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Quantifying the effect of thermal stress on milk yields is essential to effectively manage present and future risks in dairy systems. Despite the existence of numerous heat indices designed to communicate stress thresholds, little information is available regarding the accuracy of different indices in estimating milk yield losses from both cold and heat stress at large spatiotemporal scales. To address this gap, we comparatively analyzed the performance of existing thermal indices in capturing US milk yield response to both cold and heat stress at the national scale. We selected 4 commonly used thermal indices: the temperature-humidity index (THI), black globe humidity index (BGHI), adjusted temperature-humidity index (THIadj), and comprehensive climate index (CCI). Using a statistical panel regression model with observational and reanalysis weather data from 1981 to 2020, we systematically compared the patterns of yield sensitivities and statistical performance of the 4 indices. We found that the US state-level milk yield variability was better explained by the THIadj and CCI, which combine the effects of temperature, humidity, wind, and solar radiation. Our analysis also reveals continuous and nonlinear responses of milk yields to a range of cold to heat stresses across all 4 indices. This implies that solely relying on fixed thresholds of these indices to model milk yield changes may be insufficient to capture cumulative thermal stress. Cold extremes reduced milk yields comparably to those affected by heat extremes on the national scale. Additionally, we found large spatial variability in milk yield sensitivities, implying further limitations to the use of fixed thresholds across locations. Moreover, we found decreased yield sensitivity to thermal stress in the most recent 2 decades, suggesting adaptive changes in management to reduce weather-related risks.
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Temperatura Alta , Leite , Animais , Bovinos/fisiologia , Feminino , Indústria de Laticínios , Temperatura Baixa , Umidade , Lactação , Estados Unidos , Resposta ao Choque TérmicoRESUMO
This study compares different approaches for the quantification of the massic activity of 36Cl in graphite samples. All approaches consisted of a combustion step in combination with a trapping solution to collect the volatile elements. Two different resins were used to separate 36Cl from the matrix (CL resin and PS resin). Liquid scintillation counting (LSC), scintillation counting (SC) and tandem inductively coupled plasma mass spectrometry (ICP-MS/MS) were used to quantify 36Cl activity. The chemical yield in all approaches was determined by means of ion chromatography (IC). In addition, the methods were applied to a real activated graphite sample.
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No Brasil, o cuidado em psiquiatria passou a requerer pessoal de enfermagem desde as primeiras internações de pessoas com sofrimento psíquico nas enfermarias das Santas Casas de Misericórdia (SCM) da capital, Rio de Janeiro, até que, no século XIX, o primeiro hospítal psiquiátrico doi criado no Brasil. Depois de anos trabalhando dentro das instituições psiquiátricas, de forma integral, sem preparo e sem condições de trabalho dignas, o desenvolvimento socio-político da profissão de enfermagem impôs limites e critérios para o cuidado em psiquiatria [Fragmento de texto] (AU)
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Humanos , Hospitais Psiquiátricos/história , Enfermagem Psiquiátrica/história , Reforma dos Serviços de Saúde , Pesquisa Qualitativa , Gravação em Vídeo , BrasilRESUMO
Arboviruses have become a major public health concern in Brazil, especially after Zika virus (ZIKV) and Chikungunya virus (CHIKV) introduction, leading to massive epidemics. We conducted an investigation of arboviruses in patients with acute febrile illness for less than five days in Mato Grosso state (MT) during the period of ZIKV and CHIKV dissemination in Brazil. To achieve that, 453 human serum samples of patients suspected of Dengue (DENV), Yellow Fever (YFV), ZIKV or CHIKV collected in health units of 31 cities of MT were subjected to RT-PCR protocols for 10 flaviviruses, 5 alphaviruses and orthobunyaviruses from Simbu serogroup, nucleotide sequencing and viral isolation. Regarding flaviviruses, five (1.1%) patients were infected with DENV-1 genotype V, 22 (4.4%) with DENV-4 genotype II, 3 (0.7%) with YFV South American genotype II and five (1.1%) with ZIKV Asian genotype. The first human case of ZIKV in MT was detected in this study during August, 2015 in Tapurah. Alphaviruses were detected in 2 (0.4%) patients infected with CHIKV genotype ECSA, 1 (0.2%) with Madariaga (EEEV) lineage III and 34 (7.5%) with Mayaro (MAYV) genotype L. Four (11.4%) patients presented dual infections with DENV-1/ZIKV, DENV-1/DENV4, DENV-4/MAYV and ZIKV/MAYV. The majority - 13/34 positive for MAYV, one for Madariaga virus - are residents in Várzea Grande (VG), metropolitan region of Cuiabá, capital of MT. The first CHIKV infection in MT was detected in this study in Mirassol D'Oeste, during July, 2015. In addition, 20 (4.4%) patients were positive for OROV Segment S genotype IA. These results reinforce the variation in arboviruses frequency and distribution during outbreaks, highlinghing the importance of differential diagnosis to identify agents silently co-circulating with major health problem arboviruses.
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Arbovírus/genética , Arbovírus/isolamento & purificação , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Febre/virologia , Infecção por Zika virus/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Vírus Chikungunya/isolamento & purificação , Criança , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/virologia , Dengue/virologia , Vírus da Dengue/genética , Vírus da Dengue/isolamento & purificação , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Febre Amarela/epidemiologia , Febre Amarela/virologia , Vírus da Febre Amarela/genética , Vírus da Febre Amarela/isolamento & purificação , Adulto Jovem , Zika virus/genética , Zika virus/isolamento & purificação , Infecção por Zika virus/virologiaAssuntos
Alérgenos/imunologia , Quimiocina CCL2/imunologia , Interleucina-10/imunologia , Schistosoma mansoni/imunologia , Esquistossomose mansoni/imunologia , Adolescente , Adulto , Animais , Brasil , Criança , Feminino , Humanos , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
We use energy landscape methods to investigate the response of a supercooled liquid to random pinning. We classify the structural similarity of different energy minima using a measure of overlap. This analysis reveals a correspondence between distinct particle packings (which are characterised via the overlap) and funnels on the energy landscape (which are characterised via disconnectivity graphs). As the number of pinned particles is increased, we find a crossover from glassy behavior at low pinning to a structure-seeking landscape at high pinning, in which all thermally accessible minima are structurally similar. We discuss the consequences of these results for theories of randomly pinned liquids. We also investigate how the energy landscape depends on the fraction of pinned particles, including the degree of frustration and the evolution of distinct packings as the number of pinned particles is reduced.
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We study the dynamical behaviour of a computer model for viscous silica, the archetypal strong glass former, and compare its diffusion mechanism with earlier studies of a fragile binary Lennard-Jones liquid. Three different methods of analysis are employed. First, the temperature and time scale dependence of the diffusion constant is analysed. Negative correlation of particle displacements influences transport properties in silica as well as in fragile liquids. We suggest that the difference between Arrhenius and super-Arrhenius diffusive behaviour results from competition between the correlation time scale and the caging time scale. Second, we analyse the dynamics using a geometrical definition of cage-breaking transitions that was proposed previously for fragile glass formers. We find that this definition accurately captures the bond rearrangement mechanisms that control transport in open network liquids, and reproduces the diffusion constants accurately at low temperatures. As the same method is applicable to both strong and fragile glass formers, we can compare correlation time scales in these two types of systems. We compare the time spent in chains of correlated cage breaks with the characteristic caging time and find that correlations in the fragile binary Lennard-Jones system persist for an order of magnitude longer than those in the strong silica system. We investigate the origin of the correlation behaviour by sampling the potential energy landscape for silica and comparing it with the binary Lennard-Jones model. We find no qualitative difference between the landscapes, but several metrics suggest that the landscape of the fragile liquid is rougher and more frustrated. Metabasins in silica are smaller than those in binary Lennard-Jones and contain fewer high-barrier processes. This difference probably leads to the observed separation of correlation and caging time scales.
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Genetic improvement is essential to achieve increments in maize (Zea mays L.) grain yield components. It may be obtained through crosses, which enable to exploit the effects of intervarietal heterosis, allelic complementarity, as well as gene actions and effects. This study estimated the components of variance and genetic parameters (REML/BLUP) of an intervarietal diallel to select and predict the best genotypes for maize yield components. The experimental design was randomized blocks containing 60 intervarietal maize hybrids arranged in three repetitions. They were obtained through intervarietal crosses and evaluated in a diallel scheme, where 14 open-pollinated varieties were designated as parentals. Thus, 10 crosses were performed for each hybrid combination to obtain the number of seeds necessary for the competition test. The measured traits were: grain volume relative index, the mass of one hundred grains, and grain yield. The male parents and the additive genetic fraction were determinants for grain volume relative index. Mass of one hundred grains and grain yield were defined by the specific combining ability, and female parents revealed low narrow sense heritability. The female parent Taquarão and male parent Argentino Amarelo presented the best general combining abilities for the measured traits. The specific combining abilities were expressed for crosses AL 25 x Dente de Ouro Roxo, AL 25 x BRS Pampeano, and Taquarão x Argentino Branco. Genetic estimates and predictions were consistent and applicable to breeding programs and could be applied in future quantitative genetic studies of maize.
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Hibridização Genética , Modelos Genéticos , Melhoramento Vegetal/métodos , Polimorfismo Genético , Zea mays/genética , Alelos , Genótipo , Característica Quantitativa Herdável , Sementes/genética , Sementes/crescimento & desenvolvimento , Zea mays/crescimento & desenvolvimentoRESUMO
The REML/BLUP statistics are analyses that can be used as selective criteria in the routine of maize breeding programs. The present study aims to determine the genetic potential in crosses of landrace populations applying the REML/BLUP methodology, and to identify populations for the synthesis of new populations and intrapopulation selection for family farming systems, as well as genetic constitutions for use in maize breeding programs. Nine top cross hybrids obtained in the 2012/2013 harvest were evaluated along with their testator, the landraces used as parents, and four commercial hybrids, in a randomized block design, with information taken from the average of each plot. The evaluated traits were: leaf angle, number of ramifications of the tassel, spike insertion height, plant height, spike diameter, number of grains per spike, mass of grains per spike, spike mass, spike length, prolificity, mass of one hundred grains, and grain yield per plot. The data were analyzed using the Selegen-REML/BLUP software. The top cross hybrids Cateto Branco x Planalto, Amarelão x Planalto and the population Cateto Branco are ranked among the ten best crosses, simultaneously, for the traits: leaf angle, number of ramifications of the tassel, spike insertion height, and plant height (Cateto Branco x Planalto), and leaf angle, spike insertion height, and plant height (Amarelão x Planalto and Cateto Branco). The top cross hybrids Criolão x Planalto, Branco 8 Carreiras x Planalto, Caiano Rajado x Planalto, Amarelão x Planalto, Branco Roxo Índio x Planalto stand out for their high genotypic value of the individual BLUP mean components among the ten best genotypes for grain yield, and by combining three or more traits of interest together, being, for effects of selection, the most indicated.
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Cruzamento/métodos , Cruzamentos Genéticos , Zea mays/genética , Característica Quantitativa HerdávelRESUMO
Given the importance of selecting lines to obtain hybrids, we aimed to verify the relationship between morphological traits that can be used as the criteria for the selection of sorghum lines with high grain yield and earliness. A total of 18 traits were evaluated in 160 sorghum elite lines, in an incomplete block design with two replicates. A correlation network was used to graphically express the estimates of phenotypic and genotypic correlations between the traits. Two path analyses were processed, the first considering grain yield and the second considering flowering as the principle dependent variable. In general, most of the variation in the grain yield and flowering of sorghum lines was explained by the traits evaluated. Selecting sorghum lines with greater width of the third leaf blade from flag leaf, panicle weight, and panicle harvest index might lead to increased grain yield, and selecting sorghum genotypes with higher plant height might lead to reduced earliness and increased grain yield. Thus, the results suggest the establishment of selection indices aiming at simultaneously increasing the grain yield and earliness in sorghum genotypes.
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Grão Comestível/genética , Característica Quantitativa Herdável , Sorghum/genética , Grão Comestível/crescimento & desenvolvimento , Genótipo , Sorghum/crescimento & desenvolvimentoRESUMO
The emergence of observable properties from the organisation of the underlying potential energy landscape is analysed, spanning a full range of complexity from self-organising to glassy and jammed systems. The examples include atomic and molecular clusters, a ß-barrel protein, the GNNQQNY peptide dimer, and models of condensed matter that exhibit structural glass formation and jamming. We have considered measures based on several different properties, namely, the Shannon entropy, an equilibrium thermodynamic measure that uses a sample of local minima, and indices that require additional information about the connections between local minima in the form of transition states. A frustration index is defined that correlates directly with key properties that distinguish relaxation behaviour within this diverse set. The index uses the ratio of the energy barrier to the energy difference with reference to the global minimum. The contributions for each local minimum are weighted by the equilibrium occupation probabilities. Hence we obtain fundamental insight into the connections and distinctions between systems that cover the continuum from efficient structure-seekers to landscapes that exhibit broken ergodicity and rare event dynamics.
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Peptídeos/química , Proteínas/química , Termodinâmica , Água/química , Vidro/químicaRESUMO
The State of Rio Grande do Sul (RS) stands out as the largest wheat producer in Brazil. Wheat is the most emphasized winter cereal in RS, attracting public and private investments directed to wheat genetic breeding. The study of genetic progress should be performed routinely at breeding programs to study the behavior of cultivars developed for homogeneous regions of cultivation. The objectives of this study were: 1) to evaluate the genetic progress of wheat grain yield in RS; 2) to evaluate the influence of cultivar competition trial stratification in homogeneous regions of cultivation on the study of genetic progress. Grain yield data of 122 wheat cultivars evaluated in 137 trials arranged in randomized block design with three or four replications were used. Field trials were carried out in 23 locations in RS divided into two homogeneous regions during the period from 2002 to 2013. Genetic progress for RS and homogeneous regions was studied utilizing the method proposed by Vencovsky. Annual genetic progress for wheat grain yield during the period of 12 years in the State of RS was 2.86%, oscillating between homogeneous regions of cultivation. The difference of annual genetic progress in region 1 (1.82%) in relation to region 2 (4.38%) justifies the study of genetic progress by homogeneous regions of cultivation.
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Grão Comestível/genética , Triticum/genética , Agricultura/métodos , Brasil , Variação Genética , Melhoramento Vegetal , Triticum/crescimento & desenvolvimentoRESUMO
AIM: To evaluate the diagnostic performance of ultra-low-dose computed tomography (ULDCT) in comparison to standard coronary calcium score (CCS) acquisition for the evaluation of coronary artery calcification (CAC). MATERIALS AND METHODS: Standard CCS acquisition and ULDCT were performed in patients referred for coronary CT angiography for the evaluation of coronary artery disease. CAC in ULDCT was graded subjectively using a four-point scale (from 0, no calcification, to 3, severe calcification) for the complete study and for each individual coronary segment. The summation of all individual coronary segment scores generated an ULDCT total CAC score. ULDCT results were compared to standard Agatston score and sensitivity and specificity of ULDCT were calculated. RESULTS: CCS and ULDCT were performed in 74 patients, with a mean DLP of 77.7 mGy·cm (±12.1) and 9.3 mGy·cm (±0.6), respectively (p<0.001). Coronary calcification was detected in 47 patients (63.5%) in standard CCS acquisition (median Agatston score of 41; interquartile range [IQR]:0263), in comparison to 42 patients (56.8%) in ULDCT (p<0.001). The sensitivity and specificity of the ULDCT total CAC score ≥1 was 80.9% and 85.2%, respectively, with an accuracy of 82.4%. The area under the receiver operating characteristic curve for the presence of CAC was 0.87. CONCLUSION: ULDCT shows good sensitivity, specificity, and overall accuracy for the detection of coronary calcification with a markedly lower radiation dose in comparison to CCS. ULDCT is unlikely to miss coronary calcification in individuals with at least moderate calcium load (Agatston score >100).
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Angiografia por Tomografia Computadorizada/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Calcificação Vascular/diagnóstico por imagem , Técnicas de Imagem de Sincronização Cardíaca , Doença da Artéria Coronariana/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Sensibilidade e Especificidade , Calcificação Vascular/classificaçãoRESUMO
OBJECTIVE: The present study aimed to determine whether Irisin levels are correlated with body composition changes following 16 weeks of resistance training (RT) in older women with and without obesity. Design, Setting, Participants, Intervention: We recruited 49 inactive women (n = 23, non-obese: < 41.0% and n = 26, obese: ≥ 41.0% of body fat) aged 61-68 years to perform 16-week of RT consisting of 10 exercises (three sets of 10 exercises, 6-12 repetitions maximum and 1-min and 30-s rest intervals between sets and exercises, respectively) with two sessions per week. MEASUREMENTS: Before and after the intervention period, blood samples were collected to determine Irisin levels and body composition (percentage body fat and fat-free mass) was measured by dual energy x-ray absorptiometry. RESULTS: Circulating Irisin displayed a decrease for the non-obese group as compared with pre-intervention and obese group (p = 0.01 and p = 0.04, respectively), with no change for the obese group (p = 0.79). In addition, fat mass displayed a significant reduction (p < 0.05) following the training period only for the obese group. Furthermore, there was no association between changes in circulating Irisin with body mass index, body fat, fat-free mass and muscle strength. There was an increase in muscle strength (p < 0.05), regardless of obesity status. CONCLUSION: The modulation of body composition and muscle strength induced by 16-week of resistance training in older women with and without obesity is not associated with changes in circulating Irisin levels.
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Tecido Adiposo/fisiologia , Composição Corporal/fisiologia , Índice de Massa Corporal , Fibronectinas/sangue , Força Muscular/fisiologia , Treinamento Resistido , Absorciometria de Fóton , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/sangueRESUMO
Methodologies using restricted maximum likelihood/best linear unbiased prediction (REML/BLUP) in combination with sequential path analysis in maize are still limited in the literature. Therefore, the aims of this study were: i) to use REML/BLUP-based procedures in order to estimate variance components, genetic parameters, and genotypic values of simple maize hybrids, and ii) to fit stepwise regressions considering genotypic values to form a path diagram with multi-order predictors and minimum multicollinearity that explains the relationships of cause and effect among grain yield-related traits. Fifteen commercial simple maize hybrids were evaluated in multi-environment trials in a randomized complete block design with four replications. The environmental variance (78.80%) and genotype-vs-environment variance (20.83%) accounted for more than 99% of the phenotypic variance of grain yield, which difficult the direct selection of breeders for this trait. The sequential path analysis model allowed the selection of traits with high explanatory power and minimum multicollinearity, resulting in models with elevated fit (R2 > 0.9 and ε < 0.3). The number of kernels per ear (NKE) and thousand-kernel weight (TKW) are the traits with the largest direct effects on grain yield (r = 0.66 and 0.73, respectively). The high accuracy of selection (0.86 and 0.89) associated with the high heritability of the average (0.732 and 0.794) for NKE and TKW, respectively, indicated good reliability and prospects of success in the indirect selection of hybrids with high-yield potential through these traits. The negative direct effect of NKE on TKW (r = -0.856), however, must be considered. The joint use of mixed models and sequential path analysis is effective in the evaluation of maize-breeding trials.
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Modelos Genéticos , Zea mays/genética , Cruzamentos Genéticos , Grão Comestível/genética , Técnicas de Genotipagem/métodos , Funções Verossimilhança , Melhoramento Vegetal/métodos , Probabilidade , Locos de Características Quantitativas , Análise de Regressão , Reprodutibilidade dos Testes , Seleção GenéticaRESUMO
The relationship between primary hematologic disease and rheumatologic manifestations is well known, especially acute lymphocytic leukemia, lymphomas, plasma cell dyscrasias and myelodysplastic syndrome (MDS). Currently, more has been described about autoimmune manifestations in chronic myelomonocytic leukemia (CMML). Many different clinical scenarios may lead a patient with MDS/CMML initially to seek a rheumatological unit. Autoimmune features such as polymyalgia rheumatic symptoms, myositis, neutrophilic dermatosis, cutaneous vasculitis and positive antinuclear antibodies (ANA) are some examples of clinical presentation of MDS/CMML. Moreover, peripheral cytopenias are a common initial presentation both for systemic lupus erythematous (SLE) and MDS/CMML. The aim of this study was to describe a case of an elderly woman with thrombocytopenia and positivity of antibodies to anti-extractable nuclear antigens (anti-ENA) as initial manifestation of CMML mimicking SLE, and to present some clues that encourage the clinician to perform a bone marrow study in such a clinical scenario.
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Anticorpos Antinucleares/sangue , Leucemia Mielomonocítica Crônica/sangue , Lúpus Eritematoso Sistêmico/sangue , Trombocitopenia/sangue , Idoso de 80 Anos ou mais , Antimetabólitos Antineoplásicos/uso terapêutico , Azacitidina/uso terapêutico , Biomarcadores/sangue , Exame de Medula Óssea , Diagnóstico Diferencial , Feminino , Hemólise , Humanos , Leucemia Mielomonocítica Crônica/diagnóstico , Leucemia Mielomonocítica Crônica/tratamento farmacológico , Leucemia Mielomonocítica Crônica/imunologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Valor Preditivo dos Testes , Trombocitopenia/diagnóstico , Trombocitopenia/imunologiaRESUMO
The State of Rio Grande do Sul (RS) is the largest producer of oat in Brazil with the aid of consolidated breeding programs, which are constantly releasing new cultivars. The main objectives of this study were to: 1) evaluate the annual genetic progress in grain yield and hectoliter weight of the oat cultivars in RS, with and without fungicide use on aerial parts of plants; and 2) evaluate the efficiency of oat breeding programs in introducing disease-resistant genes in the released cultivars through network yield trials conducted with and without fungicide use on aerial plant parts. The data on grain yield and hectoliter weight were obtained from 89 competition field trials of oat cultivars carried out from 2007 to 2014 in nine municipalities of RS. Of the total 89 trials, 44 were carried out with fungicide application on aerial plant parts and 45 were carried out without fungicide application. The annual genetic progress in oat cultivars was studied using the methodology proposed by Vencovsky (1988). The annual genetic progress in oat grain yield was 1.02% with fungicide use and 4.02% without fungicide use during the eight-year study period in RS. The annual genetic progress with respect to the hectoliter weight was 0.08% for trials with fungicide use and 0.71% for trials without fungicide use. Performing network yield trials with and without fungicide use on the aerial plants parts is a feasible method to evaluate the efficiency of oat breeding programs in introducing disease-resistant genes in the released cultivars.
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Avena/genética , Resistência à Doença , Fungicidas Industriais/farmacologia , Locos de Características Quantitativas , Avena/efeitos dos fármacos , Brasil , Grão Comestível , Melhoramento Vegetal , Seleção GenéticaRESUMO
Relaxation times and transport processes of many glass-forming supercooled liquids exhibit a super-Arrhenius temperature dependence. We examine this phenomenon by computer simulation of the Lewis-Wahnström model for ortho-terphenyl. We propose a microscopic definition for a single-molecule cage-breaking transition and show that, when correlation behaviour is taken into account, these rearrangements are sufficient to reproduce the correct translational diffusion constants over an intermediate temperature range in the supercooled regime. We show that super-Arrhenius behaviour can be attributed to increasing negative correlation in particle movement at lower temperatures and relate this to the cage-breaking description. Finally, we sample the potential energy landscape of the model and show that it displays hierarchical ordering. Substructures in the landscape, which may correspond to metabasins, have boundaries defined by cage-breaking transitions. The cage-breaking formulation provides a direct link between the potential energy landscape and macroscopic diffusion behaviour.
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AIM: To assess the computed tomography (CT) findings of solitary cavitary lesions which could potentially aid in differentiating malignant from non-malignant lung disease. MATERIALS AND METHODS: A retrospective study of patients diagnosed with a solitary lung cavity at two university hospitals, who underwent multidetector CT examinations of the chest between 2012 and 2014, was performed. Lesions were evaluated for maximum diameter, maximum wall thickness, and associated findings. Statistical analyses were then conducted and a receiver operating characteristic (ROC) curve was calculated to select the most accurate cut-off value for malignant and non-malignant lesions. RESULTS: CT and clinical records from 96 patients were reviewed. The most frequent aetiologies of non-malignant and malignant lung cavities were mycobacterial infection sequelae (50%, 33/66) and primary lung carcinoma (94%, 28/30), respectively. Significant differences (p<0.05) were found between malignant and non-malignant cases when comparing the averages of maximum wall thickness (15.2 and 7.8 mm, respectively) and maximum diameter of lesions (51 and 35 mm, respectively). The presence of either perilesional consolidation or centrilobular nodules favoured the diagnosis of non-malignant conditions (p<0.05). Maximum wall thicknesses thresholds of ≤7 or ≥24 mm were the most accurate in suggesting non-malignant and malignant aetiologies, respectively. CONCLUSION: Malignant and non-malignant solitary lung cavities differ significantly at CT. Non-malignant lesions tend to exhibit thinner walls, but more perilesional consolidation and centrilobular nodules than malignant lesions. The results reveal that maximum wall thicknesses of ≤7 and ≥24 mm are indicative of non-malignant and malignant disease, respectively.
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Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
OBJECTIVES: Opportunistic outreach services have been commissioned to overcome potential barriers to uptake, by offering health checks in accessible community venues. This study aimed to evaluate the ability of an outreach health check service to reach key target groups: men, people of South Asian ethnicity and people from deprived areas. The comparator was the health check service provided by GP practices. One aim was to investigate whether the addition of an outreach service would result in a higher percentage of health checks being done for people from the target groups compared to a GP-based service alone. The second aim was to assess which types of venues used for outreach health checks were most effective in reaching these groups. STUDY DESIGN: Evaluation of Public Health Programme with retrospective control group comparison. METHODS: The percentages of completed health checks in men, people of South Asian ethnicity, and participants registered at general practices with lowest quintile area-level deprivation status were compared between all opportunistic community checks conducted by the Outreach Service over a ten month period and checks conducted in general practice in a partially-overlapping time period of the same financial year. For the venue-based comparison of Outreach Service checks, the number of checks per visit and percentage of checks in each target group were calculated for each venue. RESULTS: Of 3849 Outreach Service checks, 38% were in men (compared to 50% of checks conducted in Primary Care), and 11% were in people of South Asian ethnicity (compared to 3% in Primary Care). 3558 Outreach check participants were registered with a general practice in the County (92%), and of these, 32% of checks were in people registered with a general practice in the lowest deprivation quintile (compared to 13% of checks in Primary Care). There were 519 visits by the outreach service to 23 different types of venue. Certain venues recorded large numbers of checks e.g. supermarkets and libraries, but they were not always the most efficient places to recruit people for checks. Mosques and bus stations were the venues with the broadest reach to all target groups. Other venues, despite having lower turnover or recruitment rates, were still good settings to reach specific target groups. CONCLUSION: The NHS Health Check can successfully be targeted at people from deprived areas and people of South Asian ethnicity using a targeted opportunistic community outreach approach. Our findings show that the reach to different groups varies substantially by venue, and therefore best results may be achieved by combining venues and strategies specific to the target group.