113 research outputs found
Hypoplastic Left Heart Syndrome with in Utero Closed Foramen Ovale: Case Report
Apresenta-se o caso clínico de um recém-
-nascido (RN) do sexo masculino, com
diagnóstico pré-natal de síndrome do coração
esquerdo hipoplásico (SCEH), referenciado às
37 semanas de gestação.
No ecocardiograma fetal apresentava SCEH
clássico com atrésia da aorta, válvula mitral
permeável e septo interauricular espessado,
mas com foramen ovale (FO) aparentemente
permeável. Parto eutócico de termo, PN =
2540g, necessidade de intubação
endotraqueal com ventilação assistida e
prostaglandina E1 intravenosa.
Imediatamente após o parto verificou-se
agravamento clínico com deterioração dos
valores gasimétricos. O ecocardiograma
confirmou o diagnóstico, levantando a
suspeita de encerramento do FO, que se
confirmou no exame hemodinâmico, feito de
seguida. Tentativa de atrioseptostomia de
Rashkind, sem sucesso. O RN faleceu, tendo
a autópsia revelado SCEH com FO encerrado,
seio coronário aumentado e extensas
linfangiectasias pulmonares. O aumento do
seio coronário levou, neste caso, ao
diagnóstico pré-natal errado de FO permeável
com shunt esquerdo-direito
Sotalol in the Treatment of Fetal Tachyarrhythmia
A taquicardia fetal é uma situação rara, que,
quando mantida coloca em risco a vida do
feto. O modo de tratamento não é consensual,
existindo várias modalidades farmacológicas.
O objectivo deste estudo foi avaliar a eficácia e segurança do sotalol no tratamento de taquicardias fetais.
Material e métodos: Estudo retrospectivo, com
base nos registos de consulta e entrevista às
mães dos fetos com taquicardia supraventricular, referenciados ao Serviço de
Cardiologia Pediátrica do Hospital de Santa
Marta, durante um período de dez anos.
Resultados: Foram diagnosticados oito fetos
com taquicardia supraventricular, dos quais
seis foram tratados com sotalol. A idade
média de gestação na apresentação foi de 30
semanas. Nenhum feto apresentava cardiopatia estrutural, em dois verificou-se hidropisia fetal e outro apresentou hidrocefalia. A taquicardia era supraventricular em todos, sendo em dois por flutter auricular. Em todos os casos, excepto um, houve conversão a ritmo sinusal, não se registando efeitos secundários nas mães nem mortalidade fetal. No período neonatal em três crianças foram registados episódios de taquicardia supraventricular paroxística.
Conclusão: O sotalol mostrou-se seguro e
eficaz no tratamento das taquicardias fetais,
mas, dada a pequenez da amostra, outros
estudos mais alargados são necessários para
se tirarem conclusões válidas
Technical note: Validation of an automatic recording system to assess behavioural activity level in sheep (Ovis aries)
The welfare of an individual can be assessed by monitoring behavioural changes, such as inactivity, that may indicate injury or disease. In this study we validated the Actiwatch Mini® activity monitor (AM) for automatic recording of behavioural activity levels of nine Texel ewes. The AM devices were attached to collars placed around the necks of the ewes. AM recordings were taken at 25 second intervals for 21 consecutive days and in addition, direct behavioural observations made on days 9–13. AM recordings were compared with direct behavioural observations to investigate whether different levels of behaviour activity could be distinguished by the AM. Six different behaviours were matched to the activity scores recorded by the AM which were low activity (lying ruminating, lying), medium activity (standing, standing ruminating, and grazing) and high activity behaviours (walking). There were differences in the activity scores for all three scores. However, higher levels of accuracy in distinguishing between activity levels were achieved when combining high and medium activity level behaviours. This method of capturing data provides a practical tool in studies assessing the impact of disease or injury. For example, assessing the effects of lameness on the activity level of sheep at pasture, without the presence of an observer influencing behaviour.The authors thank the staff at the farm, at which data were collected, for supporting the study and for taking good care of the animals. This study was part of a project funded by the EU VII Framework programme Animal Welfare Indicators (Grant no. FP7-KBBE-2010-4) who had no involvement in the study design, data collection, data analysis or writing of the report. The Actiwatches’ were provided to AJM through funding from CHDI Foundation, Inc.This is the author accepted manuscript. The final version is available from Elsevier at http://www.sciencedirect.com/science/article/pii/S0921448815001455
What are we measuring? A critique of range of motion methods currently in use for Dupuytren's disease and recommendations for practice
Background: Range of motion is the most frequently reported measure used in practice to evaluate outcomes.
A goniometer is the most reliable tool to assess range of motion yet, the lack of consistency in reporting prevents comparison between studies. The aim of this study is to identify how range of motion is currently assessed and reported in Dupuytren’s disease literature. Following analysis recommendations for practice will be made to enable consistency in future studies for comparability. This paper highlights the variation in range of motion reporting in Dupuytren’s disease.
Methods: A Participants, Intervention, Comparison, Outcomes and Study design format was used for the search strategy and search terms. Surgery, needle fasciotomy or collagenase injection for primary or recurrent Dupuytren’s disease in adults were included if outcomes were monitored using range of motion to record change. A literature search was performed in May 2013 using subject heading and free-text terms to also capture electronic publications ahead of print. In total 638 publications were identified and following screening 90 articles met the inclusion criteria. Data was extracted and entered onto a spreadsheet for analysis. A thematic analysis was carried out to establish any duplication, resulting in the final range of motion measures identified.
Results: Range of motion measurement lacked clarity, with goniometry reportedly used in only 43 of the 90 studies, 16 stated the use of a range of motion protocol. A total of 24 different descriptors were identified describing range of motion in the 90 studies. While some studies reported active range of motion, others reported passive or were unclear. Eight of the 24 categories were identified through thematic analysis as possibly describing the same measure, ‘lack of joint extension’ and accounted for the most frequently used. Conclusions: Published studies lacked clarity in reporting range of motion, preventing data comparison and
meta-analysis. Percentage change lacks context and without access to raw data, does not allow direct comparison of baseline characteristics. A clear description of what is being measured within each study was required. It is recommended that range of motion measuring and reporting for Dupuytren’s disease requires consistency to address issues that fall into 3 main categories:-
Definition of terms
Protocol statement
Outcome reportin
Bat conservation and zoonotic disease risk: a research agenda to prevent misguided persecution in the aftermath of COVID-19
Letter to the EditorCOVID-19 has spread around the globe, with massive
impacts on global human health, national economies and
conservation activities. In the timely editorial about conservation
in the maelstrom of COVID-19, Evans et al. (2020)
urged the conservation community to collaborate with other
relevant sectors of society in the search for solutions to the
challenges posed by the current pandemic, as well as future
zoonotic outbreaks. Considering the association of COVID 19 with bats (Zhou et al., 2020), bat conservationists will
undoubtedly be key actors in this dialogue, and thus an
action plan on how best to adjust bat conservation to this
new reality, alongside a transdisciplinary research agenda,
are clear prioritiesinfo:eu-repo/semantics/publishedVersio
Optimal functional outcome measures for assessing treatment for Dupuytren's disease: A systematic review and recommendations for future practice
This article is available through the Brunel Open Access Publishing Fund. Copyright © 2013 Ball et al.; licensee BioMed Central Ltd.Background: Dupuytren's disease of the hand is a common condition affecting the palmar fascia, resulting in progressive flexion deformities of the digits and hence limitation of hand function. The optimal treatment remains unclear as outcomes studies have used a variety of measures for assessment. Methods: A literature search was performed for all publications describing surgical treatment, percutaneous needle aponeurotomy or collagenase injection for primary or recurrent Dupuytren’s disease where outcomes had been monitored using functional measures. Results: Ninety-one studies met the inclusion criteria. Twenty-two studies reported outcomes using patient reported outcome measures (PROMs) ranging from validated questionnaires to self-reported measures for return to work and self-rated disability. The Disability of Arm, Shoulder and Hand (DASH) score was the most utilised patient-reported function measure (n=11). Patient satisfaction was reported by eighteen studies but no single method was used consistently. Range of movement was the most frequent physical measure and was reported in all 91 studies. However, the methods of measurement and reporting varied, with seventeen different techniques being used. Other physical measures included grip and pinch strength and sensibility, again with variations in measurement protocols. The mean follow-up time ranged from 2 weeks to 17 years. Conclusions: There is little consistency in the reporting of outcomes for interventions in patients with Dupuytren’s disease, making it impossible to compare the efficacy of different treatment modalities. Although there are limitations to the existing generic patient reported outcomes measures, a combination of these together with a disease-specific questionnaire, and physical measures of active and passive individual joint Range of movement (ROM), grip and sensibility using standardised protocols should be used for future outcomes studies. As Dupuytren’s disease tends to recur following treatment as well as extend to involve other areas of the hand, follow-up times should be standardised and designed to capture both short and long term outcomes
Physical constraints on a class of two-Higgs doublet models with FCNC at tree level
We analyse the constraints and some of the phenomenological implications of a class of two Higgs doublet models where there are flavour-changing neutral currents (FCNC) at tree level but the potentially dangerous FCNC couplings are suppressed by small entries of the CKM matrix V. This class of models have the remarkable feature that, as a result of a discrete symmetry of the Lagrangian, the FCNC couplings are entirely fixed in the quark sector by V and the ratio v(2)/v(1) of the vevs of the neutral Higgs. The discrete symmetry is extended to the leptonic sector, so that there are FCNC in the leptonic sector with their flavour structure fixed by the leptonic mixing matrix. We analyse a large number of processes, including decays mediated by charged Higgs at tree level, processes involving FCNC at tree level, as well as loop induced processes. We show that in this class of models one has new physical scalars beyond the standard Higgs boson, with masses reachable at the next round of experiments
Two-Higgs Leptonic Minimal Flavour Violation
We construct extensions of the Standard Model with two Higgs doublets, where
there are flavour changing neutral currents both in the quark and leptonic
sectors, with their strength fixed by the fermion mixing matrices and
. These models are an extension to the leptonic sector of the class
of models previously considered by Branco, Grimus and Lavoura, for the quark
sector. We consider both the cases of Dirac and Majorana neutrinos and identify
the minimal discrete symmetry required in order to implement the models in a
natural way.Comment: 25 pages. No figure
Evaluation of a novel magneto-optical method for the detection of malaria parasites
Improving the efficiency of malaria diagnosis is one of the main goals of current malaria research. We have recently developed a magneto-optical (MO) method which allows high-sensitivity detection of malaria pigment (hemozoin crystals) in blood via the magnetically induced rotational motion of the hemozoin crystals. Here, we evaluate this MO technique for the detection of Plasmodium falciparum in infected erythrocytes using in-vitro parasite cultures covering the entire intraerythrocytic life cycle. Our novel method detected parasite densities as low as approximately 40 parasites per microliter of blood (0.0008% parasitemia) at the ring stage and less than 10 parasites/microL (0.0002% parasitemia) in the case of the later stages. These limits of detection, corresponding to approximately 20 pg/microL of hemozoin produced by the parasites, exceed that of rapid diagnostic tests and compete with the threshold achievable by light microscopic observation of blood smears. The MO diagnosis requires no special training of the operator or specific reagents for parasite detection, except for an inexpensive lysis solution to release intracellular hemozoin. The devices can be designed to a portable format for clinical and in-field tests. Besides testing its diagnostic performance, we also applied the MO technique to investigate the change in hemozoin concentration during parasite maturation. Our preliminary data indicate that this method may offer an efficient tool to determine the amount of hemozoin produced by the different parasite stages in synchronized cultures. Hence, it could eventually be used for testing the susceptibility of parasites to antimalarial drugs
Isomorphic diffuse glioma is a morphologically and molecularly distinct tumour entity with recurrent gene fusions of MYBL1 or MYB and a benign disease course
The “isomorphic subtype of diffuse astrocytoma” was identified histologically in 2004 as a supratentorial, highly differentiated glioma with low cellularity, low proliferation and focal diffuse brain infiltration. Patients typically had seizures since childhood and all were operated on as adults. To define the position of these lesions among brain tumours, we histologically, molecularly and clinically analysed 26 histologically prototypical isomorphic diffuse gliomas. Immunohistochemically, they were GFAP-positive, MAP2-, OLIG2- and CD34-negative, nuclear ATRX-expression was retained and proliferation was low. All 24 cases sequenced were IDH-wildtype. In cluster analyses of DNA methylation data, isomorphic diffuse gliomas formed a group clearly distinct from other glial/glio-neuronal brain tumours and normal hemispheric tissue, most closely related to paediatric MYB/MYBL1-altered diffuse astrocytomas and angiocentric gliomas. Half of the isomorphic diffuse gliomas had copy number alterations of MYBL1 or MYB (13/25, 52%). Gene fusions of MYBL1 or MYB with various gene partners were identified in 11/22 (50%) and were associated with an increased RNA-expression of the respective MYB-family gene. Integrating copy number alterations and available RNA sequencing data, 20/26 (77%) of isomorphic diffuse gliomas demonstrated MYBL1 (54%) or MYB (23%) alterations. Clinically, 89% of patients were seizure-free after surgery and all had a good outcome. In summary, we here define a distinct benign tumour class belonging to the family of MYB/MYBL1-altered gliomas. Isomorphic diffuse glioma occurs both in children and adults, has a concise morphology, frequent MYBL1 and MYB alterations and a specific DNA methylation profile. As an exclusively histological diagnosis may be very challenging and as paediatric MYB/MYBL1-altered diffuse astrocytomas may have the same gene fusions, we consider DNA methylation profiling very helpful for their identification
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