RESUMO
Localized scleroderma (LS) is a rare fibrosing disorder of skin and underlying tissues. Although it can affect all races, it has a higher prevalence in whites. Deep LS is the least common among seven LS variants, representing less than 5% of cases, and typically affects areas of pressure such as the hips and waist. We report a unique clinical case of bilateral lower extremity deep LS in a 51-year-old Puerto Rican woman with chronic kidney disease (CKD). In patients with CKD, it is important to distinguish LS from nephrogenic systemic fibrosis (NSF). Both can present with skin fibrosis and contractures over joints yet have significantly differing treatment approaches and prognosis. Our case report is unique due to the patient's Puerto Rican ethnicity, CKD history, and isolated anterior lower extremity involvement. In this report, we highlight key clinical and histopathological findings of LS, and how they differ from that of NSF.
Assuntos
Dermopatia Fibrosante Nefrogênica , Insuficiência Renal Crônica , Esclerodermia Localizada , Dermatopatias , Meios de Contraste , Progressão da Doença , Feminino , Gadolínio , Humanos , Masculino , Pessoa de Meia-Idade , Dermopatia Fibrosante Nefrogênica/etiologia , Dermopatia Fibrosante Nefrogênica/patologia , Dermopatia Fibrosante Nefrogênica/terapia , Insuficiência Renal Crônica/complicações , Esclerodermia Localizada/complicaçõesRESUMO
La cultura popular ha empleado la esquizofrenia y otras enfermedades mentales como un recurso narrativo útil. Sin embargo, esto puede llegar a estigmatizar a las personas que las padecen, creando una imagen errónea. Por ejemplo, la película Joker (2019) puede malinterpretarse y concluir que las personas con esquizofrenia son potenciales homicidas. Es por ello por lo que debemos prestar atención a las conclusiones de la comunidad científica respecto a la relación de la esquizofrenia con la violencia y los homicidios. En este sentido, las evidencias científicas con las que contamos hasta el momento no nos permiten asumir que la esquizofrenia sea la causa principal de la violencia y, mucho menos, del homicidio. De hecho, son necesarias más variables, no directamente relacionas con la enfermedad, como el consumo de drogas, la psicopatía o el maltrato durante la infancia para que exista una relación entre este enfermedad y la violencia o el homicidio.
Pop culture has used schizophrenia and other mental illnesses as a helpful narrative resource. However, this can stigmatize people who suffer from these illnesses, creating a distorted image. For example, the movie Joker (2019) can be misinterpreted and conclude that people with schizophrenia are potential murderers. Thus, We must pay attention to the findings of the scientific community about schizophrenia's relationship with violence and homicides. In this regard, we cannot conclude that schizophrenia is the leading cause of violence and much less homicide. Other variables are necessary that are not directly related to the disease, such as drug use, psycho-pathy, or childhood abuse, for there to be a relationship between schizophrenia and violence or homicide.
RESUMO
The proper combination of environment and flock-based variables plays a critical role in broiler production. However, the housing environment control is mainly focused on temperature monitoring during the broiler growth process. The present study developed a novel predictive model to predict the broiler (Gallus gallus domesticus) rearing conditions' suitability using a data-mining process centered on flock-based and environmental variables. Data were recorded inside four commercial controlled environment broiler houses. The data analysis was conducted in three steps. First, we performed an exploratory and descriptive analysis of the environmental data. In the second step, we labeled the target variable that led to a specific broiler-rearing scenario depending on the age of the birds, the environmental dry-bulb temperature and relative humidity, the ammonia concentration, and the ventilation rate. The output (final rearing condition) was discretized into four categories ('Excellent', 'Good', 'Moderate', and 'Inappropriate'). In the third step, we used the dataset to develop tree models using the data-mining process. The random-tree model only presented accuracy for predicting the 'Excellent' and 'Moderate' rearing conditions. The decision-tree model had high accuracy and indicated that broiler age, relative humidity, and ammonia concentration play a critical role in proper rearing conditions. Using a large amount of data allows the data-mining approach to building up 'if-then' rules that indicate suitable environmental control decision-making by broiler farmers.
RESUMO
Application-oriented hydrogel properties can be obtained by modifying the synthesis conditions of the materials. The purpose of this study is to achieve customized properties for sensing applications of hydrogel membranes based on poly(2-hydroxyethyl methacrylate), HEMA and N,N-dimethylacrylamide, DMAa. Copolymer p(HEMA-co-DMAa) hydrogels were prepared by varying the DMAa monomer ratio from 0-100% in 20% increments. Hydrogel membranes were characterized by attenuated infrared spectroscopy. Swelling and sorption were evaluated using cation solutions. Copolymers were also synthesized on the gold surface of quartz crystal microbalances (QCM) as coating membranes. A proof of concept was conducted for approaching the design and development of QCM sensors based on P(DMAa-co-HEMA)-membranes. Results showed that the water and ion adsorption capacity of hydrogel membranes increased with higher DMAa content. Membranes are not selective to a specific location but did show different transport features with each cation. The QCM coated with the selected membrane presented linear relationships between resonance frequency and ions concentration in solution (10-120 ppm). As a consequence, hydrogel membranes obtained are promising for the development of future biosensing devices.
RESUMO
RESUMEN Introducción: Existen varias escalas a nivel mundial en la predicción de riesgo de los pacientes con infarto, pero aún no se ha encontrado la "escala ideal". Objetivos: Determinar la capacidad de discriminación para la mortalidad hospitalaria por infarto agudo de miocardio de las escalas GRACE, TIMI Risk Score, InTIME e ICR. Método: Se realizó un estudio prospectivo en el Servicio de Cardiología del Hospital General Docente Dr. Ernesto Guevara de la Serna de Las Tunas, Cuba, entre 2018 y 2019. El universo estuvo conformado por 452 pacientes ingresados en las primeras 24 horas del infarto y la muestra, por 430 casos a los cuales se les pudo recoger la totalidad de las variables en estudio. Se utilizó la estadística descriptiva. Para determinar la capacidad de discriminación de la escalas de riesgo se determinaron sensibilidad, especificidad y área bajo la curva. Resultados: El 70% de los pacientes fallecidos eran del sexo masculino y su media de edad fue 10 años mayor que en los egresados vivos. La hipertensión arterial fue el factor asociado más frecuente tanto en los pacientes fallecidos (90%) como en los egresados vivos (73.4%). El 70% de los fallecidos presentaron algún grado de disfunción sistólica del ventrículo izquierdo. El área bajo la curva de las escalas ICR, InTIME y GRACE fue de 0,683; 0,681 y 0,662, respectivamente. El TIMI Risk Score presentó un área bajo la curva de 0,598. Conclusiones: Las escalas ICR, InTime y GRACE presentaron pobre capacidad predictiva para la mortalidad hospitalaria. La escala TIMI Risk Score presentó una fallida capacidad predictiva.
ABSTRACT Introduction: There are several scores worldwide for risk stratification in patients with myocardial infarction, but the "ideal score" has not yet been found. Objectives: To determine the discriminatory capacity of GRACE, TIMI Risk Score, InTIME and ICR scores for in-hospital mortality due to acute myocardial infarction. Method: A prospective study was carried out in the Department of Cardiology of the Hospital General Docente Dr. Ernesto Guevara de la Serna of Las Tunas, Cuba, between 2018 and 2019. The study's population consisted of 452 patients admitted in the first 24 hours after myocardial infarction, and the sample consisted of 430 cases from which all the variables under study could be collected. Descriptive statistics were used. Sensitivity, specificity and area under the curve were determined to be able to determine the discriminatory capacity of the risk scores as well. Results: The 70% of the deceased patients were male and their mean age was 10 years older than in the patients discharged alive. High blood pressure was the most frequent associated risk factor in both deceased patients (90%) and in those who left the hospital alive (73.4%). The 70% of deaths had certain degree of left ventricular systolic dysfunction. The area under the curve of ICR, InTIME and GRACE scores was of 0.683; 0.681 and 0.662 respectively. TIMI Risk Score had an area under the curve of 0.598. Conclusions: ICR, InTime and GRACE scores had poor predictive capacity for in-hospital mortality. TIMI Risk Score had a very poor predictive capacity.
RESUMO
This paper presents a computational method based on non-classical logic dedicated to routing management and information stream control in communication networks. Paraconsistent logic (PL) was used to create an algorithmic structure whose main property is to accept contradiction. Moreover, a computational structure, the denominated paraconsistent data analyzer (PDAPAL2v), was constructed to perform routing management in communication networks. Direct comparisons of PDAPAL2v with a classical logic system that simulates routing conditions were made in the laboratory. In the conventional system, the paraconsistent algorithms were considered as binary logic gates, and in the tests, the same adjustment limits of PDAPAL2v were applied. Using a database with controlled insertion of noise, we obtained an efficacy of 97% in the detection of deteriorated packets with PDAPAL2v and 72% with the conventional simulation system. Functional tests were carried out, showing that PDAPAL2v is able to assess the conditions and degradation of links and perform the analysis and correlation of various inputs and variables, even if the signals have contradictory values. From practical tests in the laboratory, the proposed method represents a new way of managing and controlling communication network routes with good performance.
Assuntos
Algoritmos , Redes de Comunicação de Computadores , Comunicação , Simulação por Computador , LógicaRESUMO
Detection and quantification of diverse analytes such as molecules, cells receptor and even particles and nanoparticles, play an important role in biomedical research, particularly in electrochemical sensing platform technologies. In this study, gold nanoparticles (AuNPs) prepared by green synthesis from Sargassum sp. were characterized using ultraviolet-visible (UV-Vis) and Fourier transform-infrared (FT-IR) spectroscopies, X-ray diffraction (XRD), scanning electron microscopy (SEM), dynamic light scattering (DLS) and zeta potential (ζ) obtaining organic capped face-centered cubic 80-100 nm AuNPs with an excellent stability in a wide range of pH. The AuNPs were used to modify a carbon nanotubes-screen printed electrode (CNT-SPE), through the drop-casting method, to assemble a novel portable electrochemical sensing platform for glucose, using a novel combination of components, which together have not been employed. The ability to sense and measure glucose was demonstrated, and its electrochemical fundamentals was studied using cyclic voltammetry (CV). The limits of detection (LOD) and quantification (LOQ) to glucose were 50 µM and 98 µM, respectively, and these were compared to those of other sensing platforms.
Assuntos
Eletrodos , Nanopartículas Metálicas , Nanotubos de Carbono , Sargassum/química , Ouro , Química Verde , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
La esclerosis múltiple (EM) es una enfermedad inflamatoria crónica que cursa con la desmielinización y la neurodegeneración a nivel del sistema nervioso central. Existen tres tipos de EM en función de la progresión de la enfermedad, pero la mayor parte de los pacientes tienden a presentar déficits cognitivos. Por lo tanto, resulta imprescindible el desarrollo de programas de entrenamiento cognitivos dirigidos a la mejora de estos déficits y, en definitiva, a la mejora de la calidad de vida de estos pacientes. En este sentido, el objetivo principal de este estudio fue la puesta en marcha de un programa de entrenamiento cognitivo dirigido a un paciente con esclerosis múltiple progresiva primaria (EMPP) a lo largo de un año. Los resultados pusieron de manifiesto que algunos de los déficits cognitivos que presentó inicialmente el paciente mejoraron tras varios meses de intervención. En este sentido, el paciente presentó notables mejoras en el control inhibitorio y la flexibilidad cognitiva. No obstante, los déficits en la velocidad de procesamiento se mantuvieron constantes a lo largo de toda la intervención. Asimismo, aparecieron otros déficits a lo largo de la intervención que remitieron tras la adecuación de los objetivos de intervención. Por todo ello, nuestro estudio reforzó la importancia de la puesta en marcha de los programas de rehabilitación cognitiva dirigidos a pacientes con enfermedades desmielinizantes para paliar las secuelas cognitivas derivadas de las mismas. Además, es importante que estos programas de entrenamiento cognitivo sean revisados periódicamente para adecuar los objetivos del tratamiento.
Multiple sclerosis (MS) is a chronic inflammatory disease that involves demyelination and neurodegeneration at the level of the central nervous system. Despite the different characteristics of each of the three types of MS, most patients with this disease present significant cognitive deficits. Therefore, it is essential to develop cognitive training programs to improve these deficits and, ultimately, increase the quality of life of these patients. Thus, the main objective of this study was to implement a one-year cognitive training program with a patient with progressive primary multiple sclerosis (PPMS). The results showed that some of the cognitive deficits the patient initially presented improved after several months of intervention. In this regard, the patient presented noteworthy improvements in inhibitory control and cognitive flexibility. However, deficits in processing speed remained constant throughout the intervention. Likewise, other deficits appeared during the intervention that remitted after adapting the intervention objectives to the patient's needs. Therefore, our study reinforces the importance of implementing cognitive rehabilitation programs for patients with demyelinating diseases to alleviate the cognitive sequelae they produce. In addition, it is important to evaluate these cognitive training programs periodically in order to adapt the objectives and improve the patient's functionality.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/reabilitação , Qualidade de Vida , Doenças Desmielinizantes , Resultado do Tratamento , Cognição/fisiologia , Função Executiva/fisiologia , Memória/fisiologia , Esclerose Múltipla/fisiopatologiaRESUMO
In this study, new polyurethanes (PUs) were prepared by using inulin and polycaprolactone as polyols. Their structure and morphology were determined by Fourier transform infrared spectroscopy (FTIR), Raman dispersive spectroscopy, Nuclear magnetic resonance spectroscopy (1H NMR and 13C NMR), and scanning electron microscopy (SEM), whereas their mechanical properties were evaluated by a universal testing machine. Additionally, their water uptake, swelling behavior, and degradation were evaluated to be used as drug delivery carriers. Therefore, an anti-cancer drug was loaded to these PUs with 25% of loading efficiency and its release behavior was studied using different theoretical models to unveil its mechanism. Finally, the ability of the new PUs to be used as a clip marker in breast biopsy was evaluated. The results clearly demonstrate that these PUs are safe and can be used as intelligent drug release matrices for targeted drug delivery and exhibits positive results to be used for clip marker and in general for breast cancer applications.
RESUMO
Objective: The objective of this study was to report the application of photobiomodulation therapy (PBMT) in the treatment of two patients diagnosed with acute cervical radiodermatitis (RD) induced by radiotherapy. Background data: An undesirable effect of radiotherapy, RD often poses a limitation to the continuity of treatment that can negatively affect the control and prognosis of the disease. RD is frequently associated with pain and aesthetic impairment and can significantly influence quality of life. Many agents used to prevent and treat RD do not have sufficient scientific evidence to support its use. Materials and methods: In both clinical cases, the patients presented RD degree 3 and were in drug treatment, with no satisfactory response, and PBMT was started. Two diode lasers were used, with a dose of 35.71 J/cm2, 10 sec/point, 100 mW of power, and a beam area of 0.028 cm2 and dose of 27.77 J/cm2, 25 sec/point, 40 mW, and 0.036 cm2 beam area. Both lasers were applied at the wavelength of red, daily, in contact and perpendicular to the skin, to deliver 1 J/point/1.5 cm, which covered the entire area affected with RD. Results: The PBMT made possible an expressive improvement in the healing process and reduction of painful symptoms associated with RD. Conclusions: Although PBMT facilitated healing and reduced pain experienced with RD, randomized controlled trials are needed to evaluate all of its possible benefits.