Nonalcoholic Steatohepatitis

Os autores apresentam um caso de esteatohepatite não alcoólica numa mulher obesa, não diabética, que evoluiu para cirrose hepática. A propósito desta entidade revêem a literatura discutindo a sua história natural e os principais processos patológicos a ela associados. Destacam a importância da obesidade no desenvolvimento da esteatohepatite e da vantagem, em casos seleccionados, da execução de biópsia hepática, como técnica de diagnóstico fundamental

Estrogen receptor, progesterone receptor, and bcl-2 are markers with prognostic significance in CIN III

There are no known biological markers or technologies to predict the natural history of an individual CIN III. The probability of progression is considered greater with the persistence of high-risk human papillomavirus (HPV) infection and age. p53 polymorphism has been associated with cervical carcinogenesis. Hormone-induced cervical cancer is mediated by estrogen receptor (ER) and progesterone receptor (PR). In cervical cancer, increased bcl-2 and Bax immunoreactivity is generally associated with a better prognosis. The purpose of this study was to evaluate the value of HPV 16 and HPV 18 typing and p53 codon polymorphism genotyping by polymerase chain reaction and ER, PR, bcl-2, and Bax expression by immunohistochemistry in predicting the CIN III clinical behavior of CIN III lesions. We studied the expression of these prognostic factors in the CIN III adjacent to squamous cell microinvasive carcinomas of the cervix (MIC) from 29 patients with FIGO stage IA1 cervical cancer and in 25 patients with CIN III and no documented focus of invasion. In the MIC group, only the CIN III was considered at least 2 mm away from the microinvasive complex. The ER, PR, bcl-2, and Bax immunoreactivity was scored as positive (>10% staining cells) and negative (<10% staining cells). No significant difference was observed between MIC and CIN III group concerning HPV infection and p53 polymorphism. The ER, PR, bcl-2, and Bax immunohistochemical expression was stronger and more frequent in the CIN III group. After multivariable analysis, coexpression of ER, PR, and bcl-2 was the only independent factor in defining low risk of progression for CIN III. Our study suggests that coexpression of ER, PR, and bcl-2 may be a useful tool in identifying the CIN III lesions with low risk of progression to cervical cance

Semi-automatic algorithm for construction of the left ventricular area variation curve over a complete cardiac cycle

<p>Abstract</p> <p>Background</p> <p>Two-dimensional echocardiography (2D-echo) allows the evaluation of cardiac structures and their movements. A wide range of clinical diagnoses are based on the performance of the left ventricle. The evaluation of myocardial function is typically performed by manual segmentation of the ventricular cavity in a series of dynamic images. This process is laborious and operator dependent. The automatic segmentation of the left ventricle in 4-chamber long-axis images during diastole is troublesome, because of the opening of the mitral valve.</p> <p>Methods</p> <p>This work presents a method for segmentation of the left ventricle in dynamic 2D-echo 4-chamber long-axis images over the complete cardiac cycle. The proposed algorithm is based on classic image processing techniques, including time-averaging and wavelet-based denoising, edge enhancement filtering, morphological operations, homotopy modification, and watershed segmentation. The proposed method is semi-automatic, requiring a single user intervention for identification of the position of the mitral valve in the first temporal frame of the video sequence. Image segmentation is performed on a set of dynamic 2D-echo images collected from an examination covering two consecutive cardiac cycles.</p> <p>Results</p> <p>The proposed method is demonstrated and evaluated on twelve healthy volunteers. The results are quantitatively evaluated using four different metrics, in a comparison with contours manually segmented by a specialist, and with four alternative methods from the literature. The method's intra- and inter-operator variabilities are also evaluated.</p> <p>Conclusions</p> <p>The proposed method allows the automatic construction of the area variation curve of the left ventricle corresponding to a complete cardiac cycle. This may potentially be used for the identification of several clinical parameters, including the area variation fraction. This parameter could potentially be used for evaluating the global systolic function of the left ventricle.</p

The tumbling rotational state of 1I/‘Oumuamua

The discovery of 1I/2017 U1 (1I/‘Oumuamua) has provided the first glimpse of a planetesimal born in another planetary system. This interloper exhibits a variable colour within a range that is broadly consistent with local small bodies, such as the P- and D-type asteroids, Jupiter Trojans and dynamically excited Kuiper belt objects. 1I/‘Oumuamua appears unusually elongated in shape, with an axial ratio exceeding 5:1. Rotation period estimates are inconsistent and varied, with reported values between 6.9 and 8.3 h. Here, we analyse all the available optical photometry data reported to date. No single rotation period can explain the exhibited brightness variations. Rather, 1I/‘Oumuamua appears to be in an excited rotational state undergoing non-principal axis rotation, or tumbling. A satisfactory solution has apparent lightcurve frequencies of 0.135 and 0.126 h−1 and implies a longest-to-shortest axis ratio of ≳5:1, although the available data are insufficient to uniquely constrain the true frequencies and shape. Assuming a body that responds to non-principal axis rotation in a similar manner to Solar System asteroids and comets, the timescale to damp 1I/‘Oumuamua’s tumbling is at least one billion years. 1I/‘Oumuamua was probably set tumbling within its parent planetary system and will remain tumbling well after it has left ours

Psychosocial aspects and support networks associated with disability in two longevous populations in Brazil: a cross-sectional study

© 2022 The Authors. Published by Springer. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1186/s12877-022-02810-4Background Among the oldest old, aged 80 years and over, the prevalence of disability is higher than in other age groups and can be considered a predictor of mortality. Objective To evaluate how psychosocial aspects and support networks influence the disability of these oldest-old individuals, performing a comparison between two longevous populations, one living in one of the poorest regions of Brazil, in the backlands of Paraíba, and another living in one of the largest urban centres in Latin America. Method A cross-sectional study in which 417 oldest-old persons aged 80 years and older were interviewed, with data collected through the “Health, Welfare and Ageing” survey conducted in two Brazilian cities. Disability was assessed by reporting the need for assistance in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Bivariate and multiple analyses were performed using R statistical software. Results Food insufficiency in the first years of life had negative repercussions on the disability of oldest old people living in the northeast. On the other hand, in this region, older people have a higher rate of support and live longer with their peers, which may contribute to reducing feelings of loneliness, depressive symptoms, and worse self-perception of health. In the Southeast, financial constraints, subjective poverty, and unmet needs may favour the development of functional limitations between long-lived people. Conclusion Our findings indicate that regional differences in Brazil may influence the disability of older people aged 80 and older. In northeast Brazil, having no partner may contribute to disability for ADLs and IADLs; while, in the longevous population of São Paulo, having a worse self-rated health may contribute to disability for IADLs.The current study was funded by Universidade Estadual da Paraíba (PROPESQ) and Fundação de Apoio à Pesquisa do Estado da Paraíba (FAPESQ/CNPq— PPSUS 015/2014); CAPES (INCT 14/50931–3), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP-CEPID 2013/08028–1; 1999/ 05125, 2005/54947–2, 2009/53778–3).Published onlin