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1.
Magn Reson Med ; 92(3): 967-981, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38297511

ABSTRACT

PURPOSE: Hyperpolarized xenon MRI suffers from heterogeneous coil bias and magnetization decay that obscure pulmonary abnormalities. Non-physiological signal variability can be mitigated by measuring and mapping the nominal flip angle, and by rescaling the images to correct for signal bias and decay. While flip angle maps can be calculated from sequentially acquired images, scan time and breath-hold duration are doubled. Here, we exploit the low-frequency oversampling of 2D-spiral and keyhole reconstruction to measure flip angle maps from a single acquisition. METHODS: Flip angle maps were calculated from two images generated from a single dataset using keyhole reconstructions and a Bloch-equation-based model suitable for hyperpolarized substances. Artifacts resulting from acquisition and reconstruction schemes (e.g., keyhole reconstruction radius, slice-selection profile, spiral-ordering, and oversampling) were assessed using point-spread functions. Simulated flip angle maps generated using keyhole reconstruction were compared against the paired-image approach using RMS error (RMSE). Finally, feasibility was demonstrated for in vivo xenon ventilation imaging. RESULTS: Simulations demonstrated accurate flip angle maps and B1-inhomogeneity correction can be generated with only 1.25-fold central-oversampling and keyhole reconstruction radius = 5% (RMSE = 0.460°). These settings also generated accurate flip angle maps in a healthy control (RSME = 0.337°) and a person with cystic fibrosis (RMSE = 0.404°) in as little as 3.3 s. CONCLUSION: Regional lung ventilation images with reduced impact of B1-inhomogeneity can be acquired rapidly by combining 2D-spiral acquisition, Bloch-equation-based modeling, and keyhole reconstruction. This approach will be especially useful for breath-hold studies where short scan durations are necessary, such as dynamic imaging and applications in children or people with severely compromised respiratory function.


Subject(s)
Artifacts , Image Processing, Computer-Assisted , Lung , Magnetic Resonance Imaging , Xenon Isotopes , Humans , Magnetic Resonance Imaging/methods , Xenon Isotopes/chemistry , Image Processing, Computer-Assisted/methods , Lung/diagnostic imaging , Computer Simulation , Algorithms , Male , Female , Phantoms, Imaging , Adult , Breath Holding , Cystic Fibrosis/diagnostic imaging
2.
J Dairy Sci ; 106(1): 202-218, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36460513

ABSTRACT

Saccharomyces cerevisiae fermentation products are commonly used in dairy cattle ration to improve production efficiency and health. However, whether these benefits will persist during feed-restriction-induced negative energy balance is unknown. The objective of this experiment was to examine the effect of a Saccharomyces cerevisiae fermentation product (NT, NutriTek, Diamond V) on performance, metabolic, inflammatory, and immunological responses to a feed-restriction challenge in mid-lactation dairy cows. Sixty Holstein cows were blocked by parity, days in milk, and milk yield and then randomly assigned to 1 of the 2 supplements: NT or placebo (CTL). The supplements were mixed in total mixed ration before feeding at a rate of 19 g/d per cow. The production phase of the experiment lasted 12 wk. Intake and milk yield were recorded daily, and milk composition was measured weekly. After the production trial, a subset of cows (NT: n = 16; CTL: n = 16) were immediately enrolled in a 5-d feed-restriction challenge with 40% ad libitum intake followed by a 5-d realimentation. Milk yield and composition were measured at each milking from d -2 to 10 relative to feed restriction. Blood samples were collected on d -2, -1, 1, 2, 3, 4, 5, 6, 8, and 10 relative to the initiation of feed restriction to measure circulating metabolites, insulin, cortisol, IL-10, tumor necrosis factor-α, lipopolysaccharide binding protein, and haptoglobin. Immune function assessments, including peripheral mononuclear cell proliferation and functional assays of circulating granulocytes, were performed on d -3 and 4 of the feed restriction. No differences were observed in dry matter intake, milk yield, or concentrations or yield of components except for fat yield. An interaction of parity and treatment was observed for milk fat yield that was lower for CTL than NT in primiparous cows, but no differences were observed among treatments in milk fat yield of multiparous cows. Feed restriction successfully induced negative energy balance and its associated metabolic changes, including reduced concentrations of plasma glucose and increased nonesterified fatty acids and ß-hydroxybutyrate. Cows fed NT had a similar decrease in milk yield but had a more pronounced reduction in plasma glucose concentration and greater ß-hydroxybutyrate concentration during feed restriction than those fed CTL. Feed restriction did not induce evidence of systemic inflammation but did reduce granulocyte functional activity. Compared with CTL, feeding NT improved the reactive oxygen species production by granulocytes after stimulation by extracellular antigens. In conclusion, feeding NT increased milk fat production of first-lactation cows but did not affect overall productive performance. However, supplementation with NT improved induced granulocyte oxidative burst. This may explain the greater glucose utilization by cows fed NT rather than CTL during feed restriction.


Subject(s)
Blood Glucose , Saccharomyces cerevisiae , Pregnancy , Female , Cattle , Animals , Fermentation , Saccharomyces cerevisiae/metabolism , 3-Hydroxybutyric Acid , Blood Glucose/metabolism , Diet/veterinary , Lactation/physiology , Milk/chemistry , Animal Feed/analysis
3.
BMC Pediatr ; 22(1): 270, 2022 05 12.
Article in English | MEDLINE | ID: mdl-35549910

ABSTRACT

BACKGROUND: Childhood fractures can have a significant impact on the daily lives of families affecting children's normal activities and parent's work. Wrist fractures are the most common childhood fracture. The more serious wrist fractures, that can look visibly bent, are often treated with surgery to realign the bones; but this may not be necessary as bent bones straighten in growing children. The children's radius acute fracture fixation trial (CRAFFT) is a multicentre randomised trial of surgery versus a cast without surgery for displaced wrist fractures. Little is known about how families experience these wrist fractures and how they manage treatment uncertainty. This study aimed to understand families' experience of this injury and what it is like to be asked to include their child in a clinical trial. METHODS: Nineteen families (13 mothers, 7 fathers, 2 children) from across the UK participated in telephone interviews. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. RESULTS: Our findings highlight parents' desire to be a good parent through the overarching theme "protecting my injured child". To protect their child after injury, parents endeavoured to make the right decisions about treatment and provide comfort to their child but they experienced ongoing worry about their child's recovery. Our findings show that parents felt responsible for the decision about their child's treatment and their child's recovery. They also reveal the extent to which parents worried about the look of their child's wrist and their need for reassurance that the wrist was healing. CONCLUSION: Our findings show that protecting their child after injury can be challenging for parents who need support to make decisions about treatment and confidently facilitate their child's recovery. They also highlight the importance of providing information about treatments, acknowledging parents' concerns and their desire to do the right thing for their child, reassuring parents that their child's wrist will heal and ensuring parents understand what to expect as their child recovers.


Subject(s)
Radius Fractures , Child , Emotions , Female , Humans , Mothers , Parents , Qualitative Research , Radius Fractures/therapy
4.
BMC Pregnancy Childbirth ; 21(1): 357, 2021 May 05.
Article in English | MEDLINE | ID: mdl-33952188

ABSTRACT

BACKGROUND: There are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE. We aimed to evaluate the prevalence of non-severe maternal morbidities in puerperal women and factors associated to impaired clinical, social and mental health conditions. METHOD: A cross-sectional study with postpartum women at a high-risk outpatient clinic in southeast Brazil, from November 2017 to December 2018. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; the second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- impaired if ≥10), functionality (WHODAS- high disability scores when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with positive findings was performed, with a Poisson regression to investigate factors associated to impaired non-clinical and clinical conditions. RESULTS: Five hundred seventeen women were included, majority (54.3%) multiparous, between 20 and 34 years (65.4%) and with a partner (75,6%). Over a quarter had (26.2%) preterm birth. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance use and 5.9% reported exposure to violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and impaired functioning in 4.4% of women. Poisson regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduced perception of women on the presence of clinical morbidities. CONCLUSION: During postpartum care of a high-risk population, over one third of the considered women presented anxiety and depression; 10% reported substance use and around 6% exposure to violence. These aspects of women's health need further evaluation and specific interventions to improve quality of care.


Subject(s)
Depression, Postpartum/epidemiology , Pregnancy, High-Risk , Puerperal Disorders/epidemiology , Adult , Anxiety/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Exposure to Violence/statistics & numerical data , Female , Health Surveys , Humans , Poisson Distribution , Postpartum Period , Pregnancy , Premature Birth/epidemiology , Substance-Related Disorders/epidemiology , World Health Organization , Young Adult
5.
Lupus ; 28(12): 1417-1426, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31551036

ABSTRACT

OBJECTIVES: The objective of this article is to describe maternal and perinatal outcomes in women with systemic lupus erythematosus (SLE) followed in a high-risk prenatal outpatient clinic at a referral center. METHODS: This observational study included pregnant women with SLE who underwent prenatal follow-up and childbirth at the Women's Hospital, University of Campinas, from January 2012 to January 2018. All women were followed according to the institution's protocol for pregnant women with SLE. They were subdivided into two groups according to the presence of disease activity during the preconception and gestation periods, and evaluated according to the Systemic Lupus Erythematosus Disease Activity Index and Systemic Lupus Erythematosus Pregnancy Disease Activity Index scales. Data were retrieved from patients' medical records. Chi-square, Fisher exact and Mann-Whitney tests and multivariable analyses were performed. Statistical significance level was 5% (p < .05). RESULTS: A total of 125 cases were initially included; those who were lost to follow-up or gave birth at another hospital were further excluded, with 102 pregnancies (of 95 women) remaining. The mean age of the women was 27.7 years (SD 5.44), and 48% were in their first gestation. The average duration of disease was 6.79 years (SD 5.38), with 92.1% receiving SLE-specific therapy. SLE flare occurred in 8.9% during the preconception period and 23.5% during gestation. Preterm premature rupture of membranes (16.6%), preeclampsia or eclampsia (15.6%) and preterm labor (12.7%) were the most frequent complications. The mean gestational age at birth was 34.4 weeks (SD 5.9); the preterm birth rate was 46.8%, the low birth weight rate was 35.1%, and intensive neonatal care admission was 40.4%. Four fetal deaths and one maternal death occurred, all of them in the group with SLE flares. Multivariable logistic regression analysis showed that preconception lupus activity had a six-fold increased rate of gestational loss (odds ratio (OR): 6.14 (95% confidence interval (CI) 1.26-29.99)), and lupus activity during pregnancy had a five-fold increased rate of prematurity at less than 34 weeks (OR: 5.02 (95% CI: 1.90-13.30)). CONCLUSIONS: Despite the low percentages of women with pregestational and pregnancy-active disease, we found high incidences of maternal and perinatal complications. Preconception SLE activity increased gestational loss, and SLE activity during pregnancy increased prematurity. Effective immunosuppressive therapy was able to decrease clinical and laboratory activity of SLE; however, unfavorable perinatal outcomes still occurred, even when lupus activity was under control. Pregnancy in women with SLE is always a challenge.


Subject(s)
Lupus Erythematosus, Systemic/complications , Pregnancy Complications/prevention & control , Prenatal Care/standards , Adult , Brazil/epidemiology , Female , Fetal Death/etiology , Fetal Membranes, Premature Rupture/epidemiology , Gestational Age , Humans , Immunosuppressive Agents/therapeutic use , Incidence , Infant, Low Birth Weight , Intensive Care, Neonatal/statistics & numerical data , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/epidemiology , Maternal Death/statistics & numerical data , Obstetric Labor, Premature , Pre-Eclampsia/epidemiology , Preconception Care/standards , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Outcome/epidemiology , Premature Birth , Prenatal Care/methods , Retrospective Studies
6.
ScientificWorldJournal ; 2018: 6268276, 2018.
Article in English | MEDLINE | ID: mdl-30622442

ABSTRACT

Preeclampsia currently remains one of the leading causes of death and severe maternal morbidity. Although its prevalence is still underestimated in some places due to underreporting, preeclampsia is a disease that health professionals need to know how to deal with and take action. For this reason, the studies about the theme remain along with the advances in their understanding that often implies improvement and change of concepts and conducts. The complexity of its etiology is a challenge and requires further studies for its full understanding. Apparently, poor adaptation of the maternal organism to the conceptus, marked by the nonoccurrence of changes in the uterine spiral arteries, determines a series of systemic repercussions that compound the various forms of preeclampsia presentation. In recent years, the use of acetylsalicylic acid to prevent cases of early onset of the disease has been consolidated and, alongside, studies have advanced the development of accessible and effective methods of identifying women at risk of preeclampsia. The aim of this review is to discuss updates on the occurrence, concept, pathophysiology, repercussion, prevention, and prediction of preeclampsia.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antihypertensive Agents/therapeutic use , Aspirin/therapeutic use , Placenta/physiopathology , Pre-Eclampsia/physiopathology , Uterine Artery/physiopathology , ADAM12 Protein/genetics , ADAM12 Protein/metabolism , Adult , Biomarkers/metabolism , Female , Galectins/genetics , Galectins/metabolism , Humans , Laser-Doppler Flowmetry , Membrane Proteins/genetics , Membrane Proteins/metabolism , Placenta/blood supply , Placenta/diagnostic imaging , Placenta/drug effects , Pre-Eclampsia/diagnostic imaging , Pre-Eclampsia/genetics , Pre-Eclampsia/prevention & control , Pregnancy , Pregnancy Proteins/genetics , Pregnancy Proteins/metabolism , Pregnancy-Associated Plasma Protein-A/genetics , Pregnancy-Associated Plasma Protein-A/metabolism , Prognosis , Risk Factors , Uterine Artery/diagnostic imaging , Uterine Artery/drug effects , Vascular Endothelial Growth Factor Receptor-1/genetics , Vascular Endothelial Growth Factor Receptor-1/metabolism
7.
Genet Mol Res ; 16(3)2017 Aug 31.
Article in English | MEDLINE | ID: mdl-28873208

ABSTRACT

Citrus canker, caused by the Gram-negative bacterium Xanthomonas citri subsp citri (Xac), severely affects most economically important citrus varieties worldwide. A previous study showed that disruption of the ORF XAC1201 from the Xac 306 strain by transposon Tn5 decreased bacterium virulence in the Rangpur lime host (Citrus limonia L. Osbeck). However, little is known regarding the possible function of the hypothetical protein XAC1201 and how it affects the virulence of Xac 306. Here, we confirmed that disruption of ORF XAC1201 reduces Xac 306 virulence in two different hosts, delaying the onset of typical symptoms. In silico analysis suggested that XAC1201 interacts with the flagellar proteins FliM and FliL, known to be an important factor for virulence. In fact, motility assays revealed that the XAC1201 mutant has a significant difference in motility compared to the wild-type Xac 306. Also, a 3-D structure model revealed modified cofactor binding sites and suggested that XAC1201 has a non-functional HD domain. This hypothesis was confirmed by enzymatic assays performed in purified, XAC1201 recombinant protein expressed in Escherichia coli, which revealed no significant activities previously associated with HD domains for the tested substrates. Thus, the role of the XAC1201 protein in Xac 306 virulence seems to be related to flagellar motility, although a non-classic role for the HD domain cannot be dismissed.


Subject(s)
Flagella/metabolism , Movement , Open Reading Frames , Xanthomonas/genetics , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Flagella/genetics , Membrane Proteins/genetics , Membrane Proteins/metabolism , Mutation , Protein Binding , Protein Domains , Virulence/genetics , Xanthomonas/pathogenicity , Xanthomonas/physiology
8.
Trop Med Int Health ; 21(2): 183-93, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26578103

ABSTRACT

OBJECTIVE: To identify the burden of severe infection within the Brazilian Network for Surveillance of Severe Maternal Morbidity and factors associated with worse maternal outcomes. METHODS: This was a multicentre cross-sectional study involving 27 referral maternity hospitals in Brazil. WHO's standardised criteria for potentially life-threatening conditions and maternal near miss were used to identify cases through prospective surveillance and the main cause of morbidity was identified as infection or other causes (hypertension, haemorrhage or clinical/surgical). Complications due to infection were compared to complications due to the remaining causes of morbidity. Factors associated with a severe maternal outcome were assessed for the cases of infection. RESULTS: A total of 502 (5.3%) cases of maternal morbidity were associated with severe infection vs. 9053 cases (94.7%) with other causes. Considering increased severity of cases, infection was responsible for one-fourth of all maternal near miss (23.6%) and nearly half (46.4%) of maternal deaths, with a maternal near miss to maternal death ratio three times (2.8:1) that of cases without infection (7.8:1) and a high mortality index (26.3%). Within cases of infection, substandard care was present in over one half of the severe maternal outcome cases. Factors independently associated with worse maternal outcomes were HIV/AIDS, hysterectomy, prolonged hospitalisation, intensive care admission and delays in medical care. CONCLUSIONS: Infection is an alarming cause of maternal morbidity and mortality and timely diagnosis and adequate management are key to improving outcomes during pregnancy. Delays should be addressed, risk factors identified, and specific protocols of surveillance and care developed for use during pregnancy.


Subject(s)
Hospitals, Maternity , Infections/epidemiology , Maternal Death/etiology , Maternal Mortality , Pregnancy Complications, Infectious/epidemiology , Prenatal Care , Quality of Health Care , Brazil/epidemiology , Critical Care , Cross-Sectional Studies , Female , Hospitals, Maternity/standards , Humans , Infections/mortality , Length of Stay , Morbidity , Pregnancy , Pregnancy Complications, Infectious/mortality , Prenatal Care/standards , Prospective Studies , Risk Factors , Sepsis/epidemiology , Sepsis/mortality , Severity of Illness Index
9.
BMC Infect Dis ; 16: 220, 2016 05 21.
Article in English | MEDLINE | ID: mdl-27207244

ABSTRACT

BACKGROUND: The aim of this study was to assess the burden of respiratory disease, considering the influenza A pandemic season (H1N1pdm09), within the Brazilian Network for Surveillance of Severe Maternal Morbidity, and factors associated with worse maternal outcome. METHODS: A multicenter cross-sectional study, involving 27 referral maternity hospitals in five Brazilian regions. Cases were identified in a prospective surveillance by using the WHO standardized criteria for potentially life-threatening conditions (PLTC) and maternal near miss (MNM). Women with severe complications from respiratory disease identified as suspected or confirmed cases of H1N1 influenza or respiratory failure were compared to those with other causes of severe morbidity. A review of suspected H1N1 influenza cases classified women as non-tested, tested positive and tested negative, comparing their outcomes. Factors associated with severe maternal outcome (SMO = MNM + MD) were assessed in both groups, in comparison to PLTC, using PR and 95 % CI adjusted for design effect of cluster sampling. RESULTS: Among 9555 cases of severe maternal morbidity, 485 (5 %) had respiratory disease. Respiratory disease occurred in one-quarter of MNM cases and two-thirds of MD. H1N1 virus was suspected in 206 cases with respiratory illness. Around 60 % of these women were tested, yielding 49 confirmed cases. Confirmed H1N1 influenza cases had worse adverse outcomes (MNM:MD ratio < 1 (0.9:1), compared to 12:1 in cases due to other causes), and a mortality index > 50 %, in comparison to 7.4 % in other causes of severe maternal morbidity. Delay in medical care was associated with SMO in all cases considered, with a two-fold increased risk among respiratory disease patients. Perinatal outcome was worse in cases complicated by respiratory disease, with increased prematurity, stillbirth, low birth weight and Apgar score < 7. CONCLUSIONS: Respiratory disease, especially considering the influenza season, is a very severe cause of maternal near miss and death. Increased awareness about this condition, preventive vaccination during pregnancy, early diagnosis and treatment are required to improve maternal health.


Subject(s)
Influenza A Virus, H1N1 Subtype/physiology , Influenza, Human/complications , Pregnancy Complications/mortality , Respiratory Tract Diseases/mortality , Adult , Brazil/epidemiology , Cross-Sectional Studies , Female , Hospitals, Maternity , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Influenza, Human/virology , Maternal Mortality , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/virology , Prospective Studies , Referral and Consultation , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/etiology , Young Adult
10.
BJOG ; 123(6): 946-53, 2016 May.
Article in English | MEDLINE | ID: mdl-26412586

ABSTRACT

OBJECTIVE: To identify cases of severe maternal morbidity (SMM) during pregnancy and childbirth, their characteristics, and to test the feasibility of scaling up World Health Organization criteria for identifying women at risk of a worse outcome. DESIGN: Multicentre cross-sectional study. SETTING: Twenty-seven referral maternity hospitals from all regions of Brazil. POPULATION: Cases of SMM identified among 82 388 delivering women over a 1-year period. METHODS: Prospective surveillance using the World Health Organization's criteria for potentially life-threatening conditions (PLTC) and maternal near-miss (MNM) identified and assessed cases with severe morbidity or death. MAIN OUTCOME MEASURES: Indicators of maternal morbidity and mortality; sociodemographic, clinical and obstetric characteristics; gestational and perinatal outcomes; main causes of morbidity and delays in care. RESULTS: Among 9555 cases of SMM, there were 140 deaths and 770 cases of MNM. The main determining cause of maternal complication was hypertensive disease. Criteria for MNM conditions were more frequent as the severity of the outcome increased, all combined in over 75% of maternal deaths. CONCLUSIONS: This study identified around 9.5% of MNM or death among all cases developing any severe maternal complication. Multicentre studies on surveillance of SMM, with organised collaboration and adequate study protocols can be successfully implemented, even in low-income and middle-income settings, generating important information on maternal health and care to be used to implement appropriate health policies and interventions. TWEETABLE ABSTRACT: Surveillance of severe maternal morbidity was proved to be possible in a hospital network in Brazil.


Subject(s)
Hospitals, Maternity/statistics & numerical data , Population Surveillance/methods , Pregnancy Complications/epidemiology , Brazil/epidemiology , Cooperative Behavior , Cross-Sectional Studies , Female , Hospitals, Maternity/organization & administration , Humans , Maternal Mortality , Near Miss, Healthcare/statistics & numerical data , Pregnancy , Pregnancy Complications/etiology , Pregnancy Complications/mortality , Prospective Studies , Severity of Illness Index , World Health Organization
11.
J Insect Sci ; 16(1)2016.
Article in English | MEDLINE | ID: mdl-27638956

ABSTRACT

As the incidence of Anastrepha fraterculus (Wiedemann) has increased in Southern Brazil in the past 3 yr, an initiative to release sterile flies and parasitoids has started. In order to make feasible the mass-rearing of the parasitoid Diachasmimorpha longicaudata (Ashmed), this study investigated the suitability of A. fraterculus larvae derived from irradiated eggs as host for D. longicaudata Two different ages of A. fraterculus eggs (24 and 48 h old) were analyzed for hatchability after the exposure to a range of radiation doses. The hatchability of 48-h-old eggs was not affected by radiation, and no fly emerged at doses higher than 27.5 Gy. The larvae derived from irradiated eggs proved to be suitable hosts for the parasitoid development, with observed parasitism rates higher than 70% and sex ratio values above 0.6. The parasitism capability and longevity of D. longicaudata reared on larvae derived from irradiated eggs were also assessed. During the 10 d of parasitism evaluated, D. longicaudata from the treatments were able to parasitize nonirradiated larvae similarly as the parasitoids from controls and the laboratory colony. The longevity of D. longicaudata from the treatments was not affected either, with survival rates higher than 80% after 20 d of evaluation. The age of 48 h and a dose of 30 Gy could be considered the best age and dose for A. fraterculus eggs to be used in the mass-rearing of D. longicaudata The results of this study will decrease the costs of mass-rearing D. longicaudata on A. fraterculus.


Subject(s)
Hymenoptera/physiology , Ovum/radiation effects , Pest Control, Biological/methods , Tephritidae/parasitology , Tephritidae/radiation effects , Animals , Larva/growth & development , Larva/parasitology , Larva/physiology , Larva/radiation effects , Radiation Exposure/analysis , Tephritidae/growth & development
12.
Br Med Bull ; 115(1): 165-72, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26311503

ABSTRACT

INTRODUCTION: Hip fracture poses a significant global challenge both to healthcare systems and to patients themselves. We outline the management of this injury, highlight areas where the evidence is deficient and discuss research efforts towards improving the quality of the evidence base. SOURCES OF DATA: We searched MEDLINE, PubMed and the Cochrane Library, using the core search terms 'hip fracture' and 'proximal femoral fracture'. In addition we reviewed national treatment guidelines for hip fracture care and references from relevant articles. Only articles published in English from inception to March 2015 were included. AREAS OF AGREEMENT: Modern hip fracture management should consist of a coordinated multidisciplinary approach with orthogeriatrician input, early surgery, adequate analgesia and liaison with related services to facilitate safe supported discharge. AREAS OF CONTROVERSY: The optimum thromboprophylaxis to reduce venous thromboembolism remains a topic for debate. The use of bone cement has received much attention recently with concerns about its safety in the frailest of hip fracture patients. GROWING POINTS: An increasing understanding of the severity and impact of sustaining a hip fracture upon quality of life. AREAS TIMELY FOR DEVELOPING RESEARCH: Strategies to improve postoperative mobility, postoperative nutrition and the role of home-based rehabilitation. There is a need to identify the optimum analgesic regimes and assessment tools for hip fracture patients with cognitive impairment.


Subject(s)
Fracture Fixation, Internal/methods , Hip Fractures/surgery , Osteoporotic Fractures/surgery , Analgesia/methods , Anesthesia/methods , Fracture Fixation, Internal/adverse effects , Hip Fractures/diagnosis , Hip Fractures/prevention & control , Humans , Osteoporotic Fractures/diagnosis , Osteoporotic Fractures/prevention & control , Patient Care Team , Thrombosis/prevention & control
13.
Anaesthesia ; 70(5): 623-6, 2015 May.
Article in English | MEDLINE | ID: mdl-25866041

ABSTRACT

Concise guidelines are presented for the preparation and conduct of anaesthesia and surgery in patients undergoing cemented hemiarthroplasty for hip fracture. The Working Party specifically considered recent publications highlighting complications occurring during the peri-operative period. The advice presented is based on previously published advice and clinical studies.


Subject(s)
Arthroplasty/adverse effects , Arthroplasty/standards , Bone Cements/adverse effects , Consensus , Humans , Ireland , Patient Safety , Perioperative Care/standards , Syndrome , United Kingdom
14.
Br J Surg ; 101(8): 959-64, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24915789

ABSTRACT

BACKGROUND: Centralization of complex healthcare services into specialist high-volume centres is believed to improve outcomes. For injured patients, few studies have evaluated the centralization of major trauma services. The aim of this study was to evaluate how a regional trauma network affected trends in admissions, case mix, and outcomes of injured patients. METHODS: A retrospective before-after study was undertaken of severely injured patients attending four hospitals that became major trauma centres (MTCs) in March 2012. Consecutive patients with major trauma were identified from a national registry and divided into two groups according to injury before or after the launch of a new trauma network. The two cohorts were compared for differences in case mix, demand on hospital resources, and outcomes. RESULTS: Patient volume increased from 442 to 1326 (200 per cent), operations from 349 to 1231 (253 per cent), critical care bed-days from 1100 to 3704 (237 per cent), and total hospital bed-days from 7910 to 22,772 (188 per cent). Patient age increased on MTC designation from 45.0 years before March 2012 to 48.2 years afterwards (P = 0.021), as did the proportion of penetrating injuries (1.8 versus 4.1 per cent; P = 0.025). Injury severity fell as measured by median Injury Severity Score (16 versus 14) and Revised Trauma Score (4.1 versus 7.8). Fewer patients required secondary transfer to a MTC from peripheral hospitals (19.9 versus 16.1 per cent; P = 0.100). There were no significant differences in total duration of hospital stay, critical care requirements or mortality. However, there was a significant increase, from 55.5 to 62.3 per cent (P < 0.001), in the proportion of patients coded as having a 'good recovery' at discharge after institution of the trauma network. CONCLUSION: MTC designation leads to an increased case volume with considerable implications for operating theatre capacity and bed occupancy. Although no mortality benefit was demonstrated within 6 months of establishing this trauma network, early detectable advantages included improved functional outcome at discharge.


Subject(s)
Hospitalization/statistics & numerical data , Trauma Centers/organization & administration , Wounds and Injuries/surgery , Adult , Bed Occupancy/statistics & numerical data , Critical Care/statistics & numerical data , Diagnosis-Related Groups , England , Hospitalization/trends , Humans , Injury Severity Score , Middle Aged , Retrospective Studies , Trauma Centers/statistics & numerical data , Wounds and Injuries/mortality
15.
J Radiol Prot ; 33(4): 839-53, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24080901

ABSTRACT

Radiation sources have being widely used in industrial applications, but their inappropriate use presents a large potential for hazards to human health and the environment. These hazards can be minimised by development of specific radiation protection rules and adequate procedures for the handling, use and storage of radiation sources, which should be established in a national normative framework. Recently, due to discovery of new oil and gas reservoirs on the Brazilian continental shelf, especially in deep water and the pre-salt layer, there has been a large and rapid increase in the use of radiation sources for well logging. Generic radiation protection regulations have been used for licensing the use of radiation sources for well logging, but these are not comprehensive or technically suitable for this purpose. Therefore it is necessary to establish specific Brazilian safety regulations for this purpose. In this work, an assessment is presented of the relevant radiation protection aspects of nuclear well logging not covered by generic regulations, with the aim of contributing to the future development of specific safety regulations for the licensing of radioactive facilities for oil and gas well logging in Brazil. The conclusions of this work relate to four areas, which include the specific requirements to control (1) radiation sources, (2) radiation survey meters and (3) access to radiation workplaces and (4) to control and identify the workers who are occupationally exposed.


Subject(s)
Natural Gas/analysis , Oil and Gas Fields/chemistry , Petroleum/analysis , Radiation Injuries/prevention & control , Radiation Monitoring/methods , Radiation Protection/methods , Radioisotopes/analysis , Brazil , Humans , Occupational Exposure/analysis , Occupational Exposure/prevention & control , Safety Management/methods
16.
Braz J Med Biol Res ; 56: e13052, 2023.
Article in English | MEDLINE | ID: mdl-37909498

ABSTRACT

Darwin's theory of evolution, which is based on variation, heredity, and selection, includes all biological fields and spreads to other areas such as philosophy. Medicine is an example of how the evolutionary perspective can greatly improve the understanding of concepts in an area, as human health and pathological conditions are under the effect of evolution. Evolutionary medicine is an emerging paradigm for understanding human heterogeneity, health, and diseases. Nevertheless, there are indications that medical research and practice are only marginally affected by these ideas. Here, we investigate how concepts of biological evolution are employed in medical research. We use a bibliometric approach to look for the presence and frequency of biological evolution-related concepts in medical articles. The distribution of these concepts over the years is analyzed according to the medical specialty and the impact of the journal. Our data showed that: i) only a small percentage of articles in medical journals have an evolutionary perspective; ii) medical journals where these evolution-based articles are published focus on basic science, theoretical medicine, and less frequently, on applied medicine; iii) these articles are mostly from the microbiology, immunology, neurology, psychology, behavior, and oncology fields; and iv) viruses are the most frequently covered microorganisms, followed by bacteria, fungi, and protozoans. The collection of our results, considering the importance of evolutionary medicine in the medical field, highlights the need for a decisive change in perspective in medical research.


Subject(s)
Biological Evolution , Medicine , Humans , Biology
17.
Osteoporos Int ; 23(6): 1691-8, 2012 Jun.
Article in English | MEDLINE | ID: mdl-21881967

ABSTRACT

UNLABELLED: Prospective cohort study performed to evaluate bone mineral density (BMD) changes up to 12 months postpartum of healthy women and its association with breastfeeding, contraceptive methods, amenorrhea, and body mass index (BMI). There is a trend in bone loss during the first 6 months with posterior recovery, with evidence of a protective effect of hormonal contraception. INTRODUCTION: This study was conducted to evaluate bone mineral density (BMD) changes during postpartum period among healthy women and its association with breastfeeding, use of contraceptive methods, amenorrhea and body mass index (BMI). METHODS: A prospective cohort study including 100 healthy women. Distal BMD was measured 7-10 days, 3, 6, and 12 months postpartum at the nondominant forearm using dual-energy X-ray absorptiometry. Data about breastfeeding duration, amenorrhea, contraceptive use and BMI were collected. RESULTS: Seventy-eight women had a complete set of BMD measurements. The mean duration of exclusive breastfeeding was 125.9 (±66.6) days, with a median total lactation period of 263.5 days. The mean duration of amenorrhea was 164.2 (±119.2) days. BMD measurements showed a significant decrease in the distal radius, however with no significance in the ultradistal radius. When considering only the nonhormonal contraceptive users, the difference at 12 months was significant. Multivariate analysis of variance showed that both BMI and contraceptive use were significantly correlated with BMD. Multiple linear regression analysis showed significant correlation of distal radius with baseline BMD at the same site, pregestational BMI, age, years of schooling and difference in BMI. For ultradistal radius, there was a significant direct correlation with its baseline BMD and pregestational BMI. CONCLUSIONS: There was a trend in bone loss during the first 6 months postpartum with posterior recovery. Also, hormonal contraceptive methods provided protection of bone loss. However, the long duration of breastfeeding and the follow-up were not sufficient to draw definitive conclusions on postweaning BMD conditions.


Subject(s)
Amenorrhea/physiopathology , Bone Density/physiology , Breast Feeding , Radius/diagnostic imaging , Absorptiometry, Photon , Adolescent , Adult , Body Mass Index , Contraceptive Agents/pharmacology , Female , Follow-Up Studies , Humans , Postpartum Period/physiology , Prospective Studies , Radius/drug effects , Young Adult
18.
J Phys Chem A ; 115(30): 8447-57, 2011 Aug 04.
Article in English | MEDLINE | ID: mdl-21707051

ABSTRACT

Methyl 2-azidopropionate (N(3)CH(3)CHCOOCH(3), M2AP) has been synthesized and characterized by different spectroscopic methods, and the thermal decomposition of this molecule has been investigated by matrix isolation infrared (IR) spectroscopy and ultraviolet photoelectron spectroscopy (UVPES). Computational methods have been employed in the spectral simulation of both UVPES and matrix IR spectra and in the rationalization of the thermal decomposition results. M2AP presents a HOMO vertical ionization energy (VIE) of 9.60 ± 0.03 eV and contributions from all four lowest-energy conformations of this molecule are detected in the gas phase. Its thermal decomposition starts at ca. 400 °C and is complete at ca. 650 °C, yielding N(2), CO, CO(2), CH(3)CN, and CH(3)OH as the final decomposition products. Methyl formate (MF) and CH(4) are also found during the pyrolysis process. Analysis of the potential energy surface of the decomposition of M2AP indicates that M2AP decomposes preferentially into the corresponding imine (M2IP), through a 1,2-H shift synchronous with the N(2) elimination (Type 1 mechanism), requiring an activation energy of 160.8 kJ/mol. The imine further decomposes via two competitive routes: one accounting for CO, CH(3)OH, and CH(3)CN (ΔE(G3) = 260.2 kJ/mol) and another leading to CO(2), CH(4), and CH(3)CN (ΔE(G3) = 268.6 kJ/mol). A heterocyclic intermediate (Type 2 mechanism)-4-Me-5-oxazolidone-can also be formed from M2AP via H transfer from the remote O-CH(3) group, together with the N(2) elimination (ΔE(G3) = 260.2 kJ/mol). Finally, a third pathway which accounts for the formation of MF through an M2AP isomer is envisioned.


Subject(s)
Azides/chemistry , Heterocyclic Compounds/chemistry , Imines/chemical synthesis , Propionates/chemistry , Thermodynamics , Ultraviolet Rays , Azides/chemical synthesis , Imines/chemistry , Models, Molecular , Photoelectron Spectroscopy , Propionates/chemical synthesis , Quantum Theory , Spectrophotometry, Infrared
19.
J Nanosci Nanotechnol ; 11(10): 9025-31, 2011 Oct.
Article in English | MEDLINE | ID: mdl-22400296

ABSTRACT

Composite of multi-walled carbon nanotubes (MWCNT) and epoxy resin DGEBA were obtained with DDM hardener. The MWCNT were synthesized with length of millimeters by camphor/ferrocene pyrolysis. Different cure temperatures of DGEBA/DDM with addition of up to 1% MWCNT were studied to evaluate eventual changes in cure kinetics by differential scanning calorimetry (DSC). No change was detected in glass transition temperature with insertion of MWCNT although the cure enthalpy has been reduced.

20.
Braz J Med Biol Res ; 54(12): e11728, 2021.
Article in English | MEDLINE | ID: mdl-34669784

ABSTRACT

A close interaction between basic science and applied medicine is to be expected. Therefore, it is important to measure how far apart the field of cell biology and medicine are. Our approach to estimating the distance between these fields was to compare their vocabularies and to quantify the difference in word repertoire. We compared the vocabulary of the title and abstract of articles available in PubMed in two selected high-impact journals in each field: cell biology, medicine, and translational science. Although each journal has its own editorial policy, we showed that within each field there is a small vocabulary difference between the two journals. We developed a word similarity index that can measure how much journals share a common vocabulary. We found a high similarity index between each cell biology (91%), medical (71-74%), and translational journal (65%). In contrast, the comparison between medicine and biology journals produced low correlation values (22-36%), suggesting that their vocabularies are quite dissimilar. Translational medicine journals had medium similarity values when compared to cell biology journals (52-70%) and medicine journals (27-59%). This approach was also performed in 10-year periods to evaluate the evolution of each field. Using the "onomics" strategy presented here, we observed that differences in vocabulary of basic science and medicine have been increasing over time. Since translational medicine has an intermediate vocabulary, we confirmed that translational medicine is an efficient approach to bridge this gap.


Subject(s)
Vocabulary
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