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1.
J Therm Biol ; 121: 103862, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38703597

RESUMO

Elevation gradients provide powerful study systems for examining the influence of environmental filters in shaping species assemblages. High-mountain habitats host specific high-elevation assemblages, often comprising specialist species adapted to endure pronounced abiotic stress, while such harsh conditions prevent lowland species from colonizing or establishing. While thermal tolerance may drive the altitudinal segregation of ectotherms, its role in structuring aquatic insect communities remains poorly explored. This study investigates the role of thermal physiology in shaping the current distribution of high-mountain diving beetles from the Sierra Nevada Iberian mountain range and closely related lowland species. Cold tolerance of five species from each altitudinal zone was measured estimating the supercooling point (SCP), lower lethal temperature (LLT) and tolerance to ice enclosure, while heat tolerance was assessed from the heat coma temperature (HCT). Alpine species exhibited wider fundamental thermal niches than lowland species, likely associated with the broader range of climatic conditions in high-mountain areas. Cold tolerance did not seem to prevent lowland species from colonizing higher elevations, as most studied species were moderately freeze-tolerant. Therefore, fundamental thermal niches seem not to fully explain species segregation along elevation gradients, suggesting that other thermal tolerance traits, environmental factors, and biotic interactions may also play important roles.


Assuntos
Altitude , Termotolerância , Animais , Besouros/fisiologia , Ecossistema , Aclimatação , Temperatura Baixa
2.
Br J Anaesth ; 120(1): 127-137, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29397119

RESUMO

BACKGROUND: Postoperative delirium occurs frequently in elderly hip fracture surgery patients and is associated with poorer overall outcomes. Because xenon anaesthesia has neuroprotective properties, we evaluated its effect on the incidence of delirium and other outcomes after hip fracture surgery. METHODS: This was a phase II, multicentre, randomized, double-blind, parallel-group, controlled clinical trial conducted in hospitals in six European countries (September 2010 to October 2014). Elderly (≥75yr-old) and mentally functional hip fracture patients were randomly assigned 1:1 to receive either xenon- or sevoflurane-based general anaesthesia during surgery. The primary outcome was postoperative delirium diagnosed through postoperative day 4. Secondary outcomes were delirium diagnosed anytime after surgery, postoperative sequential organ failure assessment (SOFA) scores, and adverse events (AEs). RESULTS: Of 256 enrolled patients, 124 were treated with xenon and 132 with sevoflurane. The incidence of delirium with xenon (9.7% [95% CI: 4.5 -14.9]) or with sevoflurane (13.6% [95% CI: 7.8 -19.5]) were not significantly different (P=0.33). Overall SOFA scores were significantly lower with xenon (least-squares mean difference: -0.33 [95% CI: -0.60 to -0.06]; P=0.017). For xenon and sevoflurane, the incidence of serious AEs and fatal AEs was 8.0% vs 15.9% (P=0.05) and 0% vs 3.8% (P=0.06), respectively. CONCLUSIONS: Xenon anaesthesia did not significantly reduce the incidence of postoperative delirium after hip fracture surgery. Nevertheless, exploratory observations concerning postoperative SOFA-scores, serious AEs, and deaths warrant further study of the potential benefits of xenon anaesthesia in elderly hip fracture surgery patients. CLINICAL TRIAL REGISTRATION: EudraCT 2009-017153-35; ClinicalTrials.gov NCT01199276.


Assuntos
Anestésicos Inalatórios , Delírio do Despertar/psicologia , Fraturas do Quadril/cirurgia , Xenônio , Idoso , Idoso de 80 Anos ou mais , Anestesia por Inalação , Delírio do Despertar/epidemiologia , Feminino , Fraturas do Quadril/mortalidade , Humanos , Incidência , Masculino , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/mortalidade , Estudos Prospectivos , Sevoflurano , Resultado do Tratamento
3.
Acta Anaesthesiol Scand ; 62(5): 608-619, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29377061

RESUMO

BACKGROUND: We conducted this study to test whether pulse-oximetry hemoglobin saturation (SpO2 ) can personalize the implementation of an open-lung approach during laparoscopy. Thirty patients with SpO2  ≥ 97% on room-air before anesthesia were studied. After anesthesia and capnoperitoneum the FIO2 was reduced to 0.21. Those patients whose SpO2 decreased below 97% - an indication of shunt related to atelectasis - completed the following phases: (1) First recruitment maneuver (RM), until reaching lung's opening pressure, defined as the inspiratory pressure level yielding a SpO2 ≥ 97%; (2) decremental positive end-expiratory (PEEP) titration trial until reaching lung's closing pressure defined as the PEEP level yielding a SpO2  < 97%; (3) second RM and, (4) ongoing ventilation with PEEP adjusted above the detected closing pressure. RESULTS: When breathing air, in 24 of 30 patients SpO2 was < 97%, PaO2 /FIO2  Ë‚ 53.3 kPa and negative end-expiratory transpulmonary pressure (PTP-EE ). The mean (SD) opening pressures were found at 40 (5) and 33 (4) cmH2 O during the first and second RM, respectively (P < 0.001; 95% CI: 3.2-7.7). The closing pressure was found at 11 (5) cmH2 O. This SpO2 -guided approach increased PTP-EE (from -6.4 to 1.2 cmH2 O, P < 0.001) and PaO2 /FIO2 (from 30.3 to 58.1 kPa, P < 0.001) while decreased driving pressure (from 18 to 10 cmH2 O, P < 0.001). SpO2 discriminated the lung's opening and closing pressures with accuracy taking the reference parameter PTP-EE (area under the receiver-operating-curve of 0.89, 95% CI: 0.80-0.99). CONCLUSION: The non-invasive SpO2 monitoring can help to individualize an open-lung approach, including all involved steps, from the identification of those patients who can benefit from recruitment, the identification of opening and closing pressures to the subsequent monitoring of an open-lung condition.


Assuntos
Laparoscopia/métodos , Oximetria/métodos , Respiração com Pressão Positiva/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC
4.
Lupus ; 24(11): 1198-203, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25716418

RESUMO

BACKGROUND: Of all anti-dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test (CLIF) is considered to have the highest specificity for systemic lupus erythematosus (SLE). OBJECTIVE: The objective of this report is to evaluate whether the presence of anti-dsDNA antibodies detected by the CLIF method is associated with a specific clinical phenotype in recently diagnosed SLE. METHODS: This retrospective cross-sectional study included all patients with newly diagnosed SLE between 1990 and 2011 and followed up in our institution. Demographic, clinical and laboratory findings were assessed. Correlations between positivity of anti-dsDNA by the CLIF method, clinical and laboratory data were analyzed. RESULTS: A total of 104 patients were included in the analysis. Patients who were positive for anti-dsDNA by the CLIF method at the time of diagnosis had (statistically) significantly higher titers of anti-dsDNA by the ELISA method, antinuclear (ANA) and anticardiolipin antibodies, lymphopenia and complement consumption compared with the other two groups. Also they presented significantly more musculoskeletal symptoms at baseline. CONCLUSION: The presence of anti-dsDNA by the CLIF method in newly diagnosed SLE was associated with certain markers of increased disease activity. Its use could be a useful biomarker for a specific clinical phenotype suggestive of a more severe involvement at the time of the diagnosis.


Assuntos
Anticorpos Antinucleares/análise , Lúpus Eritematoso Sistêmico/imunologia , Adulto , Anticorpos Anticardiolipina/análise , Quimotripsina/química , Proteínas do Sistema Complemento/imunologia , Crithidia/química , Estudos Transversais , Feminino , Imunofluorescência , Técnica Indireta de Fluorescência para Anticorpo/métodos , Humanos , Proteínas de Insetos , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/patologia , Linfopenia/imunologia , Masculino , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos
5.
Phys Rev Lett ; 113(23): 233901, 2014 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-25526129

RESUMO

Experimental evidence demonstrating that anomalous localization of waves can be induced in a controllable manner is reported. A microwave waveguide with dielectric slabs randomly placed is used to confirm the presence of anomalous localization. If the random spacing between slabs follows a distribution with a power-law tail (Lévy-type distribution), unconventional properties in the microwave-transmission fluctuations take place revealing the presence of anomalous localization. We study both theoretically and experimentally the complete distribution of the transmission through random waveguides characterized by α=1/2 ("Lévy waveguides") and α=3/4, α being the exponent of the power-law tail of the Lévy-type distribution. As we show, the transmission distributions are determined by only two parameters, both of them experimentally accessible. Effects of anomalous localization on the transmission are compared with those from the standard Anderson localization.

6.
Prenat Diagn ; 34(11): 1049-54, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24861354

RESUMO

OBJECTIVES: To analyze trends in cytogenetic prenatal diagnosis in Cuba and to analyze possible causes leading to a low Down syndrome prevalence in a country where the triple test is not available. METHODS: An analysis of the Cuban program in prenatal cytogenetic diagnosis from 1984 to 2012 was conducted. Results are described, with particular emphasis on indications, abnormal results, types of invasive procedures, and terminations of pregnancy. RESULTS: Cytogenetic prenatal diagnostic analyses (n = 75,095) were conducted; maternal age was the indication for 77.9% of the amniocenteses and chorionic villus samplings. The detection rate of chromosomally abnormal pregnancies was 2.3% for maternal age and increased to 8-9% for other indications. When a chromosomal abnormality was identified, 88.5% terminated the pregnancy. In 2002, the live birth prevalence of Down syndrome was 8.4 per 10,000 live births, and in 2012, 7 per 10,000. CONCLUSION: Prenatal diagnosis in Cuba has contributed to a significant reduction in chromosomal aberrations. The impact increased because of the demographic trends of the population, the high index of terminations of pregnancy, and the establishment of a network of cytogenetic laboratories throughout Cuba.


Assuntos
Síndrome de Down/diagnóstico , Síndrome de Down/epidemiologia , Diagnóstico Pré-Natal/estatística & dados numéricos , Adulto , Amniocentese/estatística & dados numéricos , Amostra da Vilosidade Coriônica/estatística & dados numéricos , Estudos Transversais , Cuba/epidemiologia , Análise Citogenética/estatística & dados numéricos , Feminino , Humanos , Idade Materna , Gravidez , Prevalência , Sistema de Registros , Adulto Jovem
7.
Rheumatol Int ; 34(5): 723-5, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23292188

RESUMO

We report an adult female patient with Takayasu arteritis (TA) receiving conventional medical treatment and anti-TNF therapy, which developed progressive thoracic and abdominal aortic aneurysms. She developed imminent rupture of the thoracic aneurysm and an endovascular stent-graft (EVSG) was emergency implanted and a year after this procedure the abdominal aneurysm increased in size requiring reoperation and placement of another EVSG. Both procedures had a very good outcome. This case shows the effectivity and security of multiple EVSG implantations in multiple aortic aneurisms in patients with TA.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Procedimentos Endovasculares/instrumentação , Stents , Arterite de Takayasu/complicações , Arterite de Takayasu/tratamento farmacológico , Adulto , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/etiologia , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/etiologia , Aortografia/métodos , Produtos Biológicos/uso terapêutico , Feminino , Humanos , Reoperação , Arterite de Takayasu/diagnóstico , Arterite de Takayasu/imunologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Fator de Necrose Tumoral alfa/antagonistas & inibidores
8.
Scand J Rheumatol ; 42(6): 437-44, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23607571

RESUMO

OBJECTIVES: To monitor repair of bone erosions using magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) during etanercept combination therapy. METHOD: The study population comprised 29 RA patients [biologic-naïve, 28-joint Disease Activity Score (DAS28) ≥ 3.2] starting etanercept combination therapy with disease-modifying anti-rheumatic drugs (DMARDs) and completing the 1-year study period with the same treatment. Clinical and laboratory assessments and MRI of the hand were performed at baseline and at 1 year. MRI findings were scored by two readers using the Rheumatoid Arthritis MRI Scoring System (RAMRIS). Both readers were blind to the chronological order of the MRI scans, the identity of the patients, and clinical and other imaging data. Tenosynovitis was also scored. The intra- and inter-reader intraclass correlation coefficients (ICCs) were calculated, along with the sensitivity to change with the smallest detectable difference (SDD). Repair of erosions was defined as a RAMRIS score of at least 1 point lower than baseline. RESULTS: The mean RAMRIS score for erosions did not change but all other inflammatory MRI parameters decreased significantly. In 19 patients, the RAMRIS score for erosions remained unchanged after 1 year. In five patients the score decreased after 1 year, although the decrease exceeded the SDD in only one patient (3.4%). CONCLUSIONS: Etanercept combined with DMARDs stopped the progression of erosions, as measured by the RAMRIS, in 82.8% of our RA patients and occasional repair of bone erosions occurred after 1 year of treatment.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/patologia , Osso e Ossos/patologia , Imunoglobulina G/uso terapêutico , Receptores do Fator de Necrose Tumoral/uso terapêutico , Adulto , Progressão da Doença , Quimioterapia Combinada , Etanercepte , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Tenossinovite/patologia , Resultado do Tratamento
9.
Mol Ecol ; 20(24): 5167-81, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22097887

RESUMO

Genetic connectivity and geographic fragmentation are two opposing mechanisms determining the population structure of species. While the first homogenizes the genetic background across populations the second one allows their differentiation. Therefore, knowledge of processes affecting dispersal of marine organisms is crucial to understand their genetic distribution patterns and for the effective management of their populations. In this study, we use genetic analyses of eleven microsatellites in combination with oceanographic satellite and dispersal simulation data to determine distribution patterns for Serranus cabrilla, a ubiquitous demersal broadcast spawner, in the Mediterranean Sea. Pairwise population F(ST) values ranged between -0.003 and 0.135. Two genetically distinct clusters were identified, with a clear division located between the oceanographic discontinuities at the Ibiza Channel (IC) and the Almeria-Oran Front (AOF), revealing an admixed population in between. The Balearic Front (BF) also appeared to dictate population structure. Directional gene flow on the Spanish coast was observed as S. cabrilla dispersed from west to east over the AOF, from north to south on the IC and from south of the IC towards the Balearic Islands. Correlations between genetic and oceanographic data were highly significant. Seasonal changes in current patterns and the relationship between ocean circulation patterns and spawning season may also play an important role in population structure around oceanographic fronts.


Assuntos
Peixes/genética , Fluxo Gênico , Oceanografia , Filogeografia , Animais , DNA/genética , DNA/isolamento & purificação , Peixes/classificação , Marcadores Genéticos , Variação Genética , Mar Mediterrâneo , Repetições de Microssatélites , Filogenia , Análise de Sequência de DNA/métodos , Especificidade da Espécie
10.
J Med Vasc ; 46(2): 80-89, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33752850

RESUMO

INTRODUCTION: May-Thurner syndrome has been recognized as a cause of chronic venous insufficiency and a trigger for venous thromboembolism. There is no consensus about the definition, diagnosis, and therapeutic approach. We are aiming to describe its characteristics and a scoping literature review. METHODS: A retrospective review of patients with May-Thurner syndrome from March 2010 to May 2018 and scoping literature review were made. RESULTS: Seven patients were identified. All patients were female with a median age of 36 (20-60) years. The median time from the first symptom to diagnosis was 3.41 (0.01-9) years. The primary clinical presentation was post-thrombotic syndrome (4 patients). Six patients had at least one risk factor for deep venous thrombosis. All patients underwent angioplasty with stent; patients with acute deep venous thrombosis, furthermore mechanic thrombectomy with or without catheter-directed thrombolysis were done. There were three complications (one patient, lymphedema, and two venous stent thrombosis). Scoping review results were descriptively summarized. CONCLUSION: May-Thurner syndrome has a varied spectrum of clinical presentation, and clinical awareness is paramount for diagnosis. Its principal complication is the post-thrombotic syndrome, which is associated with high morbidity. There is no consensus on the antithrombotic treatment approach.


Assuntos
Angioplastia , Síndrome de May-Thurner/terapia , Síndrome Pós-Trombótica/terapia , Trombectomia , Terapia Trombolítica , Trombose Venosa/terapia , Adulto , Angioplastia/efeitos adversos , Angioplastia/instrumentação , Feminino , Humanos , Masculino , Síndrome de May-Thurner/complicações , Síndrome de May-Thurner/diagnóstico por imagem , Pessoa de Meia-Idade , Síndrome Pós-Trombótica/diagnóstico , Síndrome Pós-Trombótica/etiologia , Recidiva , Estudos Retrospectivos , Stents , Trombectomia/efeitos adversos , Terapia Trombolítica/efeitos adversos , Resultado do Tratamento , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Adulto Jovem
11.
Clin Exp Rheumatol ; 28(6 Suppl 63): S87-93, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21176427

RESUMO

OBJECTIVES: To develop a questionnaire assessing the burden of fibromyalgia's impacts on patients' lives. METHODS: A literature review was conducted to identify impacts of fibromyalgia and their consequences on patients' lives. Exploratory interviews were performed with 15 fibromyalgia patients in France, Germany and Spain. Using patients' wording, items were generated simultaneously in French, German, Spanish, and UK English. Relevance and comprehension of the resulting questionnaire versions were tested with 21 additional fibromyalgia patients; questionnaires were revised accordingly. RESULTS: Three domains, Burden associated with the impacts of fibromyalgia, Symptoms and Influencing factors, were identified from the literature review. Following patient interviews, the burden domain was further divided based on the nature of the impact: Pain, Physical impact (including tiredness, sleep problems and other symptoms), Activities of Daily Living impact (including autonomy and coping), Social and Family Life impact, Work, Studies and Personal Finances impact, Psychological impact (including cognitive impact), and Relationship to Medicine and Disease. The resulting test versions of the questionnaire contained 79 items. Comprehension tests identified problematic items and cultural differences and suggested deletions or rewording. After revision and linguistic harmonization, the pilot version of the questionnaire contained 62 items divided into 7 sections, and was named Fibromyalgia Burden Assessment (FMBA©). CONCLUSIONS: The FMBA is a self-reported questionnaire allowing the assessment and a better understanding of the impacts of fibromyalgia and the burden associated with these on patients' daily lives. It is available in UK English, French, German and Spanish. Its scoring and validation remain to be undertaken.


Assuntos
Efeitos Psicossociais da Doença , Autoavaliação Diagnóstica , Avaliação da Deficiência , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Atividades Cotidianas/psicologia , Adulto , Idoso , Feminino , França , Alemanha , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida/psicologia , Espanha , Reino Unido
12.
Rev Esp Anestesiol Reanim (Engl Ed) ; 67(2): 55-62, 2020 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31889529

RESUMO

INTRODUCTION: In lung resection surgery, restrictive fluid therapy is recommended due to the risk of acute lung injury. In contrast, this recommendation increases the risk of hypoperfusion. Guided fluid therapy allows individualization of fluid intake. The use of dynamic volume response parameters is not validated during one-lung ventilation. The main objective is the validation of dynamic parameters, stroke volume variation (SVV) and pulse pressure variation (PPV), during lung resection surgery as fluid response predictors, after the administration of 250ml crystalloid volume loads, if IC<2.5ml/min/m2 and if SVV≥8% and/or PPV≥10%. MATERIAL AND METHODS: Pilot, prospective, observational and single centre study. Twenty-five patients monitored with the PiCCO system were included during open lung resection surgery with the patient in a lateral position, one lung ventilation with tidal volume (TV): 6ml/kg and open chest. Hemodynamic variables were collected before and after volume loading. The results were classified into two groups: volume responders (increase IC≥10% and/or VSI≥10% after volume loading) and non-responders (no increase or increase IC<10% and/or VSI<10% after volume loading). We assess the diagnostic efficacy of SVV and PPV by analyzing the AUC (area under curve) in the ROC curves. RESULTS: In the analysis of ROC curves, SVV and PPV did not reach a discriminative value (AUCSVV: 0.47; AUCPPV: 0.50), despite the decrease in the threshold value of SVV and PPV to initiate an overload of volume during one-lung ventilation, in lateral position and open chest. CONCLUSIONS: The results obtained show that the values of the dynamic parameters of volume response (SVV≥8% and PPV≥10%) do not discriminate against responders patients and non-responders during open lung resection surgery.


Assuntos
Pressão Sanguínea/fisiologia , Hidratação/métodos , Pulmão/cirurgia , Volume Sistólico/fisiologia , Soluções Cristaloides/administração & dosagem , Feminino , Hidratação/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Ventilação Monopulmonar/métodos , Projetos Piloto , Pneumonectomia , Estudos Prospectivos , Curva ROC , Valores de Referência , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/prevenção & controle , Sístole/fisiologia
13.
J Mater Sci Mater Med ; 20(11): 2181-7, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19475340

RESUMO

To obtain images of the articular surface of fresh osteochondral grafts using an environmental scanning electron microscope (ESEM). To evaluate and compare the main morphological aspects of the chondral surface of the fresh grafts. To develop a validated classification system on the basis of the images obtained via the ESEM. The study was based on osteochondral fragments from the internal condyle of the knee joint of New Zealand rabbits, corresponding to fresh chondral surface. One hundred images were obtained via the ESEM and these were classified by two observers according to a category system. The Kappa index and the corresponding confidence interval (CI) were calculated. Of the samples analysed, 62-72% had an even surface. Among the samples with an uneven surface 17-22% had a hillocky appearance and 12-16% a knobbly appearance. As regards splits, these were not observed in 92-95% of the surfaces; 4-7% showed superficial splits and only 1% deep splits. In 78-82% of cases no lacunae in the surface were observed, while 17-20% showed filled lacunae and only 1-2% presented empty lacunae. The study demonstrates that the ESEM is useful for obtaining and classifying images of osteochondral grafts.


Assuntos
Cartilagem Hialina/química , Microscopia Eletrônica de Varredura/métodos , Animais , Cartilagem Articular/patologia , Condrócitos/citologia , Extremidades/patologia , Feminino , Cartilagem Hialina/transplante , Estudos Longitudinais , Estudos Prospectivos , Coelhos , Reprodutibilidade dos Testes , Propriedades de Superfície
14.
Rheumatology (Oxford) ; 47(7): 1088-92, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18511475

RESUMO

OBJECTIVE: To estimate the incidence of early arthritis (EA) and of RA in adults (>16 yrs) in Spain. METHODS: Primary care physicians were instructed in the detection of new cases using a checklist. All cases were evaluated at EA units (EAUs) within 15 days of detection. ACR criteria for the classification of RA were assessed every 6 months thereafter. RESULTS: In an area covering 4,342,378 inhabitants over the age of 16 yrs, 2467 patients were referred to the EAU, of whom 1063 fulfilled EA criteria (43.1%). After 6 months, 362 patients fulfilled RA criteria. The estimated annual incidence of EA was 25/100,000 population (95% CI: 23, 26). The annual incidence of RA was 8.3 cases/100,000 (95% CI: 7.5, 9.2): 11.3/100,000 in women (95% CI: 10.0, 12.8), and 5.2/100,000 in men (95% CI: 4.3, 6.3). The incidence of RA increased with age in both sexes. At the 6 months' assessment, 187 (51.7%) of the patients with RA were RF positive. The presentation of RA was mainly polyarticular (n = 268; 74.0%). There were 701/1063 patients with EA who did not fulfil RA criteria by 6 months after the first rheumatologist visit. If all cases of undifferentiated arthritis (n = 118; 17%) became RA, the incidence would be in the range of 10 cases/100,000 population. CONCLUSIONS: RA incidence in Spain is in the lower range of published data. The incidence of EA is about three times that of RA.


Assuntos
Artrite Reumatoide/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Artrite/diagnóstico , Artrite/epidemiologia , Diagnóstico Precoce , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/estatística & dados numéricos , Sistema de Registros , Distribuição por Sexo , Espanha/epidemiologia
15.
Comput Mech ; 61(6): 639-655, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-31007328

RESUMO

The Particle Finite Element Method, a lagrangian finite element method based on a continuous Delaunay re-triangulation of the domain, is used to study machining of Ti6Al4V. In this work the method is revised and applied to study the influence of the cutting speed on the cutting force and the chip formation process. A parametric methodology for the detection and treatment of the rigid tool contact is presented. The adaptive insertion and removal of particles are developed and employed in order to sidestep the difficulties associated with mesh distortion, shear localization as well as for resolving the fine-scale features of the solution. The performance of PFEM is studied with a set of different two-dimensional orthogonal cutting tests. It is shown that, despite its Lagrangian nature, the proposed combined finite element-particle method is well suited for large deformation metal cutting problems with continuous chip and serrated chip formation.

16.
J Insect Physiol ; 98: 59-66, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27915134

RESUMO

Ongoing climate change is driving dramatic range shifts in diverse taxa worldwide, and species responses to global change are likely to be determined largely by population responses at geographical range margins. Here we investigate the metabolic and reproductive plasticity in response to water temperature and salinity variation of two populations of the eurythermic saline water bug Sigara selecta: one population located close to the northern edge of its distribution, in a relatively cold, thermally stable region (SE England - 'marginal'), and one close to the range centre, in a warmer and more thermally variable Mediterranean climate (SE Spain - 'core'). We compared metabolic and oviposition rates and egg size, following exposure to one of four different combinations of temperature (15 and 25°C) and salinity (10 and 35gL-1). Oviposition rate was significantly higher in the marginal population, although eggs laid were smaller overall. No significant differences in oxygen consumption rates were found between core and marginal populations, although the marginal population showed higher levels of plasticity in both metabolic and reproductive traits. Our results suggest that population-specific responses to environmental change are complex and may be mediated by differences in phenotypic plasticity. In S. selecta, the higher plasticity of the marginal population may facilitate both its persistence in current habitats and northward expansion with future climatic warming. The less plastic core population may be able to buffer current environmental variability with minor changes in metabolism and fecundity, but could be prone to extinction if temperature and salinity changes exceed physiological tolerance limits in the future.


Assuntos
Metabolismo Energético , Heterópteros/fisiologia , Oviposição , Termotolerância , Animais , Ecossistema , Europa (Continente) , Óvulo/fisiologia , Águas Salinas/análise , Espanha
17.
Clin Microbiol Infect ; 23(10): 775.e1-775.e6, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28192235

RESUMO

OBJECTIVES: This study aimed to characterize the chronically infected general hepatitis C virus (HCV) population in Barcelona using a highly sensitive subtyping method that can identify the 67 recognized HCV subtypes and diagnose mixed infection by various genotypes/subtypes in a single individual. The resulting information has implications for selecting optimal direct-acting antiviral (DAA) treatment for each patient and establishing public healthcare policies in our setting. METHODS: Consecutive HCV patients (treatment-naïve or interferon-based failures) attending Vall d'Hebron Hospital outpatient clinics from February 2015 to May 2016 (N=1473) were included in the study. Patient samples were characterized using HCV subtyping by next-generation ultra-deep pyrosequencing. RESULTS: The following genotypes (G) were found: G1 (1126/1473 (76.4%)), G4 (145/1473 (9.8%)), G3 (135/1473 (9.2%)), G2 (51/1473 (3.5%)), and G5 (1/1473 (0.1%)). Twenty-two subtypes were seen: 1b (790/1473 (53.6%)), 1a (332/1473 (22.5%)), 3a (133/1473 (9.0%)), 4d (105/1473 (7.1%)), 4a (29/1473 (2.0%)), and 2c (25/1473 (1.7%)), with 16 low-prevalence subtypes accounting for the remaining 3.0% (44/1473). There was a worrisome 1.0% (15/1473) of mixed infections. G2 (51/1473 (3.5%)) showed a high level of heterogeneity. Analyses by age groups showed a predominance of G1b over G1a (428/506 (84.6%) vs. 24/506 (4.7%)) in patients born before 1950 (N=506/1473), and similar percentages of these subtypes in those born between 1951 and 1975 (N=834/1473) (315/834, 37.8% vs. 266/834, 31.9%) and after 1976 (N=133/1473) (47/133, 35.3% vs. 42/133, 31.6%). CONCLUSIONS: Subtype distribution showed a higher level of heterogeneity than was expected, particularly for G2. Prevalence of mixed infections was around 1%. HCV subtype distribution related to patient age group suggested that patients born from 1936 to 1975 in our setting should undergo screening for the infection. Next-generation sequencing enabled better classification of candidates for DAA-based treatment.


Assuntos
Variação Genética , Genótipo , Técnicas de Genotipagem/métodos , Hepacivirus/classificação , Hepacivirus/genética , Hepatite C Crônica/virologia , Adolescente , Adulto , Idoso , Coinfecção/epidemiologia , Coinfecção/virologia , Feminino , Hepacivirus/isolamento & purificação , Hepatite C Crônica/epidemiologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Prevalência , Espanha/epidemiologia , Adulto Jovem
18.
J Food Prot ; 69(8): 2016-8, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16924935

RESUMO

Pulsed electric field treatment has been claimed to produce more acceptable chilled citrus juices than those obtained by conventional thermal treatment. The pectin methylesterase activity and the acceptability of nine juices obtained from Clementine mandarins, Valencia oranges, and Ortanique fruits (hybrid of mandarin and orange), untreated, pasteurized (85 degrees C for 10 s), and treated by pulsed electric fields (25 kV/cm for 330 micros), were evaluated. The treatments, selected to reach a similar level of pectin methylesterase inactivation, produced juices that did not differ in acceptability from each other for the three varieties and in all cases were less acceptable than the untreated juice.


Assuntos
Bactérias/crescimento & desenvolvimento , Bebidas/microbiologia , Citrus/microbiologia , Campos Eletromagnéticos , Conservação de Alimentos/métodos , Temperatura Alta , Bebidas/normas , Hidrolases de Éster Carboxílico/metabolismo , Qualidade de Produtos para o Consumidor , Microbiologia de Alimentos , Humanos , Paladar
19.
Forensic Sci Int Genet ; 25: 63-72, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27500650

RESUMO

Since 1992, the Spanish and Portuguese-Speaking Working Group of the ISFG (GHEP-ISFG) has been organizing annual Intercomparison Exercises (IEs) coordinated by the Quality Service at the National Institute of Toxicology and Forensic Sciences (INTCF) from Madrid, aiming to provide proficiency tests for forensic DNA laboratories. Each annual exercise comprises a Basic (recently accredited under ISO/IEC 17043: 2010) and an Advanced Level, both including a kinship and a forensic module. Here, we show the results for both autosomal and sex-chromosomal STRs, and for mitochondrial DNA (mtDNA) in two samples included in the forensic modules, namely a mixture 2:1 (v/v) saliva/blood (M4) and a mixture 4:1 (v/v) saliva/semen (M8) out of the five items provided in the 2014 GHEP-ISFG IE. Discrepancies, other than typos or nomenclature errors (over the total allele calls), represented 6.5% (M4) and 4.7% (M8) for autosomal STRs, 15.4% (M4) and 7.8% (M8) for X-STRs, and 1.2% (M4) and 0.0% (M8) for Y-STRs. Drop-out and drop-in alleles were the main cause of errors, with laboratories using different criteria regarding inclusion of minor peaks and stutter bands. Commonly used commercial kits yielded different results for a micro-variant detected at locus D12S391. In addition, the analysis of electropherograms revealed that the proportions of the contributors detected in the mixtures varied among the participants. In regards to mtDNA analysis, besides important discrepancies in reporting heteroplasmies, there was no agreement for the results of sample M4. Thus, while some laboratories documented a single control region haplotype, a few reported unexpected profiles (suggesting contamination problems). For M8, most laboratories detected only the haplotype corresponding to the saliva. Although the GHEP-ISFG has already a large experience in IEs, the present multi-centric study revealed challenges that still exist related to DNA mixtures interpretation. Overall, the results emphasize the need for further research and training actions in order to improve the analysis of mixtures among the forensic practitioners.


Assuntos
Cromossomos Humanos X , Cromossomos Humanos Y , Impressões Digitais de DNA , DNA Mitocondrial/genética , Laboratórios/normas , Repetições de Microssatélites , Amelogenina/genética , Análise Química do Sangue , Feminino , Genética Forense , Marcadores Genéticos , Haplótipos , Humanos , Masculino , Saliva/química , Sêmen/química
20.
Plant Physiol ; 107(3): 865-872, 1995 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12228409

RESUMO

Enzymatic activities involved in putrescine metabolism in ovaries of Pisum sativum L. during ovary senescence and fruit set were investigated. Accumulation of putrescine was observed during incubation of extracts from gibberellic acid-treated unpollinated ovaries (young developing fruits) but not in extracts from untreated ovaries (senescent ovaries). Extracts from pea ovaries showed arginine decarboxylase (ADC) activity, but ornithine decarboxylase and arginase activity were not detected. ADC activity decreased in presenescent ovaries and increased markedly after induction of fruit set with gibberellic acid. Increases in ADC activity were also observed with application of other plant growth substances (benzy-ladenine and 2,4-dichlorophenoxyacetic acid), after pollination, and in the slender (la crys) pea mutant. By contrast, putrescine oxidase activity increased in presenescent ovaries but did not increase during early fruit development. All of these results suggest that ADC and putrescine oxidase are involved in the control of putrescine metabolism. Ovary senescence is characterized by the absence of putrescine biosynthesis enzymes and increased levels of putrescine oxidase and fruit development by an increase in ADC and a constant level of putrescine oxidase.

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