Ultrasound-guided aspiration of cystic ovarian lesions

Introduction and Objective: In the last two decades the increased accuracy of ultrasonography has allowed simple ovarian cysts to be reliably identified. As clinical data suggest that simple cystic lesions rarely become malignant, surgical treatment of these cysts may therefore represent overtreatment. Our study aimed to evaluate the results of ultrasound (US) guided aspiration of cystic ovarian lesions performed in our institution in the last ten years

The suicide of slaves in Sao Paulo during the last two decades of slavery

News stories printed in Gazeta de Campinas (1871-1887) are used to investigate the views expressed at the time of the suicides of captives and freedmen in Sao Paulo province, and to discuss the data available. As suicide is a form of human behavior which cannot be reduced to one single explanation, it does not seem justifiable that amongst the slaves, these cases should also be taken as self-explanatory because of the conditions in which they occurred. By noting the circumstances in which these acts took place, it is hoped that the fallacy of oversimplified explanations can be belied, which refer to the suicide of slaves as quite simply being due to a 'dislike of captivity'.15237138

Visfatin, glucose metabolism and vascular disease: a review of evidence

The adipose tissue is an endocrine organ producing substances called adipocytokines that have different effects on lipid metabolism, metabolic syndrome, and cardiovascular risk. Visfatin was recently described as an adipocytokine with potentially important effects on glucose metabolism and atherosclerosis. Visfatin has been linked to several inflammatory conditions, beta cell function, and cardiovascular disease. The growing number of publications on the subject shall bring further evidence about this adipocytokine. Its findings may contribute in the identification of higher risk individuals for diabetes and cardiovascular disease with a better comprehension about the complex intercorrelation between adiposity, glucose metabolism and vascular disease

Vulnerability of Brazilian municipalities to hantavirus infections based on multi‑criteria decision analysis

Background: Hantavirus infection is an emerging zoonosis transmitted by wild rodents. In Brazil, high case-fatality rates among humans infected with hantavirus are of serious concern to public health authorities. Appropriate preventive measures partly depend on reliable knowledge about the geographical distribution of this disease. Methods: Incidence of hantavirus infections in Brazil (1993–2013) was analyzed. Epidemiological, socioeconomic, and demographic indicators were also used to classify cities’ vulnerability to disease by means of multi-criteria decision analysis (MCDA). Results: From 1993 to 2013, 1752 cases of hantavirus were registered in 16 Brazilian states. The highest incidence of hantavirus was observed in the states of Mato Grosso (0.57/100,000) and Santa Catarina (0.13/100,000). Based on MCDA analysis, municipalities in the southern, southeastern, and midwestern regions of Brazil can be classified as highly vulnerable. Most municipalities in northern and northeastern Brazil were classified as having low vulnerability to hantavirus cardiopulmonary syndrome. Conclusions: Although most human infections by hantavirus registered in Brazil occurred in the southern region of the country, a greater vulnerability to hantavirus was found in the Brazilian Midwest. This result reflects the need to strengthen surveillance where the disease has thus far gone unreported

Gastrointestinal complaints in runners are not due to small intestinal bacterial overgrowth

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal complaints are common among long distance runners. We hypothesised that small intestinal bacterial overgrowth (SIBO) is present in long distance runners frequently afflicted with gastrointestinal complaints.</p> <p>Findings</p> <p>Seven long distance runners (5 female, mean age 29.1 years) with gastrointestinal complaints during and immediately after exercise without known gastrointestinal diseases performed Glucose hydrogen breath tests for detection of SIBO one week after a lactose hydrogen breath test checking for lactose intolerance. The most frequent symptoms were diarrhea (5/7, 71%) and flatulence (6/7, 86%). The study was conducted at a laboratory.</p> <p>In none of the subjects a pathological hydrogen production was observed after the intake of glucose. Only in one athlete a pathological hydrogen production was measured after the intake of lactose suggesting lactose intolerance.</p> <p>Conclusions</p> <p>Gastrointestinal disorders in the examined long distance runners were not associated with small intestinal bacterial overgrowth.</p

Prognostic value of disability on mortality: 15-year follow-up of the Bambuí Cohort Study of Aging

BACKGROUND: Disability is a concern in the context of population ageing. The extent of an individual’s disability is a major determinant of whether or not they require long-term care or survival time. We investigated the effect of three disability domains as predictors of all-cause mortality over 15-year follow-up in a Brazilian socioeconomically disadvantaged and multiracial older adult population. METHODS: We estimated Cox proportional hazards models using data from 1333 community-dwelling individuals aged 60 and older from the Bambuí Cohort Study of Ageing. Disability was defined as a great difficulty or not being able to perform one and two or more activities in each domain: mobility, instrumental activities of daily living (IADL) and basic activities of daily living (BADL). RESULTS: The overall mortality rate was 46.1 per 1000 person-years at risk (pyrs) and it was higher in men. Among men, the fully adjusted Hazard Ratios (HRs) were 1.92 (95%CI: 1.43-2.58), 2.07 (95%CI: 1.53-2.79) and 1.65 (95%CI: 1.11-2.45), and among women 1.75 (95%CI: 1.38-2.21), 1.43 (95%CI: 1.11-1.84) and 1.43 (95%CI: 1.05-1.95), for two or more disability in mobility tasks, IADLs and BADLs, respectively, compared to those with no difficulty or some difficulty to perform all the tasks. CONCLUSION: A similar risk of death for mobility, IADL and BADL in both genders was found, suggesting that any of these domains can be used to identify risk of all-cause mortality among older adults. The number of activities with limitations in each domain was an important factor

Improving healthcare delivery with new interactive visualization methods

Over the last years, the implementation and evolution of computer resources in hospital institutions has been improving both the financial and temporal efficiency of clinical processes, as well as the security in the transmission and maintenance of their data, also ensuring the reduction of clinical risk. Diagnosis, treatment and prevention of human illness are some of the most information-intensive of all intellectual tasks. Health providers often do not have or cannot find the information they need to respond quickly and appropriately to patient’s medical problems. Failure to review and follow up on patient’s test results in a timely manner, for example, represents a patient’s safety and malpractice concern. Therefore, it was sought to identify problems in a medical exams results management system and possible ways to improve this system in order to reduce both clinical risks and hospital costs. In this sense, a new medical exams visualization platform (AIDA-MCDT) was developed, specifically in the Hospital Center of Porto (CHP), with several new functionalities in order to make this process faster, intuitive and efficient, always guaranteeing the confidentiality and protection of patients’ personal data and significantly improving the usability of the system, leading to a better health care delivery.FCT - Fundação para a Ciência e a Tecnologia (UID/CEC/00319/2019

Tissue Localization and Extracellular Matrix Degradation by PI, PII and PIII Snake Venom Metalloproteinases: Clues on the Mechanisms of Venom-Induced Hemorrhage

20 páginas, 4 figuras, 3 tablas y 7 tablas en material suplementario.Snake venom hemorrhagic metalloproteinases (SVMPs) of the PI, PII and PIII classes were compared in terms of tissue localization and their ability to hydrolyze basement membrane components in vivo, as well as by a proteomics analysis of exudates collected in tissue injected with these enzymes. Immunohistochemical analyses of co-localization of these SVMPs with type IV collagen revealed that PII and PIII enzymes co-localized with type IV collagen in capillaries, arterioles and post-capillary venules to a higher extent than PI SVMP, which showed a more widespread distribution in the tissue. The patterns of hydrolysis by these three SVMPs of laminin, type VI collagen and nidogen in vivo greatly differ, whereas the three enzymes showed a similar pattern of degradation of type IV collagen, supporting the concept that hydrolysis of this component is critical for the destabilization of microvessel structure leading to hemorrhage. Proteomic analysis of wound exudate revealed similarities and differences between the action of the three SVMPs. Higher extent of proteolysis was observed for the PI enzyme regarding several extracellular matrix components and fibrinogen, whereas exudates from mice injected with PII and PIII SVMPs had higher amounts of some intracellular proteins. Our results provide novel clues for understanding the mechanisms by which SVMPs induce damage to the microvasculature and generate hemorrhage.This work was performed in partial fulfillment of the requirements for the PhD degree for Cristina Herrera at Universidad de Costa Rica.Peer reviewe