The Molecular Footprint of Peptides on the Surface of Ultrasmall Gold Nanoparticles (2 nm) Is Governed by Steric Demand.

Ultrasmall gold nanoparticles were functionalized with peptides of two to seven amino acids that contained one cysteine molecule as anchor via a thiol-gold bond and a number of alanine residues as nonbinding amino acid. The cysteine was located either in the center of the molecule or at the end (C-terminus). For comparison, gold nanoparticles were also functionalized with cysteine alone. The particles were characterized by UV spectroscopy, differential centrifugal sedimentation (DCS), high-resolution transmission electron microscopy (HRTEM), and small-angle X-ray scattering (SAXS). This confirmed the uniform metal core (2 nm diameter). The hydrodynamic diameter was probed by 1H-DOSY NMR spectroscopy and showed an increase in thickness of the hydrated peptide layer with increasing peptide size (up to 1.4 nm for heptapeptides; 0.20 nm per amino acid in the peptide). 1H NMR spectroscopy of water-dispersed nanoparticles showed the integrity of the peptides and the effect of the metal core on the peptide. Notably, the NMR signals were very broad near the metal surface and became increasingly narrow in a distance. In particular, the methyl groups of alanine can be used as probe for the resolution of the NMR spectra. The number of peptide ligands on each nanoparticle was determined using quantitative 1H NMR spectroscopy. It decreased with increasing peptide length from about 100 for a dipeptide to about 12 for a heptapeptide, resulting in an increase of the molecular footprint from about 0.1 to 1.1 nm2.

Basal or stimulated thyroglobulin in evaluating response to treatment in papillary thyroid carcinoma? A retrospective cohort study.

OBJECTIVE: It is not clear whether response to initial treatment in papillary thyroid carcinoma (PTC) patients is best evaluated by measuring thyroglobulin (Tg) in the presence of levothyroxine (BTg) or when stimulated by elevated TSH (STg). The aim of this study was to evaluate whether response to therapy 1 year after initial treatment changes with the use of STg in relation to BTg in PTC patients treated with total thyroidectomy (TT) and radioiodine (131I), and, if observed, to assess which response is better associated with clinical course. SUBJECTS AND METHODS: This is a retrospective study of 148 PTC patients submitted to TT and 131I. We analyzed the response to therapy (excellent, biochemical incomplete, or indeterminate) at 1 year after initial treatment, using BTg or STg, and compared which method was better associated with "excellent response at final evaluation." RESULTS: Twenty-eight patients (20.4%) presented change in response to therapy, with 17 of these (60.7%) presenting a worse response. Response using STg was 1.6 times better associated with proposed outcome [odds ratio (OR) = 4.61; confidence interval 95% (IC95%): 2.13-9.98] than with BTg (OR = 2.84; IC95%: 1.33-6.06). CONCLUSION: Response to therapy at 1 year using STg was altered in approximately 20% of cases and therefore proved to be a better predictor of excellent response in the last evaluation.

Methylene blue as an adjuvant during cardiopulmonary resuscitation: an experimental study in rats

Abstract Introduction: Methylene Blue (MB) has been shown to attenuate oxidative, inflammatory, myocardial, and neurological lesions during ischemia-reperfusion and has great potential during cardiac arrest. This study aimed to determine the effects of MB combined with epinephrine during cardiac arrest on myocardial and cerebral lesions. Method: Thirty-eight male Wistar rats were randomly assigned to four groups: the sham group (SH, n = 5), and three groups subjected to cardiac arrest (n = 11 /group) and treated with EPI 20 μg.kg−1 (EPI), EPI 20 μg.kg−1 + MB 2 mg.kg−1 (EPI + MB), or saline 0.9% 0.2 ml (CTL). Ventricular fibrillation was induced by direct electrical stimulation in the right ventricle for 3 minutes, and anoxia was maintained for 5 minutes. Cardiopulmonary Resuscitation (CPR) consisted of medications, ventilation, chest compressions, and defibrillation. After returning to spontaneous circulation, animals were observed for four hours. Blood gas, troponin, oxidative stress, histology, and TUNEL staining measurements were analyzed. Groups were compared using generalized estimating equations. Results: No differences in the Returning of Spontaneous Circulation (ROSC) rate were observed among the groups (EPI: 63%, EPI + MB: 45%, CTL: 40%, p = 0.672). The mean arterial pressure immediately after ROSC was higher in the EPI+MB group than in the CTRL group (CTL: 30.5 [5.8], EPI: 63 [25.5], EPI+MB: 123 [31] mmHg, p = 0.007). Serum troponin levels were high in the CTL group (CTL: 130.1 [333.8], EPI: 3.70 [36.0], EPI +MB: 43.7 [116.31] ng/mL, p < 0.05). Conclusion: The coadministration of MB and epinephrine failed to yield enhancements in cardiac or brain lesions in a rodent model of cardiac arrest.

Postoperative serum magnesium levels as a predictor for the need for calcium replacement after total thyroidectomy: a prospective study

ABSTRACT Objective: Our aim was to assess the ability of serum magnesium (Mg), measured on the first postoperative day (Mg1PO), to predict the need for calcium (Ca) replacement in patients undergoing total thyroidectomy (TT). Subjects and methods: Eighty patients undergoing TT, with Mg1PO and PTH dosage in the first (PTH1h) and eighth (PTH8h) hours after TT, were evaluated for the need for Ca replacement. Data were evaluated by uni/multivariate logistic regression and Receiver Operating Characteristic (ROC) curve. Results: 32 patients (40%) required Ca replacement. Median PTH1h, PTH8h and Mg1PO were higher in the no replacement group: 17 versus (vs) 3 pg/mL (p < 0.001), 18.2 vs 3.0 pg/mL (p < 0.001) and 2 vs 1.6 mg/dL (p < 0.001), respectively. Mg1PO was the isolated predictor for this replacement (odds ratio = 0.0004, 95% confidence interval: 0.000003-0.04; p = 0.001), with the cut-off value of 1.8 mg/dL showing sensitivity and specificity of 78.1% and 87.5%, respectively. Conclusions: In this group of patients, serum Mg1PO was the isolated predictor for the need for Ca replacement.

Auditory middle latency responses and hearing skills in adults / Potencial evocado auditivo de média latência e habilidades auditivas em adultos

ABSTRACT Purpose: to compare the Auditory Middle Latency Response in adults, one group with and another group without altered auditory skills. In addition, the aim was to compare cut-off values of 30% and 50% for the Ear Effect in terms of sensitivity and specificity. Methods: the sample comprised 32 individuals of both genders with no hearing loss who were divided into Group 1 (16 individuals with no alterations in auditory skills) and Group 2 (16 individuals with alterations in auditory skills). All participants received an audiological evaluation and measurement of Brainstem and Auditory Middle Latency Potentials. Results: when Group 1 and Group 2 were compared, a statistically significant difference was only observed in Na and Pa amplitude of waves A1C3 and A2C3. In the analysis of sensitivity and specificity of the Auditory Middle Latency Response, a cut-off value of 50% gave a better balance between sensitivity and specificity. Conclusion: adults presented with altered auditory abilities had smaller response amplitudes in the Na and Pa components of the waves generated in the left hemisphere. A cut-off value of 50% gave a better discrimination of the Ear Effect for identifying subjects with altered auditory skills.

RESUMO Objetivo: comparar a latência e a amplitude dos componentes Na, Pa, Nb e Pb do Potencial Evocado Auditivo de Média Latência em adultos com e sem alterações em habilidades auditivas, bem como analisar a sensibilidade e a especificidade dos valores de corte de 30% e 50% para o Efeito de Orelha. Métodos: compuseram a amostra 32 indivíduos de ambos os sexos e sem perda auditiva, sendo subdivididos em Grupo 1 (16 indivíduos sem alterações em habilidades auditivas) e Grupo 2 (16 indivíduos com alterações em habilidades auditivas). Todos os participantes foram submetidos a uma avaliação audiológica e aos Potenciais Evocados Auditivos de Tronco Encefálico de Média Latência. O teste ANOVA foi utilizado na análise dos dados, considerando significantes os valores de p menores ou iguais a 0,05. Resultados: foi observada diferença estatisticamente significante apenas na amplitude de Na e Pa, quando Grupo 1 e Grupo 2 foram comparados. Esta diferença foi observada nas ondas A1C3 e A2C3. Na análise de sensibilidade e especificidade do Potencial Evocado Auditivo de Média Latência, observou-se que o valor de corte de 50% apresentou um melhor equilíbrio entre os critérios de sensibilidade e especificidade. Conclusão: os indivíduos adultos com alterações nas habilidades auditivas apresentaram menor amplitude de resposta nos componentes Na e Pa das ondas geradas no hemisfério esquerdo. O valor de corte de 50% apresentou um melhor equilíbrio na análise do Efeito de Orelha para a contribuição no diagnóstico de alterações de habilidades auditivas.

Acute effects of different intervals between repeated sprints on performance responses in amateur futsal athletes / Efeitos agudos de diferentes intervalos entre sprint repetidos sobre as respostas de desempenho em atletas amadores de futsal

ABSTRACT Objective: Verify the influence of different break times between sprints on the performance of amateur futsal athletes. Methods: 10 individuals, men, amateur futsal athletes (Age: 21.5 ± 1.6; Weight: 72.4 ± 6.88; Height: 1.72 ± 0.05; BMI: 24.3 ± 1.2; Fat%: 13.7 ± 3.3, VO2peak: 49.1 ± 10.5) participated in the study. Individuals were randomly selected to perform sessions with sprints (10 sets 20 m) with different pause times of 15 (S15), 30 (S30) and 60 (S60) seconds. For performance analysis, the speed (km / h) applied to each sprint was used and monitored by a device with a photocell (CEFISE Biotecnologia Esportiva®). Results: There was an interaction between speed and interval time (p = 0.000). For condition S15, a greater reduction in performance was observed (p ≤ 0.05), while for S30 and S60, no significant reduction in performance was observed (p > 0.05). The data for the area under the curve showed a significant difference (p = 0.000), where the interval of 60 s (S60) was longer compared to the values of 30 (S30) (p = 0.000) and 15 s (S15) (p = 0.000). However, there were no significant differences between the 30 and 15 s data (p = 0.248). Conclusion: A shorter time (15 s) interval between repeated sprints can significantly affect performance compared to longer breaks (30 and 60 s), but all the conditions tested here can be positive for the improvement of performance, mainly in sports that demand fast and efficient motor actions such as futsal.

RESUMO Objetivo: Verificar a influência dos diferentes tempos de intervalo entre os sprints no desempenho dos atletas de futsal amadores. Métodos: 10 indivíduos, homens, atletas de futsal amadores (Idade: 21,5 ± 1,6; Peso: 72,4 ± 6,88; Altura: 1,72 ± 0,05; IMC: 24,3 ± 1,2; Gordura%: 13,7 ± 3,3, VO2peak: 49,1 ± 10,5) participou no estudo. Os indivíduos foram selecionados aleatoriamente para realizar sessões com sprints (10 conjuntos 20 m) com diferentes tempos de pausa de 15 (S15), 30 (S30) e 60 (S60) segundos. Para análise do desempenho, a velocidade (km/h) aplicada a cada sprint foi utilizada e monitorizada por um dispositivo com uma fotocélula (CEFISE Biotecnologia Esportiva®). Resultados: Houve uma interação entre velocidade e tempo de intervalo (p = 0,000). Para a condição S15, observou-se uma maior redução no desempenho (p ≤ 0,05), enquanto para S30 e S60, não se observou qualquer redução significativa no desempenho (p > 0,05). Os dados para a área sob a curva mostraram uma diferença significativa (p = 0,000), onde o intervalo de 60 s (S60) foi mais longo em comparação com os valores de 30 (S30) (p = 0,000) e 15 s (S15) (p = 0,000). No entanto, não houve diferenças significativas entre os dados de 30 e 15 s (p = 0,248). Conclusão: Um intervalo de tempo mais curto (15 s) entre sprints repetidos pode afetar significativamente o desempenho em comparação com os intervalos mais longos (30 e 60 s), mas todas as condições aqui testadas podem ser positivas para a melhoria do desempenho, principalmente nos desportos que exigem ações motoras rápidas e eficientes, tais como o futsal.

The role of immunohistochemistry in the assessment of classical Hodgkin lymphoma microenvironment.

INTRODUCTION: Classical Hodgkin lymphoma (CHL) has a unique cellular composition, containing a minority of neoplastic cells - Hodgkin and Reed-Sternberg (HRS) cells - in an inflammatory background. Investigations into this microenvironment have been given special importance in scientific hematopathology, playing an important role in elucidating its composition and its relationship to the prognosis of patients. OBJECTIVE: To investigate microenvironment tumor markers in CHL, in order to analyze their interactions with clinical-morphological aspects of interest in onco-hematopathology. METHODS: This retrospective study analyzed 184 patients with a pathologic diagnosis of CHL. Clinical data were reviewed from medical records. A morphological and immunophenotypic study with CD20, CD30, CD15, PAX-5, CD3, CD4, CD8, CD68, CD34, CD138 and PD-1 were performed. The data were tabulated and p value less than 0.05 was considered significant. RESULTS: The time-to-cure was shorter in CD20+ patients, especially in those with more than 25% positivity (P=0.0183). The time-to-cure (P=0.0309) and the death (P=0.016) rates were shorter in PD-1 negative patients. Among patients with the presence of plasma cells in the microenvironment, those with lower numbers tend to be cured earlier (P=0.0374). Higher vascular density is associated with lower frequency of B symptoms (P=0.036) and presence of disease recurrence (P=0.004). CONCLUSIONS: The microenvironment is certainly the setting of increasingly robust studies and the findings of this work highlight non-neoplastic B lymphocytes, plasma cells, PD-1 lymphocytes, and vascular density, related to prognosis of CHL patients.

Adjuvant effect of mesoporous silica SBA-15 on anti-diphtheria and anti-tetanus humoral immune response.

Routine immunization against diphtheria and tetanus has drastically reduced the incidence of these diseases worldwide. Anti-diphtheria/tetanus vaccine has in general aluminum salt as adjuvant in its formulation that can produce several adverse effects. There is a growing interest in developing new adjuvants. In this study, we evaluated the efficiency of SBA-15 as an adjuvant in subcutaneous immunization in mice with diphtheria (dANA) and tetanus (tANA) anatoxins as well as with the mixture of them (dtANA). The tANA molecules and their encapsulation in SBA-15 were characterized using Small-Angle X-ray Scattering (SAXS), Dynamical Light Scattering (DLS), Nitrogen Adsorption Isotherm (NAI), Conventional Circular Dichroism (CD)/Synchrotron Radiation Circular Dichroism (SRCD) Spectroscopy, and Tryptophan Fluorescence Spectroscopy (FS). The primary and secondary antibody response elicited by subcutaneous immunization of High (HIII) and Low (LIII) antibody responder mice with dANA, tANA, or dtANA encapsulated in the SBA-15 were determined. We demonstrated that SBA-15 increases the immunogenicity of dANA and tANA antigens, especially when administered in combination. We also verified that SBA-15 modulates the antibody response of LIII mice, turning them into high antibody responder. Thus, these results suggest that SBA-15 may be an effective adjuvant for different vaccine formulations.

Diffuse large B-cell lymphoma: morphologic and immunohistochemical analysis of bone marrow for staging, with emphasis on lymphoid aggregates.

Diffuse large B-Cell lymphoma (DLBCL) may infiltrate bone marrow (BM) and evaluation of BM plays an important role in DLBCL staging. This study used BM samples from DLBCL patients for staging and analyzed the use of immunohistochemistry in the diagnostic management of these cases by the pathologist. Patients with DLBCL submitted to BM biopsy/aspiration for staging were studied according to clinical aspects, morphologic aspects, and expression of CD20 and CD3. The characteristics of lymphoid aggregates in the bone marrow and the power of histopathological diagnosis were studied, with immunohistochemistry as the gold standard for the decision of a neoplastic infiltration definition. An isolated morphological analysis showed low sensitivity (42.9%) for lymphoma detection in BM, which is disadvantageous. The median of three lymphoid aggregates in the BM (p-value = 0.02) and the presence of increased reticulin fibers (grade 2) in the lymphoid aggregate (p-value = 0.01) had significant associations with neoplastic infiltration. A morphological analysis must be accompanied by an immunohistochemical analysis in all cases, or when this is not possible, in cases with two or more lymphoid aggregates or an increase of reticulin within them.

Patients with Classical Hodgkin Lymphoma with Less Than 10.5 CD20-Positive Reed-Sternberg Cells in 10 High-Power Fields Have Better Prognosis.

The CD20 immunoexpression in classical Hodgkin lymphoma (CHL) is variable and it may represent an intersection between the pathophysiology of CHL and the clinical prognosis of patients. Retrospective study with 174 patients with pathological diagnosis of CHL. Clinical data were reviewed from medical records. Immunophenotypic study with CD20 were performed in two ways: hotspot count and in 10 high-power fields (HPF). The data were tabulated and the p value less than 0.05 was considered significant. The CD20-positive phenotype was found in 45 (25.9%) of the total of 174 patients with available material. Patients with CD20 positivity on neoplastic cells tend to heal earlier, particularly those with less than 10.5 cells/10 HPF (p = 0.037). Patients with CHL with less than 10.5 CD20-positive Reed-Sternberg cells in 10 HPF have better prognosis.

Mucosa-associated lymphoid tissue lymphoma in the terminal ileum: A case report.

BACKGROUND: The lymphoma of the mucosa-associated lymphoid tissue (MALT) is predominantly found in the stomach. The few cases reported in the literature of MALT lymphomas affecting the ileum are in patients who are already symptomatic and with clear advanced endoscopic findings. We present the first case of an asymptomatic female patient who underwent colonoscopy as a routine examination with the findings of an ulcer in the distal ileum region, which histopathological examination and associated immunohistochemistry revealed the diagnosis of MALT lymphoma. CASE SUMMARY: A 57-year-old asymptomatic female patient underwent a colonoscopy exam for screening. The examination revealed an ulcer of medium depth with well-defined borders covered by a thin layer of fibrin and a halo of hyperemia in the distal ileum portion. Findings are nonspecific but may signal infections by viruses, protozoa, and parasites or inflammatory diseases such as Crohn's disease. Biopsies of the ulcer were taken. The anatomopathological result revealed an atypical diffuse lymphocytic infiltrate of small cells with a characteristic cytoplasmic halo of marginal zone cells. The immunohistochemical study was performed and the results demonstrated a negative neoplastic infiltrate for the expression of cyclin D1 and cytokeratin AE1/AE3 and a positive for BCL60 in the germinal center. The test also revealed CD10 positivity in the glandular epithelium and germinal center of a reactive follicle with dual-labeling of CD20 and CD3 demonstrating the B lymphocyte nature of the neoplastic infiltrate. In BCL2 protein labeling, the neoplastic infiltrate is strongly positive with a negative germinal center. The findings are consistent with immunophenotype B non-Hodgkin's lymphoma, better classified as extranodal MALT. The patient was treated with chemotherapy and showed complete regression of the disease, as evidenced by colonoscopy performed after treatment. CONCLUSION: MALT lymphomas in the terminal ileum are extremely rare and only 4 cases have been reported in the literature. Given the low sensitivity and specificity of endoscopic images in these cases, the pathology can be confused with other important differential diagnoses such as inflammatory diseases or infectious diseases and which makes the biopsy important, even in asymptomatic patients, paired with anatomopathological analysis and immunohistochemistry which is the gold standard for correct diagnosis.

Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study.

Objective: Cytological analysis and Bethesda classification of thyroid nodules is the standard method of diagnosing differentiated thyroid carcinoma (DTC). However, even for nodules with a non-malignant cytological diagnosis, there is a not insignificant risk of cancer. There are doubts whether this lack of certainty would influence patient prognosis. Our aim was to compare patients with DTC, classified according to the preoperative cytological diagnosis, regarding their evolution. Methods: A retrospective study was carried out with 108 DTC patients submitted to total thyroidectomy (TT) between 2009 and 2015, divided into three groups according to preoperative cytological diagnosis (Bethesda classification): classes I/II, III/IV, and V/VI. Groups were compared for evolution considering response to treatment at last evaluation as well as time disease free. Statistical analysis used ANOVA, chi squared, and Kaplan-Meier curves with p<0.05 considered significant. Results: Groups differed for time between nodule puncture and TT [in months; V/VI (2.35 ± 2.48) < III/IV (7.32 ± 6.34) < I/II (13.36 ± 8.9); p < 0.0001]. There was no significant difference between groups for evolution at final evaluation (disease free status; classes I/II: 71.4%; classes III/IV: 60%; classes V/VI: 66.6%; p = 0.7433), as well as time disease free (in months; classes I/II: 34.57 ± 25.82; classes III/IV: 38.04 ± 26.66; classes V/VI: 30.84 ± 26.34; p = 0.3841). Conclusion: DTC patients classified according to preoperative cytological diagnosis did not differ for evolution. Although patients with non-malignant cytological diagnoses were submitted to TT later, this did not affect the evolution of the cases.

Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study

ABSTRACT Objective: Cytological analysis and Bethesda classification of thyroid nodules is the standard method of diagnosing differentiated thyroid carcinoma (DTC). However, even for nodules with a non-malignant cytological diagnosis, there is a not insignificant risk of cancer. There are doubts whether this lack of certainty would influence patient prognosis. Our aim was to compare patients with DTC, classified according to the preoperative cytological diagnosis, regarding their evolution. Subjects and methods: A retrospective study was carried out with 108 DTC patients submitted to total thyroidectomy (TT) between 2009 and 2015, divided into three groups according to preoperative cytological diagnosis (Bethesda classification): classes I/II, III/IV, and V/VI. Groups were compared for evolution considering response to treatment at last evaluation as well as time disease free. Statistical analysis used ANOVA, chi squared, and Kaplan-Meier curves with p<0.05 considered significant. Results: Groups differed for time between nodule puncture and TT [in months; V/VI (2.35 ± 2.48) < III/IV (7.32 ± 6.34) < I/II (13.36 ± 8.9); p < 0.0001]. There was no significant difference between groups for evolution at final evaluation (disease free status; classes I/II: 71.4%; classes III/IV: 60%; classes V/VI: 66.6%; p = 0.7433), as well as time disease free (in months; classes I/II: 34.57 ± 25.82; classes III/IV: 38.04 ± 26.66; classes V/VI: 30.84 ± 26.34; p = 0.3841). Conclusions: DTC patients classified according to preoperative cytological diagnosis did not differ for evolution. Although patients with non-malignant cytological diagnoses were submitted to TT later, this did not affect the evolution of the cases.

Aplicabilidade e considerações clínicas do Sistema Contralateral Routing of Signal (CROS): revisão sistemática / Applicability and clinical considerations of the Contralateral Routing of Signal System (CROS): systematic review / Aplicabilidad y consideraciones clínicas del sistema de enrutamiento de señal contralateral (CROS): revisión sistemática

Introdução: O Sistema Contralateral Routing of Signal (CROS) é uma opção de intervenção auditiva com propósito de melhorar a percepção monoaural e minimizar as dificuldades da perda auditiva unilateral. Objetivo: analisar e descrever o público-alvo, o tempo de adaptação, o controle de uso do Sistema CROS, as avaliações utilizadas para medir os seus benefícios, sua efetividade e limitações. Método: Este estudo foi conduzido de acordo com as diretrizes PRISMA. A pesquisa bibliográfica foi realizada através dos bancos de dados científicos online na área da saúde, PubMed e Scopus, foram utilizadas as palavras-chave "Unilateral hearing loss", "Hearing aid", "CROS" e "Contralateral Routing of Signal". Os resultados da pesquisa limitaram-se a artigos científicos experimentais, que abordavam diretamente o sistema CROS, publicados em inglês, português ou espanhol. Resultados: Onze artigos foram selecionados para a revisão do texto completo. Quanto aos usuários do CROS, a faixa etária variou entre nove a 84 anos; prevalência do sexo masculino. Observou-se grande diversidade nas avaliações, sendo realizadas com tempo de uso inferior a 30 dias e superior a seis meses, após adaptação do CROS. Tal avaliação era realizada por meio de questionários não padronizados e avaliações objetivas com estímulos controlados. O uso do CROS proporcionou benefícios na localização sonora, efeito sombra da cabeça e inteligibilidade de fala, porém não mostrou eficácia em situações ruidosas. Conclusão: Por ser um dispositivo, não invasivo, de fácil adaptação e manuseio que traz benefícios imediatos, o CROS deve ser a primeira opção na reabilitação da perda auditiva unilateral.

Introducción: El Sistema Contralateral Routing of Signal (CROS) es una opción de intervención auditiva con el propósito de mejorar la percepción monoaural y minimizar las dificultades de la pérdida auditiva unilateral. Objetivo: analizar y describir el público objetivo, el tiempo de adaptación, el control del uso del Sistema CROS, las evaluaciones utilizadas para medir sus beneficios, su efectividad y limitaciones. Metodo: Este estudio se realizó de acuerdo con las pautas PRISMA. La búsqueda bibliográfica se realizó a través de bases de datos científicas online del área de salud, PubMed y Scopus, utilizando las palabras clave "Unilateral hearing loss", "Hearing aid", "CROS" y "Contralateral Routing of Signal". Los resultados de la investigación se limitaron a artículos científicos experimentales, que abordaron directamente el sistema CROS, publicados en inglés, portugués o español. Resultados: Se seleccionaron once artículos para revisión de texto completo. En cuanto a los usuarios de CROS, la edad osciló entre los nueve y los 84 años; prevalencia masculina. Hub gran diversidad en las evaluaciones, realizadas con tiempos de uso de menos de 30 días y más de seis meses tras la adaptación del CROS. Dicha evaluación se realizó mediante cuestionarios no estandarizados y evaluaciones objetivas con estímulos controlados. El uso de CROS proporcionó beneficios en la localización del sonido, el efecto de sombra de la cabeza y la inteligibilidad del habla, pero no fue efectivo en situaciones ruidosas. Conclusión: Al tratarse de un dispositivo no invasivo, de fácil adaptación y manejo que aporta beneficios inmediatos, CROS debería ser la primera opción en la rehabilitación de la hipoacusia unilateral.

Introduction: The system Contralateral Routing of Signal (CROS) is an option of auditory intervention in order to improve the monaural perception and minimize the difficulties of unilateral hearing loss. Objective: to analyze and describe the target users, the adaptation time and the control use of CROS system, the evaluations utilized to measure its benefits, as well as its effectiveness and limitations. Method: This study was conducted according to the PRISMA guidelines. The bibliographic research was through the scientific data online banks in the health area, PubMed and Scopus, using the keywords "Unilateral hearing loss", "Hearing aid", "CROS" and "Contralateral Routing of Signal". The results of the research were limited to experimental scientific articles, which address directly the CROS system, published in English, Portuguese or Spanish. Results: Eleven studies were selected to review. The age of CROS users ranged from nine to 84 years and male sex prevalence. There was great diversity in the evaluations being carried out. The performance's evaluation date varied between less than 30 days and more than six months after the adaptation. Such assessments were performed using non-standardized questionnaires and objective evaluations with controlled stimuli. The use of CROS provides benefits in sound localization, head shadow effect and speech intelligibility, but it is not effective in noisy situations. Conclusion: CROS should be the first option in unilateral hearing loss rehabilitation for being a non-invasive, easy adaption, handling dispositive and with good benefits to the client.

Influence of the Mixtures of Vegetable Oil and Vitamin E over the Microstructure and Rheology of Organogels.

Candelilla wax (CW) and 12-hydroxystearic acid (12HSA) are classic solid-fiber-matrix organogelators. Despite the high number of studies using those ingredients in oily systems, there is scarce literature using a mixture of oil and antioxidants. Vitamin E (VE) is an important candidate for its lipophilicity and several applications on pharmaceutical, cosmetics, and food industries. In this work, we investigated the influences of mixtures between vegetable oil (VO) and VE on the microstructures and rheological properties of CW and 12HSA organogels. A weak gel (G''/G' > 0.1) with a shear-thinning behavior was observed for all samples. The presence of VE impacted the gel strength and the phase transition temperatures in a dose-dependent pattern. Larger and denser packed crystals were seen for 12HSA samples, while smaller and more dispersed structures were obtained for CW organogels. The results obtained in this work allowed the correlation of the structural and mechanical properties of the organogels, which plays an important role in the physical-chemical characteristics of these materials.

Frequency-Following Response and Auditory Middle Latency Response: an analysis of central auditory processing in young adults / Frequency-Following Response e Potencial Evocado Auditivo de Média Latência: uma análise frente ao processamento auditivo central de jovens adultos

ABSTRACT Purpose: to compare the latency and amplitude of the Frequency-Following Response and the Auditory Middle Latency Response in typical individuals and those with altered auditory abilities, as well as to investigate the sensitivity and specificity of both assessments in relation to central auditory processing. Methods: 32 individuals of both sexes were distributed into Group 1 (without altered auditory abilities) and Group 2 (with altered auditory abilities). The groups were divided according to behavioral tests of central auditory processing. Individuals in both groups underwent auditory evoked potentials. Student's t-test was used for analysis, considering a 5% significance. Results: in Group 2, V and A had higher latency and lower amplitude and slope. Group 2 also had lower Na and Pa amplitudes in waves A1C3 and A2C3. The Frequency-Following Response showed 93% sensitivity and specificity, while the Auditory Middle Latency Response showed 87% sensitivity and 93% specificity. Conclusion: the individuals presented with altered hearing abilities showed higher latency and lower response amplitude in the Frequency Following Response and Auditory Middle Latency Response compared to typical individuals. The Frequency- Following Response showed a better balance of sensitivity and specificity.

RESUMO Objetivo: comparar a latência e a amplitude do Frequency-Following Response e do Potencial Evocado Auditivo de Média Latência em indivíduos típicos e com alterações das habilidades auditivas, assim como investigar a sensibilidade e especificidade de ambas as avaliações frente ao processamento auditivo central. Métodos: 32 indivíduos de ambos os sexos foram distribuídos em Grupo 1 (sem alterações de habilidades auditivas) e Grupo 2 (com alteração em habilidades auditivas). Os grupos foram divididos de acordo com testes comportamentais do processamento auditivo central. Os indivíduos de ambos os grupos foram submetidos aos potenciais evocados auditivos. O teste T de Student foi utilizado para a análise, considerando 5% de significância. Resultados: no Grupo 2, V e A apresentaram maior latência e menor amplitude e slope. O Grupo 2 também apresentou menores amplitudes de Na e Pa nas ondas A1C3 e A2C3. O Frequency-Following Response apresentou 93% de sensibilidade e especificidade, enquanto o Potencial Evocado Auditivo de Média Latência apresentou 87% de sensibilidade e 93% de especificidade. Conclusão: os indivíduos com alteração das habilidades auditivas apresentaram maior latência e menor amplitude de resposta no Frequency Following Response e Potencial Evocado Auditivo de Média Latência em relação aos indivíduos típicos. O Frequency-Following Response apresentou melhor equilíbrio de sensibilidade e especificidade.

Hybrid Nanoparticles as an Efficient Porphyrin Delivery System for Cancer Cells to Enhance Photodynamic Therapy.

Photodynamic therapy (PDT) is a potential non-invasive approach for application in oncological diseases, based on the activation of a photosensitizer (PS) by light at a specific wavelength in the presence of molecular oxygen to produce reactive oxygen species (ROS) that trigger the death tumor cells. In this context, porphyrins are interesting PS because they are robust, have high chemical, photo, thermal, and oxidative stability, and can generate singlet oxygen (1O2). However, porphyrins exhibit low solubility and a strong tendency to aggregate in a biological environment which limits their clinical application. To overcome these challenges, we developed hybrid nanostructures to immobilize 5,10,15,20-tetrakis[(4-carboxyphenyl) thio-2,3,5,6-tetrafluorophenyl] (P), a new third-generation PS. The biological effect of this system was evaluated against bladder cancer (BC) cells with or without light exposition. The nanostructure composed of lipid carriers coated by porphyrin-chitosan (P-HNP), presented a size of ca. 130 nm and low polydispersity (ca. 0.25). The presence of the porphyrin-chitosan (P-chitosan) on lipid nanoparticle surfaces increased the nanoparticle size, changed the zeta potential to positive, decreased the recrystallization index, and increased the thermal stability of nanoparticles. Furthermore, P-chitosan incorporation on nanoparticles increased the stability and enhanced the self-organization of the system and the formation of spherical structures, as observed by small-angle X-ray scattering (SAXS) analysis. Furthermore, the immobilization process maintained the P photoactivity and improved the photophysical properties of PS, minimizing its aggregation in the cell culture medium. In the photoinduction assays, the P-HNP displayed high phototoxicity with IC50 3.2-folds lower than free porphyrin. This higher cytotoxic effect can be correlated to the high cellular uptake of porphyrin immobilized, as observed by confocal images. Moreover, the coated nanoparticles showed mucoadhesive properties interesting to its application in vivo. Therefore, the physical and chemical properties of nanoparticles may be relevant to improve the porphyrin photodynamic activity in BC cells.

Telemedicine Evaluations in Neuro-Ophthalmology During the COVID-19 Pandemic: Patient and Physician Surveys.

BACKGROUND: The novel coronavirus 2019 (COVID-19) pandemic has transformed health care. With the need to limit COVID-19 exposures, telemedicine has become an increasingly important format for clinical care. Compared with other fields, neuro-ophthalmology faces unique challenges, given its dependence on physical examination signs that are difficult to elicit outside the office setting. As such, it is imperative to understand both patient and provider experiences to continue to adapt the technology and tailor its application. The purpose of this study is to analyze both neuro-ophthalmology physician and patient satisfaction with virtual health visits during the time of the COVID-19 pandemic. METHODS: Across three institutions (NYU Langone Health, Indiana University Health, and Columbia University Medical Center), telemedicine surveys were administered to 159 patients. Neuro-ophthalmologists completed 157 surveys; each of these were linked to a single patient visit. Patient surveys consisted of 5 questions regarding visit preparation, satisfaction, challenges, and comfort. The physician survey included 4 questions that focused on ability to gather specific clinical information by history and examination. RESULTS: Among 159 patients, 104 (65.4%) reported that they were satisfied with the visit, and 149 (93.7%) indicated that they were comfortable asking questions. Sixty-eight (73.9%) patients found the instructions provided before the visit easy to understand. Potential areas for improvement noted by patients included more detailed preparation instructions and better technology (phone positioning, Internet connection, and software). More than 87% (137/157) of neuro-ophthalmologists surveyed reported having performed an examination that provided enough information for medical decision-making. Some areas of the neuro-ophthalmologic examination were reported to be easy to conduct (range of eye movements, visual acuity, Amsler grids, Ishihara color plates, and pupillary examination). Other components were more difficult (saccades, red desaturation, visual fields, convergence, oscillations, ocular alignment, and smooth pursuit); some were especially challenging (vestibulo-ocular reflex [VOR], VOR suppression, and optokinetic nystagmus). Clinicians noted that virtual health visits were limited by patient preparation, inability to perform certain parts of the examination (funduscopy and pupils), and technological issues. CONCLUSIONS: Among virtual neuro-ophthalmology visits evaluated, most offer patients with appointments that satisfy their needs. Most physicians in this cohort obtained adequate clinical information for decision-making. Even better technology and instructions may help improve aspects of virtual health visits.

Thyroglobulin/thyrotropin ratio for predicting long-term response in differentiated thyroid carcinoma: a retrospective study

ABSTRACT Objective: Thyrotropin-stimulated thyroglobulin (STg) after total thyroidectomy is a prognosis marker for differentiated thyroid carcinoma (DTC). As Tg level is influenced by thyrotropin (TSH), perhaps the STg/TSH ratio is also a prognosis marker for these tumours. We aimed to compare STg/TSH ratio and first STg level in differentiated thyroid carcinoma patients for their ability to predict the long-term response to initial treatment. Subjects and methods: This retrospective study evaluated data from 181 DTC patients for first (1st) STg and STg/TSH ratio, at 1-3 months post-total thyroidectomy and before iodine-131 therapy, according to response to initial therapy [Excellent/Indeterminate or Incomplete (Biochemical/Structural)] observed at final evaluation, and with the survival time with excellent/indeterminate response. Results: Cases with incomplete response presented higher STg level [225.13 ± 585.26 ng/mL versus (vs) 20.4 ± 192.9 ng/mL; p < 0.001] and STg/TSH ratio (3.01 ± 7.8 vs 0.27 ± 2.58; p < 0.001). Cutoffs of 5 ng/mL for STg and 0.085 for STg/TSH displayed sensitivities of 76.7% and 76.9%, and specificities of 79.2% and 82.6%, respectively, in predicting response to therapy. Values below these cutoffs were associated with longer survival time in excellent/indeterminate response (140.4 vs 15.9 and 144.6 vs 15.9 months, respectively). Conclusion: STg/TSH ratio has a similar performance to the 1st STg in predicting long-term response to initial therapy.