Intraoperative Transient Left Bundle Branch Block Under General Anesthesia

O aparecimento de bloqueio de ramo esquerdo transitório, durante a anestesia, é raro, podendo estar mais frequentemente relacionado com hipertensão ou taquicardia. Apesar de ser geralmente uma condição benigna, o seu aparecimento pode evidenciar uma fase precoce de Doença Isquémica Cardíaca ou ser indicativo de Síndrome Coronário Agudo. Apresentamos um caso clínico de bloqueio de ramo esquerdo transitório de aparecimento no intraoperatório, sem relação com hipertensão ou taquicardia, em mulher de 72 anos submetida a correção de fraturas múltiplas da face em contexto de urgência, sob anestesia geral balanceada. Salientamos a importância da deteção de provável doença aterosclerótica numa doente assintomática, que permitirá investigação complementar e intervenção atempadas.info:eu-repo/semantics/publishedVersio

Crazy? Not Really! A Brainstorming on Ideas to Change Anesthesia Practice on the Next Ten Years

info:eu-repo/semantics/publishedVersio

Gastric microbial community profiling reveals a dysbiotic cancer-associated microbiota

Objective Gastric carcinoma development is triggered by Helicobacter pylori. Chronic H. pylori infection leads to reduced acid secretion, which may allow the growth of a different gastric bacterial community. This change in the microbiome may increase aggression to the gastric mucosa and contribute to malignancy. Our aim was to evaluate the composition of the gastric microbiota in chronic gastritis and in gastric carcinoma. Design The gastric microbiota was retrospectively investigated in 54 patients with gastric carcinoma and 81 patients with chronic gastritis by 16S rRNA gene profiling, using next-generation sequencing. Differences in microbial composition of the two patient groups were assessed using linear discriminant analysis effect size. Associations between the most relevant taxa and clinical diagnosis were validated by real-time quantitative PCR. Predictive functional profiling of microbial communities was obtained with PICRUSt. Results The gastric carcinoma microbiota was characterised by reduced microbial diversity, by decreased abundance of Helicobacter and by the enrichment of other bacterial genera, mostly represented by intestinal commensals. The combination of these taxa into a microbial dysbiosis index revealed that dysbiosis has excellent capacity to discriminate between gastritis and gastric carcinoma. Analysis of the functional features of the microbiota was compatible with the presence of a nitrosating microbial community in carcinoma. The major observations were confirmed in validation cohorts from different geographic origins. Conclusions Detailed analysis of the gastric microbiota revealed for the first time that patients with gastric carcinoma exhibit a dysbiotic microbial community with genotoxic potential, which is distinct from that of patients with chronic gastritis.This research was supported by a Worldwide Cancer Research grant to CF and JCM (Reference 16-1352). RMF, JPM and IPR have fellowships from Fundacao para a Ciencia e a Tecnologia (FCT; SFRH/BPD/84084/2012, PD/BD/114014/2015 and SFRH/BD/110803/2015, respectively) through Programa Operacional Capital Humano (POCH) and the European Union. JPM's fellowship is in the framework of FCT's PhD Programme BiotechHealth (Ref PD/0016/2012). i3S-Instituto de Investigacao e Inovacao em Saude is funded by Fundo Europeu de Desenvolvimento Regional (FEDER) funds through the COMPETE 2020-Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through Fundacao para a Ciencia e a Tecnologia (FCT)/Ministerio da Ciencia, Tecnologia e Inovacao (POCI-01-0145-FEDER-007274)

Kerr-CFT From Black-Hole Thermodynamics

We analyze the near-horizon limit of a general black hole with two commuting killing vector fields in the limit of zero temperature. We use black hole thermodynamics methods to relate asymptotic charges of the complete spacetime to those obtained in the near-horizon limit. We then show that some diffeomorphisms do alter asymptotic charges of the full spacetime, even though they are defined in the near horizon limit and, therefore, count black hole states. We show that these conditions are essentially the same as considered in the Kerr/CFT corresponcence. From the algebra constructed from these diffeomorphisms, one can extract its central charge and then obtain the black hole entropy by use of Cardy's formula.Comment: 19 pages, JHEP3, no figures. V2: References added, small typos fixe

The adaptive immune landscape of the colorectal adenoma–carcinoma sequence

Background. The tumor immune microenvironment exerts a pivotal influence in tumor initiation and progression. The aim of this study was to analyze the immune context of sporadic and familial adenomatous polyposis (FAP) lesions along the colorectal adenoma–carcinoma sequence (ACS). Methods. We analyzed immune cell counts (CD3+, CD4+, CD8+, Foxp3+, and CD57+), tumor mutation burden (TMB), MHC-I expression and PD-L1 expression of 59 FAP and 74 sporadic colorectal lesions, encompassing adenomas with low-grade dysplasia (LGD) (30 FAP; 30 sporadic), adenomas with high-grade dysplasia (22 FAP; 30 sporadic), and invasive adenocarcinomas (7 FAP; 14 sporadic). Results. The sporadic colorectal ACS was characterized by (1) a stepwise decrease in immune cell counts, (2) an increase in TMB and MHC-I expression, and (3) a lower PD-L1 expression. In FAP lesions, we observed the same patterns, except for an increase in TMB along the ACS. FAP LGD lesions harbored lower Foxp3+ T cell counts than sporadic LGD lesions. A decrease in PD-L1 expression occurred earlier in FAP lesions compared to sporadic ones. Conclusions. The colorectal ACS is characterized by a progressive loss of adaptive immune infiltrate and by the establishment of a progressively immune cold microenvironment. These changes do not appear to be related with the loss of immunogenicity of tumor cells, or to the onset of an immunosuppressive tumor microenvironment.This research was funded by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020-Operational Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by FCT-Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Inovação in the framework of the projects “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274), and “O papel dos Tregs na resposta imune ao cancro” (PTDC/MED-PAT/32462/2017)

Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Despite the importance of collecting individual data of socioeconomic status (SES) in epidemiological oral health surveys with children, this procedure relies on the parents as respondents. Therefore, type of school (public or private schools) could be used as an alternative indicator of SES, instead of collecting data individually. The aim of this study was to evaluate the use of the variable type of school as an indicator of socioeconomic status as a substitute of individual data in an epidemiological survey about dental caries in Brazilian preschool children.</p> <p>Methods</p> <p>This study followed a cross-sectional design, with a random sample of 411 preschool children aged 1 to 5 years, representative of Catalão, Brazil. A calibrated examiner evaluated the prevalence of dental caries and parents or guardians provided information about several individual socioeconomic indicators by means of a semi-structured questionnaire. A multilevel approach was used to investigate the association among individual socioeconomic variables, as well as the type of school, and the outcome.</p> <p>Results</p> <p>When all significant variables in the univariate analysis were used in the multiple model, only mother's schooling and household income (individual socioeconomic variables) presented significant associations with presence of dental caries, and the type of school was not significantly associated. However, when the type of school was used alone, children of public school presented significantly higher prevalence of dental caries than those enrolled in private schools.</p> <p>Conclusions</p> <p>The type of school used as an alternative indicator for socioeconomic status is a feasible predictor for caries experience in epidemiological dental caries studies involving preschool children in Brazilian context.</p

Anesthesia of Epinephelus marginatus with essential oil of Aloysia polystachya: an approach on blood parameters

This study investigated the anesthetic potential of the essential oil (EO) of Aloysia polystachya in juveniles of dusky grouper (Epinephelus marginatus). Fish were exposed to different concentrations of EO of A. polystachya to evaluate time of induction and recovery from anesthesia. In the second experiment, fish were divided into four groups: control, ethanol and 50 or 300 mu L L-1 EO of A. polystachya, and each group was submitted to induction for 3.5 min and recovery for 5 or 10 min. The blood gases and glucose levels showed alterations as a function of the recovery times, but Na+ and K+ levels did not show any alteration. In conclusion, the EO from leaves of A. polystachya is an effective anesthetic for dusky grouper, because anesthesia was reached within the recommended time at EO concentrations of 300 and 400 mu L L-1. However, most evaluated blood parameters showed compensatory responses due to EO exposure.Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul/Programa de Apoio a Nucleos de Excelencia (FAPERGS/PRONEX) [10/0016-8]; Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [470964/2009-0]; Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Brazil (CAPES)info:eu-repo/semantics/publishedVersio

Cd44v6 high membranous expression is a predictive marker of therapy response in gastric cancer patients

In gastric cancer (GC), biomarkers that define prognosis and predict treatment response remain scarce. We hypothesized that the extent of CD44v6 membranous tumor expression could predict prognosis and therapy response in GC patients. Two GC surgical cohorts, from Portugal and South Korea (n = 964), were characterized for the extension of CD44v6 membranous immuno-expression, clinicopathological features, patient survival, and therapy response. The value of CD44v6 expression in predicting response to treatment and its impact on prognosis was determined. High CD44v6 expression was associated with invasive features (perineural invasion and depth of invasion) in both cohorts and with worse survival in the Portuguese GC cohort (HR 1.461; 95% confidence interval 1.002–2.131). Patients with high CD44v6 tumor expression benefited from conventional chemotherapy in addition to surgery (p < 0.05), particularly those with heterogeneous CD44v6-positive and-negative populations (CD44v6_3+) (p < 0.007 and p < 0.009). Our study is the first to identify CD44v6 high membranous expression as a potential predictive marker of response to conventional treatment, but it does not clarify CD44v6 prognostic value in GC. Importantly, our data support selection of GC patients with high CD44v6-expressing tumors for conventional chemotherapy in addition to surgery. These findings will allow better stratification of GC patients for treatment, potentially improving their overall survival.This work was funded by FEDER-Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020–Operacional Programme for Competitiveness and Internationalization (POCI), Portugal 2020, and by Portuguese funds through FCT–Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Inovação in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274). This work was also financed by the projects NORTE-01-0145-FEDER-000003 and NORTE-01-0145-FEDER-000029, supported by the Norte Portugal Regional Programme (NORTE 2020) under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF); project POCI-01-0145-FEDER-016390 and SAICTPAC/0022/2015, funded by ERDF, POCI, and FCT; project PTDC/CTM-NAN/120958/2010, from FCT; and by project PTDC/BTM-TEC/30164/2017 funded by ERDF funds through the COMPETE 2020–POCI, Portugal 2020, and by FCT. Salary support to G.M.A. by PTDC/BTM-TEC/30164/2017 project; C.P. was supported by the grant SFRH/BD/113031/2015 from FCT

Determination of diquat by flow injection-chemiluminescence

A simple, economic, sensitive and rapid method for the determination of the pesticide diquat was described. This new method was based on the coupling of flow injection analysis methodology and direct chemiluminescent detection; to the authors' knowledge, this approach had not been used up to now with this pesticide. It was based on its oxidation with ferricyanide in alkaline medium; significant improvements in the analytical signal were achieved by using high temperatures and quinine as sensitiser. Its high throughput (144 h(-1)), together with its low limit of detection (2 ng mL(-1)), achieved without need of preconcentration steps, permitted the reliable quantification of diquat over the linear range of (0.01-0.6) mu g mL(-1) in samples from different origins (river, tap, mineral and ground waters), even in the presence of a 40-fold concentration of paraquat, a pesticide commonly present in the commercial formulations of diquat.López-Paz, JL.; Catalá-Icardo, M.; Antón Garrido, B. (2009). Determination of diquat by flow injection-chemiluminescence. Analytical and Bioanalytical Chemistry. 394(4):1073-1079. doi:10.1007/s00216-009-2609-zS107310793944Hayes WJ Jr, Laws ER Jr (1991) Handbook of pesticide toxicology, Academic Press, San DiegoUS Environmental Protection Agency. http://www.epa.gov/06WDW/contaminants/dw_contamfs/diquat.html (accessed in August 2008)Horwitz W (2000) Official methods of analysis of AOAC International 17th edition. AOAC International, Gaithersburg, MD, USAHara S, Sasaki N, Takase D, Shiotsuka S, Ogata K, Futagami K, Tamura K (2007) Anal Sci 23(5):523–531Rial Otero R, Cancho Grande B, Pérez Lamela C, Simal Gandara J, Aria Estevez M (2006) J Chromatogr Sci 44(9):539–542Aramendia MA, Borau V, Lafont F, Marinas JM, Moreno JM, Porras JM, Urbano FJ (2006) Food Chem 97(1):181–188Nuñez O, Moyano E, Galceran MT (2004) Anal Chim Acta 525(2):183–190Martinez Vidal JL, Belmonte Vega A, Sanchez Lopez FJ, Garrido Frenich AJ (2004) Chromatogr A 1050(2):179–184Lee XP, Kumazawa T, Fujishiro M, Hasegawa C, Arinobu T, Seno H, Sato K (2004) J Mass Spectrom 39(10):1147–1152De Almeida RM, Yonamine M (2007) J Chromatogr B 853(1–2):260–264De Souza D, Machado SAS (2006) Electroanalysis 18(9):862–872De Souza D, Da Silva MRC, Machado SAS (2006) Electroanalysis 18(23):2305–2313Picó Y, Rodriguez R, Manes J (2003) Trends Anal Chem 22(3):133–151Ishiwata T (2004) Bunseki Kagaku 53(8):863–864Carneiro MC, Puignou L, Galcerán MT (2000) Anal Chim Acta 408:263Luque M, Rios A, Valcarcel M (1998) Analyst 123(11):2383–2387Perez Ruiz T, Martínez Lozano C, Tomas V (1991) Int J Environ Anal Chem 44(4):243–252Perez Ruiz T, Martínez Lozano C, Tomas V (1991) Anal Chim Acta 244(1):99–104Townshend A (1990) Analyst 115:495–500López Paz JL, Catalá Icardo M (2008) Anal Chim Acta 625:173–179Pawlicová Z, Sahuquillo I, Catalá Icardo M, García Mateo JV, Martínez Calatayud J (2006) Anal Sci 22:29–34Albert García JR, Catalá Icardo M, Martínez Calatayud J (2006) Talanta 69:608–614Tomlin CDS (1997) The pesticide manual, 11th edn.The British Crop Protection CouncilUKCatalá-Icardo M, Martínez-Calatayud J (2008) Crit Rev Anal Chem 38:118–130Ministerio de Medio Ambiente y Medio Rural y Marino. http://www.marm.es/ (accessed in September 2008)US Environmental Protection Agency. http://www.epa.gov/OGWWDW/contaminants (accessed in October 2008

Family coordination in families who have a child with autism spectrum disorder

Little is known about the interactions of families where there is a child with autism spectrum disorder (ASD). The present study applies the Lausanne Trilogue Play (LTP) to explore both its applicability to this population as well as to assess resources and areas of deficit in these families. The sample consisted of 68 families with a child with ASD, and 43 families with a typically developing (TD) child. With respect to the global score for family coordination there were several negative correlations: the more severe the symptoms (based on the child’s ADOS score), the more family coordination was dysfunctional. This correlation was particularly high when parents had to play together with the child. In the parts in which only one of the parents played actively with the child, while the other was simply present, some families did achieve scores in the functional range, despite the child’s symptom severity. The outcomes are discussed in terms of their clinical implications both for assessment and for interventio