Webcam technology on neonatal wards-examining the objective and subjective workload of nurses: a combined observational and survey study.

BACKGROUND: This study was conducted to estimate the additional objective and perceived workload of nurses resulting from the use of webcams. The successful implementation of webcam technology into routine care requires an analysis to prevent adverse events of increased nursing workload. METHODS: The study took place on three neonatal wards in two University Hospitals in Germany. In the first Hospital, the study was conducted from February to July 2021; in the second one it was conducted between June and November 2021. Data were collected using a combined approach of a standardised diary questionnaire study and passive observations. The participants were accompanied in their daily work and their activities were recorded 65 nurses participated. RESULTS: 2,031 h were observed in 1,630 observation blocks. In 14.74% of the observation blocks webcam activities were detected. The extent to which the nurses had webcam-related additional workloads was rated as no additional workload in 82.16% of the daily questionnaires (n = 1,026). CONCLUSION: The observed low workload due to the webcams is in line with the nurses' perception. The observational data revealed, on a number of different analysis levels, that a limited additional workload was generated. There was no decrease in activity performance observed and no clear indication for interruptions due to the webcam-related activities for the nurses. However, it is important to raise awareness about the individual workload levels for the successful implementation. Additional education programs can be provided for nurses. TRIAL REGISTRATION: The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755 .

Variability of interferon-λ induction and antiviral activity in Nipah virus infected differentiated human bronchial epithelial cells of two human donors.

Highly pathogenic Nipah virus (NiV) generally causes severe encephalitis in humans. Respiratory symptoms are infrequently observed, likely reflecting variations in infection kinetics in human airways. Supporting this idea, we recently identified individual differences in NiV replication kinetics in cultured airway epithelia from different human donors. As type III interferons (IFN-λ) represent major players in the defence mechanism against viral infection of the respiratory mucosa, we studied IFN-λ induction and antiviral activity in NiV-infected primary differentiated human bronchial epithelial cells (HBEpCs) cultured under air-liquid interface conditions. Our studies revealed that IFN-λ was upregulated in airway epithelia upon NiV infection. We also show that IFN-λ pretreatment efficiently inhibited NiV replication. Interestingly, the antiviral activity of IFN-λ varied in HBEpCs from two different donors. Increased sensitivity to IFN-λ was associated with higher expression levels of IFN-λ receptors, enhanced phosphorylation of STAT1, as well as enhanced induction of interferon-stimulated gene expression. These findings suggest that individual variations in IFN-λ receptor expression affecting IFN responsiveness can play a functional role for NiV replication kinetics in human respiratory epithelial cells of different donors.

Experiences of reduced work hours for nurses and assistant nurses at a surgical department: a qualitative study.

BACKGROUND: There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work-family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses' and assistant nurses' job satisfaction, work-life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nurses and assistant nurses in order to improve the working situation. The aim of the study was to investigate the experiences of reduced work hours and no lunch breaks among nurses and assistant nurses at an orthopaedic surgery department at a hospital in Sweden, with a particular focus on recovery and psychosocial working environment. METHODS: A qualitative design was used in the study. Eleven nurses and assistant nurses working at the particular orthopaedic department took part in the study, and semi-structured interviews were used to collect data. The interviews were analysed by interpretative phenomenological analysis. RESULTS: Four main themes were developed in the analysis of the data: A more sustainable working situation, Improved work-life balance, Consequences of being part of a project, and Improved quality of care. Each theme consisted of subthemes. CONCLUSIONS: Overall, reduced work hours appeared to have many, mainly positive, effects for the participants in both work and home life.

Small-scale urban design interventions: A framework for deploying cities as resource for mental health and mental health literacy.

With roughly half of the global population living in cities, urban environments become central to public health often perceived as health risk factors. Indeed, mental disorders show higher incidences in urban contexts compared to rural areas. However, shared urban environments also provide a rich potential to act as a resource for mental health and as a platform to increase mental health literacy. Based on the concepts of salutogenesis and restorative environments, we propose a framework for urban design interventions. It outlines (a) an output level, i.e., preventive and discursive potentials of such interventions to act as biopsychosocial resources, and (b) a process level, i.e., mechanisms of inter- and transdisciplinary collaboration of researchers and citizens in the design process. This approach aims at combining evidence-based, salutogenic, psychosocially-supportive design with a focus on mental health. Implementing low-threshold, resource-efficient options in the existing urban context brings this topic to the public space. Implications for the implementation of such interventions for citizens, researchers, and municipality stakeholders are discussed. This illustrates new directions of research for urban person-environment interactions, public health, and beyond.

A process to foster pathology-related effects of design primes - how orthopedic patients might benefit from design features that influence health behaviour intention.

A growing body of literature mainly in the context of consumer research indicates that the formal-aesthetic and conceptual design of objects can influence users' thoughts, emotions and even behavioural patterns. While there is strong evidence regarding these effects on actual purchasing decisions, evidence on the effect of aesthetic design features (e.g., haptics, colour) on health-related mental concepts and intentions for health behaviour change is scarce. Based on insights from material and conceptual priming, this article illustrates the research-driven and evidence-based design process of two design primes and comprises pre-tests and an experiment in two settings on the effect of design on health behaviour focusing i.a. on intention for health behaviour change. In an evidence-based and research-driven process, two lecterns were designed to work as primes, i.e., to have a positive vs. negative influence on several mental constructs (sense of control, sense of coherence, resiliency, self-efficacy) and health-related intention. The lecterns differed mainly in terms of aesthetic appearance (e.g., material, colour, proportion, steadiness). They were tested in (a.) a university setting with students (n = 83) and (b.) a clinical setting with orthopaedic rehabilitation patients (n = 38). Participants were asked to perform an unrelated task (evaluation of an unrelated product) while standing at and using the lecterns. Overall, t-tests and Mann-Whitney-U tests show no significant differences but differing tendencies in a mentioning task. When asked to name health-promoting activities, in the clinical setting, participants using the "positive" prime (i.e., the steady lectern, n = 13) mentioned more sport-related aspects on average and a higher portion of sport-related aspects of their answers than participants using the "negative" prime (n = 11). In the university setting (positive: n = 36; negative n = 38), no such differences emerged. This finding gives reason to believe that the prime might be specifically effective in the clinical setting as it relates to physical activity being the most relevant topic of the patients' pathology.

Catholic Ownership, Physician Leadership and Operational Strategies: Evidence from German Hospitals.

Previous research has revealed that Catholic hospitals are more likely follow a strategy of horizontal diversification and maximization of the number of patients treated, whereas Protestant hospitals follow a strategy of horizontal specialization and focus on vertical differentiation. However, there is no empirical evidence pertaining to this mechanism. We conduct an empirical study in a German setting and argue that physician leadership mediates the relationship between ownership and operational strategies. The study includes the construction of a model combining data from a survey and publicly available information derived from the annual quality reports of German hospitals. Our results show that Catholic hospitals opt for leadership structures that ensure operational strategies in line with their general values, i.e., operational strategies of maximizing volume throughout the overall hospital. They prefer part-time positions for chief medical officers, as chief medical officers are identified to foster strategies of maximizing the overall number of patients treated. Hospital owners should be aware that the implementation of part-time and full-time leadership roles can help to support their strategies. Thus, our results provide insights into the relationship between leadership structures at the top of an organization, on the one hand, and strategic choices, on the other.

Development and characterization of an indirect ELISA to detect SARS-CoV-2 spike protein-specific antibodies.

The current Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) pandemic is a public health emergency of international concern. Sensitive and precise diagnostic tools are urgently needed. In this study, we developed a SARS-CoV-2 spike (S1) protein enzyme-linked immunosorbent assay (ELISA) to detect SARS-CoV-2-specific antibodies. The SARS-CoV-2 S1 ELISA was found to be specific [97.8% (95% CI, 96.7% - 98.5%)], reproducible and precise (intra-assay coefficient of variability (CV) 5.3%, inter-assay CV 7.9%). A standard curve and the interpolation of arbitrary ELISA units per milliliter served to reduce the variability between different tests and operators. Cross-reactivity to other human coronaviruses was addressed by using sera positive for MERS-CoV- and hCoV HKU1-specific antibodies. Monitoring antibody development in various samples of twenty-three and single samples of twenty-nine coronavirus disease 2019 (COVID-19) patients revealed seroconversion and neutralizing antibodies against authentic SARS-CoV-2 in all cases. The comparison of the SARS-CoV-2 (S1) ELISA with a commercially available assay showed a better sensitivity for the in-house ELISA. The results demonstrate a high reproducibility, specificity and sensitivity of the newly developed ELISA, which is suitable for the detection of SARS-CoV-2 S1 protein-specific antibody responses.

Changes in cardiac arrest profiles after the implementation of a Rapid Response Team. / Modificações no perfil de paradas cardíacas após implantação de um Time de Resposta Rápida.

OBJECTIVE: To evaluate changes in the characteristics of in-hospital cardiac arrest after the implementation of a Rapid Response Team. METHODS: This was a prospective observational study of in-hospital cardiac arrest that occurred from January 2013 to December 2017. The exclusion criterion was in-hospital cardiac arrest in the intensive care unit, emergency room or operating room. The Rapid Response Team was implemented in July 2014 in the study hospital. Patients were classified into two groups: a Pre-Rapid Response Team (in-hospital cardiac arrest before Rapid Response Team implementation) and a Post-Rapid Response Team (in-hospital cardiac arrest after Rapid Response Team implementation). Patients were followed until hospital discharge or death. RESULTS: We had a total of 308 cardiac arrests (64.6 ± 15.2 years, 60.3% men, 13.9% with initial shockable rhythm). There was a decrease from 4.2 to 2.5 in-hospital cardiac arrest/1000 admissions after implementation of the Rapid Response Team, and we had approximately 124 calls/1000 admissions. Pre-Rapid Response Team cardiac arrest was associated with more hypoxia (29.4 versus 14.3%; p = 0.006) and an altered respiratory rate (14.7 versus 4.2%; p = 0.004) compared with post-Rapid Response Team cardiac arrest. Cardiac arrest due to hypoxia was more common before Rapid Response Team implementation (61.2 versus 38.1%, p < 0.001). In multivariate analysis, return of spontaneous circulation was associated with shockable rhythm (OR 2.97; IC95% 1.04 - 8.43) and witnessed cardiac arrest (OR 2.52; IC95% 1.39 - 4.59) but not with Rapid Response Team implementation (OR 1.40; IC95% 0.70 - 2.81) or premonitory signs (OR 0.71; IC95% 0.39 - 1.28). In multivariate analysis, in-hospital mortality was associated with non-shockable rhythm (OR 5.34; IC95% 2.28 - 12.53) and age (OR 1.03; IC95% 1.01 - 1.05) but not with Rapid Response Team implementation (OR 0.89; IC95% 0.40 - 2.02). CONCLUSION: Even though Rapid Response Team implementation is associated with a reduction in in-hospital cardiac arrest, it was not associated with the mortality of in-hospital cardiac arrest victims. A significant decrease in cardiac arrests due to respiratory causes was noted after Rapid Response Team implementation.

OBJETIVO: Avaliar as modificações nas características das paradas cardíacas no hospital após a implantação de um Time de Resposta Rápida. MÉTODOS: Este foi um estudo observacional prospectivo de paradas cardíacas ocorridas no hospital entre janeiro de 2013 e dezembro de 2017. O critério de exclusão foi parada cardíaca na unidade de terapia intensiva, na emergência ou na sala cirúrgica. O Time de Resposta Rápida foi introduzido no hospital do estudo em julho de 2014. Os pacientes foram classificados em dois grupos: Pré-Time de Resposta Rápida (parada cardíaca no hospital antes da implantação do Time de Resposta Rápida) e Pós- Time de Resposta Rápida (parada cardíaca no hospital após a implantação do Time de Resposta Rápida). Os pacientes foram seguidos até a alta hospitalar ou óbito. RESULTADOS: Ocorreram 308 paradas cardíacas (64,6 ± 15,2 anos; 60,3% homens; 13,9% com ritmo inicial chocável). Houve diminuição de 4,2 para 2,5 no índice de parada cardíaca no hospital por 1.000 admissões após o início da atuação do Time de Resposta Rápida, além de cerca de 124 chamados por 1.000 admissões. A parada antes da implantação do Time de Resposta Rápida se associou com hipóxia (29,4 versus 14,3%; p = 0,006) e alteração da frequência respiratória (14,7 versus 4,2%; p = 0,004) em comparação aos dados referentes à parada cardíaca após a implantação do Time de Resposta Rápida. Parada cardíaca por hipóxia foi mais comum antes da implantação do Time de Resposta Rápida (61,2 versus 38,1%; p < 0,001). Na análise multivariada, o retorno à circulação espontânea se associou com ritmo chocável (RC 2,97; IC95% 1,04 - 8,43) e parada cardíaca testemunhada (RC 2,52; IC95% 1,39 - 4,59) mas não com a implantação do Time de Resposta Rápida (RC 1,40; IC95% 0,70 - 2,81) ou sinais premonitórios (RC 0,71; IC95% 0,39 - 1,28). Na análise multivariada, a mortalidade hospitalar se associou com ritmo não chocável (RC 5,34; IC95% 2,28 - 12,53) e idade (RC 1,03; IC95% 1,01 - 1,05), porém não com a implantação do Time de Resposta Rápida (RC 0,89; IC95% 0,40 - 2,02). CONCLUSÃO: Apesar de a implantação de um Time de Resposta Rápida se associar com redução na incidência de parada cardíaca no hospital, ela não se associou com a redução da mortalidade das vítimas de parada cardíaca no hospital. Observou-se significante diminuição nas paradas cardíacas devidas a causas respiratórias após a implantação do Time de Resposta Rápida.

Chemokine homeostasis vs. chemokine presentation during severe acute lung injury: the other side of the Duffy antigen receptor for chemokines.

Acute lung injury (ALI) still poses a major challenge in critical care medicine. Neutrophils, platelets, and chemokines are all considered key components in the development of ALI. The Duffy antigen receptor for chemokines (DARC) is thought to be involved in scavenging, transendothelial transport, and presentation of neutrophil-specific chemokines. DARC is expressed on endothelial cells and erythrocytes but not on leukocytes. Here, we show that DARC is crucial for chemokine-mediated leukocyte recruitment in vivo. However, we also demonstrate that changes in chemokine and chemokine receptor homeostasis, associated with Darc gene deficiency, exert strong anti-inflammatory effects. Neutrophils from Darc gene-deficient (Darc(-/-)) mice display a more prolonged downregulation of CXCR2 during severe inflammation than neutrophils from wild-type mice. In a CXCR2-dependent model of acid-induced ALI, Darc gene deficiency prevents ALI. Darc(-/-) mice demonstrate fully preserved oxygenation, only a small increase in vascular permeability, and a complete lack of pulmonary neutrophil recruitment. Further analysis reveals that only neutrophils but neither endothelial cells nor erythrocytes from Darc(-/-) mice confer protection from ALI. The protection appears to be due to abolished pulmonary recruitment of neutrophils from Darc(-/-) mice. The generation of neutrophil-platelet aggregates, a key mechanism in both pulmonary neutrophil recruitment and thrombus formation, is also affected by altered CXCR2 homeostasis in Darc(-/-) mice. CXCR2 blockade enhances the formation of platelet-neutrophil aggregates and thereby corrects a formerly unknown bleeding defect in Darc(-/-) mice. In summary, our study suggests that chemokine/chemokine receptor homeostasis plays a previously unrecognized and crucial role in severe ALI.

Adjuvant formulated virus-like particles expressing native-like forms of the Lassa virus envelope surface glycoprotein are immunogenic and induce antibodies with broadly neutralizing activity.

Lassa mammarenavirus (LASV) is a rodent-borne arenavirus endemic to several West African countries. It is the causative agent of human Lassa fever, an acute viral hemorrhagic fever disease. To date, no therapeutics or vaccines against LASV have obtained regulatory approval. Polyclonal neutralizing antibodies derived from hyperimmunized animals may offer a useful strategy for prophylactic and therapeutic intervention to combat human LASV infections. The LASV envelope surface glycoprotein complex (GP) is the major target for neutralizing antibodies, and it is the main viral antigen used for the design of an LASV vaccine. Here, we assessed the immunogenic potential of mammalian cell-derived virus-like particles (VLPs) expressing GP from the prototypic LASV strain Josiah in a native-like conformation as the sole viral antigen. We demonstrate that an adjuvanted prime-boost immunization regimen with GP-derived VLPs elicited neutralizing antibody responses in rabbits, suggesting that effective antigenic epitopes of GP were displayed. Notably, these antibodies exhibited broad reactivity across five genetic lineages of LASV. VLP-based immunization strategies may represent a powerful approach for generating polyclonal sera containing cross-reactive neutralizing antibodies against LASV.

Cutaneous melanoma: descriptive epidemiological study.

CONTEXT AND OBJECTIVE: Cutaneous melanoma represents around 3% of all skin tumors. About 20% of such patients will have advanced disease and will die before reaching five years of survival. The aim of this paper was to describe the clinical and histopathological variables and their correlations. DESIGN AND SETTING: Retrospective, descriptive, epidemiological study at the Melanoma Unit, Dermatological Clinic, Irmandade da Santa Casa de Misericórdia, São Paulo. METHODS: Records from 364 cases between May 1993 and January 2006 were analyzed. The frequencies of all study variables and their 95% confidence intervals were determined. The chi-squared test was used to evaluate associations among the variables, adopting a significant level of 0.05. RESULTS: Females predominated, with 1.4 women for each man. The patients mean age was 58.9 years. Nonwhite patients represented 13.7% of the sample. The prevalent anatomical sites for cutaneous melanoma were the trunk and feet, for both men and women. Acral lentiginous melanoma represented 22.3% of the cohort. In situ primary lesions were observed in few cases and a high percentage of thick cutaneous melanoma was detected. Ulceration was found in 13.4% of the thin tumors (< 1.0 mm). Thicker and ulcerated lesions predominated in male patients (p = 0.011 and p < 0.001 respectively) and in elderly patients (p = 0.021 and p = 0.015). CONCLUSIONS: The cohort mostly presented thick and ulcerated tumors, denoting late diagnosis and bad prognosis. Also, the sample was characterized by considerable prevalence of female patients, nonwhite patients, limb lesions and acral lentiginous melanoma.

Planar chip device for PCR and hybridization with surface acoustic wave pump.

We have developed a microfluidic device operating at a planar surface instead of a closed channel network. The fluid is transported in single droplets using surface acoustic waves (SAW) on a piezoelectric LiNbO(3) substrate. The surface of the piezo is chemically structured to induce high contact angles of the droplets or enclose areas where the liquid can wet the substrate. Combining the SAW technique with thin film resistance heaters, a biological analysis chip with integrated DNA amplification by PCR and hybridization was designed. To prevent evaporation of the PCR reagents at high temperatures the sample is enclosed in droplets of mineral oil. On this chip the SAW resolves dried primers, shifts the oil capped liquid between the two heaters and mixes during hybridization. The chip is able to perform a highly sensitive, fast and specific PCR with a volume as low as 200 nl. During the temperature cycles an online monitoring of the DNA concentration is feasible with an optical unit, providing a sensitivity of 0.1 ng. After PCR the product is moved to the second heater for the hybridization on a spotted DNA array. With our chip we were able to detect a single nucleotide polymorphism (SNP) responsible for the Leiden Factor V syndrome from human blood.

Macroglossia secondary to systemic amyloidosis: case report and literature review.

Amyloidosis is characterized by an abnormal extracellular deposition of amyloid in different tissues and organs, where it usually causes some type of dysfunction. Its cause is unknown. The two main forms of amyloidosis are systemic and localized; the latter is rare. No satisfactory treatment for systemic amyloidosis has been discovered, and mean survival is poor, ranging from 5 to 15 months depending on the presence or absence of multiple myeloma. We report a case of primary systemic amyloidosis in a 71-year-old man. The diagnosis of amyloidosis was established by tongue biopsy, and its systemic nature was identified by analysis of aspirated abdominal fat. At the 1-year follow-up, the patient's clinical condition had not changed, and he was thereafter lost to follow-up.

Severe multi-resistant pemphigus vulgaris: prolonged remission with a single cycle of rituximab.

Pemphigus vulgaris is an autoimmune bullous disease whose therapy is based on systemic corticosteroids, with or without immunosuppressants. Rituximab is a chimeric monoclonal antibody of the IgG class, directed at a specific CD20 B cell surface antigen, used in pemphigus vulgaris empirically since 2002, with success in 90% of the cases and long periods of remission. Male patient, 33 years old, diagnosed with pemphigus vulgaris, confirmed by histopathology and direct immunofluorescence. He was treated for seven months with numerous treatments, including immunosuppressive drugs, with an unsatisfactory response, until he had complete remission with the use of rituximab. During a 34-month follow-up period, the patient presented a slight clinical relapse, which was successfully controlled with prednisone in a daily dose of 120 mg, soon reduced to 20mg.

Emergence and establishment of native and non-native species in soils of remnant and converted highland grasslands - southern Brazil / Emergência e estabelecimento de espécies nativas e exóticas em solos de campos convertidos e nativos remanescentes do Planalto - Sul do Brasil

Abstract Native grasslands in the Campos de Cima da Serra, Brazil, are being converted at speed for exotic tree plantations and cropland. The impact of modified and novel soil conditions on the establishment of native grassland species is unknown; establishment of non-native species, deliberately or accidentally introduced, could be favoured. In a common garden composed of fully randomized replicate samples of soils collected from remnant grassland, former cropland and pine plantations, we tested emergence and establishment of five cold-season species: Native low-tussock grass Piptochaetium montevidense (Spreng.) Parodi; native legume Trifolium riograndense Burkart; naturalized low-tussock grass Vulpia bromoides (L.) Gray; low-tussock grass Holcus lanatus L., cultivated and naturalized in Brazil; and a cultivar of non-native Trifolium repens. Other than expected, soil type and species*soil type interactions had no significant effect on seedling emergence after 132 days in the field. Species effect on seedling emergence, however, was highly significant. Vulpia bromoides emergence was significantly highest in all soil types. Holcus lanatus and Trifolium riograndense both achieved second highest emergence rates and did not differ significantly from each other. Lowest overall emergence rates were found in the non-native clover cultivar. Lab germination tests failed for Piptochaetium, although it showed reasonable emergence in the field. Good performance of the native clover is encouraging for future grassland restoration, but the value of highly germinable Vulpia as a forage remains to be tested. Holcus tolerates a wide range of soil conditions and its life history traits may promote naturalization, or even invasiveness. Native grasslands of the region should be monitored for this species. Studies like these, but set up on a larger geographical scale and with a wider array of native species, will be essential in developing ecological restoration methods for southern Brazilian grasslands.

Resumo Uma acelerada conversão do campo nativo em plantações de espécies florestais exóticas e lavouras tem ocorrido nos Campos de Cima da Serra, Sul do Brasil. Ainda é desconhecido o impacto que as condições edáficas, em solos alterados ou preservados, exercem no estabelecimento de espécies nativas do campo; as espécies exóticas, introduzidas deliberada ou acidentalmente, talvez sejam favorecidas. Em um common garden composto por repetições aleatórias de amostras de solo, coletadas em áreas de antigas plantações de pinus, de antigas lavouras ou em áreas com campo nativo preservado, foram testados a emergência e o estabelecimento de cinco espécies hibernais: Piptochaetium montevidense (Spreng.) Parodi, gramínea cespitosa nativa; Trifolium riograndense Burkart, leguminosa nativa; Vulpia bromoides (L.) Gray, gramínea cespitosa naturalizada no sul do Brasil; Holcus lanatus L., gramínea cespitosa exótica, cultivada e disseminada no Brasil; e um cultivar de Trifolium repens, leguminosa exótica largamente utilizada. Diferentemente do esperado, o tipo de solo e interações espécie*tipo de solo não tiveram efeito significativo na emergência de plântulas após 132 dias de teste a campo. O efeito da espécie na emergência das plântulas, entretanto, foi altamente significativo. A emergência de Vulpia bromoides foi significativamente superior em qualquer tipo de solo. Ambos Holcus lanatus e Trifolium riograndense apresentaram as segundas maiores taxas de emergência, não diferindo significativamente entre si; as taxas mais baixas foram apresentadas pelo cultivar de trevo não nativo. O Teste de Germinação em laboratório falhou para o Piptochaetium, apesar de este ter demonstrado razoável emergência a campo. O bom desempenho do trevo nativo é encorajador para futuras restaurações de pastagens nativas; o valor forrageiro de Vulpia, que apresentou alta germinação, ainda precisa ser testado. Holcus tolera uma ampla faixa de condições de solo, e suas características adaptativas podem vir a torná-lo naturalizado ou mesmo invasivo. Os campos da região devem ser monitorados em função dessa espécie. Estudos como esse, mas configurados em escala geográfica maior e com maior variedade de espécies nativas, serão essenciais no desenvolvimento de métodos de restauração para os Campos Sulinos Brasileiros.

Buschke -Loewenstein tumor: identification of HPV type 6 and 11.

The authors report a case of exuberant giant condyloma acuminatum of Buschke-Loewenstein in a male patient, slow-growing, progressive and with locally destructive behavior in the inguinal, body of the penis, scrotum, perineal and perianal regions. After surgery he showed no signs of recurrence in 20 months of follow-up. The identification of HPV types 6 and 11 was performed using in situ hybridization.

O'Brien's actinic granuloma: an unusually extensive presentation.

O'Brien's actinic granuloma is a rare skin disease. Controversy continues over whether it should be considered a specific condition or a form of granuloma annulare located in sun-exposed areas. Its pathogenesis is unknown; however, the most widely accepted hypothesis suggests that solar radiation is the triggering factor. This paper describes the case of a 78-year old, fair-skinned male, who presented with a 10-year history of an infiltrate of annular erythematous papules on his forehead and left malar region. The diagnosis of O'Brien actinic granuloma was established from histopathology, since the clinical condition of the patient was extensive, unlike cases reported in the literature.

Comedonic lupus: a rare presentation of discoid lupus erythematosus.

Chronic cutaneous lupus erythematosus is a polymorphous autoimmune disease which may mimic some other clinical conditions, causing diagnostic difficulties. Acneiform lesions, including comedones and pitting scars are occasionally atypical presentations of cutaneous discoid lupus erythematosus.

Oral lichen planus (OLP): clinical and complementary diagnosis.

Lichen planus is a common disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral Lichen Planus (OLP) affects middle-aged women and shows distribution patterns and characteristics such as white striations, white plaques or papules, erythema, blisters and erosions, and may be associated with medication and/or dental materials used by the patient. The clinical diagnosis can only be made if the disease presents classical patterns such as concomitant lesions in the oral mucosa and skin. The laboratory diagnosis is histopathologically characterized by the presence of projections of the epithelium in the form of sawtooth and Civatte bodies and allows the exclusion of dysplasia and malignancy. Direct immunofluorescence is used when there is suspicion of other diseases, such as pemphigus and pemphigoid. OLP is treated with anti-inflammatory agents, particularly topical corticosteroids; new agents and techniques have proved effective. The malignant transformation of OLP and its exact incidence remain controversial. This work aims at presenting, through literature review, the etiopathogenesis, clinical diagnosis, laboratory tests, and complications of OLP.

PSGL-1-dependent myeloid leukocyte activation.

Cell-cell interactions mediating leukocyte recruitment and inflammation are crucial for host defense. Leukocyte recruitment into injured tissue proceeds in a multistep process. The first contact of leukocytes with endothelial cells ("capturing" or "tethering") is mediated by selectins and their counter-receptor P-selectin glyco-protein ligand (PSGL)-1. During capture and rolling, leukocytes collect different inflammatory signals, which can activate various pathways. Integration of these signals leads to leukocyte activation, integrin-mediated arrest, cytoskeleton rearrangement, polarization, and transmigration. PSGL-1 on leukocytes also binds to activated platelets, where P-selectin is expressed at locally high site densities following alpha-granule fusion with the plasma membrane. Here, we review the signaling functions of PSGL-1 and speculate how the different known signaling events might relate to different phases of leukocyte recruitment.