Bone mass, fracture risk, and associated factors in postmenopausal women living with HIV.

OBJECTIVE: The aim of this study was to assess the prevalence of low bone mass (osteopenia/osteoporosis), the factors associated with low bone mass, and the risk of fractures in Brazilian postmenopausal women living with HIV (WLH) in the Amazon region. METHODS: This is a cohort study with a cross-sectional assessment at baseline conducted between March 2021 to August 2022 with 100 postmenopausal WLH undergoing antiretroviral therapy (ART) between 45 and 60 years of age and 100 age-matched HIV-negative women. Data on bone mineral density in the lumbar spine (LS) and femoral neck (FN) were collected using dual x-ray absorptiometry and the 10-year risk of hip and major osteoporotic fractures was assessed using the Fracture Risk Assessment tool (FRAX). RESULTS: The age of menopause onset occurred earlier in WLH ( P < 0.001). No differences in prevalence of osteoporosis and osteopenia in LS and FN were observed except for a lower T score in FN in WLH ( P = 0.039). The FRAX for major osteoporotic fracture and hip fracture were low in both groups, despite the mean of both FRAX scores was higher in WLH ( P < 0.001). Multivariate analysis showed that years since menopause onset, higher body mass index and higher FRAX major osteoporotic fracture were associated with the WLH group, while a higher frequency of physical activity was registered in the HIV-negative group. Multivariate analysis also showed that in WLH, a lower T score in FN was associated with years since menopause onset and body mass index and that the number of years since menopause onset was associated with a lower T score in the LS and a higher score in the FRAX hip fracture. CONCLUSIONS: Our findings show a high prevalence of low bone mass (osteopenia/osteoporosis) in Brazilian postmenopausal women from the Amazon region. Women living with HIV have higher FRAX scores than HIV-negative women and a lower T score in the FN.

Effect of Cell Therapy and Exercise Training in a Stroke Model, Considering the Cell Track by Molecular Image and Behavioral Analysis.

The goal of this study is to see how combining physical activity with cell treatment impacts functional recovery in a stroke model. Molecular imaging and multimodal nanoparticles assisted in cell tracking and longitudinal monitoring (MNP). The viability of mesenchymal stem cell (MSC) was determined using a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay and bioluminescent image (BLI) after lentiviral transduction and MNP labeling. At random, the animals were divided into 5 groups (control-G1, and experimental G2-G5). The photothrombotic stroke induction was confirmed by local blood perfusion reduction and Triphenyltetrazolium chloride (TTC), and MSC in the G3 and G5 groups were implanted after 24 h, with BLI and near-infrared fluorescence image (NIRF) tracking these cells at 28 h, 2, 7, 14, and 28 days. During a 28-day period, the G5 also conducted physical training, whereas the G4 simply did the training. At 0, 7, 14, and 28 days, the animals were functionally tested using a cylinder test and a spontaneous motor activity test. MNP internalization in MSC was confirmed using brightfield and fluorescence microscopy. In relation to G1 group, only 3% of cell viability reduced. The G2-G5 groups showed more than 69% of blood perfusion reduction. The G5 group performed better over time, with a progressive recovery of symmetry and an increase of fast vertical movements. Up to 7 days, BLI and NIRF followed MSC at the damaged site, demonstrating a signal rise that could be connected to cell proliferation at the injury site during the acute phase of stroke. Local MSC therapy mixed with physical activity resulted in better results in alleviating motor dysfunction, particularly during the acute period. When it comes to neurorehabilitation, this alternative therapy could be a suitable fit.

Case-fatality From Orally-transmitted Acute Chagas Disease: A Systematic Review and Meta-analysis.

Orally-transmitted acute Chagas disease (CD) is emerging as an important public health problem. The prognosis of acute infection following oral transmission is unknown. The aim of this study was to analyze and summarize data on orally-transmitted acute CD. We searched for publications from 1968 to 31 January 2018. We included studies and unpublished data from government sources that reported patients with acute orally-transmitted CD. We identified 41 papers and we added 932 unpublished cases. In all, our study covered 2470 cases and occurrence of 97 deaths. Our meta-analysis estimated that the case-fatality rate was 1.0% (95% CI 0.0-4.0%). Lethality rates have declined over time (P = .02). In conclusion, orally-transmitted acute CD has considerable lethality in the first year after infection. The lethality in symptomatic cases is similar to that from other routes of infection. The lethality rate of orally-acquired disease has declined over the years.

Noninvasive Tracking of Hematopoietic Stem Cells in a Bone Marrow Transplant Model.

The hematopoietic stem cell engraftment depends on adequate cell numbers, their homing, and the subsequent short and long-term engraftment of these cells in the niche. We performed a systematic review of the methods employed to track hematopoietic reconstitution using molecular imaging. We searched articles indexed, published prior to January 2020, in PubMed, Cochrane, and Scopus with the following keyword sequences: (Hematopoietic Stem Cell OR Hematopoietic Progenitor Cell) AND (Tracking OR Homing) AND (Transplantation). Of 2191 articles identified, only 21 articles were included in this review, after screening and eligibility assessment. The cell source was in the majority of bone marrow from mice (43%), followed by the umbilical cord from humans (33%). The labeling agent had the follow distribution between the selected studies: 14% nanoparticle, 29% radioisotope, 19% fluorophore, 19% luciferase, and 19% animal transgenic. The type of graft used in the studies was 57% allogeneic, 38% xenogeneic, and 5% autologous, being the HSC receptor: 57% mice, 9% rat, 19% fish, 5% for dog, porcine and salamander. The imaging technique used in the HSC tracking had the following distribution between studies: Positron emission tomography/single-photon emission computed tomography 29%, bioluminescence 33%, fluorescence 19%, magnetic resonance imaging 14%, and near-infrared fluorescence imaging 5%. The efficiency of the graft was evaluated in 61% of the selected studies, and before one month of implantation, the cell renewal was very low (less than 20%), but after three months, the efficiency was more than 50%, mainly in the allogeneic graft. In conclusion, our review showed an increase in using noninvasive imaging techniques in HSC tracking using the bone marrow transplant model. However, successful transplantation depends on the formation of engraftment, and the functionality of cells after the graft, aspects that are poorly explored and that have high relevance for clinical analysis.

Therapeutic Efficiency of Multiple Applications of Magnetic Hyperthermia Technique in Glioblastoma Using Aminosilane Coated Iron Oxide Nanoparticles: In Vitro and In Vivo Study.

Magnetic hyperthermia (MHT) has been shown as a promising alternative therapy for glioblastoma (GBM) treatment. This study consists of three parts: The first part evaluates the heating potential of aminosilane-coated superparamagnetic iron oxide nanoparticles (SPIONa). The second and third parts comprise the evaluation of MHT multiple applications in GBM model, either in vitro or in vivo. The obtained heating curves of SPIONa (100 nm, +20 mV) and their specific absorption rates (SAR) stablished the best therapeutic conditions for frequencies (309 kHz and 557 kHz) and magnetic field (300 Gauss), which were stablished based on three in vitro MHT application in C6 GBM cell line. The bioluminescence (BLI) signal decayed in all applications and parameters tested and 309 kHz with 300 Gauss have shown to provide the best therapeutic effect. These parameters were also established for three MHT applications in vivo, in which the decay of BLI signal correlates with reduced tumor and also with decreased tumor glucose uptake assessed by positron emission tomography (PET) images. The behavior assessment showed a slight improvement after each MHT therapy, but after three applications the motor function displayed a relevant and progressive improvement until the latest evaluation. Thus, MHT multiple applications allowed an almost total regression of the GBM tumor in vivo. However, futher evaluations after the therapy acute phase are necessary to follow the evolution or tumor total regression. BLI, positron emission tomography (PET), and spontaneous locomotion evaluation techniques were effective in longitudinally monitoring the therapeutic effects of the MHT technique.

Neurological complications associated with emerging viruses in Brazil.

OBJECTIVE: To test the hypotheses that emerging viruses are associated with neurological hospitalizations and that statistical models can be used to predict neurological sequelae from viral infections. METHODS: An ecological study was carried out to observe time trends in the number of hospitalizations with inflammatory polyneuropathy and Guillain-Barré syndrome (GBS) in the state of Rio de Janeiro from 1997 to 2017. Increases in GBS from month to month were assessed using a Farrington test. In addition, a cross-sectional study was conducted analyzing 50 adults hospitalized for inflammatory polyneuropathies from 2015 to 2017. The extent to which Zika virus symptoms explained GBS hospitalizations was evaluated using a calibration test. RESULTS: There were significant increases (Farrington test, P<0.001) in the incidence of GBS following the introduction of influenza A/H1N1 in 2009, dengue virus type 4 in 2013, and Zika virus in 2015. Of 50 patients hospitalized, 14 (28.0%) were diagnosed with arboviruses, 9 (18.0%) with other viruses, and the remainder with other causes of such neuropathies. Statistical models based on cases of emerging viruses accurately predicted neurological sequelae, such as GBS. CONCLUSION: The introduction of novel viruses increases the incidence of inflammatory neuropathies.

Analysing phase progression in Susan's case.

This study adds a phase-by-phase perspective to the case of Susan, with the aim of better understanding the processes of change in this therapeutic case. A team of 3 raters integrated the sequential phases of the Paradigmatic Complementarity Metamodel with a moment-by-moment tracking method-the Developmental Analysis of Psychotherapy Process method-to analyse this therapeutic process and clarify what happened throughout that may explain phase gains and how the therapist facilitated them. The results suggest that Susan evolved in accordance with the sequence of phases proposed by the Paradigmatic Complementarity Metamodel. We illustrate and explain this with therapeutic interactions representative of Susan's development within the evolving therapeutic process. This case study is the third of a series intended to contribute towards the optimization of clinical decisions in therapeutic processes by identifying markers of phase progression and assessing the value of the therapeutic interventions offered.

Phototransformation of 5-nitro-2-furaldehyde in aqueous solution. A laser flash photolysis and product analysis study.

Laser flash photolysis of 5-nitro-2-furaldehyde (NFA) in solution shows a short-lived transient absorption with λmax = 475 ± 5 nm, which is relatively insensitive to solvent polarity and is assigned to the lowest triplet state of NFA (3NFA*). In water, the 3NFA* absorption decays to a long-lived absorption, the study of which, at different times after the end of the laser pulse, reveals it to be due to a furyloxyl radical (λmax ≈ 375 nm) and to the radical anion NFA˙- (λmax ≈ 400 nm). These radicals were produced independently to confirm the assignment. The lifetime of 3NFA* depends both on the solvent and the ground-state concentration of NFA. An (n, π*) nature is attributed to 3NFA* on the basis of the propensity of 3NFA* to abstract a hydrogen-atom from the solvent. Kinetic evidence for triplet excimer formation was obtained from the self-quenching of 3NFA* in solvents where the triplet decay is slower. The effect of acidity on the triplet lifetime is discussed with respect to an electron-transfer self-quenching mechanism, assisted by the triplet excimer which is proposed to dissociate into radical ions. Chromatographic and spectroscopic analysis of the photolysed aqueous solution of NFA enabled the identification of 5-hydroxymethylene-2(5H)-furanone, nitrite ion and an unknown substance as the major photoproducts. Conclusive evidence is presented that the observed 5-hydroxymethylene-2(5H)-furanone is formed from the furyloxyl radical. It is shown that the unknown substance can also be obtained from both the photoreduction of NFA in propan-2-ol and chemical reduction of NFA by Fe(s) in water (along with 5-amino-2-furaldehyde). Based on 1H- and 13C-NMR (with 2-D HMQC) and vibrational absorption spectroscopy, a tentative structure is proposed for the substance of tR 3.69 minutes obtained as a photoreduction product of NFA in water. Inorganic anions are shown to be one-electron oxidised by 3NFA* (as indicated by the observation of both the radical anion of NFA and the inorganic radical) with second-order rate constants being dependent on E of the inorganic radical. The implications of the results from complete quenching of 3NFA* by inorganic anions, and subsequent product analysis, for the phototransformation mechanism of NFA in water are discussed.

Exploring Phase Progression Throughout the Therapeutic Process: The Case of Eva.

This study intends to clarify how Eva [a good-outcome case] developed a more differentiated and integrated sense of herself and her experience, and how the therapist facilitated this developmental process. It aims to deepen our understanding of the processes of change throughout the therapeutic process by analysing a longitudinal case study integrating a phase-by-phase map-the sequential phases of the Paradigmatic Complementarity Metamodel [PCM]-with a moment-by-moment tracking method-the Developmental Analysis of Psychotherapy Process [DAPP] Method. A team of three researchers analysed the sessions from the first year of therapy, identified phase transitions and consolidations, and discussed what in the process appears to have fostered them. The results suggest that Eva evolved in accordance with the sequence of phases proposed by the PCM, which we illustrate and explain with therapeutic interactions representative of Eva's development within the evolving therapeutic process. This case study is one of a series intended to contribute to the optimization of clinical decision making by identifying markers of phase progression and assessing the usefulness of the therapeutic interventions offered. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Integrating moment-by-moment and phase-by-phase guiding maps facilitates the understanding of therapeutic processes. Therapists' attunement and responsiveness to patients' assimilation capacities supports therapeutic progress. Being aware of both phase-by-phase and moment-by-moment movements in psychotherapy helps lead to better clinical decisions.

In vivo measurement of the pressure signal in the intervertebral disc of an anesthetized sheep.

The purpose of the present study was to measure the intradiscal pressure signal of an anesthetized sheep under spontaneous breathing. An ultra-miniature fiber optic high-pressure sensor was implanted into the nucleus pulposus of the fifth lumbar intervertebral using a dorsolateral transforaminal approach. Results suggested the periodicity of the intradiscal pressure signal was similar to the mean respiratory rate of the animal. The average resting intradiscal pressure was also calculated and compared to available data.