Charge-based continuous model for long-channel Symmetric Double-Gate Junctionless Transistors

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A PROBLEMÁTICA DO MONITORAMENTO DAS INFECÇÕES DE SÍTIO CIRÚRGICO E A NECESSIDADE DE PADRONIZAÇÃO DE CRITÉRIOS PARA SEU DIAGNÓSTICO E NOTIFICAÇÃO.

Las infecciones hospitalarias (IH) ocurren como un problema de salud pública mundial, siendo la Infección del Sitio Quirúrgico la tercera topografia más común, de 14% a 16% de todas las IH. Cuando un paciente muere por una causa asociada a la IH, 77% están relacionadas con la ISC; 93% de ellas con infecciones serias que invaden órganos o espacios accedidos durante un procedimiento quirúrgico. Directamente, las repercusiones de las ISC aparecen en los costos hospitalarios, pues aumentan la permanencia hospitalaria entre 7 a 10 días, amén de las readmisiones; pero, de manera indirecta, igualmente o más importante, están los costos indirectos que causan impactos emocionales desastrosos en los pacientes y en la familia. Los criterios más utilizados para diagnóstico de ISC son los Centers for Diseases Control (CDC); otros criterios desarrollados por especialistas ingleses como el National Prevalence Survey Study (NPS) también son utilizados. El objetivo de este estudio fue buscar una respuesta, en la literatura, para la práctica del controlador de infección hospitalaria en lo que respecta a la existencia de un “patrón-oro” para el diagnóstico de ISC, con el fin de soportar los resultados obtenidos y las consecuentes acciones. Una revisión sistemática ha mostrado que comparándose las definiciones del CDC y NPS de 93 heridas operatorias, 24% han quedado sin diagnóstico al utilizarse criterios del CDC y 19% cuando se utilizaron criterios del NPS. La conclusión de este estudio es que no hay un “patrón-oro” para el diagnóstico de ISC, pues el juicio es subjetivo, y sujeto a variaciones de acuerdo con el observador. Es necesario que cada servicio de salud junto al grupo Comissão de Controle de Infeccção Hospitalar -CCIH (Comisión de Control de Infección Hospitalaria) asuma y reglamente, por medio de la mejor evidencia científica, cuáles son los mejores criterios para diagnóstico y notificación de ISC, cuál es el mejor método de trabajo para vigilancia después del alta, teniendo en cuenta la factibilidad y las necesidades locales.As infecções hospitalares (IH) surgem como um problema de saúde pública mundial sendo a Infecção de Sítio Cirúrgico (ISC) a terceira topografia mais comum, de 14% a 16% de todas as IH. Quando um paciente morre por causa associada à IH, 77% estão relacionadas a ISC; 93% deles com infecções sérias que invadem órgãos ou espaços acessados durante o procedimento cirúrgico. Diretamente, as repercussões das ISC aparecem nos custos hospitalares pois aumentam a permanência hospitalar entre 7 a 10 dias, além das readmissões; mas de forma indireta e tão ou mais importante, estão os custos indiretos que provocam impactos emocionais desastrosos nos pacientes e familiares. Os critérios mais utilizados para diagnóstico de ISC são os do Centers for Diseases Control (CDC), outros critérios desenvolvidos por especialistas ingleses como o National Prevalence Survey Study (NPS) também são utilizados. O objetivo deste estudo foi buscar resposta, na literatura, para a pratica do controlador de infecção hospitalar no que tange a existência de um padrão ouro para o diagnostico de ISC, a fim de respaldar os resultados obtidos e as conseqüentes ações. Uma revisão sistemática mostrou que se comparando as definições do CDC e NPS de 93 feridas operatórias, 24% ficaram sem diagnóstico quando usados critérios do CDC e 19% quando usados critérios do NPS. A conclusão deste estudo é que não há padrão ouro, no diagnóstico de ISC, pois o julgamento é subjetivo e sujeito a variações de acordo com o observador. É preciso que cada serviço de saúde, junto ao grupo da Comissão de Controle de Infecção Hospitalar (CCIH) assuma e normatize, por meio da melhor evidência científica, quais os melhores critérios para diagnóstico e notificação de ISC, qual o melhor método de trabalho para vigilância no pós-alta; levando em conta a factibilidade e as necessidades locais

Policies for control and prevention of infections related to healthcare assistance in Brazil: a conceptual analysis

Abstract This article is a theoretical-reflexive study that aims to discuss the development and changes in the quality of healthcare assistance to the patient over the years in Brazil, in light of the policies of control and prevention of Healthcare-associated Infection (HAI). Aspects of HAI and the process of change in health policy in Brazil, as well as the quality of assistance associated with its control, are approached in relation to policies of patient safety. There are various new theoretical and practical proposals created in Brazil. In spite of the difficulty of measuring patient safety, directed to the prevention and control of HAI, we emphasize that to only create policies and establish norms, guidelines, and indicators is not sufficient. If no structural support or conditions exist for interventions in the practices of healthcare professionals, aiming at results in acceptable levels, the control of HAI will not be achieved

Primary DNA damage and genetic polymorphisms for CYP1A1, EPHX and GSTM1 in workers at a graphite electrode manufacturing plant

<p>Abstract</p> <p>Background</p> <p>The results of a cross-sectional study aimed to evaluate whether genetic polymorphisms (biomarkers of susceptibility) for <it>CYP1A1</it>, <it>EPHX </it>and <it>GSTM1 </it>genes that affect polycyclic aromatic hydrocarbons (PAH) activation and detoxification might influence the extent of primary DNA damage (biomarker of biologically effective dose) in PAH exposed workers are presented. PAH-exposure of the study populations was assessed by determining the concentration of 1-hydroxypyrene (1OHP) in urine samples (biomarker of exposure dose).</p> <p>Methods</p> <p>The exposed group consisted of workers (n = 109) at a graphite electrode manufacturing plant, occupationally exposed to PAH. Urinary 1OHP was measured by HPLC. Primary DNA damage was evaluated by the alkaline comet assay in peripheral blood leukocytes. Genetic polymorphisms for <it>CYP1A1</it>, <it>EPHX</it> and <it>GSTM1</it> were determined by PCR or PCR/RFLP analysis.</p> <p>Results</p> <p>1OHP and primary DNA damage were significantly higher in electrode workers compared to reference subjects. Moreover, categorization of subjects as normal or outlier highlighted an increased genotoxic risk OR = 2.59 (CI95% 1.32–5.05) associated to exposure to PAH. Polymorphisms in <it>EPHX</it> exons 3 and 4 was associated to higher urinary concentrations of 1OHP, whereas none of the genotypes analyzed (<it>CYP1A1</it>, <it>EPHX</it>, and <it>GSTM1</it>) had any significant influence on primary DNA damage as evaluated by the comet assay.</p> <p>Conclusion</p> <p>The outcomes of the present study show that molecular epidemiology approaches (i.e. cross-sectional studies of genotoxicity biomarkers) can play a role in identifying common genetic risk factors, also attempting to associate the effects with measured exposure data. Moreover, categorization of subjects as normal or outlier allowed the evaluation of the association between occupational exposure to PAH and DNA damage highlighting an increased genotoxic risk.</p

Genome-wide interaction study of smoking and bladder cancer risk

Bladder cancer is a complex disease with known environmental and genetic risk factors. We performed a genome-wide interaction study (GWAS) of smoking and bladder cancer risk based on primary scan data from 3002 cases and 4411 controls from the National Cancer Institute Bladder Cancer GWAS. Alternative methods were used to evaluate both additive and multiplicative interactions between individual single nucleotide polymorphisms (SNPs) and smoking exposure. SNPs with interaction P values < 5 x 10(-) (5) were evaluated further in an independent dataset of 2422 bladder cancer cases and 5751 controls. We identified 10 SNPs that showed association in a consistent manner with the initial dataset and in the combined dataset, providing evidence of interaction with tobacco use. Further, two of these novel SNPs showed strong evidence of association with bladder cancer in tobacco use subgroups that approached genome-wide significance. Specifically, rs1711973 (FOXF2) on 6p25.3 was a susceptibility SNP for never smokers [combined odds ratio (OR) = 1.34, 95% confidence interval (CI) = 1.20-1.50, P value = 5.18 x 10(-) (7)]; and rs12216499 (RSPH3-TAGAP-EZR) on 6q25.3 was a susceptibility SNP for ever smokers (combined OR = 0.75, 95% CI = 0.67-0.84, P value = 6.35 x 10(-) (7)). In our analysis of smoking and bladder cancer, the tests for multiplicative interaction seemed to more commonly identify susceptibility loci with associations in never smokers, whereas the additive interaction analysis identified more loci with associations among smokers-including the known smoking and NAT2 acetylation interaction. Our findings provide additional evidence of gene-environment interactions for tobacco and bladder cancer

Hereditary renal adysplasia, pulmonary hypoplasia and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a case report

<p>Abstract</p> <p>Background</p> <p>Hereditary renal adysplasia is an autosomal dominant trait with incomplete penetrance and variable expression that is usually associated with malformative combinations (including Müllerian anomalies) affecting different mesodermal organs such as the heart, lung, and urogenital system.</p> <p>Case report</p> <p>A case showing pulmonary hypoplasia, hip dysplasia, hereditary renal adysplasia, and Mayer-Rokitansky-Kuster-Hauser syndrome in adulthood is reported here. The i.v. pyelography showed right renal agenesis with a normal left kidney and ureter. Ultrasound and Magnetic Resonance Imaging also showed right renal agenesis with multicystic embryonary remnants in the right hemipelvis probably corresponding to a dysgenetic kidney. An uretrocystoscopy showed absence of ectopic ureter and of the right hemitrigone. She was scheduled for a diagnostic laparoscopy and creation of a neovagina according to the McIndoe technique with a prosthesis and skin graft. Laparoscopy confirmed the absence of the uterus. On both sides, an elongated, solid, rudimentary uterine horn could be observed. Both ovaries were also elongated, located high in both abdominal flanks and somewhat dysgenetics. A conventional cytogenetic study revealed a normal female karyotype 46, XX at a level of 550 GTG bands. A CGH analysis was performed using a 244K oligoarray CGH detecting 11 copy number variants described as normal variants in the databases. The 17q12 and 22q11.21 microdeletions described in other MRKH patients were not present in this case. Four years after operation her evolution is normal, without symptoms and the neovagina is adequately functional. The geneticists have studied her family history and the pedigree of the family is shown.</p> <p>Conclusions</p> <p>We suggest that primary damage to the mesoderm (paraaxil, intermediate, and lateral) caused by mutations in a yet unidentified gene is responsible for: 1) skeletal dysplasia, 2) inappropriate interactions between the bronchial mesoderm and endodermal lung bud as well as between the blastema metanephric and ureteric bud, and eventually 3) Müllerian anomalies (peritoneal mesothelium) at the same level. These anomalies would be transmitted as an autosomal dominant trait with incomplete penetrance and variable expressivity.</p

Laparoscopic right hemicolectomy: the SICE (Societ\ue0 Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Background: While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons\u2019 attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods: One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results: ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients\u2019 characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions: In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration: Clinical trial (Identifier: NCT03934151)