Successful Pregnancy Outcome after Laparoscopic Cerclage in a Patient with Cervicovaginal Fistula

Obstetric fistula usually originates from obstructed labor or, less often, from invasive maneuvers on the genital tract or the pregnant uterus. Overall, it is a rare finding in the obstetric practice of high income countries. In this report we describe the case of a successful term pregnancy in a patient with a history of recurrent late miscarriage due to a large cervical fistula of traumatic origin, connecting the uterine cavity and the posterior vaginal fornix. A combined approach of laparoscopic cerclage and transvaginal fistula repair effectively restored cervical competence and created the conditions for a viable birth in a subsequent pregnancy. This unusual cause of cervical incompetence may be included in the indications which benefit from an abdominal cerclage carried out as a minimally invasive procedure in the nonpregnant state

Untargeted Metabolomics Investigation on Selenite Reduction to Elemental Selenium by Bacillus mycoides SeITE01

Bacillus mycoides SeITE01 is an environmental isolate that transforms the oxyanion selenite ( SeO3 2- ) into the less bioavailable elemental selenium (Se0 ) forming biogenic selenium nanoparticles (Bio-SeNPs). In the present study, the reduction of sodium selenite (Na2SeO3) by SeITE01 strain and the effect of SeO3 2- exposure on the bacterial cells was examined through untargeted metabolomics. A time-course approach was used to monitor both cell pellet and cell free spent medium (referred as intracellular and extracellular, respectively) metabolites in SeITE01 cells treated or not with SeO3 2- . The results show substantial biochemical changes in SeITE01 cells when exposed to SeO3 2- . The initial uptake of SeO3 2- by SeITE01 cells (3 h after inoculation) shows both an increase in intracellular levels of 4-hydroxybenzoate and indole-3-acetic acid, and an extracellular accumulation of guanosine, which are metabolites involved in general stress response adapting strategies. Proactive and defensive mechanisms against SeO3 2- are observed between the end of lag (12h) and beginning of exponential (18h) phases. Glutathione and N-acetyl-L-cysteine are thiol compounds that would be mainly involved in Painter-type reaction for the reduction and detoxification of SeO3 2- to Se0 . In these growth stages, thiol metabolites perform a dual role, both acting against the toxic and harmful presence of the oxyanion and as substrate or reducing sources to scavenge ROS production. Moreover, detection of the amino acids L-threonine and ornithine suggests changes in membrane lipids. Starting from stationary phase (24 and 48h), metabolites related to the formation and release of SeNPs in the extracellular environment begin to be observed. 5-hydroxyindole acetate, D-[+]-glucosamine, 4-methyl-2-oxo pentanoic acid, and ethanolamine phosphate may represent signaling strategies following SeNPs release from the cytoplasmic compartment, with consequent damage to SeITE01 cell membranes. This is also accompanied by intracellular accumulation of trans-4-hydroxyproline and L-proline, which likely represent osmoprotectant activity. The identification of these metabolites suggests the activation of signaling strategies that would protect the bacterial cells from SeO3 2- toxicity while it is converting into SeNPs

Brown rice and pulses for the development of shelf-stable and low glycemic index ready-to-eat meals

Shelf-stable low glycemic index ready-to-eat (RTE) risotto meals (in pouches) containing brown rice and pulses (recipe A = chickpeas; recipe B = lentils, and beans) were developed, stored for 12-months at room temperature, and characterized over time. RTE meals were heated in microwave (replicating home consumption procedure), and analyzed for in vitro starch digestibility, textural attributes, and consumer acceptability. Digestible starch fractions were similar in the formulations during storage, and in vivo testing demonstrated low glycemic indexes (recipe A = 43.5 ± 6.8; recipe B = 31.8 ± 6.5) for the two meals. Hardness of risotto components increased during storage and microwave heating did not fully recover textural attibutes characteristic of the fresh product. Consumers’ (50) acceptability remained high (>5.5 out of 9) until the end of storage. This study demonstrates brown rice with pulses can be used for developing stable and accepted ready-to-eat meals having low glycemic indexes

Damage patterns in the town of Amatrice after August 24th 2016 Central Italy earthquakes

The impact of the two seismic events of August 24th 2016 on the municipality of Amatrice was highly destructive. There were 298 victims, 386 injured, about 5000 homeless, and the historical center of the town suffered a great number of partial and total collapses. The 260 strong motion records obtained for the first event were analyzed and plotted in a shakemap, comparing them with the macroseismic damage surveys made in 305 localities. On the basis of an inspection survey made in September 2016, a map of the damage patterns of the buildings in the historical center was elaborated according to the EMS 98 classification. The damage level resulted very high with more than 60% of the inspected buildings showing partial or total collapse. The elevated level of destruction was mainly caused by the high vulnerability of the masonry buildings, mostly due to specific vulnerability factors such as the poor quality of masonry, the lack of connections between walls and the poor connection between external walls and floors

Effects of massage therapy on sleep quality after coronary artery bypass graft surgery

INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0), during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3) using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m²) were randomized into control (n = 20) and massage therapy (n = 20) groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006) and Day 2 (p=0.028) in addition, they reported a more effective sleep during all three days (p=0.019) when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep

Metabolic Syndrome and All-Cause and Cardiovascular Mortality in an Italian Elderly Population: The Progetto Veneto Anziani (Pro.V.A.) Study

OBJECTIVE—The purpose of this study was to explore the association of metabolic syndrome and each of its components with all-cause and cardiovascular mortality in a general Italian elderly population

Intracranial Subdural Hematoma after Spinal Anesthesia for Cesarean Section

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthesia for cesarean section. Early recognition of symptoms of neurologic impairment led to an emergency craniotomy for hematoma evacuation with good recovery of neurologic functions. The possibility of subdural hematoma should be considered in any patient complaining of severe persistent headache following regional anesthesia, unrelieved by conservative measures. Only early diagnosis and an appropriate treatment may avoid death or irreversible neurologic damage

Melhoramento por haplodiploidização androgenética: variação genotípica no tamanho das anteras e no estágio de desenvolvimento dos micrósporos em aveia

Oat (Avena spp.) is poorly responsive to the haplodiploidization process, which leads to the production of homozygous lines in one step, increasing breeding efficiency. Androgenetic haploids in small grain cereal crops are obtained from microspores cultured at the mononucleate stage, which can be identified by the size of anthers. In order to identify the appropriate anther size for in vitro culture, microspore cytological analyses were made in Avena sativa cultivars UPF 7, UPF 18, UFRGS 14, Stout and Avena sterilis CAV 3361, cultivated in growth chamber under controlled light and temperature conditions. Variation was observed within and among genotypes for anther size at each microspore developmental stage and according to the position of spikelets in the panicle. Architecture variation in panicle shape and non-linear microsporogenesis maturation increased the challenge of identifying potentially androgenetic oat anthers. Cytological screening before culture is critical in identifying microspores at the right stage for oat androgenesis.A aveia (Avena spp.) tem sido pouco responsiva à haplodiploidização, um processo que aumenta a eficiência da seleção no melhoramento por gerar, em uma etapa, linhas puras homozigóticas. A fase mononucleada do micrósporo é critica para o sucesso da androgênese in vitro nos cereais de inverno e, em geral, pode ser inferida pelo tamanho da antera. Foram medidas anteras e analisados citológicamente micrósporos das cultivares de Avena sativa UPF 7, UPF 18, UFRGS 14, Stout e da linhagem CAV 3361 de Avena sterilis, cultivadas em câmaras de crescimento sob temperaturas dia-noite variando de 16ºC a 9ºC e 12 horas de intensidade luminosa de 300 mol m-2 s-1. O tamanho das anteras em cada fase de desenvolvimento dos micrósporos variou significativamente entre genótipos e de acordo com a região de inserção das espiguetas na panícula. A variação na arquitetura da panícula e a maturação não linear das espiguetas aumentam as dificuldades para a identificação das anteras potencialmente androgenéticas e podem explicar, em parte, os baixos resultados da androgênese na aveia. Os dados mostram a necessidade de uma análise citológica prévia para auxiliar a determinar a fase ideal de desenvolvimento dos micrósporos potencialmente responsivos à cultura de anteras, para o uso da androgenese na aveia

COVID-19 Fears and Preventive Behaviors among Prison Staff.

This study focused on COVID-19 preventive behaviors and fears among prison staff members after the first wave of the pandemic. Cross-sectional data from 171 participants were collected in Switzerland. The level of fears (58.5%) and protective behaviors (100%) were high. Correctional officers adhered less to preventive measures than other staff members (p = .001). Fears were related to a reduction of social contacts (p = .006) and worries about physical health was related to preventive behaviors in general (p = .006). There is a need to raise prison staff awareness regarding their vulnerability to the SARS-CoV-2 in order to improve the effectiveness of health campaigns in prison settings. Special attention should be given to correctional officers

Avaliação da presença de ácaros em cereais armazenados na grande São Paulo

Microscopic examinations of 160 samples of cereals (rice, beans, wheat corn, oats, peas and sorghum), 40% provided by Instituto Adolfo Lutz and collected from large distributors as COBAL, CIBRAZEM, PETROPACK, CEAGESP and DECOM, and 60% acquired at many small retailers, realized upon receipt and after 42 days incubation at 25°C and 70% relative humidity showed that 49% of the samples presented primary stored food mites. Of the infested samples, 48% had Tyrophagus putrescentiae (Schrank), 17.5% Aleuroglyphus ovatus (Troupeau), 6.8% Glycyphagus domesticus (DeGeer) , 4.37% Chortoglyphus arcuatus (Troupeau), 3.8% Suidasia pontifica Oudemans, 3.12% Blomia tropicalis Bronswijck, Cock & Oshima, 1.25% Histiostoma sp. and 0.6% Dermatophagoides pteronyssinus (Trouessart). Secondary mites were also present, mainly Tarsonemus sp. , Cheyletus malaccensis Oudemans and Blattosocius dentriticus (Berlese). Samples originating from the large distributors, when infested, had much fewer mites than those from the small retailers where the cereals remain over much longer periods before they are sold out and replaced. The presence of mites in samples after 42 days of incubation when their examination upon receipt was negative for these pests does not preclude the presence of mite eggs. Sitophilus oryzae (L.) (Insecta, Coleoptera) was common in rice, corn and wheat samples.O exame microscópico de 160 amostras de cereais (arroz, feijão, trigo, milho, a veia, ervilha e sorgo), 40% fornecidas pelo Instituto Adolfo Lutz e provenientes de distribuidores como COBAL, CIBRAZEM, PETROPACK, CEAGESP, DECOM e do 2º Exército, e 60% adquiridas em mercadinhos e armazéns na Grande São Paulo, feito no ato e após 42 dias de incubação a 25°C e 70% UR revelou que 49% das amostras apresentavam populações de ácaros primários de alimentos armazenados. Destas, 48% revelaram a presença de Tyrophagus putrescentiae (Schrank), 17,5% Aleuroglyphus ovatus (Troupeau), 6,8% Glycyphagus domesticus (DeGeer), 4,37% Chortoglyphus arcuatus (Troupeau), 3,8% Suidasia pontifica Oudemans, 3,12% Blomia tropicallis Bronswijck, Cook & Oshima, 1,25% Histiostoma sp. e Dermatophagoides pteronyssinus (Trouessart). Ácaros secundários também foram encontra dos destacando-se Tarsonemus sp., Cheyletus malaccensis Oudemans e Blattisocius dentriticus (Berlese), entre outros. As amostras originárias dos grandes distribuidores apresentavam bem menos ácaros do que aquelas dos pequenos armazéns onde a rotatividade de estoque é bem menor. O resultado positivo para ácaros de amostras mantidas em incubador por 42 dias quando seu exame no ato não os revelou, mostra que o simples exame de uma amostra de cereal num dado momento não exclui a hipótese dele estar contaminado por ovos de ácaros primários de alimentos. Dentre os insetos, o mais frequente foi o gorgulho Sitophilus orizae (L.) presente em amostras de arroz, milho e trigo