Effects of simvastatin/ezetimibe on microparticles, endothelial progenitor cells and platelet aggregation in subjects with coronary heart disease under antiplatelet therapy

It is not known whether the addition of ezetimibe to statins adds cardiovascular protection beyond the expected changes in lipid levels. Subjects with coronary heart disease were treated with four consecutive 1-week courses of therapy (T) and evaluations. The courses were: T1, 100 mg aspirin alone; T2, 100 mg aspirin and 40 mg simvastatin/10 mg ezetimibe; T3, 40 mg simvastatin/10 mg ezetimibe, and 75 mg clopidogrel (300 mg initial loading dose); T4, 75 mg clopidogrel alone. Platelet aggregation was examined in whole blood. Endothelial microparticles (CD51), platelet microparticles (CD42/CD31), and endothelial progenitor cells (CD34/CD133; CDKDR/CD133, or CD34/KDR) were quantified by flow cytometry. Endothelial function was examined by flow-mediated dilation. Comparisons between therapies revealed differences in lipids (T2 and T3<T1 and T4 for total cholesterol, LDL-C, and triglycerides; P<0.002 for all), as well as for endothelial function (T2>T1 and T4, P=0.001). Decreased platelet aggregation was observed after aspirin (arachidonic acid, T1<T3 and T4, P=0.034) and clopidogrel (adenosine, T3 and T4<T1 and T2, P<0.0001) therapy. Simvastatin/ezetimibe diphosphate did not change platelet aggregation, the amount of circulating endothelial and platelet microparticles, or endothelial progenitor cells. Cardiovascular protection following therapy with simvastatin/ezetimibe seems restricted to lipid changes and improvement of endothelial function not affecting the release of microparticles, mobilization of endothelial progenitor cells or decreased platelet aggregation.

Tomografia computadorizada da matriz óssea mineralizada heteróloga fragmentada e metilmetacrilato na reparação de falhas ósseas segmentares produzidas em tíbia de coelhos / Computed tomography to evaluate the association of fragmented heterolog cortical bone and methylmethacrylate to repare segmental bone defect produced in tibia of rabbits

Foi realizada falha segmentar de 6mm na região metafisária medial da tíbia de 12 coelhos, seguida de preenchimento desta por matriz óssea mineralizada heteróloga fragmentada conservada em glicerina (98%) e metilmetacrilato autoclavado, bem como avaliação por meio da tomografia computadorizada de feixe cônico (cone beam) aos 30, 60 e 90 dias. Houve incorporação gradativa do implante no leito receptor em relação ao tempo em 100% dos casos, o que mostra ser este biologicamente compatível, ao promover reparação da falha óssea, sem sinais de infecção, migração e/ou rejeição, caracterizando-se, assim, como nova opção de substituto ósseo para preenchimento de falhas ósseas.

A 6mm segmental defect was performed on the metaphyseal region of the tibia of 12 rabbits and the autoclaved fragmented heterolog cortical bone conserved in glycerin (98%) and methylmethacrylate was used as a bone graft for the reconstruction. The graft was placed in the receptor bed and its integration was evaluated by computed tomography after 30, 60 and 90 days. There was gradual bone graft incorporation in the receptor bed during the time in 100% of the cases. Fragmented cortical bone heterograft and methylmethacrylate was biologically compatible and promotes bone defect reparation without signs of infection, migration and or rejection, featuring a new option of osseous substitute to fill in bone defects.

Anticorpos anti-Leptospira spp. em ovinos do município de Monte Negro, estado de Rondônia / Anti-Leptospira spp. antibodies in ovines from Monte Negro municipality, Rondonia state, Brazil

O presente estudo determinou a prevalência de anticorpos anti-Leptospira spp. em ovinos do Município de Monte Negro, RO. Foram examinados soros de 141 ovinos de raça, idade e sexo variados provenientes de 15 fazendas, pela técnica de Soroaglutinação Microscópica. Doze (80,0%) propriedades apresentaram pelo menos um animal reagente. Títulos de anticorpos iguais ou superiores a 100 foram detectados em 47 (33,3%) animais, e os sorovares mais frequentes foram Patoc (29,7%), Autumnalis (14,8%), Pyrogenes (10,6%), Australis (4,2%), Bratislava (4,2%), Hardjo (4,2%), Icterohaemorrhagiae (4,2%), Castellonis (2,1%) e Hebdomadis (2,1%). Em 11 (23,4%) soros não foi possível a determinação do provável sorovar envolvido na reação. Alerta-se também para a possibilidade de infecção no homem, tendo em vista as características regionais de fronteira agrícola amazônica.

The present study determined the prevalence of anti-Leptospira spp.antibodies in 141 ovines from 15 farms of the Monte Negro Municipality, Rondonia State, Brazil, by the microscopic agglutination test. Twelve (80.0%) farms presented at least 1 reactive animal. Antibodies titers of ? 100 were detected in 47 (33.3%) animals, the most frequent serovars being Patoc (29.7%), Autumnalis (14.8%), Pyrogenes (10.6%), Australis (4.2%), Bratislava (4.2%), Hardjo (4.2%), Icterohaemorrhagiae (4.2%), Castellonis (2.1%) and Hebdomadis (2.1%). In 11 (23.4%) sera it was not possible to determine the most frequent serovar involved. The results raise a warning as to the possibility of infection in the human being by Leptospira in light of the regional characteristics of the Amazon agricultural frontier.

Aspectos histológicos de fragmentos esplênicos autotransplantados em ratos / Histopathologic aspects of splenic fragments autotransplanted in rats

Estudou-se a viabilidade do autotransplante de tecido esplênico, um terço do baço, associado à esplenectomia parcial, e verificou-se a cinética evolutiva de sua regeneração, sob o aspecto macroscópico e histológico. Foram utilizados 28 ratos Wistar, adultos, machos, com média de peso de 300g, distribuídos em quatro grupos experimentais. Cada animal foi submetido à esplenectomia parcial, e um fragmento de baço foi transplantado para o omento maior, por períodos de 30, 60, 90 e 120 dias. Após cada período pré-estipulado, os tecidos esplênicos autotransplantados foram coletados e analisados histologicamente. Os resultados mostraram regeneração da cápsula esplênica, dos vasos sanguíneos e das polpas branca e vermelha. Aos 90 dias, a arquitetura microscópica apresentava-se semelhante à do baço normal.

The splenic tissue autograft viability (one third of the spleen) associated to parcial splenectomy was studied to verify the evolutive kinetic of its regeneration by macroscopic and histological aspects. Twenty-eight adult male Wistar rats, weighting 300g, were distributed in four experimental groups. Each animal was submitted to parcial splenectomy and one fragment of each spleen was autotransplanted to the greater omentum, for a period of 30, 60, 90, and 120 days. After each period, the autotransplanted splenic tissues were collected and histopathologically analyzed. The results showed regeneration of the splenic capsule, blood vessels, white pulp, and red pulp. After 90 days, the microscopic architecture was similar to the normal spleen.

Aspectos morfológicos, morfométricos e ultraestruturais do baço de ratos após o clampeamento total do pedículo hepático / Morphologic, morphometric, and ultrastructural aspects of the spleen of rats after hepatic pedicle total clamping

Avaliaram-se as alterações morfológicas, morfométricas e ultraestruturais que ocorreram no baço devido à isquemia produzida pelo clampeamento total do pedículo hepático. Para tanto, foram utilizados 40 ratos machos, distribuídos em quatro grupos de 10 animais. O grupo-controle (C) não foi submetido à isquemia, e os grupos tratados (E1, E2e E3) foram submetidos ao clampeamento por 10, 20 e 30 minutos, respectivamente. Fragmentos do baço foram retirados e analisados histologicamente pela microscopia de luz (hematoxilina-eosina, ferrocianeto-férrico) e pela microscopia eletrônica de transmissão. Os resultados demonstraram que 10 minutos de clampeamento do pedículo hepático são suficientes para apresentar sinais de congestão esplênica e 20 e 30 minutos promovem intensa digestão de hemácias pelos macrófagos, com presença de grânulos de ferro (hemossiderina) no parênquima esplênico.

The macro and microscopic alterations that occurred in the spleen during an ischemia produced by the hepatic pedicle total clamping were studied. Forty male rats were distributed in four groups of 10 animals each. The control group (C) was not submitted to ischemia and the treated groups (E1, E2, and E3) were submitted to the clamping during 10, 20, and 30 minutes, respectively. Spleen fragments were collected and histologically analyzed by the light microscopy (eosin-hematoxilin and ferric ferrocyanide) and by the transmission electron microscopy. The results showed that 10 minutes of hepatic pedicle total clamping was enough produce signs of splenic congestion and 20 and 30 minutes promoted intense red bood cels digestion by the macrophages with the presence of iron granules (hemosiderin) in the splenic parenchyma.

Differential response to gepirone but not to chlordiazepoxide in malnourished rats subjected to learned helplessness

The learned helplessness (LH) paradigm is characterized by learning deficits resulting from inescapable events. The aims of the present study were to determine if protein-calorie malnutrition (PCM) alters learning deficits induced by LH and if the neurochemical changes induced by malnutrition alter the reactivity to treatment with GABA-ergic and serotonergic drugs during LH. Well-nourished (W) and PCM Wistar rats (61 days old) were exposed or not to inescapable shocks (IS) and treated with gepirone (GEP, 0.0-7.5 mg/kg, intraperitoneally, N = 128) or chlordiazepoxide (0.0-7.5 mg/kg, intraperitoneally, N = 128) 72 h later, 30 min before the test session (30 trials of escape learning). The results showed that rats exposed to IS had higher escape latency than non-exposed rats (12.6 ± 2.2 vs 4.4 ± 0.8 s) and that malnutrition increased learning impairment produced by LH. GEP increased the escape latency of W animals exposed or non-exposed to IS, but did not affect the response of PCM animals, while chlordiazepoxide reduced the escape deficit of both W and PCM rats. The data suggest that PCM animals were more sensitive to the impairment produced by LH and that PCM led to neurochemical changes in the serotonergic system, resulting in hyporeactivity to the anxiogenic effects of GEP in the LH paradigm.

Fatores de risco associados à ocorrência de anticorpos anti-Leptospira spp. em cães do município de Monte Negro, Rondônia, Amazônia Ocidental Brasileira / Risk factors associated with anti-Leptospira spp antibodies occurrence in dogs from Monte Negro County, Rondônia, Brazilian Western Amazon

Foram testados, pela técnica de soroaglutinação microscópica aplicada à leptospirose, 329 cães provenientes do município de Monte Negro, RO, dos quais 156 eram da área urbana e 173 da área rural. Simultaneamente foi aplicado questionário para verificar a existência de possíveis fatores de risco pela regressão logística. Abordaram-se questões referentes a idade, sexo, dieta, tipo de criação, ambiente, contato com outras espécies e hábito de caça. Foram detectadas reações com títulos >100 em 27,3 por cento, com 90 cães positivos ao agente, das quais 23,7 por cento eram da área (37/156) urbana e 30,6 por cento (53/173), da área rural (P>0,05). Os sorovares predominantes, reatores com títulos mais elevados, foram Autumnalis (22 por cento), Pyrogenes (12 por cento), Canicola (10 por cento) e Shermani (7,5 por cento). Cães com idade acima de 12 meses apresentaram maior ocorrência de anticorpos quando comparados aos cães mais jovens (P<0,05). Dentre os fatores de risco analisados, foram significativos a alimentação (dieta à base de ração comercial - odds ratio: 3,3; intervalo de confiança: 95 por cento: 1,2 - 9,2; P=0,02) e o sexo (macho - odds ratio: 2,3; intervalo de confiança: 95 por cento: 1,3 - 3,9; P=0,003). Ressalta-se a ocorrência de reações para sorovares mantidos na natureza por animais silvestres.

The microscopic agglutination test was applied to 329 samples taken from 156 dogs from urban area and 173 from rural areas of Monte Negro County, Rondônia State, Brazil, to determine anti-Leptospira spp. antibodies. A survey was concomitantly done to detect eventual risk factors thru the use of logistic regression. Studied variables were age, sex, diet, management, environment, contact with other species and hunting habit. Titers >100 were detected in 27.3 percent (90/329) of the dogs, being 23.7 percent (37/156) urban and 30.6 percent (53/173) rural dogs. The most frequent serovars were Autumnalis (22.0 percent), Pyrogenes (12.0 percent), Canicola (10.0 percent) and Shermani (7.5 percent). Dogs older than 12 months showed higher positive frequencies than younger animals (P<0.05). Risk factor were associated with commercial food as compared to homemade food (odds ratio: 3.3; 95 percent confidence interval : 1.3 - 3.9; P=0.02) and associated with sex, with higher occurrence in males than in females (odds ratio: 2.3; 95 percent confidence interval: 1.3 - 3.9; P=0.003). It was emphasized the serological occurrence of serovars kept and spread in nature by wild animals.

An in vivo test to assess mefloquine 25 mg/kg for the treatment of uncomplicated falciparum malaria in Rondônia, Brazil

Drug-resistant Plasmodium falciparum is undermining malaria control efforts worldwide. In Brazil, mefloquine (MQ) at a dose of 15 mg/kg body weight is used to treat P. falciparum. At this dose, MQ resistance developed rapidly in Thailand. Use of a higher MQ dose may retard the development of resistance. We treated 50 patients aged one to 67 years who had acute, uncomplicated P falciparum malaria using MQ 25 mg/kg. There were no serious adverse events. Two patients complained of dizziness and insomnia. Assessing evaluable patients, the day 42 cure rate was 40/42 [95.2 percent (95 percent confidence interval 83.8 to 99.4 percent)]. Mefloquine was efficacious and well tolerated in this small cohort from the state of Rôndonia.

Fixaçäo externa de fratura metacarpiana com pinos transcorticais e gesso sintético em bezerro Simental / External fixation of the metacarpal fracture with transcortical pins and fiberglass cast in Simmental calf

A six-month-old 245 kg male Simmental calf was referred to the Veterinary Hospital in Cuiabá, MT, with closed comminuted diaphyseal fracture in metacarpus. It was given preference to external fixation as means of fracture immobilization, and transcortical pins and fiberglass cast were used. This technique showed effective immobilization of the fracture, less expensive and feasible to be done in the field

A rural community in a Brazilian Western Amazonian region: some demographic and epidemiological patterns

Some demographic and epidemiological patterns of the rural population of Monte Negro, locality situated in the State of Rondônia (Brazil), Western Amazonia, are described based on a sample of 924 randomly selected individuals, approximately 10 percent of the whole population. The main features of this sample are (1) the illiteracy rates in the parental generation were 23 percent for fathers and 20 percent for mothers. Among children, this figure dropped to 6 percent; (2) housing in Monte Negro is characterized by being constructed with wood (92 percent), and also a floor (75 percent). Nevertheless, only 32 percent of these houses had electric energy; (3) the mean ages for the parental generation were 41.9 for males and 36.3 for females. These values for the offspring generation were 12.2 and 10.5, respectively; (4) the sex-ratio of the offspring generation was 1.32;(5) the bioassay of kinship was estimated as .033 for this long range migrant population; (6) the prevalence of some macrophage dependent infectious disease was conspicuously high; (7) the reported number of malarial episodes among males and females was statistically different, suggesting that malaria may be, in part, a "professional" disease; (8) the prevalence of serum-positive reactions against B-hepatitis is distressing. It has a strong age dependence and reaches 74 percent among adult males. Conversely, signs of active infection (AgHbs) rises to 16 percent among children

Avaliação da eficácia do artesunato associado à tetraciclina na terapêutica da malária falciparum / The evaluation of the efficacy of artesunate combined with tetracycline in the therapy of falciparum malaria

Realizou-se um ensaio clínico, randomizado e controlado, comparando o artesunato com o quinino e a mefloquina, em casos de malária não grave. Foram tratados 42 pacientes em regime de internação e o seguimento durou 28 dias. Realizou-se exame de gota espessa cada 12 horas até sua negativação, hemograma e bioquímica sanguínea, pré e pós-tratamento. A média da parasitemia inicial foi 42.568 parasitas/ml. Vinte e seis pacientes foram acompanhados durante 28 dias e 16 durante menos de 28 dias. Um paciente de cada grupo apresentou R I tardia e um paciente do grupo do quinino apresentou R III. As porcentagens de cura foram 88,8%, 85,7% e 81,8% para o artesunato, a mefloquina e o quinino, respectivamente, sem mostrar diferença significativa. O tempo de desaparecimento da febre não mostrou diferença significativa entre os grupos. O grupo do artesunato teve um tempo menor de clareamento da parasitemia (37,33 ± 11,52 horas) quando comparado com o quinino (65,25 ± 17,44 horas), sendo estatisticamente significativa (p = 0,0016). O grupo da mefloquina (58,9 ± 16,68 horas) não mostrou diferença com os outros grupos. Não se apresentaram efeitos adversos importantes em nenhum dos esquemas usados, sendo bem tolerados pelos pacientes.

A controlled clinical therapeutic study in hospitalized patients compared artesunate with quinine and mefloquine in patients with uncomplicated falciparum malaria. Forty two patients entered the trial and the follow up was for 28 days with thick blood film taken every 12 hours until became negative. Laboratory examinations included haematological and biochemical tests before and after treatment. Patients had a mean parasitaemia of 42.568 per microliter. Twenty six patients completed 28 days of follow up but 16 did not fulfil this protocol. One in each of the therapeutic groups showed delayed R I resistance. A further patient in the quinine group showed R III resistance. The cure rate was 88.8% for artesunate. 85.7% for mefloquine and 81.8% for quinine; no significant difference was found, the same occurring with the clearance of fever. The artesunate group had a quicker parasitaemia clearance time (37.3 +/- 11.5 hours) when compared with quinine (65.2 +/- 17.4) showing a significant difference (p = 0.0016). Parasite clearance with mefloquine, was intermediate (58.9 +/- 16.6 ours) between the artesunate and quinine. No important side effects were observed with any of the therapeutic regimens and no deaths registered.