79 results on '"Cunha ML"'
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2. (18) F-FDG PET imaging of rheumatoid articular and extraarticular synovitis.
- Author
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Fonseca A, Wagner J, Yamaga LI, Osawa A, da Cunha ML, Scheinberg M, Fonseca, Andrea, Wagner, Jairo, Yamaga, Lilian Itaya, Osawa, Akemi, da Cunha, Marcelo Livorsi, and Scheinberg, Morton
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- 2008
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3. Advancements in LAMP-Based Diagnostics: Emerging Techniques and Applications in Viral Detection with a Focus on Herpesviruses in Transplant Patient Management.
- Author
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Gomes Torres ACMB, Mathias C, Baal SCS, Kohler AF, Cunha ML, and Blanes L
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- Humans, COVID-19 diagnosis, COVID-19 virology, Herpesviridae Infections diagnosis, Herpesviridae Infections virology, SARS-CoV-2 genetics, SARS-CoV-2 isolation & purification, Immunocompromised Host, Transplant Recipients, Herpesviridae genetics, Herpesviridae isolation & purification, Molecular Diagnostic Techniques methods, Nucleic Acid Amplification Techniques methods
- Abstract
Loop-mediated isothermal amplification (LAMP) is a highly effective molecular diagnostic technique, particularly advantageous for point-of-care (POC) settings. In recent years, LAMP has expanded to include various adaptations such as DARQ-LAMP, QUASR, FLOS-LAMP, displacement probes and molecular beacons. These methods enable multiplex detection of multiple targets in a single reaction, enhancing cost-effectiveness and diagnostic efficiency. Consequently, LAMP has gained significant traction in diagnosing diverse viruses, notably during the COVID-19 pandemic. However, its application for detecting Herpesviridae remains relatively unexplored. This group of viruses is of particular interest due to their latency and potential reactivation, crucial for immunocompromised patients, including organ and hematopoietic stem cell transplant recipients. This review highlights recent advancements in LAMP for virus diagnosis and explores current research trends and future prospects, emphasizing the detection challenges posed by Herpesviridae.
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- 2024
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4. How is feedback perceived by Brazilian students and faculty from a nursing school?
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Cardoso MD, Dias PLM, da Rocha Cunha ML, Mohallem A, and Dutra LA
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- Humans, Brazil, Female, Male, Feedback, Schools, Nursing, Perception, Adult, Students, Nursing psychology, Faculty, Nursing psychology, Qualitative Research, Focus Groups, Education, Nursing, Baccalaureate
- Abstract
Aim: This study aims to explore the perceptions of feedback among undergraduate students and faculty members at a Brazilian private nursing school., Background: Feedback plays a crucial role in the socioemotional development of learners, with its interpretation varying across different sociocultural contexts. Student evaluations frequently express dissatisfaction regarding both the quality and quantity of feedback received. Conversely, delivering feedback poses a challenge for faculty, requiring the establishment of an empathetic connection that fosters trust and credibility. Brazil, being a developing country characterized by social disparities and economic challenges, presents a unique backdrop for examining feedback dynamics., Design: Qualitative research, employing Inductive Content Analysis, was used to understand feedback perceptions in Brazilian nursing education. Symbolic interactionism was adopted as methodological framework and guided data interpretation., Methods: We carried out five virtual focus groups composed of a group of teachers (n=5) and four of students (n=34). Semi-structured interviews guided data collection. The recorded sessions were subsequently analyzed to identify key themes and codes. Symbolic interactionism was employed as a framework to derive meaning from qualitative data., Results: Content analysis generated two categories that reveal the perception of teachers and students in the feedback process. The first, called "Feedback in Education: Sociocultural Influences for Students and Teachers", expresses the beliefs and interpretations of students and teachers within the shared feedback environment. The second called "Challenging resonance, transformative construction: Navigating the dualities of feedback for teachers and students", which elucidated how relational dynamics shape behaviors and attitudes, promoting the development of social skills and learning. Faculty's previous feedback experiences significantly influence their self-perception and behavior with students. As a result of the resonance of these past interactions, we recognize that the teaching self also plays a crucial role in the quality and perception of feedback. Furthermore, students construct social reality with similar beliefs and values, they believe in the learning potential generated by feedback. Our findings also corroborate that perceptions of feedback are deeply influenced by the sociocultural context and the narratives corroborate previous findings indicating that, in Brazil, honest feedback can be implicitly perceived as criticism rather than an opportunity for growth., Conclusions: Faculty members often draw on their past experiences when providing feedback, highlighting the adaptive nature of feedback interactions. Additionally, the feedback process is consistently influenced by the commitment to maintaining positive relationships with students. Students recognize the constructive dimension of feedback as a valuable tool for learning and personal growth., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Published
- 2024
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5. Staphylococcus capitis Bloodstream Isolates: Investigation of Clonal Relationship, Resistance Profile, Virulence and Biofilm Formation.
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Romero LC, Silva LP, Teixeira NB, de Camargo KV, Del Masso Pereira MA, Corrente JE, Pereira VC, and Ribeiro de Souza da Cunha ML
- Abstract
Staphylococcus capitis has been recognized as a relevant opportunistic pathogen, particularly its persistence in neonatal ICUs around the world. Therefore, the aim of this study was to describe the epidemiological profile of clinical isolates of S. capitis and to characterize the factors involved in the persistence and pathogenesis of these strains isolated from blood cultures collected in a hospital in the interior of the state of São Paulo, Brazil. A total of 141 S. capitis strains were submitted to detection of the mecA gene and S CCmec typing by multiplex PCR. Genes involved in biofilm production and genes encoding enterotoxins and hemolysins were detected by conventional PCR. Biofilm formation was evaluated by the polystyrene plate adherence test and phenotypic resistance was investigated by the disk diffusion method. Finally, pulsed-field gel electrophoresis (PFGE) was used to analyze the clonal relationship between isolates. The mecA gene was detected in 99 (70.2%) isolates, with this percentage reaching 100% in the neonatal ICU. SCC mec type III was the most prevalent type, detected in 31 (31.3%) isolates and co-occurrence of SCC mec was also observed. In vitro biofilm formation was detected in 46 (32.6%) isolates but was not correlated with the presence of the ica operon genes. Furthermore, biofilm production in ICU isolates was favored by hyperosmotic conditions, which are common in ICUs because of the frequent parenteral nutrition. Analysis of the clonal relationship between the isolates investigated in the present study confirms a homogeneous profile of S. capitis and the persistence of clones that are prevalent in the neonatal ICU and disseminated across the hospital. This study highlights the adaptation of isolates to specific hospital environments and their high clonality.
- Published
- 2024
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6. How Did Patients Living With Immune-Mediated Rheumatic Diseases Face the Beginning of the COVID-19 Pandemic in Brazil? Results of the COnVIDa Study.
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Pugliesi A, Sachetto Z, de Medeiros Pinheiro M, Salviato Pileggi G, Sarot Pereira da Cunha G, Hajar FN, Marques Negrisolli Cunha ML, Henrique da Mota LM, Lopes Marques CD, Kakehasi AM, Rodrigues Ferreira WH, Araújo NC, Monteiro Gomides Reis AP, Rodrigues de Abreu Vieira RM, Ferreira GA, Danowski A, de Souza VA, Soares Egypto de Brito DC, Dos Santos Paiva E, Provenza JR, and Feijó Azevedo V
- Subjects
- Humans, Female, Adult, Middle Aged, Brazil epidemiology, Pandemics, Cross-Sectional Studies, COVID-19, Rheumatic Diseases epidemiology
- Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has brought additional burden to patients living with immune-mediated rheumatic diseases (IMRDs), especially at the beginning of 2020, for which information for this population is lacking., Methods: COnVIDa is a cross-sectional study on patients with IMRD from all regions of Brazil who were invited to answer a specific and customized Web questionnaire about how they were facing the COVID-19 pandemic, especially focusing on health care access, use of medications, and patient-reported outcomes related to IMRD activity. The questionnaire was applied from June 1 to 30, 2020., Results: In total, 1722 of 2576 patients who answered the Web questionnaire were included in the final analysis. Participants were most frequently women, 56% were between 31 and 50 years old, and most (55%) has private health insurance. The most commonly reported IMRD was rheumatoid arthritis (39%), followed by systemic lupus erythematosus (28%). During the study period, 30.7% did not have access to rheumatology consultations, and 17.6% stopped chronic medications. Telemedicine was reported in 44.8% of patients., Conclusion: COnVIDa demonstrated a negative impact on health care access and treatment maintenance of patients living with IMRD during the COVID-19 pandemic. However, it also presented an uptake of telemedicine strategies. Data presented in this study may assist future coping policies., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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7. Radiochemical and biological assessments of a PSMA-I&S cold kit for fast and inexpensive 99m Tc-labeling for SPECT imaging and radioguided surgery in prostate cancer.
- Author
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Fuscaldi LL, Sobral DV, Durante ACR, Mendonça FF, Miranda ACC, Salgueiro C, de Castiglia SG, Yamaga LYI, da Cunha ML, Malavolta L, de Barboza MF, and Mejia J
- Abstract
The expression of prostate-specific membrane antigen (PSMA) is upregulated in prostate cancer (PCa) cells and PSMA-ligands have been radiolabeled and used as radiopharmaceuticals for targeted radionuclide therapy (TRT), single photon emission computed tomography (SPECT) or positron emission tomography (PET) molecular imaging, and radioguided surgery in PCa patients. Herein, we aimed at radiolabeling the PSMA-I&S cold kit with
99m Tc, resulting in a radiopharmaceutical with high radiochemical yield (RCY) and stability for SPECT imaging and radioguided surgery in PCa malignancies. Various pre-clinical assays were conducted to evaluate the [99m Tc]Tc-PSMA-I&S obtained by the cold kit. These assays included assessments of RCY, radiochemical stability in saline, lipophilicity, serum protein binding (SPB), affinity for LNCaP-PCa cells (binding and internalization studies), and ex vivo biodistribution profile in naive and LNCaP-PCa-bearing mice. The radiopharmaceutical was obtained with good RCY (92.05% ± 2.20%) and remained stable for 6 h. The lipophilicity was determined to be -2.41 ± 0.06, while the SPB was ∼97%. The binding percentages to LNCaP cells were 9.41% ± 0.57% (1 h) and 10.45% ± 0.45% (4 h), with 63.12 ± 0.93 (1 h) and 65.72% ± 1.28% (4 h) of the bound material being internalized. Blocking assays, employing an excess of unlabeled PSMA-I&S, resulted in a reduction in the binding percentage by 2.6 times. The ex vivo biodistribution profile confirmed high accumulation of [99m Tc]Tc-PSMA-I&S in the tumor and the tumor-to-contralateral muscle ratio was ∼6.5. In conclusion, [99m Tc]Tc-PSMA-I&S was successfully obtained by radiolabeling the cold kit using freshly eluted [99m Tc]NaTcO4 , exhibiting good RCY and radiochemical stability. The preclinical assays demonstrated that the radiopharmaceutical shows favorable characteristics for SPECT imaging and radioguided surgery in PCa patients., Competing Interests: SG was employed by Tecnonuclear-Eckert Ziegler The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Fuscaldi, Sobral, Durante, Mendonça, Miranda, Salgueiro, de Castiglia, Yamaga, da Cunha, Malavolta, de Barboza and Mejia.)- Published
- 2023
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8. A Study on the Epidemiological-Molecular Role of Staphylococcus aureus Strains in the Development of Ventilator-Associated Pneumonia in a Tertiary Hospital in Brazil.
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Bonesso MF, Fortaleza CMCB, Cavalcante RS, Sobrinho MT, Ronchi CF, Abraão LM, Joo HS, Otto M, and Ribeiro de Souza da Cunha ML
- Abstract
This study aimed to explore the molecular epidemiology of Staphylococcus aureus isolated from patients on mechanical ventilation and the participation of virulence factors in the development of ventilator-associated pneumonia (VAP). A prospective cohort study was conducted on patients under mechanical ventilation, with periodic visits for the collection of tracheal aspirates and clinical data. The S. aureus isolates were analyzed regarding resistance profile, virulence, expression of protein A and alpha-toxin using Western blot, clonal profile using PFGE, sequence type using MLST, and characterization and quantification of phenol-soluble modulins. Among the 270 patients in the study, 51 S. aureus strains were isolated from 47 patients. The incidence density of S. aureus and MRSA VAP was 2.35/1000 and 1.96/1000 ventilator days, respectively; of these, 45% (n = 5) were resistant to oxacillin, with 100% (n = 5) harboring SCC mec types II and IV. The most frequent among the tested virulence factors were ica A, hla , and hld . The clonal profile showed a predominance of sequence types originating from the community. Risk factors for VAP were the presence of solid tumors and the sea gene. In conclusion, patient-related risk factors, together with microbiological factors, are involved in the development of S. aureus VAP, which is caused by the patient's own strains.
- Published
- 2023
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9. Advancements and future directions in cardiac biomarker detection using lateral flow assays.
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Schuster da Silva S, Cunha ML, Ayres LB, Garcia CD, and Blanes L
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- Humans, Biomarkers, Troponin I, Point-of-Care Systems, Cardiovascular Diseases diagnosis
- Abstract
Lateral flow assays (LFAs) have emerged as one of the most prominent paper-based biosensor platforms for rapidly detecting and quantifying analytes. Their selectivity, cost-effectiveness, efficiency, and simplicity make them ideal candidates for point-of-care (POC) applications, particularly when time-sensitive decisions are needed, such as cardiovascular events. The profound impact of cardiovascular diseases (CVDs), characterized by their high morbidity, mortality, and rehospitalization rates, necessitates an optimized approach for the early detection of cardiac muscle damage. This comprehensive review aims to consolidate the existing scientific literature on LFAs that specifically target cardiovascular biomarkers, including myoglobin and cardiac troponin I, over the past decade. By examining the advancements and findings in this field, valuable insights can be gained regarding the potential and future directions of LFAs in cardiovascular diagnostics.
- Published
- 2023
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10. Staphylococcus aureus and CA-MRSA Carriage among Brazilian Indians Living in Peri-Urban Areas and Remote Communities.
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Abraão LM, Fortaleza CMCB, Camargo CH, Barbosa TA, Pereira-Franchi EPL, Riboli DFM, Hubinger L, Bonesso MF, Medeiros de Souza R, and Ribeiro de Souza da Cunha ML
- Abstract
The emergence of Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among indigenous populations has been reported. Usually, indigenous communities live in extreme poverty and are at risk of acquiring infections. In Brazil, healthcare inequality is observed in this population. To date, there are no reports of CA-MRSA infections, and no active search for asymptomatic S. aureus carriage has been conducted among Brazilian Indians. The aim of this study was to investigate the prevalence of colonization with S. aureus and CA-MRSA among Brazilian Indians. We screened 400 Indians (from near urban areas and remote hamlets) for S. aureus and CA-MRSA colonization. The isolates were submitted to clonal profiling by pulsed-field gel electrophoresis (PFGE), and selected isolates were submitted to multilocus sequence typing (MLST). Among 931 specimens (nasal and oral) from different indigenous individuals in remote hamlets, S. aureus was cultured in 190 (47.6%). Furthermore, CA-MRSA was found in three isolates (0.7%), all SCC mec type IV. PFGE analysis identified 21 clusters among the S. aureus isolates, and MLST analysis showed a predominance of sequence type 5 among these isolates. Our study revealed a higher prevalence of S. aureus carriage among Shanenawa ethnicity individuals (41.1%). Therefore, ethnicity appears to be associated with the prevalence of S. aureus in these populations.
- Published
- 2023
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11. Molecular Epidemiology of Staphylococcus aureus and MRSA in Bedridden Patients and Residents of Long-Term Care Facilities.
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Silva LP, Fortaleza CMCB, Teixeira NB, Silva LTP, de Angelis CD, and Ribeiro de Souza da Cunha ML
- Abstract
At present, multidrug-resistant microorganisms are already responsible for community-acquired infections. Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious public health risk worldwide because of the rapid spread and diversification of pandemic clones that are characterized by increasing virulence and antimicrobial resistance. The aim of this study was to identify the prevalence and factors associated with nasal, oral and rectal carriage of S. aureus and MRSA in bedridden patients and residents of long-term care facilities for the elderly (LTCFs) in Botucatu, SP, Brazil. Nasal, oral and rectal swab isolates obtained from 226 LTCF residents or home-bedridden patients between 2017 and 2018 were submitted to susceptibility testing, detection of the mecA gene, SCCmec characterization, and molecular typing by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Logistic regression analysis was used to identify risk factors associated with the presence of S. aureus and MRSA. The prevalence of S. aureus and MRSA was 33.6% (n = 76) and 8% (n = 18), respectively. At the nine LTCFs studied, the prevalence of S. aureus ranged from 16.6% to 85.7% and that of MRSA from 13.3% to 25%. Living in an LTCF, male gender, a history of surgeries, and a high Charlson Comorbidity Index score were risk factors associated with S. aureus carriage, while MRSA carriage was positively associated with male gender. This study showed a high prevalence of S. aureus among elderly residents of small (<15 residents) and medium-sized (15−49 residents) LTCFs and a higher prevalence of MRSA in the oropharynx.
- Published
- 2022
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12. Phenotypic and Molecular Characterization of Nonfermenting Gram-Negative Bacilli Causing Peritonitis in Peritoneal Dialysis Patients.
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Moro Lima Dos Santos AC, Monteiro ACM, Barbosa TA, Riboli DFM, Camargo CH, Ferreira AM, Mondelli AL, Montelli AC, Hernandes RT, Ribeiro de Souza da Cunha ML, and Barretti P
- Abstract
(1) Background: Peritonitis due to nonfermenting Gram-negative bacilli (NF-GNB) is a dramatic complication of peritoneal dialysis (PD) with bad outcomes. Previous studies of PD-related peritonitis due to Pseudomonas species have shown a low-resolution rate, without a high resistance rate to antipseudomonal antibiotics. This suggests that bacterial virulence factors can act and influence peritonitis evolution. This study aimed to describe the microbiological characteristics of NF-GNB causing PD-related peritonitis and analyze their influence on the outcome. (2) Methods: We analyze the 48 isolates from NF-GNB peritonitis, which were stored in our culture collection regarding bacterial resistance, biofilm, and other virulence factors' production, and clonal profile. Additionally, we collected data on treatment and outcomes from patients' clinical registers. (3) Results: The etiologies were species of Pseudomonas (50%), Acinetobacter (36%), and other NF-GNB (14%). There was a high (75%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low-resolution rate (<45%) among the episodes attributable to them. Pseudomonas species have a polyclonal profile, while we found a clone of five multiresistant Acinetobacter baumannii over an 8-year interval (2000-2008), which suggest an origin from the healthcare environment. (4) Conclusions: We are not able to identify any predictor of outcome, but it is possible that biofilm and others virulence factors can act in concert and contribute to the bad outcome.
- Published
- 2022
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13. Sample Preparation for Lab-on-a-Chip Systems in Molecular Diagnosis: A Review.
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Cunha ML, da Silva SS, Stracke MC, Zanette DL, Aoki MN, and Blanes L
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- Humans, Nucleic Acid Amplification Techniques, Pathology, Molecular, Point-of-Care Systems, Specimen Handling, Lab-On-A-Chip Devices, Nucleic Acids
- Abstract
Rapid and low-cost molecular analysis is especially required for early and specific diagnostics, quick decision-making, and sparing patients from unnecessary tests and hospitals from extra costs. One way to achieve this objective is through automated molecular diagnostic devices. Thus, sample-to-answer microfluidic devices are emerging with the promise of delivering a complete molecular diagnosis system that includes nucleic acid extraction, amplification, and detection steps in a single device. The biggest issue in such equipment is the extraction process, which is normally laborious and time-consuming but extremely important for sensitive and specific detection. Therefore, this Review focuses on automated or semiautomated extraction methodologies used in lab-on-a-chip devices. More than 15 different extraction methods developed over the past 10 years have been analyzed in terms of their advantages and disadvantages to improve extraction procedures in future studies. Herein, we are able to explain the high applicability of the extraction methodologies due to the large variety of samples in which different techniques were employed, showing that their applications are not limited to medical diagnosis. Moreover, we are able to conclude that further research in the field would be beneficial because the methodologies presented can be affordable, portable, time efficient, and easily manipulated, all of which are strong qualities for point-of-care technologies.
- Published
- 2022
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14. Can 2,4-D promote the hormesis effect in upland rice?
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Marsala L, Oliveira Cunha ML, do Nascimento V, Pereira Prado E, da Silva Viana R, and Ferrari S
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- Nitrogen, Plant Leaves, Crop Production, Random Allocation, 2,4-Dichlorophenoxyacetic Acid metabolism, Hormesis, Oryza growth & development, Oryza metabolism
- Abstract
This study aimed to evaluate the influence of low doses of 2,4-D on the agronomic traits of upland rice applied at different stages of crop growth. The work was carried out in a randomized completly blocks, and consisted of the application of 5 low doses of the 2,4-D herbicide (0, 0.68, 1.36, 2.04, 3.40 and 5.44 g acid equivalent (e.a.) ha
-1 ) in two stages of rice development (tillering and floral differentiation). Nitrogen contentes in leaves, SPAD index and yield are higher when low doses of 2,4-D is applied in the tillering stage. Application of 2,4-D at a dose of 2.04 g a.e ha-1 results in a 19% increase in the number of spikelet per panicle. On the other hand, there is no effect of the application of low doses of 2,4-D on height, number of stems, active tillering and weight of 100 seeds. Our results contribute to increase knowledge of the hormesis effect in plants in order to increase crop yield.- Published
- 2022
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15. Performance of [ 68 Ga]Ga-PSMA-11 PET/CT in patients with recurrent prostate cancer after prostatectomy-a multi-centre evaluation of 2533 patients.
- Author
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Afshar-Oromieh A, da Cunha ML, Wagner J, Haberkorn U, Debus N, Weber W, Eiber M, Holland-Letz T, and Rauscher I
- Subjects
- Brazil, Edetic Acid, Gallium Radioisotopes, Germany, Humans, Male, Neoplasm Recurrence, Local diagnostic imaging, Prostate-Specific Antigen, Prostatectomy, Retrospective Studies, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms surgery
- Abstract
Purpose: To evaluate the performance of [
68 Ga]Ga-PSMA-11 PET/CT in the diagnosis of recurrent prostate cancer (PC) after prostatectomy in a large multicentre cohort., Methods: The centres, which contributed to this study, were the departments of nuclear medicine of Heidelberg (Germany), Technical University of Munich (Germany) and Albert Einstein Hospital of São Paulo (Brazil). A total of 2533 patients who were scanned with [68 Ga]Ga-PSMA-11 PET/CT at 1 h p.i. due to recurrent PC after prostatectomy were included in this retrospective analysis. Exclusion criteria were as follows: patients with untreated primary tumour, previous chemotherapy or Xofigo®; those previously treated with exclusively external beam radiation therapy or HIFU; those referred for PSMA-therapy; and those treated with ADT (including first- and second-generation ADT) within the last 6 months. Potential influences of different factors such as PSA level, PSA doubling-time (PSADT ), PSA velocity (PSAVel ), Gleason Score (GSC, including the separate analysis of 7a and 7b), age and amount of injected tracer were evaluated in a multivariable analysis., Results: The rate of pathologic PET/CT-scans was 43% for PSA ≤ 0.2 ng/ml, 58% for PSA > 0.2 to ≤ 0.5, 72% for PSA > 0.5 to ≤ 1.0 and increased to a maximum of 93% for PSA > 10 ng/ml. A pathological PET/CT was significantly (p = 0.001) associated with PSA level and higher GSC. Amount of injected tracer, age, PSADT and PSAVel were not associated with a higher probability of a pathological scan., Conclusion: [68 Ga]Ga-PSMA-11 PET/CT at 1 h p.i. confirmed its high performance in the largest patient cohort yet analysed. Tumour detection showed a clear association with higher PSA and higher GSC. No association was found between a pathological [68 Ga]Ga-PSMA-11 PET/CT and age, amount of injected tracer, PSADT or PSAVel .- Published
- 2021
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16. Coagulase-Negative Staphylococci Clones Are Widely Distributed in the Hospital and Community.
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Pinheiro-Hubinger L, Moraes Riboli DF, Abraão LM, Pereira Franchi EPL, and Ribeiro de Souza da Cunha ML
- Abstract
Coagulase-negative staphylococci (CoNS) may be considered contaminants when isolated from clinical specimens but may also be a cause of true infection. This study aimed to compare the clonality and SCC mec type of a collection of CoNS isolated from blood cultures of inpatients, nasal swabs of healthy individuals, and patients with chronic wounds, all from the same community, using SCC mec typing, pulsed-field gel electrophoresis (PFGE), and MLST. Staphylococcus epidermidis , exhibited high clonal diversity, but hospital and community clusters were observed. Nosocomial S. epidermidis clones belonged to sequence types ST2, ST6, and ST23. Some Staphylococcus haemolyticus clones were found to circulate in the hospital and community, while Staphylococcus saprophyticus exhibited very high clonal diversity. Staphylococcus lugdunensis , Staphylococcus warneri , and Staphylococcus capitis revealed several isolates belonging to the same clone in the hospital and community. The detection of different SCC mec types within the same cluster indicated high diversity. S. epidermidis was associated with SCC mec I and III, S. haemolyticus with I and II, S. capitis with type V, Staphylococcus hominis with mec complex type A and ccr1 , and S. warneri and S. saprophyticus with SCC mec I. The generation of elements and new combinations of cassette genes were highly associated with CoNS isolates, suggesting that SCC mec may not be a good marker of clonality in these bacteria.
- Published
- 2021
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17. Standardization of the [ 68 Ga]Ga-PSMA-11 Radiolabeling Protocol in an Automatic Synthesis Module: Assessments for PET Imaging of Prostate Cancer.
- Author
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Fuscaldi LL, Sobral DV, Durante ACR, Mendonça FF, Miranda ACC, da Cunha ML, Malavolta L, Mejia J, and de Barboza MF
- Abstract
Prostate-specific membrane antigen (PSMA) is a glycoprotein present in the prostate, that is overexpressed in prostate cancer (PCa). Recently, PSMA-directed radiopharmaceuticals have been developed, allowing the pinpointing of tumors with the Positron Emission Tomography (PET) or Single Photon Emission Computed Tomography (SPECT) imaging techniques. The aim of the present work was to standardize and validate an automatic synthesis module-based radiolabeling protocol for [
68 Ga]Ga-PSMA-11, as well as to produce a radiopharmaceutical for PET imaging of PCa malignancies. [68 Ga]Ga-PSMA-11 was evaluated to determine the radiochemical purity (RCP), stability in saline solution and serum, lipophilicity, affinity to serum proteins, binding and internalization to lymph node carcinoma of the prostate (LNCaP) cells, and ex vivo biodistribution in mice. The radiopharmaceutical was produced with an RCP of 99.06 ± 0.10%, which was assessed with reversed-phase high-performance liquid chromatography (RP-HPLC). The product was stable in saline solution for up to 4 h (RCP > 98%) and in serum for up to 1 h (RCP > 95%). The lipophilicity was determined as -3.80 ± 0.15, while the serum protein binding (SPB) was <17%. The percentages of binding to LNCaP cells were 4.07 ± 0.51% (30 min) and 4.56 ± 0.46% (60 min), while 19.22 ± 2.73% (30 min) and 16.85 ± 1.34% (60 min) of bound material was internalized. High accumulation of [68 Ga]Ga-PSMA-11 was observed in the kidneys, spleen, and tumor, with a tumor-to-contralateral-muscle ratio of >8.5 and a tumor-to-blood ratio of >3.5. In conclusion, an automatic synthesis module-based radiolabeling protocol for [68 Ga]Ga-PSMA-11 was standardized and the product was evaluated, thus verifying its characteristics for PET imaging of PCa tumors in a clinical environment.- Published
- 2021
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18. Molecular characterization of methicillin-resistant Staphylococcus aureus among insulin-dependent diabetic individuals in Brazil.
- Author
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Teixeira NB, Castelo Branco Fortaleza CM, de Souza MC, Monteiro Pereira TA, de Camargo Colenci BP, and Ribeiro de Souza da Cunha ML
- Subjects
- Aged, Carrier State epidemiology, Cross-Sectional Studies, Electrophoresis, Gel, Pulsed-Field, Female, Humans, Male, Methicillin-Resistant Staphylococcus aureus classification, Methicillin-Resistant Staphylococcus aureus drug effects, Microbial Sensitivity Tests, Middle Aged, Molecular Typing, Risk Factors, Sex Characteristics, Diabetes Mellitus, Type 1 microbiology, Methicillin-Resistant Staphylococcus aureus genetics
- Abstract
Background: People with diabetes mellitus, especially insulin-dependent diabetic patients, are a risk group for staphylococcal infections. Asymptomatic infection with Staphylococcus aureus is common and favors dissemination of the microorganism, rendering these individuals a source of infection. This study aimed to characterize the resistance profile, clonal profile and sequence type, as well as to analyze the prevalence and risk factors for nasal and oropharyngeal carriage of methicillin-susceptible (MSSA) and methicillin-resistant S. aureus (MRSA) isolated from insulin-dependent diabetic individuals in the city of Botucatu, SP, Brazil., Methods: Staphylococcus aureus was collected from the nasopharynx and oropharynx of 312 community-dwelling insulin-dependent diabetic individuals over a period of 3 years (October 2015 to December 2018). The isolates were characterized by susceptibility profiling, detection of the mecA gene, SCCmec typing, and molecular typing by PFGE and MLST. The risk factors associated with S. aureus and MRSA carriage were determined by logistic regression analysis., Results: The overall prevalence of colonization with S. aureus and MRSA was 30.4% and 4.8%, respectively. Fifteen of the 112 S. aureus isolates carried the mecA gene; SCCmec type IV was identified in 10 isolates, SCCmec type I in three, and SCCmec type II in two. Among the 15 resistant isolates (MRSA), four were susceptible to oxacillin/cefoxitin by the disc diffusion method and one MSSA isolate was resistant to sulfamethoxazole/trimethoprim. The analysis of risk factors revealed a protective effect of age and lung disease, while lower-extremity ulcers were a risk factor for S. aureus. For MRSA, only male gender was significantly associated as a risk factor in multivariate analysis. Clonal profile analysis demonstrated the formation of clusters among MRSA isolates from different patients, with the identification of ST5-IV, ST5-I, and ST8-IV. Isolates carrying ST398 were identified among MSSA and MRSA (ST398-IV)., Conclusion: Our findings reinforce the importance of epidemiological studies of S. aureus carriage, especially in populations at high risk of infections such as diabetics. The data suggest widespread dissemination of MRSA in the population of insulin-dependent diabetic patients studied, as well as the emergence of important lineages among these individuals.
- Published
- 2021
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19. Can the application of low doses of glyphosate induce the hormesis effect in upland rice?
- Author
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Ferrari S, Marsala L, Oliveira Cunha ML, Dos Santos Cordeiro LF, Tropaldi L, de Mattos Barretto VC, and Alves de Oliveira LC
- Subjects
- Chlorophyll, Glycine analogs & derivatives, Glycine toxicity, Hormesis, Plant Leaves, Glyphosate, Oryza
- Abstract
The aim of this research was to verify the effect of glyphosate low doses on leaf macronutrient levels and vegetative traits of upland rice in two growth stages. The treatments were arranged in 2 × 6 factorial scheme. The first factor consisted of applications in two growth stages of rice crop (tillering and floral differentiation) and the second factor was the low doses of glyphosate (0, 10, 20, 40, 70 and 100 g e.a. ha
-1 ). In full bloom, the chlorophyll content was determined in a sample of 30 flag leaves. In these leaves, the contents of macronutrients were determined. At the maturity of the rice plant, the stem count was performed per m2 , effective tiller and the plant height was measured. The low doses did not influence the leaf content of macronutrients. The plant height was reduced with an increase in the low doses of glyphosate, having a greater effect on the floral differentiation stage. When applied low doses of glyphosate at the floral differentiation stage, chlorophyll content increases and when applied to tillering there is a linear decrease in chlorophyll content. The number of stems increases with the application of low doses at floral differentiation.- Published
- 2021
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20. Atypical metastases from prostate cancer detected on 68Ga-PSMA PET/CT: a case series.
- Author
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Yamaga LYI and da Cunha ML
- Subjects
- Edetic Acid analogs & derivatives, Gallium Isotopes, Gallium Radioisotopes, Humans, Male, Membrane Glycoproteins, Oligopeptides, Positron Emission Tomography Computed Tomography, Organometallic Compounds, Prostatic Neoplasms diagnostic imaging
- Abstract
Competing Interests: None declared.
- Published
- 2021
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21. Staphylococcus spp. Isolated from Bovine Subclinical Mastitis in Different Regions of Brazil: Molecular Typing and Biofilm Gene Expression Analysis by RT-qPCR.
- Author
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Mello PL, Riboli DFM, Martins LA, Brito MAVP, Victória C, Calixto Romero L, and Ribeiro de Souza da Cunha ML
- Abstract
Bovine mastitis is mainly caused by bacteria of the genus Staphylococcus spp., which possess different virulence factors, including the capacity for biofilm formation that provides enhanced protection against the action of immune system components and serves as a barrier against the penetration of antimicrobial agents. This study aimed to characterize 181 Staphylococcus spp. Strains-including Staphylococcus aureus and coagulase-negative staphylococci (CoNS) isolated from bovine subclinical mastitis in six Brazilian states-by molecular methods. RT-qPCR was used to verify the expression of genes of the ica operon-mainly responsible for biofilm formation-as well as bap and bhp . Chromosome similarity among the isolates was investigated by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). The ica A gene was detected in 79 (43.6%) isolates, ica B in 24 (13.2%), ica C in 57 (31.4%), and ica D in 127 (70.1%). The bap gene was identified in 66 (36.4%) isolates, while the bhp gene was found in nine (4.9%). RT-qPCR confirmed the expression of the ica A gene in 60 (75.9%) isolates, of ica B in six (25%), of ica C in 26 (45.6%), and of ica D in 80 (63%). Clonal typing of the isolates by PFGE permitted the identification of eight Staphylococcus aureus clusters that simultaneously included ≥3 strains, with a similarity of ≥80%. Regarding the other species studied, three clusters were observed for Staphylococcus chromogenes and four clusters for Staphylococcus epidermidis . Only one cluster each was identified for Staphylococcus saprophyticus and Staphylococcus simulans , while the other species did not form any cluster. With respect to MLST, ST126 and ST1 were the prevalent sequence types in S. aureus , while in S. epidermidis all sequence types were different. These results reveal strains with the same evolutionary origin as other isolates, which might cause infections in humans and animals, suggesting their ability to spread between these species.
- Published
- 2020
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22. Detection of the agr System and Resistance to Antimicrobials in Biofilm-Producing S. epidermidis .
- Author
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Cataneli Pereira V, Pinheiro-Hubinger L, de Oliveira A, Moraes Riboli DF, Benini Martins K, Calixto Romero L, and Ribeiro de Souza da Cunha ML
- Subjects
- Brazil, Electrophoresis, Gel, Pulsed-Field methods, Humans, Microbial Sensitivity Tests methods, Multilocus Sequence Typing methods, Staphylococcal Infections microbiology, Virginiamycin pharmacology, Anti-Bacterial Agents pharmacology, Bacterial Proteins metabolism, Biofilms drug effects, Drug Resistance, Bacterial drug effects, Staphylococcal Infections drug therapy, Staphylococcus epidermidis drug effects, Staphylococcus epidermidis metabolism
- Abstract
The ability of Staphylococcus epidermidis to produce virulence factors, such as biofilm, added to its increased resistance to antimicrobials can cause infections that are difficult to treat. Many staphylococcal virulence factors are under the control of the accessory gene regulator ( agr ). The objective of this study was to establish the agr locus and susceptibility of biofilm-producing S. epidermidis specimens to antimicrobial agents, through PCR reactions, reverse transcription polymerase chain reaction (RT-PCR), and the determination of minimum inhibitory concentration (MIC), and to analyze the clonal profile of 300 strains isolated from blood culture specimens from inpatients at a University Hospital in Brazil, over a 20-year period by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) techniques. The ica operon expression was shown in 83.6% strains, bhp gene in 11.5%, and aap gene in 32.8%. Oxacillin resistance was detected in 90.1%, while 4.9% showed tigecycline resistance, and intermediate resistance to quinupristin/dalfopristin was identified in 0.4%. Clonal profile determination showed 11 clusters, with the ST2 type determined as the major cluster. The S. epidermidis biofilm producer demonstrated a predominance of agr I locus, oxacillin resistance, and SCC mec III as well as the potential dissemination of pathogenic clones in hospital settings over long periods.
- Published
- 2020
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23. Kinetic modeling of 68 Ga-PSMA-11 and validation of simplified methods for quantification in primary prostate cancer patients.
- Author
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Ringheim A, Campos Neto GC, Anazodo U, Cui L, da Cunha ML, Vitor T, Martins KM, Miranda ACC, de Barboza MF, Fuscaldi LL, Lemos GC, Colombo Junior JR, and Baroni RH
- Abstract
Background: The positron emission tomography (PET) ligand
68 Ga-Glu-urea-Lys(Ahx)-HBED-CC (68 Ga-PSMA-11) targets the prostate-specific membrane antigen (PSMA), upregulated in prostate cancer cells. Although68 Ga-PSMA-11 PET is widely used in research and clinical practice, full kinetic modeling has not yet been reported nor have simplified methods for quantification been validated. The aims of our study were to quantify68 Ga-PSMA-11 uptake in primary prostate cancer patients using compartmental modeling with arterial blood sampling and to validate the use of standardized uptake values (SUV) and image-derived blood for quantification., Results: Fifteen patients with histologically proven primary prostate cancer underwent a 60-min dynamic68 Ga-PSMA-11 PET scan of the pelvis with axial T1 Dixon, T2, and diffusion-weighted magnetic resonance (MR) images acquired simultaneously. Time-activity curves were derived from volumes of interest in lesions, normal prostate, and muscle, and mean SUV calculated. In total, 18 positive lesions were identified on both PET and MR. Arterial blood activity was measured by automatic arterial blood sampling and manual blood samples were collected for plasma-to-blood ratio correction and for metabolite analysis. The analysis showed that68 Ga-PSMA-11 was stable in vivo. Based on the Akaike information criterion,68 Ga-PSMA-11 kinetics were best described by an irreversible two-tissue compartment model. The rate constants K1 and k3 and the net influx rate constants Ki were all significantly higher in lesions compared to normal tissue (p < 0.05). Ki derived using image-derived blood from an MR-guided method showed excellent agreement with Ki derived using arterial blood sampling (intraclass correlation coefficient = 0.99). SUV correlated significantly with Ki with the strongest correlation of scan time-window 30-45 min (rho 0.95, p < 0.001). Both Ki and SUV correlated significantly with serum prostate specific antigen (PSA) level and PSA density., Conclusions:68 Ga-PSMA-11 kinetics can be described by an irreversible two-tissue compartment model. An MR-guided method for image-derived blood provides a non-invasive alternative to blood sampling for kinetic modeling studies. SUV showed strong correlation with Ki and can be used in routine clinical settings to quantify68 Ga-PSMA-11 uptake.- Published
- 2020
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24. Paradoxical Early Increase in Prostate-Specific Membrane Antigen Uptake Following Cryoablation for Local Recurrence After Radical Prostatectomy.
- Author
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Mariotti GC, Cunha ML, Carneiro A, Smaletz O, Baroni RH, and Garcia RG
- Subjects
- Adult, Edetic Acid analogs & derivatives, Gallium Isotopes, Gallium Radioisotopes, Humans, Male, Neoplasm Recurrence, Local pathology, Oligopeptides, Postoperative Complications surgery, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Radiopharmaceuticals, Cryosurgery, Neoplasm Recurrence, Local diagnostic imaging, Positron Emission Tomography Computed Tomography, Postoperative Complications diagnostic imaging, Prostatectomy, Prostatic Neoplasms diagnostic imaging
- Abstract
We report a case of a 43-year-old man who underwent a radical prostatectomy 3 years before the procedure (June 2015) for a locally advanced Gleason 7(4 + 3) prostate adenocarcinoma (pT3aN0), with negative surgical margins, followed by salvage radiotherapy. He also underwent antiandrogen therapy for biochemical relapse (bicalutamide) from October 2016 through May 2017, but prostate-specific antigen continued to rise (2.5 ng/mL [December 2017] and 3.3 ng/mL [February 2018]). At this point, he underwent a Ga-prostate-specific membrane antigen PET/CT, and after multidisciplinary discussion, the therapeutic option chosen was image-guided salvage cryoablation.
- Published
- 2019
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25. Reproducibility of standardized uptake values of same-day randomized 68 Ga-PSMA-11 PET/CT and PET/MR scans in recurrent prostate cancer patients.
- Author
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Ringheim A, Campos Neto GC, Martins KM, Vitor T, da Cunha ML, and Baroni RH
- Subjects
- Aged, Biological Transport, Edetic Acid metabolism, Gallium Isotopes, Gallium Radioisotopes, Humans, Male, Recurrence, Reference Standards, Reproducibility of Results, Time Factors, Edetic Acid analogs & derivatives, Magnetic Resonance Imaging standards, Oligopeptides metabolism, Positron Emission Tomography Computed Tomography standards, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms metabolism
- Abstract
Objective: Positron emission tomography in association with magnetic resonance imaging (PET/MR) and
68 Ga-PSMA-11 has shown superior detection in recurrent prostate cancer patients as compared to PET/computed tomography (PET/CT). There are, however, several technological differences between PET/CT and PET/MR systems which affect the PET image quality. The objective of this study was to assess the reproducibility of PET/CT and PET/MR SUV's in recurrent prostate cancer patients. We randomized the patients regarding the order of the PET/CT and PET/MR scans to reduce the influence of tracer uptake as a function of time., Methods: Thirty patients, all with biochemical recurrence after radical prostatectomy, underwent whole-body PET/CT and PET/MR scans after intravenous injection of a single dose of68 Ga-PSMA-11. Fifteen patients underwent PET/CT first and 15 patients underwent PET/MR first. Volumes of interest on tumor lesions were outlined and maximum standardized uptake value (SUVmax) corrected for lean body mass was calculated. Correlation and agreement between scans were assessed by generalized linear mixed-effects models and Bland-Altman analysis. The association between SUV, patient characteristics and imaging parameters was assessed., Results: Eighteen of the 30 evaluated patients had at least one positive lesion, giving an overall detection rate of 60%. In total, there were 34 visible lesions: 5 local recurrences, 22 lymph node metastases and 7 bone metastases. One group acquired PET/CT and PET/MR at median time points of 63.0 and 159.0 min, while the other group acquired PET/MR and PET/CT at median time points of 92.0 and 149.0 min. SUVmax between scans was linearly correlated, described by the equation Y(PET/CT SUVmax) = 0.75 + 1.00 × (PET/MR SUVmax), on average 20% higher on PET/CT than on PET/MR. SUV associated significantly only with type of lesion, scan time post-injection and acquisition time per bed position., Conclusions: SUVmax from PET/CT and PET/MR are linearly correlated, on average 20% higher on PET/CT than on PET/MR and should, therefore, not be used interchangeably in patient follow-up.- Published
- 2018
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26. Determination of main fruits in adulterated nectars by ATR-FTIR spectroscopy combined with multivariate calibration and variable selection methods.
- Author
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Miaw CSW, Assis C, Silva ARCS, Cunha ML, Sena MM, and de Souza SVC
- Subjects
- Brazil, Calibration, Citrus sinensis, Fruit chemistry, Least-Squares Analysis, Plant Nectar chemistry, Prunus persica, Spectrophotometry, Infrared, Spectroscopy, Fourier Transform Infrared statistics & numerical data, Vitis, Food Contamination analysis, Plant Nectar analysis, Spectroscopy, Fourier Transform Infrared methods
- Abstract
Grape, orange, peach and passion fruit nectars were formulated and adulterated by dilution with syrup, apple and cashew juices at 10 levels for each adulterant. Attenuated total reflectance Fourier transform mid infrared (ATR-FTIR) spectra were obtained. Partial least squares (PLS) multivariate calibration models allied to different variable selection methods, such as interval partial least squares (iPLS), ordered predictors selection (OPS) and genetic algorithm (GA), were used to quantify the main fruits. PLS improved by iPLS-OPS variable selection showed the highest predictive capacity to quantify the main fruit contents. The selected variables in the final models varied from 72 to 100; the root mean square errors of prediction were estimated from 0.5 to 2.6%; the correlation coefficients of prediction ranged from 0.948 to 0.990; and, the mean relative errors of prediction varied from 3.0 to 6.7%. All of the developed models were validated., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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27. Tracer uptake in mediastinal and paraaortal thoracic lymph nodes as a potential pitfall in image interpretation of PSMA ligand PET/CT.
- Author
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Afshar-Oromieh A, Sattler LP, Steiger K, Holland-Letz T, da Cunha ML, Mier W, Neels O, Kopka K, Weichert W, and Haberkorn U
- Subjects
- Aged, Aged, 80 and over, Germany, Humans, Lymph Nodes, Male, Prostatic Neoplasms pathology, Retrospective Studies, Lymphatic Metastasis diagnostic imaging, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms diagnostic imaging
- Abstract
Purpose: Since the introduction of
68 Ga-PSMA-11 PET/CT for imaging prostate cancer (PC) we have frequently observed mediastinal lymph nodes (LN) showing tracer uptake despite being classified as benign. The aim of this evaluation was to further analyze such LN., Methods: Two patient groups with biphasic68 Ga-PSMA-11 PET/CT at 1 h and 3 h p.i. were included in this retrospective evaluation. Group A (n = 38) included patients without LN metastases, and group B (n = 43) patients with LN metastases of PC. SUV of mediastinal/paraaortal LN of group A (n = 100) were compared to SUV of LN metastases of group B (n = 91). Additionally, 22 randomly selected mediastinal and paraaortal LN of patients without PC were immunohistochemically (IHC) analyzed for PSMA expression., Results: In group A, 7/38 patients (18.4%) presented with at least one PSMA-positive mediastinal LN at 1 h p.i. and 3/38 (7.9%) positive LN at 3 h p.i. with a SUVmax of 2.3 ± 0.7 at 1 h p.i. (2.0 ± 0.7 at 3 h p.i.). A total of 11 PSMA-positive mediastinal/paraaortal LN were detected in nine patients considering both imaging timing points. SUVmax of LN-metastases was 12.5 ± 13.2 at 1 h p.i. (15.8 ± 17.0 at 3 h p.i.). SUVmax increased clearly (> 10%) between 1 h and 3 h p.i. in 76.9% of the LN metastases, and decreased significantly in 72.7% of the mediastinal/paraaortal LN. By IHC, PSMA-expression was observed in intranodal vascular endothelia of all investigated LN groups and to differing degrees within germinal centers of 15/22 of them (68.1%). Expression was stronger in mediastinal nodes (p = 0.038) and when follicular hyperplasia was present (p = 0.050)., Conclusion: PSMA-positive mediastinal/paraaortal benign LN were visible in a notable proportion of patients. PSMA-positivity on the histopathological level was associated with the activation state of the LN. However, in contrast to LN metastases of PC, they presented with significantly lower uptake, which, in addition, usually decreased over time.- Published
- 2018
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28. Solitary testicular metastasis from prostate cancer. A case report diagnosed by PET/CT with PSMA.
- Author
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da Cunha ML, de Oliveira Rodrigues C, de Araújo MPL, de Freitas Junior CH, and Ferrigno R
- Subjects
- Adenocarcinoma diagnostic imaging, Aged, Humans, Male, Prostate-Specific Antigen, Prostatectomy, Testicular Neoplasms diagnostic imaging, Adenocarcinoma secondary, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms pathology, Testicular Neoplasms secondary
- Published
- 2018
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29. 68 Ga-DOTATATE PET/CT in recurrent medullary thyroid carcinoma: a lesion-by-lesion comparison with 111 In-octreotide SPECT/CT and conventional imaging.
- Author
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Yamaga LYI, Cunha ML, Campos Neto GC, Garcia MRT, Yang JH, Camacho CP, Wagner J, and Funari MBG
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Recurrence, Young Adult, Carcinoma, Neuroendocrine drug therapy, Octreotide analogs & derivatives, Organometallic Compounds, Single Photon Emission Computed Tomography Computed Tomography methods, Thyroid Neoplasms drug therapy
- Abstract
Purpose: The aim of this study was to prospectively compare the detection rate of
68 Ga-DOTATATE PET-CT with111 In-octreotide SPECT-CT and conventional imaging (CI) in medullary thyroid carcinoma (MTC) patients with increased calcitonin (Ctn) levels but negative CI after thyroidectomy., Methods: Fifteen patients with raised Ctn levels and/or CI evidence of recurrence underwent68 Ga-DOTATATE PET-CT,111 In-octreotide SPECT-CT and CI. Histopathology, CI and biochemical/clinical/imaging follow-up were used as the reference standard. PET/CT, SPECT/CT and CI were compared in a lesion-based and organ-based analysis., Results: PET/CT evidenced recurrence in 14 of 15 patients. There were 13 true positive (TP), 1 true negative (TN), 1 false positive (FP) and no false negative (FN) cases, resulting in a sensitivity and accuracy of 100% and 93%. SPECT/CT was positive in 6 of 15 cases. There were 6 TP, 2 TN, 7 FN and no FP cases, resulting in a sensitivity of 46% and accuracy of 53%. CI procedures detected tumor lesions in 14 of 15 patients. There were 13 TP, 1TN, 1 FP and no FN cases with a sensitivity of 100% and accuracy of 93%. A significantly higher number of lesions was detected by PET/CT (112 lesions, p = 0.005) and CI (109 lesions, p = 0.005) in comparison to SPECT/CT (16 lesions). There was no significant difference between PET/CT and CI for the total number of detected lesions (p = 0.734). PET/CT detected more lesions than SPECT/CT regardless of the organ. PET/CT detected more bone lesions but missed some neck nodal metastases evidenced by CI. The number of lesions per region demonstrated by PET/CT and CI were similar in the other sites., Conclusion:68 Ga-DOTATATE PET/CT is superior to111 In-octreotide SPECT/CT for the detection of recurrent MTC demonstrating a significantly higher number of lesions.68 Ga-DOTATATE PET/CT showed a superior detection rate compared to CI in demonstrating bone metastases.- Published
- 2017
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30. Short communication: β-Lactam resistance and vancomycin heteroresistance in Staphylococcus spp. isolated from bovine subclinical mastitis.
- Author
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Mello PL, Pinheiro L, Martins LA, Brito MAVP, and Ribeiro de Souza da Cunha ML
- Subjects
- Animals, Anti-Bacterial Agents therapeutic use, Cattle, Female, Mastitis, Bovine drug therapy, Microbial Sensitivity Tests, Staphylococcal Infections drug therapy, Vancomycin therapeutic use, beta-Lactams therapeutic use, Mastitis, Bovine microbiology, Staphylococcal Infections veterinary, Staphylococcus drug effects, Vancomycin Resistance, beta-Lactam Resistance
- Abstract
The use of antimicrobial agents has led to the emergence of resistant bacterial strains over a relatively short period. Furthermore, Staphylococcus spp. can produce β-lactamase, which explains the survival of these strains in a focus of infection despite the use of a β-lactam antibiotic. The aim of this study was to evaluate the resistance of Staphylococcus spp. isolated from bovine subclinical mastitis to oxacillin and vancomycin (by minimum inhibitory concentration) and to detect vancomycin heteroresistance by a screening method. We also evaluated β-lactamase production and resistance due to hyperproduction of this enzyme and investigated the mecA and mecC genes and performed staphylococcal cassette chromosome mec typing. For this purpose, 181 Staphylococcus spp. isolated from mastitis subclinical bovine were analyzed. Using the phenotypic method, 33 (18.2%) of Staphylococcus spp. were resistant to oxacillin. In contrast, all isolates were susceptible to vancomycin, and heteroresistance was detected by the screening method in 13 isolates. Production of β-lactamase was observed in 174 (96%) of the Staphylococcus spp. isolates. The mecA gene was detected in 8 isolates, all of them belonging to the species Staphylococcus epidermidis, and staphylococcal cassette chromosome mec typing revealed the presence of type I and type IV isolates., (Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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31. Neurodegeneration Alters Metabolic Profile and Sirt 1 Signaling in High-Fat-Induced Obese Mice.
- Author
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Lima LCF, Saliba SW, Andrade JMO, Cunha ML, Cassini-Vieira P, Feltenberger JD, Barcelos LS, Guimarães ALS, de-Paula AMB, de Oliveira ACP, and Santos SHS
- Subjects
- Animals, Body Composition drug effects, Body Weight drug effects, Corpus Striatum drug effects, Corpus Striatum pathology, Diet, High-Fat, Male, Metabolic Networks and Pathways drug effects, Metabolic Syndrome complications, Metabolic Syndrome metabolism, Mice, Obese, Models, Biological, Motor Activity drug effects, Quinolinic Acid pharmacology, Rotarod Performance Test, Metabolome drug effects, Nerve Degeneration metabolism, Signal Transduction drug effects, Sirtuin 1 metabolism
- Abstract
Different factors may contribute to the development of neurodegenerative diseases. Among them, metabolic syndrome (MS), which has reached epidemic proportions, has emerged as a potential element that may be involved in neurodegeneration. Furthermore, studies have shown the importance of the sirtuin family in neuronal survival and MS, which opens the possibility of new pharmacological targets. This study investigates the influence of sirtuin metabolic pathways by examining the functional capacities of glucose-induced obesity in an excitotoxic state induced by a quinolinic acid (QA) animal model. Mice were divided into two groups that received different diets for 8 weeks: one group received a regular diet, and the other group received a high-fat diet (HF) to induce MS. The animals were submitted to a stereotaxic surgery and subdivided into four groups: Standard (ST), Standard-QA (ST-QA), HF and HF-QA. The QA groups were given a 250 nL quinolinic acid injection in the right striatum and PBS was injected in the other groups. Obese mice presented with a weight gain of 40 % more than the ST group beyond acquiring an insulin resistance. QA induced motor impairment and neurodegeneration in both ST-QA and HF-QA, although no difference was observed between these groups. The HF-QA group showed a reduction in adiposity when compared with the groups that received PBS. Therefore, the HF-QA group demonstrated a commitment-dependent metabolic pathway. The results suggest that an obesogenic diet does not aggravate the neurodegeneration induced by QA. However, the excitotoxicity induced by QA promotes a sirtuin pathway impairment that contributes to metabolic changes.
- Published
- 2017
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32. Co-referential Processing of Pronouns and Repeated Names in Italian.
- Author
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de Carvalho Maia J, Vernice M, Gelormini-Lezama C, Lima ML, and Almor A
- Subjects
- Adolescent, Adult, Female, Humans, Italy, Male, Psycholinguistics, Young Adult, Linguistics
- Abstract
In this study, we investigate whether co-referential processing across sentence boundaries is driven by universal properties of the general architecture of memory systems and whether cross-linguistic differences concerning the number of anaphoric forms available in a language's referential inventory can impact the process of inter-sentential co-reference resolution. As a window into these questions, we test whether the repeated-name penalty (RNP) and the overt-pronoun penalty (OPP)-comprehension delays associated with repeated names and overt pronouns, respectively, in comparison to more reduced anaphoric forms in reference to salient antecedents-occur in Italian, examining the extent to which Italian resembles other null-subject languages, with focus on Spanish. Our self-paced reading experiment with factors Antecedent (Subject, Object) and Anaphor (Null Pronoun, Overt Pronoun, Repeated Name) found that Italian exhibits both an OPP and a (weaker) RNP, extending previous research that showed these effects in Spanish and strengthening the claim that co-reference resolution might be subject to universal principles.
- Published
- 2017
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33. Modifications to the composition of the hyphal outer layer of Aspergillus fumigatus modulates HUVEC proteins related to inflammatory and stress responses.
- Author
-
Neves GW, Curty NA, Kubitschek-Barreira PH, Fontaine T, Souza GH, Cunha ML, Goldman GH, Beauvais A, Latgé JP, and Lopes-Bezerra LM
- Subjects
- Aspergillus fumigatus genetics, Endothelial Cells metabolism, Fungal Proteins physiology, Gene Deletion, Host-Pathogen Interactions, Humans, Polysaccharides biosynthesis, Thrombosis etiology, Thrombosis microbiology, Tumor Necrosis Factor-alpha metabolism, Aspergillus fumigatus chemistry, Human Umbilical Vein Endothelial Cells chemistry, Human Umbilical Vein Endothelial Cells microbiology, Hyphae chemistry, Inflammation, Stress, Physiological
- Abstract
Aspergillus fumigatus, the main etiologic agent causing invasive aspergillosis, can induce an inflammatory response and a prothrombotic phenotype upon contact with human umbilical vein endothelial cells (HUVECs). However, the fungal molecules involved in this endothelial response remain unknown. A. fumigatus hyphae produce an extracellular matrix composed of galactomannan, galactosaminogalactan and α-(1,3)-glucan. In this study, we investigated the consequences of UGM1 gene deletion in A. fumigatus, which produces a mutant with increased galactosaminogalactan production. The ∆ugm1 mutant exhibited an HUVEC-hyperadhesive phenotype and induced increased endothelial TNF-α secretion and tissue factor mRNA overexpression in this "semi-professional" immune host cell. Using a shotgun proteomics approach, we show that the A. fumigatus ∆ugm1 strain can modulate the levels of proteins in important endothelial pathways related to the inflammatory response mediated by TNF-α and to stress response pathways. Furthermore, a purified galactosaminogalactan fraction was also able to induce TNF-α secretion and the coincident HUVEC pathways regulated by the ∆ugm1 mutant, which overexpresses this component, as demonstrated by fluorescence microscopy. This work contributes new data regarding endothelial mechanisms in response to A. fumigatus infection., Significance: Invasive aspergillosis is the main opportunistic fungal infection described in neutropenic hematologic patients. One important clinical aspect of this invasive fungal infection is vascular thrombosis, which could be related, at least in part, to the activation of endothelial cells, as shown in previous reports from our group. It is known that direct contact between the A. fumigatus hyphal cell wall and the HUVEC cell surface is necessary to induce an endothelial prothrombotic phenotype and secretion of pro-inflammatory cytokines, though the cell surface components of this angioinvasive fungus that trigger this endothelial response are unknown. The present work employs a discovery-driven proteomics approach to reveal the role of one important cell wall polysaccharide of A. fumigatus, galactosaminogalactan, in the HUVEC interaction and the consequent mechanisms of endothelial activation. This is the first report of the overall panel of proteins related to the HUVEC response to a specific and purified cell wall component of the angioinvasive fungus A. fumigatus., (Copyright © 2016 Elsevier B.V. All rights reserved.)
- Published
- 2017
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34. Correlation of phenotypic tests with the presence of the blaZ gene for detection of beta-lactamase.
- Author
-
Ferreira AM, Martins KB, Silva VR, Mondelli AL, and Cunha ML
- Subjects
- Disk Diffusion Antimicrobial Tests, Genotype, Penicillin Resistance, Sensitivity and Specificity, Staphylococcal Infections microbiology, Staphylococcus saprophyticus drug effects, Staphylococcus saprophyticus genetics, Staphylococcus saprophyticus metabolism, Urinary Tract Infections microbiology, Microbial Sensitivity Tests, beta-Lactam Resistance, beta-Lactamases genetics, beta-Lactamases metabolism
- Abstract
Staphylococcus aureus and Staphylococcus saprophyticus are the most common and most important staphylococcal species associated with urinary tract infections. The objective of the present study was to compare and to evaluate the accuracy of four phenotypic methods for the detection of beta-lactamase production in Staphylococcus spp. Seventy-three strains produced a halo with a diameter ≤28mm (penicillin resistant) and all of them were positive for the blaZ gene. Among the 28 susceptible strain (halo ≥29mm), 23 carried the blaZ gene and five did not. The zone edge test was the most sensitive (90.3%), followed by MIC determination (85.5%), but the specificity of the former was low (40.0%). The nitrocefin test was the least sensitive (28.9%). However, the nitrocefin test together with the disk diffusion method showed the highest specificity (100%). The present results demonstrated that the zone edge test was the most sensitive phenotypic test for detection of beta-lactamase, although it is still not an ideal test to detect this type of resistance since its specificity was low. However, the inhibition halo diameter of the penicillin disk can be used together with the zone edge test since the same disk is employed in the two tests. Combined analysis of the two tests shows a sensitivity of 90.3% and specificity of 100%, proving better sensitivity, especially for S. saprophyticus. This is a low-cost test of easy application and interpretation that can be used in small and medium-sized laboratories where susceptibility testing is usually performed by the disk diffusion method., (Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.)
- Published
- 2017
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35. Manchester Triage System: main flowcharts, discriminators and outcomes of a pediatric emergency care.
- Author
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Amthauer C and Cunha ML
- Subjects
- Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Male, Outcome Assessment, Health Care, Emergency Medical Services, Software Design, Triage methods
- Abstract
Objetive: to characterize the care services performed through risk rating by the Manchester Triage System, identifying demographics (age, gender), main flowcharts, discriminators and outcomes in pediatric emergency., Method: cross-sectional quantitative study. Data on risk classification were obtained through a search of computerized registration data from medical records of patients treated in the pediatric emergency within one year. Descriptive statistics with absolute and relative frequencies was used for the analysis., Results: 10,921 visits were conducted in the pediatric emergency, mostly male (54.4%), aged between 29 days and two years (44.5%). There was a prevalence of the urgent risk category (43.6%). The main flowchart used in the care was worried parents (22.4%) and the most prevalent discriminator was recent event (15.3%). The hospitalization outcome occurred in 10.4% of care performed in the pediatric emergency, however 61.8% of care needed to stay under observation and / or being under the health team care in the pediatric emergency., Conclusion: worried parents was the main flowchart used and recent events the most prevalent discriminator, comprising the hospitalization outcomes and permanency in observation in the pediatric emergency before discharge from the hospital.
- Published
- 2016
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36. Dataset of differentially regulated proteins in HUVECs challenged with wild type and UGM1 mutant Aspergillus fumigatus strains.
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Neves GW, Curty N, Kubitschek-Barreira PH, Fontaine T, Souza GH, Cunha ML, Goldman GH, Beauvais A, Latgé JP, and Lopes-Bezerra LM
- Abstract
Invasive aspergillosis is the primary opportunistic invasive fungal infection described in neutropenic hematologic patients, caused by the angioinvasive pathogen Aspergillus fumigatus. The molecular mechanisms associated with A. fumigatus infection in the vascular endothelium are poorly understood. In this context, we used a high-throughput proteomic approach to unveil the proteins modulated in HUVECs after interaction with a wild type strain and the UGM1 mutant (Δugm1) of A. fumigatus. The proteomic analysis was also performed in HUVECs challenged with a galactosaminogalactan (GAG) purified from A. fumigatus cell wall. The dataset presented here correspond to all proteins identified that fit a 2-fold change criteria (log 2 ratio ≥ 1 or ≤ -1), disregarding the statistical validation cut off, in order to supplement the research article entitled "Modifications to the composition of the hyphal outer layer of Aspergillus fumigatus modulates the HUVEC proteins associated with inflammatory and stress responses" (G.W.P. Neves, N.A. Curty, P.H. Kubitschek-Barreira, T. Fontaine, G.H.M.F. Souza, M. Lyra Cunha, G.H. Goldman, A. Beauvais, J.P. Latgé, L.M. Lopes-Bezerra, 2016) [1]. The mass spectrometry proteomic data have been deposited in the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PRIDE: PXD002823.
- Published
- 2016
- Full Text
- View/download PDF
37. Susceptibility Profile of Staphylococcus epidermidis and Staphylococcus haemolyticus Isolated from Blood Cultures to Vancomycin and Novel Antimicrobial Drugs over a Period of 12 Years.
- Author
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Pinheiro L, Brito CI, Pereira VC, Oliveira A, Bartolomeu AR, Camargo CH, and Cunha ML
- Subjects
- Bacterial Typing Techniques, Blood Culture, Brazil epidemiology, Daptomycin pharmacology, Electrophoresis, Gel, Pulsed-Field, Gene Expression, Humans, Linezolid pharmacology, Minocycline analogs & derivatives, Minocycline pharmacology, Mutation, Oxacillin pharmacology, Prevalence, Staphylococcal Infections drug therapy, Staphylococcal Infections epidemiology, Staphylococcal Infections microbiology, Staphylococcus epidermidis genetics, Staphylococcus epidermidis growth & development, Staphylococcus epidermidis isolation & purification, Staphylococcus haemolyticus genetics, Staphylococcus haemolyticus growth & development, Staphylococcus haemolyticus isolation & purification, Tigecycline, Vancomycin pharmacology, Virginiamycin pharmacology, Anti-Bacterial Agents pharmacology, Bacterial Proteins genetics, Drug Resistance, Multiple, Bacterial genetics, Hospitals, Teaching statistics & numerical data, Staphylococcus epidermidis drug effects, Staphylococcus haemolyticus drug effects
- Abstract
The aim of this study was to evaluate the antimicrobial susceptibility profile of 85 Staphylococcus epidermidis and 84 Staphylococcus haemolyticus strains isolated from blood cultures to oxacillin, vancomycin, tigecycline, linezolid, daptomycin, and quinupristin/dalfopristin over a period of 12 years. S. epidermidis and S. haemolyticus isolated from blood cultures of inpatients, attended at a teaching hospital, were analyzed for the presence of the mecA gene and by SCCmec typing. The minimum inhibitory concentration (MIC) values of tigecycline, linezolid, daptomycin, quinupristin/dalfopristin, and vancomycin were determined. Isolates exhibiting vancomycin MICs of ≥2 μg/ml were typed by pulsed-field gel electrophoresis (PFGE). The rate of mecA positivity was 92.9% and 100% in S. epidermidis and S. haemolyticus, respectively. The most frequent SCCmec types were type III (53.2%) in S. epidermidis and type I (32.1%) in S. haemolyticus. All isolates were susceptible to linezolid and daptomycin, but 7.1% of S. haemolyticus and 2.3% of S. epidermidis isolates were resistant to tigecycline, and 1.2% each of S. haemolyticus and S. epidermidis were resistant and intermediately resistant to quinupristin/dalfopristin, respectively. S. epidermidis exhibited higher vancomycin MICs (40% with MIC of ≥2 μg/ml). Clonal typing of strains with vancomycin MIC of ≥2 μg/ml revealed the presence of different PFGE types of S. epidermidis and S. haemolyticus over a period of up to 4 years (2002-2004, 2005-2008, 2006-2009, 2010-2011). Despite the observation of a high prevalence of mecA, the clinical strains were fully susceptible to vancomycin and to the new drugs linezolid, daptomycin, tigecycline, and quinupristin/dalfopristin. The PFGE types with vancomycin MIC of ≥2 μg/ml exhibited a great diversity of SCCmec cassettes, demonstrating that S. epidermidis and S. haemolyticus may easily acquire these resistance-conferring genetic elements.
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- 2016
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- View/download PDF
38. Circulating nucleosomes and elastase α1-antitrypsin complexes and the novel thrombosis susceptibility locus SLC44A2.
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Heestermans M, Cunha ML, Reitsma PH, Zeerleder SS, Middeldorp S, and van Vlijmen BJ
- Subjects
- Humans, Thrombosis pathology, Leukocyte Elastase blood, Membrane Glycoproteins genetics, Membrane Transport Proteins genetics, Nucleosomes pathology, Polymorphism, Single Nucleotide, Thrombosis blood, Thrombosis genetics, alpha 1-Antitrypsin blood
- Published
- 2016
- Full Text
- View/download PDF
39. Taking care of the newborn dying and their families: Nurses' experiences of neonatal intensive care.
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Almeida Fde A, Moraes MS, and Cunha ML
- Subjects
- Attitude to Death, Brazil, Grief, Humans, Infant, Newborn, Qualitative Research, Adaptation, Psychological, Family, Intensive Care, Neonatal psychology, Neonatal Nursing, Nursing Staff, Hospital psychology, Perinatal Death
- Abstract
Objective: To understand the experiences of nurses when caring for dying newborns and their families in the NICU; and redeem their perceptions about acting before the death and grieving process., Method: A descriptive exploratory study with a qualitative approach, developed with nine nurses at the ICU of a hospital in São Paulo (SP), Brazil. Data was collected through semi-structured interviews and analyzed using the Collective Subject Discourse (CSD)., Results: Caring for newborns who are dying and their families is very difficult for nurses, due to the intense involvement. They seek strategies to deal with the situation and, before the newborn's death, despite the suffering, express the feeling of accomplishment., Conclusions: Facing death and grief triggers mechanisms that emerge life references, coming across painful issues. Learning to deal with these questions is a daily challenge for nurses of the NICU., Objetivo: Compreender as experiências vivenciadas por enfermeiros ao cuidar de neonatos que estão morrendo e seus familiares na UTIN; e resgatar as suas percepções sobre a atuação diante do processo de morte e luto., Método: Estudo descritivo exploratório, de abordagem qualitativa, desenvolvido com nove enfermeiras da UTIN de um hospital de São Paulo (SP), Brasil. Os dados foram coletados por meio de entrevista semi-estruturada e analisados pela técnica do Discurso de Sujeito Coletivo (DSC)., Resultados: Cuidar de neonatos que estão morrendo e suas famílias é muito difícil para as enfermeiras, devido ao intenso envolvimento. Buscam estratégias para lidar com a situação e, diante do óbito do neonato, apesar do sofrimento, manifestam o sentimento de dever cumprido., Conclusión: Enfrentar a morte e o luto aciona mecanismos que afloram referências de vida, deparando-se com questões dolorosas. Aprender a lidar com essas questões é um desafio diário para os enfermeiros de UTIN.
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- 2016
- Full Text
- View/download PDF
40. 99mTc-HYNIC-TOC increased uptake can mimic malignancy in the pancreas uncinate process at somatostatin receptor SPECT/CT.
- Author
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Yamaga LY, Neto GC, da Cunha ML, Osawa A, Oliveira JC, Fonseca RQ, Nogueira SA, Wagner J, and Funari MG
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Liver metabolism, Male, Middle Aged, Neuroendocrine Tumors diagnosis, Octreotide pharmacokinetics, Receptors, Somatostatin, Retrospective Studies, Multimodal Imaging, Octreotide analogs & derivatives, Organotechnetium Compounds pharmacokinetics, Pancreas metabolism, Radiopharmaceuticals pharmacokinetics, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed
- Abstract
Objective: The aim of this study was to assess the occurrence and frequency of increased physiologic uptake of 99mTc-HYNIC-TOC by the uncinate process of the pancreas in SPECT/CT images., Methods: Forty-six scans of 41 patients were evaluated retrospectively. The uptake of 99mTc-HYNIC-TOC was considered to be physiologic in patients with normal findings at dedicated abdominal CT or MR and lack of neoplastic lesions in clinical follow-ups. The intensity of uncinate process uptake was compared to the uptake of the normal liver., Results: Focal uptake was attributed to the presence of pancreatic NET in 5 patients. Among the 36 patients without any evidence of malignancy in CT, MR and follow-up, 7 (19.4 %) showed increased uptake in the uncinate process. The intensity of uptake was lesser in 3 (8.3 %), similar in 3 and greater than the normal liver in 1 (2.8 %) case., Conclusion: Increased 99mTc-HYNIC-TOC uptake occurred in 19.4 % of those subjects without any evidence of neuroendocrine tumor in the uncinate process.
- Published
- 2016
- Full Text
- View/download PDF
41. Key Role of α-Toxin in Fatal Pneumonia Caused by Staphylococcus aureus Sequence Type 398.
- Author
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Bonesso MF, Yeh AJ, Villaruz AE, Joo HS, McCausland J, Fortaleza CM, Cavalcante RS, Sobrinho MT, Ronchi CF, Cheung GY, Cunha ML, and Otto M
- Subjects
- Adult, Aged, Animals, DNA, Bacterial genetics, Disease Models, Animal, Humans, Male, Mice, Middle Aged, Pneumonia, Staphylococcal microbiology, Staphylococcus aureus genetics, Staphylococcus aureus pathogenicity, Bacterial Toxins genetics, Hemolysin Proteins genetics, Methicillin-Resistant Staphylococcus aureus genetics, Pneumonia, Staphylococcal genetics
- Published
- 2016
- Full Text
- View/download PDF
42. [Late-onset neonatal sepsis in preterm infants with birth weight under 1.500 g].
- Author
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Silva SM, de Cássia Pinheiro da Motta G, Nunes CR, Schardosim JM, and da Cunha ML
- Subjects
- Female, Humans, Incidence, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Male, Prospective Studies, Time Factors, Infant, Premature, Diseases epidemiology, Sepsis epidemiology
- Abstract
Objective: The research objective was to characterize preterm infants with birth weight under 1500 g, and to identify the incidence of late-onset neonatal sepsis among this population., Methods: A prospective cohort study with a sample of 30 preterm newborns that weighed under 1500 g and were hospitalized in the NICU of the university hospital. Data were collected from January to December 2013 using a structured instrument., Results: Of the 30 neonates included in the study, 14 developed late-onset neonatal sepsis with a prevalence of coagulase-negative staphylococci., Conclusions: The incidence of late-onset neonatal sepsis indicates a vulnerability in preterm infants due to immunological immaturity. These results reveal that knowledge of the profile of newborn infants admitted to the NICU and the risk factors to which they are exposed are central to the planning of nursing care for these patients. Future studies should address strategies for preventing nosocomial infection.
- Published
- 2015
- Full Text
- View/download PDF
43. Safety culture in the operating room of a public hospital in the perception of healthcare professionals.
- Author
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Carvalho PA, Göttems LB, Pires MR, and de Oliveira ML
- Subjects
- Adult, Attitude of Health Personnel, Cross-Sectional Studies, Female, Hospitals, Public, Humans, Job Satisfaction, Male, Middle Aged, Organizational Culture, Patient Safety, Stress, Psychological, Surveys and Questionnaires, Work Engagement, Operating Rooms standards, Personnel, Hospital psychology, Safety Management
- Abstract
Objective: To evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ)., Method: Descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis., Results: Participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD ± 9.2) years. And Cronbach's α of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit's management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages., Conclusions: The results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.
- Published
- 2015
- Full Text
- View/download PDF
44. Introduction to the analysis of next generation sequencing data and its application to venous thromboembolism.
- Author
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Cunha ML, Meijers JC, and Middeldorp S
- Subjects
- Computational Biology, Genetic Association Studies, Genetic Predisposition to Disease, Humans, Polymorphism, Genetic, Venous Thromboembolism genetics, DNA Mutational Analysis methods, High-Throughput Nucleotide Sequencing, Mutation genetics, Venous Thromboembolism diagnosis
- Abstract
Despite knowledge of various inherited risk factors associated with venous thromboembolism (VTE), no definite cause can be found in about 50% of patients. The application of data-driven searches such as GWAS has not been able to identify genetic variants with implications for clinical care, and unexplained heritability remains. In the past years, the development of several so-called next generation sequencing (NGS) platforms is offering the possibility of generating fast, inexpensive and accurate genomic information. However, so far their application to VTE has been very limited. Here we review basic concepts of NGS data analysis and explore the application of NGS technology to VTE. We provide both computational and biological viewpoints to discuss potentials and challenges of NGS-based studies.
- Published
- 2015
- Full Text
- View/download PDF
45. Neonatal Infant Pain Scale: Cross-Cultural Adaptation and Validation in Brazil.
- Author
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Motta Gde C, Schardosim JM, and Cunha ML
- Subjects
- Brazil, Canada, Cross-Cultural Comparison, Female, Humans, Infant, Newborn, Male, Neonatal Nursing methods, Nurses, Pilot Projects, Psychometrics, Reproducibility of Results, Translations, Pain diagnosis, Pain Measurement methods
- Abstract
Context: The Neonatal Infant Pain Scale (NIPS), initially developed in Canada, has been previously used but not adequately adapted and validated for use in Brazil., Objectives: The goal of the present study was to perform a cross-cultural adaptation and clinical validation of the NIPS for use in the Brazilian population., Methods: The instrument was adapted based on the method outlined by Beaton et al., including the production and combination of translated versions, back-translation, committee review, and pilot testing. The psychometric properties of the adapted instrument, including its validity, reliability, and internal consistency, were tested in a clinical validation study. The sample comprised 60 at-term newborns who were evaluated by six nurses as they experienced vaccination. Psychometric properties were evaluated using Student's t-tests, prevalence-adjusted and bias-adjusted kappa scores, the Bland-Altman method, and Cronbach's alpha coefficients., Results: The Brazilian version of the NIPS (Escala de Dor no Recém-Nascido [NIPS-Brazil]) demonstrated excellent interobserver and intraobserver reliability. Total NIPS-Brazil scores yielded prevalence-adjusted and bias-adjusted kappa scores of 0.93, whereas the Bland-Altman method revealed interobserver and intraobserver reliability values of 95% and 90%, respectively. The NIPS-Brazil had adequate internal consistency, as evidenced by a Cronbach's alpha of 0.762., Conclusion: The NIPS was successfully adapted for use in Brazil and is now available for use in the assessment of acute pain in at-term newborns in Brazil., (Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
46. Therapeutic play: preparing the child for the vaccine.
- Author
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Pontes JE, Tabet E, Folkmann MÁ, Cunha ML, and Almeida Fde A
- Subjects
- Child, Child, Preschool, Female, Humans, Male, Non-Randomized Controlled Trials as Topic, Patient Compliance psychology, Vaccination adverse effects, Vaccination nursing, Child Behavior psychology, Play Therapy methods, Vaccination psychology
- Abstract
Objective: To identify and compare behaviors of children during vaccination, who were prepared or not for the procedure using an instructional therapeutic play., Methods: A quasi experimental study, with quantitative approach of 60 children aged 3 to 6 years. The child's reactions were recorded in a checklist. Data were analyzed using descriptive and inferential statistics and Fisher's test., Results: The main reactions in the experimental group were stay still (25;83%) and spontaneously collaborate (24;80%). In the control group, the main reactions were cries and cling to parents (15; 50%), flushing (11;36.67%) and moving the body/agitated (10;33.3%)., Conclusion: The reactions of cooperation were more frequent in the experimental group, while low acceptance was observed only in the control group. Therapeutic play has proved an important tool in preparing for the vaccine.
- Published
- 2015
- Full Text
- View/download PDF
47. A novel mutation in the F5 gene (factor V Amsterdam) associated with bleeding independent of factor V procoagulant function.
- Author
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Cunha ML, Bakhtiari K, Peter J, Marquart JA, Meijers JC, and Middeldorp S
- Subjects
- Alternative Splicing, Blood Coagulation Disorders, Inherited blood, DNA genetics, Exome, Factor V chemistry, Factor V metabolism, Female, Humans, Lipoproteins blood, Lipoproteins genetics, Male, Netherlands, Pedigree, Peptide Fragments blood, Peptide Fragments chemistry, Peptide Fragments genetics, Thrombin biosynthesis, Blood Coagulation Disorders, Inherited genetics, Factor V genetics, Mutation
- Abstract
We investigated a small Dutch family with a bleeding diathesis, prolonged prothrombin, and activated partial thromboplastin times, in whom no classifying diagnosis was made. The 2 affected relatives had severely decreased in vitro thrombin generation, and levels of tissue factor pathway inhibitor (TFPI) were strongly increased. To identify the genetic cause of the bleeding diathesis, we performed whole exome sequencing analysis of all living relatives. We found a novel gain-of-function mutation in the F5 gene (c.C2588G), which leads to an aberrant splicing of F5 and ultimately to a short factor V protein (missing 623 amino acids from the B domain), which we called factor V Amsterdam. Factor V Amsterdam binds to TFPI, prolonging its half-life and concentration. This is the second report of an association between a shorter form of factor V and increased TFPI levels, resulting in severely reduced thrombin generation and a bleeding tendency., (© 2015 by The American Society of Hematology.)
- Published
- 2015
- Full Text
- View/download PDF
48. Low-dose radiation protocol using 3D mode in a BGO PET/CT.
- Author
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Nogueira SA, Dimenstein R, Cunha ML, Wagner J, Funari MB, and Lederman HM
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Clinical Protocols, Humans, Middle Aged, Prospective Studies, Young Adult, Bismuth, Germanium, Imaging, Three-Dimensional, Positron-Emission Tomography, Radiation Dosage, Tomography, X-Ray Computed
- Abstract
Background: The use of positron emission tomography combined with computed tomography (PET/CT) has brought about significant technological advancement in diagnostic imaging, and a number of PET/CT scanners with bismuth germanate detectors can perform imaging in both 2D and 3D acquisition modes. Nevertheless, certain image acquisition parameters and physical features of patients have to be considered when designing low-dose protocols in the 3D mode., Purpose: The aim of this study was to compare images acquired in 2D and 3D modes and establish a low-dose protocol for use in PET/CT imaging, decreasing patient exposure to radiation without compromising results., Methods: A total of 30 patients, aged 4-72 years, participated in this prospective study, which was conducted at Albert Einstein Hospital, São Paulo, Brazil. Images were evaluated for picture quality, presence/absence of lesions and the number of lesions that were detectable in both acquisition modes., Results: The results consistently showed that the loss in image quality in the 3D mode did not affect exam interpretation and lesion detection when compared with 2D at higher dose and for a longer time., Conclusions: We therefore conclude that administration of 3.7 MBq [(18)F]-fluorodeoxyglucose (FDG)/kg for an acquisition time of 3 min per FOV (field of view) is optimal for image acquisition in the 3D mode. This protocol, which reduces the acquisition time and radiation dose, is quite beneficial, especially for children.
- Published
- 2015
- Full Text
- View/download PDF
49. Prevention and non-pharmacological management of pain in newborns.
- Author
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da Motta Gde C and da Cunha ML
- Subjects
- Humans, Infant, Newborn, Intensive Care Units, Neonatal, Pain prevention & control, Pain Management methods
- Abstract
Objective: To describe the main non-pharmacological interventions for pain relief in newborns available in Neonatal Intensive Care Unit., Method: An exploratory search of the MedLine, Lilacs and Scielo online databases was conducted to retrieve references of studies published from 2004 to 2013., Results: Several non-pharmacological interventions were shown to be effective, to represent low risk for neonates and to have a low operational cost. The ones most often discussed in the literature were: oral administration of glucose/sucrose, non-nutritive sucking, breastfeeding, skin-to-skin contact, facilitated tucking and swaddling., Conclusion: Healthcare teams should be familiar with these methods and use them more effectively in Neonatal Intensive Care Unit daily routines, so as to ensure that newborns receive qualified and more human care.
- Published
- 2015
- Full Text
- View/download PDF
50. Cross-cultural adaptation and clinical validation of the Neonatal Skin Condition Score to Brazilian Portuguese.
- Author
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Schardosim JM, Ruschel LM, da Motta Gde C, and da Cunha ML
- Subjects
- Brazil, Cross-Cultural Comparison, Cross-Sectional Studies, Female, Humans, Infant, Newborn, Male, Translations, Cultural Characteristics, Neonatal Screening, Skin Diseases diagnosis
- Abstract
Objective: To describe the process of cross-cultural adaptation and clinical validation of the Neonatal Skin Condition Score., Methods: This methodological cross-cultural adaptation study included five steps: initial translation, synthesis of the initial translation, back translation, review by an Committee of Specialists and testing of the pre-final version, and an observational cross-sectional study with analysis of the psychometric properties using the Adjusted Kappa, Intraclass Correlation Coefficient, and Bland-Altman Method statistical tests. A total of 38 professionals were randomly recruited to review the clarity of the adapted instrument, and 47 newborns hospitalized in the Neonatology Unit of the Clinical Hospital of Porto Alegre were selected by convenience for the clinical validation of the instrument., Results: The adapted scale showed approximately 85% clarity. The statistical tests showed moderate to strong intra and interobserver item to item reliability and from strong to very strong in the total score, with a variation of less than 2 points among the scores assigned by the nurses to the patients., Conclusions: The scale was adapted and validated to Brazilian Portuguese. The psychometric properties of the Brazilian version of the Neonatal Skin Condition Score instrument were similar to the validation results of the original scale.
- Published
- 2014
- Full Text
- View/download PDF
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