RESUMO
GMO control laboratories in the EU routinely monitor the presence and content of genetically modified organisms (GMOs) in food and feed products collected from the EU market. As the vast majority of GMOs comprize genetically modified plants, most control samples have a plant-based origin. For the first time, a pilot proficiency test was organised requiring the analysis of GMOs in a meat matrix. Meat pâté, a product in which soybean is occasionally identified, was spiked with GM soybean event MON89788, homogenised by mixing, aliquoted in sachets and frozen. The assigned value was determined by two independent expert laboratories. Several DNA extraction methods were tested and proved to be insufficient for the removal of PCR inhibitors present in the DNA extracts, resulting in a GM content underestimated by at least 30%. This problem was solved either by using hot-start qPCR chemistry or by applying the same method in a digital PCR format. A total of 52 laboratories participated in the study. They were requested to verify the presence of any GM soybean in the test item and to quantify the GM event(s) identified by their method of choice. All but one laboratory identified the MON89788 soybean event present in the pâté matrix. The majority of the quantitative results reported were below the assigned value, but did not deviate more than 50% from it. This study demonstrated the proficiency of most GMO control laboratories for the analysis of GMOs in a meat-based product. It also shows that method optimisation for GMO analysis in meat products is nevertheless advisable.
RESUMO
This work is devoted to study numerically the self-diffusion of spherocylindrical particles flowing down an inclined plane, using the discrete element method (DEM). This system is challenging due to particles being non-spherical and because they are subjected to a non-uniform shear rate. We performed simulations for several aspect ratios and inclination angles, tracking individual particle trajectories. Using the simulation data, we computed the diffusion coefficients D, and a coarse-graining methodology allowed accessing the shear rate spatial profiles î¢(z). This data enabled us to identify the spatial regions where the diffusivity strongly correlates with the local shear rate. Introducing an effective particle size dâ¥, we proposed a well-rationalized scaling law between D and î¢. Our findings also identified specific locations where the diffusivity does not correlate with the shear rate. This observation corresponds to zones where î¢ has non-linear spatial variation, and the velocity probability density distributions exhibit asymmetric shapes.
RESUMO
BACKGROUND: To investigate the incidence of non-cancer mortalities and prognostic factors associated with competitive causes of death in a homogeneous cohort of patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment. METHODS: This study included 284 patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment between 2005 and 2017. The cumulative incidence of death associated with tumour, second tumours, treatment, side effects and comorbidity was calculated. A Fine and Gray regression model was used to investigate factors associated with cancer and competitive mortality. RESULTS: The cumulative incidence of tumoral death at 5 and 10 years were 35 and 47% respectively, whereas the cumulative incidence of competitive mortality were 10 and 12% respectively. In the multivariate analysis, age and comorbidity were independent factors for non-cancer mortality. Patients with a high risk of non-cancer mortality presented a cumulative incidence of 17.3% at 5 years and 18.4% at 10 years. CONCLUSIONS: This study demonstrated a high incidence of competing mortality in older patients with comorbidities. Non-cancer deaths should be considered when selecting patients for combination therapies and in the study design ofclinical trials.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Causas de Morte , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/terapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia/mortalidade , Comorbidade , Feminino , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/radioterapia , Estudos Retrospectivos , Espanha/epidemiologia , Taxa de SobrevidaRESUMO
Over the past decades, the development of high performance lightweight polymer nanocomposites and, in particular, of epoxy nanocomposites has become one the greatest challenges in material science. The ultimate goal of epoxy nanocomposites is to extrapolate the exceptional intrinsic properties of the nanoparticles to the bulk matrix. However, in spite of the efforts, this objective is still to be attained at commercially attractive scales. Key aspects to achieve this are ultimately the full understanding of network structure, the dispersion degree of the nanoparticles, the interfacial adhesion at the phase boundaries and the control of the localization and orientation of the nanoparticles in the epoxy system. In this Personal Account, we critically discuss the state of the art and evaluate the strategies to overcome these barriers.
RESUMO
BACKGROUND AND PURPOSE: Patients with acute intracerebral hemorrhage (ICH) pretreated with antithrombotic drugs may have increased early hematoma growth, which would increase mortality risk. The effect of antiplatelet (AP) and vitamin K antagonist (VKA) pretreatment on ultra-early hematoma growth (uHG) and its relationship with mortality in patients with acute supratentorial ICH was analyzed. METHODS: This is an observational retrospective study of a prospective register of 197 ICH patients with first computed tomography (CT) scan taken <6 h from ICH symptom onset. ICH volume was calculated by the ABC/2 formula and uHG by the baseline ICH volume/onset-to-CT time (ml/h) formula. The uHG analysis took into account the patient's pretreatment (none, AP or VKA) and the relationship between uHG and very-early (first 24 h) and 3-month mortality. RESULTS: In the pretreatment group, 50 (25.4%) patients were treated with AP and 37 (18.8%) with VKA. The median (interquartile range 25-75) uHG was 19.7 ml/h (2.9-44.8) for AP pretreated patients, 16.2 ml/h (5.1-42.5) for VKA pretreated patients and 8.4 ml/h (2.4-21.8) for non-pretreated patients, P = 0.019. The uHG was higher in patients with very-early [42.1 ml/h (20.1-79.6)] and total 3-month mortality [28.0 ml/h (15.8-52.5)] compared with survivors [3.9 ml/h (1.5-10.4)], P < 0.0001. Adjusted by ICH severity and previous functional status, uHG was an independent factor related to very-early (P = 0.028) and total 3-month mortality (P = 0.014). CONCLUSIONS: Patients pretreated with antithrombotics have much higher uHG, which would explain the increased mortality in these patients compared to untreated patients.
Assuntos
Anticoagulantes/uso terapêutico , Antifibrinolíticos/uso terapêutico , Encéfalo/diagnóstico por imagem , Hemorragia Cerebral/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Inibidores da Agregação Plaquetária/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/farmacologia , Antifibrinolíticos/farmacologia , Encéfalo/efeitos dos fármacos , Hemorragia Cerebral/mortalidade , Feminino , Hematoma/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/farmacologia , Estudos Prospectivos , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND PURPOSE: Alcohol overuse (AOu) is considered an important risk factor for spontaneous intracerebral hemorrhage (ICH). The clinical and outcome characteristics of these patients (AOu-ICH) are not well known. METHODS: All patients with ICH admitted to a single university tertiary stroke center were prospectively studied from May 2005 to May 2015. Demographic profiles, radiologic characteristics and clinical outcomes of patients with acute ICH and previous AOu (>40 g/day or >300 g/week) were analyzed. RESULTS: During the study period, 555 patients with spontaneous primary ICH met the inclusion criteria. A total of 81 patients (14.6%) reported AOu (24.3% of men vs. 3.1% of women; P < 0.0001; mean age, 63 years old for AOu vs. 74 years old for non-AOu; P < 0.0001). Of the classic cardiovascular risk factors, only smoking was associated with AOu (63% vs. 12.2% of non-AOu; P < 0.0001). Initial severity and hematoma volume were similar in both groups, with no observed differences in stroke care or in-hospital medical complications. Patients with AOu had worse outcome (modified Rankin Scale score, 3-6 points) than patients without AOu at 3 months [odds ratio (OR), 2.50; 95% confidence interval (CI), 1.32-4.75; P = 0.005] and 12 months (OR, 2.47; 95% CI, 1.23-5.00; P = 0.011). A similar trend was observed at 5 years (OR, 2.48; 95% CI, 0.96-6.39; P = 0.059). CONCLUSIONS: Alcohol overuse was present in 14.6% of patients with ICH, who were predominantly male, smokers and a mean of 11 years younger than the non-AOu group. Despite a lack of differences in initial clinical severity, stroke care and early medical complications, patients with AOu had worse short- and long-term outcomes.
Assuntos
Alcoolismo/complicações , Hemorragia Cerebral/etiologia , Acidente Vascular Cerebral/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , FumarRESUMO
BACKGROUND AND PURPOSE: Epilepsy has been associated with cardiovascular comorbidity. Risk prediction equations are the standard tools in primary prevention of cardiovascular disease. Our aim was to compare the prevalence of cardiovascular risk factors (CVRFs), cardiovascular risk and statin use in people with epilepsy (PWE) and the general population. METHODS: The CVRFs and cardiovascular risk score were compared between 815 PWE from an outpatient register and 5336 participants from a general population cohort. RESULTS: People with epilepsy had less hypertension (43.3% vs. 50.4%), less diabetes (15.8% vs. 19.2%), more dyslipidemia (40.2% vs. 34.6%) and lower cardiovascular risk than the general population (P < 0.01). No etiology was associated with a worse CVRF profile or higher cardiovascular risk. Patients taking enzyme-inducing antiepileptic drugs (EIAEDs) had more dyslipidemia than the general population (41.6% vs. 34.6%) but similar cardiovascular risk. Independently of risk or CVRFs, PWE had 60% more probability of receiving statins than the general population. CONCLUSIONS: People with epilepsy had more dyslipidemia, related to EIAEDs, and lower cardiovascular risk but still took more statins than the general population. Physicians should use clinical judgement to decide on further treatment of CVRFs in PWE who are below the recommended risk threshold for treatment and should consider lipid abnormalities a potential side-effect of EIAEDs. Other therapy options may need to be evaluated before starting lipid-lowering treatment.
Assuntos
Doenças Cardiovasculares/epidemiologia , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Idoso , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus/epidemiologia , Uso de Medicamentos , Dislipidemias/induzido quimicamente , Dislipidemias/complicações , Dislipidemias/epidemiologia , Epilepsia/complicações , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de RiscoRESUMO
AIMS: To perform a comparative study for determining the optimum culture method (direct plating or enrichment) and medium (ampicillin dextrin agar (ADA), starch ampicillin agar (SAA), bile salts irgasan brilliant green modified (BIBG-m)) for recovering Aeromonas species from water and shellfish samples. METHODS AND RESULTS: By direct culture, Aeromonas was detected in 65% (13/20) of the water samples and in 54·5% (6/11) of the shellfish samples. However, when a pre-enrichment step was included, the number of positive water samples increased to 75% (15/20) and the ones of shellfish to 90·1% (10/11). The enriched culture significantly favoured (P < 0·05) the isolation of Aeromonas allosaccharophila from water, Aeromonas salmonicida from shellfish and Aeromonas caviae from both types of samples. The most specific (P < 0·05) culture medium for detecting Aeromonas from water was ADA. However, no differences were observed in the case of shellfish samples (P > 0·05). Isolation of Aeromonas media from water was favoured (P < 0·05) in the ADA medium, while SAA enhanced (P < 0·05) the isolation of Aer. salmonicida from shellfish. CONCLUSIONS: The culture method and medium used influenced the recovery of some Aeromonas species from water and shellfish samples. SIGNIFICANCE AND IMPACT OF THE STUDY: This fact should be considered in future prevalence studies to avoid overestimating the above mentioned Aeromonas species.
Assuntos
Aeromonas/crescimento & desenvolvimento , Técnicas Bacteriológicas/métodos , Meios de Cultura/metabolismo , Água Doce/microbiologia , Frutos do Mar/microbiologia , Aeromonas/isolamento & purificação , Aeromonas/metabolismo , Técnicas Bacteriológicas/instrumentação , Meios de Cultura/químicaRESUMO
Several theoretical predictions of the mass flow rate of granular media discharged from a silo are based on the spontaneous development of a free-fall arch region, the existence of which is still controversial. In this Letter, we study experimentally and numerically the particle flow through an orifice placed at the bottom of 2D and 3D silos. The implementation of a coarse-grained technique allows a thorough description of all the kinetic and micromechanical properties of the particle flow in the outlet proximities. Though the free-fall arch does not exist as traditionally understood--a region above which particles have negligible velocity and below which particles fall solely under gravity action--we discover that the kinetic pressure displays a well-defined transition in a position that scales with the outlet size. This universal scaling explains why the free-fall arch picture has served as an approximation to describe the flow rate in the discharge of silos.
RESUMO
We synthesized graphene oxide sheets of different functionalization by oxidation of two different starting materials, graphite and GANF nanofibers, followed by purification based on alkaline washing. The chemical structure of graphene oxide materials was determined by X-ray photoelectron spectroscopy (XPS), and the nanoplatelets were characterized by ζ potential and dynamic light scattering (DLS) measurements. The XPS results indicated that the chemical structure depends on the starting material. Two different deposition methodologies, Langmuir-Blodgett (LB) and Langmuir-Schaefer (LS), were employed to build the graphene oxide thin films. The film morphology was analyzed by scanning electron microscopy (SEM). The SEM images allow us to conclude that the LB methodology provides the highest coverage. This coverage is almost independent of the chemical composition of sheets. Conversely, the coverage obtained by the LS methodology increases with the percentage of C-O groups attached to sheets. Surface-pressure isotherms of these materials were interpreted according to the Volmer model.
RESUMO
Fasciola spp., infections are distributed worldwide including the Andes region of Ecuador, affecting cattle, sheep, porcine, humans, and other herbivores. Triclabendazole (TCBZ) is commonly used to treat animal infections. However, prospective studies on TCBZ efficacy and fascioliosis prevalence have not been studied in the highlands of Ecuador. This study was performed in a rural community at central of the Ecuadorian Andes in freely roaming bovine and ovine aimed to 1) evaluate the efficacy of TCBZ by administering a single oral dose of 12 mg/kg body weight, 2) assess the prevalence of F. hepatica infection and 3) to monitor re-infections for a follow-up period of five months. In total, 122, 86, 111, 110, 89, and 90 and 49, 34, 47, 28, 27, and 31 stool samples were collected each month from bovines and ovine, respectively. Besides, 32 stool samples from porcine were also collected at the beginning of the study. Stools were microscopically analyzed by formalin-ether concentration method to detect F. hepatica ova. The prevalence of F. hepatica infections before treatment was 55,7% and 63,3% for bovine and ovine, respectively. The infection prevalence was of 22% in porcine. The efficacity of triclabendazole was 83% and 97% in bovines and ovine, respectively, at 30 days post-treatment. The re-infection reaches to 54,4% in bovines and 61,3% in ovine after five months. TCBZ had a high efficacy and could be used for bovines and ovine Fasciola infections in the study region; however, re-infections reach the initial prevalence after five months. Therefore, we recommend integrated control strategies, including chemotherapy with a single oral dose of TCBZ, vector control, and future drug resistance studies.
Assuntos
Doenças dos Bovinos , Fasciola hepatica , Mariposas , Doenças dos Ovinos , Doenças dos Suínos , Humanos , Animais , Bovinos , Ovinos , Suínos , Triclabendazol/uso terapêutico , Equador/epidemiologia , Reinfecção/veterinária , Prevalência , Estudos Prospectivos , Doenças dos Bovinos/tratamento farmacológico , Doenças dos Bovinos/epidemiologia , Doenças dos Ovinos/tratamento farmacológico , Doenças dos Ovinos/epidemiologiaRESUMO
Trypanosomosis is a tropical disease caused by various protozoan haemoparasites, which affects wild and domestic animals, the latter ones related to worldwide livestock production systems. Species such as Trypanosoma vivax and Trypanosoma evansi have been described using serological and molecular tools in several countries from South and Central America. However, Ecuador presents a relevant knowledge gap in the associated general epidemiology and risk factors of the disease. Therefore, the objective of this study was to determine the seroprevalence of trypanosomosis in cattle from different regions of Ecuador. 745 serum samples from 7 Coastal and 3 Amazon provinces were screened for IgG anti-Trypanosoma spp. antibodies, using an in-house indirect ELISA. The seropositivity was explored and associated with several variables such as sex, age, breed, region, management, and province, using statistical tools. The general seroprevalence of trypanosomosis was 19.1% (95% CI: 16.30-22.1%). The Amazonian provinces of Sucumbíos and Napo and the Coastal province of Esmeraldas presented the highest seroprevalence values of 36.7% (95% CI: 27.67-46.47%), 23.64% (95% CI: 16.06-32.68%) and 25% (95% CI: 15.99-35.94%), respectively. Statistical significance was found for the region, province, and management variables, indicating as relevant risk factors the extensive management and Amazon location of the cattle analyzed. Specific actions should be taken to identify the exact species on reservoirs and susceptible hosts, evaluate the implication of farm management and cattle movement as risk factors, and implement surveillance and treatment plans for affected herds.
Assuntos
Trypanosoma , Animais , Bovinos , Estudos Soroepidemiológicos , Equador/epidemiologia , Fatores de Risco , Feminino , Masculino , Trypanosoma/isolamento & purificação , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/parasitologia , Doenças dos Bovinos/sangue , Tripanossomíase Bovina/epidemiologia , Tripanossomíase Bovina/sangue , Tripanossomíase/veterinária , Tripanossomíase/epidemiologia , Tripanossomíase/parasitologia , Anticorpos Antiprotozoários/sangue , Ensaio de Imunoadsorção Enzimática/veterináriaRESUMO
It is widely recognized that Aeromonas infections produce septicaemia, and ulcerative and haemorrhagic diseases in fish, causing significant mortality in both wild and farmed freshwater and marine fish species that damage the economics of the aquaculture sector. The descriptions of the complete genomes of Aeromonas species have allowed the identification of an important number of virulence genes that affect the pathogenic potential of these bacteria. This review will focus on the most relevant information derived from the available Aeromonas genomes in relation to virulence and on the diverse virulence factors that actively participate in host adherence, colonization and infection, including structural components, extracellular factors, secretion systems, iron acquisition and quorum sensing mechanisms.
Assuntos
Aeromonas/genética , Proteínas de Bactérias/metabolismo , Regulação Bacteriana da Expressão Gênica/fisiologia , Genoma Bacteriano/genética , Fatores de Virulência/metabolismo , Proteínas de Bactérias/genética , Fatores de Virulência/genéticaRESUMO
We present experimental and numerical results regarding the stability of arches against external vibrations. Two-dimensional strings of mutually stabilizing grains are geometrically analyzed and subsequently submitted to a periodic forcing at fixed frequency and increasing amplitude. The main factor that determines the granular arch resistance against vibrations is the maximum angle among those formed between any particle of the arch and its two neighbors: the higher the maximum angle is, the easier it is to break the arch. On the basis of an analysis of the forces, a simple explanation is given for this dependence. From this, interesting information can be extracted about the expected magnitudes of normal forces and friction coefficients of the particles composing the arches.
RESUMO
PURPOSE: We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. METHODS: We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. RESULTS: We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. CONCLUSIONS: Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.
Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Infecção Hospitalar/epidemiologia , Controle de Infecções/métodos , Infecções Urinárias/epidemiologia , América/epidemiologia , Ásia/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/prevenção & controle , Países em Desenvolvimento/estatística & dados numéricos , Europa (Continente)/epidemiologia , Feminino , Higiene das Mãos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Cateteres Urinários/estatística & dados numéricos , Infecções Urinárias/prevenção & controleRESUMO
It is well known that granular mixtures that differ in size or shape segregate when sheared. In the past, two mechanisms have been proposed to describe this effect, and it is unclear if both exist. To settle this question, we consider a bidisperse mixture of spheroids of equal volume in a rotating drum, where the two mechanisms are predicted to act in opposite directions. We present evidence that there are two distinct segregation mechanisms driven by relative overstress. Additionally, we showed that, for nonspherical particles, these two mechanisms (kinetic and gravity) can act in different directions leading to a competition between the effects of the two. As a result, the segregation intensity varies nonmonotonically as a function of aspect ratio (AR), and, at specific points, the segregation direction changes for both prolate and oblate spheroids, explaining the surprising segregation reversal previously reported. Consistent with previous results, we found that the kinetic mechanism is dominant for (almost) spherical particles. Furthermore, for moderate aspect ratios, the kinetic mechanism is responsible for the spherical particles' segregation to the periphery of the drum, and the gravity mechanism plays only a minor role. Whereas, at the extreme values of AR, the gravity mechanism notably increases and overtakes its kinetic counterpart.
RESUMO
BACKGROUND: Evidence for the association between environmental exposures and ischemic stroke (IS) is limited and inconsistent. We aimed to assess the relationship between exposure to air pollutants, residential surrounding greenness, and incident IS, and to identify population subgroups particularly sensitive to these exposures. METHODS: We used data from administrative health registries of the public healthcare system in Catalonia, Spain to construct a cohort of individuals aged 18 years and older without a previous stroke diagnosis at 1st January 2016 (n = 3 521 274). We collected data on sociodemographic characteristics and cerebrovascular risk factors, and derived exposure at the participant's residence to ambient levels of fine particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2), and Normalized Difference Vegetation Index (NDVI) in a 300 m buffer as an indicator of greenness. The primary outcome was IS diagnosis at any point during the follow-up. We used Cox proportional hazards models to estimate associations between environmental exposures and incident IS and stratified analyses to investigate effect modification. RESULTS: Between 1st January 2016 and 31st December 2017, 10 865 individuals were admitted to public hospitals with an IS diagnosis. Median exposure levels were: 17 µg/m3 PM2.5, 35 µg/m3 NO2, 2.28 µg/m3 BC and 0.27 NDVI. Individuals with higher residential exposure to air pollution were at greater risk of IS: HR 1·04 (95% CI:0·99-1·10) per 5 µg/m3 of PM2.5; HR 1.05 (95% CI:1·00-1·10) per 1 µg/m3 of BC; HR 1·04 (95% CI:1·03-1·06) per 10 µg/m3 of NO2. Conversely, individuals with higher residential surrounding green space, had lower risk of IS (HR 0·84; CI 95%:0·7-1.0). There was no evidence of effect modification by individual characteristics. CONCLUSIONS: Higher incidence of IS was observed in relation to long-term exposures to air pollution, particularly NO2, in a region that meets European health-based air quality standards. Residential surrounding greenness was associated with lower incidence of IS.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , AVC Isquêmico , Adolescente , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Material Particulado/efeitos adversos , Material Particulado/análiseRESUMO
INTRODUCTION: Relapsing-remitting multiple sclerosis (RRMS) treatment has significantly changed in recent years because of the discovery of new molecules that have shown efficacy as maintenance treatment. However, the classical treatment for acute attacks is based on corticosteroids administration, being the periodical plasmapheresis the alternative treatment in the case of refractory patients. We introduce a case of relapsing-remitting multiple sclerosis treated with a classical acute attacks therapy: plasmapheresis. CASE REPORT: The case of a 39-year-old patient who was diagnosed with relapsing-remitting multiple sclerosis, postpartum debut and aggresive course, who, after suboptimal response to disease modifying therapies (alemtuzumab and ocrelizumab), receives combination treatment with outpatient periodic plasmapheresis every 3 weeks as maintenance therapy. Good tolerance and response. Clinical stability with this treatment. She has not required new hospital admissions for acute attacks of multiple sclerosis from February 2020 to March 2021. CONCLUSION: Although more specific studies are needed, this case provides information on a potential new maintenance treatment for patients with relapsing-remitting multiple sclerosis refractory to disease-modifying drug therapies.
TITLE: Plasmaféresis periódica como tratamiento de mantenimiento en la esclerosis múltiple remitente-recurrente, ¿nueva línea terapéutica? A propósito de un caso.Introducción. El tratamiento de la esclerosis múltiple remitente-recurrente ha evolucionado significativamente en los últimos años con el descubrimiento de nuevas moléculas eficaces como tratamiento de mantenimiento. Por otro lado, el tratamiento de los brotes de esta enfermedad se basa clásicamente en corticoides, y en los casos refractarios a esta terapia se utiliza plasmaféresis. Presentamos un caso de esclerosis múltiple remitente-recurrente tratada periódicamente con una terapia que se ha utilizado clásicamente para los brotes: plasmaféresis. Caso clínico. Mujer de 39 años con esclerosis múltiple remitente-recurrente de inicio en el posparto, gran carga lesional y curso agresivo, en quien, ante una respuesta subóptima a terapias modificadoras de la enfermedad (alemtuzumab y ocrelizumab), se decide iniciar un tratamiento combinado junto con plasmaféresis periódicas ambulatorias cada tres semanas como tratamiento de mantenimiento. Se constata una buena tolerancia a esta terapia y evolución, y se produce estabilidad clínica. No ha requerido nuevos ingresos hospitalarios por brotes desde febrero de 2020 a marzo de 2021. Conclusión. Aunque es necesario que se realicen más estudios, este caso ofrece información sobre un potencial tratamiento de mantenimiento para pacientes con esclerosis múltiple remitente-recurrente refractaria a terapias con fármacos modificadores de la enfermedad.
Assuntos
Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Adulto , Alemtuzumab/uso terapêutico , Feminino , Humanos , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , PlasmafereseRESUMO
Two freshwater isolates (WB4.1-19(T) and WB4.4-101), sharing 99.9â% 16S rRNA gene sequence similarity, were highly related to Aeromonas sobria (99.7â% similarity; 6 bp differences). A phylogenetic tree derived from a multi-locus phylogenetic analysis (MLPA) of the concatenated sequences of five housekeeping genes (gyrB, rpoD, recA, dnaJ and gyrA; 3684 bp) revealed that both strains clustered as an independent phylogenetic line next to members of Aeromonas molluscorum and Aeromonas bivalvium. The DNA-DNA reassociation value between the two new isolates was 89.3â%. Strain WB4.1-19(T) had a DNA-DNA relatedness value of <70â% with the type strains of the other species tested. Phenotypic characterization differentiated the two novel strains from all other type strains of species of the genus Aeromonas. It is concluded that the two new strains represent a novel species of the genus Aeromonas, for which the name Aeromonas rivuli sp. nov. is proposed, with the type strain WB4.1-19(T) (=CECT 7518(T)=DSM 22539(T)=MDC 2511(T)).
Assuntos
Aeromonas/classificação , Técnicas de Tipagem Bacteriana , Água Doce/microbiologia , Aeromonas/isolamento & purificação , DNA Bacteriano/genética , Genes Bacterianos , Dados de Sequência Molecular , Tipagem de Sequências Multilocus , Fenótipo , Filogenia , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
We present experimental and numerical results of the effect that a partial discharge has on the morphological and micro-mechanical properties of non-spherical, convex particles in a silo. The comparison of the particle orientation after filling the silo and its subsequent partial discharge reveals important shear-induced orientation, which affects stress propagation. For elongated particles, the flow induces an increase in the packing disorder which leads to a reduction of the vertical stress propagation developed during the deposit generated prior to the partial discharge. For square particles, the flow favors particle alignment with the lateral walls promoting a behavior opposite to the one of the elongated particles: vertical force transmission, parallel to gravity, is induced. Hence, for elongated particles the flow developed during the partial discharge of the silo leads to force saturation with depth whereas for squares the flow induces hindering of the force saturation observed during the silo filling.