RESUMO
PURPOSE: To investigate the accuracy of cutoff values of the morning serum cortisol (MSC) using the cortisol stimulus test (CST) insulin tolerance test (ITT) and 250 mcg short Synacthen test (SST) as the reference standard tests, to better define its clinical role as a tool in the diagnostic investigation of adrenal insufficiency (AI) AI. METHODS: An observational study was conducted with a retrospective analysis of MSC in adult patients who had been submitted to a CST to investigate AI between January 2014 and December 2020. The normal cortisol response (NR) to stimulation was defined based on the cortisol assay. RESULTS: 371 patients underwent CST for suspected AI, 121/371 patients (32.6%) were diagnosed with AI. ROC curve analysis showed an area under the curve (AUC) for MSC of 0.75 (95% CI 0.69 - 0.80). The best MSC cutoff values to confirm AI were < 3.65, < 2.35 and < 1.5 mcg/dL with specificity of 98%, 99%, and 100%, respectively. MSC > 12.35, > 14.2 and > 14.5 mcg/dL had sensitivity of 98%, 99%, and 100%, respectively, being the best cutoff values to exclude AI. Almost 25% of patients undergoing CST for possible AI had MSC values between < 3.65 mcg/dL (6.7% of patients) and > 12.35 mcg/dL (17.5% of patients), making the formal CST testing unnecessary if we consider these cutoff values. CONCLUSION: With the most modern cortisol assays, MSC could be used as a diagnostic tool, with high accuracy to confirm or exclude AI, avoiding unnecessary CST; thus, reducing expenses and safety risks during AI investigation.
Assuntos
Insuficiência Adrenal , Hidrocortisona , Adulto , Humanos , Estudos Retrospectivos , Insuficiência Adrenal/diagnóstico , Curva ROC , Fatores de TempoRESUMO
Prenatal hypoxic-ischemic insult (HI) may lead to a variety of neurological consequences that may persist throughout adulthood. In the most severe cases, HI is known to increase pain sensitivity which profoundly impacts quality of life. Periaqueductal gray matter (PAG) is a relevant region of the descending pain pathway and its function may be modulated by a complex network that includes nitrergic neurons and glial response, among other factors. Astrocytes, central players in pain modulation, are known to respond to HI by inducing hyperplasia, hypertrophy and increasing the number of their processes and the staining of glial fibrillary acidic protein (GFAP). In this work we investigated the effects of prenatal HI on touch and pain sensitivity, besides the distribution of the neuronal isoform of Nitric Oxide Synthase (nNOS) and GFAP in the PAG of young and adult male rats. At 18 days of gestation, rats had their uterine arteries clamped for 45 min (HI group). SHAM-operated animals were also generated (SHAM group). At post-natal day 30 (P30) or 90 (P90), the offspring was submitted to the behavioral tests of Von Frey and formalin or histological processing to perform immunohistochemistry for nNOS and GFAP. Although there was no significant difference between the groups concerning touch sensitivity, we observed an increase in pain sensitivity in HI P30 and HI P90. The number of nNOS + cells was reduced in HI adult animals in dlPAG and vlPAG. GFAP immunostaining was increased in HI P90 in dlPAG and dmPAG. Our results demonstrated for the first time an increase in pain sensitivity as a consequence of prenatal HI in an animal model. It reinforces the relevance of this model to mimic the effects of prenatal HI, as hyperalgesia.
Assuntos
Hiperalgesia , Hipóxia-Isquemia Encefálica , Feminino , Gravidez , Ratos , Animais , Masculino , Hiperalgesia/metabolismo , Substância Cinzenta Periaquedutal/metabolismo , Gliose/metabolismo , Qualidade de Vida , Isquemia/metabolismo , Hipóxia/metabolismo , Óxido Nítrico Sintase/metabolismo , Limiar da Dor , Hipóxia-Isquemia Encefálica/metabolismoRESUMO
The goal of the present study was to propose a set of preliminary regional diagnostic reference levels (DRLs) for pediatric interventional cardiology (IC) procedures in Latin America and the Caribbean countries, classified by age and weight groups. The study was conducted in the framework of the Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency. The first step of the program was focused on pediatric IC. Dose data from diagnostic and therapeutic procedures were collected between December 2020 and December 2021. Regional DRLs were set as the third quartile of patient dose data (kerma area product) collected in 18 hospitals from 10 countries in an initial sample of 968 procedures. DRLs were set for four age bands and five weight ranges. The values obtained for the four age bands (<1 yr, 1 to <5 yr, 5 to <10 yr and 10 to <16 yr) were 2.9, 6.1, 8.8 and 14.4 Gy cm2for diagnostic procedures, and 4.0, 5.0, 10.0 and 38.1 Gy cm2for therapeutic procedures, respectively. The values obtained for the five weight bands (<5 kg, 5 to <15 kg, 15 to <30 kg, 30 to <50 kg and 50 to <80 kg) were 3.0, 4.5, 8.1, 9.2 and 26.8 Gy cm2for diagnostic procedures and 3.7, 4,3, 7.3, 16.1 and 53.4 Gy cm2for therapeutic procedures, respectively. While initial data were collected manually as patient dose management systems (DMSs) were not available in most of the hospitals involved in the program, a centralized automatic DMS for the collection and management of patient dose indicators has now been introduced and is envisaged to increase the sample size. The possibility of alerting on high dose values and introducing corrective actions will help in optimization.
Assuntos
Cardiologia , Níveis de Referência de Diagnóstico , Cardiologia/métodos , Criança , Fluoroscopia , Humanos , América Latina , Doses de Radiação , Radiografia Intervencionista/métodos , Radiologia Intervencionista , Valores de ReferênciaAssuntos
Animais , Bufonidae/fisiologia , Anuros/fisiologia , Dieta/veterinária , Comportamento Alimentar , Zona Tropical , BrasilRESUMO
PURPOSE: In Ecuador, knowledge of the diversity and geographic distribution of ticks, as well as their importance as vectors, is scarce. Within the family Ixodidae, the genus Amblyomma is the most diverse and parasitizes wild and domestic animals. This genus is represented by 19 species in Ecuador, 12 of which occur in the continental territory and 7 in the Galapagos Islands. In this way, the objective of this work was to update the diversity of ticks reported for Ecuador on wild and domestic animals. METHODS: The specimens were collected manually on mammals and birds, in four localities belonging to the Sierra and Amazon of Ecuador and were kept in tubes with 96% ethyl alcohol. After that, all specimens were separated into immatures, males and females and were identified using their morphological characters. RESULTS: This study records Amblyomma coelebs Neumann, 1899, Amblyomma longirostre (Koch, 1844) Neumann, 1905 and Amblyomma varium Koch, 1844 for the first time in Ecuador. Thus, the genus Amblyomma is currently represented by 22 species. In addition, their hosts, distribution, and importance are also discussed. CONCLUSIONS: Knowing the diversity of ticks that wildlife possesses, its interrelation with the domestic fauna, and the possible pathogens that could be transmitting could significantly contribute to wildlife's conservation.
Assuntos
Amblyomma/classificação , Vetores Aracnídeos/classificação , Amblyomma/anatomia & histologia , Amblyomma/microbiologia , Animais , Animais Domésticos/parasitologia , Animais Selvagens/parasitologia , Vetores Aracnídeos/anatomia & histologia , Vetores Aracnídeos/microbiologia , Biodiversidade , Aves , Equador , Feminino , Humanos , Masculino , Mamíferos , Rickettsia/isolamento & purificaçãoRESUMO
The objective of the present study was to analyze the serum levels of the tumor marker Ca15.3 in healthy bitches and those with mammary neoplasms, correlating results with tumor type, clinical staging, time until presentation, and presence of ulceration and vascularization. For the study, 30 bitches with mammary tumors and 30 healthy bitches (control group) were selected. Histopathology was performed for identification of tumor type, and blood was collected for measurement of serum concentration of the marker via the chemiluminescence method using a commercial kit. A higher frequency of malignant neoplasms was observed (76.7%), with a higher quantity of carcinoma in mixed tumor (26.7%). Regarding serum concentration of the marker Ca15.3, there was no difference in serum values when comparing the means from bitches with neoplasia and healthy bitches, nor when comparing the other characteristics. The majority of results for serum concentration of Ca15.3, whether in bitches with neoplasia or in healthy bitches, was zero. It is concluded that the measurement of the marker Ca15.3 using the chemiluminescence method and commercial kits for humans did not offer significant results that would make this method or this marker a useful tool for patient monitoring and evaluation of the prognosis of bitches with mammary neoplasms.(AU)
Assuntos
Animais , Feminino , Cães , Biomarcadores Tumorais/sangue , Neoplasias Mamárias Animais , Mucina-1/administração & dosagem , Luminescência , Eletroquimioterapia/veterináriaRESUMO
The objective of the present study was to analyze the serum levels of the tumor marker Ca15.3 in healthy bitches and those with mammary neoplasms, correlating results with tumor type, clinical staging, time until presentation, and presence of ulceration and vascularization. For the study, 30 bitches with mammary tumors and 30 healthy bitches (control group) were selected. Histopathology was performed for identification of tumor type, and blood was collected for measurement of serum concentration of the marker via the chemiluminescence method using a commercial kit. A higher frequency of malignant neoplasms was observed (76.7%), with a higher quantity of carcinoma in mixed tumor (26.7%). Regarding serum concentration of the marker Ca15.3, there was no difference in serum values when comparing the means from bitches with neoplasia and healthy bitches, nor when comparing the other characteristics. The majority of results for serum concentration of Ca15.3, whether in bitches with neoplasia or in healthy bitches, was zero. It is concluded that the measurement of the marker Ca15.3 using the chemiluminescence method and commercial kits for humans did not offer significant results that would make this method or this marker a useful tool for patient monitoring and evaluation of the prognosis of bitches with mammary neoplasms.(AU)
Assuntos
Animais , Feminino , Cães , Biomarcadores Tumorais/sangue , Neoplasias Mamárias Animais , Mucina-1/administração & dosagem , Luminescência , Eletroquimioterapia/veterináriaRESUMO
Distal femur pseudoarthrosis also called «distal femur non-union¼ (DFNU) represents a rare complication associated with a fracture caused by high-energy trauma; its treatment is controversial, as there is a wide variety of surgical techniques that can be implemented, from open reduction plus internal fixation with plates, to the use of fixed angle plates combined with bone autograft. We expose the case of a 24-year-old man who shows up for consultation with the history of having presented a left femoral supracondylar fracture with a year of evolution, treated by osteosynthesis of the distal femur with dynamic condylar screws (DCS plate); developed a torpid evolution with severe pain in the distal third of the left thigh and functional limitation, developed a progressive varus deformity of the left thigh that caused a shortening of 3.8 cm of the limb. A focus of pseudoarthrosis was identified, which was surgically removed, the intramedullary canal was recanalized, and a lateral closed wedge osteotomy was performed to correct the angulation and allow reduction. 5.5 mm (three proximal and three distal) hydroxyapatite screws and an external fixator were placed. In addition, a review of the literature focused on the use of external fixation was carried out as a treatment for the pseudoarthrosis of the distal femur.
La seudoartrosis del fémur distal, también llamada «no unión del fémur distal¼ (NUFD), representa una complicación poco frecuente asociada a una fractura causada por un traumatismo de alta energía; su tratamiento es controversial, ya que existe una gran variedad técnicas quirúrgicas que pueden ser implementadas desde la reducción abierta más la fijación interna con placas hasta el uso de placas de ángulo fijo combinadas con autoinjerto óseo. Exponemos el caso de un hombre de 24 años de edad, el cual se presenta a la consulta con el antecedente de haber sufrido una fractura supracondílea femoral izquierda con un año de evolución, tratada mediante una osteosíntesis del fémur distal con tornillos condilares dinámicos (placa DCS); mostró una evolución tórpida con dolor severo en el tercio distal del muslo izquierdo y limitación funcional, desarrolló una deformidad en varo progresiva del muslo izquierdo que causó un acortamiento de 3.8 cm de la extremidad. Se identificó un foco de seudoartrosis, el cual se retiró quirúrgicamente, se recanalizó el canal intramedular y se realizó una osteotomía de cuña cerrada lateral para corregir la angulación y permitir la reducción. Se colocaron tornillos de hidroxiapatita de 5.5 mm (tres proximales y tres distales) y un fijador externo. Además se hizo una revisión de la literatura enfocada en el uso de la fijación externa como tratamiento de la seudoartrosis del fémur distal.
Assuntos
Fraturas do Fêmur , Pseudoartrose , Adulto , Placas Ósseas , Fixadores Externos , Fraturas do Fêmur/cirurgia , Fêmur/cirurgia , Fixação de Fratura , Fixação Interna de Fraturas , Humanos , Masculino , Pseudoartrose/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
The changing of the electronic and vibronic states due to the insertion of Zn(II), Cu(II), Ni(II) or Co(II) ions in the meso-tetrakis(4-pyridyl)porphyrin ring center is investigated. The combination of absorption, photoluminescence, Raman and infrared spectroscopies with second-derivative-based spectral deconvolution analysis reveals that the structuration of both B- and Q-bands is very sensitive to the decorating ion. Similar to free base porphyrins, metal(II) meso-tetra(4-pyridyl)porphyrins also present their Q-band constituted of multiple electronic transitions, where the central ion plays an important role in the selection of vibration modes that mediate the vibronic transitions. Our novel results will expand and reinterpret current assignments for metal(II) meso-tetra(4-pyridyl)porphyrins vibrational modes available in the literature.
RESUMO
The aim of this study was to compare the alterations in three regions of the airway-nasopharynx, oropharynx, and hypopharynx-in relation to the area of the midsagittal plane, volume, and minimal axial area after maxillomandibular advancement (MMA) surgery. Thirty patients who had undergone MMA surgery were evaluated at four time points: preoperative (T0), immediately postoperative (T1), 1year postoperative (T2), and ≥5 years postoperative (T3). All measurements were performed using computed tomography, analyzed in Dolphin Imaging 11.0 Premium 3D software. The area in the midsagittal plane presented a mean increase of 22.0% between T0 and T3 (P<0.001), with the highest increase in the oropharynx (24.1%, P<0.001). The total volumetric increase at T3 was 16.7% (P<0.001), with the highest increase in the nasopharynx (15.7%; P<0.001). The lowest minimal axial area was found for the oropharynx at all time points, and the highest increase in minimal axial area was found for the nasopharynx (114.9%; P<0.001). MMA surgery showed the highest increase in upper posterior airway between T0 and T1, and this was followed by a progressive reduction until T3, but with a statistically significant increase at T3 compared with T0 in all cases.
Assuntos
Avanço Mandibular , Maxila , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Seguimentos , Humanos , Imageamento Tridimensional , Mandíbula , Faringe , Estudos RetrospectivosRESUMO
The mineral exploration of rare earth elements (REEs) and their entry into the soil via fertilizers has generated concern about environmental impacts and human health risks. We evaluated 60 samples of limestone, gypsum and phosphate fertilizers marketed in Brazil in order to characterize their contents, signature and solubility of REEs. The fertilizers from igneous origin presented the largest accumulation of REEs. Accumulation of the light REEs Ce, La, Nd, Pr, Sm and Eu were larger than the heavy REEs (Y, Dy, Gd, Er, Yb, Ho, Tb and Lu). The solubility of fertilizers produced from sedimentary sources was greater than that of igneous sources. The mean annual REEs contribution of SSP and organo-mineral + phosphate rock (both of igneous origin) to soils was > 4000 t year-1, with highest additions for Ce, La, Nd and Y. Thus, phosphate fertilization and liming were considered to be significant sources of REEs and soils receiving continuously high doses of these inputs are likely to be enriched in REEs. Risk assessment studies are necessary to evaluate the impact of these REEs additions to soils on human health.
Assuntos
Metais Terras Raras , Solo , Agricultura , Brasil , Fertilizantes , HumanosRESUMO
AIMS: The AGT1 gene encodes for a general α-glucoside-H+ symporter required for efficient maltotriose fermentation by Saccharomyces cerevisiae. In the present study, we analysed the involvement of four charged amino acid residues present in this transporter that are required for maltotriose consumption and fermentation by yeast cells. METHODS AND RESULTS: By using a knowledge-driven approach based on charge, conservation, location, three-dimensional (3D) structural modelling and molecular docking analysis, we identified four amino acid residues (Glu-120, Asp-123, Glu-167 and Arg-504) in the AGT1 permease that could mediate substrate binding and translocation. Mutant permeases were generated by site-directed mutagenesis of these charged residues, and expressed in a yeast strain lacking this permease (agt1∆). While mutating the Arg-504 or Glu-120 residues into alanine totally abolished (R504A mutant) or greatly reduced (E120A mutant) maltotriose consumption by yeast cells, as well as impaired the active transport of several other α-glucosides, in the case of the Asp-123 and Glu-167 amino acids, it was necessary to mutate both residues (D123G/E167A mutant) in order to impair maltotriose consumption and fermentation. CONCLUSIONS: Based on the results obtained with mutant proteins, molecular docking and the localization of amino acid residues, we propose a transport mechanism for the AGT1 permease. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results present new insights into the structural basis for active α-glucoside-H+ symport activity by yeast transporters, providing the molecular bases for improving the catalytic properties of this type of sugar transporters.
Assuntos
Aminoácidos/química , Proteínas de Transporte de Monossacarídeos/química , Proteínas de Saccharomyces cerevisiae/química , Simportadores/química , Trissacarídeos/metabolismo , Transporte Biológico Ativo , Fermentação , Simulação de Acoplamento Molecular , Proteínas de Transporte de Monossacarídeos/genética , Proteínas de Transporte de Monossacarídeos/metabolismo , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo , Simportadores/genética , Simportadores/metabolismoRESUMO
We present the first report on Euphoria lurida (Fabricius) (Coleoptera: Scarabaeidae) infestation on safflower (Carthamus tinctorius L.), a crop of industrial and medicinal importance. Between September and October 2013-2015 in Paraná State, we observed E. lurida adults feeding on safflower plants from the inception of flower head formation onwards, over an area of approximately 400 m2. Losses in the productivity of infested plants were estimated between 15 and 50%. The damage was characterized by perforations in the upper portion and at the base of the developing flower heads or open flowers, resulting in withering and abortion of the reproductive structures.
Assuntos
Asteraceae , Carthamus tinctorius , Distribuição Animal , Animais , Brasil , Besouros , EuforiaRESUMO
BACKGROUND: This study aimed to evaluate patients undergoing placement of zygomatic implants by Stella and Warner's technique, considering the survival rate of conventional and zygomatic implants, and assess the health of the maxillary sinuses and the level of patient satisfaction. METHODS: In this retrospective cohort study, 28 patients had received a combination of conventional and zygomatic implants (group I) and 14 were rehabilitated with only conventional implants (group II). RESULTS: The results showed that Stella and Warner's technique, thought to minimize the presence of the implant into the maxillary sinus, improving the emergence of the implant, proved to be effective, allowing a high survival rate of conventional and zygomatic implants (100 %). The follow-up period ranged from a minimum of 15 months to a maximum of 53 months after prosthetic rehabilitation (average of 34 months). No pathological changes were found on the periimplant tissues. Radiographs showed satisfactory bone levels in conventional implants of oral rehabilitation with zygomatic implants and a good positioning of the apex of the zygomatic implants in relation to the zygomatic bone. The tomographic findings revealed no characteristics of sinus disease. There were no cases of obstruction of the maxillary sinus ostium. CONCLUSIONS: The placement of zygomatic implants by Stella and Warner's technique proved to be a predictable technique with high implant survival rate in patients with atrophic maxilla and was not associated with sinus disease in the sample analyzed. However, a long-term follow-up is necessary to confirm the initial findings of this study.
RESUMO
The objective of this study was to evaluate the process of L-methionine incorporation in the blood plasma, liver, breast muscle, and abdominal fat of 35- to 59-d-old broiler chickens using the carbon stable isotope (12C and 13C) technique for the estimation of methionine requirements. In this experiment, 51 male broiler chickens orally received a solution of L-[13C1] methionine (92 atm % 13C) at 29 µmol/kg live weight/h for 6 h. Three birds were sacrificed for tissue collection at times 0 h (control), 0.5, 1, 2, 3, 4, 5, 6, 12, 24, 48, 72, 96, 120, 144, 168, and 336 h after the administration of the first dose. Tissue L-[13C1] methionine incorporation mass and percentage results were analyzed using Minitab 16 statistical software. Except for abdominal fat, tissue methionine levels gradually increased after the administration of the methionine solution. The calculated half-lives of methionine in the blood plasma, liver, and breast muscle were 2.52, 1.36, and 3.57 h, respectively, suggesting a greater rate of methionine incorporation in the liver, followed by blood plasma and breast muscle. The isotopic dilution showed that 2.81, 4.79, and 23.64% of the administered L-methionine were retained in the blood plasma, liver, and breast muscle, respectively. The methionine requirements of finisher broilers may be estimated using the carbon isotope technique, and approximately 3, 5, and 24% methionine is used for the synthesis of blood plasma, liver, and breast muscle, respectively, at the evaluated dose.(AU)