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1.
Int J Mol Sci ; 25(8)2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38673802

RESUMO

Despite being the most common abdominal surgical emergency, the cause of acute appendicitis (AA) remains unclear, since in recent decades little progress has been made regarding its etiology. Obstruction of the appendicular lumen has been traditionally presented as the initial event of AA; however, this is often the exception rather than the rule, as experimental data suggest that obstruction is not an important causal factor in AA, despite possibly occurring as a consequence of the inflammatory process. Type I hypersensitivity reaction has been extensively studied, involving Th2 lymphocytes, and cytokines such as IL-4, IL-5, IL-9 and IL-13, which have well-defined functions, such as a positive-feedback effect on Th0 for differentiating into Th2 cells, recruitment of eosinophils and the release of eosinophilic proteins and the production of IgE with the activation of mast cells, with the release of proteins from their granules. Cytotoxic activity and tissue damage will be responsible for the clinical manifestation of the allergy. AA histological features are similar to those found in allergic reactions like asthma. The intestine has all the components for an allergic immune response. It has contact with hundreds of antigens daily, most of them harmless, but some can potentially induce an allergic response. In recent years, researchers have been trying to assess if allergy is a component of AA, with their latest advances in the understanding of AA as a Th2 reaction shown by the authors of this article.


Assuntos
Apendicite , Células Th2 , Humanos , Células Th2/imunologia , Apendicite/imunologia , Apendicite/patologia , Apendicite/etiologia , Animais , Citocinas/metabolismo , Doença Aguda
2.
Int J Mol Sci ; 25(3)2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38338923

RESUMO

The aetiology of acute appendicitis (AA), the most frequent abdominal surgical emergency, is still unclarified. Recent epidemiologic, clinical and laboratorial data point to an allergic component in the pathophysiology of AA. Mastocytes participate in the Th2 immune response, releasing inflammatory mediators from their granules upon stimulation by IgE-specific antigens. Among the well-known mediators are histamine, serotonin and tryptase, which are responsible for the clinical manifestations of allergies. We conducted a prospective single-centre study to measure histamine and serotonin (commercial ELISA kit) and tryptase (ImmunoCAP System) concentrations in appendicular lavage fluid (ALF) and serum. Consecutive patients presenting to the emergency department with a clinical diagnosis of AA were enrolled: 22 patients with phlegmonous AA and 24 with gangrenous AA The control group was composed of 14 patients referred for colectomy for colon malignancy. Appendectomy was performed during colectomy. Tryptase levels were strikingly different between histological groups, both in ALF and serum (p < 0.001); ALF levels were higher than serum levels. Tryptase concentrations in ALF were 109 times higher in phlegmonous AA (APA) (796.8 (194.1-980.5) pg/mL) and 114 times higher in gangrenous AA (AGA) (837.4 (272.6-1075.1) pg/mL) than in the control group (7.3 (4.5-10.3) pg/mL. For the diagnosis of AA, the discriminative power of serum tryptase concentration was good (AUC = 0.825), but discriminative power was weak (AUC = 0.559) for the differential diagnosis between APA and AGA. Mastocytes are involved in AA during clinical presentations of both phlegmonous and gangrenous appendicitis, and no significant differences in concentration were found. No differences were found in serum and ALF concentrations of histamine and serotonin between histological groups. Due to their short half-lives, these might have elapsed by the time the samples were collected. In future research, these determinations should be made immediately after appendectomy. Our findings confirm the hypersensitivity type I reaction as an event occurring in the pathogenesis of AA: tryptase levels in ALF and serum were higher among patients with AA when compared to the control group, which is in line with a Th2 immune response and supports the concept of the presence of an allergic reaction in the pathogenesis of acute appendicitis. Our results, if confirmed, may have clinical implications for the treatment of AA.


Assuntos
Apendicite , Hipersensibilidade , Humanos , Apendicite/diagnóstico , Apendicite/cirurgia , Apendicite/etiologia , Triptases , Histamina , Estudos Prospectivos , Serotonina , Hipersensibilidade/complicações
3.
Proc Natl Acad Sci U S A ; 117(22): 12281-12287, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32424099

RESUMO

Sepsis is a life-threatening organ dysfunction condition caused by a dysregulated host response to an infection. Here we report that the circulating levels of growth and differentiation factor-15 (GDF15) are strongly increased in septic shock patients and correlate with mortality. In mice, we find that peptidoglycan is a potent ligand that signals through the TLR2-Myd88 axis for the secretion of GDF15, and that Gdf15-deficient mice are protected against abdominal sepsis due to increased chemokine CXC ligand 5 (CXCL5)-mediated recruitment of neutrophils into the peritoneum, leading to better local bacterial control. Our results identify GDF15 as a potential target to improve sepsis treatment. Its inhibition should increase neutrophil recruitment to the site of infection and consequently lead to better pathogen control and clearance.


Assuntos
Bacteriemia/imunologia , Quimiocina CXCL5/imunologia , Fator 15 de Diferenciação de Crescimento/imunologia , Neutrófilos/imunologia , Animais , Bacteriemia/genética , Bacteriemia/microbiologia , Bacteriemia/prevenção & controle , Quimiocina CXCL5/genética , Feminino , Fator 15 de Diferenciação de Crescimento/genética , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Infiltração de Neutrófilos , Cavidade Peritoneal/microbiologia
4.
Sensors (Basel) ; 23(5)2023 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-36905072

RESUMO

Smart, and ultra-low energy consuming Internet of Things (IoTs), wireless sensor networks (WSN), and autonomous devices are being deployed to smart buildings and cities, which require continuous power supply, whereas battery usage has accompanying environmental problems, coupled with additional maintenance cost. We present Home Chimney Pinwheels (HCP) as the Smart Turbine Energy Harvester (STEH) for wind; and Cloud-based remote monitoring of its output data. The HCP commonly serves as an external cap to home chimney exhaust outlets; they have very low inertia to wind; and are available on the rooftops of some buildings. Here, an electromagnetic converter adapted from a brushless DC motor was mechanically fastened to the circular base of an 18-blade HCP. In simulated wind, and rooftop experiments, an output voltage of 0.3 V to 16 V was realised for a wind speed between 0.6 to 16 km/h. This is sufficient to operate low-power IoT devices deployed around a smart city. The harvester was connected to a power management unit and its output data was remotely monitored via the IoT analytic Cloud platform "ThingSpeak" by means of LoRa transceivers, serving as sensors; while also obtaining supply from the harvester. The HCP can be a battery-less "stand-alone" low-cost STEH, with no grid connection, and can be installed as attachments to IoT or wireless sensors nodes in smart buildings and cities.

5.
Int J Mol Sci ; 24(10)2023 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-37240441

RESUMO

Several pieces of evidence point to an allergic component as a trigger of acute appendicitis. As the Th2 immune response is characterized by eosinophil mobilization to the target organ and release of their cationic granule proteins, it is reasonable to investigate if the degranulation of eosinophils could be associated with the local injury. The primary aim of this study is to evaluate the participation of eosinophils granules proteins in acute appendicitis, both at local and systemic levels and the secondary aim is to evaluate the diagnostic accuracy of eosinophils granules proteins for the detection of acute appendicitis, as well as for distinguishing between complicated and uncomplicated acute appendicitis. Eosinophil-derived neurotoxin (EDN), eosinophil cationic protein (ECP) and eosinophil peroxidase (EP) are the most well-known eosinophil granule proteins. From August 2021 to April 2022, we present a prospective single-center study to evaluate the EDN, ECP, and EP concentrations simultaneously in appendicular lavage fluid (ALF) and the serum of 22 patients with acute phlegmonous appendicitis (APA), 24 with acute gangrenous appendicitis (AGA), and 14 normal controls. Concerning EDN, no differences were found between groups. ECP concentrations in ALF and serum were significantly higher in the histologically confirmed acute appendicitis compared to the control groups (p < 0.0001 and p < 0.0001, respectively). In ALF, no differences were found between ECP levels in APA: 38.85 ng/mL (IQR 26.50-51.77) and AGA 51.55 ng/mL (IQR 39.55-70.09) groups (p = 0.176). In the serum, no difference was found between ECP levels at APA: 39 ng/mL (IQR 21.30-56.90) and AGA: 51.30 ng/mL (IQR 20.25-62.59) (p = 0.100). For EP, the concentrations in ALF (p < 0.001) and serum (p < 0.001) were both higher in acute appendicitis compared to the control. In ALF, no difference was found between APA: 240.28 ng/mL (IQR 191.2-341.3) and AGA: 302.5 (IQR 227.7-535.85) (p = 0.236). In the serum, no differences were found between APA: 158.4 ng/mL (IQR 111.09-222.1) and AGA: 235.27 (IQR 192.33-262.51) (p = 0.179). Globally, the ALF concentrations were higher than serum concentrations, reflecting an intense inflammatory local reaction in AA. The optimal ECP cut-off for discriminating between acute appendicitis and the controls was >11.41 ng/mL, with a sensitivity of 93.5%, but with a specificity for identifying appendicitis of 21.4%, good discriminative power (AUC = 0.880). For EP, the optimal cut-off was >93.20 ng/mL, with a sensitivity of 87%, but with a specificity of 14.3% (AUC = 0.901), excellent discriminative power. For the diagnosis of perforated AA, the discriminative power of ECP and EP serum concentrations are weak (AUC = 0.562 and AUC = 0.664, respectively). Concerning the presence of peritonitis, the discriminative power of ECP and EP serum concentrations is acceptable, respectively: AUC = 0.724 and AUC = 0.735. Serum levels of EDN (p = 0.119), ECP (p = 0.586) and EP (p = 0.08) in complicated appendicitis were similar to uncomplicated appendicitis. Serum concentrations of ECP and EP can be added to decision-making AA diagnosis. A Th2-type immune response is present in AA. These data bring forward the role of an allergic reaction in the pathogenesis of acute appendicitis.


Assuntos
Apendicite , Humanos , Proteínas Granulares de Eosinófilos/metabolismo , Apendicite/diagnóstico , Apendicite/metabolismo , Apendicite/patologia , Estudos Prospectivos , Proteínas Sanguíneas/metabolismo , Ribonucleases/metabolismo , Eosinófilos/metabolismo , Neurotoxina Derivada de Eosinófilo/metabolismo , Proteína Catiônica de Eosinófilo/metabolismo , Doença Aguda
6.
GeoJournal ; 88(2): 2233-2246, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36065414

RESUMO

Gambling tourism is a subject that has been gaining a lot of interest and notoriety over the last two decades. Push and pull factors have for long been the backbone of tourism studies and this research seeks to expound on this theory within the area of casinos. In this study, 1383 google reviews from five different countries in coastal Europe: Casino Vila Moura, Algarve (Portugal), Casino Barrière Le Croisette, Cannes (France), Casino de Monte-Carlo, (Monaco), Casino Malta, (Malta), and Regency Casino Thessaloniki, (Greece) were analyzed with the software Leximancer. The main objective of this study was to identify the concepts in the reviews and then pinpoint what push and pull factor these concepts belonged to and how important this was when choosing a casino destination in Europe. The results highlight the importance of the pull factor while choosing a destination and reveals that gamers seek mainly table games as they attract both players and other tourists who tend to gather around the tables to watch. Among the greatest push-factors is the excitement of winning money in slot machines. Findings also demonstrate that casinos located in Europe offer world-class gambling services that are both engaging and fun to engage in. This study adds to earlier research by employing the push and pull motivation framework within the area of casinos based on user-generated content.

7.
Int J Mol Sci ; 23(23)2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36499410

RESUMO

Appendicitis is the most common abdominal surgical emergency, but its aetiology is not fully understood. We and others have proposed that allergic responses play significant roles in its pathophysiology. Eosinophils and Interleukin (IL)-5 are involved in a hypersensitivity type I reaction. Eosinophil infiltration is common in the allergic target organ and is dependent on IL-5. In the presence of an allergic component, it is expected that the eosinophil count and IL-5 local and systemic concentrations become elevated. To address this hypothesis, we designed a prospective study that included 65 patients with acute appendicitis (grouped as acute phlegmonous or gangrenous according to the histological definition) and 18 patients with the clinical diagnosis of acute appendicitis, but with normal histological findings (control group) were enrolled. Eosinophil blood counts and appendicular wall eosinophil infiltration were determined. IL-5 levels in blood and appendicular lavage fluid were evaluated. Appendicular lavage fluid was collected by a new methodology developed and standardized by our group. Appendicular wall eosinophil infiltration was higher in acute phlegmonous appendicitis than in gangrenous appendicitis (p = 0.000). IL-5 blood levels were similar in both pathologic and control groups (p > 0.05). In the appendicular lavage fluid, the higher levels of IL-5 were observed in the phlegmonous appendicitis group (p = 0.056). We found a positive correlation between the appendicular wall eosinophilic infiltration and the IL-5 concentrations, in both the blood and the appendicular lavage fluid, supporting the IL-5 reliance in eosinophil local infiltration. We observed the highest presence of eosinophils at phlegmonous appendicitis walls. In conclusion, the present data are compatible with a hypersensitivity type I allergic reaction in the target organ, the appendix, during the phlegmonous phase of appendicitis.


Assuntos
Apendicite , Eosinofilia , Hipersensibilidade Imediata , Hipersensibilidade , Humanos , Interleucina-5 , Estudos Prospectivos , Apendicite/diagnóstico , Apendicite/patologia , Apendicite/cirurgia , Hipersensibilidade/patologia , Eosinofilia/complicações , Eosinófilos/patologia , Doença Aguda
8.
Mediators Inflamm ; 2021: 4194859, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34707461

RESUMO

BACKGROUND: IgE mediates type I hypersensitivity reaction and can be found in the mucosa of organs affected by allergy. Acute appendicitis (AA) is a common disease, but its etiology remains poorly understood. Here, we investigated IgE deposition in histological sections of AA samples to test the hypothesis that an allergic reaction may substantially contribute to the pathophysiology of AA. MATERIALS AND METHODS: In a retrospective study, we assessed the presence of IgE in appendicular specimens of histologically confirmed appendicitis and in the control group, comprised of negative appendicitis and incidental appendectomies, using a monoclonal antibody against human IgE. Samples from 134 appendectomies were included: 38 phlegmonous and 27 gangrenous appendicitis from the study group and 52 incidental appendectomies and 17 negative appendicitis from the control group. The slides were visualized by light microscopy, and a standard procedure was used to manually count the positive IgE staining cells. RESULTS: IgE staining was present in the cells of all but 5 appendicular specimens. We found a significantly increased number of IgE-positive cells in phlegmonous AA (median = 28) when compared to incidental appendectomy (median = 17) (p = 0.005; p < 0.0001 when adjusted for age and gender). No difference was found for gangrenous appendicitis. Discussion. The presence of IgE supports the contribution of an allergic reaction for the pathophysiology of phlegmonous appendicitis. The reduced number of IgE staining cells in gangrenous appendicitis can be due to tissue destruction, or, as been claimed by others, gangrenous appendicitis is a distinct entity, with different etiology. CONCLUSION: In this study, phlegmonous appendicitis had the highest number of IgE-positive appendicular cells. These findings suggest that an allergic reaction can contribute to the pathophysiology of AA, opening a novel possibility for preventive measures in a disease that typically requires surgery.


Assuntos
Apendicite/imunologia , Apêndice/imunologia , Hipersensibilidade Imediata/imunologia , Imunoglobulina E/análise , Doença Aguda , Adulto , Idoso , Apendicite/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
Sensors (Basel) ; 21(13)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34210035

RESUMO

The main goal of this paper is to present a three-dimensional (3D) antenna array to improve the performance of wireless power transmission (WPT) systems, as well as its characterization with over-the-air (OTA) multi-sine techniques. The 3D antenna consists of 15 antenna elements attached to an alternative 3D structure, allowing energy to be transmitted to all azimuth directions at different elevation angles without moving. The OTA multi-sine characterization technique was first utilized to identify issues in antenna arrays. However, in this work, the technique is used to identify which elements of the 3D antenna should operate to transmit the energy in a specific direction. Besides, the 3D antenna design description and its characterization are performed to authenticate its operation. Since 3D antennas are an advantage in WPT applications, the antenna is evaluated in a real WPT scenario to power an RF-DC converter, and experimental results are presented.


Assuntos
Tecnologia sem Fio
10.
Sensors (Basel) ; 20(22)2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33182749

RESUMO

Internet of Things (IoT) has been developing to become a free exchange of useful information between multiple real-world devices. Already spread all over the world in the most varied forms and applications, IoT devices need to overcome a series of challenges to respond to the new requirements and demands. The main focus of this manuscript is to establish good practices for the design of IoT devices (i.e., smart devices) with a focus on two main design challenges: power and connectivity. It groups IoT devices in passive, semi-passive, and active, giving details on multiple research topics. Backscatter communication, Wireless Power Transfer (WPT), Energy Harvesting (EH), chipless devices, Simultaneous Wireless Information and Power Transfer (SWIPT), and Wake-Up Radio (WUR) are some examples of the technologies that will be explored in this work.

11.
Mediators Inflamm ; 2019: 8146257, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31772507

RESUMO

Acute appendicitis is the most frequent surgical abdominal emergency, but its etiology remains poorly understood. Histological examination of the appendix, following its removal due to acute appendicitis, consistently shows features in common with bronchial asthma, suggesting an allergic reaction as a candidate etiologic factor. Here, we propose the concept of appendicular lavage and use it to study the levels of the Th2 cytokines IL-4, IL-5, and IL-9 in patients with a clinical diagnosis of acute appendicitis. The study group included 20 patients with a histological diagnosis of phlegmonous appendicitis, 13 patients with gangrenous appendicitis, and a control group of 8 patients with a clinical diagnosis of appendicitis but with normal histology. Cytokine levels were higher in acute appendicitis. The difference was more pronounced when comparing phlegmonous appendicitis with nonpathological appendicitis (p = 0.01) for IL-4 (48.3 vs. 21.3 pg/mL), IL-5 (29.2 vs. 8.0 pg/mL), and IL-9 (34.1 vs. 16.6 pg/mL). This Th2 cytokine profile is compatible with the hypothesis of allergy as an etiologic factor for acute appendicitis and may have important implications for the diagnosis, prevention, and treatment of this condition.


Assuntos
Apendicite/etiologia , Apendicite/metabolismo , Citocinas/metabolismo , Hipersensibilidade/complicações , Hipersensibilidade/metabolismo , Células Th2/metabolismo , Doença Aguda , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Sensors (Basel) ; 17(10)2017 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-28972554

RESUMO

In this work, three different concepts are used to develop a fully passive sensor that is capable of measuring different types of data. The sensor was supplied by Wireless Power Transmission (WPT). Communication between the sensor and reader is established by a backscatter, and to ensure minimum energy consumption, low power techniques are used. In a simplistic way, the process starts by the transmission of two different waves by the reader to the sensor, one of which is used in power transmission and the other of which is used to communicate. Once the sensor is powered, the monitoring process starts. From the monitoring state, results from after processing are used to modulate the incoming wave, which is the information that is sent back from the reader to the tag. This new combination of technologies enables the possibility of using sensors without any cables or batteries to operate 340 cm from the reader. The developed prototype measures acceleration and temperature. However, it is scalable. This system enables a new generation of passive Internet of Things (IoT) devices.

13.
Eur J Pediatr ; 175(4): 573-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26646145

RESUMO

UNLABELLED: Growth impairment in infants with unrestrictive ventricular septal defects (VSD) is common, and normalisation of growth has been reported after surgical correction. Literature is inconsistent about growth velocity after surgery in term and preterm infants. We aimed to establish the pattern of catch-up growth in term and preterm infants submitted to VSD surgical correction before 1 year of age. Fifty-two infants (41 term, 11 preterm) were studied. Anthropometric data at birth, surgery and 3, 6, 12 and 24 months after surgery were collected retrospectively. Statistic analyses were performed in SPSS® version 21. At the time of surgery, growth was severely impaired in term and preterm infants. Term infants underwent a period of fast growth within the first 6 months after surgery, achieving posteriorly a normal growth pattern, as both weight and height were not significantly different from the reference population at 24 months after surgery. Preterms caught-up later than term infants but with a significant weight gain within 3 months after surgery. CONCLUSION: Early surgical repair of VSD leads to a significant acceleration of growth within 3 to 6 months after surgery, for both groups. WHAT IS KNOWN: • Growth impairment in infants with unrestrictive ventricular septal defects is well documented in literature. • Surgical correction in the first months of life is the current option for most ventricular septal defects, leading to a more favourable growth pattern. • Rapid growth during infancy may be associated with the development of insulin resistance, metabolic syndrome, obesity and cardiovascular disease later in life. What is New: • Literature is inconsistent about catch-up growth velocities after ventricular correction for term infants. • Preterm infants have never been enrolled in previous studies that aimed to establish a pattern of growth after surgery. • This group of children, who underwent a rapid post-surgery catch-up growth that follows a period of failure to thrive, may be at a higher risk of insulin resistance, metabolic syndrome, obesity and cardiovascular disease.


Assuntos
Desenvolvimento Infantil , Comunicação Interventricular/cirurgia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Antropometria/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Feminino , Comunicação Interventricular/fisiopatologia , Humanos , Lactente , Recém-Nascido , Masculino , Nascimento a Termo
14.
Rev Esp Enferm Dig ; 108(11): 738, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27822956

RESUMO

A 62-year-old female was referenced to our outpatient clinic for a single episode of right upper quadrant pain and weight loss of 3 kg in the last 6 months. No other complaints were reported. Her past medical history was unremarkable except for total hysterectomy. The upper abdominal ultrasonography and abdominal plain X-ray revealed a porcelain gallbladder.


Assuntos
Doenças da Vesícula Biliar/diagnóstico por imagem , Colecistectomia Laparoscópica , Feminino , Doenças da Vesícula Biliar/cirurgia , Humanos , Pessoa de Meia-Idade , Ultrassonografia
15.
Acta Med Port ; 37(1): 42-45, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-37983974

RESUMO

Arterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and technically straightforward procedure, due to its considerable use, it is of vital importance to be able to promptly recognize its potential complications. We present the case of a 96-year-old female patient admitted to the emergency department with dyspnea and cough who underwent left radial arterial puncture for arterial blood gas. A total of three puncture attempts were performed until arterial blood was collected. Roughly two weeks upon observation, the patient was readmitted to the emergency department after the insidious appearance of a painful swelling in the left wrist, with progressive worsening since hospital discharge. On physical examination, a painful erythematous pulsatile swelling in the left wrist's volar aspect was observed, and further point-of-care ultrasound evaluation documented a cysticlike collection, communicating with the radial artery's lumen, and suggesting the probable diagnosis of iatrogenic radial pseudoaneurysm. The patient was hospitalized and underwent surgical resection of radial pseudoaneurysm, with subsequent arterial repair. Although severe complications from arterial blood gas have a low incidence rate, prompt diagnosis and management are required. Therefore, point-of-care ultrasound, as an additional diagnostic tool, may play a role in minimizing the risk of procedural complications.


Assuntos
Falso Aneurisma , Artéria Radial , Feminino , Humanos , Idoso de 80 Anos ou mais , Artéria Radial/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Punções/efeitos adversos , Ultrassonografia , Dor , Dispneia
16.
Respir Med ; 229: 107675, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38782137

RESUMO

BACKGROUND: A pneumonic infiltrate might hide an occult lung cancer (LC). This awareness depends on each clinician personal experience, turning definitive LC diagnosis challenging and possibly delayed. In this study we aimed to develop a clinical score to better identify those cases. MATERIALS AND METHODS: We conducted a retrospective case-control study, including previously undiagnosed LC patients admitted in our institution, with a presumptive suspicious of community acquired pneumonia (CAP). Cases were compared with random CAP inpatient controls, using a matched 2:1 ratio. Demographic, clinical, and laboratorial variables were assessed for a possible association with the presence of a CAP with underlying LC (CAP-uLC). RESULTS: Among 535 hospitalized LC patients, 43 cases had a presentation compatible with CAP and were compared with 86 CAP controls. A scoring system was built using 6 independent variables, which positively correlated with CAP-uLC: smoking history (OR: 8.3 [1.9-36.2]; p = 0.005); absence of fever (6.5 [2.0-21.5]; p = 0.002); sputum with blood (5.9 [1.2-29.9]; p = 0.033); platelet count ≥ 232x103/µL (5.8 [1.6-20.6]; p = 0.006); putative alternative diagnosis than CAP (4.6 [1.5-14.7]; p = 0.009); and duration of symptoms ≥ 10 days (3.7 [1.1-13.0]; p = 0.037). Our score presented an AUC of 0.910 (95 % CI, 0.852-0.967; p < 0.001), a sensitivity of 88.1 % and specificity of 84.7 %, in predicting the risk of presenting a CAP-uLC, when set to a cutoff of 18. CONCLUSION: We propose a novel risk score aimed to aid clinicians identifying patients with CAP-uLC in the acute setting, possibly prompting early LC diagnosis.

17.
medRxiv ; 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38352440

RESUMO

While genetic factors, behavior, and environmental exposures form a complex web of interrelated associations in type 2 diabetes (T2D), their interaction is poorly understood. Here, using data from ~500K participants of the UK Biobank, we identify the genetic determinants of a "polyexposure risk score" (PXS) a new risk factor that consists of an accumulation of 25 associated individual-level behaviors and environmental risk factors that predict longitudinal T2D incidence. PXS-T2D had a non-zero heritability (h2 = 0.18) extensive shared genetic architecture with established clinical and biological determinants of T2D, most prominently with body mass index (genetic correlation [rg] = 0.57) and Homeostatic Model Assessment for Insulin Resistance (rg = 0.51). Genetic loci associated with PXS-T2D were enriched for expression in the brain. Biobank scale data with genetic information illuminates how complex and cumulative exposures and behaviors as a whole impact T2D risk but whose biology have been elusive in genome-wide studies of T2D.

18.
Sci Rep ; 14(1): 5358, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438457

RESUMO

In this paper, the authors, for the first time, have shown the use of 2D conformal microwave absorbing material (MAM) in the design and fabrication of a portable Anechoic chamber (AC). The MAM is fabricated on the transparent and conductive metal oxide layer named indium-tin-oxide (ITO) with Polyethylene terephthalate as the substrate and the ground plane for zero transmission having overall thickness of 0.012 λ where λ is calculated at 0.7 GHz. The MAM is characterized for 0.7 to 18 GHz for both TE- and TM-polarisation and oblique incidence. High sheet resistance, dipole-like resonance structure patterned on the ITO, and the air-spacing between the layers is optimized to achieve broadband absorption. The MAM is used to line the six sides of the rectangular anechoic chamber having inner dimensions of: (L × W × H: 850 × 650 × 720 mm3). The return loss (RL), gain, and radiation pattern of three antenna working at 1.56, 2.43, and 4.93 GHz are analyzed inside the AC. The measurement results for all frequencies very well match with the simulation studies, thus validating and opening the door for the future use of ultra-thin and planar MAM in the AC.

19.
Opt Express ; 21(3): 3354-62, 2013 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-23481795

RESUMO

In this paper, we propose a wideband dynamic behavioral model for a bulk reflective semiconductor optical amplifier (RSOA) used as a modulator in colorless radio over fiber (RoF) systems using a tapped-delay multilayer perceptron (TDMLP). 64 quadrature amplitude modulation (QAM) signals with 20 Msymbol/s were used to train, validate and test the model. Nonlinear distortion and dynamic effects induced by the RSOA modulator are demonstrated. The parameters of the model such as the number of nodes in the hidden layer and memory depth were optimized to ensure the generality and accuracy. The normalized mean square error (NMSE) is used as a figure of merit. The NMSE was up to -44.33 dB when the number of nodes in the hidden layer and memory depth were set to 20 and 3, respectively. The TDMLP model can accurately approximate to the dynamic characteristics of the RSOA modulator. The dynamic AM-AM and dynamic AM-PM distortions of the RSOA modulator are drawn. The results show that the single hidden layer TDMLP can provide accurate approximation for behaviors of the RSOA modulator.


Assuntos
Amplificadores Eletrônicos , Desenho Assistido por Computador , Modelos Teóricos , Redes Neurais de Computação , Dispositivos Ópticos , Semicondutores , Simulação por Computador , Desenho de Equipamento , Análise de Falha de Equipamento
20.
Appl Microbiol Biotechnol ; 97(11): 5055-67, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23435899

RESUMO

The yeast Kluyveromyces marxianus has been pointed out as a promising microorganism for a variety of industrial bioprocesses. Although genetic tools have been developed for this yeast and different potential applications have been investigated, quantitative physiological studies have rarely been reported. Here, we report and discuss the growth, substrate consumption, metabolite formation, and respiratory parameters of K. marxianus CBS 6556 during aerobic batch bioreactor cultivations, using a defined medium with different sugars as sole carbon and energy source, at 30 and 37 °C. Cultivations were carried out both on single sugars and on binary sugar mixtures. Carbon balances closed within 95 to 101 % in all experiments. Biomass and CO2 were the main products of cell metabolism, whereas by-products were always present in very low proportion (<3 % of the carbon consumed), as long as full aerobiosis was guaranteed. On all sugars tested as sole carbon and energy source (glucose, fructose, sucrose, lactose, and galactose), the maximum specific growth rate remained between 0.39 and 0.49 h(-1), except for galactose at 37 °C, which only supported growth at 0.31 h(-1). Different growth behaviors were observed on the binary sugar mixtures investigated (glucose and lactose, glucose and galactose, lactose and galactose, glucose and fructose, galactose and fructose, fructose and lactose), and the observations were in agreement with previously published data on the sugar transport systems in K. marxianus. We conclude that K. marxianus CBS 6556 does not present any special nutritional requirements; grows well in the range of 30 to 37 °C on different sugars; is capable of growing on sugar mixtures in a shorter period of time than Saccharomyces cerevisiae, which is interesting from an industrial point of view; and deviates tiny amounts of carbon towards metabolite formation, as long as full aerobiosis is maintained.


Assuntos
Metabolismo dos Carboidratos , Carbono/metabolismo , Metabolismo Energético , Kluyveromyces/crescimento & desenvolvimento , Kluyveromyces/metabolismo , Aerobiose , Biomassa , Reatores Biológicos/microbiologia , Meios de Cultura/química
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