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PURPOSE: To evaluate feasibility of accelerated partial breast irradiation (APBI) using stereotactic radiotherapy (SBRT) Thirty Gy delivered in 5 fractions for patients with early breast cancer. METHODS: Between January 1st, 2018, and December 31s, 2022, we conducted 117 treatments for patients with early-stage breast cancer. All patients underwent conservative surgery followed by APBI using stereotactic external beam radiotherapy. We analyzed local, regional, distant control, overall survival, toxicity, and cosmetic outcomes. RESULTS: The average age was 62 years. 21.3% ductal and 78.7% invasive carcinomas. Regarding the PTV volume, the median was 198.8 cc (38-794 cc). Treatments were completed in all cases. The median follow-up period was of 21 months (1-62 months). Regarding acute toxicity, no Grade 3-4 toxicities were recorded. One patient experienced Grade 2 neuropathic pain. One patient developed subacute fibrosis and two patients developed telangiectasia as subacute and chronic toxicity. Cosmetic results were "good" or "very good" in 96.3% of cases. None of the patients relapsed at any level (local, regional, or distant) and overall survival during follow.up was 100%. CONCLUSION: APBI with SBRT 30 Gy in 5 fractions in early-stage breast cancer is a feasible technique, very-well tolerated and has excellent oncologic and cosmetic outcome during our follow-up period.
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Neoplasias da Mama , Fracionamento da Dose de Radiação , Estudos de Viabilidade , Radiocirurgia , Humanos , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Neoplasias da Mama/mortalidade , Pessoa de Meia-Idade , Radiocirurgia/métodos , Radiocirurgia/efeitos adversos , Idoso , Adulto , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Ductal de Mama/mortalidade , Idoso de 80 Anos ou mais , Seguimentos , Estudos Retrospectivos , Mastectomia SegmentarRESUMO
The European Commission requested the EFSA Panel on Plant Health to prepare and deliver risk assessments for commodities listed in Commission Implementing Regulation (EU) 2018/2019 as 'High risk plants, plant products and other objects. This Scientific Opinion covers plant health risks posed by tubers of Ullucus tuberosus imported from Peru, taking into account the available scientific information, including the technical information provided by Peru. The relevance of an EU quarantine pest for this opinion was based on evidence that: (i) the pest is present in Peru, (ii) U. tuberosus is a host of the pest and (iii) the pest can be associated with the commodity. The relevance of any other pest, not regulated in the EU, was based on evidence that: (i) the pest is present in Peru (ii) the pest is absent in the EU; (iii) U. tuberosus is a host of the pest; (iv) the pest can be associated with the commodity and (v) the pest may have an impact and can pose a potential risk for the EU territory. There are five pests i.e. one insect (Amathynetoides nitidiventris), two nematodes (Atalodera andina and Nacobbus aberrans) and two viruses (the Andean potato latent virus (APLV) and the potato virus T (PVT)) that fulfilled all relevant criteria were selected for further evaluation. For the five pests, the risk mitigation measures proposed in the technical dossier from Peru were evaluated taking into account the possible limiting factors. For each of the five pests, an expert judgement is given on the likelihood of pest freedom taking into consideration the risk mitigation measures acting on the pest, including uncertainties associated with the assessment. The degree of pest freedom varies among the pests evaluated, with PVT being the pest most frequently expected on the imported commodities. The Expert Knowledge Elicitation indicated, with 95% certainty, that between 9,157 and 10,000 tubers out of 10,000 would be free of PVT.
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Hospitais Especializados , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Distúrbios Distônicos/diagnóstico , Distúrbios Distônicos/epidemiologia , Distúrbios Distônicos/terapia , Feminino , Honduras/epidemiologia , Hospitais Especializados/organização & administração , Hospitais Especializados/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/epidemiologia , Doença de Parkinson/diagnóstico , Doença de Parkinson/epidemiologia , Doença de Parkinson/terapiaRESUMO
Introduction: Tertiary care hospitals' physicians require high emotional competence, since they are faced with the demands of terminally ill patients and their families. Objective: to assess the attitude of physicians of a pediatrics department towards patient death. Method: Pediatrics staff and resident physicians anonymously answered the Attitudes Towards Death (ATD) questionnaire. Absolute frequencies, percentages, means, standard deviations, Student's t-test and the chi-square test were used. Statistical significance was considered with p < 0.05. Results: The questionnaire was answered by 38 physicians, 26 (68.4%) were residents and 12 (37.6%) staff physicians; 15 (39.4%) were males and 23 (60.6%) females. Four residents (15.4%) had a positive attitude versus 2 staff physicians (16.7%) (p = 0.920). Statistical significance was found in items 1 (69.2% of residents versus 100% of staff physicians, p = 0.03), 16 (23% of residents versus 100% of staff physicians, p = 0.001) and 19 (92.3% of residents versus 58.3% of staff physicians, p = 0.01), corresponding to the avoidance, acceptance and professional perspective dimensions. Conclusion: Less than 20% of pediatric physicians have a positive attitude towards death. Most didn't value death as a passage or transition to a better life, or as a solution to life's problems.
Introducción: Los médicos de hospitales de tercer nivel requie-ren alta competencia emocional, ya que enfrentan las de-mandas de enfermos terminales y sus fami-liares. Objetivo: Evaluar la actitud de médicos de un servicio de pediatría ante la muerte de los pacientes. Método: Médicos adscritos y residentes de pediatría contestaron anónimamente el Cuestionario de Actitudes ante la Muerte (CAM). Se utilizaron frecuencias absolutas, porcentajes, medias, desviaciones estándar, t de Student y chi cuadrado. Se consideró significación estadística con p < 0.05. Resultados: Contestaron el cuestionario 38 médicos, 26 (68.4 %) residentes y 12 (37.6 %) adscritos; 15 (39.4 %) hombres y 23 (60.6 %) mujeres. Cuatro residentes (15.4 %) tuvieron actitud positiva versus dos médicos adscritos (16.7 %) (p = 0.920). Se encontró significación estadística en los ítems 1 (69.2 % de residentes versus 100 % de adscritos, p = 0.03), 16 (23 % de residentes versus 100 % de adscritos, p = 0.001) y 19 (92.3 % de residentes versus 58.3 % de adscritos, p = 0.01), correspondientes a las dimensiones evitación, aceptación y perspectiva profesional. Conclusión: Menos de 20 % de los médicos de pediatría tiene una actitud positiva ante la muerte. La mayoría no valoró la muerte como un pasaje o tránsito hacia una vida mejor, ni como una salida a los problemas de la vida.
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Atitude do Pessoal de Saúde , Atitude Frente a Morte , Corpo Clínico Hospitalar , Pediatria , Autorrelato , Adulto , Feminino , Humanos , MasculinoRESUMO
Marker-assisted selection (MAS) in stone fruit (Prunus species) breeding is currently difficult to achieve due to the polygenic nature of the most relevant agronomic traits linked to fruit quality. Genotyping by sequencing (GBS), however, provides a large quantity of useful data suitable for fine mapping using Single Nucleotide Polymorphisms (SNPs) from a reference genome. In this study, GBS was used to genotype 272 seedlings of three F1 Japanese plum (Prunus salicina Lindl) progenies derived from crossing "98-99" (as a common female parent) with "Angeleno," "September King," and "September Queen" as male parents. Raw sequences were aligned to the Peach genome v1, and 42,909 filtered SNPs were obtained after sequence alignment. In addition, 153 seedlings from the "98-99" × "Angeleno" cross were used to develop a genetic map for each parent. A total of 981 SNPs were mapped (479 for "98-99" and 502 for "Angeleno"), covering a genetic distance of 688.8 and 647.03 cM, respectively. Fifty five seedlings from this progeny were phenotyped for different fruit quality traits including ripening time, fruit weight, fruit shape, chlorophyll index, skin color, flesh color, over color, firmness, and soluble solids content in the years 2015 and 2016. Linkage-based QTL analysis allowed the identification of genomic regions significantly associated with ripening time (LG4 of both parents and both phenotyping years), fruit skin color (LG3 and LG4 of both parents and both years), chlorophyll degradation index (LG3 of both parents in 2015) and fruit weight (LG7 of both parents in 2016). These results represent a promising situation for GBS in the identification of SNP variants associated to fruit quality traits, potentially applicable in breeding programs through MAS, in a highly heterozygous crop species such as Japanese plum.
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La noción de "imaginarios sociales" ha sido utilizada con frecuencia en la investigación sociológica en general y los estudios de la comunicación mediática en particular, sin alcanzar un estatuto conceptual claro y preciso que permita su utilización como una categoría de análisis cuyo significado cuente con un acuerdo generalizado en la comunidad de investigadores. Para una Semiótica del discurso en cuanto proceso social, hace falta un abordaje que sistematice el concepto de imaginarios sociales, en relación con los procesos de producción de sentido y construcción social de la realidad a través de las prácticas comunicativas, con particular referencia a la comunicación mediática. En este marco, la semiosis es descripta en tres niveles de investidura de sentido: (i) bases de la representación (nivel de los imaginarios), (ii) representaciones (nivel de los textos) y (iii) sistemas de representaciones (discursos y regímenes de significación). Especial atención se presta a las funciones de la narratividad en cuanto esquema cognitivo básico de percepción e interpretación del mundo, en relación con los relatos audiovisuales mediáticos y la legitimación del poder simbólico
The notion of "Social Imaginaries" has frequently been utilized in the sociological research in general, and in the studies of media communication, in particular, without obtaining a conceptual statute clear and precise that may allow its utilization as a category of analysis whose meaning could count with a generalized agreement in the community of researches. For a discourse Semiotics in a social process, it needs an approach that systematizes the concept of social imaginaries, in relation to processes of production of a sense and social construction of reality through communicative practices, with special reference to the media reference. In this frame, semiosis is descriptive at three levels of sense investiture (I) bases of the representation (level of the imaginaries) (II) representation (text level) and (III) representation systems (discourses and regimen of signification). Special attention is paid to the functions of narration in all basic, cognitive outline of perception and interpretation of the world, in relation to audiovisual media stories and the legitimation of the symbolic power
A noção de "Imaginários sociais" tem sido utilizada frequentemente na pesquisa sociológica, em geral, e nos estudos da comunicação mediática, em particular, sem atingir um estatuto conceitual claro e preciso que a coloque como uma categoria de análise com significação reconhecida pela comunidade de pesquisadores em geral. Para uma semiótica do discurso entendido como processo social, é necessária uma abordagem que sistematize o conceito de imaginarios sociais ligado aos processos de produção de sentido e de construção social do real mediante as práticas comunicativas, especialmente no que diz respeito à comunicação mediática. Neste quadro, descreve-se a semiose em três níveis de captação de significado: (i) bases da representação (níveis dos imaginários), (ii) representações (nível dos textos) e (iii) sistema de representações (discurso e regimes de significado). Presta-se especial atenção às funções narrativas como esquema cognitivo básico para a percepção e interpretação do mundo, no que dis respeito aos relatos audiovisuais mediáticos e à legitimação do poder simbólico
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Humanos , Sociologia , Pesquisa ComportamentalRESUMO
Introducción: El dolor perineal posparto es un problema clínico frecuente, no abordado en profundidad en Colombia. Objetivo: Determinar la prevalencia, severidad y posibles factores asociados con el dolor perineal postparto en una muestra de mujeres en el Hospital La Victoria-Instituto Materno Infantil de Bogotá. Materiales y métodos: Estudio observacional prospectivo. Se evaluó el grado de dolor perineal percibido en 133 pacientes en posparto, mediante la escala análoga numérica de dolor, estando acostada, sentada, caminando y yendo al baño (micción y/o defecación), a las 12 y 48 horas postparto. Datos demográficos, del parto y recién nacido fueron tomados directamente de las historias clínicas. Resultados: Prevalencia global del dolor perineal moderado a severo 36-39,5% dependiendo de la actividad a las 12 horas del parto y entre 28-31,6% a las 48 horas. El dolor perineal se encontró asociado, en cualquiera de las actividades valoradas, con el uso de analgesia epidural durante el trabajo de parto, desgarro grado II o mayor, peso y perímetro cefálico del recién nacido. Se registra mejor efecto analgésico con dosis de acetaminofén de 3 g diarios o más. Conclusiones: El dolor perineal moderado a severo afecta a menos del 50% de las mujeres postparto vaginal; se asocia con la frecuencia y magnitud del trauma perineal. Los resultados sugieren la necesidad de profundizar en el estudio del manejo analgésico más adecuado para estas pacientes.
Introduction: Postpartum perineum pain is a common clinical problem, which is not addressed in detail in Colombia. Objective: To assess prevalence, magnitude and possible factors associated with postpartum perineum pain in a sample of women in the Hospital "La Victoria-Instituto Materno Infantil", in Bogotá. Materials and methods: A prospective observational study was performed where the degree of perineum pain perceived by 133 postpartum patients was evaluated by using numerical analog scale of pain when they were sitting down, lying, walking and going to the bathroom (urination and/or defecation), at 12 and 48 hours of postpartum . Demographic, birth and newborn data were taken directly from the medical records. Results: Overall prevalence of moderate to severe perineum pain 36 to 39.5% depending on the activity at 12 hours of delivery, and since 28 to 31.6% at 48 hours after it. Perineum pain was associated, during any of the activities assessed, with the use of epidural analgesia during labor, laceration of degree II or greater, birth weight and head circumference of the newborn. Better analgesic effect of acetaminophen doses as 3 g per day or more was registered. Conclusions: Moderate to severe perineum pain affects less than 50 % of women with vaginal postpartum. It is associated with the frequency and degree of perineum trauma. The results suggest the need for further study of the most appropriate analgesic doses for these patients.
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Período Pós-Parto , Dor , Analgesia ObstétricaRESUMO
Resumen: La nutrición adecuada durante los primeros dos años de vida es fundamental para el desarrollo pleno del potencial de cada ser humano; actualmente se reconoce que este periodo es una ventana crítica para la promoción de un crecimiento y desarrollo óptimos y un buen estado de salud. Por tanto, cumplir con una alimentación adecuada en esta etapa de la vida tiene impacto sobre la salud, estado de nutrición, crecimiento y desarrollo de los niños; no sólo en el corto plazo, sino en el mediano y largo plazo. El presente trabajo ofrece recomendaciones de alimentación complementaria (AC) que se presentan en forma de preguntas o enunciados que consideran temas importantes para quienes atienden niños durante esta etapa de la vida; por ejemplo: inicio de la alimentación complementaria a los 4 o 6 meses de edad; exposición a alimentos potencialmente alergénicos; introducción de bebidas azucaradas; uso de edulcorantes artificiales y productos light; secuencia de introducción de alimentos; modificaciones de consistencia de alimentos de acuerdo a la maduración neurológica; número de días para probar aceptación y tolerancia a los alimentos nuevos; cantidades por cada tiempo de comida; prácticas inadecuadas de alimentación complementaria; mitos y realidades de la alimentación complementaria; hitos del desarrollo; práctica del "Baby Led Weaning" y práctica de vegetarianismo.
Abstract: A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism.
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The incidence of Multilocular cystic renal cell carcinoma (MCRCC) in literature is very low and confounding MCRCC with cystic nephroma (CN) is even more unusual. The aim of this report is to present a case of MCRCC and emphasize the importance of the preoperative radiologic evaluation and immunohistochemical staining confirmation to obtain an accurate diagnosis. A 73-year-old woman presented with a history of 4-month right flank pain. CT showed a Bosniak type III renal mass. After laparoscopic partial nephrectomy the initial report was cystic nephroma. Immunohistochemical staining was performed being positive for Epithelial Membrane Antigen thus changing the diagnosis to MCRCC. Multilocular cystic renal cell carcinoma cannot reliably be distinguished from cystic nephroma neither by physical examination nor by radiologic evaluation; immunohistochemical staining assay is useful to differentiate between these conditions allowing an accurate diagnosis and proper follow-up.
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A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism.
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Many plant processes depend on differential gene expression, which is generally controlled by complex proteins called transcription factors (TFs). In peach, 1533 TFs have been identified, accounting for about 5.5% of the 27,852 protein-coding genes. These TFs are the reference for the rest of the Prunus species. TF studies in Prunus have been performed on the gene expression analysis of different agronomic traits, including control of the flowering process, fruit quality, and biotic and abiotic stress resistance. These studies, using quantitative RT-PCR, have mainly been performed in peach, and to a lesser extent in other species, including almond, apricot, black cherry, Fuji cherry, Japanese apricot, plum, and sour and sweet cherry. Other tools have also been used in TF studies, including cDNA-AFLP, LC-ESI-MS, RNA, and DNA blotting or mapping. More recently, new tools assayed include microarray and high-throughput DNA sequencing (DNA-Seq) and RNA sequencing (RNA-Seq). New functional genomics opportunities include genome resequencing and the well-known synteny among Prunus genomes and transcriptomes. These new functional studies should be applied in breeding programs in the development of molecular markers. With the genome sequences available, some strategies that have been used in model systems (such as SNP genotyping assays and genotyping-by-sequencing) may be applicable in the functional analysis of Prunus TFs as well. In addition, the knowledge of the gene functions and position in the peach reference genome of the TFs represents an additional advantage. These facts could greatly facilitate the isolation of genes via QTL (quantitative trait loci) map-based cloning in the different Prunus species, following the association of these TFs with the identified QTLs using the peach reference genome.
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The addition of opioids to bupivacaine for spinal anesthesia has been shown to improve quality of anesthesia by the action of fentanyl, and extend postoperative analgesia by the effect of morphine. Side effects, particularly respiratory depression, have prevented their widespread use. Studies are not consistent regarding the incidence of respiratory depression due to the variety of definitions of this complication and the doses of opioids used. Low dose regimens currently used do not produce further respiratory depression than parenteral opioids. The high levels of progesterone, a potent respiratory stimulant, makes safe the use of neuroaxial opioids in scenarios such as obstetrical anesthesia or analgesia, hence their use should not be overlooked.
La adición de opioides a la bupivacaína para la anestesia raquídea ha demostrado mejorar la calidad de ésta por la acción del fentanilo y prolongar la analgesia postoperatoria por el efecto de la morfina. Los efectos secundarios, en particular la depresión respiratoria, han impedido la generalización de su uso. Los estudios no son consistentes en cuanto a la incidencia de depresión respiratoria por la variedad de definiciones sobre esta complicación y las dosis de opiáceos empleadas. Las bajas dosis utilizadas actualmente no producen mayor depresión respiratoria que los opiáceos parenterales. Los altos niveles de progesterona, un potente estimulante respiratorio, hacen seguro el empleo de opiáceos neuroaxiales en escenarios como la anestesia o la analgesia obstétricas, por lo que no deberían omitirse.
Assuntos
HumanosRESUMO
Desde los años ochenta del siglo XX se observa en todo el mundo, un aumento tanto en la demanda de atención terapéutica bajo el método homeopático, como en el número de profesionales médicos que ejercen la homeopatía. Actualmente en Colombia no existen publicaciones sobre el conocimiento que de la homeopatía tiene la población que acude a las farmacias homeopáticas y a los consultorios de médicos homeópatas unicistas de Bogotá. Como médico homeópata unicista, considero que es importante evaluar qué conocimiento tienen de la homeopatía las personas que buscan atención médica homeopática unicista y las que acuden a las farmacias homeopáticas en la ciudad de Bogotá, para contribuir a su divulgación. Para llevar a cabo el estudio, se diseñó un estudio cualitativo de tipo descriptivo en donde se realizó una encuesta de respuesta múltiple. Se incluyeron a todos los usuarios mayores de edad que acudieron a cuatro farmacias homeopáticas (n= 226) y seis consultorios de médicos homeópatas (n=96) en la ciudad de Bogotá, durante el todo el mes de Abril del 2015. Para el análisis de los resultados se compararon las dos poblaciones. En el estudio se encontró que las personas que acuden frecuentemente a la consulta homeopática y que utilizan la homeopatía como método terapéutico en la ciudad de Bogotá, son principalmente mujeres (73%) con educación universitaria (36%). Con relación al conocimiento de la homeopatía se observó que existe una buena percepción en cuanto a la seguridad, eficacia y prevención de la homeopatía en ambas poblaciones, a pesar de que se encontró un mayor entendimiento sobre el método terapéutico en los pacientes que acuden a consulta con médico especialista con respecto a los usuarios de las farmacias. Sin embargo, de los pacientes que acuden al médico se observa que menos de la mitad (47%) reconoce que la homeopatía clásica utiliza un único remedio, sólo la mitad conoce de donde provienen los remedios homeopáticos y el 14% de la población no comprende el método terapéutico. En cuanto al grupo de usuarios que acuden a las farmacias homeopáticas, se observó que el 32% no comprende el método terapéutico, sólo el 19% reconoce que la homeopatía clásica utiliza un único remedio y sólo el 44% de los entrevistados conoce de donde provienen los remedios homeopáticos. Para ambos grupos la principal motivación para iniciar tratamiento con homeopatía es para tratar una enfermedad o molestia, la forma más común de conocer la homeopatía es a través de un conocido, familiar o amigo y la gran mayoría recomendaría el tratamiento homeopático dado que se encuentran satisfechos o muy satisfechos con la terapia. En conclusión, ambos grupos evidencian altos niveles de conocimiento con respecto a la homeopatía, no obstante, existe mayor conocimiento de la homeopatía en los pacientes que asisten a una consulta médica en comparación con los usuarios de farmacias homeopáticas
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Humanos , Masculino , Feminino , Clínica Homeopática , Farmácias Homeopáticas , Homeopatia , Conhecimento do Paciente sobre a Medicação , ColômbiaRESUMO
A pesar de las múltiples declaraciones de los organismos internacionales, el manejo del dolor en el trabajo de parto y el parto es insuficiente debido a las barreras que impone el sistema de salud, pero también por las concepciones equivocadas sobre la analgesia epidural de las pacientes y, peor aún, también de enfermeras, obstetras y anestesiólogos. El presente artículo menciona el punto de vista de reconocidas instituciones internacionales sobre el tema, los problemas atribuibles al sistema de salud y discute las limitaciones que imponen los especialistas médicos, enfatizando, de manera particular, en las prevalecientes concepciones de obstetras y anestesiólogos, por las cuales una gran proporción de las maternas sufren, innecesariamente, de dolor durante el trabajo de parto y el parto.
Despite countless statements from international agencies, pain management during labor and delivery is insufficient due to the hurdles imposed by the health system, and also to the misconceptions regarding epidural analgesia among patients, but worse still, among nurses, obstetricians and anesthesiologists. This article mentions the point of view of outstanding international institutions on the subject, the problems that may be attributed to the health system, and the limitations imposed by specialists, emphasizing in particular the views prevailing among obstetricians and gynecologists that explain why a large proportion of women in child birth experience pain unnecessarily.
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HumanosRESUMO
La gravedad fue establecida como el factor determinante de las diferencias en la distribución de la ventilación y la perfusión pulmonares por John West, concepto que continúa exponiéndose hoy en día como principio básico de la fisiología pulmonar. Las imágenes diagnósticas modernas permiten demostrar que la gravedad no es el factor determinante de estas diferencias, hecho que genera grandes interrogantes sobre los conceptos que, entre muchos otros, sustentan la ventilación mecánica, los modos ventilatorios y la ventilación unipulmonar en decúbito lateral durante la cirugía de tórax. El presente artículo reflexiona sobre los recientes hallazgos de los estudios sobre perfusión y ventilación que cuestionan el paradigma de la gravedad como su determinante fundamental, y sobre sus implicaciones clínicas.
Gravity was established as the determinant factor regarding differences in the distribution of ventilation and perfusion in the lung by John West, concept that continue to be exposed, up to day, as a basic principle of the lung physiology. The modern diagnostic images permit to demonstrate that gravity is not the determinant factor of these differences, a fact that generate big questions about concepts, among many others, support mechanical ventila-tions, ventilatory modes and one lung ventilation in lateral position during thoracic surgery. This article reflects on the recent findings of perfusion and ventilation studies that question the paradigm of gravity as its main determinant, and their clinical implications.
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HumanosRESUMO
BACKGROUND: The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. METHODOLOGY/PRINCIPAL FINDINGS: This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge) that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients' depression levels were negatively correlated with performance on empathy tasks. CONCLUSIONS/SIGNIFICANCE: Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.
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Transtorno Bipolar , Transtornos Cognitivos , Empatia , Esquizofrenia/fisiopatologia , Transtornos do Comportamento Social , Adulto , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/psicologia , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Feminino , Humanos , Masculino , Transtornos do Comportamento Social/fisiopatologia , Transtornos do Comportamento Social/psicologia , Análise e Desempenho de TarefasRESUMO
DNA-based molecular markers have been extensively utilized for a variety of studies in both plant and animal systems. One of the major uses of these markers is the construction of genome-wide molecular maps and the genetic analysis of simple and complex traits. However, these studies are generally based on linkage analysis in mapping populations, thus placing serious limitations in using molecular markers for genetic analysis in a variety of plant populations. Therefore, alternative approach has been suggested, linkage disequilibrium-based association analysis which detects and locates quantitative trait loci (QTL) by the strength of the correlation between a trait and a marker. Although association analysis has already been used for studies on genetics of complex traits in humans, its use in plants has newly started. In the present review, we describe what is known about variation in linkage disequilibrium (LD) and summarize published results on association studies in crop plant species. We give a list of different factors affecting LD, and discuss the current issues of LD research in plants. Later, we also describe the various uses of LD in crop plants research and summarize the present status of LD researches in different plant genomes. Finally, future key issues about the application of these studies on the localization of genes in these crop plants have been also discussed.
Assuntos
Mapeamento Cromossômico , Genoma de Planta , Desequilíbrio de Ligação , Locos de Características Quantitativas , Marcadores Genéticos , Genética Populacional , Produtos AgrícolasRESUMO
Even though trifluralin (alpha,alpha,alpha-2,6-dinitro-N-N-dipropyl-p-toluidine) is effective for the treatment of experimental Chagas disease, more preclinical toxicity studies need to be performed. Cell toxicity of trifluralin was studied in Hep-G2 and Vero C76 cells treated with 50 and 150 microM trifluralin. The results show that duplication time, amount of cellular protein and cell protein/DNA values were normal. Histological, haematological and chemical parameters were measured in CF1 mice after oral trifluralin administration. Acute toxic effects were assayed by administration of 50 or 200 mg/kg body weight daily for 30 days, and chronic effects by administration of 200 mg/kg body weight once a week for 90 days (n = 20). In the acute scheme treatment, hepatic (glutamic-pyruvic, glutamic-oxalacetic and alkaline phosphatase activities; proteins and albumin plasma concentrations) and pancreatic (amylase, glycaemia) functions were normal. Mean corpuscular volume, haemoglobin and haematocrit decreased. Creatine phosphokinase, lactate dehydrogenase and glutamic-oxalacetic activity increased, suggesting lesion in myocardial tissue. Histology was normal, excepting for the heart (mild myocarditis). Similar results were observed in acutely treated animals. There were no differences in body weight gain for treated mice compared to controls. In view of the published therapeutic effects of trifluralin on CF1 Chagas disease model and considering the present results, trifluralin seems to be a moderately toxic drug with a potential selective effect on the myocardium.