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Accuracy of gestalt perception of acute chest pain in predicting coronary artery disease

World Journal of Cardiology 2017年第3期9卷 241-247页

作者： Cláudio Marcelo Bittencourt das Virgens Laudenor Lemos Jr Márcia Noya-Rabelo Manuela Campelo Carvalhal Antonio Maurício dos santos Cerqueira Junior Fernanda Oliveira de Andrade Lopes Nicole Cruz de Sá Jéssica Gonzalez Suerdieck Thiago Menezes Barbosa de Souza Vitor Calixto de Almeida Correia gabriella sant’ana sodré AndréBarcelos da Silva Felipe Kalil Beirao Alexandre Felipe Rodrigues Marques Ferreira Luís Cláudio Lemos Correia Department of Cardiology Hospital Sao Rafael Department of Cardiology Hospital Português Bahiana School of Medicine and Public Health

AIM To test accuracy and reproducibility of gestalt to predict obstructive coronary artery disease(CAD)in patients with acute chest *** We studied individuals who were consecutively admitted to our Chest Pain *** admission,investigators performed a standardized interview and recorded14 chest pain *** on these features,a cardiologist who was blind to other clinical characteristics made unstructured judgment of CAD probability,both numerically and *** the reference standard for testing the accuracy of gestalt,angiography was required to rule-in CAD,while either angiography or non-invasive test could be used to *** order to assess reproducibility,a second cardiologist did the same *** In a sample of 330 patients,the prevalence of obstructive CAD was 48%.Gestalt’s numerical probability was associated with CAD,but the area under the curve of0.61(95%CI:0.55-0.67)indicated low level of ***,categorical definition of typical chest pain had a sensitivity of 48%(95%CI:40%-55%)and specificity of 66%(95%CI:59%-73%),yielding a negligible positive likelihood ratio of 1.4(95%CI:0.65-2.0)and negative likelihood ratio of 0.79(95%CI:0.62-1.02).Agreement between the two cardiologists was poor in the numerical classification(95%limits of agreement=-71%to 51%)and categorical definition of typical pain(Kappa=0.29;95%CI:0.21-0.37).CONCLUSION Clinical judgment based on a combination of chest pain features is neither accurate nor reproducible in predicting obstructive CAD in the acute setting.

关键词： Acute chest pain Clinical judgment Gestalt Coronary artery disease Acute coronary syndrome

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Immune response modulation in inflammatory bowel diseases by Helicobacter pylori infection

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World Journal of Gastroenterology 2023年第30期29卷 4604-4615页

作者： gabriella Feilstrecker Balani Mariana dos santos Cortez Jayme Euclydes Picasky da Silveira Freitas Fabrício Freire de Melo ana Carla Zarpelon-Schutz Kádima Nayara Teixeira Campus Toledo Universidade Federal do ParanáToledo 85.919-899ParanáBrazil Campus Anísio Teixeira Universidade Federal da BahiaInstituto Multidisciplinar em SaúdeVitória da Conquista 45.029-094BahiaBrazil Programa de Pós-graduação em Biotecnologia-Setor Palotina Universidade Federal do ParanáPalotina 85.950-000ParanáBrazil Programa Multicêntrico de Pós-graduação em Bioquímica e Biologia Molecular-Setor Palotina Universidade Federal do ParanáPalotina 85.950-000ParanáBrazil

Many studies point to an association between Helicobacter pylori(***)infection and inflammatory bowel diseases(IBD).Although controversial,this association indicates that the presence of the bacterium somehow affects the course of *** appears that *** infection influences IBD through changes in the diversity of the gut microbiota,and hence in local chemical characteristics,and alteration in the pattern of gut immune *** gut immune response appears to be modulated by *** infection towards a less aggressive inflammatory response and the establishment of a targeted response to tissue ***,a T helper 2(Th2)/macrophage M2 response is stimulated,while the Th1/macrophage M1 response is *** immunomodulation appears to be associated with intrinsic factors of the bacteria,such as virulence factors-such oncogenic protein cytotoxin-associated antigen A,proteins such *** neutrophil-activating protein,but also with microenvironmental changes that favor permanence of *** in the *** changes include the increase of gastric mucosal pH by urease activity,and suppression of the stomach immune response promoted by evasion mechanisms of the ***,there is a causal relationship between *** infection and components of the innate immunity such as the NLR family pyrin domain containing 3 inflammasome that directs IBD toward a better prognosis.

关键词： Cytotoxin-associated antigen A oncoprotein Gut microbiota Helicobacter pylori Helicobacter pylori neutrophilactivating protein Immunological modulation Inflammatory bowel disease NLR family pyrin domain containing 3 inflammasome

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Mechanism of origin in two cases of chimerism

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Open Journal of Pediatrics 2011年第4期1卷 79-86页

作者： Antonella Minelli Andrea Guala Alberto Groppo gabriella Restagno Roberto Lala Silvia Einaudi Mariaelena Repici Emilio Merlini Luca Sbaiz Valentina Asnaghi ana Graciela Lopez Paola Angellotti Silvia Cristina Cesare Danesino 不详

Chimerism is defined as the presence in a subject of more than one stable and genetically distinct cell line;cases reported so far include both patients with ambiguous genitalia and healthy subjects. The biological mechanisms, which may give origin to chimeras, are complex, and can be understood by analyzing DNA samples of the patients and their parents using molecular techniques. The objective of this study is to identify the mechanism of origin for the 2 cases we report. The first patient is a phenotipically normal girl with normal (external and internal) genitalia;the second patient had ambiguous genitalia and underwent surgery. DNA was purified from blood samples and, limited to Patient 1, from a sample of biliary cyst. Short tandem repeat polymorphisms were analyzed in order to identify the relative parental contribution to the patients. Molecular analyses carried out on the first patient are not fully informative because of two possible explanations (i.e. parthenogenetic and andrognetic chimera), while in the second case the presence of four alleles at some markers allowed us to identify a tetragametic chimera originnated from the fusion of two distinct embryos. Studies carried on one single tissue may not always be conclusive as they do not allow the precise identification of the mechanism of origin. In these cases, studies on more tissues are strongly suggested.

关键词： Chimerism Androgenetic Chimera Parthenogenetic Chimera Tetragametic Chimera Microsatellite Polymorphism analysis

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