Thumb basal joint arthritis: New classification, diagnostic and therapeutic algorithm.

The assessment of thumb basal joint arthritis requires a radiographic evaluation and a classification of the lesions to guide the treatment choice. Arthritis of the thumb basal joint is not limited to trapeziometacarpal arthritis. The radiographic assessment must consider the scaphotrapeziotrapezoid joint, the entire carpus and the rest of the thumb column, in particular the metacarpophalangeal joint. There is currently no classification that captures all these items. This article reviews the existing classifications, proposes a new classification system that takes into account the entire thumb column and sets out the therapeutic options.

Real-world data from the Portuguese Nivolumab Expanded Access Program (EAP) in previously treated Non Small Cell Lung Cancer (NSCLC).

OBJECTIVE: The main aim of the study was to evaluate the efficacy and safety profile of Nivolumab, an immune-checkpoint-inhibitor antibody, in advanced, previously treated, Non-Small Cell Lung Cancer (NSCLC) patients, in a real world setting. METHODS: We performed a retrospective, multicentre data analysis of patients who were included in the Portuguese Nivolumab Expanded Access Program (EAP). Eligibility criteria included histologically or citologically confirmed NSCLC, stage IIIB and IV, evaluable disease, sufficient organ function and at least one prior line of chemotherapy. The endpoints included Overall Response Rate (ORR), Disease Control Rate (DCR), Progression Free Survival (PFS) and Overall Survival (OS). Safety analysis was performed with the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 4.0, and immune-related Adverse Events (irAEs) were treated according to protocol treatment guidelines. Tumour response was assessed using the Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1. Data was analysed using SPSS, version 21.0 (IBM Statistics). RESULTS: From June 2015 to December 2016, a total of 229 patients with advanced NSCLC were enrolled at 30 Portuguese centres. Clinical data were collected up to the end of July 2018. The baseline median age was 64 years (range 37-83) and the majority of patients were males (70.3%) and former/current smokers (69.4%). Patients with non-squamous histology predominated (88.1%), and 67.6% of the patients had received 2 or more prior lines of chemotherapy. Out of 229 patients, data was available for 219 patients (3 patients did not start treatment, while data was unavailable in 7 patients); of the 219 patients, 15.5% were not evaluated for radiological tumour assessment, 1.4% had complete response (CR), 21% partial response (PR), 31% stable disease (SD) and 31.1% progressive disease (PD). Thus, the ORR was 22.4% and DCR was 53.4% in this population. At the time of survival analysis the median PFS was 4.91 months (95% CI, 3.89-6.11) and median OS was 13.21 months (95% CI, 9.89-16.53). The safety profile was in line with clinical trial data. CONCLUSIONS: Efficacy and safety results observed in this retrospective analysis were consistent with observations reported in clinical trials and from other centres.

Three-dimensional surface models of the facial soft tissues acquired with a low-cost scanner.

Although there has been an increase in three-dimensional (3D) scanning methods available on the market, they are generally expensive. The DI3D system is considered a good scanner for the acquisition of soft tissue surface images. The Microsoft Kinect scanner is a much more affordable alternative for acquiring 3D models. The aim of this study was to determine whether the precision and accuracy of Kinect are similar to those of DI3D. To verify the accuracy, 10 patients were scanned with both methods The models of each patient acquired from the two scanners were superimposed using a surface-to-surface registration technique, and the distances between the models were recorded for 10 different anatomical regions of interest. For the evaluation of precision, one patient was scanned 11 different times with the Kinect scanner, and these models were compared using the same superimposition method. It was found that the average difference between the two methods was 0.3±2.03mm. The assessment of reproducibility showed an average difference between the images taken with Kinect of 0.1±0.6mm (P<0.05, one-sample t-test). Thus, Kinect showed good precision and reasonable accuracy, and appears to be an interesting and promising resource for facial analysis.

Impact of cesarean section in a private health service in Brazil: indications and neonatal morbidity and mortality rates.

OBJECTIVE: To evaluate the incidence of, indications of, and maternal and neonatal morbidity and mortality rates in cesarean sections in a private health service in Brazil. DESIGN: Retrospective and observational study. SETTING: Private health service in Vitória, Espírito Santo, Brazil. METHODS: The patients were interviewed using a structured questionnaire to determine maternal age, gestational age at the time of delivery, number of previous deliveries, type of delivery performed, duration of labor, indications for cesarean delivery, point at which cesarean section was performed, physician responsible for delivery, and maternal morbidity, fetal morbidity, and fetal mortality rates. A descriptive analysis of the data was conducted. Students t-test was performed to compare quantitative variables, and Fishers exact test was performed for categorical variables. RESULTS: A total of 584 patients were evaluated. Of these, 91.8% (536/584) had cesarean sections, while only 8.2% (48/584) had vaginal deliveries. There were no reports of forceps-assisted vaginal deliveries. In 87.49% of the deliveries, the number of gestational weeks was more than 37. In terms of indications for performing cesarean section, 48.5% were for maternal causes, 30.41% were for fetal causes, and 17.17% were elective. Maternal re-hospitalization due to puerperal complications was necessary in 10.42% of the vaginal deliveries and in 0.93% of the cesarean deliveries (p<0.001). Complications were observed in 18.75% of the vaginally delivered newborns and in 17.16% of those delivered by cesarean section. Of the newborns with complications at birth, 40.59% (41/101) had to be admitted to the neonatal intensive care unit. There were no cases of maternal death. There were seven cases of fetal/neonatal death. CONCLUSION: We observed that the vast majority of deliveries in the private sector are performed by cesarean section, without labor, and by the patients obstetrician. We found no serious maternal complications or increased neonatal morbidity rates associated with cesarean section.

Structural evolution, growth mechanism and photoluminescence properties of CuWO4 nanocrystals.

Copper tungstate (CuWO4) crystals were synthesized by the sonochemistry (SC) method, and then, heat treated in a conventional furnace at different temperatures for 1h. The structural evolution, growth mechanism and photoluminescence (PL) properties of these crystals were thoroughly investigated. X-ray diffraction patterns, micro-Raman spectra and Fourier transformed infrared spectra indicated that crystals heat treated and 100°C and 200°C have water molecules in their lattice (copper tungstate dihydrate (CuWO4·2H2O) with monoclinic structure), when the crystals are calcinated at 300°C have the presence of two phase (CuWO4·2H2O and CuWO4), while the others heat treated at 400°C and 500°C have a single CuWO4 triclinic structure. Field emission scanning electron microscopy revealed a change in the morphological features of these crystals with the increase of the heat treatment temperature. Transmission electron microscopy (TEM), high resolution-TEM images and selected area electron diffraction were employed to examine the shape, size and structure of these crystals. Ultraviolet-Visible spectra evidenced a decrease of band gap values with the increase of the temperature, which were correlated with the reduction of intermediary energy levels within the band gap. The intense photoluminescence (PL) emission was detected for the sample heat treat at 300°C for 1h, which have a mixture of CuWO4·2H2O and CuWO4 phases. Therefore, there is a synergic effect between the intermediary energy levels arising from these two phases during the electronic transitions responsible for PL emissions.

Diffusion Processes and Drug Release: Capsaicinoids - Loaded Poly (ε-caprolactone) Microparticles.

We present a generalmodel based on fractional diffusion equation coupled with a kinetic equation through the boundary condition. It covers several scenarios that may be characterized by usual or anomalous diffusion or present relaxation processes on the surface with non-Debye characteristics. A particular case of this model is used to investigate the experimental data obtained from the drug release of the capsaicinoids-loaded Poly (ε-caprolactone) microparticles. These considerations lead us to a good agreement with experimental data and to the conjecture that the burst effect, i.e., an initial large bolus of drug is released before the release rate reaches a stable profile, may be related to an anomalous diffusion manifested by the system.

Cluster coordination and photoluminescence properties of α-Ag2WO4 microcrystals.

In this paper, we report our initial research to obtain hexagonal rod-like elongated silver tungstate (α-Ag(2)WO(4)) microcrystals by different methods [sonochemistry (SC), coprecipitation (CP), and conventional hydrothermal (CH)] and to study their cluster coordination and optical properties. These microcrystals were structurally characterized by X-ray diffraction (XRD), Rietveld refinements, Fourier transform infrared (FT-IR), X-ray absorption near-edge structure (XANES), and extended X-ray absorption fine structure (EXAFS) spectroscopies. The shape and average size of these α-Ag(2)WO(4) microcrystals were observed by field-emission scanning electron microscopy (FE-SEM). The optical properties of these microcrystals were investigated by ultraviolet-visible (UV-vis) spectroscopy and photoluminescence (PL) measurements. XRD patterns and Rietveld refinement data confirmed that α-Ag(2)WO(4) microcrystals have an orthorhombic structure. FT-IR spectra exhibited four IR-active modes in a range from 250 to 1000 cm(-1). XANES spectra at the W L(3)-edge showed distorted octahedral [WO(6)] clusters in the lattice, while EXAFS analyses confirmed that W atoms are coordinated by six O atoms. FE-SEM images suggest that the α-Ag(2)WO(4) microcrystals grow by aggregation and the Ostwald ripening process. PL properties of α-Ag(2)WO(4) microcrystals decrease with an increase in the optical band-gap values (3.19-3.23 eV). Finally, we observed that large hexagonal rod-like α-Ag(2)WO(4) microcrystals prepared by the SC method exhibited a major PL emission intensity relative to α-Ag(2)WO(4) microcrystals prepared by the CP and CH methods.

First record of culex (Culex) brethesi (Dyar) (Diptera: Culicidae) in Rio Grande do Sul State, Brazil.

This is the first record of Culex (Culex) brethesi (Dyar) in Rio Grande do Sul state, Brazil. The species was identified from specimens collected in a sand bar vegetation with the aid of a Nasci's trap, during an expedition for surveillance of the West Nile Virus in July of 2006, in the city of Mostardas, Rio Grande do Sul, Brazil.

Soft tissue response to mandibular advancement using 3D CBCT scanning.

This prospective longitudinal study assessed the 3D soft tissue changes following mandibular advancement surgery. Cranial base registration was performed for superimposition of virtual models built from cone beam computed tomography (CBCT) volumes. Displacements at the soft and hard tissue chin (n = 20), lower incisors and lower lip (n = 21) were computed for presurgery to splint removal (4-6-week surgical outcome), presurgery to 1 year postsurgery (1-year surgical outcome), and splint removal to 1 year postsurgery (postsurgical adaptation). Qualitative evaluations of color maps illustrated the surgical changes and postsurgical adaptations, but only the lower lip showed statistically significant postsurgical adaptations. Soft and hard tissue chin changes were significantly correlated for each of the intervals evaluated: presurgery to splint removal (r = 0.92), presurgery to 1 year postsurgery (r = 0.86), and splint removal to 1 year postsurgery (r = 0.77). A statistically significant correlation between lower incisor and lower lip was found only between presurgery and 1 year postsurgery (r = 0.55). At 1 year after surgery, 31% of the lower lip changes were explained by changes in the lower incisor position while 73% of the soft tissue chin changes were explained by the hard chin. This study suggests that 3D soft tissue response to mandibular advancement surgery is markedly variable.

In vivo anthelmintic activity of an aqueous extract from sisal waste (Agave sisalana Perr.) against gastrointestinal nematodes in goats.

The resistance of gastrointestinal nematodes (GINs) of small ruminants to anthelmintics has required the investigation of new alternatives. The aim of the present study was to evaluate the in vivo anthelmintic activity of an aqueous extract from sisal waste (Agave sisalana) (AESW) against GINs in goats and to observe the animals for toxic effects. Thirty animals that were naturally infected with GINs were distributed into three groups: group I, was treated with daily doses of AESW (1.7 g/kg) for eight days; Group II, the positive control, was treated with a single dose of levamisole phosphate (6.3mg/kg); and group III, the negative control, was left untreated. Faecal eggs counts (FECs), coprocultures and post-mortem worm counts were performed to assess the efficacy of the treatments. Clinical and laboratory analyses were performed to evaluate any toxic effects associated with the treatment. In the goats in groups I and II, a significant reduction (p<0.05) of the number of eggs and infective larvae (L(3)) was observed. The maximum reductions of the FECs were 50.3% and 93.6% for groups I and II, respectively, whereas the percent reductions of the total number of L(3) larvae were 80% (group I) and 85.6% (group II). There was no difference between groups I and III with respect to worm burden, and the percent reductions were 28.8% and 63.4% for Oesophagostomum columbianum and Trichostrongylus colubriformis, respectively. No reduction was detected for the Haemonchus contortus. The positive control group demonstrated a 74% reduction of the parasites that were recovered from the digestive tract. There were no changes in clinical and haematological parameters. The levels of serum urea and creatinine were higher in group I, but remained within the normal range. At necropsy, pale mucous membranes, abomasitis and enteritis were associated with parasitism. In addition, a histological analysis of the liver and kidney did not reveal any changes suggestive of toxicity. A chemical analysis of the AESW demonstrated the presence of saponins, which after acid-hydrolyses reaction, gave the sapogenins hecogenin and tigogenin. The AESW had a low efficacy for the parasitic stages and was moderately effective against eggs and free-living stages. Furthermore, the treatment was not toxic to the goats.

Longevidade pós-colheita de alpínia [Alpinia purpurata (Vieill.) K. Schum.] tratada com soluções de sacarose e extratos aquosos naturais / Postharvest longevity of red ginger [Alpinia purpurata (Vieill.) K. Schum.] treated with sucrose solutions and natural water extracts

A alpínia (Alpinia purpurata) é uma planta tropical encontrada em diversas regiões do Brasil com excelente potencial para a comercialização como flor de corte. Entretanto, a senescência das hastes pela exaustão da sacarose é um dos principais fatores que afetam a durabilidade comercial, sendo suprimida através da adição de sacarose nas soluções de pulsing. O presente trabalho objetivou avaliar o efeito de extratos aquosos de estévia (Stevia rebaudiana), anis estrelado (Illicium verum) e sacarose em solução de pulsing na manutenção da qualidade pós-colheita de inflorescências de alpínia. Hastes florais uniformizadas em tamanho foram submetidas à solução de pulsing, por 12 horas, nas concentrações de 0,5; 1,0; 2,0 e 3,0 por cento, tendo água destilada como controle. A melhor qualidade comercial das inflorescências foi obtida quando as hastes foram colocadas em pulsing em extratos de anis estrelado e estévia 1 por cento e em solução de sacarose 2 por cento, não apresentando diferença estatística entre si. A longevidade total das hastes não foi influenciada pelos tratamentos. A solução de sacarose pode ser substituída pelos extratos das plantas medicinais estudadas, na conservação pós-colheita de inflorescências de alpínia.

Red ginger (Alpinia purpurata) is a tropical plant found in several Brazilian regions with excellent potential for commercialization as cut flower. However, the senescence of flower stems due to the exhaustion of sucrose is a major factor that affects commercial durability and is suppressed through addition of sucrose in pulsing solutions. The aim of this work was to evaluate the effect of water extracts from stevia (Stevia rebaudiana), star anise (Illicium verum) and sucrose in pulsing solution on the postharvest quality maintenance of red ginger inflorescences. Flower stems of uniform size were subjected to the pulsing solution for 12h at 0.5, 1.0, 2.0 and 3.0 percent concentrations, with distilled water as control. The best commercial quality of inflorescences was obtained when flower stems were kept in pulsing solutions from 1 percent star anise and stevia extracts and in 2 percent sucrose solution, not presenting statistical difference. Total longevity of flower stems was not influenced by treatments. Sucrose solution may be replaced by extracts of the studied medicinal plants in the postharvest conservation of red ginger inflorescences.

Efeito inibitório in vitro de extrato vegetal de Allium sativum sobre Aspergillus niger Tiegh / In vitro inhibitory effect of Allium sativum extract on Aspergillus niger Tiegh

O sisal (Agave sisalana Perrine ex Engelm.) é a principal fonte de extração de fibras duras vegetais do mundo. No Brasil, o cultivo ocupa extensa área de solos pobres na região semi-árida dos Estados da Bahia, Paraíba e Rio Grande do Norte, em regiões com escassa ou nenhuma alternativa para exploração de outras culturas. Tendo em vista a propriedade inibitória dos extratos vegetais sobre o desenvolvimento de fungos, avaliou-se o efeito inibitório do extrato vegetal de alho (Allium sativum L.) sobre o fungo Aspergillus niger isolados da cultura do sisal. O extrato vegetal foi incorporado ao meio BDA fundente, aproximadamente 45ºC, nas concentrações 0, 500, 1000, 2000, 50000, 10000 e 50000 mg L-1. Os resultados demonstraram que a dose de 50000 mg L-1 de alho foi eficiente na inibição do crescimento do fungo Aspergillus niger "extraídos" da cultura do sisal.

Sisal (Agave sisalana Perrine ex Engelm.) is the main source of plant hard fiber extraction in the world. In Brazil, its cultivation occupies a large area of poor soils in the semi-arid region of Bahia, Paraiba and Rio Grande do Norte States, and in regions with scarce or no alternative to explore other crops. Based on the inhibitory property of plant extracts on fungal development, the inhibitory effect of garlic (Allium sativum L.) extract was evaluated on the fungus Aspergillus niger isolated from sisal crop. The plant extract was incorporated into melting PDA medium around 45ºC, at the following concentrations: 0, 500, 1000, 2000, 50000, 10000, and 50000 mg L-1. (OBS: M. Elena, há duas doses repetidas; creio que a primeira seja 5000). The concentration 50000 mg L-1 garlic extract was effective in inhibiting the growth of the fungus Aspergillus niger extracted from sisal crop.

Effect of homeopathic medicines on helminth parasitism and resistance of Haemonchus contortus infected sheep.

This study evaluated the effects of homeopathic treatment on control of Haemonchus contortus infection in sheep. Twenty lambs were randomized to three treatments: treated with the homeopathic medicines, Ferrum phosphoricum, Arsenicum album and Calcarea carbonica; treated with a conventional antihelminthic, doramectin, and an untreated control group. Fecal and blood samples were taken from each animal on days 18, 38 and 68 after start of treatment. A significant reduction in number of H. contortus larvae (p<0.01) was observed for animals in the homeopathic treatment group compared to the control group. Fecal egg counts showed negative correlation between haematocrit and haemoglobin concentrations in the homeopathic treatment group (p<0.01); however, the biochemical and immunological parameters showed better correlation, indicating that the homeopathic medicine improved vital functions. Daily weight gain in the homeopathic treatment group was superior to the control and to the antihelminthic groups, 31 and 6.5%, respectively. The cost benefit analysis confirmed that homeopathy group increases economic trend when compared with the other groups.

Chickens (Gallus domesticus) are natural intermediate hosts of Neospora caninum.

Neospora caninum naturally infects many mammal species, but has not previously been demonstrated in birds. We examined sera for N. caninum antibodies from 200 outdoor chickens and from 200 chickens confined indoors in the state of Bahia, Brazil. Seroprevalence was greater in outdoor chickens (23.5% versus 1.5%, P<0.001). PCR testing for N. caninum was positive in six of 10 seropositive chickens. Amplicons from two of these were sequenced and had 97-98% nucleotide identity with N. caninum. This finding extends the list of intermediate hosts of N. caninum to include birds and may have important epidemiological consequences.

Anti-neosporal IgG and IgE antibodies in canine neosporosis.

Neospora caninum infection provokes neurological disorders, recurrent abortion and death in dogs and cattle. Dogs are both intermediate and definitive host of N. caninum. Thus, the development of sensitive and specific immunoassays to diagnose canine neosporosis is essential to control this disease. This work investigated serum anti-neosporal IgG and IgE antibodies in 140 dogs represented by 30 healthy animals (group I), 11 dogs showing acute N. caninum infection (group II), 50 urban dogs with serological evidence of canine neosporosis in indirect fluorescent antibody test (IFAT) (group III) and 49 urban dogs without clinical and laboratory evidences of neosporosis (group IV). Enzyme-linked immunosorbent assay (ELISA) and western immunoblotting, both using a soluble N. caninum tachyzoite antigen (SNA), investigated these two isotypes of antibodies, while a Urea-ELISA measured the avidity of the IgG antibodies. Anti-Toxoplasma gondii IgG antibodies were also investigated in the animals. Anti-neosporal IgG was found in all animals from groups II and III, whereas 32.7% (16/49) of dogs from group IV were reactive. IgG antibodies of low avidity were demonstrated in dogs from group II (median 35.3%), while animals from groups III and IV had IgG antibodies of high avidity (medians of 61.5% and 61.7% respectively). IgE antibodies were found in four (13.3%) and five (16.6%) dogs from groups III and IV respectively. Dogs presenting acute infection (group II) or chronic infection (group III) had IgG antibodies to several neosporal antigens, mainly of 29-30 and 35 kDa, while 13 of 16 dogs from group IV recognized antigens from 14 to 170 kDa. Antibodies to T. gondii were detected in 36 of 50 (72%) sera from group III and 25 of 49 (51%) sera from group IV. We concluded that IgG-ELISA and Urea-ELISA with SNA may substitute for IFAT in both laboratory routine and epidemiological studies of canine neosporosis.

Bacterial productivity distribution during a rainy year in an estuarine system.

Bacterial density and productivity were investigated along four salinity gradients within the estuary Ria de Aveiro. Bacterial variables and environmental parameters were measured at three to four stations spanning the entire salinity gradient of the four channels. The rather high variation in bacterial productivity (0.16-7.6 microg C L(-1) h(-1)) along the profiles of salinity indicates that bacterial activity shows a reactive behavior to environmental changing. Bacterial density (0.5-11.2 x 10(9) cells L(-1)) with a comparative smaller variation showed a more conservative behavior, mainly reflecting the phytoplankton distribution. Contrary to expectation, minimal values of bacterial productivity were not observed in November-December but in June. In fact, in November-December, the deep zone near the mouth showed the highest values of bacterial activity. At the upper stations, the highest values were observed in October. The relatively high values of bacterial production during the cold rainy season suggest that allochthonous substrates leached out from the surroundings by rain controlled the distribution of bacterial activity in the estuarine system. The substantial decrease in salinity during the rainy season negatively affected bacterial productivity, namely in the marine zone, where water column was highly stratified. Salinity seems to play an indirect role in the regulation of estuarine bacteria because there are different bacterial communities adapted to a wide salinity range.

Freqüência de cães reagentes para Neospora caninum em São Luís, Maranhão / Frequency of Neospora caninum in dogs from São Luís, Maranhão

The frequency of antibodies to Neospora caninum (Protozoa: Apicomplexa) in dog sera was investigated. Blood samples from 100 mongrel dogs, captured in the streets of São Luís, State of Maranhão, were analized using imunofluorescent antibody test. Forty five percent of the dogs were positive, and the titers ranged from 1:50 to 1:800. No sex difference was observed for frequency of N. caninum (60 percent in males and 40 percent in females). This is the first report of antibodies to N. caninum in dogs from Maranhão.

Astroglial cells in primary culture: a valid model to study Neospora caninum infection in the CNS.

The protozoan Neospora caninum has a veterinary importance because it causes abortion in cattle and neuromuscular alterations in dogs. We infected rat astrocytes, in vitro, with different concentrations of N. caninum. Astrocytes responded to infection by producing the pro-inflammatory cytokine TNF-alpha and the neurotoxic-free radical NO, 24 and 72 h post-infection. These data suggest that astrocytes, which are essential for brain function, are targets for the parasite and this represents a practical and valid model to study the effects of N. caninum on the CNS.

Proteinograma de caprinos da raça Pardo-Alpina infectados naturalmente por parasitos gastrintestinais / Proteinogram of Alpine goat naturally infected by gastrointestinal parasites

The proteinogram of six 12 month-old Alpine goats, intensively raised and naturally infected by gastrointestinal parasites, was evaluated. Blood and feces samples of each animal were monthly collected. Total serum protein and their fractions were determined by agarose gel eletrophoresis, using Tris buffer, pH 9.2. The identified protein fractions were albumin, alfa-globulin, beta1-globulin, beta2-globulin and gama-globulin, whose average and standard deviation (g/dl) were, respectively: 2.35±0.39, 0.69±0.36, 0.70±0.08, 0.48±0.08 and 1.52±0.41. It was not observed significative correlation (P>0.05), according to the Spearman non-parametric test, either between the Strongyloides eggs count per gram of feces or the Haemonchus spp. larval count per gram of feces and the fraction electrophorectly variable.