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1.
BMC Cancer ; 22(1): 982, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104682

RESUMO

EZH2 is mutated in nearly 25% of follicular lymphoma (FL) cases. Little is known about how EZH2 affects patients' response to therapy. In this context, the aim of this study was to retrospectively analyze the frequency of mutations in EZH2 at diagnosis in tissue and ctDNA in patients with FL and to assess the patients' outcomes after receiving immunochemotherapy, depending on the EZH2 mutation status. Among the 154 patients included in the study, 27% had mutated EZH2 (46% with high-grade and 26% with low-grade FL). Of the mutated tissue samples, the mutation in ctDNA was identified in 44% of cases. EZH2 mutation in ctDNA was not identified in any patient unmutated in the tissue.Unmutated patients who received R-CHOP had significantly more relapses than patients who received R-Bendamustine (16/49 vs. 2/23, p = 0.040). Furthermore, our results show that patients with mutated EZH2 treated with R-CHOP vs. those treated with R-Bendamustine present a lower incidence of relapse (10% vs. 42% p = 0.09 at 4 years), a higher PFS (92% vs. 40% p = 0.039 at 4 years), and higher OS (100% vs. 78% p = 0.039 at 4 years). Based on these data, RCHOP could be a more suitable regimen for mutated patients, and R-bendamustine for unmutated patients. These findings could mean the first-time identification of a useful biomarker to guide upfront therapy in FL.


Assuntos
Linfoma Folicular , Cloridrato de Bendamustina , Biomarcadores , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Proteína Potenciadora do Homólogo 2 de Zeste/genética , Humanos , Linfoma Folicular/diagnóstico , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/genética , Mutação , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/genética , Prednisona/uso terapêutico , Estudos Retrospectivos , Rituximab/uso terapêutico , Vincristina/uso terapêutico
2.
Phys Rev Lett ; 126(19): 194102, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34047597

RESUMO

Chains of coupled oscillators exhibit energy propagation by means of waves, pulses, and fronts. Nonreciprocal coupling radically modifies the wave dynamics of chains. Based on a prototype model of nonlinear chains with nonreciprocal coupling to nearest neighbors, we study nonlinear wave dynamics. Nonreciprocal coupling induces a convective instability between unstable and stable equilibrium. Increasing the coupling level, the chain presents a propagative pattern, a traveling wave. This emergent phenomenon corresponds to the self-assembly of localized structures. The pattern wavelength is characterized as a function of the coupling. Analytically, the phase diagram is determined and agrees with numerical simulations.

3.
Phys Rev Lett ; 126(21): 211802, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34114842

RESUMO

We performed a search for a new generic X boson, which could be a scalar (S), pseudoscalar (P), vector (V), or an axial vector (A) particle produced in the 100 GeV electron scattering off nuclei, e^{-}Z→e^{-}ZX, followed by its invisible decay in the NA64 experiment at CERN. No evidence for such a process was found in the full NA64 dataset of 2.84×10^{11} electrons on target. We place new bounds on the S, P, V, A coupling strengths to electrons, and set constraints on their contributions to the electron anomalous magnetic moment a_{e}, |Δa_{X}|≲10^{-15}-10^{-13} for the X mass region 1 MeV≲m_{X}≲1 GeV. These results are an order of magnitude more sensitive compared to the current accuracy on a_{e} from the electron g-2 experiments and recent high-precision determination of the fine structure constant.

4.
J Asthma ; 58(8): 991-994, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-32482150

RESUMO

In Latin-America, with 603 million inhabitants, the average prevalence of asthma is estimated at 17%, but with wide fluctuations, ranging from 5% in some cities (Mexico) to 30% in Costa Rica. The risk of severe exacerbations seems to be higher in Latin America compared with other regions. A majority of patients uses daily quick-relief medication, with the belief that it is the most important treatment because of its rapid onset of action; without treating the underlying inflammation. Overuse of short-acting beta2 agonists (SABAs) is associated with increased risk of asthma deaths in a dose-response manner. Beta2 agonists increase the severity of asthma through enhanced bronchial hyperresponsiveness and reduced lung function. Also, it has been shown that overreliance on SABA delays recognition of a potentially life-threatening asthma attack. We believe that overreliance on SABA in asthma is also an important public health issue. The fact that SABA use in GINA is not supported by a randomized trial but by an anonymous paper; makes us guess that we use SABA just because we are used to do so. In 2019 GINA strategy introduces one of the most important changes in the management of Asthma in the past 30 years, highlighting anti-inflammatory reliever therapy. A combination of low dose ICS/fast action bronchodilator will not only treat symptoms, but more importantly the underlying inflammation, protecting patients from preventable asthma attacks. After 50 years of a SABA centric approach in asthma management, it is time to leave behind a treatment based just on the bronchodilation and tackle the inflammation.


Assuntos
Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Asma/tratamento farmacológico , Asma/epidemiologia , Broncodilatadores/uso terapêutico , Humanos , América Latina/epidemiologia
5.
Pituitary ; 24(3): 374-383, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33433887

RESUMO

PURPOSE: Pituitary abscesses (PAs) are a rare clinical entity which may arise from normal pituitary tissue or underlying lesions within the gland. Rathke's cleft cysts (RCCs) are not commonly associated with the development of PA. METHODS: Retrospective chart review of three patients with PAs within RCCs at a single university center and review of the literature. RESULTS: Three cases are reported. The first case presented with fever and headache and a history of prior surgery due to RCC and a recent respiratory tract infection. The second case had a history of recent skin infections and presented with sudden onset headache and hypopituitarism. In the third case, chronic visual field impairment prompted an ophthalmologic evaluation resulting in a diagnosis of an adenoma and an infected RCC. In all three cases, an endoscopic endonasal approach was performed to drain infected tissue and allowed microbiological identification of gram-positive cocci, followed by treatment with antibiotics for at least three weeks. Cases in the literature are scarce and the diagnosis is usually made intraoperatively due to non-specific manifestations and imaging. PAs arising from underlying pituitary lesions are less common than primary PAs. Differential diagnosis should include pituitary apoplexy, hypophysitis and other cystic lesions. CONCLUSION: PAs occurring in RCCs are infrequent. Clinical manifestations are commonly subacute, without septic symptoms. Imaging is usually non-specific. Preoperative diagnosis is infrequent and a broad differential diagnosis should be considered. Empirical antimicrobial therapy should be initiated and adjusted after obtaining cultures to reduce the rate of recurrence and improve clinical outcomes.


Assuntos
Carcinoma de Células Renais , Cistos do Sistema Nervoso Central , Neoplasias Renais , Doenças da Hipófise , Neoplasias Hipofisárias , Abscesso , Cistos do Sistema Nervoso Central/diagnóstico , Cistos do Sistema Nervoso Central/cirurgia , Cefaleia , Humanos , Doenças da Hipófise/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Estudos Retrospectivos
6.
Public Health Nutr ; 24(5): 924-934, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32838832

RESUMO

OBJECTIVE: To elucidate mechanisms across family function, home environment and eating behaviours within sociocultural context among Hispanic youth. DESIGN: Two models tested via path analysis (youth fruit and vegetable (FV) consumption; empty energy consumption) using data from the Study of Latino Youth (2011-2013). SETTING: Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA. PARTICIPANTS: Youth (8-16-year-olds), n 1466. RESULTS: Youth ate 2·4 servings of FV per d and received 27 % of total energy from empty energies. Perceiving higher acculturative stress was indirectly associated with lower FV consumption via a pathway of low family function and family support for FV (ß = -0·013, P < 0·001) and via lower family closeness and family support (ß = -0·004, P = 0·004). Being >12-year-olds was indirectly associated with lower FV consumption via lower family closeness and family support (ß = -0·006, P < 0·001). Household food security was indirectly associated with greater FV consumption via family closeness and family support (ß = 0·005, P = 0·003). In contrast, perceiving higher acculturative stress was indirectly associated with higher empty energy consumption (via family closeness and family support: ß = 0·003, P = 0·028 and via low family function and low family support: ß = 0·008, P = 0·05). Being older was associated with higher consumption of empty energies via family closeness (related to family support: ß = 0·04, P = 0·016; parenting strategies for eating: ß = 0·002, P = 0·049). CONCLUSIONS: Findings suggest pathways of influence across demographic and sociocultural context, family dynamics and home environment. The directionality of these associations needs confirmation using longitudinal data.


Assuntos
Saúde da Criança , Hispânico ou Latino , Aculturação , Adolescente , Criança , Comportamento Alimentar , Humanos , Poder Familiar , Verduras
7.
Phys Rev Lett ; 125(8): 081801, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32909809

RESUMO

We carried out a model-independent search for light scalar (s) and pseudoscalar axionlike (a) particles that couple to two photons by using the high-energy CERN SPS H4 electron beam. The new particles, if they exist, could be produced through the Primakoff effect in interactions of hard bremsstrahlung photons generated by 100 GeV electrons in the NA64 active dump with virtual photons provided by the nuclei of the dump. The a(s) would penetrate the downstream HCAL module, serving as a shield, and would be observed either through their a(s)→γγ decay in the rest of the HCAL detector, or as events with a large missing energy if the a(s) decays downstream of the HCAL. This method allows for the probing of the a(s) parameter space, including those from generic axion models, inaccessible to previous experiments. No evidence of such processes has been found from the analysis of the data corresponding to 2.84×10^{11} electrons on target, allowing us to set new limits on the a(s)γγ-coupling strength for a(s) masses below 55 MeV.

8.
J Neurooncol ; 147(2): 247-260, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32140976

RESUMO

PURPOSE: Epstein Barr virus (EBV)-associated smooth muscle tumors (SMT) in the central nervous system are rare tumors. EBV-associated SMT mainly occur in patient with compromised immune status. We report on a case of a HIV positive patient, who developed multiple EBV-SMTs, intracranially and in the spine. We systematically review the literature on the topic. CASE REPORT: A 46 years old female with HIV was imaged for complaints of headaches for 2 years, when an intracranial lesion was found. The patient was followed with sequential MRI scans before an excision was performed 5 years later. Pathology revealed an EBV-associated SMT. Multiple other lesions appearing in the brain and in the spine over years were treated by stereotactic radiosurgery or by surgery. At the time of this report, the patient is alive under HARRT treatment without recurrence. METHODS: A systematic PRISMA guided literature research was conducted on the topic reviewing multiple databases for EBV-associated SMT located in brain or spine. We identified 52 patients from the literature and performed a pooled analysis. RESULTS: All patients in this cohort except one were immuno-suppressed from HIV, post-transplant therapy or because of CIS. Female predominance and a median age of 35 years was identified as was frequent multifocality. Therapeutic strategies varied but were mostly multidisciplinary with surgery. CONCLUSION: Based on our results, EBV-associated SMT should be included in the differential diagnosis of intracranial lesions mimicking meningiomas in immuno-suppressed patients. Stereotactic radiosurgery can be offered as an alternate treatment option for suitable lesions. Long-term surveillance via MRI scanning is recommended for follow up.


Assuntos
Neoplasias do Sistema Nervoso Central/fisiopatologia , Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/isolamento & purificação , Tumor de Músculo Liso/patologia , Infecções por Vírus Epstein-Barr/virologia , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Radiocirurgia , Tumor de Músculo Liso/etiologia , Tumor de Músculo Liso/cirurgia
9.
Virus Genes ; 56(2): 217-227, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31894468

RESUMO

We isolated and compared three tomato spotted wilt virus (TSWV) isolates from lettuce (TSWV-Let), pepper (TSWV-Pep), and tomato (TSWV-Tom) from central Mexico to determine their ability to infect a set of eighteen differential plant species from seven families. TWSV-Let was an aggressive isolate with the ability to infect up to 52% of the differential plants, including maize, under greenhouse conditions. The nucleotide (nt) sequences of the three isolates are more than 90% similar in the M and S RNA segments. In the M segment of the TSWV-Let isolate, we detected nt changes in their intergenic region (IGR) and, in the Gc gene, a region containing a recombination site, as well as a synapomorphy associated with one of three sites under positive selection with a change in one aa residue (a cysteine-to-valine mutation). We speculate on the association of these features in the Gc gene with host selection, adaptation, aggressiveness, and ability to infect maize plants.


Assuntos
Filogenia , Doenças das Plantas/virologia , Solanum lycopersicum/virologia , Tospovirus/genética , Genoma Viral/genética , Solanum lycopersicum/genética , Doenças das Plantas/genética , RNA Viral/genética , Recombinação Genética , Tospovirus/classificação , Tospovirus/patogenicidade
10.
BMC Med Inform Decis Mak ; 20(1): 40, 2020 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-32093701

RESUMO

BACKGROUND: The penetration level of mobile technology has grown exponentially and is part of our lifestyle, at all levels. The use of the smartphone has opened up a new horizon of possibilities in the treatment of health, not in vain, around 40% of existing applications are linked to the mHealth segment. Taking advantage of this circumstance to study new approaches in the treatment of obesity and prescription of physical activity is growing interest in the field of health. The primary outcome (obese adult women) will be assessed according to age, fitness status, weight, and body composition status. Data will be collected at enrollment and weekly during 6 months of intervention on dietary practices, physical activity, anthropometry, and body composition. Analysis of effect will be performed comparing the outcomes between intervention and control arms. The message delivery is in progress. METHODS: A 3-arm clinical trial was established. A series of quantitative and qualitative measures were used to evaluate the effects of self-weighing and the establishment of objectives to be reached concerning the prescription of physical activity. At the end of this pilot study, a set of appropriate measures and procedures were identified and agreed upon to determine the effectiveness of messaging in the form of PUSH technology. The results were recorded and analyzed to begin a randomized controlled trial to evaluate the effectiveness of the proposed methodology. CONCLUSIONS: The study is anticipated to establish feasibility of using PUSH notifications to evaluate whether or not an intervention of 6 months, directed by a team formed by Dietician-Nutritionist and nursing professionals, by means of an application for Smartphone and a personal consultation, improves the body composition of adult women with a fat percentage equal to or higher than 30% at the beginning of the study. TRIAL REGISTRATION: Clinical Trials ID: NCT03911583. First Submitted: April 9, 2019. Ethical oversight is provided by the Bioethical Committee of Córdoba University and registered in the platform clinicaltrials.gov. The results will be published in peer-reviewed journals and analysis data will be made public.


Assuntos
Composição Corporal , Aplicativos Móveis , Obesidade/terapia , Sobrepeso/terapia , Telemedicina/métodos , Envio de Mensagens de Texto , Adulto , Peso Corporal , Dieta , Exercício Físico , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Smartphone
11.
Chaos ; 30(5): 053138, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32491917

RESUMO

Homogeneously driven dynamical systems exhibit multistability. Depending on the initial conditions, fronts present a rich dynamical behavior between equilibria. Qualitatively, this phenomenology is persistent under spatially modulated forcing. However, the understanding of equilibria and front dynamics organization is not fully established. Here, we investigate these phenomena in the high-wavenumber limit. Based on a model that describes the reorientation transition of a liquid crystal light valve with spatially modulated optical forcing and the homogenization method, equilibria and fronts as a function of forcing parameters are studied. The forcing induces patterns coexisting with the uniform state in regions where the system without forcing is monostable. The front dynamics is characterized theoretically and numerically. Experimental results verify these phenomena and the law describing bistability, showing quite good agreement.

12.
Phys Rev Lett ; 123(12): 121801, 2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31633975

RESUMO

A search for sub-GeV dark matter production mediated by a new vector boson A^{'}, called a dark photon, is performed by the NA64 experiment in missing energy events from 100 GeV electron interactions in an active beam dump at the CERN SPS. From the analysis of the data collected in the years 2016, 2017, and 2018 with 2.84×10^{11} electrons on target no evidence of such a process has been found. The most stringent constraints on the A^{'} mixing strength with photons and the parameter space for the scalar and fermionic dark matter in the mass range ≲0.2 GeV are derived, thus demonstrating the power of the active beam dump approach for the dark matter search.

13.
BMC Womens Health ; 19(1): 167, 2019 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-31882009

RESUMO

BACKGROUND: There is evidence showing the effectiveness of a hypocaloric diet and the increase in physical activity on weight loss. However, the combined role of these factors, not only on weight loss but also body composition, remains unclear. The purpose of this study was to investigate the effect of a hypocaloric diet on the body composition of obese adult women throughout different degrees of physical activity during a weight loss program. METHODS: One hundred and seventeen healthy female volunteers were randomly assigned to one of the experimental groups: a control group with a low-level prescription of physical activity (1-4 METs), moderate physical activity group that performed 10.000 steps walking (5-8 METs) and intense physical activity group that trained exercises by at least 70% of VO2max three times a week (> 8 METs). All subjects followed a hypocaloric diet designed with a reduction of 500 kcal/day. Nutritional counseling was provided throughout the study period to help ensure dietary adherence. RESULTS: We found no differences in body weight compared to moderate and intense physical activity (ßstand. = - 0.138 vs. ßstand. = - 0.139). Body fat was lower in women following an intense activity (ßstand. = - 0.436) than those with moderate exercise (ßstand. = - 0.231). The high-intense activity also increased muscle mass at the end of the intervention, standing out above the moderate activity (ßstand. = 0.182 vs. ßstand. = 0.008). CONCLUSIONS: These findings indicate that a hypocaloric diet, without prescription of physical activity, is adequate to lose weight in the short term (12 weeks), but physical activity is vital to modify the body composition in women with obesity. Body fat was lower when women practiced a moderate exercise compared to hypocaloric diet only, but an intense physical activity was the most effective protocol to obtain a reduction of body fat and maintain muscle mass. TRIAL REGISTRATION: The study protocol complied with the Declaration of Helsinki for medical studies, it was approved by the bioethical committee of Córdoba University, in the Department of Health at the Regional Government of Andalusia (Act n°284, ref.4156) and retrospectively registered in clinicaltrials.gov (NCT03833791). Registered 2 January 2019.


Assuntos
Composição Corporal/fisiologia , Dieta Redutora/métodos , Obesidade/terapia , Condicionamento Físico Humano/métodos , Programas de Redução de Peso/métodos , Adulto , Peso Corporal , Exercício Físico/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Estudos Retrospectivos , Comportamento Sedentário , Fatores de Tempo , Resultado do Tratamento , Redução de Peso
14.
Pharm Dev Technol ; 24(4): 465-478, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30124097

RESUMO

Pediatric patients present changing physiological features. Because of the lack of land suitable for commercial management, pediatric specialties very often need to prepare extemporaneous formulations to improve the dosage and administration of drugs for children. Oral liquid formulations are the most suitable for pediatric patients. Clonidine is widely used in the pediatric population for opioid withdrawal, hypertensive crisis, attention deficit disorders and hyperactivity syndrome, and as an analgesic in neuropathic cancer pain. The objective was to study the physicochemical and microbiological stability and determine the shelf life of an oral solution containing 20 µg/mL clonidine hydrochloride in different storage conditions (5 ± 3 °C, 25 ± 3 °C, and 40 ± 2 °C). Using raw material with excipients safe for all pediatric age groups, two oral liquid formulations of clonidine hydrochloride were designed (with and without preservatives). Solutions stored at 5 ± 3 °C (with and without preservatives) were physically and microbiologically stable for at least 90 days in closed containers and for 42 days after opening. Two oral solutions of clonidine hydrochloride 20 µg/mL were developed for pediatric use from raw materials that are readily available and easy to process, containing safe excipients that are stable over a long period of time.


Assuntos
Analgésicos/administração & dosagem , Analgésicos/química , Clonidina/administração & dosagem , Clonidina/química , Administração Oral , Fenômenos Químicos , Criança , Composição de Medicamentos/métodos , Estabilidade de Medicamentos , Escherichia coli , Humanos , Soluções Farmacêuticas/administração & dosagem , Soluções Farmacêuticas/química , Pseudomonas aeruginosa/isolamento & purificação
15.
Trop Anim Health Prod ; 51(1): 165-169, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30027489

RESUMO

The aim of this study was to assess transmission of Taenia solium cysticercosis in Palmarito Arriba, a small village in the rural area of the Portuguesa state of Venezuela, through (1) an evaluation of T. solium transmission risk factors present in the community and (2) serological detection of the secreted metacestode HP10 antigen (HP10 Ag) and of anti-metacestode antibodies in sera from rural pigs. Risk factors associated with transmission of cysticercosis were the following: 100% (23/23) of the households lacked piped water, 87.0% (20/23) of households lacked latrines, 88.0% (100/114) of inhabitants routinely defecated in the open/air, 19.05% (12/63) of the interviewed population had observed proglottids in their stools. More significantly, 9/13 householders breeding pigs reported seeing proglottids in their stools. Of the 25 pigs available for bleeding and serological testing, 64% (16/25) were free roaming and 36% (9/25) were "backyard" animals; 28% (7/25) were seropositive for both the HP10 Ag and antibody, 20.0% (5/25) were seropositive for HP10 Ag alone, and 36.0% (9/25) were seropositive for antibody alone. Given this clear evidence of endemic porcine cysticercosis, further studies are needed to assess and control the level of porcine and human taeniasis and cysticercosis in this and neighboring communities.


Assuntos
Cisticercose/veterinária , Doenças dos Suínos/epidemiologia , Taenia solium/fisiologia , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/sangue , Cisticercose/epidemiologia , Cisticercose/parasitologia , Cisticercose/transmissão , Feminino , Masculino , Fatores de Risco , Estudos Soroepidemiológicos , Sus scrofa , Suínos , Doenças dos Suínos/parasitologia , Doenças dos Suínos/transmissão , Venezuela/epidemiologia
16.
Phys Rev Lett ; 120(23): 231802, 2018 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-29932721

RESUMO

We report the first results on a direct search for a new 16.7 MeV boson (X) which could explain the anomalous excess of e^{+}e^{-} pairs observed in the excited ^{8}Be^{*} nucleus decays. Because of its coupling to electrons, the X could be produced in the bremsstrahlung reaction e^{-}Z→e^{-}ZX by a 100 GeV e^{-} beam incident on an active target in the NA64 experiment at the CERN Super Proton Synchrotron and observed through the subsequent decay into a e^{+}e^{-} pair. With 5.4×10^{10} electrons on target, no evidence for such decays was found, allowing us to set first limits on the X-e^{-} coupling in the range 1.3×10^{-4}≲ε_{e}≲4.2×10^{-4} excluding part of the allowed parameter space. We also set new bounds on the mixing strength of photons with dark photons (A^{'}) from nonobservation of the decay A^{'}→e^{+}e^{-} of the bremsstrahlung A^{'} with a mass ≲23 MeV.

17.
Ultrasound Obstet Gynecol ; 51(5): 677-683, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28782264

RESUMO

OBJECTIVES: To establish the prevalence of external (EAS) and internal (IAS) anal sphincter defects present 15-24 years after childbirth according to mode of delivery, and their association with development of fecal incontinence (FI). The study additionally aimed to compare the proportion of women with obstetric anal sphincter injuries (OASIS) reported at delivery with the proportion of women with sphincter defect detected on ultrasound 15-24 years later. METHODS: This was a cross-sectional study including 563 women who delivered their first child between 1990 and 1997. Women responded to a validated questionnaire (Pelvic Floor Distress Inventory) in 2013-2014, from which the proportion of women with FI was recorded. Information about OASIS was obtained from the National Birth Registry. Study participants underwent four-dimensional transperineal ultrasound examination. Defect of EAS or IAS of ≥ 30° in at least four of six slices on tomographic ultrasound was considered a significant defect and was recorded. Four study groups were defined based on mode of delivery of the first child. Women who had delivered only by Cesarean section (CS) constituted the CS group. Women in the normal vaginal delivery (NVD) group had NVD of their first child and subsequent deliveries could be NVD or CS. The forceps delivery (FD) group included women who had FD, NVD or CS after FD of their first born. The vacuum delivery (VD) group included women who had VD, NVD or CS after VD of their first born. Multiple logistic regression was used to calculate adjusted odds ratios (aORs) for comparison of prevalence of an EAS defect following different modes of delivery and to test its association with FI. Fisher's exact test was used to calculate crude odds ratios (ORs) for IAS defects. RESULTS: Defects of EAS and IAS were found after NVD (n = 201) in 10% and 1% of cases, respectively, after FD (n = 144) in 32% and 7% of cases and after VD (n = 120) in 15% and 4% of cases. No defects were found after CS (n = 98). FD was associated with increased risk of EAS defect compared with NVD (aOR = 3.6; 95% CI, 2.0-6.6) and VD (aOR = 3.0; 95% CI, 1.6-5.6) and with increased risk of IAS defect compared with NVD (OR = 7.4; 95% CI, 1.5-70.5). The difference between VD and NVD was not significant for EAS or IAS. FI was reported in 18% of women with an EAS defect, in 29% with an IAS defect and in 8% without a sphincter defect. EAS and IAS defects were associated with increased risk of FI (aOR = 2.5 (95% CI, 1.3-4.9) and OR = 4.2 (95% CI, 1.1-13.5), respectively). Of the ultrasonographic sphincter defects, 80% were not reported as OASIS at first or subsequent deliveries. CONCLUSIONS: Anal sphincter defects visualized on transperineal ultrasound 15-24 years after first delivery were associated with FD and development of FI. Ultrasound revealed a high proportion of sphincter defects that were not recorded as OASIS at delivery. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Canal Anal/lesões , Extração Obstétrica/efeitos adversos , Incontinência Fecal/epidemiologia , Lacerações/epidemiologia , Adulto , Canal Anal/diagnóstico por imagem , Estudos Transversais , Extração Obstétrica/estatística & dados numéricos , Incontinência Fecal/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Ultrassonografia/métodos
18.
Philos Trans A Math Phys Eng Sci ; 376(2135)2018 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-30420547

RESUMO

The Brusselator reaction-diffusion model is a paradigm for the understanding of dissipative structures in systems out of equilibrium. In the first part of this paper, we investigate the formation of stationary localized structures in the Brusselator model. By using numerical continuation methods in two spatial dimensions, we establish a bifurcation diagram showing the emergence of localized spots. We characterize the transition from a single spot to an extended pattern in the form of squares. In the second part, we incorporate delayed feedback control and show that delayed feedback can induce a spontaneous motion of both localized and periodic dissipative structures. We characterize this motion by estimating the threshold and the velocity of the moving dissipative structures.This article is part of the theme issue 'Dissipative structures in matter out of equilibrium: from chemistry, photonics and biology (part 2)'.

19.
Chaos ; 28(8): 083126, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30180634

RESUMO

Coupled nonlinear oscillators can present complex spatiotemporal behaviors. Here, we report the coexistence of coherent and incoherent domains, called chimera states, in an array of identical Duffing oscillators coupled to their nearest neighbors. The chimera states show a significant variation of amplitude in the desynchronized domain. These intriguing states are observed in the bistability region between a homogeneous state and a spatiotemporal chaotic one. These dynamical behaviors are characterized by their Lyapunov spectra and their global phase coherence order parameter. The local coupling between oscillators prevents one domain from invading the other one. Depending on initial conditions, a family of chimera states appear, organized in a snaking-like diagram.

20.
J Anim Physiol Anim Nutr (Berl) ; 102(2): e525-e533, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28990224

RESUMO

Amaranthus dubius is an alternative source of fibre and protein for the feed formulation for growing rabbits, although its effects on their health status are yet unknown. Therefore, this study aimed to evaluate the effects of three dietary levels (0, 160 and 320 g/kg) of A. dubius on haematological, serum biochemical and histopathological parameters of fattening rabbits. One hundred and thirteen New Zealand White rabbits were fed ad libitum from weaning (35 days) to slaughter (87 days). The health status of the animals was monitored, and mortality was recorded. Before slaughtering, 30 rabbits were randomly selected for haematological and serum biochemical analysis. During slaughter, 18 rabbits were randomly selected for histopathological study in heart, liver, lung and small intestine. The health status of rabbits was good, with no differences among treatments in mortality. Diet and sex did not affect the values of most haematological and serum biochemical parameters. Fibrinogen, glucose and high-density lipoprotein values increased significantly from 0 to 320 g/kg A. dubius diets. The white blood cell count and glutamic oxaloacetic transaminase values decreased significantly from 0 to 320 g/kg A. dubius diets. The organs showed histologically well-structured tissues. However, in all experimental groups several samples with lesions were observed, always highly focalized in small tissue areas. The main lesions observed, probably related to conditions of thermal stress affecting the rabbits, were cholesterolosis (heart), steatosis (liver), inflammatory lymphoplasmacytic infiltrate (lung) and chronic inflammatory tissue damage (small intestine). In conclusion, the inclusion of up to 320 g/kg A. dubius in diet did not jeopardize the health status of growing rabbits. Therefore, A. dubius can become an alternative raw material for the formulation of feeds in tropical and subtropical countries where this plant is widespread.


Assuntos
Ração Animal/análise , Dieta/veterinária , Coelhos/sangue , Coelhos/crescimento & desenvolvimento , Amaranthus , Fenômenos Fisiológicos da Nutrição Animal , Animais , Feminino , Intestino Delgado/patologia , Fígado/patologia , Pulmão/patologia , Masculino , Miocárdio
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