Abstract
Objective
Develop a consensus for the nomenclature and definition of adrenal histopathologic features in unilateral primary aldosteronism (PA).
Context
Unilateral PA is the most common ...surgically treated form of hypertension. Morphologic examination combined with CYP11B2 (aldosterone synthase) immunostaining reveals diverse histopathologic features of lesions in the resected adrenals.
Patients and Methods
Surgically removed adrenals (n = 37) from 90 patients operated from 2015 to 2018 in Munich, Germany, were selected to represent the broad histologic spectrum of unilateral PA. Five pathologists (Group 1 from Germany, Italy, and Japan) evaluated the histopathology of hematoxylin-eosin (HE) and CYP11B2 immunostained sections, and a consensus was established to define the identifiable features. The consensus was subsequently used by 6 additional pathologists (Group 2 from Australia, Brazil, Canada, Japan, United Kingdom, United States) for the assessment of all adrenals with disagreement for histopathologic diagnoses among group 1 pathologists.
Results
Consensus was achieved to define histopathologic features associated with PA. Use of CYP11B2 immunostaining resulted in a change of the original HE morphology-driven diagnosis in 5 (14%) of 37 cases. Using the consensus criteria, group 2 pathologists agreed for the evaluation of 11 of the 12 cases of disagreement among group 1 pathologists.
Conclusion
The HISTALDO (histopathology of primary aldosteronism) consensus is useful to standardize nomenclature and achieve consistency among pathologists for the histopathologic diagnosis of unilateral PA. CYP11B2 immunohistochemistry should be incorporated into the routine clinical diagnostic workup to localize the likely source of aldosterone production.
The economic viability of cultivating the seaweed
Kappaphycus alvarezii
, also known by the commercial name “cottonii,” on the southeastern coast of Brazil was evaluated in large-scale production ...systems with 13 polyvinyl chloride (PVC) rafts containing 11.44 km of tubular and family-size nets with 4 rafts and 3.52 km of nets. Deployment and operating costs and profitability ratios were estimated for three tonnes per raft production scenarios: (A) 4.0 (pessimistic), (B) 4.5 (normal conditions), and (C) 5.0 (optimistic). A sensitivity analysis simulated the loss of one crop among the five proposed growing cycles, as well as the variation in the number of rafts and selling prices for both systems. At a selling price of US$ 120.00 t
−1
, the 13-raft, four-crop annual large-scale production system was impractical in all proposed productivity scenarios. In the family-size production system, at a selling price of US$ 120.00 t
−1
, 4 rafts were not economically viable. Only the three scenarios that reached 11 rafts were viable, displaying, respectively, Internal Rates of Return (IRR) of 38.17%, 70.73% and 87.81%, a Payback Period (PP) of 31, 17 and 14 months with a Break-even Point (BP) at 78.41 tons of fresh algae. It is concluded that the activity is only economically viable on a small scale, carried out in a family-sized production system, starting with 11 rafts or 9.68 km of nets, compatible with an area of 2 ha established by the low impact aquaculture legislation in the region.
Acromegaly is a rare disorder caused by chronic growth hormone (GH) hypersecretion. While diagnostic and therapeutic methods have advanced, little information exists on trends in acromegaly ...characteristics over time. The
, a relational database, is designed to assess the profile of acromegaly patients at diagnosis and during long-term follow-up at multiple treatment centers. The following results were obtained at diagnosis. The study population consisted of 3173 acromegaly patients from ten countries; 54.5% were female. Males were significantly younger at diagnosis than females (43.5 vs 46.4 years;
< 0.001). The median delay from first symptoms to diagnosis was 2 years longer in females (
= 0.015). Ages at diagnosis and first symptoms increased significantly over time (
< 0.001). Tumors were larger in males than females (
< 0.001); tumor size and invasion were inversely related to patient age (
< 0.001). Random GH at diagnosis correlated with nadir GH levels during OGTT (
< 0.001). GH was inversely related to age in both sexes (
< 0.001). Diabetes mellitus was present in 27.5%, hypertension in 28.8%, sleep apnea syndrome in 25.5% and cardiac hypertrophy in 15.5%. Serious cardiovascular outcomes like stroke, heart failure and myocardial infarction were present in <5% at diagnosis. Erythrocyte levels were increased and correlated with IGF-1 values. Thyroid nodules were frequent (34.0%); 820 patients had colonoscopy at diagnosis and 13% had polyps. Osteoporosis was present at diagnosis in 12.3% and 0.6-4.4% had experienced a fracture. In conclusion, this study of >3100 patients is the largest international acromegaly database and shows clinically relevant trends in the characteristics of acromegaly at diagnosis.
The human thymus suffers a transient neonatal involution, recovers and then starts a process of decline between the 1st and 2nd years of life. Age-related morphological changes in thymus were ...extensively investigated, but the genomic mechanisms underlying this process remain largely unknown. Through Weighted Gene Co-expression Network Analysis (WGCNA) and TF-miRNA-mRNA integrative analysis we studied the transcriptome of neonate and infant thymic tissues grouped by age: 0-30 days (A); 31days-6 months (B); 7-12 months (C); 13-18 months (D); 19-31months (E). Age-related transcriptional modules, hubs and high gene significance (HGS) genes were identified, as well as TF-miRNA-hub/HGS co-expression correlations. Three transcriptional modules were correlated with A and/or E groups. Hubs were mostly related to cellular/metabolic processes; few were differentially expressed (DE) or related to T-cell development. Inversely, HGS genes in groups A and E were mostly DE. In A (neonate) one third of the hyper-expressed HGS genes were related to T-cell development, against one-twentieth in E, what may correlate with the early neonatal depletion and recovery of thymic T-cell populations. This genomic mechanism is tightly regulated by TF-miRNA-hub/HGS interactions that differentially govern cellular and molecular processes involved in the functioning of the neonate thymus and in the beginning of thymic decline.
Stability of potassium norbixinate and curcumin by microencapsulation with maltodextrin DE20 and freeze-drying was evaluated as a function of exposition to light, air, different pH, water solubility, ...and in food applications. The best results were obtained with microencapsulated potassium norbixinate 1:20, which, when vacuum-packed and in the presence of natural light, showed color retention of 78%, while microencapsulated curcumin 1:20 showed color retention of 71%. Differential scanning calorimetry and thermogravimetry provided an indication of interaction between colorants and maltodextrin. Photoacoustic spectroscopy (PAS) showed that free and microencapsulated colorants exhibited high rates of absorption throughout the measured spectral region. This work evidenced that the freeze-drying process is favorable for microencapsulation of curcumin by maltodextrin, providing improved solubility to the microencapsulated colorant. Both microencapsulated colorants showed relevant results for use in a wide range of pH and food applications. The PAS technique was useful for the evaluation of the stability of free and microencapsulated colorants.
Large wood (LW) is an integral part of natural river ecosystems and determines their ecological integrity by modulating hydromorphology and providing habitats. Hence, LW installations are a common ...restoration measure in large rivers, even if effects on biodiversity are ambiguous or unknown for ecosystem functioning. Here we quantified the hydromorphological, biological, and functional effects of LW 8 months after installation in a large gravel‐bed river. Both morphological and flow diversity increased strongly by 821% and 127%, respectively. Similarly, fish abundance increased nearly 10‐fold, and macroinvertebrate diversity increased by 35%. Ecosystem functions benefited from LW installation and increased significantly (e.g., by up to 390% for bacterial production) at sites influenced by LW compared to those without LW. Our results highlight the role of the bark habitat of LW that increased the direct effects of LW via the provision of new habitat and stimulated ecosystem‐wide processes. Our integrative approach evaluating the success of LW installations in a large river revealed cascading effects from the provisioning of new habitats, the increase of species diversity to higher ecosystem functioning. It also demonstrated that hydromorphological parameters or community composition alone are insufficient to quantify the complex effects of LW installation, which underlines the necessity to evaluate restoration success with different measures.
Resumo: Neste texto, estamos trazendo alguns apontamentos baseados nas obras de Marx sobre trabalho produtivo e improdutivo. Refletimos também sobre aquele trabalho não remunerado realizado pela ...mulher no espaço doméstico. Com este pano de fundo, estamos dialogando criticamente com o texto “Salários contra o trabalho doméstico” (“Wages against housework”), presente no livro O ponto zero da revolução: trabalho doméstico, reprodução e luta feminista, de Silvia Federici.
Abstract: In this text we are bringing some notes based on Marx, about productive and unproductive work. We also reflect on the unpaid work performed by women in the domestic space. And against this backdrop, we are critically dialoguing with the text “Wages against housework”, present in the book Revolution at point zero: housework, reproduction and feminist struggle by Silvia Federici.
Objectives/Hypothesis
The Draf IIb aims at widening the frontal sinus drainage in a minimally invasive fashion. However, this technique is associated with a high stenosis rate. Hence, local nasal ...flaps have been recently introduced or designed to speed up mucosal healing and prevent scarring.
Study Design
The objective of this study was to present the septoturbinal flap (STF), its use in a Draf IIb, and to examine postoperative outcomes of this procedure.
Methods
From an initial pool of 48 patients with frontal sinus disease to be treated with a Draf IIb, we prospectively selected 46 (95.84%) patients, submitted to a Draf IIb with STF in two Institutions, from November 2010 to November 2014. We excluded two cases (4.16%) for which a flap could not be performed for anatomic restrictions. We present the STF technique and describe demographic data, indication for surgery, and surgery type.
Results
Indications for surgery included 24 (52.17%) mucoceles or mucopyoceles, 12 (26.1%) chronic rhinosinusitis, four (8.7%) osteomas, two (4.35%) meningoencephaloceles, and four (8.7%) inverted papillomas. Difficult anatomic conditions were encountered in half of the patients.
Restenosis of the frontal sinus drainage pathway occurred in one (2.17%) patient. Far‐seated frontal mucoceles recurred in two cases (4.35%), with frontal drainage pathway remaining patent. Rescue treatment comprised a Draf III in two cases and one frontal sinus obliteration. Outcome was favorable for 43 (93.5%) patients.
Conclusion
The use of STF was associated with a high rate of success for a Draf IIb.
Level of Evidence
4. Laryngoscope, 126:2428–2432, 2016
Adrenocortical carcinoma (ACC) is an aggressive endocrine cancer with few molecular predictors of malignancy and survival, especially in paediatric patients. Stathmin 1 (STMN1) regulates microtubule ...dynamics and has been involved in the malignant phenotype of cancer cells. Recently, it was reported that STMN1 is highly expressed in ACC patients, and STMN1 silencing reduces the clonogenicity and migration of ACC cell lines. However, the prognostic significance of STMN1 and its therapeutic potential remain undefined in ACC. In the present study,
STMN1
mRNA levels were significantly higher (
p
< 0.05) in ACC patients, especially in an advanced stage, and correlated with
BUB1B
and
PINK1
expression, the prognostic-related genes in ACC. In paediatric tumours, high
STMN1
expression was observed in both adrenocortical carcinoma and adrenocortical adenoma patients. Among the adult malignant tumours,
STMN1
level was an independent predictor of survival outcomes (overall survival: hazard ratio = 6.08,
p
= 0.002; disease-free survival: hazard ratio = 4.65,
p
< 0.0001). Paclitaxel, a microtubule-stabilizing drug, reduces the activation of STMN1 and significantly decreases cell migration and invasion in ACC cell lines and ACC cells from secondary cell culture (all
p
< 0.0001). In summary, STMN1 expression may be of great value to clinical and pathological findings in therapeutic trials and deserves future studies in ACC.
No presente artigo objetivamos analisar os impactos da pandemia do vírus COVID-19 sobre a divisão sociossexual e racial do trabalho no cenário brasileiro. A partir das pesquisas desenvolvidas ...pela(o/a)s autor(o/a) s sobre o trabalho feminino, procurou-se destacar o trabalho doméstico e de cuidados compreendendo que esse é executado majoritariamente pelas mulheres negras e pobres. Nesse caminho, o texto está divido em duas partes: na primeira, propomos dialogar com Heleieth Saffioti – pioneira para a compreensão do lugar social da mulher no capitalismo – em torno do tema da divisão sociossexual e racial do trabalho e suas expressões na sociedade contemporânea; e, na segunda, problematizamos sobre os efeitos da epidemia do COVID-19 no mercado de trabalho brasileiro, dando ênfase às mulheres negras e ao trabalho feminino doméstico e de cuidado assalariado. THE SOCIOSEXUAL AND RACIAL DIVISION OF WORK IN THE EPIDEMIC SCENARIO OF COVID-19: considerations from Heleieth SaffiotiIn this article we aim to analyze the impacts of the COVID-19 virus pandemic on the socio-sexual and racial division of labor in the Brazilian scenario. Based on the research carried out by the authors on women’s work, it was sought to highlight domestic and care work, understanding that it is performed mainly by black and poor women. In this way, the text is divided into two parts: the first where we propose to dialogue with HeleiethSaffioti – pioneer for the understanding of the social place of women in capitalism – on the sociosexual and racial division of labor and its expressions in contemporary society, and the second, we questioned the effects of the COVID-19 epidemic on the Brazilian labor market, emphasizing black women and female domestic work and wage care.Keywords: Work. Women. COVID-19. Female Work. HeleiethSaffioti. LA DIVISION SOCIOSEXUELLE ET RACIALE DU TRAVAIL DANS LE SCÉNARIO ÉPIDÉMIQUE DE COVID-19: considérations d’Heleieth SaffiotiDans cet article, nous visons à analyser les impacts de la pandémie du virus COVID-19 sur la division socio-sexuelle et raciale du travail dans le scénario brésilien. Sur la base des recherches menées par les auteurs sur le travail des femmes, il a été cherché à mettre en évidence le travail domestique et de soin, sachant qu’il est principalement réalisé par des femmes noires et pauvres. De cette façon, le texte est divisé en deux parties: la première où nous proposons de dialoguer avec HeleiethSaffioti – pionnière pour la compréhension de la place sociale des femmes dans le capitalisme – sur la división socio-sexuelle et raciale du travail et ses expressions dans la société contemporaine, et la seconde , nous nous sommes interrogés sur les effets de l’épidémie de COVID-19 sur le marché du travail brésilien, en mettantl’accent sur les femmes noires et le travail domestique féminin et les salaires.Mots-clés: Travail. Femmes. COVID-19. Travail féminin. HeleiethSaffioti.
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