Giant primary paraganglioma of the left ventricle

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Apanhado sobre a Teoria dos Sistemas de Niklas Luhmann

O anseio deste artigo acadêmico é introduzir os conceitos gerais da teoria de sistemas de Niklas Luhmann. Para atingir seus objetivos, esta teoria é hermética e filosófica, com uma ampla gama de definições e busca apresentar um conjunto de conceitos que proporcionem um suporte adequado para a sociedade como um todo. Luhmann abordou a questão da complexidade em vários estudos e desenvolveu uma metodologia baseada em uma noção de sistemas autopoiéticos, funcionalmente fechados e distintos. A observação de segunda ordem é um dos conceitos centrais da teoria de sistemas de Luhmann, assim como a comunicação é elemento importante na formação dos sistemas sociais e na sua distinção de outros sistemas existentes. O método utilizado na presente pesquisa foi uma revisão qualitativa de literatura acadêmica sobre o assunto

Excretion of dietary cow’s milk derived peptides into breast milk

Nanoflow-HPLC-tandem mass spectrometry (MS/MS) was used to analyze the peptide fraction of breast milk samples collected from a single non-atopic donor on different days (ten samples) after receiving an oral load of cow’s milk (by drinking 200 mL of bovine milk). In addition, breast milk was sampled from the same lactating mother over a 6-h period at 5 time points after drinking cow’s milk. We aimed to trace the intra-individual variability and to define a time profile of the excretion of dietary peptides into breast milk. Overall, 21 peptides exclusively originating from both bovine caseins and whey proteins with no match within the human milk proteome were identified in the breast milk samples. These peptides were missing in the breast milk obtained from the mother after a prolonged milk- and dairy-free diet (three samples). The time course of cow’s milk-derived β-Lg f(125-135) and β-casein f(81-92) in breast milk

Similar long-term results of mitral valve repair for anterior compared with posterior leaflet prolapse

ObjectiveThe results of mitral valve repair for anterior leaflet prolapse have been less gratifying than those reported for posterior leaflet prolapse. We compared the long-term durability of 2 different surgical techniques: the edge-to-edge repair, which is used for the treatment of anterior leaflet prolapse, and quadrangular resection, which has been adopted for correction of posterior leaflet prolapse.MethodsFrom 1991 through April 2004, 133 patients with anterior leaflet prolapse and 605 with posterior leaflet prolapse caused by degenerative mitral disease underwent valve repair. The edge-to-edge repair was used for correction of anterior leaflet prolapse, and quadrangular resection of the posterior leaflet, with or without sliding plasty, was used for correction of posterior leaflet prolapse. All patients received a concomitant annuloplasty procedure.ResultsNo hospital deaths occurred in the anterior leaflet prolapse group, whereas 2 (0.3%) patients died in the posterior leaflet prolapse group (P = .7). Follow-up was 100% and 97.2% complete in the anterior and posterior leaflet prolapse groups, respectively. At 10 years, overall survival was 91% ± 4.06% for anterior leaflet prolapse and 93.5% ± 1.81% for posterior leaflet prolapse (P = .18), and freedom from cardiac death was 95.8% ± 2.83% for anterior leaflet prolapse and 97.4% ± 0.95% posterior leaflet prolapse (P = .27). Freedom from reoperation was 96% ± 2.3% in the anterior leaflet prolapse group and 96.5% ± 1.18% in the posterior leaflet prolapse group (P = .37). At follow-up (mean, 4.5 ± 3.12 years; range, 1 month-13.2 years), New York Heart Association functional class I or II was documented in 93.2% of patients in the anterior leaflet prolapse group and 92.8% in the posterior leaflet prolapse group (P = .98).ConclusionsThe long-term results of the edge-to-edge repair in the setting of anterior leaflet prolapse are similar to those obtained with quadrangular resection for the treatment of posterior leaflet prolapse

Infectious endocarditis during pregnancy, problems in the decision-making process: a case report

Infective endocarditis in pregnancy has a low incidence, often being associated with a previous history of rheumatic or congenital heart disease. In most reports the disease tends to run a subacute course and to appear more frequently in the third trimester of pregnancy. We present the case of a 36-year-old woman with large vegetations on the mitral valve due to infective endocarditis detected at the 32nd week of her first pregnancy. The difficulties in selecting the appropriate management strategy, particularly optimal time and mode of delivery, optimal time and type of valve surgery, are emphasized

Intravesical Instillations of Hyaluronic Acid as First-Line Treatment in Patients with Interstitial Cystitis/Bladder Pain Syndrome: Use, Efficacy and Effects on Quality of Life

: The efficacy of hyaluronic acid instillations as therapy for patients with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) has been demonstrated in some clinical studies, with response rates up to 70%. The aim of the study is to investigate the change in symptoms and quality of life in female patients with IC/BPS after intravesical instillations of hyaluronic acid used as first-line treatment. A retrospective single-center cohort study was conducted. Female patients, whose symptoms were compatible with the diagnosis of IC/BPS as defined by the International Continence Society, were treated with a variable number of intravesical instillations of a hyaluronic acid-based drug. Three validated questionnaires were administered by telephone to all patients, before the beginning of the treatment and 6 months after the last administration of the drug. A total of 50 patients with symptoms compatible with the diagnosis of IC/BPS were included in the study. The median number of instillations performed is 4. For all questionnaires, the median value was significantly reduced following treatment with intravesical instillations (p = 0.000). The present study has shown that intravesical hyaluronic acid treatment results in both statistically and clinically significant symptomatic improvement, thereby improving the quality of life of patients with IC/BPS

Estimation of Mycobacterium avium subsp. paratuberculosis load in raw bulk tank milk in Emilia-Romagna Region (Italy) by qPCR

Consumption of milk and dairy products is considered one of the main routes of human exposure to Mycobacterium avium subsp. paratuberculosis (MAP). Quantitative data on MAP load in raw cows’ milk are essential starting point for exposure assessment. Our study provides this information on a regional scale, estimating the load of MAP in bulk tank milk (BTM) produced in Emilia‐Romagna region (Italy). The survey was carried out on 2934 BTM samples (88.6% of the farms herein present) using two different target sequences for qPCR (f57 and IS900). Data about the performances of both qPCRs are also reported, highlighting the superior sensitivity of IS900‐qPCR. Seven hundred and eighty‐nine samples tested MAP‐positive (apparent prevalence 26.9%) by IS900 qPCR. However, only 90 of these samples were quantifiable by qPCR. The quantifiable samples contained a median load of 32.4 MAP cells mL (−1) (and maximum load of 1424 MAP cells mL (−1)). This study has shown that a small proportion (3.1%) of BTM samples from Emilia‐Romagna region contained MAP in excess of the limit of detection (1.5 × 10(1) MAP cells mL (−1)), indicating low potential exposure for consumers if the milk subsequently undergoes pasteurization or if it is destined to typical hard cheese production

Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis

<p>Abstract</p> <p>Background</p> <p>Primary orbital lymphoma is a rare disease that accounts for 10% of all orbital tumors. Radiotherapy on the orbital cavity is the treatment of choice for this unusual presentation of localized non-Hodgkin's lymphoma (NHL). The aim of this study is to retrospectively evaluate the effectiveness and the toxicity of radiation treatment in patients with primary orbital lymphoma.</p> <p>Methods</p> <p>Forty-seven consecutive patients having primary orbital lymphoma treated in our department between May 1983 and September 2006 were investigated in a retrospective study. Either ⁶⁰Co γ rays or 6 MV X rays were used to deliver daily fractions of 1.8 or 2.0 Gy, 5 times/week, with total doses ranging from 34.2 to 50 Gy. Forty-three patients had stage IE, three had stage II and one stage IV disease. Thirty-eight patients had marginal zone B-cell lymphoma, 5 diffuse large B cell lymphoma, 3 mantle cell lymphoma and 1 Burkitt lymphoma. Local control (LC), disease free survival (DFS), overall survival (OS) and late side effects were evaluated in all patients.</p> <p>Results</p> <p>With a median follow up of 45 months, LC was obtained in 100% of patients. The estimated 5- and 7-year DFS rates were 75.8% and 55.3%, and the 5- and 7-year OS rates were 88.7% and 79.9% respectively. Acute toxicity was minimal. Late toxicity such as cataract, keratitis, retinopathy and xerophthalmia occurred respectively in 12 (25.5%), 5 (10.6%), 1 (2.1%), and 9 (19.1%) patients.</p> <p>Conclusion</p> <p>Radiotherapy is an effective and at the same time well tolerated treatment for primary orbital lymphoma.</p

Excretion of Dietary Cow's Milk Derived Peptides Into Breast Milk

Nanoflow-HPLC-tandem mass spectrometry (MS/MS) was used to analyze the peptide fraction of breast milk samples collected from a single non-atopic donor on different days (10 samples) after receiving an oral load of cow's milk (by drinking 200 mL of bovine milk). In addition, breast milk was sampled from the same lactating mother over a 6-h period at five time points after drinking cow's milk. We aimed to trace the intra-individual variability and to define a time profile of the excretion of dietary peptides into breast milk. Overall, 21 peptides exclusively originating from both bovine caseins and whey proteins with no match within the human milk proteome were identified in the breast milk samples. These peptides were missing in the breast milk obtained from the mother after a prolonged milk- and dairy-free diet (three samples). The time course of cow's milk-derived β-Lg f(125–135) and β-casein f(81–92) in breast milk was determined from the MS ion intensity of the peptide signals. No intact cow's milk gene products were detected by HPLC-MS/MS analysis and Western blotting with anti-β-Lg antibody, but dot-blot analysis confirmed the occurrence of β-Lg fragments in the enriched peptide fraction of breast milk. These data suggest shifting the analytical perspective for the detection of dietary food allergens in breast milk from intact proteins to digested peptide fragments. The possible sensitization and elicitation potential or the tolerogenic properties of such low amounts of dietary peptides for the breastfed newborns remain to be explored

Rainfall interception through canopies of high montane mixed ombrophilous forest in Campos do Jordão State Park, SP, Brazil.

Diferentes fitofisionomias influenciam a partição das chuvas pela floresta. O objetivo deste estudo foi quantificar a precipitação interna e estimar a interceptação em Floresta Ombrófila MistaAlto-Montana no Parque Estadual de Campos do Jordão, SP. Para tanto, 30 pluviômetros foram instalados sob o dossel em uma parcela de 600 m2 e 3 pluviômetros foram alocados em área aberta adjacente. O escoamento pelo tronco não foi medido. As medições foram realizadas diariamente, entre 22 de dezembro de 2013 e 21 de dezembro de 2014. A precipitação no aberto no período somou 1.055 mm em 112 dias de coletas, a precipitação interna contabilizou 907,3 mm e a floresta interceptou 147,7 mm. Esses valores correspondem, em média, a 86% de precipitação interna e 14% de interceptação do total precipitado. A precipitação interna foi maior que a precipitação fora da floresta em 16 eventos, com 6,3% de interceptação negativa em agosto. A precipitação interna e a precipitação no aberto se relacionam por meio de uma regressão linear simples com coeficiente de determinação (R2) superior a 90%, tanto para o período chuvoso como para o período seco.Different vegetation types influence the partition of rainfall by forest. The objective of this study was to quantify the throughfall and estimate the interception in HighMontaneMixedOmbrophilousForestin Camposdo JordãoState Park, São Paulo, Brazil. To this purpose, 30 rain gauges were installed under the canopy on a plot of 600 m2, and 3 gauges were placed in open area next to it. The stemflow was not measured. Measurements were made every day between 22 December 2013 and 21 December 2014. The gross precipitation in the period amounted to 1,055 mm in 112 days of collection, the throughfall recorded 907.3 mm and 147.7 mm was intercepted by forest. These values correspond, on average, 86% of throughfall and 14% of rainfall interception of the precipitation. Throughfall was greater than the gross precipitation in 16 events, with 6.3% of negative interception in August. Throughfall and gross precipitation are related by a simple linear regression with coefficient of determination greater than 90% for both the rainy and dry seasons