Neuroimaging characterization of multiple sclerosis lesions in pediatric patients: an exploratory radiomics approach.

Introduction: Multiple sclerosis (MS), a chronic inflammatory immune-mediated disease of the central nervous system (CNS), is a common condition in young adults, but it can also affect children. The aim of this study was to construct radiomic models of lesions based on magnetic resonance imaging (MRI, T2-weighted-Fluid-Attenuated Inversion Recovery), to understand the correlation between extracted radiomic features, brain and lesion volumetry, demographic, clinical and laboratorial data. Methods: The neuroimaging data extracted from eleven scans of pediatric MS patients were analyzed. A total of 60 radiomic features based on MR T2-FLAIR images were extracted and used to calculate gray level co-occurrence matrix (GLCM). The principal component analysis and ROC analysis were performed to select the radiomic features, respectively. The realized classification task by the logistic regression models was performed according to these radiomic features. Results: Ten most relevant features were selected from data extracted. The logistic regression applied to T2-FLAIR radiomic features revealed significant predictor for multiple sclerosis (MS) lesion detection. Only the variable "contrast" was statistically significant, indicating that only this variable played a significant role in the model. This approach enhances the classification of lesions from normal tissue. Discussion and conclusion: Our exploratory results suggest that the radiomic models based on MR imaging (T2-FLAIR) may have a potential contribution to characterization of brain tissues and classification of lesions in pediatric MS.

Detection of coinfection with Primate Erythroparvovirus 1 and arboviruses (DENV, CHIKV and ZIKV) in individuals with acute febrile illness in the state of Rio Grande do Norte in 2016.

BACKGROUND: Arthropod-borne viruses, known as arboviruses, pose substantial risks to global public health. Dengue (DENV), Chikungunya (CHIKV) and Zika (ZIKV) viruses stand out as significant concerns in Brazil and worldwide. Their overlapping clinical manifestations make accurate diagnosis a challenge, underscoring the need for reliable laboratory support. This study employs a comprehensive molecular diagnostic approach to track viral infections in individuals with acute febrile illness, a period marked by widespread outbreaks of DENV, CHIKV and ZIKV. METHODS: Between January and August 2016, we received a total of 713 serum samples obtained from individuals with acute febrile illness, previously tested for DENV, CHIKV or ZIKV, with initial negative results, from LACEN-NATAL. Of the total 713 samples, 667 were from females (354 of them pregnant) and 46 from males. Molecular diagnosis was conducted using the Multiplex RT-qPCR technique for simultaneous detection of DENV, CHIKV and ZIKV. Additionally, we performed differential diagnosis by RT-qPCR for other viruses of the Flavivirus, Alphavirus Enterovirus genera and qPCR for Primate Erythroparvovirus 1 (B19V) species, in accordance with Ministry of Health guidelines. RESULTS: Among the 713 cases, 78.2% tested positive for viral infections, including 48% with CHIKV viremia, 0.6% with DENV and 0.1% with ZIKV. Arboviral coinfections totaled 2.4%, including DENV-CHIKV (1.7%) and CHIKV-ZIKV (0.7%). Moreover, 8% exhibited B19V viremia. Simultaneous infections were identified in 17.5%, encompassing B19V-CHIKV (17.1%), B19V-DENV (0.1%), and B19V-ZIKV (0.3%) Triple infections were observed in 1.3% of cases with B19V-DENV-CHIKV (1%) and B19V-CHIKV-ZIKV (0.3%). CONCLUSION: Molecular testing demonstrated high efficacy in diagnosing prevalent arboviruses and detecting multiple coinfections. This approach helps to elucidate etiologies for symptomatic cases, especially during arbovirus outbreaks, and aids comprehensive surveillance. Our findings underscore the importance of monitoring co-circulating pathogens, such as B19V, with implications for clinical management, particularly in pregnant individuals. This study enhances our understanding of arbovirus epidemiology and reinforces the critical role of molecular diagnosis in disease surveillance and control.

Efficacy and Safety of a Nasopharyngeal Catheter for Selective Brain Cooling in Patients with Traumatic Brain Injury: A Prospective, Non-randomized Pilot Study.

BACKGROUND: The efficacy objective was to determine whether a novel nasopharyngeal catheter could be used to cool the human brain after traumatic brain injury, and the safety objective was to assess the local and systemic effects of this therapeutic strategy. METHODS: This was a prospective, non-randomized, interventional clinical trial that involved five patients with severe traumatic brain injury. The intervention consisted of inducing and maintaining selective brain cooling for 24 h by positioning a catheter in the nasopharynx and circulating cold water inside the catheter in a closed-loop arrangement. Core temperature was maintained at ≥ 35 °C using counter-warming. RESULTS: In all study participants, a brain temperature reduction of ≥ 2 °C was achieved. The mean brain temperature reduction from baseline was 2.5 ± 0.9 °C (P = .04, 95% confidence interval). The mean systemic temperature was 37.3 ± 1.1 °C at baseline and 36.0 ± 0.8 °C during the intervention. The mean difference between the brain temperature and the systemic temperature during intervention was - 1.2 ± 0.8 °C (P = .04). The intervention was well tolerated with no significant changes observed in the hemodynamic parameters. No relevant variations in intracranial pressure and transcranial Doppler were observed. The laboratory results underwent no major changes, aside from the K+ levels and blood counts. The K+ levels significantly varied (P = .04); however, the variation was within the normal range. Only one patient experienced an event of mild localized and superficial nasal discoloration, which was re-evaluated on the seventh day and indicated complete recovery. CONCLUSION: The results suggest that our noninvasive method for selective brain cooling, using a novel nasopharyngeal catheter, was effective and safe for use in humans.

Racismo e necropolítica: um debate entre teoria social e psicanálise / Racism and necropolitics: a debate between social theory and psychoanalysis / Racismo y necropolítica: un debate entre teoría social y psicoanálisis

Ao tomar a pandemia de Covid-19 como contexto e analisador, este artigo discute os elos históricos entre o racismo e a gestão medicalizada do direito de vida e de morte no Brasil. Parte-se do entendimento de que a escuta e manejo clínicos das situações de sofrimento psíquico no contexto da medicalização da vida (na pandemia, e mesmo fora dela) implicam, necessariamente, fazer também crítica social. Para tal, propomos um debate que enoda teoria da clínica, as histórias da medicina social e da psicanálise no Brasil, e os conceitos de bio e necropolítica. Nossa hipótese é a de que se por um lado, em sua chegada ao Brasil, a psicanálise foi "cooptada" por uma tradição médica higienista (o que polarizou por anos a forma como ela foi vista em nosso país), por outro, por sua estrutura conceitual, pelo contraponto inicial com o modernismo brasileiro, e por seu atual debate sobre a segregação, essa práxis pode explicitar sua potência e vocação antirracista.

Taking Covid-19 Pandemic as a context and analyzer, this article discusses the historical links between racism and the medicalized management of the right to life and death in Brazil. It is based on the understanding that listening and clinical management of situations of psychological distress in the context of the medicalization of life (in Pandemic, and even outside it) necessarily imply making social criticism as well. To this end, we propose a debate that encapsulates clinical theory, the histories of social medicine and psychoanalysis in Brazil, and the concepts of bio and necropolitics. Our hypothesis is that if, on the one hand, on its arrival in Brazil, psychoanalysis was "co-opted" by a hygienist medical tradition (which for years polarized the way it was seen in our country), on the other, by its conceptual structure, by the initial counterpoint with Brazilian modernism, and by its current debate on segregation, this praxis can make explicit its anti-racist power and vocation.

Tomando como como contexto y analizador la Pandemia Covid-19, este artículo analiza los vínculos históricos entre el racismo y la gestión medicalizada del derecho a la vida y muerte en Brasil. Se basa en el entendimiento de que la escucha y el manejo clínico de situaciones de malestar psicológico en el contexto de la medicalización de la vida (en Pandemia, e incluso fuera de ella) implica necesariamente hacer también crítica social. Para ello, proponemos un debate que encapsula la teoría clínica, las historias de la medicina social y el psicoanálisis en Brasil, y los conceptos de biopoder y necropolítica. Nuestra hipótesis es que, si, por un lado, a su llegada a Brasil, el psicoanálisis fue "cooptado" por una tradición médica higienista (que durante años polarizó la forma en que se veía en nuestro país), por el otro, por su estructura conceptual, por el contrapunto inicial con el modernismo brasileño, y por su actual debate sobre la segregación, esta praxis puede hacer explícito su poder y vocación antirracista.

Stages of sarcopenia, bone mineral density, and the prevalence of osteoporosis in older women.

A better understanding of the relationship between osteoporosis and sarcopenia may help to develop effective preventive and therapeutic strategies. In the present study, the association between different stages of sarcopenia, BMD, and osteoporosis was examined. The salient findings indicate that a dose-response relationship exists between sarcopenia stages and bone-related phenotypes. PURPOSE: To assess the association between sarcopenia stages, bone mineral density (BMD), and the prevalence of osteoporosis in older women. METHODS: Two hundred thirty-four women (68.3 ± 6.3 years) underwent body composition and BMD measurements using dual-energy X-ray absorptiometry. Quadriceps isokinetic torque was evaluated, and the timed up-and-go test was conducted as a measure of function. Sarcopenia stages were classified according to European Working Group on Sarcopenia in Older People (EWGSOP): nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. Osteoporosis was defined as BMD value (hip or spine) 2.5 standard deviations below a young-adult reference population. Between-group differences were examined using ANOVA for continuous variables and chi-squared for categorical variables. Logistic regression was performed to evaluate the association between sarcopenia stages and osteoporosis. RESULTS: Rates of osteoporosis were 15.8%, 19.2%, 35.3%, and 46.2% for nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia, respectively (P = 0.002). Whole-body and femoral neck BMD values were significantly lower among all sarcopenia stages when compared to nonsarcopenia (all P values < 0.05, η2p 0.113 to 0.109). The severe sarcopenia group also showed significantly lower lumbar spine BMD values and T-scores (both P values < 0.05; η2p 0.035 and 0.037, respectively). When clustered, sarcopenia and severe sarcopenia exhibited lower BMD values for all sites (all P values < 0.01), and presented a significantly higher risk for osteoporosis (odds ratio 3.445; 95% CI 1.521-7.844). CONCLUSION: The observed results provide support for the concept that a dose-response relationship exists between sarcopenia stages, BMD, and the presence of osteoporosis. These findings strengthen the clinical significance of the EWGSOP sarcopenia definition and indicate that severe sarcopenia should be viewed with attention by healthcare professionals.

EscreverCOM: com quem? com o quê? para quê? / WritingWITH: with whom? with what? For what? / EscribirCON: ¿con quién? ¿con qué? ¿para qué?

Este artigo problematiza a escrita do trabalho acadêmico. Toma por base o argumento de que a escrita é parte inerente à investigação e, a partir das considerações de Haraway (2008, 1995), afirma a escrita como prática situada e marcada. O trabalho aposta no fazerCOM como direção ética e epistemológica da pesquisa e apresenta discussão acerca da partilha da escrita de diários de campo, entre pesquisadores e pesquisados. O texto conclui indicando que a escrita partilhada dos diários de campo abre possibilidades inéditas na construção das narrativas acerca da deficiência, menos como déficit e mais como reinvenção da vida. (AU)

This paper problematizes academic writing by arguing that writing is an inherent part of research. Based on considerations of Haraway (2008, 1995) it affirms that writing is a situated and marked practice. The work bets on doingWITH as the ethical and epistemological direction of the research and presents a discussion about the sharing of written field diaries, between researchers and researched. The text concludes by pointing out that the shared writing of the field diaries opens up new possibilities in the construction of narratives about disability, less as deficits and more as a reinvention of life. (AU)

En este artículo se analiza la escritura del trabajo académico. Se basa en el argumento de la escritura como parte inherente de la investigación y desde las consideraciones de Haraway (2008, 1995) plantea la escritura como práctica situada y marcada. El trabajo apuesta en el hacerCON como dirección ética y epistemológica de la investigación y presenta la discusión acerca de compartir los diarios de campo entre investigadores e investigados. El texto concluye indicando que la escritura compartida de los diarios de campo abre nuevas posibilidades en la construcción de narrativas sobre la discapacidad, sin tomarla como déficit sino como reinvención de la vida. (AU)

EscreverCOM: com quem? com o quê? para quê? / WritingWITH: with whom? with what? For what? / EscribirCON: ¿con quién? ¿con qué? ¿para qué?

Este artigo problematiza a escrita do trabalho acadêmico. Toma por base o argumento de que a escrita é parte inerente à investigação e, a partir das considerações de Haraway (2008, 1995), afirma a escrita como prática situada e marcada. O trabalho aposta no fazerCOM como direção ética e epistemológica da pesquisa e apresenta discussão acerca da partilha da escrita de diários de campo, entre pesquisadores e pesquisados. O texto conclui indicando que a escrita partilhada dos diários de campo abre possibilidades inéditas na construção das narrativas acerca da deficiência, menos como déficit e mais como reinvenção da vida.

This paper problematizes academic writing by arguing that writing is an inherent part of research. Based on considerations of Haraway (2008, 1995) it affirms that writing is a situated and marked practice. The work bets on doingWITH as the ethical and epistemological direction of the research and presents a discussion about the sharing of written field diaries, between researchers and researched. The text concludes by pointing out that the shared writing of the field diaries opens up new possibilities in the construction of narratives about disability, less as deficits and more as a reinvention of life.

En este artículo se analiza la escritura del trabajo académico. Se basa en el argumento de la escritura como parte inherente de la investigación y desde las consideraciones de Haraway (2008, 1995) plantea la escritura como práctica situada y marcada. El trabajo apuesta en el hacerCON como dirección ética y epistemológica de la investigación y presenta la discusión acerca de compartir los diarios de campo entre investigadores e investigados. El texto concluye indicando que la escritura compartida de los diarios de campo abre nuevas posibilidades en la construcción de narrativas sobre la discapacidad, sin tomarla como déficit sino como reinvención de la vida.

[Publications committee of a multicenter study and computerized support system--publiELSA]. / Comitê de publicações em estudo multicêntrico e sistema informatizado de apoio ­ publiELSA.

The publications committee of a multicenter study has the aim of organizing the proposals for articles, so as to ensure wide-ranging access to the data, quality and precedence. An online information and management system for study proposals (publiELSA) was developed, composed of three modules: (i) submission and approval of proposals; (ii) follow-up of approved proposals; and (iii) consolidated reports. The first module allows any interested party to search for and become acquainted with articles that have already been published or are in progress and submit new proposals. The approval process and data transfer to the researcher responsible is organized at this stage. In the second module, the aim is to monitor proposals approved until they are finally published. The third module enables searching for and viewing proposals and articles. The system has innovative characteristics, especially with regard to encouraging cooperation between different researchers, through circulation of information on each proposal submitted. In this manner, interaction between different viewpoints and experiences involved in the research is stimulated.

Comite de publicacoes em estudo multicentrico e sistema informatizado de apoio - publiELSA / Publications committee of a multicenter study and computerized support system - publiELSA

O comitê de publicações de um estudo multicêntrico visa organizar as propostas de artigos, garantindo: amplo acesso aos dados, qualidade e precedência. Foi desenvolvido um sistema online de informação e gerenciamento de propostas de estudos - o publiELSA - , composto por três módulos: (i) submissão e aprovação da proposta; (ii) acompanhamento da proposta aprovada; e (iii) relatórios consolidados. O primeiro permite a qualquer interessado buscar e conhecer artigos já publicados e em andamento, e submeter novas propostas. O processo de aprovação e transferência dos dados para o pesquisador responsável é organizado nessa etapa. O segundo módulo visa ao monitoramento das propostas aprovadas até sua publicação final e o terceiro permite buscas e visualização de propostas e artigos. O sistema tem aspectos inovadores, sobretudo o incentivo à cooperação entre os diversos pesquisadores, por meio da circulação de informes sobre cada proposta submetida. Estimula-se assim a interação dos diferentes olhares e experiências envolvidos nesta pesquisa.

The publications committee of a multicenter study has the aim of organizing the proposals for articles, so as to ensure wide-ranging access to the data, quality and precedence. An online information and management system for study proposals (publiELSA) was developed, composed of three modules: (i) submission and approval of proposals; (ii) follow-up of approved proposals; and (iii) consolidated reports. The first module allows any interested party to search for and become acquainted with articles that have already been published or are in progress and submit new proposals. The approval process and data transfer to the researcher responsible is organized at this stage. In the second module, the aim is to monitor proposals approved until they are finally published. The third module enables searching for and viewing proposals and articles. The system has innovative characteristics, especially with regard to encouraging cooperation between different researchers, through circulation of information on each proposal submitted. In this manner, interaction between different viewpoints and experiences involved in the research is stimulated.