Sacrococcygeal Teratoma: From Diagnosis to Surgery

Os teratomas sacrococcígeos (TSC) são os tumores mais frequentes do recém-nascido, sendo frequentemente diagnosticados in utero. Apresenta-se o caso de um recém-nascido com um volumoso TSC, diagnosticado às 22 semanas de gestação. A gravidez foi vigiada por uma equipa multidisciplinar, atendendo ao elevado risco de complicações materno-fetais. Realizou-se cesariana electiva às 38 semanas. Ao 8º dia de vida, procedeu-se à ressecção cirúrgica do TSC em bloco com o cóccix e reposicionamento posterior do ânus. Não existiram intercorrências no intra ou pós-operatório. O seguimento da gravidez por uma equipa pluridisciplinar foi fulcral, per - mitindo a vigilância de complicações, planeamento anestésico-cirúrgico do nascimento e antecipação do tratamento apropriado, nomeadamente dos cuidados perinatais e da cirurgia neonatal

Surveying the spirit of absolute summability on multilinear operators and homogeneous polynomials

[EN] We draw a fundamental compendium of the most valuable results of the theory of summing linear operators and detail those that are not shared by known multilinear and polynomial extensions of absolutely summing linear operators. The lack of such results in the theory of non-linear summing operators justifies the introduction of a class of polynomials and multilinear operators that satisfies at once all related non-linear results. Surprisingly enough, this class, defined by means of a summing inequality, happens to be the well known ideal of composition with a summing operator.D. Pellegrino acknowledges with thanks the support of CNPq Grant 401735/2013-3-PVE (Linha 2)-Brazil. P. Rueda acknowledges with thanks the support of the Ministerio de Economia y Competitividad (Spain) MTM2011-22417. E. A. Sanchez Perez acknowledges with thanks the support of the Ministerio de Economia y Competitividad (Spain) MTM2012-36740-C02-02.Pellegrino, D.; Rueda, P.; Sánchez Pérez, EA. (2016). 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Mouse Protocadherin-1 gene expression is regulated by cigarette smoke exposure in vivo

Protocadherin-1 (PCDH1) is a novel susceptibility gene for airway hyperresponsiveness, first identified in families exposed to cigarette smoke and is expressed in bronchial epithelial cells. Here, we asked how mouse Pcdh1 expression is regulated in lung structural cells in vivo under physiological conditions, and in both short-term cigarette smoke exposure models characterized by airway inflammation and hyperresponsiveness and chronic cigarette smoke exposure models. Pcdh1 gene-structure was investigated by Rapid Amplification of cDNA Ends. Pcdh1 mRNA and protein expression was investigated by qRT-PCR, western blotting using isoform-specific antibodies. We observed 87% conservation of the Pcdh1 nucleotide sequence, and 96% conservation of the Pcdh1 protein sequence between men and mice. We identified a novel Pcdh1 isoform encoding only the intracellular signalling motifs. Cigarette smoke exposure for 4 consecutive days markedly reduced Pcdh1 mRNA expression in lung tissue (3 to 4-fold), while neutrophilia and airway hyperresponsiveness was induced. Moreover, Pcdh1 mRNA expression in lung tissue was reduced already 6 hours after an acute cigarette-smoke exposure in mice. Chronic exposure to cigarette smoke induced loss of Pcdh1 protein in lung tissue after 2 months, while Pcdh1 protein levels were no longer reduced after 9 months of cigarette smoke exposure. We conclude that Pcdh1 is highly homologous to human PCDH1, encodes two transmembrane proteins and one intracellular protein, and is regulated by cigarette smoke exposure in vivo

Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report

<p>Abstract</p> <p>Introduction</p> <p><it>Coxiella burnetii</it>, the causative agent of Q fever, may cause endocarditis and vascular infections that result in severe morbidity and mortality. We report a case of a <it>C. burnetii</it>-infected abdominal aorta and its management in a patient with a previous endovascular aortic aneurysm repair.</p> <p>Case presentation</p> <p>A 62-year-old Caucasian man was admitted to our hospital three months after endovascular aortic aneurysm repair with a bifurcated stent graft. He had increasing abdominal complaints and general malaise. A computed tomography scan of his abdomen revealed several para-aneurysmal abscesses. Surgery was performed via midline laparotomy. The entire abdominal wall of his aneurysmal sac, including the abscesses, was removed. The vascular endoprosthesis showed no macroscopic signs of infection. The decision was made to leave the endograft in place because of the severe cardiopulmonary comorbidities, thereby avoiding suprarenal clamping and explantation of this device with venous reconstruction. The proximal and distal parts of the endograft were secured to the aortic wall and common iliac artery walls, respectively, to avoid future migration. Polymerase chain reaction for <it>C. burnetii </it>was positive in all specimens of aortic tissue. Specific antibiotic therapy was initiated. Our patient was discharged in good clinical condition after six days.</p> <p>Conclusions</p> <p>In our patient, the infection was limited to the abdominal aneurysm wall, which was removed, leaving the endograft in place. Vascular surgeons should be familiar with this bailout procedure in high-risk patients.</p

Assessment of cumulative damage by using ultrasonic C-scan on carbon fiber/epoxy composites under thermal cycling

In recent years, structural composites manufactured by carbon fiber/epoxy laminates have been employed in large scale in aircraft industries. These structures require high strength under severe temperature changes of -56° until 80 °C. Regarding this scenario, the aim of this research was to reproduce thermal stress in the laminate plate developed by temperature changes and tracking possible cumulative damages on the laminate using ultrasonic C-scan inspection. The evaluation was based on attenuation signals and the C-scan map of the composite plate. The carbon fiber/epoxy plain weave laminate underwent temperatures of -60° to 80 °C, kept during 10 minutes and repeated for 1000, 2000, 3000 and 4000 times. After 1000 cycles, the specimens were inspected by C-scanning. A few changes in the laminate were observed using the inspection methodology only in specimens cycled 3000 times, or so. According to the found results, the used temperature range did not present enough conditions to cumulative damage in this type of laminate, which is in agreement with the macro - and micromechanical theory.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)UNESP Guaratinguetá Faculty of Engineering Materials and Technology DepartmentUniversity of São Paulo Escola de Engenharia de Lorena - EELUNESP Guaratinguetá Faculty of Engineering Materials and Technology DepartmentFAPESP: 11/01937-0FAPESP: 09/04123-4FAPESP: 06/02121-6FAPESP: 05/54358-

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Structural effects induced by dialysis-based purification of carbon nanomaterials

Dialysis plays a crucial role in the purification of nanomaterials but its impact on the structural properties of carbon nanomaterials was never investigated. Herein, a carbon-based nanomaterial generated electrochemically in potassium phosphate buffer, was characterized before and after dialysis against pure water. It is shown that dialysis affects the size of the carbon domains, structural organization, surface functionalization, oxidation degree of carbon, and grade of amorphicity. Accordingly, dialysis drives the nanomaterial organization from discrete roundish carbon domains, with sizes ranging from 70 to 160 nm, towards linear stacking structures of small nanoparticles (<15 ​nm). In parallel, alcohol and ether (epoxide) surface groups evolve into more oxidized carbon groups (e.g., ketone and ester groups). Investigation of the as-prepared nanomaterial by electron paramagnetic resonance (EPR) revealed a resonance signal consistent with carbon-oxygen centred radicals. Additionally, this study brings to light the selective affinity of the carbon nanomaterial under study to capture Na+ ions, a property greatly enhanced by the dialysis process, and its high ability to trap oxygen, particularly before dialysis. These findings open new perspectives for the application of carbon-based nanomaterials and raise awareness of the importance of structural changes that can occur during the purification of carbon-based nanomaterials