Remote Emotion Recognition Using Continuous-Wave Bio-Radar System

The Bio-Radar is herein presented as a non-contact radar system able to capture vital signs remotely without requiring any physical contact with the subject. In this work, the ability to use the proposed system for emotion recognition is verified by comparing its performance on identifying fear, happiness and a neutral condition, with certified measuring equipment. For this purpose, machine learning algorithms were applied to the respiratory and cardiac signals captured simultaneously by the radar and the referenced contact-based system. Following a multiclass identification strategy, one could conclude that both systems present a comparable performance, where the radar might even outperform under specific conditions. Emotion recognition is possible using a radar system, with an accuracy equal to 99.7% and an F1-score of 99.9%. Thus, we demonstrated that it is perfectly possible to use the Bio-Radar system for this purpose, which is able to be operated remotely, avoiding the subject awareness of being monitored and thus providing more authentic reactions.

Disclosing the native blueberry rhizosphere community in Portugal-an integrated metagenomic and isolation approach

Backgorund

The production of red fruits, such as blueberry, has been threatened by several stressors from severe periods of drought, nutrient scarcity, phytopathogens, and costs with fertilization programs with adverse consequences. Thus, there is an urgent need to increase this crop's resilience whilst promoting sustainable agriculture. Plant growth-promoting microorganisms (PGPMs) constitute not only a solution to tackle water and nutrient deficits in soils, but also as a control against phytopathogens and as green compounds for agricultural practices.

Methods

In this study, a metagenomic approach of the local fungal and bacterial community of the rhizosphere of Vaccinium corymbosum plants was performed. At the same time, both epiphytic and endophytic microorganisms were isolated in order to disclose putative beneficial native organisms.

Results

Results showed a high relative abundance of Archaeorhizomyces and Serendipita genera in the ITS sequencing, and Bradyrhizobium genus in the 16S sequencing. Diversity analysis disclosed that the fungal community presented a higher inter-sample variability than the bacterial community, and beta-diversity analysis further corroborated this result. Trichoderma spp., Bacillus spp., and Mucor moelleri were isolated from the V. corymbosum plants.

Discussion

This work revealed a native microbial community capable of establishing mycorrhizal relationships, and with beneficial physiological traits for blueberry production. It was also possible to isolate several naturally-occurring microorganisms that are known to have plant growth-promoting activity and confer tolerance to hydric stress, a serious climate change threat. Future studies should be performed with these isolates to disclose their efficiency in conferring the needed resilience for this and several crops.

The angry versus happy recognition advantage: the role of emotional and physical properties

Facial emotional expressions are pivotal for social communication. Their fast and accurate recognition is crucial to promote adaptive responses to social demands, for the development of functional relationships, and for well-being. However, the literature has been inconsistent in showing differentiated recognition patterns for positive vs. negative facial expressions (e.g., happy and angry expressions, respectively), likely due to affective and perceptual factors. Accordingly, the present study explored differences in recognition performance between angry and happy faces, while specifically assessing the role of emotional intensity and global/regional low-level visual features. 98 participants categorized angry and happy faces morphed between neutral and emotional across 9 levels of expression intensity (10-90%). We observed a significantly higher recognition efficiency (higher accuracy and shorter response latencies) for angry compared to happy faces in lower levels of expression intensity, suggesting that our cognitive resources are biased to prioritize the recognition of potentially harmful stimuli, especially when briefly presented at an ambiguous stage of expression. Conversely, an advantage for happy faces was observed from the midpoint of expression intensity, regarding response speed. However, when compensating for the contribution of regional low-level properties of distinct facial key regions, the effect of emotion was maintained only for response accuracy. Altogether, these results shed new light on the processing of facial emotional stimuli, emphasizing the need to consider emotional intensity and regional low-level image properties in emotion recognition analysis.

Autism traits dimensionality and multivariate relationship with alexithymia and anxiety in the general population

BACKGROUND

Autism is characterized by social and non-social alterations observed beyond the clinical diagnosis. Research analyzing the expression of autism traits in the general population helps to unravel the relationship between autism dimensions and other associated variables, such as alexithymia and anxiety. The Autism-Spectrum Quotient (AQ) was developed to assess autism traits in the general population; however, inconsistent results regarding its dimensionality have emerged.

AIMS

This study aimed to extend evidence about the AQ measurement model, and explore the multivariate relationship between autism traits, alexithymia, and trait anxiety.

METHODS

292 adults of the general population were recruited. An Exploratory Factor Analysis and Confirmatory Factor Analysis were performed to assess the factorial structure of AQ. A path analysis was carried out to explore the relationship between autism traits, alexithymia, and trait anxiety.

RESULTS

The results supported a three-factor model of AQ. The path analysis model showed evidence of a significant role of alexithymia as a mediator of the relationship between autism traits and anxiety.

CONCLUSIONS AND IMPLICATIONS

The present study provides empirical support for a three-factor model of AQ in the general population. The association between autism traits, alexithymia, and anxiety dimensions highlights the multidimensional nature of these variables and the need to account for their distinct impact on autism-related variables.

Pitfalls of cubital electrical nerve stimulation for neuromuscular transmission monitoring: A case report of familial amyloid polyneuropathy

Transthyretin familial amyloid polyneuropathy (FAP) is a rare autosomal dominant disease that provokes systemic deposition of amyloid. It affects the nervous system and it is characterized by progressive sensory, motor, and autonomic neuropathy. Patients with FAP often require surgery and anesthetic care for hepatic transplantation and cardioverter-defibrillator/pacemaker implantation. Peripheric neuropathy is a common finding, but there are no reported cases of its interference with anesthetic neuromuscular transmission monitoring. We report a case of a FAP patient where lack of awareness and distracting factors led to misinterpretation of neuromuscular monitoring and unnecessary sedation and ventilation in the post anesthetic care unit. FAP may interfere with the usual cubital nerve neuromuscular monitoring. Anesthesiologists should be aware of potential neuromuscular compromise to find the best monitoring location for each patient. Sugammadex was safe and reliable in the antagonism of rocuronium neuromuscular blockade in this case, despite the lack of adequate quantitative monitoring.

Multidimensional assessment of anxiety through the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): From dimensionality to response prediction across emotional contexts

The assessment of mal-adaptive anxiety is crucial, considering the associated personal, economic, and societal burden. The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a self-report instrument developed to provide multidimensional anxiety assessment in four dimensions: trait-cognitive, trait-somatic, state-cognitive and state-somatic. This research aimed to extend STICSA’s psychometric studies through the assessment of its dimensionality, reliability, measurement invariance and nomological validity in the Portuguese population. Additionally, the predictive validity of STICSA-Trait was also evaluated, through the analysis of the relationship between self-reported trait anxiety and both the subjective and the psychophysiological response across distinct emotional situations. Similarly to previous studies, results supported both a four-factor and two separated bi-factor structures. Measurement invariance across sex groups was also supported, and good nomological validity was observed. Moreover, STICSA trait-cognitive dimension was associated with differences in self-reported arousal between groups of high/low anxiety, whereas STICSA trait-somatic dimension was related to differences in both the subjective and psychophysiological response. Together, these results support STICSA as a useful instrument for a broader anxiety assessment, crucial for an informed diagnosis and practice.

Pitfalls of cubital electrical nerve stimulation for neuromuscular transmission monitoring: a case report of familial amyloid polyneuropathy

Transthyretin familial amyloid polyneuropathy (FAP) is a rare autosomal dominant disease that provokes systemic deposition of amyloid. It affects the nervous system and it is characterized by progressive sensory, motor, and autonomic neuropathy. Patients with FAP often require surgery and anesthetic care for hepatic transplantation and cardioverter-defibrillator/pacemaker implantation. Peripheric neuropathy is a common finding, but there are no reported cases of its interference with anesthetic neuromuscular transmission monitoring. We report a case of a FAP patient where lack of awareness and distracting factors led to misinterpretation of neuromuscular monitoring and unnecessary sedation and ventilation in the post anesthetic care unit. FAP may interfere with the usual cubital nerve neuromuscular monitoring. Anesthesiologists should be aware of potential neuromuscular compromise to find the best monitoring location for each patient. Sugammadex was safe and reliable in the antagonism of rocuronium neuromuscular blockade in this case, despite the lack of adequate quantitative monitoring.

Exogenous attention to social stimuli in the neurotypical population: The impact of autism traits

Introduction

Autism Spectrum Disorders (ASD) have been associated with decreased spontaneous attention to social stimuli. Several studies further suggest that a higher expression of autism traits (AT) in the neurotypical population (NTP) may also be related to decreased social attention, although the evidence is still scarce, especially when considering faces as task-irrelevant distractors.

Objectives

This study aimed to explore the relationship between the expression of AT in the NTP and exogenous attention to social stimuli.

Methods

Fifty-one adult participants were recruited and asked to complete the Autism Spectrum Quotient (AQ), to measure AT, and to perform an attentional capture task. In the latter, they were instructed to detect a target letter in the middle of perceptually similar (high perceptual load) or dissimilar (low perceptual load) distractor letters. In 25% of the trials, task-irrelevant distractors, consisting of images of faces (social) or houses (non-social), were shown flanking the letter stimuli.

Results

Response times were found to be affected by distractor-response compatibility, increasing for contralateral distractors, but decreasing for ipsilateral distractors, in relation to trials with no distractors (baseline). Importantly, these trends were magnified for distractor faces in the group with less AT, considering the social skills dimension of AQ, while the same tendency was observed in the group with higher AT, but for distractor houses.

Conclusions

Our results support an altered attentional performance in the subclinical phenotype of the autism spectrum. Furthermore, they also add to existing literature documenting similar attentional abnormalities in both the clinical and subclinical extremes of the spectrum, hinting possible shared mechanisms.

Disclosure

No significant relationships.

A forensic analysis of SARS-CoV-2 cases and COVID-19 mortality misreporting in the Brazilian population

Objective

The study aimed to investigate the misreporting number of positively tested individuals for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) succumbed or not to coronavirus disease 2019 (COVID-19) pandemic in Brazil at the city, state, and national scales using statistical forensic analysis.

Study design

This is a register-based study over public health data collected, organized, and maintained by the Ministry of Health covering the Brazilian population.

Methods

We evaluated the Brazilian notifications of positively tested cases for SARS-CoV-2 who have succumbed or not to COVID-19 between February 26th to September 7th of 2020 at the city, state, and national scales for conformity to expected distribution provided by Benford's law (BL).

Results

Statistical analyzes demonstrated a significant rejection of SARS-CoV-2 notification cases at the city and the number of deaths by COVID-19 in all regional levels according to the hypothesis of conformity to BL.

Conclusion

We demonstrated by BL, which has been widely applied to query the quality and reliability of different numerical data sources, the misreporting number of cases and deaths throughout the SARS-CoV-2 pandemic in Brazil. Therefore, we brought to light pieces of evidence that raise questions about the reliability of SARS-CoV-2 data in Brazil. This situation may have led to inconsistencies in public health policy actions, recommendations, and drastic humanitarian, social, and economic consequences such as the intensive unit care overload in some Brazilian regions.

Subjective responses to emotional body odors and common odors in autism-spectrum disorders

Introduction

Autism-spectrum disorders (ASD) are characterized by deficits in social domains, associated with abnormal socioemotional perception. Although olfaction provides access to socioemotional cues, little is known about the perception of emotional odors considering their social meaning in ASD.

Objectives

To investigate the subjective responses to emotional body odors (BOs) versus non-social, common odors (COs) in ASD.

Methods

Eleven ASD and 49 typically developed (TD) adults were asked to smell negative, positive, and neutral BOs (axillary sweat from healthy individuals exposed to fearful, happy, and neutral film-clips) and COs, and to rate each odor on perceived pleasantness, intensity, familiarity and arousal. Odors were presented for 5 sec. Analyses were performed with linear mixed-effect models with fixed factors (group × odor type × valence) and covariates (e.g., age; intensity for arousal/familiarity; familiarity for pleasantness). Post-hoc comparisons were Bonferroni-corrected.

Results

Odors were perceived as significantly more intense (p=.044) and pleasant (p<.001) in ASD than TD. Distinct response patterns were found in ASD and TD. First, positive BOs and COs were similarly arousing and pleasant in ASD (p>.05), but not in TD (p<.001). Second, positive and neutral COs were equally arousing, familiar and pleasant in ASD (p>.05), but not in TD (p<.001). No differences were observed between BOs in ASD and TD (p>.05).

Conclusions

ASD is associated with abnormal subjective responses to emotional odors, which could contribute to the social communication difficulties characterizing ASD. Since emotional BOs elicit psychological responses in others, analyses on subjective and automatic responses will allow a better understanding of the role of olfaction in ASD.

Disclosure

No significant relationships.

Ghost fishing impacts on hydrocorals and associated reef fish assemblages

Ghost fishing is a threat to many marine environments, as lost or discarded fishing gear (e.g., fishing lines, nets) continues to fish by entangling, damaging or killing various organisms. Among the benthic organisms that live on tropical reefs, the group probably most affected, due to their shape, are the branching corals. These corals provide refuge, foraging and breeding sites, especially for fishes and therefore impacts on coral structure could compromise the ecology of associated species. We tested if fishing lines entangled on the branching coral Millepora alcicornis would result in an increase in colony mortality, decrease in abundance and richness of fishes and changes in the behavior of associated reef fish. In the field, we estimated the volume of M. alcicornis colonies and its mortality percentages, and videos were recorded to evaluate abundance and richness of fish assemblages and fish behavior. Our results showed that coral mortality increased with increasing amounts of entangled fishing lines. Fish assemblages were similar in M. alcicornis colonies with or without entangled fishing lines. Nevertheless, we observed a significant decrease in the frequency of feeding attempts in two herbivore fish species (Acanthurus bahianus and Ophioblennius trinitatis) that play an important role in coral-reef dynamics, controlling algae abundances. Therefore, ghost fishing has negative impacts on shallow reef ecosystems, directly affecting branching corals and important coral-fish interactions. Management of tropical shallow reef environments should consider regulation and monitoring of coastal fisheries to ensure reef integrity.

Sensory Processing in the Autism Spectrum: The Role of Attention to Detail and Somatic Trait Anxiety in the Olfactory Perception of the General Population

Autism Spectrum Disorders, as well as autism traits (AT), have been associated with altered sensory processing. However, the role of AT in olfactory processing is still unclear. We analyzed the impact of AT and trait anxiety (TANX), relevant in the context of autism and olfactory perception, in the olfactory abilities of a nonclinical adult sample. Participants (N = 116) completed the Autism-Spectrum Quotient (AQ), the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and the Sniffin' Sticks Extended Test to measure AT, TANX and olfactory abilities, respectively. A hierarchical multiple regression analysis suggested that women and higher scores on the Attention to Detail subscale of AQ were associated with better odor discrimination, and higher somatic TANX was related to poorer odor discrimination.

Giving meaning to the social world in autism spectrum disorders: Olfaction as a missing piece of the puzzle?

Altered social cognition is a core feature of Autism Spectrum Disorders (ASD). These impairments have been explained as the consequence of compromised social motivational mechanisms that limit social interest and activate a cascade of social deficits. Following this rational, we argue that approaches capable of surpassing ASD usual restraints (e.g., deficits in verbal abilities), and able to assign social meaning, could be more effective at responding to these difficulties. In this framework, we propose that olfaction, as well as cross-modal integration strategies involving both visual and olfactory domains, may have such potential. In fact, most of socioemotional processing deficits in ASD have been shown in an uni-modal perspective, mainly with visual stimuli. However, the social environment involves other modalities and is typically multisensorial. Given the potential of olfaction as a gateway for socioemotional information in ASD, we argue in favor of studying olfactory perception, as well as visuo-olfactory integration, given the potential of these approaches to drive effective interventions and give the access to a meaningful social world in ASD.

Image-scoring system for umbilical and uterine artery pulsed-wave Doppler ultrasound measurement

OBJECTIVES

To develop an objective image-scoring system for pulsed-wave Doppler measurement of maternal uterine and fetal umbilical arteries, and evaluate how this compares with subjective assessment.

METHODS

As an extension to the INTERGROWTH-21^st Project, we developed a scoring system based on six predefined criteria for uterine and umbilical artery pulsed-wave Doppler measurements. Objective evaluation using the scoring system was compared with subjective assessment which consisted of classifying an image as simply acceptable or unacceptable. Based on sample size estimation, a total of 120 umbilical and uterine artery Doppler images were selected randomly from the INTERGROWTH-21^st image database. Two independent reviewers evaluated all images in a blinded fashion, both subjectively and using the six-point scoring system. Percentage agreement and kappa statistic were compared between the two methods.

RESULTS

The overall agreement between reviewers was higher for objective assessment using the scoring system (agreement, 85%; adjusted kappa, 0.70) than for subjective assessment (agreement, 70%; adjusted kappa, 0.47). For the six components of the scoring system, the level of agreement (adjusted kappa) was 0.97 for anatomical site, 0.88 for sweep speed, 0.77 for magnification, 0.68 for velocity scale, 0.68 for image clarity and 0.65 for angle of insonation.

CONCLUSION

In quality assessment of umbilical and uterine artery pulsed-wave Doppler measurements, our proposed objective six-point image-scoring system is associated with greater reproducibility than is subjective assessment. We recommend this as the preferred method for quality control, auditing and teaching. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

A tropical bay as a reference area defined by multiple lines of evidences

References areas are sites that have undergone little or no anthropogenic impact and therefore represent the natural state of an environment. The objective of this study was to test if the Camamu Bay (CB), Bahia, can be used as a reference area for tropical coastal environments. Trace and major elements, polycyclic aromatic hydrocarbons (PAH), and the structure of the benthic macrofauna were determined. To compare the studied sites and identify the possible occurrence of anomalous concentrations, trace elements were normalized by Al and linear regressions were also performed. For all trace elements (except Cu), regressions showed a significant correlation (p<0.05) and few outliers (<3% of cases), showing that the concentrations found represent natural values for this bay. In the case of Cu, the highest concentrations were found near small municipalities, which may be associated with domestic sewage. About 60% of the organic compounds occurred at levels below the limit of quantification (<0.26ngg^-1). The sum of PAHs was low for all stations, ranging from 1.17 to 313ngg^-1. The benthic assemblages also indicated that the CB is a healthy, well-preserved ecosystem that deserves conservation efforts. The integrated use of geochemical and biotic data supported the use of CB as a reference area. Capsule: Organic and inorganic contaminants together with macrobenthic assemblages indicated that Camamu Bay is a pristine, tropical reference area.

The effect of comorbidities and complications on the mortality of burned patients

The World Health Organization has defined 'elderly' as 65 years or older. Age is a known major prognostic factor after burn injury. The objective of this study is to establish whether epidemiologic differences in the elderly contribute to higher mortality compared to younger patients. Patients admitted to the burn unit between 2011 and 2014 (229 patients) were included: 159 were under 65 years old and 70 (30.6%) were 65 or over. The elderly group had a higher mortality rate, 24.6% versus 8.2% (p=0.002). Patients over 65 presented more pre-existing co-morbidities (1.7 ± 1.1) than patients under 65 (1.1 ± 1.0), p<0.001, and COPD was significantly associated with higher mortality rate (p=0.014). Patients over and under 65 suffered similar TBSA, 15.7 versus 14.1, p=0.720. Regarding burn depth, deeper burns were significantly more prevalent in the over 65 group (17.1% vs. 5.0%, p=0.003). Patients over 65 developed more complications (0.9 ± 1.1) than the under 65s (0.5 ± 0.9), p=0.009, and sepsis was significantly associated with higher mortality rate (p=0.042). Over-65-year-old burn victims have a higher mortality risk than the under 65s. Elderly patients generally have more pre-existing comorbidities and develop more complications during hospital stay, which increase the mortality risk. Apparently, history of COPD or sepsis complication during hospital stay are independent risk factors for death in the elderly group. Although over-65-year-olds presented similar TBSA to the younger patients, the proportion of deep burns was higher, which suggests that burns might be more aggressive in the elderly.

Karyotype diversity and genome size variation in Neotropical Maxillariinae orchids

Orchidaceae is a widely distributed plant family with very diverse vegetative and floral morphology, and such variability is also reflected in their karyotypes. However, since only a low proportion of Orchidaceae has been analysed for chromosome data, greater diversity may await to be unveiled. Here we analyse both genome size (GS) and karyotype in two subtribes recently included in the broadened Maxillariinea to detect how much chromosome and GS variation there is in these groups and to evaluate which genome rearrangements are involved in the species evolution. To do so, the GS (14 species), the karyotype - based on chromosome number, heterochromatic banding and 5S and 45S rDNA localisation (18 species) - was characterised and analysed along with published data using phylogenetic approaches. The GS presented a high phylogenetic correlation and it was related to morphological groups in Bifrenaria (larger plants - higher GS). The two largest GS found among genera were caused by different mechanisms: polyploidy in Bifrenaria tyrianthina and accumulation of repetitive DNA in Scuticaria hadwenii. The chromosome number variability was caused mainly through descending dysploidy, and x=20 was estimated as the base chromosome number. Combining GS and karyotype data with molecular phylogeny, our data provide a more complete scenario of the karyotype evolution in Maxillariinae orchids, allowing us to suggest, besides dysploidy, that inversions and transposable elements as two mechanisms involved in the karyotype evolution. Such karyotype modifications could be associated with niche changes that occurred during species evolution.

Face and/or neck burns: a risk factor for respiratory infection?

Infections are a common cause of morbidity and mortality in burn patients, and almost 50% of infection-related deaths in burn patients are caused by pneumonia. The proportion of facial and/or neck burns (FNB) in burn centre admissions is high, and these patients have a well known respiratory risk. However, it is not well established in the literature if the occurrence of a FNB is a risk factor for respiratory infection during hospitalization. A retrospective, single-centre trial at the burn unit of the Prelada Hospital was conducted, including patients admitted between January 2011 and December 2014. The primary objective was to investigate the existence of a relation between face and/or neck burns and occurrence of respiratory infection. A total of 229 patients were included in the study, 126 with FNB and 103 without FNB. Higher total body surface area (TBSA) burned, inhalation injury and early endotracheal intubation were statistically more frequent in the FNB group. These variables were also more prevalent in the group that developed respiratory infection during the burn unit stay. Concerning FNB patients, the most frequent microbiological strains isolated in respiratory secretion cultures were Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumonia, while in nFNB patients it was Klebsiella pneumoniae. In our population, only early ETI, inhalation injury and higher TBSA appear to be independent risk factors for respiratory infection in FNB patients, although age, male sex and co-morbidities are also known risk factors for respiratory infection in burn patients.

Pre-burn centre management of the airway in patients with face burns

Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013. Specific goals included assessment of whether these intubations were clinically appropriate and if these procedures determined significant changes in clinical course and outcome. A total of 136 patients were admitted to our burn centre with facial burns. 38.2% (n=52) of them arrived endotracheally-intubated, with 75% (n=39) intubated at the scene of the burn injury and 25% (n=13) in the emergency room because of the suspicion of smoke inhalation injury. In only 23% of the cases (n=12) was the lesion confirmed by bronchoscopy. The overall mortality rate was 12.5% (n=17): 3.6% (n=3) were patients who had not been subjected to pre-burn centre intubation, and 27% (n=14) were in the group of patients arriving intubated. A face burn is a warning sign of a possible upper airway injury, and pre-burn centre prophylactic intubation might be life-saving. However, unnecessary intubation may impair clinical evolution. Therefore, it is imperative that updated practice guidelines for pre-burn centre airway management are adhered to, and that these guidelines are subject to revision in order to improve airway management in burn patients.

B-mode and Doppler sonography of the mammary glands in dairy goats for mastitis diagnosis

This study aimed to evaluate the sonographic characteristics of the udder and teats and to determine the Doppler indexes of mammary artery in healthy and undergoing subclinical and clinical mastitis goats. Thirty animals among Saanen and Alpine Brown goats were arranged in three groups, healthy goats (HG), goats with subclinical mastitis (SMG) and goats with clinical mastitis (CMG). Using the B-mode, the sonographic characteristics (echotexture and echogenicity) and biometry (diameter and area of the udder cistern, diameter and area of the teat cistern and thickness of the teat wall) were evaluated. Using Doppler ultrasonography, the vascular indexes of the mammary artery were obtained. It was observed hyperechogenicity with solid component in the gland cistern when comparing animals with clinical mastitis and healthy mammary tissue. Regarding the echotexture of the breast tissue, there was heterogeneity in the mammary parenchyma on the three groups, for the milk, it was observed homogeneity for animals on HG and SMG and heterogeneity for animals on CMG. Grey-scale quantitative assessment revealed increase in echogenicity (mean value) for all the structures when comparing the three groups. Biometry did not reveal statistical difference between groups, for none of the evaluated structures. Doppler examination of the mammary artery showed the decrease of end diastolic velocity and raise of pulsatility index between groups. The association of B-mode and Doppler ultrasonography is useful for the evaluation of the udder of dairy goats with mastitis. It is a sensitive and specific method for the study of this disease. Doppler mode was unable to establish reliable criteria for diagnosis of subclinical mastitis. Moreover, the quantification of echogenicity is a useful technique for the evaluation of the milk in animals with mastitis; therefore, it is suggested that it can be used as complementary technique for the diagnosis of mastitis in goats.

Síndrome de Dificuldade Respiratória Aguda: Casuística de Dois Anos numa Unidade de Cuidados Intensivos

<strong>Introduction:</strong> Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years.<br /><strong>Material and Methods:</strong> This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days at<br />Intensive Care Unit and obits were searched for and were submitted to statistic description and analysis.<br /><strong>Results:</strong> A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88mmHg (CI 95%: 78.5–97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7–8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome ‘non-death in Intensive Care Unit’ was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients &lt; 65 years old.<br /><strong>Discussion and Conclusions:</strong> Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use.

[Acute respiratory distress syndrome: case series, two years at an intensive care unit]

INTRODUCTION

Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years.

MATERIAL AND METHODS

This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days at Intensive Care Unit and obits were searched for and were submitted to statistic description and analysis.

RESULTS

A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88 mmHg (CI 95%: 78.5-97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7-8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome 'non-death in Intensive Care Unit' was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients < 65 years old.

DISCUSSION AND CONCLUSIONS

Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use.

Neurofibromatosis without Neurofibromas: Confirmation of a Genotype-Phenotype Correlation and Implications for Genetic Testing

Neurofibromatosis type 1 (NF1) is a multisystem disease with autosomal dominant inheritance and complete penetrance diagnosed by clinical findings. Cutaneous neurofibromas are present in almost all adult patients in the dermis, epidermis or along the peripheral nerves. Plexiform neurofibromas are subcutaneous or deep lesions involving nerve plexuses or roots. Neurofibromas can degenerate into malignant tumors, with important prognostic implications. NF1 shows a broad clinic variability even within a single family. Exceptions are cases reporting the in-frame microdeletion c.2970_2972delAAT, presenting with the typical pigmentary features of NF1, but no cutaneous or plexiform neurofibromas. We report a patient with a de novo c.2970_2972delAAT mutation who had few café-au-lait spots, only 2 of which measured >15 mm, axillary and submammary freckling, a flat angioma extending over the neck, arm and trunk, a high arched palate, micrognathia, macrocephaly, pes cavus and scoliosis. There was complete absence of observable cutaneous neurofibromas as well as external plexiform neurofibromas. She had had epileptic seizures since childhood; however, a diagnosis of NF1 had not been confirmed until she was 38, partly due to the paucity of characteristic cutaneous stigmata. We confirm the association of the c.2970_2972delAAT mutation in NF1 with a particular clinical phenotype, especially with lack of detectable neurofibromas. For an appropriate management of patients and family counseling, molecular study of the NF1 gene should be considered in patients not fulfilling NIH criteria when other features suggestive of NF1 are present. In the absence of neurofibromas, starting NF1 testing with the screening of exon 17 may be worthwhile.

Pharmacogenetic studies on the antipsychotic treatment. Current status and perspectives

Based on present knowledge, in this work we review the importance of the pharmacogenetic tests in the treatment with antipsychotic drugs. Many associations have been reported between different genetic markers and response to treatment as well as to the appearance of adverse reactions. However, up to now, no "prime" biomarker capable of unequivocally predicting the clinical benefits of a specific treatment or its toxicity has been identified. The use of individual pharmacogenetic markers has been demonstrated to have little clinical utility, and therefore the combination of information obtained from the analysis of different genes seems to be a more promising strategy. Inclusion of pharmacogenetic tests in clinical trials conducted prospectively and that include a large number of cases could, undoubtedly, significantly contribute to the development of individualized medicine protocols.

Analysis of pharmacogenetic biomarkers in rectal patients trated with chemoradiotherapy

e15051

Background: 5FU-based chemoradiotherapy before total mesorectal excision (TME) is currently the gold standard treatment for stage II and III rectal cancer patients. Pathological complete response (pCR) is related with a longer survival. We have used known predictive pharmacogenetics biomarkers to identify in our series responders and non responders to preoperative RQ. Methods: 77 stage II/III rectal patients were genotyped using direct sequencing (TS VNTR) and SNAPshot (DPYD, EGFR) techniques. DNA was obtained from peripheral blood samples. We have studied Thymidylate synthetase (TS VNTR; high expression haplotypes: TSER 2R/3R, 3C/3G, 3G/3G and low expression: TSER 2R/2R, 2R/3C, 3C/3C; TS 1494del6: associated to a better efficay of 5Fu), dihydropyrimidine dehydrogenase (DPYD; DPYD*2 associated to worse toxicity), EGFR (CA repeats in intron 1: 16/16 associated to worse efficacy) polymorphisms. Median age of our study cohort was 65 years old (37–85). There were 24 female and 53 male patients. All of them were Caucasian. 21 patients (27.3%) had stage II and 56 (72.7%) stage III. They were staged by TC, colonoscopy and endorectal ultrasonography. The patients received 5fu 325 mg/m2/day continuous infusion along the hyperfractionated accelerated radiotherapy schedule (50,4 Gy). All were submitted to TME. Outcomes after surgery are measured by tumour regression grade (from TRG1= complete pathological response, to TRG5=no regression). Data were studied by univariate and multivariate analysis. Results: The sample was in Hardy-Weinberg equilibrium for all polymorphisms, irrespectively of the response status. 50 patients (64.9%) and 27 (35.1%) had low and high expression genotype for TS respectively. pCR (TRG1) was obtained in 24 patients (31,6%) and microscopic foci (TRG2) in 14 (18,2%), TRG 3–4 in 38 (49,3%), and 1 patient had no response (TRG5). We haven’t found a statistically significant relationship between TRG1 and TS status, or any other biomarker studied. There's no relationship also with initial clinical stage. Conclusions: Biomarkers EGFR (intron 1 CA repeats), TS (TS 1494del6, TS VNTR) and DPYD in blood samples, are not good enough to predict response to RQ in rectal cancer.

No significant financial relationships to disclose.

Three novel mutations in the CFTR gene identified in Galician patients

We report three novel CFTR missense mutations detected in Spanish patients from Galicia (North West of Spain). In the first case, a patient homozygous for a novel S1045Y mutation died due to pulmonary problems. In the other two cases, both heterozygous for novel mutations combined with the F508del mutation, clinical symptoms were different depending on the mutation, detected as M595I and A107V.

Duplication and deletion analysis by fluorescent real-time PCR-based genotyping

BACKGROUND

Gene dosage determination is an increasingly important field for the study of genome variation and organization. In parallel, the advances in our understanding of the genetic basis of disease have produced an exponential increase in the demand for molecular diagnostic analyses. Although efforts have been spent on increasing both the accuracy and the throughput of the gene dosage analysis, the success has been limited.

METHODS

A large number of suitable methods has been proposed; most are based on quantitative real-time PCR or amplification of multiple targets. A new approach exploits the differences between fluorescent signals of SNP alleles in heterozygous samples to assess duplications. The SNP typing-dependent fluorescent signal allelic asymmetry is an intrinsic characteristic of a SNP typing assay and can lead to a simple and cost-effective gene dosage method. This strategy provides sufficient throughput and sensitivity for duplication analysis.

CONCLUSIONS

There are advantages and disadvantages of real-time methodology when applying the approach to the molecular diagnostic field.

[Cryptogenic organizing pneumonia -- case report]

Cryptogenic organizing pneumonia (COP) is one of the new recognized histological patterns of idiopathic interstitial pneumonias, in witch no cause or association is identified. Idiopathic bronchiolitis obliterans-organizing pneumonia (BOOP) is a synonymous. This rare entity is characterized by involvement of alveoli and bronchioles, which are filled by intraluminal polyps of fibroblastic tissue (Masson bodies). The clinical presentation often mimics that of community-acquired pneumonia. Persistent non-productive cough, dyspnoea with exertion and weight loss are common features, and in one-half of the cases the onset is heralded by a flu-like syndrome. Definitive diagnosis depends on histological data, and video-assisted thoracoscopic (VAT) has become the established technique. Spontaneous recovery is rare; corticosteroid therapy provides cure in two thirds of cases. The authors present a case of a patient whose lung biopsy by VAT confirmed the diagnosis. She was treated with corticoids without recurrence in a two year follow-up.

CARD15/NOD2 analysis in rheumatoid arthritis susceptibility

OBJECTIVE

To determine if the mutations in the CARD15/NOD2 gene predisposing to Crohn's disease (CD) contribute also to the genetic susceptibility to rheumatoid arthritis (RA).

METHODS

The frequencies of the three commonest mutations of CARD15/NOD2 predisposing to CD (2104C > T, 2722G>C and 3020insC) were determined in 210 RA patients and 227 controls.

RESULTS

Allelic frequencies of the CARD15/NOD2 mutations in RA patients (2104C>T, 2.8%; 2722G>C, 0.9%; and 3020insC, 2.4%) did not differ significantly from the controls (2104C>T, 5.3%; 2722G>C, 0.7%; and 3020insC, 1.1%).

CONCLUSION

There was no evidence of association between the commonest CD CARD15/NOD2 mutations and RA susceptibility.