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Abstract Objectives To investigate the associations between caregivers' burden, family quality of life (QoL), and siblings' QoL in Brazilian families of children with cerebral palsy, and to analyze siblings' QoL using as a parameter the QoL of typically developed Brazilian children. Methods It was a cross-sectional study. The 212 families, 212 caregivers and 131 siblings completed the Family Quality of Life Scale, Burden Interview, and KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires at a neurorehabilitation center in southeast Brazil. Univariable and multivariable models were used. Results Family QoL significantly worsened as caregivers' burden increased (95 % CI -0.66 to -0.38). Caregivers' burden was significantly lower with increasing family QoL scores (95 % CI -0.52 to -0.30). Self-reported siblings' QoL was significantly worse than that of their typically developed peers (95 % CI -7.6 to -3.6). Self-reported siblings' QoL was significantly lower as siblings' age (95 % CI -2.52 to -0.59) and caregivers' burden (95 % CI -0.35 to -0.05) increased. Parent-reported siblings' QoL was significantly lower with increasing caregivers' burden (95 % CI -0.45 to -0.16) and higher as family QoL increased (95 % CI 0.09 to 0.37). Conclusions The cross-sectional nature of these data precludes any statement of causality. Family QoL worsened with higher caregivers' burden levels. Lower caregivers' burden scores were associated with a higher family QoL. Siblings' QoL was impaired as compared to typically developed peers, worse among older siblings, and as caregivers' burden increased and better with higher family QoL levels. Future multicenter studies may validate the generalizability of the present findings.
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This study analyzed arbuscular mycorrhizal fungi (AMF) activity and soil chemical properties in Aspidosperma pyrifolium, Bauhinia ungulata, Caesalpinia pyramidalis, and Caesalpinia ferrea. AMF spores, root colonization, total glomalin-related soil protein (T-GRSP), easily extracted GRSP (EE-GRSP), and soil chemical properties were measured four times (July 2019, 2020 and December 2019, 2020). Significant differences were observed in AMF spores, root colonization, T-GRSP, and EE-GRSP among the plant species and across seasons. For soil chemical properties, we observed differences among plant species. During the dry season, B. ungulata and C. pyramidalis had the highest AMF spores and root colonization (57.3 ± 0.27 spores 50 g soil-1 and 48.8 ± 1.05, respectively), whereas during the rainy season, C. pyramidalis and C. ferrea showed the highest AMF spores and root colonization (36.6 ± 0.13 spores 50 g soil-1 and 62.2 ± 1.17, respectively). A. pyrifolium showed the highest T-GRSP in both seasons. On the basis of the soil chemical properties, we found that (i) A. pyrifolium, B. ungulata, and C. ferrea showed the highest soil organic carbon (1.32 ± 0.03 g kg-1), phosphorus (7.01 ± 0.26 mg kg-1), and soil pH (5.85 ± 0.23) and (ii) C. pyramidalis showed the highest Ca2+, Mg2+, Na+, H+ + Al3+, K+, and soil total nitrogen (1.36 ± 0.04, 0.73 ± 0.01, 3.72 ± 0.85, 4.56 ± 0.12 cmolc kg-1, 15.43 ± 1.53 mg kg-1, and 0.16 ± 0.01 g kg-1, respectively). Our results highlight the advantage of AMF spores as perennating structures over other AM fungal propagules in seasonal vegetation like Caatinga.
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Micorrizas , Raíces de Plantas , Rizosfera , Estaciones del Año , Microbiología del Suelo , Suelo , Esporas Fúngicas , Micorrizas/fisiología , Raíces de Plantas/microbiología , Suelo/química , Esporas Fúngicas/crecimiento & desarrollo , Esporas Fúngicas/aislamiento & purificación , Árboles/microbiología , Proteínas Fúngicas , GlicoproteínasRESUMEN
OBJECTIVE: Our study aimed to evaluate the impact of bacillus Calmette-Guérin shortage on recurrence and progression in patients with non-muscle invasive bladder cancer in a Brazilian cohort. METHODS: We retrospectively reviewed the clinicopathological data of 409 patients who had their first transurethral resection of the bladder tumor for intermediate or high-risk non-muscle invasive bladder cancer between June 2014 and May 2021 in a tertiary public hospital in Brazil. Patients included had non-muscle-invasive urothelial carcinoma of the bladder resected completely for the first time, regardless of bacillus Calmette-Guérin use. Low-risk disease patients were excluded from the analysis. Demographic, clinicopathological, and bacillus Calmette-Guérin use data were collected from our database. Recurrence and progression data were obtained from patient records or through telephone interviews. Recurrence-free survival and progression-free survival were calculated from the date of transurethral resection of the bladder tumor until the events of recurrence, progression, last office visit, or phone interview. RESULTS: Within a median follow-up period of 26.7 months, 168 (41.1%) patients experienced a recurrence in a median time of 27 months (95%CI 16.1-38). Bacillus Calmette-Guérin was administered to 57 (13.9%) individuals after transurethral resection of the bladder tumor. Patients with ≥3 lesions (p<0.001), those with lesions >3 cm (p=0.02), and those without bacillus Calmette-Guérin treatment (p<0.001) had shorter recurrence-free survival. According to a Cox multivariate regression model, bacillus Calmette-Guérin use was independently associated with a reduced recurrence rate, with an HR of 0.43 (95%CI 0.25-0.72). Out of the patients studied, 26 (6.4%) experienced progression. T1 stage (p<0.001) and high-grade (p<0.001) were associated with shorter progression-free survival. Bacillus Calmette-Guérin did not influence bladder cancer progression. In the Cox multivariate analysis, high-risk disease was independently associated with progression (p<0.001). CONCLUSION: Our study confirms that non-muscle invasive bladder cancer exhibits a high recurrence rate. The use of adjuvant bacillus Calmette-Guérin in intermediate and high-risk patients significantly reduces this rate. Furthermore, the bacillus Calmette-Guérin shortage could have negatively impacted these patients.
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Vacuna BCG , Recurrencia Local de Neoplasia , Neoplasias de la Vejiga Urinaria , Humanos , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía , Masculino , Vacuna BCG/uso terapéutico , Femenino , Estudios Retrospectivos , Brasil/epidemiología , Anciano , Persona de Mediana Edad , Factores de Riesgo , Adyuvantes Inmunológicos/uso terapéutico , Progresión de la Enfermedad , Administración Intravesical , Anciano de 80 o más Años , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/cirugíaRESUMEN
Background: Orbital hypertelorism is a rare congenital condition caused by craniofacial malformations. It consists of complete orbital lateralization, characterized by an increase in distance (above the 95th percentile) of the inner canthal (ICD), outer canthal, and interpupillary distances. It can be approached surgically, and the main techniques are box osteotomy and facial bipartition. The surgical procedure is usually performed before the age of 8. We describe here two patients who underwent late surgical correction using the box osteotomy technique. Case Description: Patient 1: A 13-year-old female presenting isolated hypertelorism with 5 cm ICD and left eye amblyopia. Patient 2: A 15-year-old female with orbital hypertelorism, 4.6 cm ICD, and nasal deformity. Both patients underwent orbital translocation surgery and had no neurological disorders. Conclusion: The article reports two cases of isolated hypertelorism treated late with the box osteotomy technique. Both surgeries were successful, with no postoperative complications. It appears that it is possible to obtain good surgical results even in patients who have not been able to undergo surgery previously.
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OBJECTIVES: To investigate the associations between caregivers' burden, family quality of life (QoL), and siblings' QoL in Brazilian families of children with cerebral palsy, and to analyze siblings' QoL using as a parameter the QoL of typically developed Brazilian children. METHODS: It was a cross-sectional study. The 212 families, 212 caregivers and 131 siblings completed the Family Quality of Life Scale, Burden Interview, and KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires at a neurorehabilitation center in southeast Brazil. Univariable and multivariable models were used. RESULTS: Family QoL significantly worsened as caregivers' burden increased (95 % CI -0.66 to -0.38). Caregivers' burden was significantly lower with increasing family QoL scores (95 % CI -0.52 to -0.30). Self-reported siblings' QoL was significantly worse than that of their typically developed peers (95 % CI -7.6 to -3.6). Self-reported siblings' QoL was significantly lower as siblings' age (95 % CI -2.52 to -0.59) and caregivers' burden (95 % CI -0.35 to -0.05) increased. Parent-reported siblings' QoL was significantly lower with increasing caregivers' burden (95 % CI -0.45 to -0.16) and higher as family QoL increased (95 % CI 0.09 to 0.37). CONCLUSIONS: The cross-sectional nature of these data precludes any statement of causality. Family QoL worsened with higher caregivers' burden levels. Lower caregivers' burden scores were associated with a higher family QoL. Siblings' QoL was impaired as compared to typically developed peers, worse among older siblings, and as caregivers' burden increased and better with higher family QoL levels. Future multicenter studies may validate the generalizability of the present findings.
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Cuidadores , Parálisis Cerebral , Calidad de Vida , Hermanos , Humanos , Parálisis Cerebral/rehabilitación , Parálisis Cerebral/psicología , Niño , Masculino , Femenino , Brasil , Estudios Transversales , Hermanos/psicología , Cuidadores/psicología , Adolescente , Encuestas y Cuestionarios , Preescolar , Factores Socioeconómicos , Carga del Cuidador/psicología , Familia/psicología , Padres/psicología , Rehabilitación NeurológicaRESUMEN
BACKGROUND: Children with meningomyelocele may require continuous care. Consequently, there is a risk for caregiver burden and impact on family quality of life (QoL), including siblings' QoL. Some studies analysed caregivers' burden and family QoL separately. However, none of these studies evaluated siblings' QoL and the associations between these three dimensions. This study investigated the associations between caregivers' burden, family QoL and siblings' QoL in Brazilian families of children with meningomyelocele and its correlations with sociodemographic, functional and clinical variables. Siblings' QoL was specifically assessed using as a parameter the QoL of typically developed Brazilian children. METHODS: One hundred and fifty families, 150 caregivers and 68 siblings completed the Family Quality of Life Scale, Burden Interview, KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires. RESULTS: Most families and caregivers reported a high family QoL and a low caregiver burden. Family QoL was significantly lower as caregivers' burden increased. Caregiver's burden was significantly lower with increasing family QoL levels. Self-reported siblings' QoL was significantly worse than that of typically developed peers. There were no significant differences between self and parent-reported siblings' QoL. Self-reported siblings' QoL was significantly worse as their age increased and better with increasing family QoL levels. Parent-reported siblings' QoL was significantly worse with increasing levels of caregiver's burden and significantly better as family QoL increased. There were no significant associations with functional and clinical variables. CONCLUSIONS: Despite the cross-sectional nature of the available data precludes any statements of causality, our results reinforce the relevance of knowing the factors that influence the QoL of families and siblings of children and adolescents with meningomyelocele and the relevance of actions aimed at reducing caregivers' burden, improving family QoL and meeting siblings' individual needs. Future multicenter studies may validate the generalizability of our findings.
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Meningomielocele , Calidad de Vida , Niño , Humanos , Adolescente , Hermanos , Estudios Transversales , Cuidadores , Encuestas y CuestionariosRESUMEN
SUMMARY OBJECTIVE: Our study aimed to evaluate the impact of bacillus Calmette-Guérin shortage on recurrence and progression in patients with non-muscle invasive bladder cancer in a Brazilian cohort. METHODS: We retrospectively reviewed the clinicopathological data of 409 patients who had their first transurethral resection of the bladder tumor for intermediate or high-risk non-muscle invasive bladder cancer between June 2014 and May 2021 in a tertiary public hospital in Brazil. Patients included had non-muscle-invasive urothelial carcinoma of the bladder resected completely for the first time, regardless of bacillus Calmette-Guérin use. Low-risk disease patients were excluded from the analysis. Demographic, clinicopathological, and bacillus Calmette-Guérin use data were collected from our database. Recurrence and progression data were obtained from patient records or through telephone interviews. Recurrence-free survival and progression-free survival were calculated from the date of transurethral resection of the bladder tumor until the events of recurrence, progression, last office visit, or phone interview. RESULTS: Within a median follow-up period of 26.7 months, 168 (41.1%) patients experienced a recurrence in a median time of 27 months (95%CI 16.1-38). Bacillus Calmette-Guérin was administered to 57 (13.9%) individuals after transurethral resection of the bladder tumor. Patients with ≥3 lesions (p<0.001), those with lesions >3 cm (p=0.02), and those without bacillus Calmette-Guérin treatment (p<0.001) had shorter recurrence-free survival. According to a Cox multivariate regression model, bacillus Calmette-Guérin use was independently associated with a reduced recurrence rate, with an HR of 0.43 (95%CI 0.25-0.72). Out of the patients studied, 26 (6.4%) experienced progression. T1 stage (p<0.001) and high-grade (p<0.001) were associated with shorter progression-free survival. Bacillus Calmette-Guérin did not influence bladder cancer progression. In the Cox multivariate analysis, high-risk disease was independently associated with progression (p<0.001). CONCLUSION: Our study confirms that non-muscle invasive bladder cancer exhibits a high recurrence rate. The use of adjuvant bacillus Calmette-Guérin in intermediate and high-risk patients significantly reduces this rate. Furthermore, the bacillus Calmette-Guérin shortage could have negatively impacted these patients.
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The concept is part of the essence of a mentally represented element. The concept is part of the process of identification, categorization and description, which allows researchers to define and compare themes between two or more different categories. Following this idea, the main objective of this article is to establish a non-exhaustive reflection on the conceptual bases of Geotourism and its sub-segments Celestial Geotourism, Space Geotourism and Astrotourism. The main reason for carrying out this research is because there isn't a one definition yet for the terms. This is perhaps the reason for the conflicts that exist between the themes of this tourism practice and the three categories - Celestial Geotourism, Space Geotourism and Astrotourism. The methodology was developed through secondary sources and based on the results obtained, it was possible to identify and distinguish the most important concepts to establish a univocal operational definition for each term. Finally, it was possible to conclude that although there are conflicts, this happens due to the inadequate interpretative representation of the themes between the categories.
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This work presents the results of a study that analyzed the processes and communication strategies by the entities represented in the National Health Council (NHC), 2018-2021 administration. The production of alternative communication by civil society constitutes one of the fundamental principles of democratic regimes for an important American institutionalist author (Robert Dahl). The emergence of the Internet and social networks has brought new demands for these organizations to disseminate their ideas and be present in this network society (Castells). Our study aimed to analyze the extent to which these entities are present in the digital media and to verify if there were significant differences in the communication capacity among the segments represented in the NHC. A survey was applied to the communication departments of the 42 NHC entities from September 2019 to February 2020. Thirty-four answers were obtained (81%). The results show the existence of 3 different levels of development in communication within these entities, regardless of the macro-institutional categories. Our article ends by discussing the results in light of the polyarchy and the digital democracy models and highlighting new steps towards effective democratic communication policies and participation.
Apresentamos os resultados de uma pesquisa inédita que analisou os processos e as estratégias de comunicação das entidades titulares do Conselho Nacional de Saúde, gestão 2018-2021. A produção autônoma de comunicação alternativa pela sociedade civil consiste num dos princípios fundamentais dos regimes democráticos para um importante autor norte-americano institucionalista (Robert Dahl). A emergência da Internet e das redes sociais trouxe novas necessidades para essas organizações divulgarem suas ideias e se fazerem presentes na sociedade em rede (Castells). O estudo teve como objetivo analisar em que medida essas entidades estão inseridas no meio digital e verificar se havia diferenças expressivas na capacidade de comunicação entre os segmentos representados no Conselho. Um inquérito foi aplicado às áreas de comunicação de 42 entidades do CNS de setembro de 2019 a fevereiro de 2020. Foram obtidas 34 respostas (81%). Os resultados mostram a existência de 3 níveis de desenvolvimento no trabalho de comunicação entre essas entidades, independentemente das categorias macro institucionais. Ao final, discute-se os resultados à luz dos modelos da poliarquia e da democracia digital, e são apontados novos passos para uma comunicação e participação efetivamente democráticas.
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Comunicación , Internet , Humanos , Encuestas y CuestionariosRESUMEN
Resumo Apresentamos os resultados de uma pesquisa inédita que analisou os processos e as estratégias de comunicação das entidades titulares do Conselho Nacional de Saúde, gestão 2018-2021. A produção autônoma de comunicação alternativa pela sociedade civil consiste num dos princípios fundamentais dos regimes democráticos para um importante autor norte-americano institucionalista (Robert Dahl). A emergência da Internet e das redes sociais trouxe novas necessidades para essas organizações divulgarem suas ideias e se fazerem presentes na sociedade em rede (Castells). O estudo teve como objetivo analisar em que medida essas entidades estão inseridas no meio digital e verificar se havia diferenças expressivas na capacidade de comunicação entre os segmentos representados no Conselho. Um inquérito foi aplicado às áreas de comunicação de 42 entidades do CNS de setembro de 2019 a fevereiro de 2020. Foram obtidas 34 respostas (81%). Os resultados mostram a existência de 3 níveis de desenvolvimento no trabalho de comunicação entre essas entidades, independentemente das categorias macro institucionais. Ao final, discute-se os resultados à luz dos modelos da poliarquia e da democracia digital, e são apontados novos passos para uma comunicação e participação efetivamente democráticas.
Abstract This work presents the results of a study that analyzed the processes and communication strategies by the entities represented in the National Health Council (NHC), 2018-2021 administration. The production of alternative communication by civil society constitutes one of the fundamental principles of democratic regimes for an important American institutionalist author (Robert Dahl). The emergence of the Internet and social networks has brought new demands for these organizations to disseminate their ideas and be present in this network society (Castells). Our study aimed to analyze the extent to which these entities are present in the digital media and to verify if there were significant differences in the communication capacity among the segments represented in the NHC. A survey was applied to the communication departments of the 42 NHC entities from September 2019 to February 2020. Thirty-four answers were obtained (81%). The results show the existence of 3 different levels of development in communication within these entities, regardless of the macro-institutional categories. Our article ends by discussing the results in light of the polyarchy and the digital democracy models and highlighting new steps towards effective democratic communication policies and participation.
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INTRODUCTION: Research in Orthodontics and Oral Surgery has been relying on three-dimensional (3D) models to evaluate treatment results with displacement color map techniques, even though it has important limitations. OBJECTIVES: This study proposed a method of tracking translational movements of 3D objects to evaluate displacements in surfaces with no shape modification. METHODS: Cone Beam Computed Tomography (CBCT) data of ten patients were imported to the Dolphin software. A hypothetical virtual surgical plan (randomly defined) was developed in the software and afterwards verified using the proposed method. All the procedures were carried out by two evaluators, in two different time-points, with a 15-day interval. ITK-Snap software was used to generate high quality STL models. Centroid points were automatically generated and their coordinates were compared to confirm if they represented the known displacements simulated. The paired t-test and the Bland-Altman plots were used, as well as the intraclass correlation coefficient. RESULTS: Interexaminers and intra-examiner tests showed excellent reliability of the method, with mean displacement measurement error values under 0.1mm. The paired t-test did not show any statistically significant differences. CONCLUSION: The method showed excellent reliability to track the simulated translational displacements of bone segments.
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Imagenología Tridimensional , Ortodoncia , Imagenología Tridimensional/métodos , Reproducibilidad de los Resultados , Tomografía Computarizada de Haz Cónico/métodos , Programas InformáticosRESUMEN
Two experiments were designed to evaluate the effects of different probiotic combinations on rumen fermentation characteristics, performance, and carcass characteristics of feedlot Bos indicus beef bulls offered a high-concentrate diet. In experiment 1, 30 rumen-fistulated Nellore steers were blocked by initial body weight (BW = 350 ± 35.0 kg) and within blocks (n = 10), animals were randomly assigned to receive: 1) high-concentrate diet without probiotic supplementation (n = 10; CONT), 2) CONT plus 1 g per head of a probiotic mixture containing three strains of Enterococcus faecium and one strain of Saccharomyces cerevisiae (3.5 × 109 CFU/g; n = 10; EFSC), and 3) CONT plus 2 g per head of a probiotic mixture containing Bacillus licheniformis and Bacillus subtilis (3.2 × 109 CFU/g; n = 10; BLBS). The experimental period lasted 35 d, being 28 d of adaptation and 7 d of sampling. From day 34 to day 35 of the experimental period, ruminal fluid and fecal samples were collected every 3 h, starting immediately before feeding (0 h) for rumen fermentation characteristics and apparent nutrient digestibility analysis, respectively. In experiment 2, 240 Nellore bulls were ranked by initial shrunk BW (375 ± 35.1 kg), assigned to pens (n = 4 bulls per pen), and pens randomly assigned to receive the same treatments as in experiment 1 (n = 20 pens per treatment). Regardless of treatment, all bulls received the same step-up and finishing diets throughout the experimental period, which lasted 115 d. In both experiments, data were analyzed as orthogonal contrasts to partition-specific treatment effects: 1) probiotic effect: CONT vs. PROB and 2) probiotic type: EFSC vs. BLBS (SAS Software Inc.). In experiment 1, no contrast effects were observed on nutrient intake, overall nutrient digestibility, and rumen fermentation analyses (P ≥ 0.13). Nonetheless, supplementation of probiotics, regardless of type (P = 0.59), reduced mean acetate:propionate ratio and rumen ammonia-N concentration vs. CONT (P ≤ 0.05). In experiment 2, no significant effects were observed for final BW and dry matter intake (P ≥ 0.12), but average daily gain and feed efficiency tended to improve (P ≤ 0.10) when probiotics were offered to the animals. Probiotic supplementation or type of probiotic did not affect carcass traits (P ≥ 0.22). In summary, supplementation of probiotics containing a mixture of E. faecium and S. cerevisiae or a mixture of B. licheniformis and B. subtilis reduced rumen acetate:propionate ratio and rumen ammonia-N levels and tended to improve the performance of feedlot cattle offered a high-concentrate diet.
Two experiments were designed to evaluate the effects of different probiotic combinations on rumen fermentation characteristics, performance, and carcass characteristics of feedlot Bos indicus beef bulls offered a high-concentrate diet. The two probiotics consisted of a mixture containing three strains of Enterococcus faecium and one strain of Saccharomyces cerevisiae or a mixture of Bacillus licheniformis and Bacillus subtilis. Supplementation of probiotics, regardless of type, reduced acetate:propionate ratio, and mean rumen ammonia-N concentration and tended to improve the performance of feedlot cattle offered a high-concentrate diet, demonstrating the potential of this technology to be used as a feed additive for beef cattle.
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Alimentación Animal , Probióticos , Bovinos , Animales , Masculino , Alimentación Animal/análisis , Amoníaco/metabolismo , Saccharomyces cerevisiae/metabolismo , Propionatos/farmacología , Rumen/metabolismo , Dieta/veterinaria , Fermentación , Probióticos/farmacologíaRESUMEN
Plant diseases caused by phytopathogens result in huge economic losses in agriculture. In addition, the use of chemical products to control such diseases causes many problems to the environment and to human health. However, some bacteria and fungi have a mutualistic relationship with plants in nature, mainly exchanging nutrients and protection. Thus, exploring those beneficial microorganisms has been an interesting and promising alternative for mitigating the use of agrochemicals and, consequently, achieving a more sustainable agriculture. Microorganisms are able to produce and excrete several metabolites, but volatile organic compounds (VOCs) have huge biotechnology potential. Microbial VOCs are small molecules from different chemical classes, such as alkenes, alcohols, ketones, organic acids, terpenes, benzenoids and pyrazines. Interestingly, volatilomes are species-specific and also change according to microbial growth conditions. The interaction of VOCs with other organisms, such as plants, insects, and other bacteria and fungi, can cause a wide range of effects. In this review, we show that a large variety of plant pathogens are inhibited by microbial VOCs with a focus on the in vitro and in vivo inhibition of phytopathogens of greater scientific and economic importance in agriculture, such as Ralstonia solanacearum, Botrytis cinerea, Xanthomonas and Fusarium species. In this scenario, some genera of VOC-producing microorganisms stand out as antagonists, including Bacillus, Pseudomonas, Serratia and Streptomyces. We also highlight the known molecular and physiological mechanisms by which VOCs inhibit the growth of phytopathogens. Microbial VOCs can provoke many changes in these microorganisms, such as vacuolization, fungal hyphal rupture, loss of intracellular components, regulation of metabolism and pathogenicity genes, plus the expression of proteins important in the host response. Furthermore, we demonstrate that there are aspects to investigate by discussing questions that are still not very clear in this research area, especially those that are essential for the future use of such beneficial microorganisms as biocontrol products in field crops. Therefore, we bring to light the great biotechnological potential of VOCs to help make agriculture more sustainable.
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ABSTRACT Introduction: Research in Orthodontics and Oral Surgery has been relying on three-dimensional (3D) models to evaluate treatment results with displacement color map techniques, even though it has important limitations. Objectives: This study proposed a method of tracking translational movements of 3D objects to evaluate displacements in surfaces with no shape modification. Methods: Cone Beam Computed Tomography (CBCT) data of ten patients were imported to the Dolphin software. A hypothetical virtual surgical plan (randomly defined) was developed in the software and afterwards verified using the proposed method. All the procedures were carried out by two evaluators, in two different time-points, with a 15-day interval. ITK-Snap software was used to generate high quality STL models. Centroid points were automatically generated and their coordinates were compared to confirm if they represented the known displacements simulated. The paired t-test and the Bland-Altman plots were used, as well as the intraclass correlation coefficient. Results: Interexaminers and intra-examiner tests showed excellent reliability of the method, with mean displacement measurement error values under 0.1mm. The paired t-test did not show any statistically significant differences. Conclusion: The method showed excellent reliability to track the simulated translational displacements of bone segments.
RESUMO Introdução: Grande parte das pesquisas em Ortodontia e Cirurgia Oral tem utilizado modelos tridimensionais e realizado avaliações por meio de mapa de cores de deslocamento, apesar das limitações existentes. Objetivo: O presente estudo teve como objetivo propor um método de rastreamento de movimentos translacionais de objetos 3D, para avaliar deslocamentos em superfícies sem modificação de forma. Métodos: Dez adultos que seriam submetidos à cirurgia ortognática tiveram suas tomografias computadorizadas de feixe cônico pré-cirúrgicas importadas para o software Dolphin. Um plano cirúrgico virtual hipotético com deslocamentos conhecidos foi desenvolvido e posteriormente verificado pelo método proposto. Todos os procedimentos foram realizados por dois avaliadores, em dois momentos diferentes, com intervalo de 15 dias. O software ITK-Snap foi usado para gerar modelos STL de alta qualidade dos ossos do paciente. Os pontos do centroide foram gerados automaticamente, e suas coordenadas foram comparadas, para confirmar se representavam os deslocamentos conhecidos simulados. Para análise estatística, foram usados teste t pareado, coeficiente de correlação intraclasse e os gráficos de Bland-Altman. Resultados: O teste inter e intraexaminadores mostrou boa confiabilidade do método, com valores médios abaixo de 0,1mm para os erros de medida de deslocamento. Conclusão: O método mostrou boa confiabilidade para avaliar o deslocamento de segmentos ósseos após cirurgia ortognática, devendo ser aplicado como uma ferramenta completa de avaliação verdadeiramente tridimensional.
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Plant growth-promoting rhizobacteria (PGPR) associated with plant roots can trigger plant growth promotion and induced systemic resistance. Several bacterial determinants including cell-wall components and secreted compounds have been identified to date. Here, we review a group of low-molecular-weight volatile compounds released by PGPR, which improve plant health, mostly by protecting plants against pathogen attack under greenhouse and field conditions. We particularly focus on C4 bacterial volatile compounds (BVCs), such as 2,3-butanediol and acetoin, which have been shown to activate the plant immune response and to promote plant growth at the molecular level as well as in large-scale field applications. We also disc/ uss the potential applications, metabolic engineering, and large-scale fermentation of C4 BVCs. The C4 bacterial volatiles act as airborne signals and therefore represent a new type of biocontrol agent. Further advances in the encapsulation procedure, together with the development of standards and guidelines, will promote the application of C4 volatiles in the field.
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The characterization of pulmonary arterial hypertension (PAH) relies mainly on right heart catheterization (RHC). Electrical impedance tomography (EIT) provides a non-invasive estimation of lung perfusion that could complement the hemodynamic information from RHC. To assess the association between impedance variation of lung perfusion (ΔZQ) and hemodynamic profile, severity, and prognosis, suspected of PAH or worsening PAH patients were submitted simultaneously to RHC and EIT. Measurements of ΔZQ were obtained. Based on the results of the RHC, 35 patients composed the PAH group, and eight patients, the normopressoric (NP) group. PAH patients showed a significantly reduced ΔZQ compared to the NP group. There was a significant correlation between ΔZQ and hemodynamic parameters, particularly with stroke volume (SV) (r = 0.76; P < 0.001). At 60 months, 15 patients died (43%) and 1 received lung transplantation; at baseline they had worse hemodynamics, and reduced ΔZQ when compared to survivors. Patients with low ΔZQ (≤154.6%.Kg) presented significantly worse survival (P = 0.033). ΔZQ is associated with hemodynamic status of PAH patients, with disease severity and survival, demonstrating EIT as a promising tool for monitoring patients with pulmonary vascular disease.
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Presión Sanguínea/fisiología , Composición Corporal/fisiología , Hemodinámica/fisiología , Hipertensión Arterial Pulmonar/fisiopatología , Adulto , Impedancia Eléctrica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía , Adulto JovenRESUMEN
Objective: To report the outcomes of a systematic literature review of guidelines and consensus on the management of paroxysmal nocturnal hemoglobinuria (PNH) and describe the main therapeutic options available worldwide. Methods: A systematic literature review was conducted in April 2018 with no time limit and reported in line with the PRISMA statement. The AGREE II instrument was used to determine the quality of each guideline included in the systematic review. Results: Eight guidelines/consensus were eligible, one developed by an international group, two in Spain, and one each in Turkey, Germany, Argentina, Australia and the United Kingdom. Supportive treatment with erythrocyte transfusion, anticoagulants and steroids is indicated by all guidelines and consensus. The use of erythropoietin is suggested by three of them. Recommendations for the prescription of eculizumab were consistent in all but one guideline, published in 2005. Allogeneic hematopoietic stem cell transplantation is reported as the only potentially curative treatment for PNH, although its association with high mortality and morbidity rates is emphasized, being indicated for a selected group of patients. The AGREE II scores applied for each domain showed in general a low and heterogeneous methodological quality among guidelines. Conclusion: Despite the low and heterogeneous methodological quality, in general the comparison of guidelines and consensus for PNH management showed consistent recommendations regarding supportive care, eculizumab and hematopoietic stem cell transplantation.
Objetivo: Relatar os desfechos de uma revisão sistemática da literatura de diretrizes e documentos de consenso sobre o manejo da hemoglobinúria paroxística noturna (HPN) e descrever as principais opções terapêuticas disponíveis mundialmente. Métodos: Uma revisão sistemática da literatura foi conduzida em abril de 2018 sem limite temporal e realizada de acordo com a recomendação PRISMA. O instrumento AGREE II foi utilizado para determinar a qualidade de cada diretriz incluída na revisão. Resultados: Foram elegíveis oito diretrizes/consensos, um desenvolvido por um grupo internacional, dois na Espanha e um em cada um dos países a seguir: Turquia, Alemanha, Argentina, Austrália e Reino Unido. O tratamento de suporte com transfusão de eritrócitos, anticoagulantes e esteroides é indicado por todos os documentos. A eritropoetina é indicada por três deles. A recomendação de prescrição do eculizumabe foi consistente em todos, exceto em um publicado em 2005. O transplante alogênico de células-tronco hematopoéticas é reportado como o único tratamento com potencial curativo para a HPN, apesar de uma enfática associação com maiores taxas de mortalidade e morbidade, sendo indicado para grupos selecionados de pacientes. Os escores AGREE II aplicados para cada domínio demonstraram, em geral, qualidade metodológica baixa e heterogênea entre as diretrizes. Conclusão: Apesar da qualidade metodológica baixa e heterogênea, em geral, a comparação de diretrizes e consensos para o manejo da HPN demonstrou recomendações consistentes quanto ao uso de tratamento de suporte, eculizumabe e transplante alogênico de células-tronco hematopoiéticas.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Revisión Sistemática , Hemoglobinuria ParoxísticaRESUMEN
BACKGROUND: Rives-Stoppa retromuscular technique: A) polypropylene mesh fixed on the posterior rectus sheath; B) rectus abdominal muscle; C) anterior rectus sheath being sutured. The best technique for incisional hernioplasty has not been established yet. One of the difficulties to compare these techniques is heterogeneity in the profile of the patients evaluated. AIM: To analyze the results of three techniques for incisional hernioplasty after open bariatric surgery. METHOD: Patients who underwent incisional hernioplasty were divided into three groups: onlay technique, simple suture and retromuscular technique. Results and quality of life after repair using Carolina's Comfort Scale were evaluated through analysis of medical records, telephone contact and elective appointments. RESULTS: 363 surgical reports were analyzed and 263 were included: onlay technique (n=89), simple suture (n=100), retromuscular technique (n=74). The epidemiological profile of patients was similar between groups. The onlay technique showed higher seroma rates (28.89%) and used a surgical drain more frequently (55.56%). The simple suture technique required longer hospital stay (2.86 days). The quality of life score was worse for the retromuscular technique (8.43) in relation to the onlay technique (4.7) and the simple suture (2.34), especially because of complaints of chronic pain. There was no difference in short-term recurrence. CONCLUSION: The retromuscular technique showed a worse quality of life than the other techniques in a homogeneous group of patients. The three groups showed no difference in terms of short-term hernia recurrence.
Asunto(s)
Cirugía Bariátrica , Hernia Ventral , Herniorrafia/métodos , Hernia Incisional , Adulto , Femenino , Hernia Ventral/cirugía , Humanos , Hernia Incisional/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Calidad de Vida , Recurrencia , Mallas Quirúrgicas , Técnicas de SuturaRESUMEN
ABSTRACT Background: The best technique for incisional hernioplasty has not been established yet. One of the difficulties to compare these techniques is heterogeneity in the profile of the patients evaluated. Aim: To analyze the results of three techniques for incisional hernioplasty after open bariatric surgery. Method: Patients who underwent incisional hernioplasty were divided into three groups: onlay technique, simple suture and retromuscular technique. Results and quality of life after repair using Carolina's Comfort Scale were evaluated through analysis of medical records, telephone contact and elective appointments. Results: 363 surgical reports were analyzed and 263 were included: onlay technique (n=89), simple suture (n=100), retromuscular technique (n=74). The epidemiological profile of patients was similar between groups. The onlay technique showed higher seroma rates (28.89%) and used a surgical drain more frequently (55.56%). The simple suture technique required longer hospital stay (2.86 days). The quality of life score was worse for the retromuscular technique (8.43) in relation to the onlay technique (4.7) and the simple suture (2.34), especially because of complaints of chronic pain. There was no difference in short-term recurrence. Conclusion: The retromuscular technique showed a worse quality of life than the other techniques in a homogeneous group of patients. The three groups showed no difference in terms of short-term hernia recurrence.
RESUMO Racional: A melhor técnica de hernioplastia incisional ainda não foi definida. Uma das dificuldades na comparação é a heterogenicidade no perfil dos pacientes avaliados. Objetivo: Analisar os resultados de três técnicas de hernioplastia incisional após cirurgia bariátrica aberta. Método: Os pacientes que realizaram hernioplastias incisionais foram estudados e divididos em três grupos: técnica onlay, sutura simples e técnica retromuscular. Resultados e qualidade de vida após o reparo utilizando o Carolina's Comfort Scale foram avaliados através de análise de prontuários, contato telefônico e consultas eletivas. Resultados: Foram analisados 363 relatos cirúrgicos e 263 foram incluídos: técnica onlay (n=89), sutura simples (n=100), técnica retromuscular (n=74). O perfil epidemiológico dos pacientes foi similar entre os grupos. A técnica onlay apresentou maiores taxas de seroma (28,89%) e usou dreno com maior frequência (55,56%). A sutura simples obteve maior tempo de internação (2,86 dias). O escore de qualidade de vida foi pior na técnica retromuscular (8,43) em relação à onlay (4,7) e à sutura simples (2,34), especialmente devido às queixas de dor crônica. Não houve diferença quanto a recidiva em curto prazo. Conclusão: A técnica retromuscular apresentou pior qualidade de vida do que as demais técnicas em um grupo homogêneo de pacientes. Os três grupos não mostraram diferenças em termos de recidiva de hérnia em curto prazo.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Cirugía Bariátrica , Herniorrafia/métodos , Hernia Incisional/cirugía , Hernia Ventral/cirugía , Complicaciones Posoperatorias/epidemiología , Calidad de Vida , Recurrencia , Mallas Quirúrgicas , Técnicas de SuturaRESUMEN
ABSTRACT Some species of Cyclocephala Dejean, 1821 (Coleoptera, Scarabaeidae, Dynastinae, Cyclocephalini) were reported as crop or pasture pests. Within this genus, Cyclocephla tucumana Bréthes, 1904 was noticed in cultivated areas in South Brazil, 2009 − 2010. Other study found larvae of the species associated with pastures in Aquidauana, Mato Grasso do Sul State (MS), 2009. In the present study, larvae of C. tucumana were collected in pasture areas from August 2015 to July 2016, in Cassilândia, MS. The material was reared in laboratory for the description of immatures, and the regional population was studied to clarify its dynamics. Immatures were abundant throughout the years and are described for the first time. Taxonomic discussion, updated key to larvae and pupae, and a teratological note are also added.