Self-reported variables as determinants of upper limb musculoskeletal symptoms in assembly line workers

Background: Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms—discomfort/pain–during a 6-month follow-up. Methods: This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. Results: Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, “having upper limb symptoms during the previous 6 months” and “education” were possible predictors. Conclusion: Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future.publishersversionpublishe

Altered plasma protein profiles in genetic FTD – a GENFI study

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: Plasma biomarkers reflecting the pathology of frontotemporal dementia would add significant value to clinical practice, to the design and implementation of treatment trials as well as our understanding of disease mechanisms. The aim of this study was to explore the levels of multiple plasma proteins in individuals from families with genetic frontotemporal dementia. Methods: Blood samples from 693 participants in the GENetic Frontotemporal Dementia Initiative study were analysed using a multiplexed antibody array targeting 158 proteins. Results: We found 13 elevated proteins in symptomatic mutation carriers, when comparing plasma levels from people diagnosed with genetic FTD to healthy non-mutation controls and 10 proteins that were elevated compared to presymptomatic mutation carriers. Conclusion: We identified plasma proteins with altered levels in symptomatic mutation carriers compared to non-carrier controls as well as to presymptomatic mutation carriers. Further investigations are needed to elucidate their potential as fluid biomarkers of the disease process.Open access funding provided by Karolinska Institute. C.G. received funding from EU Joint Programme—Neurodegenerative Disease Research -Prefrontals Vetenskapsrådet Dnr 529–2014-7504, Vetenskapsrådet 2015–02926, Vetenskapsrådet 2018–02754, the Swedish FTD Inititative-Schörling Foundation, Alzheimer Foundation, Brain Foundation, Dementia Foundation and Region Stockholm ALF-project. PN received funding from KTH Center for Applied Precision Medicine (KCAP) funded by the Erling-Persson Family Foundation, the Swedish FTD Inititative-Schörling Foundation and Åhlén foundation. D.G. received support from the EU Joint Programme—Neurodegenerative Disease Research and the Italian Ministry of Health (PreFrontALS) grant 733051042. E.F. has received funding from a Canadian Institute of Health Research grant #327387. F.M. received funding from the Tau Consortium and the Center for Networked Biomedical Research on Neurodegenerative Disease. J.B.R. has received funding from the Welcome Trust (103838) and is supported by the Cambridge University Centre for Frontotemporal Dementia, the Medical Research Council (SUAG/051 G101400) and the National Institute for Health Research Cambridge Biomedical Research Centre (BRC-1215–20014). J.C.V.S. was supported by the Dioraphte Foundation grant 09–02-03–00, Association for Frontotemporal Dementias Research Grant 2009, Netherlands Organization for Scientific Research grant HCMI 056–13-018, ZonMw Memorabel (Deltaplan Dementie, project number 733 051 042), Alzheimer Nederland and the Bluefield Project. J.D.R. is supported by the Bluefield Project and the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre, and has received funding from an MRC Clinician Scientist Fellowship (MR/M008525/1) and a Miriam Marks Brain Research UK Senior Fellowship. M.M. has received funding from a Canadian Institute of Health Research operating grant and the Weston Brain Institute and Ontario Brain Institute. M.O. has received funding from Germany’s Federal Ministry of Education and Research (BMBF). R.S-V. is supported by Alzheimer’s Research UK Clinical Research Training Fellowship (ARUK-CRF2017B-2) and has received funding from Fundació Marató de TV3, Spain (grant no. 20143810). R.V. has received funding from the Mady Browaeys Fund for Research into Frontotemporal Dementia. This work was also supported by the EU Joint Programme—Neurodegenerative Disease Research GENFI-PROX grant [2019–02248; to J.D.R., M.O., B.B., C.G., J.C.V.S. and M.S.info:eu-repo/semantics/publishedVersio

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Essential oils of Calamintha nepeta, Origanum vulgare and Thymus mastichina of Alentejo (Portugal): a pharmacological approach

Alentejo, in the south of Portugal, is rich in endemic aromatic plants, that are used as condiments and food additives by the local population. The aim of this study was to evaluate the antioxidant, antimicrobial and antiproliferative activities of EOs of autochthones Calamintha nepeta (L.) Savi (syn. Clinopodium nepeta (L.) Kuntze), Origanum vulgare L., and Thymus mastichina L. EOs were extracted from the aerial part of the plants by hydrodistillation and the chemical composition was analyzed by GC-FID and GC-MS. Antioxidant potential of the oils was evaluated by three different assays: DPPH radical, β-carotene/linoleic acid and reducing power methods. Antimicrobial activity of the oils was evaluated by a solid disk diffusion assay and minimal inhibitory concentrations (MIC) were determined by a microdilution broth method. Toxicity of the EOs was screened by the brine shrimp lethality test (LC50) and the oral lethal doses (DL50) were determined for mice. Cell viability was assessed by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay using MDAMB231 breast cancer cells

Toxicological and pharmacological properties of essential oils of Calamintha nepeta, Origanum virens and Thymus mastichina of Alentejo (Portugal)

Three autochthonous flavouring herbs from Alentejo (Portugal), Calamintha nepeta (syn. Clinopodium nepeta), Origanun virens and Thymus mastichina, were selected to evaluate toxicological, antioxidant, antiproliferative and antimicrobial potential of their essential oils (EOs). C. nepeta and T. mastichina EOs showed a high content of oxygenated monoterpenes (86–91%) while O. virens had similar content of oxygenated and hydrocarbon monoterpenes (45%). Toxicological assessment suggests high activity against A. salina (31.8 < CL50 < 128.4 mg/L) and very low toxicity in Swiss mice (DL50≥1500 mg/kg). EOs showed high antioxidant ability by DPPH radical scavenging assay (0.1–0.6 mg QE/mL EO), total reducing power method (0.2–1.7 mg QE/mL EO) and β-carotene/ linoleic acid system (11–501 mg QE/mL EO). An important antiproliferative effect against human breast tumour cell line was observed (88.9 < EC50 < 108.5 mg/L). Moreover, EOs presented a large antibacterial spectrum. Results point out the low toxicity and high antioxidant, antiproliferative and antimicrobial activities of EOs of these endemic aromatic plants, suggesting their potential use in biotechnological, food and/or pharmaceutical industries

Peak left atrial longitudinal strain is associated with all-cause mortality in patients with ventricular functional mitral regurgitation

Abstract Purpose Chronic mitral regurgitation promotes left atrial (LA) remodeling. However, the significance of LA dysfunction in the setting of ventricular functional mitral regurgitation (FMR) has not been fully investigated. Our aim was to assess the prognostic impact of peak atrial longitudinal strain (PALS), a surrogate of LA function, in patients with FMR and reduced left ventricular ejection fraction (LVEF). Methods Patients with at least mild ventricular FMR and LVEF < 50% under optimized medical therapy who underwent transthoracic echocardiography at a single center were retrospectively identified in the laboratory database. PALS was assessed by 2D speckle tracking in the apical 4-chamber view and the study population was divided in two groups according to the best cut-off value of PALS, using receiver operating characteristics (ROC) curve analysis. The primary endpoint-point was all-cause mortality. Results A total of 307 patients (median age 70 years, 77% male) were included. Median LVEF was 35% (IQR: 27 – 40%) and median effective regurgitant orifice area (EROA) was 15mm2 (IQR: 9 – 22mm2). According to current European guidelines, 32 patients had severe FMR (10%). During a median follow-up of 3.5 years (IQR 1.4 – 6.6), 148 patients died. The unadjusted mortality incidence per 100 persons-years increased with progressively lower values of PALS. On multivariable analysis, PALS remained independently associated with all-cause mortality (adjusted hazard ratio 1.052 per % decrease; 95% CI: 1.010 – 1.095; P = 0.016), even after adjustment for several (n = 14) clinical and echocardiographic confounders. Conclusion PALS is independently associated with all-cause mortality in patients with reduced LVEF and ventricular FMR. Graphical Abstrac

Sensibilidade e resistência de amostras de Salmonella Typhimurium isoladas de suínos abatidos no Rio Grande do Sul/Brasil frente aos desinfetantes químicos quaternário de amônio e iodofor Sensitivity and resistance of samples of Salmonella Typhimurium isolated in slaughter swines in the state Rio Grande do Sul/Brazil, front to disinfectants quaternary ammonium and iodophor

Na prevenção da ocorrência ou na interrupção da evolução de enfermidades infecto-transmissíveis comuns aos animais e aos seres humanos, como é o caso da salmonelose, o uso de um desinfetante capaz de agir sobre o agente causal quando em vida livre, no ambiente, exerce grande importância. No entanto, a resistência microbiana, intrínseca ou adquirida, pode apresentar-se como um limitante no uso deste instrumento sanitário. Objetivando monitorar a sensibilidade da Salmonella Typhimurium, 96 amostras isoladas de suínos abatidos no Estado do Rio Grande do Sul,Brasil, foram confrontadas com dois compostos químicos desinfetantes (origem comercial) de uso freqüente em ambientes de produção animal e de transformação de seus subprodutos: um quaternário de amônio e o iodofor. Foram usadas as concentrações indicadas pelo fabricante e uma menor para simular possível situação de sub-concentração. O método de verificação foi o de diluição através do teste de suspensão, observando a inativação bacteriana nos tempos de contato 5, 15, 30 e 60 minutos. Como resultados obtidos, todas as amostras foram inativadas quando utilizado o composto quaternário de amônio, em ambas as concentrações. Frente ao iodofor, 4 (quatro) amostras mostraram-se resistentes a este composto na concentração indicada e 59 frente à sub-concentração. Conclui-se ser necessário, seja para a eleição ou para o monitoramento da eficácia, o confronto dos desinfetantes/anti-sépticos com bactérias presentes nos ambientes específicos de produção animal ou mesmo nos de transformação de seus subprodutos.<br>For prevention of infectious diseases common to man and animals such as salmonellosis, the successful use of disinfectants is of great importance. However, intrinsic or acquired resistance presented by microorganism against these compounds may constitute a limiting aspect in disinfections protocols. This study was aimed at monitoring the sensitivity of 96 Salmonella Typhimurium strains isolated from slaughter pigs in the state of Rio Grande do Sul, Brazil. The isolates were tested against quaternary ammonium and iodophor, which represent two commercial disinfectants commonly used in animal production. The tested disinfectants were used in the concentration recommended by the fabricant and in a sub-concentration in order to simulate a possible field situation. Dilution suspension tests were conducted, observing the inactivation of each S.Typhimurium isolate after 5, 15, 30 and 60 minutes of contact with each compound. All tested isolates were inactivated by the quaternary ammonium compound in both concentrations. Four isolates revealed resistant to iodophor in the recommended concentration and 59 isolates when a sub-concentration was tested. The testing of resistance against disinfectants in microorganisms present on farm and in food processing plants might be an important step on monitoring the effectiveness of adopted disinfections protocols

A phase 1b single-arm trial of intratumoral oncolytic virus V937 in combination with pembrolizumab in patients with advanced melanoma: results from the CAPRA study.

Background: CAPRA (NCT02565992) evaluated Coxsackievirus A21 (V937) + pembrolizumab for metastatic/unresectable stage IIIB-IV melanoma. Methods: Patients received intratumoral V937 on days 1, 3, 5, and 8 (then every 3 weeks [Q3W]) and intravenous pembrolizumab 2 mg/kg Q3W from day 8. Primary endpoint was safety. Results: Median time from first dose to data cutoff was 32.0 months. No dose-limiting toxicities occurred; 14% (5/36) of patients experienced grade 3‒5 treatment-related adverse events. Objective response rate was 47% (complete response, 22%). Among 17 responders, 14 (82%) had responses ≥ 6 months. Among 8 patients previously treated with immunotherapy, 3 responded (1 complete, 2 partial). Responses were associated with increased serum CXCL10 and CCL22, suggesting viral replication contributes to antitumor immunity. For responders versus nonresponders, there was no difference in baseline tumor PD-L1 expression, ICAM1 expression, or CD3+ infiltrates. Surprisingly, the baseline cell density of CD3+CD8- T cells in the tumor microenvironment was significantly lower in responders compared with nonresponders (P = 0.0179). Conclusions: These findings suggest responses to this combination may be seen even in patients without a typical immune-active microenvironment. Trial registration number: NCT02565992. Keywords: Clinical trial; Melanoma; Oncolytic virus; Pembrolizumab; V937

Doença cerebrovascular na infância: II. Aspectos clínicos em 42 casos Cerebrovascular disease in children: II. Clinical aspects in 42 cases

Entre 1990 e 1998 foram analisadas, do ponto de vista clínico, 42 crianças com diagnóstico de doença cerebrovascular, internadas no Hospital das Clínicas da FCM-UNICAMP. O distúrbio cerebrovascular mais frequente foi do tipo isquêmico com acometimento predominante da artéria cerebral média, sendo o quadro clínico agudo caracterizado por manifestações epilépticas e alterações motoras, principalmente em crianças de idade precoce. A avaliação do seguimento das crianças mostrou predomínio de sequelas motoras.<br>We report the findings recorded in 42 children suffering cerebrovascular disease and assisted at the Hospital das Clínicas FCM-UNICAMP, over a 8 years period (January 1990 until April 1998). The ischemic type was the most common, and involvement of the middle cerebral artery, sudden onset of clinical manifestation with seizures and motor disability were more common in early aged children. Motor sequelae predominated in the follow-up of these children