contribution of bronchial biopsies in the evaluation of pathogenesis and progression of copd

This review summarizes and discusses the lung pathology of COPD patients emphasising on inflammatory cell phenotypes and mechanisms which prevail in different clinical conditions. In bronchial biopsies a series of events takes place during the progression of the disease from mild to severe. T-lymphocytes, particularly CD8+ cells and macrophages are the prevalent inflammatory cells in the lungs of healthy smokers and patients with mild/moderate COPD. This T-cell activation seems to be sustained by CD4+, CD8+ cells and macrophages expressing transcription factors and Tc1 cytokines such as NF-kB, STAT4 and IFNγ. In contrast, severe disease is characterized by lymphocytes producing greater amounts of TGF-ß1 and by an increase of nitrotyrosine immunoreactivity and activated neutrophils, macrophages and MPO+ cells. However, the mechanisms involved in neutrophilic migration and adhesion are currently under investigation. Recent data has shown that in severe COPD there is an impaired neutrophil capability to respond to chemotactic stimuli, as well as an increased collagen adhesion of neutrophils due to the up-regulation of CD44 and CD11b receptors. This data together, may account for the increased neutrophilia observed in the severe disease states of COPD. In this context, insights obtained from the tissutal analysis of bronchial biopsies represent an irreplaceable route to further progresses in to the pathogenesis of this disease

RESÍDUOS DOMICILIARES E A SÚMULA 448 DO TRIBUNAL SUPERIOR DO TRABALHO

O presente trabalho trata da relação entre os resíduos domiciliares e a aplicabilidade da Súmula 448 do Tribunal Superior do Trabalho (TST). Tal temática assume relevância ao englobar os requisitos para a concessão de adicional de insalubridade para trabalhadores que manejam diretamente os resíduos domiciliares. Para analisar a aplicabilidade da súmula, utilizaram-se artigos, leis e jurisprudência. Sob o aporte deste robusto conhecimento, como resultado, averiguou-se desarmonia entre os tribunais e a Constituição Federal, mormente quanto aos critérios de aplicabilidade da súmula utilizados pelos tribunais. 

Recursos fisioterapêuticos utilizados no tratamento das disfunções sexuais femininas

Introdução: As disfunções sexuais femininas vêm aumentando a cada ano, repercutindo na satisfação e qualidade de vida dessa população. A fisioterapia dispõe de alguns recursos para tratar tal problema. Objetivo: Investigar quais recursos fisioterapêuticos são utilizados nos tratamentos das disfunções sexuais femininas. Método: Foi realizada uma revisão sistemática nas bases de dados da Scielo, Pubmed, Bireme e Lilacs com as palavras chaves: fisioterapia, disfunções sexuais femininas, dispareunia, vaginismo, anorgasmia, cinesioterapia, ginastica hipopressiva, eletroestimulação, biofeedback, terapia manual e cones vaginais. Os termos foram pesquisados em dois idiomas, o inglês e o português.  Foram escolhidos artigos compreendidos entre 1950 e 2013. Foram utilizados também os seguintes livros: Tratado de Ginecologia; Fisioterapia aplicada à ginecologia e obstetrícia e Fisioterapia aplicada a Saúde da Mulher. Resultados: Foram encontrados artigos que utilizaram a cinesioterapia, a ginastica hipopressiva, a eletroestimulação, o biofeedback, as terapias manuais e os cones vaginais associados ou não, sendo esses utilizados nas dispareunias, anorgasmia, vaginismo e na diminuição da lubrificação e libido vaginal. Conclusão: Nesta revisão pode se constatar que a fisioterapia dispõe de diversos recursos para tratar as disfunções sexuais femininas. Entretanto é fundamental novas pesquisas a respeito do tema, principalmente os ensaios clínicos que possibilitem respostas mais substanciais referentes à eficácia e a contribuição da intervenção fisioterapêutica nas disfunções sexuais femininas

Ripensare la condivisione delle risorse: riflessioni sulla realtà italiana - Rethinking Resource Sharing: Reflections on the Italian situation.

La comunicazione descrive l'attività del Comitato Biblioteche Nilde per la gestione della crescita del Network e l'integrazione con altri sistemi e servizi nazionali ed internazionali. Il CBN si è sforzato di far propri i suggerimenti e le indicazioni del Manifesto Rethinking Resource Sharing, elaborato da un gruppo di bibliotecari statunitensi, partner commerciali e specialisti in automazione per le biblioteche. L'attività si è sostanziata con la partecipazione all'11° Convegno Interlending and Document Supply Conference di Hannover nell'autunno 2009, al quale è stata presentata l'esperienza di NILDE che applica i punti del Manifesto. Nel confronto con queste diverse realtà emerge la necessità di esprimere ancora un rilevante lavoro di indirizzo per colmare le lacune del sistema bibliotecario italiano. Viene espressa infine l’intenzione di giungere alla creazione di un Manifesto Italiano per la condivisione delle risorse che recepisca i valori e le proposte provenienti dal mondo delle biblioteche italiane

NILDE World: un nuovo spazio per la comunità

This paper describes the birth, the development, the structure, and the governance of NILDE World. Designed and managed by the Libraries Committee NILDE, CBN, it is thought as an open space and a virtual place available to the NILDE communit

Mastectomy with immediate breast reconstruction during "phase 1" COVID-19 emergency: An Italian experience.

n/

Surgical findings and outcomes after unilateral adrenalectomy for primary hyperaldosteronism in cats: a multi-institutional retrospective study

Case series summary: Twenty-nine cats from different institutions with confirmed or highly suspected primary hyperaldosteronism treated by unilateral adrenalectomy were retrospectively included in this study. The most frequent clinical signs were lethargy (n = 20; 69%) and neck ventroflexion (n = 17; 59%). Hypokalaemia was present in all cats, creatinine kinase was elevated in 15 and hyperaldosteronism was documented in 24. Hypertension was frequently encountered (n = 24; 89%). Preoperative treatment included potassium supplementation (n = 19; 66%), spironolactone (n = 16; 55%) and amlodipine (n = 11; 38%). There were 13 adrenal masses on the right side, 15 on the left and, in one cat, no side was reported. The median adrenal mass size was 2 × 1.5 cm (range 1-4.6 × 0.4-3.8); vascular invasion was present in five cats, involving the caudal vena cava in four cats and the renal vein in one. Median duration of surgery was 57 mins. One major intraoperative complication (3%) was reported and consisted of haemorrhage during the removal of a neoplastic thrombus from the caudal vena cava. In 4/29 cats (14%), minor postoperative complications occurred and were treated medically. One fatal complication (3%) was observed, likely due to disseminated intravascular coagulation. The median duration of hospitalisation was 4 days; 97% of cats survived to discharge. The potassium level normalised in 24 cats within 3 months of surgery; hypertension resolved in 21/23 cats. Follow-up was available for 25 cats with a median survival of 1082 days. Death in the long-term follow-up was mainly related to worsening of comorbidities. Relevance and novel information: Adrenalectomy appears to be a safe and effective treatment with a high rate of survival and a low rate of major complications. Long-term medical treatment was not required

Early onset lactating adenoma and the role of breast MRI: a case report

<p>Abstract</p> <p>Introduction</p> <p>Lactating adenoma is a benign condition, representing the most prevalent breast lesion in pregnant women and during puerperium; in this paper, a case of a woman with lactating adenoma occurring during the first trimester of pregnancy is reported. There have been no reports in the literature, according to our search, focusing on magnetic resonance imaging findings in cases of lactating adenomas. Also the early onset of the lesion during the first trimester of pregnancy is quite unusual and possibly unique.</p> <p>Case presentation</p> <p>We report the case of a primiparous 30-year-old Caucasian woman, who noted an asymptomatic lump within her left breast during the 9^thweek of gestation, slightly increasing in size over the next few weeks. Ultrasound demonstrated a hypoecoic solid mass, hypervascularized and measuring 4 cm. On magnetic resonance imaging, performed in the first month after delivery, the lesion appeared as an ovoidal homogeneous mass, with regular margins and a significant contrast enhancement indicative of a giant adenoma.</p> <p>Conclusion</p> <p>Magnetic resonance imaging could play an important role in the differential diagnosis of pregnancy-related breast lumps, particularly during puerperium, thus avoiding unnecessary surgical biopsies.</p

Imaging features and ultraearly hematoma growth in intracerebral hemorrhage associated with COVID-19

Purpose: Intracerebral hemorrhage (ICH) is an uncommon but deadly event in patients with COVID-19 and its imaging features remain poorly characterized. We aimed to describe the clinical and imaging features of COVID-19-associated ICH. Methods: Multicenter, retrospective, case-control analysis comparing ICH in COVID-19 patients (COV19\u2009+) versus controls without COVID-19 (COV19\u2009-). Clinical presentation, laboratory markers, and severity of COVID-19 disease were recorded. Non-contrast computed tomography (NCCT) markers (intrahematoma hypodensity, heterogeneous density, blend sign, irregular shape fluid level), ICH location, and hematoma volume (ABC/2 method) were analyzed. The outcome of interest was ultraearly hematoma growth (uHG) (defined as NCCT baseline ICH volume/onset-to-imaging time), whose predictors were explored with multivariable linear regression. Results: A total of 33 COV19\u2009+\u2009patients and 321 COV19\u2009-\u2009controls with ICH were included. Demographic characteristics and vascular risk factors were similar in the two groups. Multifocal ICH and NCCT markers were significantly more common in the COV19\u2009+\u2009population. uHG was significantly higher among COV19\u2009+\u2009patients (median 6.2&nbsp;mL/h vs 3.1&nbsp;mL/h, p\u2009=\u20090.027), and this finding remained significant after adjustment for confounding factors (systolic blood pressure, antiplatelet and anticoagulant therapy), in linear regression (B(SE)\u2009=\u20090.31 (0.11), p\u2009=\u20090.005). This association remained consistent also after the exclusion of patients under anticoagulant treatment (B(SE)\u2009=\u20090.29 (0.13), p\u2009=\u20090.026). Conclusions: ICH in COV19\u2009+\u2009patients has distinct NCCT imaging features and a higher speed of bleeding. This association is not mediated by antithrombotic therapy and deserves further research to characterize the underlying biological mechanisms