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The impact of invasive pulmonary aspergillosis (IPA) on non-neutropenic critically ill patients in intensive care units (ICU) has been demonstrated in recent decades. Furthermore, after the start of the COVID-19 pandemic, COVID-19 associated with pulmonary aspergillosis (CAPA) has become a major concern in ICUs. However, epidemiological data from different regions are scarce. We evaluated the prevalence and clinical-epidemiological data of IPA in patients with COVID-19 requiring mechanical ventilation (MV) in the ICU (“severe COVID-19”) and non-COVID ICU patients in MV of a tertiary hospital in the southern region of Brazil. Eighty-seven patients admitted between June 2020 and August 2022 were included; 31 with severe COVID-19. For the diagnosis of IPA or CAPA, algorithms including host factors and mycological criteria (positive culture for Aspergillus spp., immunoassay for galactomannan detection, and/or qPCR) were utilized. The overall incidence of IPA and CAPA in our ICU was 73 cases/1000 ICU hospitalizations. Aspergillosis occurred in 13% (4/31) of the COVID-19 patients, and in 16% (9/56) of the critically ill patients without COVID-19, with mortality rates of 75% (3/4) and 67% (6/9), respectively. Our results highlight the need for physicians enrolled in ICU care to be aware of aspergillosis and for more access of the patients to sensitive and robust diagnostic tests by biomarkers detection. [ABSTRACT FROM AUTHOR]

O objetivo do presente artigo é demonstrar situações concretas em que a livre iniciativa deve ser avaliada conforme os efeitos sociais que ela provoca. Parte-se da hermenêutica do valor social da livre iniciativa como um dos fundamentos da República Federativa do Brasil, com a finalidade de verificar qual é o seu conteúdo. Assentado que o princípio constitucional não se refere à livre iniciativa em si mesma, mas aos efeitos sociais que ela produz, a segunda parte do artigo vai apurar externalidades negativas e positivas da atividade econômica, tomando como referência as doenças crônicas não transmissíveis – DCNT.

Rafael M Grochot,1,2 Janaína Brollo,2 Floriano Riva Neto,2,3 Aline C Tregnago,2,3 Cassiano Scholze,3 Rui Norris,3 Sargeele Silva,2 Débora C Weschenfelder,2 André B Reiriz,1,2 Lessandra Michelin,1 Fábio F Pasqualotto11Department of Health Sciences, School of Medicine, University of Caxias do Sul, Caxias do Sul, RS, Brazil; 2UNACON Cancer Center, Caxias do Sul General Hospital, Caxias do Sul, RS, Brazil; 3CPM Laboratory, Caxias do Sul, RS, BrazilBackground: The PD-1/PD-L1 signaling axis is currently the most elucidated mechanism for tumor evasion of T-cell-mediated immunity. Nevertheless, few data are available regarding its impact on cervical cancer and the relationship with lymphocytic infiltrates.Methods: A retrospective assessment of all cases of cervical neoplasia treated in Caxias do Sul General Hospital, Brazil, between 2012 and 2016 was performed. Clinical and pathological data were collected from electronic records and analyzed. Original slides were independently reviewed by three pathologists to confirm diagnoses and to assess the immunohistochemical expression of PD-L1 and FoxP3 in tumor cells and lymphocytic infiltrates.Results: PD-L1 staining was present in 32.2% of the 59 cervical samples. Median overall survival time of the PD-L1-negative group was 47.8 months, a time point not yet reached by the PD-L1-positive group (p=0.968). Median progression-free survival was 24.3 months for PD-L1-negative and 11.5 months for PD-L1-positive patients (p=0.263). PD-L1 staining was found in 27.1% of the lymphocytic infiltrates, and survival analysis revealed no difference between PD-L1-positive and PD-L1-negative samples. There was no impact on survival related to FoxP3 staining in neither tumor samples nor lymphocytic infiltrates.Conclusion: Although the median progression-free survival times differed, the difference was not statistically significant. Our study corroborates the rationale that PD-L1 expression in cervical neoplasms has no impact on survival. PD-L1 expression in peritumoral lymphocytes revealed no impact on infiltration volume nor survival.Keywords: uterine cervical neoplasms, tumor-infiltrating lymphocytes, cancer, tumor microenvironment, survival

Abstract Reconstruction of the medial patellofemoral ligament (MPFL) has been increasing as a surgical solution for treatment of recurrent lateral patellofemoral dislocation. Recent attention has been given to fibers extending from the femur to the quadriceps tendon, proximal to the MPFL, termed the medial quadriceps tendon-femoral ligament. This article briefly reviews the proximal medial patellar restraints and surgical procedures for their reconstruction.

Introduction: Severe Enamel Fluorosis is frequently found in young adolescents with aesthetic concerns. Colourimetric alterations could vary from diffuse opacities to demarcated brown and white areas. Material and methods: One young patient with a severe fluorosis was treated by a combined use of at-home bleaching and at-office resin infiltration. Results: In all the affected teeth, existing aesthetic enamel alterations, were successfully treated by the combined use of bleaching and Icon® resin application. Given the minimal substance loss due to the erosion infiltration procedure, the patient was extremely satisfied with the results. Conclusions: Our case report show the capability of treating severe fluorosis with bleaching and subsequent Icon® resin infiltration. Longer observation periods in studies with larger patients population are needed to validate the clinical significance found in this case report.

Endemic fungal infections are responsible for high rates of morbidity and mortality in certain regions of the world. The diagnosis and management remain a challenge, and the reason could be explained by the lack of disease awareness, variability of symptoms, and insidious and often overlooked clinical presentation. Imaging findings are nonspecific and frequently misinterpreted as other more common infectious or malignant diseases. Patient demographics and clinical and travel history are important clues that may lead to a proper diagnosis. The purpose of this paper is to review the presentation and differential diagnosis of endemic mycoses based on the most common chest imaging findings.

ABSTRACT: This study aimed to evaluate the antagonistic effect of the mixture ofacetyl coenzyme-A carboxylase (ACCase) enzyme inhibiting herbicides and auxin herbicides in Lolium multiflorum and to determine mechanisms to mitigate this possible effect. The first experiments were conducted by associating the herbicide clethodim (108 g a.i. ha−1), quizalofop-p-ethyl (54 g a.i. ha−1), and clethodim + quizalofop-p-ethyl (108+54 g a.i. ha−1) with 2,4-D (1005 g a.e. ha−1) or triclopyr (720 g a.e. ha−1), in addition to the sole application of the respective graminicides. Another experiment included clethodim (54; 81; 108; 162; 216 g a.i. ha−1), quizalofop-p-ethyl (27; 40.5; 54; 81; 108 g a.i. ha−1), and clethodim + quizalofop-p-ethyl (54+27; 81+40.5; 108+54; 162+81; 216+108 g a.i. ha−1) mixed with 2,4-D (1005 g a.e. ha−1), or triclopyr (720 g a.e. ha−1), in addition to the control treatments without herbicide application. In the second experiment, herbicides clethodim (108 g a.i. ha−1), quizalofop-p-ethyl (54 g a.i. ha−1), and clethodim + quizalofop-p-ethyl (108+54 g a.i. ha−1) in combination with the herbicides 2,4-D (1005 g a.e. ha−1) or triclopyr (720 g a.e. ha−1)had malathion (1000 g a.i. ha−1) or glyphosate (720 g a.e. ha−1) mixed, in addition to the sole applications of the graminicides. The herbicide clethodim + quizalofop-p-ethyl did not present an antagonistic interaction with the auxin herbicides, and obtained 85% weed control. To obtain control similar to the sole application of this graminicide, the dose of the herbicide clethodim needs to be increased by 20%. However, the mixture of the herbicide quizalofop-p-ethyl with 2,4-D and triclopyr affects the ryegrass control. The use of strategies that increase the absorption of ACCase herbicides or the inhibition of P450 enzymes are ways to mitigate the antagonistic effect caused by the association of the two auxin herbicides.

BackgroundLimited data is available regarding the frequency of COVID-19 in populations that are highly exposed to SARS-CoV-2. In this cross-section study we evaluated COVID-19 seroprevalence in military police forces of 10 major cities in Rio Grande do Sul, South of Brazil.MethodsSampling was randomly performed in clusters, in respect to the number of professionals at service per city and military unit. Research subjects were evaluated on July 23, 2020 (first wave peak in Brazil). Clinical information was obtained, and venous blood was taken for ELISA testing (IgA, and IgG antibodies). Sample size consisted of 1,592 military workers (33.6% of study population). They were mostly man (81.2%) and young (median 34 years-old). Most had been asymptomatic (75.3%) during pandemic, and 27.5% reported close contact with COVID-19 cases (after a median time of 21 days). Antibodies were detected in 3.3% of the participants, mostly IgA (2.7%), and IgG (1.7%). After 3 weeks, 66.7% of IgA and IgG results turned negative, in addition to 78.3% and 100% of borderline IgA and IgG results, respectively.ConclusionThe seroprevalence of COVID-19 amongst military police was at least 3.4 higher than the findings of other studies performed in the general population, in the same cities and dates. Most detectable antibodies were of IgA class, which implies recent exposure. Asymptomatic people were more prone to have negative antibody titters in the second run.

ABSTRACT Objective: To describe and analyze the practices suggested in social media for the elaboration of Birth Plans, available on Blogs/Sites and not included in the WHO recommendations. Method: Qualitative, exploratory, descriptive study with thematic analysis. A total of 41 e-mail addresses were selected for analysis among the 200 web addresses previously identified between March and July 2016. Three web addresses were in Portugal and the others in Brazil. Results: 48 practices not included in the recommendations of the World Health Organization (WHO) were identified. Conclusion: Blogs/Websites, as means of transmission, circulation and production of knowledge, enable the horizontal expression of values, encourage women to plan the events considered important for their deliveries and put childbirth decisions on the hands of women, which has caused controversy in the discourse of humanization of childbirth.

The androgen receptor (AR) plays an important role in normal prostate gland development as well as in prostatic neoplasms. Transcriptional regulation by AR is modulated by its interaction with co-activators or co-repressors, such as NCoR1 (nuclear receptor co-repressor 1), which is involved in the reduction of AR activity over the target gene transcription. To identify the role of NCoR1 in the prostate cancer androgen independence in a cell line model, we aimed to evaluate the effects of silencing NCoR1 on prostate-specific antigen (PSA) gene expression, the proliferative response and PSA secretion on the supernatant of C4-2B and LNCaP cells that were submitted to small interfering RNAs (siRNAs) transfection and to treatments with different androgen dosages. In LNCaP and C4-2B cells with no dihydrotestosterone (DHT) treatment, a decrease of PSA mRNA expression was observed 48 hours and 72 hours after gene silencing in the siNCoR group when compared to the control and siNC groups. LNCaP and C4-2B cells showed a biphasic pattern in response to dihydrotestosterone treatment in transfected groups (siNCoR and siNC) as well as in the control condition (no transfection). The secretion of PSA in cell supernatant of LNCaP and C4-2B cells was higher in the siNCoR group, and, regarding the hormonal treatment, higher in the 10-8 M DHT group. A reduction in the levels of NCoR1 seems to have a double influence on the activity of AR in PCa cells. These results suggest that NCoR can act as AR a co-repressor depending upon hormonal stimulation.

Abstract We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support. Histopathology and peripheral blood galactomannan antigen testing confirmed IPA. Aspergillus penicillioides infection was confirmed by nucleotide sequencing and BLAST analysis. Further reports are needed to assess the occurrence and frequency of IPA in SARS-CoV-2 infections, and how they interact clinically.

There is strong evidence that numbers are spatially represented. However, much of the research has been concerned with investigating number representation within the horizontal rather than the vertical dimension. It has been suggested that the organisation of the writing system, by rows or by columns, plays a pivotal role in shaping the mental number representation. We investigated the vertical number representation in British and Japanese participants, who were asked to randomly generate numbers after turning their heads up or down. Previous works showed that this method facilitated the access to the corresponding portions of the horizontal mental number representation. We found that neither group seemed to be affected by the up/ down head turns. These results are discussed in terms of cultural crossover, differences in the horizontal vs. vertical spatial and numerical representation, and sensitivity of the random number generation task.