Unveiling a hidden biomarker of inflammation and tumor progression: The 65 kDa isoform of MMP-9 new horizons for therapy

Cancer metastasis is a stage of the disease where therapy is mostly ineffective; hence, the need to find reliable markers of its onset. The metalloproteinase-9 (MMP-9, gelatinase B) in its 82 kDa active form, is a good candidate, but here we show that the correspondent little known 65 kDa active MMP-9 isoform, often misrepresented with the other gelatinase MMP-2, is a more suitable marker. Sera from patients with lung and breast cancer were analyzed by bidimensional zymography to detect the activity of MMP-9 and MMP-2. Enzyme identity was confirmed by comparison with MMP-9 standards and by western blotting. The 65 kDa isoform of MMP-9 is a suitable biomarker to monitor tumor progression from tissue neoplasms to metastatic stage, as its activity begins to appear when disease severity increases and becomes very high in metastasis. Moreover, the 65 kDa MMP-9, which derives from the 82 kDa MMP-9, no longer responds to natural MMP-9 inhibitors. As its activity cannot be controlled, its appearance may warn that the pathological process is becoming irreversible. Identification and inhibition of the enzymes converting the inhibitor-sensitive 82 kDa MMP-9 into the corresponding “wild” 65 kDa MMP-9 may allow to develop therapies capable of blocking metastases

A critical analysis of 33 patients with substernal goiter surgically treated by neck incision

The possibility of needing a combined access, with neck and chest incisions makes the treatment of substernal goiter a challenge both in the pre-op and the intraoperative. We hereby, discuss a standardization of the surgical technique to minimize the need for a chest approach, making the substernal goiter a surgically treatable disease, through a single neck incision, and with low indices of complication. AIM: to assess the substernal goiter surgically approach through a neck incision and to analyze the surgical complications. MATERIALS AND METHODS: we carried out a historical cohort by retrospective analysis of the charts of patients submitted to thyroidectomy, and 33 of them (10.4%) had substernal goiter. RESULTS: all 33 patients were surgically treated through a neck incision without the need for sternotomy. We did not observe definitive lesions in the inferior laryngeal nerve or definitive hypoparathyroidism. Only 2 patients had recurrent nerve paresis; and 2 patients were re-operated because of a neck hematoma. CONCLUSION: patients with substernal goiter can be safely treated surgically through a single neck incision, bearing low complication rates.A possibilidade de ser necessário um acesso combinado, com uma incisão cervical e outra torácica, torna o tratamento do bócio mergulhante um desafio tanto no pré quanto no intra-operatório. Discutimos uma padronização da técnica cirúrgica para minimizar a necessidade da abordagem torácica, tornando o bócio mergulhante uma patologia tratável cirurgicamente, por uma única incisão cervical, e com baixos índices de complicações. OBJETIVO: Avaliar a abordagem cirúrgica do bócio mergulhante por cervicotomia e analisar as complicações cirúrgicas. MATERIAL E MÉTODOS: Foi realizada uma coorte histórica com corte transversal por análise retrospectiva dos prontuários de pacientes submetidos à tireoidectomia no período de maio de 2002 a julho de 2007. Um total de 316 pacientes foi submetido à tireoidectomia sendo 33 (10,4%) por bócio mergulhante. RESULTADOS: Todos os 33 pacientes foram tratados cirurgicamente por via cervical sem necessidade de esternotomia. Não foram observadas lesões definitivas de nervo laríngeo inferior ou hipoparatireoidismo definitivo. Apenas 2 pacientes apresentaram paresia de nervo recorrente e 2 pacientes foram reabordados por hematoma cervical. CONCLUSÃO: Pacientes com bócio mergulhante podem ser tratados cirurgicamente por uma única incisão cervical com segurança e baixos índices de complicação.UNIFESPUNIFESPSciEL

Transformaciones en la ciudad e impacto en las organizaciones de base territorial del Noreste Montevideo (Transformations in the city and the impact on territorial-based organizations of the Northeast Montevideo)

Resumen: La reestructuración productiva impone nuevos usos al territorio, pudiendo identificar como transformaciones territoriales urbanas actuales: la competencia entre ciudades por inversiones privadas, el aumento de la desigualdad socio-espacial, privatización y nuevas formas de uso de los espacios públicos, disminución del encuentro y relaciones entre clase, debilitamiento y fragmentación del tejido social urbano. Estos procesos, impactaron em la sociabilidad y vínculos interpersonales, exacerbando los proyectos individuales y debilitando las capacidades de construcción de lo colectivo. Ello impacta en los diferentes sujetos colectivos de base territorial, fundamentalmente en aquellos que habitan en contextos precarizados, en sus formas de organización, movilización y capacidad de agregar intereses a la agenda pública y/o política. En efecto, este estudio exploratorio tiene por objeto analizar, a partir de las referencias bibliográficas existentes y del acumulado empírico que el grupo universitario presenta, los impactos generados por las transformaciones socio-urbano económicas, así como los cambios en la matriz de política pública sobre los diferentes sujetos colectivos de base territorial. Específicamente el análisis se centra en aquellos ubicados en el noreste de Montevideo. Palabras claves: Sujetos colectivos. Organización popular. Precariedad   Resumo: A reestruturação produtiva impõe novos usos ao território, podendo identificar como transformações territoriais urbanas atuais a: competição entre cidades por investimentos privados, o aumento da desigualdade socioespacial, a privatização e novas formas de uso dos espaços públicos, a diminuição do encontro e as relações entre enfraquecimento e fragmentação do tecido social urbano. Esses processos serão afinados na sociabilidade e nos vínculos interpessoais, exacerbando projetos individuais e enfraquecendo a capacidade de construção do coletivo. Isso impacta nos diferentes sujeitos coletivos de base territorial, fundamentalmente naqueles que vivem em contextos precários, em suas formas de organização, mobilização e capacidade de agregar interesses à agenda pública e / ou política. Com efeito, este estudo exploratório tem como objetivo analisar, a partir das referências bibliográficas existentes e do empírico acumulado que o grupo universitário apresenta, os impactos gerados pelas transformações econômicas sócio-urbanas, bem como as mudanças na matriz de políticas públicas sobre os diferentes sujeitos coletivos de base territorial. Especificamente, a análise se concentra naqueles localizados no nordeste de Montevidéu. Palavras-chave: Sujeitos coletivos. Organização popular. Precariedade   Abstract: The productive restructuring imposes new uses to the territory, being able to identify as current urban territorial transformations: the competition among cities for private investments, the increase of socio-spatial inequality, privatization and new forms of use of public spaces, diminution of the encounter and relations between class, weakening and fragmentation of the urban social fabric. These processes will affine on sociability and interpersonal links, exacerbating individual projects and weakening the capacity for building the collective. This impacts on the different collective subjects of territorial base, fundamentally in those who live in precarious contexts, in their forms of organization, mobilization and ability to add interests to the public and / or political agenda. In effect, this exploratory study aims to analyze, from the existing bibliographic references and the accumulated empirical that the university group presents, the impacts generated by socio-urban economic transformations, as well as the changes in the public policy matrix on the different collective subjects of territorial. Specifically, the analysis focuses on those located in the northeast of Montevideo. Keywords: Collective subjects. Popular organization. Precariousnes

Evaluation of the capacity to consent to treatment among patients with bipolar disorder: Comparison between the acute psychopathological episode and the stable mood phase

Objective: Treatment decision-making capacity (TDMC) is basic to therapeutic processes and can be measured with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). TDMC may fluctuate in bipolar disorder (BD). We used the MacCAT-T to compare BD inpatients with an acute manic or depressive episode with euthymic BD outpatients on their TDMC. Methods: We used the MacCAT-T to cross-sectionally assessed from May 2018 through October 2019 the TDCM of adult BD patients with a Mini Mental State Examination score ≥ 18, a group of acutely ill hospitalized patients for a manic/hypomanic episode and another of euthymic outpatients during their regular visits at our outpatient clinic. Patients were assessed with other specific psychiatric rating scales. We also tested their TDCM to an alternative treatment. Results: The inpatient group consisted of 53 patients and the outpatient of 47. Inpatients scored worse than out- patients on the MacCAT-T understanding, reasoning and expressing a choice subscale, but not on the appreciating scale. Outpatients were more capable in understanding the characteristics of an alternative advance treatment. MacCAT-T subscales correlated directly with mental state scores, and inversely with mania and psychopathology scores, while only the appreciating subscale correlated inversely with depression scores. Limitations: The limitations include small sample size and cross-sectional design. Conclusions: TDCM is higher in BD patients at their euthymic state, hence this is the right time to obtain consent from a BD patient in view of possibly depositing psychiatric advance directives

Large scale phenotyping and molecular analysis in a germplasm collection of rocket salad (Eruca vesicaria) reveal a differentiation of the gene pool by geographical origin

[EN] Cultivated rocket (Eruca vesicaria) is a leafy vegetable highly appreciated for its healthpromoting virtues and consumed both raw and cooked as ready-to-use vegetable. Despite Eruca being cultivated worldwide, only a few cultivars are available and limited breeding activities have been carried out so far. Therefore, the genetic resources available represent an unexploited potential source of variation for breeding. In the present study, 155 E. vesicaria accessions from 30 countries across Europe, Asia, Africa, and America have been characterized for 54 qualitative and quantitative morphological and quality traits. Conventional descriptors and automated tools for the determination of the quality, morphology, and colour of leaves have been used. Genetic diversity was assessed using 15 inter simple sequence repeat and simple sequence repeat markers. A high level of diversity was evidenced in the collection. Significant differences were found in most of the traits with the exception of five pseudo-qualitative descriptors. The first and second dimensions of the principal components analysis with phenotypic traits accounted for 25.69% of total variation showing a stratification of the genotypes according to the European and Asian origins. In total, 75% of the variation was contained in the first 15 components having eigenvalues higher than 1.0. Also, the population structure divided the collection into two main clusters separating European genotypes from the rest. Furthermore, hierarchical cluster analysis confirmed a geographical separation, grouping the accessions into three major clusters, which were differentiated by plant architecture, leaf and flower colour, leaf water status, leaf blade shape and hairiness of the leaves and stem. Our approach has broadened the knowledge of the diversity within the Eruca gene pool, thus contributing to identify sources of variation and to select the best candidates for cultivated rocket breeding programs, as well as to determine the genetic basis of plant and leaf traits in future genome-wide association studies.The work was supported by 'RGV-FAO' project funded by the Italian Ministry of Agriculture, Food and Forestry. C. Guijarro-Real thanks the Ministerio de Educacion, Cultura y Deporte of Spain (MECD) for its financial support by means of a predoctoral FPU Grant (FPU14/06798), and for the specific grant for mobility (EST17/00354) from the same Organization.Guijarro-Real, C.; Navarro, A.; Esposito, S.; Festa, G.; Macellaro, R.; Di Cesare, C.; Fita, A.... (2020). Large scale phenotyping and molecular analysis in a germplasm collection of rocket salad (Eruca vesicaria) reveal a differentiation of the gene pool by geographical origin. Euphytica. 216(3):1-20. https://doi.org/10.1007/s10681-020-02586-xS1202163Andrey P, Maurin Y (2005) Free-D: an integrated environment for three-dimensional reconstruction from serial sections. J Neurosci Methods 145:233–244Awada L, Phillips PWB, Smyth SJ (2018) The adoption of automated phenotyping by plant breeders. Euphytica 214:148. https://doi.org/10.1007/s10681-018-2226-zBarrs HD, Weatherley PE (1962) A re-examination of the relative turgidity technique for estimating water deficits in leaves. Aust J Biol Sci 15(3):413–428Bell L, Wagstaff C (2014) Glucosinolates, myrosinase hydrolysis products, and flavonols found in rocket (Eruca sativa and Diplotaxis tenuifolia). J Agric Food Chem 62:4481–4492Bell L, Oruna Concha MJ, Wagstaff C (2015) Identification and quantification of glucosinolate and flavonol compounds in rocket salad (Eruca sativa, Eruca vesicaria and Diplotaxis tenuifolia) by LC-MS: highlighting the potential for improving nutritional value of rocket crops. Food Chem 172:852–861Bell L, Methven L, Wagstaff C (2017) The influence of phytochemical composition and resulting sensory attributes on preference for salad rocket (Eruca sativa) accessions by consumers of varying TAS2R38 diplotype. Food Chem 222:6–17Bennett RN, Mellon FA, Botting NP, Eagles J, Rosa EAS, Williamson G (2002) Identification of the major glucosinolate (4-mercaptobutyl glucosinolate) in leaves of Eruca sativa L. (salad rocket). Phytochemistry 61:25–30Bozokalfa MK, Eşiyok D, Ilbi H, Kaygisiz AT (2010) Estimates of genetic variability and association studies in quantitative plant traits of Eruca spp. landraces. Genetika 42(3):501–512Bozokalfa MK, Eşiyok D, Ilbi H, Kavak S, Kaygisiz AT (2011) Evaluation of phenotypic diversity and geographical variation of cultivated (Eruca sativa L.) and wild (Diplotaxis tenuifolia L.) rocket plant. Plant Genet Resour C 9:454–563CBI Centre for the Promotion of Imports from developing countries (2019) https://www.cbi.eu/market-information/fresh-fruit-vegetables/fresh-herbs/europe/. Accessed 21 Sept 2019Cheruiyot EK, Mumera LM, Ngetich WK, Hassanali A, Wachira F (2007) Polyhenols as potential indicators for osmotic tolerance in tea (Camellia sinensis L.). Biosci Biotechnol Biochem 71:2190–2197. https://doi.org/10.1271/bbb.70156Curtin F, Schulz P (1998) Multiple correlations and Bonferroni’s correction. Biol Psychiatr 44:775–777D’Antuono LF, Elementi S, Neri R (2008) Glucosinolates in Diplotaxis and Eruca leaves: diversity, taxonomic relations and applied aspects. Phytochemistry 69:187–199Daayf F, El Hadrami A, El-Bebany AE, Henriquez MA, Yao Z, Derksen H, El-Hadrami I, Adam LR (2012) Phenolic compounds in plant defense and pathogen counter-defense mechanisms. Rec Adv Polyphen Res 3:191–208Dalin P, Agren J, Björkman C, Huttumen P, Kärkkäinen K (2008) Leaf trichome formation and plant resistance to herbivory. In: Schaller A (ed) Induced plant resistance to herbivory. Springer, Berlin, pp 89–105Earl DA, vonHoldt BM (2012) STRUCTURE HARVESTER: a website and program for visualizing STRUCTURE output and implementing the Evanno method. Conserv Genet Resour 4:359–361Egea-Gilabert C, Fernandez JA, Migliaro D, Martinez Sanchez JJ, Vicente MJ (2009) Genetic variability in wild vs. cultivated Eruca vesicaria populations as assessed by morphological, agronomical and molecular analyses. Sci Hortic 121:260–266Fine PVA (2015) Ecological and evolutionary drivers of geographic variation in species diversity. Annu Rev Ecol Evol Syst 46:369–392. https://doi.org/10.1146/annurev-ecolsys-112414-054102Gilardi G, Chen G, Garibaldi A, Zhiping C, Gullino ML (2007) Resistance of different rocket cultivars to wilt caused by strains of Fusarium oxysporum under artificial inoculation conditions. J Plant Pathol 89:113–117Gómez-Campo C (2003) Morphological characterization of Eruca vesicaria (Cruciferae) germplasm. Bocconea 16:615–624Guijarro-Real C, Prohens J, Rodriguez-Burruezo A, Adalid-Martínez AM, López-Gresa MP, Fita A (2019) Wild edible fool’s watercress: a potential crop with high nutraceutical properties. PeerJ 7:e6296Hall MKD, Jobling JJ, Rogers GS (2012) Some perspectives on rocket as a vegetable crop: a review. Veg Crop Res Bull 76:21–41Hanldey R, Ekbom B, Ågren J (2005) Variation in trichome density and resistance against a specialist insect herbivore in natural populations of Arabidopsis thaliana. Ecol Entomol 30:284–292Hauser MT (2014) Molecular basis of natural variation and environmental control of trichome patterning. Front Plant Sci 5:320Higdon JV, Delage B, Williams DE, Dashwood RH (2007) Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 55:224–236IPGRI (1999) Descriptors for rocket (Eruca spp.). International Plant Genetic Resources Institute, RomeLenzi A, Tesi R (2000) Effect of some cultural factors on nitrate accumulation in rocket [Diplotaxis tenuifolia (L.) D.C. – Eruca sativa Mill.]. Riv Agronomia 34(4):419–424Mantel NA (1967) The detection of disease clustering and a generalized regression approach. Cancer Res 27:209–220Meyer RS, Purugganan MD (2013) Evolution of crop species: genetics of domestication and diversification. Nat Rev Genet 14:840–852Ninfali P, Mea G, Giorgini S, Rocchi M, Bacchiocca M (2005) Antioxidant capacity of vegetables spices and dressings relevant to nutrition. Br J Nutr 93:257–266Padulosi S, Pignone D (1996) Rocket: a mediterranean crop for the world. Report of a workshop. IPGRI International Plant Genetic Resources Institute, Bioversity International, Rome, p 101Pane C, Sigillo L, Caputo M, Serratore G, Zaccardelli M, Tripodi P (2017) Response of rocket salad germplasm (Eruca and Diplotaxis spp.) to major pathogens causing damping-off, wilting and leaf spot diseases. Arch Phytopathol Plant Protect 50:167–177Pariyar S, Eichert T, Goldbach HE, Hunsche M, Burkhardt J (2013) The exclusion of ambient aerosols changes the water relations of sunflower (Helianthus annuus) and bean (Vicia vaba) plants. Environ Exp Bot 88:43–52Pasini F, Verardo V, Caboni MF, D’Antuono LF (2012) Determination of glucosinolates and phenolic compounds in rocket salad by HPLC-DAD−MS: evaluation of Eruca sativa Mill. and Diplotaxis tenuifolia L. genetic resources. Food Chem 133:1025–1033Powell W, Morgante M, Andre C, Hanafey M, Vogel J, Tingey S, Rafalski A (1996) The utility of RFLP, RAPD, AFLP and SSR (microsatellite) markers for germplasm analysis. Mol Breed 2:225–238Prevost A, Wilkinson MJ (1999) A new system of comparing PCR primers applied to ISSR fingerprinting of potato cultivars. Theor Appl Genet 98:107–112Pritchard JK, Stephens M, Donnelly P (2000) Inference of population structure using multilocus genotype data. Genetics 155:945–959Singleton VL, Rossi JA Jr (1965) Colorimetry of total phenolics with phosphomolybdic-phosphotungstic acid reagents. Am J Enol Viticult 16:144–158Taiz L, Zeiger E (2006) Plant physiology, 4th edn. Sinauer Associates Inc., SunderlandTanentzap FM, Stempel A, Ryser P (2015) Reliability of leaf relative water content (RWC) measurements after storage: consequences for in situ measurements. Botany 93:535–541Taranto F, Francese G, Di Dato F, D’Alessandro A, Greco B, Onofaro Sanajà V, Pentangelo A, Mennella G, Tripodi P (2016) Leaf metabolic, genetic, and morphophysiological profiles of cultivated and wild rocket salad (Eruca and Diplotaxis spp.). J Agric Food Chem 64:5824–5836Thakur AK, Singh KH, Singh L, Nanjundan J, Khan YJ, Singh D (2018) SSR marker variations in Brassica species provide insight into the origin and evolution of Brassica amphidiploids. Hereditas 155:6. https://doi.org/10.1186/s41065-017-0041-5The Plant List (2019). http://www.theplantlist.org/tpl1.1/search?q=Eruca. Accessed 21 Sept 2019Tripodi P, Francese G, Mennella G (2017) Rocket salad: crop description, bioactive compounds and breeding perspectives. Adv Hortic Sci. https://doi.org/10.13128/ahs-21087Vavilov NI (1926) Centers of origin of cultivated plants. Bull Appl Bot Genet Plant Breed 16:1–248Wagner GJ (1991) Secreting glandular trichomes: more than just hairs. Plant Physiol 96:675–679Warwick SI, Gukel RK, Gomez-Campo C, James T (2007) Genetic variation in Eruca vesicaria (L.) Cav. Plant Genet Resour C 5:142–15

Clinical utility of F-18-FDG PET/CT in the follow-up of a large cohort of patients with high-risk differentiated thyroid carcinoma

Objective: To evaluate the clinical utility of F-18-FDG PET/CT in patients with high-risk DTC. Subjects and methods: Single-center retrospective study with 74 patients with high-risk differentiated thyroid cancer (DTC), classified in 4 groups. Group 1: patients with positive sTg or TgAb, subdivided in Group 1A: negative RxWBS and no foci of metastases identified at conventional image (n = 9)Group 1B: RxWBS not compatible with suspicious foci at conventional image or not proportional to sTg level (n = 13)Group 2: patients with histological findings of aggressive DTC variants (n = 21) and Group 3: patients with positive RxWBS (n = 31). Results: F-18-FDG PET/CT identified undifferentiated lesions and helped restage the disease in groups 1B and 2. The scan helped guide clinical judgment in 9/13 (69%) patients of group 1B, 10/21 (48%) patients of group 2 and 2/31 (6%) patients of group 3. There was no clinical benefit associated with group 1A. F-18-FDG PET/CT was associated with progressive disease. Conclusion: F-18-FDG PET/CT is a useful tool in the follow-up of patients with high-risk DTC, mainly in the group of RxWBS not compatible with suspicious foci at conventional image or not proportional to sTg level and in those with aggressive DTC variants. Additionally, this study showed that F-18-FDG PET/CT was associated with progression and helped display undifferentiated lesions guiding clinical assessments regarding surgeries or expectant treatments.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Ministério da Saúde (MS)Univ Fed São Paulo EPM Unifesp, Escola Paulista Med, Ctr Doencas Tireoide, São Paulo, SP, BrazilUniv Fed São Paulo EPM Unifesp, Escola Paulista Med, Lab Endocrinol Mol & Translac, Dept Med,Div Endocrinol, São Paulo, SP, BrazilHIAE, Dept Imagem, São Paulo, SP, BrazilUniv Fed São Paulo EPM Unifesp, Escola Paulista Med, Ctr Doencas Tireoide, São Paulo, SP, BrazilUniv Fed São Paulo EPM Unifesp, Escola Paulista Med, Lab Endocrinol Mol & Translac, Dept Med,Div Endocrinol, São Paulo, SP, BrazilFAPESP: 2006/60402-1MS: 25000.168513/2008-11Web of Scienc

Sujetos colectivos, integralidad y trabajo social

La presente ponencia busca reflexionar sobre las posibilidades, apuestas y tensiones de la integralidad de las funciones universitarias a partir de la experiencia desarrollada desde 2011 nuestro equipo en la Licenciatura en Trabajo Social-, el cual se orienta a desarrollar espacios de trabajo con sujetos colectivos, redes y organizaciones sociales de base territorial y/o vinculadas al mundo del trabajo. A partir del desarrollo de algunos conceptos claves presenta, analiza y debate dichas posibilidades, en particular desde la opción de aportar a los procesos de organización y participación de los sujetos colectivos y populares, en una propuesta de enseñanza-aprendizaje singular y desde la concepción del conocimiento como una producción plural, enraizada en prácticas sociales más amplias y con vocaciones emancipatorias.Eje 2: Debates sobre el trabajo social y las ciencias sociales: su implicancia en el contexto actual.Facultad de Trabajo Socia

Líquen plano da conjuntiva ocular

O líquen plano (LP) é uma doença autoimune, recorrente, de etiologia desconhecida. Pode apresentar associação com distúrbios psíquicos, hipertensão arterial e alcoolismo crônico. Líquen plano ocular (LPO), por sua vez, é uma doença rara, com incidência de 0,22% a 5% em todo o mundo. Afeta principalmente adultos de meia-idade, entre 30-60 anos, e não apresenta predileção de gênero ou raça. O presente relato de caso trata-se de um paciente com LPO isolado com remissão total da lesão após introdução de corticoide sistêmico

Evaluation of clinical, laboratorial and ultrasonographic predicting factors of malignancy in thyroid nodules

OBJECTIVE: To evaluate the risk of malignancy in thyroid nodules through clinical, laboratory, ultrasonographic and cytological aspects. PATIENTS AND METHODS: 741 nodules of 407 patients. RESULTS: The cytology was benign (60,5%), indeterminate (23,3%), malignant (8,3%) or nondiagnostic (7,6%). The prevalence of cancer in indeterminate citology was 18,5% (16% in follicular lesions, 44% in suspicious). The diagnosis of malignancy was 17,2% (n = 70). The frequency of cancer in women (15,2%) was lower than in men (27,9%). There was an inverse relation between age and cancer risk. There was no statistical significance in the prevalence of cancer according to number, size of nodules or TSH levels. Hypoechogenicity and microcalcifications on ultrasound were risk factors. CONCLUSION: The risk of malignancy was higher in men, hypoechoic nodules, with microcalcifications and was inversely related to age. The TSH level was not an independent factor predictive of malignancy.OBJETIVO: Avaliar risco de malignidade de nódulos tiroidianos por meio de aspectos clínicos, laboratoriais, ultrassonográficos e citológicos. PACIENTES E MÉTODOS: 741 nódulos de 407 pacientes. RESULTADOS: A citologia foi benigna (60,5%), indeterminada (23,3%), maligna (8,6%) ou não diagnóstica (7,6%). A prevalência de câncer nas citologias indeterminadas foi 18,5% (16% nas lesões foliculares, 44% nas suspeitas). O diagnóstico de malignidade foi 17,2% (n = 70). A frequência de câncer em mulheres (15,2%) foi menor do que em homens (27,9%). Houve uma relação inversa entre idade e risco de câncer. Não houve significância estatística na prevalência de câncer de acordo com número, tamanho dos nódulos ou níveis de TSH. Hipoecogenicidade e microcalcificações ao ultrassom foram fatores de risco. CONCLUSÃO: O risco de malignidade foi maior em homens, nódulos hipoecogênicos, com microcalcificações e inversamente relacionado à idade. O nível de TSH não foi um preditor independente de malignidade.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de MedicinaInstituto Israelita de Ensino e Pesquisa Albert Einstein Centro de Doenças TiroidianasFleury Medicina e SaúdeUNIFESP, EPM, Depto. de MedicinaSciEL

Accounting for Bacterial Overlap Between Raw Water Communities and Contaminating Sources Improves the Accuracy of Signature-Based Microbial Source Tracking

Microbial source tracking (MST) analysis is essential to identifying and mitigating the fecal pollution of water resources. The signature-based MST method uses a library of sequences to identify contaminants based on operational taxonomic units (OTUs) that are unique to a certain source. However, no clear guidelines for how to incorporate OTU overlap or natural variation in the raw water bacterial community into MST analyses exist. We investigated how the inclusion of bacterial overlap between sources in the library affects source prediction accuracy. To achieve this, large-scale sampling – including feces from seven species, raw sewage, and raw water samples from water treatment plants – was followed by 16S rRNA amplicon sequencing. The MST library was defined using three settings: (i) no raw water communities represented; (ii) raw water communities selected through clustering analysis; and (iii) local water communities collected across consecutive years. The results suggest that incorporating either the local background or representative bacterial composition improves MST analyses, as the results were positively correlated to measured levels of fecal indicator bacteria and the accuracy at which OTUs were assigned to the correct contamination source increased fourfold. Using the proportion of OTUs with high source origin probability, underpinning a contaminating signal, is a solid foundation in a framework for further deciphering and comparing contaminating signals derived in signature-based MST approaches. In conclusion, incorporating background bacterial composition of water in MST can improve mitigation efforts for minimizing the spread of pathogenic and antibiotic resistant bacteria into essential freshwater resources