That\u27s So Gay!: Queer Texts in the U.S.

Gender is facing an identity crisis: queer identities in the new era of gender and genre are subverting paradigms of communication and genre by working with language and narrative in new ways. Queer biography and autobiography mark an important turn in contemporary literature and poetics: the shift from a male-dominant gaze towards a kaleidoscopic perspective on queer embodiment, trans and non-binary narrative, and speculative writing about other worlds & possibilities, which offer us as readers new opportunities for storytelling and thinking about writing. These forms also make space for other identities traditionally excluded from mainstream cultural narrative spaces, and we’re witnessing the emergence of queerness as digital, hybrid, and ephemeral. This course will center the expanding lexicon offered by queer writers, and ground students through including some of the queer studies canon

Analysis of the molecular mobility of collagen and elastin in safe, atheromatous and aneurysmal aortas

Aim of the study : In this study, we propose to use a thermal technique, Differential Scanning Calorimetry (DSC) to follow the evolution of elastin and collagen in safe and pathological cardiovascular tissues. Patients and methods : The first part of this study deals with the analysis of the elastin network and associated proteins during ageing (from children to old persons) in aortic walls. The second part is devoted to the characterization of the collagenic phase in aneurysms. In both cases, physical data are correlated with biochemical analyses. Results and conclusion : For old persons aortas with atheromatous stades, elastin and associated proteins are found to interpenetrate to form a homogenous phase. Abdominal aortic aneurysms (AAA) are characterized by structural alterations of the aortic wall resulting from the degradation of elastic fibers and an increase of collagen/elastin ratio. Notable modifications are evidenced between collagen from control tissue and collagen from AAA, particularly concerning the thermal denaturation. Biochemical and thermal results are compatible with the increase of new collagen deposition and/or impairment of the collagen phase stability in the extracellular matrix of AAAs

Polimorfismo XmnI está associado com os níveis de hemoglobina fetal em hipoplasias medulares

CONTEXT AND OBJECTIVE: Acquired fetal hemoglobin (HbF) elevation has been implicated as a prognostic factor in dyserythropoietic disorders. Our objectives were to examine acquired HbF increases in aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH) patients, and to evaluate whether there is an association between the presence of XmnI and 5' hypersensitive site locus control region (LCR-HS2) polymorphisms and the HbF levels. DESIGN AND SETTING: Cross-sectional study at the Hematology and Blood Transfusion Service of Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina. METHODS: We studied a group of 37 patients with AA and/or PNH. Polymerase chain reaction (PCR) and enzymatic digestion were utilized to analyze XmnI polymorphisms; and PCR, cloning and automated sequencing for the HS2 polymorphisms. RESULTS: The mean HbF level was 2.32%, but there was no significant difference in HbF level between the AA and PNH groups (p = 0.46). HbF levels of less than 1.0% showed a significant correlation with absence of the XmnI (+) polymorphism (p = 0.02). The presence of the XmnI allele was greater in the AA group (p = 0.007). CONCLUSIONS: XmnI polymorphism absence reduction is associated with acquired HbF elevation. Further studies are required to confirm these observations and make treatment, prognosis and survival comparisons.CONTEXTO E OBJETIVO: O aumento adquirido da hemoglobina fetal (HbF) já foi implicado como fator prognóstico em distúrbios diseritropoiéticos. Nossos objetivos foram de examinar elevações adquiridas na HbF em pacientes com anemia aplástica (AA) e hemoglobinúria paroxística noturna (PNH), e de avaliar se há associação entre a presença de polimorfismos XmnI e de região de controle de locus gênico 5' (LCR-HS2) e os níveis de HbF. TIPO DE ESTUDO E LOCAL: Estudo longitudinal no Serviço de Hematologia e Transfusão de Sangue da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina. MÉTODOS: Estudamos um grupo de 37 pacientes com AA e/ou PNH. Reação de polimerase em cadeia (PCR) e digestão enzimática foram usadas para analisar polimorfismos XmnI; e PCR para clonagem e sequenciamento automático dos polimorfismos HS2. RESULTADOS: O nível médio de HbF foi de 2,32%, mas não houve diferença significativa entre o nível de HbF dos pacientes AA e PNH (p = 0.46). Os níveis de HbF menores que 1,0% mostraram correlação estatisticamente significativa com ausência do polimorfismo XmnI (+) (p = 0.007). CONCLUSÕES: Ausência de polimorfismo XmnI está associado com diminuição de HbF. Mais estudos são necessários para confirmar estas observações e fazer comparações sobre tratamento, prognóstico e sobrevida.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Hematology and Blood Transfusion ServiceUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPM, Hematology and Blood Transfusion ServiceUNIFESP, EPMSciEL

The effects of photobiomodulation therapy for the treatment of dentin hypersensitivity

Objective: This case report proposes a treatment for dentin hypersensitivity (DH) using photobiomodulation (PBT) with low power diode laser. Methods and Results: Male patient, 28 years old, reporting “dental sensitivity,” diagnosed by anamnesis and intraoral examination, with non-carious cervical lesions (NCCL) and DH on teeth 15 to 25, with different pain intensities, measured with visual analogue scale (VAS). For DH treatment, a PBT was proposed, with 808nm, 100mW, 20s and 2J of energy, applied during 3 sessions, with one-week interval and reevaluation after 30 days. After the first session, the patient reported improvement of sensitivity in all teeth, except for 15, that remained sensitive even during the reevaluation. Conclusion: PBT was effective in DH treatment, with desensitization being observed for 30 days in 90% of treated teeth.Objetivo: Este relato de caso propõe um tratamento para a hipersensibilidade dentinária (HD) usando fotobiomodulação (FBM) com laser de diodo de baixa potência. Métodos e Resultados: Paciente do sexo masculino, 28 anos, relatando “sensibilidade da dentina”, diagnosticado por anamnese e exame intraoral, com lesões cervicais não cariosas (LCNC) e HD nos dentes 15 a 25, com diferentes intensidades de dor, medidas com escala visual analógica (EVA). Para o tratamento da HD, foi proposto uma FBM, com 808nm, 100mW, 20s e 2J de energia, aplicada durante 3 sessões, com intervalo de uma semana e reavaliação após 30 dias. Após a primeira sessão, o paciente relatou melhora da sensibilidade em todos os dentes, exceto no 15, que permaneceu sensível mesmo durante a reavaliação. Conclusão: FBM foi eficaz no tratamento da HD, com dessensibilização sendo observada por 30 dias em 90% dos dentes tratados

AVALIAÇÃO DA MICRODUREZA DO ESMALTE APÓS CLAREAMENTO COM PERÓXIDO DE HIDROGÊNIO A 35% CONTENDO CÁLCIO / EVALUATION OF ENAMEL MICROHARDNESS AFTER BLEACHING WITH 35% HYDROGEN PEROXIDE CONTAINING CALCIUM

Introdução: A estética vem ganhando destaque na Odontologia e o clareamento aparece como uma forma conservadora para se obter harmonia de cor nos dentes. Objetivo: Avaliar, in vitro, a microdureza do esmalte dental humano após o clareamento de consultório com agente a base de peróxido de hidrogênio a 35%, contendo ou não cálcio. Métodos: Vinte e quatro dentes humanos, que foram seccionados para confeccionar fragmentos de esmalte de aproximadamente 5 x 5 mm. Os fragmentos foram incluídos em resina acrílica, polidos e distribuídos aleatoriamente em 2 grupos (n=12), conforme o agente clareador utilizado: G1: fragmentos clareados com peróxido de hidrogênio a 35% sem cálcio, (3 aplicações de 15 minutos cada) e G2: utilização do agente clareador com cálcio (única aplicação de 45 minutos). A avaliação da microdureza Knoop utilizando 100 Kgf de carga por 15 segundos foi realizada inicialmente (baseline), imediatamente e 07 dias após o término do clareamento. Os dados foram submetidos a ANOVA com nível de significância de 5%. Resultados: Houve diminuição da microdureza do esmalte logo após o clareamente, sendo que o grupo que com agente clareador sem cálcio apresentou diminuição mais acentuada. G1: 319,02 ± 40,08; 200,01 ± 25,32; 256,02 ± 25,01 e G2 = 329,04 ± 34,71; 236,03 ± 34,23; 267,03 ± 40,53. Conclusão: O clareamento realizado com peróxido de hidrogênio a 35% diminui a microdureza imediatamente após o término do mesmo, independentemente do agente clareador conter ou não cálcio em sua composição, porém quando o agente clareador não contém cálcio esta diminuição é mais acentuada. No entanto, os valores de microdureza retornam aos valores iniciais no período de 7 dias após o término do clareamento.Palavras-chave: Clareamento dental. Dureza. Esmalte dentário.AbstractIntroduction: Aesthetics is gaining prominence in dentistry and whitening appears as a conservative way to achieve color harmony in the teeth. Objective: To evaluate, in vitro, the microhardness of human dental enamel after office bleaching with 35% hydrogen peroxide-based agent, with or without calcium. Methods: Twenty-four human teeth that were sectioned for making enamel fragments of approximately 5 x 5 mm. The fragments were embedded in acrylic resin, polished and randomly divided into 2 groups (n = 12) according to the bleaching agent used: G1: bleached fragments with 35% hydrogen peroxide without calcium, (3 applications of 15 minutes each) and G2: use of bleaching agents with calcium (only one application of 45 minutes). The evaluation of Knoop microhardness using 100 kgf load for 15 seconds was carried out initially (baseline), immediately and 07 days after bleaching. Data were analyzed by ANOVA at 5% significance. Results: There was decreased enamel hardness after the clareamente, and the group with bleaching agent without calcium showed a more severe decrease. G1: 319.02 ± 40.08; 200.01 ± 25.32; 256.02 ± 25.01 and 329.04 ± G2 = 34.71; 236.03 ± 34.23; 267.03 ± 40.53. Conclusion: The whitening performed with 35% hydrogen peroxide reduces the microhardness immediately after the same regardless of the bleaching agent may or may not contain calcium in their composition, but when the bleaching agent does not contain calcium, such decrease is more pronounced. However, the microhardness values returned to baseline levels within 7 days after the end of bleaching.Keywords: Tooth whitening. Toughness. Tooth enamel

Desempenho ocupacional de indivíduos com osteoartrite de mão /Occupational performance of individuals with hand osteoarthritis

Introdução: A osteoartrite de mãos pode provocar prejuízos na função manual e limitar a participação em ocupações significativas. O conhecimento desse impacto é importante para direcionar a assistência às pessoas acometidas, através de abordagens que favoreçam seu desempenho ocupacional. Objetivo: Descrever a influência da osteoartrite de mãos no desempenho ocupacional de indivíduos com a doença. Métodos: Estudo transversal e descritivo, realizado no ambulatório de reumatologia de um hospital de referência, entre novembro de 2014 e maio de 2015. Foram utilizados para a coleta de dados: ficha de avaliação inicial e Medida Canadense de Desempenho Ocupacional (COPM). Para análise dos dados utilizou-se estatística descritiva, através de medidas de tendência central e distribuição de probabilidade. Resultados: Participaram do estudo 28 pacientes. As áreas de desempenho ocupacional com maior comprometimento foram a produtividade e o autocuidado, sendo identificadas com maior frequência tarefas domésticas e do vestuário. Os participantes apresentaram média de desempenho de 3,6 e satisfação de 2,9 nas atividades relatadas. Não houve relação entre o tempo de diagnóstico e o comprometimento no desempenho ocupacional. Conclusão: O impacto da osteoartrite de mãos no desempenho ocupacional reflete prejuízos nas atividades e ocupações nas áreas da produtividade, autocuidado e lazer. AbstractIntroduction: The hand osteoarthritis may cause impairments in hand function and limit the performance of several activities, restricting participation in meaningful occupations.  The knowledge of this impact is essential to direct assistance to affected people through approaches that benefit their occupational performance. Objective:  Describe the influence of hand osteoarthritis on occupational performance of individuals with the disease. Methods: Cross-sectional study and descriptive study, held at the rheumatology outpatient clinic of a reference hospital in the period between November 2014 and May 2015. The assessments used for data collection were an initial evaluation form, and the Canadian Occupational Performance Measure (COPM). For data analysis descriptive statistics were used, through central tendency measures and probability distribution.  Results: 28 outpatients were included in the study. The occupational performance areas with greater commitment were productivity and self-care, identified most frequently activities related to household tasks and dressing. Participants showed average of 3.6 of performance, and 2.9 of satisfaction in the reported activities. There was no relationship between the time of diagnosis and the commitment on the occupational performance. Conclusion: The impact of hand osteoarthritis on occupational performance reflects impairments in activities and occupations in the areas of productivity, self-care and leisure.Keywords: Activities of Daily Living. Hand. Osteoarthritis. Occupational Therapy. ResumenIntroducción: La osteoartritis de manos puede provocar daños en la función manual y limitar la realización de diversas actividades, restringiendo la participación en ocupaciones significativas. El conocimiento de este impacto es esencial para dirigir la asistencia a las personas acometidas, a través de enfoques que favorezcan su desempeño ocupacional. Objetivo: Describir la influencia de la osteoartritis de manos en el desempeño ocupacional de los individuos con la enfermedad. Métodos: Estudio transversal y descriptivo, realizado en el ambulatorio de reumatología de un hospital de referencia, en el período entre noviembre de 2014 y mayo de 2015. Los instrumentos utilizados para la recolección de datos fueron una ficha de evaluación inicial, y la Medida Canadiense de Desempeño Ocupacional (COPM). Para el análisis de los datos se utilizó estadística descriptiva, a través de medidas de tendencia central y distribución de probabilidad. Resultados: Participaron del estudio 28 pacientes del ambulatorio. Las áreas de desempeño ocupacional con mayor compromiso fueron la productividad y el autocuidado, siendo identificadas con mayor frecuencia actividades relacionadas a las tareas domésticas y al vestuario. Los participantes presentaron un promedio de rendimiento de 3,6, y satisfacción de 2,9 en las actividades relatadas. No hubo relación entre el tiempo de diagnóstico y el compromiso en el desempeño ocupacional. Conclusión:Palabras llave: Actividades cotidianas. Mano. Osteoartritis. Terapia ocupacional.

Immunophenotypic features of tumor infiltrating lymphocytes from mammary carcinomas in female dogs associated with prognostic factors and survival rates

<p>Abstract</p> <p>Background</p> <p>The immune system plays an important role in the multifactorial biologic system during the development of neoplasias. However, the involvement of the inflammatory response in the promotion/control of malignant cells is still controversial, and the cell subsets and the mechanisms involved are poorly investigated. The goal of this study was to characterize the clinical-pathological status and the immunophenotyping profile of tumor infiltrating lymphocytes and their association with the animal survival rates in canine mammary carcinomas.</p> <p>Methods</p> <p>Fifty-one animals with mammary carcinomas, classified as carcinomas in mixed tumors-MC-BMT = 31 and carcinomas-MC = 20 were submitted to systematic clinical-pathological analysis (tumor size; presence of lymph node and pulmonary metastasis; clinical stage; histological grade; inflammatory distribution and intensity as well as the lymphocytic infiltrate intensity) and survival rates. Twenty-four animals (MC-BMT = 16 and MC = 8) were elected to the immunophenotypic study performed by flow cytometry.</p> <p>Results</p> <p>Data analysis demonstrated that clinical stage II-IV and histological grade was I more frequent in MC-BMT as compared to MC. Univariate analysis demonstrated that the intensity of inflammation (moderate/intense) and the proportion of CD4⁺(≥ 66.7%) or CD8⁺T-cells (<33.3%) were not associated with worse survival rate. Multivariate analysis demonstrated that only lymphocytic infiltrate intensity ≥ 600 (<it>P </it>= 0.02) remained as independent prognostic factor. Despite the clinical manifestation, the lymphocytes represented the predominant cell type in the tumor infiltrate. The percentage of T-cells was higher in animals with MC-BMT without metastasis, while the percentage of B-lymphocytes was greater in animals with metastasized MC-BMT (<it>P </it>< 0.05). The relative percentage of CD4⁺T-cells was significantly greater in metastasized tumors (both MC-BMT and MC), (<it>P </it>< 0.05) while the proportion of CD8⁺T-cells was higher in MC-BMT without metastasis. Consequently, the CD4⁺/CD8⁺ratio was significantly increased in both groups with metastasis. Regardless of the tumor type, the animals with high proportions of CD4⁺and low CD8⁺T-cells had decreased survival rates.</p> <p>Conclusion</p> <p>The intensity of lymphocytic infiltrate and probably the relative abundance of the CD4⁺and CD8⁺T-lymphocytes may represent important survival prognostic biomarkers for canine mammary carcinomas.</p

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat