Long-term outcome of low-activity radioiodine administration preceded by adjuvant recombinant human TSH pretreatment in elderly subjects with multinodular goiter

<p>Abstract</p> <p>Background</p> <p>Large multinodular goiter (MNG) in elderly people is a common finding which can require intervention. The long-term effect of radioiodine therapy on thyroid volume (TV) and function after recombinant human (rh) TSH pre-treatment was evaluated.</p> <p>Methods</p> <p>After baseline evaluation, 40 subjects over 60 years old with a large MNG were treated with ¹³¹I up to the activity of 600 MBq. Nineteen patients were pretreated with rhTSH (0.1 mg on 2 consecutive days; group 1) while 21 subjects underwent treatment without rhTSH pretreatment (group 2). TV was monitored every 6–12 months by ultrasonography. The median follow-up period was 36 months.</p> <p>Results</p> <p>At the baseline, the groups matched in terms of TV, 24-h radioiodine uptake (RAIU), urinary iodine and neck complaints. The number of subjects pretreated with anti-thyroid drugs was significantly (P = 0.01) greater in group 2 than in group 1; TSH was more suppressed (P = 0.003) and f-T3 was more elevated (P = 0.005) in group 2 than in group 1 patients. RhTSH increased 24-h RAIU in group 1 up to the baseline level observed in group 2. The ¹³¹I activity administered was similar in both groups. Adverse events were slight and similar in both groups. A permanent post-radioiodine toxic condition was reported only in 2 patients in group 2. After radioiodine therapy, hypothyroidism was observed in significantly more group 1 patients than group 2 patients (P = 0.002). While TV was reduced in both groups, the percentage TV reduction recorded at the last examination was significantly higher (P = 0.03) in group 1 than in group 2. MNG-related complaints were significantly reduced in both group 1 (P = 0.0001 vs baseline) and group 2 (P = 0.001) patients.</p> <p>Conclusion</p> <p>Low radioiodine activities after pretreatment with low-dosage rhTSH are able to reduce TV and improve MNG-related symptoms in elderly subjects.</p

Discovery of novel anelloviruses in small mammals expands the host range and diversity of the Anelloviridae

The Anelloviridae comprises single-stranded DNA viruses currently grouped in sixty-eight species classified in twelve genera. They have been found in many vertebrate hosts including primates. In this study, we describe the application of the high-throughput sequencing to examine the frequency and diversity of anelloviruses in rodents, bats and opossums captured in São Paulo State, Brazil. We report a total of twenty-six anelloviruses with sixteen nearly complete genomes and ten partial genomes, which include eleven potential novel species identified in rodents (Cricetidae), bats (Molossidae and Phyllostomidae), and opossums (Didelphidae). We also propose the inclusion of two potential new genera within the Anelloviridae family, provisionally named Omegatorquevirus and Sigmatorquevirus, including six and three novel species of anelloviruses, respectively. In summary, this study expands the diversity and the host range of the known anelloviruses

Remoção de capivaras (Hydrochoerus hydrochaeris) como ação para controle da população de carrapatos Amblyomma e redução do risco de transmissão da Febre Maculosa Brasileira em um Condomínio Residencial em Bragança Paulista (SP, Brasil) – Estudo de Caso

Este estudo relata os fatores que levaram um Residencial localizado em Bragança Paulista (SP, Brasil), área não-endêmica para Febre Maculosa Brasileira (FMB), a ser classificado como Área de Risco para a doença, mostrando que uma crescente população residente de capivaras (Hydrochoerus hydrochaeris) na área era a provável responsável por uma proliferação de carrapatos Amblyomma sculptum e estava atuando como hospedeiro amplificador da bactéria Rickettsia rickettsii, principal agente etiológico da FMB. Relatamos as ações de manejo ambiental propostas para controlar a quantidade de carrapatos no local e reduzir o risco de transmissão da doença, incluindo medidas para o controle de populações de carrapatos parasíticas e no ambiente e a eliminação da população residente de capivaras. Análises de dados populacionais de carrapatos e testes serológicos para R. rickettsii indicaram que as medidas tomadas foram efetivas, causando grande redução da população de carrapatos no ambiente e reduzindo o risco de transmissão de FMB na área.This study reports the factors which led a gated community located in Bragança Paulista (SP, Brazil), a non-endemic area for Brazilian Spotted Fever (BSF), to be classified as a Risk Area for transmission of this disease, showing that an increasing resident population of capybaras (Hydrochoerus hydrochaeris) in the area was likely responsible for a proliferation of Amblyomma sculptum ticks and acted as an amplifying host for Rickettsia rickettsii, the main etiologic agent of BSF. We report management actions proposed to control the local tick burden and reduce BSF risk, including measures to control parasitic and free-living tick populations and exclusion of the resident capybara population. Analyses of tick population data and R. rickettsii serology tests indicate that these measures were effective, greatly reducing the environmental burden of Amblyomma sculptum ticks and reducing the BSF transmission risk at the area

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity &gt; 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Survey of Leishmania sp in sandflies and mammals in forest fragments in the Pontal of Paranapanema region, SP

As alterações ambientais antrópicas são os principais fatores de emergência ou reemergência de doenças infecciosas. A leishmaniose cutânea é uma doença que está relacionada, em caráter epidêmico, com episódios de desmatamento. No entanto, o caráter endêmico da doença ocorre quando o homem se encontra próximo de áreas florestais já colonizadas. O Pontal do Paranapanema é uma área onde ocorreu intenso desmatamento e a mata nativa remanescente está representada pelo Parque Estadual Morro do Diabo e alguns fragmentos florestais. Casos de leishmaniose cutânea em humanos são comuns na região, principalmente em áreas marginais de floresta. O objetivo deste trabalho foi realizar um levantamento da fauna flebotomínica e de mamíferos silvestres potencialmente reservatórios no Parque Estadual Morro do Diabo e alguns fragmentos da região, buscando avaliar se o tamanho do fragmento tem influência na ocorrência das espécies e na freqüência de Leishmania sp, através da técnica da PCR. Foram capturadas 26 espécies de flebótomos e sete espécies de mamíferos silvestres. O gênero Brumptomyia foi predominante em quase todas as áreas florestais, com exceção da borda do Parque, que apresentou dominância de Nyssomyia neivai. Os resultados das análises da PCR demonstraram quatro espécies de mamíferos portadores de Leishmania sp, Akodon cursor, Dasyprocta azarae, Didelphis albiventris e Oligoryzomys sp. As amostras de pools de flebotomíneos apresentaram resultados negativos. Não foi observada diferença significativa na freqüência de mamíferos infectados em relação ao tamanho da área florestal.Anthropogenic environmental changes are the main factors of emergence or reemergence of infectious diseases. Cutaneous leishmaniasis is a disease that is related, in an epidemic form, with episodes of deforestation. However, the endemicity of the disease occurs when the man is close to forest areas already colonized. The Pontal of Paranapanema is an area where massive deforestation has occurred and the remaining native forest is represented by the Morro do Diabo State Park and a few forest fragments. Cases of cutaneous leishmaniasis in humans are common in the region, especially in marginal areas of forest. The aim of this study was a survey of sand flies and mammals potentially reservoirs, in Morro do Diabo State Park and some fragments of the region, seeking to assess whether the fragment size has an influence on species occurrence and frequency of Leishmania, through the PCR technique. We captured 26 species of sandflies and seven species of wild mammals. The genus Brumptomyia was prevalent in almost all forest areas, except the edge of the park, which showed dominance of Nyssomyia neivai. The results of PCR analysis revealed four species of mammals suffering from Leishmania, Akodon cursor, Dasyprocta azarae, Didelphis albiventris and Oligoryzomys sp. Samples of sandfly pools tested negative. There was no significant difference in the frequency of infected mammals in relation to the size of the forest

Survey of Leishmania sp in sandflies and mammals in forest fragments in the Pontal of Paranapanema region, SP

As alterações ambientais antrópicas são os principais fatores de emergência ou reemergência de doenças infecciosas. A leishmaniose cutânea é uma doença que está relacionada, em caráter epidêmico, com episódios de desmatamento. No entanto, o caráter endêmico da doença ocorre quando o homem se encontra próximo de áreas florestais já colonizadas. O Pontal do Paranapanema é uma área onde ocorreu intenso desmatamento e a mata nativa remanescente está representada pelo Parque Estadual Morro do Diabo e alguns fragmentos florestais. Casos de leishmaniose cutânea em humanos são comuns na região, principalmente em áreas marginais de floresta. O objetivo deste trabalho foi realizar um levantamento da fauna flebotomínica e de mamíferos silvestres potencialmente reservatórios no Parque Estadual Morro do Diabo e alguns fragmentos da região, buscando avaliar se o tamanho do fragmento tem influência na ocorrência das espécies e na freqüência de Leishmania sp, através da técnica da PCR. Foram capturadas 26 espécies de flebótomos e sete espécies de mamíferos silvestres. O gênero Brumptomyia foi predominante em quase todas as áreas florestais, com exceção da borda do Parque, que apresentou dominância de Nyssomyia neivai. Os resultados das análises da PCR demonstraram quatro espécies de mamíferos portadores de Leishmania sp, Akodon cursor, Dasyprocta azarae, Didelphis albiventris e Oligoryzomys sp. As amostras de pools de flebotomíneos apresentaram resultados negativos. Não foi observada diferença significativa na freqüência de mamíferos infectados em relação ao tamanho da área florestal.Anthropogenic environmental changes are the main factors of emergence or reemergence of infectious diseases. Cutaneous leishmaniasis is a disease that is related, in an epidemic form, with episodes of deforestation. However, the endemicity of the disease occurs when the man is close to forest areas already colonized. The Pontal of Paranapanema is an area where massive deforestation has occurred and the remaining native forest is represented by the Morro do Diabo State Park and a few forest fragments. Cases of cutaneous leishmaniasis in humans are common in the region, especially in marginal areas of forest. The aim of this study was a survey of sand flies and mammals potentially reservoirs, in Morro do Diabo State Park and some fragments of the region, seeking to assess whether the fragment size has an influence on species occurrence and frequency of Leishmania, through the PCR technique. We captured 26 species of sandflies and seven species of wild mammals. The genus Brumptomyia was prevalent in almost all forest areas, except the edge of the park, which showed dominance of Nyssomyia neivai. The results of PCR analysis revealed four species of mammals suffering from Leishmania, Akodon cursor, Dasyprocta azarae, Didelphis albiventris and Oligoryzomys sp. Samples of sandfly pools tested negative. There was no significant difference in the frequency of infected mammals in relation to the size of the forest

Macchina ginnica con tappeto scorrevole configurata per favorire la mobilità di un soggetto con mobilita’ ridotta

none8L’invenzione consiste in una macchina ginnica con tappeto scorrevole dotata di una struttura tale da poter essere utilizzata da un soggetto con ridotta autonomia di cammino per recuperare o mantenere la propria mobilità.L’invenzione si riferisce ad un macchina ginnica configurata per favorire la mobilità di un soggetto la cui autonomia di cammino è ridotta a causa di una patologia cronica o dell’età. Più specificatamente, l’innovazione riguarda la struttura di una macchina ginnica elettrica, dotata di un tappeto scorrevole, di una seduta, di un manubrio e di altri mezzi di supporto e di collegamento, concepita per essere utilizzata da un soggetto con ridotta autonomia di cammino allo scopo di recuperare o mantenere la propria mobilità. La seduta permette al soggetto di riposare o di eseguire esercizi in cui una fase di lavoro è alternata ad una fase di recupero; i mezzi di supporto permettono al soggetto di alzarsi facilmente. Un dispositivo presente consente al soggetto di arrestare il movimento del tappeto scorrevole avvicinando il manubrio a sè, volontariamente o involontariamente in caso di perdita di equilibrio.mixedEmiliano Mucchi; Fabio Manfredini; Giorgio Dalpiaz; Marcello Bonfè; Marco Schiavo; Nicola Lamberti; Roberto Manfredini; Nino Basaglia.Mucchi, Emiliano; Manfredini, Fabio; Dalpiaz, Giorgio; Bonfe', Marcello; Schiavo, Marco; Lamberti, Nicola; Manfredini, Roberto; Basaglia, Nin