Facile Synthesis of Highly Stretchable, Tough, and Photodegradable Hydrogels.

Recently, highly stretchable and tough hydrogels that are photodegradable on-demand have been reported. Unfortunately, the preparation procedure is complex due to the hydrophobic nature of the photocrosslinkers. Herein, a simple method is reported to prepare photodegradable double-network (DN) hydrogels that exhibit high stretchability, toughness, and biocompatibility. Hydrophilic ortho-nitrobenzyl (ONB) crosslinkers incorporating different poly(ethylene glycol) (PEG) backbones (600, 1000, and 2000 g mol-1 ) are synthesized. These photodegradable DN hydrogels are prepared by the irreversible crosslinking of chains by using such ONB crosslinkers, and the reversible ionic crosslinking between sodium alginate and divalent cations (Ca2+ ). Remarkable mechanical properties are obtained by combining ionic and covalent crosslinking and their synergistic effect, and by reducing the length of the PEG backbone. The rapid on-demand degradation of these hydrogels is also demonstrated by using cytocompatible light wavelength (λ = 365 nm) that degrades the photosensitive ONB units. The authors have successfully used these hydrogels as skin-worn sensors for monitoring human respiration and physical activities. A combination of excellent mechanical properties, facile fabrication, and on-demand degradation holds promise for their application as the next generation of substrates or active sensors eco-friendly for bioelectronics, biosensors, wearable computing, and stretchable electronics.

Geochemistry and mineralogy of auriferous tailings deposits and their potential for reuse in Nova Lima Region, Brazil.

Since the mid-nineteenth century, gold ores, mainly hosted in sulfides, have been processed at metallurgical plants located in Nova Lima, Brazil. The generated wastes have been accumulated over the years in tailings dams or in piles. These materials represent wasted from old circuits, as well as from plants still in production. In this study, geochemical, mineralogical, 3D modelling, and metallurgical analyses wastes were carried out to evaluate potential reuse of these wastes. The performed characterization detected residues of very fine grain size containing sulfides and oxides. The wastes show high grades of Au hosted in different minerals. In addition to Au, samples contain S, Fe, Zn, Pb, Sc, Si, and As. The 3D modelling for spatial definition of Au was performed using ordinary kriging with dimensional variograms. The results indicated the occurrence of Au enrichment zones and allowed to reveal the most attractive tailing deposits in terms of Au content. Metallurgical tests showed recovery of 70% of Au and suggested other potential reuse of the wastes, such as aggregates for the civil construction sector and recovery of other metals. The present work highlights the importance of an integrative characterization within the scope of the circular economy and the value of tailings in the production chain of the mineral sector.

Exploring Molecular Dynamics of Adsorbed CO2 Species in Amine-Modified Porous Silica by Solid-State NMR Relaxation.

Previous studies on CO2 adsorbents have mainly addressed the identification and quantification of adsorbed CO2 species in amine-modified porous materials. Investigation of molecular motion of CO2 species in confinement has not been explored in depth yet. This work entails a comprehensive study of molecular dynamics of the different CO2 species chemi- and physisorbed at amine-modified silica materials through the determination of the rotating frame spin-lattice relaxation times (T 1ρ) by solid-state NMR. Rotational correlation times (τC) were also estimated using spin relaxation models based on the Bloch, Wangsness, and Redfield and the Bloembergen-Purcell-Pound theories. As expected, the τC values for the two physisorbed CO2 species are considerably shorter (32 and 20 µs) than for the three identified chemisorbed CO2 species (162, 62, and 123 µs). The differences in molecular dynamics between the different chemisorbed species correlate well with the structures previously proposed. In the case of the physisorbed CO2 species, the τC values of the CO2 species displaying faster molecular dynamics falls in the range of viscous liquids, whereas the species presenting slower dynamics exhibit T 1ρ and τC values compatible with a CO2 layer of weakly interacting molecules with the silica surface. The values for chemical shift anisotropy (CSA) and 1H-13C heteronuclear dipolar couplings have also been estimated from T 1ρ measurements, for each adsorbed CO2 species. The CSA tensor parameters obtained from fitting the relaxation data agree with the experimentally measured CSA values, thus showing that the theories are well suited to study CO2 dynamics in silica surfaces.

Photo-degradable, tough and highly stretchable hydrogels.

We present for the first time highly stretchable and tough hydrogels with controlled light-triggered photodegradation. A double-network of alginate/polyacrylamide (PAAm) is formed by using covalently and ionically crosslinked subnetworks. The ionic Ca2+ alginate interpenetrates a PAAm network covalently crosslinked by a bifunctional acrylic crosslinker containing the photodegradable o-nitrobenzyl (ONB) core instead of the commonly used methylene bisacrylamide (MBAA). Remarkably, due to the developed protocol, the change of the crosslinker did not affect the hydrogel's mechanical properties. The incorporation of photosensitive components in hydrogels allows external temporal control of their properties and tuneable degradation. Cell viability and cell proliferation assays revealed that hydrogels and their photodegradation products are not cytotoxic to the NIH3T3 cell line. In one example of application, we used these hydrogels for bio-potential acquisition in wearable electrocardiography. Surprisingly, these hydrogels showed a lower skin-electrode impedance, compared to the common medical grade Ag/AgCl electrodes. This work lays the foundation for the next generation of tough and highly stretchable hydrogels that are environmentally friendly and can find applications in a variety of fields such as health, electronics, and energy, as they combine excellent mechanical properties with controlled degradation.

3D Printed Poly(𝜀-caprolactone)/Hydroxyapatite Scaffolds for Bone Tissue Engineering: A Comparative Study on a Composite Preparation by Melt Blending or Solvent Casting Techniques and the Influence of Bioceramic Content on Scaffold Properties.

Bone tissue engineering has been developed in the past decades, with the engineering of bone substitutes on the vanguard of this regenerative approach. Polycaprolactone-based scaffolds are fairly applied for bone regeneration, and several composites have been incorporated so as to improve the scaffolds' mechanical properties and tissue in-growth. In this study, hydroxyapatite is incorporated on polycaprolactone-based scaffolds at two different proportions, 80:20 and 60:40. Scaffolds are produced with two different blending methods, solvent casting and melt blending. The prepared composites are 3D printed through an extrusion-based technique and further investigated with regard to their chemical, thermal, morphological, and mechanical characteristics. In vitro cytocompatibility and osteogenic differentiation was also assessed with human dental pulp stem/stromal cells. The results show the melt-blending-derived scaffolds to present more promising mechanical properties, along with the incorporation of hydroxyapatite. The latter is also related to an increase in osteogenic activity and promotion. Overall, this study suggests polycaprolactone/hydroxyapatite scaffolds to be promising candidates for bone tissue engineering, particularly when produced by the MB method.

Protein digestibility and bioavailability in an F2 mouse cross between the selected fat mouse line and an M2 congenic line carrying the anti-obesity and anti-diabetic Tst allele.

The study was performed to investigate protein digestibility and utilization in an F2 cross (M2-F2 cross) between the selected Fat (F) line and an M2 congenic line. The congenic M2 line carried the Fob3b2 quantitative trait locus (QTL) from the selected Lean (L) line previously shown to contain the Tst gene with leanness, anti-diabetic and resistance to diet-induced obesity effects. The main objective of the study was to test if some of the effects on leanness and obesity resistance of the L-line Fob3b2 could also be due to the effect of this QTL on nutrient digestibility and bioavailability. The F2 littermates carrying either the Fat line segment within the Fob3b2 region or the L-line were compared when fed the high-fat diet. Eleven mice per genotype were individually housed in metabolic cages. In 5-day experimental period, body mass and diet intake were measured. The part of study was done on the F and L line and tested the difference in apparent protein digestibility on low-fat (LFD) and high-fat (HFD) diet. The nitrogen content was determined in the diet, faeces, and urine based on which, the apparent protein digestibility, apparent protein biological value and apparent net protein utilization were calculated There were no significant differences in any of these parameters on congenic line, confirming that the phenotypic effect on adiposity between the genotypes in the M2-F2 population was not due to the differential effect of the Fob3b2 locus carrying the Tst gene on protein utilization. We conclude that the observed phenotypic effects of this gene region are due to direct metabolic actions rather than the effects on nutrient absorption and nitrogen utilization since there were no differences in apparent protein digestibility between L and F lines, irrespective to HFD or LFD. The age of animals had significant effect on the level of digestibility.

"Hidden" CO2 in Amine-Modified Porous Silicas Enables Full Quantitative NMR Identification of Physi- and Chemisorbed CO2 Species.

Although spectroscopic investigation of surface chemisorbed CO2 species has been the focus of most studies, identifying different domains of weakly interacting (physisorbed) CO2 molecules in confined spaces is less trivial as they are often indistinguishable resorting to (isotropic) NMR chemical shift or vibrational band analyses. Herein, we undertake for the first time a thorough solid-state NMR analysis of CO2 species physisorbed prior to and after amine-functionalization of silica surfaces; combining 13C NMR chemical shift anisotropy (CSA) and longitudinal relaxation times (T 1). These methods were used to quantitatively distinguish otherwise overlapping physisorbed CO2 signals, which contributed to an empirical model of CO2 speciation for the physi- and chemisorbed fractions. The quantitatively measured T 1 values confirm the presence of CO2 molecular dynamics on the microsecond, millisecond, and second time scales, strongly supporting the existence of up to three physisorbed CO2 species with proportions of about 15%, 15%, and 70%, respectively. Our approach takes advantage from using adsorbed 13C-labeled CO2 as probe molecules and quantitative cross-polarization magic-angle spinning to study both physi- and chemisorbed CO2 species, showing that 45% of chemisorbed CO2 versus 55% of physisorbed CO2 is formed from the overall confined CO2 in amine-modified hybrid silicas. A total of six distinct CO2 environments were identified from which three physisorbed CO2 were discriminated, coined here as "gas, liquid, and solid-like" CO2 species. The complex nature of physisorbed CO2 in the presence and absence of chemisorbed CO2 species is revealed, shedding light on what fractions of weakly interacting CO2 are affected upon pore functionalization. This work extends the current knowledge on CO2 sorption mechanisms providing new clues toward CO2 sorbent optimization.

Ureteral duplication with an heterotopic ureteric implantation: a less common cause of adult urinary incontinence.

A 25-year-old woman with a history of frequent urinary tract infections and dribbling urinary incontinence since early childhood was referred to our urology clinic. An accurate investigation revealed a complete right ureteral duplication, with a dysplastic upper-pole renal moiety and an ectopic right ureter draining into the vagina. The patient underwent surgical exploration which confirmed the diagnosis. It was also possible to see a communication between renal moieties which allowed for a laparoscopic ligation and excision of the heterotopic right ureter. The patient had a good recovery, with a complete resolution of her complaints and a great improvement of her quality of life.

Strategy to improve the mechanical properties of bioabsorbable materials based on chitosan for orthopedic fixation applications.

Bioabsorbable polymeric fixation devices have been used as an alternative to metallic implants in orthopedics, preventing the stress shielding effect and avoiding a second surgery for implant removal. However, several problems are still associated with current bioabsorbable implants, including the limited mechanical stiffness and strength, and the adverse tissue reactions generated. To minimize or even eliminate the problems associated with these implants, strategies have been developed to synthesize new implant materials based on chitosan. To overcome the brittle behavior of most 3D chitosan-based structures, glycerol and sorbitol were blended to chitosan and the effect of these plasticizers in the produced specimens was analyzed by flexural tests, Berkovich tests, scanning electron microscopy (SEM) and micro-CT analyzes. The improvement of the mechanical properties was also tested by adding ceramics, namely hydroxyapatite powder and biphasic mixtures of hydroxyapatite (HA) and beta-tricalcium phosphate (ß-TCP). In the plasticizers group, the best combination of the measured properties was obtained for chitosan with 10% glycerol (flexural strength of 53.8 MPa and indentation hardness of 19.4 kgf/mm2), while in the ceramics group the best mechanical behavior was obtained for chitosan with 10% HA+ß-TCP powder (flexural strength of 67.5 MPa and indentation hardness 28.2 kgf/mm2). All the tested material compositions were dense and homogeneous, fundamental condition for a good implant performance. These are encouraging results, which support the continued development of chitosan-based materials for orthopedic fixation applications.

Sexual Dysfunction and Satisfaction in Kidney Transplant Patients.

INTRODUCTION: 10% of the world's population suffers from chronic kidney disease. Kidney transplants provide an improvement in the quality of life of those patients. Sexual dysfunction is common after kidney transplantation, and its etiology is presumed to be multifactorial. It has a negative impact on sexual satisfaction and health-related quality-of-life. The integration of a new organ into the body can imply an adjustment of body image, which may eventually have a negative influence on intimacy and sexual behaviors. AIM: To evaluate male sexual function, sexual satisfaction, and body image satisfaction among a convenience sample of patients who have had a kidney transplant. METHODS: This is a cross-sectional study that included 460 patients, from a single healthcare center, who had undergone a kidney transplant procedure >4 weeks ago. A total of 112 respondents (mean = 55.5 years, SD = 11.4) answered the questionnaires properly. MAIN OUTCOME MEASURES: All recruited patients answered a self-reported sociodemographic questionnaire, in addition to the International Index of Erectile function, the New Scale of Sexual Satisfaction, the Brief Symptom Inventory, and the Body Image Scale. RESULTS: A correlation was found between sexual function and sexual satisfaction (r = 0.598, P < .001, n = 112), as well as between body image satisfaction and sexual function (r = -0.193, P = .042, n = 112). The length of time after a kidney transplant (≤ or >36 months) was not associated with a difference in sexual functioning or sexual satisfaction. CLINICAL IMPLICATIONS: This study showed the obvious implications of sexual function on sexual satisfaction, which should alert healthcare professionals to the importance of identifying and managing sexual dysfunction in patients with chronic kidney disease, to optimize their global and sexual health satisfaction. STRENGTH & LIMITATIONS: This study identified a high prevalence of sexual dysfunction among kidney transplant recipients. This should reinforce the need for the medical community to evaluate the quality-of-life domains of patients with chronic disease. There is still a lack of information concerning any longitudinal evaluation of kidney transplant patients' sexual function and the effects that this surgery has on sexuality. CONCLUSIONS: This study corroborated the severe effects that kidney transplant patients often report regarding their sexuality. Among the patients who participated in the study, sexual function proved to be relevant in relation to sexual satisfaction. Mota RL, Fonseca R, Santos JC, et al. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019;16:1018-1028.

A referenciação para a consulta de andrologia - Quem e como são referenciados? / Andrology - Whom and how are patients being referred?

Introdução: A andrologia é uma área médica que estuda a sexualidade e a fertilidade no sexo masculino. A referenciação de utentes deve ser feita de forma criteriosa e adequada para assegurar o acesso a tratamentos diferenciados sempre que haja indicação. Objetivo: Caracterizar a referenciação específica para a consulta de andrologia no nosso centro hospitalar. Material e métodos: Avaliação retrospectiva da casuística da consulta de andrologia entre janeiro de 2014 e dezembro de 2015. Resultados: Consultaram‐se os registos clínicos de 96 das 102 consultas de primeira vez de andrologia. Cerca de 60% dos doentes foram referenciados por disfunção eréctil, 15% por curvatura peniana e 8% por disfunção ejaculatória. Apenas 27% dos doentes com disfunção eréctil já tinham efetuado prova terapêutica e 40% não tinham perfil metabólico recente. Discussão: A elevada prevalência de comorbilidades sexuais e a elevada prevalência de doentes naïve na população referenciada levam a ponderar se existe dificuldade entre os médicos referenciadores de categorizar e tratar a disfunção sexual masculina de acordo com o modelo tetrafásico da resposta sexual. A ausência de estratificação de doentes segundo os critérios de Princeton III demonstra a dificuldade na seleção de doentes que podem iniciar terapêuticas de primeira linha antes da referenciação. Conclusão: As disfunções sexuais têm uma elevada prevalência na população geral. Os cuidados de saúde necessitam de ter uma maior capacidade de intervenção diagnóstica e terapêutica

Introduction: Andrology focuses in male sexual and fertility diseases. Its referral should be thoughtful and tailored in order to select the correct cases. Objectives: The aim of this work was to evaluate the referral to our department and improvement points. Material and methods: A retrospective analysis was performed of the Andrology consults between January 2014 and December 2015. Results: We evaluated 96 of the 102 consults performed. About 60% of patients were referred with erectile dysfunction complaints, 15% with penile curvature and 8% with ejaculatory dysfunction. About 27% had previously tried phosphodiesterase 5 inhibitor, and 40% lacked recent metabolic workup. Discussion: The high prevalence of sexual complaints coupled with a high number of naïve patients could be due to difficulties by the referral doctors when analyzing and characterizing male sexual dysfunction according to the current sexual response cycle model. The lack of patient categorization accordingly to Princeton criteria (III) shows the difficulties found when selecting patients to start the first line of treatment for erectile dysfunction. Conclusion: Sexual dysfunction are highly prevalent in the general population. Healthcare providers should improve diagnostic and treatment skills in this field of Urology

[Andrology - Whom and how are patients being referred?] / A referenciação para a consulta de andrologia ­ Quem e como são referenciados?

INTRODUCTION: Andrology focuses in male sexual and fertility diseases. Its referral should be thoughtful and tailored in order to select the correct cases. OBJECTIVES: The aim of this work was to evaluate the referral to our department and improvement points. MATERIAL AND METHODS: A retrospective analysis was performed of the Andrology consults between January 2014 and December 2015. RESULTS: We evaluated 96 of the 102 consults performed. About 60% of patients were referred with erectile dysfunction complaints, 15% with penile curvature and 8% with ejaculatory dysfunction. About 27% had previously tried phosphodiesterase 5 inhibitor, and 40% lacked recent metabolic workup. DISCUSSION: The high prevalence of sexual complaints coupled with a high number of naïve patients could be due to difficulties by the referral doctors when analyzing and characterizing male sexual dysfunction according to the current sexual response cycle model. The lack of patient categorization accordingly to Princeton criteria (III) shows the difficulties found when selecting patients to start the first line of treatment for erectile dysfunction. CONCLUSION: Sexual dysfunction are highly prevalent in the general population. Healthcare providers should improve diagnostic and treatment skills in this field of Urology.

Dynamic flexion/extension and non-weight bearing ultrasonography is helpful for identifying manica flexoria tears in horses.

Lesions of the manica flexoria are a tenoscopic finding in horses with digital flexor tendon sheath tenosynovitis. This retrospective case series study describes the ultrasonographic findings in seven horses admitted for digital flexor tendon sheath swelling associated with lameness and tenoscopic confirmation of a manica flexoria tear. Six horses had a partial manica flexoria tear, one a complete rupture. The ultrasonographic examination included a static examination on the weight and non-weight bearing limb and a dynamic limb assessment during flexion and extension. The main ultrasonographic finding at the static weight bearing examination in horses with a partial tear was an asymmetrical appearance of the manica flexoria at the level of the junction with the lateral border of the superficial digital flexor tendon, or an incomplete visualization of the manica flexoria in case of complete rupture. The split edges of the completed ruptured manica flexoria were seen floating in the synovial fluid at the examination in flexion. In six of seven cases, the superficial digital flexor tendon slid abnormally relative to the deep digital flexor tendon, during flexion/extension movements, with medial displacement of the superficial digital flexor tendon, appearance of an anechoic gap between the flexor tendons or reduced superficial digital flexor tendon sliding. Because ultrasonographic diagnosis of the manica flexoria tear is considered challenging, detection of these ultrasonographic features is helpful to increase the likelihood of identifying manica flexoria tears prior to tenoscopy. Authors recommend static ultrasonographic examination of the manica flexoria using a flexed limb position and dynamic ultrasonographic examination using flexion and extension positioning for horses with suspected digital sheath injury.

Ultrasound and Radiographic Abnormalities in a Patient With Chronic Severe Acromegaly / Los hallazgos ecográficos y radiográficos en una paciente con acromegalia crónica severa

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Clinical phenotype and outcome in lupus according to age: a comparison between juvenile and adult onset / Fenotipo clínico y resultado en el lupus de acuerdo con la edad: una comparación del lupus de comienzo juvenil y lupus del adulto

Objective. To study differences in demographic, clinical and immunologic characteristics, activity and cumulative organ damage according to age of onset in systemic lupus erythematosus (SLE). Methods. Cross-sectional study was performed including 204 SLE patients. Characteristics were compared between juvenile and adult-onset SLE patients using parametric and nonparametric tests (SPSS 23.0). Results. Juvenile-SLE patients had malar rash more often (78.9% vs 53%; p=0.001), oral ulcers (45.5% vs 17.5%; p=0.001), neurological involvement (13.1% vs 3.6%; p=0.02) nephritis (50% vs 33.9%), p=0.04) and haematological manifestations such as hemolytic anaemia (23.6% vs 5.4%; p=0.002) and leukopenia (46.1% vs 4.2%; p<0.001). Arthritis was more prevalent in adult-onset patients (70.9% vs 90%; p<0.04). Overall, 20% of juvenile patients had chronic damage (Systemic Lupus International Collaborating Clinics/Damage Index [SLICC/DI]≥1), However, the percentage of patients with irreversible damage was higher in the adult SLE patient group (24%, p=0.04). No statistically significant differences were found in other characteristics studied. Conclusion. In summary, our study confirms the existence of differences in clinical manifestations, according to age at diagnosis of SLE. Juvenile-SLE patients showed a more aggressive clinical presentation

Objetivo. Estudiar las diferencias en las características demográficas, clínicas, inmunológicas, en la actividad y daño crónico de acuerdo con la edad de aparición del lupus eritematoso sistémico (LES). Métodos. Se realizó un estudio de corte transversal incluyendo 204 pacientes con LES. Las características se compararon entre los pacientes con lupus de comienzo juvenil y del adulto utilizando testes paramétricos y no paramétricos (SPSS 23.0). Resultados. Los pacientes con LES juvenil tenian más frecuentemente rash malar (78,9 vs. 53%; p = 0,001), úlceras orales (45,5 vs. 17,5%; p = 0,001), afectación neurológica (13,1 vs. 3,6%; p = 0,02) nefritis (50 vs. 33,9%, p = 0,04) y las manifestaciones hematológicas como anemia hemolítica (23,6 vs. 5,4%; p = 0,002) y leucopenia (46,1 vs. 4,2%; p < 0,001). La artritis era más frecuente en los pacientes con lupus del adulto (70,9 vs. 90%; p 0,04). El 20% de los pacientes juveniles tenían daño crónico (Systemic Lupus International Collaborating Clinics/Damage Index [SLICC/DI]≥1). Sin embargo,el porcentaje de pacientes con daño irreversible fue superior en adultos (24%, p = 0,04). No se encontraron diferencias estadísticamente significativas en relación con las otras características estudiadas. Conclusión. En resumen, nuestro estudio confirma la existencia de diferencias en las manifestaciones clínicas según la edad al momento del diagnóstico del LES. Pacientes con LES de comienzo juvenil mostraron una presentación clínica más agresiva

Clinical phenotype and outcome in lupus according to age: a comparison between juvenile and adult onset.

OBJECTIVE: To study differences in demographic, clinical and immunologic characteristics, activity and cumulative organ damage according to age of onset in systemic lupus erythematosus (SLE). METHODS: Cross-sectional study was performed including 204 SLE patients. Characteristics were compared between juvenile and adult-onset SLE patients using parametric and nonparametric tests (SPSS 23.0). RESULTS: Juvenile-SLE patients had malar rash more often (78.9% vs 53%; p=0.001), oral ulcers (45.5% vs 17.5%; p=0.001), neurological involvement (13.1% vs 3.6%; p=0.02) nephritis (50% vs 33.9%), p=0.04) and haematological manifestations such as hemolytic anaemia (23.6% vs 5.4%; p=0.002) and leukopenia (46.1% vs 4.2%; p<0.001). Arthritis was more prevalent in adult-onset patients (70.9% vs 90%; p<0.04). Overall, 20% of juvenile patients had chronic damage (Systemic Lupus International Collaborating Clinics/Damage Index [SLICC/DI]≥1), However, the percentage of patients with irreversible damage was higher in the adult SLE patient group (24%, p=0.04). No statistically significant differences were found in other characteristics studied. CONCLUSION: In summary, our study confirms the existence of differences in clinical manifestations, according to age at diagnosis of SLE. Juvenile-SLE patients showed a more aggressive clinical presentation.

High prevalence of diarrheagenic Escherichia coli carrying toxin-encoding genes isolated from children and adults in southeastern Brazil.

BACKGROUND: Diarrheagenic Escherichia coli (DEC) are important bacterial causes of childhood diarrhea in Brazil, but its impact in adults is unknown. This study aimed at investigating DEC among children and adults living in endemic areas. METHODS: A total of 327 stools specimens were collected from children (n = 141) and adults (n = 186) with diarrhea attending health centers. Diarrheagenic E. coli (DEC) were identified by their virulence genes (multiplex polymerase chain reaction) and HEp-2 cell adherence patterns. RESULTS: DEC were detected in 56 (40%) children and 74 (39%) adults; enteroaggregative E. coli (EAEC) (23%) was the most prevalent pathotype, followed by diffusely adherent E. coli (DAEC) (13%), and occurred at similar frequencies in both diarrheal groups. Atypical enteropathogenic E. coli (aEPEC) strains were recovered more frequently from children (6%) than from adults (1%). Twenty-six percent of the EAEC were classified as typical EAEC possessing aggR gene, and carried the aap gene. EAEC strains carrying aggR-aap-aatA genes were significantly more frequent among children than adults (p < 0.05). DAEC strains possessing Afa/Dr. genes were detected from children (10%) and adults (6%). EAEC and DAEC strains harboring genes for the EAST1 (astA), Pet, Pic, and Sat toxins were common in both diarrheal groups. The astA and the porcine AE/associated adhesin (paa) genes were found in most of aEPEC strains. High levels of resistance to antimicrobial drugs were found among DAEC and aEPEC isolates. CONCLUSION: The results show a high proportion of EAEC and DAEC carrying toxin-encoding genes among adults with diarrhea.

Depression and unemployment incidence rate evolution in Portugal, 1995-2013: General Practitioner Sentinel Network data.

OBJECTIVE: Quantify, for both genders, the correlation between the depression incidence rate and the unemployment rate in Portugal between 1995 and 2013. METHODS: An ecological study was developed to correlate the evolution of the depression incidence rates estimated by the General Practitioner Sentinel Network and the annual unemployment rates provided by the National Statistical Institute in official publications. RESULTS: There was a positive correlation between the depression incidence rate and the unemployment rate in Portugal, which was significant only for males (R2 = 0.83, p = 0.04). For this gender, an increase of 37 new cases of depression per 100,000 inhabitants was estimated for each 1% increase in the unemployment rate between 1995 and 2013. CONCLUSIONS: Although the study design does not allow the establishment of a causal association between unemployment and depression, the results suggest that the evolution of unemployment in Portugal may have had a significant impact on the level of mental health of the Portuguese, especially among men.

Autoimmune pitfalls in treatment with TNFα inhibitors / Los escollos autoinmunes en el tratamiento de pacientes con anti-TNFα

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