Laboratorio clínico de citogenética

Objetivo. Detectar anomalías cromosómicas que afectantanto el número de cromosomas como su estructurapara definir la etiología de la enfermedad permitiéndoleal clínico establecer posteriores planes de manejo yasesoramiento genético.Materiales y métodos. Para reconocer y detectarvariaciones inusuales en la morfología cromosómica,se aplican distintas técnicas de cultivo celular y bandeocromosómico. Entre ellas el laboratorio de citogenéticade la Universidad Nacional presta el servicio de:Cariotipo convencional bandeo C y G, Cariotipo dealta resolución cromosómica con bandeo Q, G y R,Cariotipo para evaluación de fragilidad cromosómica delcromosoma X, Cariotipo para evaluación de fragilidadcromosómica en presencia de mitomicina C (MMC),Cariotipo para evaluación de estados leucémicos(cromosoma Philadelphia), Cariotipo de líquidoamniótico.Resultados. Entre 2005 y 2013 se han atendidoaproximadamente 3000 pacientes que gracias a losdiagnósticos citogenéticos realizados por medio detécnicas citogenéticas convencionales y molecularesy a la unión con estrategias de prevención primordialy primaria (asesoría preconcepcional, diagnostico ytamizaje prenatal y neonatal), secundaria (diagnósticooportuno) y terciaria (guías de manejo anticipatorio) seha comprobado la mejora en la mortalidad, morbilidad,discapacidad, reducción en costos de aseguramientoy promoción de una mejoría en la calidad de vida delos pacientes, sus familias y los perfiles en salud de lacomunidad.Conclusiones. El acceso a los servicios de análisiscitogenético ha permitido detectar anomalías ydesarrollar estrategias de manejo adecuadas paralos pacientes atendidos y ha servido de base para lainvestigación y la enseñanza en la institución

A 50% higher prevalence of life-shortening chronic conditions among cancer patients with low socioeconomic status

Background: Comorbidity and socioeconomic status (SES) may be related among cancer patients. Method : Population-based cancer registry study among 72 153 patients diagnosed during 1997-2006. Results : Low SES patients had 50% higher risk of serious comorbidity than those with high SES. Prevalence was increased for each cancer site. Low SES cancer patients had significantly higher risk of also having cardiovascular disease, chronic obstructive pulmonary diseases, diabetes mellitus, cerebrovascular disease, tuberculosis, dementia, and gastrointestinal disease. One-year survival was significantly worse in lowest vs highest SES, partly explained by comorbidity. Conclusion : This illustrates the enormous heterogeneity of cancer patients and stresses the need for optimal treatment of cancer patients with a variety of concomitant chronic conditions

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Quantifying the Spatial Ecology of Wide-Ranging Marine Species in the Gulf of California: Implications for Marine Conservation Planning

There is growing interest in systematic establishment of marine protected area (MPA) networks and representative conservation sites. This movement toward networks of no-take zones requires that reserves are deliberately and adequately spaced for connectivity. Here, we test the network functionality of an ecoregional assessment configuration of marine conservation areas by evaluating the habitat protection and connectivity offered to wide-ranging fauna in the Gulf of California (GOC, Mexico). We first use expert opinion to identify representative species of wide-ranging fauna of the GOC. These include leopard grouper, hammerhead sharks, California brown pelicans and green sea turtles. Analyzing habitat models with both structural and functional connectivity indexes, our results indicate that the configuration includes large proportions of biologically important habitat for the four species considered (25–40%), particularly, the best quality habitats (46–57%). Our results also show that connectivity levels offered by the conservation area design for these four species may be similar to connectivity levels offered by the entire Gulf of California, thus indicating that connectivity offered by the areas may resemble natural connectivity. The selected focal species comprise different life histories among marine or marine-related vertebrates and are associated with those habitats holding the most biodiversity values (i.e. coastal habitats); our results thus suggest that the proposed configuration may function as a network for connectivity and may adequately represent the marine megafauna in the GOC, including the potential connectivity among habitat patches. This work highlights the range of approaches that can be used to quantify habitat protection and connectivity for wide-ranging marine species in marine reserve networks

INTERVENÇÕES DO PSICÓLOGO HOSPITALAR NA UNIDADE DE TERAPIA INTENSIVA DO SISTEMA ÚNICO DE SAÚDE (SUS) NO HOSPITAL GERAL

Neste trabalho de pesquisa nos propusemos a elucidar as práticas e intervenções do profissional de Psicologia atuante no contexto da Unidade de Terapia Intensiva (UTI) do Sistema Único de Saúde (SUS) do Hospital de Clínicas da Faculdade de Medicina de Marília (SP). Foi realizada entrevista com uma psicóloga inserida neste contexto, bem como revisão bibliográfica a respeito das normativas de trabalho desta área de atuação. Posteriormente, foram efetuadas reflexões sobre o tema, as quais demonstram as potencialidades e dificuldades da profissional frente ao trabalho multidisciplinar nos cuidados em saúde na UTI. Sendo expostos aspectos como: a importância da atuação da psicóloga na tríade paciente/família/equipe enquanto criadora de espaços de diálogo e expressão dos sentimentos e afetos; a importância de seu papel enquanto agente promotora de um olhar humanitário dentro da UTI e da transformação do modelo biomédico presente neste espaço; a importância do papel do psicólogo para a abordagem e reflexão sobre a morte e o morrer, aspectos presentes no contexto da UTI; a necessidade da educação continuada em serviços de saúde de forma a complementar a formação do psicólogo neste contexto; e ainda, a importância da consolidação e investimentos em políticas publicas nas instituições hospitalares, sendo aqui imprescindível a participação do psicólogo para a consolidação da Política Nacional de Humanização dos Serviços de Saúde, cujos eixos e diretrizes norteiam a atuação do psicólogo na UTI. Tais aspectos contribuíram para uma melhor compreensão da prática e intervenções da Psicóloga Hospitalar no âmbito UTI do SU

Physical and mechanical properties of particleboard bamboo waste bonded with urea formaldehyde and castor oil based adhesive

This study evaluated the physical and mechanical characteristics of particleboards made of bamboo waste from the species Dendrocalamus giganteus bonded with two different types of adhesives: urea-formaldehyde (UF) and a castor oil based adhesive (M). Thus, eight types of particleboards were produced in the proportions of 6%, 8%, 10% and 12% for each adhesive. The results showed that particleboards produced with UF and M adhesives had acceptable behavior for physical tests according to the Brazilian standard NBR 14810. The results attained in mechanical tests (MOR and MOE), for all particleboards, were below the requirements for structural usage. This indicates that the residue of bamboo is a feasible raw material alternative for particleboards produced for non structural purposes, such as liners, partitions and other uses for internal seal. Regarding the adhesives, the particleboards produced with UF particleboards showed superior results for both physical and mechanical characteristics, when compared to M particleboards with the same percentage of adhesive.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Estadual Paulista Julio de Mesquita Filho UN, Fac Engn Bauru, Programa Posgrad Engn Prod, Sao Paulo, BrazilUniv Estadual Paulista Julio de Mesquita Filho UN, Fac Engn Ind Madeireira, Sao Paulo, BrazilUniv Estadual Paulista Julio de Mesquita Filho UN, Fac Engn Bauru, Programa Posgrad Engn Prod, Sao Paulo, BrazilUniv Estadual Paulista Julio de Mesquita Filho UN, Fac Engn Ind Madeireira, Sao Paulo, BrazilFAPESP: 07/59434-