An integrated approach to identify bimodal genes associated with prognosis in câncer.

Bimodal gene expression (where a gene expression distribution has two maxima) is associated with phenotypic diversity in different biological systems. A critical issue, thus, is the integration of expression and phenotype data to identify genuine associations. Here, we developed tools that allow both: i) the identification of genes with bimodal gene expression and ii) their association with prognosis in cancer patients from The Cancer Genome Atlas (TCGA). Bimodality was observed for 554 genes in expression data from 25 tumor types. Furthermore, 96 of these genes presented different prognosis when patients belonging to the two expression peaks were compared. The software to execute the method and the corresponding documentation are available at the Data access section.

Effect of intravitreal dexamethasone solution on the reduction of macular thickness in pseudophakic diabetic patients in a public hospital in Brazil: a randomized clinical trial.

PURPOSE: To determine the effect of short-term 4 mg/mL dexamethasone solution treatment in diabetic macular edema (DME). PATIENTS AND METHODS: Twenty-seven pseudophakic diabetic patients with visual impairment caused by DME were randomized to receive 0.01 mL (40 µg), 0.03 mL (120 µg) or 0.05 mL (200 µg) intravitreal dexamethasone solution. Eyes were evaluated in terms of macular thickness, best-corrected visual acuity (BCVA) and intraocular pressure (IOP) at 3, 7 and 28 days after injection (D). RESULTS: There was a significant reduction in macular thickness between D0 and D3 for all groups (0.01 mL - P=0.008, 0.03 mL - P=0.038, and 0.05 mL - P=0.008). Between D0 and D7, a significant reduction in macular thickness was observed in 0.01 mL and 0.05 mL groups (0.01 mL - P=0.013 and 0.05 mL - P=0.021). Between D0 and D28, no significant reduction of macular thickness was observed for any group. Between D0 and D3, a significant improvement in BCVA in the 0.03 mL group (P=0.028) was observed. Between D0 and D7, a significant improvement in BCVA was observed in 0.01 mL and 0.03 mL groups (0.01 mL - P=0.018 and 0.03 mL - P=0.027). Between D0 and D28, a significant improvement in BCVA was observed for the 0.01 mL group (P=0.017). No significant differences in IOP measurements were observed for any group. Safety analysis revealed no serious ocular or systemic events. CONCLUSION AND RELEVANCE: Intravitreal dexamethasone solution is effective in reducing macular thickness secondary to DME in the short-term. Improvement in short-term visual acuity was observed. Although DME requires long-term treatment, it may be a low cost therapeutic option used in specific short-term situations.Trial registration: NCT03608839 (http://www.clinicaltrials.gov).

Control of visceral leishmaniasis in Brazil: recommendations from Brasileish.

On 26 October 2012, veterinary medicine clinicians and researchers, members of Brasileish - Study Group about Animal Leishmaniasis - met at the Regional Council of Veterinary Medicine of Minas Gerais, in the city Belo Horizonte, in order to discuss many aspects of the situation of canine visceral leishmaniasis (CVL) in Brazil. In the face of recent national and international scientific evidence, we, the members of Brasileish, have elaborated some recommendations for the management and control of CVL in Brazil.

Factors associated with the employment situation and driving license of patients with epilepsy / Fatores associados a situação laboral e licença para dirigir em pacientes com epilepsia

INTRODUCTION: It is estimated that approximately 50 percent of patients with epilepsy have difficulty finding employment. OBJECTIVE: Evaluate the employment situation and driving license of patients with symptomatic or probably symptomatic focal epilepsy and correlate it with clinical and socio-demographic aspects. METHODS: Ninety-two patients were classified into 3 groups: "employed", "unemployed" and "retired/on leave". The relationship between employment and socio-demographic aspects and those of epilepsy was studied, and also whether the patients were holders of national driving licenses. RESULTS: Thirty-one (33.7 percent) of the patients were employed, 19 (20.7 percent) unemployed and 33 (35.9 percent) retired/on leave. Patients with formal education of less than 9 years predominated (p<0.05) in the "retired/on leave" group and non-white patients were more frequently unemployed. Of 58 patients who lost their jobs, 27 (46.6 percent) reported that epilepsy was the main reason (p<0.05). There was a significant relationship between the occurrence of ES at work and unemployment and "leave/retirement" (p<0.05). There was no relationship between clinical aspects and the employment situation. Nineteen (33.9 percent) of the 56 surveyed reported being holders of driving licenses. DISCUSSION: There was a high index of unemployment and retired/on leave individuals. There was a relationship between unemployment and the occurrence of ES at work and with a low scholastic level. CONCLUSION: The low scholastic level/professional qualifications and the stigma aggravated the employment perspectives of these individuals, contributing to their social exclusion.

INTRODUÇÃO: Estima-se que aproximadamente 50 por cento dos pacientes com epilepsia têm problemas para encontrar emprego. OBJETIVO: O objetivo desta pesquisa foi avaliar a situação laboral e a licença para dirigir de 92 pacientes com epilepsia focal sintomática ou provavelmente sintomática e, correlaciona-la a aspectos clínicos e sociodemográficos. RESULTADOS: 31 (33,7 por cento) pacientes estavam empregados, 19 (20,7 por cento) desempregados, 33 (35,9 por cento) afastados/aposentados. Os pacientes com maior escolaridade formal, da cor branca, e do gênero masculino estavam mais empregados (ANOVA; p<0,05). 30 (46,1 por cento) pacientes referiram que a epilepsia motivou a demissão. Houve relação significativa entre ocorrência de CE no trabalho com desemprego e afastamento/aposentadoria (χ2; p=0,03). Não houve relação entre aspectos clínicos da epilepsia e situação ocupacional. DISCUSSÃO: Foram observados índices elevados de desemprego e afastamentos/aposentadoria. Houve relação entre desemprego e ocorrência de CE no trabalho, e baixa escolaridade e qualificação profissional. CONCLUSÃO: A baixa escolaridade/qualificação profissional e o estigma agravaram a perspectiva de empregabilidade dos indivíduos, contribuindo para a exclusão social.

Epilepsia e depressão: aspectos sociodemográficos e clínicos associados / Sociodemographic and clinical factors associated with depression in epilepsy

Objetivo Avaliar, em pacientes adultos com epilepsia focal, a ocorrência de depressão e sua relação com variáveis sociodemográficas e clínicas. Métodos Foram estudados 87 pacientes adultos (idade média de 44,2 anos) com diagnóstico de epilepsia focal sintomática ou provavelmente sintomática, acompanhados no ambulatório de neurologia clínica do Hospital e Maternidade Celso Pierro da Pontifícia Universidade Católica de Campinas. Foram realizados anamnese, exame clínico-neurológico e aplicação da Escala de Depressão de Hamilton. Foi estudada a relação dos aspectos sociodemográficos e clínicos com a ocorrência de depressão. Foram utilizados testes estatísticos, com nível de significância p<0,05. Resultados Cinquenta e três pacientes apresentaram depressão conforme a Escala de Depressão de Hamilton (leve em 42, moderada em 8, e grave em 3 casos). Foi observada maior ocorrência de depressão entre as mulheres e em pacientes com epilepsia do lobo temporal com esclerose hipocampal (análise de regressão p<0,05). Não foram observadas relações estatisticamente significativas entre as outras variáveis clínicas e a ocorrência de depressão. Conclusão A depressão é frequente em pacientes com epilepsia e pode ser um fator de impacto, na qualidade de vida, por vezes mais importante do que a frequência das crises. O presente estudo sugere a existência de fatores sociodemográficos e biológicos associados à depressão. O conhecimento adequado desses fatores pode ter importância nas estratégias de diagnóstico e de atenção ao portador de epilepsia.

Objective This study aimed to evaluate the occurrence of depression and its relationships with sociodemographic and clinical factors in adult patients with focal epilepsy. Methods A total of 87 adult patients (age = 44.2 standard deviation=14.8 years) were assessed using medical history, neurological evaluation and Hamilton depression scale. They had symptomatic or probably symptomatic focal epilepsy. The relationships between depression in the Hamilton depression scale and sociodemographic and clinical aspects were studied. Statistical tests were done with the significance level set at p<0.05. Results Fifty-three patients had depression in the Hamilton depression scale (mild in 42 cases, moderate in 8, and severe in 3 cases). Depression was more prevalent in women and in temporal lobe epilepsy patients with hippocampus sclerosis (regression analysis, p<0.05). There were no significant statistical relationships among the other clinical variables and the presence of depression. Conclusion Depression is common among patients with focal epilepsy and may impact quality of life more than the frequency of seizures. The present study suggests the existence of sociodemographic and biological factors associated with depression. Good knowledge of these factors can be important for the diagnostic and care strategies provided to epilepsy patients.