Quantification of Maceration Changes using Post Mortem MRI in Fetuses

BACKGROUND: Post mortem imaging is playing an increasingly important role in perinatal autopsy, and correct interpretation of imaging changes is paramount. This is particularly important following intra-uterine fetal death, where there may be fetal maceration. The aim of this study was to investigate whether any changes seen on a whole body fetal post mortem magnetic resonance imaging (PMMR) correspond to maceration at conventional autopsy. METHODS: We performed pre-autopsy PMMR in 75 fetuses using a 1.5 Tesla Siemens Avanto MR scanner (Erlangen, Germany). PMMR images were reported blinded to the clinical history and autopsy data using a numerical severity scale (0 = no maceration changes to 2 = severe maceration changes) for 6 different visceral organs (total 12). The degree of maceration at autopsy was categorized according to severity on a numerical scale (1 = no maceration to 4 = severe maceration). We also generated quantitative maps to measure the liver and lung T2. RESULTS: The mean PMMR maceration score correlated well with the autopsy maceration score (R(2) = 0.93). A PMMR score of ≥4.5 had a sensitivity of 91%, specificity of 64%, for detecting moderate or severe maceration at autopsy. Liver and lung T2 were increased in fetuses with maceration scores of 3-4 in comparison to those with 1-2 (liver p = 0.03, lung p = 0.02). CONCLUSIONS: There was a good correlation between PMMR maceration score and the extent of maceration seen at conventional autopsy. This score may be useful in interpretation of fetal PMMR

Metastatic cutaneous Crohn's disease of the face - a successful case treated with ustekinumab

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Multimorbidity and tooth loss: the Brazilian National Health Survey, 2019

BACKGROUND: Little is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults. METHODS: We analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1-12 teeth) and severe tooth loss (lost 23-32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss. RESULTS: For 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings. CONCLUSIONS: Brazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition

Influence of normal mammary epithelium on breast cancer progression: the protective role of early pregnancy

AIMS AND BACKGROUND: The microenvironment has a well recognized role in breast cancer progression. Despite different theories, the mechanism of early pregnancy protection in mammary carcinogenesis is unknown. Since pregnancy is responsible for mammary gland differentiation, we tested the hypothesis that differentiated mammary epithelial cells may inhibit breast cancer progression. In other words, the protective role of early pregnancy could be due to the inhibitory influences of the more differentiated mammary tissue. METHODS: In order to test our hypothesis, we used 30 female Balb/c nude mice and MCF-7 cells of breast adenocarcinoma. The female mice were divided into two test groups, group I (GI) and group II (GII), and a control group. In GII, the animals were submitted to epithelial removal in the left fourth inguinal mammary gland at 3 weeks of age. Both groups were given continuous hormonal treatment to simulate the pregnancy development of the mammary gland. Two million MCF-7 cells were then injected into the fourth inguinal mammary gland (GI) or in the respective cleared mammary fat pad (GII). Five weeks later the mice were sacrificed and their tumors removed. Tumor development rates and tumor volumes were determined and proliferation and apoptosis were evaluated by immunohistochemistry. RESULTS: Tumors of GII mice had a larger mean volume than those of GI mice (P = 0.001, Mann-Whitney U-test) and an apparent increase in proliferation, demonstrated by a higher staining intensity for proliferating cell nuclear antigen (PCNA). As tumors presented caspase 8 staining, there may be apoptotic activation involved in cell death, mainly through an extrinsic pathway. CONCLUSIONS: These results suggest that a differentiated intact mammary gland may have an inhibitory influence on mammary tumor growth in mice

Wilkie Syndrome behind Crohn Disease? Superior Mesenteric Artery Syndrome Mimicking and Complicating Crohn Disease of the Upper Gastrointestinal Tract.

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Minimally processed fruit salad enriched with Lactobacillus acidophilus: Viability of anti-browning compounds in the preservation of color

Minimal processing promotes browning of some vegetal tissues due to cell membrane disruption, which results in the release of oxidative enzymes. This study evaluated the efficiency of citric acid, ascorbic acid, sodium metabisulfite and L-cysteine hydrochloride to retard enzymatic browning of minimally processed fruit salad and enriched this product with Lactobacillus acidophilus LA-5. Control treatment was fruit salad immersed in water. Polyphenol oxidase (PPO) and color (L*, a*, b*, index color - CI, browning index - BI, c*, and h°) were analyzed. The viability of L. acidophilus was also evaluated using Rogosa agar in fruit salads containing anti-browning compounds in higher concentrations. PPO presented a significant difference among control and fruit salad treated with ascorbic acid and L-cysteine hydrochloride, indicating the highest anti-browning activity of these compounds. The fruit color was affected by processing and storage time, with a reduction in the values of L* over time. Values of a*, c*, h° angle and CI indicated a predominance of red color in the fruit salad. Salads containing anti-browning compounds in higher concentrations presented viability of L. acidophilus above 7.43 log CFU/g up to the fifth day of storage, indicating that the product can be promised as probiotic. Thus, the fruit salad treated with anti-browning compounds has potential use as a probiotic carrier.Keywords: Fresh-cut fruits, color, ascorbic acid, vegetable matrix, probiotic culture

Diagnosis and outcome of oesophageal Crohn's disease

BACKGROUND AND AIMS: Crohn's disease (CD) can involve any part of the gastrointestinal tract. We aimed to characterize clinical, endoscopic, histologic features and treatment outcomes of CD patients with oesophageal involvement. METHODS: We collected cases through a retrospective multicentre European Crohn's and Colitis Organisation CONFER [COllaborative Network For Exceptionally Rare case reports] project. Clinical data were recorded in a standardized case report form. RESULTS: A total of 40 patients were reported [22 males, mean (±SD, range) age at oesophageal CD diagnosis: 25 (±13.3, 10-71) years and mean time of follow-up: 67 (±68.1, 3-240) months]. Oesophageal involvement was established at CD diagnosis in 26 patients (65%) and during follow-up in 14. CD was exclusively located in the oesophagus in 2 patients. Thirteen patients (32.2%) were asymptomatic at oesophageal disease diagnosis. Oesophageal strictures were present in 5 patients and fistulizing oesophageal disease in one. Eight patients exhibited granulomas on biopsies. Proton-pump inhibitors (PPIs) were administered in 37 patients (92.5%). Three patients underwent endoscopic dilation for symptomatic strictures and none oesophageal-related surgery. Diagnosis in pre-established CD resulted in treatment modifications in 9/14 patients. Clinical remission of oesophageal disease was seen in 33/40 patients (82.5%) after a mean time of 7 (±5.6, 1-18) months. Follow-up endoscopy was performed in 29/40 patients and 26/29 (89.7%) achieved mucosal healing. CONCLUSION: In this case series the endoscopic and histologic characteristics of isolated oesophageal CD were similar to those reported in other sites of involvement. Treatment was primarily conservative, with PPIs administered in the majority of patients and modifications in pre-existing IBD-related therapy occurring in two thirds of them. Clinical and endoscopic remission was achieved in more than 80% of the patients.info:eu-repo/semantics/publishedVersio

A new viscoelastic benchmark flow: Stationary bifurcation in a cross-slot

AbstractIn this work we propose the cross-slot geometry as a candidate for a numerical benchmark flow problem for viscoelastic fluids. Extensive data of quantified accuracy is provided, obtained via Richardson extrapolation to the limit of infinite refinement using results for three different mesh resolutions, for the upper-convected Maxwell, Oldroyd-B and the linear form of the simplified Phan-Thien–Tanner constitutive models. Furthermore, we consider two types of flow geometry having either sharp or rounded corners, the latter with a radius of curvature equal to 5% of the channel’s width. We show that for all models the inertialess steady symmetric flow may undergo a bifurcation to a steady asymmetric configuration, followed by a second transition to time-dependent flow, which is in qualitative agreement with previous experimental observations for low Reynolds number flows. The critical Deborah number for both transitions is quantified and a set of standard parameters is proposed for benchmarking purposes

Influence of channel aspect ratio on the onset of purely-elastic flow instabilities in three-dimensional planar cross-slots

In this work, we perform creeping-flow simulations of upper-convected Maxwell and simplified Phan-Thien-Tanner fluids to study the purely-elastic steady bifurcation and transition to time-dependent flow in three-dimensional planar cross-slots. By analysing the flow in geometries with aspect ratios ranging from the near Hele-Shaw flow like limit, up to the very deep, two-dimensional limit, we are able to characterize the mechanism of the cross-slot bifurcation with significant detail. We conclude that the bifurcation mechanism is similar to a buckling instability, by which fluid is redirected via paths of least resistance, resulting in the emergence of peripheral stagnation points, above and below the central stagnation point. The intake of matter at the centre via the inlet axis is thus reduced, being compensated by fluid flowing through low resistance corridors along the central vertical axis, above and below the central point. Furthermore, we propose and locally compute a modified Pakdel-McKinley criterion, thereby producing a scalar stability field and suggesting emergent peripheral stagnation points also indirectly contribute to the onset of time-dependent flow. (c) 2015 The Authors. Published by Elsevier B.V