The prometastatic relevance of tumor-infiltrating B lymphocytes in laryngeal squamous cell carcinoma.

Objectives: Laryngeal squamous cell carcinomas (LSCCs) typically have an excellent prognosis for stage I tumors but a significant risk of locoregional and distant recurrence for intermediate to advanced disease. This study will investigate the clinical relevance of the tumor microenvironment in a large cohort of treatment-naïve patients affected by stage II-IV LSCC. Methods: Whole slide-based digital pathology analysis was applied to measure six immune cell populations identified by immunohistochemistry (IHC) staining for CD3, CD8, CD20, CD66b, CD163 and CD38. Survival analysis was performed by Cox proportional hazards models and unsupervised hierarchical clustering using the k-means method. Double IHC staining and in-situ hybridisation by RNAscope allowed further analysis of a protumoral B cell population. Results: A cohort of 98 patients was enrolled and analysed. The cluster of immune-infiltrated LSCCs demonstrated a significantly worse disease-specific survival rate. We also discovered a new association between high CD20+ B cells and a greater risk of distant recurrence. The phenotypic analysis of infiltrating CD20+ B cells showed a naïve (BCL6-CD27-Mum1-) regulatory phenotype, producing TGFß but not IL10, according to an active TGFß pathway, as proved by positive pSMAD2 staining. Conclusion: The identification of regulatory B cells in the context of LSCC, along with the activation of the TGFß pathway, could provide the basis for new trials investigating the efficacy of already available molecules targeting the TGFß pathway in the treatment of LSCC.

Are fascial strains involved in chronic pelvic pain syndrome? An exploratory matched case-control study.

BACKGROUND: Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) do not have a definite cause, even if their impact on quality of life was demonstrated. Furthermore, there is evidence of myofascial dysfunctions in a large number of CPP/CPPS, so that the role of fascia can be hypothesized. METHODS: The aim of this exploratory matched case-control study was to assess whether fascial strains (FS) represent a factor associated with CPP/CPPS. The study followed the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) statement. We collected data from 189 subjects (cases: 58; controls: 131) who attended the clinic. The participants were managed through a 2:1 enrollment ratio. A standardized booklet requested for clinical information, previous FS and the following questionnaires: "National Institutes of Health Chronic Prostatitis Symptom Index" (NIH-CPSI), "Hospital Anxiety and Depression Scale" (HADS), "Fear Avoidance Belief Questionnaire" (FABQ). Each subject underwent a palpatory assessment to detect abnormal palpatory findings in the pelvic area. RESULTS: The analyses showed that episiotomy, genito-urinary infections and surgery had a significantly increased odds ratio (OR) of 4.13, 3.1 and 3.08, respectively. FS as a whole had a significantly raised OR: 2.22 (1.14 to 4.33). The analysis was adjusted for physical activity and for type of job and OR decreased to 1.94 (0.82 to 4.61), losing its significance (p = 0.129). A strong correlation between symptoms' impact and CPP/CPPS was detected (rpbs = 0.710; p < 0.001) and a moderate one (0.3 < rpbs < 0.7; p < 0.001) was found considering anxiety, depression and abnormal palpatory findings. CONCLUSION: This exploratory study suggests that FS could represent an etiological factor for developing CPP/CPPS. However, further research on fascial dysfunctions and relative implications in CPP/CPPS is needed for confirmation.

O trabalhar nas intervenções em saúde e segurança no trabalho: reflexões sobre a construção de uma política integrada / Working in health and safety at work: reflections on the construction of an integrated policy

Resumo As intervenções em ambientes, processos e situações de trabalho contemplam a prevenção de doenças, acidentes e a manutenção da saúde dos trabalhadores. Iniciaram-se no Ministério do Trabalho; foram ampliadas para a Saúde e por fim assumidas pelo Ministério Público do Trabalho. Buscou-se conhecer e dar visibilidade ao trabalhar dos atores dos diferentes setores e instituições do município de São Paulo envolvidos nessas intervenções e compreender entraves e consequências dos limites da intersetorialidade. Entre 2017 e 2019 realizou-se grupos de reflexão sobre o trabalho com profissionais do MT, Saúde e MPT. Para a produção de dados e análise do material, utilizou-se o referencial da Psicodinâmica do Trabalho. Os três setores estão intimamente ligados nos seus objetivos, mas em São Paulo, seguem com dificuldades em consolidar a intersetorialidade prevista nas políticas de saúde e segurança no trabalho. Apesar de existirem parcerias pontuais, somar suas especificidades de ação, reconhecer e respeitar reciprocamente a expertise de cada um, evitar sobreposições, e construir práticas conjuntas, cooperativas e colaborativas é um desafio.

Abstract Interventions in work environments, processes, and situations encompass the prevention of diseases and accidents and workers' health promotion. Historically, these actions were originally the responsibility of the Ministry of Labor, being extended to the Ministry of Health, and later to the Ministry of Labor. The aim of this study was to understand and give visibility to the work of the actors working in the different sectors and institutions involved in health and safety at work in the municipality of São Paulo and gain an insight into the barriers to intersectorality and the consequences of the lack of intersectoral collaboration for this area. Work reflection groups were created between 2017 and 2019 with professionals working in the abovementioned ministries and in the Labor Prosecution Office. The data were produced and analyzed drawing on the theoretical bases of the psychodynamics of work. Despite having intrinsically linked objectives, these three bodies in São Paulo continue to encounter difficulties in consolidating intersectorality as envisioned in occupational health and safety policies. Despite sporadic partnerships, merging specific actions, recognizing and mutually respecting each other's expertise, avoiding overlaps, and building joint, cooperative, and collaborative practices remain challenges.

Working in health and safety at work: reflections on the construction of an integrated policy. / O trabalhar nas intervenções em saúde e segurança no trabalho: reflexões sobre a construção de uma política integrada.

Interventions in work environments, processes, and situations encompass the prevention of diseases and accidents and workers' health promotion. Historically, these actions were originally the responsibility of the Ministry of Labor, being extended to the Ministry of Health, and later to the Ministry of Labor. The aim of this study was to understand and give visibility to the work of the actors working in the different sectors and institutions involved in health and safety at work in the municipality of São Paulo and gain an insight into the barriers to intersectorality and the consequences of the lack of intersectoral collaboration for this area. Work reflection groups were created between 2017 and 2019 with professionals working in the abovementioned ministries and in the Labor Prosecution Office. The data were produced and analyzed drawing on the theoretical bases of the psychodynamics of work. Despite having intrinsically linked objectives, these three bodies in São Paulo continue to encounter difficulties in consolidating intersectorality as envisioned in occupational health and safety policies. Despite sporadic partnerships, merging specific actions, recognizing and mutually respecting each other's expertise, avoiding overlaps, and building joint, cooperative, and collaborative practices remain challenges.

As intervenções em ambientes, processos e situações de trabalho contemplam a prevenção de doenças, acidentes e a manutenção da saúde dos trabalhadores. Iniciaram-se no Ministério do Trabalho; foram ampliadas para a Saúde e por fim assumidas pelo Ministério Público do Trabalho. Buscou-se conhecer e dar visibilidade ao trabalhar dos atores dos diferentes setores e instituições do município de São Paulo envolvidos nessas intervenções e compreender entraves e consequências dos limites da intersetorialidade. Entre 2017 e 2019 realizou-se grupos de reflexão sobre o trabalho com profissionais do MT, Saúde e MPT. Para a produção de dados e análise do material, utilizou-se o referencial da Psicodinâmica do Trabalho. Os três setores estão intimamente ligados nos seus objetivos, mas em São Paulo, seguem com dificuldades em consolidar a intersetorialidade prevista nas políticas de saúde e segurança no trabalho. Apesar de existirem parcerias pontuais, somar suas especificidades de ação, reconhecer e respeitar reciprocamente a expertise de cada um, evitar sobreposições, e construir práticas conjuntas, cooperativas e colaborativas é um desafio.

What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis.

BACKGROUND: Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients. OBJECTIVE: The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities. METHODS: A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories. RESULTS: Stroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (-0.80 [-1.14; -0.46], p > .05). CONCLUSIONS: The evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.

Nutrient content and nutrient availability of sorghum wet distiller's grain in comparison with the parental grain for ruminants.

BACKGROUND: The present study aimed to compare wet sorghum distiller's grain (WSDG) with sorghum grain (SG) in terms of: (i) chemical composition; (ii) in situ rumen degradation kinetics of organic matter (OM) and neutral detergent fiber (NDF); (iii) crude protein (CP) sub-fractions; (iv) in situ disappearance at 12 and 48 h; and (v) energy values. The WSDG intestinal digestibility (ID) of undegradable crude protein (UCP) was compared to soybean meal (SBM). RESULTS: Compared to SG, WSDG exhibited: (i) lower (P < 0.01) dry matter and non-fiber carbohydrate content, whereas the other chemical components were higher (P < 0.01); (ii) higher (P < 0.01) degradation rates of OM and NDF and lower (P < 0.01) degradable fraction of OM and NDF; (iii) lower (P < 0.05) contents of CP sub-fractions A, B1 and B2, and higher (P < 0.05) contents of B3 and C; (iv) lower (P < 0.05) protein disappearance at 12 and 48 h and higher UCP; and (v) lower (P < 0.05) energy content. The ID of UCP for WSDG was lower (P < 0.05) compared to SBM. CONCLUSION: The WSDG as a supplement provides a good source of energy. To enable its use as a protein supplement, further studies should be performed. © 2016 Society of Chemical Industry.

A new organ transplantation location-allocation policy: a case study of Italy.

In this paper, we propose a location model for the optimal organization of transplant system. Instead of simulation approach, which is typical when facing many health care applications, our approach is distinctively based on a mathematical programming formulation of the relevant problem. In particular, we focus on the critical role of time in transplantation process as well as on a spatial distribution of transplant centers. The allocation of transplantable organs across regions with the objective of attaining regional equity in health care, is the aim of this paper. Our model differs from previous modeling approaches in that it considers the nationwide reorganization of the transplant system, identifying system barriers that may impair equity and efficiency. The demolition of these barriers may leads on a reduction of waiting lists and of wasted organs. We provide the basic structure and the properties of the model, and validate it on a real case study. The experimental validation of the model demonstrates the effectiveness and robustness of our proposal.

Seroprevalencia de hantavirus en roedores y humanos en el sur de la Argentina / Hantavirus seroprevalence in rodents and human cases in southern Argentina

En la Provincia de Rio Negro, Argentina, se presentaron casos humanos de síndrome pulmonar por hantavírus (SPH) en la región de la cordillera andino paragónica. El virus Andes há sido identificado en la región, tanto en el roedor Oligoryzomys longícaudatus como en seres humanos, demostrándose la transmisión principalmente del roedor al hombre y la factibilidad de la transmisión de persona a persona. El objetivo del presente trabajo es presentar nueva información sobre especies de roedores portadores de hantavirus en Argentina, su prevalencia de anticuepos para hantavirus (período 1999-2001) y la relación del tamaño de las poblaciones de roedores y su seroprevalencia com la ocurrencia de casos humanos (período 1996-2001). Para ello, se procedió a la colocación de 3973 trampas para captura viva de roedores, tipo sherman en seis operativos efectuados entre octubre de 1999 y mayo de 2001. Se obtuvieron muestras de sangue de los roedores las que fueron procesadas mediante enzimoinmunoensayo com antígenos elaborados a partir de virus Andes. Una síntesis de los resultados indica 397 roedores capturados, com un éxito de trampeo del 10 por cento y una prevalencia de anticuerpos contra hantavirus del 1.0por cento. Se observaron importantes diferencias en las especies capturadas en cada una de las regiones. Se capturaron O longicaudatus y A Olivaceus seropositivos y A flavescens y C. Laucha potencialmente portadores de hantavirus. Se registraron 6 casos humanos en el período 1993-1995 (correspondientes a estudios retrospectivos), 21 casos se notificaron en el período 1996-1998 y 6 en el período 1999-2001. Se analiza la correlación entre ocurrencia de casos humanos, seroprevalencia en roedores y éxito de trampeo

Evaluacion de la técnica de utilización del azul de metileno en la localización del ganglio centinela en la disección axilar / Evaluation of the technique of methylene blue in the localization of the centinel ganglion in the axillary dissection

En el período comprendido ente julio del 97 y marzo del 99, se evaluaron en estudio prospectivo 36 pacientes que requirieron disección axilar oncológica, 34 de ellos con diagnóstico de cáncer de mama y 2 fueron pacientes con diagnóstico de melanoma de miembro superior. Para identificar el ganglio centinela se inyectaron 6 cc de solución de azul de metileno al 1 por ciento peritumoral y 20 minutos después se inició la identificación y resección del ganglio centinela seguido de la disección axilar. El 80 por ciento de las disecciones axilares resultaron negativas cuando el ganglio centinela fue negativo. De 460 ganglios examinados 80 fueron positivos y de éstos el 90 por ciento fueron positivos cuando el ganglio centinela fue positivo. De los 17 pacientes con ganglios positivos en el 29,4 por ciento de ellos el único ganglio positivo fue el centinela. La utilización del azul de metileno resultó ser un método eficaz y sin complicaciones que representa una útil herramienta de trabajo en la identificación y evaluación del ganglio centinela en al disección axilar