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Even with over 80% of the population being vaccinated against COVID-19, the disease continues to claim victims. Therefore, it is crucial to have a secure Computer-Aided Diagnostic system that can assist in identifying COVID-19 and determining the necessary level of care. This is especially important in the Intensive Care Unit to monitor disease progression or regression in the fight against this epidemic. To accomplish this, we merged public datasets from the literature to train lung and lesion segmentation models with five different distributions. We then trained eight CNN models for COVID-19 and Common-Acquired Pneumonia classification. If the examination was classified as COVID-19, we quantified the lesions and assessed the severity of the full CT scan. To validate the system, we used Resnetxt101 Unet++ and Mobilenet Unet for lung and lesion segmentation, respectively, achieving accuracy of 98.05%, F1-score of 98.70%, precision of 98.7%, recall of 98.7%, and specificity of 96.05%. This was accomplished in just 19.70 s per full CT scan, with external validation on the SPGC dataset. Finally, when classifying these detected lesions, we used Densenet201 and achieved accuracy of 90.47%, F1-score of 93.85%, precision of 88.42%, recall of 100.0%, and specificity of 65.07%. The results demonstrate that our pipeline can correctly detect and segment lesions due to COVID-19 and Common-Acquired Pneumonia in CT scans. It can differentiate these two classes from normal exams, indicating that our system is efficient and effective in identifying the disease and assessing the severity of the condition.

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To map and assess evidence regarding use of the levonorgestrel-releasing intrauterine system (LNG-IUS) and its association with breast cancer, we conducted a systematic review and meta-analysis. A search strategy was developed using the terms "Levonorgestrel-releasing," "LNG-IUS," "intrauterine system," and "breast cancer. The electronic databases searched were MEDLINE, Embase, Cochrane Library, Latin American & Caribbean Health Sciences Literature, and Google Scholar for studies published until August 2020. We included observational studies: prospective or retrospective cohort, case-control, and cross-sectional. A total of 494 studies were identified, 294 studies were evaluated by title and abstract, and 262 were excluded because they did not meet the inclusion criteria. A total of 32 studies were read in full, and 24 were excluded. Thus, eight studies were included in the systematic review. The meta-analysis included four studies (two cohort and two case-control studies). Two subgroup analyses were performed for different study designs. The estimated relative risk for the two cohort studies (144,996 cases), with moderate-quality evidence, was 0.93 (95% confidence interval [CI], 0.840-1.03). The odds ratio estimated for the two case-control studies (5556 cases and 35987 controls), with moderate-quality evidence, was 1.07 (95% CI, 0.91-1.26). Evidence of an increased risk of breast cancer was not observed in levonorgestrel-releasing intrauterine system users.

Assuntos

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Ontogenetic changes in venom composition have been described in Bothrops snakes, but only a few studies have attempted to identify the targeted paralogues or the molecular mechanisms involved in modifications of gene expression during ontogeny. In this study, we decoded B. jararacussu venom gland transcripts from six specimens of varying sizes and analyzed the variability in the composition of independent venom proteomes from 19 individuals. We identified 125 distinct putative toxin transcripts, and of these, 73 were detected in venom proteomes and only 10 were involved in the ontogenetic changes. Ontogenetic variability was linearly related to snake size and did not correspond to the maturation of the reproductive stage. Changes in the transcriptome were highly predictive of changes in the venom proteome. The basic myotoxic phospholipases A2 (PLA2s) were the most abundant components in larger snakes, while in venoms from smaller snakes, PIII-class SVMPs were the major components. The snake venom metalloproteinases (SVMPs) identified corresponded to novel sequences and conferred higher pro-coagulant and hemorrhagic functions to the venom of small snakes. The mechanisms modulating venom variability are predominantly related to transcriptional events and may consist of an advantage of higher hematotoxicity and more efficient predatory function in the venom from small snakes.

Assuntos

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Approximately 140 snake species are known to occur in the Atlantic Forest with nearly half being endemic to this ecoregion. However, the Atlantic forest is one of the most threatened tropical ecoregions, with only 16% of its original area remaining as forest. This extensive habitat loss must have had a negative effect on its snake fauna. Indeed, 53% of the threatened snakes of Brazil occur in the Atlantic forest. Therefore, basic natural history information that can potentially contribute to the conservation of Atlantic forest snakes are urgently needed. Here the natural history of a snake assemblage at Etá Farm region, Sete Barras municipality, south-eastern Brazil is described, and a visual guide and an identification key provided that can be used by researchers and local people to identify snakes from this region. Most of the species found in the field use both open areas and forests, are primarily terrestrial, present diurnal activity, and include frogs in their diet. A higher number of enlarged follicles, eggs, and/or embryos were recorded during the warm and rainy season. Seventeen different types of defensive tactics were recorded in the species found in the field. This study provides useful information for understanding the structure of snake assemblages of the Atlantic Forest and is potentially useful for conservation assessments and for designing conservation plans.

Assuntos

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AIMS: To evaluate the role of nitric oxide, reactive oxygen species (ROS), and natriuretic peptide receptor-B activation in C-type natriuretic peptide-anti-contractile effect on Phenylephrine-induced contraction in aorta isolated from septic rats. METHODS AND RESULTS: Cecal ligation and puncture (CLP) surgery was used to induce sepsis in male rats. Vascular reactivity was conducted in rat aorta and resistance mesenteric artery (RMA). Measurement of survival rate, mean arterial pressure (MAP), plasma nitric oxide, specific protein expression, and localization were evaluated. Septic rats had a survival rate about 37% at 4 h after the surgery, and these rats presented hypotension compared to control-operated (Sham) rats. Phenylephrine-induced contraction was decreased in sepsis. C-type natriuretic peptide (CNP) induced anti-contractile effect in aortas. Plasma nitric oxide was increased in sepsis. Nitric oxide-synthase but not natriuretic peptide receptor-B expression was increased in septic rat aortas. C-type natriuretic peptide-anti-contractile effect was dependent on nitric oxide-synthase, ROS, and natriuretic peptide receptor-B activation. Natriuretic peptide receptor-C, protein kinase-Cα mRNA, and basal nicotinamide adenine dinucleotide phosphate (NADPH)-dependent ROS production were lower in septic rats. Phenylephrine and CNP enhanced ROS production. However, stimulated ROS production was low in sepsis. CONCLUSION: CNP induced anti-contractile effect on Phenylephrine contraction in aortas from Sham and septic rats that was dependent on nitric oxide-synthase, ROS, and natriuretic peptide receptor-B activation.

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The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.

Assuntos

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BACKGROUND: The objective of the study was to verify the accuracy of hyperbilirubinaemia as a marker for acute perforated appendicitis. METHODS: A comprehensive search of the MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, Congress Abstracts and Grey literature from January 1969 to July 2014. We included cross-sectional and cohort studies, prospective and retrospective, which evaluated hyperbilirubinaemia level in perforated appendicitis and compared them with histological analysis of all appendectomy specimens. RESULTS: Eleven studies were analysed, which included 5395 patients. Pooled sensitivity was 54.6% (95% confidence interval (CI), 42.8-65.8) and specificity was 70.0% (95% CI, 54.7-81.9%) using STATA. The diagnostic odds ratio was 2.82 (95% CI, 1.38-5.72%). Summary receiver operating characteristic curves were constructed. The area under the curve was 0.65. CONCLUSION: This meta-analysis showed that the value of hyperbilirubinaemia alone cannot predict acute perforated appendicitis.

Assuntos

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Endothelium-derived factors play an important role in vascular tone control. This study aimed to evaluate how endothelium and reactive oxygen species (ROS) contribute to phenylephrine (PE)-induced contraction in renovascular hypertensive (2K-1C) and normotensive (2K) rats aortas. The effects of the superoxide scavenger Tiron (0.1mM and 1mM) or catalase (30 U/ml, 90 U/ml, 150 U/ml and 300 U/ml) on the PE-induced contraction were evaluated in both intact endothelium (E+) and denuded (E-) aortas. Endothelium removal increased the PE-induced contractions. The maximum contractile response decreased only in 2K-1C rat E+ aorta, and catalase (30 U/ml, 90 U/ml, 150 U/ml) partially reversed this effect. Endothelium increased the basal hydrogen peroxide (H2O2) production in 2K and 2K-1C rats aortas. PE-stimulated H2O2 production was higher in 2K-1C (E+/E-) than in 2K (E+/E-). Inhibition of the enzymes cyclooxygenase, NADPH-oxidase, xanthine-oxidase, and superoxide dismutase reduced the PE-stimulated H2O2 production in 2K-1C rat aorta. The decreased contraction to PE in 2K-1C rat aorta is partially due to endothelial H2O2 production; however, in denuded aorta, it contributes to maintaining the contractile response. Superoxide plays an important role on the PE-induced contraction in 2K rat denuded aorta, whereas in 2K-1C rat aorta, it is H2O2 that plays an important role in this effect.

Assuntos

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OBJECTIVE: To investigate the efficacy, compared to placebo, of fluconazole 150 mg weekly, given for six months as prophylaxis against recurrent vulvovaginal candidiasis (RVVC). STUDY DESIGN: A quantitative systematic review was performed, and randomized controlled trials were included. We conducted searches at Medline, EMBASE, Lilacs, Cochrane Library and ICI Web of Science from 1980 to March 2012. We used the odds ratio (OR) with confidence intervals (CI) of 95% using a random effects model of Mantel-Haenszel. The software used was Review Manager version 5.0. RESULTS: Through the search strategies we identified 249 articles, of which only two were part of the meta-analysis. Fluconazole was more effective than placebo in reducing symptomatic episodes of VVC, immediately after treatment (OR 0.10, 95% CI 0.03-0.34), 3 months after treatment (OR 0.23, 95% CI 0.07-0.74) and 6 months after treatment (OR 0.39, 95% CI 0.24-0.64). CONCLUSION: Weekly treatment with fluconazole (150 mg) for six months is effective against RVVC.

Assuntos