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Clinical Criteria for Airway Assessment: Correlations with Laryngoscopy and Endotracheal Intubation Conditions

Open Journal of Anesthesiology 2013年第7期3卷 320-325页

作者： gustavo Henrique S. Wanderley Luciana Cavalcanti Lima Tania Cursino de Menezes Couceiro Waston Vieira Silva Raquel Queiroz G. A. Coelho Andrea Cavalcanti C. Lucena Anne Danielle Santos Soares Agreste Regional Hospital Caruaru Brazil Brazilian Society of Anesthesiology Accredited Teaching and Training Center IMIP Recife Brazil. Instituto de Medicina Integral Professor Fernando Figueira (IMIP) Recife Brazil

Difficult intubation, inadequate ventilation and esophageal intubation are the principal causes of death or brain damage related to airway manipulation. The objective of this cross-sectional study was to correlate a preanesthetic evaluation that may be capable of predicting a difficult intubation with the conditions encountered at laryngoscopy and endotracheal intubation. Eighty-one patients submitted to general anesthesia were evaluated at a preanesthetic consultation according to the modified Mallampati classification, the Wilson score and the American Society of Anesthesiologists (ASA) difficult airway algorithm. Findings were then correlated with the Cormack-Lehane classification and with the number of attempts at endotracheal intubation. No statistically significant correlations were found between the patients’ Mallampati classification and their Cormack-Lehane grade or between the Mallampati classification and the number of attempts required to achieve endotracheal intubation. Laryngoscopy proved difficult in four patients and in all of these cases the Wilson score had been indicative of a possibly difficult airway, highlighting its good predicting sensitivity. However, the specificity of this test was low, since another 24 patients had the same Wilson score but were classified as Cormack-Lehane I/II. Moreover, two patients who had a Wilson score ≥ 4 were also classified as Cormack-Lehane grade I/II. The study concluded that the Wilson score, although seldom used in clinical practice, is a highly sensitive predictor of a difficult airway;its specificity, however, is low.

关键词： Preanesthetic Evaluation Respiratory System Airway Endotracheal Intubation Measurement Tech-niques Mallampati Wilson Cormack-Lehane

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Neoadjuvant Radiotherapy in Stage I Cancer of the Lower Rectum

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Journal of Cancer Therapy 2014年第6期5卷 560-564页

作者： Antonio Jose Tiburcio Alves Junior gustavo Alejandro Gutierrez Espinoza Luciane Hiane Oliveira Sergio Oliva Banci Joaquim Simoes Neto Odorino Hideyoshi Kagohara Jose Alfredo Reis Junior Jose Alfredo Reis Neto Coloproctology Department Clínica Reis Neto Campinas Brazil Coloproctology Department Clinica Reis Neto Catholic University Campinas Campinas Brazil Surgery Department Catholic University of Campinas Campinas Brazil Surgery Department Clinica Reis Neto Catholic University Campinas Campinas Brazil

Introduction: The mortality rate in cancer of the lower rectum is related to the incidence of local recurrence, in the first 5 years. For stage I tumors, local excision has being increasingly used, but recent studies showed a higher incidence rate of local recurrence. Therefore, preoperative radiotherapy should be considered even for these tumors, as an attempt to prevent recurrence and provide cure. Objective: To show the effectiveness of neoadjuvant radiotherapy in stage I cancer of the lower rectum of a cohort population. Materials and Method: A cohort study in a prospective database was made with a total of 75 patients considered as stage I cancer of the lower rectum. Preoperative long course of 4500 cG radiotherapy was performed in this selected group of patients and followed up for a minimum period of five years. Results: Stage I/TI group had 27 patients. All of them presented complete response to the treatment and did not need to be submitted to surgery. Five years follow up with no recurrence. The stage I/TII group had 48 patients. After neoadjuvant radiotherapy, 8 patients had to be submitted to surgery for persistent tumor. All were submitted to full total local excision (FTLE), but anatomopathological examination showed no residual cancer. Conclusion: Preoperative long course of 4500 cG irradiation, not only reduced the local recurrence and mortality rate in lower rectal cancer, but also reduced indication for surgery in patients with stage I cancer of the lower rectum.

关键词： Rectal Cancer Cancer of the Lower Rectum Irradiation Preoperative Radiotherapy Local Recurrence Mortality Survival

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Assessment of Climate Change over South America under RCP 4.5 and 8.5 Downscaling Scenarios

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American Journal of Climate Change 2014年第5期3卷 512-527页

作者： Sin Chan Chou Andre Lyra Caroline Mourao Claudine Dereczynski Isabel Pilotto Jorge Gomes Josiane Bustamante Priscila Tavares Adan Silva Daniela Rodrigues Diego Campos Diego Chagas gustavo Sueiro Gracielle Siqueira Jose Marengo National Institute for Space Research Cachoeira PaulistaBrazil Department of Meteorology Federal University of Rio de JaneiroRio de JaneiroBrazil National Center for Natural Disaster Monitoring and Warning Sao Jose dos CamposBrazil

Four sets of downscaling simulations based on the Eta Regional Climate Model forced by two global climate models, the HadGEM2-ES and the MIROC5, and two RCP scenarios—8.5 and 4.5, have been carried out. The objective of this work is to assess the climate change over South America based on the Eta simulations. The future changes are shown in timeslices of 30 years: 2011-2040;2041-2070 and 2071-2100. The climate change response of the Eta simulations nested in HadGEM2-ES is larger than the Eta nested in MIROC5. Major warming area is located in the central part of Brazil. In austral summer, the reduction of precipitation in the central part and the increase in the southeastern part of the continent are common changes in these simulations, while the EtaHadGEM2-ES intensifies the decrease of precipitation in central Brazil, the Eta-MIROC5 expands the area of increase of precipitation in southern Brazil toward the end of the century. In austral winter, precipitation decrease is found in the northern part of South America and in most of Central America, whereas the reduction in southeastern South America is limited to near coastal region. The time series of temperatures show that warming trends are larger in the Eta-HadGEM2-ES than in the Eta-MIROC5 simulations. Heavier precipitation rates are projected in the Central-South of Brazil toward the end of the century. Increase in the length of consecutive dry days (CDD) in Northeast of Brazil and the decrease of consecutive wet days (CWD) in the Amazon region are common features in these simulations.

关键词： South America Climate Downscaling Climate Change Assessment Climatic Extreme Indicators Eta Model

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Subclinical Hypothyroidism, Its Manifestations and Management a Case Report

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Open Journal of Internal Medicine（内科学期刊） 2023年第3期

作者： Pablo Sisiruca gustavo Adolfo Socorro Calderas

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Adaptability and Stability of Yield and Industrial Grain Quality with and without Fungicide in Brazilian Oat Cultivars

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American Journal of Plant Sciences 2015年第9期6卷 1560-1569页

作者： José Antonio Gonzalez da Silva Maisa Didoné Wohlenberg Emilio Ghisleni Arenhardt Antonio Costa de Oliveira gustavo Mazurkievicz Mariele Müller Lorenzo Ghisleni Arenhardt Manuel Osorio Binelo Guilherme Arnold Rafael Pretto Department of Agrarian Studies Regional University of the Northwest of Rio Grande do Sul Ijuí Brazil Department of Crop Plants Federal University of Rio Grande do Sul Porto Alegre Brazil Faculty of Agronomy EliseuMaciel Federal University of Pelotas Pelotas Brazil Faculty of Agronomy University of Passo Fundo Passo Fundo Brazil Department of Exact Sciences and Engineering Regional University of the Northwest of Rio Grande do Sul Ijuí Brazil

The use of productive cultivars with adaptability and stability and less demanding to fungicide use are critical to the sustainability of production factors. The objective of this work was to determine the per se performance of white oat cultivars and parameters of adaptability and stability on yield and grain quality in the proposition of cultivars more responsive in reducing the use fungicide. The study was conducted in Augusto Pestana, RS, Brazil, between the years 2010 and 2013. The experimental design was randomized blocks with six replicates, three with and three without fungicide. The study evaluated 14 white oat cultivars for yield and industrial capability. The white oat cultivars FAEM 4 Carlasul and URS Corona indicate high grain yield with stability and general adaptability, independent of chemical control. The cultivar URS Corona shows together high yield and thousand grain weight and hectoliter with general adaptability and stability in the absence of fungicide. Although no stability has been detected in industrial yield without the use of fungicides, cultivars of URS Charrua, URS Corona and URS Taura show high means with general adaptability.

关键词： Avena sativa L. Grain Quality Fungicide Climatic Variations

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Applications of artificial intelligence in, early detection of cancer, clinical diagnosis and personalized medicine

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Artificial Intelligence in Cancer 2020年第2期1卷 39-44页

作者： Mujib Ullah Asma Akbar gustavo Yannarelli Institute for Immunity TransplantationStem Cell Biology and Regenerative MedicineSchool of MedicineStanford UniversityPalo AltoCA 94304United States Molecular Medicine Department of RadiologySchool of MedicineStanford UniversityPalo AltoCA 94304United States Laboratorio de Regulación Génica y Células Madre Instituto de Medicina TraslacionalTrasplante y BioingenieríaUniversidad Favaloro-CONICETBuenos Aires 1078Argentina

Artificial intelligence(AI)refers to the simulation of human intelligence in machines programmed to convert raw input data into decision-making actions,like *** programs are designed to make decisions,often using deep learning and computer-guided programs that analyze and process raw data into clinical decision making for effective *** techniques for predicting cancer at an early stage are needed as conventional methods have poor accuracy and are not applicable to personalized *** has the potential to use smart,intelligent computer systems for image interpretation and early diagnosis of *** has been changing almost all the areas of the medical field by integrating with new emerging *** has revolutionized the entire health care system through innovative digital diagnostics with greater precision and *** is capable of detecting cancer at an early stage with accurate diagnosis and improved survival *** is an innovative technology of the future that can be used for early prediction,diagnosis and treatment of cancer.

关键词： Artificial intelligence Cancer Clinical tumor prediction Early detection of cancer Clinical diagnosis Personalized medicine

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Stpp2A-c,the gene encoding the catalytic subunit of PP2A,negatively regulates conidiation and melanin biosynthesis in Setospheria turcica

Stpp2A-c,the gene encoding the catalytic subunit of PP2A,neg...

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中国植物病理学会2015年学术年会

作者： HAO Zhi-min WU Di SHEN Shen gustavo Caetano-Anolles LIU Ning WANG Jing-jing CAO Zhi-yan LI Zhi-yong DONG Jin-gao Agricultural University of Hebei College of Life Sciences University of Illinois at Urbana-Champaign Department of Crop Sciences

The type 2A protein phosphatase（PP2A） is a major subgroup of Ser/Thr phosphatases important for the activity of diverse signal transduction *** enzymes always function antagonistically against protein kinases to modulate the phosphorylation level of downstream *** play crucial roles in multiple cellular processes,including the cell cycle,morphogenesis,differentiation and DNA *** their importance,how this enzyme functions in filamentous fungi is still poorly *** a previous experiment,we used the specific inhibitor cantharidin to explore the functions of PP2 A in Setosphaeria turcica,the fungal pathogen causing Northern corn leaf *** improved conidiation and increased the content of intracellular melanin of *** we isolate the gene encoding the catalytic subunit of PP2A（Stpp2A-c） to construct Stpp2A-c knock-out mutants and *** with the wild-type strain（WT）,ΔStpp2A-c mutants displayed slower radial growth,darker colonial color and fewer aerial ***,both the canidial amount and the content of intracellular melanin of mutants were higher than that of *** results are consistent with the effects induced by ***,the pathogenicity of mutants was also stronger than that of *** results show that Stpp2A-c negatively regulates conidial development and intracellular melanin biosynthesis in ***,impacting fungal pathogenicity.

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Interaction Between Heficoverpa zea Damage with Corncob Diseases on Genetically Modified Corn in Sinaloa, México

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Journal of Life Sciences 2014年第4期8卷 329-334页

作者： Luis A. Aguirre Uribe gustavo A. Frías Trevino Agustín Hernández Juárez Mariano Flores Davila Emesto Cerna Chavez Jerónimo Landeros Flores Yisa M. Ochoa Fuentes Plant Health Department Universidad A utónoma Agraria Antonio Narro Buenavista Saltillo 25315 Coahuila México

GM （genetically modified） corn with the CrylAb, mCry3A and Vip3Aa20 protein of Bt （Bacillus thuringiensis） and its respective isoline as control with and without chemical control for corn earworm were used in this research. Fusarium corncob damage was lower on GM corn with （12.5%） and without （25.7%） insecticide treatment as compared with the isoline that had 48.3% and 83.1% of damaged corncobs with and without chemical control, respectively. Corn smut cob damage was also lower on GM corn with （3.2%） and without （6.3%） insect control compared with 15.5% and 49.7% damage with and without insecticide treatment, respectively. Fusarium sp. corncob rot was also lower on GM corn with 5.7% and 9.5% whereas a 24.6% and 63% rot was observed on the isoline with and without insecticide control, respectively. Ustilago maydis severity was also lower on Bt corn finding 0.07% and 0.25% damage on treatments with and without insect control as compared with the isoline that showed an 11.6% and a 41.4% smut rot with and without insecticide treatment, respectively. The authors conclude that GM corn resistant to Helicoverpa zea prevents damage by the pest, eliminating the entrance pathway for Fusarium sp. and Ustilago maydis.

关键词： Bacillus thuringiensis transgenic Fusarium Ustilago maydis mycotoxins corn smut.

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Immunohistochemical Profile of Human Epidermal Growth Factor Receptor 2 in Gastric Cancer in Rwanda

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Open Journal of Gastroenterology 2022年第11期12卷 336-346页

作者： Elisée Hategekimana Déogratias Ruhangaza Christian Hansen Emile Musoni Belson Rugwizangoga Kelsey Hammel Rosen Daniel gustavo Djibril Mbarushimana Theoneste Nizeyimana Theogene Twagirumugabe Jules Ndoli Felicité Mukamana Christian Ngarambe Emmanuel Habimana Callie Weber Department of Pathology University Teaching Hospital of Butare Huye Rwanda Department of Pathology Butaro District Hospital Burera Rwanda Department of Pathology Community Hospital of the Monteley Peninsula California USA University Teaching Hospital of Kigali Department of Pathology University of Rwanda Kigali Rwanda Department of Pathology Baylor College of Medicine Texas USA University Teaching Hospital of Butare Department of Anesthesia University of Rwanda Huye Rwanda Department of Ophthalmology University Teaching Hospital of Butare Huye Rwanda Department of Surgery University Teaching Hospital of Butare Huye Rwanda Department of Obstetrics and Gynecology University Teaching Hospital of Butare Huye Rwanda Administration Department Bioventures for Global Health Seattle USA

Background: Of the cancers diagnosed in Rwanda, stomach cancer is one of the most encountered. In fact, Rwanda belongs to the region where it is most incident in Africa. Most of the patients present with advanced disease. Studies showed that some gastric cancers overexpress Human Epidermal Growth Factor Receptor 2 (HER2/neu) protein and can be treated with Herceptin/Tras-tuzumab. This targeted therapy improves survival in patients with advanced disease. We conducted a study on Immunohistochemical profile of HER2/neu in gastric adenocarcinomas at two main Rwandan tertiary centers. Methodology: We tested for HER2/NEU in gastric adenocarcinomas diagnosed at University Teaching Hospital of Kigali (CHUK) and University Teaching Hospital of Butare (CHUB). Demographic and pathologic parameters were collected. Immunohistochemistry (IHC) for HER2/neu using c-erb/HER-2/neu (clone SP3) Rabbit Monoclonal antibody was done. Using the guidelines established by Hoffman et al., the agreed score between 2 Rwandan pathologists and 1 USA pathologist was considered each time. Data were entered and statistically analyzed using SPSS 22. Descriptive statistical analysis method was used. P-value calculated with Chi-square analysis for positive vs negative and equivocal negative to correlate HER2/neu overexpression with other variables across both hospitals. Results: A total of 286 cases were tested. HER2/neu overexpression (score 3+ or positive) was found in 29 cases (10.1%). 8 cases (2.8%) were equivocal negative (score 2+) while 249 cases (87.1%) were negative (score 0 and 1+). Conclusion: HER2/neu is overexpressed in a subset of gastric cancers in Rwanda, a phenomenon that has been reported in other areas of the world. Testing for HER2/neu could identify patients who would get a targeted treatment with Herceptin.

关键词： Gastric Cancer Rwanda HER2 Immunohistochemistry

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Use of High Definition Multileaf Colimator for the Treatment of Trigeminal Neuralgia

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2022年第3期11卷 150-159页

作者： Eduardo Cabello Murillo Ana Milanés Gaillet gustavo Pozo Rodriguez Ángel Gaitán Simón Pedro Adaimi Hernández Marta Manzano Rodríguez Alejandro Ferrando Sánchez Raúl Díaz Fuentes Medical Physicist Department Hospital 12 de Octubre Madrid Spain

In the present work, a treatment technique for trigeminal neuralgia (TN) using LINAC radiosurgery is shown. The technique is based on the optimization of ten static arcs in such a way as to minimize the overlapping of the treatment fields with the brainstem. We will call this technique brainstem-optimized (BO). The results are compared with another technique described in the literature known as a virtual cone (VC). The comparison of dosimetry results that have been carried out essentially shows that the doses in the brainstem V12Gy-brainstem, D0.5cm3-brainstem and D0.035 cm3-brainstem are lower in the BO versus VC technique, and with the parameters V50% (whole brain) and V12Gy-cerebrum higher in BO versus VC. Our goal is to keep the dose to the brainstem as low as possible and, if possible, at most between 12 Gy and 15 Gy. The BO technique meets our purposes and is considered clinically acceptable at our institution.

关键词： Trigeminal Neuralgia Radiosurgery Brainstem Brainstem-Optimized Technique (BO) Virtual Cone (VC)

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