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1.
BMJ Case Rep ; 17(3)2024 Mar 27.
Article in English | MEDLINE | ID: mdl-38538101

ABSTRACT

Uterine leiomyomas are rare in the paediatric population. This report describes a rare case of a submucous leiomyoma in an adolescent girl. The patient presented with a history of abnormal and painful period which was refractory to medical treatment. Sonographic findings revealed a uterine mass that protruded through the cervix until the upper third of the vagina. A hysteroscopic resection was performed, and a pathological examination confirmed a leiomyoma. 12 months after surgery, there were no signs of recurrence. Conservative sparing-fertility management, such as hysteroscopic resection, is the best option with a type 0 submucosal fibroid, especially in adolescents and young women.


Subject(s)
Leiomyoma , Menorrhagia , Uterine Neoplasms , Adolescent , Female , Humans , Pregnancy , Dysmenorrhea , Hysteroscopy/adverse effects , Leiomyoma/complications , Leiomyoma/diagnostic imaging , Leiomyoma/surgery , Menorrhagia/etiology , Uterine Neoplasms/pathology , Vagina/pathology
2.
Chem Mater ; 36(3): 1333-1341, 2024 Feb 13.
Article in English | MEDLINE | ID: mdl-38370275

ABSTRACT

Persistent neutral organic radicals are excellent building blocks for the design of functional molecular materials due to their unique electronic, magnetic, and optical properties. Among them, triphenylmethyl radical derivatives have attracted a lot of interest as luminescent doublet emitters. Although neutral organic radicals have been underexplored as linkers for building metal-organic frameworks (MOFs), they hold great potential as organic elements that could introduce additional electronic properties within these frameworks. Herein, we report the synthesis and characterization of a novel multicomponent metal-organic radical framework (PTMTCR@NR-Zn MORF), which is constructed from the combination of luminescent perchlorotriphenylmethyl tricarboxylic acid radical (PTMTCR) and nonemissive nonradical (PTMTCNR) organic linkers and Zn(II) ions. The PTMTCR@NR-Zn MORF structure is layered with microporous one-dimensional channels embedded within these layers. Kelvin probe force microscopy further confirmed the presence of both organic nonradical and radical linkers in the framework. The luminescence properties of the PTMTCR ligand (first studied in solution and in the solid state) were maintained in the radical-containing PTMTCR@NR-Zn MORF at room temperature as fluorescence solid-state quenching is suppressed thanks to the isolation of the luminescent radical linkers. In addition, magnetic and electrochemical properties were introduced to the framework due to the incorporation of the paramagnetic organic radical ligands. This work paves the way for the design of stimuli-responsive hybrid materials with tunable luminescence, electrochemical, and magnetic properties by the proper combination of closed- and open-shell organic linkers within the same framework.

3.
J Vasc Interv Radiol ; 35(5): 751-758, 2024 May.
Article in English | MEDLINE | ID: mdl-38342222

ABSTRACT

PURPOSE: To assess the incidence of fever at diagnosis in children with leukemia and determine if fever at diagnosis is a predictor of bloodstream infection (BSI) or central venous access device (CVAD) removal for infection either within the first 30 days or between 30 and 90 days after CVAD insertion. MATERIALS AND METHODS: One hundred fifty-one patients with acute leukemia (July 1, 2018, to December 31, 2020) who underwent a CVAD insertion within 2 weeks of diagnosis were included. Patient data included demographic characteristics, fever at diagnosis, CVAD type, antibiotics before and/or on the day of CVAD insertion, BSI incidence, BSI rates per 1,000 catheter days, and need for catheter removal after CVAD insertion within 30 days and between 30 and 90 days. RESULTS: Patients with fever at diagnosis had a significantly higher incidence of BSI within the first 30 days after CVAD insertion (17/23) than that among patients without fever (6/23) (P = .046) at diagnosis. No statistically significant difference was observed in the incidence of BSI between 30 and 90 days after CVAD insertion between patients with fever (5/11) and those without fever at diagnosis (6/11) (P = .519). Fever at diagnosis was not a predictor of CVAD removal within 30 days (9 patients required CVAD removal; 7/9 had fever and 2/9 had no fever) (P = .181) or between 30 and 90 days (4 patients required CVAD removal; 1/4 had fever and 3/4 had no fever at diagnosis) (P = .343) after insertion. CONCLUSIONS: Fever at diagnosis in patients with leukemia is not a predictor of CVAD removal for infection.


Subject(s)
Catheter-Related Infections , Catheterization, Central Venous , Central Venous Catheters , Device Removal , Fever , Humans , Male , Female , Child , Child, Preschool , Catheter-Related Infections/diagnosis , Catheter-Related Infections/microbiology , Catheter-Related Infections/epidemiology , Incidence , Time Factors , Fever/diagnosis , Fever/etiology , Catheterization, Central Venous/adverse effects , Catheterization, Central Venous/instrumentation , Retrospective Studies , Risk Factors , Adolescent , Central Venous Catheters/adverse effects , Infant , Risk Assessment , Leukemia/therapy , Leukemia/complications , Treatment Outcome , Age Factors , Predictive Value of Tests , Bacteremia/diagnosis , Bacteremia/epidemiology
4.
Pediatr Radiol ; 53(11): 2245-2252, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37568041

ABSTRACT

BACKGROUND: Due to the rarity of pediatric diseases, collaborative research is the key to maximizing the impact of research studies. A research needs assessment survey was created to support initiatives to foster pediatric interventional radiology research. OBJECTIVE: To assess the status of pediatric interventional radiology research, identify perceived barriers, obtain community input on areas of research/education/support, and create metrics for evaluating changes/responses to programmatic initiatives. MATERIALS AND METHODS: A survey link was sent to approximately 275 members of the Society for Pediatric Interventional Radiology (SPIR) between May and October 2020. Data was collected using a web-based interface. Data collected included practice setting, clinical role, research experience, research barriers, and suggestions for future initiatives. RESULTS: Fifty-nine surveys were analyzed with a staff physician survey response rate of 28% (56/198). A wide range of practice sizes from 15 countries were represented. Respondents were predominantly staff physicians (95%; 56/59) with an average of 11 years (range: 1-25 years) of clinical experience working at academic or freestanding children's hospitals. A total of 100% (59/59) had research experience, and 70% (41/58) had published research with a mean of 30 peer-reviewed publications (range: 1-200). For job security, 56% (33/59) of respondents were expected or required to publish, but only 19% (11/58) had research support staff, and 42% (25/59) had protected research time, but of those, 36% (9/25) got the time "sometimes or never." Lack of support staff, established collaborative processes, and education were identified as top barriers to performing research. CONCLUSIONS: The needs assessment survey demonstrated active research output despite several identified barriers. There is a widespread interest within the pediatric interventional radiology community for collaborative research.

5.
J Vasc Interv Radiol ; 34(12): 2110-2119.e1, 2023 12.
Article in English | MEDLINE | ID: mdl-37652298

ABSTRACT

PURPOSE: To assess the reported safety and effectiveness of sclerotherapy for the treatment of nonparasitic splenic cysts through a systematic review and meta-analysis. MATERIALS AND METHODS: A systematic search of PubMed MEDLINE, Embase, Web of Science, and the Cochrane Library through July 2023 was performed. Studies including at least 5 patients reporting percutaneous sclerotherapy of nonparasitic splenic cysts, initial and posttreatment cyst size, clinical symptoms as well as adverse events (AEs), and recurrence rates were included. A 0-8-point scale for case reports and case series was used to assess bias. Data were analyzed using random-effects meta-analysis. RESULTS: Twenty-three of 833 citations were selected for full-text assessment, and 7 studies were included for a total of 99 patients. The methodological quality of the studies included scored 3-7. Composite analysis demonstrated 38% (95% CI, 23%-55%) rate of recurrence after treatment with significant heterogeneity; however, when assessed for a cyst size of <8 cm, recurrence dropped to 7% (95% CI, 2%-20%). Residual symptoms after treatment completion were present in 17% (95% CI, 7%-33%). Intraprocedural and postprocedural AE rates were 6% (95% CI, 3%-13%) and 6% (95% CI, 3%-12%) respectively. CONCLUSIONS: Sclerotherapy of splenic cysts seemed to be safe, with a high rate of recurrence for cysts ≥8 cm.


Subject(s)
Cysts , Splenic Diseases , Humans , Sclerotherapy/adverse effects , Cysts/diagnostic imaging , Cysts/therapy , Splenic Diseases/diagnostic imaging , Splenic Diseases/therapy
6.
Science ; 380(6648): eabn8153, 2023 06 02.
Article in English | MEDLINE | ID: mdl-37262156

ABSTRACT

Personalized genome sequencing has revealed millions of genetic differences between individuals, but our understanding of their clinical relevance remains largely incomplete. To systematically decipher the effects of human genetic variants, we obtained whole-genome sequencing data for 809 individuals from 233 primate species and identified 4.3 million common protein-altering variants with orthologs in humans. We show that these variants can be inferred to have nondeleterious effects in humans based on their presence at high allele frequencies in other primate populations. We use this resource to classify 6% of all possible human protein-altering variants as likely benign and impute the pathogenicity of the remaining 94% of variants with deep learning, achieving state-of-the-art accuracy for diagnosing pathogenic variants in patients with genetic diseases.


Subject(s)
Genetic Variation , Primates , Animals , Humans , Base Sequence , Gene Frequency , Primates/genetics , Whole Genome Sequencing
7.
bioRxiv ; 2023 May 02.
Article in English | MEDLINE | ID: mdl-37205491

ABSTRACT

Personalized genome sequencing has revealed millions of genetic differences between individuals, but our understanding of their clinical relevance remains largely incomplete. To systematically decipher the effects of human genetic variants, we obtained whole genome sequencing data for 809 individuals from 233 primate species, and identified 4.3 million common protein-altering variants with orthologs in human. We show that these variants can be inferred to have non-deleterious effects in human based on their presence at high allele frequencies in other primate populations. We use this resource to classify 6% of all possible human protein-altering variants as likely benign and impute the pathogenicity of the remaining 94% of variants with deep learning, achieving state-of-the-art accuracy for diagnosing pathogenic variants in patients with genetic diseases. One Sentence Summary: Deep learning classifier trained on 4.3 million common primate missense variants predicts variant pathogenicity in humans.

8.
Cien Saude Colet ; 28(4): 1139-1150, 2023 Apr.
Article in Portuguese, English | MEDLINE | ID: mdl-37042895

ABSTRACT

This study aimed to theorize, by means of social actors' conception, about the reasons for the non-inclusion of oral health in the Family Health Strategy (FHS) in the city of Juiz de Fora, Minas Gerais, Brazil. This is a qualitative, exploratory, descriptive, and analytical study based on the grounded theory methodology and the National Oral Health Policy. Eleven interviews were performed with public managers, delegates who participate in the municipal health council, and dental surgeons who belong to the public health service. The theorization of the study was created through the data analysis process, which resulted in "a consequence of the dominant disease-centered oral health care model" as the main category. Data were categorized according to a methodological framework. The health concept set forth by local social actors contributed to the non-inclusion of oral healthcare teams (OHTs) in the FHS. This theorization identified the origins of the studied phenomenon and can aid in future policy decision-making carried out by local social actors.


Este estudo objetivou construir teorização a partir da concepção de atores sociais acerca das razões da não inserção da atenção à saúde bucal na Estratégia de Saúde da Família (ESF) no município de Juiz de Fora, Minas Gerais. Trata-se de um estudo qualitativo, fundamentado no referencial teórico construído com base na Política Nacional de Saúde Bucal e metodológico na Teoria Fundamentada nos Dados (TFD). Foram realizadas 11 entrevistas intensivas com atores sociais da gestão, do controle social e cirurgiões-dentistas do serviço público do município. Os dados foram categorizados segundo a TFD e a partir do processo de análise dos dados, construiu-se a teorização do estudo e obteve-se como categoria central "Consequência de uma concepção hegemônica doença-centrada da saúde para o modelo de atenção à saúde bucal". A concepção de saúde dos atores sociais do município contribuiu para a não inserção da atenção à saúde bucal na ESF. A teorização permitiu a identificação da origem das condições do fenômeno estudado e poderá contribuir para tomada de decisões dos atores sociais em futuras ações políticas.


Subject(s)
Family Health , Oral Health , Humans , Policy Making , Health Policy , Cities , Brazil
9.
Ciênc. Saúde Colet. (Impr.) ; 28(4): 1139-1150, abr. 2023. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1430170

ABSTRACT

Resumo Este estudo objetivou construir teorização a partir da concepção de atores sociais acerca das razões da não inserção da atenção à saúde bucal na Estratégia de Saúde da Família (ESF) no município de Juiz de Fora, Minas Gerais. Trata-se de um estudo qualitativo, fundamentado no referencial teórico construído com base na Política Nacional de Saúde Bucal e metodológico na Teoria Fundamentada nos Dados (TFD). Foram realizadas 11 entrevistas intensivas com atores sociais da gestão, do controle social e cirurgiões-dentistas do serviço público do município. Os dados foram categorizados segundo a TFD e a partir do processo de análise dos dados, construiu-se a teorização do estudo e obteve-se como categoria central "Consequência de uma concepção hegemônica doença-centrada da saúde para o modelo de atenção à saúde bucal". A concepção de saúde dos atores sociais do município contribuiu para a não inserção da atenção à saúde bucal na ESF. A teorização permitiu a identificação da origem das condições do fenômeno estudado e poderá contribuir para tomada de decisões dos atores sociais em futuras ações políticas.


Abstract This study aimed to theorize, by means of social actors' conception, about the reasons for the non-inclusion of oral health in the Family Health Strategy (FHS) in the city of Juiz de Fora, Minas Gerais, Brazil. This is a qualitative, exploratory, descriptive, and analytical study based on the grounded theory methodology and the National Oral Health Policy. Eleven interviews were performed with public managers, delegates who participate in the municipal health council, and dental surgeons who belong to the public health service. The theorization of the study was created through the data analysis process, which resulted in "a consequence of the dominant disease-centered oral health care model" as the main category. Data were categorized according to a methodological framework. The health concept set forth by local social actors contributed to the non-inclusion of oral healthcare teams (OHTs) in the FHS. This theorization identified the origins of the studied phenomenon and can aid in future policy decision-making carried out by local social actors.

10.
BMC Pediatr ; 23(1): 22, 2023 01 14.
Article in English | MEDLINE | ID: mdl-36639762

ABSTRACT

BACKGROUND: Biliary atresia (BA) is one of the causes of conjugated hyperbilirubinemia in infants which if untreated leads to end-stage liver disease and death. Percutaneous Trans-hepatic Cholecysto-Cholangiography (PTCC) is a minimally invasive study which can be utilized in the diagnostic work-up of these patients. This study's purpose is to describe the experience with PTCC in neonates, the imaging findings encountered, and the abnormal patterns which warrant further investigation. METHODS: A 16-year single-center retrospective study of patients with persistent neonatal cholestasis (suspected BA) undergoing PTCC. Patient demographics, laboratory values, PTCC images, pathology and surgical reports were reviewed. RESULTS: 73 patients underwent PTCC (68% male, mean age 8.7 weeks, mean weight 4.0 Kg). The majority of studies were normal (55%). Abnormal patterns were identified in 33 cases, 79% were diagnosed with BA and 12% with Alagille syndrome. Non-opacification of the common hepatic duct with a narrowed common bile duct (42%) and isolated small gallbladder (38%) were the most common patterns in BA. CONCLUSION: PTCC is a minimally invasive study in the diagnostic work-up of infants presenting with conjugated hyperbilirubinemia (suspected BA). Further invasive investigations or surgery can be avoided when results are normal.


Subject(s)
Biliary Atresia , Cholestasis , Infant, Newborn , Infant , Humans , Male , Female , Gallbladder/diagnostic imaging , Diagnosis, Differential , Retrospective Studies , Cholangiography/methods , Cholestasis/diagnostic imaging , Cholestasis/etiology , Biliary Atresia/diagnosis , Biliary Atresia/diagnostic imaging , Hyperbilirubinemia/etiology
11.
Pediatr Radiol ; 53(5): 942-952, 2023 05.
Article in English | MEDLINE | ID: mdl-36595081

ABSTRACT

BACKGROUND: Knowledge of radiation quantities delivered in routine practice is an essential responsibility of a pediatric interventional radiology department. OBJECTIVE: To review radiation indices in frequently performed vascular and enterostomy access procedures at a quaternary pediatric hospital to formulate dosimetric reference levels and achievable levels. MATERIALS AND METHODS: A retrospective review of patient demographics, procedure information and quantitative dose metrics over a 2-year period was performed. Dosimetric details for common procedures (central line insertions, gastrostomy/gastrojejunostomy insertions and maintenance) were evaluated, correlated with demographic data and stratified across five weight groups (0-5 kg, 5-15 kg, 15-30 kg, 30-50 kg, 50-80 kg). Achievable (50th percentile) and reference (75th percentile) levels with confidence intervals were established for each procedure. RESULTS: Within the evaluation period, 3,165 studies satisfied the inclusion criteria. Five were classified as device insertions (peripherally inserted central catheter, n=1,145; port-a-catheter, n=321; central venous line, n=285; gastrostomy-tube [G-tube], n=262, and gastrojejunostomy-tube [GJ-tube], n=66), and two were classified as maintenance procedures (G-tube, n=358, and GJ-tube, n=728, checks, exchanges and reinsertions). Representative reference and achievable levels were calculated for each procedure category and weight group. CONCLUSION: This work highlights the creation of local reference and achievable levels for common pediatric interventional procedures. These data establish a dosimetric reference to understand the quantity of radiation routinely applied, allowing for improved relative radiation risk assessment and enriched communication to interventionalists, health care providers, parents and patients.


Subject(s)
Catheterization, Central Venous , Enterostomy , Child , Humans , Radiology, Interventional , Radiography, Interventional/methods , Gastrostomy , Retrospective Studies , Radiation Dosage
12.
Chemistry ; 28(61): e202203093, 2022 Nov 02.
Article in English | MEDLINE | ID: mdl-36253142

ABSTRACT

Invited for the cover of this issue is the group of Tito Trindade and colleagues at the University of Aveiro. The image depicts dendritic magneto-plasmonic substrates for surface-enhanced Raman scattering (SERS) detection. Read the full text of the article at 10.1002/chem.202202382.


Subject(s)
Nanostructures , Spectrum Analysis, Raman , Spectrum Analysis, Raman/methods , Nanostructures/chemistry
13.
Life (Basel) ; 12(10)2022 Sep 26.
Article in English | MEDLINE | ID: mdl-36294926

ABSTRACT

Multidrug-resistant bacteria are of critical importance and a problem for human health and food preservation; the discovery of new antimicrobial substances to control their proliferation is part of the solution. This work reports on 57 antagonistic Aeromonas strains, of which 38 strains were antagonistic towards problematic human pathogens. The genome of the most antagonistic strain was sequenced and identified as Aeromonas allosaccharophila. Its genome was fully annotated and mined for genes that might explain that activity. Strain AE59-TE was antagonistic toward clinically relevant gram-negative and gram-positive multidrug-resistant bacteria, including Klebsiella pneumoniae KPC, Escherichia coli ESBL, Salmonella typhimurium, and Staphylococcus aureus MRSA. Strain AE59-TE2 was identified by multilocus sequence analysis. Genome mining identified four genes homologous to the bacteriocin, zoocin A from Streptococcus equi and a gene 98% similar to cvpA linked to colicin V production. A. allosaccharophila strain AE59-TE2 produced antimicrobial activity against a broad range of bacteria, including important gram-negative bacteria, not typically targeted by bacteriocins. Herewere described novel zoocin genes that are promising for industrial applications in the food and health sectors. Interesting and important antagonistic activity is described combined with the first detailed genomic analysis of the species Aeromonas allosaccharophila.

14.
Chemistry ; 28(61): e202202382, 2022 Nov 02.
Article in English | MEDLINE | ID: mdl-36083195

ABSTRACT

Chemical analyses in the field using surface-enhanced Raman scattering (SERS) protocols are expected to be part of several analytical procedures applied to water quality monitoring. To date, these endeavors have been supported by developments in SERS substrate nanofabrication, instrumentation portability, and the internet of things. Here, we report distinct chemical strategies for preparing magneto-plasmonic (Fe3 O4 : Au) colloids, which are relevant in the context of trace-level detection of water contaminants due to their inherent multifunctionality. The main objective of this research is to investigate the role of poly(amidoamine) dendrimers (PAMAMs) in the preparation of SERS substrates integrating both functionalities into single nanostructures. Three chemical routes were investigated to design magneto-plasmonic nanostructures that translate into different ways for assessing SERS detection by using distinct interfaces. Hence, a series of magneto-plasmonic colloids have been characterized and then assessed for their SERS activity by using a model pesticide (thiram) dissolved in aqueous samples.


Subject(s)
Metal Nanoparticles , Nanostructures , Spectrum Analysis, Raman/methods , Gold/chemistry , Metal Nanoparticles/chemistry , Nanostructures/chemistry , Thiram/analysis
15.
ACS Appl Mater Interfaces ; 14(38): 43498-43507, 2022 Sep 28.
Article in English | MEDLINE | ID: mdl-36099579

ABSTRACT

Zero thermal expansion (ZTE) composites are typically designed by combining positive thermal expansion (PTE) with negative thermal expansion (NTE) materials acting as compensators and have many diverse applications, including in high-precision instrumentation and biomedical devices. La(Fe1-x,Six)13-based compounds display several remarkable properties, such as giant magnetocaloric effect and very large NTE at room temperature. Both are linked via strong magnetovolume coupling, which leads to sharp magnetic and volume changes occurring simultaneously across first-order phase transitions; the abrupt nature of these changes makes them unsuitable as thermal expansion compensators. To make these materials more useful practically, the mechanisms controlling the temperature over which this transition occurs and the magnitude of contraction need to be controlled. In this work, ball-milling was used to decrease particles and crystallite sizes and increase the strain in LaFe11.9Mn0.27Si1.29Hx alloys. Such size and strain tuning effectively broadened the temperature over which this transition occurs. The material's NTE operational temperature window was expanded, and its peak was suppressed by up to 85%. This work demonstrates that induced strain is the key mechanism controlling these materials' phase transitions. This allows the optimization of their thermal expansion toward room-temperature ZTE applications.

16.
BMC Ophthalmol ; 22(1): 296, 2022 Jul 07.
Article in English | MEDLINE | ID: mdl-35799154

ABSTRACT

BACKGROUND: Firework-related ocular injuries (FWROI) are a major cause of preventable visual impairment. This study aimed to analyze the occurrence and outcome of FWROI in Switzerland. METHODS: This retrospective multicenter study included patients with FWROI from seven centers in Switzerland from January 2009 to August 2020. Demographic information, type of injuries, medical and surgical treatments, the best corrected visual acuity (BCVA) at baseline and end of follow-up, occurrence and type of secondary complications, and duration of hospitalization were analyzed. RESULTS: A total of 105 patients (119 eyes) with a mean age of 27.1 ± 15.9 years were included in the study (71.4% male patients; 29.5% underage). Most injuries occurred around New Year's Eve (32.4%) and the Swiss national holiday on 1 August (60.9%). The most common anterior segment findings were conjunctival or corneal foreign bodies (58%), whereas Berlin's edema was the most common posterior segment finding (11.4%). Globe ruptures were found in four patients. The mean BCVA in all patients at first presentation was 0.4 ± 0.8 logMAR and improved to 0.3 ± 0.8 logMAR at last follow-up. A primary surgical intervention was performed in 48 eyes (40.3%). Hospitalization directly after the trauma was necessary for 18 patients for a mean of 5.8 ± 4.1 days, and a total of 4.9 ± 7.6 follow-up visits were needed. CONCLUSION: This study provides the first data on FWROI in Switzerland, which are helpful for further preventive and educational programs and comparisons with other countries.


Subject(s)
Blast Injuries , Eye Foreign Bodies , Adolescent , Adult , Blast Injuries/epidemiology , Blast Injuries/surgery , Child , Female , Humans , Male , Retrospective Studies , Switzerland/epidemiology , Visual Acuity , Young Adult
17.
Pediatrics ; 149(6)2022 06 01.
Article in English | MEDLINE | ID: mdl-35514122

ABSTRACT

CONTEXT: Despite frequency of gastrostomy placement procedures in children, there remains considerable variability in preoperative work-up and procedural technique of gastrostomy placement and a paucity of literature regarding patient-centric outcomes. OBJECTIVES: This review summarizes existing literature and provides consensus-driven guidelines for patients throughout the enteral access decision-making process. DATA SOURCES: PubMed, Google Scholar, Medline, and Scopus. STUDY SELECTION: Included studies were identified through a combination of the search terms "gastrostomy," "g-tube," and "tube feeding" in children. DATA EXTRACTION: Relevant data, level of evidence, and risk of bias were extracted from included articles to guide formulation of consensus summaries of the evidence. Meta-analysis was conducted when data afforded a quantitative analysis. EVIDENCE REVIEW: Four themes were explored: preoperative nasogastric feeding tube trials, decision-making surrounding enteral access, the role of preoperative imaging, and gastrostomy insertion techniques. Guidelines were generated after evidence review with multidisciplinary stakeholder involvement adhering to GRADE methodology. RESULTS: Nearly 900 publications were reviewed, with 58 influencing final recommendations. In total, 17 recommendations are provided, including: (1) tTrial of home nasogastric feeding is safe and should be strongly considered before gastrostomy placement, especially for patients who are likely to learn to eat by mouth; (2) rRoutine contrast studies are not indicated before gastrostomy placement; and (3) lLaparoscopic placement is associated with the best safety profile. LIMITATIONS: Recommendations were generated almost exclusively from observational studies and expert opinion, with few studies describing direct comparisons between GT placement and prolonged nasogastric feeding tube trial. CONCLUSIONS: Additional patient- and family-centric evidence is needed to understand critical aspects of decision-making surrounding surgically placed enteral access devices for children.


Subject(s)
Gastrostomy , Pediatrics , Child , Enteral Nutrition/methods , Humans , Intubation, Gastrointestinal/methods
18.
Mol Phylogenet Evol ; 173: 107509, 2022 08.
Article in English | MEDLINE | ID: mdl-35589052

ABSTRACT

Bald uakaris, genus Cacajao, are Amazonian primates currently classified as one species and four subspecies based on the patterns of pelage coloration. In this study, we test if their current taxonomy is represented by the phylogenetic relationship of the main lineages retrieved from molecular data. We included, for the first time, all bald uakari taxa in a mitochondrial (cytochrome b) and genome-wide (ddRAD) phylogenetic analyses. We also examined the pattern of pelage colouration in specimens from zoological collections. Having determined the number of lineages using Maximum Likelihood and the species tree using coalescent analyses, we test their divergence time using a Bayesian approach. While the cytochrome b analysis only recovered two clades, the ddRAD analysis supported the reciprocal monophyly of five lineages of bald uakaris, with all clades including only individuals with distinct and exclusive diagnostic phenotypic characters. We found that species diversification in Cacajao occurred during the last 300 Kya and may have been influenced by the formation of rivers and flooded forests in western Amazonia. We propose that the four bald uakari subspecies currently recognised can be upgraded to species level and we describe the white uakaris from the basin of the Rio Tarauacá as a new species.


Subject(s)
Pitheciidae , Animals , Bayes Theorem , Cytochromes b/genetics , DNA, Mitochondrial/genetics , Genome , Phylogeny
19.
Microorganisms ; 10(3)2022 Mar 09.
Article in English | MEDLINE | ID: mdl-35336163

ABSTRACT

Antibiotic resistance is one of the biggest health challenges of our time. We are now facing a post-antibiotic era in which microbial infections, currently treatable, could become fatal. In this scenario, antimicrobial peptides such as bacteriocins represent an alternative solution to traditional antibiotics because they are produced by many organisms and can inhibit bacteria, fungi, and/or viruses. Herein, we assessed the antimicrobial activity and biotechnological potential of 54 Streptococcus agalactiae strains isolated from bovine mastitis. Deferred plate antagonism assays revealed an inhibition spectrum focused on species of the genus Streptococcus-namely, S. pyogenes, S. agalactiae, S. porcinus, and S. uberis. Three genomes were successfully sequenced, allowing for their taxonomic confirmation via a multilocus sequence analysis (MLSA). Virulence potential and antibiotic resistance assessments showed that strain LGMAI_St_08 is slightly more pathogenic than the others. Moreover, the mreA gene was identified in the three strains. This gene is associated with resistance against erythromycin, azithromycin, and spiramycin. Assessments for secondary metabolites and antimicrobial peptides detected the bacteriocin zoocin A. Finally, comparative genomics evidenced high similarity among the genomes, with more significant similarity between the LGMAI_St_11 and LGMAI_St_14 strains. Thus, the current study shows promising antimicrobial and biotechnological potential for the Streptococcus agalactiae strains.

20.
Article in English | MEDLINE | ID: mdl-35328871

ABSTRACT

The aim of this study was to verify and compare the effects of electromyostimulation training (EMS), strength training (ST), and both combined (STEMS), through the analysis of the elbow flexors muscle thickness. Forty subjects (24.45 ± 3.53 years), were randomly divided equally in 4 groups: 3 experimental groups and 1 control group. Each experimental group was submitted to one of three interventions, either an ST protocol, an EMS protocol, or a STEMS protocol. The control group (CG) did not perform any type of physical activity. Ultrasonography (US) was used to measure muscle thickness (MT) at 50 and 60% of the distance between the acromion and the olecranon. The results showed a significant difference in the elbow flexors muscle thickness after 8 weeks, both in the STG, EMSG, and STEMSG, but not in the CG. However, no significant differences were observed between the intervention protocols. It seems that an increase in MT can be obtained using either with ST, EMS, or both combined, however, the results doesn't support the overlap of one method in relation to the others. EMS can be another interesting tool to induce muscle hypertrophy, but not necessarily better.


Subject(s)
Electric Stimulation Therapy , Resistance Training , Electric Stimulation Therapy/methods , Exercise , Exercise Therapy/methods , Humans , Muscle Strength/physiology , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/physiology , Young Adult
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