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During the COVID-19 pandemic, many patients in intensive care units (ICUs) were affected by invasive fungal infections, including aspergillosis, contributing to a high mortality rate. Diagnosing proven COVID-19-associated pulmonary aspergillosis (CAPA) requires clinical and radiological evaluations, along with laboratory testing of bronchoalveolar lavage samples or lung biopsies. However, these procedures and equipment are often inaccessible in developing countries or regions with limited resources, including Brazil. Consequently, alternative diagnostic methods, such as measuring Aspergillus galactomannan (GM) in tracheal aspirate (TA), have been explored for CAPA diagnosis. Nonetheless, research on the efficacy of TA-based diagnostic tests is limited. This study aimed to assess the performance of the IMMY® Sona Aspergillus lateral flow assay (LFA) for GM detection in TA samples from 60 ICU patients with suspected CAPA at two tertiary hospitals in Campo Grande, Brazil. The ELISA method (Platelia Aspergillus AG, Bio-Rad®) was used to detect Aspergillus GM in TA samples, serving as the microbiological criterion and reference test. Fifteen patients (12.4%) were identified as having possible CAPA. The overall accuracy of LFA was 94%, and the tests demonstrated an agreement of 93.1% (Cohen's kappa of 0.83). Based on our findings, the LFA for Aspergillus GM detection in TA samples exhibited excellent performance, proving to be a valuable diagnostic tool for potential CAPA. In a systematic review, two studies were included, and the meta-analysis revealed pooled estimates provided a sensitivity of 86% (95% CI, 80%-91%) and specificity of 93% (95% CI, 86%-97%). The diagnostic odds ratio (DOR) for identification of Aspergillus using LFA was 103.38 (95% CI, 38.03-281.03). Despite its lower sensitivity compared to our study, the LFA appears to be a promising diagnostic option for CAPA, particularly in suspected cases that have not received antifungal therapy. This enables timely antifungal treatment and could reduce mortality rates in regions where bronchoscopy is unavailable or limited.
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Aspergillus , COVID-19 , Galactose , Mananas , Sensibilidade e Especificidade , Traqueia , Humanos , Galactose/análogos & derivados , Mananas/análise , Brasil , COVID-19/complicações , COVID-19/diagnóstico , Aspergillus/isolamento & purificação , Traqueia/microbiologia , Pessoa de Meia-Idade , Estudos Transversais , Masculino , Feminino , Aspergilose Pulmonar/diagnóstico , Idoso , Adulto , SARS-CoV-2/isolamento & purificação , Unidades de Terapia IntensivaRESUMO
Recent studies indicate emission factors used to generate bottom-up methane inventories may have considerable regional variability. The US's Environmental Protection Agency's emission factors for plugged and unplugged abandoned oil and gas wells are largely based on measurement of historic wells and estimated at 0.4 g and 31 g CH4 well-1 h-1, respectively. To investigate if these are representative of wells more recently abandoned, methane emissions were measured from 128 plugged and 206 unplugged abandoned wells in Colorado, finding the first super-emitting abandoned well (76 kg CH4 well-1 h-1) and average emissions of 0 and 586 g CH4 well-1 h-1, respectively. Combining these with other states' measurements, we update the US emission factors to 1 and 198 g CH4 well-1 h-1, respectively. Correspondingly, annual methane emissions from the 3.4 million abandoned wells in the US are estimated at between 2.6 Tg, following current methodology, and 1.1 Tg, where emissions are disaggregated for well-type. In conclusion, this study identifies a new abandoned well-type, recently-producing orphaned, that contributes 74 % to the total abandoned wells methane emissions. Including this new well-type in the bottom-up inventory suggests abandoned well emissions equate to between 22 and 49 % of total emissions from US active oil and gas production operations.
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Background: Biomechanical assessment of meniscal repairs is essential for evaluating different meniscal suturing methods and techniques. The continuous meniscal suture technique is a newer method of meniscal repair that may have biomechanical differences compared with traditional techniques. Purpose: To evaluate the displacement, stiffness after cyclical loading, and load to failure for a continuous vertical inside-out meniscal suture versus a traditional vertical inside-out meniscal suture in a porcine medial meniscus. Study Design: Controlled laboratory study. Methods: A total of 28 porcine knees were acquired and divided into 2 test groups of 14 medial meniscus each. A 2.0-cm longitudinal red-white zone cut was made in the body of the medial meniscus for each knee. The continuous suture (CS) group received 4 vertical stitches performed with a continuous vertical meniscal suture technique, and the inside-out suture (IO) group received a traditional vertical suture with 4 stitches. Two traction tapes were passed between the sutures and positioned in the biomechanical testing fixture device. Each specimen underwent load-to-failure testing at 5 mm/s, and displacement, system stiffness, and maximum load to failure were compared between the groups. Results: The displacement after the cyclic test was 0.53 ± 0.12 and 0.48 ± 0.07 mm for the CS and IO groups, respectively. There was no significant difference between the groups (P = .2792). The stiffness at the ultimate load testing was 36.3 ± 1.9 and 35.3 ± 2.4 N/mm for groups CS and IO, respectively, with no significant difference between the groups (P = .2557). In the load-to-failure test, the ultimate load was 218.2 ± 63.9 and 238.3 ± 71.3 N in the CS and IO groups, respectively, with no significant group differences (P = .3062). Conclusion: A continuous vertical meniscal suture created a configuration for treating longitudinal meniscal lesions that was beneficial and biomechanically similar to a traditional vertical suture technique. Clinical Relevance: The study findings indicate that use of the continuous vertical inside-out meniscal suture technique is a possible therapeutic option.
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We report a two-month-old male cat weighing 630 grams with congenital hypothyroidism. The main complaints were difficulty defecating for more than three days and prostration. Physical examination revealed a broad, flat face, a short neck, enlarged submandibular lymph nodes, chemosis, mild bilateral mucopurulent ocular discharge, seborrheic coat, with gingival thickening around the upper and lower deciduous incisor teeth with partial eruption. The abdomen was distended due to constipation and right unilateral cryptorchidism. Based on this, feline congenital hypothyroidism was suspected. Hormonal tests (free T4 by equilibrium dialysis of 0.06 ng/dl, total T4 of 0.1 ng/ml and TSH of 4.7 ng/ml) confirmed this. Treatment was started with levothyroxine sodium (5-32.2 µg/kg/day). After 120 days of treatment, there was clinical stabilization. Then the patient underwent orchiectomy of the left and of the right ectopic testicles, and at 380 days of treatment, the thyroid scintigraphy showed intense uptake of the radiopharmaceutical by both thyroid lobes and a significant increase in volume. Clinical evaluation showed weight gain (2.6 kilograms during treatment), improvement in the shape of the skull, and a notable increase in body size. At 17 months of age, hormone values were within the reference limits after administration of levothyroxine sodium (32.2µg/kg/day).
O objetivo deste trabalho foi relatar o caso de hipotireoidismo congênito em um felino, macho, pelo curto brasileiro (PCB), com dois meses de idade, pesando 630 gramas. Apresentava como queixa principal dificuldade para defecar por mais de três dias e prostração. O exame físico geral constatou face larga e plana, pescoço curto, linfonodos submandibulares aumentados, quemose e discreta secreção ocular mucopurulenta bilateral. A pelagem apresentava-se opaca e seborreica, espessamento gengival em torno dos dentes decíduos incisivos superiores e inferiores com parcial erupção. À palpação, o abdômen apresentava-se distendido pela presença de fezes em cólon e criptorquidismo unilateral direito. Diante das alterações supracitadas, suspeitou-se de hipotireoidismo congênito felino. O qual foi confirmado através de exames complementares hormonais específicos (T4 livre por diálise do equilíbrio 0,06 ng/dl, T4 total 0,1 ng/ml e TSH 4,7 ng/ml). Iniciou-se o tratamento com levotiroxina sódica na dose de 5 a 32,2µg/kg/dia. Com 120 dias de tratamento houve estabilização clínica e então o paciente foi submetido à orquiectomia dos testículos esquerdo ectópico e direito. E aos 380 dias de tratamento ao exame de cintilografia de tireoide onde foi evidenciado intensa captação do radiofármaco por ambos os lobos tireoidianos e importante aumento de volume. Na avaliação clínica, foi observado ganho de peso (2,6 quilogramas ao longo do tratamento), melhora na conformação do crânio e notável aumento de tamanho corporal. Aos 17 meses de idade, os valores hormonais se encontravam dentro dos limites de referência, após a administração da dose de lexotiroxina sódica na dose de 32,2µg/kg/dia.
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BACKGROUND: The biomechanical assessment of tendon repair is essential for the evaluation of different tendon suturing techniques. The shoelace suture technique with absorbable Vicryl® is a modified technique of Achilles tendon repair that may have biomechanical advantages depending on the number of threads used and the direction of the suture. PURPOSE: To evaluate the creep under constant pre-load, the stiffness, the maximum strength, and the failure mode for three different configurations of the shoelace suture in a bovine tendon biomechanical model. STUDY DESIGN: Controlled Laboratory Study. METHODS: 36 bovine Achilles tendon specimens were acquired and divided into three test groups of 12 Achilles tendons each. A model of the calcaneal tendon rupture was created through a transverse cut with a scalpel, performed 5 centimeters proximal to the calcaneal bone insertion. Group 1 was repaired using the simple shoelace technique with just one suture. Group 2 was repaired using the shoelace technique with three sutures individually sutured from distal to proximal at the site of rupture. Group 3 was repaired using the shoelace technique with three sutures individually sutured from proximal to distal at the site of rupture. RESULTS: System creep after constant pre-load was 5.9 ± 2.5 mm, 3.0 ± 0.4 mm and 2.9 ± 0.4 mm for groups 1, 2 and 3, respectively. The system's stiffness was 23.2 ± 2.8 N/mm, 30.3 ± 1.1 N/mm and 29.8 ± 2.3 N/mm for groups 1, 2 and 3, respectively. In the final load-to-failure test, the ultimate load force (ULF) was 158.2 ± 27.5 N, 346.5 ± 47.6 N and 358.1 ± 41.6 N for groups 1, 2 and 3, respectively. There was statistical significance in the comparative tests between groups 1-2 and 1-3 in terms of means of creep, system stiffness and maximum system strength. No statistically significant difference was found between groups 2 and 3 when analyzing creep, system stiffness and ULF. Suture breakage was the prevalent mode of failure for all tested groups. CONCLUSION: The shoelace with three sutures significantly reduced creep in the preloading phase and increased the stiffness and ultimate load force. The biomechanical results demonstrate better overall mechanical performance of the technique than the simple shoelace technique. The better mechanical performance indicates that the shoelace with three sutures could result in early postoperative rehabilitation. CLINICAL RELEVANCE: This study indicates that the shoelace suture technique with three sutures is biomechanically strong and stiff, being a possible therapeutic option to be used.
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Tendão do Calcâneo , Procedimentos de Cirurgia Plástica , Traumatismos dos Tendões , Humanos , Animais , Bovinos , Tendão do Calcâneo/cirurgia , Fenômenos Biomecânicos , Traumatismos dos Tendões/cirurgia , Técnicas de Sutura , Suturas , Ruptura/cirurgiaRESUMO
The increasing demand for natural gas as a clean energy source has emphasized the need for efficient gas separation technologies. Metal-organic frameworks (MOFs) have emerged as a promising class of materials for gas separation, with anion-pillared MOFs (APMOFs) gaining attention for their fine-tuned pore design and shape/size selectivity. In this study, we investigate the dynamical and electronic properties of three APMOFs, SIFSIX-3-Cu, SIFSIX-2-Cu-i, and SIFSIX-2-Cu, for the separation of methane from ethane, ethene, propane, propene, and N using computational simulations. Our simulations employ Grand Canonical Monte Carlo (GCMC) and Molecular Dynamics (MD) techniques combined with Density Functional Theory (DFT) calculations. We find that that all three APMOFs exhibit promising separation capabilities for methane from propane and propene based on both thermodynamics and kinetics parameters. In addition, we use Noncovalent Interaction (NCI) analysis to investigate intermolecular interactions and find that the fluorine atoms in the MOF can polarize gas molecules and establish electrostatic interactions with hydrogen atoms in the molecule. Finally, we show that SIFSIX-2-Cu-i is a potential candidate for separating N2/CH4 due to its interpenetration.
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Alzheimer's Disease (AD) is an irreversible neurodegenerative disease clinically characterized by the presence of ß-amyloid plaques and tau deposits in various regions of the brain. However, the underlying factors that contribute to the development of AD remain unclear. Recently, the fusiform gyrus has been identified as a critical brain region associated with mild cognitive impairment, which may increase the risk of AD development. In our study, we performed gene co-expression and differential co-expression network analyses, as well as gene-expression-based prediction, using RNA-seq transcriptome data from post-mortem fusiform gyrus tissue samples collected from both cognitively healthy individuals and those with AD. We accessed differential co-expression networks in large cohorts such as ROSMAP, MSBB, and Mayo, and conducted over-representation analyses of gene pathways and gene ontology. Our results comprise four exclusive gene hubs in co-expression modules of Alzheimer's Disease, including FNDC3A, MED23, NRIP1, and PKN2. Further, we identified three genes with differential co-expressed links, namely FAM153B, CYP2C8, and CKMT1B. The differential co-expressed network showed moderate predictive performance for AD, with an area under the curve ranging from 0.71 to 0.76 (+/- 0.07). The over-representation analysis identified enrichment for Toll-Like Receptors Cascades and signaling pathways, such as G protein events, PIP2 hydrolysis and EPH-Epherin mechanism, in the fusiform gyrus. In conclusion, our findings shed new light on the molecular pathophysiology of AD by identifying new genes and biological pathways involved, emphasizing the crucial role of gene regulatory networks in the fusiform gyrus.
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Este artigo tem como objetivo fazer algumas reflexões sobre a utilização da Cartografia de Gilles Deleuze e Félix Guattari e a Arqueogenealogia de Michel Foucault como abordagens metodológicas para a elaboração de estudos em determinados territórios e campos de saber. Para isso, conceitua-se as duas abordagens a partir das pistas conceituais deixadas pelos autores em seus escritos. Em seguida, realiza-se uma análise das abordagens de modo a pensar sobre as condições que estas podem oferecer para conversações com estudos históricos e do campo psi. O artigo analisa os operadores conceituais dos estudos de arquivos, da recepção e dos usos das práticas na História Cultural; do rizoma, multiplicidade, acontecimento e singularidade na Cartografia e das análises de saber-poder na Arqueogenealogia. A História Cultural oferece ferramentas potentes para a realização de trabalhos com documentos por meio da Arqueogenealogia e da Cartografia, na medida em que apresenta modos de trabalhar com as práticas singulares e múltiplas na tensão dos fazeres locais em forças processuais em conversação entre o campo psi e o histórico por meio da Arqueogenealogia, da Cartografia e da História Cultural. (AU)
This article aims to make some reflections on the use of Cartography by Gilles Deleuze and Félix Guattari and the Archeogenealogy of MichelFoucault as methodological approaches for the elaboration of studies in certain territories and fields of knowledge. For this, the two approaches are conceptualized from the conceptual clues left by the authors in their writings. Then, an analysis of the approaches is performed in order to think about the conditions they can offer for conversations with historical studies and the psi field. The article analyzes the conceptual operators of the studies of archives, the reception and the uses of practices in cultural history; rhizome, multiplicity, event and singularity in Cartography and the analyses of knowledge-power in Archeogenealogy. Cultural History offers powerful tools for carrying out works with documents through Archeogenealogy and Cartography, as it presentsways of working with singular and multiple practices in the tension of local activities in procedural forces in conversation between the psi and historical field through Archeogenealogy, Cartography and Cultural History. (AU)
Este artículo pretende hacer algunas reflexiones sobre el uso de la Cartografía por Gilles Deleuzey Félix Guattari y la Arqueogenealogía de Michel Foucault como enfoques metodológicos para la elaboración de estudios endeterminados territorios y campos del conocimiento. Para ello, los dos enfoques se conceptualizan a partir de las pistas conceptuales dejadas por los autores en sus escritos. Luego, se realiza un análisis de los enfoques con el fin de pensar en las condiciones que pueden ofrecer para las conversaciones con estudios históricos y el campo psi. El artículo analiza los operadores conceptuales de los estudios de archivos, la recepción y los usos de las prácticas en la historia cultural; rizoma, multiplicidad, acontecimiento y singularidad en la Cartografía y los análisis del poder-conocimiento en la Arqueogenealogía.La Historia Cultural ofrece poderosas herramientas para realizar trabajos con documentos a través de la Arqueogenealogíay la Cartografía, ya que presenta formas de trabajar con prácticas singulares y múltiples en la tensión de las actividades locales en las fuerzas procedimentales en la conversación entre el psi el campo histórico a través de la Arqueogenealogía, la Cartografía y la Historia Cultural. (AU)
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Psicologia Social/métodos , Pesquisa , Metodologia como Assunto , HistóriaRESUMO
The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications.
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Peixes , Água Doce , Animais , Ecossistema , México , Região do Caribe , BiodiversidadeRESUMO
Background: Considering the potential role of miRNAs as biomarkers and their interaction with both nuclear and mitochondrial genes, we investigated the miRNA expression profile in type 1 diabetes (T1DM) patients, including the pathways in which they are involved considering both nuclear and mitochondrial functions. Methods: We analyzed samples of T1DM patients and control individuals (normal glucose tolerance) by high throughput miRNA sequencing (miRNome). Next, five miRNAs - hsa-miR-26b-5p, hsa-let-7i-5p, hsa-miR-143-3p, hsa-miR-501-3p and hsa-miR-100-5p - were validated by RT-qPCR. The identification of target genes was extracted from miRTarBase and mitoXplorer database. We also performed receiver operating characteristic (ROC) curves and miRNAs that had an AUC > 0.85 were considered potential biomarkers. Results: Overall, 41 miRNAs were differentially expressed in T1DM patients compared to control. Hsa-miR-21-5p had the highest number of predicted target genes and was associated with several pathways, including insulin signaling and apoptosis. 34.1% (14/41) of the differentially expressed miRNAs also targeted mitochondrial genes, and 80.5% (33/41) of them targeted nuclear genes involved in the mitochondrial metabolism. All five validated miRNAs were upregulated in T1DM. Among them, hsa-miR-26b-5p showed AUC>0.85, being suggested as potential biomarker to T1DM. Conclusion: Our results demonstrated 41 DE miRNAs that had a great accuracy in discriminating T1DM and control group. Furthermore, we demonstrate the influence of these miRNAs on numerous metabolic pathways, including mitochondrial metabolism. Hsa-miR-26b-5p and hsa-miR-21-5p were highlighted in our results, possibly acting on nuclear and mitochondrial dysfunction and, subsequently, T1DM dysregulation.
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Diabetes Mellitus Tipo 1 , MicroRNAs , Humanos , Diabetes Mellitus Tipo 1/genética , MicroRNAs/genética , MicroRNAs/metabolismo , Sequenciamento de Nucleotídeos em Larga Escala , Mitocôndrias/genética , Mitocôndrias/metabolismo , BiomarcadoresRESUMO
Ozone is a colorless gas with a characteristic odor present in nature in the form of trivalent oxygen. In 2015, the Federal Council of Dentistry (CFO/Brazil) approved the use of ozone therapy and in 2018 the Ministry of Health (MS/Brazil) approved the application of Ozone Therapy as a Complementary Integrative Practice in the Unified Health System. Therefore, the objective of this study was to verify the applicability of ozone therapy in dental practice. This is an integrative literature review whose search was performed in the Medline/Pubmed, LILACS, SciElo, and Google Scholar databases. Studies published in the last 5 years in English, Portuguese or Spanish were eligible. After the search, 312 titles were found and after exclusion of duplicates and analysis of abstracts and full text, 13 articles were included in this review. The literature reports the application of ozone therapy in several areas in the treatment of acute and chronic diseases. As a mechanism of action, ozone has a direct antimicrobial effect, immunoregulation, antioxidant defenses, analgesic, and vasodilator effects. In dentistry, its applicability is mainly in preventive dentistry and as a complement in surgical procedur es, endodontic, and periodontal treatments.
El ozono es un gas incoloro de olor característico presente en la naturaleza en forma de oxígeno trivalente. En 2015, el Consejo Federal de Odontología (CFO) aprobó el uso de la ozonoterapia y en 2018 el Ministerio de Salud aprobó la aplicación de la Ozonoterapia como Práctica Integrativa Complementaria en el Sistema Único de Salud. Por lo tanto, el objetivo de este estudio fue verificar la aplicabilidad de la ozonoterapia en la práctica odontológica. Esta es una revisión integrativa de la literatura cuya búsqueda se realizó en las bases de datos Medline/Pubmed, LILACS, SciElo y Google Scholar. Fueron elegibles los estudios publicados en los últimos 5 años en inglés, portugués o español. Después de la búsqueda, se encontraron 312 títulos y después de la exclusión de duplicados y análisis de resúmenes y texto completo, se incluyeron 13 artículos en esta revisión. La literatura reporta la aplicación de la ozonoterapia en varias áreas en el tratamiento de enfermedades agudas y crónicas. Como mecanismo de acción, el ozono tiene un efecto antimicrobiano directo, de inmunorregulación, defensas antioxidantes, efectos analgésicos y vasodilatadores. En odontología su aplicabilidad es principalmente en odontología preventiva y como complemento en procedimientos quirúrgicos, tratamientos endodónticos y periodontales.
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Feline sporotrichosis is a major clinical problem among cats in Brazil and is also a neglected, but important, public health issue, due to its zoonotic potential. The nasal clinical form of the disease is particularly challenging, having treatment refractoriness and clinical signs relapse as common features. This case series study aimed to preliminarily describe the effects of the azolic antifungal drug, clotrimazole, as a topical 1% solution spray, together with per os itraconazole on inducing disease remission, as well as treatment tolerability and safety. Medical records of the Feline Medicine Service from the Universidade Federal Rural do Rio de Janeiro were reviewed, and 7 feline patients met the inclusion criteria (confirmatory diagnostic reached, available follow-up records, and use of intranasal clotrimazole 1% solution -1 spray per nostril every 24 hours- as adjunctive therapy to itraconazole - 100 mg/cat per os every 24 hours). Among these, 4 had a history of treatment refractoriness done until then. Follow-up records included clinical evaluation, along with complementary tests and owner reports on tolerability and occurrence of adverse reactions. All patients have undergone clinical remission within 60 days. Tolerability were satisfactory, and adverse reactions were only found on complementary tests (hepatic enzyme elevation), without clinical repercussion. The intranasal use of 1% clotrimazole solution has shown as a promising adjunctive therapy to itraconazole for feline nasal sporotrichosis, even in previous refractory cases.
A esporotricose felina é um dos principais problemas clínicos entre os gatos no Brasil. É também um problema de saúde pública negligenciado, mas importante, devido ao seu potencial zoonótico. A forma clínica nasal da doença é particularmente desafiadora, sendo a refratariedade ao tratamento e a recidiva dos sinais clínicos características comuns. Este estudo de série de casos teve como objetivo descrever preliminarmente o efeito da infusão intranasal do antifúngico azólicos clotrimazol, na forma de solução "spray" a 1%, com itraconazol dado via oral, na indução da remissão da doença em pacientes felinos, bem como a tolerabilidade e segurança do tratamento. Os registros médicos do Serviço de Medicina Felina da Universidade Federal Rural do Rio de Janeiro foram revisados, e 7 pacientes felinos atenderam aos critérios de inclusão (diagnóstico confirmatório alcançado, prontuários de acompanhamento disponíveis e uso de solução intranasal de clotrimazol 1% 1 borrifada por narina a cada 24 horas como terapia adjuvante ao itraconazol 100 mg / gato por via oral a cada 24 horas). Destes, 4 tinham história de refratariedade ao tratamento realizado até então. Os registros de acompanhamento incluíram avaliação clínica, realização de testes complementares e relatórios dos responsáveis pelos animais acerca da tolerabilidade e ocorrência de efeitos adversos. Todos os pacientes apresentaram remissão clínica em até 60 dias. A tolerabilidade e a segurança foram satisfatórias, sendo encontrados efeitos adversos apenas em exames complementares (elevação das enzimas hepáticas), sem repercussão clínica. O uso tópico de solução de clotrimazol a 1% mostrou-se uma promissora terapia adjuvante ao itraconazol dado por via oral para o tratamento da esporotricose nasal felina, mesmo em casos previamente refratários.
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ClinVar is a web platform that stores â¼789,000 genetic associations with complex diseases. A partial set of these cataloged genetic associations has challenged clinicians and geneticists, often leading to conflicting interpretations or uncertain clinical impact significance. In this study, we addressed the (re)classification of genetic variants by AmazonForest, which is a random-forest-based pathogenicity metaprediction model that works by combining functional impact data from eight prediction tools. We evaluated the performance of representation learning algorithms such as autoencoders to propose a better strategy. All metaprediction models were trained with ClinVar data, and genetic variants were annotated with eight functional impact predictors cataloged with SnpEff/SnpSift. AmazonForest implements the best random forest model with a one hot data-encoding strategy, which shows an Area Under ROC Curve of ≥0.93. AmazonForest was employed for pathogenicity prediction of a set of â¼101,000 genetic variants of uncertain significance or conflict of interpretation. Our findings revealed â¼24,000 variants with high pathogenic probability (RFprob≥0.9). In addition, we show results for Alzheimer's Disease as a demonstration of its application in clinical interpretation of genetic variants in complex diseases. Lastly, AmazonForest is available as a web tool and R object that can be loaded to perform pathogenicity predictions.
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Whipple's disease is a rare systemic infection caused by a diastase-resistant and Gram-positive bacillus called Tropheryma whipplei. The diagnosis of the disease is difficult and often late due to the variety of the symptoms. The objective of this study was to report a rare case of Whipple's disease treated at the Internal Medicine service of a hospital in the Midwest of Santa Catarina, Brazil. The patient was invited for an interview to describe the history of symptoms and previous treatments. Additionally, test results and treatments performed during hospitalization were assessed through the medical records. The case report describes a 39-year-old white male who presented, at the time of diagnosis, severe diarrhea, hematochezia, weight loss, fever, and inguinal adenomegaly, in addition to preceding migratory polyarthritis. After investigation, the diagnosis of Whipple's disease was achieved in conjunction with antibiotic treatment, with improvement of clinical and laboratory symptoms after 15 days. This case highlights the broad array of symptoms and the non-specific features of the Whipple's disease. Establishing an early diagnosis is essential for the success of the treatment, avoiding a long-lasting escalation of symptoms, which lead to cachexia and a devastating loss of the patient's quality of life.
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A identidade de Psalidodon eigenmanniorum (Cope, 1894) e a possibilidade de se constituir em mais de uma espécie é testada através de análises da morfometria (19 medidas), dos caracteres merísticos (14 contagens) e do padrão de colorido de 705 exemplares provenientes dos sistemas dos rios Tramandaí/Mampituba, da laguna dos Patos e drenagem do baixo rio Uruguai. Foram diafanizados e corados 40 exemplares. Os dados morfométricos foram utilizados na Análise de Componentes Principais, Análise Discriminante, Morfometria Geométrica e Função Discriminante. As análises foram feitas considerando os sexos em separado dentro de cada sistema hidrográfico, bem como comparando as populações entre os sistemas hidrográficos e finalmente no conjunto de sistemas representando a área de ocorrência da espécie. A partir dos dados analisados não foram encontradas diferenças entre os sexos. Os resultados mostraram variação morfológica que não sustenta o reconhecimento de possíveis espécies crípticas. A variação encontrada nos dados merísticos, morfométricos e no padrão de colorido justifica a redescrição da espécie. Os resultados das comparações entre as populações indicaram variações nesses caracteres indicando que a espécie possui considerável plasticidade fenotípica.(AU)
The identity of Psalidodon eigenmanniorum (Cope, 1894) and the possibility of constituting more than one species is tested through analyzes of morphometry (19 measurements), meristic characters (14 counts) and the color pattern of 705 specimens from the Tramandaí/Mampituba, from the Patos lagoon and from the lower Uruguay River drainage. Forty specimens were cleared and stained. Morphometric data were used in Principal Component Analysis, Discriminant Analysis, Geometric Morphometry and Discriminant Function. The analysis was carried out considering the sexes separately within each hydrographic system, as well as comparing the populations between the hydrographic systems and finally in the set of systems representing the area of occurrence of the species. No differences were found between the sexes in the analyzed data. The results showed morphological variation that does not support the recognition of possible cryptic species. The variation found in meristic, morphometric and color pattern data justifies the redescription of the species. The species is described to the aforementioned drainages, and the results demonstrate its phenotypic plasticity.(AU)
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Animais , Masculino , Feminino , Análise de Componente Principal/métodos , Characidae/classificação , Análise Discriminante , Variação Biológica da PopulaçãoRESUMO
Resumo: Introdução: O ensino híbrido pode ser utilizado como recurso pedagógico às formas tradicionais de ensinar. A ausência de um laboratório de patologia renal pode gerar uma lacuna na formação de médicos residentes em nefrologia. Este estudo descreve como a complementação do conteúdo com o uso de um atlas on-line de patologia renal foi descrita por médicos residentes. Relato de experiência: Um atlas virtual de patologia renal elaborado por preceptores das residências médicas de nefrologia e patologia foi apresentado a oito médicos residentes matriculados no serviço, que, durante 15 dias, incluíram os estudos desse conteúdo em suas atividades. Os residentes avaliaram a experiência de ensino-aprendizagem por meio de um grupo focal. Discussão: Estratégias de ensino on-line podem ser utilizadas para complementar o conhecimento adquirido durante a residência médica. No entanto, é importante que essa etapa da estratégia de ensino híbrido seja motivadora na visão do estudante e se adapte ao momento vivenciado pelos médicos residentes, os quais já possuem carga de trabalho determinada. Esses pontos estiveram entre os temas emergentes na análise temática do conteúdo do grupo focal, que também incluiu sugestões dos alunos em como modificar a apresentação do conteúdo. Conclusão: A inserção de estratégias de ensino híbrido pode auxiliar a formação dos médicos residentes, bem como abrir espaço para a produção discente. Parcerias interinstitucionais devem ser desenvolvidas para suprir barreiras à elaboração de e-learning pelos formadores médicos.
Abstract: Introduction: Blended Learning can be used as a pedagogical resource to the traditional ways of teaching. The lack of a Renal Pathology laboratory can result in a gap in the training of resident physicians in Nephrology. This study describes how complementing the content with the use of an online Renal Pathology atlas was described by resident physicians. Experience report: A virtual atlas of Renal Pathology prepared by preceptors of the Medical Residencies of Nephrology and Pathology was presented to eight resident physicians enrolled in the service, who, for fifteen days, included the studies of this content in their activities. The residents evaluated the teaching-learning experience through a focus group. Discussion: Online teaching strategies can be used to complement the knowledge acquired during Medical Residency. However, it is important that this stage of the blended learning strategy be motivating in the students' view, adapting to the moment experienced by resident physicians, who already have a pre-determined workload. These points were among the emerging topics in the thematic analysis of the content of the focus group, which also included suggestions from the students on how to modify the content presentation. Conclusion: The inclusion of blended learning strategies can help the training of resident physicians, as well as open space for student production. Inter-institutional partnerships should be developed to overcome barriers to e-learning development by medical trainers.
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PURPOSE: To investigate the metal screw-in anchor failure mode and load to failure for 2 different eyelet alignments after anchor insertion in ovine humeri. METHODS: Sixteen ovine humeri were dissected, and a 5-mm metal anchor with 2 nonabsorbable polyblend polyethylene sutures was inserted into them in the proximal position of the greater tuberosity. The alignment of the anchors after insertion was adjusted to make 2 test groups, each with 8 specimens: In group 1, the anchor eyelets were malpositioned, whereas in group 2, the anchor eyelets were aligned according to the manufacturer's instructions. After insertion, cyclic tests from 10 N to 180 N were performed with a frequency of 1 Hz for 200 cycles; specimens were then loaded to failure to evaluate the maximum load of the system and observe the associated failure mode. RESULTS: The mean ultimate failure load in group 2 was not significantly different from that in group 1 (P = .472). CONCLUSIONS: For metallic screw-in suture anchors, the alignment of the eyelet does not change the failure mode and the load to failure after cyclic loading of the bone-anchor-suture system in ovine humeri. CLINICAL RELEVANCE: Our results indicate that on the basis of this anchor model, the position of the eyelet in the greater tuberosity does not interfere directly with the biomechanical performance of the system.
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The role of regulatory elements such as small ncRNAs and their mechanisms are poorly understood in infectious diseases. Tuberculosis is one of the oldest infectious diseases of humans and it is still a challenge to prevent and treat. Control of the infection, as well as its diagnosis, are still complex and current treatments used are linked to several side effects. This study aimed to identify possible biomarkers for tuberculosis by applying NGS techniques to obtain global miRNA expression profiles from 22 blood samples of infected patients with tuberculosis (n = 9), their respective healthy physicians (n = 6) and external healthy individuals as controls (n = 7). Samples were run through a pipeline consisting of differential expression, target genes, gene set enrichment and miRNA-gene network analyses. We observed 153 altered miRNAs, among which only three DEmiRNAs (hsa-let-7g-5p, hsa-miR-486-3p and hsa-miR-4732-5p) were found between the investigated patients and their respective physicians. These DEmiRNAs are suggested to play an important role in granuloma regulation and their immune physiopathology. Our results indicate that miRNAs may be involved in immune modulation by regulating gene expression in cells of the immune system. Our findings encourage the application of miRNAs as potential biomarkers for tuberculosis.
Assuntos
MicroRNAs/sangue , Tuberculose/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Análise de Sequência de RNARESUMO
This study evaluated the performance of 6 commercially available hard hat designs-differentiated by shell design, number of suspension points, and suspension tightening system-in regard to their ability to attenuate accelerations during vertical impacts to the head. Tests were conducted with impactor materials of steel, wood, and lead shot (resembling commonly seen materials in a construction site), weighing 1.8 and 3.6 kg and dropped from 1.83 m onto a Hybrid III head/neck assembly. All hard hats appreciably reduced head acceleration to the unprotected condition. However, neither the addition of extra suspension points nor variations in suspension tightening mechanism appreciably influenced performance. Therefore, these results indicate that additional features available in current hard hat designs do not improve protective capacity as related to head acceleration metrics.
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Aceleração , Dispositivos de Proteção da Cabeça , Fenômenos Biomecânicos , Cabeça , Humanos , PescoçoRESUMO
Gastric cancer (GC) represents a notable amount of morbidity and mortality worldwide. Understanding the molecular basis of CG will offer insight into its pathogenesis in an attempt to identify new molecular biomarkers to early diagnose this disease. Therefore, studies involving small non-coding RNAs have been widely explored. Among these, PIWI-interacting RNAs (piRNAs) are an emergent class that can play important roles in carcinogenesis. In this study, small-RNA sequencing was used to identify the global piRNAs expression profile (piRNome) of gastric cancer patients. We found 698 piRNAs in gastric tissues, 14 of which were differentially expressed (DE) between gastric cancer (GC), adjacent to gastric cancer (ADJ), and non-cancer tissues (NC). Moreover, three of these DE piRNAs (piR-48966*, piR-49145, piR-31335*) were differently expressed in both GC and ADJ samples in comparison to NC samples, indicating that the tumor-adjacent tissue was molecularly altered and should not be considered as a normal control. These three piRNAs are potential risk biomarkers for GC, especially piR-48966* and piR-31335*. Furthermore, an in-silico search for mRNAs targeted by the differentially expressed piRNAs revealed that these piRNAs may regulate genes that participate in cancer-related pathways, suggesting that these small non-coding RNAs may be directly and indirectly involved in gastric carcinogenesis.