Assessing recovery after cold challenge and thumb involvement can help to rule out systemic sclerosis in patients presenting with Raynaud?s phenomenon

Objective: Our aim was to study whether recovery from a Raynaud?s attack and involvement of the thumb are differentiators for systemic sclerosis (SSc) in patients with Raynaud?s phenomenon (RP). Method: A stepwise cooling and recovery procedure was performed, provoking an RP attack, in patients with primary Raynaud?s phenomenon (PRP, n =?68) and SSc (n?=?18). During the procedure, the perfusion of all five fingers during cooling and recovery was assessed by photoelectric plethysmography. Results: In SSc patients, perfusion after 10?min in one or more fingers was more frequently not restored than in PRP patients (p?=?0.001), with a negative predictive value of 98%. The thumb was more frequently involved in SSc patients (p?=?0.036), with a negative predictive value of 95%. Positive predictive values were low. Conclusions: In patients with RP, when there is restoration of perfusion in all fingers after 10?min or when the thumb is spared, the presence of an underlying SSc is very unlikely. Although these results need to be validated in a clinical setting in a larger prospective study, these signs can help physicians to select additional testing for SSc in RP patients

Low body weight and involuntary weight loss are associated with Raynaud's phenomenon in both men and women

Objectives: Low body weight is an easily assessable cause of Raynaud’s phenomenon (RP), and is frequently overlooked by clinicians. We aim to investigate the association of low body weight (body mass index < 18.5 kg/m2), involuntary weight loss, and nutritional restrictions with the presence of RP. Method: Participants from the Lifelines Cohort completed a validated self-administered connective tissue disease questionnaire. Subjects who reported cold-sensitive fingers and biphasic or triphasic colour changes were considered to suffer from RP. Patient characteristics, anthropometric measurements, and nutritional habits were collected. Statistical analyses was stratified for gender. Results: Altogether, 93 935 participants completed the questionnaire. The prevalence of RP was 4.2% [95% confidence interval (CI) 4.1–4.4%], and was three-fold higher in women than in men (5.7% vs 2.1%, p < 0.001). Subjects with RP had a significantly lower daily caloric intake than those without RP. Multivariate analysis, correcting for creatinine level, daily caloric intake, and other known aetiological factors associated with RP, revealed that low body weight [men: odds ratio (OR) 5.55 (95% CI 2.82–10.93); women: 3.14 (2.40–4.10)] and involuntary weight loss [men: OR 1.32 (1.17–1.48); women: 1.31 (1.20–1.44)] were significantly associated with the presence of RP. Low-fat diet was also associated with RP in women [OR 1.27 (1.15–1.44)]. Conclusion: Low body weight and prior involuntary weight loss are associated with an increased risk of RP in both men and women. This study emphasizes that low body weight and weight loss are easily overlooked risk factors for RP, and should be assessed and monitored in subjects with RP

Eye–hand coordination during manual object transport with the affected and less affected hand in adolescents with hemiparetic cerebral palsy

In the present study we investigated eye–hand coordination in adolescents with hemiparetic cerebral palsy (CP) and neurologically healthy controls. Using an object prehension and transport task, we addressed two hypotheses, motivated by the question whether early brain damage and the ensuing limitations of motor activity lead to general and/or effector-specific effects in visuomotor control of manual actions. We hypothesized that individuals with hemiparetic CP would more closely visually monitor actions with their affected hand, compared to both their less affected hand and to control participants without a sensorimotor impairment. A second, more speculative hypothesis was that, in relation to previously established deficits in prospective action control in individuals with hemiparetic CP, gaze patterns might be less anticipatory in general, also during actions performed with the less affected hand. Analysis of the gaze and hand movement data revealed the increased visual monitoring of participants with CP when using their affected hand at the beginning as well as during object transport. In contrast, no general deficit in anticipatory gaze control in the participants with hemiparetic CP could be observed. Collectively, these findings are the first to directly show that individuals with hemiparetic CP adapt eye–hand coordination to the specific constraints of the moving limb, presumably to compensate for sensorimotor deficits

Otimização da produção de lacase pelo fungo Trametes sp. para a biorremediação de bisfenol A em meio aquoso

Orientadora : Prof. Dr. Jörg Wolfgang MetzgerCoorientadores: Profª. Drª. Arislete Dantas de Aquino e Prof. Dr. José Domingos FontanaDissertação (mestrado) - Universidade Federal do Paraná, Setor de Tecnologia, Programa de Mestrado Profissional em Meio Ambiente Urbano e Industrial, em parceria com o Serviço Nacional de Aprendizagem Industrial e a Universität Stuttgart. Defesa: Curitiba, 28/08/2017Inclui referências : f. 114-134Resumo: O bisfenol A (BFA) é um monômero empregado na fabricação de resinas epóxi e plásticos policarbonatados, e também como insumo para outros fins industriais. Este composto é classificado como um interferente endócrino capaz de causar perturbações no sistema endócrino, imunológico e nervoso dos seres vivos, além de causar sérios distúrbios ambientais. Os tratamentos físico-químicos para remoção deste tipo de poluente são dispendiosos. Assim, tratamentos com o emprego de enzimas fúngicas como as lacases podem ser uma alternativa promissora para este fim. Este trabalho teve como objetivo otimizar a produção da enzima lacase por meio do cultivo do fungo Trametes sp. com a adição de extratos de lignina bruta e indutores químicos, e sua aplicação na biorremediação de BFA em meio aquoso. O estudo da produção da lacase teve início com a aplicação de seis extratos de lignina bruta de bracatinga, peroba, pinus, bagaço de cana-de-açúcar, casca de soja e casca de trigo, em concentração de 1 g L-1 nos experimentos. Os extratos de peroba e bagaço de cana-de-açúcar apresentaram maior potencial indutor frente aos demais, de modo que foram empregados na otimização da produção de lacase por meio de um delineamento de experimentos fatorial fracionáro5-2, juntamente com os potenciais indutores químicos: dioxano, siringol e sulfato de cobre, estes na concentração de 1 mmol L-1. A biorremediação do BFA foi realizada pela aplicação de 500 U L-1 de lacase bruta em meio tamponado em pH 5 contendo 100 mg L-1 do contaminante que foi quantificado por cromatografia líquida (HPLC-DAD). A técnica analítica de espectrofotometria UV-Vis derivativa foi avaliada para a determinação do BFA em solução multicomponente. A faixa de pH ótimo para a lacase foi observada entre os valores de 4 a 6, na qual a atividade enzimática se manteve estável por um período de 72h. O melhor efeito indutor obtido na otimização da produção de lacase ocorreu pela interação dos cinco indutores atingindo uma atividade de 45.185 + 321 U L-1 em 24 dias de cultivo. Também ocorreu um forte efeito indutor com os extratos de bagaço de cana-de-açúcar e de peroba juntamente com o CuSO4, e com o extrato de peroba, dioxano e CuSO4 que obtiveram resultados de 35.926 + 642 U L-1 e 35.556 + 1.111 U L-1, respectivamente. A biorremediação do BFA pela lacase bruta se mostrou eficiente, sendo que na primeira hora de reação foi reduzida cerca de 50% da concentração inicial, e após 10 h de reação já não foi mais possível detectar a presença do contaminante em solução aquosa. A avaliação da técnica de espectrofotometria UV-Vis derivativa foi positiva para a análise do BFA em solução contendo lacase bruta de Trametes sp., quando comparada com a técnica de HPLC-DAD. Palavras-chave: Dioxano. Espectrofotometria UV Vis derivativa. Interferentes endócrinos. Lignina. Siringol.Abstract: The bisphenol A (BPA) is a monomer widely used in the manufacture of epoxy resins and polycarbonate plastics, and also as an input for other industrial purposes. This compound is classified as an endocrine interferent capable of causing disturbances in the endocrine, immune and nervous system of living beings, besides causing serious environmental disturbances. The physical-chemical treatments for this type of pollutant are quite expensive, so treatments using fungal enzymes, such as laccases, can be a very promising alternative. The objective of this study was to optimize the laccase enzyme production through the cultivation of Trametes sp. fungus, with the addition of crude lignin extracts and chemical inducers, and its application in bioremediation of BPA in water base. The laccase production study began by applying six gross lignin extracts of bracatinga wood, peroba wood, pinus wood, sugarcane bagasse, soybean hull and wheat husk, in a concentration of 1 g L-1 in the experiments. The extracts of peroba wood and sugarcane bagasse presented higher inductive potential compared to the others, so that they were used in the lacase optimization production through a fractional 5-2 factorial experimental design, along with the potential chemical inducers: dioxane, syringol and copper sulphate 1 mmol L-1 concentration. The BPA bioremediation was performed by applying 500 U L-1 crude laccase in buffered medium at pH 5 containing 100 mg L-1 of the contaminant which was quantified by liquid chromatography (HPLC-DAD). The analytical technique of derivative ultraviolet spectrophotometry was evaluated for BPA determination in multicomponent solution. The optimum pH range for the laccase was observed between the values of 4 to 6, in which the enzymatic activity remained stable for a period of 72h. The best inducing effect on laccase production occurred through the interaction of the five inducers reaching an activity of 45.185 + 321 U L-1 in 24 days of cultivation, also a strong inducing effect occurred between the extracts of sugarcane bagasse and peroba together with the CuSO4, and between the peroba extract, dioxane and CuSO4 that obtained results of 35.926 + 642 U L-1 and 35.556 + 1.111 U L-1, respectively. The BPA bioremediation by the crude laccase was efficient, and in the first hour of reaction, about 50% of the initial concentration was reduced, and after 10 hours of reaction it was no longer possible to detect the presence of the contaminant in the aqueous solution. The evaluation of the derivative ultraviolet spectrophotometry technique was satisfactory for the analysis of the BPA in solution containing Trametes sp. crude laccase, when compared with the HPLC-DAD technique. Key-words: Dioxane. Derivative ultraviolet spectrophotometry. Endocrine disruptors. Lignin. Syringol

Sympathicotomy in patients with drug resistant Raynaud's phenomenon

Raynaud's phenomenon (RP) is a disorder of the microvasculature which causes poor blood flow to the digits. This disorder is common in young females and may be associated with several underlying connective tissue diseases including systemic sclerosis. Although RP may have a tremendous impact on quality of life, treatment options are limited. Conventional medical treatment mainly consists of vasodilatory drugs, which are not effective in all patients and may induce undesired side effects. The current clinical lesson describes three patients with severe RP who all underwent a novel, minimally invasive, single-port thoracoscopic sympathicotomy (SPTS). Although this procedure seems promising in patients with treatment-resistant RP, as shown with patients A and B, future research has yet to show what the long-term effects are.</p