Prospects and Opportunities for Microsystems and Microfluidic Devices in the Field of Otorhinolaryngology

Microfluidic systems can be used to control picoliter to microliter volumes in ways not possible with other methods of fluid handling. In recent years, the field of microfluidics has grown rapidly, with microfluidic devices offering possibilities to impact biology and medicine. Microfluidic devices populated with human cells have the potential to mimic the physiological functions of tissues and organs in a three-dimensional microenvironment and enable the study of mechanisms of human diseases, drug discovery and the practice of personalized medicine. In the field of otorhinolaryngology, various types of microfluidic systems have already been introduced to study organ physiology, diagnose diseases, and evaluate therapeutic efficacy. Therefore, microfluidic technologies can be implemented at all levels of otorhinolaryngology. This review is intended to promote understanding of microfluidic properties and introduce the recent literature on application of microfluidic-related devices in the field of otorhinolaryngology.

Aprendizaje cooperativo e higiene de manos en estudiantes de enfermería / Aprendizagem cooperativo e higiene de mãos em estudantes de enfermagem / Cooperative Learning and Hand Disinfection in Nursing Students

Objetivo. Evaluar la efectividad de una intervención educativa basada en el aprendizaje cooperativo sobre la adquisición de conocimientos y habilidades en lavado de manos. Métodos. Estudio pre-posintervención realizado con la participación de 49 estudiantes de segundo curso de grado en enfermería. Se evaluaron los siguientes aspectos: i) adquisición de conocimientos con un cuestionario ad hoc, ii) habilidades en lavado de manos mediante la realización de la técnica con solución reactiva y verificación con lámpara fluorescente, y iii) interés y autopercepción de la importancia de adquisición de conocimientos y habilidades con preguntas específicas. Resultados. La edad media fue 21.8 años, 83.7% mujeres y el 32.6% tenía estudios previos relacionados con salud. Hubo una mejoría significativa post-intervención en el nivel de conocimientos (p<0.001) y habilidades (p<0.001). El interés por la intervención (m=4.1±0.6) y la percepción sobre la adquisición de conocimientos (m=4.4±0.6) y habilidades (m=4.3±0.5) se calificaron como elevados (escala de 1 a 5). Conclusión. La intervención de aprendizaje cooperativo mejoró los conocimientos y habilidades sobre lavado de manos en estudiantes de enfermería, además, despertó su interés(AU)

Descriptores: enfermería; educación en enfermería; estudiantes de enfermería; desinfección de las manos; solución hidroalcohólica; aprendizaje. Aprendizagem cooperativo e higiene de mãos em estudantes de enfermagem Objetivo. Avaliar a efetividade de uma intervenção educativa baseada na aprendizagem cooperativa sobre a aquisição de conhecimentos e habilidades no lavado de mãos. Ademais, se estudou o interesse e a auto-percepção dos participantes sobre a aquisição de conhecimentos e habilidades neste assunto. Métodos. Estudo pré-pós intervenção realizada com a participação de 49 estudantes de segundo curso de grau em enfermagem. Se avaliou: i) aquisição de conhecimentos com um questionário ad hoc, ii) habilidades em lavado de mãos mediante a realização da técnica com solução reativa e verificação com luz fluorescente, y iii) interesse e auto-percepção da importância de aquisição de conhecimentos e habilidades com perguntas específicas. Resultados. A idade média foi 21.8 anos, 83.7% eram mulheres e 32.6% tinham estudos prévios relacionados com saúde. Houve uma melhoria significativa pós-intervenção no nível de conhecimentos (p<0.001) e habilidades (p<0.001). O interesse pela intervenção (m=4.1±0.6) e a percepção sobre a aquisição de conhecimentos (m=4.4±0.6) e habilidades (m=4.3±0.5) foram qualificados como elevados (escala de 1 a 5). Conclusão. A intervenção de aprendizagem cooperativo melhorou os conhecimentos e habilidades sobre lavado de mãos em estudantes de enfermagem e ademais despertou seu interesse.(AU)

Objective. The study sought to evaluate the effectiveness of an educational intervention based on cooperative learning on the acquisition of knowledge and skills on hand washing. In addition, the interest and self-perception was studied of the participants on the acquisition of knowledge and skills. Methods. This was a pre-post intervention study with 49 students from the second course of the Nursing degree, evaluating: i) acquisition of knowledge with an ad hoc questionnaire; ii) skills on hand washing by conducting the technique with reagent solution and verification with fluorescent lamp; and iii) interest and self-perception of the importance of acquiring knowledge and skills with specific questions. Results. The mean age was 21.8 years, 83.7% were women, and 32.6% had prior studies related with health. Significant post-intervention improvement was evident in the level of knowledge (p<0.001) and skills (p<0.001). Interest for the intervention (m=4.1±0.6) and perception on the acquisition of knowledge (m=4.4±0.6) and skills (m=4.3±0.5) were scored high (scale from 1 to 5). Conclusion. The cooperative learning intervention improved knowledge and skills on hand washing in nursing students and awakened their interest.(AU)

Identification and susceptibility of clinical isolates of Candida spp. to killer toxins

Abstract Although invasive infections and mortality caused by Candida species are increasing among compromised patients, resistance to common antifungal agents is also an increasing problem. We analyzed 60 yeasts isolated from patients with invasive candidiasis using a PCR/RFLP strategy based on the internal transcribed spacer (ITS2) region to identify different Candida pathogenic species. PCR analysis was performed from genomic DNA with a primer pair of the ITS2-5.8S rDNA region. PCR-positive samples were characterized by RFLP. Restriction resulted in 23 isolates identified as C. albicans using AlwI, 24 isolates as C. parapsilosis using RsaI, and 13 as C. tropicalis using XmaI. Then, a group of all isolates were evaluated for their susceptibility to a panel of previously described killer yeasts, resulting in 75% being susceptible to at least one killer yeast while the remaining were not inhibited by any strain. C. albicans was the most susceptible group while C. tropicalis had the fewest inhibitions. No species-specific pattern of inhibition was obtained with this panel of killer yeasts. Metschnikowia pulcherrima, Pichia kluyveri and Wickerhamomyces anomalus were the strains that inhibited the most isolates of Candida spp.

Resumo Embora as infecções invasivas e a mortalidade causada por espécies de Candida estejam aumentando entre pacientes comprometidos, a resistência a agentes antifúngicos comuns também é um problema crescente. Analisamos 60 leveduras isoladas de pacientes com candidíase invasiva utilizando como estratégia PCR/RFLP baseada na região espaçadora transcrita interna (ITS2) para identificar diferentes espécies patogênicas de Candida. A análise por PCR foi realizada a partir de ADN genómico com um par de iniciadores da região ITS2-5.8S rDNA. As amostras PCR-positivas foram caracterizadas por RFLP. A restrição resultou em 23 isolados identificados como C. albicans usando AlwI, 24 isolados como C. parapsilosis usando RsaI e 13 como C. tropicalis usando XmaI. Em seguida, avaliou-se o grupo de todos os isolados quanto à sua susceptibilidade a um painel de leveduras killer previamente descritas, resultando em 75% sendo suscetíveis a pelo menos uma levedura killer, enquanto que as restantes não foram inibidas por qualquer cepa. C. albicans foi o grupo mais suscetível enquanto C. tropicalis teve o menor número de inibições. Não se obteve um padrão de inibição específico da espécie com este painel de leveduras killer. Metschnikowia pulcherrima, Pichia kluyveri e Wickerhamomyces anomalus foram as cepas que inibiram a maioria dos isolados de Candida spp.

Identification and susceptibility of clinical isolates of Candida spp. to killer toxins

Abstract Although invasive infections and mortality caused by Candida species are increasing among compromised patients, resistance to common antifungal agents is also an increasing problem. We analyzed 60 yeasts isolated from patients with invasive candidiasis using a PCR/RFLP strategy based on the internal transcribed spacer (ITS2) region to identify different Candida pathogenic species. PCR analysis was performed from genomic DNA with a primer pair of the ITS2-5.8S rDNA region. PCR-positive samples were characterized by RFLP. Restriction resulted in 23 isolates identified as C. albicans using AlwI, 24 isolates as C. parapsilosis using RsaI, and 13 as C. tropicalis using XmaI. Then, a group of all isolates were evaluated for their susceptibility to a panel of previously described killer yeasts, resulting in 75% being susceptible to at least one killer yeast while the remaining were not inhibited by any strain. C. albicans was the most susceptible group while C. tropicalis had the fewest inhibitions. No species-specific pattern of inhibition was obtained with this panel of killer yeasts. Metschnikowia pulcherrima, Pichia kluyveri and Wickerhamomyces anomalus were the strains that inhibited the most isolates of Candida spp.

Resumo Embora as infecções invasivas e a mortalidade causada por espécies de Candida estejam aumentando entre pacientes comprometidos, a resistência a agentes antifúngicos comuns também é um problema crescente. Analisamos 60 leveduras isoladas de pacientes com candidíase invasiva utilizando como estratégia PCR/RFLP baseada na região espaçadora transcrita interna (ITS2) para identificar diferentes espécies patogênicas de Candida. A análise por PCR foi realizada a partir de ADN genómico com um par de iniciadores da região ITS2-5.8S rDNA. As amostras PCR-positivas foram caracterizadas por RFLP. A restrição resultou em 23 isolados identificados como C. albicans usando AlwI, 24 isolados como C. parapsilosis usando RsaI e 13 como C. tropicalis usando XmaI. Em seguida, avaliou-se o grupo de todos os isolados quanto à sua susceptibilidade a um painel de leveduras killer previamente descritas, resultando em 75% sendo suscetíveis a pelo menos uma levedura killer, enquanto que as restantes não foram inibidas por qualquer cepa. C. albicans foi o grupo mais suscetível enquanto C. tropicalis teve o menor número de inibições. Não se obteve um padrão de inibição específico da espécie com este painel de leveduras killer. Metschnikowia pulcherrima, Pichia kluyveri e Wickerhamomyces anomalus foram as cepas que inibiram a maioria dos isolados de Candida spp.

Clinical recommendations for women exposed to Zika

Zika is an infectious disease that continues to pose an enduring threat worldwide. The disease is of particular concern to women of childbearing age, as the virus can cause devastating birth defects or fetal loss if acquired during pregnancy. Clinicians caring for women capable of becoming pregnant must inform women regarding the potential for Zika transmission via mosquito bites in affected regions as well as by sexual contact with exposed partners. Because of the global scope of the disease, clinicians caring for pregnant patients should evaluate for risk of Zika exposure to provide patients guidance in decision making related to virus prevention and testing.

Zika es una enfermedad infecciosa que aún representa una amenaza de largo plazo en todo el mundo. La enfermedad es especialmente peligrosa para las mujeres en edad fértil, ya que si se adquiere durante el embarazo, el virus puede causar defectos congénitos devastadores o pérdida del feto. Profesionales de la salud encargados del cuidado de las mujeres con planes de quedar embarazadas deberían informar a estas pacientes sobre el potencial de transmisión de Zika a través de picaduras de mosquitos en regiones afectadas, así como, por contacto sexual con parejas expuestas. Debido a los resultados de la extensión global de la enfermedad, los profesionales de salud que cuidan a las pacientes embarazadas también necesitan evaluar el riesgo de contacto con Zika para proporcionar orientación a los pacientes en la adopción de decisiones relacionadas con la prevención y las pruebas de este virus.

Brote psicótico agudo y rabdomiólisis tras el uso de lovastatina / Psychotic acute episode and rhabdomyolysis after lovastatin ingestion

Introducción: Las estatinas son los medicamentos más recetados en el mundo, por el beneficio y la seguridad que ofrecen. Sin embargo, pueden causar reacciones adversas a escala neurológica, gastrointestinal, renal y muscular. Objetivo: Es describir el curso clínico de una paciente con reacción adversa medicamentosa a la lovastatina. Métodos: Reporte de caso y revisión de la literatura. Resultados: Mujer de 52 años con psicosis súbita y rabdo-miólisis secundaria al consumo de lovastatina, clínica que remite con la suspensión del fármaco. La relación causal se establece a través de la escala de Naranjo, con puntuación de 6 (probable reacción adversa medicamentosa). Conclusión: La manifestación simultánea de psicosis y rabdomiólisis representa un caso clínico atípico y único consecuente a la ingesta de lovastatina…

Introduction: Statins are the most prescribed drugs worldwide given the benefit and security they offer. However, they can cause severe neurological, gastrointestinal, renal and mus-cular side effects. Objective: To describe the clinical course of a female patient with adverse drug reaction to Lovastatin. Methods: Case report and literature review. Results: 52-year old woman with sudden psychosis and rhabdomyolysis secondary to Lovastatin and ending after the drug suspension. The causal relationship was corroborated with a score of 6 (probable ADR) on Naranjo’s Scale. Conclusions: The simultaneous manifestation of psychosis and rhabdomiolysis represents an atypical and unique case following Lovastatin ingestion…

Molecular characterization of Escherichia coli O157:H7 strains isolated from different sources and geographic regions

Escherichia (E.) coli serotype O157:H7 is a globally distributed human enteropathogen and is comprised of microorganisms with closely related genotypes. The main reservoir for this group is bovine bowels, and infection mainly occurs after ingestion of contaminated water and food. Virulence genetic markers of 28 O157:H7 strains were investigated and multilocus enzyme electrophoresis (MLEE) was used to evaluate the clonal structure. O157:H7 strains from several countries were isolated from food, human and bovine feces. According to MLEE, O157:H7 strains clustered into two main clonal groups designated A and B. Subcluster A1 included 82% of the O157:H7 strains exhibiting identical MLEE pattern. Most enterohemorrhagic E. coli (EHEC) O157:H7 strains from Brazil and Argentina were in the same MLEE subgroup. Bovine and food strains carried virulence genes associated with EHEC pathogenicity in humans.

Ex vivo antioxidant effects of D-004, a lipid extract from Roystonea regia fruits, on rat prostate tissue / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate whether oral treatment with D-004, a lipid extract of the Cuban royal palm fruit, produces antioxidant effects in the prostate tissue of normal and testosterone (T)-treated rats.</p><p><b>METHODS</b>In our first experiment, normal rats were distributed into five groups: one group treated with the vehicle and four groups treated with D-004 (100, 200, 400 or 800 mg/kg). In our second experiment, rats were randomized into five groups: a negative control group and four T-injected groups. The latter were comprised of a positive control group treated with the vehicle, and three groups treated with D-004 (200, 400 or 800 mg/kg).</p><p><b>RESULTS</b>In normal rats, D-004 (100-800 mg/kg) inhibited significantly and dose-dependently iron-initiated malondialdehyde (MDA) accumulation in prostate homogenates (35.7%-80.0%) vs the controls. D-004 (200-800 mg/kg) significantly reduced baseline MDA and carbonyl groups in prostate homogenates of normal rats to approximately 80% and 50%, respectively, and totally (100%) in T-treated rats.</p><p><b>CONCLUSION</b>Oral treatment with D-004 reduced MDA and carbonyl groups dose-dependently and markedly in normal and T-injected rats. These findings show that D-004 given at doses effective to prevent prostate hyperplasia also produces antioxidant effects in the prostate tissue.</p>

Acondroplasia (AC) y sus complicaciones neurológicas: a propósito de un caso / Achondroplasia (AC) and its Neurological Complications: a Case Report

Introducción: La acondroplasia (AC) es la condición más común asociada a una estatura baja con grave desprorción anatómica. Las complicaciones neurológicas constituyen la causa más frecuente de su morbilidad y mortalidad, entre las que pueden citarse: hidrocefalia, compresión cervicomedular, estenosis del canal lumbar, hidrosiringomielia, etc. Caso Clínico: Paciente de sexo femenino, de 2 años 6 meses de edad con diagnóstico pre-natal de AC por ecografía obstétrica de control. Parto sin complicaciones, RN con aplanamiento de la cara, nariz corta y redondeada. Presentó sostén cefálico a los 7 meses, caminó a los 18 meses y habló a partir de los 2 años. Hospitalizada por cuadro respiratorio grave, presentó al examen físico: Fuerza muscular global y simétrica Oxford 1/5, ROT disminuidos los rotulianos y abolidos los aquíleos, cutáneo abdominales ausentes; ingresada a UTIP, en ARM. Se le realizó estudio RMN donde se observó compresión medular a nivel de C1 con cavidades intramedulares (siringomielia). Se le practicó cirugía descompresiva. Actualmente traqueostomizada, continúa dependiente de ARM. Los pediatras en su práctica diaria pueden ver a niños con AC durante la infancia, realizar el diagnóstico en el RN o tal vez sean requeridos para aconsejar a embarazadas que han recibido el diagnóstico pre-natal de AC; por lo tanto, deben estar adecuadamente informados sobre la necesidad de cuidados especiales que requieren estos niños en su difícil manejo y así evitar posibles complicaciones neurológicas. Palabras claves: Acondroplasia, Complicaciones neurológicas, niño

The treatment of primary and metastatic renal cell carcinoma (RCC) with image-guided stereotactic body radiation therapy (SBRT)

Purpose: Brain metastases from renal cell carcinoma (RCC) have been successfully treated with stereotactic radiosurgery (SRS). Metastases to extra-cranial sites may be treated with similar success using stereotactic body radiation therapy (SBRT), where image-guidance allows for the delivery of precise high-dose radiation in a few fractions. This paper reports the authors’ initial experience with image-guided SBRT in treating primary and metastatic RCC. Materials and methods: The image-guided Brainlab Novalis stereotactic system was used. Fourteen patients with 23 extra-cranial metastatic RCC lesions (orbits, head and neck, lung, mediastinum, sternum, clavicle, scapula, humerus, rib, spine and abdominal wall) and two patients with biopsy-proven primary RCC (not surgical candidates) were treated with SBRT (24-40 Gy in 3-6 fractions over 1-2 weeks). All patients were immobilised in body cast or head and neck mask. Image-guidance was used for all fractions. PET/CT images were fused with simulation CT images to assist in target delineation and dose determination. SMART (simultaneous modulated accelerated radiation therapy) boost approach was adopted. 4D-CT was utilised to assess tumour/organ motion and assist in determining planning target volume margins. Results: Median follow-up was nine months. Thirteen patients (93%) who received SBRT to extra-cranial metastases achieved symptomatic relief. Two patients had local progression, yielding a local control rate of 87%. In the two patients with primary RCC, tumour size remained unchanged but their pain improved, and their renal function was unchanged post SBRT. There were no significant treatment-related side effects. Conclusion: Image-guided SBRT provides excellent symptom palliation and local control without any significant toxicity. SBRT may represent a novel, non-invasive, nephron-sparing option for the treatment of primary RCC as well as extra-cranial metastatic RCC.

Ultra-sonografia intervencionista: drenagem percutânea de cistos e abscessos prostáticos em cães. Estudo de casos

O artigo não apresenta resumo.

Ultra-sonografia intervencionista: drenagem percutânea de lesões renais e peri-renais. Estudos de casos

O artigo não apresenta resumo.

Significant and transitory control of lesions development in mice immunized with a genomic library of Leishmania amazonensis

DNA from a genomic library of Leishmania amazonensis and from pcDNA3 plasmid were used to immunize BALB/c mice. Three immunizations at two weeks intervals were done, with 50µg/0.1ml of DNA. A control group was also injected with the same volume of saline solution. Afterward, all mice were challenged with infective promastigotes of the parasite, and the development of lesions was followed during 16 weeks by dorsoventral measures of the footpad. Mice previously immunized with the genomic library were capable of controlling lesions at a significant level, with major significance between 9 and 13 weeks post challenge.

Patología por Trypanosoma cruzy. Cepa dependiente? / Is Trypanosoma cruzy pathology strain dependent?

En la actualidad existe consenso en el papel que las características de la población de Trypanosoma cruzi tienen en la patogésesis de las distintas formas clínicas de la enfermedad de Chagas. En nuestro laboratorio, estudiamos en el modelo murino las consecuencias de la infección con dos poblaciones de características biológicas polares: RA y CA-I. Demostramos que el daño neuromuscular es, en parte, mediato por diferentes subpoblaciones de linfocitos T. Además, observamos que el fenotipo celular responsable de la patologia y los distintos blancos tisulares dependen de la población parasitaria. A pesar de no haber observado diferencias en la reactividad jugaría un papel adicional en el desarrollo de la patología neuromuscular: sueros de ratones infectados con RA, pero no con CA-I, desencadenaron alteraciones en el potencial de acción nerviosa. También hemos detectado, en el modelo murino, una disminución en la fertilidad de las hembras infectadas con CA-I/K-98, mientras las hembras infectadas con RA se comportaron igual a los controles. Sin embargo, sólo pudo comprobarse pasaje transplacentario de T. cruzi en la cepa RA. Las diferencias encontradas en la fertilidad, en la sobrevida de las crías nacidas de madres infectadas, así como en el número de resorciones fetales detectadas con la cepa miotrópica, podrían atribuirse a la respuesta inflamatoria hallada en el útero de estas hembras, ya que no se observaron alteraciones en el estro de ambos grupos infectados con respecto a los controles.

Remoção da dentina cariada / Removal of the carious dentin

O diagnóstico clínico da dentina cariada baseado nas alterações de cor e dureza deste tecido não apresenta correlação com o diagnóstico histológico. Os métodos propostos para minimizar estas limitações de diagnóstico, que empregam corantes e equipamentos eletrônicos na remoção da cárie, suscitou-nos o interesse em testá-los. Utilizou-se hemisecções de 52 dentes humanos com cárie de dentina em uma das faces proximais e/ou oclusal. A dentina corada pela solução de fucsina básica em propileno glicol foi removida. O registro da pressão manual exercida nesta remoção foi efetuado no "Sensor Digital", cujos estensômetros foram acoplados à colher de dentina. Os dentes foram posteriormente submetidos ao processamento histológico de rotina para a avaliação de dentina remanescente pelas colorações de HE e histobateriológica de Gram para tecidos. Os resultados demonstram que a solução de fucsina auxilia a remoção clínica da cárie mas não assegura a ausência de microrganismos na dentina remanescente, a qual mostrou contaminação em 75//dos casos examinados. O uso do "Sensor Digital" permitiu quantificar a pressão de remoção da dentina cariada