Laminin concentration in ascites of patients with hepatic cirrhosis and peritoneal carcinomatosis

Laminin levels in ascitic fluid have been proposed as a marker for neoplastic ascites. We compared the concentration of laminin in serum and in ascitic fluid from patients with hepatic cirrhosis and peritoneal carcinomatosis and assessed the diagnostic value of serum laminin levels in differentiating neoplastic from benign ascites. Laminin concentrations were determined by ELISA with antibodies against laminin extracted from the human placenta, in patients with ascites due to peritoneal carcinomatosis (N = 20) and hepatic cirrhosis (N = 33). Patients with infected or hemorrhagic ascites were excluded. The receiver operating characteristic curve was used to determine the sensitivity and specificity of serum laminin for the diagnosis of neoplastic ascites. When compared to the group with cirrhosis, the carcinomatosis group presented significantly higher mean laminin levels in serum (3.3 ± 0.5 vs 2.1 ± 0.4 µg/ml, mean ± SD, P 2.25 µg/ml showed 100% sensitivity and 73% specificity for the diagnosis of neoplastic ascites. Serum concentration seems to be the main determinant of laminin levels in ascitic fluid and its values can be used as a diagnostic parameter in the study of neoplastic ascites.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de GastroenterologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de ImunologiaUNIFESP, EPM, Disciplina de GastroenterologiaUNIFESP, EPM, Disciplina de ImunologiaSciEL

Clubes de convergência nos municipios mineiros: uma análise via modelo threshold

This paper is makes an analysis of the process of convergence of income between the municipalities of the Minas Gerais (Brazil) in the period of 1980 to 2005, trying to identify the existence of clubs of convergence using a model threshold. Results indicated for the formation of four clubs of convergence, among them shows a process of convergence between the all clubs. Human capital proved to be significant in explaining the process of growth of the intermediate groups of municipalities richer. The results also indicated that the physical capital was significantly negative for explaining the process of economic growth of most rich clubs of convergence, demonstrating in this way, a negative role for public investment undertaken in the districts of the region.Income Convergence, Threshold Effect, Minas Gerais (Brazil), Community/Rural/Urban Development, Research Methods/ Statistical Methods, R11,

Stenosis of reverse great saphenous vein graft in infrainguinal arterial revascularization

SummaryObjectiveThe aim of this study was to evaluate the prevalence of hemodynamically significant infrainguinal bypasses stenosis using reverse great saphenous vein graft.MethodsFrom March of 2008 to March of 2009, 56 infrainguinal bypasses were performed with reverse great saphenous vein graft in 56 patients. On the 30th post-operative day, 32 out of 56 patients were submitted to vascular ultrasonography. The prevalence of significant graft stenosis was determined. In addition, the diagnosis of stenosis was related to the clinical and surgical characteristics of the patients. The variables analyzed at the moment of diagnosis were the localization of the graft stenosis, the risk factors associated with stenosis and the association of vascular ultrasonography findings with ankle-brachial pressure index (ABI).ResultsThe overall prevalence of significant graft stenosis was 48.4%. Out of the total number of observed stenosis, 19.4% were considered severe, and 29% mild or moderate. There was no significant association between the presence of significant stenosis and the following variables: gender, diabetes, hypertension, smoking, hipercholesterolemia, graft diameter, site of the distal anastomosis, and graft composition. There was a weak agreement between ABI and vascular ultrasonography in detecting stenosis in general (K=0.30; CL95% 0.232 - 0.473; p=0.018). However, there was a substantial agreement in detecting severe stenosis (K=0.75; CL95% 0.655 - 0.811; p=0.0001).ConclusionThere was a high prevalence of stenosis on the 30th post-operative day, mostly localized in the proximal half of the vein graft. There was no significant association of stenosis with clinical and surgical factors analyzed. ABI and vascular ultrasonography had weak agreement with the diagnosis of stenosis in general and an important agreement for the diagnosis of severe stenosis

Intensive treatment of breast cancer-related lymphedema in patients with neurological injuries

The aim of this study is to report on the intensive treatment of lymphedema resulting from breast cancer therapy in a 51-year-old patient who experienced loss of muscle strength of the arm. This patient developed lymphedema after a mastectomy, axillary resection, chemotherapy and radiation therapy to treat breast cancer. When the patient arrived at the Clinica Godoy for treatment in August 2012, she was evaluated using bioimpedance and volumetry before and then every day during treatment. Intensive treatment was carried out for six hours per day on three consecutive days employing Manual Lymphatic Therapy, Mechanic Lymphatic therapy (RA Godoy®) and a grosgrain compression sleeve with daily adjustments to the size. In the initial physical examination the patient reported a score for the intensity of pain of 10 (Pain Scale), paresthesia in the entire arm and there was a 577 mL difference in volume due to edema compared to the contralateral limb. On Treatment Day 1 the paresthesia was reduced using the grosgrain sleeve and Mechanical Lymphatic Therapy; on Treatment Day 2, the pain had dropped to an intensity of 7 (Pain Scale); on Treatment Day 3, the pain decreased to an intensity of 5 (Pain Scale) and the difference in the volume of edema was only 193 mL. The patient returned home but followed the recommendations and treatment program used at the clinic. Monitoring was by routine assessments and guidance on the importance of using the grosgrain sleeve and Mechanical Lymphatic Therapy to maintain the results and prevent neurological damage.O objetivo do presente estudo é relatar o tratamento intensivo do linfedema, após câncer de mama, em paciente com perda da força muscular do membro. Relata-se o caso de uma paciente de 51 anos de idade, que evoluiu com linfedema pós-tratamento do câncer de mama, com mastectomia + esvaziamento axilar + quimioterapia e radioterapia. Após procurar a Clínica Godoy para tratamento em agosto de 2012, foi avaliada com a bioimpedância e volumetria inicial e diária. Realizou tratamento intensivo durante três dias consecutivos, por um período de 6 horas, com Terapia Linfática Manual, Terapia Linfática Mecânica (RA Godoy®) e uso de braçadeira de gorgorão, sendo feitos ajustes diários. Na avaliação inicial, apresentava dor de intensidade 10 (Escala de Dor), parestesia em todo o braço e uma diferença de volume total do edema de 577g em relação ao membro contra-lateral. No primeiro dia de tratamento obteve redução da parestesia com o uso da braçadeira de gorgorão e Terapia Linfática Mecânica; no segundo dia, a dor havia diminuído para a intensidade sete (Escala de Dor); no terceiro dia, a dor diminuiu para intensidade cinco (Escala de Dor) e a diferença de volume total do edema passou a ser de 193g. A paciente retornou para sua casa mantendo as mesmas recomendações e tratamento propostos na clínica. O acompanhamento é feito com avaliações de rotina e orientações sobre a importância do uso da braçadeira de gorgorão e drenagem linfática mecânica

The axis IL-10/claudin-10 is implicated in the modulation of aggressiveness of melanoma cells by B-1 lymphocytes

B-1 lymphocytes are known to increase the metastatic potential of B16F10 melanoma cells via the extracellular signal-regulated kinase (ERK) pathway. Since IL-10 is associated with B-1 cells performance, we hypothesized that IL-10 could be implicated in the progression of melanoma. In the present work, we found that the C57BL/6 mice, inoculated with B16F10 cells that were co-cultivated with B-1 lymphocytes from IL-10 knockout mice, developed fewer metastatic nodules than the ones which were injected with the melanoma cells that were cultivated in the presence of wild-type B-1 cells. The impairment of metastatic potential of the B16F10 cells was correlated with low activation of the ERK signaling pathway, supporting the idea that the production of IL-10 by B-1 cells influences the behavior of the tumor. A microarray analysis of the B-1 lymphocytes revealed that IL-10 deficiency is associated with down-regulation of the genes that code for claudin-10, a protein that is involved in cell-to-cell contact and that has been linked to lung adenocarcinoma. In order to determine the impact of claudin-10 in the cross-talk between B-1 lymphocytes and the B16F10 tumor cells, we took advantage of small interfering RNA. The silencing of claudin-10 gene in B-1 lymphocytes inhibited activation of the ERK pathway and abrogated the B-1-induced aggressive behavior of the B16F10 cells. Thus, our findings suggest that the axis IL-10/claudin-10 is a promising target for the development of therapeutic agents against aggressive melanoma.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Univ Paulista, Environm & Expt Pathol Program, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Escola Paulista Med UNIFESP EPM, Dept Microbiol Immunol & Parasitol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Pharmaceut Sci, Campus Diadema, Diadema, SP, BrazilCtr Univ Sao Camilo, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Escola Paulista Med UNIFESP EPM, Nephrol Div, Dept Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Escola Paulista Med UNIFESP EPM, Dept Microbiol Immunol & Parasitol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Pharmaceut Sci, Campus Diadema, Diadema, SP, BrazilUniv Fed Sao Paulo Escola Paulista Med UNIFESP EPM, Nephrol Div, Dept Med, Sao Paulo, SP, BrazilFAPESP: 11/50256-6FAPESP: 08/50632-5FAPESP: 2016/02189-1CNPq: 472035/2011-8CNPq: 308374/2016-9Web of Scienc

A multilevel hypernetworks approach to capture meso-level synchronisation processes in football

Understanding team behaviours in sports performance requires understanding the interdependencies established between their levels of complexity (micro-meso-macro). Previously, most studies examined interactions emerging at micro- and macro-levels, thus neglecting those emerging at a meso-level (reveals connections between player and team levels, depicted by the emergence of coordination in specific sub-groups of players-simplices during performance). We addressed this issue using the multilevel hypernetworks approach, adopting a cluster-phase method, to record player-simplice synchronies in two performance conditions where the number, size and location of goals were manipulated (first-condition: 6 × 6 + 4 mini-goals; second-condition: Gk + 6 × 6 + Gk). We investigated meso-level coordination tendencies, as a function of ball-possession (attacking/defending), field-direction (longitudinal/lateral) and teams (Team A/Team B). Generally, large synergistic relations and more stable patterns were observed in the longitudinal direction of the field than the lateral direction for both teams, and for both game phases in the first condition. The second condition displayed higher synchronies and more stable patterns in the lateral direction than the longitudinal plane for both teams, and for both game phases. Results suggest: (i) usefulness of hypernetworks in assessing synchronisation of teams at a meso-level; (ii) coaches may consider manipulating these task constraints to develop levels of local synchronies within teams