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1.
Front Microbiol ; 15: 1359670, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38946909

RESUMO

The microbial population in the pig's gastrointestinal tract can be influenced by incorporating fibrous by-products into the diets. This study investigated the impact of including two types of dried olive cake (OC) in pigs' diets on fecal bacterial composition. The correlation between fecal microbiota and growth performance, nutrient digestibility, gut fermentation pattern and slurry gas emissions was also evaluated. Thirty male Pietrain x (Landrace x Large white) pigs (47.9 ± 4.21 kg) were assigned to three groups: a control group (C), a group fed a diet with 20% partially defatted OC (20PDOC), and a group fed a diet with 20% cyclone OC (20COC) for 21 days. Fecal samples collected before and after providing the experimental diets were analyzed for the V3-V4 region of the 16S rRNA gene. Pigs were weighed, and feed intake was recorded throughout the study. Potential ammonia and methane emissions from slurry were measured. No significant differences in alpha diversity indexes were found. The taxonomic analysis revealed that Firmicutes and Bacteroidota phyla were dominant at the phylum level across all groups. Differential abundance analysis using ALDEx showed significant differences among groups for various bacteria at the phylum, genus, and species levels at the end of the experiment. Pigs from 20PDOC and 20COC groups exhibited increased abundances of health-promoting bacteria, such as Plactomycetota at the phylum level and Allisonella and an unidentified genus from the Eggerthellaceae family at the genus level. These changes influenced short-chain fatty acids' (SCFA) concentration in slurries, leading to greater acetic, butyric, caproic and heptanoic acids in OC-fed groups, especially 20COC pigs. A volatility analysis revealed significant positive correlations (p < 0.05) between Uncultured_Bacteroidales and Unculured_Selenomonadaceae and energy digestibility. Monoglobus and Desulfovibrio showed a positive significant (p < 0.05) correlation with total SCFA, indicating a high impact on gut fermentation. However, growth performance parameters and potential gas emission displayed no significant correlations with a specific bacterial genus. In conclusion, our results suggest that OC inclusion into pig diets could positively modulate and contribute to the gut microbiota's favorable composition and functionality. Also, nutrient digestibility and gut fermentation patterns can be associated with specific microbial populations.

3.
Cancers (Basel) ; 15(21)2023 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-37958437

RESUMO

Squamous cell carcinoma and its precursor lesion actinic keratosis are often found together in areas of skin chronically exposed to sun, otherwise called cancerisation fields. The clinical assessment of cancerisation fields and the correct diagnosis of lesions within these fields is usually challenging for dermatologists. The recent adoption of skin cancer diagnostic imaging techniques, particularly LC-OCT, helps clinicians in guiding treatment decisions of cancerization fields in a non-invasive way. The combination of artificial intelligence and non-invasive skin imaging opens up many possibilities as AI can perform tasks impossible for humans in a reasonable amount of time. In this text we review past examples of the application of AI to dermatological images for actinic keratosis/squamous cell carcinoma diagnosis, and we discuss about the prospects of the application of AI for the characterization and management of cancerization fields.

4.
Ital J Dermatol Venerol ; 158(3): 180-189, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37278496

RESUMO

INTRODUCTION: Line-field confocal optical coherence tomography (LC-OCT) is a recently introduced, non-invasive skin imaging technique combining the technical advantages of reflectance confocal microscopy and conventional OCT in terms of isotropic resolution and in-tissue penetration. Several studies have been published so far about the use of LC-OCT in melanocytic and non-melanocytic skin tumors. The aim of this review was to summarize the currently available data on the use of LC-OCT for benign and malignant melanocytic and non-melanocytic skin tumors. EVIDENCE ACQUISITION: We searched scientific databases for any literature published up to 30th April 2023 and concerning the use of LC-OCT for melanocytic and non-melanocytic skin tumors. Identified papers were evaluated, and relevant information was extracted. EVIDENCE SYNTHESIS: A total of 29 studies were found including original articles, short reports, and letters to the Editor: 6 applied to melanocytic skin tumors, 22 to non-melanocytic skin tumors and 1 to both. The use of LC-OCT increased the diagnostic accuracy for melanocytic and non-melanocytic skin lesions. The highest diagnostic performance was found for basal cell carcinoma (BCC), but significant improvements in the diagnostic accuracy were also detected for the differentiation of actinic keratosis (AK) from squamous cell carcinoma (SCC) and of melanoma from nevi. The LC-OCT features of other skin tumors were also described and successfully correlated with histopathology. CONCLUSIONS: LC-OCT proved to increase the diagnostic accuracy for melanocytic and non-melanocytic skin lesions, thanks to the combination of high resolution/penetration, 3D reconstructions, and integrated dermoscopy. Although BCC seems the most suitable tumors for LC-OCT examination, the device is extremely performant for the differentiation of AK from SCC and the discrimination of melanoma from nevi as well. Additional studies on diagnostic performance and new investigations about the presurgical assessment of tumor margins with LC-OCT and its association with human and artificial intelligence algorithms are in progress.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Ceratose Actínica , Melanoma , Nevo , Neoplasias Cutâneas , Humanos , Tomografia de Coerência Óptica/métodos , Inteligência Artificial , Neoplasias Cutâneas/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Ceratose Actínica/diagnóstico por imagem , Ceratose Actínica/patologia , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem
5.
Zoonoses Public Health ; 70(3): 223-237, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36533513

RESUMO

Wild lagomorphs including rabbits and hares can act as natural carriers or reservoirs of bacterial and parasitic zoonotic diseases. However, little is known on the epidemiology and potential public health significance of intestinal eukaryotes in wild leporids. We examined faecal samples from European wild rabbits (Oryctolagus cuniculus, n = 438) and Iberian hares (Lepus granatensis, n = 111) collected in the Autonomous Region of Andalusia in southern Spain during 2012-2021. We searched for the presence of DNA from the main intestinal protist and microsporidial pathogens of veterinary and public health concerns using molecular methods (PCR followed by Sanger and next-generation sequencing). Giardia duodenalis was the most prevalent species found (27.8%, 153/550; 95% CI: 24.1-31.8), followed by Cryptosporidium spp. (1.3%, 7/550; 95% CI: 0.5-2.6), Blastocystis sp. (1.1%, 6/550; 95% CI: 0.4-2.4) and Encephalitozoon intestinalis (0.2%, 1/550; 95% CI: 0.0-10.1). All samples tested negative for Enterocytozoon bieneusi. Sequence analyses revealed the presence of sub-assemblage BIV (n = 1) within G. duodenalis, and Cryptosporidium cuniculus (n = 6) and Cryptosporidium andersoni (n = 1) within Cryptosporidium. The presence of ruminant-adapted C. andersoni is indicative of a potential cross-species transmission event, although a spurious infection (mechanical carriage) cannot be ruled out. Samples assigned to C. cuniculus belonged to the gp60 subtype families Va (n = 3) and Vb (n = 2). The six Blastocystis-positive samples were identified as ST2 (n = 3) and ST1 + ST2 (n = 3). Our molecular results suggest that wild rabbits and hares were primarily infected by leporid-adapted species of eukaryotic pathogens. However, the occasional findings of zoonotic G. duodenalis sub-assemblage BIV, Blastocystis sp. ST1 and ST2, and Encephalitozoon intestinalis could be of public health relevance.


Assuntos
Blastocystis , Criptosporidiose , Cryptosporidium , Giardia lamblia , Giardíase , Lebres , Lagomorpha , Animais , Coelhos , Giardíase/epidemiologia , Giardíase/veterinária , Giardíase/parasitologia , Criptosporidiose/epidemiologia , Criptosporidiose/parasitologia , Cryptosporidium/genética , Espanha/epidemiologia , Ecossistema , Proteína 1 Semelhante a Receptor de Interleucina-1/genética , Giardia lamblia/genética , Ruminantes , Blastocystis/genética , Fezes/parasitologia , Genótipo
6.
Front Immunol ; 13: 941663, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36032171

RESUMO

Background: Chemerin is an extracellular protein with chemotactic activities and its expression is increased in various diseases such as metabolic syndrome and inflammatory conditions. Its role in lung pathology has not yet been extensively studied but both known pro- and anti-inflammatory properties have been observed. The aim of our study was to evaluate the involvement of the chemerin/ChemR23 system in the physiopathology of COVID-19 with a particular focus on its prognostic value. Methods: Blood samples from confirmed COVID-19 patients were collected at day 1, 5 and 14 from admission to Erasme Hospital (Brussels - Belgium). Chemerin concentrations and inflammatory biomarkers were analyzed in the plasma. Blood cells subtypes and their expression of ChemR23 were determined by flow cytometry. The expression of chemerin and ChemR23 was evaluated on lung tissue from autopsied COVID-19 patients by immunohistochemistry (IHC). Results: 21 healthy controls (HC) and 88 COVID-19 patients, including 40 in intensive care unit (ICU) were included. Plasma chemerin concentration were significantly higher in ICU patients than in HC at all time-points analyzed (p<0.0001). Moreover, they were higher in deceased patients compared to survivors (p<0.05). Logistic univariate regression and multivariate analysis demonstrated that chemerin level at day 14 of admission was an independent risk factor for death. Accordingly, chemerin levels correlated with inflammatory biomarkers such as C-reactive protein and tumor necrosis factor α. Finally, IHC analysis revealed a strong expression of ChemR23 on smooth muscle cells and chemerin on myofibroblasts in advanced acute respiratory distress syndrome (ARDS). Discussion: Increased plasma chemerin levels are a marker of severity and may predict death of COVID-19 patients. However, multicentric studies are needed, before chemerin can be considered as a biomarker of severity and death used in daily clinical practice. Further studies are also necessary to identify the precise mechanisms of the chemerin/ChemR23 system in ARDS secondary to viral pneumonia.


Assuntos
COVID-19 , Síndrome do Desconforto Respiratório , Quimiocinas , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Receptores de Quimiocinas , Fatores de Risco
7.
Clin Exp Dermatol ; 47(12): 2222-2233, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35988042

RESUMO

BACKGROUND: Line-field confocal optical coherence tomography (LC-OCT) is a new in vivo emerging technique that provides cellular resolution, allows deep imaging (400 µm) and produces real-time images in both the horizontal and vertical plane and in three dimensions. No previous description of different subtypes of melanocytic lesions and their correlation with histopathology and reflectance confocal microscopy has been reported. AIM: To describe the features of melanocytic lesions by LC-OCT and their correlation with histopathology and reflectance confocal microscopy (RCM) findings. METHODS: Selected melanocytic benign lesions and melanomas were imaged in vivo with RCM and LC-OCT at the Fundación Hospital Clinic (Barcelona, Spain). A minimum area of 4 × 4 mm (block image) at four depths (stratum granulosum, suprabasal, layer dermoepidermal junction and upper dermis) were acquired with RCM and a minimum of three cubes with LC-OCT. Horizontal, vertical sections and three-dimensional (3D) cubes of LC-OCT were matched with RCM (Vivablock two-dimensional composite mosaic) and histopathology, with ~5 µm lateral resolution accuracy (the same cell nuclei were measured in X, Y and Z) and evaluated by three observers experienced in using RCM and histopathology. RESULTS: In total, 12 melanocytic tumours (2 in situ melanomas, 2 invasive melanomas, 4 atypical naevi, 2 intradermal naevi, 1 compound naevus and 1 junctional naevus) were included. High correlation with 5 µm accuracy between RCM and LC-OCT was observed for each tumour. The 3D images of melanocytic lesions were obtained with cellular resolution and correlated with both RCM and histopathology, allowing an understanding of the architecture and precise correlation at the cellular level with RCM. Similarities between LC-OCT and RCM for the described diagnostic features and architecture (nests of melanocytic cells, ringed and meshwork pattern, and cellular details of tumour cells as dendritic and pagetoid cells) were confirmed. The main advantage of diagnosis by RCM fixed probe was the ability to produce larger scans of the lesion using mosaicing compared with an LC-OCT handheld probe. CONCLUSION: LC-OCT allows the architectural and cellular description of different types of melanocytic lesions. LC-OCT showed high correlation with histopathology (vertical sections) and RCM (horizontal sections) in melanocytic lesions. Diagnostic criteria for RCM were similar to those for LC-OCT.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Projetos Piloto , Tomografia de Coerência Óptica/métodos , Melanoma/patologia , Neoplasias Cutâneas/patologia , Microscopia Confocal/métodos
8.
J Food Prot ; 85(10): 1446-1451, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35880909

RESUMO

ABSTRACT: Organic matter (OM) accumulation is common in chill tanks used to decontaminate raw poultry parts during processing. OM negatively affects the antimicrobial activity of chlorine-based compounds, but its effect on the antimicrobial effectiveness of peroxyacetic acid (PAA) on poultry meat has not been described. Therefore, this study evaluated the effect of OM on the efficacy of PAA solutions in simulated postchill tanks to reduce Salmonella artificially inoculated onto chicken parts. Chicken thighs were inoculated with a five-strain cocktail of poultry-borne Salmonella enterica serovars at ca. 6 log CFU/mL. Then, the thighs were immersed for 30 or 45 s in PAA solutions (500 or 1,000 ppm) with chicken slurry to simulate OM accumulation (0, 15, or 30 g/L). The thighs were rinsed with neutralizing buffered peptone water (100 mL), and rinsates were plated onto xylose lysine desoxycholate agar. Experiments were performed in triplicate (three thighs per treatment per replicate). Chemical oxygen demand, total nitrogen, and pH were measured as the water quality parameters of the PAA solutions before and after use. Chemical oxygen demand ranged from 2,905 mg/L in unused 500-ppm solutions without added OM to 6,290 mg/L in used 1,000-ppm solutions with 30 g/L OM. Initial total nitrogen was 42.5 ± 2.0 and 60.9 ± 8.3 mg/L for 15 and 30 g/L OM, which increased by 27 ± 17 mg/L after use. The pH of solutions ranged from 3.16 ± 0.14 to 3.42 ± 0.09 for the 1,000-ppm solutions and from 3.59 ± 0.06 to 3.96 ± 0.06 for the 500-ppm solutions. Mean Salmonella reductions were 0.9 ± 0.1 log CFU/mL of rinsate for the 500-ppm PAA treatment and 1.1 ± 0.1 log CFU/mL of rinsate for 1,000-ppm PAA treatment. Exposure time did not have a significant effect on the logarithmic reductions. There was no significant effect of OM concentration (P > 0.05) on the reductions, indicating that the antimicrobial efficacy was not affected and that PAA solutions may continue to be reused as long as the PAA concentration is actively monitored.


Assuntos
Anti-Infecciosos , Ácido Peracético , Animais , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Galinhas , Contagem de Colônia Microbiana , Microbiologia de Alimentos , Nitrogênio , Ácido Peracético/farmacologia , Aves Domésticas , Salmonella
9.
J Food Sci ; 87(8): 3611-3619, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35762639

RESUMO

Chicken wings are among the most popular poultry products for home and foodservice consumption. Poultry products must be handled and cooked safely to decrease the risk of foodborne salmonellosis for consumers. This study aims to validate the use of domestic appliances (convection and air fryer ovens) for the thermal inactivation of Salmonella on chicken wings. Wings (n = 3, 46.5 ± 4.3 g) were inoculated with a five-strain cocktail of Salmonella (ca. 8 log10 CFU/wing) and cooked in a convection oven (179.4°C) or an air fryer (176, 190, or 204°C) for 2, 5, 10, 15, 20, 22, or 25 min. Thermocouples recorded temperature profiles of wings and appliances. Salmonella counts were determined on XLD agar for rinsates (100 ml/sample), and rinsates were enriched to recover bacteria below the limit of quantification. The recommended internal cooking temperature (73.8°C) was achieved after a range of 7.5 to 8.5 min in both appliances. Salmonella counts were reduced by 6.5 log10 CFU/wing when this temperature was achieved. Cumulative lethality (F-value) calculations predicted a 9-log reduction after 7.0 to 8.1 min of cooking. However, sample enrichments tested positive for Salmonella for all cooking times below 22 min. Ultimately, cooking at the temperature-time combinations recommended by manufacturers and online recipes helped achieve complete microbial elimination in both appliances. This study contributes to the validation of home cooking methods to ensure consumer safety.


Assuntos
Galinhas , Convecção , Animais , Contagem de Colônia Microbiana , Culinária/métodos , Manipulação de Alimentos/métodos , Microbiologia de Alimentos , Salmonella
11.
Front Immunol ; 13: 769839, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35422799

RESUMO

The new pandemic virus SARS-CoV-2 is characterized by uncontrolled hyper-inflammation in severe cases. As the IL-22/IL-22R1 axis was reported to be involved in inflammation during viral infections, we characterized the expression of IL-22 receptor1, IL-22 and IL-22 binding protein in COVID-19 patients. Blood samples were collected from 19 non-severe and 14 severe patients on the day they presented (D0), at D14, and six months later, and from 6 non-infected controls. The IL-22R1 expression was characterized by flow cytometry. Results were related to HLA-DR expression of myeloid cells, to plasma concentrations of different cytokines and chemokines and NK cells and T lymphocytes functions characterized by their IFN-γ, IL-22, IL-17A, granzyme B and perforin content. The numbers of IL-22R1+ classical, intermediate, and non-classical monocytes and the proportions of IL-22R1+ plasmacytoid DC (pDC), myeloid DC1 and DC2 (mDC1, mDC2) were higher in patients than controls at D0. The proportions of IL-22R1+ classical and intermediate monocytes, and pDC and mDC2 remained high for six months. High proportions of IL-22R1+ non-classical monocytes and mDC2 displayed HLA-DRhigh expression and were thus activated. Multivariate analysis for all IL-22R1+ myeloid cells discriminated the severity of the disease (AUC=0.9023). However, correlation analysis between IL-22R1+ cell subsets and plasma chemokine concentrations suggested pro-inflammatory effects of some subsets and protective effects of others. The numbers of IL-22R1+ classical monocytes and pDC were positively correlated with pro-inflammatory chemokines MCP-1 and IP-10 in severe infections, whereas IL-22R1+ intermediate monocytes were negatively correlated with IL-6, IFN-α and CRP in non-severe infections. Moreover, in the absence of in vitro stimulation, NK and CD4+ T cells produced IFN-γ and IL-22, and CD4+ and CD8+ T cells produced IL-17A. CD4+ T lymphocytes also expressed IL-22R1, the density of its expression defining two different functional subsets. In conclusion, we provide the first evidence that SARS-CoV-2 infection is characterized by an abnormal expression of IL22R1 on blood myeloid cells and CD4+ T lymphocytes. Our results suggest that the involvement of the IL-22R1/IL-22 axis could be protective at the beginning of SARS-CoV-2 infection but could shift to a detrimental response over time.


Assuntos
COVID-19 , Linfócitos T CD8-Positivos , Quimiocinas/metabolismo , Antígenos HLA-DR/metabolismo , Humanos , Inflamação/metabolismo , Interleucina-17/metabolismo , Receptores de Interleucina , SARS-CoV-2
12.
JCI Insight ; 7(9)2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35380990

RESUMO

Severe COVID-19 disease is associated with dysregulation of the myeloid compartment during acute infection. Survivors frequently experience long-lasting sequelae, but little is known about the eventual persistence of this immune alteration. Herein, we evaluated TLR-induced cytokine responses in a cohort of mild to critical patients during acute or convalescent phases (n = 97). In the acute phase, we observed impaired cytokine production by monocytes in the patients with the most severe COVID-19. This capacity was globally restored in convalescent patients. However, we observed increased responsiveness to TLR1/2 ligation in patients who recovered from severe disease, indicating that these cells display distinct functional properties at the different stages of the disease. In patients with acute severe COVID-19, we identified a specific transcriptomic and epigenomic state in monocytes that can account for their functional refractoriness. The molecular profile of monocytes from recovering patients was distinct and characterized by increased chromatin accessibility at activating protein 1 (AP1) and MAF loci. These results demonstrate that severe COVID-19 infection has a profound impact on the differentiation status and function of circulating monocytes, during both the acute and the convalescent phases, in a completely distinct manner. This could have important implications for our understanding of short- and long-term COVID-19-related morbidity.


Assuntos
COVID-19 , Citocinas/metabolismo , Progressão da Doença , Humanos , Monócitos/metabolismo , SARS-CoV-2
13.
Educ. med. super ; 36(1)mar. 2022. ilus, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1404528

RESUMO

Introducción: El proceso de enseñanza y aprendizaje en enfermería se caracteriza por articular teoría y práctica. La propuesta se estructuró en el aprendizaje experiencial, donde el sujeto deja de ser observador y se vuelve partícipe de su propia experiencia de aprendizaje. Objetivo: Diseñar una estrategia pedagógica para la mejora de la práctica clínica en la asignatura de Cuidado del Adulto II. Métodos: Estudio cuantitativo, no experimental. Participaron 37 estudiantes de Enfermería de la asignatura Cuidado del Adulto II. Se realizó sistematización de la literatura, revisión de los informes académicos anteriores, exámenes diagnósticos sobre procedimientos básicos y específicos, y diagnóstico rápido de curso, lo que sirvió de insumo para el diseño de la estrategia. Resultados: La alineación de la asignatura permitió definir la relación Resultado Aprendizaje Enfermería (RAE)-Resultado Aprendizaje Parcial (RAP)-Resultado de Aprendizaje de Curso (RAC) y elaborar la "Matriz Resultados de Aprendizaje-Actividades de Aprendizaje y Valoración Cuidado II", que facilitó estructurar la práctica clínica. Se incorporaron varias Técnicas de Aprendizaje Colaborativo. Se estructuraron las tarjetas de habilidades, las rotaciones de la práctica clínica, y se ajustaron las listas de chequeo para los procedimientos de Enfermería generales y específicos. Conclusiones: Resulta significativo que el docente genere estrategias pedagógicas que ayuden al estudiante a construir y conectar su conocimiento a partir de las herramientas que los servicios clínicos le puedan proporcionar, para que este participe, decida y sea personaje, al fomentar el ser y el hacer para un conocer y convivir(AU)


Introduction: The teaching and learning process in nursing is characterized by articulating theory and practice. The proposal was structured upon experiential learning, in which the subject is not an observer anymore and becomes a participant in his/her own learning experience instead. Objective: To design a pedagogical strategy for improving clinical practice in the subject Adult Care II. Methods: Quantitative and nonexperimental study carried out with 37 Nursing students during their Adult Care II course. Literature systematization, review of previous academic reports, diagnostic tests on basic and specific procedures, as well as rapid course test, were carried out, which served as an input for the strategy design. Results: The alignment of the subject allowed to define the relationship between nursing learning outcome, partial learning outcome and course learning outcome (NLO-PLO-CLO) and create a matrix relating learning outcomes, learning activities and Adult Care II assessment, which facilitated structuring the clinical practice. Several collaborative learning techniques were incorporated. Skill cards and clinical practice rotations were structured, and checklists for general and specific nursing procedures were adjusted. Conclusions: It is significant that the professor creates pedagogical strategies that help the student build and connect his/her knowledge based on the tools that clinical services can provide them with, in order for the student to participate, decide and be a direct player, by encouraging being and doing in view of knowing and interacting with others(AU)


Assuntos
Humanos , Ensino , Estratégias de Saúde , Competência Clínica , Conhecimento , Educação em Enfermagem , Aprendizagem , Estágio Clínico/métodos
14.
Radiology ; 303(2): 361-370, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35166585

RESUMO

Background Most radiologists reporting CT colonography (CTC) do not undergo compulsory performance accreditation, potentially lowering diagnostic sensitivity. Purpose To determine whether 1-day individualized training in CTC reporting improves diagnostic sensitivity of experienced radiologists for 6-mm or larger lesions, the durability of any improvement, and any associated factors. Materials and Methods This prospective, multicenter cluster-randomized controlled trial was performed in National Health Service hospitals in England and Wales between April 2017 and January 2020. CTC services were cluster randomized into intervention (1-day training plus feedback) or control (no training or feedback) arms. Radiologists in the intervention arm attended a 1-day workshop focusing on CTC reporting pitfalls with individualized feedback. Radiologists in the control group received no training. Sensitivity for 6-mm or larger lesions was tested at baseline and 1, 6, and 12 months thereafter via interpretation of 10 CTC scans at each time point. The primary outcome was the mean difference in per-lesion sensitivity between arms at 1 month, analyzed using multilevel regression after adjustment for baseline sensitivity. Secondary outcomes included per-lesion sensitivity at 6- and 12-month follow-up, sensitivity for flat neoplasia, and effect of prior CTC experience. Results A total of 69 hospitals were randomly assigned to the intervention (31 clusters, 80 radiologists) or control (38 clusters, 59 radiologists) arm. Radiologists were experienced (median, 500-999 CTC scans interpreted) and reported CTC scans routinely (median, 151-200 scans per year). One-month sensitivity improved after intervention (66.4% [659 of 992]) compared with sensitivity in the control group (42.4% [278 of 655]; difference = 20.8%; 95% CI: 14.6, 27.0; P < .001). Improvements were maintained at 6 (66.4% [572 of 861] vs 50.5% [283 of 560]; difference = 13.0%; 95% CI: 7.4, 18.5; P < .001) and 12 (63.7% [310 of 487] vs 44.4% [187 of 421]; difference = 16.7%; 95% CI: 10.3, 23.1; P < .001) months. This beneficial effect applied to flat lesions (difference = 22.7%; 95% CI: 15.5, 29.9; P < .001) and was independent of career experience (≥1500 CTC scans: odds ratio = 1.09; 95% CI: 0.88, 1.36; P = .22). Conclusion For radiologists evaluating CT colonography studies, a 1-day training intervention yielded sustained improvement in detection of clinically relevant colorectal neoplasia, independent of previous career experience. Clinical trial registration no. NCT02892721 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Pickhardt in this issue. An earlier incorrect version appeared online and in print. This article was corrected on February 28, 2022.


Assuntos
Colonografia Tomográfica Computadorizada , Neoplasias Colorretais , Colonografia Tomográfica Computadorizada/métodos , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Detecção Precoce de Câncer , Humanos , Estudos Prospectivos , Medicina Estatal
16.
J Biophotonics ; 15(2): e202100236, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34608756

RESUMO

Epidermal three-dimensional (3D) topography/quantification has not been completely characterized yet. The recently developed line-field confocal optical coherence tomography (LC-OCT) provides real-time, high-resolution, in-vivo 3D imaging of the skin. This pilot study aimed at quantifying epidermal metrics (epidermal thicknesses, dermal-epidermal junction [DEJ] undulation and keratinocyte number/shape/size) using 3D LC-OCT. For each study participant (8 female, skin-type-II, younger/older volunteers), seven body sites were imaged with LC-OCT. Epidermal metrics were calculated by segmentations and measurements assisted by artificial intelligence (AI) when appropriate. Thicknesses of epidermis/SC, DEJ undulation and keratinocyte nuclei volume varied across body sites. Evidence of keratinocyte maturation was observed in vivo: keratinocyte nuclei being small/spherical near the DEJ and flatter/elliptical near the skin surface. Skin microanatomy can be quantified by combining LC-OCT and AI. This technology could be highly relevant to understand aging processes and conditions linked to epidermal disorders. Future clinical/research applications are to be expected in this scenario.


Assuntos
Inteligência Artificial , Tomografia de Coerência Óptica , Epiderme/diagnóstico por imagem , Feminino , Humanos , Projetos Piloto , Pele , Tomografia de Coerência Óptica/métodos
17.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1367134

RESUMO

Las epifisiólisis tibiales proximales son un cuadro poco frecuente debido a la protección que aportan las estructuras circundantes de dicha zona. Por el desplazamiento que se origina es necesario realizar una exploración vascular junto a una reducción urgente para prevenir la lesión de la arteria poplítea y la aparición de un síndrome compartimental. Presentamos a un varón de 10 años con epifisiólisis de tibia proximal tipo I de Salter-Harris. Nivel de Evidencia: IV


Epiphysiolysis of the proximal tibia is a rare injury due to the surrounding structures that protect the area. In displaced fractures, the evaluation of vascular structures is mandatory to detect injury to the popliteal artery or the presence of compartment syndrome. We present a Salter & Harris type I epiphyseal injury of the proximal tibia in a 10-year-old boy Level of Evidence: IV


Assuntos
Criança , Tíbia , Síndromes Compartimentais , Epifise Deslocada
18.
ChemMedChem ; 16(23): 3600-3614, 2021 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-34665510

RESUMO

Leishmaniasis and Chagas diseases are two of the most important parasitic diseases in the world. Both belong to the category of Neglected Tropical Diseases, and they cannot be prevented by vaccination. Their treatments are founded in outdated drugs that possess many pernicious side-effects and they're not easy to administer. With the aim of discovering new compounds that could serve as anti-trypanosomal drugs, an antiparasitic study of a synthetic compound family has been conducted. A series of new 1,4-bis(alkylamino)- and 1-alkylamino-4-chloroazine and benzoazine derivatives 1-4 containing imidazole rings have been synthesized and identified. Their structures showed a possible interest based on previous work. Their in vitro anti-Leishmania infantum, anti-L. braziliensis, anti-L. donovani and anti-T. cruzi activity were tested, as well as the inhibition of Fe-SOD enzymes. It was found that some of them exhibited quite relevant values indicative of being worthy of future more detailed studies, as most of them showed activity to more than only one parasite species, especially compound 3 c was active for the three studied Leishmania species and also for T. cruzi, which is a very interesting trait as it covers a wide spectrum.


Assuntos
Imidazóis/farmacologia , Ftalazinas/farmacologia , Piridazinas/farmacologia , Tripanossomicidas/farmacologia , Animais , Chlorocebus aethiops , Imidazóis/síntese química , Imidazóis/toxicidade , Leishmania braziliensis/efeitos dos fármacos , Leishmania donovani/efeitos dos fármacos , Leishmania infantum/efeitos dos fármacos , Testes de Sensibilidade Parasitária , Ftalazinas/síntese química , Ftalazinas/toxicidade , Piridazinas/síntese química , Piridazinas/toxicidade , Tripanossomicidas/síntese química , Tripanossomicidas/toxicidade , Trypanosoma cruzi/efeitos dos fármacos , Células Vero
19.
J Food Prot ; 84(10): 1772-1783, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34086895

RESUMO

ABSTRACT: Poultry remains one of the top food commodities responsible for foodborne illness in the United States, despite poultry industry efforts since the inception of hazard analysis and critical control point to reduce the burden of foodborne illness implicating poultry products. The appropriate use of antimicrobial compounds during processing of raw poultry can help minimize this risk. Currently, peroxyacetic acid (PAA) is the most popular antimicrobial in the poultry industry, displacing chlorine compounds and others. The aim of this review was to compare the effectiveness of PAA to that of other antimicrobials for the decontamination of raw poultry carcasses and parts. Twenty-six articles were found that compared PAA with over 20 different antimicrobials, applied as spray or immersion treatments for different exposure times and at different concentrations. The most common comparisons were to chlorine compounds (17 articles), to lactic acid compounds (five articles), and to cetylpyridinium chloride (six articles). Studies measured effectiveness by reductions in native flora or inoculated bacteria, usually Salmonella or Campylobacter. PAA was found to be more effective than chlorine under most conditions studied. Effectiveness of PAA was higher than or comparable to that of lactic acid compounds and cetylpyridinium chloride depending on product and treatment conditions. Overall, the results of primary literature studies support the popularity of PAA as an effective intervention against pathogenic bacteria during poultry processing.


Assuntos
Anti-Infecciosos , Campylobacter , Animais , Galinhas , Descontaminação , Manipulação de Alimentos , Microbiologia de Alimentos , Ácido Peracético/farmacologia , Produtos Avícolas
20.
Reumatol. clín. (Barc.) ; 17(4): 197-202, Abr. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-211864

RESUMO

Objetivos: Estudiar las diferencias en pacientes con artritis reumatoide (AR) y enfermedad pulmonar intersticial (EPID) y pacientes con AR sin EPID, e identificar factores asociados con la EPID en pacientes con AR. Pacientes y métodos: Estudio observacional de casos y controles. Pacientes: se seleccionaron pacientes de una cohorte con AR y EPID de diferentes centros de Andalucía. Controles: pacientes con AR sin EPID pareados por edad, género y tiempo de evolución. Protocolo: los pacientes con AR se revisan cada 3-6meses en consulta. Todos los pacientes son revisados de acuerdo con un protocolo predeterminado con recogida de datos sistemática. Desenlaces: descripción del tipo radiológico de EPID, diferencias en los marcadores de gravedad en casos y controles y en la actividad de la enfermedad. Otras variables: descripción del tipo de EPID por TACAR: neumonía intersticial usual (NIU), neumonía intersticial no específica (NINE) y de la función pulmonar por PFR; marcadores de actividad y gravedad de artritis: DAS28, HAQ, FR, ACPA, erosiones. Tratamiento con FAME. Análisis: descriptivo, χ2 o t de Student, seguida de regresión logística binaria (Vd:EPID en pacientes con AR). Resultados: Se incluyeron 82 pacientes: 41 con AR y EPID y 41 controles AR sin EPID. Los pacientes con EPID presentaron un mayor porcentaje de pacientes con FR y ACPA positivos y una mayor frecuencia de serositis y osteoporosis. No hubo diferencias significativas en DAS28 en casos y controles(p=0,145), pero los pacientes de AR con EPID presentaron peor HAQ (p=0,006). Todos los pacientes estaban en tratamiento con FAME. El análisis multivariante mostró que los pacientes con AR exfumadores y con artritis erosiva triplicaron el riesgo de presentar EPID (R2=0,36). Conclusiones: Los resultados de nuestro estudio apoyan la mayor frecuencia de NIU y NINE en pacientes con AR, así como la alteración de DLCO como el parámetro más importante.(AU)


Objectives: To study the differences between rheumatoid arthritis (RA)-interstitial lung disease (ILD) patients and RA patients without ILD in severity markers and disease activity and to identify factors associated with the presence of ILD in RA patients. Patients and methods: Patients: RA-ILD patients selected from a multicentre cohort in Andalusia, Spain. Controls: RA-patients without ILD paired by sex, age and disease duration. Protocol: RA patients are reviewed every 3-6months in rheumatology consultation. All patients are reviewed according to a predetermined protocol with systematic data collection. Outcomes: description of ILD type, differences in severity markers and disease activity in both groups. Other variables: ILD type by imaging technique (HRCT): nonspecific interstitial pneumonia (NSIP)/usual interstitial pneumonia (UIP). Lung function by PTF. Activity and severity markers of arthritis by DAS28-ESR, HAQ, RF, ACPA and erosions. Treatment with DMARD. Statistical analysis: descriptive and paired T-test or Chi-square test followed by binary logistic regression (DV: ILD in patients with RA). Results: Eighty-two patients were included, 41 RA-ILD and 41 RA controls. RF and ACPA positivity, serositis and osteoporosis were more frequent in RA-ILD patients. No significant differences in DAS28 were observed (P=.145) between RA-ILD and RA control patients. RA-ILD patients presented worse HAQ scores (P=.006). All patients were treated with disease modifying antirheumatic drugs (DMARDs). The risk of developing ILD in RA patients is tripled by a history of smoking or the presence of erosive arthritis (R2=.36). Conclusions: The results of our study support the higher frequency of UIP and NSIP in RA patients. DLCO is the most sensitive parameter to detect ILD in RA patients. Our study showed that ILD in RA patients was associated with RA severity (presence of erosions and ACPA) and with a history of smoking.(AU)


Assuntos
Humanos , Masculino , Feminino , Artrite Reumatoide , Pneumopatias , Comorbidade , Doenças Pulmonares Intersticiais , Doenças Transmissíveis , Reumatologia , Doenças Reumáticas , Estudos de Casos e Controles
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