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Objetivo Avaliar o perfil dos pacientes com Sindrome Mielodisplasica (SMD) diagnosticados e tratados no setor de hematologia do Hospital Israelita Albert Einstein (HIAE). Material e metodos Estudo retrospectivo, de levantamento em prontuario de dados de pacientes com diagnostico de SMD no HIAE entre 2001 e 2020. Inclusao: Pacientes acima dos 18 anos em seguimento medico e tratamento no HIAE, com diagnostico realizado ou confirmado (caso diagnostico externo) em nossa instituicao. Exclusao: Incapacidade de determinar retrospectivamente pelo prontuario informacoes sobre o diagnostico ou tratamento do paciente. Resultados Revisamos retrospectivamente os prontuarios de 202 pacientes com diagnostico de SMD em nosso servico, apenas 86 preenchiam os criterios de inclusao. O predominio e do sexo masculino (53,5%), com mediana de idade de 66 anos ao diagnostico e aproximadamente 33% apresentava o historico pessoal de tabagismo ativo ou previo. Segundo a classificacao de 2016 da OMS, a maioria (25%) dos pacientes enquadrava-se como displasia de multilinhagem, 27% apresentaram alto e muito alto risco de desfecho negativo conforme a classificacao do IPSS-R (Revised International Prognosis Scoring System) e 51% possuiam dependencia transfusional. Apenas 29 pacientes possuiam resultado de mutacoes mieloides, destes, 27,5% (n = 8) portavam pelo menos uma das alteracoes moleculares de pior prognostico (RUNX1, ASXL1, TP53). As terapias mais utilizadas foram os agentes estimuladores de granulocitos e analogos de eritropoietina como primeira linha de tratamento em 50% dos pacientes; seguida pelos hipometilantes na progressao em 48% deles. Em nossa amostra, 26% (n = 22) apresentou evolucao leucemica e 33% (n = 28) dos pacientes seguiu para transplante de medula ossea alogenico. A sobrevida global (SG) e sobrevida livre de eventos (SLE) encontradas foram de aproximadamente 43 e 33 meses, respectivamente. Discussao A Sindrome Mielodisplasica (SMD) e uma doenca clonal adquirida da medula ossea, marcada por citopenias perifericas associada a displasia de uma ou mais linhagens. Opcoes terapeuticas sao os agentes hipometilantes e imunomoduladores como a Lenalidomida, principalmente nos pacientes com delecao do 5q. Essas medicacoes, porem, nao estao disponiveis no cenario do Sistema Unico de Saude (SUS) brasileiro, o que dificulta o acesso e impacta no tratamento em nosso pais. Nao possuimos registros nacionais sobre incidencia e prognostico dos pacientes tratados. A analise do banco de dados Norte Americano (SEER), realizado por XiaoMei e colegas, se assemelha ao de nossa populacao (predominio de pacientes acima de 60 anos, do sexo masculino e com sobrevida global media inferior a 3 anos). Sabemos que a avaliacao prognostica depende de fatores como risco citogenetico e perfil de mutacoes, porem, nao foi objetivo deste trabalho fazer esta correlacao. Conhecer as caracteristicas e desfecho de nossa populacao permite identificar pontos de melhoria e aprimorar fluxos diagnosticos e terapeuticos. Conclusao Apresentamos neste trabalho o perfil epidemiologico e prognostico dos pacientes portadores de SMD tratados no Hospital Israelita Albert Einstein, que se assemelha com o apresentado em literatura internacional.

In many regions of the globe, the seismic data associated with higher magnitude seismic events usable in the characterization of the seismic hazard is scarce. Therefore, seismologists have been estimating the magnitude and probable epicentral location of historical earthquakes using the historical records and intensity scales to map the observed damage. Another method, employed by earthquake engineers, uses fragility functions, a ground motion model and the Bayes’ theorem to estimate the probable magnitude of historical seismic events. Nevertheless, this method requires assembling an approach consistent with the local seismicity and building stock of the period of reference. This paper implements and validates an approach for the estimation of the magnitude of historical seismic events in Azores Islands, Portugal, that uses fragility functions. In order to carry out this study, data from the damage surveys, a vulnerability distribution and approximate epicentral positions of the 1998 Faial earthquake Mw = 6.0–6.2, as well as a specific attenuation model, are utilized in a calibration phase. The vulnerability index methodology is employed to derive fragility functions from a detailed vulnerability assessment. Afterwards, the approach is validated using analogous data corresponding to the 1980 Terceira earthquake Mw = 6.8–7.2. The different assumptions and results are discussed and compared. The results show that this approach can model expected magnitude values with accuracy: Mw = 6.01–5.76 for the 1998 Faial and Mw = 6.90–6.55 for the 1980 Terceira earthquakes. Additionally, the real PGAs may have been in several locations lower than those predicted by the selected ground motion equation. info:eu-repo/semantics/publishedVersion

Inflammatory myofibroblastic tumors (IMT) were previously included in the âinflammatory pseudotumorsâ family, but have emerged as a distinct entity recently. The management of IMT may be challenging due to its intermediate malignant potential. We present a case of a young patient with an asymptomatic retroperitoneal mass with some imaging findings that could point to the IMT diagnosis pre-operatively. After two failed attempts to fully characterize the lesion by percutaneous and surgical biopsy, surgical resection was conducted and the final diagnosis was achieved. Keywords: Inflammatory myofibroblastic tumor, MIBG, Hypervascular mass, Retroperitoneal mass

Background: Breast milk is considered an essential food segment for children up to 6 months; however, it can be contaminated with some mycotoxins, such as aflatoxin M1 (AFM1) and ochratoxin A (OTA) as a consequence of ingestion of dietary mycotoxins by lactating mothers. Moreover, the health of infants can be threatened due to simultaneous exposure to a mixture of mycotoxins mainly due to their potential synergistic effects. Scope and approach: An overview of the prevalence of mycotoxins in breast milk and infant formula, fruit- and cereal-based products as routine diets of infants during the last 10 years, besides the associated health risks, were presented. In this regard, the relevant citations published in international databases such as PubMed, Science direct from 2008 to 2019 were screened by the aid of a systematic review approach. Key findings and conclusions: The high prevalence of AFM1 and OTA in breast milk reported in several countries highlighted the extent of mycotoxin occurrence in the diet of lactating mothers. Furthermore, the exposure rates of infants to mycotoxins in breast milk and infant formula while generated a margin of exposure values lower than 10,000, indicating a huge public health concern. Thus, reducing the dietary exposure of mycotoxins for lactating mothers and approaching the required controlling steps during the processing and distribution of infant formulas are crucial. Further studies are recommended to evaluate the health risks to infants due to dietary exposure to multiple mycotoxins in infant foods. Highlights: Assessment of 73 studies on mycotoxin occurrence in breast milk and infant foods during 2008–2019; AFM1 and OTA were the main occurring mycotoxins in breast milk and infant foods; High health risks associated with the exposure of children to dietary aflatoxins; Co-occurrence of mycotoxins in fruit products and cereal-based infant formula should be a concern. The authors would like to thank Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) for the fellowship (Grant #2017/12956-2). A.S. Sant'Ana acknowledges the financial support from CNPq (Grant #302763/2014-7, #305804/2017-0) and CAPES (Financial code 01). This work was also supported by the National Institute of Health Dr. Ricardo Jorge, Projeto Incentivo de Estudos de Biomonitorização Humana de Âmbito Nacional | BioMAN [BioMAN/DAN/01] and CESAM, through the Fundação para a Ciência e a Tecnologia [UID/AMB/50017/2013], national funds, and the co-funding by the FEDER [POCI-01-0145-FEDER-00763], within the PT2020 Partnership. info:eu-repo/semantics/publishedVersion

Objective Anterior cruciate ligament (ACL) reconstruction is recommended in athletes with high physical demands. Several techniques are used in reconstruction; however, themost relevant question still is the best biomechanical positioning for the graft. The present study aimed to analyze the biomechanical effect of the position of bone tunnels on load distribution and joint kinetics, as well as the medium-term functional outcomes after ACL reconstruction. Methods A biomechanical study using a finite element model of the original knee (without anterior cruciate ligament rupture) and reconstruction of the ACL (neoACL) was performed in four combinations of bone tunnel positions (central femoral-central tibial, anterior femoral-central tibial, posterosuperior femoral-anterior tibial, and central femoral-anterior tibial) using the same type of graft. Each neo-ACL model was compared with the original knee model regarding cartilaginous contact pressure, femoral and meniscal rotation and translation, and ligamentous deformation. Results No neo-ACL model was able to fully replicate the original knee model. When the femoral tunnel was posteriorly positioned, cartilage pressures were 25% lower, and the mobility of the meniscus was 12 to 30% higher compared with the original knee model. When the femoral tunnel was in the anterior position, internal rotation was 50% lower than in the original knee model. Conclusion Results show that the femoral tunnel farther from the central position appears to be more suitable for a distinct behavior regarding the intact joint. The most anterior position increases rotational instability. Resumo Objetivo A reconstrução do ligamento cruzado anterior é aconselhável sobretudo em atletas de alta demanda física. Diversas técnicas são usadas na reconstrução,mas a grande questão é qual o melhor posicionamento para o enxerto. Analisar o efeito biomecânico da posição dos túneis ósseos na repartição de carga e cinemática da articulação, bemcomo os resultados funcionais em médio prazo, após reconstrução do ligamento cruzado anterior. Métodos Fez-se um estudo de simulação biomecânica computacional com modelos de elementos finitos do joelho original e com reconstrução do ligamento cruzado anterior (Neo-LCA) em quatro combinações de posição dos túneis ósseos (femoral central-tibial central, femoral anterior-tibial central, femoral posterossuperior-tibial anterior e femoral central-tibial anterior) com o mesmo tipo de enxerto. Para cada modelo, foram comparadas a pressão de contato na cartilagem, a rotação e translação do fêmur e dos meniscos e a deformação nos ligamentos. Resultados Nenhum modelo de Neo-LCA foi capaz de reproduzir, na íntegra, o modelo do joelho original. Quando o túnel femoral era colocado em posição mais posterior, observaram-se pressões na cartilagem 25% mais baixas e translação dos meniscos superiores entre 12% e 30% relativamente aomodelo intacto. Quando o túnel femoral estava em posição mais anterior, observou-se uma rotação interna do fêmur 50% inferior ao modelo intacto. Conclusão Os resultados evidenciam que uma localização do túnel femoral mais distante da posição central parece ser mais preponderante para um comportamento mais díspar relativamente à articulação intacta. Na posição mais anterior existe um aumento da instabilidade rotatória.

Cheese is one of the most important ready-to-eat foods produced worldwide, playing a significant role in human nutrition. The high nutritional content of cheeses also favors the development of some pathogenic bacteria in the product. Consumption of contaminated cheese has been associated with cases and outbreaks of foodborne diseases caused by Listeria monocytogenes, Staphylococcus aureus, Escherichia coli, and Salmonella enterica, among others. In this chapter, a comprehensive description of the most important pathogenic bacteria that occur in cheeses and their respective human diseases will be presented, including a discussion of the main factors contributing for contamination, and the preventive measures at industrial and retail levels. The ability of some pathogens to produce biofilms on surfaces and how these biofilms can affect the efficiency of cleaning practices in the dairy industry will also be discussed.

Mycotoxins are secondary toxic metabolites produced by some specific strains of filamentous fungi, mainly belonging to the genera of Aspergillus, Penicillium, and Fusarium, which invade crops and may grow in feedstuffs during storage. Approximately one-fourth of the global food crop is tainted with one or more mycotoxins. Diseases caused by mycotoxins are called mycotoxicoses, which can be acute or chronic depending on the concentration of mycotoxins in the feed and the duration of exposure. Domestic fowl is among the animals that are most sensitive to several types of mycotoxins which ultimately can affect egg laying performance. In this chapter, a comprehensive description of the most important toxin-producing fungi and their respective mycotoxins that can affect laying hens and egg production will be presented including the biochemical and toxicological aspects of mycotoxicoses.

The food industry uses important quality management tools, mainly Good Manufacturing Practices (GMP), Sanitation Standard Operating Procedures (SSOP), and Hazard Analysis and Critical Control Point (HACCP). The main objective of the HACCP system is prevention of risks to human health, as well as prevention of changes in foodstuffs by means of control practices in production steps in which there is a greater probability of health hazards. HACCP may be applied to all production steps, from raw material production to the manufacture of the final product. Before the HACCP system is implemented in food industries, prerequisite programs, such as GMP and SSOP have to be established. This chapter presents a comprehensive description of the GMP, SSOP, and HACCP principles and practices, taking into account their positive impact as important safety strategies in the food industry and the barriers to its implementation.

Mycotoxins are secondary metabolites produced by fungi that grow naturally in food and feedstuffs, leading to a wide variety of toxic effects in vertebrates, including men. Diseases caused by mycotoxins are called mycotoxicoses, and are characterized by diffuse syndromes. However, depending on the type of toxin, lesions will predominantly affect a given organ or tissue, such as liver, kidneys, epithelial tissue, and central nervous system. In this article, a comprehensive description of the most important toxin-producing fungi and their respective mycotoxins that can affect animal health will be presented, including biochemical and toxicological aspects of mycotoxicosis.

Laser glazing has been revealing a high potential for the improvement of plasma-sprayed (PS) thermal barrier coatings (TBCs) by reducing surface roughness, eliminating open porosity on the surface and generating a controlled segmented crack network, although the relationship of the processing parameters with the resultant properties has not yet been completely established. In this investigation, TBCs consisting of atmospheric plasma-sprayed (APS) ZrO2–8wt.%Y2O3 were subjected to a CO2 continuous wave laser-glazing process in order to seal its surface porosity, generating an external dense layer. For that purpose, different amounts of radiation resulting from different scanning speeds were applied to the specimens as well as different track overlapping. Results have shown a significant decrease of the surface roughness after the laser treatment. All specimens presented a fully dense and porous free external layer with a polyfaceted columnar microstructure highly adherent to the plasma-sprayed coating. Controlled surface crack networks, extremely dependent on the laser scanning speed and track overlapping, were achieved for each set of processing parameters. The cracks were found to have a tendency to be oriented in two perpendicular directions, one in the direction of the laser-beam travel direction, the other perpendicular to it. Moreover, the cracks parallel to the beam travel direction are found to be on the overlapping zone, coinciding with the edge of the subsequent track. The cracks are perpendicular to the surface along the densified layer and tend to branch and deviate from the vertical direction below it, within the porous PS coating. XRD results revealed mainly tV nontransformable tetragonal zirconia with a small percentage of residual monoclinic zirconia for the as-sprayed coating. All glazed coatings presented only tV nontransformable tetragonal zirconia with some variations on preferable crystal orientation. Grain sizes varied from 26 to 52 nm, increasing with an increase of laserirradiated energy; microstrain behaved inversely., Fundação para a Ciência e a Tecnologia (FCT) - Project POCTI/CTM/44590/2002., União Europeia (UE). Fundo Europeu de Desenvolvimento Regional (FEDER) .

Thermal Barrier Coating (TBC) systems are frequently used in gas turbine engines to provide thermal insulation to the hot-section metallic components and also to protect them from oxidation, hot corrosion and erosion. Surface sealing treatments, namely laser-glazing, have been showing a high potential for extending in-service lifetimes of these systems by improving chemical and thermo-mechanical resistance. In this investigation, both as-sprayed and laser-glazed TBCs were exposed to hot corrosion in molten salts. The glazed coatings were obtained by scanning the surface of the plasma-sprayed coatings with either a CO2 or a Nd:YAG laser. The hot corrosion investigation was accomplished by subjecting the specimens to an isothermal air furnace testing under V2O5 and/or Na2SO4 at a temperature of 1000 °C for 100 h. Spallation has been observed in coatings in the as-sprayed condition under V2O5 or V2O5+Na2SO4. Na2SO4 itself had no or minimal effect on the degradation of the laser-glazed or as-sprayed condition coatings, respectively. The degradation in V2O5 was accomplished by destabilization of YSZ as a consequence of depletion of yttria from the solid solution to form YVO4 and therefore led to the disruptive transformation of the metastable tetragonal phase to the monoclinic phase. Moreover, the presence of both corrosive salts induced the formation of large high aspect ratio YVO4 crystals that introduced additional stresses and contributed to the degradation of the coatings. The laser-glazed specimens were not efficient in avoiding the molten salt penetration along the thickness direction due to the presence of cracks on the glazed layer. However due to a reduced specific surface area of the dense glazed layer, the corrosion reaction of the molten salts with the YSZ has been lower than in coatings in the assprayed condition., Fundo Europeu de Desenvolvimento Regional(FEDER) - Programa Operacional "Ciência, Tecnologia e Inovação" (POCTI)., Fundação para a Ciência e a Tecnologia (FCT) - Project POCTI/CTM/ 44590/2002.