Uma ferramenta para treinamento na avaliação de imagens mamográficas via Internet

Este trabalho consiste na implementação de um esquema computacional instalado em um "site" associado à "homepage" do Laboratório de Análise e Digitalização de Imagens do Departamento de Engenharia Elétrica da Escola de Engenharia de São Carlos ¾ Universidade de São Paulo, São Carlos, SP, para proporcionar um procedimento de interatividade com o usuário remoto na elaboração de laudo a partir da análise de imagens mamográficas via rede, com avaliação automática do parecer emitido. Isto foi feito a partir da implantação de um banco de imagens mamográficas digitalizadas, adequadamente pré-selecionadas, associado a uma base de dados com os laudos fornecidos por radiologistas especialistas. Como o processo tem a finalidade de ser utilizado para treinamento na avaliação diagnóstica em mamografia, o laudo do especialista é disponibilizado para comparação após a finalização de cada avaliação, juntamente com o parecer fornecido pelo usuário e sua porcentagem de acerto. Esse esquema, denominado "Laudos Online", objetiva também permitir ao usuário aprimorar seus conhecimentos, funcionando como uma ferramenta de ensino a distância.

Pronóstico y tratamiento de la boca seca. Revisión sistemática

No existen protocolos claramente establecidos para el tratamiento de la boca seca. El objetivo de este trabajo es realizar una revisión sistemática de la literatura médica de los últimos 10 años. Hemos utilizado las palabras: «dry mouth», «prognosis», «treatment» y «dentistry». En una primera búsqueda hemos encontrado 1.450 entradas. Con la restricción «clinical trials OR randomized controlled trial OR systemic reviews» se han reducido a 522, de las que 145 eran metaanálisis y revisiones sistemáticas. Se han eliminado las que no eran pertinentes al tema y han quedado reducidas a 53. Posteriormente se descartaron 24 (8 no pertinentes, 7 revisiones y 9 opiniones personales). De los 29 artículos analizados, 15 son ensayos clínicos controlados, 2 ensayos no controlados, 4 estudios observacionales, 2 revisiones sistemáticas y 5 revisiones. Los enfermos mejor estudiados son los pacientes con síndrome de Sjögren y los pacientes irradiados. El tratamiento se centra en el etiológico, preventivo, sintomático, de estimulación salival local y sistémicos. Podemos concluir que el tratamiento debe ser individualizado, pudiéndose aplicar sustitutos salivales y diferentes técnicas de estimulación mecánica. There are no clearly established protocols for the treatment of dry mouth. The aim of this paper is a systematic review of the literature of the past 10 years using the words «dry mouth», «prognosis», «treatment» and «dentistry». The initial search found 1,450 entries and within the restriction «clinical trials OR randomized controlled trial OR systemic reviews» it has been reduced to 522, which 145 were meta-analysis and systematic reviews. Papers not relevant to the issue were removed reducing the entries to 53. Twenty-four were dismissed (8 irrelevant, 7 reviews without adequate information and 9 personal opinions). Of the 29 items tested, 15 were controlled trials, 2 uncontrolled trials, 4 observational studies, 2 systematic reviews and 5 non systematic reviews. The most studied patients were Sjögren's syndrome and the irradiated patients. Treatments are focused on the etiology, prevention, symptomatic, local salivary stimulation and systemic treatments. It can be concluded that treatment must be individualized, salivary substitutes and mechanical stimulation techniques can be applied.

Avaliação da velocidade de processamento de processadoras automáticas ultilizado o método "STEP test"

A avaliação do processamento radiográfico utilizando o "STEP test" ("sensitometric test for the evaluation of processing") tem como objetivo a identificação de desvios importantes no sistema processadora-químicos-filmes. Neste tipo de avaliação são estabelecidas as condições ideais para o processamento. Um filme padrão é revelado de acordo com as condições do fabricante, ou seja, com padrão igual a 100. O filme é exposto à luz de um sensitômetro calibrado e os valores dos degraus são avaliados com o uso de um densitômetro, sendo obtida sua curva característica (densidade óptica × degrau). O desvio porcentual máximo deve ser de 20% quando comparado com a curva padrão. Este método é útil na identificação de problemas no processamento radiográfico. Várias processadoras de hospitais públicos/universitários foram avaliadas empregando este método, e verificou-se que aproximadamente 33% das instalações apresentam condições inadequadas de processamento.

Diverse Routes from School, via Higher Education, to Employment. A Comparison of Nine European Countries

The central theme for this study is graduate employment and employability in European-wide discussion. In this study, the complex relationships between higher education and the world of work are explored from the vantage point of how individuals make use of the higher education system in their transition from education to employment. The variation among individual transition processes in nine European countries is analysed with the help of a comparable graduate survey. Countries in this study are Italy, Spain, France, Austria, Germany, the Netherlands, the United Kingdom, Finland, and Norway. The data used for the study is commonly known as the “CHEERS” or “Careers after Higher Education, A European Research Survey.” The data was collected in 1999. The study discusses the possibilities and limitations the higher education system has in supporting the initial education-to-work transitions of youth. The study also addresses problems with comparing national higher education systems in terms of enrolment and graduate employability. A central purpose for this study is to reflect on concerns about the prolongation of individual transitions with a framework that simultaneously considers both the graduate employability and the duration of the education-to-work transition process. The key concept for this study is the standard student/graduate; synonym concepts are the traditional and the conventional student/graduate. Standard graduates are relatively young individuals who are performing their initial transition from education to working-life and who complete the degree-earning process within the stipulated time frame. In all nine countries, standard graduates make up a considerable share of the student flow, passing from higher education to the labour markets. The share of standard graduates is by far the largest in France, where they comprise the overwhelming mass. The proportion of the standard graduates is the lowest in Italy, Finland, and Austria where approximately one in four graduates completed the process of higher education within the stipulated time frame. Of the nine countries compared, employability of the whole graduate population is the greatest in Norway, the UK, Finland, and the Netherlands. Compared with employability of the whole graduate population, variation among the countries is considerably reduced when reviewing the employability of only the standard graduates. Thereby, even though the ranking among countries remains largely unchanged, the variations among them are smaller when the duration of degree earning process is standardized. The study also discusses other ideal types of student careers (or transition processes) besides the standard student/graduate. Results of regression analyses indicate that that at the pan-European level analysis, the graduate labour markets are not heavily segmented in terms of the type of the individual transition process. When considering within-country differences between the graduates, the field of studies is clearly a more powerful explanatory variable than the type of the transition process. There are, nevertheless, clear indications that, irrespective of the country, chances of finding a high status job are, on the average, highest amongst those who graduate within the stipulated duration of the degree program and who thereby have experienced the standard student career, whereas, participating in working life while studying protects against unemployment after finishing one’s degree.

Anti-C1q autoantibodies from systemic lupus erythematosus patients activate the complement system via both the classical and lectin pathways.

Autoantibodies against complement C1q (anti-C1q) strongly correlate with the occurrence of lupus nephritis and hypocomplementemia in systemic lupus erythematosus (SLE). Although a direct pathogenic role of anti-C1q has been suggested, the assumed complement-activating capacity remains to be elucidated. Using an ELISA-based assay, we found that anti-C1q activate the classical (CP) and lectin pathways (LP) depending on the anti-C1q immunoglobulin-class repertoire present in the patient's serum. IgG anti-C1q resulted in the activation of the CP as reflected by C4b deposition in the presence of purified C1 and C4 in a dose-dependent manner. The extent of C4b deposition correlated with anti-C1q levels in SLE patients but not in healthy controls. Our data indicate that SLE patient-derived anti-C1q can activate the CP and the LP but not the alternative pathway of complement. These findings are of importance for the understanding of the role of anti-C1q in SLE suggesting a direct link to hypocomplementemia.

Meta-analysis of correlated traits via summary statistics from GWASs with an application in hypertension

Genome-wide association studies (GWASs) have identified many genetic variants underlying complex traits. Many detected genetic loci harbor variants that associate with multiple-even distinct-traits. Most current analysis approaches focus on single traits, even though the final results from multiple traits are evaluated together. Such approaches miss the opportunity to systemically integrate the phenome-wide data available for genetic association analysis. In this study, we propose a general approach that can integrate association evidence from summary statistics of multiple traits, either correlated, independent, continuous, or binary traits, which might come from the same or different studies. We allow for trait heterogeneity effects. Population structure and cryptic relatedness can also be controlled. Our simulations suggest that the proposed method has improved statistical power over single-trait analysis in most of the cases we studied. We applied our method to the Continental Origins and Genetic Epidemiology Network (COGENT) African ancestry samples for three blood pressure traits and identified four loci (CHIC2, HOXA-EVX1, IGFBP1/IGFBP3, and CDH17; p < 5.0 × 10(-8)) associated with hypertension-related traits that were missed by a single-trait analysis in the original report. Six additional loci with suggestive association evidence (p < 5.0 × 10(-7)) were also observed, including CACNA1D and WNT3. Our study strongly suggests that analyzing multiple phenotypes can improve statistical power and that such analysis can be executed with the summary statistics from GWASs. Our method also provides a way to study a cross phenotype (CP) association by using summary statistics from GWASs of multiple phenotypes.

Avaliação radiográfica da idade óssea em crianças infectadas pelo HIV por via vertical

OBJETIVO: O presente trabalho teve por objetivo avaliar o desenvolvimento de crianças infectadas pelo vírus da imunodeficiência adquirida (HIV) por contaminação vertical, comparando-se dois métodos determinantes da idade óssea. MATERIAIS E MÉTODOS: Analisou-se uma amostra de 100 crianças, com idades variando de 4 anos e 2 meses a 11 anos e 9 meses, que realizaram radiografias de mão e punho tecnicamente padronizadas e que, posteriormente, foram analisadas segundo os critérios dos métodos de Greulich e Pyle (1959) e de Eklöf e Ringertz (1967). RESULTADOS: Os resultados obtidos mostraram diferenças estatísticas entre os métodos de análise radiográfica do desenvolvimento esquelético utilizados, com destaque para a maior sensibilidade em relação ao método de Eklöf e Ringertz (p < 0,05). O grupo feminino apresentou diferenças estatisticamente significantes entre os casos controle e HIV+ (sete casos) quando avaliados por este método (p < 0,05). CONCLUSÃO: Constatou-se, com a presente pesquisa, que houve a influência do HIV sobre o desenvolvimento esquelético neste grupo de pacientes.

La síndrome del dolor miofascial i la punció seca.

Introducció. La punció seca (PS) és una tècnica invasiva per al tractament de la síndrome del dolor miofascial (SDM), un trastorn no inflamatori que presenta un conjunt de símptomes originats per un punt gallet miofascial (PGM). Objectius. Comprovar si la punció seca és efectiva per al tractament de la SDM i dels PGM i si acompanyada d’altres tècniques podria augmentar la seva efectivitat. Material i mètodes. Es realitza una revisió bibliogràfica d’estudis experimentals (queden excloses altres revisions bibliogràfiques) a les bases de dades següents: Medline, Cochrane, PEDro, Enfispo, Scopus i Dialnet. La recerca es limita a treballs experimentals amb humans publicats en els últims 10 anys que utilitzin la punció seca com a tractament de la SDM i dels PGM. En total es revisen 4 articles. Resultats i discussió. En dos dels estudis revisats s’afirma que la punció seca juntament amb un programa d’exercicis actius i d’estiraments de la musculatura és, almenys, igual d’efectiva que la injecció d’anestèsic local i l’administració de flurbiprofen oral (AINE) en el tractament de la SDM (18,19). També s’afirma que la PS és més efectiva que el placebo (21). I com a resultat del quart article revisat s’obté que la PS i la manipulació de colze no són més efectius que el placebo en la SDM (20). Conclusions. Després de l’anàlisi i la discussió dels resultats obtinguts es conclou que falten més estudis i de més qualitat per tal d’aportar evidència a la PS en el tractament de la SDM i dels PGM.

Desenvolvimento de um programa computacional para avaliar e controlar as características sensitométricas em processamento automático

OBJETIVO: Desenvolver um programa computacional para avaliar e controlar as características das curvas sensitométricas. MATERIAIS E MÉTODOS: Para o desenvolvimento do programa, foi elaborado um método de obtenção dos valores das características sensitométricas, de filmes de baixo e alto contraste, sem a necessidade da fixação de degraus de referência. RESULTADOS: O programa, denominado Sensito, foi implementado e testado utilizando dados sensitométricos de curvas características dos departamentos de radiologia convencional, hemodinâmica e mamografia. Ficou comprovada a possibilidade da análise das curvas sensitométricas destas áreas sem a necessidade de ajustes, dependentes dos usuários, e sem incorrer em desvios nos parâmetros sensitométricos avaliados e na variação destes. CONCLUSÃO: O programa possibilita a criação de um banco de dados de curvas sensitométricas para diferentes processadoras de uma instituição, gerando com facilidade as curvas sensitométrica e gama, de um registro, e os gráficos de constância das características sensitométricas avaliadas, fornecendo importante ferramenta para manter o controle sensitométrico.

Ectodysplasin/NF-κB Promotes Mammary Cell Fate via Wnt/β-catenin Pathway.

Mammary gland development commences during embryogenesis with the establishment of a species typical number of mammary primordia on each flank of the embryo. It is thought that mammary cell fate can only be induced along the mammary line, a narrow region of the ventro-lateral skin running from the axilla to the groin. Ectodysplasin (Eda) is a tumor necrosis factor family ligand that regulates morphogenesis of several ectodermal appendages. We have previously shown that transgenic overexpression of Eda (K14-Eda mice) induces formation of supernumerary mammary placodes along the mammary line. Here, we investigate in more detail the role of Eda and its downstream mediator transcription factor NF-κB in mammary cell fate specification. We report that K14-Eda mice harbor accessory mammary glands also in the neck region indicating wider epidermal cell plasticity that previously appreciated. We show that even though NF-κB is not required for formation of endogenous mammary placodes, it is indispensable for the ability of Eda to induce supernumerary placodes. A genome-wide profiling of Eda-induced genes in mammary buds identified several Wnt pathway components as potential transcriptional targets of Eda. Using an ex vivo culture system, we show that suppression of canonical Wnt signalling leads to a dose-dependent inhibition of supernumerary placodes in K14-Eda tissue explants.

Probiotic Sonicates Selectively Induce Mucosal Immune Cells Apoptosis Through Ceramide Generation Via Neutral Sphingolyelinase.

Background: Probiotics appear to be beneficial in inflammatory bowel disease, but their mechanism of action is incompletely understood. We investigated whether probiotic-derived sphingomyelinase mediates this beneficial effect. Methodology/Principal Findings: Neutral sphingomyelinase (NSMase) activity was measured in sonicates of the probiotic L.brevis (LB)and S. thermophilus (ST) and the non-probiotic E. coli EC) and E. faecalis (EF). Lamina propria mononuclear cells (LPMC) were obtained from patients with Crohn"s disease (CD) and Ulcerative Colitis (UC), and peripheral blood mononuclear cells (PBMC) from healthy volunteers, analysing LPMC and PBMC apoptosis susceptibility, reactive oxygen species (ROS) generation and JNK activation. In some experiments, sonicates were preincubated with GSH or GW4869, a specific NSMase inhibitor. NSMase activity of LB and ST was 10-fold that of EC and EF sonicates. LB and ST sonicates induced significantly more apoptosis of CD and UC than control LPMC, whereas EC and EF sonicates failed to induce apoptosis. Pre-stimulation with anti-CD3/CD28 induced a significant and time-dependent increase in LB-induced apoptosis of LPMC and PBMC. Exposure to LB sonicates resulted in JNK activation and ROS production by LPMC. NSMase activity of LB sonicates was completely abrogated by GW4869, causing a dose-dependent reduction of LB -induced poptosis. LB and ST selectively induced immune cell apoptosis, an effect dependent on the degree of cell activation and mediated by bacterial NSMase. Conclusions: These results suggest that induction of immune cell apoptosis is a mechanism of action of some probiotics and that NSMase-mediated ceramide generation contributes to the therapeutic effects of probiotics.

Stable eusociality via maternal manipulation when resistance is costless.

In many eusocial species, queens use pheromones to influence offspring to express worker phenotypes. Although evidence suggests that queen pheromones are honest signals of the queen's reproductive health, here I show that queen's honest signalling can result from ancestral maternal manipulation. I develop a mathematical model to study the coevolution of maternal manipulation, offspring resistance to manipulation and maternal resource allocation. I assume that (i) maternal manipulation causes offspring to be workers against offspring's interests; (ii) offspring can resist at no direct cost, as is thought to be the case with pheromonal manipulation; and (iii) the mother chooses how much resource to allocate to fertility and maternal care. In the coevolution of these traits, I find that maternal care decreases, thereby increasing the benefit that offspring obtain from help, which in the long run eliminates selection for resistance. Consequently, ancestral maternal manipulation yields stable eusociality despite costless resistance. Additionally, ancestral manipulation in the long run becomes honest signalling that induces offspring to help. These results indicate that both eusociality and its commonly associated queen honest signalling can be likely to originate from ancestral manipulation.

Avaliação da via lacrimal pelos métodos radiológicos

Os autores realizam um estudo revisional e iconográfico das vias lacrimais através dos métodos radiológicos, sendo eles a radiografia convencional, a tomografia linear, a tomografia computadorizada e a ressonância magnética. Os métodos de imagem são fundamentais para definir diagnóstico e terapia, pois, além de demonstrarem as alterações das vias lacrimais, sugerem quais os pacientes que terão melhor prognóstico com a abordagem cirúrgica. Pelo seu custo mais baixo, menor dose de radiação, baixo índice de complicações e pela informação que pode ser obtida, recomenda-se que a dacriocistografia por tomografia linear seja o método inicial de investigação.

Caveolin-1 down-regulates inducible nitric oxide synthase via the proteasome pathway in human colon carcinoma cells.

To investigate whether caveolin-1 (cav-1) may modulate inducible nitric oxide synthase (iNOS) function in intact cells, the human intestinal carcinoma cell lines HT29 and DLD1 that have low endogenous cav-1 levels were transfected with cav-1 cDNA. In nontransfected cells, iNOS mRNA and protein levels were increased by the addition of a mix of cytokines. Ectopic expression of cav-1 in both cell lines correlated with significantly decreased iNOS activity and protein levels. This effect was linked to a posttranscriptional mechanism involving enhanced iNOS protein degradation by the proteasome pathway, because (i) induction of iNOS mRNA by cytokines was not affected and (ii) iNOS protein levels increased in the presence of the proteasome inhibitors N-acetyl-Leu-Leu-Norleucinal and lactacystin. In addition, a small amount of iNOS was found to cofractionate with cav-1 in Triton X-100-insoluble membrane fractions where also iNOS degradation was apparent. As has been described for endothelial and neuronal NOS isoenzymes, direct binding between cav-1 and human iNOS was detected in vitro. Taken together, these results suggest that cav-1 promotes iNOS presence in detergent-insoluble membrane fractions and degradation there via the proteasome pathway.