The complete blood count (CBC) is a highly requested test that is generally restricted to centralized laboratories, which are limited by high cost, being maintenance-demanding, and requiring costly equipment. The Hilab System (HS) is a small, handheld hematological platform that uses microscopy and chromatography techniques, combined with machine learning (ML) and artificial intelligence (AI), to perform a CBC test. This platform uses ML and AI techniques to add higher accuracy and reliability to the results besides allowing for faster reporting. For clinical and flagging capability evaluation of the handheld device, the study analyzed 550 blood samples of patients from a reference institution for oncological diseases. The clinical analysis encompassed the data comparison between the Hilab System and a conventional hematological analyzer (Sysmex XE-2100) for all CBC analytes. The flagging capability study compared the microscopic findings from the Hilab System and the standard blood smear evaluation method. The study also assessed the sample collection source (venous or capillary) influences. The Pearson correlation, Student t-test, Bland-Altman, and Passing-Bablok plot of analytes were calculated and are shown. Data from both methodologies were similar (p > 0.05; r ≥ 0.9 for most parameters) for all CBC analytes and flagging parameters. Venous and capillary samples did not differ statistically (p > 0.05). The study indicates that the Hilab System provides humanized blood collection associated with fast and accurate data, essential features for patient wellbeing and quick physician decision making.
The complete blood count (CBC) is one of the most requested tests by physicians. CBC tests, most realized in conventional hematological analyzers, are restricted to centralized laboratories due to frequent maintenance, large devices, and expensive costs required. On the other hand, most handheld CBC devices commercially available show high prices and are not liable to calibration or control procedures, which results in poor quality compared to standard hematology instruments. The Hilab system is a small-handed hematological platform that uses microscopy and chromatography techniques for blood cells and hematimetric parameters analysis through artificial intelligence, machine learning, and deep learning techniques. For clinical evaluation of the handheld CBC device, 450 blood samples were analyzed. The samples encompassed normal (82%) and pathological conditions (18%), such as thalassemias (2.2%), anemias (6.6%), and infections (9.2%). For all analytes, accuracy, precision, method comparison, and flagging capabilities of the Hilab System, were compared with the Sysmex XE-2100 (Sysmex, Japan) results. The sample source (venous and capillary) influences were also evaluated. Pearson correlation, Student t test, bias, and the Bland-Altman plot of each blood count analyte were calculated and shown. The significance level was set at p ≤ 0.05. For clinical evaluation, Hilab System and the Sysmex XE-2100 showed a strong correlation (r ≥ 0.9) for most evaluated parameters. In the precision study, analytes showed CV inside the limits established according to European Federation of Clinical Chemistry and Laboratory Medicine guidelines. The flagging capabilities of the Hilab system, compared to the manual microscopy technique, presented high sensibility, specificity, and accuracy. Venous and capillary samples (p > 0.05) do not differ statistically. Considering the need for point-of-care CBCs, the study indicated that the Hilab system provides fast, accurate, low cost, and robust analysis for reliable clinical use.
Hematology , Internet of Things , Artificial Intelligence , Blood Cell Count/methods , Humans , Point-of-Care Systems , Reproducibility of Results
Introdução: O câncer bucal ainda é destacado como preocupante problema de saúde pública. Objetivo: Verificar a tendência de mortalidade por câncer bucal por Região brasileira e fatores de risco, avaliando o intervalo de tempo entre o diagnóstico e o tratamento. Método: Estudo com dados secundários do DATASUS (taxa de mortalidade e tempo para tratamento) e do Vigitel (consumo de álcool e cigarro); análises de séries temporais e correlações entre taxas de mortalidade (2010-2019) e consumo de álcool e cigarro (2010-2019), para idade superior a 40 anos, e análise descritiva do tempo entre diagnóstico e tratamento. Resultados: Houve aumento da tendência de câncer bucal por Regiões e sexo, com predominância para o sexo masculino. A variação percentual anual (VPA) da ingestão de álcool e o uso de cigarro foram considerados estacionários na maioria das Regiões analisadas. Ao correlacionar as variáveis, verificou-se correlação estatisticamente significativa entre taxa de mortalidade (2010-2019) e percentual de consumo de álcool (p=0,011; r=0,957), percentual de consumo de cigarro (p=0,019; r=0,936) e taxa bruta de mortalidade em homens (2019) (p=0,005; r=0,97). Verificou-se que, na maioria dos casos (74%), o tempo para início do tratamento é de mais de 60 dias. Conclusão: Embora o consumo de álcool e o tabagismo sejam fatores de risco para o câncer bucal, o presente estudo concluiu que houve aumento da mortalidade por câncer e os fatores de risco analisados permaneceram estacionários. O início de tratamento foi maior do que 60 dias a partir do diagnóstico. Palavras-chave: neoplasias bucais/mortalidade; tabagismo; consumo de bebida alcoólica; estudos de séries temporais; saúde pública
Introduction: Oral cancer still stands out as a concerning public health issue. Objective: Verify the trend of oral cancer mortality by Brazilian regions and risk factors, evaluating the time interval between diagnosis and treatment. Method: Study with secondary data from DATASUS (mortality rate and time to treatment) and Vigitel (alcohol and cigarette use). Time series analyzes and correlations were performed among mortality rates (2010-2019) and alcohol and cigarette use (2010-2019) for over 40 years of age. Descriptive analysis of the time between diagnosis and treatment was also performed. Results: There was an increase in the tendency to oral cancer by region and sex, with a predominance of males. The annual percentage change (APC) of alcohol intake and cigarette use was considered stationary in most regions analyzed. When correlating the variables, there was a statistically significant correlation for mortality rate (2010-2019) and percentage of alcohol use (p=0.011; r=0.957), percentage of cigarette use (p=0.019; r=0.936) and crude mortality rate in men (2019) (p=0.005; r=0.97). It was found that most cases (74%) take more than 60 days to start treatment. Conclusion: Although alcohol and tobacco use are risk factors for oral cancer, the present study showed an increase in cancer mortality and stationary for the risk factors analyzed. The beginning of the treatment was over 60 days after diagnosis
Introducción: El cáncer oral todavía se destaca como un problema de salud pública preocupante. Objetivo: Verificar la tendencia de la mortalidad por cáncer bucal por región brasileña y factores de riesgo, evaluando el intervalo de tiempo entre el diagnóstico y el tratamiento. Método: Estudio con datos secundarios de DATASUS (tasa de mortalidad y tiempo de tratamiento) y Vigitel (consumo de alcohol y cigarrillos). Se realizaron análisis de series de tiempo y correlaciones entre las tasas de mortalidad (2010-2019) y el consumo de alcohol y cigarrillos (2010-2019) para los mayores de 40 años. También se realizó un análisis descriptivo del tiempo transcurrido entre el diagnóstico y el tratamiento. Resultados: Hubo un incremento en la tendencia al cáncer bucal por región y sexo, con predominio del sexo masculino. El cambio porcentual anual (APV) de la ingesta de alcohol y el consumo de cigarrillos se consideró estacionario en la mayoría de las regiones analizadas. Al correlacionar las variables, hubo una correlación estadísticamente significativa para tasa de mortalidad en hombres (2010- 2019) y porcentaje de consumo de alcohol para hombres (p=0,011; r=0,957), porcentaje de consumo de cigarrillos en hombres (p=0,019; r=0,936) y tasa bruta de mortalidad en hombres (2019) (p=0,005; r=0,97). Se encontró que la mayoría de los casos (74%) demoran más de 60 días en comenzar el tratamiento. Conclusión: Aunque el consumo de alcohol y el tabaquismo son factores de riesgo para el cáncer oral, el presente estudio mostró un aumento en la mortalidad por cáncer y estacionario para los factores de riesgo analizados. Hubo un alto porcentaje de inicio del tratamiento durante 60 días después del diagnóstico
Humans , Male , Female , Adult , Middle Aged , Tobacco Use Disorder , Alcohol Drinking , Mouth Neoplasms/mortality , Time Series Studies , Public Health
The South American and West Indian Casque-headed Treefrogs (Hylidae: Hylinae: Lophyohylini) include 85 species. These are notably diverse in morphology (e.g. disparate levels of cranial hyperossification) and life history (e.g. different reproductive modes, chemical defences), have a wide distribution, and occupy habitats from the tropical rainforests to semiarid scrubland. In this paper, we present a phylogenetic analysis of this hylid tribe based on sequence fragments of up to five mitochondrial (12S, 16S, ND1, COI, Cytb) and six nuclear genes (POMC, RAG-1, RHOD, SIAH, TNS3, TYR). We included most of its species (> 96%), in addition to a number of new species. Our results indicate: (i) the paraphyly of Trachycephalus with respect to Aparasphenodon venezolanus; (ii) the nonmonophyly of Aparasphenodon, with Argenteohyla siemersi, Corythomantis galeata and Nyctimantis rugiceps nested within it, and Ap. venezolanus nested within Trachycephalus; (iii) the polyphyly of Corythomantis; (iv) the nonmonophyly of the recognized species groups of Phyllodytes; and (v) a pervasive low support for the deep relationships among the major clades of Lophyohylini, including C. greeningi and the monotypic genera Itapotihyla and Phytotriades. To remedy the nonmonophyly of Aparasphenodon, Corythomantis, and Trachycephalus, we redefined Nyctimantis to include Aparasphenodon (with the exception of Ap. venezolanus, which we transferred to Trachycephalus), Argenteohyla, and C. galeata. Additionally, our results indicate the need for taxonomic work in the following clades: (i) Trachycephalus dibernardoi and Tr. imitatrix; (ii) Tr. atlas, Tr. mambaiensis and Tr. nigromaculatus; and (iii) Phyllodytes. On the basis of our phylogenetic results, we analyzed the evolution of skull hyperossification and reproductive biology, with emphasis on the multiple independent origins of phytotelm breeding, in the context of Anura. We also analyzed the inter-related aspects of chemical defences, venom delivery, phragmotic behaviour, co-ossification, and prevention of evaporative water loss.
Anura/classification , Anura/genetics , Phylogeny , Animals , Biological Evolution , Cell Nucleus/genetics , Genes, Mitochondrial , RNA, Ribosomal, 16S , Sequence Analysis, DNA , Skull/anatomy & histology
METHODS: Ten prosthesis bases prepared with each brand of resin were subjected to neutral and low pH conditions (pH 7 and pH 4) by submerging them in artificial saliva for 30 days. After exposure, the fatigue resistance of the resins was tested using a Dental CS® Testing Machine. Statistical Analysis Test. The data sets were described quantitatively in terms of mean (M) and standard deviation (SD). Shapiro-Wilk tests and unilateral analysis of variance (ANOVA) were performed and complemented by Tukey's multiple comparison tests. The effect size (η2), whose cohort points followed Cohen's recommendations: 0.01 (low), 0.06 (medium), and 0.14 (high), was calculated. The results were considered significant if p < 0.05 and marginally significant if p < 0.10. RESULTS: One-way ANOVA showed that Megacryl® had the highest fracture resistance at pH 7 (52.23 Kgf), compared with Triplex Hot® (p < 0.001) and RS Vertex® (p=0.034). Two-way ANOVA confirmed the interaction between brand and pH (p=0.022), also revealing that brands comparison is significant or marginally significant, when pH is not considered (Megacryl® versus Triplex Hot®, p < 0.001, and RS Vertex®, p=0.058; Triplex Hot® versus RS Vertex®, p=0.051), and pH 7 results were significantly higher (p=0.003), even when brands are not considered. Hence, Megacryl® at pH 7 was found to have the highest fracture resistance, detached from other brands and pH values. CONCLUSION: It can be concluded within the limitations of this study that there are differences in the fracture resistance among the three brands of acrylic resin. Megacryl® was found to have the highest fracture resistance, and Triplex Hot® was the lowest. The results also show that exposure to a low pH environment decreases the fracture resistance of the Megacryl® and RS Vertex® resins.
The presence of dental abnormalities in the same individual may be related to syndromic cases and occur through associated systemic changes. Kabuki syndrome presents well-defined systemic changes, but its clinical characteristics related to the oral cavity have not been fully explained. This study aimed to report the dental changes in a child diagnosed with Kabuki syndrome. A male brown patient aged 2 years and 7 months, accompanied by his mother to the dental visit, they main complaint was the presented of an additional tooth behind upper right central incisor. Anamnesis, intra- and extraoral examinations, and dental X-rays were performed, revealing a talon cusp. Considering the dental clinical findings, the patient was referred to a medical geneticist who additionally requested cardiological and genetic examinations, which established the Kabuki syndrome. The caregivers were advised that the talon cusp would not cause any injury to the natural exfoliation of the tooth and that oral hygiene should be performed carefully. Abnormalities in the oral cavity and developmental delay may be associated with a potential undiagnosed syndrome. The medical evaluation becomes decisive for investigation, diagnosis, and final conduct of the case.
Tooth Abnormalities , Tooth Crown , Abnormalities, Multiple , Child , Child, Preschool , Dentition , Face/abnormalities , Follow-Up Studies , Hematologic Diseases , Humans , Male , Vestibular Diseases
BACKGROUND: Studies on the elderly have reported that the risk of cognitive impairment is affected by chewing difficulty. OBJECTIVE: To determine whether there is a relationship between the number of pairs of antagonist teeth that come into contact when the mouth is closed (functional masticatory units [FMUs]) and the level of cognitive impairment. METHODS: We conducted a cross-sectional observational study with 502 institutionalised White individuals older than 65 years, living in the northwest of Spain and Portugal. Through a direct visual inspection, we recorded the number of FMUs. Cognitive impairment was assessed by applying the Mini-Cognitive Examination (MCE), a test derived from the Mini-Mental State Examination. To describe the statistical relationship between the FMUs and the MCE values, a generalised linear model (GLM) was applied. We assessed the GLM predictive capacity for detecting cognitive impairment (MCE ≤23) in a new study group consisting of 156 elderly individuals. RESULTS: A large number of FMUs was significantly associated with a lower probability of cognitive impairment, regardless of the nature of the contact and its location (explained deviance, 30.1%). The model's discriminatory capacity for cognitive impairment based on the FMUs was "good" (0.820). The model's predictive capacity for cognitive impairment was "acceptable" (sensitivity, 0.786; positive predictive value, 0.900; accuracy, 0.729). CONCLUSION: In White, elderly institutionalised individuals, the absolute number of FMUs is significantly related to their MCE scores.
Cognitive Dysfunction/physiopathology , Deglutition/physiology , Geriatric Assessment , Mastication/physiology , Tooth Loss/physiopathology , Aged , Aged, 80 and over , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/psychology , Cross-Sectional Studies , Disability Evaluation , Female , Humans , Male , Neuropsychological Tests , Portugal/epidemiology , Spain/epidemiology
Long non-coding RNAs (lncRNAs) are involved in multiple regulatory pathways and its versatile form of action has disclosed a new layer in gene regulation. LncRNAs have their expression levels modulated during plant development, and in response to stresses with tissue-specific functions. In this study, we analyzed lncRNA from leaf samples collected from the legume Copaifera langsdorffii Desf. (copaíba) present in two divergent ecosystems: Cerrado (CER; Ecological Station of Botanical Garden in Brasília, Brazil) and Atlantic Rain Forest (ARF; Rio de Janeiro, Brazil). We identified 8020 novel lncRNAs, and they were compared to seven Fabaceae genomes and transcriptomes, to which 1747 and 2194 copaíba lncRNAs were mapped, respectively, to at least one species. The secondary structures of the lncRNAs that were conserved and differentially expressed between the populations were predicted using in silico methods. A few selected lncRNA were confirmed by RT-qPCR in the samples from both biomes; Additionally, the analysis of the lncRNA sequences predicted that some might act as microRNA (miRNA) targets or decoys. The emerging studies involving lncRNAs function and conservation have shown their involvement in several types of biotic and abiotic stresses. Thus, the conservation of lncRNAs among Fabaceae species considering their rapid turnover, suggests they are likely to have been under functional conservation pressure. Our results indicate the potential involvement of lncRNAs in the adaptation of C. langsdorffii in two different biomes.
INTRODUCTION: Diabetes Mellitus has been considered an epidemic by the World Health Organization, with a high risk of morbidity and mortality. The treatment of this pathology consists in glycemic control, which can be done by oral hypoglycemic agents, insulin therapy, dietary guidance, regular physical activity, and psychosocial support. In addition, other adjuvant treatments are employed, such as phytotherapic, and one of the most used plants is Bauhinia forficata. AREAS COVERED: In the current review, patents using Bauhinia forficata for the Diabetes Mellitus treatment have been analyzed. There were 03 patents in WIPO, 01 in Espacenet, 01 in USPTO, and 02 in INPI. EXPERT OPINION: Patents on the adjuvant treatment of Diabetes Mellitus by Bauhinia forficata are discussed. Although there are some phytotherapy products containing this medicinal plant which has hypoglycemic effect here is still a need for the development of more products based on natural resources, for the treatment of this pathology, without side effects and with other benefits, to assist in the glycemia control in diabetic patients, and to improve their quality of life.
Bauhinia/chemistry , Diabetes Mellitus/drug therapy , Plant Extracts/pharmacology , Animals , Blood Glucose/drug effects , Diabetes Mellitus/physiopathology , Drug Design , Humans , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/isolation & purification , Hypoglycemic Agents/pharmacology , Patents as Topic , Phytotherapy/methods , Plant Extracts/adverse effects
OBJETIVO: Determinar los niveles de estrés y calidad de vida de estudiantes de primero y quinto ciclo de la carrera de medicina para compararlos y determinar la influencia de estos factores en su rendimiento académico. MÉTODO: Se realizó un estudio observacional, desarrollado en un modelo longitudinal y comparativo. Incluyó a los estudiantes de primero y quinto ciclo de la facultad de Medicina. Se realizó una medición del cortisol plasmático durante el periodo de clases regulares y en la semana de exámenes finales para comparar los resultados, así como se aplicó el cuestionario Q LES Q para determinar calidad de vida. RESULTADOS: Se evaluaron 78 estudiantes, 43 fueron de primer ciclo y 35 de quinto ciclo. La calidad de vida fue catalogada como buena en un 27 % de estudiantes. La media de cortisol inicial fue 9.88 ±3.35 µg/dl en alumnos de primer ciclo y 14.88 ±7.09 µg/dl en los alumnos de quinto (p: Ë0.05). Luego del periodo de exámenes, la media de cortisol llegó a 14.36 ±5.43 µg/dl en alumnos de primer ciclo y 18.23 ±5.83 µg/dl en los alumnos de quinto (p: Ë0.05). Dos personas reprobaron primer ciclo, sin embargo ninguno de ellos tuvo valores de cortisol para determinar la existencia de estrés. Se encontraron diferencias significativas entre los valores de cortisol obtenidos antes y después del período de exámenes. No se demostró asociación entre el desenlace académico y los resultados del cuestionario Q LES Q en relación a los niveles plasmáticos de cortisol (Fisher Ë0.05). CONCLUSIÓN: Existieron diferencias significativas entre los niveles plasmáticos de cortisol de los alumnos de primero y quinto ciclo así como al comparar los valores en los dos periodos examinados. No se demostró que una calidad de vida regular se relacione con un desempeño académico negativo ni con los niveles plasmáticos de cortisol.(au)
OBJECTIVE: To determine stress level and quality of life of students from first and fifth cycle of Medicine, compareand determine the influence of these factors on their academic performance. METHODS: A longitudinal observational and comparative study was performed. It included students from first and fifth cycle of Medicine career. Cortisol serum levels were measured during regular classes and final examination period to compare results; Q LES Q was also applied to determine life quality. RESULTS: 78 students were part of the study, 43 from first and 35 from fifth cycle. Life quality was rated as «good¼ in 27 % of them. Initial cortisol means were 9.88 ±3.35 µg/dl in first cycle students and 14.88 ±7.09 µg/dl in fifth cycle students (p: Ë0.05). After examination period it reached 14.36 ±5.43 µg/dl for the first cycle students and 18.23 ±5.83 µg/dl in fifth cycle students (p: Ë0.05). Two students reproved and none of them had high cortisol levels. Significant differences were found between cortisol levels before and after examination period. There was no association among academic outcome and Q LES Q results compared with cortisol serum levels (Fisher: Ë0.05). CONCLUSIONS: Significant differences were found between cortisol levels in first and fifth cycle students and also before and after examination period. A relation was not established between cortisol levels, life quality and a negative academic outcome.(au)
Humans , Male , Female , Adult , Quality of Life/psychology , Stress, Psychological , Hydrocortisone/biosynthesis , Mental Health
A Reforma Psiquiátrica, por meio do processo de desinstitucionalização e criação de serviços substitutivos ao modelo hospitalocêntrico, chamou as famílias para assumirem uma parcela da responsabilidade na atenção à pessoa com transtorno mental. Os familiares passaram a ser parte imprescindível para a sua reinserção social sem, no entanto, receberem treinamento e orientação para isso. Objetivos: Averiguar a contribuição da Terapia Ocupacional no apoio e assistência aos familiares de pessoas com transtornos mentais no contexto da Reforma Psiquiátrica e da desinstitucionalização. Procedimentos metodológicos: A discussão é amparada em uma revisão não sistemática da literatura científica nacional e internacional, utilizando capítulos de livros e artigos científicos. A pesquisa de artigos científicos foi realizada nas bases de dados Bireme e Medline, em publicações do período de 2001 a 2011. Resultados: Constatou-se que ao receber suporte para enfrentar as dificuldades no relacionamento com o familiar com transtorno mental a sobrecarga emocional da família é amenizada e que a Terapia Ocupacional possui um arcabouço teórico bastante significativo no que diz respeito a esse tipo de assistência, derivado de uma prática consistente e que parece pouco explorado. Conclusões: Existe uma lacuna nos serviços, relacionada à elaboração de programas de atendimento às necessidades da família, pois não se pode negar a sobrecarga que a presença do indivíduo com transtorno mental acarreta ao núcleo familiar, especialmente a partir da Reforma Psiquiátrica, e o Terapeuta Ocupacional, por meio de sua prática, pode contribuir de maneira significativa nesse trabalho.
Vitamin D has been described as an essential element for maintaining the homeostasis of mineral content in the body and bone architecture. However, our view of the physiological functions of this micronutrient has radically changed, owing to the vast number of properties, not calcium-related, mediated by its nuclear receptor. This receptor has been found in a variety of cells, including the immune cells, where many of the functions performed by vitamin D are related to inflammation. Although the effect of vitamin D has been widely studied in many diseases caused by viruses or bacteria, very little is known about its role in parasitic diseases, such as leishmaniasis, which is a vector-borne disease caused by different species of the intracellular parasite Leishmania spp. This disease occurs as a spectrum of different clinical syndromes, all of them characterized by a large amount of tissue damage, sometimes leading to necrosis. Owing to the involvement of vitamin D in inflammation and wound healing, its role in leishmaniasis must be relevant, and could be used as an adjuvant for the control of this parasitic disease, opening a possibility for a therapeutic application.
Leishmania , Leishmaniasis/drug therapy , Leishmaniasis/epidemiology , Vitamin D/therapeutic use , Animals , Humans , Leishmania/drug effects , Leishmaniasis/metabolism , Receptors, Calcitriol/metabolism , Vitamin D/metabolism , Vitamin D/pharmacology
PURPOSE: This retrospective study was conducted to determine the difference in the cost of genioplasty according to the osseous fixation technique used. PATIENTS AND METHODS: A retrospective study among orthognathic surgery patients treated over a 54-month period ending in June 30, 2011 was conducted. Immediately post surgery, panoramic and cephalometric radiographs of these patients were assessed to determine the presence of genioplasty procedure and the type of fixation used. The cost of the actual fixation used by the surgeons was compared with that which the cost would have been had the surgeons used the criteria described in the hypotheses, for plate and screws fixation when genioplasty is performed. RESULTS: A review of 1,498 orthognathic surgery patients revealed that 473 of these patients underwent genioplasty. Out of 473 patients, 425 had genioplasty to either advance and-or superiorly reposition the chin. Of these, 230 had wire osteosynthesis and 243 had some form of rigid fixation. The unit cost of fixation for genioplasty when wire osteosynthesis is used is less than C$5.00. The mean unit cost estimate in our patient group when pre-bent plates are used was C$542.00. All 230 patients in whom wire osteosynthesis was used demonstrated stable fixation of the bony parts and no immediate postsurgical adjustment was required in any patient. CONCLUSIONS: For patients requiring genioplasty to advance and-or superiorly reposition the chin, it is possible to use wire osteosynthesis to achieve accurate and stable fixation while reducing the fixation cost by more than C$500.00 per case. The surgeon should include cost considerations in the selection of treatment methods.
Bone Plates/economics , Bone Screws/economics , Bone Wires/economics , Genioplasty/economics , Cost-Benefit Analysis , Genioplasty/instrumentation , Humans , Orthognathic Surgical Procedures/economics , Orthognathic Surgical Procedures/instrumentation , Retrospective Studies
Aminopeptidase N (APN or CD13) is a membrane ectopeptidase expressed by many cell types, including myelomonocytic lineage cells: monocytes, macrophages, and dendritic cells. CD13 is known to regulate the biological activity of various peptides by proteolysis, and it has been proposed that CD13 also participates in several functions such as angiogenesis, cell adhesion, metastasis, and tumor invasion. We had previously reported that, in human monocytes and macrophages, CD13 modulates the phagocytosis mediated by receptors for the Fc portion of IgG antibodies (FcγRs). In this work, we analyzed the possible interaction of CD13 with other phagocytic receptors. We found out that the cross-linking of CD13 positively modulates the phagocytosis mediated by receptors of the innate immune system, since a significant increase in the phagocytosis of zymosan particles or heat-killed E. coli was observed when CD13 was cross-linked using anti-CD13 antibodies, in both macrophages and dendritic cells. Also, we observed that, during the phagocytosis of zymosan, CD13 redistributes and is internalized into the phagosome. These findings suggest that, besides its known functions, CD13 participates in phagocytic processes in dendritic cells and macrophages.
CD13 Antigens/metabolism , Dendritic Cells/cytology , Dendritic Cells/enzymology , Macrophages/cytology , Macrophages/enzymology , Phagocytosis , Cross-Linking Reagents/pharmacology , Cytokines/metabolism , Dendritic Cells/drug effects , Endocytosis/drug effects , Escherichia coli/drug effects , Escherichia coli/metabolism , Humans , Intracellular Membranes/drug effects , Intracellular Membranes/metabolism , Macrophages/drug effects , Male , Monocytes/cytology , Phagocytes/cytology , Phagocytes/drug effects , Phagocytes/metabolism , Phagocytosis/drug effects , Phenotype , Protein Transport/drug effects , Toll-Like Receptor 2/metabolism , Zymosan/metabolism
CONTEXT: Spinal morphine is a common form of postoperative analgesia after caesarean section, but it is associated with postoperative nausea and vomiting. OBJECTIVE: To evaluate the hypothesis that dexamethasone reduces nausea and vomiting in patients undergoing caesarean section under spinal anaesthesia with morphine. DESIGN: Interventional, randomised, double-blinded, placebo-controlled study to evaluate a preoperative single dose of dexamethasone. SETTING: Patients from a tertiary hospital in the city of Sao Paulo, Sao Paulo, Brazil observed from 1 January through 30 June 2008. PATIENTS OR OTHER PARTICIPANTS: Seventy full-term pregnant patients (American Society of Anesthesiologists 1 or 2) were studied. Patients were randomly allocated into two groups determined by a computerised table. Exclusion criteria were contraindication to regional anaesthesia, allergy to dexamethasone, opioids or local anaesthetics, hypertension or diabetes originated during pregnancy and use of any antiemetic drug received before surgery. Spinal anaesthesia consisted of hyperbaric bupivacaine and morphine. INTERVENTION: Patients received either dexamethasone 10 mg in 100 ml of isotonic saline, intravenously or 100 ml of isotonic saline (placebo) prior to surgery. MAIN OUTCOME: Incidence of postoperative nausea and vomiting in the first 24 h were rated and recorded. Pain scores at rest and on movement were evaluated using a visual analogue scale. RESULTS: During the first 24 hours, nausea occurred in 12/35 (34.4%) patients receiving dexamethasone and in 32/35 (91.4%) receiving placebo (P<0.001). During the same time period, vomiting occurred in 12/35 (34.4%) patients receiving dexamethasone and in 29/35 (82.9%) receiving placebo (P<0.001). Pain at rest and pain on movement was lower in patients who received dexamethasone at some time points during the study period. CONCLUSION: Dexamethasone reduced the cumulative incidence of nausea and vomiting after caesarean section under spinal anaesthesia with morphine and lowered pain scores on the first postoperative day.
Antiemetics/administration & dosage , Cesarean Section/methods , Dexamethasone/administration & dosage , Pain, Postoperative/prevention & control , Postoperative Nausea and Vomiting/prevention & control , Vomiting/prevention & control , Adult , Anesthesia, Spinal/methods , Brazil , Double-Blind Method , Female , Humans , Morphine/administration & dosage , Postoperative Complications , Pregnancy , Time Factors , Young Adult
BACKGROUND: DNA barcoding has been successfully established in animals as a tool for organismal identification and taxonomic clarification. Slower nucleotide substitution rates in plant genomes have made the selection of a DNA barcode for land plants a much more difficult task. The Plant Working Group of the Consortium for the Barcode of Life (CBOL) recommended the two-marker combination rbcL/matK as a pragmatic solution to a complex trade-off between universality, sequence quality, discrimination, and cost. METHODOLOGY/PRINCIPAL FINDINGS: It is expected that a system based on any one, or a small number of plastid genes will fail within certain taxonomic groups with low amounts of plastid variation, while performing well in others. We tested the effectiveness of the proposed CBOL Plant Working Group barcoding markers for land plants in identifying 46 bromeliad species, a group rich in endemic species from the endangered Brazilian Atlantic Rainforest. Although we obtained high quality sequences with the suggested primers, species discrimination in our data set was only 43.48%. Addition of a third marker, trnH-psbA, did not show significant improvement. This species identification failure in Bromeliaceaecould also be seen in the analysis of the GenBank's matK data set. Bromeliaceae's sequence divergence was almost three times lower than the observed for Asteraceae and Orchidaceae. This low variation rate also resulted in poorly resolved tree topologies. Among the three Bromeliaceae subfamilies sampled, Tillandsioideae was the only one recovered as a monophyletic group with high bootstrap value (98.6%). Species paraphyly was a common feature in our sampling. CONCLUSIONS/SIGNIFICANCE: Our results show that although DNA barcoding is an important tool for biodiversity assessment, it tends to fail in taxonomy complicated and recently diverged plant groups, such as Bromeliaceae. Additional research might be needed to develop markers capable to discriminate species in these complex botanical groups.
Bromeliaceae/classification , Bromeliaceae/genetics , DNA Barcoding, Taxonomic/methods , Base Sequence , Databases, Genetic , Phylogeny , Plastids/genetics , Polymerase Chain Reaction , Sequence Analysis, DNA
Los déficits cognitivos, tales como los trastornos de atención, afectan alrededor del 98 por ciento de las personas con esquizofrenia, aspecto muy importante para determinar el nivel de discapacidad. Constituye muchas veces, un factor de mayor disfunción, que los síntomas reales de la propia esquizofrenia. El factor atención es importante por la relación directa que este tiene con la calidad de vida, con las actividades sociales, funcionales y profesionales del individuo. La recuperación no se alcanza solamente en el control de los síntomas, sino preeminentemente con habilitación cognitiva. Considerando que dichos déficits interfieren directamente en la ejecución de actividades que influyen en la autonomía del individuo, se optó por verificar el impacto del déficit de atención en la realización de actividades de vida diaria (AVD): cuidados con los dispositivos personales - gafas. Las actividades de vida diaria se consideran importantes en todos los ámbitos de atención en Terapia Ocupacional; la recuperación de las AVD contribuyen de manera provechosa y significativa para la calidad de vida. Con el propósito de discutir teórica y prácticamente estos aspectos, fue realizado un estudio bibliográfico y una investigación de campo en donde se usaron dos cuestionarios: Cuidados con las Gafas (de la autora, 2009) y Cuestionario de la Atención [1], aplicados en dos individuos con esquizofrenia que cumplieron con los criterios de inclusión. Los resultados apuntan que aunque los déficits de atención estén presentes en estos individuos, no interfieren de manera significativa en las AVD y no influyen en la ejecución de los cuidados de los dispositivos personales gafas. Es mas, el 20 por ciento de las personas de esta encuesta deben usar gafas por prescripción médica, aunque desestiman su uso.
Cognitive deficits, such as attention disorders, affect about 98 percent of individuals with schizophrenia, very important aspect in determining the level of disability. It often represents a major factor of dysfunction than the symptoms of schizophrenia. The ability to pay attention is relevant because of the direct relation with quality of life and social, functional and professional performance of individuals. Recovery is not only achieved by controlling symptoms, but overall with the cognitive recovery. Considering that those deficits directly interfere in the performance of activities that influence in individuals autonomy, it was opted to verify the impact of attention deficit in activities of daily living (ADL) performance; personal devices care glasses. Activities of Daily Living are considered important in all the modes of health care in Occupational Therapy. The recovery of ADL contributes in a significant and productive way to the quality of life. With the purpose of discussion theory and practice of these aspects, a bibliographic study was done. Furthermore a field research was carried out in which two questionnaires were used: Care with glasses (from the author, 2009) and Attention questionnaire [1], these were applied in two individuals with schizophrenia that fulfilled the inclusion criteria. Results point that, though attention deficits were present in these individuals, they not interfere significantly in ADLs, and not influence the performance in personal devices care glasses. Even more, 20 percent of the people in this survey must use glasses by medical prescription, though they do not use them.
Humans , Male , Female , Activities of Daily Living , Attention , Cognition , Eyeglasses , Schizophrenic Psychology , Personal Autonomy , Surveys and Questionnaires , Self Care , Self Concept
BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.
Anesthesia, Conduction , Anesthesia, Spinal , Cardiac Output/physiology , Cesarean Section , Adolescent , Adult , Blood Pressure/physiology , Female , Hemodynamics/physiology , Humans , Monitoring, Physiologic/instrumentation , Pilot Projects , Pregnancy , Prospective Studies , Stroke Volume/physiology , Young Adult
BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.
Adolescent , Adult , Female , Humans , Pregnancy , Young Adult , Anesthesia, Conduction , Anesthesia, Spinal , Cesarean Section , Cardiac Output/physiology , Blood Pressure/physiology , Hemodynamics/physiology , Monitoring, Physiologic/instrumentation , Pilot Projects , Prospective Studies , Stroke Volume/physiology
BACKGROUND: Epigenetic modifications, such as cytosine methylation, are inherited in plant species and may occur in response to biotic or abiotic stress, affecting gene expression without changing genome sequence. Laguncularia racemosa, a mangrove species, occurs in naturally contrasting habitats where it is subjected daily to salinity and nutrient variations leading to morphological differences. This work aims at unraveling how CpG-methylation variation is distributed among individuals from two nearby habitats, at a riverside (RS) or near a salt marsh (SM), with different environmental pressures and how this variation is correlated with the observed morphological variation. PRINCIPAL FINDINGS: Significant differences were observed in morphological traits such as tree height, tree diameter, leaf width and leaf area between plants from RS and SM locations, resulting in smaller plants and smaller leaf size in SM plants. Methyl-Sensitive Amplified Polymorphism (MSAP) was used to assess genetic and epigenetic (CpG-methylation) variation in L. racemosa genomes from these populations. SM plants were hypomethylated (14.6% of loci had methylated samples) in comparison to RS (32.1% of loci had methylated samples). Within-population diversity was significantly greater for epigenetic than genetic data in both locations, but SM also had less epigenetic diversity than RS. Frequency-based (G(ST)) and multivariate (beta(ST)) methods that estimate population structure showed significantly greater differentiation among locations for epigenetic than genetic data. Co-Inertia analysis, exploring jointly the genetic and epigenetic data, showed that individuals with similar genetic profiles presented divergent epigenetic profiles that were characteristic of the population in a particular environment, suggesting that CpG-methylation changes may be associated with environmental heterogeneity. CONCLUSIONS: In spite of significant morphological dissimilarities, individuals of L. racemosa from salt marsh and riverside presented little genetic but abundant DNA methylation differentiation, suggesting that epigenetic variation in natural plant populations has an important role in helping individuals to cope with different environments.
Ecosystem , Epigenesis, Genetic , Genetic Variation , Rhizophoraceae/genetics , CpG Islands , DNA Methylation , Rivers , Salinity , Wetlands
