沿岸海洋景観のGISデータベースの構築

<p>Superimposition of the top poses of LASSBio-448 obtained by docking with PDE4A and PDE4C (light purple surface, PDE4A) (A), PDE4B and PDE4D (gold surface, PDE4D) (B). Hydrogen atoms have been omitted for clarity.</p

Enxaqueca em 746 pacientes com esclerose múltipla

Enxaqueca piora o sofrimento do paciente que tem esclerose múltipla (EM). ID-migraine é uma ferramenta útil para seleção de pacientes com enxaqueca e Migraine Disability Assessment (MIDAS) é um questionário que avalia o impacto da doença. O objetivo do presente estudo foi avaliar a presença e impacto de enxaqueca em pacientes com EM. Métodos: Pacientes diagnosticados com EM e tratados em clínicas especializadas foram convidados a responder um questionário online se também apresentassem cefaleia. Resultados: O estudo incluiu 746 participantes com cefaleia e EM que preencheram completamente as respostas. Foram 625 mulheres e 121 homens, sendo 69% dos pacientes com idade entre 20 e 40 anos. Enxaqueca foi identificada em 404 pacientes (54,1%) e moderado a grave impacto da doença foi observado em 68,3% dos casos. Conclusão: Enxaqueca é uma cefaleia primária frequente e incapacitante relatada por pacientes com EM.Migraine adds to the burden of patients suffering from multiple sclerosis (MS). The ID-migraine is a useful tool for screening migraine, and the Migraine Disability Assessment questionnaire can evaluate disease burden. The aim of the present study was to assess the presence and burden of migraine in patients with MS. Methods: Patients diagnosed with MS attending specialized MS units were invited to answer an online survey if they also experienced headache. Results: The study included 746 complete responses from patients with MS and headache. There were 625 women and 121 men, and 69% of all the patients were aged between 20 and 40 years. Migraine was identified in 404 patients (54.1%) and a moderate-to-high burden of disease was observed in 68.3% of the patients. Conclusion: Migraine is a frequent and disabling type of primary headache reported by patients with MS

Consenso brasileiro para o tratamento da esclerose múltipla : Academia Brasileira de Neurologia e Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla

O crescent arsenal terapêutico na esclerose múltipla (EM) tem permitido tratamentos mais efetivos e personalizados, mas a escolha e o manejo das terapias modificadoras da doença (TMDs) tem se tornado cada vez mais complexos. Neste contexto, especialistas do Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla e do Departamento Científico de Neuroimunologia da Academia Brasileira de Neurologia reuniram-se para estabelecer este Consenso Brasileiro para o Tratamento da EM, baseados no entendimento de que neurologistas devem ter a possibilidade de prescrever TMDs para EM de acordo com o que é melhor para cada paciente, com base em evidências e práticas atualizadas. Por meio deste documento, propomos recomendações práticas para o tratamento da EM, com foco principal na escolha e no manejo das TMDs, e revisamos os argumentos que embasam as estratégias de tratamento na EM.The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Clinicopathologic and immunohistochemical features of oral neurofibroma

Objective. The purposes of this study were to assess clinical, histopathological and immunohistochemical features of 22 oral neurofibromas (NFs) and discuss with previously described literature, addressing the main aspects regarding the differential diagnosis. Materials and methods. Immunohistochemical reactions included S-100, CD34, GLUT-1, EMA, Ki-67, p53 and Collagen IV and histochemical reactions for Alcian blue. Results. Clinically, the preferential location was the maxillary bones, tongue and buccal mucosa. Microscopically, widely spread spindle-shaped cells with scant cytoplasm and elongated nuclei were observed. Immunostaining revealed that the tumor cells weakly expressed GLUT-1, Collagen IV, Ki-67 and p53. They were variably positive for CD34, S-100 protein and membrane epithelial antigen (EMA). Conclusions. The different types of nerve sheath cells observed in the present series reinforce the presence of heterogeneous population in NFs. The strong positivity for S-100 suggests that the lesions were more composed by S-100-positive Schwann cells than other cells. Besides, the high number of CD34-positive cells suggests that this marker can be useful for the differential diagnosis of NFs against PEN, traumatic neuromas and Schwannomas. Finally, the low immunostaining for p53 and Ki-67 may indicate that NFs massively composed by S-100-positive Schwann cells present low potential of aggressiveness and malignant transformation

Percepção de adolescentes sobre sexualidade e saúde reprodutiva: a escola como espaço para a educação sexual

Objetivo: Analisar a percepção e o conhecimento dos adolescentes sobre Infecções Sexualmente Transmissíveis (IST’s), gravidez e formas de prevenção através os métodos contraceptivos. Metodologia: Trata-se de um estudo descritivo com abordagem qualitativa. Para a coleta de dados utilizamos questionário autoaplicável nos adolescentes escolares do 6º ao 9º ano do ensino fundamental e a análise dos dados foi realizada por meio a análise de conteúdo, em sua modalidade temática. Resultados: Sobre informações das IST’s e os Métodos Contraceptivos, observa-se que os/as adolescentes pesquisados estão vulneráveis, pois a pesquisa revelou que a maioria dos/das adolescentes desconhece sobre o assunto ou não tem informações necessárias para se protegerem. Conclusão: Podemos considerar que há uma lacuna no conhecimento dos adolescentes escolares sobre os métodos contraceptivos, os tipos de infecções sexualmente transmissíveis e os métodos preventivos, o que implica em aumentarem as chances para um comportamento sexual de risco.Objetivo: Analizar la percepción y el conocimiento de los adolescentes sobre Infecciones Sexualmente Transmisibles (IST's), embarazo y formas de prevención por medio de los métodos anticonceptivos. Metodología: Se trata de un estudio descriptivo con enfoque cualitativo. Para la recolección de datos utilizamos cuestionario autoaplicable en los adolescentes escolares del 6º al 9º año de la enseñanza fundamental y el análisis de los datos fue realizado por medio del análisis de contenido, en su modalidad temática. Resultados: Sobre las informaciones de las IST's y los Métodos anticonceptivos, se observa que los / las adolescentes encuestados son vulnerables, pues la investigación reveló que la mayoría de los adolescentes desconocen sobre el tema o no tienen informaciones necesarias para protegerse. Conclusión: Podemos considerar que hay una laguna en el conocimiento de los adolescentes escolares sobre los métodos anticonceptivos, los tipos de infecciones sexualmente transmisibles y los métodos preventivos, lo que implica aumentar las posibilidades de un comportamiento sexual de riesgo.Objective: To analyze adolescents' perceptions and knowledge about Sexually Transmitted Infections (STIs), pregnancy and prevention methods through contraceptive methods. Methodology: This is a descriptive study with a qualitative approach. We used a self-administered questionnaire to collect data in school adolescents from the 6th to the 9th year of elementary school and data analysis was performed through content analysis in its thematic modality. Results: Information on STIs and Contraceptive Methods shows that the adolescents surveyed are vulnerable. The research revealed that most of the adolescents are unaware of the subject or do not have the necessary information to protect themselves. Conclusion: We may consider that there is a gap in the knowledge of school adolescents about contraceptive methods, types of sexually transmitted infections and preventive methods which increases the chances for risky sexual behavior

Effect of LASSBio-448 and cilomilast on lung pathological changes caused by LPS in mice.

<p>LASSBio-448 (2.5 and 10 mg/kg, oral) or cilomilast (1 mg/kg, oral) were given 1 h before challenge (LPS, 25 μg/25 μL), and analyses on airway hyper-reactivity (A) and neutrophil infiltration, attested by MPO activity of lung tissue samples (B), were carried out 24 h post challenge. Values represent mean ± SEM from at least 7 animals. + <i>P</i><0.05 as compared to vehicle-stimulated group; *<i>P</i><0.05 as compared to LPS-stimulated mice.</p

Reduction by LASSBio-448, rolipram or cilomilast in duration of the ketamine/xylazine anesthesia (%).

<p>Mice of the strain A/J were injected with ketamine/ xylazine solution and then treated orally with LASSBio-448 (3, 10 and 30 mg/kg), rolipram (1, 3 and 10 mg/kg) or cilomilast (1 mg/kg). Values represent mean ± SEM from at least 7 animals. Figures in brackets shown in the top of each column are correspondent doses expressed in μmol/kg. *<i>P</i><0.05 as compared to vehicle-treated group.</p

PDE4 recombinant isoform inhibition (IC₅₀, μM) for sulfonamide 6a (LASSBio-448) and rolipram.

<p>PDE4 recombinant isoform inhibition (IC₅₀, μM) for sulfonamide 6a (LASSBio-448) and rolipram.</p

Genesis concept of sulfonamides (5 and 6a-k) designed as PDE4 inhibitors.

<p>Genesis concept of sulfonamides (5 and 6a-k) designed as PDE4 inhibitors.</p