•This cohort, which includes the three subtypes of the disease, Anti-AQP4 Abs+, Anti-MOG Abs+ and seronegative, shows that one in every four patients with NMOSD has a late onset form of the ...disease.•Recognition of this subgroup of patients is relevant since the disease course appears to be characterized by less relapses, but with a more aggressive course and less time to reach increased disability.•Anti-AQP4 Abs+ were associated with increased disability, underscoring the importance of studying the serostatus in NMOSD management.
Several neuroimmunological disorders have distinct phenotypes according to the age of onset, as in multiple sclerosis or myasthenia gravis. It is also described that late onset NMOSD (LONMOSD) has a different phenotype.
To describe the clinical/demographic characteristics of the LONMOSD and distinguish them from those with early onset (EONMOSD).
From a nationwide Portuguese NMOSD study we analyzed the clinical/demographic characteristics of the LONMOSD.
From the 180 Portuguese patients 45 had disease onset after 50 years old, 80% were female. 23 had anti-AQP4 antibodies (51.1%), 13 anti-MOG antibodies (28.9%) and 9 were double seronegative (20.0%). The most common presenting phenotypes in LONMOSD were transverse myelitis (53.3%) and optic neuritis (26.7%), without difference from EONMOSD (p = 0.074). The mean EDSS for LONMOSD was 6.0 (SD=2.8), after a mean follow-up time of 4.58 (SD=4.47) years, which was significantly greater than the mean EDSS of EONMOSD (3.25, SD=1.80)(p = 0.022). Anti-AQP4 antibodies positive LONMOSD patients had increased disability compared to anti-MOG antibodies positive LONMOSD (p = 0.022). The survival analysis showed a reduced time to use a cane for LONMOSD, irrespective of serostatus (p<0.001).
LONMOSD has increased disability and faster progression, despite no differences in the presenting clinical phenotype were seen in our cohort.
Left atrial dissection is a rare entity, mostly occurring after mitral valve surgery, with only a few cases described after myocardial infarction. The authors report a case of a 60‐year‐old man who ...presented with an inferior myocardial infarction, complicated with pseudoaneurysm of basal segment of left ventricular inferior wall, which expanded through the mitral ring to left atria, causing left atrial free wall dissection. The left ventriculo‐atrial communication through the pseudoaneurysm caused major para‐mitral regurgitation and the development of acute heart failure. Good clinical outcome was achieved with stabilization of acute heart failure with high‐dose diuretic therapy and delayed cardiac surgery with closure of left ventriculo‐atrial communication.
Globalement, la question de l’arrière a été relativement peu mobilisée de manière transversale et transnationale par une historiographie de la Grande Guerre longtemps assez indifférente à cet « autre ...front ». Si les mobilisations militaires ont été largement étudiées, celles propres aux sociétés civiles européennes traversées par la guerre constituent en revanche encore un champ à la fois très vaste et partiellement défriché : comment, loin du front, dans une Europe déchirée par la guerre, les populations ont-elles réussi à s’adapter à un quotidien complètement bouleversé ? Quelles ont été les formes et les degrés de leurs mobilisations ou de leurs résistances ? C’est à ces questions que le présent ouvrage entend répondre en articulant quatre thématiques principales jusqu’à présent assez peu abordées dans un cadre européen, emboîtant les échelles nationales régionales, départementales voire villageoises. Les aspects économiques sont ainsi essentiels à la compréhension d’un conflit qui s’appuie comme jamais auparavant sur des productions de masse reconfigurant le cadre productif. L’encadrement des individus par les initiatives privées ou étatiques contribue de manière décisive à la mobilisation dans la durée des populations civiles. Par ailleurs, le croisement des expériences rurales et citadines, dans des espaces encore mal connus, met en lumière des acteurs locaux pris entre les pratiques ordinaires et l’extraordinaire du temps de guerre. Enfin, l’étude de la construction et de l’hybridation des identités et des représentations à l’arrière permet une relecture neuve des expériences vécues du conflit.
The modular carbohydrate‐active enzyme belonging to glycoside hydrolase family 30 (GH30) from Clostridium thermocellum (CtXynGH30) is a cellulosomal protein which plays an important role in plant ...cell‐wall degradation. The full‐length CtXynGH30 contains an N‐terminal catalytic module (Xyn30A) followed by a family 6 carbohydrate‐binding module (CBM6) and a dockerin at the C‐terminus. The recombinant protein has a molecular mass of 45 kDa. Preliminary structural characterization was carried out on Xyn30A crystallized in different conditions. All tested crystals belonged to space group P1 with one molecule in the asymmetric unit. Molecular replacement has been used to solve the Xyn30A structure.
To evaluate prostate-specific antigen response (PSAr) defined as a ≥50% decrease in PSA concentration from the pretreatment value, as a prognostic factor in patients with metastatic ...castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA).
Retrospective evaluation of patients with mCRPC treated with AA.
124 patients were identified. Median overall survival and progression-free survival for patients achieving PSAr versus patients without PSAr were 29.3 versus 9.7 months and 17.0 versus 5.2 months, respectively. Multivariate analysis confirmed that PSAr correlated with better overall survival (hazard ratio: 0.19; 95% CI: 0.10−0.38; p < 0.001) and progression-free survival (hazard ratio: 0.24; 95% CI: 0.14−0.41; p < 0.001).
PSAr can be utilized as prognostic and predictive factors in mCRPC patients treated with AA.
Therapeutic options for metastatic castration-resistant prostate cancer are expanding. However, biomarkers with predictive and prognostic value to assist in treatment guidance are lacking. The aim of this study was to evaluate prostate-specific antigen response as a prognostic factor in patients treated with abiraterone acetate. It was possible to confirm that prostate-specific antigen response correlated with better overall survival and progression-free survival in this patient cohort, evidencing the possible role of biochemical markers as surrogates for response and prognosis, especially in diseases that are difficult to evaluate radiographically.
Kaurenes
3–
5 and beyeranes
6–
10 were prepared and tested for plant growth regulation activity using lettuce hypocotyl and barley aleurone bioassays. Steviol (
3) and isosteviol (
9) were also ...tested in field-grown grapes.
This work describes the preparation of tetracyclic diterpenoids and determination of their plant growth regulator properties. Stevioside (
2) was used as starting material and the derivatives 13-hydroxy-
ent-kaur-16-en-19-oic acid (steviol,
3),
ent-7α,13-dihydroxy-kaur-16-en-19-oic acid (
4), 13-hydroxy,
ent-kaur-16,17-epoxi-19-oic acid (steviol epoxide,
5), 17-hydroxy-16-ketobayeran-19-oic acid (17-hydroxyisosteviol,
6), 17-hydroxy-16-hydroxyiminobayeran-19-oic acid (
7), 16-ketobayeran-19-oic acid (isosteviol,
9), 16,17-dihydroxybeyeran-19-oic acid (
8), and 16-hydroxyiminobayeran-19-oic acid (isosteviol oxime,
10) were obtained by simple chemical procedures. Another derivative,
ent-7α,13-dihydroxycaur-15-en-19-oic acid (
4), was obtained by biotransformation of steviol (
3) by
Penicillium citrinum. In order to determine the plant growth regulator activity the compounds were submitted to the lettuce hypocotyl and barley aleurone bioassays. All compounds showed significant activities in both bioassays. Steviol (
3) and isosteviol (
9) were also tested in field-grown grapes resulting in an increase in berry weight and size.
Ochrobactrum anthropi is a Gram-negative bacillus widely distributed in nature. It is a low virulence and low pathogenic microorganism and human infection by this agent is considered rare. This ...microorganism can cause bacteremia and in some cases can lead to osteomyelitis and endocarditis. Included in Brucellaceae family, this bacterium is phenotypically and genetically closely related to the Brucella genus and may be misidentified by rapid identification systems. The authors describe a patient admitted to the Infectious Diseases Department with vertebral osteomyelitis initially identified as Ochrobactrum anthropi. Despite appropriate antimicrobial therapy, the blood cultures remained positive and there were no signs of clinical improvement. This raised suspicion of a possible misidentification. It was decided to initiate antimicrobial therapy to include the Brucella genus, with slow but progressive clinical improvement. Samples were sent to Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) for genotyping, confirming the initial suspicion of misidentification and identifying Brucella melitensis as the causal agent. Timely diagnosis of brucellosis is essential for the correct management and prevention of its consequences for the patient and for safe handling of the laboratory samples, preventing laboratory-acquired infection
A detailed dielectric characterization of
n-ethylene glycol dimethacrylate monomers with
n
=
2 and 4 is provided. Besides the
α relaxation associated to the glass transition, two secondary relaxation ...processes were detected: the
γ process assigned to the twisting motions within the ethylene glycol moiety, and the
β process related with hindered rotations of carboxylic groups. While the relaxation time of the
γ process is independent of the size of the ethylene glycol group, the
β process deviates to higher times with increasing
n. Upon polymerization the
α process goes to extinction, faster in the 4-ethylene monomer, with a concomitant depletion of the
β process that remains at higher polymerization degrees relatively to the
α process, thus acting as a more sensitive probe to evaluate conversion. The height decrease of
α and
β processes of monomers with the polymerization progress, occurs without significant changes of position. At intermediate states of polymerization, a new relaxation process evolves being only detectable in a narrow temperature range. In the end, the polymer networks show, in addition to the
γ
pol relaxation identical to the
γ relaxation of the monomer, a
β
pol relaxation with similar features to the
β relaxation found in poly
n-alkyl methacrylates originated by a π flip of the ester unit accompanied by a restricted main chain rearrangement. The main dielectric relaxation corresponding to the swollen polymer network should appear at quite high temperatures already in early stages of the polymerization process because phase segregation occurs and only a limited amount of liquid monomer plasticizes the newly formed material.
Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models.
First to 6th ...year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum.
The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training.
1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.
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