Search

Women have a specific hormonal risk associated with contraception, pregnancy and menopause, in addition to more risk factors for the development of cardiovascular diseases (CVD); and rapid, non-invasive, low-cost cardiovascular risk prediction tools can streamline the identification and prevention of CVD. Objective of the study to evaluate the risk of developing CVD in adult women using cardiometabolic indices such as plasma atherogenic index (AIP) and triglyceride-glucose (TyG) index for insulin resistance. This is an observational, cross-sectional and retrospective study. Data on the metabolic, clinical and anthropometric profile of adult women were analyzed and used for risk stratification of developing CVD through the use of TyG and AIP indices. Of the participating women (n = 60, 28.55 ± 8.30 years), 50% women had an increased risk according to AIP despite having normolipidemia, normoglycemia, and normal BMI. Also, they had higher TyG index values. Further, the correlations of TyG and AIP with biometric and lipid parameters were associated with metabolic syndrome. AIP and TyG index can identify the risk of developing CVD, even in the presence of normal anthropometric and biochemical parameters.

Background:. Body contouring surgery and surgical drawings are usually performed based on the surgeon’s experience without considering the nature of the unique anatomical structures of each patient. Thus, we propose a more reliable surgical design approach that considers the anatomical structures of each patient. Ultrasonography is increasingly used in plastic surgery and helps plastic surgeons to highlight anatomical features representing results in their interventions by providing a better understanding of the patients’ unique structures. Methods:. This study presents a series of cases involving 100 recruited patients (36 men and 64 women) between 18 and 60 years of age. Five surgeons examined the patients and created a presurgical design based on palpation, which was validated later by a physician skilled in evaluating the anterior wall of the abdomen using ultrasonography. The concordance between the findings of the palpation and ultrasonography was assessed for each patient. Results:. The concordance rate for each structure in both evaluations was midline (49%) (P > 0.92), diastasis recti (15%), semilunar line (23%), upper edge of rectus abdominis muscles (12%), lower edge of pectoral muscles (16%), border of oblique muscle (13%), number of tendinous intersections (12%), shape of tendinous intersections (11%), serratus anterior muscle (15%), subcostal triangle (15%), and oblique triangle (26%) (P < 0.0001). Conclusion:. All the structures evaluated by palpation in comparison with ultrasound show discordance, except the midline where agreement is evident, with a very good level of statistical significance.

With Gaia Data Release 3 (DR3), new and improved astrometric, photometric, and spectroscopic measurements for 1.8 billion stars have become available. Alongside this wealth of new data, however, there are challenges in finding efficient and accurate computational methods for their analysis. In this paper, we explore the feasibility of using machine learning regression as a method of extracting basic stellar parameters and line-of-sight extinctions from spectro-photometric data. To this end, we built a stable gradient-boosted random-forest regressor (xgboost), trained on spectroscopic data, capable of producing output parameters with reliable uncertainties from Gaia DR3 data (most notably the low-resolution XP spectra), without ground-based spectroscopic observations. Using Shapley additive explanations, we interpret how the predictions for each star are influenced by each data feature. For the training and testing of the network, we used high-quality parameters obtained from the StarHorse code for a sample of around eight million stars observed by major spectroscopic stellar surveys, complemented by curated samples of hot stars, very metal-poor stars, white dwarfs, and hot sub-dwarfs. The training data cover the whole sky, all Galactic components, and almost the full magnitude range of the Gaia DR3 XP sample of more than 217 million objects that also have reported parallaxes. We have achieved median uncertainties of 0.20 mag in V-band extinction, 0.01 dex in logarithmic effective temperature, 0.20 dex in surface gravity, 0.18 dex in metallicity, and 12% in mass (over the full Gaia DR3 XP sample, with considerable variations in precision as a function of magnitude and stellar type). We succeeded in predicting competitive results based on Gaia DR3 XP spectra compared to classical isochrone or spectral-energy distribution fitting methods we employed in earlier works, especially for parameters AV and Teff, along with the metallicity values. Finally, we showcase some potential applications of this new catalogue, including extinction maps, metallicity trends in the Milky Way, and extended maps of young massive stars, metal-poor stars, and metal-rich stars. [ABSTRACT FROM AUTHOR]

Patient Reported Outcomes (PROs) are a report that comes from patients on a specific subject, describing how they feel about a condition or therapy. The term includes a range of constructions and methodology and can cover concepts such as symptoms to physical assessment, well-being and social involvement. The process can be described as a measure of patient reported outcome (Patient Reported Outcome Measure - PROM). In oncology, PROMs help healthcare professionals and systems to reduce the impact of treatment on patient’s quality of life. In recent years, several studies have shown improvement in the evaluated outcomes. In our country, there is still little information on this subject, especially when it comes to cancer patients. Hence, we think that it is of utmost importance to review the particularities of this tool, in order to stimulate further discussion of the subject in our country.

What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a “new normal” are discussed in this article.

Introduction: Sepsis is a systemic inflammatory response to suspected or confirmed infection. Clinical evaluations are essential for its early detection and treatment. Blood cultures may take as long as 2 days to yield a result and are not always reliable. However, recent studies have suggested that neutrophil CD64 expression may be a sensitive and specific alternative for the diagnosis of systemic infection. Objective: The objective of the study was to analyze the difference in CD64 values between subjects with systemic inflammatory response syndrome (SIRS), suspected or confirmed sepsis, who meet diagnostic criteria for SIRS upon arriving at an emergency department. Materials and Methods: This was a prospective observational cohort study, an accuracy study of CD64 prospectively evaluated. The sample consisted of 109 patients aged 18 years with criteria for SIRS on arrival to emergency department. CD64 expression was measured within 6 h of hospital admission and once again after 48 h. Results: ROC curve analysis suggested that a cutoff of 1.45 for CD64 expression could diagnose sepsis with a sensitivity of 0.85, a specificity of 0.75, an accuracy of 82.08%, a positive predictive value of 0.96, a negative predictive value of 0.38 and a positive likelihood ratio of 3.33. The area under the curve was 0.83. Conclusion: CD64 seems to be a useful, sensitive, and specific biomarker in discriminating between SIRS and sepsis.

ABSTRACT Introdution: Chronic myeloid leukemia (CML) is a genetic disorder of hematopoietic stem cells, resulting in a myeloproliferative expansion of blood cells. CML is associated with the presence of the Philadelphia chromosome (Ph), generating an oncogene (BCR-ABL). The current treatment of choice is imatinib mesylate (IM). Objective: To correlate serum levels of MI with hematological parameters in patients with CML. Method: A retrospective cross-sectional study in patients treated for CML. Serum level of IM was determined by a high-performance liquid chromatography with diode array detector (HPLC-DAD), and statistical analysis was performed using SPSS version 20.0 software. Results: We studied 55 CML patients - 24 men (43.6%) and 31 women (56.4 %) - with a mean age of 54 years, who used IM. Among these, 45 patients were in the chronic phase (81.6 %); seven, in the accelerated phase (13.1%); and three, in the blast crisis (5.2%). Patients received a mean IM dose of 434 mg/day. Serum levels of the patients presented an average of 1,092 ± 617 ng/ml, and, in all, 47 patients (85.4%) had hematologic response (HR). Conclusion: There was no correlation between the number of leukocytes, platelets and hemoglobin and the serum level of IM, although there is a trend with respect to hemoglobin (p = 0.062).

A geração Y é representada por adolescentes e jovens adultos nascidos entre 1980 e 2000. É uma geração de consumidores com grande poder econômico, com capacidade estimada de compra anual de 200 bilhões de dólares. Nesse cenário, o objetivo desta pesquisa é identificar a relação entre as dimensões da imagem de varejo de vestuário e a lealdade dos consumidores da geração Y. O framework proposto baseou-se na revisão bibliográfica sobre imagem de loja e lealdade. A pesquisa é do tipo survey, com 394 consumidores da geração Y. Os resultados apontam que a imagem de loja tem impacto sobre a dimensão da lealdade. Dentre as dimensões que mais explicam a imagem de loja, destacaram-se as de serviços, mix de produtos (mercadorias) e atmosfera da loja.

We present a sample of 19 583 ultracool dwarf candidates brighter than z ≤23 selected from the Dark Energy Survey DR2 coadd data matched to VHS DR6, VIKING DR5, and AllWISE covering ∼ 480 deg2. The ultracool candidates were first pre-selected based on their (i–z), (z–Y), and (Y–J) colours. They were further classified using a method that compares their optical, near-infrared, and mid-infrared colours against templates of M, L, and T dwarfs. 14 099 objects are presented as new L and T candidates and the remaining objects are from the literature, including 5342 candidates from our previous work. Using this new and deeper sample of ultracool dwarf candidates we also present: 20 new candidate members to nearby young moving groups and associations, variable candidate sources and four new wide binary systems composed of two ultracool dwarfs. Finally, we also show the spectra of 12 new ultracool dwarfs discovered by our group and presented here for the first time. These spectroscopically confirmed objects are a sanity check of our selection of ultracool dwarfs and photometric classification method. [ABSTRACT FROM AUTHOR]

Este artigo objetiva discutir o emprego de práticas grupais na Estratégia Saúde da Família, com destaque às tensões presentes nas práticas discursivas de profissionais de saúde acerca desse tema. As informações apresentadas foram obtidas a partir da gravação em áudio e transcrição de grupos de discussão, realizados com profissionais de saúde da família de um município do interior do estado de São Paulo, e foram analisadas com base em procedimentos qualitativos de análise temática. Resultou dessa análise, a nomeação de três tensões discursivas: Grupo terapêutico versus Grupo não terapêutico; Adesão como responsabilidade do paciente ou da equipe; e Manejo Diretivo versus Manejo Participativo. Discutimos que tais tensões representam desafios ao emprego dos grupos como ação de cuidado em saúde, pois refletem ainda a presença de uma perspectiva fragmentada de cuidado, um distanciamento na relação dos profissionais com a comunidade, e o predomínio do discurso de responsabilização individual pela adesão ao tratamento

In the past, extrapulmonary tuberculosis affected approximately 70% of patients with advanced pulmonary tuberculosis. However, with the advent of highly effective therapy, intestinal tuberculosis has become rare ― even more unusual in patients without immunodeficiency, HIV and pulmonary disease. The purpose of this study was to report the case of two patients diagnosed with intestinal tuberculosis and no immunodeficiency, HIV or lung disease. The first patient was diagnosed by colonoscopy performed in a mass located in the ileocecal region. After the tuberculosis treatment, the patient presented improvement regarding the mass and symptoms. The diagnosis of the second patient was achieved only with surgical resection of the lesion in proximal transverse colon. It is important for health professionals to know that intestinal tuberculosis should be considered as differential diagnosis of intestinal diseases, also for immunocompetent patients, even regarded as a rare disease.No passado, a tuberculose extrapulmonar acometia cerca de 70% dos pacientes com tuberculose pulmonar avançada. Porém, com o surgimento da terapia de alta eficácia, a tuberculose intestinal tornou-se de ocorrência mais rara - sendo ainda mais incomum de ocorrer em pacientes sem imunodeficiência, HIV e doença pulmonar. O objetivo deste estudo foi apresentar o caso de dois pacientes diagnosticados com tuberculose intestinal, sem sinais de imunodeficiência, HIV ou doença pulmonar. A primeira paciente foi diagnosticada por meio de biópsias realizadas por colonoscopia em uma massa localizada em região ileocecal; após o tratamento da tuberculose a paciente apresentou melhora da lesão e dos sintomas. O diagnóstico do segundo paciente só foi obtido com a ressecção cirúrgica da lesão em cólon transverso proximal. É importante que os profissionais da saúde saibam que a tuberculose intestinal deve ser considerada como diagnóstico diferencial de patologias intestinais, até mesmo em pacientes imunocompetentes, mesmo sendo rara.

INTRODUCTION: Cancer is a disease that affects a large population, being the colorectal cancer one of the most prevalent. The early diagnosis of these neoplasms represents a better life expectancy. The high cost of diagnostic tests and the low socioeconomic status are considered factors leading to delayed diagnosis. OBJECTIVES: Assess the difference between colorectal cancer staging in patients of private clinics and patients of the Brazilian National Health Service (SUS) and assess the changes in cancer staging in the past five years. METHODS: This retrospective study was conducted with 53 patients divided in two groups (SUS and private clinic) diagnosed with colorectal cancer and treated in 2009. Staging of patients diagnosed in 2009 was compared with data from patients diagnosed in 2004, already published in 2005. RESULTS: Both groups were similar in gender and age. Regarding the staging of patients, no statistical difference was observed between the two groups (p=0.147). When comparing the staging of patients diagnosed in 2009 with that of patients studied in 2004, patients diagnosed in 2009 presented early stages (II and III) in relation to patients analyzed in 2004 (III and IV), pINTRODUÇÃO: O câncer é uma doença que afeta grande parte da população, sendo o câncer colorretal um dos mais prevalentes. O diagnóstico precoce dessas neoplasias resulta em uma melhor expectativa de vida. O alto custo dos exames diagnósticos e o baixo nível socioeconômico são apontados como fatores que levam ao atraso no diagnóstico. OBJETIVOS: Avaliar a diferença no estadiamento de câncer colorretal no momento do diagnóstico de pacientes oriundos da clínica privada e pacientes do Sistema Único de Saúde (SUS), assim como, avaliar as mudanças no estadiamento nos últimos cinco anos. MÉTODOS: Estudo retrospectivo envolvendo 54 pacientes divididos em dois grupos (SUS e clínica privada) diagnosticados no ano de 2009. Os estadiamentos dos pacientes diagnosticados em 2009 foram comparados com os dados de pacientes diagnosticados em 2004, já publicados em 2005. RESULTADOS: Ambos os grupos eram similares em gênero e idade. Em relação ao estadiamento dos pacientes não houve diferença estatística entre os dois grupos (p=0,147). Na comparação entre os pacientes de 2009 e os pacientes estudados em 2004 se evidencia que os pacientes de 2009 apresentaram-se com estádios mais precoces (II e III) em relação aos pacientes de 2004 (III e IV), p

Granular cell tumor rarely affects the gastrointestinal tract. The symptoms are often unspecific and the diagnosis is reached accidentally by colonoscopy. We report the case of a 42-year-old patient diagnosed with granular cell carcinoma of the colon based on an incidental finding in colonoscopy, who was treated successfully by endoscopic excision of the tumor.O tumor de células granulares raramente acomete o trato gastrointestinal. Os sintomas muitas vezes são inespecíficos e o diagnóstico é feito ao acaso através da colonoscopia. Nós reportamos o caso de um paciente de 42 anos diagnosticado com tumor de células granulares de cólon devido a um achado incidental da colonoscopia e tratado com sucesso com remoção endoscópica.

BACKGROUND: At energy distribution companies, office and operational employees work in different occupational environments. Cardiovascular diseases (CVD) can develop due to occupational factors and can often lead to morbidity and disability. OBJECTIVE: To evaluate the risk of CVD in workers with different occupations in an energy distribution company, using cardiometabolic indices. METHODS: Workers (men), aged between 20 and 70 years, were divided into two groups: operational (n = 78) and office (n = 106) workers. Their metabolic profiles were analyzed using anthropometric and laboratory data to obtain the atherogenic plasma index (AIP) and insulin resistance index (TyG), and to identify the hypertriglyceridemic waist (HTGW) phenotype as cardiometabolic indicators. RESULTS: There was no difference in CVD risk between the two groups. However, 82% of the test subjects presented a high risk for the development of atherosclerosis based on the AIP, and 11.4% presented the HTGW phenotype, along with the presence of dyslipidemia, insulin resistance, and being overweight as risk factors for CVD. CONCLUSIONS: Although the identified risk factors are not related to the type of occupation at work, companies in the electricity sector can invest in the implementation of measures for health promotion to protect and prevent diseases and improve labor productivity and quality. [ABSTRACT FROM AUTHOR]

We present the discovery of 255 binary and 6 multiple system candidates with wide (> 5 arcsec) separation composed by ultracool dwarfs (UCDs) companions to stars, plus nine double ultracool dwarf systems. These systems were selected based on common distance criteria. About 90 per cent of the total sample has proper motions available and 73 per cent of the systems also satisfy a common proper motion criterion. The sample of ultracool candidates was taken from the Dark Energy Survey (DES) and the candidate stellar primaries are from Gaia DR2 and DES data. We compute chance alignment probabilities in order to assess the physical nature of each pair. We find that 174 candidate pairs with Gaia DR2 primaries and 81 pairs with a DES star as a primary have chance alignment probabilities |$\lt 5{{\ \rm per\ cent}}$|⁠. Only nine candidate systems composed of two UCDs were identified. The sample of candidate multiple systems is made up of five triple systems and one quadruple system. The majority of the UCDs found in binaries and multiples are of early L type and the typical wide binary fraction over the L spectral types is |$2\!-\!4{{\ \rm per\ cent}}$|⁠. Our sample of candidate wide binaries with UCDs as secondaries constitutes a substantial increase over the known number of such systems, which are very useful to constrain the formation and evolution of UCDs. [ABSTRACT FROM AUTHOR]

In this paper we present a catalogue of 11 745 brown dwarfs with spectral types ranging from L0 to T9, photometrically classified using data from the Dark Energy Survey (DES) year 3 release matched to the Vista Hemisphere Survey (VHS) DR3 and Wide-field Infrared Survey Explorer (WISE) data, covering ≈2400 deg2 up to i AB = 22. The classification method follows the same phototype method previously applied to SDSS-UKIDSS-WISE data. The most significant difference comes from the use of DES data instead of SDSS, which allow us to classify almost an order of magnitude more brown dwarfs than any previous search and reaching distances beyond 400 pc for the earliest types. Next, we also present and validate the GalmodBD simulation, which produces brown dwarf number counts as a function of structural parameters with realistic photometric properties of a given survey. We use this simulation to estimate the completeness and purity of our photometric LT catalogue down to i AB = 22, as well as to compare to the observed number of LT types. We put constraints on the thin disc scale height for the early L (L0–L3) population to be around 450 pc, in agreement with previous findings. For completeness, we also publish in a separate table a catalogue of 20 863 M dwarfs that passed our colour cut with spectral types greater than M6. Both the LT and the late M catalogues are found at DES release page https://des.ncsa.illinois.edu/releases/other/y3-mlt. [ABSTRACT FROM AUTHOR]

Understanding the formation and evolution of our Galaxy requires accurate distances, ages, and chemistry for large populations of field stars. Here, we present several updates to our spectrophotometric distance code, which can now also be used to estimate ages, masses, and extinctions for individual stars. Given a set of measured spectrophotometric parameters, we calculate the posterior probability distribution over a given grid of stellar evolutionary models, using flexible Galactic stellar-population priors. The code (called StarHorse) can accommodate different observational data sets, prior options, partially missing data, and the inclusion of parallax information into the estimated probabilities. We validate the code using a variety of simulated stars as well as real stars with parameters determined from asteroseismology, eclipsing binaries, and isochrone fits to star clusters. Our main goal in this validation process is to test the applicability of the code to field stars with known Gaia-like parallaxes. The typical internal precisions (obtained from realistic simulations of an APOGEE+Gaia-like sample) are ≃8 per cent in distance, ≃20 per cent in age, ≃6 per cent in mass, and ≃0.04 mag in AV. The median external precision (derived from comparisons with earlier work for real stars) varies with the sample used, but lies in the range of ≃[0, 2] per cent for distances, ≃[12, 31] per cent for ages, ≃[4, 12] per cent for masses, and ≃ 0.07 mag for AV. We provide StarHorse distances and extinctions for the APOGEE DR14, RAVE DR5, GES DR3, and GALAH DR1 catalogues. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis is a systemic inflammatory response to suspected or confirmed infection. Clinical evaluations are essential for its early detection and treatment. Blood cultures may take as long as 2 days to yield a result and are not always reliable. However, recent studies have suggested that neutrophil CD64 expression may be a sensitive and specific alternative for the diagnosis of systemic infection. Objective: The objective of the study was to analyze the difference in CD64 values between subjects with systemic inflammatory response syndrome (SIRS), suspected or confirmed sepsis, who meet diagnostic criteria for SIRS upon arriving at an emergency department. Materials and Methods: This was a prospective observational cohort study, an accuracy study of CD64 prospectively evaluated. The sample consisted of 109 patients aged 18 years with criteria for SIRS on arrival to emergency department. CD64 expression was measured within 6 h of hospital admission and once again after 48 h. Results: ROC curve analysis suggested that a cutoff of 1.45 for CD64 expression could diagnose sepsis with a sensitivity of 0.85, a specificity of 0.75, an accuracy of 82.08%, a positive predictive value of 0.96, a negative predictive value of 0.38 and a positive likelihood ratio of 3.33. The area under the curve was 0.83. Conclusion: CD64 seems to be a useful, sensitive, and specific biomarker in discriminating between SIRS and sepsis. [ABSTRACT FROM AUTHOR]

Human muscle hypertrophy brought about by voluntary exercise in laboratorial conditions is the most common way to study resistance exercise training, especially because of its reliability, stimulus control and easy application to resistance training exercise sessions at fitness centers. However, because of the complexity of blood factors and organs involved, invasive data is difficult to obtain in human exercise training studies due to the integration of several organs, including adipose tissue, liver, brain and skeletal muscle. In contrast, studying skeletal muscle remodeling in animal models are easier to perform as the organs can be easily obtained after euthanasia; however, not all models of resistance training in animals displays a robust capacity to hypertrophy the desired muscle. Moreover, some models of resistance training rely on voluntary effort, which complicates the results observed when animal models are employed since voluntary capacity is something theoretically impossible to measure in rodents. With this information in mind, we will review the modalities used to simulate resistance training in animals in order to present to investigators the benefits and risks of different animal models capable to provoke skeletal muscle hypertrophy. Our second objective is to help investigators analyze and select the experimental resistance training model that best promotes the research question and desired endpoints. J. Cell. Physiol. 229: 1148-1156, 2014. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]