Trasplante cardíaco y autólogo de células progenitoras hematopoyéticas en pacientes con amiloidosis AL / Cardiac and autologous stem cell transplantation hematopoietic in patients with AL amyloidosis

Resumen Objetivo: Describir la evolución de las cadenas livianas libres séricas (CLL) en el período comprendido entre el trasplante cardíaco ortotópico (TCO) y el trasplante de células progenitoras hematopoyéticas (TCPH), la respuesta hematológica al año tras el TCPH y el tratamiento quimioterápico e inmunosupresor en pacientes con amiloidosis AL. Método: Serie de casos de pacientes consecutivos con diagnóstico de amiloidosis AL que recibieron TCO seguido de TCPH del Registro Institucional de Amiloidosis del Hospital Italiano de Buenos Aires, entre enero de 2010 y noviembre de 2021. Se reportaron los valores de CLL entre trasplantes y al año del TCPH. Las variables cuantitativas se describieron como mediana e intervalo intercuartil, y las variables categóricas como frecuencias absolutas y relativas. Resultados: De 106 pacientes con amiloidosis AL, seis tuvieron TCO seguido de TCPH. La mediana de edad fue de 55 años. La mayoría eran hombres (n = 5). En el período entre trasplantes, la CLL involucrada disminuyó en dos pacientes y se mantuvo estable en tres. Todos lograron la remisión hematológica completa al año del TCPH. Un solo paciente presentó recaída en el órgano sólido trasplantado. Tacrolimus, micofenolato de mofetilo y corticoides fue el esquema inmunosupresor utilizado después del TCO. Conclusiones: El TCO representa una opción de tratamiento en pacientes con falla cardíaca grave por amiloidosis, permitiendo luego un tratamiento intensivo con quimioterapia de inducción y TCPH. Si bien faltan estudios, la terapia inmunosupresora después del TCO podría tener algún efecto sobre las células plasmáticas clonales.

Abstract Objective: To describe the evolution of serum free light chains (FLC) in the period between orthotopic heart transplantation (OHT) and autologous stem cell transplantation (ASCT), the hematological response one year after ASCT and chemotherapy and immunosuppressive treatment in patients with AL amyloidosis. Method: Case series of consecutive patients diagnosed with AL amyloidosis who received OHT followed by ASCT from the Institutional Registry of Amyloidosis of the Italian Hospital of Buenos Aires, between January 2010 and November 2021. FLC values between transplants and at year post ASCT. Quantitative variables were described with their median and interquartile range. Categorical variables as absolute and relative frequencies. Results: Of 106 patients with AL amyloidosis, 6 had an OHT followed by ASCT. The median age was 55 years. Most were men (n = 5). In the period between transplants, the involved CLL decreased in two patients and remained stable in three. All achieved complete hematologic remission 1 year after ASCT. A single patient presented relapse in the transplanted solid organ. Tacrolimus, mycophenolate mofetil, and corticosteroids were the immunosuppressive regimen used after OHT. Conclusions: OHT represents a treatment option in patients with severe heart failure due to amyloidosis, allowing later intensive treatment with induction chemotherapy and ASCT. Although studies are lacking, immunosuppressive therapy after OHT might have some effect on clonal plasma cells.

Demanda asistencial del Servicio de Urgencias del Hospital Distrital de Hernandarias, Alto Paraná, Paraguay. Año 2015 / Assistance request from the Emergency Department of the District Hospital of Hernandarias, Alto Paraná, Paraguay. Year 2015

Una urgencia puede definirse como "una situación clínica que precisa de una atención sanitaria inmediata". Actualmente se observa un aumento desmedido en la utilización de los servicios de urgencias, lo cual afecta a la calidad de la atención y los costes, ya que se ha estimado que el coste de una enfermedad no urgente atendida en el Servicio de Urgencia hospitalario es entre 2,5 y 3 veces mayor que si la misma fuera atendida en una consulta. El objetivo es describir la demanda asistencial del Servicio de Urgencias del Hospital Distrital de Hernandarias (HDH) del año 2015. El estudio fue descriptivo, transversal y retrospectivo, realizado en el HDH, desde 01 de enero al 31 de diciembre del 2015. La fuente de datos, fueron los registros del Departamento de Estadística del HDH, siendo excluidas las consultas extramurales, externas y los casos pediátricos. De acuerdo a la prioridad de atención fueron clasificadas en emergencias, urgencias y consulta normal y los motivos de consulta fueron clasificados por causa médica, quirúrgica y traumas. Fue garantizada la confidencialidad de los pacientes. Durante el 2015 fueron atendidos 95.099 casos, 23.967 registrados como urgencias de adultos. El 70 % (15.815) fueron mujeres. El promedio de edad fue de 41 años. El 95% (22.160) de los pacientes provino de la ciudad de Hernandarias. Los meses con mayor demanda fueron agosto 12% (2930), julio (2701) y setiembre (2540) 11%, enero presento 2% (484). Los días de mayor afluencia fueron los miércoles (17%) y martes (16%). El motivo de consulta fueron Urgencias 71%, 9% Emergencias 9% y Consultas 20%. Los motivos de consultas fueron debidas a casos médicos (85%), traumas 9% y por causas quirúrgicas 6%. El 69% (16.638) fueron internados. Se debe realizar una correcta utilización de los servicios de urgencias para optimizar el servicio.

An urgency can be defined as "a clinical situation that needs immediate health care." There is currently an excessive increase in the use of Emergency Services, which affects the quality of care and costs, since it has been estimated that the cost of a non-urgent case taken care of in the Hospital Emergency Service is between 2.5 and 3 times greater than if the same case was taken care of in a consultation. The objective of this research is to describe the demand of the Emergency Department of the District Hospital of Hernandarias (HDH) of 2015. This study was descriptive, cross-sectional and retrospective, performed in the HDH, from january the 1st to december 31st, 2015. The data source was the records of the HDH Department of Statistics, excluding external consultations and pediatric cases. According to the priority of attention they were classified in emergencies, urgencies and normal consultation. The reasons for consultation were medical, surgical and trauma. Confidentiality of patients was guaranteed. During 2015, 95,099 cases were treated, 23,967 were registered as adult emergencies. 70% (15,815) were male. The average age was 41 years old. 95% (22,160) of the patients came from the city of Hernandarias. The months with the highest demand were August with 12% (2930), July (2701) and September (2540) 11%. January presented 2% of the cases (484). The days of greater affluence were wednesday (17%) and tuesday (16%). The reasons for consultation were 71% urgencies, 9% emergencies 9% and 20% consultations. The motives were due to medical cases (85%), trauma 9% and surgery cases in a 6%. 69% (16,638) were hospitalized. There must be a correct use of Emergencies Services in order to optimize it.

Validação de um método analítico rápido por CLAE-UV para determinação de cumarina em guaco (Mikania glomerata Sprengel) confirmado com espectrometria de massas / Validation of a rapid analytical method by HPLC for determining coumarin in guaco (Mikania glomerata Sprengel) confirmed with mass spectrometry

RESUMO A espécie Mikania glomerata Sprengel, popularmente conhecida no Brasil como guaco, é amplamente utilizada como expectorante para tratar doenças respiratórias e tem a sua atividade farmacológica atribuída principalmente a cumarina. Os resultados mostraram que o método apresenta linearidade de 0,05 a 0,8 mg mL-1. Ele foi considerado seletivo, exato e preciso. A proposta de um método rápido para determinação de cumarina em extratos de guaco torna-se interessante para a rotina de controle de qualidade industrial, visando à obtenção de medicamentos fitoterápicos padronizados.

ABSTRACT The species Mikania glomerata Sprengel, popularly known in Brazil as “guaco”, is widely used as an expectorant to treat respiratory diseases. Its pharmacological activity is mainly attributed to coumarin. The results showed that the method for determining coumarin presented linearity from 0.05 to 0.8 mg mL-1. It was considered selective, accurate, and precise according to the specific resolution from ANVISA, the Brazilian regulatory agency. The proposal of a rapid method for the determining coumarin in extracts of guaco is interesting for routine industrial quality control in order to obtain standardized, efficient, and safe phytotherapic medicines.

Efecto del masaje terapéutico como cuidado de enfermería en la capacidad funcional del adulto mayor / The effect of therapeutic massage as part of nursing care for the functional capacity of the elderly / Efeito da massagem terapêutica como cuidado da enfermagem na capacidade funcional do idoso

Objetivo: Evaluar el efecto del masaje terapéutico clásico como cuidado de enfermería en la capacidad funcional del adulto mayor en una casa hogar. Métodos: Estudio cuantitativo, longitudinal, cuasiexperimental. Se evaluó la capacidad funcional del adulto mayor antes y después del masaje terapéutico clásico con el índice de Barthel, alfa de Cronbach de 0.95. Muestreo no probabilístico por conveniencia. En total se estudiaron 15 adultos mayores divididos aleatoriamente en grupo de estudio y control, con base en Epidat 3.1. El análisis se realizó con estadística descriptiva y no paramétrica a través de T de Wilcoxon y U de Mann Whitney para lo cual se utilizó el programa SPSS v.19. Resultados: El promedio de edad fue de 84.14 ± 9.68 vs. 80.25 ± 10.49 para el grupo control y de estudio respectivamente; el 73% del género masculino. Previo y posterior al masaje terapéutico en la prueba de Wilcoxon, el resultado fue: grupo control (Z = 0, p = 1) vs. grupo experimental (Z = 2.47, p = 0.01). En la U de Mann Whitney (U = 0.5, p = 0.001). En la posprueba del grupo de estudio se observó un aumento significativo de la capacidad funcional. No existen estudios similares, sin embargo, algunas investigaciones han demostrado que el masaje terapéutico es efectivo para mejorar el dolor, la amplitud de movimiento y la fuerza de agarre en adultos mayores. Conclusiones: El masaje terapéutico clásico es efectivo para incrementar la capacidad funcional del adulto mayor institucionalizado.

Objective: To assess the effect of traditional therapeutic massage on the functional capacity of elderly adults in a residential care facility. Methods: Quasi-experimental, longitudinal and quantitative study. The elderly adults' functional capacity was assessed before and after the classic therapeutic massage using Barthel's index. Cronbach alpha turned out to be 0.95. The sampling was by convenience and not probabilistic. In total, 15 studied elderly adults were randomly assigned to a control group and a study group using Epidat 3.1. Descriptive and not parametric analysis was performed using Wilcoxon T and Mann Whitney U tests with the SPSS v.19 program. Results: The average age was 84.14 ± 9.68 and 80.25 ± 10.49 in the control and study groups respectively. Seventy-three percent were masculine. The Wilcoxon test results were Z = 0, P = 1 in the control group, and Z = 2.47, P = .01 in the experimental group. The Mann Whitney test result was U = 0.5, P = .001. The study group post-test showed a significant increase in the functional capacity. There are not many similar works in the literature; however some research studies have demonstrated that therapeutic massage is effective in improving movement and gripping strength, and also in reducing pain among elderly adults. Conclusions: Traditional therapeutic massage is effective in increasing the functional capacity of institutionalized elderly adults.

Objetivo: Avaliar o efeito da massagem terapêutica clássica como um cuidado de enfermagem na capacidade funcional do idoso no Lar. Métodos: Estudo qualitativo, longitudinal, quase experimental. Avaliou-se a capacidade funcional do idoso antes e depois da massagem terapêutica clássica com o índice de Barthel, alfa de Cronbach de 0.95. Amostragem não probabilística por conveniência. No total estudaram-se 15 idosos divididos aleatoriamente em grupo de estudo e de controle, utilizando Epidat 3.1. A análise realizou-se com estatística descritiva e não paramédica a través de T de Wilcoxon e U de Mann Whitney para o qual se utilizou o programa SPSS v. 19. Resultados: A média de idade foi de 84.14 ± 9.68 vs 80.25 ± 10.49 grupo controle e de estudo respectivamente, 73% gênero masculino. Prévio e posterior à massagem terapêutica na prova de Wilcoxon, o resultado foi: o grupo controle (Z = 0, p = 1) vs grupo experimental (Z = 2.47, p = 0.01). No U de Mann Whitney (U = 0.5, p = 0.001). No pós-teste do grupo de estudo observou-se um aumento significativo da capacidade funcional. Não existem estudos similares, porém, algumas pesquisas têm demonstrado que a massagem terapêutica é efetiva para a melhoria da dor, da amplitude de movimento e da força de preensão em idosos. Conclusões: A massagem terapêutica clássica é efetiva para incrementar a capacidade funcional do idoso numa instituição.

Levedura seca integral na alimentação de vacas lactantes / Dry yeast for lactating dairy cows

Os efeitos da inclusão de levedura seca de cana-de-açúcar (Saccharomyces cerevisiae) na dieta de vacas lactantes foram avaliados com base no fornecimento de quatro dietas constituídas de diferentes níveis de substituição do farelo de soja pela levedura de cana-de-açúcar (0,00; 0,33; 0,67 e 1,00kg/kg de MS). O delineamento utilizado foi o quadrado latino 4 × 4. Não houve efeito dos tratamentos sobre o consumo de MS, MO, EE, FDNi e NDT, porém ocorreu redução linear no consumo de PB e FDNcp e aumento do consumo de CNF. Diferenças estatísticas não foram verificadas para os coeficientes de digestibilidade aparente da MS, MO, PB, CNF e NDT; no entanto os coeficientes do FDNcp e do EE decresceram linearmente. Não foi observado efeito sobre a produção e eficiência de síntese microbiana, utilização dos componentes nitrogenados e produção e composição do leite. Conclui-se que a levedura seca pode substituir 100% o farelo de soja na alimentação de vacas lactantes.

The effects of the inclusion of sugar cane dry yeast (Saccharomyces cerevisiae) in dairy cows feeding were evaluated based on the provision of four different diets with increasing proportions of sugar cane dry yeast (0.00; 0.33; 0.67 and 1.00kg/kg of DM). The design adopted for this research was the latin square, 4 × 4. It was observed that the levels of yeast inclusion did not affect the intake of DM, OM, EE, NDFi and TDN. However, the CP and NDFcp intake decreased linearly, whereas the NFC intake increased linearly with the increasing levels of yeast. No effect on the digestibility coefficient of DM, OM, CP, NDFcp and NCF was observed. Nevertheless, the EE digestibility coefficient linearly decreased with the yeast inclusion in the experimental diets. There was no treatment effect on the production and efficiency of microbial synthesis, usage of nitrogenous components, as well as milk production and composition. It was concluded that the dried yeast can fully replace the soybean meal in diets of dairy cows.

Effects of triamcinolone acetonide on human trabecular meshwork cells in vitro.

Aim: To study the effects of triamcinolone acetonide (TA) on cultured human trabecular meshwork (HTM) cells. Materials and Methods: HTM cells were cultured and treated with 125, 250, 500 and 1000 μg/mL concentration of TA for 24 h. The cells were treated with both crystalline TA (TA‑C) (commercial preparation) and solubilized TA (TA‑S). Cell viability was measured by a trypan blue dye exclusion test. The activity of caspse‑3/7 was measured by a fluorescence caspase kit and DNA laddering was evaluated by electrophoresis on 3% agarose gel. Levels of lactate dehydrogenase (LDH) were assessed with LDH cytotoxicity assay kit‑II. Results: Mean cell viabilities of HTM cells after 24 h exposure to TA‑C 125, 250, 500, and 1000 μg/mL were 75.4 ±2.45% (P < 0.0001), 49.43 ± 1.85% (P < 0.0001), 17.07 ± 2.39% (P < 0.0001), and 3.7 ± 0.9% (P < 0.0001), respectively, compared with the untreated HTM cells 92.49 ± 1.21%. The mean cell viabilities with 125, 250, 500, and 1000 μg/mL of TA‑S were 94.47 ± 1.60% (P > 0.05), 90.13 ± 0.40% (P < 0.01), 85.57 ± 0.47% (P < 0.001), and 71.67 ± 3.30% (P < 0.0001), respectively, compared to DMSO‑equivalent cultures. Untreated HTM control had a cell viability of 96.57 ± 1.98%. DMSO‑treated controls of 125, 250, 500, and 1000 μg/mL had a cell viability of 94.73 ± 0.57%, 96.97 ± 1.08%, 93.97 ± 1.85%, and 97.27 ± 1.15%, respectively. There was no increase of caspase‑3/7 activity in cultures treated with either TA‑C or TA‑S. DNA laddering showed no bands in the TA‑C or TA‑S treated cultures. There were significantly higher LDH release rates at all concentrations of TA‑C compared to TA‑S. Conclusions: Results show that the effect of TA‑C and TA‑S on HTM cells is due to cell death by necrosis at all concentrations except 125 μg/mL of TA‑S. Elevated levels of LDH confirmed necrotic cell death. Our study also infers the relative safety of TA‑S over TA‑C.

Serial superficial digital flexor tendon biopsies for diagnosing and monitoring collagenase-induced tendonitis in horses / Biópsias seriadas do tendão flexor digital superficial para o diagnóstico e monitoração da tendinite induzida por colagenase em equinos

The purpose of this investigation was to demonstrate the feasibility of a biopsy technique by performing serial evaluations of tissue samples of the forelimb superficial digital flexor tendon (SDFT) in healthy horses and in horses subjected to superficial digital flexor tendonitis induction. Eight adult horses were evaluated in two different phases (P), control (P1) and tendonitis-induced (P2). At P1, the horses were subjected to five SDFT biopsies of the left forelimb, with 24 hours (h) of interval. Clinical and ultrasonographic (US) examinations were performed immediately before the tendonitis induction, 24 and 48 h after the procedure. The biopsied tendon tissues were analyzed through histology. P2 evaluations were carried out three months later, when the same horses were subjected to tendonitis induction by injection of bacterial collagenase into the right forelimb SDFT. P2 clinical and US evaluations, and SDFT biopsies were performed before, and after injury induction at the following time intervals: after 24, 48, 72 and 96 h, and after 15, 30, 60, 90, 120 and 150 days. The biopsy technique has proven to be easy and quick to perform and yielded good tendon samples for histological evaluation. At P1 the horses did not show signs of localised inflammation, pain or lameness, neither SDFT US alterations after biopsies, showing that the biopsy procedure per se did not risk tendon integrity. Therefore, this procedure is feasible for routine tendon histological evaluations. The P2 findings demonstrate a relation between the US and histology evaluations concerning induced tendonitis evolution. However, the clinical signs of tendonitis poorly reflected the microscopic tissue condition, indicating that clinical presentation is not a reliable parameter for monitoring injury development. The presented method of biopsying SDFT tissue in horses enables the serial collection of material for histological analysis causing no clinical signs and tendon damage seen by US images. Therefore, this technique allows tendonitis to be monitored and can be considered an excellent tool in protocols for evaluating SDFT injury.

Objetivou-se demonstrar a viabilidade de uma técnica de biópsia na realização de avaliações sequenciais de amostras de tecido do tendão flexor digital superficial (TFDS) do membro torácico, em equinos hígidos e em equinos submetidos à indução de tendinite do TFDS. Oito equinos adultos foram avaliados em duas fases (F) diferentes, controle (F1) e apresentando tendinite induzida (F2). Na F1, os equinos foram submetidos a cinco biópsias do TFDS do membro torácico esquerdo, com 24 horas (h) de intervalo entre as mesmas. Avaliações clínicas e ultrassonográficas (US) foram realizadas imediatamente antes e, 24 e 48 h após cada procedimento. O tecido tendíneo coletado por biópsia foi analisado histologicamente. A F2 ocorreu três meses depois, quando os mesmos equinos foram submetidos à indução de tendinite do TFDS do membro torácico direito por injeção intratendínea de colagenase. Na P2, Avaliações clínicas e US foram realizadas antes da indução da tendinite e após a mesma nos seguintes momentos: 24, 48, 72 e 96 h depois e, 15, 30, 60, 90, 120 e 150 dias depois. A técnica de biópsia se demonstrou ser de fácil e rápida realização, fornecendo fragmentos de tecido tendíneo adequados para a realização de histologia. Na F1, os equinos não demonstraram sinais de inflamação local, dor ou claudicação, bem como não apresentaram alterações na avaliação US do TFDS após as biópsias, demonstrando que o dano físico ao tendão provocado pela biópsia não compromete sua integridade. Assim, o procedimento pode ser utilizado rotineiramente para avaliações histológicas do tecido tendíneo. Na F2, observou-se uma relação entre os achados US e histológicos no que se refere à evolução da tendinite induzida. Entretanto, observou-se que os sinais clínicos da tendinite não acompanham a condição microscópica do tecido, o que indica que a apresentação clínica não pode ser utilizada como parâmetro para a monitoração da evolução da enfermidade. A técnica de biópsia apresentada para colheita de tecido do TFDS em equinos, permite a obtenção de tecido para avaliação histológica seriada sem provocar sinais clínicos e alterações ultrassonográficas que indiquem dano tecidual. Assim, a técnica permite a monitoração da tendinite e pode ser considerada uma excelente ferramenta na avaliação de injúrias do TFDS.

Hambúrgueres de aparas de jacaré-do-pantanal (Caiman yacare) submetidos a diferentes técnicas de defumação / Hamburguers from pantanal caiman meat (Caiman yacare) subjected to different smoking techniques

Avaliaram-se hambúrgueres de aparas de jacaré-do-pantanal (Caiman yacare) quanto à composição centesimal, cor e análise sensorial. O delineamento foi inteiramente ao acaso, em três tratamentos: T1= sem defumação; T2= defumação a quente e T3= defumação líquida, e nove repetições. As aparas foram moídas e condimentadas para o hambúrguer. Os hambúrgueres para defumação a quente foram colocados no defumador 60 min a 60ºC com gerador de fumaça por fricção. Foi pulverizada fumaça líquida, sobre os produtos (T3), e estes foram colocados em desidratador por 60 min a 60ºC. Houve diferença significativa quanto à composição centesimal entre os hambúrgueres defumados, T2 = 43,1% e T3 = 60,9%, e verificou-se menor teor de umidade em relação aos sem defumação, 73,3%. A proteína, 39,9%, e as cinzas, 6,1%, foram mais altas nos defumados a quente. Os hambúrgueres defumados a quente apresentaram menor luminosidade, 42,05, e maiores valores do croma a*, 14,65, e b*, 28,57, em relação aos demais tratamentos. As variáveis sensoriais foram significativas para sabor, textura e aceitação geral. Os produtos defumados a quente apresentaram a pior aceitação. Concluiu-se que a defumação a quente proporciona produtos com menor teor de umidade, com pigmentação mais intensa, porém menos aceitos pelos provadores.

Hamburgers made from minced meat of Pantanal caiman (Caiman yacare) were evaluated for their centesimal composition, color and sensory perception. The experiment was structured in a completely randomized design with three treatments (T1 = no smoke; T2 = smoked with hot smoke and T3 = smoked with liquid smoke), with nine repetitions each. The meat was minced and seasoned for the hamburgers. The hamburgers destined to hot smoking were placed in the smoker (60 min at 60ºC) with smoke generated through friction. The liquid smoke was sprayed in the samples (T3), next they were placed in dehydrators (60 min at 60ºC). There was a significant difference in centesimal composition, the smoked hamburgers (T2 = 43.1% and T3 = 60.9%) presenting significantly less moisture than non-smoked products (73.3%). Protein (39.9%) and ash (6.1%) were higher for the hot-smoked samples. The hot-smoked hamburgers had less luminosity (42.05) and higher values of chroma a* (14.65) and b* (28.57) than the other treatments. The sensorial parameters evaluated were significant for flavor, texture and general acceptance. The hot-smoked products had the worst acceptance. It was concluded that the hot smoke provided products with less moisture and higher pigmentation, but with less acceptance from the judges.

Aspergellus niger como produtor de enzimas celuloliticas a partir farelo de cacau (theobroma cacao) / Aspergellus niger as a producer of cellulolytic enzymes from cocoa (Theobroma cacao) meal

O objetivo deste trabalho foi estudar a aplicação do fungo Aspergillus niger como produtor das enzimas celulolíticas CMCase, FPase e Xilanase, através da fermentação em estado sólido de cacau (Theobroma cacao). Avaliaram-se o efeito do tempo de fermentação (24, 72, e 120 horas) e da atividade de água (0,963; 0,976 e 0,983) sobre a produção das enzimas. As fermentações foram realizadas a 30º C em estufa bacteriológica. A otimização das condições ideais para produção de enzimas foi realizada a partir da Metodologia de Superfície de Resposta (MSR). Estatisticamente, as melhores atividades para a CMCase obtidas foram 14,18 U/mL em 0,972 aw e 70,07 horas de fermentação, para a FPase 7,51 U/mL 0,974 aw 80,56 horas e para a Xilanase foi 11,86 U/mL 0,971 aw e 64,24 horas.

Aspergellus niger as a producer of cellulolytic enzymes from cocoa (Theobroma cacao) meal. The aim of this work was to study the application of the fungus Aspergillus niger as a producer of the cellulolytic enzymes CMCase, FPase and Xylanase by solid-state fermentation of cocoa (Theobroma cacao). We evaluated the effect of fermentation time (24, 72, and 120 hours) and water activity (0.963, 0.976 and 0.983) on the production of enzymes. Fermentations were performed at 30º C in a bacteriological incubator. The optimization of ideal conditions for enzyme production was carried out using the response surface methodology (RSM). Statistically, the best activity obtained for CMCase was 14.18 U/mL at aw 0.972 and 70.07 hours fermentation, for FPase it was 7.51 U/mL at 0.974 aw and 80.56 hours, while for Xylanase was 11.86 U/mL at aw 0.971 and 64.24 hours.

Molecular identification and thermoresistance to boiling of Nocardia farcinica and Nocardia cyriacigeorgica from bovine bulk tank milk

Two strains of Nocardia spp. were isolated from bovine milk of two individual bulk tank. Molecular identification classified the strains as Nocardia farcinica and Nocardia cyriacigeorgica. The thermorresistance to boiling of the isolates was carried out and was observed bacterial growth after boiling. Our findings indicate the potential risk of pathogen transmission to humans through contaminated milk with Nocardia spp.

Prostatic carcinomas with neuroendocrine differentiation diagnosed in needle biopsies, a morphologic study of 7 cases among 465 sequential biopsies in a tertiary cancer center

PURPOSE: Neuroendocrine carcinomas (NEC) of the prostate are rare, with only a few series hitherto reported. The objective of this study was to assess in a single institution the clinical and morphologic characteristics of neuroendocrine carcinomas diagnosed in needle core biopsies. MATERIALS AND METHODS: The current study analyses seven cases diagnosed in needle biopsies at a large tertiary regional cancer center from Northeastern Brazil. Two pathologists reviewed specimens retrospectively, and demographic and morphologic characteristics were compared to 458 acinar tumors diagnosed in the same period. RESULTS: There were five small cell carcinomas and two low-grade neuroendocrine carcinomas (carcinoid). NEC were associated with an acinar component in 5/7 cases and the Gleason score of the acinar component was always > 6. The number of cores involved in prostates with NEC was greater (65 percent compared to 24 percent of acinar tumors, p < 0.05). The mean PSA at diagnosis was 417.7 (range 5.7-1593, SD 218.3), compared to 100.5 (p = 0.1) of acinar tumors (range 0.3-8545, SD 22.7). Prostates harboring NEC were bigger (p < 0.001, mean volume 240 mL vs. 53 mL of acinar tumors). Treatment of NEC included palliative surgery, chemotherapy, and hormonal therapy. CONCLUSIONS: NEC of the prostate is rare and often associated with a high-grade acinar component. Prostates with NEC tend to be larger and involve a greater number of cores than acinar tumors. PSA at diagnosis does not seem to predict the presence of NE tumors in needle biopsy.

Estudo dos métodos de rotina diagnóstica de mastite no leite de éguas / Study of routine diagnosis methods of mastitis in mares

Routine diagnosis methods used in bovine mastitis were studied in 55 mares in lactation. The findings of strip cup test, California Mastitis Test-CMT, electronic somatic cell count-CCS, microbiological culture, and in vitro antimicrobial susceptibility profile of isolates were discussed. Streptococcus spp., Staphylococcus spp, and enterobacteria were the most common microorganisms isolated in health and CMT-positive mammary glands. Staphylococcus aureus and Arcanobacterium pyogenes were identified in two mares presenting clinical mastitis. Mean somatic cell count of eight mares without presence of microorganisms in milk was 247.57x10³/mL and 1.621,86x10³/mL in 47 mares with positive microbiological culture. Moderate concordance (63.8 percent) between positive reactions in CMT (1 to 3+) and microbiological culture was observed. Amicacin (78.9 percent), ceftiofur (74.7 percent), sulpha-trimetoprim (69,0 percent) and norfloxacin (69.0 percent), were the most effective drugs, while resistance of isolates was mainly observed against penicillin (64.8 percent), gentamycin (35.2 percent), azithromycin (35.2 percent), enrofloxacin (28.2 percent), and florfenicol (28.2 percent).

Presencia de linfocitos T reguladores en periodontitis crónica / Presence of T regulatory cells in chronic periodontitis

La enfermedad periodontal requiere de un hospedero susceptible para su desarrollo y progresión. Dentro de las características del hospedero se encuentra la respuesta T reguladora, que otorga tolerancia frente a antígenos propios, participa durante las enfermedades infecciosas limitando el daño tisular, sin disminuir la respuesta antibacteriana. El presente estudio tiene por objetivo determinar la presencia, reclutamiento y función de Tregs en pacientes con periodontitis crónica. En 10 biopsias de tejido periodontal sano y con periodontits crónica se realizó inmunohistoquímica para marcadores (CD4, CD25, Foxp3), quimioquinas (CCL17, CCL22) y citoquinas (TGF-B, IL-10) de Tregs. Además de Western-Blot para detectar las citoquinas. Los resultados obtenidos sugieren una posible asociación entre células Tregs y la infección periodontal, ya que se confirma su reclutamiento y presencia. Sin embargo, son necesarios más estudios del posible desbalance con su contraparte pro-inflamatoria Th17, que expliquen en parte la compleja etiopatogenia de la enfermedad periodontal.

Periodontal disease requires a susceptible host to initiation, development and progression. T regulatory response is one of these inmunoregulatory characteristics of the susceptible host, which provide tolerance, tissular protection during infection without impairing the control of periodontopathogens. The aim of this study is to determinate the presence, homing and function of T regulatory cells (Tregs) in patients with chronic periodontitis. Ten biopsies were taken from pockets, the presence of Tregs markers (CD4, CD25, Foxp3), chemokines (CCL17, CCL22) and cytokines (TGF-p, IL-10) were determinate by immunohistochemistry. Cytokines also were detected with Western-Blot. Our results suggest a possible association between Tregs and periodontal infection, confirming homing and presence of Tregs. However, further studies are required to determine the possible imbalance with pro-inflammatory part Th17, that might explain the complex etiopathogenesis of periodontal disease.

Glomerular damage as a predictor of renal allograft loss

Interstitial fibrosis and tubular atrophy (IF/TA) are the most common cause of renal graft failure. Chronic transplant glomerulopathy (CTG) is present in approximately 1.5-3.0 percent of all renal grafts. We retrospectively studied the contribution of CTG and recurrent post-transplant glomerulopathies (RGN) to graft loss. We analyzed 123 patients with chronic renal allograft dysfunction and divided them into three groups: CTG (N = 37), RGN (N = 21), and IF/TA (N = 65). Demographic data were analyzed and the variables related to graft function identified by statistical methods. CTG had a significantly lower allograft survival than IF/TA. In a multivariate analysis, protective factors for allograft outcomes were: use of angiotensin-converting enzyme inhibitor (ACEI; hazard ratio (HR) = 0.12, P = 0.001), mycophenolate mofetil (MMF; HR = 0.17, P = 0.026), hepatitis C virus (HR = 7.29, P = 0.003), delayed graft function (HR = 5.32, P = 0.016), serum creatinine ≥1.5 mg/dL at the 1st year post-transplant (HR = 0.20, P = 0.011), and proteinuria ≥0.5 g/24 h at the 1st year post-transplant (HR = 0.14, P = 0.004). The presence of glomerular damage is a risk factor for allograft loss (HR = 4.55, P = 0.015). The presence of some degree of chronic glomerular damage in addition to the diagnosis of IF/TA was the most important risk factor associated with allograft loss since it could indicate chronic active antibody-mediated rejection. ACEI and MMF were associated with better outcomes, indicating that they might improve graft survival.

Cáncer de mama e índice de masa corporal: en mujeres posmenopáusicas / Breast cancer and body mass index: in posmenopausal women

El cáncer de mama representa la segunda causa de muerte por neoplasias malignas en mujeres venezolanas. Sobrepeso y obesidad son factores de riesgo de esta patología, por la producción de estrógenos en el tejido adiposo por procesos enzimáticos. Comprobar la relación entre carcinoma mamario e índice de masa corporal en mujeres posmenopáusicas. Estudio cuantitativo con nivel correlacional, tipo casos y controles. La muestra de tipo no probabilística estuvo compuesta por 103 mujeres posmenopáusicas con cáncer de mama (casos), y 100 mujeres posmenopáusicas sin carcinoma mamario (controles) que acudieron a consulta de la Unidad de Mastología del Centro Médico “Dr. Rafael Guerra Méndez” en Valencia, Estado Carabobo entre 1992 y 2007. La recolección de datos se hizo mediante revisión de historias clínicas, representándose los resultados en mediana, rango intercuartil, prueba de Chi cuadrado, Chi cuadrado con corrección de Yates y la prueba de Wilcoxon. Se clasificaron a las pacientes con y sin cáncer de mama según su índice de masa corporal, el 44,66 por ciento tenían sobrepeso y 36,9 por ciento obesidad; y en los controles el 38 por ciento presentó sobrepeso, 36 por ciento obesidad y 1 por ciento desnutrición. No se estableció una asociación estadísticamente significativa al 95 por ciento de confianza entre el índice y cáncer de mama. No existe relación entre cáncer de mama y el índice de masa corporal en la muestra estudiada. Se sugiere realizar estudios similares en muestras más significativas para así obtener resultados más fidedignos.

Breast cancer is currently the second leading cause of death from malignant tumours in women’s. Recent investigations classified overweight and obesity as risk factors for this disease, the association is due to the production of estrogens in fatty tissue by enzymatic processes. In these work we can determine the relationship between breast carcinoma and body mass index in postmenopausal women. A quantitative correlation study, type cases and controls. The non-probability sample consisted of 103 postmenopausal women with breast cancer (cases), 100 postmenopausal women without breast carcinoma (controls) who came to consult at hospital “Dr. Guerra Mendez” mastology unit, in Valencia, Carabobo between 1992 and 2007. Data collection was done through review of medical records, representing the results in median, interquartile range, Chi square test, Chi square with Yates’ correction and the Wilcoxon test. Patients were classifying in two groups, with and without breast cancer, according to body mass index, noting that in the cases the 44.66 percent were overweight and the 36.9 percent were obese. In the other hand the controls had 38 percent of overweight people, 36 percent obese and 1 percent malnutrition. There was no a statistically significant 95 percent confidence association between index and breast cancer. There is no relationship between breast cancer and the body mass index in the sample studied. These studied suggested to make similar projects with a more samples, and let us to get meaningful and more reliable results.

Effect of felodipine on myocardial and renal injury induced by aldosterone-high salt hypertension in uninephrectomized rats

It has been recently shown that calcium channel blockers might have a protective effect on cardiac fibrogenesis induced by aldosterone. The objective of this study was to evaluate the protective effect of felodipine, a dihydropyridine calcium channel blocker, against heart and kidney damage caused by aldosterone-high sodium intake in uninephrectomized rats. Wistar rats were divided into three groups: CNEP (uninephrectomized + 1 percent NaCl in the drinking water, N = 9); ALDO (same as CNEP group plus continuous infusion of 0.75 µg/h aldosterone, N = 12); ALDOF (same as ALDO group plus 30 mg·kg-1·day-1 felodipine in the drinking water, N = 10). All results were compared with those of age-matched, untreated rats (CTL group, N = 10). After 6 weeks, tail cuff blood pressure was recorded and the rats were killed for histological analysis. Blood pressure (mmHg) was significantly elevated (P < 0.05) in ALDO (180 ± 20) and ALDOF (168 ± 13) compared to CTL (123 ± 12) and CNEP (134 ± 13). Heart damage (lesion scores - median and interquartile range) was 7.0 (5.5-8.0) in ALDO and was fully prevented in ALDOF (1.5; 1.0-2.0). Also, left ventricular collagen volume fraction ( percent) in ALDOF (2.9 ± 0.5) was similar to CTL (2.9 ± 0.5) and CNEP (3.4 ± 0.4) and decreased compared to ALDO (5.1 ± 1.6). Felodipine partially prevented kidney injury since the damage score for ALDOF (2.0; 2.0-3.0) was significantly decreased compared to ALDO (7.5; 4.0-10.5), although higher than CTL (null score). Felodipine has a protective effect on the myocardium and kidney as evidenced by decreased perivascular inflammation, myocardial necrosis and fibrosis.

Testes físico-mecânicos e físico-químicos do couro da tilápia vermelha / Physical-mechanical and physical-chemical tests of red tilapia leather

Realizaram-se testes físico-mecânicos e físico-químicos em couro de tilápia vermelha (Oreochromis spp.) a fim de testar a sua resistência. As amostras foram distribuídas em delineamento inteiramente ao acaso com dois tratamentos: no T1, procedeu-se à retirada do corpo-de-prova no sentido longitudinal e, no T2, à retirada do corpo-de-prova no sentido transversal. Para os testes de determinação da resistência à tração, alongamento e rasgamento progressivo, foi utilizado o dinamômetro EMIC, com velocidade de afastamento entre as cargas de 100 ± 20mm/min, em ambiente climatizado (± 23ºC e UR do ar de 50 por cento), por 24 horas. A espessura do couro variou de 0,61 a 0,75mm, mas não houve diferença entre os sentidos analisados. O couro apresentou maior resistência à tração no sentido transversal, 25,89N/mm², (P<0,01), comparado ao sentido longitudinal, 14,20 N/mm². O alongamento foi significativamente (P<0,05) maior no sentido longitudinal, 80,8 por cento, em relação ao transversal, 62,6 por cento. Não houve diferença para o rasgamento progressivo entre os tratamentos. O couro apresentou teor de óxido de cromo de 3,8 por cento, graxa de 15,1 por cento e pH e cifra diferencial de 3,5 e 0,5, respectivamente. Os valores nos testes de resistência e físico-químicos apresentados pelo couro indicam que ele pode ser utilizado para a confecção de vestuário e artefatos de couro em geral.

Physical-mechanical and physical-chemical tests were carried out on red tilapia leather. They were distributed in a completely randomized design with two treatments: T1 = longitudinal body of proof; T2 = transversal body of proof. It was used the EMIC dynamometer for the tests of resistance to traction and elongation and the progressive tearing, with the speed of 100±20mm/min away between the charges, in an acclimatized room (±23ºC and relative humidity of 50 percent) during 24 hours. The thickness of the analyzed leathers ranged from 0.61 to 0.75mm, without differing between the analyzed ways. The leather demonstrated a higher resistance to traction in the transversal direction (25.89N/mm²) (P<0.01), when compared to the longitudinal one (14.20N/mm²). However, the elongation was significantly higher (P<0.05) in the longitudinal direction (80.8 percent) when compared to the transversal (62.6 percent). There was no significant difference for the progressive tearing between the treatments (longitudinal = 18.56N/mm; transversal = 21.90N/mm). The leather demonstrated a content of 3.8 percent of chromium oxide, 15.1 percent of grease, and pH and difference value of 3.5 and 0.5, respectively. The values in the resistance and physical-chemical tests shown by the leather indicate that it may be used for clothing and leather artifacts in general.

Mutants with heteroresistance to amphotericin B and fluconazole in Candida

Several studies have reported the occurrence of infections caused by Candida yeasts as well as the increasing prevalence of non albicans species. The aim of the present work is focused on the obtaining of heteroresistance to amphotericin B and fluconazole in Candida species using two distinct methodologies: selection and induction. Resistant samples were obtained by selective pressure using a medium with fluconazole for growth, followed by growth in a medium with amphotericin B. The selective pressure was also created beginning with growth in amphotericin B medium followed by growth in fluconazole medium. Concomitantly, samples were submitted to the induction of resistance through cultivation in increasing concentrations of fluconazole, followed by cultivation in increasing concentrations of amphotericin B. Subsequently, the induction began with amphotericin B followed by fluconazole. Three samples resistant to fluconazole and amphotericin B were obtained, two by induction (C. glabrata and C. tropicalis) and one by selection (C. tropicalis). Both C. tropicalis originated from the same wild sample. After successive transfers for drug free medium, only the sample obtained by selection was able to maintain the resistance phenotype. These results suggest that the phenotype of heteroresitance to fluconazole and amphotericin B can be produced by two methodologies: selection and induction.

Cystatin C and renal function in pediatric kidney transplant recipients

In clinical practice, the glomerular filtration rate (GFR) is often determined with serum creatinine. However, studies have shown cystatin C to be a better parameter for the diagnosis of impaired renal function. We compared GFR estimated by plasma cystatin C with GFR estimated by serum creatinine in a sample of 50 pediatric renal transplant recipients and 24 healthy children. The correlation between GFR estimated by serum creatinine and by cystatin C was significant (r = 0.75; P < 0.001, Person’s correlation); however, in pediatric kidney transplant recipients, the GFR was 6.7 mL/min lower when determined using cystatin C rather than serum creatinine. Moreover, using GFR estimated by cystatin C we found that 42 percent of the pediatric kidney transplant recipients had an estimated GFR <60 mL·min-1·1.73 (m²)-1, whereas when GFR was estimated by the serum creatinine formula only 16 percent of the children had values below this cutoff point indicative of chronic kidney disease (P < 0.001). We conclude that, in pediatric kidney transplant recipients, estimation of GFR yields lower values when cystatin C is used rather than serum creatinine.