Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect.

INTRODUCTION: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. OBJECTIVE: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. METHODS: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. RESULTS: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. CONCLUSIONS: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.

Whole body vibration influence on bus fare collectors evaluated by using a brain training mobile app.

PURPOSE: The present work aims to study the effects of whole body vibration (WBV) on bus fare collectors through the use of cognitive tests. It is of interest for all individuals working as bus fare collectors or any other activity where logic is of paramount importance and that is performed on a vibrating environment. METHODS: Laboratory simulations were performed in 24 volunteers employing a vibrating platform subjected to vertical vibration. The influence of WBV on cognition was assessed using the performance on a logic game. The frequencies used were 5 Hz and 30 Hz. The acceleration amplitude values were set up as 0.7 m/s2 and 0.2 m/s2. A daily commute was simulated, based on data of the public transport system in the city of Belo Horizonte. A vibration-free test was initially performed to serve as a basis for comparison. RESULTS: The data obtained in all situations were compared and statistically analyzed. At 5 Hz, variation only shows significant after 5 min of vibration ceased as if the residual effect had passed after 5 min of rest. The gender variable was not significant. However, the older the volunteer, the worse the performance. Regarding 30 Hz frequency, the hypotheses did not meet the condition of significance at 5% but showed an opposite tendency indicating, in this situation, a score increase. It is noticed that the female volunteers presented a better performance in relation to the male gender The residual effect lasts for less than 10 min for short exposure intervals, since the score of test 8, in 5 Hz and 30 Hz, show a reduction of performance. CONCLUSIONS: From the results, it was possible to conclude that the frequency of 5 Hz may be related to reduced performance for long exposure times while the 30 Hz frequency has positive effects on cognition as the exposure time increases. In fact, it is a tendency much more than a clear statistical finding. Regarding comfort, most reports related to the frequency of 5 Hz are linked to the sensation of discomfort and difficulty in focusing visually, whereas, for the frequency of 30 Hz, the reports indicate a feeling of muscular comfort and increased easiness of concentration.

Contribution of the interferon-gamma release assay to tuberculosis diagnosis in children and adolescents.

SETTING: As conclusive data on the performance of interferon-gamma release assays (IGRAs) in paediatric TB are lacking, many guidelines do not recommend their use for TB diagnosis in this population in Brazil. OBJECTIVE: To evaluate the performance of an IGRA by investigating its concordance with the tuberculin skin test (TST) and the role of IGRAs in clinical management and treatment outcomes in children with TB. DESIGN: A historic cohort study was used to evaluate the performance of T-SPOT®.TB (ELISpot) and other tests, such as the TST, in paediatric patients with or without immunodeficiency who were under investigation for latent tuberculous infection (LTBI) or active tuberculosis (TB). RESULTS: Of 86 paediatric patients evaluated, 41 (48%) were immunocompetent and 45 (52%) immunocompromised. All patients underwent T-SPOT.TB, while 63 underwent both ELISpot and TST; test results were concordant in 50 patients (79.4%): 22/31 (71%) in immunocompetent (κ = 0.418, P = 0.02) and 28/32 (87.5%) in immunocompromised patients (κ = 0.526, P = 0.003). TB was diagnosed on the basis of the ELISpot result in 21% (18/86) cases; the contribution of the ELISpot assay was greater in immunocompetent patients than in those who were immunocompromised (13/41, 31.7% vs. 5/45, 11.1%, χ2 P = 0.038). CONCLUSION: ELISpot and TST results were moderately concordant in both groups of patients. ELISpot contribution was higher among immunocompetent patients than among immunocompromised patients.

Chemical composition and morphology study of bovine enamel submitted to different sterilization methods.

OBJECTIVES: The morphology and chemical composition of enamel submitted to different sterilization methods was studied. METHODS: X-ray photoelectron spectroscopy (XPS), field emission gun scanning electron microscopy (FEG-SEM), and energy-dispersive X-ray spectroscopy (EDS) were performed to evaluate 50 bovine enamel specimens sterilized using four methods: microwaving (MI), gamma irradiation (GI), ethylene oxide (EO), and steam autoclave (SA). Non-sterilized specimens were used as control. RESULTS: XPS indicated that the concentration of P (phosphorus), CO3 (carbonate), and CO3/P was not changed in all groups. GI produced no significant change on elemental composition. SA produced the major decrease in calcium (Ca), Ca/P ratio, and increase in N (nitrogen). MI was found to decrease Ca, Ca/P ratio and O (oxygen), and increase in C (carbon) and N. EO produced decrease in Ca and O with increased C concentration. FEG-SEM revealed surface and in-depth morphological changes on SA specimens. Minor surface alterations were observed for EO and for MI groups, and no alteration was observed on GI group. EDS indicated no difference on elemental composition of enamel bulk among groups. CONCLUSIONS: SA produced mineral loss and morphological alterations on surface and in depth. MI and EO sterilization caused mineral loss showing only slight alteration on enamel surface. GI sterilization preserves the morphological characteristics of enamel. The sterilization methods could be classified from lower to high damage as GI < MI < EO < SA. CLINICAL RELEVANCE: This is a comprehensive comparative study where different methods for enamel sterilization were investigated in terms of chemical changes. The results presented here may help researchers to choose the most appropriate method for their research setting and purpose.

Age Influence on Sexual Behavior of the Lesser Cornstalk Borer, Elasmopalpus lignosellus (Zeller) (Lepidoptera: Pyralidae).

The objective of this work was to evaluate the reproductive behavior and response of Elasmopalpus lignosellus (Zeller) males to calling females. Frequency of mating was recorded in couples during the first 7 days of the adult stage. Calling behavior of females was observed during the first 4 days of the adult stage and responses of males, in the same age intervals, to calling females were recorded in wind tunnel bioassays. The maximum number of matings occurred when the couple was between 24 and 48 h old. The scotophase period significantly influenced mating behavior, which peaked between 6 and 8 h of darkness and the mean mating duration was 93.9 ± 4.2 min. Calling females, when evaluated in a wind tunnel, attracted significantly more males than in bioassays with clean air (control). The number of individuals in calling behavior was significantly lower for females that were between 0 to 24 h old compared to the other females evaluated, but this did not influence male response. A lower proportion of males between 48 to 72 h old responded to calling females and these responses were delayed in comparison with males of other ages (0 to 24, 24 to 48, and 72 to 96 h old). These results indicate that the age of E. lignosellus males influences the response to conspecific calling females.

Epilepsia partialis continua after an anterior circulation ischaemic stroke.

BACKGROUND AND PURPOSE: Although cerebrovascular disorders are the main cause of epilepsia partialis continua (EPC) in adulthood, the frequency of EPC after stroke is unknown. The aim was to prospectively ascertain its frequency 1 year after an ischaemic stroke. METHODS: This was a prospective study of consecutive acute anterior circulation ischaemic stroke patients, previously independent, with an admission National Institutes of Health Stroke Scale score ≥4, an acute ischaemic lesion on imaging and no previous epileptic seizures. During admission patients received standardized diagnostic and medical care and were submitted to a neurophysiological evaluation protocol. One year after stroke, patients were re-evaluated by an epilepsy expert neurologist and performed a video-electroencephalogram with electromyography co-registration whenever myoclonus was observed during neurological examination for jerk-locked back averaging analysis (JLBA). EPC was defined as continuously repeated fragments of epileptic seizures, with preserved consciousness, lasting at least 1 h, and representing locally restricted epileptic activity. RESULTS: In all, 151 acute anterior circulation stroke patients were consecutively included and prospectively evaluated, but 23 died in the first year. One year after stroke, from 127 patients alive, 117 (92.1%) underwent clinical and neurophysiological evaluation. In two (1.7%) patients, EPC diagnosis was made both by clinical and electroencephalographic criteria, namely JLBA. Both patients had a history of remote symptomatic seizures and one of them acute symptomatic seizures and non-convulsive status epilepticus criteria during the first 7 days after stroke. CONCLUSIONS: Despite its low frequency, the high stroke incidence makes post-stroke EPC relevant. This study draws attention to this recognizable condition with therapeutic and eventually prognostic implications.

Sleep bruxism associated with obstructive sleep apnoea syndrome - A pilot study using a new portable device.

Sleep bruxism (SB) and obstructive sleep apnoea syndrome (OSAS) share common pathophysiologic pathways. We aimed to study the presence and relationship of SB in a OSAS population. Patients referred with OSAS suspicion and concomitant SB complains were evaluated using a specific questionnaire, orofacial evaluation and cardio-respiratory polygraphy that could also monitor audio and EMG of the masseter muscles. From 11 patients studied 9 had OSAS. 55.6% were male, mean age was 46.3±11.3 years, and apnea hypopnea index of 11.1±5.7/h. Through specific questionnaire 55.6% had SB criteria. Orofacial examination (only feasible in 3) confirmed tooth wear in all. 77.8% had polygraphic SB criteria (SB index>2/h). Mean SB index was 5.12±3.6/h, phasic events predominated (72.7%). Concerning tooth grinding episodes, we found a mean of 10.7±9.2 per night. All OSAS patients except two (77.8%) had more than two audible tooth-grinding episodes. These two patients were the ones with the lowest SB index (1.0 and 1.4 per hour). Only in one patient could we not detect tooth grinding episodes. There was a statistically significant positive correlation between tooth grinding episodes and SB index and phasic event index (R=0.755, p=0.019 and R=0.737, p=0.023 respectively, Pearson correlation). Mean apnoea to bruxism index was 0.4/h, meaning that only a minority of SB events were not secondary to OSAS. We could not find any significant correlation between AHI and bruxism index or phasic bruxism index (R=-0.632 and R=-0.611, p>0.05, Pearson correlation). This pilot study shows that SB is a very common phenomenon in a group of mild OSAS patients, probably being secondary to it in the majority of cases. The new portable device used may add diagnostic accuracy and help to tailor therapy in this setting.

Cyclic adenosine monophosphate protects renal cell lines against amphotericin B toxicity in a PKA-independent manner.

Amphotericin B is the "gold standard" agent in the management of serious systemic fungal infections. However, this drug can cause nephrotoxicity, which contributes up to 25% of all acute kidney injuries in critically ill patients. Cyclic adenosine monophosphate can protect kidney cells from death due to injury or drug exposure in some cases. Hence, the objective of this work was to evaluate if cAMP could prevent cell death that occurs in renal cell lines subjected to AmB treatment and, if so, to assess the involvement of PKA in the transduction of this signal. Two different renal cell lines (LLC-PK1 and MDCK) were used in this study. MTT and flow cytometry assays showed increased cell survival when cells were exposed to cAMP in a PKA-independent manner, which was confirmed by western blot. This finding suggests that cAMP (db-cAMP) may prevent cell death caused by exposure to AmB. This is the first time this effect has been identified when renal cells are exposed to AmB's nephrotoxic potential.

Oncidiinae (Orchidaceae) on the great curve of the Xingu River, Pará state, Brazil.

Among the studies on Orchidaceae in the Amazon, none comprised the region of the Great Curve of the Xingu River, located in the lower Xingu river. The aim of this study was to inventory and taxonomically study the species of Oncidiinae (Orchidaceae) in the Great Curve of the Xingu River, Pará state. The floristic survey was performed in the area of the Belo Monte hydroelectric plant, in the Vitória do Xingu municipality, centrally inserted in the called Great Curve of the Xingu River. Botanical collections were accomplished between June 2011 and December 2013. A total of 27 species of Oncidiinae, distributed in 15 genera, was inventoried in the study area. Notylia Lindl. and Trichocentrum Poepp. & Endl. were the richest genera, with five and four species, respectively, followed by Erycina Lindl., Ionopsis Kunth, Lockhartia Hook., Macradenia R.Br., and Ornithocephalus Hook., with two species each. The remaining eight genera are represented by a single species each in the study area. Morphological descriptions, a key for taxonomic identification, illustrations, and comments on distribution, ecology, phenology and morphology are provided for all inventoried species.

Oncidiinae (Orchidaceae) on the great curve of the Xingu River, Pará state, Brazil / Oncidiinae (Orchidaceae) na volta grande do Rio Xingu, Pará, Brasil

Among the studies on Orchidaceae in the Amazon, none comprised the region of the Great Curve of the Xingu River, located in the lower Xingu river. The aim of this study was to inventory and taxonomically study the species of Oncidiinae (Orchidaceae) in the Great Curve of the Xingu River, Pará state. The floristic survey was performed in the area of the Belo Monte hydroelectric plant, in the Vitória do Xingu municipality, centrally inserted in the called Great Curve of the Xingu River. Botanical collections were accomplished between June 2011 and December 2013. A total of 27 species of Oncidiinae, distributed in 15 genera, was inventoried in the study area. Notylia Lindl. and Trichocentrum Poepp. & Endl. were the richest genera, with five and four species, respectively, followed by Erycina Lindl., Ionopsis Kunth, Lockhartia Hook., Macradenia R.Br., and Ornithocephalus Hook., with two species each. The remaining eight genera are represented by a single species each in the study area. Morphological descriptions, a key for taxonomic identification, illustrations, and comments on distribution, ecology, phenology and morphology are provided for all inventoried species.

Entre os estudos com Orchidaceae na Amazônia, nenhum compreende a região da Volta Grande do rio Xingu, localizada no baixo Xingu. O objetivo deste estudo foi inventariar e estudar taxonomicamente as espécies de Oncidiinae (Orchidaceae) na Volta Grande do rio Xingu, estado do Pará, Brasil. O levantamento florístico foi realizado na área da Usina Hidrelétrica de Belo Monte, no município de Vitória do Xingu, inserido centralmente na chamada Volta Grande do Xingu. Foram realizadas coletas botânicas entre junho de 2011 e dezembro de 2013. Na área de estudo, foram inventariadas 27 espécies de Oncidiinae, distribuídas em 15 gêneros. Notylia Lindl. e Trichocentrum Poepp. & Endl. foram os mais ricos, com cinco e quatro espécies respectivamente, seguidos por Erycina Lindl., Ionopsis Kunth, Lockhartia Hook., Macradenia R.Br., e Ornithocephalus Hook., com duas espécies cada. Os oito gêneros restantes estão representados na área de estudo por uma única espécie. São fornecidas descrições morfológicas, chave taxonômica para identificação, ilustrações e comentários sobre distribuição, ecologia, fenologia e morfologia para todas as espécies inventariadas.

Immunophenotypic profile and increased risk of hospital admission for infection in infants born to female kidney transplant recipients.

Children born to female kidney recipients are exposed to immunosuppressive drugs during gestation. Little is known about their immune system at birth or in the long term. Twenty-eight children born to female kidney recipients and 40 full-term children born to healthy mothers were evaluated. T, B, NK, NKT, γδT cells were assessed by flow cytometry and functional evaluation of T and dendritic cells after in vitro activation was performed at birth and at 8 months of age. At birth, infants born to female kidney recipients showed lower numbers of CD4+ T, NKT and intense reduction of B cells (median cells/mm(3) , transplant: 153.7 X control: 512.4; p < 0.001). There was also a reduced percentage of activated CD8+ T and of CD4+ regulatory T cells. Activated memory and exhausted memory B cells showed higher percentages among children exposed to immunosuppressors when compared to control group. At 8 months, most immune alterations were no longer observed, but four children still had low numbers of some lymphocyte subsets at this age. Children born to female kidney recipients had 4.351 (95% CI: 1.026-15.225; p = 0.046) higher risk of hospital admission in the first months of life-some, with severe clinical manifestations-than those born to healthy women.

Embryological, clinical and ultrastructural study of human oocytes presenting indented zona pellucida.

Human oocyte dysmorphisms attain a large proportion of retrieved oocytes from assisted reproductive technology (ART) treatment cycles. Extracytoplasmic defects involve abnormal morphology of the zona pellucida (ZP), perivitelline space and first polar body. The aim of the present study was to describe a novel dysmorphism affecting the ZP, indented ZP. We also evaluated the clinical, embryological and ultrastructural features of these cases. We evaluated all ART treatment cycles during 7 consecutive years and found 13 treatment cycles (six patients) with all oocytes presenting an indented ZP. In addition, these oocytes presented total or partial absence of the perivitelline space, absence of resistance to ZP and oolemma penetration during microinjection, and low ooplasm viscosity during aspiration. This novel described dysmorphism was recurrent and attained all oocytes in three cases that had more than one treatment cycle. When compared with controls, data showed significant low oocyte maturity (42% versus 81.6%) and high cycle cancellation (30.8% versus 8.5%) rates, normal degeneration (3.4% versus 6.3%) and fertilization rates (69% versus 69.5%), and low pregnancy (15.4% versus 33.3%) and live-birth delivery (7.7% versus 27.7%) rates per cycle. Ultrastructure analysis revealed a zona pellucida structure with large empty electrolucent regions, an outer ZP layer with an indented surface with protuberances and a thick inner ZP that obliterated the perivitelline space. There was evidence of exocytosis of ZP material by the oocyte. In conclusion, oocytes with this novel described dysmorphism (indented ZP) are associated with low maturity, pregnancy and live-birth delivery rates.

Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children.

The aim of this work was to present the clinical and embryological outcomes of 65 azoospermic patients with non-mosaic Klinefelter syndrome (KS), treated by testicular sperm extraction (TESE), followed by intracytoplasmic sperm injection (ICSI), either with fresh or cryopreserved testicular spermatozoa. In total, spermatozoa were recovered in 25/65 (38.5%) of the cases. Of the 48 patients who choose to perform TESE followed by ICSI using fresh testicular spermatozoa (treatment TESE), spermatozoa was recovered in 19 patients (40%), with birth of 12 newborn. Of the 17 patients who choose to perform TESE followed by testicular sperm cryopreservation, spermatozoa were recovered in six patients (35%), with birth of one child. Of the patients who performed treatment TESE, nine went for a new cycle using cryopreserved spermatozoa. Of these, five patients had a previous failed treatment cycle (two patients, three newborn) and four with a previous success went for a new cycle (one patient, one newborn). Overall, the embryological and clinical rates were as follows: 52% of fertilization, 41% of blastocyst, 27% of implantation, 39% of live birth delivery and 47% of newborn. Of the 16 clinical pregnancies, 14 had a successful delivery (12 girls and 5 boys). The 17 newborns had a mean gestation time of 37.2 weeks (35.3% pre-term) and a mean newborn weight of 2781.3 g (37.5% low weight). Comparisons between cycles with fresh and frozen-thaw spermatozoa revealed higher fertilization and clinical pregnancy rates with fresh spermatozoa, with no differences regarding implantation or newborn rates. Of the 17 newborns, no abnormal karyotypes (n = 3) or numerical abnormalities in chromosomes 13, 18, 21, X and Y (n = 14) as evaluated by Multiplex Ligation-dependent Probe Amplification were observed. In conclusion, this study presents further data that reassures that men with KS have no increased risk of transmitting their genetic problem to the offspring.

Disinfection of bovine enamel by microwave irradiation: effect on the surface microhardness and demineralization/remineralization processes.

Enamel specimens need to be disinfected before being used in intraoral appliances and the disinfection method must not affect the integrity of the tooth. This study evaluated the effectiveness of microwave bovine enamel disinfection and its effect on the surface microhardness (SMH) and cross-sectional microhardness (CSMH) of sound, demineralized and remineralized enamel. Forty enamel specimens were divided into two groups (n = 20): control (nonirradiated) and microwave. Microwave specimens were immersed in water and irradiated (650 W/3 min). Specimens were incubated at 37 degrees C for 7 days under aerobic and anaerobic conditions. An aliquot was removed for counting, plated at serial dilutions on blood agar plates, which were incubated aerobically and anaerobically. The colony-forming units were calculated. Other 20 enamel specimens (4 x 4 mm) were embedded in acrylic resin, polished and sliced into two halves: one of the fragments was reserved as control while the other was microwaved. SMH and CSMH of sound enamel were analyzed for both groups. The CSMH was further evaluated after demineralization and remineralization cycles. The Knoop integral (DeltaKI) was also calculated. Data were analyzed statistically by paired Student's t test (alpha = 0.05). While control specimens showed microbial growth, those microwaved were disinfected. There were no significant differences in SMH, CSMH and DeltaKI between the control and microwave groups. Microwave irradiation for 3 min at 650 W was effective for the complete disinfection of bovine enamel specimens without affecting the SMH and CSMH of sound, demineralized and remineralized enamel.

Evaluating a bioremediation tool for atrazine contaminated soils in open soil microcosms: the effectiveness of bioaugmentation and biostimulation approaches.

A previously developed potential cleanup tool for atrazine contaminated soils was evaluated in larger open soil microcosms for optimization under more realistic conditions, using a natural crop soil spiked with an atrazine commercial formulation (Atrazerba FL). The doses used were 20x or 200x higher than the recommended dose (RD) for an agricultural application, mimicking over-use or spill situations. Pseudomonas sp. strain ADP was used for bioaugmentation (around 10(7) or 10(8) viable cells g(-1) of soil) and citrate for biostimulation (up to 4.8 mg g(-1) of soil). Bioremediation treatments providing fastest and higher atrazine biodegradation proved to differ according to the initial level of soil contamination. For 20x RD of Atrazerba FL, a unique inoculation with Pseudomonas sp. ADP (9 +/- 1 x 10(7) CFU g(-1)) resulted in rapid atrazine removal (99% of the initial 7.2 +/- 1.6 microg g(-1) after 8d), independent of citrate. For 200x RD, an inoculation with the atrazine-degrading bacteria (8.5 +/- 0.5 x 10(7) CFU g(-1)) supplemented with citrate amendment (2.4 mg g(-1)) resulted in improved biodegradation (87%) compared with bioaugmentation alone (79%), even though 7.8 +/- 2.1 microg of atrazine g(-1) still remained in the soil after 1 wk. However, the same amount of inoculum, distributed over three successive inoculations and combined with citrate, increased Pseudomonas sp. ADP survival and atrazine biodegradation (to 98%, in 1 wk). We suggest that this bioremediation tool may be valuable for efficient removal of atrazine from contaminated field soils thus minimizing atrazine and its chlorinated derivatives from reaching water compartments.