Early integration of palliative care in hematology: an urgency for patients, a challenge for physicians

ABSTRACT Introduction: Early integration between palliative care and other medical specialties in the care of patients with serious illnesses is consolidating itself as good medical practice, based on scientific and ethical evidence. Despite this, palliative care is still not part of the routine care of patients with hematological diseases, even in specialized centers. Objective and method: In this article, we review the benefits and the main barriers described in the literature for early integration of hematology and palliative care. We also point out the challenges encountered in clinical practice, such as end-of-life prognosis assessment in patients with hematological diseases and management of the most common symptoms in hematology. Finally, we review models of integration between palliative care and oncology centers in outpatient and inpatient settings. Results and conclusion: Patients with hematological diseases can greatly benefit from early integration with palliative care, with improvement in symptom control, quality of life, reduction of emotional distress and the development of advanced care directives. It is necessary to make hematologists aware of the benefits of palliative care, provide adequate training for multidisciplinary teams and encourage specific studies of palliative care in patients with hematological diseases.

Ingeniería genética contra estrés abiótico en cultivos neotropicales: osmolitos, factores de transcripción y CRISPR/Cas9 / Genetic engineering against abiotic stress in Neotropical crop plants: osmolites, transcription factors and CRISPR/Cas9

RESUMEN El neotrópico es sitio de origen de gran variedad de plantas que actualmente son cultivadas con éxito en diferentes regiones del mundo. Sin embargo, condiciones climáticas adversas, que se pueden ver acrecentadas por efectos del cambio climático antropogénico, pueden afectar su rendimiento y productividad debido a las situaciones de estrés abiótico que se pueden generar. Como alternativa para contrarrestar estos efectos, se ha experimentado con modificaciones genéticas, particularmente en genes relacionados con la producción de osmolitos y factores de transcripción que han llevado a que estas plantas, a nivel experimental, tengan mayor tolerancia a estrés oxidativo, altas y bajas temperaturas y fotoinhibición, sequía y salinidad, mediante la acumulación de osmoprotectores, la regulación en la expresión de genes y cambios en el fenotipo. En este trabajo se presentan y describen las estrategias metodológicas planteadas con estos fines y se complementan con ejemplos de trabajos realizados en cultivos de origen neotropical de importancia económica, como maíz, algodón, papa y tomate. Además, y debido a la novedad y potencial que ofrece la edición génica por medio del sistema CRISPR/Cas9, también se mencionan trabajos realizados en plantas con origen neotropical, enfocados en comprender e implementar mecanismos de tolerancia a sequía. Las metodologías aquí descritas podrían constituirse en opciones prácticas para mejorar la seguridad alimentaria con miras a contrarrestar las consecuencias negativas del cambio climático antropogénico.

ABSTRACT The neotropics are the site of origin of a large variety of plants that are currently successfully cultivated in different regions of the world. However, adverse climatic conditions, which can be exacerbated by the effects of anthropogenic climate change, can affect their yield and productivity due to the abiotic stresses that can be generated. As an alternative to counteract these effects, genetic modifications have been experimentally implemented, particularly in genes related to osmolyte production and transcription factors, which have ultimately led to increased tolerance of these plants to oxidative stress, high and low temperatures and photoinhibition, drought and salinity, through the accumulation of osmoprotectants, regulation of gene expression and changes in phenotype. In this work, the methodological strategies proposed to these aims are presented and described, and they are complemented with examples of studies carried out in economically important crops of neotropical origin, such as corn, cotton, potato and tomato. In addition, and due to the novelty and potential that gene editing offers through the CRISPR/Cas9 system, works conducted in plants with neotropical origin, focused on understanding and implementing drought tolerance mechanisms, are also mentioned. The methodologies described here could become practical options to achieve food security in the frame of the adverse effects caused by anthropogenic climate change.

Sou mãe: e agora? Vivências do puerpério / Je suis mère: et maintenant ? Expériences du post-partum / Soy mamá: ¿y ahora? Vivencias del puerperio / I'm a mother: what now? Postpartum experiences

Resumo O presente estudo é parte de uma pesquisa mais ampla sobre maternidade e cuidados na primeira infância, e tem como objetivo investigar como as mulheres vivenciam o puerpério atualmente. Para tanto, foi realizada uma pesquisa qualitativa, na qual foram entrevistadas dez mulheres das camadas médias da população carioca, atuantes profissionalmente, com idades entre 29 e 37 anos, casadas, legalmente ou não, heterossexuais primíparas e com o filho(a) entre 8 meses e 2 anos de idade. Os resultados foram analisados segundo o método de análise de conteúdo na sua vertente categorial. Para atingir os objetivos deste estudo, serão discutidas as seguintes categorias de análise: baby blues; rede de apoio; e a história não foi bem assim… Os resultados apontaram o puerpério como um período idealizado pelas mulheres, mas vivido com sofrimento e instabilidade emocional. Constatamos a importância da rede de apoio para a mãe e o bebê.

Résumé La présente étude s'inscrit dans le cadre d'une recherche plus large sur la maternité et les soins de la petite enfance, et vise à examiner comment les femmes vivent actuellement le post-partum. Une recherche qualitative a été menée, au cours de laquelle dix femmes âgées de 29 à 37 ans, de la classe moyenne de Rio de Janeiro ont été interviewées. Elles étaient mariées (officiellement ou non), hétérosexuelles, primipares et avaient un enfant âgé de 8 mois à 2 ans. Les résultats ont été analysés selon la méthode d'analyse du contenu catégorique. Pour atteindre les objectifs de cette étude, les catégories d'analyse suivantes ont été discutées : baby blues ; réseau de soutien ; et « Cela ne s'est pas tout à fait passée comme-ça... ¼. Les résultats montrent que la période post-partum était idéalisée par les femmes, mais vécue avec souffrance et instabilité émotionnelle. Nous soulignons l'importance du réseau de soutien pour les mères et les enfants.

Resumen El presente estudio forma parte de una investigación más amplia acerca de la maternidad y los cuidados en la primera infancia y tiene como objetivo investigar la forma en la que las mujeres viven el postparto en la actualidad. Por lo anterior, se llevó a cabo una investigación cualitativa, en la que fueron entrevistadas diez mujeres de clase media de la población de Río de Janeiro, activas profesionalmente, con edades entre los 29 y los 37 años, casadas legalmente o no, heterosexuales, primíparas y con hijo/a de entre 8 meses y 2 años de edad. Se analizaron los resultados según la técnica de análisis de contenido en su vertiente categorial. Para alcanzar los objetivos de este estudio, se discutirán las siguientes categorías de análisis: baby blues; red de apoyo; y la historia no era como la contaban.... Los resultados mostraron que el puerperio es un periodo idealizado por las mujeres, pero es vivido con sufrimiento e inestabilidad emocional. Se corroboró la importancia de la red de apoyo tanto para la madre como para el bebé.

Abstract Our study is part of a broader research on maternity and early childhood care. It aims to investigate how women experience their postpartum period today. Qualitative research was conducted for such purpose, and ten middle-class women from Rio de Janeiro were interviewed. The women were professionally active, aged between 29 and 37 years, married (formally or otherwise), primiparous, heterosexual, and had a child aged between eight months and two years old. The results were analyzed according to the content analysis method and its categorical aspect. To achieve the goals of this study, we discussed the following analysis categories: baby blues; support network; and The story was not quite like that... The results showed that women idealize the postpartum period, actually experiencing distress and emotional instability. We emphasize the importance of the support network for both mothers and their children.

Tratamento de endoleak tipo 1A mediante embolização com molas: relato de caso / Treatment of type 1A endoleak using coil embolization: a case report

No endoleak tipo 1A, a endoprótese não sela completamente o colo do aneurisma proximal, e o fluxo arterial está presente entre a parede do colo aórtico e o material do implante. Este é um relato de um caso no qual foi utilizada embolização com molas, associado a uma revisão de literatura (PubMed, LILACS e SciELO). Foram pesquisados artigos publicados nos últimos 5 anos com os descritores "endoleak 1A", "coil embolization" e "treatment", combinados de formas aleatórias, sendo encontrados 25 artigos. O tipo 1A ocorre em 1,1% dos pacientes após 30 dias do implante. O tratamento consiste em aumentar a vedação do implante proximal, principalmente com o uso de stents e balões para alargar a zona de aterragem ou aumentar a força radial do implante. Alguns trabalhos sugerem técnicas de embolização com cianoacrilato, cola de fibrina e uso de Onyx, mostrando taxas de sucesso superiores a 97%. Contudo, a correção de endoleaks tipo 1A mediante embolização com molas é pouco descrita

In a type 1A endoleak, the endograft is unable to fully seal the proximal aneurysm neck and blood flow leaks between the wall of the aortic neck and the graft material. This article reports a case in which coil embolization was used and presents a literature review (PubMed, LILACS, and SciELO). Searches were run for articles published in the past 5 years using the descriptors "endoleak 1A", "coil embolization," and "treatment". Type 1A endoleak occurs in 1.1% of patients within 30 days of graft placement. Treatment of an endoleak is obligatory and usually consists of sealing the proximal graft neck using stents and balloons to expand the landing zone or to increase the radial force of the graft. Some studies have suggested using embolization techniques with cyanoacrylate, fibrin glue, and Onyx, demonstrating success rates that exceed 97%. However, correction of type 1A endoleak using coil embolization has seldom been described

IL32 expression in peripheral blood CD3+ cells from myelodysplastic syndromes patients

Background: Myelodysplastic syndromes (MDS) are a heterogeneous group of disorders characterized by ineffective hematopoiesis and risk of leukemia transformation. There is evidence to suggest the participation of immune system deregulation in MDS pathogenesis. Interleukin-32 (IL-32) is a newly described multifunctional cytokine reported as an important mediator in autoimmune and inflammatory disorders. In the present study, we reported the expression of IL32 and IL32 transcript variants (α, ß, γ and δ) in peripheral blood CD3+ cells from healthy controls and MDS patients. Methods: CD3+ cells were isolated by immunomagnetic cell sorting from thirty-nine untreated MDS patients and twenty-nine healthy donors. Gene expression was evaluated by quantitative PCR. For statistical analysis, Mann­Whitney test, Kruskal-Wallis test with Dunns post test and Log-rank (Mantel-Cox) were used, as appropriate. A p value <0.05 was considered statistically significant. Results: IL32 expression and IL32 transcript variants IL32α, IL32ß, IL32γ, and IL32δ, were similar in peripheral blood CD3+ cells from healthy donors and MDS patients. Increased IL-32α expression was an independent predictor for MDS disease progression by univariate and multivariate analysis. Conclusions: We observed that IL32 expression is not differently expressed in CD3+ cells from MDS patients; nevertheless IL32α has a potential role in disease progression (AU)

SIVA, a target of p53, is downregulated in myelodysplastic syndromes

Background: SIVA is a transcriptional target of p53 that plays a potential role in the development and progression of cancer. In this study, we analyzed SIVA1 and SIVA2 expression, and its association with clinical features and TP53 and MDM2 expression in bone marrow cells from healthy donors and myelodysplastic syndrome (MDS) patients. Methods: Fifty-five untreated patients with MDS and 22 healthy donors were included. Gene expression was evaluated by quantitative PCR. For statistical analysis, Mann­Whitney test, Spearman correlation analysis and Log-rank (Mantel-Cox) were used, as appropriate. A p value <0.05 was considered statistically significant. Results: SIVA1 and SIVA2 transcripts were significantly decreased in bone marrow samples from MDS patients compared to healthy donors, and positively correlated with MDM2 and TP53 expression in MDS patients (all p < 0.05). MDM2 expression was also downregulated in bone marrow samples from MDS patients compared to healthy donors (p < 0.05). However, SIVA1, SIVA2, MDM2 and TP53 expressions did not impact on MDS outcomes. Conclusions: SIVA1 and SIVA2 transcripts are downregulated in bone marrow samples from MDS patients (AU)

Synthesis of structured triacylglycerols enriched in n-3 fatty acids by immobilized microbial lipase

Abstract The search for new biocatalysts has aroused great interest due to the variety of micro-organisms and their role as enzyme producers. Native lipases from Aspergillus niger and Rhizopus javanicus were used to enrich the n-3 long-chain polyunsaturated fatty acids content in the triacylglycerols of soybean oil by acidolysis with free fatty acids from sardine oil in solvent-free media. For the immobilization process, the best lipase/support ratios were 1:3 (w/w) for Aspergillus niger lipase and 1:5 (w/w) for Rhizopus javanicus lipase using Amberlite MB-1. Both lipases maintained constant activity for 6 months at 4 °C. Reaction time, sardine-free fatty acids:soybean oil mole ratio and initial water content of the lipase were investigated to determine their effects on n-3 long-chain polyunsaturated fatty acids incorporation into soybean oil. Structured triacylglycerols with 11.7 and 7.2% of eicosapentaenoic acid + docosahexaenoic acid were obtained using Aspergillus niger lipase and Rhizopus javanicus lipase, decreasing the n-6/n-3 fatty acids ratio of soybean oil (11:1 to 3.5:1 and 4.7:1, respectively). The best reaction conditions were: initial water content of lipase of 0.86% (w/w), sardine-free faty acids:soybean oil mole ratio of 3:1 and reaction time of 36 h, at 40 °C. The significant factors for the acidolysis reaction were the sardine-free fatty acids:soybean oil mole ratio and reaction time. The characterization of structured triacylglycerols was obtained using easy ambient sonic-spray ionization mass spectrometry. The enzymatic reaction led to the formation of many structured triacylglycerols containing eicosapentaenoic acid, docosahexaenoic acid or both polyunsaturated fatty acids.

Primary myelofibrosis: current therapeutic options

Primary myelofibrosis is a Philadelphia-negative myeloproliferative neoplasm characterized by clonal myeloid expansion, followed by progressive fibrous connective tissue deposition in the bone marrow, resulting in bone marrow failure. Clonal evolution can also occur, with an increased risk of transformation to acute myeloid leukemia. In addition, disabling constitutional symptoms secondary to the high circulating levels of proinflammatory cytokines and hepatosplenomegaly frequently impair quality of life. Herein the main current treatment options for primary myelofibrosis patients are discussed, contemplating disease-modifying therapeutics in addition to palliative measures, in an individualized patient-based approach

Myelodysplastic syndrome with synchronous gastric cancer: when the symptoms suggest something else

Although myelodysplastic syndromes have a clear definition in theory, the morphologic dysplasia associated with ineffective hematopoiesis may be subtle and difficult to recognize and can commonly be mimicked by systemic conditions, such as infections, autoimmune disorders, nutritional deficiencies, toxic factors and non-hematological malignancies. However, myelodysplastic syndromes may truly coexist with other systemic diseases, which can be masked when the patient's symptoms are attributed exclusively to myelodysplastic syndromes without further investigation. To better illustrate this, we herein describe two cases associated with synchronous gastric cancers...

Gestão integrada de políticas públicas relacionadas às mudanças climáticas na região metropolitana de São Paulo / Integrated Management of Public Policies Related to Climate Change in the Metropolitan Region of São Paulo

O planejamento e a gestão de políticas públicas aplicadas às mudanças climáticas exigem por parte de diferentes atores mediados pelo Estado, adoção de estratégias de adaptação e mitigação. Estas políticas envolvem setores distintos e precisam ser capazes de interferir e corrigir a evolução das atividades de uso/ocupação/transformação do solo urbano de forma que as atividades favoreçam o equilíbrio entre as dimensões ambientais, econômicas e sociais nas metrópoles. O desafio de associar as políticas climáticas e urbanas passa pela complexidade dos diálogos federativos nas metrópoles brasileiras. Estes aspectos da gestão e planejamento de políticas a nível inter federativo atuam no sentido de dificultar a gestão integrada e a realização dos objetivos das políticas com impacto na questão climática. Admitindo a relevância da legislação como elemento estruturador do processo de implementação de políticas públicas, o presente estudo tem por objetivo identificar, no texto das políticas urbana e climática de alguns municípios integrantes da Região Metropolitana de São Paulo, assim como na legislação correspondente do Estado de São Paulo e da União, elementos de articulação e integração para a superação dos desafios apontados. Para isso foi utilizada pesquisa documental e técnica de análise de conteúdo partindo de quadro de categorias teóricas, fundamentado na literatura da área. Em paralelo, foi feita análise comparativa de políticas europeias e portuguesas de Mudanças Climáticas...

The planning and management of environmental public politics related to the climate changes, require from the state mediated actors, an adoption of mitigation and adaptation strategies. These strategies need to be able to step in and correct the evolution of the use / occupation / transformation of urban land activities so that activities favoring the balance between environmental, economic and social dimensions in the metropolises. The challenge of linking climate and urban policies involves the complexity of federal dialogues in Brazilian metropolises. This problem in the management and planning policies to inter federal level acts to hinder the integrated management and the achievement of policy objectives with impact on climate change. Admitting the importance of legislation as the structuring element of the implementation of public policies, this present research aims to identify elements of integration on environmental and sectorial policies concerning the interface with the climate changes by involving different federal dimensions and the governmental sectors. Therefore we will use documental research, comparative analysis of Portuguese and European politics of Climate Changes with the collected information in 2013 and the analysis technique of the categories framework build by the literature taken elements which once contemplated by politics, indicate positive conditions of integrated management. Among the results, the analysis of selected normative indicate...

Síndrome DRESS (SD) / Drug Rash with eosinophilia and systemic symptom Syndrome

El síndrome DRESS (SD) es una entidad poco frecuente causada por una reacción adversa a un fármaco cuyo mecanismo patogénico es desconocido. El compromiso varíadesde manifestaciones cutáneas hasta gran compromiso sistémico. Objetivos: Presentación de tres casos clínicos y revisión bibliográfica. Caso clínico: Reportamos tres pacientes, femeninas, de 25 a 31 años, con SD internadas en el servicio de clínica médica de nuestro hospital. En todas ellas existía el antecedente de la ingesta de anticonvulsivantes debido a patología psiquiátrica y neurológica. Se presentaron con el mismo cuadro clínico: exantema morbiliforme, enantema y solo dos pacientespresentaron fiebre. Se indicó suspender el fármaco causal en todos los casos e iniciar tratamiento con corticoides sistémicos y antihistamínicos, sumado a las medidas generales de soportevital. La evolución fue favorable en los tres casos con buena respuesta al tratamiento con glucocorticoides.Discusión: El SD es un síndrome de hipersensibilidad a drogas, potencialmente mortal. Las manifestaciones clínicas y humoraleslo distinguen de otras farmacodermias. Por el compromiso sistémico, es importante saber diagnosticar este cuadro. La suspensión precoz del fármaco responsable es la medidaterapéutica más eficaz para evitar la progresión del daño orgánico así como también el uso de glucocorticoides, siendo este último prioritario en situaciones de afectación sistémica,como pudimos comprobar en nuestros pacientes...

DRESS syndrome (SD) is a rare condition caused by an adverse reaction to a drug which pathogenic mechanism is unknown. The severity varies from cutaneous to large systemicpresentation. Objectives: Presentation of three study cases and literaturereview. Case Report: We report three female patients from 25 to 31 years of age, with SD admitted at the clinical service of our hospital. All of them showed intake of anticonvulsants due topsychiatric and neurological disorders. They showed the same symptoms: morbilliform rash, enanthem and only two patients with fever. It was suggested to suspend the medication inquestion in all cases and start treatment with systemic corticosteroids and antihistamines, coupled with the general life support measures. The outcome was successful in all three cases with good response to treatment with glucocorticoids. Discussion: The SD is a drug hypersensitivity syndrome,potentially fatal. Clinical and humeral manifestations distinguish this syndrome from other drug-induced skin disorders. It is important to diagnose this condition due to its systemicpresentation. Early cessation of the drug-causing disease is the most effective therapeutic measure to prevent progression of organ damage as well as the use of glucocorticoids, very valuable in situations of systemic presentation, as seen in our patients...

Screening for hotspot mutations in PI3K, JAK2, FLT3 and NPM1 in patients with myelodysplastic syndromes

INTRODUCTION: Myelodysplastic syndromes encompass a heterogeneous group of clonal hematopoietic stem cell disorders characterized by ineffective hematopoiesis, refractory cytopenia and a tendency to progress toward acute myeloid leukemia. The accumulation of genetic alterations is closely associated with the progression of myelodysplastic syndromes toward acute myeloid leukemia. OBJECTIVE: To investigate the presence of mutations in the points most frequent for mutations (hotspot mutations) in phosphatidylinositol-3-kinase (PI3K), Janus kinase 2 (JAK2), FMS-like tyrosine kinase 3 (FLT3) and nucleophosmin (NPM1), which are involved in leukemia and other cancers, in a population of Brazilian MDS patients. METHODS: Fifty-one myelodysplastic syndromes patients were included in the study. According to French-American-British classification, the patients were distributed as follows: 31 with refractory anemia, 8 with refractory anemia with ringed sideroblasts, 7 with refractory anemia with excess blasts, 3 with refractory anemia with excess blasts in transformation and 2 with chronic myelomonocytic leukemia. Bone marrow samples were obtained and screened for the presence of hotspot mutations using analysis based on amplification with the polymerase chain reaction, sequencing, fragment size polymorphisms or restriction enzyme digestion. All patients were screened for mutations at the time of diagnosis, and 5 patients were also screened at the time of disease progression. RESULTS: These results show that hotspot mutations in the PI3K, JAK2, FLT3 and NPM1 genes are not common in MDS patients; nevertheless, JAK2 mutations may be present in myelodysplasia during disease progression. CONCLUSIONS: These results show that hotspot mutations in the PI3K, JAK2, FLT3 and NPM1 genes are not common in MDS patients; nevertheless, JAK2 mutations may be present in myelodysplasia during disease progression.

Avaliação do tratamento antifúngico oral e tópicooral para a candidíase vulvovaginal / Clinical cure after treatment regimens oral, topical, oral and topical for vulvovaginal candidiasis

Em avaliação clínica do tratamento oral e tópico oral para a candidíase vulvovaginal, verificou-se que não há diferença entre o tratamento oral e tópico oral (p>0,05). Desta forma, acredita-se que o tratamento oral deva ser estimulado, não associado ao medicamento tópico, pois incrementa o custo, sem benefícios adicionais.

The authors present the clinical evaluation of oral treatment, topical and oral-topic for vulvovaginal candidiasis, and ensure that there is no difference between the oral and topical oral treatment (p> 0.05). Believe that the oral treatment should be encouraged, not associated with the drug topic, it increases the cost without additional benefit. Believe that the topical medication should be limited to patients with contra-indication tooral maedication.

First occurrence of Dolicholagus longirostris larvae (Maul 1948) (Osmeriformes, Bathylagidae) near the mouth of the Amazon River / Primeira ocorrência de larvas de Dolicholagus longirostris (Maul 1948) (Osmeriformes, Bathylagidae) próximas à foz do rio Amazona

The family Bathylagidae contains eight genera and 22 species, of which only five occur in the Southwest Atlantic. Until recently, only adult specimens of the bathylaginin Melanolagus bericoides had been recorded off southern Brazil, between the Santa Marta Cape and Rio Grande (31º S and 49º W). The present work reports the first occurrence of Dolicholagus longirostris larvae on the northern Brazilian coast, expanding its distribution in the Southwest Atlantic. The two specimens found were collected near the mouth of the Amazon River (02º 00' 19" N, 47º 03' 30" W, and 00º 49' 06" N, 46º 25' 09" W).

A família Bathylagidae apresenta oito gêneros e 22 espécies, sendo que apenas cinco destas espécies ocorrem no Atlântico Sudoeste. No sul do Brasil já havia sido registrada a ocorrência de exemplares adultos de Melanolagus bericoides entre o Cabo de Santa Marta e Rio Grande (31º S e 49º W). Este trabalho registra a primeira ocorrência de larvas de Dolicholagus longirostris na costa norte brasileira, ampliando sua distribuição no Atlântico Sudoeste. Os dois exemplares encontrados foram coletados na foz do Rio Amazonas (02º 00' 19" N, 47º 03' 30" W, e 00º 49' 06" N, 46º 25' 09" W).

Desbalance autonómico y procoagulación debido a contaminación atmosférica en Santiago: un estudio prospectivo / Autonomic imbalance and procoagulation due to Santiago’s atmospheric pollution: a prospective study

La contaminación atmosférica (CA) está asociada a aumento de morbilidad cardiovascular a través de mecanismos poco conocidos. Postulamos que la CA por partículas finas se asocia a disminución de la variabilidad de la frecuencia cardíaca (VFC) y a aumento de parámetros procoagulantes. Métodos: Cohorte prospectiva de 6 meses de duración en Santiago (n=88; edad 57±1 años; 44 pts.s con enfermedad coronaria y 44 controles pareados por edad, sexo y comuna de residencia). En cada sujeto se realizó Holter de arritmias de 24 hrs y se determinó proteína C reactiva, viscosidad plasmática, hematocrito y recuento de plaquetas durante un episodio de aumento de la CA y 6 meses después. Se obtuvieron los niveles diarios contemporáneos de partículas PM 2,5 y se analizaron sus efectos sobre la VFC y sobre los parámetros circulantes utilizando modelos aditivos generalizados con ajuste por condiciones meteorológicas, condición caso/control, edad, sexo, índice de masa corporal, colesterol total y HDL, presión arterial sistólica y diastólica, creatinina y uso de aspirina o de betabloqueadores. Resultados: Las concentraciones elevadas de partículas PM 2,5 en el aire los días previos a la medición se asociaron en forma independiente y significativa (p<0,05) con aumento de la FC y disminución en la desviación standard de los intervalos RR normales (SDNN). Se observó además una asociación independiente y significativa (p<0,05) con aumento de la viscosidad plasmática, hematocrito, VHS y del recuento de plaquetas. Conclusiones: Los resultados muestran que la CA por partículas pequeñas disminuye la VFC y aumenta parámetros circulantes de procoagulación, que podrían ser mecanismos que expliquen un aumento de la morbimortalidad cardiovascular debido a CA.

Isolamento e seleção de microorganismos produtores de lipase como biocatalisadores na hidrólise parcial de óleo de sardinha / Isolation and selection of lipase producing microorganisms as biocatalysts in the partial hydrolysis of sardine oil

O trabalho descreve o isolamento e a seleção de microorganismos produtores de enzimas lipolíticas e a utilização do extrato enzimático bruto como biocatalisador na hidrólise do óleo de sardinha brasileiro. A biocatálise tem por objetivo enriquecer o óleo em ácidos graxos pliinsaturados, os quais possuem efeitos benéficos em doenças cardiovasculares, processos inflamatórios e alérgicos. Os produtos resultantes da hidrólise foram analisados por cromatografia gás-liquido. Dentre as quatrocentos e vinte e cinco amostras de fungos isoladas e testadas, uma delas (nº 122) foi capaz de produzir modificações favoráveis na composição em ácidos graxos de sardinha, mostrando-se promissora no enriquecimento de ácidos graxos poliinsaturados.