neotropical taxa, including terrestrial and marine animals, fungi, and plants downloaded from GBIF. We find that a total of 44.3% of the records are potentially problematic, with large variation across taxonomic groups (25-90%). A small fraction of records was identified as erroneous in the strict sense (4.2%), and a much larger proportion as unfit for most downstream analyses (41.7%). Filters of duplicated information, collection year, and basis of record, as well as coordinates in urban areas, or for terrestrial taxa in the sea or marine taxa on land, have the greatest effect. Automated filtering can help in identifying problematic records, but requires customization of which tests and thresholds should be applied to the taxonomic group and geographic area under focus. Our results stress the importance of thorough recording and exploration of the meta-data associated with species records for biodiversity research.

Beta-catenin/Tcf-4 inhibition after progastrin targeting reduces growth and drives differentiation of intestinal tumors.

BACKGROUND & AIMS: Aberrant activation of the beta-catenin/Tcf-4 transcriptional complex represents an initiating event for colorectal carcinogenesis, shifting the balance from differentiation toward proliferation in colonic crypts. Here, we assessed whether endogenous progastrin, encoded by a target gene of this complex, was in turn able to regulate beta-catenin/Tcf-4 activity in adenomatous polyposis coli (APC)-mutated cells, and we analyzed the impact of topical progastrin depletion on intestinal tumor growth in vivo. METHODS: Stable or transient RNA silencing of the GAST gene was induced in human tumor cells and in mice carrying a heterozygous Apc mutation (APCDelta14), which overexpress progastrin but not amidated or glycine-extended gastrin. RESULTS: Depletion of endogenous progastrin production strongly decreased intestinal tumor growth in vivo through a marked inhibition of constitutive beta-catenin/Tcf-4 activity in tumor cells. This effect was mediated by the de novo expression of the inhibitor of beta-catenin and Tcf-4 (ICAT), resulting from a down-regulation of integrin-linked kinase in progastrin-depleted cells. Accordingly, ICAT down-regulation was correlated with progastrin overexpression and Tcf-4 target gene activation in human colorectal tumors, and ICAT repression was detected in the colon epithelium of tumor-prone, progastrin-overexpressing mice. In APCDelta14 mice, small interfering RNA-mediated progastrin depletion not only reduced intestinal tumor size and numbers, but also increased goblet cell lineage differentiation and cell apoptosis in the remaining adenomas. CONCLUSIONS: Thus, depletion of endogenous progastrin inhibits the tumorigenicity of APC-mutated colorectal cancer cells in vivo by promoting ICAT expression, thereby counteracting Tcf-4 activity. Progastrin targeting strategies should provide an exciting prospect for the differentiation therapy of colorectal cancer.

Human teeth biobank: Microbiological analysis of the teeth storage solution.

The cross-infections may occur during handling of dental elements, affecting the health of dental practitioners and researchers. This study aimed to analyze the influence of the storage medium temperature on the bacterial contingent of the human teeth used for research purposes. Thirty human teeth were donated to the Human Teeth Biobank immediately after extraction. The teeth were cleaned with tap water and neutral soap. The teeth were randomly distributed according to the temperature of the storage solution (deionized water): at 4 °C (refrigerator) or at -10 °C (freezer) and were stored individually in sterile vials during 60 days. After this period, a microbiological analysis (CFU/mL) of the storage solutions was performed and teeth were submitted to SEM analysis. Data were analyzed by Kruskal-Wallis test followed by Dunn's post-test (p ≤ .05). Total aerobic bacteria ranged from 5.8 to 8.4 log10 CFU/mL for refrigerated solution and from 1.9 to 8.5 log10 CFU/mL for frozen solution. No statistical differences were found between the storage solutions (p > .05). The counts of Streptococcus spp., Lactobacillus spp., and Staphylococcus spp. were similar for both storage solutions (p > .05). SEM analysis showed spiral- and rod-shaped bacteria attached on teeth stored under 4 °C, which may suggest the presence of Treponema spp. and Lactobacillus spp. Similar morphological forms were found on teeth stored under -10 °C. A biofilm organized in honeycomb-like form was found in the frozen teeth. Cocci were eventually found in all the samples. It was concluded that bacterial growth and survival were not influenced by the temperature of the teeth storage solution.

Prevenção do câncer de colo uterino em homens transgênero: desafios e novas perspectivas de rastreio / Prevention of cervical cancer in transgender men: challenges and new screening perspectives

O homem transgênero apresenta alta susceptibilidade às neoplasias de colo uterino devido à escassez de exames preventivos. O estudo objetiva levantar informações acerca dos desafios e estratégias para a promoção do rastreio e prevenção do câncer cervical em homens transgênero. Trata-se de uma revisão integrativa, desenvolvida em seis etapas a partir da pergunta norteadora: "Quais os desafios e estratégias atuais para a promoção do rastreio efetivo e prevenção de câncer de colo uterino em homens transgênero?". Utilizaram-se descritores combinados com operador booleano "cervical cancer" AND "transgender persons", e foram incluídos artigos completos de 2018 a 2022. Verificou-se que os desafios enfrentados incluem preconceito, despreparo profissional e susceptibilidade à disforia de gênero. Estudos mostraram benefícios relacionados ao uso de swabs vaginais autocolhidos para reduzir o impacto psicológico do exame Papanicolaou, com vistas a reduzir os desafios enfrentados por essa população, e a necessidade de implementar estratégias que aumentem a adesão aos serviços de saúde.

Transgender men are highly susceptible to cervical cancer due to the lack of preventive screening exams. This study aims to gather information about the challenges and strategies for promoting cervical cancer screening and prevention in transgender men. This is an integrative review, developed in six stages, based on the guiding question: "What are the current challenges and strategies for promoting effective screening and prevention of cervical cancer in transgender men?". Descriptors combined with Boolean operator "cervical cancer" AND "transgender persons" were used and full articles from 2018 to 2022 were included. It was found that the challenges faced include prejudice, professional unpreparedness and susceptibility to gender dysphoria. Studies have shown benefits related to the use of self-collected vaginal swabs to reduce the psychological impact of the Pap smear exam, aiming to reduce the challenges faced by this population and to implement strategies to increase adherence to health services.

Patient information for liver biopsy: impact of a video movie.

AIMS: The information given to patients before a medical procedure is usually delivered verbally and in the form of a written document. Viewing a video movie about the procedure might be helpful in improving the quality of patient information and thus contributed to reduce patient anxiety. The aim of this prospective study on the methods used to deliver information to patients scheduled for liver biopsy was to determine, in comparison with standard information delivery, the impact on anxiety and understanding of additional information provided by a video movie. METHODS: Patients included in this study were scheduled for liver biopsy. Three days before the procedure, a physician informed the patients about liver biopsy and gave them a written information document. After this standard information delivery, the patients were randomly assigned to two groups, to view or not a video movie illustrating liver biopsy and recalling the information provided in the information document. Anxiety was measured after the information visit and just before the biopsy procedure using Spielberger's self-administered STAI-Y questionnaire. Patient understanding of and satisfaction with the information received were evaluated respectively before and after the procedure. RESULTS: Among the 67 patients retained for analysis, 33 viewed the information video and 34 did not. The level of anxiety measured at the information visit and before liver biopsy was similar in the two groups (38.8 and 37.4 with video versus 38.9 and 40.1 without video). The patients had an excellent understanding of the information received (12.3/14 with video; 12.7/14 without video) and were well satisfied with the information received. CONCLUSION: The patients understood and were well satisfied with the information received about liver biopsy. Complementary information in the form of a video movie had no effect on patient anxiety.

Influence of Apical Diameter on Filling Material Extrusion during Retreatment - A Micro-CT and CBCT evaluation

Abstract Aim: To investigate whether foraminal widening performed at primary treatment has an effect on the amount of apically extruded obturator material during retreatment and to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting extruded obturator material. Methods: Forty palatal roots of maxillary molars were selected based on micro-CT and divided into two groups (n=20): with foraminal widening (WE) and without foraminal widening (NE). To standardize the apical foramen, all specimens were instrumented to the foramen using the Protaper Next system, up to instrument X3. The WE group was instrumented to the foramen up to instrument X5, and the NE group was instrumented 1 mm lower. The canals were obturated 1 mm below the apical foramen with gutta-percha and AH Plus and stored for 7 days at 37 °C and 95% humidity. Roots were fixed in microtubes filled with 1.5% agar gel. The obturation material was removed with Reciproc R50. Scans of the teeth and agar were performed using micro-CT and CBCT. Comparison between groups and between methods was performed using Mann-Withney test (p ≤0.05). Results: No statistical difference was found when comparing the extruded material between groups using micro-CT (p = 0.589) or CBCT (p = 0.953). CBCT measured a greater volume of extruded material than micro- CT (p = 0.0004). Conclusion: Foraminal widening had no effect on the extrusion of filling material during retreatment. The CBCT favored the evaluation of apically extruded filling material.

Resumo Objetivo: Investigar se o alargamento do foramen realizado durante o tratamento primário tem um efeito na quantidade de material obturador apicalmente extruído durante oretratamento e verificar a sensibilidade da tomografia computorizada de feixe cônico (TCFC) na detecção de material obturador extruído. Métodos: Quarenta raízes palatinas de molares superiores foram selecionadas de acordo com a microtomografia computorizada, e foram divididas em dois grupos (n=20): com alargamento do foraminal (CA) e sem alargamento do foraminal (SA). Para padronizar o forame apical, todas as amostras foram instrumentadas com o sistema ProTaper Next até ao instrumento X3 até o forame. O grupo CA foi instrumentado até ao instrumento X5 até o forame, e o grupo SA foi instrumentado 1 mm aquém. Os canais foram obturados 1 mm abaixo do forame apical com gutta-percha e AH Plus e armazenados durante 7 dias a 37 °C e 95% de umidade. As raízes foram fixadas em microtubos preenchidos com gel de ágar a 1,5%. O material obturador foi removido com Reciproc R50. Os escaneamentos dos dentes e do ágar foram realizados com micro-CT e CBCT. A comparação entre grupos e entre métodos foi realizada utilizando o teste Mann-Withney (p ≤0.05). Resultados: Não foi encontrada diferença estatística ao comparar o material extruído entre grupos utilizando o Micro-CT (p = 0,589) ou TCFC (p = 0,953). Foi medido um volume maior de material extruído com a TCFC do que com a Micro- CT (p = 0,0004). Conclusão: O alargamento foraminal não teve qualquer efeito na extrusão do material obturador durante o retratamento. A TCFC favoreceu a avaliação do material de obturador apicalmente extruído.

Gender expectations and their crossings in playtime activities in early childhood education / Expectativas de gênero e seus atravessamentos nas brincadeiras da educação infantil

ABSTRACT The present study aimed to analyze gender crossings in the pedagogical practices and playtime activities in a nursery group - "Maternal 3", highlighting what was expected from boys and girls in regard to their behavior. As a data collection strategy, semi-structured interviews and observation, in which notes were taken and registered in a journal, were the methods adopted. This process took six months. It was evident that gender produced normative pedagogical practices which tried to make invisible the subjects who deviated from the center. This invisibility seemed necessary to reinforce the power relations that were present in the routines and crossed the pedagogical practices, keeping the students in "their places".

RESUMO O presente estudo teve por objetivo analisar os atravessamentos de gênero nas práticas pedagógicas e nas brincadeiras de uma turma de "Maternal 3", evidenciando as expectativas acerca dos comportamentos de meninos e meninas. Como estratégia de coleta de dados, adotaram-se, privilegiadamente as observações com registro em diário de campo; processo que teve a duração de seis meses. Além disso, de forma complementar, foram feitas entrevistas semiestruturadas com a professora e auxiliar de ensino da turma, bem como com a diretora e coordenadora pedagógica da escola. A análise dos dados se deu por meio dos procedimentos da Análise de Conteúdo. Evidenciou-se que gênero produziu práticas pedagógicas normativas que tentaram invisibilizar os sujeitos que se desviavam do centro. Essa invisibilidade pareceu necessária para reforçar as relações de poder que estiveram presentes nas rotinas e atravessaram as práticas pedagógicas, direcionando os alunos aos seus "devidos locais".

Consequences of chemical residue formation during potentiation of final irrigation - in vitro study

Seeking to increase the efficiency of endodontic irrigation, the association of different solutions as final irrigant has been investigated, such as sodium hypochlorite with chlorhexidine. The literature shows that the combination of these substances leads to the formation of a brownish precipitate, but does not reveal measurements of the intensity of this precipitate and its consequences. Aim: The present study aimed to evaluate the change in dentin color and the obliteration of the dentinal tubules after the association of sodium hypochlorite (NaOCl) with chlorhexidine (CHX) in the final irrigation. Methods: Fifty sterile human lower premolars were prepared with a ProDesign R 35.05 files and divided into 6 groups. Four different NaOCl concentrations (0.5%; 1%, 2.5% and 5.25%) associated with 2% CHX were tested, in addition to 2 control groups, using only 2.5% NaOCl and 2% CHX, respectively. After the final irrigation protocol, the dentin color change was evaluated by spectrophotometry immediately and after 24 hours, and the dentinal tubule obliteration was assessed by scanning electron microscopy. Results: It was possible to verify that regardless the NaOCl concentration used when associated with CHX, a chemical residue was formed, with consequent dentin pigmentation and tubular obstruction. There was a trend towards increased dentin pigmentation and tubular obstruction due to the deposition of the chemical residue formed by this association. Conclusion: It can be concluded that all concentrations of NaOCl associated with CHX caused color changes and tubular obstruction, being proportional to the concentration of NaOCl used

Anti-TNFα therapy early improves hemodynamics in local intestinal and extraintestinal circulations in active Crohn's disease.

BACKGROUND AND AIMS: Active Crohn's disease affects intestine but may alter other locations as eyes vasculature. Previous studies provide evidence of elevated blood flow velocities (BFv) and volume (BFV) in superior mesenteric artery (SMA). We prospectively studied hemodynamics in feeding arteries of bowel and eyes before and 2 weeks after treatment induction with anti-TNFα. METHODS: Fifteen patients (5 females, 10 males, 35.4 ± 9.0 years, mean ± SD) with active Crohn's disease for 7.5 ± 7.7 years were enrolled. Ultrasound imaging was performed before and 2 weeks after treatment in SMA and retrobulbar arteries: central retinal (CRA), temporal posterior ciliary (TPCA) and ophthalmic (OA) arteries. Serum markers of inflammation (CRP and fibrinogen), arterial blood pressures (ABP) and skin flow-mediated dilation (sFMD) were measured and patients were compared to 10 control age- and sex-matched subjects. RESULTS: Before treatment, CRP and fibrinogen plasma concentrations, SMA BFV (339 ± 100 mL/min) were higher in patients than in controls by 8.5-fold (p<0.001), 1.4-fold (p<0.01) and 1.5-fold, respectively (p<0.01). BFv in CRA (3.5 ± 0.7 cm/s) and TPCA (4.4 ± 1.0 cm/s), sFMD (371 ± 469%) were significantly lower than in controls by 83%, 73% and 52% respectively (p<0.05). Two weeks after treatment, CRP and fibrinogen decreased, SMA BFV was normalized (230 ± 39L/min, p<0.01), BFv in CRA, TPCA and OA increased respectively to 4.0 ± 1.1 (p<0.05), 5.2 ± 1.4 (p<0.001), 8.9 ± 3 cm/s (p<0.05). ABP and sFMD remained unchanged. CONCLUSIONS: In active Crohn's disease, a first anti-TNFα administration rapidly normalized concomitantly plasma inflammatory markers and blood-flows in the mesenteric and retrobulbar arteries without affecting blood pressure and endothelial function.

Serum proteoglycans as prognostic biomarkers of hepatocellular carcinoma in patients with alcoholic cirrhosis.

BACKGROUND: Proteoglycans are involved in neoangiogenesis and transduction of oncogenic signals, two hallmarks of carcinogenesis. METHODS: This study sought to assess the prognostic value of serum levels of three proteoglycans (endocan, syndecan-1, and glypican-3) and VEGF in 295 patients with alcoholic cirrhosis: 170 without hepatocellular carcinoma, 58 with early hepatocellular carcinoma, and 67 with advanced hepatocellular carcinoma at inclusion. We analyzed the association between proteoglycan levels and prognosis using Kaplan-Meier and Cox methods. RESULTS: Serum levels of the three proteoglycans and VEGF were increased in patients with advanced hepatocellular carcinoma compared with those without hepatocellular carcinoma or with early hepatocellular carcinoma. In multivariate analysis, high levels of serum endocan (>5 ng/mL) were independently associated with death [HR, 2.84; 95% confidence interval (CI,) 1.18-6.84; P = 0.02], but not with hepatocellular carcinoma occurrence, in patients without hepatocellular carcinoma at baseline. High serum endocan (>5 ng/mL) and syndecan-1 (>50 ng/mL) levels were significantly associated with greater risk of tumor recurrence (P = 0.025) in patients with early hepatocellular carcinoma treated by radiofrequency ablation. In patients with advanced hepatocellular carcinoma, high serum levels of endocan (P = 0.004) and syndecan-1 (P = 0.006) were significantly associated with less favorable overall survival. However, only a high level of serum syndecan-1 (>50 ng/mL) was independently associated with greater risk of death (HR, 6.21 95% CI, 1.90-20.30; P = 0.0025). CONCLUSION: Serum endocan and syndecan-1 are easily assessable prognostic serum biomarkers of overall survival in alcoholic cirrhosis with and without hepatocellular carcinoma. IMPACT: These new biomarkers will be useful to manage patients with hepatocellular carcinoma developed on alcoholic cirrhosis.

Perceptions of young offenders about the police: a qualitative study conducted in Brazil / Percepções de adolescentes infratores sobre a polícia: um estudo qualitativo realizado no Brasil / Percepciones de jóvenes delincuentes sobre la policía: estudio cualitativo realizado en Brasil

The objective of this article is to better understand young offenders' perceptions of the police, as well as to investigate how the context of police violence is implicated in the process of criminalization of this group. A qualitative study was conducted with young offenders who have had experiences of being policed within their development contexts. From an ecological approach, we emphasize the psychosocial dimensions of adolescent experiences within a systemic model of violence. The findings highlighted the damaging effects of truculent police approaches in adolescents' lives and how such actions reinforce the social stigmas that accompany young people exposed to social exclusion, undermining the rights ensured by the Child and Adolescent Statute.

O objetivo deste artigo é compreender as percepções que adolescentes envolvidos em atos infracionais têm sobre a polícia, bem como averiguar como o contexto de violência policial implica no processo de criminalização do grupo supracitado. Foi realizado um estudo qualitativo com adolescentes infratores que haviam tido experiências de abordagens policiais em seus contextos de desenvolvimento. A partir de uma abordagem ecológica, enfatizamos as dimensões psicossociais das experiências dos adolescentes dentro de um modelo sistêmico. A pesquisa evidenciou os efeitos danosos das abordagens policiais truculentas na vida dos adolescentes e como essas ações reforçam os estigmas sociais que acompanham jovens em situação de exclusão social, implicando na desconsideração dos preceitos expressos nas políticas de atenção psicossocial voltadas a esse segmento.

El objetivo de este artículo es comprender las percepciones que los adolescentes involucrados en actos infractores tienen sobre la policía, así como averiguar cómo el contexto de violencia policial implica el proceso de criminalización de este grupo. Se realizó un estudio cualitativo con adolescentes infractores que habían tenido experiencias de abordajes policiales en sus contextos de desarrollo. A partir de un enfoque ecológico, enfatizamos las dimensiones psicosociales de las experiencias de los adolescentes dentro de un modelo sistémico. La investigación evidenció los efectos dañinos de las abordajes policiales truculentas en la vida de los adolescentes y cómo estas acciones refuerzan los estigmas sociales que acompañan a jóvenes en situación de exclusión social, implicando en la desconsideración de los preceptos expresados en las políticas de atención psicosocial dirigidas a ese segmento.

A influência da dupla tarefa no desempenho funcional de idosos institucionalizados e não institucionalizados / The influence of dual task in functional performance in institutionalized and not institutionalized elderly / La influencia de la doble tarea en el desempeño funcional de ancianos institucionalizados y no institucionalizados

Este estudo avaliou a influência da dupla tarefa no desempenho funcional de idosos institucionalizados e não institucionalizados, os quais realizaram as atividades de apoio unipodal, caminhada, subir e descer de um step, e sentar e levantar de uma cadeira (tarefa simples) e as mesmas tarefas segurando um copo com água, contando do número 10 ao um dupla tarefa motora - DTM), contando do número 10 ao um (dupla tarefa cognitiva - DTC) e segurando um copo de água e contando do número 10 ao um (dupla tarefa motora-cognitiva - DTMC), verificando-se um pior desempenho nos idosos institucionalizados.

This study evaluated the influence of the dual task on the functional performance of institutionalized and non-institutionalized elderly people, who performed the activities of unipodal support, walking, climbing and descending a step, and sitting and lifting from a chair (simple task) holding a glass with water, counting from number 10 to a double motor task (DMT), counting from number 10 to one (dual cognitive task - DCT) and holding a glass of water and counting from number 10 to one (double motor task (DMCT), with poorer performance in the institutionalized elderly.

Este estudio evaluó la influencia de la doble tarea en el desempeño funcional de ancianos institucionalizados y no institucionalizados, los cuales realizaron las actividades de apoyo unipodal, caminata, subir y bajar de un step, y sentarse y levantarse de una silla (tarea simple) y las mismas (DTC), contando del número 10 al uno (doble tarea cognitiva - DTC) y sosteniendo un vaso de agua y contando del número 10 al uno (doble tarea motora) - cognitiva - DTMC), verificándose un peor desempeño en los ancianos institucionalizados.

Treatment of gastrointestinal angiodysplasia and unmet needs.

BACKGROUND: Gastrointestinal angiodysplasia (GIAD) may either be asymptomatic or induce overt or obscure bleeding with a high risk of recurrence. Numerous therapeutic options are available but evidence bases are lacking. AIM: We conducted a comprehensive review of pharmacological and endoscopic treatments for previous or active bleeding GIAD and established the unmet needs of the clinicians. METHODS: Clinical trials, series, and reports, having been selected through PubMed inquiry, manual searching, and reference list reviewing, were classified by levels of evidence. RESULTS: Controlled studies focusing on GIAD treatment, excluding other GI vascular malformations, are rare. Endoscopic destruction, preferably using non-contact endoscopic techniques, is most often proposed as a first-line treatment for GIAD (expert level). In addition, APC is preferred over Nd:Yag laser due to the lower risk of perforation (expert level). Pharmacological treatments for GIAD are considered either when endoscopy fails to access the AD or in order to prevent rebleeding for "chronic bleeding patients." Octreotide and oestroprogestative treatments are the best evaluated drugs; however, no appropriate comparison on cost-effectiveness and tolerance has been performed. CONCLUSIONS: The most effective therapeutic strategy for bleeding GIAD is currently inconclusive, and new trials should be performed to address unmet needs.

Epistaxe / Epistaxis

Existem diversas alternativas de tratamento para o manejo da epistaxe. O objetivo desse artigo é fornecer parâmetros teóricos para o médico emergencista intervir com segurança no sangramento nasal, sabendo identificar situações que necessitem da avaliação do especialista.

There are several treatment modalities to manage epistaxis. The aim of this article is to provide theorical parameters to the emergency physician safely handle nasal bleeding and guide him when to request specialist evaluation.