Intestinal complications in patients with Crohn's disease in the Brazilian public healthcare system between 2011 and 2020

BACKGROUND This is a secondary database study using the Brazilian public healthcare system database.AIM To describe intestinal complications(ICs)of patients in the Brazilian public healthcare system with Crohn’s disease(CD)who initiated and either only received conventional therapy(CVT)or also initiated anti-tumor necrosis factor(anti-TNF)therapy between 2011 and 2020.METHODS This study included patients with CD[international classification of diseases–10th revision(ICD-10):K50.0,K50.1,or K50.8](age:≥18 years)with at least one claim of CVT(sulfasalazine,azathioprine,mesalazine,or methotrexate).IC was defined as a CD-related hospitalization,pre-defined procedure codes(from rectum or intestinal surgery groups),and/or associated disease(pre-defined ICD-10 codes),and overall(one or more type of ICs).RESULTS In the 16809 patients with CD that met the inclusion criteria,the mean follow-up duration was 4.44(2.37)years.In total,14697 claims of ICs were found from 4633 patients.Over the 1-and 5-year of follow-up,8.3%and 8.2%of the patients with CD,respectively,presented at least one IC,of which fistula(31%)and fistulotomy(48%)were the most commonly reported.The overall incidence rate(95%CI)of ICs was 6.8(6.5–7.04)per 100 patient years for patients using only-CVT,and 9.2(8.8–9.6)for patients with evidence of anti-TNF therapy.CONCLUSION The outcomes highlighted an important and constant rate of ICs over time in all the CD populations assessed,especially in patients exposed to anti-TNF therapy.This outcome revealed insights into the real-world treatment and complications relevant to patients with CD and highlights that this disease remains a concern that may require additional treatment strategies in the Brazilian public healthcare system.

Microstructure features and mechanical/electrochemical behavior of directionally solidified Al−6wt.%Cu−5wt.%Ni alloy

The effects of the addition of 5.0 wt.%Ni to an Al−6wt.%Cu alloy on the solidification cooling rate(T),growth rate(V_(L)),length scale of the representative phase of the microstructure,morphology/distribution of intermetallic compounds(IMCs)and on the resulting properties were investigated.Corrosion and tensile properties were determined on samples solidified under a wide range of T along the length of a directionally solidified Al−6wt.%Cu−5.0wt.%Ni alloy casting.Experimental growth laws were derived relating the evolution of primary(λ_(1))and secondary(λ_(2))dendritic spacings with T and V_(L).The elongation to fracture(δ)and the ultimate tensile strength(σ_(U))were correlated with the inverse of the square root of λ_(1) along the length of the casting by Hall−Petch type experimental equations.The reinforcing effect provided by the addition of Ni in the alloy composition is shown to surpass that provided by the refinement of the dendritic microstructure.The highest corrosion resistance is associated with a microstructure formed by thin IMCs evenly distributed in the interdendritic regions,typical of samples that are solidified under higher T.

Analysis of in vivo absorption of didanosine tablets in male adult dogs by HPLC

Didanosine is an effective antiviral drug in untreated and antiretroviral therapy-experienced patients with Human Immunodeficiency Virus (HIV). An automated system using on-line solid extraction and High Performance Liquid Chromatography (HPLC) with ultraviolet (UV) detection was developed and validated for pharmacokinetic analysis of didanosine in dog plasma. Modifications were introduced on a previous methodology for simultaneous analysis of antiretroviral drugs in human plasma. Extraction was carried out on C18 cartridges, with high extraction yield as stationary phase, whereas mobile phase consisted of a mixture of 0.02 M potassium phosphate buffer, acetonitrile (KH2PO4: acetonitrile: 96:4, v/v) and 0.5% (w/v) of heptane sulphonic acid. The pH was adjusted to 6.5 with triethylamine. All samples and standard solutions were chromatographed at 28 1C. For an isocratic run, the fiux was 1.0 mL/min, detection was at 250 nm and injected volume was 20 mL. The method was selective and linear for concentrations between 50 and 5000 ng/mL. Drug stability data ranged from 96% to 98%, and limit of quantification was 25 ng/mL. Extraction yield was up to 95%. Drug stability in dog plasma was kept frozen at 20 1C for one month after three freeze–thaw cycles, and for 24 h after processing in the auto sampler. Assay was successfully applied to measure didanosine concentrations in plasma dogs.

Tailoring microstructure and microhardness of Zn-1wt.%Mg-(0.5wt.%Mn, 0.5wt.%Ca) alloys by solidification cooling rate

Biodegradable Zn-based alloys, particularly Zn-Mg alloys with the addition of alloying elements, have been intensively investigated aiming to improve both mechanical properties and corrosion behavior. Since such properties are strongly dependent on the alloy microstructure, any evaluation should commence on understanding the conditions influencing its formation. In this study, the effect of the solidification cooling rate on the microstructural evolution of Zn-1 wt.%Mg-(0.5 wt.%Ca, 0.5 wt.%Mn) alloys during transient solidification was investigated. The results show that the microstructures of both alloys have three phases in common: η-Zn dendritic matrix, intermetallic compounds(IMCs) Zn11Mg2, and Zn2 Mg in the eutectic mixture. MnZn9 and two Ca-bearing phases(CaZn11 and CaZn13) are associated with Mn and Ca additions, respectively. These additions are shown to refine the dendritic matrix and the eutectic mixture as compared to the Zn-1 wt.%Mg alloy. A correlation between cooling rate, dendritic or eutectic spacings was developed, thus permitting experimental growth laws to be proposed. Additionally, hardness tests were performed to evaluate the effects of additions of Ca and Mn. Experimental correlations between Vickers microhardness and secondary dendritic spacings were proposed, showing that the microstructural refinement and characteristic Ca and Mn based IMCs induce an increase in hardness as compared to the binary alloy.

Periodontal research contributions to basic sciences:From cell communication and host-parasite interactions to inflammation and bone biology

The periodontium comprises all structures surrounding the teeth,including gingiva,root cementum,periodontal ligament and alveolar bone.Those tissues aim to protect and support the teeth and are challenged by a residing microbiota that leads to subclinical inflammation even in physiological conditions.Periodontitis,a prevalent multicausal inflammatory and destructive disease,develops as a result from complex host-parasite interactions.This unique physiologic and pathologic scenario enables the development of research methods which allows conclusions beyond the simple understanding of periodontal homeostasis.The aim of this viewpoint was to explore potential contributions of periodontal research to a wide array of basic science specialties,such as cell and molecular biology,microbiology,immunology,endocrinology,rheumatology,among others.

Correlation of Disgust and Contempt Expressions with Conjugal Dissatisfaction

Research has shown that dissatisfied couples in the relationship commonly exhibit facial expressions of contempt in interactions. At this point, based on the study of cognition and physiology, researchers were able to predict by longitudinal studies the probability of divorce in a marriage, with accuracy of up to 94%. Our objective was to investigate whether the occurrence of facial expressions of disgust and contempt in married women is associated with marital dissatisfaction. This is an experimental study that correlated, through filmed interviews, the frequency of facial expressions of disgust and disgust (Facial Action Coding System) to the Marital State’s Golombok Rust Inventory, in a sample composed of 20 women. Data analysis based on the Spearman Correlation Test showed a positive correlation between facial expressions of disgust and disdain and conjugal dissatisfaction (rs = 0.2198, p = 0.0280), corroborating the data in the literature.

Like father, like son: Pulmonary thromboembolism due to inflammatory or hereditary condition? Two case reports

BACKGROUND Venous thromboembolism,which includes deep venous thrombosis and pulmonary embolism,is a well-known causal disorder with high morbidity and mortality rates.Inherited or acquired conditions affecting components of coagulation and fibrinolysis systems have been linked to venous thromboembolism pathogenesis as they may lead to a pro-inflammatory state in human bodies.Toxoplasmosis is a zoonosis that potentially leads to acute systemic cachectic-inflammatory effects in experimental animal models but is not yet proven in humans.It is known that venous thrombosis can occur during acute inflammatory/infectious diseases,although it is not well established with regard to toxoplasmosis alone.CASE SUMMARY A 70-year-old Caucasian man and his 32-year-old son developed general malaise,chills,fever,and myalgia,having established a diagnosis of toxoplasmosis.Twenty days later,they presented dry cough leading to further investigations that revealed an incidental deep venous thrombosis plus pulmonary embolism in them both.Thrombophilia screening showed both patients had a factor V Leiden mutation heterozygosis.Father and son completely recovered without any sequalae after anticoagulant treatment.They have not presented symptom recurrence of either medical disorder during 1 year of follow-up.CONCLUSION Toxoplasmosis may enhance the risk of venous thromboembolism in patients showing factor V Leiden mutation heterozygosis.

Hepatobiliary phases in magnetic resonance imaging using liverspecific contrast for focal lesions in clinical practice

BACKGROUND Challenging lesions,difficult to diagnose through non-invasive methods,constitute an important emotional burden for each patient regarding a still uncertain diagnosis(malignant x benign).In addition,from a therapeutic and prognostic point of view,delay in a definitive diagnosis can lead to worse outcomes.One of the main innovative trends currently is the use of molecular and functional methods to diagnosis.Numerous liver-specific contrast agents havebeen developed and studied in recent years to improve the performance of liver magnetic resonance imaging(MRI).More recently,one of the contrast agents introduced in clinical practice is gadoxetic acid(gadoxetate disodium).AIM To demonstrate the value of the hepatobiliary phases using gadoxetic acid in MRI for the characterization of focal liver lesions(FLL)in clinical practice.METHODS Overall,302 Lesions were studied in 136 patients who underwent MRI exams using gadoxetic acid for the assessment of FLL.Two radiologists independently reviewed the MRI exams using four stages,and categorized them on a 6-point scale,from 0(lesion not detected)to 5(definitely malignant).The stages were:stage 1-images without contrast,stage 2-addition of dynamic phases after contrast(analogous to usual extracellular contrasts),stage 3-addition of hepatobiliary phase after 10 min(HBP 10’),stage 4-hepatobiliary phase after 20 min(HBP 20’)in addition to stage 2.RESULTS The interobserver agreement was high(weighted Kappa coefficient:0.81-1)at all stages in the characterization of benign and malignant FLL.The diagnostic weighted accuracy(Az)was 0.80 in stage 1 and was increased to 0.90 in stage 2.Addition of the hepatobiliary phase increased Az to 0.98 in stage 3,which was also 0.98 in stage 4.CONCLUSION The hepatobiliary sequences improve diagnostic accuracy.With growing potential in the era of precision medicine,the improvement and dissemination of the method among medical specialties can bring benefits in the management of patients with FLL that are difficult to diagnose.

Predicting of the Fibrous Filters Efficiency for the Removal Particles from Gas Stream by Artificial Neural Network

In this paper, artificial neural networks are used for predicting single fiber efficiency in the process of removing smaller particles from gas stream by fiber filters. For this, numerical simulations are obtained of a classic model of literature for fiber efficiency, which is numerically solved along with the convection diffusion equation in polar coordinates for particle concentration, with associated initial and boundary conditions. A sufficient number of examples from two numerical simulations are employed to construct a database, from which parameters of a novel neural model are adjusted. This model is constructed based on the back propagation algorithm in order to map two features, namely Peclet number and packing density, which are extracted from the numerical simulations into the corresponding single fiber efficiency. The results indicate that the developed neural model can be trained in a reasonable computational time and is capable of estimating single fiber efficiency from examples of the test set with a maximum error of 1.7%.