Risk of Anticoagulation in Gluteal Compartment Syndrome After Surgical Intervention.

Gluteal compartment syndrome (GCS) is a rare form of acute compartment syndrome. There are some causes, such as prolonged periods of immobilization and traumatic or iatrogenic events. We report two cases of gluteal compartment syndrome after orthopedic surgical intervention for fracture stabilization. The patients were both hypocoagulated due to the presence of two mechanical heart valves. Despite early treatment, both patients remained with neurological deficits. Orthopedic and trauma surgeons must be aware of the possibility of gluteal compartment syndrome in perioperative patients. Recognizing and managing risk factors such as hypocoagulation is crucial for its prevention.

Neutron radiation effects on an electronic system on module.

The NUMEN (NUclear Matrix Elements for Neutrinoless double beta decay) project was recently proposed with the aim to investigate the nuclear response to Double Charge Exchange reactions for all the isotopes explored by present and future studies of 0νßß decay. The expected level of radiation in the NUMEN experiment imposes severe limitations on the average lifetime of the electronic devices. During the experiments, it is expected that the electronic devices will be exposed to about 105 neutrons/cm2/s according to FLUKA simulations. This paper investigates the reliability of a System On Module (SOM) under neutron radiation. The tests were performed using thermal, epithermal, and fast neutrons produced by the Instituto de Pesquisas Energéticas e Nucleares 4.5 MW Nuclear Research Reactor. The results show that the National Instruments SOM is robust to neutron radiation for the proposed applications in the NUMEN project.

Arthroscopically Assisted Reduction and Internal Fixation of Talar Neck Fracture: A Case Report.

INTRODUCTION: Arthroscopic-assisted reduction and internal fixation (ARIF) is a recent concept and is increasingly used for articular fractures, due to the minimally invasive nature and high accuracy. However, there are few reports in literature about this procedure in talar fractures. CASE REPORT: The authors describe a clinical case of a 22-year-old woman with a closed right articular talar neck fracture, Hawkins type II, treated with arthroscopically ARIF. CONCLUSION: This is a minimally invasive technique that can allow close accurate reduction and stable fixation of selected articular talar fractures. It avoids some complications of multiple and large incisions of the conventional open surgery, with good functional outcomes and patient satisfaction.

Inborn-like errors of metabolism are determinants of breast cancer risk, clinical response and survival: a study of human biochemical individuality.

Breast cancer remains a leading cause of morbidity and mortality worldwide yet methods for early detection remain elusive. We describe the discovery and validation of biochemical signatures measured by mass spectrometry, performed upon blood samples from patients and controls that accurately identify (>95%) the presence of clinical breast cancer. Targeted quantitative MS/MS conducted upon 1225 individuals, including patients with breast and other cancers, normal controls as well as individuals with a variety of metabolic disorders provide a biochemical phenotype that accurately identifies the presence of breast cancer and predicts response and survival following the administration of neoadjuvant chemotherapy. The metabolic changes identified are consistent with inborn-like errors of metabolism and define a continuum from normal controls to elevated risk to invasive breast cancer. Similar results were observed in other adenocarcinomas but were not found in squamous cell cancers or hematologic neoplasms. The findings describe a new early detection platform for breast cancer and support a role for pre-existing, inborn-like errors of metabolism in the process of breast carcinogenesis that may also extend to other glandular malignancies. Statement of Significance: Findings provide a powerful tool for early detection and the assessment of prognosis in breast cancer and define a novel concept of breast carcinogenesis that characterizes malignant transformation as the clinical manifestation of underlying metabolic insufficiencies.

Bacteria-targeted biomaterials: Glycan-coated microspheres to bind Helicobacter pylori.

Gastric cancer is the third leading cause of cancer related deaths worldwide and Helicobacter pylori (H. pylori) persistent infection has been pointed as a causative agent of this disease. Current antibiotic based treatments to eradicate this bacterium fail in 20% of the patients, potentially leaving 140 million people in the world without alternative therapy. It is herein proposed the use of azide-alkyne coupling ("click chemistry") to produce glycan-coated mucoadhesive microspheres that bind and remove the H. pylori adherent to the gastric mucosa through specific bacterial adhesin-glycan interactions. Glycan immobilization is performed via chitosan's primary alcohol group, rather than the more reactive primary amines in order to preserve the amine groups that confer chitosan its mucoadhesiveness. It is shown that chitosan microspheres decorated with Lewis b glycans (Leb-Mic) bind specifically to H. pylori strains expressing the BabA adhesin (strains recognized as highly pathogenic) (∼230 bacteria/microsphere), are non-cytotoxic, are retained in the stomach of C57BL/6 mice for around 1.5h. Also, these Leb-Mic are able to prevent and remove H. pylori adhesion to gastric mucosa expressing the same glycan, in tissue sections from mice and human gastric mucosa (in vitro) and in fresh mice stomachs (ex vivo). These results provide proof-of-concept on the potential of glycan-decorated microspheres as an innovative therapeutic strategy against H. pylori and highlight the prospective of using targeted biomaterials to fight gastrointestinal infection. STATEMENT OF SIGNIFICANCE: Gastric cancer has been associated with persistent infection by Helicobacter pylori, a bacterium that colonizes half of world population and whose available antibiotic treatment fails in 20% of cases. H. pylori adhesion to gastric epithelium is mediated between bacterial adhesins and glycans expressed in gastric mucosa. We demonstrate that these glycans can be immobilized in a controlled orientation into mucoadhesive chitosan microspheres, making them selective for different H. pylori strains. Efficacy studies (in vitro and ex vivo) with mice and human gastric mucosa that express the same glycan, revealed microspheres capacity to remove/prevent specific H. pylori adhesion, envisaging their future application as bacteria scavenging from stomach. This bacteria-binding strategy can be extrapolated to target other cells/bacteria using suitable ligands.

Reduced cortical folding in schizophrenia: an MRI morphometric study.

OBJECTIVE: Although well documented, regional brain structural abnormalities in schizophrenia are nonspecific, and morphometric parameters show significant overlapping between patients and healthy comparison subjects. An increasing number of studies have focused on supraregional models involving abnormalities of the neuronal circuitry between cortical regions in schizophrenia. The aim of the present study was to investigate cortical folding as an index of the neuronal wiring in different subtypes of schizophrenia. METHOD: Magnetic resonance imaging measures of gyrification index in intervals of 3.6 mm along the total cerebral cortex were compared in 40 patients with DSM-IV schizophrenia and 20 healthy subjects. Psychopathology was assessed with the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, and the Negative Symptom Rating Scale. RESULTS: The schizophrenia patients showed significantly reduced bilateral cortical folding relative to healthy comparison subjects. Such reductions were more pronounced in those with the disorganized subtype and showed an inverse correlation with negative symptoms and a positive correlation with positive symptoms. The paranoid subtype showed reduced cortical folding that was restricted to the left hemisphere. CONCLUSIONS: These results from a larger patient group confirm a previous report of reduced cortical folding in schizophrenia patients. They also suggest a distinct pattern of abnormality between schizophrenia subtypes regarding the process of cerebral lateralization and are in agreement with the neurodevelopmental hypothesis of schizophrenia.

Rightward cerebral asymmetry in subtypes of schizophrenia according to Leonhard's classification and to DSM-IV: a structural MRI study.

Although well documented, brain structural abnormalities in schizophrenia are non-specific, and morphometric parameters show significant overlap between patients and healthy controls. Such inconsistencies in neuroimaging findings could represent different levels of severity along a single pathogenic process or distinct clinical and etiopathological psychoses within a schizophrenic spectrum. The aim of the present study was the investigation of distinct brain abnormalities in different subtypes of schizophrenia. Forty patients were classified according to DSM-IV and Leonhard's classifications. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS) and the Negative Symptom Rating Scale (NSRS). Patients were compared to 20 healthy volunteers on volumetric measures of cerebral structures (hemisphere, hippocampus and planum temporale) and ventricular-brain ratio (VBR) obtained by magnetic resonance imaging. Patients showed rightward asymmetry of cerebral hemispheres and increased VBR. Rightward asymmetry correlated with severity of negative symptoms and prevailed in the systematic forms of Leonhard, suggesting a distinct pattern of left hemisphere abnormality in this subgroup of psychoses. Increased VBR values showed a single normal distribution in the subgroups, indicating that ventricular enlargement is not restricted to a subgroup but is present to a certain degree in all cases.

Estudo comparativo entre levobupivacaína a 0, 5% e bupivacaína racêmica a 0, 5% associadas ao sufentanil na anestesia peridural para cesariana / Comparative study of 0. 5% levobupivacaine and 0. 5% racemic bupivacaine associated to sufentanil in epidural anesthesia for cesarean delivery / Estudio comparativo entre levobupivacaína a 0, 5% y bupivacaína racémica a 0, 5% asociadas al sufentanil en la anestesia peridural para cesáre

Justificativa e Objetivos: Apesar do uso freqüente de anestésicos locais em procedimentos cirúrgicos e obstétricos, a bupicavaína racêmica é associada à cardiotoxicidade potencialmente fatal. Estudos sugerem que a levobupivacaína apresenta açäo anestésica local semelhante à bupivacaína racêmica, com a vantagem de menor toxidade tanto no sistema nervoso central como cardiovascular. Os trabalhos têm demonstrado melhor qualidade anestésica com uso de bupivacaína racêmica associada à sufentanil, via peridural para cesariana. O presente estudo compara a eficácia da bupivacaína racêmica associada à sufentanil, via peridural para cesariana. O presente estudo compara a eficácia da bupivacaína racêmica 0,5 por cento com levobupivacaina 0,5 por cento ambas associadas o sufentanil, via peridural, em parturientes submetidas a cesariana