Extended trochanteric osteotomy (ETO) and fluted tapered modular stems in revision hip arthroplasty. Does ETO integrity or consolidation, really matter?

INTRODUCTION: The objective of this study was to assess if the fracture and/or non-union of extended trochanteric osteotomy (ETO) affected the behavior and survival of modular fluted and tapered distal fixation stems in revision total hip arthroplasties (rTHA). METHODS: We retrospectively analyzed 52 rTHA in 52 patients. Preoperative diagnoses were mechanical loosening (42 cases), septic loosening (8), periprosthetic fracture (1), and femoral stem fracture (1). According to the Paprosky classification, femoral bone stock deficiencies were 19 type-II, 26 type IIIA, and 7 type IIIB. We assessed the behavior of the osteotomy (union, fracture, migration) and the survival and behavior (integration and subsidence) of prosthetic femoral stems. RESULTS: ETO union and non-union rates were 84.61% (44 patients) and 15.38% (8 cases) respectively. There were twelve (23%) intra-operative fractures of the osteotomy fragment and 11 (21.15%) migrations (4.5 mm on average). We observed bone union in 39 (75%) stems and 13 (25%) stable fibrous unions. Nine (17.3%) stems subsided 7 mm (2-15 mm) on average before becoming stable. Stem subsidence and integration was not significantly affected by ETO fracture/no fracture or union/non-union. The postoperative Harris Hip Score (HHS) improved significantly as compared to the pre-operative HHS (38.41 ± 3.54 vs 85.29 ± 3.36; p < 0.01). Patients were followed up for 55 (24-100) months. The overall implant survival at the end of follow-up was 100%. CONCLUSIONS: In this series, neither the non-union nor the intra-operative fracture of the ETO segment affected the behavior or medium-term survival of femoral stems.

Accuracy of air temperature forecasts and its use for prediction of the reference evapotranspiration / Acurácia das previsões da temperatura do ar e uso na estimativa da evapotranspiração de referência

The objective of this study was to verify the quality of the short-term forecasts made by some web sites, as well as the potential of its use in estimating reference evapotranspiration (ETo). For the period 2012-2013, every 4-days, the maximum (Tmax) and minimum (Tmin) air temperature forecasts for horizons of 24, 48, 72 and 96 hours provided by public sites for Uberlandia-MG were collected and used for calculating the reference evapotranspiration (ETo) by the Hargreaves-Samani (HS) calibrated equation. The sites www.accuweather.com (WEATHER); www.cemig.com.br (CEMIG); jornaldotempo.uol.com.br; (JORNAL) and www.climatempo.com.br (CLIMA) were evaluated. For the same period, the meteorological data were taken at the National Institute of Meteorology (www.inmet.gov.br). The performance of the Tmax and Tmin forecasts as well as the ETo estimates were made by regression analysis, the mean bias error (MBE), root mean square error (RMSE) and t-test. For all sites, there was a better performance in the prediction of Tmin when compared to Tmax, especially by a reduction in errors (MBE and RMSE) and an increase in coefficients b and R2. For ETo, the site CLIMA had lowest MBE and RMSE (0.9 mm d-1) following by the WEATHER and JORNAL. On the other hand, the site CEMIG presented higher values for MBE (-1.3 mm d-1) and RMSE (1.6 mm d-1). There was no worsening with an increase of the forecast horizon in these indices, except for R² values. The site CLIMA was the only one that did not differ significantly from the ETo values observed. The results of diagnostic verification procedures indicate the potential use of air temperature forecasts in irrigation management.

O objetivo deste trabalho foi verificar a qualidade das previsões de curto prazo feitas por alguns endereços eletrônicos da internet, bem como a potencialidade de seu uso na estimativa da evapotranspiração de referência (ETo). No período de 2012 a 2013, a cada quatro dias, foram coletadas as previsões de 24,48,72 e 96 de horizonte, da temperatura máxima (Tmax) e mínima (Tmin) do ar de quatro endereços eletrônicos para a cidade de Uberlândia, MG. Os dados previstos de temperatura, foram utilizados na equação calibrada do modelo de Hargreaves-Samani (HS) para a obtenção da estimativa da ETo. Os endereços avaliados foram: www.accuweather.com (WEATHER); www.cemig.com.br (CEMIG); jornaldotempo.uol.com.br; (JORNAL) e www.climatempo.com.br (CLIMA). No mesmo período, dados meteorológicos da cidade foram obtidos junto ao Instituto Nacional de Meteorologia (www.inmet.gov.br). A performance das previsões da temperatura e estimativas de ETo foram feitas por meio da análise de regressão, erro médio (EM), raiz quadrada do quadrado médio do erro (RQME) e pelo teste-t. Para todos os endereços, houve uma melhor performance na previsão da Tmin em relação a Tmax, especialmente pela redução dos erros (ME e RQME) e aumento nos coeficientes b e R2. Para ETo, o endereço CLIMA obteve os menores valores de EM e RQME (0,9 mm d-1) seguido do endereço WEATHER e JORNAL. Por outro lado, o endereço CEMIG apresentou os maiores valores para EM (-1,3 mm d-1) e RQME (1,6 mm d-1). Não houve piora na estimativa com aumento do horizonte de previsão nesses índices, exceto para R2. O endereço CLIMA foi o único que não diferiu significativamente dos valores de ETo observados. Os resultados de verificação indicam potencial uso das previsões para o manejo da irrigação.

La biología molecular en la precisión diagnósticade las leucemias / Molecular biology in the diagnostic accuracy of leukemia

Los estudios de citogenética y biología molecular permiten correlacionar la presencia de determinadas anomalías cromosómicas y moleculares con tipos específicos de leucemias y linfomas. Este conocimiento ha hecho posible el perfeccionamiento progresivo del sistema de clasificación de las enfermedades oncohematológicas. Actualmente la presencia de ciertas anomalías citogenéticas o moleculares son suficientes para identificar algunas de estas entidades y en ocasiones, el diagnóstico cambia después de un análisis integrado de la citomorfología con la citogenética y la biología molecular. Este reporte pretende resaltar la importancia del estudio molecular cuando la citomorfología es compleja y propicia diagnósticos erróneos. Mediante la reacción en cadena de la polimerasa, previa reverso-transcripción del ARN aislado de sangre medular, se estudiaron cuatro biomarcadores: los genes de fusión AML1-ETO, BCR-ABL, CBFβ-MYH11 y PML-RARα. Fueron estudiados 14 pacientes con diagnósticos inicial citomorfológico de: leucemia promielocítica (n= 6), leucemia aguda de linaje indefinido (n= 3) y dudoso entre leucemia mieloide crónica en crisis blástica mieloide y leucemia mieloide aguda (LMA) (n= 5). Al culminar la caracterización molecular todos fueron diagnosticados como LMA. Los resultados ilustran la importancia del estudio molecular en la clasificación de las leucemias, lo cual redunda en que el paciente reciba el tratamiento más adecuado y alcance una mejor respuesta.

Cytogenetic and molecular studies have correlated the presence of certain chromosomal and molecular anomalies with leukemia and lymphomas specific types. These evidences have allowed the progressive improvement of the system of classification of the oncohematological entities. Currently, the presence of certain cytogenetic or molecular anomalies is sufficient to identify specific entities and, in some occasions, the diagnostic changes after an integral analysis of cytomorfologic, cytogenetic and molecular studies. T This report aims to highlight the importance of molecular study when cytomorphology is complex and leads to erroneous diagnoses. Through polymerase chain reaction, prior reverse transcription of the RNA isolated from medullary blood, four biomarkers were studied: the fusion genes AML1-ETO, BCR-ABL, CBFβ-MYH11 and PML-RARα. Fourteen patients with initial diagnosis of: promyelocytic leukemia (n= 6), acute leukemia without lineage definition (n= 3) and chronic myeloid leukemia in myeloid blastic crisis or acute myeloid leukemia (AML) (n= 5) were studied. At the end of the molecular characterization all were diagnosed as AML. These results enlightened the role of the molecular studies in the classification of leukemia, which permit the patient receives the more appropriate treatment and achieve a better response.

A Complex Molecular Interplay of Auxin and Ethylene Signaling Pathways Is Involved in Arabidopsis Growth Promotion by Burkholderia phytofirmans PsJN.

Modulation of phytohormones homeostasis is one of the proposed mechanisms to explain plant growth promotion induced by beneficial rhizobacteria (PGPR). However, there is still limited knowledge about the molecular signals and pathways underlying these beneficial interactions. Even less is known concerning the interplay between phytohormones in plants inoculated with PGPR. Auxin and ethylene are crucial hormones in the control of plant growth and development, and recent studies report an important and complex crosstalk between them in the regulation of different plant developmental processes. The objective of this work was to study the role of both hormones in the growth promotion of Arabidopsis thaliana plants induced by the well-known PGPR Burkholderia phytofirmans PsJN. For this, the spatiotemporal expression patterns of several genes related to auxin biosynthesis, perception and response and ethylene biosynthesis were studied, finding that most of these genes showed specific transcriptional regulations after inoculation in roots and shoots. PsJN-growth promotion was not observed in Arabidopsis mutants with an impaired ethylene (ein2-1) or auxin (axr1-5) signaling. Even, PsJN did not promote growth in an ethylene overproducer (eto2), indicating that a fine regulation of both hormones signaling and homeostasis is necessary to induce growth of the aerial and root tissues. Auxin polar transport is also involved in growth promotion, since PsJN did not promote primary root growth in the pin2 mutant or under chemical inhibition of transport in wild type plants. Finally, a key role for ethylene biosynthesis was found in the PsJN-mediated increase in root hair number. These results not only give new insights of PGPR regulation of plant growth but also are also useful to understand key aspects of Arabidopsis growth control.

Gen de fusión AML-1/ETO y mutación NPM-1A en leucemia mieloide crónica en crisis blástica mieloide / AML-1/ETO fusion gene and mutation NPM-1A in myeloid chronic leukemia in myeloid blast crisis

La leucemia mieloide crónica es una neoplasia mieloproliferativa de naturaleza clonal que generalmente y de manera progresiva transita por tres fases: crónica, acelerada y crisis blástica. Alrededor del 80 por ciento de los enfermos con leucemia mieloide crónica son diagnosticados durante la fase crónica, 10 por ciento en fase acelerada y otro 10 por ciento durante la crisis blástica. A la presencia del cromosoma Filadelfia y la formación del gen de fusión BCR/ABL, que se traduce en la proteína quimérica pBCR/ABL, le sigue una gran inestabilidad genómica y la adquisición de alteraciones cromosómicas y moleculares adicionales. Algunas alteraciones moleculares, que suelen estar presentes en otras hemopatías malignas, pueden ser adquiridas durante la progresión de la leucemia mieloide crónica a crisis blástica. Se presenta el caso de un paciente que debutó con una leucemia mieloide crónica en crisis blástica, con positividad del gen de fusión BCR/ABL, el gen de fusión AML-1/ETO y la mutación NPM-1A(AU)

Chronic myeloid leukemia is a clonal myeloproliferative neoplasm which generally and progressively goes through three phases: chronic, accelerated and blast crisis. About 80 percent of patients with chronic myeloid leukemia are diagnosed in chronic phase, 10 % in accelerated phase and 10 percent in blast crisis. The presence of Philadelphia chromosome and the formation of BCR/ABL fusion gene, resulting in the chimeric protein pBCR/ABL, generates a large genomic instability and the acquisition of additional chromosomal and molecular alterations. Some molecular alterations, which are usually present in other hematological malignancies, could be acquired during the progression of chronic myeloid leukemia to blast crisis. This report presents the case of a patient with de novo chronic myeloid leukemia in blast crisis, with positivity of BCR/ABL fusion gene, AML-1/ETO fusion gene and mutation NPM-1A(AU)

Gen de fusión AML1-ETO: particularidades en la leucemia mieloide aguda / AML1-ETO fusion gen: characteristics in acute myeloid leukemia

La leucemia mieloide aguda (LMA) es una enfermedad neoplásica de la médula ósea en la que los pacientes con la translocación (8;21) representan un subgrupo con características clínicas y biológicas específicas. Esta alteración citogenética resulta de la fusión de dos genes, dando lugar a una proteína quimérica formada por un dominio N-terminal del gen AML1 y cuatro dominios C-terminales del gen ETO. Esta proteína tiene múltiples efectos en la regulación de la proliferación, la diferenciación y la viabilidad de las células leucémicas. La translocación puede ser detectada como una sola anomalía genética o como parte de anomalías complejas. A diferencia de otros pacientes, el diagnóstico de LMA con t(8;21) puede ser realizado con menos del 20 por ciento de blastos en la médula ósea. La enfermedad se caracteriza por anomalías genéticas adicionales, las células leucémicas muestran un perfil de expresión global de genes y un perfil de microARNs. Usualmente hay un bajo riesgo de recaída de la leucemia después de altas dosis de citosina arabinósido

Acute myeloid leukemia (AML) is a heterogeneous bone marrow malignancy where patients with the cytogenetic t(8;21) abnormality represent a subset with specific clinical and biological characteristics. The translocation results in an in-frame fusion of two genes, resulting in a fusion protein of one N-terminal domain from the AML1 gene and four C-terminal domains from the ETO gene. This protein has multiple effects on the regulation of the proliferation, the differentiation and the viability of leukemic cells. The translocation can be detected as the only genetic abnormality or as part of more complex abnormalities. In contrast to other AML patients, the diagnosis of t(8;21) AML can be made even when less than 20 percent leukemic blasts are present in the bone marrow. The leukemic cells show specific global gene expression and microRNA profiles; and usually there is a low risk of leukemia relapse after high-dose cytarabine therapy

Breakpoint regions of ETO gene involved in (8; 21) leukemic translocations are enriched in acetylated histone H3.

One of the most frequent chromosomal translocation found in patients with acute myeloid leukemia (AML) is the t(8;21). This translocation involves the RUNX1 and ETO genes. The breakpoints regions for t(8;21) are located at intron 5 and intron 1 of the RUNX1 and ETO gene respectively. To date, no homologous sequences have been found in these regions to explain their recombination. The breakpoint regions of RUNX1 gene are characterized by the presence of DNasaI hypersensitive sites and topoisomerase II cleavage sites, but no information exists about complementary regions of ETO gene. Here, we report analysis of chromatin structure of ETO breakpoint regions. Chromatin immunoprecipitation (ChIP) were performed with antibodies specific to acetylated histone H3, H4, and total histone H1. Nucleosomal distribution at the ETO locus was evaluated by determining total levels of histone H3. Our data show that in myeloid cells, the breakpoint regions at the ETO gene are enriched in hyperacetylated histone H3 compared to a control region of similar size where no translocations have been described. Moreover, acetylated H4 associates with both the whole ETO breakpoint regions as well as the control intron. Interestingly, we observed no H1 association either at the breakpoint regions or the control region of the ETO gene. Our data indicate that a common chromatin structure enriched in acetylated histones is present in breakpoint regions involved in formation of (8;21) leukemic translocation.

Methods of estimation of reference crop evapotranspiration for the conditions of northeastern semi-arid, Brazil / Métodos de estimativa da evapotranspiração de referência para as condições do semi árido Nordestino

The objective of this work was to evaluate methods of estimation of reference crop evapotranspiration (ETo) in conditions of low and high air relative humidity, using the Penman Monteith-FAO 56 method as reference. Data from the period between January 2002 and June 2008 were obtained from a conventional meteorological station at Semiarid Federal Rural University, in Mossoró, RN, Brazil. Evaluation of methods was made by means of the precision index r, accuracy d, and of confidence or performance c. Methods Kimberly-Penman 1982, Kimberly-Penman 1972, Benevides-Lopez 1970 and Hargreaves-Samani 1985 obtained an important improvement in their performance when high air relative humidity conditions were considered (UR > 70%), compared to low air relative humidity conditions (UR 70%). Equations of Makkink 1957 and Hamon 1961 underestimated ETo in both periods, and the method Penman modified-FAO24 showed tendency to overestimate the reference method. Methods Penman 1948, FAO24-Radiation, FAO24-Blaney-Criddle and Frere-Popov presented the higher performance among the evaluated methods.

O objetivo deste trabalho foi avaliar métodos de estimativa da evapotranspiração de referência (ETo) em condições de baixa e elevada umidade relativa usando o método de Penman Monteith-FAO 56 como referência. Foram utilizados dados de uma estação meteorológica convencional pertencente à Universidade Federal Rural do Semiárido, em Mossoró-RN referentes ao período de janeiro de 2002 a junho de 2008. A avaliação do desempenho foi realizada por meio do índice de precisão r, um índice de exatidão d, e de confiança ou desempenho c. Os métodos Kimberly-Penman 1982, Kimberly-Penman 1972, Benevides-Lopez 1970 e Hargreaves-Samani 1985 tiveram um aumento substancial nos seus desempenhos quando utilizados em condições de elevada umidade (UR > 70%), em comparação com as condições de baixa umidade (UR 70%). As equações de Makkink 1957 e Hamon 1961 subestimaram a ETo em ambos os períodos e o método Penman modificado-FAO24 tendeu a superestimar o método padrão. Os métodos Penman 1948, FAO24-Radiação, FAO24-Blaney-Criddle e Frere-Popov apresentaram melhor desempenho entre os avaliados.

Methods of estimation of reference crop evapotranspiration for the conditions of northeastern semi-arid, Brazil / Métodos de estimativa da evapotranspiração de referência para as condições do semi árido Nordestino

The objective of this work was to evaluate methods of estimation of reference crop evapotranspiration (ETo) in conditions of low and high air relative humidity, using the Penman Monteith-FAO 56 method as reference. Data from the period between January 2002 and June 2008 were obtained from a conventional meteorological station at Semiarid Federal Rural University, in Mossoró, RN, Brazil. Evaluation of methods was made by means of the precision index r, accuracy d, and of confidence or performance c. Methods Kimberly-Penman 1982, Kimberly-Penman 1972, Benevides-Lopez 1970 and Hargreaves-Samani 1985 obtained an important improvement in their performance when high air relative humidity conditions were considered (UR > 70%), compared to low air relative humidity conditions (UR 70%). Equations of Makkink 1957 and Hamon 1961 underestimated ETo in both periods, and the method Penman modified-FAO24 showed tendency to overestimate the reference method. Methods Penman 1948, FAO24-Radiation, FAO24-Blaney-Criddle and Frere-Popov presented the higher performance among the evaluated methods.

 O objetivo deste trabalho foi avaliar métodos de estimativa da evapotranspiração de referência (ETo) em condições de baixa e elevada umidade relativa usando o método de Penman Monteith-FAO 56 como referência. Foram utilizados dados de uma estação meteorológica convencional pertencente à Universidade Federal Rural do Semiárido, em Mossoró-RN referentes ao período de janeiro de 2002 a junho de 2008. A avaliação do desempenho foi realizada por meio do índice de precisão r, um índice de exatidão d, e de confiança ou desempenho c. Os métodos Kimberly-Penman 1982, Kimberly-Penman 1972, Benevides-Lopez 1970 e Hargreaves-Samani 1985 tiveram um aumento substancial nos seus desempenhos quando utilizados em condições de elevada umidade (UR > 70%), em comparação com as condições de baixa umidade (UR 70%). As equações de Makkink 1957 e Hamon 1961 subestimaram a ETo em ambos os períodos e o método Penman modificado-FAO24 tendeu a superestimar o método padrão. Os métodos Penman 1948, FAO24-Radiação, FAO24-Blaney-Criddle e Frere-Popov apresentaram melhor desempenho entre os avaliados.