Negative impacts of the administration of hydroxycloroquine and anticoagulant in patients with SARS-COV-2 infection: a randomized clinical trial / Impactos negativos da administração de hidroxicloroquina e anticoagulante em pacientes com infecção por SARS-COV-2: um ensaio clínico randomizado

Purpose: To evaluate antimalarial with or without anticoagulant treatment, in patients with recent SARS-COV-2 infection. Methods: Clinical study carried out at Samuel Libânio Clinic Hospital, University of Vale do Sapucaí, Pouso Alegre-MG. Approved by the Ethics Committee (4.034.077) and registered in the Clinical Trials (NCT04788355). Suspected patients for COVID-19 were included in the emergency room. The groups were: C (control) with 6 patients, A (anticoagulant apixaban) with 9 patients, H (hydroxychloroquine) with 5 patients and HA (hydroxychloroquine and anticoagulant apixaban) with 8 patients. Results: there were no significant differences between groups. The HA group, in which there was an intervention with two drugs, presented a greater number of days with symptoms (p = 0.037) and worse results, when compared to the control: most relevant symptoms, were: cough (p = 0.001), and anosmia / ageusia (p = 0.011) headache (p = 0.001). Conclusion: The present study began when there were doubts about the use of drugs such as Hydroxychloroquine (HCQ) and apixaban (APX). The reduced "n" was defined through bureaucratic and polemic issues independent of the authors' actions. No clinical benefit was associated with HCQ and APX. There was an increase in the number of symptomatic days when HCQ and APX were administered. Despite the limitations, there was no therapeutic indication of the evaluated drugs. [au]

Objetivo: Avaliar antimalárico com ou sem tratamento anticoagulante, em pacientes com infecção recente por SARS-COV-2. Métodos: Estudo clínico realizado no Hospital das Clínicas Samuel Libânio da Universidade do Vale do Sapucaí, Pouso Alegre-MG. Aprovado pelo Comitê de Ética (4.034.077) e registrado nos Ensaios Clínicos (NCT04788355). Pacientes suspeitos de COVID-19 foram incluídos na sala de emergência. Os grupos foram: C (controle) com 6 pacientes, A (anticoagulante apixabana) com 9 pacientes, H (hidroxicloroquina) com 5 pacientes e HA (hidroxicloroquina e anticoagulante apixabana) com 8 pacientes. Resultados: não houve diferenças significativas entre os grupos. O grupo HA, no qual houve intervenção com dois medicamentos, apresentou maior número de dias com sintomas (p = 0,037) e piores resultados, quando comparado ao controle: os sintomas mais relevantes foram: tosse (p = 0,001), e anosmia/ageusia (p = 0,011) cefaléia (p = 0,001). Conclusão: O presente estudo teve início quando havia dúvidas sobre o uso de medicamentos como hidroxicloroquina (HCQ) e apixabana (APX). O "n" reduzido foi definido por meio de questões burocráticas e polêmicas independentes das ações dos autores. Nenhum benefício clínico foi associado com HCQ e APX. Houve um aumento no número de dias sintomáticos quando HCQ e APX foram administrados. Apesar das limitações, não houve indicação terapêutica dos medicamentos avaliados. [au]

Development of an Extraction Protocol for Fetal Sexing from the Fourth Week of Gestation by Real Time PCR

Abstract Low number of fetal cells in maternal blood limited the use of fetal materials in diagnostic and clinical applications. This research developed a technology which allowed the extraction of fetal DNA by a non-invasive method that offers no risk to the mother or fetus. A total of 132 pregnant women participated in this inquiry. The DNA extraction was performed employing an in-house method based on guanidine thiocyanate and magnetic bead. For the amplification it was used the Quantifier Y Kit™. The fetal sexing analysis of the 132 pregnant women were 100% in agreement with the ultrasound. Sensitivity and specificity for detection of Y chromosome sequences was possible using Real-Time Polymerase Chain Reaction since the 4th week of gestation. This non-invasive early determination could be employed in fetal gender and also to be extended to detection of genetic diseases in the shortest possible time avoiding invasive methods that puts the fetus at risk.

Secreted protein acidic and rich in cysteine (SPARC) induces epithelial-mesenchymal transition, enhancing migration and invasion, and is associated with high Gleason score in prostate cancer / 亚洲男科学杂志(英文版)

Secreted protein acidic and rich in cysteine (SPARC) is a matricellular protein highly expressed in bone tissue that acts as a chemoattractant factor promoting the arrival of prostate cancer (PCa) cells to the bone marrow. However, the contribution of SPARC during the early stages of tumor progression remains unclear. In this study, we show that SPARC is highly expressed in PCa tissues with a higher Gleason score. Through stable knockdown and overexpression of SPARC in PC3 and LNCaP cells, respectively, here we demonstrate that endogenous SPARC induces the epithelial-mesenchymal transition (EMT), decreasing E-cadherin and cytokeratin 18 and increasing N-cadherin and vimentin. Moreover, SPARC induces the expression of EMT regulatory transcription factors Snail family transcriptional repressor 1 (Snail), Snail family transcriptional repressor 2 (Slug), and zinc finger E-box binding homeobox 1 (Zeb1). In addition, SPARC knockdown in PC3 cells decreases migration and invasion in vitro, without modifying cell proliferation. Our results indicate that SPARC might facilitate tumor progression by modifying the cellular phenotype in cancer cells.

Physically active men show better semen parameters than their sedentary counterparts

Background: The quality of semen depends upon several factors such as environment, life style, physical activity, age, and occupation. The aim of this study was to analyze and compare the conventional and functional semen parameters in men practicing vigorous physical activity to those of sedentary men

Materials and Methods: In this descriptive cross-sectional study, semen samples of 17 physically active men and 15 sedentary men were collected for analysis. Semen analysis was performed according to the World Health Organization [WHO] guidelines, while functional parameters were evaluated by flow cytometry

Results: Results showed that several semen parameters [semen volume, viability, progressive motility, total motility, normal morphology, and moribund cells] were superior in the physically active group in comparison with the sedentary group. Semen parameters such as viability, progressive motility and total motility, as well as the percentage of moribund spermatozoa were significantly different between both groups. However, sperm DNA damage, lipid peroxidation and mitochondrial potential were not significantly different among the groups

Conclusion: Nevertheless, the physical activity shows better semen parameters than sedentary group. Taken together, our results demonstrate that regular physical activity has beneficial impact in sperm fertility parameters and such a life style can enhance the fertility status of men

Hemoptysis due to pulmonary pseudosequestration secondary to gastro-pulmonary fistula after a revisional bariatric operation

We report the case of a patient with a history of a complicated revisional bariatric operation who developed a lung pseudosequestration secondary to a gastro-pulmonary fistula. As the patient presented with recurrent hemoptysis, she was initially submitted to embolization of the aberrant vessels and later to a definite operation, which consisted on a diversion of the gastric fistula into a Roux-en-Y intestinal loop. It is an exceptional case about late complications of bariatric surgery, and it underlines the importance of discarding these complications even when the clinical manifestations affect another anatomic region different from the operated abdomen

Tai Chi Chuan em mulheres idosas: efeitos na ergoespirometria e composição corporal / Tai Chi Chuan in senior women: Effects on ergospirometry and body composition

Tai Chi Chuan (TCC) tem sido largamente praticado na China há séculos. O objetivo desta pesquisa experimental com grupo controle foi verificar os efeitos do TCC na ergoespirometria (ERGO) e na composição corporal (CC) em 34 mulheres idosas saudáveis, não praticantes de atividade física orientada. No Grupo TCC (G1) foram incluídos 16 sujeitos (idade 66,19±4,78 anos) e no Grupo Controle (G2) 18 sujeitos (idade 72,94±6,24 anos). G1 praticou o TCC estilo Yang de 24 movimentos durante 24 semanas, 2 vezes por semana. Cada aula constou de 15 min. de aquecimento, 20 min. de treinamento da coreografia do TCC e 15 min. de relaxamento. Antes e depois da intervenção, foram mensurados volume máximo de oxigênio consumido (VO2) e Tempo de Teste (T) na ERGO em esteira e massa magra (MM) e percentual de gordura (G%) da CC através de absortometria por raios-x de dupla energia (DXA). G1 apresentou incrementos de 8,20% no VO2 (p=0,001) e de 13,35% no T (p=0,01) e nenhuma alteração significativa nas variáveis da CC (p>0,05) em relação ao G2. Não foi verificada correlação significativa entre as variáveis da ERGO e CC. Os resultados indicam que, em mulheres idosas, o TCC melhora a ERGO mas não a CC, sugerindo que a ERGO não está necessariamente ligada à CC na prática desta modalidade.

Tai Chi Chuan (TCC) has been widely practiced in China for centuries. The purpose of this controlled experimental study was to verify the effects of TCC program on ergospirometry (ERGO) and on body composition (BC) in 34 healthy elderly women, who did not practice any form of oriented physical activity. TCC group (G1) included 16 subjects (age 66.19±4.78 yr) and Control Group (G2) included 18 subjects (age 2.94±6.24 yr). G1 practiced the 24 forms Yang style TCC during 24 weeks, 2 times/week. Each session included 15 min of warm-up, 20 min of TCC form practice and 15 min of cool down. They were evaluated before and at the end of the intervention: the maximal oxygen uptake (VO2) and exertion time (T) on ERGO in treadmill test and the fat free mass (FFM) and body fat percentage (BFP) on BC in Dual X-ray absorptiometry (DXA). G1 showed increases of 8.20% in VO2 (p = 0.001) and of 13,35% in T (p = 0.01) and no significant changes in the BC variables (p>0.05) in relation to G2. No significant correlation was observed between the ERGO and BC variables. The results indicate that, in elderly women, TCC program is effective for improving ERGO but not BC, indicating that ERGO is not necessarily linked to BC in this practice.

Immunologic Evaluation of Drug Allergy

Hypersensitivity drug reactions (HDR) consist of an individual abnormal response with the involvement of the immunological system. In addition to specific immunological mechanisms where specific antibodies or sensitised T cells participate, release of inflammatory mediators by non-specific immunological recognition may also occur. Within this category are one of the most common groups of drugs, the non-steroidal anti-inflammatory drugs. In addition to chemical drugs new emerging ones with an increasing protagonism are biological agents like humanised antibodies and others. For IgE dependent reactions both in vivo and in vitro tests can be used for the immunological evaluation. Sensitivity of these is not optimal and very often a drug provocation test must be considered for knowing the mechanism involved and/or establishing the diagnosis. For non-immediate reactions also both in vivo and in vitro tests can be used. Sensitivity for in vivo tests is generally low and in vitro tests may be needed for the immunological evaluation. Immunohistochemical studies of the affected tissue enable a more precise classification of non-immediate reactions. The monitorization of the acute response of the reactions has given clues for understanding these reactions and has promising results for the future of the immunological evaluation of HDR.

Amputação por pé diabético em pacientes hospitalizados da cidade do Recife / Amputations for diabetic foot among patients hospitalized in the city of Recife

Objetiva-se analisar amputações por pé diabético em pacientes de dois hospitais públicos do Recife, segundo a procedência do paciente. Trata-se de um estudo descritivo na modalidade quantitativa. Sendo que 41,6% da amostra já havia sido internada por problema com os pés. A prevalência de amputação entre os residentes na região metropolitana da cidade do Recife foi 72,2% (p menor que 0,05). Verificou-se associação entre amputações e procedência do paciente. Os resultados alertam gestores públicos para a necessidade de melhorar o acesso e utilização da população aos serviços de atenção básica de modo a prevenir e controlar o agravo pé diabético.

Tuberculose pancreática: relato de caso e revisão da literatura / Pancreatic tuberculosis: a case report and literature review

O pâncreas é raramente afetado por infecções pelo bacilo Mycobacterium tuberculosis, provavelmente em função da presença das enzimas pancreáticas, e apenas alguns casos são descritos na literatura. O diagnóstico diferencial com carcinoma pancreático é um desafio em virtude das semelhanças clínico-radiológicas. Apresentamos um caso de um paciente de 39 anos de idade, do sexo masculino, com quadro clínico de perda ponderal, náuseas e vômitos. A propedêutica radiológica com tomografia computadorizada de abdome revelou lesões em cauda do pâncreas e baço. O diagnóstico foi confirmado por exame histopatológico após laparotomia.

The pancreas is rarely affected by Mycobacterium tuberculosis infections, probably because of the presence of pancreatic enzymes, and only few cases are reported. The differential diagnosis with pancreatic carcinoma represents a challenge because of clinical and radiological similarities. We report the case of a 39-year-old male patient presenting weight loss, nausea and vomiting. Radiological workup with abdominal computed tomography has demonstrated lesions in the pancreatic tail and spleen. The diagnosis was confirmed by histopathological analysis following laparotomy.

Produção e qualidade de melão amarelo influenciado por coberturas do solo e lâminas de irrigação no período chuvoso / Yield and quality of yellow melon influenced by soil coverages and irrigation depth during rainfall period

O plantio de melão no período chuvoso tem sido um dos grandes desafios para os produtores da região do Nordeste brasileiro devido a problemas fitossanitários. Objetivou-se, neste trabalho, avaliar os efeitos de cobertura do solo e de lâminas de irrigação na produção e na qualidade do melão amarelo híbrido "Goldex", no período chuvoso. O experimento foi desenvolvido na Fazenda Santa Júlia Agrocomercial Exportadora de Frutos Tropicais Ltda, no município de Mossoró-RN, no período de abril a julho de 2003. O delineamento experimental utilizado foi o de blocos completos casualizados, com quatro repetições. Os tratamentos resultaram da combinação de cinco tipos de coberturas do solo (solo descoberto e coberturas do solo com plástico preto, prateado, amarelo e marrom) com três lâminas de irrigação (100 por cento, 86 por cento e 72 por cento da lâmina padrão, esta equivalente a 238,4mm por ciclo). As características avaliadas foram número, massa média e produtividade de frutos comercializáveis (mercados interno e externo), refugos e totais, firmeza e espessura de polpa, relação de formato e teor de sólidos solúveis totais. Houve interação significativa entre os tipos de coberturas do solo e as lâminas de irrigação para a produtividade total. A maior produtividade de frutos comercializáveis e de conteúdo de sólidos solúveis totais foi registrada nas coberturas do solo com plástico. Os números de frutos comercializáveis, refugos e totais, bem como a produtividade de frutos comercializáveis e refugos, não foram afetados significativamente pelas lâminas de irrigação.

Growing a melon crop during the rainfall period has been a great challenge for producers from the north eastern Brazil due to crop sanitary problems. This work was aimed at evaluating the effects of soil coverages and irrigation depth on yield and quality of yellow melon (hybrid Goldex) during the rainfall period. The experiment was carried out at Fazenda Santa Júlia Agro-Comercial Exportadora de Frutos Tropicais Ltda, Mossoró-RN, Northeastern Brazil, during the period of April to July 2003. The experimental design was a randomized complete blocks with four replications. The treatments were the combinations of five soil coverages (soil with no coverage and coverages with polyethylene films - black, silvery, yellow, and brown) with three irrigation depth (100 percent, 86 percent and 72 percent of the standard lamina, this equivalent to 238.44mm). The traits evaluated were number, mean weight and yield of marketable (internal and external markets), refuse and total fruits, pulp firmness and thickness, fruit shape index, and soluble solids content. Interaction between soil coverage types and irrigation depth was significant with regard to total fruit yield. The greatest marketable fruit yields and soluble solids contents were obtained with the use of polyethylene soil coverages. The numbers of marketable, refuse and total fruits, as well as the yields of marketable and refuse fruits were not significantly affected by the irrigation depth.