Association between Religiousness and Quality of Life among Patients in Brazil diagnosed with Idiopathic Parkinson's Disease.

The importance of religiousness in idiopathic Parkinson's disease (IPD) has been the subject of conflicting research. The impact of religiousness on quality of life and depressive symptoms has also been poorly studied in this population. This study investigated the correlation between religiousness and quality of life in patients with IPD. We evaluated 37 patients with IPD (according to the criteria of the Movement Disorders Society) who were from an outpatient clinic specializing in movement disorders in Brazil. We assessed the patients using the Duke University Religion Index and scales for motor impairment, cognition, quality of life, and depression. Spearman's test was used to check for possible correlations between the different dimensions of religiousness and the clinical variables analyzed. Patients with a worse quality of life and more depressive symptoms showed greater intrinsic religiousness.

Angle-closure glaucoma associated with vitreous prolapse after neodymium-doped yttrium-aluminumgarnet laser posterior capsulotomy.

Capsulotomy with neodymium-doped yttriumaluminum-garnet (Nd:YAG) laser is an effective treatment for posterior capsule opacification following cataract surgery. A wide opening of the posterior capsule associated with the ruptured anterior hyaloid can cause anterior chamber vitreous prolapse. Two patients who developed angle-closure glaucoma associated with vitreous prolapse following Nd:YAG laser posterior capsulotomy were successfully treated with antiglaucoma medication and peripheral iridotomies. Patient identification for potential risk factors and a careful postoperative follow-up are essential to avoid these serious complications.

Angle-closure glaucoma associated with vitreous prolapse after neodymium-doped yttrium-aluminum-garnet laser posterior capsulotomy

ABSTRACT Capsulotomy with neodymium-doped yttrium--aluminum-garnet (Nd:YAG) laser is an effective treatment for posterior capsule opacification following cataract surgery. A wide opening of the posterior capsule associated with the ruptured anterior hyaloid can cause anterior chamber vitreous prolapse. Two patients who developed angle-closure glaucoma associated with vitreous prolapse following Nd:YAG laser posterior capsulotomy were successfully treated with antiglaucoma medication and peripheral iridotomies. Patient identification for potential risk factors and a careful postoperative follow-up are essential to avoid these serious complications.

Diffusion-weighted imaging in pediatric extracranial germ cell tumors.

BACKGROUND: Germ cell tumors (GCTs) comprise a rare and heterogeneous group of neoplasms presenting different clinical and histological characteristics, leading to a challenging scenario in clinical practice. Diffusion-weighted imaging (DWI) has been suggested as an indirect marker of tumor density and cellularity and could be used to monitor therapeutic response. However, its role in pediatric GCTs needs to be clarified. PURPOSE: Here, we evaluated the features of DWI in pediatric extracranial GCTs in a reference Brazilian institution. MATERIAL AND METHODS: We included 43 pediatric patients with primary GCTs treated between 2008 and 2022 in Hospital de Amor de Barretos. The patients' MRI images included T1-weighted without contrast, T2-weighted, DWI and apparent diffusion coefficient (ADC) maps. DWI was evaluated in the section that exhibited the greatest restricted diffusion in the largest hypersignal area of the image. The lowest ADC value was determined to define the region of interest (ROI). We used a small ROI, avoiding necrotic, adipose tissue, noisy or nonenhancing lesion voxels as recommended. ROI determination was established by visual inspection by two radiologists in accordance. We used two values of b (b = 50 mm2/s or b = 800) for ADC values. RESULTS: The highest mean ADC (mADC) value was observed in pure teratomas (1,403.50 ± 161.76 x10-3 mm2/s; mean ± SD) compared to other histologies (yolk sac, mixed teratoma, dysgerminoma and mixed GCT) of GCT (p<0.001). Furthermore, ROC analysis determined a cutoff mADC value of 1,179.00 x 10-3 mm2/s that differentiated pure teratomas from the other GCT histologies with a sensitivity of 95.8% and a specificity of 92.9% (AUC = 0.979; p<0.01). A significant increase in mADC was observed for malignant GCTs in treatment (1,197.00 ± 372.00 mm2/s; p<0.001) compared to that exhibited at the time of diagnosis (780.00 ± 168.00 mm2/s; mean ± SD. Our findings suggest that mADC assessment could be used as a tool to distinguish pure teratomas from malignant CGT histologies at diagnosis. Additionally, we demonstrated reasonable evidence that it could be used as a complementary tool to monitor treatment response in patients with malignant GCT.

Sarcopenia in Children With Wilms Tumor: A Marker of Undernutrition Which May Impact Adversely on Clinical Outcomes.

The therapeutic approach to Wilms tumor (WT) is multidisciplinary and leads to significant patient impairment, increasing the risk of nutritional compromise and malnutrition. Children with cancer are vulnerable to sarcopenia which has been recognized as a negative impact of anticancer therapy. Recent studies have highlighted the reduction in the total psoas muscle area (TPMA) to be associated with a poor prognosis in many pediatric diseases, including cancer. This study aims to evaluate changes in the TPMA compartment during the treatment of children with WT. An observational, longitudinal, and retrospective study was undertaken in a single institution evaluating children (1 to 14 y, n=38) with WT between 2014 and 2020. TPMA was assessed by the analysis of previously collected, electronically stored computed tomography images of the abdomen obtained at 3 time points: diagnosis, preoperatively, and 1 year after surgery. For all patients, TPMA/age were calculated with a specific online calculator. Our data show a high incidence of sarcopenia (55.3%) at diagnosis which increased after 4 to 6 weeks of neoadjuvant chemotherapy (73.7%) and remained high (78.9%) 1 year after the surgical procedure. Using TPMA/age Z-score curves we have found significant and rapid muscle loss in children with WT, with little or no recovery in the study period.

Maternal Chronic Ultrasound Stress Provokes Immune Activation and Behavioral Deficits in the Offspring: A Mouse Model of Neurodevelopmental Pathology.

Neurodevelopmental disorders stemming from maternal immune activation can significantly affect a child's life. A major limitation in pre-clinical studies is the scarcity of valid animal models that accurately mimic these challenges. Among the available models, administration of lipopolysaccharide (LPS) to pregnant females is a widely used paradigm. Previous studies have reported that a model of 'emotional stress', involving chronic exposure of rodents to ultrasonic frequencies, induces neuroinflammation, aberrant neuroplasticity, and behavioral deficits. In this study, we explored whether this model is a suitable paradigm for maternal stress and promotes neurodevelopmental abnormalities in the offspring of stressed females. Pregnant dams were exposed to ultrasound stress for 21 days. A separate group was injected with LPS on embryonic days E11.5 and E12.5 to mimic prenatal infection. The behavior of the dams and their female offspring was assessed using the sucrose test, open field test, and elevated plus maze. Additionally, the three-chamber sociability test and Barnes maze were used in the offspring groups. ELISA and qPCR were used to examine pro-inflammatory changes in the blood and hippocampus of adult females. Ultrasound-exposed adult females developed a depressive-like syndrome, hippocampal overexpression of GSK-3ß, IL-1ß, and IL-6 and increased serum concentrations of IL-1ß, IL-6, IL-17, RANTES, and TNFα. The female offspring also displayed depressive-like behavior, as well as cognitive deficits. These abnormalities were comparable to the behavioral changes induced by LPS. The ultrasound stress model can be a promising animal paradigm of neurodevelopmental pathology associated with prenatal 'emotional stress'.

Sudden cardiac death multiparametric classification system for Chagas heart disease's patients based on clinical data and 24-hours ECG monitoring.

About 6.5 million people are infected with Chagas disease (CD) globally, and WHO estimates that $ > million people worldwide suffer from ChHD. Sudden cardiac death (SCD) represents one of the leading causes of death worldwide and affects approximately 65% of ChHD patients at a rate of 24 per 1000 patient-years, much greater than the SCD rate in the general population. Its occurrence in the specific context of ChHD needs to be better exploited. This paper provides the first evidence supporting the use of machine learning (ML) methods within non-invasive tests: patients' clinical data and cardiac restitution metrics (CRM) features extracted from ECG-Holter recordings as an adjunct in the SCD risk assessment in ChHD. The feature selection (FS) flows evaluated 5 different groups of attributes formed from patients' clinical and physiological data to identify relevant attributes among 57 features reported by 315 patients at HUCFF-UFRJ. The FS flow with FS techniques (variance, ANOVA, and recursive feature elimination) and Naive Bayes (NB) model achieved the best classification performance with 90.63% recall (sensitivity) and 80.55% AUC. The initial feature set is reduced to a subset of 13 features (4 Classification; 1 Treatment; 1 CRM; and 7 Heart Tests). The proposed method represents an intelligent diagnostic support system that predicts the high risk of SCD in ChHD patients and highlights the clinical and CRM data that most strongly impact the final outcome.

Antichagasic evaluation, molecular docking and ADMET properties of the chalcone (2E)-3-(2-fluorophenyl)-1-(2-hydroxy- 3,4,6-trimethoxyphenyl)prop-2-en-1-one against Trypanosoma cruzi.

Characterized as a neglected disease, Chagas disease is an infection that, in the current scenario, affects about 8 million people per year, with a higher incidence in underdeveloped countries, Chagas is responsible for physiological disabilities that result in impacts that are slightly reflected in world socioeconomic stability. Although treatments are based on drugs such as Benznidazole, the pathology lacks a continuous treatment method with low toxicological incidence. The present study estimates the anti-chagasic activity of the synthetic chalcone CPN2F based on the alignment between in vitro tests and structural classification in silico studies, molecular docking and ADMET studies. The in vitro tests showed a reduction in the protozoan metabolism in host cells (LLC-MK2). At the same time, the molecular docking models evaluate this growth inhibition through the synergistic effect associated with Benznida- zole against validated therapeutic target key stages (Cruzaine TcGAPDH and Trypanothione reductase) of the Trypanosoma cruzi development cycle. The in silico prediction results reveal an alignment between pharmacokinetic attributes, such as renal absorption and release, which allow the preparation of CPN2F as an antichagasic drug with a low incidence of organic toxicity.Communicated by Ramaswamy H. Sarma.

Prediction of sudden cardiac death for chagasic patients / Predição de morte súbita cardíaca em pacientes chagásicos / Predicción de muerte súbita cardíaca en pacientes chagásicos federados

Objective: Identify the risk of patients with Chronic Chagas Cardiomyopathy (CCC) to prevent them from having Sudden Cardiac Death (SCD). Methods: We developed an SCD prediction system using a heterogeneous dataset of chagasic patients evaluated in 9 state-of-the-art machine learning algorithms to select the most critical clinical variables and predict SCD in chagasic patients even when the interval between the most recent exams and the SCD event is months or years. Results: 310 patients were analyzed, being 81 (14,7%) suffering from SCD. In the study, Balanced Random Forest showed the best performance, with AUC:80.03 and F1:75.12. Due to their high weights in the machine learning classifiers, we suggest Holter - Non-Sustained Ventricular Tachycardia, Total Ventricular Extrasystoles, Left Ventricular Systolic Diameter, Syncope, and Left Ventricular Diastolic Diameter as essential features to identify SCD. Conclusion: The high-risk pattern of SCD in patients with CCC can be identified and prevented based on clinical and laboratory variables.

Objetivo: Identificar o risco de pacientes com Cardiomiopatia Chagásica Crônica (CCC) para prevenir a Morte Súbita Cardíaca (MSC). Métodos: Desenvolvemos um sistema de MSC usando um conjunto de dados heterogêneo de pacientes chagásicos avaliados em 9 algoritmos de aprendizado de máquina de última geração para selecionar as variáveis clínicas mais críticas e prever MSC em pacientes chagásicos mesmo quando o intervalo mais recente entre os mais recentes exames e o evento MSC é meses ou anos. Resultados: Foram analisados 310 pacientes, sendo 81 (14,7%) portadores de CCC. No estudo, o algoritmo Balanced Random Forest apresentou o melhor desempenho, com AUC:80,03 e F1:75,12. Devido ao seu alto peso nos classificadores de aprendizado de máquina, sugerimos Holter - Taquicardia Ventricular Não Sustentada, Extrassístoles Ventriculares Totais, Diâmetro Sistólico do Ventrículo Esquerdo, Síncope e Diâmetro Diastólico do Ventrículo Esquerdo como características essenciais para identificar a CCC. Conclusão: O padrão de alto risco de MSC em pacientes com CCC pode ser identificado e prevenido com base em variáveis clínicas e laboratoriais.

Objetivo: Identificar el riesgo de los pacientes con Miocardiopatía Chagásica Crónica (MCC) para evitar que presenten Muerte Cardíaca Súbita (MCS). Métodos: Desarrollamos un sistema MCS utilizando un conjunto de datos heterogéneo de pacientes chagásicos evaluados en 9 algoritmos de aprendizaje automático de última generación para seleccionar las variables clínicas más críticas y predecir MCS en pacientes chagásicos incluso cuando el intervalo más reciente entre los más recientes exámenes y el evento MCS es meses o años. Resultados: Se analizaron 310 pacientes, siendo 81 (14,7%) con MSC. En el estudio, Balanced Random Forest mostró el mejor desempeño, con AUC:80.03 y F1:75.12. Debido a su alto peso en los clasificadores de aprendizaje automático, sugerimos Holter - Taquicardia ventricular no sostenida, Extrasístoles ventriculares totales, Diámetro sistólico del ventrículo izquierdo, Síncope y Diámetro diastólico del ventrículo izquierdo como características esenciales para identificar la MSC. Conclusión: El patrón de alto riesgo de MSC en pacientes con MCC se puede identificar y prevenir con base en variables clínicas y de laboratorio.

A Unique Case Report of Infant-Type Hemispheric Glioma (Gliosarcoma Subtype) with TPR-NTRK1 Fusion Treated with Larotrectinib.

Herein, we present a rare case of a nine-month-old boy diagnosed with infant-type hemispheric glioma (gliosarcoma subtype) at the left frontal lobe. Following subtotal resection, the patient started chemotherapy with the BABY POG protocol. We describe the clinical diagnosis, histological characteristics, radiological features, molecular aspects, and management of this tumor. A comprehensive molecular analysis on the tumor tissue showed a TPR-NTRK1 gene fusion. The patient was treated with a TRK inhibitor, larotrectinib, and exhibited a stable disease with residual lesion following 8 months of target therapy. The present study is the first report of an infantile gliosarcoma harboring NTRK1 rearrangement treated with larotrectinib.

Undiagnosed Sturge-Weber Syndrome as a Differential Diagnosis of Seizures and Deep Cerebral Venous System Dilation: A Case Report.

Sturge-Weber syndrome (SWS) is a capillary-venous malformation affecting the brain, the eye, and the adjacent trigeminal dermatomes of the skin. This illness is usually diagnosed during the first years of life. If left undiagnosed (and consequently untreated), the condition could develop into severe refractory seizures, ischemic strokes, visual loss, and early cognitive impairment. We report a case of a 23-year-old female patient with a port-wine facial stain, presenting her first convulsive episode in adulthood, associated with a moderate dilation of the deep venous system in the angiography, which raised the diagnostic of Sturge-Weber syndrome.

Kinematics approach with neural networks for early detection of sepsis (KANNEDS).

BACKGROUND: Sepsis is a severe illness that affects millions of people worldwide, and its early detection is critical for effective treatment outcomes. In recent years, researchers have used models to classify positive patients or identify the probability for sepsis using vital signs and other time-series variables as input. METHODS: In our study, we analyzed patients' conditions by their kinematics position, velocity, and acceleration, in a six-dimensional space defined by six vital signs. The patient is affected by the disease after a period if the position gets "near" to a calculated sepsis position in space. We imputed these kinematics features as explanatory variables of long short-term memory (LSTM), convolutional neural network (CNN) and linear neural network (LNN) and compared the prediction accuracies with only the vital signs as input. The dataset used contained information of approximately 4800 patients, each with 48 hourly registers. RESULTS: We demonstrated that the kinematics features models had an improved performance compared with vital signs models. The kinematics features model of LSTM achieved the best accuracy, 0.803, which was nine points higher than the vital signs model. Although with lesser accuracies, the kinematics features models of the CNN and LNN showed better performances than vital signs models. CONCLUSION: Applying our novel approach for early detection of sepsis using neural networks will prove to be an invaluable, more accurate method than considering only simple vital signs as input variables. We expect that other researchers with similar objectives can use the model presented in this innovative approach to improve their results.

The southernmost record and an update of the geographical range of the Atlantic chupare, Styracura schmardae (Chondrichthyes: Myliobatiformes).

The present study established the southernmost distribution range for the Chupare stingray Styracura schmardae based on a specimen caught on the easternmost portion of Ceará State, northeastern Brazil. Identification was based on diagnostic morphological characters and molecular data (sequence of the mitochondrial DNA gene nd2; 1046 bp). This record expands the known distribution range for this species by more than 1200 km and confirms that S. schmardae is distributed in more than one biogeographical province. SIGNIFICANCE STATEMENT: There are few records of the Atlantic Chupare stingray for Brazil and most of them are associated with the Amazon River mouth. New records indicate that this species is also present in the South Atlantic portion of the Brazilian coast. Apparently having a low abundance throughout its range, these new records increase the range of occurrence of this species.

Using OPC and HL7 Standards to Incorporate an Industrial Big Data Historian in a Health IT Environment.

Health Level Seven (HL7) is one of the standards most used to centralize data from different vital sign monitoring systems. This solution significantly limits the data available for historical analysis, because it typically uses databases that are not effective in storing large volumes of data. In industry, a specific Big Data Historian, known as a Process Information Management System (PIMS), solves this problem. This work proposes the same solution to overcome the restriction on storing vital sign data. The PIMS needs a compatible communication standard to allow storing, and the one most commonly used is the OLE for Process Control (OPC). This paper presents a HL7-OPC Server that permits communication between vital sign monitoring systems with PIMS, thus allowing the storage of long historical series of vital signs. In addition, it carries out a review about local and cloud-based Big Medical Data researches, followed by an analysis of the PIMS in a Health IT Environment. Then it shows the architecture of HL7 and OPC Standards. Finally, it shows the HL7-OPC Server and a sequence of tests that proved its full operation and performance.

High Expression of HULC Is Associated with Poor Prognosis in Osteosarcoma Patients.

Osteosarcoma (OS) is the most common primary bone cancer in childhood. OS is an aggressive disease, and metastatic patients evolve with very poor clinical outcomes. Genetically, OSs are extremely complex tumors, and the related metastatic process is not well understood in terms of the biology of the disease. In this context, long non-coding RNAs (lncRNAs) have emerged as an important class of gene expression regulators that play key roles in the invasion and metastasis of several human tumors. Here, we evaluated the expression of HULC, which is an lncRNA that is associated with the tumor metastatic process, and assessed its potential role as a prognostic marker in OS. HULC expression was evaluated in primary OS samples using real-time RT-PCR. HULC expression status was determined by receiver operating characteristic (ROC) analysis, and its association with survival was assessed using the Kaplan-Meier method. The HULC expression level was not significantly associated with the clinicopathological characteristics of the OS patients. However, our data demonstrated that higher levels of expression of HULC were associated with lower survival rates in OS patients, both in terms of overall and event-free survival. Elevated HULC expression was associated with poor clinical outcomes among the OS patients, which suggests that HULC could be a potential prognostic biomarker in OS.

A atenção em saúde bucal para DST/HIV/AIDS na rede municipal de Belo Horizonte: diagnóstico loco-regional

Estudo sobre a situação e qualidade do atendimento odontológico aos portadores de DST/HIV/AIDS, no SUS da rede Municipal de Belo Horizonte.

Avaliaçäo microbiológica da água do Riacho Cavouco, Recife - PE / Evaluation of microbiological water of the Cavouco stream, Recife - PE

A água, essencial à vida de todo ser humano, atua também como importante veículo de contaminaçäo de inúmeras doenças, seja em decorrência de excretos humanos ou de outros animais, seja pela presença de substâncias químicas nocivas à saúde humana. As águas do Riacho Cavouco, no munícipio de Recife - PE, säo classificadas como águas doces, classe 04, destinadas à navegaçäo, à harmonia paisagística e aos usos menos exigentes. O nível de contaminaçäo microbiológica de cada ponto de contribuiçäo do Riacho Cavouco, no "campus" da Universidade Federal de Pernambuco, foi avaliado durante um período de 6 (seis) meses. Em alguns pontos de contribuiçäo, essas águas residuárias näo säo constituídas essencialmente de esgoto bruto. Foi detectada uma variaçäo de 100 mil a 10 bilhöes no NMP de coliformes totais e 10 mil a 1 milhäo no NMP de coliformes fecais. Os testes realizados confirmaram a presença de Eschirichia coli, Enterobacter aerogenes, Pseudomonas aeruginosa, Serratia sp., Staphylococcus aureus e Streptococcus faecalis. As águas desse Riacho precisam ser tratadas para que possam ser utilizadas para criaçäo de peixes, dentre outros objetivos incluídos na revitalizaçäo e urbanizaçäo desse riacho, como também para evitar poluiçäo de lençóis de água subterrâneos.

Estudo da concordância do diagnóstico de esquizofrenía entre CID-9 e DSM III numa populaçäo hospitalar / Concordance of diagnosis of schizophrenia between CID-9 and DSM III in a hospitalar population

Foi estudada a concordância do diagnóstico de esquizofrenia entre o CID-9 e o DSM III. A populaçäo constou de 102 pacientes internados no Hospital Ulysses Pernambucano, escolhidos ao acaso entre os que haviam sido diagnosticados esquizofrênicos pelo médico assistente. As percentagens de concordâncias e os motivos da näo-concordância säo analisados à luz das principais diferenças entre os dois sistemas de classificaçäo

Estudo da concordancia do diagnostico de esquizofrenia entre CID-9 e DSM-III numa populacao hospitalar

Foi estudada a concordancia do diagnostico de esquizofrenia entre o CID-9 e o DSM-III. A populacao constou de 102 pacientes internados no Hospital Ulysses Pernambucano, escolhidos ao entre os que haviam sido diagnosticados esquizofrenicos pelo medio assistente. As percentagens de concordancias e os motivos da nao-concordancia sao analisados a luz das principais diferencas entre os dois sistemas de classificacao.