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Persistent left superior vena cava is the most common thoracic venous anomaly. It is usually asymptomatic, but it can make implanting intracardiac devices difficult.We present a novel technique to facilitate desfibrillator lead implantation in patients with persistent left superior vena cava and the absence of the right superior vena cava. We used a fixed-curve Selectra 3D 65-42 cm sheath (Biotronik), orienting it toward the tricuspid valve (TV) by rotating it counter-clockwise. During follow-up, the electrodes remained stable.Our technique was safe, simple, and feasible for patients with this complex venous anatomy.
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Marca-Passo Artificial , Veia Cava Superior Esquerda Persistente , Humanos , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/cirurgia , CoraçãoRESUMO
Microplastic (MP) pollution has caused severe concern due to its harmful effect on human beings and ecosystems. Existing MP removal methods face many obstacles, such as high cost, high energy consumption, low efficiency, release of toxic chemicals, etc. Thus, it is crucial to find appropriate and sustainable methods to replace common MP removal approaches. Bio-electrochemical system (BES) is a sustainable clean energy technology that has been successfully applied to wastewater treatment, seawater desalination, metal removal, energy production, biosensors, etc. However, research reports on BES technology to eliminate MP pollution are limited. This paper reviews the mechanism, hazards, and common treatment methods of MP removal and discusses the application of BES systems to improve MP removal efficiency and sustainability. Firstly, the characteristics and limitations of common MP removal techniques are systematically summarized. Then, the potential application of BES technology in MP removal is explored. Furthermore, the feasibility and stability of the potential BES MP removal application are critically evalauted while recommendations for further research are proposed.
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Microplásticos , Eliminação de Resíduos Líquidos , Poluentes Químicos da Água , Poluentes Químicos da Água/análise , Microplásticos/análise , Eliminação de Resíduos Líquidos/métodos , Técnicas Eletroquímicas/métodos , Águas Residuárias/química , Purificação da Água/métodosRESUMO
Understanding the phase behavior of PEGylated phosphocholine membranes is becoming increasingly important in many biomedical applications. Here, we used binary mixtures of phosphocholines and PEG-phospholipids in monolayers on phosphate buffered saline as ideal models of PEGylated phosphocholine membranes. Several phase states and transitions between homogeneously mixed and completely immiscible phases have been visualized in these mixtures by epifluorescence microscopy, which is neither predicted nor easily explained by the existing interpretive schemes. The results of our study suggest that the phase state of PEGylated phosphocholine membranes may drastically vary depending on factors such as aliphatic chain length on phosphocholines and PEG-phospholipids, PEG content, and temperature. These findings are summarized in phase drawings and diagrams to demonstrate a striking variety of possible phases. The diagrams can also be instrumental in predicting the phase state of PEGylated phosphocholine membranes, in particular under physiological conditions.
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Fosforilcolina/química , Polietilenoglicóis/química , Modelos Moleculares , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
Staghorn calculi account for about 4% of presenting renal stones in developed countries, are source of recurrent urinary tract infection, and may be eventually treated by surgical stone removal. A 55-year-old female with a history of staghorn renal calculi and recurrent urinary tract infections presented with a left flank and lower abdominal pain following recent left robotic partial nephrectomy and nephrolithotomy. Contrast-enhanced computed tomography (CT) of the abdomen demonstrated a large left-sided retroperitoneal fluid collection with a few dropped renal stones in the dependent portion of the collection. The patient treated with early percutaneous drainage of the collection and antibiotic treatment and responded well clinically. The clinical and imaging presentation of a rare case of retroperitoneal abscess formation caused by dropped renal stones is described in this study. Imaging, particularly ultrasound and CT, plays a key role in detecting the dropped renal stones and can help with differential diagnosis and treatment plans.
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OBJECTIVE: Indications for the treatment of cerebral aneurysms with flow diversion stents are expanding. The current aneurysm occlusion rate at six months ranges between 60 and 80%. Predictability of complete vs. partial aneurysm occlusion is poorly defined. Here, we evaluate the angiographic contrast time-density as a predictor of aneurysm occlusion rate at six months' post-flow diversion stents. METHODS: Patients with unruptured cerebral aneurysms proximal to the internal carotid artery terminus treated with single flow diversion stents were included. 2D parametric parenchymal blood flow software (Siemens-Healthineers, Forchheim, Germany) was used to calculate contrast time-density within the aneurysm and in the proximal adjacent internal carotid artery. The area under the curve ratio between the two regions of interests was assessed at baseline and after flow diversion stents deployment. The area under the curve ratio between completely vs. partially occluded aneurysms at six months' follow-up was compared. RESULTS: Thirty patients with 31 aneurysms were included. Mean aneurysm diameter was 8 mm (range 2-28 mm). Complete occlusion was obtained in 19 aneurysms. Younger patients (P = 0.006) and smaller aneurysms (P = 0.046) presented higher chance of complete obliteration. Incomplete occlusion of the aneurysm was more likely if the area under the curve contrast time-density ratio showed absolute (P = 0.001) and relative percentage (P = 0.001) decrease after flow diversion stents deployment. Area under ROC curve was 0.85. CONCLUSION: Negative change in the area under the curve ratio indicates less contrast stagnation in the aneurysm and lower chance of occlusion. These data provide a real-time analysis after aneurysm treatment. If validated in larger datasets, this can prompt input to the surgeon to place a second flow diversion stents.
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Angiografia Cerebral , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Stents , Idoso , Idoso de 80 Anos ou mais , Angiografia Digital , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Impulsivity, often defined as a human behavior characterized by the inclination of an individual to act on urge rather than thought, with diminished regard to consequences, encompasses a range of maladaptive behaviors, which are in turn affected by distinct neural systems. Congruent with the above definition, behavioral studies have consistently shown that the underlying construct of impulsivity is multidimensional in nature. However, research to date has been inconclusive regarding the different domains or constructs that constitute this behavior. In addition there is also no clear consensus as to whether self-report and laboratory based measures of impulsivity measure the same or different domains. This study aimed to: (i) characterize the underlying multidimensional construct of impulsivity using a sample with varying degrees of putative impulsivity related to substance misuse, including subjects who were at-risk of substance use or addicted (ARA), and (ii) assess relationships between self-report and laboratory measures of impulsivity, using a principal component-based factor analysis. In addition, our supplementary goal was to evaluate the structural constructs of impulsivity within each group separately (healthy and ARA). We used five self-report measures (Behavioral Inhibition System/Behavioral Activation System, Barratt Impulsivity Scale-11, Padua Inventory, Zuckerman Sensation Seeking Scale, and Sensitivity to Punishment and Sensitivity to Reward Questionnaire) and two computer-based laboratory tasks (Balloon Analog Risk Task and the Experiential Discounting Task) to measure the aspects of impulsivity in a total of 176 adult subjects. Subjects included healthy controls (n = 89), nonalcoholic subjects with family histories of alcoholism (family history positive; n = 36) and both former (n = 20) and current (n = 31) cocaine users. Subjects with a family history of alcoholism and cocaine abusers were grouped together as 'at-risk/addicted' (ARA) to evaluate our supplementary goal. Our overall results revealed the multidimensional nature of the impulsivity construct as captured optimally through a five-factor solution that accounted for nearly 70% of the total variance. The five factors/components were imputed as follows 'Self-Reported Behavioral Activation', 'Self-Reported Compulsivity and Reward/Punishment', 'Self-Reported Impulsivity', 'Behavioral Temporal Discounting', and 'Behavioral Risk-Taking'. We also found that contrary to previously published reports, there was significant overlap between certain laboratory and self-report measures, indicating that they might be measuring the same impulsivity domain. In addition, our supplemental analysis also suggested that the impulsivity constructs were largely, but not entirely the same within the healthy and ARA groups.
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Comportamento/fisiologia , Comportamento Impulsivo/psicologia , Análise de Componente Principal , Autoimagem , Adulto , Feminino , Humanos , Comportamento Impulsivo/etiologia , Masculino , Pessoa de Meia-Idade , Psicometria/métodos , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias/complicações , Inquéritos e Questionários , Adulto JovemRESUMO
Portugal has some rehabilitation centers for wild animals, which are responsible for the rehabilitation and reintroduction of birds, among other animals, into the wild. Coccidian parasites of these wild birds in rehabilitation centers are especially important because these centers can introduce coccidian species into new environments through the reintroduction of their respective hosts. In this context, the current study aimed to identify intestinal coccidia from wild birds at two rehabilitation centers for wild animals located in two municipalities of Portugal. Eighty-nine wild birds of 9 orders and 11 families were sampled, of which 22 (25%) were positive for Coccidia. Avispora spp. were found in raptors. Sporocysts of Sarcocystinae subfamily were recovered from owls. An Isospora sp. was found in Turdus merula Linnaeus, 1758, and an Eimeria sp. was found in Fulica atra Linnaeus, 1758. Among the coccidian species, Avispora bubonis (Cawthorn, Stockdale, 1981) can be highlighted. The finding of this species indicates that transmission of coccidians from the New World to the Old World may be occurring, potentially through dispersion by Bubo scandiacus (Linnaeus, 1758) through Arctic regions or by means of anthropic activities, and/or through other unknown mechanisms.
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Doenças das Aves/parasitologia , Aves/parasitologia , Coccídios/isolamento & purificação , Coccidiose/veterinária , Animais , Animais Selvagens , Aves/classificação , Coccídios/classificação , Coccidiose/diagnóstico , Fezes/parasitologia , Portugal , Centros de ReabilitaçãoRESUMO
Background@#Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe hereditary channelopathy characterized by the presence of ventricular arrhythmias triggered by adrenergic stimuli, usually diagnosed in the first two decades of life. Genetic variants in the cardiac ryanodine receptor gene are the most frequently occurring that cause an increase in intracellular calcium concentration and thus induce ventricular arrhythmias due to a delayed after depolarisation-induced triggered activity.Case presentationWe present the case of a 74-year-old male, a regular athlete with no relevant family history who suffered from sinus dysfunction and frequent premature ventricular complexes with no symptoms. A treadmill test revealed severe polymorphic ventricular arrhythmias which led to the suspicion of CPVT. A genetic study was undertaken, and it identified a rare genetic variant in the RYR2 gene which was possibly associated with its development in heterozygosity: c.14465G > A, p.Arg4822His. While evaluating the co-segregation, we observed that most of his relatives exhibit polymorphic ventricular arrhythmias with exertion without symptoms and carried the same variant. @*Conclusions@#We described, for the first time, the clinical characteristics and co-segregation of a family diagnosed with CPVT secondary to a little-known genetic variant of the RYR2 gene. It is a variant that, in our case study, suggests an association with a very good prognosis.
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Background@#Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe hereditary channelopathy characterized by the presence of ventricular arrhythmias triggered by adrenergic stimuli, usually diagnosed in the first two decades of life. Genetic variants in the cardiac ryanodine receptor gene are the most frequently occurring that cause an increase in intracellular calcium concentration and thus induce ventricular arrhythmias due to a delayed after depolarisation-induced triggered activity.Case presentationWe present the case of a 74-year-old male, a regular athlete with no relevant family history who suffered from sinus dysfunction and frequent premature ventricular complexes with no symptoms. A treadmill test revealed severe polymorphic ventricular arrhythmias which led to the suspicion of CPVT. A genetic study was undertaken, and it identified a rare genetic variant in the RYR2 gene which was possibly associated with its development in heterozygosity: c.14465G > A, p.Arg4822His. While evaluating the co-segregation, we observed that most of his relatives exhibit polymorphic ventricular arrhythmias with exertion without symptoms and carried the same variant. @*Conclusions@#We described, for the first time, the clinical characteristics and co-segregation of a family diagnosed with CPVT secondary to a little-known genetic variant of the RYR2 gene. It is a variant that, in our case study, suggests an association with a very good prognosis.
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BACKGROUND: Anteromedialization is recommended for cartilage restoration of patellofemoral defects, with the presumption that it decreases contact pressures across the trochlea. No study has evaluated pressures on the trochlear side of the patellofemoral joint after anteromedialization of the tibial tubercle. HYPOTHESIS: Anteromedialization of the tibial tubercle decreases contact pressure across the trochlea. STUDY DESIGN: Controlled laboratory study. METHODS: Ten cadaveric knees were tested by placing an electroresistive pressure sensor on the femoral side of the patellofemoral joint. A validated model of nonweightbearing resisted extension was simulated by loading the extensor mechanism at 89.1 N and 178.2 N. Knees were tested 3 times per load at 30 degrees , 60 degrees , 90 degrees , and 105 degrees . The center of force and pressure across the patellofemoral articulation were compared before and after a reproducible and consistent anteromedialization. RESULTS: The mean center of force shifted medially after anteromedialization at 89.1 N and 178.2 N. At 89.1 N, the mean total contact pressure decreased significantly (P < .05) at all angles, and at 178.2 N, it decreased significantly at 30 degrees , 60 degrees , and 90 degrees of knee flexion. The mean lateral trochlear contact pressure decreased significantly (P < .05) at all flexion angles at both 89.1 N and 178.2 N. The mean central trochlear contact pressure decreased significantly (P < .05) at 30 degrees with the 89.1-N and 178.2-N loads but increased significantly (P < .05) at 90 degrees with the 89.1-N load. The mean medial trochlear contact pressure increased significantly (P < .05) at all flexion angles at 89.1 N and 178.2 N. CONCLUSION: Anteromedialization shifts the contact force to the medial trochlea and decreases the mean total contact pressure. CLINICAL RELEVANCE: Anteromedialization decreases the mean total contact pressure while shifting contact pressure toward the medial trochlea. This study suggests that anteromedialization is appropriate for unloading the lateral trochlea. However, this procedure appears to have minimal benefit on central chondral defects, and it may actually increase the load in patients with medial defects.
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Cartilagem/transplante , Articulação do Joelho/fisiologia , Articulação do Joelho/cirurgia , Tíbia/cirurgia , Adulto , Fenômenos Biomecânicos , Cadáver , Feminino , Humanos , Articulação do Joelho/anatomia & histologia , Masculino , Pessoa de Meia-Idade , PressãoRESUMO
Abstract Portugal has some rehabilitation centers for wild animals, which are responsible for the rehabilitation and reintroduction of birds, among other animals, into the wild. Coccidian parasites of these wild birds in rehabilitation centers are especially important because these centers can introduce coccidian species into new environments through the reintroduction of their respective hosts. In this context, the current study aimed to identify intestinal coccidia from wild birds at two rehabilitation centers for wild animals located in two municipalities of Portugal. Eighty-nine wild birds of 9 orders and 11 families were sampled, of which 22 (25%) were positive for Coccidia. Avispora spp. were found in raptors. Sporocysts of Sarcocystinae subfamily were recovered from owls. An Isospora sp. was found in Turdus merula Linnaeus, 1758, and an Eimeria sp. was found in Fulica atra Linnaeus, 1758. Among the coccidian species, Avispora bubonis (Cawthorn, Stockdale, 1981) can be highlighted. The finding of this species indicates that transmission of coccidians from the New World to the Old World may be occurring, potentially through dispersion by Bubo scandiacus (Linnaeus, 1758) through Arctic regions or by means of anthropic activities, and/or through other unknown mechanisms.
Resumo Portugal possui alguns centros de reabilitação de animais silvestres, responsáveis pela reabilitação e reintrodução de aves, entre outros animais, na natureza. Os coccídios parasitas dessas aves silvestres em centros de reabilitação são especialmente importantes porque esses centros podem introduzir espécies de coccídios em novos ambientes através da reintrodução de seus respectivos hospedeiros. Neste contexto, o presente estudo visou identificar coccídios intestinais de aves silvestres em dois centros de reabilitação de animais silvestres localizados em dois municípios de Portugal. Oitenta e nove aves silvestres de 9 ordens e 11 famílias foram amostradas, das quais 22 (25%) foram positivas para coccídios. Avispora spp. foram encontradas em aves de rapina. Esporocistos de coccídios da subfamilia Sarcocystinae foram encontrados em corujas. Uma Isospora sp. foi encontrada em Turdus merula Linnaeus, 1758 e uma Eimeria sp. foi encontrada em Fulica atra Linnaeus, 1758. Entre as espécies de coccídios, Avispora bubonis (Cawthorn, Stockdale, 1981) pode ser destacada. O encontro dessa espécie indica que a transmissão de coccídios do Novo Mundo para o Velho Mundo pode estar ocorrendo, potencialmente através da dispersão por Bubo scandiacus (Linnaeus, 1758) pelas regiões árticas ou por meio de atividades antrópicas, e/ou através de outros mecanismos desconhecidos.
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Animais , Doenças das Aves/parasitologia , Aves/parasitologia , Coccídios/isolamento & purificação , Coccidiose/veterinária , Portugal , Centros de Reabilitação , Aves/classificação , Coccídios/classificação , Coccidiose/diagnóstico , Fezes/parasitologia , Animais SelvagensRESUMO
BACKGROUND: Abnormal function in reward circuitry in cocaine addiction could predate drug use as a risk factor, follow drug use as a consequence of substance-induced alterations, or both. METHODS: We used a functional magnetic resonance imaging monetary incentive delay task (MIDT) to investigate reward-loss neural response differences among 42 current cocaine users, 35 former cocaine users, and 47 healthy subjects who also completed psychological measures and tasks related to impulsivity and reward. RESULTS: We found various reward processing-related group differences in several MIDT phases. Across task phases we found a control > current user > former user activation pattern, except for loss outcome, where former compared with current cocaine users activated ventral tegmental area more robustly. We also found regional prefrontal activation differences during loss anticipation between cocaine-using groups. Both groups of cocaine users scored higher than control subjects on impulsivity, compulsivity and reward-punishment sensitivity factors. In addition, impulsivity-related factors correlated positively with activation in amygdala and negatively with anterior cingulate activation during loss anticipation. CONCLUSIONS: Compared with healthy subjects, both former and current users displayed abnormal brain activation patterns during MIDT performance. Both cocaine groups differed similarly from healthy subjects, but differences between former and current users were localized to the ventral tegmental area during loss outcome and to prefrontal regions during loss anticipation, suggesting that long-term cocaine abstinence does not normalize most reward circuit abnormalities. Elevated impulsivity-related factors that relate to loss processing in current and former users suggest that these tendencies and relationships may pre-exist cocaine addiction.
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Antecipação Psicológica/fisiologia , Encéfalo/fisiopatologia , Transtornos Relacionados ao Uso de Cocaína/fisiopatologia , Recompensa , Adulto , Mapeamento Encefálico , Feminino , Humanos , Comportamento Impulsivo/fisiopatologia , Imageamento por Ressonância Magnética , MasculinoRESUMO
Objetivo: Os autores apresentam um caso de neurofibromatose, com múltiplos neurofibromas nos plexos lombar e sacral. Material e Métodos: Relato de caso de Neurofibromatose de plexo lombar. A tomografia demonstrou lesões hipoatenuantes acometendo as regiões supracitadas. Conclusão: o diagnóstico diferencial deve ser feito com linfoadenopatias ou abscessos, sendo que, a RMN foi útil para a melhor caracterização dos neurofibromas e diagnóstico diferencial
Objective: The author report a case of neurofibromatosis with multiple plexiform neurofibromes in lombar and sacral plexus. Method: Case report of plexus neurofibromatosis. Computed tomography showed markedly hypodense lesions involving both plexus, wich could mimic other diseases. Conclusion: Magnetic resonance imaging was useful to better evaluate the extension of neurofibromas
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Cocaine addiction is characterized by impulsivity, impaired social relationships, and abnormal mesocorticolimbic reward processing, but their interrelationships relative to stages of cocaine addiction are unclear. We assessed blood-oxygenation-level dependent (BOLD) signal in ventral and dorsal striatum during functional magnetic resonance imaging (fMRI) in current (CCD; nâ=â30) and former (FCD; nâ=â28) cocaine dependent subjects as well as healthy control (HC; nâ=â31) subjects while playing an interactive competitive Domino game involving risk-taking and reward/punishment processing. Out-of-scanner impulsivity-related measures were also collected. Although both FCD and CCD subjects scored significantly higher on impulsivity-related measures than did HC subjects, only FCD subjects had differences in striatal activation, specifically showing hypoactivation during their response to gains versus losses in right dorsal caudate, a brain region linked to habituation, cocaine craving and addiction maintenance. Right caudate activity in FCD subjects also correlated negatively with impulsivity-related measures of self-reported compulsivity and sensitivity to reward. These findings suggest that remitted cocaine dependence is associated with striatal dysfunction during social reward processing in a manner linked to compulsivity and reward sensitivity measures. Future research should investigate the extent to which such differences might reflect underlying vulnerabilities linked to cocaine-using propensities (e.g., relapses).
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Transtornos Relacionados ao Uso de Cocaína/fisiopatologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Recompensa , Córtex Visual/fisiopatologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Comportamento Impulsivo , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Social , Adulto JovemRESUMO
BACKGROUND: Substance-abusing individuals tend to display abnormal reward processing and a vulnerability to being impulsive. Detoxified alcoholics show differences in regional brain activation during a monetary incentive delay task. However, there is limited information on whether this uncharacteristic behavior represents a biological predisposition toward alcohol abuse, a consequence of chronic alcohol use, or both. METHODS: We investigated proposed neural correlates of substance disorder risk by examining reward system activity during a monetary incentive delay task with separate reward prospect, reward anticipation, and reward outcome phases in 30 individuals with and 19 without family histories of alcoholism. All subjects were healthy, lacked DSM-IV past or current alcohol or substance abuse histories, and were free of illegal substances as verified by a urine toxicology screening at the time of scanning. Additionally, we explored specific correlations between task-related nucleus accumbens (NAcc) activation and distinct factor analysis-derived domains of behavioral impulsivity. RESULTS: During reward anticipation, functional magnetic resonance imaging data confirmed blunted NAcc activation in family history positive subjects. In addition, we found atypical activation in additional reward-associated brain regions during additional task phases. We further found a significant negative correlation between NAcc activation during reward anticipation and an impulsivity construct. CONCLUSIONS: Overall, results demonstrate that sensitivity of the reward circuit, including NAcc, is functionally different in alcoholism family history positive individuals in multiple regards.