Comparative analysis of the frequency and the severity of diagnosed lesions between pedestrians struck by motor vehicles and other blunt trauma mechanisms victims

ABSTRACTObjective:to compare the frequency and the severity of diagnosed injuries between pedestrians struck by motor vehicles and victims of other blunt trauma mechanisms.Methods:retrospective analysis of data from the Trauma Registry, including adult blunt trauma patients admitted from 2008 to 2010. We reviewed the mechanism of trauma, vital signs on admission and the injuries identified. Severity stratification was carried using RTS, AIS-90, ISS e TRISS. Patients were assigned into group A (pedestrians struck by motor vehicle) or B (victims of other mechanisms of blunt trauma). Variables were compared between groups. We considered p<0.05 as significant.Results:a total of 5785 cases were included, and 1217 (21,0%) of which were in group A. Pedestrians struck by vehicles presented (p<0.05) higher mean age, mean heart rate upon admission, mean ISS and mean AIS in head, thorax, abdomen and extremities, as well as lower mean Glasgow coma scale, arterial blood pressure upon admission, RTS and TRISS. They also had a higher frequency of epidural hematomas, subdural hematomas, subarachnoid hemorrhage, brain swelling, cerebral contusions, costal fractures, pneumothorax, flail chest, pulmonary contusions, as well as pelvic, superior limbs and inferior limbs fractures.Conclusion:pedestrian struck by vehicles sustained intracranial, thoracic, abdominal and extremity injuries more frequently than victims of other blunt trauma mechanism as a group. They also presented worse physiologic and anatomic severity of the trauma.

Factors affecting Cyperus difformis seed germination and seedling emergence

Specific knowledge about the dormancy, germination, and emergence patterns of weed species aids the development of integrated management strategies. Laboratory studies were conducted to determine the effect of several environmental factors on seed germination and seedling emergence of Cyperus difformis. Germination of freshly harvested seeds was inhibited by darkness; however, when seeds were subsequently transferred to complete light they germinated readily. Our results showed that 2 wk of cold stratification overcome the light requirement for germination. Seeds of C. difformis were able to germinate over a broad range of temperatures (25/15, 30/20, 35/25, and 40/30 ºC day/night). The response of germination rate to temperature was described as a non-linear function. Based on model outputs, the base, the optimum and the ceiling temperatures were estimated as 14.81, 37.72 and 45 ºC, respectively. A temperature of 120 ºC for a 5 min was required to inhibit 50% of maximum germination. The osmotic potential and salinity required for 50% inhibition of maximum germination were -0.47 MPa and 135.57 mM, respectively. High percentage of seed germination (89%) was observed at pH=6 and decreased to 12% at alkaline medium (pH 9) pH. Seeds sown on the soil surface gave the greatest percentage of seedling emergence, and no seedlings emerged from seeds buried in soil at depths of 1 cm.

SEED DORMANCY BREAKING TREATMENTS FORAFRICAN PURSLANE (Zaleya pentandra)

ABSTRACT Understanding the mechanisms involved in releasing seed dormancy is crucial for effective plant management and renewal of species in the arid zone. Zaleya pentandra is an emerging invasive weed of the arid areas of Pakistan. We investigated the effects of different dormancy breaking treatments on the germination of Z. pentandra seeds. Seeds were treated with hot water (by placing them in boiling water for 5, 15, 30, 60, 90, 120, and 150 min), dry heat (by placing them in a preheated oven at 70 oC for 1, 2, and 4 hours; at 70 oC for 1, 2, 3, and 4 days, and at 200 oC for 5, 10, 15, 30, and 45 min) and stratification (by placing them at 2-5 ºC in a refrigerator for 5, 10, 30, and 60 min; for 3, 6, and 12 hours, and for 1, 2, 4, 8, 15, and 30 days). Seeds also were soaked in thiourea ([(NH2)2CS] (0, 2,500, 5,000, 7,500, and 10,000 mg L-1 for 24 h at 30 oC) and in KNO3 (0, 10,000, 20,000, 30,000, 40,000, 50,000, and 60,000 mg L-1 for 24 h at 30 oC). Additionally, seeds were scarified with HCl (for 3, 6, 9, 12, 15, 18, and 21 h), HNO3 (for 3, 6, 9, 12, 15, 18, and 21 h), and H2SO4 (for 20, 40, 60, 80, 100, and 120 min at 30 oC) and also mechanically scarified with sandpaper. Zaleya pentandra seeds showed typical signs of hard seed coat dormancy. Mechanical scarification and acid treatments promoted seed germination to a varying degree. Seed scarification with HNO3 for 12 to 18 h as well as with HCl for 12 h and 15 h was efficient in breaking dormancy of Z. pentandra seeds, providing germination up to 92.5%. Seed scarification with H2SO4 from 20 to 120 min showed little effect, whereas hot water, dry heat, stratification and various concentrations of thiourea and KNO3 were ineffective in breaking Z. pentandra seed dormancy.

Estrutura e diversidade do componente arbóreo da floresta na Estação Ecológica dos Caetetus, Gália, SP

O estudo fitossociológico, se realizado em diferentes estratos verticais da floresta, fornece dados de grande valia para a compreensão da dinâmica da comunidade. Efetuou-se levantamento das espécies arbóreas presentes em diferentes estratos, em área de 6.000 m² de floresta madura, na Estação Ecológica dos Caetetus, Gália, SP. Foram utilizadas 60 parcelas de 10 x 10 m, para indivíduos com diâmetro do caule a 1,30 m acima do nível do solo (DAP) a partir de 5 cm (estrato superior); 10 x 2 m, para indivíduos com DAP entre 1 e 5 cm (estrato intermediário) e 60 sub-parcelas de 2 x 2 m, para indivíduos menores que 1 cm de DAP (estrato inferior). Verificou-se que a diversidade, a composição florística e a densidade relativa das espécies variam entre estratos. No estrato superior, com 1.080 indivíduos.ha-1 e área basal de 31,2 m².ha-1, encontraram-se 62 espécies (28 famílias), tendo sido as mais importantes, em ordem decrescente de IVI: Metrodorea nigra, Savia dictyocarpa, Ocotea indecora, Aspidosperma polyneuron e Trichilia catigua. O estrato intermediário apresentou-se com densidade de 3.525 indivíduos.ha-1, pertencentes a 30 espécies (17 famílias), sendo as mais importantes em ordem decrescente de IVI: Metrodorea nigra, Actinostemon concolor, Trichilia catigua, Aspidosperma polyneuron e Trichilia clausenii. No estrato inferior a densidade foi de 28.875 indivíduos.ha-1, pertencentes a 37 espécies (19 famílias), sendo as mais abundantes, em ordem decrescente de densidade relativa: Metrodorea nigra, Actinostemon concolor, Trichilia catigua, Aspidosperma polyneuron e Eugenia blastantha. Constatou-se que há espécies do estrato superior da floresta que não foram observadas em regeneração, especialmente heliófitas de estádios sucessionais iniciais (p. ex. Croton floribundus). Outras ocorreram com densidade relativa decrescente nos estratos inferiores (p. ex. Savia dictyocarpa e Ocotea indecora). Para outras espécies, as sementes germinaram, mas não se desenvolveram à sombra, estando ausentes no estrato intermediário (p. ex. Cariniana estrellensis). Observou-se, ainda, um grupo de espécies, de estádios sucessionais mais avançados, que apresentaram a mesma densidade relativa em todos os estratos (p. ex. Metrodorea nigra e Aspidosperma polyneuron).

Diversity and structure of the tree community of a fragment of tropical secondary forest of the brazilian Atlantic Forest domain 15 and 40 years after logging

Two adjacent tracts of tropical secondary forest, situated in Itambé do Mato Dentro, south-eastern Brazil, which had been regenerating for 15 and 40 years after clearing, were compared with the purpose of detecting differences in species diversity and composition, species guild composition (regeneration, stratification and dispersion), and stand structure. Four and three 1,125 m² plots laid on the 15- and 40-year-old stands, respectively, sampled 2,430 trees with diameter at the base of the stem > 5 cm. The number of species (S = 199) was high for this forest type and significantly higher for the older stand. Tree density was significantly higher in the younger stand, particularly for smaller trees, whereas the two stands did not differ in both basal area and volume per hectare. Trees of shade-tolerant and understory species were significantly more abundant in the older stand. Though sharing a large proportion of species (49%), the two stands differed significantly in the abundance of many species. Live stumps probably contributed to the relatively quick restoration of some forest characteristics, particularly species diversity, basal area and volume.

Horizontal and vertical tree community structure in a lowland atlantic rain forest, southeastern Brazil

The horizontal and vertical tree community structure in a lowland Atlantic Rain Forest was investigated through a phytosociological survey in two 0.99 ha plots in the Intervales State Park, São Paulo State. All trees > 5 cm diameter at breast height were recorded. 3,078 individuals belonging to 172 species were identified and recorded. The Shannon diversity index was H' = 3.85 nat.ind.-1. The Myrtaceae family showed the greatest floristic richness (38 species) and the highest density (745 individuals) in the stand. Euterpe edulis Mart. had the highest importance value (33.98%) accounting for 21.8% of all individuals recorded. The quantitative similarity index was higher than the qualitative index, showing little structural variation between plots. However, the large number of uncommon species resulted in pronounced floristic differences. A detrended correspondence analysis (DCA) generated three arbitrary vertical strata. Stratum A (> 26 m), where Sloanea guianensis (Aubl.) Benth. and Virola bicuhyba (Schott. ex A.DC.) Warb. were predominant showed the lowest density. Stratum B (8 m < h < 26 m) had the greatest richness and diversity, and stratum C (< 8 m) showed the highest density. Euterpe edulis, Guapira opposita (Vell.) Reitz, Garcinia gardneriana (Planch. & Triana) Zappi, and Eugenia mosenii (Kausel) Sobral were abundant in strata B and C. The occurrence of strata in tropical forests is discussed and we recommend the use of DCA for others studies of the vertical distribution of tropical forest tree communities.

Clinical assessment of the effect of digital filtering on the detection of ventricular late potentials

Ventricular late potentials are low-amplitude signals originating from damaged myocardium and detected on the body surface by ECG filtering and averaging. Digital filters present in commercial equipment may interfere with the ability of arrhythmia stratification. We compared 40-Hz BiSpec (BI) and classical 40- to 250-Hz band-pass Butterworth bidirectional (BD) filters in terms of impact on time domain variables and diagnostic properties. In a transverse retrospective age-adjusted case-control study, 221 subjects with sinus rhythm without bundle branch block were divided into three groups after signal-averaged ECG acquisition: GI (N = 40), clinically normal controls, GII (N = 158), subjects with coronary heart disease without sustained monomorphic ventricular tachycardia (SMVT), and GIII (N = 23), subjects with heart disease and documented SMVT. Conventional variables analyzed from vector magnitude data after averaging to 0.3 µV final noise were obtained by application of each filter to the averaged signal, and evaluated in pairs by numerical comparison and by diagnostic agreement assessment, using conventional and optimized thresholds of normality. Significant differences were found between BI and BD variables in all groups, with diagnostic results showing significant disagreement between both filters [kappa value of 0.61 (P<0.05) for GII and 0.31 for GIII (P = NS)]. Sensitivity for SMVT was lower with BI than with BD (65.2 vs 91.3%, respectively, P<0.05). Filters provided significantly different numerical and diagnostic results and the BI filter showed only limited clinical application to risk stratification of ventricular arrhythmia.

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled). Uncontrolled asthmatics accounted for higher health care expenditures than controlled patients, US$125.45 and US$15.58, respectively [emergency room visits (US$39.15 vs US$2.70) and hospitalization (US$86.30 vs US$12.88)], per patient over 6 months. The costs with medications in the last month for patients with mild, moderate and severe asthma were US$1.60, 9.60, and 25.00 in the uncontrolled patients, respectively, and US$6.50, 19.00 and 49.00 in the controlled patients. In view of the small proportion of uncontrolled subjects receiving regular maintenance medication (22.2%) and their lack of resources, providing free medication for uncontrolled patients might be a cost-effective strategy for the public health system.

Dendritic thickness: a morphometric parameter to classify mouse retinal ganglion cells

To study the dendritic morphology of retinal ganglion cells in wild-type mice we intracellularly injected these cells with Lucifer yellow in an in vitro preparation of the retina. Subsequently, quantified values of dendritic thickness, number of branching points and level of stratification of 73 Lucifer yellow-filled ganglion cells were analyzed by statistical methods, resulting in a classification into 9 groups. The variables dendritic thickness, number of branching points per cell and level of stratification were independent of each other. Number of branching points and level of stratification were independent of eccentricity, whereas dendritic thickness was positively dependent (r = 0.37) on it. The frequency distribution of dendritic thickness tended to be multimodal, indicating the presence of at least two cell populations composed of neurons with dendritic diameters either smaller or larger than 1.8 µm ("thin" or "thick" dendrites, respectively). Three cells (4.5%) were bistratified, having thick dendrites, and the others (95.5%) were monostratified. Using k-means cluster analysis, monostratified cells with either thin or thick dendrites were further subdivided according to level of stratification and number of branching points: cells with thin dendrites were divided into 2 groups with outer stratification (0-40%) and 2 groups with inner (50-100%) stratification, whereas cells with thick dendrites were divided into one group with outer and 3 groups with inner stratification. We postulate, that one group of cells with thin dendrites resembles cat ß-cells, whereas one group of cells with thick dendrites includes cells that resemble cat a-cells.

Aberrant signaling in T-cell acute lymphoblastic leukemia: biological and therapeutic implications

T-cell acute lymphoblastic leukemia (T-ALL) is a biologically heterogeneous disease with respect to phenotype, gene expression profile and activation of particular intracellular signaling pathways. Despite very significant improvements, current therapeutic regimens still fail to cure a portion of the patients and frequently implicate the use of aggressive protocols with long-term side effects. In this review, we focused on how deregulation of critical signaling pathways, in particular Notch, PI3K/Akt, MAPK, Jak/STAT and TGF-ß, may contribute to T-ALL. Identifying the alterations that affect intracellular pathways that regulate cell cycle and apoptosis is essential to understanding the biology of this malignancy, to define more effective markers for the correct stratification of patients into appropriate therapeutic regimens and to identify novel targets for the development of specific, less detrimental therapies for T-ALL.

Circulating levels of inflammation-associated miR-155 and endothelial-enriched miR-126 in patients with end-stage renal disease

Circulating microRNAs (miRNAs) may represent a potential noninvasive molecular biomarker for various pathological conditions. Moreover, the detection of circulating miRNAs can provide important novel disease-related information. In particular, inflammation-associated miR-155 and endothelial-enriched miR-126 are reported to be associated with vascular homeostasis. Vascular damage is a common event described in end-stage renal disease (ESRD). We hypothesized that miR-155 and miR-126 may be detectable in the circulation and serve as potential biomarkers for risk stratification. In this study, we assessed miR-155 and miR-126 in the plasma of 30 ESRD patients and 20 healthy controls using real-time quantification RT-PCR. The circulating levels of miR-155 and miR-126 were significantly reduced in patients with ESRD compared to healthy controls. However, there was no significant difference of circulating miR-155 and miR-126 levels between prehemodialysis and posthemodialysis patients. Furthermore, both circulating miR-126 and miR-155 correlated positively with estimated glomerular filtration rate (miR-126: r = 0.383, P = 0.037; miR-155: r = 0.494, P = 0.006) and hemoglobin (miR-126: r = 0.515, P = 0.004; miR-155: r = 0.598, P < 0.001) and correlated inversely with phosphate level (miR-126: r = -0.675, P < 0.001; miR-155: r = -0.399, P = 0.029). Pearson’s correlation was used to compare circulating levels of miRNAs with clinical parameters. These results suggested that circulating miR-155 and miR-126 might be involved in the development of ESRD. Further studies are needed to demonstrate the role of circulating miR-155 and miR-126 as candidate biomarkers for risk estimation.

CHRNA5 polymorphism and susceptibility to lung cancer in a Chinese population

Polymorphisms in the nicotinic acetylcholine receptor subunit CHRNA5 gene have been associated with lung cancer positive susceptibility in European and American populations. In the present hospital-based, case-control study, we determined whether polymorphism in rs503464 of CHRNA5 is associated with lung cancer risk in Chinese individuals. A single nucleotide polymorphism in CHRNA5 rs503464, c.-166T>A (hereafter T>A), was identified using TaqMan-MGB probes with sequencing via PCR in 600 lung cancer cases and 600 healthy individuals. Genotype frequencies for rs503464 (T>A) were in Hardy-Weinberg equilibrium for the control population. However, genotype frequencies were significantly different between cases and controls (P < 0.05), while allele frequencies were not significantly different between groups. Compared to homozygous genotypes (TT or AA), the risk of lung cancer in those with the heterozygous genotype (TA) was significantly lower (OR = 0.611, 95%CI = 0.486-0.768, P = 0.001). Using genotype AA as a reference, the risk of lung cancer for those with genotype TA was increased 1.5 times (OR = 1.496, 95%CI = 1.120-1.997, P = 0.006). However, no difference in risk was observed between T allele carriers and A allele carriers (OR = 0.914, 95%CI = 0.779-1.073, P = 0.270). Stratification analysis showed that the protective effect of TA was more pronounced in those younger than 60 years, nonsmokers, or those without a family history of cancer, as well as in patients with adenocarcinoma or squamous cell carcinoma in clinical stages III or IV (P < 0.05). Therefore, the heterozygous genotype c.-166T>A at rs503464 of CHRNA5 may be associated with reduced risk of lung cancer, thus representing a susceptibility allele in Chinese individuals.

Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study

The SEARCH-RIO study prospectively investigated electrocardiogram (ECG)-derived variables in chronic Chagas disease (CCD) as predictors of cardiac death and new onset ventricular tachycardia (VT). Cardiac arrhythmia is a major cause of death in CCD, and electrical markers may play a significant role in risk stratification. One hundred clinically stable outpatients with CCD were enrolled in this study. They initially underwent a 12-lead resting ECG, signal-averaged ECG, and 24-h ambulatory ECG. Abnormal Q-waves, filtered QRS duration, intraventricular electrical transients (IVET), 24-h standard deviation of normal RR intervals (SDNN), and VT were assessed. Echocardiograms assessed left ventricular ejection fraction. Predictors of cardiac death and new onset VT were identified in a Cox proportional hazard model. During a mean follow-up of 95.3 months, 36 patients had adverse events: 22 new onset VT (mean±SD, 18.4±4‰/year) and 20 deaths (26.4±1.8‰/year). In multivariate analysis, only Q-wave (hazard ratio, HR=6.7; P<0.001), VT (HR=5.3; P<0.001), SDNN<100 ms (HR=4.0; P=0.006), and IVET+ (HR=3.0; P=0.04) were independent predictors of the composite endpoint of cardiac death and new onset VT. A prognostic score was developed by weighting points proportional to beta coefficients and summing-up: Q-wave=2; VT=2; SDNN<100 ms=1; IVET+=1. Receiver operating characteristic curve analysis optimized the cutoff value at >1. In 10,000 bootstraps, the C-statistic of this novel score was non-inferior to a previously validated (Rassi) score (0.89±0.03 and 0.80±0.05, respectively; test for non-inferiority: P<0.001). In CCD, surface ECG-derived variables are predictors of cardiac death and new onset VT.