Automatic Staging of Cancer Tumors Using AIM Image Annotations and Ontologies.

A second opinion about cancer stage is crucial when clinicians assess patient treatment progress. Staging is a process that takes into account description, location, characteristics, and possible metastasis of tumors in a patient. It should follow standards, such as the TNM Classification of Malignant Tumors. However, in clinical practice, the implementation of this process can be tedious and error prone. In order to alleviate these problems, we intend to assist radiologists by providing a second opinion in the evaluation of cancer stage. For doing this, we developed a TNM classifier based on semantic annotations, made by radiologists, using the ePAD tool. It transforms the annotations (stored using the AIM format), using axioms and rules, into AIM4-O ontology instances. From then, it automatically calculates the liver TNM cancer stage. The AIM4-O ontology was developed, as part of this work, to represent annotations in the Web Ontology Language (OWL). A dataset of 51 liver radiology reports with staging data, from NCI's Genomic Data Commons (GDC), were used to evaluate our classifier. When compared with the stages attributed by physicians, the classifier stages had a precision of 85.7% and recall of 81.0%. In addition, 3 radiologists from 2 different institutions manually reviewed a random sample of 4 of the 51 records and agreed with the tool staging. AIM4-O was also evaluated with good results. Our classifier can be integrated into AIM aware imaging tools, such as ePAD, to offer a second opinion about staging as part of the cancer treatment workflow.

Assessing the relationship between organic farming practices and microbiological characteristics of organic lettuce varieties (Lactuca sativa L.) grown in Sao Paulo, Brazil.

AIMS: This study aimed to gather information on farming practices employed in organic lettuce fields in Sao Paulo, Brazil and associate these practices with the microbiological characteristics of the products. METHODS AND RESULTS: Practices were surveyed using a questionnaire applied in ten farms, where 200 heads of lettuce were collected and submitted to enumeration of total coliforms and generic Escherichia coli and tested for Salmonella spp. using culture and molecular (qPCR) methods. Based on the responses, the farms could be clustered in two groups: group 1, comprised by six farms, where chicken manure was used as fertilizer in most of them and the composting process was not performed on site; and group 2, comprised by four farms, where other types of fertilizer were used, and the composting process was performed on site. Generic E. coli was detected in 56 (28%) samples, with an average of 1·1 ± 0·7 log MPN per g. Salmonella DNA was detected in two (1%) samples by qPCR. CONCLUSIONS: The prevalence and bacterial loads of generic E. coli, and the occurrence of Salmonella, even at low populations undetectable by conventional culture methods, highlight the need for control measures during farming practices to reduce microbial contamination and risks of foodborne illnesses. These measures include the use of properly composted manure and appropriate washing procedures for leafy vegetables before consumption. SIGNIFICANCE AND IMPACT OF THE STUDY: The obtained data contribute to a better understanding of the farming practices of organically grown lettuces in Sao Paulo, Brazil.

Topical application of probiotics in skin: adhesion, antimicrobial and antibiofilm in vitro assays.

AIMS: When skin dysbiosis occurs as a result of skin disorders, probiotics can act as modulators, restoring microbial balance. Several properties of selected probiotics were evaluated so that their topical application could be considered. METHODS AND RESULTS: Adhesion, antimicrobial, quorum sensing and antibiofilm assays were carried out with several probiotic strains and tested against selected skin pathogens. All tested strains displayed significant adhesion to keratin. All lactobacilli with the exception of Lactobacillus delbrueckii, showed antimicrobial activity against skin pathogens, mainly due to organic acid production. Most of them also prevented biofilm formation, but only Propioniferax innocua was able to break down mature biofilms. CONCLUSIONS: This study demonstrates that although all tested probiotics adhered to human keratin, they showed limited ability to prevent adhesion of some potential skin pathogens. Most of the tested probiotics successfully prevented biofilm formation, suggesting that they may be successfully used in the future as a complement to conventional therapies in the treatment of a range of skin disorders. SIGNIFICANCE AND IMPACT OF STUDY: The topically used probiotics may be a natural, targeted treatment approach to several skin disorders and a complement to conventional therapies which present many undesirable side effects.

Using exact relations in damage-spreading simulations: the Baxter line of the two-dimensional Ashkin-Teller model.

The nearest-neighbor-interaction ferromagnetic Ashkin-Teller model is investigated on a square lattice through a powerful computational method for dealing with correlation functions in magnetic systems. This technique, which is based on damage-spreading numerical simulations, makes use of exact relations involving special kinds of damage and correlation functions, as well as the corresponding order parameters of the model. The computation of correlation functions, which represents usually a hard task in standard Monte Carlo simulations, due to large fluctuations, turns out to be much simpler within the present approach. We concentrate our analysis along the Baxter line, well known for its continuously varying critical exponents; seven different points along this line are investigated. The critical exponents associated with correlation functions along the Baxter line are successfully evaluated, by means of numerical methods, within damage-spreading simulations. The efficiency of this method is confirmed through precise estimates of the critical exponents associated with the order parameters (magnetization and polarization), as well as with their corresponding correlation functions, in spite of the small lattice sizes considered.

Damage-spreading simulations through exact relations for the two-dimensional Potts ferromagnet.

A powerful computational method for dealing with correlation functions in magnetic systems, based on damage-spreading simulations, is reviewed and tested, by investigating the q-state Potts ferromagnet, on a square lattice, at criticality. Exact relations involving special kinds of damage and the spin-spin correlation function, as well as the magnetization, are used. The efficiency of the method arises with a significant reduction of the finite-size effects, with respect to conventional Monte Carlo simulations. Correlation functions, which represent usually a hard task within this latter procedure, appear to be much more easily estimated through the present damage-spreading simulations. The effectiveness of the technique is illustrated by an accurate estimate of the exponent eta, of the spin-spin correlation function, for q=2, 3, and 4, with rather small lattice sizes. In the cases q > or = 5, an analysis of the magnetization is consistent with the well-known first-order phase transition.

Transmission of wireless neural signals through a 0.18 µm CMOS low-power amplifier.

In the field of Brain Machine Interfaces (BMI) researchers still are not able to produce clinically viable solutions that meet the requirements of long-term operation without the use of wires or batteries. Another problem is neural compatibility with the electrode probes. One of the possible ways of approaching these problems is the use of semiconductor biocompatible materials (silicon carbide) combined with an integrated circuit designed to operate with low power consumption. This paper describes a low-power neural signal amplifier chip, named Cortex, fabricated using 0.18 µm CMOS process technology with all electronics integrated in an area of 0.40 mm(2). The chip has 4 channels, total power consumption of only 144 µW, and is impedance matched to silicon carbide biocompatible electrodes.

The occurrence of diseases and their relationship with passive immune transfer in Holstein dairy calves submitted to individual management in southern Brazil / Ocorrência de doenças e sua relação com a transferência de imunidade passiva em bezerras Holandês criadas em sistema individual no sul do Brasil

Calves are extremely dependent on colostrum intake for the acquisition of passive immunity. This study aimed to determine the occurrence of diarrhea and respiratory diseases and the impact of Failure of Passive Immune Transfer (FPIT) on the health and zootechnical performance of Holstein dairy calves in individual management. This study has been carried out in five commercial farms in Rio Grande do Sul State, Brazil, from March 2017 to January 2018. In this study, 131 calves were followed from birth to 60 days of age. Total Plasmatic Protein (TPP) has been performed to determine passive immune transfer quality in 53 calves (53/131). A daily clinical follow-up has been accomplished aiming at diagnosing diseases and their incidences, and zootechnical measures such as withers height, width of the croup and weight have been evaluated. FPIT rate was 32.07%, diarrhea occurrence and respiratory diseases were 77.9% and 49.6%, respectively. FPIT increased the chances of calves presenting diarrhea and developing respiratory diseases, but no differences on zootechnical performance were found. The frequency of FPIT is still high and is a factor that corroborated the increased risk for diarrhea and respiratory disease but did not influence the performance of calves in the preweaning phase.(AU)

Bezerras são extremamente dependentes da ingestão de colostro para adquirir imunidade passiva. Este estudo teve o objetivo de determinar os índices de ocorrência de diarreia e de doença respiratória, assim como o impacto da falha na transferência de imunidade passiva (FTIP) no desenvolvimento de doenças e no desempenho zootécnico de bezerras Holandês criadas em sistema individual. O estudo foi desenvolvido em cinco propriedades comerciais no Rio Grande do Sul, Brasil, entre março de 2017 e janeiro de 2018. Assim, 131 bezerras foram acompanhadas, do nascimento aos 60 dias de idade. Em 53 animais, foi realizada avaliação de proteínas plasmáticas totais para determinar a qualidade na transferência de imunidade passiva. Acompanhamento clínico diário foi realizado, a fim de diagnosticar doenças e suas incidências, assim como avaliações zootécnicas, como altura de cernelha, largura de garupa, perímetro torácico e peso. O percentual de FTIP foi 32,07%, a ocorrência de diarreias e de doenças respiratórias foi, respectivamente, 77,9% e 49,6%. A FTIP aumentou as chances de as bezerras apresentarem diarreia e doenças respiratórias, mas não alterou o desempenho zootécnico. Conclui-se que a frequência na FTIP ainda é elevada, fator que corroborou o aumento do risco para as diarreias e doença respiratória. Apesar disso, a FTIP não influenciou no desenvolvimento das bezerras na fase de aleitamento.(AU)

Chronic rapid atrial pacing to maintain atrial fibrillation: use to permit control of ventricular rate in order to treat tachycardia induced cardiomyopathy.

LR was a patient, followed over a 16-year period, who presented with an atrial tachycardia which was initially intermittent, but became incessant. Neither the atrial tachycardia nor the associated rapid ventricular response rate could be treated successfully with available drug therapy, resulting in a dilated cardiomyopathy and New York Heart Association (NYHA) class III-IV congestive heart failure. Acute induction of atrial fibrillation with rapid atrial pacing demonstrated that the associated ventricular rate could be satisfactorily slowed with digitalis therapy. Initially, short bursts from an implanted, radiofrequency controlled, patient activated pacemaker programmed to a rate of 600 bpm and connected to a permanent endocardial atrial J lead successfully interrupted the tachycardia and precipitated atrial fibrillation. Over a period of 3 months, this therapy changed the patient's heart failure to NYHA class II status. Subsequently, precipitation of atrial fibrillation with this technique failed, resulting in return to NYHA class III-IV congestive heart failure. Therefore, a custom-designed, high rate, rate-programmable pacemaker was implanted to pace the atria rapidly and continuously to maintain atrial fibrillation. A pacing rate of 375 bpm plus digoxin slowed the ventricular rate to 70-80 bpm, with stabilization of the congestive heart failure to NYHA class II. The pacemaker generator was replaced 6 months later, and after another 5 months, pacing was discontinued. The patient's subsequent rhythm remained stable atrial fibrillation with clinically successful control of both the ventricular rate and heart failure (NYHA class II) until the patient's death 72 months later. This unique case demonstrates another form of chronic therapy which, in selected cases, can be used for the long term control of rapid ventricular response rates to supraventricular arrhythmia.

Ausência do arco médio ou segmento pulmonar em radiografias frontais de casos com transposição das grandes artérias. Estudo de 34 casos / Absence of mid arch or pulmonary segment in frontal radiographies of cases with transposition of great vessels. Study of 34 cases

Foi verificada a ausencia do arco medio, segmento do tronco da arteria pulmonar, no contorno esquerdo da sombra cardiovascular nas radiografias frontais de 30 entre 34 casos (88%) de transposicao das grandes arterias. Discute-se a morfologia de especimes necropticos e a correlacao anatomo-radiologica da aorta e da arteria pulmonar para explicar o referido sinal radiologico, importante no diagnostico da condicao

Arritmias em gestantes / Cardiac arrhythmias during pregnancy

As arritmias cardíacas são relativamente comuns durante a gravidez; entretanto, os distúrbios de ritmo mais graves são raros nessa condição. O estado gravídico aumenta o risco para o surgimento de algumas arritmias supraventriculares e ventriculares, principalmente nas mulheres com substrato eletrofisiológico subjacente. Durante a gestação, as repercussöes clínicas das arritmias dependem da presença ou não de cardiopatia estrutural e da influência das alteraçöes metabólicas e hormonais, do sistema nervoso central e do aumento da volemia. Tais fatores podem modificar as características do circuito arritmogênico, favorecendo o surgimento de arritmias. Os sintomas são mais intensos nas mulheres com maior freqüência de arritmias; entretanto, a correlação clínico-eletrofisiológica só é estabelecida em cerca de 10 'por cento' dos casos, sugerindo que as queixas são de causa multifatorial. O tratamento das arritmias em mulheres grávidas não difere daquele das mulheres nã-grávidas. Cuidados, entretanto, devem ser tomados, principalmente com os antiarrítmicos da nova geração. Nestes últimos, segurança para o concepto e a mãe ainda não foi estabelecida. O tratamento invasivo, utilizando ablação com cateter e radiofreqüência, raramente tem indicação durante a gestação; contudo, é uma conduta a ser considerada após o parto, nas mulheres com risco de recorrências, quando outras gestaçöes estiverem programadas. Neste artigo, serão discutidas as principais arritmias cardíacas, suas causas e o manuseio clínico durante a gestação. Serão abordados, também os efeitos e a eficácia clínica dos principais antiarrítmicos disponíveis no Brasil.

Disfunçäo do nódulo sino-atrial: clínica e terapêutica / Sick sinus syndorme: clinical approach and treatment

Disfunçäo do nódulo sino-atrial é a incapacidade apresentada pelo coraçäo em manter uma frequência adequada às necessidades orgânicas, provocando sintomas, devido ao fluxo snaguineo diminuido. Habitualmente, a reduçäo da frequência cardíaca se manifesta no eletrocardiograma (ECG) como: bradicardia sinusal persistente, bloqueio sino-atrial de 2 grau, pausas ou paradas sinusais passageiras, ritmos de escape passivos, juncionais ou idioventriculares, flutter ou fibrilaçäo atrais com resposta ventricul lenta e síndrome bradicardia-taquicardia. Todos estes distúrbios devem surgir sem a utilizaçäo de agentes farmacológicos bradicardizantes. Os principais sintomas referidos säo: síncopes, pré-síncopes, lipotímias, tonturas, palpitaçöes, insuficiência cardíaca congestiva, edema agudo de pulmäo e agravamento de quadros anginosos. a investigaçäo diagnóstica compreende: história clínica, ECG (em repouso, ambulatorial e de esforço), testes da funçäo autonômica, incluindo a massagem do seio carotídeo e avaliaä dos parâmetros eletrofisiológicos do nódulo sino-atrial. A evoluçäo natural desta enfermidade é lenta e episódica: a bradicardia persiste por períodos prolongados de tempo, até a apariçäo dos sintomas. O prognóstico geralmente é benigno; entretanto podem surgir complicaçöes graves, potencialmente letais: fenômenos embólicos säo comuns, quando exite fibrilaçäo atrial paroxística. A síncope do seio carotídeo é causada por reflexo barorreceptor exagerado, ocasionando assistolias prolongadas, após manobra povocativas mínimas sobre a bifurcaçäo da artéria carótida comum; pode ser subdividida em dois tipos: cardioinibitória e vasodepressora. O uso de fármacos com açäo aceleradora da frequência cardíaca, na disfunçäo do nódulo sino-atrial, näo produz resultados satisfatórios e conduz, precocemente, ao aparecimento de efeitos secundários. Nos casos sintomáticos o tratamento ideal é o implante de marcapasso artificial definitivo: de acordo com as circunstâncias, pode-se utilizar gerador unicameral com eletroo etimulador posicionado em átrio ou dispositivo de dupla câmara, com ou sem modulaçöes de frequencia. Na miocardiopatia chagásica crônica, é relativamente comum a presença de disfunçäo do nódulo sino-atrial, sendo acompanhada, na maioria dos casos por lesöes extensas do sistema de conduçäo; apesar de todas as medidas terapêuticas, farmacológicas ou näo, existe progressäo contínua no comprometimento muscular cardíaco, evoluindo, após ...

Cardiologia: atualizaçäo e reciclagem / Cardiology: uptade

Säo aquelas originadas e mantidas por estruturas localizadas acima da bifurcaçäo do feixe de His. Os complexos QRS apresentam duraçäo de 0,11s ou menos. Podem se originar no nódulo sinusal (taquicardia sinusal secundária a hiperautomatismo ou reentrada); nos átrios (taquicardia atrial automática, taquicardia atrial multifocal, flutter atrial, fibrilaçäo atrial); no nódulo AV (taquicardia juncional paroxística por reentrada nodal, forma comum); no tronco do feixe de His (taquicardia juncional näo-paroxística); envolvendo uma via acessória (síndrome de Wolff-Parkinson-White) e reentrada atrioventricular por via acessória com conduçäo unidirecional retrógrada ("WPW oculto").