Giant gastrointestinal stromal tumor of the proximal ileum / Tumor estromal gastrointestinal gigante do íleo proximal

ABSTRACT The gastrointestinal stromal tumors (GIST) are rare and consist in mesenchymal neoplasms of the gastrointestinal tract, which may affect any part of the gastrointestinal tract, and is more frequent in stomach. We report a case of a 65-years-old male patient who presented a mass in the proximal ileum found by exploratory laparotomy. The patient underwent a segmental enterectomy with total resection of the tumor and free surgical margins with the pathological diagnosis of GIST, confirmed by immunohistochemistry (CD117).

RESUMEN Los tumores del estroma gastrointestinal (GIST) son raros, consisten en neoplasias de origen mesodérmico del tracto gastrointestinal y pueden acometer cualquier parte del tracto gastrointestinal, siendo más frecuentes en el estómago. Reportamos el caso de un paciente varón, de 65 años de edad, con una masa en el íleon proximal, descubierta mediante laparotomía exploratoria. Se ha realizado una enterectomía segmentaria, con la resección total del tumor y márgenes quirúrgicos libres. El diagnóstico anatomopatológico de GIST fue confirmado por inmunohistoquímica (CD117).

RESUMO Os tumores estromais gastrointestinais (GISTs) são raros, consistem em neoplasias mesenquimais do trato gastrointestinal e podem acometer qualquer parte do trato gastrointestinal, sendo mais frequentes no estômago. Relatamos o caso de um paciente do sexo masculino, 65 anos de idade, com uma massa em íleo proximal, descoberta em uma laparotomia exploradora. Foi realizada enterectomia segmentar com ressecção total do tumor e margens cirúrgicas livres, com o diagnóstico anatomopatológico de GIST confirmado por imuno-histoquímica (CD117).

Advances in Cryptococcus genomics: insights into the evolution of pathogenesis

Cryptococcus species are the causative agents of cryptococcal meningitis, a significant source of mortality in immunocompromised individuals. Initial work on the molecular epidemiology of this fungal pathogen utilized genotyping approaches to describe the genetic diversity and biogeography of two species, Cryptococcus neoformans and Cryptococcus gattii. Whole genome sequencing of representatives of both species resulted in reference assemblies enabling a wide array of downstream studies and genomic resources. With the increasing availability of whole genome sequencing, both species have now had hundreds of individual isolates sequenced, providing fine-scale insight into the evolution and diversification of Cryptococcus and allowing for the first genome-wide association studies to identify genetic variants associated with human virulence. Sequencing has also begun to examine the microevolution of isolates during prolonged infection and to identify variants specific to outbreak lineages, highlighting the potential role of hyper-mutation in evolving within short time scales. We can anticipate that further advances in sequencing technology and sequencing microbial genomes at scale, including metagenomics approaches, will continue to refine our view of how the evolution of Cryptococcus drives its success as a pathogen.

Diagnosing Lung Nodules on Oncologic MR/PET Imaging: Comparison of Fast T1-Weighted Sequences and Influence of Image Acquisition in Inspiration and Expiration Breath-Hold

OBJECTIVE: First, to investigate the diagnostic performance of fast T1-weighted sequences for lung nodule evaluation in oncologic magnetic resonance (MR)/positron emission tomography (PET). Second, to evaluate the influence of image acquisition in inspiration and expiration breath-hold on diagnostic performance. MATERIALS AND METHODS: The study was approved by the local Institutional Review Board. PET/CT and MR/PET of 44 cancer patients were evaluated by 2 readers. PET/CT included lung computed tomography (CT) scans in inspiration and expiration (CTin, CTex). MR/PET included Dixon sequence for attenuation correction and fast T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences (volume interpolated breath-hold examination acquired in inspiration [VIBEin], volume interpolated breath-hold examination acquired in expiration [VIBEex]). Diagnostic performance was analyzed for lesion-, lobe-, and size-dependence. Diagnostic confidence was evaluated (4-point Likert-scale; 1 = high). Jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed. RESULTS: Seventy-six pulmonary lesions were evaluated. Lesion-based detection rates were: CTex, 77.6%; VIBEin, 53.3%; VIBEex, 51.3%; and Dixon, 22.4%. Lobe-based detection rates were: CTex, 89.6%; VIBEin, 58.3%; VIBEex, 60.4%; and Dixon, 31.3%. In contrast to CT, inspiration versus expiration did not alter diagnostic performance in VIBE sequences. Diagnostic confidence was best for VIBEin and CTex and decreased in VIBEex and Dixon (1.2 ± 0.6; 1.2 ± 0.7; 1.5 ± 0.9; 1.7 ± 1.1, respectively). The JAFROC figure-of-merit of Dixon was significantly lower. All patients with malignant lesions were identified by CTex, VIBEin, and VIBEex, while 3 patients were false-negative in Dixon. CONCLUSION: Fast T1-weighted VIBE sequences allow for identification of patients with malignant pulmonary lesions. The Dixon sequence is not recommended for lung nodule evaluation in oncologic MR/PET patients. In contrast to CT, inspiration versus expiratory breath-hold in VIBE sequences was less crucial for lung nodule evaluation but was important for diagnostic confidence.

Stigma Cues Increase Self-Conscious Emotions and Decrease Likelihood of Attention to Information about Preventing Stigmatized Health Issues / Señales sobre Estigma Aumentan las Emociones Conscientes y Disminuyen la Probabilidad de Atención a la Información sobre Prevención de Cuestiones Estigmatizadas de Salud

Health communications are only effective if target audiences actually receive the messages. One potential barrier to effective health communication is the potential stigma of attending to health information, particularly for stigmatizing health issues. The purpose of the present paper was to examine when participants report self-conscious emotions (e.g., shame, embarrassment) in response to health communications, as well as likelihood of reading health information associated with these emotions. Across three studies, participants read information about preventing diseases that are either highly stigmatized or non-stigmatized. Increased accessibility of stigma cues by (a) manipulating the perceived absence vs. presence of others, or (b) measuring lower vs. higher rejection sensitivity resulted in increased self-conscious emotions in response to information about stigmatized health issues. In addition, stigma cues decreased the likelihood of reading information about stigmatized (but not non-stigmatized) health information. Implications for health outcomes and intervention design are discussed.

La comunicación en torno a la salud solo es efectiva si la audiencia meta recibe el mensaje. Una barrera potencial que tiene la comunicación efectiva sobre salud es el estigma potencial de hacer caso a la información sobre salud, particularmente en temas estigmatizados. El objetivo del presente estudio fue examinar cuándo reportan los participantes emociones conscientes (p.e. vergüenza, culpa) en respuesta a comunicación sobre salud, así como la probabilidad de leer información asociada con estas emociones. A través de tres estudios, los participantes leyeron información sobre prevención de enfermedades que son altamente estigmatizadas o que no lo son. El aumento de la accesibilidad de las señales sobre estigma mediante (a) la manipulación de la ausencia percibida vs. presencia de otros, o (b) la medición de alta o baja sensibilidad al rechazo, resultó en aumento de emociones conscientes en respuesta a la información sobre temas de salud estigmatizados. Además, las señales sobre estigma disminuyeron la probabilidad de lectura de información sobre información estigmatizada (no así para la no estigmatizada). Se discuten las implicaciones sobre consecuencias de salud y diseño de intervención.

Prevalence of overweight and obesity and its association with Hypertension and Diabetes: A study among Manakkarambai population of Thanjavur district.

Background: Obesity is a well-known risk factor of hypertension and diabetes. Aims & Objective: This study was aimed to investigate the prevalence of overweight and obesity in Manakkarambai population and to evaluate its relationship with hypertension and diabetes. Material and Methods: This Cross sectional study comprises of 163 subjects attending a local medical camp between 25- 70 years of age. Height, weight, BMI, systolic and diastolic blood pressure, fasting blood sugar and post prandial blood sugar were determined using standard methods. Results: Prevalence of overweight and obesity was 15% and 34% respectively and it was predominant among women than men. Systolic blood pressure, diastolic blood pressure and post prandial blood sugar were significantly elevated in obese subjects than in normal BMI subjects (control). Conclusion: The results showed a higher trend of hypertension and diabetes with increase in BMI.

Antilithiatic activity of poly-herbal formulation tablets by in-vitro method.

Hydroalcoholic extracts of Kalanchoe pinnata and Rotula aquatica and its combination were formulated herbal tablets, evaluated for antilithiatic in vitro method. The homogenous precipitation method was used. The study was carried out in glass tubes. The buffer system used was TRIS buffer pH 7.4. The experiment consists of the following tubes for control and test, 25 ml each of 25 mM CaCl2. 2H2O, 25 mM Na2HPO4. 2H2O or 25mM Na2C2O4. To the tubes of each set, tablet formulation or an equal amount of vehicle was added. The tubes were incubated at 37°C for 4 h. The precipitate of calcium phosphate was generated by mixing 1 ml of solution from the tubes having calcium chloride dihydrate and disodium hydrogen phosphate monohydrate and Calcium oxalate precipitate was generated by mixing 1 ml of solutions from the tubes having calcium chloride dihydrate and sodium oxalate solutions. Calcium was estimated using titrimetry and phosphorus was estimated using colorimetric analysis. Appropriate standard curves were done with each set of experiments. The amounts of precipitate of calcium and phosphate were determined in each of the respectively. The percent inhibition of the test was calculated in comparison with the control samples. Herbal tablet formulation showed antilithiatic activity to the marketed formulation in terms of inhibiting the formation of phosphate precipitate but showed a significantly better potential in preventing the formation of the calcium precipitate. The herbal tablet formulation of Kalanchoe pinnata and Rotula aquatica have inhibitory effect on calcium oxalate crystallization thus may be beneficial in the treatment of renal lithiasis.

Evaluation of Hepatoprotective and antioxidant potential of methanolic extract of Polyalthiya longifolia fruits: An In-vitro and In-vivo approach.

The aim of the study was to investigate the hepatoprotective and antioxidant potential of methanolic extract of Polyalthiya longifolia fruits (MEPL) by in-vitro and in-vivo methods.In the invitro study, Freshly isolated rat primary hepatocytes and HepG2 cells were exposed with CCl4 along with/without various concentrations of MEPL(125,250,500 μg/kg) and the effects were studied.In the in-vivo studies, CCl4 intoxication method was used and aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin and total proteins were estimated and supported with histopathological studies.MEPL (125,250,500 μg/kg) treated animals increased the percentage of viability in both primary hepatocytes (p<0.001) and in HepG2 cells (p<0.01) where as in the invivo studies,MEPL produced significant hepatoprotective effect by decreasing the elevated serum enzymes, bilirubin, LPO and significantly increased the levels of glutathione (GSH), catalase (CAT) and super oxide dismutase (SOD) .Moreover, in-vitro antioxidant studies revealed that MEPL scavenged free radicals and maximum percentage of inhibition was 62% at 800μg/mL. In addition to this, treatment with MEPL fruits showed a dose dependent reversal of histopathological changes. Based on the results, we conclude that, MEPL possesses hepatoprotective and antioxidant activity against CCl4 intoxication in both in-vitro and in-vivo methods through its free radical scavenging and antioxidant properties.

A novel deletion cluster at 13q14.2-q21.33 in an 80-year man with late onset leukemia: Clinical and molecular findings.

Chromosomal deletions are among the most common genetic events observed in hematologic malignancies; loss of genetic material is regarded as a hallmark of putative tumor suppressor gene localization. We have identified an unusual cluster of deletions at 13q14.2-13q21.33 in an 80-year-old father of a monozygotic twin pair discordant for schizophrenia, who developed chronic leukemia (CLL) at age 69. MATERIALS AND METHODS: The breakpoints for individual deletions in this cluster was identified by Affymetrix Human Array 6.0 screening. RESULTS: The deleted segments harbours a number of genes, most associated with cancer as well as a high concentration of LINEs, SINEs and related repeats. The derived chromosome represents an intra-chromosomal re-arrangement that quickly overtook blood progenitor cells probably before age 69 as a cause of CLL. CONCLUSIONS: The study highlights the role of ongoing de novo changes at susceptible sites, such as repeat rich regions, in the human genome. Also, it argues for the involvement of genes/deletions in the 13q(14.2-21.33) region in the development of CCL.

Josete Luzia Leite: opção e trajetória na enfermagem brasileira / Josete Luzia Leite: option and trajectory in the brazilian nursing

Este trabalho trata da história de vida de Josete Luzia Leite no contexto da enfermagem brasileira, tendo como objetivos identificar a inserção dessa personagem na enfermagem, discutir suas contribuições para o desenvolvimento da mesma e analisar sua participação no campo profissional. Para a construção dessa história foi utilizada a história oral como método, sendo os dados obtidos a partir de entrevista realizada com a biografada, além de livros, artigos e outras fontes que subsidiaram a coleta de dados sobre ela, como seu currículo pessoal. Como resultados desdobram-se: a escolha da profissão; a formação acadêmica em Recife e transferência para o Rio de Janeiro, onde atuou, profissionalmente, em instituições de saúde e de ensino em enfermagem; liderança junto a entidades de classe da enfermagem; visão de futuro e dos desafios presentes na profissão nos dias atuais. Considera-se que Josete constitui uma liderança na história da enfermagem e que sua vida profissional, desde a década de 1950, tem sido repleta de exemplos de dedicação e de lutas pelo reconhecimento e valorização da profissão

Household dietary practices and family nutritional status in rural Ghana

A cross-sectional study involving 400 mothers was conducted in the Manya Krobo district of Ghana with the objective of studying household dietary practices, quality of diets and family nutritional status of rural Ghana. A combination of methods, including structured interviews using questionnaire, dietary assessments and anthropometry was used to collect data for the study. The data obtained was analyzed using Statistical Package for Social Sciences (SPSS) Version 10 in Windows. Means and standard deviations were generated for continuous variables and frequency distribution for categorical variables. Most women consumed meals three times a day but only a few (12.5%) cooked all three meals at home. Breakfast and lunch were the two main meals purchased from food vendors. The most frequently consumed food items on daily basis were the starchy staples, maize, fish, pepper, onion, tomato and palm fruits. The nutritional qualities of diets were poor in terms of calcium and the B-vitamins. A significant proportion of the women were nutritionally at risk of being either underweight (12%), overweight (17%) or obese (5%). For adequate nutrition in this population, nutrition education intervention programs aimed at improving nutrient intake through improved diet diversity and increased use of local foods rich in calcium and the B-vitamins needs to be undertaken. There is also the need to intensify education on excessive weight gain and its attendant health problems in the area.

Reforçamento diferencial de comportamentos verbais alternativos de um esquizofrênico / Differential reinforcement of alternative verbal behavior of a schizophrenic patient

O presente estudo teve como objetivo investigar o comportamento verbal de um homem de 49 anos que havia sido diagnosticado como esquizofrênico crônico desde os 20 anos de idade. A intervenção foi conduzida em duas classes de respostas: falas psicóticas e falas apropriadas. Os procedimentos de reforçamento diferencial de comportamentos alternativos e extinção foram conduzidos por auxiliares de pesquisa em sessões de 45 minutos, duas vezes por semana. Controle experimental foi obtido por meio de um delineamento de reversão do tipo ABAB seguido por Follow-up. Todas as sessões foram filmadas para posterior cálculo de fidedignidade. Os resultados do estudo mostram uma redução das falas psicóticas e um aumento das falas apropriadas durante as sessões de intervenção. Os dados demonstram que o comportamento verbal da pessoa diagnosticada como esquizofrênica pode ser controlado pelo reforço social combinado com extinção. Delírios e alucinações foram discutidos como comportamentos verbais

Gestação após injeção intracitoplasmática de espermatozóides - ICSI - em casal sorodiscordante para HIV-I: tempo de refletir sobre AIDS e reprodução / Pregnancy following intracytoplasmic sperm injection - ICSI from a HIV-I serodiscordant couple time to think about AIDS and reproduction

Casal sorodiscordante para HIV-I foi submetido a ciclo de fertilização in vitro pela técnica de injeção intracitoplasmática de espermatozóides - ICSI, após preparo de sêmen em gradientes de densidade seguido de swim-up, com obtenção de gestação única em curso

The effects of topical application of sunflower-seed oil on open wound healing in lambs

PURPOSE: To demonstrate the effects of the use of sunflower seed oil on the treatment of skin wounds. METHODS: Eighteen male Saint Inês lambs were divided in 3 groups according to the pos-operative (7, 14 and 21 days). After antisepsis and local anestesia, two 4cm2 wounds on each side of the thoracic region, close to the scapule were surgically produced. The experimental wounds were treated with sunflower seed oil, with high concentration of linoleic acid (LA), and the control ones with sterilized Vaseline. Biopsies of the pos-operative wounds tissue were performed on the 7th, 14th, 21st days and histologically evaluated. RESULTS: Topic application of sunflower seed oil accelerated healing process at the 7th and 21st days, reducing wound area and increasing wound contraction. Granulation tissue increased faster on treated wounds. The epidermis of the treated wounds was completely recovered when compared to control wounds. CONCLUSION: The topic use of sunflower seed oil accelerated the healing process, and it can be used as an alternative therapy on second intention wound healing.

Chromosome characterization in Thinopyrum ponticum (Triticeae, Poaceae) using in situ hybridization with different DNA sequences

Thinopyrum ponticum (2n = 10x = 70, JJJJsJs) belongs to the Triticeae tribe, and is currently used as a source of pathogen resistance genes in wheat breeding. In order to characterize its chromosomes, the number and position of 45S and 5S rDNA sites, as well as the distribution of the repetitive DNA sequences pAs1 and pSc119.2, were identified by fluorescent in situ hybridization. The number of nucleoli and NORs was also recorded after silver nitrate staining. Seventeen 45S and twenty 5S rDNA sites were observed on the short arms of 17 chromosomes, the 45S rDNA was always located terminally. On three other chromosomes, only the 5S rDNA site was observed. Silver staining revealed a high number of Ag-NORs (14 to 17) on metaphase chromosomes, whereas on interphase nuclei there was a large variation in number of nucleoli (one to 15), most of them (82.8 percent) ranging between four and nine. The pAs1 probe hybridized to the terminal region of both arms of all 70 chromosomes. In addition, a disperse labeling was observed throughout the chromosomes, except in centromeric and most pericentromeric regions. When the pSc119.2 sequence was used as a probe, terminal labeling was observed on the short arms of 17 chromosomes and on the long arms of five others. The relative position of 45S and 5S rDNA sites, together with the hybridization pattern of pAs1 and pSc119.2 probes, should allow whole chromosomes or chromosome segments of Th. ponticum to be identified in inbred lines of wheat x Th. ponticum.