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1.
Rev Sci Instrum ; 95(3)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38517258

RESUMO

We present the development of a versatile apparatus for 6.2 eV laser-based time and angle-resolved photoemission spectroscopy with micrometer spatial resolution (time-resolved µ-ARPES). With a combination of tunable spatial resolution down to ∼11 µm, high energy resolution (∼11 meV), near-transform-limited temporal resolution (∼280 fs), and tunable 1.55 eV pump fluence up to 3 mJ/cm2, this time-resolved µ-ARPES system enables the measurement of ultrafast electron dynamics in exfoliated and inhomogeneous materials. We demonstrate the performance of our system by correlating the spectral broadening of the topological surface state of Bi2Se3 with the spatial dimension of the probe pulse, as well as resolving the spatial inhomogeneity contribution to the observed spectral broadening. Finally, after in situ exfoliation, we performed time-resolved µ-ARPES on a ∼30 µm flake of transition metal dichalcogenide WTe2, thus demonstrating the ability to access ultrafast electron dynamics with momentum resolution on micro-exfoliated materials.

2.
J Psychiatr Res ; 154: 102-110, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35933853

RESUMO

Post-traumatic stress disorder (PTSD) is a common and disabling condition with high incidence after an earthquake. The objective of the present study was to identify risk factors associated with the occurrence and persistence of PTSD. Individuals (18-65 years old) who experienced the earthquake of September 19th, 2017, attended the National Institute of Psychiatry (INPRFM) between October and November 2017 (baseline n = 68). Participants were followed 4-6 (first follow-up, n = 40) and 7-9 (second follow-up n = 41) months after the earthquake. Delay returning to normal activities, a negative emotional valence to a previous earthquake, comorbidity with depression, history of childhood maltreatment, and low expression of Glucocorticoid Receptor (GR) were associated with PTSD in the basal assessment. The earthquake-related variable associated with the persistence of PTSD at the second follow-up was that the earthquake had directly affected the participants, either because they were evicted, had damage to their homes, or suffered some injury. Comorbidity with dysthymia, history of childhood maltreatment, and higher severity of PTSD in the basal assessment were associated with persistent PTSD in the second follow-up. The lower expression of the FK506 binding protein 5 (FKBP5) in participants with persistent PTSD in the second follow-up was better explained by childhood physical abuse than with PTSD severity. These findings suggest that acute exposure to earthquake-related stressful situations is relevant for the initial risk of PTSD, while potential long-term stressful conditions are associated with its persistence. Likewise, molecular markers associated with hypothalamus-pituitary-adrenal-axis dysregulation were differentially associated with PTSD diagnosis at the different assessment times.


Assuntos
Terremotos , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Idoso , Comorbidade , Humanos , Pessoa de Meia-Idade , Receptores de Glucocorticoides , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto Jovem
4.
Nat Commun ; 13(1): 3096, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35654938

RESUMO

In spintronics, the two main approaches to actively control the electrons' spin involve static magnetic or electric fields. An alternative avenue relies on the use of optical fields to generate spin currents, which can bolster spin-device performance, allowing for faster and more efficient logic. To date, research has mainly focused on the optical injection of spin currents through the photogalvanic effect, and little is known about the direct optical control of the intrinsic spin-splitting. To explore the optical manipulation of a material's spin properties, we consider the Rashba effect. Using time- and angle-resolved photoemission spectroscopy (TR-ARPES), we demonstrate that an optical excitation can tune the Rashba-induced spin splitting of a two-dimensional electron gas at the surface of Bi2Se3. We establish that light-induced photovoltage and charge carrier redistribution - which in concert modulate the Rashba spin-orbit coupling strength on a sub-picosecond timescale - can offer an unprecedented platform for achieving optically-driven spin logic devices.

5.
Sci Adv ; 8(23): eabm5180, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35675409

RESUMO

Quantum materials are notoriously sensitive to their environments, where small perturbations can tip a system toward one of several competing ground states. Graphene hosts a rich assortment of such competing phases, including a bond density wave instability ("Kekulé distortion") that couples electrons at the K/K' valleys and breaks the lattice symmetry. Here, we report observations of a ubiquitous Kekulé distortion across multiple graphene systems. We show that extremely dilute concentrations of surface atoms (less than three adsorbed atoms every 1000 graphene unit cells) can self-assemble and trigger the onset of a global Kekulé density wave phase. Combining complementary momentum-sensitive angle-resolved photoemission spectroscopy (ARPES) and low-energy electron diffraction (LEED) measurements, we confirm the presence of this density wave phase and observe the opening of an energy gap. Our results reveal an unexpected sensitivity of the graphene lattice to dilute surface disorder and show that adsorbed atoms offer an attractive route toward designing novel phases in two-dimensional materials.

6.
Rev Neurol (Paris) ; 177(8): 852-858, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34167805

RESUMO

We discuss from a historical perspective whether the 1931 description of the "unstable ataxic hand" by Théophile Alajouanine, the fifth successor of Charcot at la Salpêtrière, and the Brazilian neurologist Abraham Akerman, then studying in France, merits being considered a distinct contribution vis-à-vis the earlier description by Oppenheim of the "useless hand syndrome". The specific object of the article by Alajouanine and Akerman was a semiologic sign, namely a pseudoathetosis localized in the hand, while the original description by Oppenheim of the symptom-complex that came to be known as useless hand syndrome did not include an abnormal movement. Moreover, as a result of the useless hand syndrome originating from a clinical classification of multiple sclerosis based on the localization of the lesions, it involves topographic and etiologic diagnoses specificities. In contrast, the unstable ataxic hand can be observed in the useless hand syndrome and other syndromes involving predominantly sensory symptoms, such as "numb clumsy hands" due to high cervical spondylosis or extramedullary tumor, and the "cortical sensory syndrome" most commonly due to parietal stroke. Because it had not been thoroughly described in the context of a symptom-complex, Alajouanine and Akerman's unstable ataxic hand merits being considered a distinct and valuable contribution.


Assuntos
Mãos , Esclerose Múltipla , Ataxia , Humanos , Neurologistas , Síndrome
7.
Colorectal Dis ; 22(11): 1677-1685, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32583513

RESUMO

AIM: The aim was to evaluate the influence of a half day, hands-on, workshop on the detection and repair of obstetric anal sphincter injuries (OASIs). METHOD: Starting in February 2011, hands-on workshops for the diagnosis and repair of OASIs were delivered by trained urogynaecologists in departments of tertiary medical centres in Israel. The structure of the hands-on workshop resembles the workshop organized at the International Urogynecological Association annual conferences. Participants included medical staff, midwives and surgical residents from each medical centre. We collected data regarding the rate of OASIs, 1 year before and 1 year following the workshop, in 11 medical centres. The study population was composed of parturients with the following inclusion criteria: singleton pregnancy, vertex presentation and vaginal delivery. Pre-viable preterm gestations (< 24 weeks), birth weight < 500 g, stillborn, and those with major congenital anomalies, multifoetal pregnancies, breech presentations and caesarean deliveries were excluded from the analysis. RESULTS: In the reviewed centres, 70 663 (49.3%) women delivered prior to the workshop (pre-workshop group) and 72 616 (50.7%) women delivered following the workshop (post-workshop group). Third- or fourth-degree perineal tears occurred in 248 women (0.35%) before the workshop, and in 328 (0.45%) following the workshop, a significant increase of 28.7% (P = 0.002). The increase in diagnosis was significant also in women with third-degree tears alone, 226 women (0.32%) before the workshop and 298 (0.41%) following the workshop, an increase of 28.3% (P = 0.005). CONCLUSION: The detection rate of OASIs has significantly increased following the hands-on workshop. The implementation of such programmes is crucial for increasing awareness and detection rates of OASI following vaginal deliveries.


Assuntos
Lacerações , Tocologia , Complicações do Trabalho de Parto , Canal Anal/lesões , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Israel/epidemiologia , Lacerações/diagnóstico , Lacerações/epidemiologia , Lacerações/terapia , Complicações do Trabalho de Parto/diagnóstico , Complicações do Trabalho de Parto/epidemiologia , Complicações do Trabalho de Parto/terapia , Gravidez , Estudos Retrospectivos , Fatores de Risco
8.
Science ; 366(6470): 1231-1236, 2019 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-31806810

RESUMO

Ultrafast spectroscopies have become an important tool for elucidating the microscopic description and dynamical properties of quantum materials. In particular, by tracking the dynamics of nonthermal electrons, a material's dominant scattering processes can be revealed. Here, we present a method for extracting the electron-phonon coupling strength in the time domain, using time- and angle-resolved photoemission spectroscopy (TR-ARPES). This method is demonstrated in graphite, where we investigate the dynamics of photoinjected electrons at the [Formula: see text] point, detecting quantized energy-loss processes that correspond to the emission of strongly coupled optical phonons. We show that the observed characteristic time scale for spectral weight transfer mediated by phonon-scattering processes allows for the direct quantitative extraction of electron-phonon matrix elements for specific modes.

9.
Sci Adv ; 5(11): eaaw5593, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31723598

RESUMO

Graphene is a powerful playground for studying a plethora of quantum phenomena. One of the remarkable properties of graphene arises when it is strained in particular geometries and the electrons behave as if they were under the influence of a magnetic field. Previously, these strain-induced pseudomagnetic fields have been explored on the nano- and micrometer-scale using scanning probe and transport measurements. Heteroepitaxial strain, in contrast, is a wafer-scale engineering method. Here, we show that pseudomagnetic fields can be generated in graphene through wafer-scale epitaxial growth. Shallow triangular nanoprisms in the SiC substrate generate strain-induced uniform fields of 41 T, enabling the observation of strain-induced Landau levels at room temperature, as detected by angle-resolved photoemission spectroscopy, and confirmed by model calculations and scanning tunneling microscopy measurements. Our work demonstrates the feasibility of exploiting strain-induced quantum phases in two-dimensional Dirac materials on a wafer-scale platform, opening the field to new applications.

10.
J Dairy Sci ; 102(7): 6595-6602, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31103303

RESUMO

Milking cows once daily is a management tool that has been implemented to improve physical and financial results of seasonal pasture-based dairy farms. The Molly cow model integrates physiology and metabolism of dairy cattle; however, milk production during short-term changes in milking frequency (e.g., 1× milking) is not well represented. The model includes a representation of variable rates of cell quiescence and death. However, the rate constants governing cell death and the return of quiescent to active cells are not affected by milking frequency. An empirical assessment of the problem was conducted, and it was hypothesized that changing the current representation of the rate of cell death in response to short-term 1× milking would more accurately represent active and quiescent cells and improve predictions of milk production. An extra senescent cell flux was added to account for cell loss during periods of 1× milking. Additional changes included a gradual decline in the rate of 1× stimulated senescence during 1× milking, and a structural change in cell cycling between active and quiescent cells during and after short-term 1× milking. Data used for parameter estimation were obtained from 5 studies where 1× milking or different feeding strategies were tested. Parameter estimates of cell loss indicated that 1× milking would affect a small proportion of quiescent cells to cause extra cell death. This added cell senescence was influenced by the length of 1× milking such that cell senescence peaked on d 1 of 1× milking and decayed from that point. The new structure in the model includes a variable rate of cell death in response to 1× milking and a gradual rate of return of quiescent cells back to the active pool in response to switching to 2× milking after short-term 1× milking. Root mean square errors, mean bias, and slope bias declined by at least 50% for predictions of energy-corrected milk yield and fat percent. The model showed quantitative agreement with production data from short-term 1× milking. The accuracy of predictions was improved and the error was reduced by implementing modifications in the model in response to changes in milking frequency.


Assuntos
Bovinos/fisiologia , Indústria de Laticínios , Glândulas Mamárias Animais/fisiologia , Leite , Modelos Biológicos , Animais , Indústria de Laticínios/métodos , Feminino , Lactação/fisiologia
11.
Rev. otorrinolaringol. cir. cabeza cuello ; 78(4): 343-352, dic. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-985738

RESUMO

Resumen Introducción: Desde la década de los 90, los implantes cocleares han progresado desde aplicaciones experimentales a un uso clínico estandarizado en niños con pérdida auditiva severa y profunda. Las investigaciones han producido cambios en la tecnología de los implantes y ha dado lugar a la expansión de los candidatos a implante para incluir a los niños menores de 2 años de edad. El objetivo principal de la implantación coclear pediátrica es facilitar el desarrollo del lenguaje hablado. A pesar de los avances en la tecnología de implantes y los cambios en el manejo de la pérdida auditiva, los resultados de lenguaje en niños son todavía muy variables, participando de este proceso tanto el tratamiento oportuno, la red familiar y nivel socioeconómico entre algunos de ellos. Objetivo: Describir resultados de niños menores 6 años sometidos a cirugía de implante coclear en un centro terciario de salud. Material y método: Estudio longitudinal de cohorte retrospectivo, análisis a 99 pacientes implantados en centro terciario de salud desde inicio programa en 1994 a 2015. Resultados: 99 pacientes, 57% hombres 43% mujeres, edad promedio implantación 16,3 meses. 54,8% casos origen congénito no especificado o prematurez. En 74,4% se objetivó presencia de lenguaje auditivo verbal. El nivel socioeconómico (NSE) mostró asociación con no desarrollo de lenguaje (p =0,009) evidenciando que pacientes de bajo NSE 20% no desarrolla lenguaje. La variable discapacidad asociada (p <0,001) y la variable NSE (p =0,036) se asociaron de manera independiente a lenguaje de señas o no desarrollo de lenguaje oral. Conclusión: Los implantes cocleares ofrecen una opción en la rehabilitación auditiva en hipoacusia sensorio neural profunda, para candidatos de todo el espectro de edad, sin embargo los resultados dependen en gran medida del entorno en el que se utilizan los implantes cocleares.


ABSTRACT Introduction: Since the 90s, cochlear implantation has progressed from experimental to standard clinical practice for children with severe and profound hearing loss. Research has produced changes in implant technology and has led to the expansion of implant candidacy to include children younger than 2 years of age. The primary goal of pediatric cochlear implantation is to facilitate spoken language development. Despite the advances in implant technology and the changes to the management of hearing loss, language outcomes for children are still highly variable, participating in this process both timely treatment, the family network and socio economic level among others. Aim: describe outcomes of patients younger than 6 years undergoing cochlear implant surgery in a tertiary care center. Material and method: retrospective longitudinal cohort study, 99 patients implanted in a tertiary health center since the program's inception in 1994 to 2015 was analyzed. Results: 99 patients, 57 % men 43 % women, average age of implantation 16.3 months. 54.8 % of cases were congenital or prematurity. In 74.4 % they had auditory verbal language. Socioeconomic status (SES) showed association with the lack of language development (p =0.009) demonstrating that low SES patients (20%) do not develop language. The disability associated variable (p <0.001) and the SES variable (p =0.036) were independently associated with sign language or no oral language development. Conclusions: Cochlear implants offer an option for hearing rehabilitation in profound hearing loss, for candidates of all ages, however the results depend largely on the environment in which cochlear implants are used.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Implantes Cocleares , Implante Coclear , Perda Auditiva/terapia , Desenvolvimento da Linguagem , Chile , Estudos Retrospectivos , Resultado do Tratamento , Surdez/reabilitação , Auxiliares de Audição , Perda Auditiva/etiologia
12.
Phys Rev Lett ; 121(7): 076401, 2018 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-30169095

RESUMO

We report on the influence of spin-orbit coupling (SOC) in Fe-based superconductors via application of circularly polarized spin and angle-resolved photoemission spectroscopy. We combine this technique in representative members of both the Fe-pnictides (LiFeAs) and Fe-chalcogenides (FeSe) with tight-binding calculations to establish an ubiquitous modification of the electronic structure in these materials imbued by SOC. At low energy, the influence of SOC is found to be concentrated on the hole pockets, where the largest superconducting gaps are typically found. This effect varies substantively with the k_{z} dispersion, and in FeSe we find SOC to be comparable to the energy scale of orbital order. These results contest descriptions of superconductivity in these materials in terms of pure spin-singlet eigenstates, raising questions regarding the possible pairing mechanisms and role of SOC therein.

13.
Rev. otorrinolaringol. cir. cabeza cuello ; 78(3): 275-280, set. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-978812

RESUMO

RESUMEN Introducción: La hipoacusia sensorioneural es la tercera causa de discapacidad en Chile, con incidencia en recién nacidos de 1 a 3 casos cada 1.000 recién nacidos vivos, y prevalencia en adultos de hasta 70%, siendo muchos casos susceptibles de ser tratados mediante implante coclear. Objetivo: Describir resultados de los pacientes sometidos a cirugía de implante coclear en Clínica Las Condes (CLC). Material y método: Estudio longitudinal de cohorte retrospectiva, se analizaron a 237 pacientes implantados en Clínica Las Condes desde 1994 al año 2015. Resultados: Se analizan 237 pacientes, 106 mujeres (44,7%) y 131 hombres (55,3%). El 65,5% de los pacientes se implantaron entre los 2-6 años de vida. Las etiologías más frecuentes fueron hipoacusia congénita no sindrómica (45,9%), genética tardía (11,8%) y posmeningitis (11,4%). Se encontró asociación significativa entre promedio tonal de la palabra (PTP) y presencia de malformación coclear (p =0,008). Sólo 9,9% de los pacientes presentaron otra discapacidad asociada a la hipoacusia. La tasa de reimplante fue 16,3% y sólo la variable malformación coclear se asoció a ella (p =0,016). Conclusión: El implante coclear es una herramienta beneficiosa en pacientes hipoacúsicos que no se benefician de otros dispositivos auditivos ofreciendo la posibilidad de reinsertarlos social y laboralmente con bajo riesgo quirúrgico y alta tasa de éxito.


ABSTRACT Introduction: Sensorineural hearing loss is the third leading cause of disability in Chile, with incidence in infants 1 to 3 cases per 1,000 newborn and prevalence in adult up to 70%, with many cases that can be treated with cochlear implant. Aim: to describe outcomes of our series of patients undergoing cochlear implant surgery at Clinica Las Condes (CLC). Material and method: Retrospective longitudinal cohort study, 237 patients implanted in our center since 1994 to 2015 were analyzed. Results: 237 patients, 106 women (44.7%) and 131 men (55.3%) received a cochlear implant during this period. 65.5% of patients were implanted between 2-6 years of age. The most common etiologies were; non-syndromic congenital deafness (45.9%), late genetic onset (11.8%) and meningitis (11.4%). A significant association between the average pure tone average and presence of cochlear malformation (p =0.008) was demonstrated. Only 9.9% of patients had other disabilities associated with hearing loss. Re-implantation rate was 16.3% and only the variable cochlear malformation was associated to it (p =0.016) Conclusions: The cochlear implant provides clear benefits to patients with hearing impairment who do not benefit from other hearing devices offering the possibility of social and labor reintegrating, with low surgical risk and high success rate.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Implantes Cocleares/estatística & dados numéricos , Perda Auditiva Neurossensorial/etiologia , Chile/epidemiologia , Epidemiologia Descritiva , Estudos de Coortes , Pessoas com Deficiência , Surdez
14.
Arch Pediatr ; 25(6): 383-388, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30041886

RESUMO

OBJECTIVES: Mortality rates of very preterm infants may vary considerably between healthcare facilities depending on the neonates' place of inclusion in the cohort study. The objective of this study was to compare the mortality rates of live-born extremely preterm neonates observed in two French tertiary referral hospitals, taking into account the occurrence of neonatal death both in the delivery room and in the neonatal intensive care unit (NICU). METHODS: Retrospective observational study including all pregnancy terminations, stillbirths and live-born infants within a 22- to 26-week 0/6 gestational age range was registered by two French level 3 university centers between 2009 and 2013. The mortality rates were compared between the two centers according to two places of inclusion: either the delivery room or the NICU. RESULTS: A total of 344 infants were born at center A and 160 infants were born at center B. Among the live-born neonates, the rates of neonatal death were similar in center A (54/125, 43.2%) and center B (33/69, 47.8%; P=0.54). However, neonatal death occurred significantly more often in the delivery room at center A (31/54, 57.4%) than at center B (6/33, 18.2%; P<0.001). Finally, the neonatal death rate of live-born very preterm neonates admitted to the NICU was significantly lower in center A (25/94, 26.6%) than in center B (27/63, 42.9%; P=0.03). CONCLUSIONS: This study points out how the inclusion of deaths in the delivery room when comparing neonatal death rates can lead to a substantial bias in benchmarking studies. Center A and center B each endorsed one of the two models of preferential place of neonatal death (delivery room or NICU) detailed in European studies. The reasons behind the two different models and their impact on how parents perceive supporting their neonate need further investigation.


Assuntos
Salas de Parto/estatística & dados numéricos , Mortalidade Infantil , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Feminino , França , Humanos , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Gravidez , Sistema de Registros , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
15.
Nat Mater ; 17(5): 416-420, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29610487

RESUMO

The possibility of driving phase transitions in low-density condensates through the loss of phase coherence alone has far-reaching implications for the study of quantum phases of matter. This has inspired the development of tools to control and explore the collective properties of condensate phases via phase fluctuations. Electrically gated oxide interfaces1,2, ultracold Fermi atoms3,4 and cuprate superconductors5,6, which are characterized by an intrinsically small phase stiffness, are paradigmatic examples where these tools are having a dramatic impact. Here we use light pulses shorter than the internal thermalization time to drive and probe the phase fragility of the Bi2Sr2CaCu2O8+δ cuprate superconductor, completely melting the superconducting condensate without affecting the pairing strength. The resulting ultrafast dynamics of phase fluctuations and charge excitations are captured and disentangled by time-resolved photoemission spectroscopy. This work demonstrates the dominant role of phase coherence in the superconductor-to-normal state phase transition and offers a benchmark for non-equilibrium spectroscopic investigations of the cuprate phase diagram.

16.
Ann Dermatol Venereol ; 145(1): 21-28, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29290414

RESUMO

BACKGROUND: Anaplastic Kaposi's sarcoma (KS) is a rare form of KS characterized clinically by the development of a tumour mass with unusual local aggressiveness and histologically by a specific architecture and cytological morphology. A very small number of limited series in endemic countries have established characteristics common to these anaplastic forms of KS. We present five patients with an anaplastic form in a context of KS ongoing for several years in a non-endemic country. MATERIALS AND METHODS: We collected 5 cases of anaplastic KS followed in our department over a period of 20years. We describe the main developmental, clinical, virological and histological features. RESULTS: The cases involved 4 men and 1 woman whose mean age at diagnosis of anaplastic KD was 70years, with an average time of 25years between initial diagnosis of KD and anaplastic transformation. Our patients were all treated with chemotherapy and/or radiotherapy (RT) prior to diagnosis of anaplastic transformation. All patients had a tumour mass of the lower limbs developing in classically indolent KS with associated chronic lymphoedema. Progression was very aggressive locally with deep invasion of the soft tissues as well as osteoarticular involvement, without visceral dissemination. At present, three patients are dead, one patient is showing partial response, and one patient is in locoregional progression. Diagnosis of the disease was based on histopathological findings. The tumour cells were undifferentiated, pseudo-cohesive, and chiefly organized in sheets. The mitotic count was high (27 mitoses per 10 fields at high magnification). Necrosis was constant. DISCUSSION: To our knowledge, this is the first series describing anaplastic Kaposi's sarcoma in a non-endemic country. The severity of the prognosis, despite the absence of visceral dissemination, is related to the local aggressiveness of anaplastic KS and to its resistance to radiotherapy and chemotherapy, with amputation being required in certain cases.


Assuntos
Sarcoma de Kaposi/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Amputação Cirúrgica , Antineoplásicos/uso terapêutico , Terapia Combinada , Progressão da Doença , Feminino , Infecções por HIV/complicações , Herpesvirus Humano 8/isolamento & purificação , Humanos , Perna (Membro) , Linfedema/complicações , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Radioterapia Adjuvante , Sarcoma de Kaposi/terapia , Sarcoma de Kaposi/virologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/virologia , Carga Viral
17.
Mol Neurobiol ; 55(5): 3698-3708, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28527108

RESUMO

A body of evidence supports a relevant role of brain-derived neurotrophic factor (BDNF) in temporal lobe epilepsy (TLE). Magnetic resonance data reveal that the cerebral atrophy extends to regions that are functionally and anatomically connected with the hippocampus, especially the temporal cortex. We previously reported an increased expression of BDNF messenger for the exon VI in the hippocampus of temporal lobe epilepsy patients compared to an autopsy control group. Altered levels of this particular transcript were also associated with pre-surgical use of certain psychotropic. We extended here our analysis of transcripts I, II, IV, and VI to the temporal cortex since this cerebral region holds intrinsic communication with the hippocampus and is structurally affected in patients with TLE. We also assayed the cyclic adenosine monophosphate response element-binding (CREB) and glucocorticoid receptor (GR) genes as there is experimental evidence of changes in their expression associated with BDNF and epilepsy. TLE and pre-surgical pharmacological treatment were considered as the primary clinical independent variables. Transcripts BDNF I and BDNF VI increased in the temporal cortex of patients with pharmacoresistant TLE. The expression of CREB and GR expression follow the same direction. Pre-surgical use of selective serotonin reuptake inhibitors, carbamazepine (CBZ) and valproate (VPA), was associated with the differential expression of specific BDNF transcripts and CREB and GR genes. These changes could have functional implication in the plasticity mechanisms related to temporal lobe epilepsy.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Córtex Cerebral/metabolismo , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Epilepsia do Lobo Temporal/metabolismo , Receptores de Glucocorticoides/metabolismo , Adolescente , Idoso , Fator Neurotrófico Derivado do Encéfalo/genética , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/genética , Epilepsia do Lobo Temporal/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptores de Glucocorticoides/genética , Adulto Jovem
18.
Eur J Dent Educ ; 21 Suppl 1: 28-35, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29205776

RESUMO

It is often the case that good teachers just "intuitively" know how to teach. Whilst that may be true, there is now a greater need to understand the various processes that underpin both the ways in which a curriculum is delivered, and the way in which the students engage with learning; curricula need to be designed to meet the changing needs of our new graduates, providing new, and robust learning opportunities, and be communicated effectively to both staff and students. The aim of this document is to draw together robust and contemporaneous methods of teaching, learning and assessment that help to overcome some of the more traditional barriers within dental undergraduate programmes. The methods have been chosen to map specifically to The Graduating European Dentist, and should be considered in parallel with the benchmarking process that educators and institutions employ locally.


Assuntos
Educação em Odontologia/normas , Avaliação Educacional , Aprendizagem , Ensino , Competência Clínica , Educação Baseada em Competências , Currículo , Educação em Odontologia/organização & administração , Europa (Continente) , Retroalimentação , Humanos , Modelos Educacionais
19.
Eur Ann Otorhinolaryngol Head Neck Dis ; 134(3): 171-175, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27964839

RESUMO

The causes of balance disorder are many and various, and the subjective syndrome of cranial trauma patients is diagnosed by elimination. Progress in otoneurologic functional exploration and brain imaging, however, now generally allow this functional complaint to be given an objective basis. In recent years, new diagnoses have improved recognition of such pathologies in the appraisal of corporal injury for compensation purposes. The present article seeks to detail etiology and, by a review of the literature, to determine factors liable to influence management and appraisal in particular.


Assuntos
Traumatismos Craniocerebrais/complicações , Vertigem/diagnóstico , Vertigem/etiologia , Diagnóstico Diferencial , Avaliação da Deficiência , Medicina Baseada em Evidências , Humanos
20.
Am J Transplant ; 17(3): 754-760, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27545327

RESUMO

The increased prevalence of obesity worldwide threatens the pool of living liver donors. Although the negative effects of graft steatosis on liver donation and transplantation are well known, the impact of obesity in the absence of hepatic steatosis on outcome of living donor liver transplantation (LDLT) is unknown. Consequently, we compared the outcome of LDLT using donors with BMI <30 versus donors with BMI ≥30. Between April 2000 and May 2014, 105 patients received a right-lobe liver graft from donors with BMI ≥30, whereas 364 recipients were transplanted with grafts from donors with BMI <30. Liver steatosis >10% was excluded in all donors with BMI >30 by imaging and liver biopsies. None of the donors had any other comorbidity. Donors with BMI <30 versus ≥30 had similar postoperative complication rates (Dindo-Clavien ≥3b: 2% vs. 3%; p = 0.71) and lengths of hospital stay (6 vs. 6 days; p = 0.13). Recipient graft function, assessed by posttransplant peak serum bilirubin and international normalized ratio was identical. Furthermore, no difference was observed in recipient complication rates (Dindo-Clavien ≥3b: 25% vs. 20%; p = 0.3) or lengths of hospital stay between groups. We concluded that donors with BMI ≥30, in the absence of graft steatosis, are not contraindicated for LDLT.


Assuntos
Índice de Massa Corporal , Transplante de Fígado/métodos , Doadores Vivos , Seleção de Pacientes , Complicações Pós-Operatórias , Obtenção de Tecidos e Órgãos/métodos , Adulto , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco
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