Cardiac involvement in patients recovered from COVID-19 identified using left ventricular longitudinal strain.

INTRODUCTION: Coronavirus disease-19 (COVID-19) has been associated with subclinical myocardial dysfunction during its acute phase and a recurring pattern of reduced basal left ventricular longitudinal strain on speckle-tracking echocardiography (STE) in hospitalized patients. But a question still remains unanswered: speckle-tracking echocardiography might also be suitable to detect residual myocardial involvement after acute stage of COVID-19? METHODS AND RESULTS: We studied 100 patients recovered from COVID-19 with STE to evaluate global (GLS) and segmentar longitudinal strain (LS) and compared with a control group of 100 healthy individuals. STE was performed at a median of 130.35 ± 76.06 days after COVID-19 diagnostic. Demographic and echocardiographic parameters are similar in both groups. Left ventricular ejection faction (LVEF) and GLS were normal in COVID-19 patients (66.20 ± 1.98% and - 19.51 ± 2.87%, respectively). A reduction in mean LS for the basal segments was found in COVID-19 (16.48 ± 5.41%) when compared to control group (19.09 ± 4.31%) (p < 0.001). CONCLUSION: The present study suggests that COVID-19-induced cardiac involvement could persist after recovery of the disease and may be detected by deformation abnormalities using STE. COVID-19-induced myocardial involvement often shows specific LV deformation patterns due to pronounced edema and/or myocardial damage in basal LV segments.

Serum biochemistry profile of laying hens fed diets with fish waste oil / [Parâmetros bioquímicos sanguíneos de poedeiras leves alimentadas com rações contendo óleo do resíduo de pescado]

The present study aimed to evaluate increasing levels of fish waste oil in diets for laying hens on serum biochemistry profile. 192 Hisex White laying hens at 29 weeks of age were used, with water and food ad libitum. The experimental design was completely randomized consisting of eight treatments corresponding to the inclusion levels of fish waste oil (0, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0 and 3.5%) in the diets, with four replicates of six birds each. Data collected were subjected to polynomial regression at 5% of significance. Significant differences (P<0.05) were observed in triglycerides, glucose, total cholesterol, and uric acid. These parameters presented a decrease when hens fed diets with higher level of fish waste oil. The results of the present study indicated that the inclusion of fish waste oil caused a significant effect in the serum biochemical profile of laying hens, especially in glucose, triglycerides, total cholesterol, and uric acid concentrations. The inclusion level of 3.5% of fish waste oil caused larger disequilibrium in the serum biochemical profile of laying hens.(AU)

O presente estudo objetivou avaliar os níveis crescentes de óleo de resíduo de pescado em dietas para poedeiras leves sobre o perfil bioquímico sérico. Foram utilizadas poedeiras Hisex White com 29 semanas, com água e ração ad libitum. O delineamento experimental foi inteiramente ao acaso, consistindo de oito tratamentos correspondentes aos níveis de inclusão de óleo de resíduo de pescado (0; 0,5; 1,0; 1,5; 2,0; 2,5; 3,0 e 3,5%) nas dietas, com quatro repetições de seis aves cada. Os dados coletados foram submetidos à regressão polinomial a 5% de significância. Diferenças significativas (P<0,05) foram observadas nas concentrações de triglicerídeos, glicose, colesterol total e ácido úrico. Esses parâmetros apresentaram uma diminuição quando as aves se alimentaram com rações contendo maior nível de óleo do resíduo de pescado. Os resultados do presente estudo indicaram que a inclusão de óleo do resíduo de pescado acarretou um efeito significativo no perfil bioquímico sérico de poedeiras, principalmente nas concentrações de glicose, triglicerídeos, colesterol total e ácido úrico. O nível de inclusão de 3,5% do óleo do resíduo de pescado acarretou maior desequilíbrio no perfil bioquímico sérico das poedeiras.(AU)

Tissue and serum immune response in chronic hepatitis C with mild histological lesions.

The immunopathogenesis of chronic hepatitis C virus (HCV) infection is a matter of great controversy and has been suggested to involve a complex balance between cytokines with pro and anti-inflammatory activity. We investigated the expression of inflammatory cells and cytokines in the liver and serum of 51 chronically HCV infected patients and compared them to data from two sets of normal controls: 51 healthy blood donors and 33 liver biopsies of healthy liver donors. We also assessed the relationship between selected cytokines and cell populations in hepatic compartments and the disease stage. Compared with controls, hepatitis C patients had a greater expression of portal TNF-alpha, TGF-beta and CD4(+) and acinar IFN-gamma, TNF-alpha, IL-1beta and IL-4, as well as a higher serum concentration of IL-2, IL-10 and TGF-beta. Significant positive correlations were found between portal CD4+ and TNF-alpha, portal CD8(+) and TGF-beta, portal CD45(+)RO and TNF-alpha, acinar CD45(+)RO and IFN-gamma and acinar CD57(+) and TGF-beta. In conclusion, we have shown that (i) in this sample of predominantly mild disease, the immune response was associated with a pro-inflammatory response pattern, (ii) CD4(+) T-lymphocytes played a major role in orchestrating the immune response and (iii) these events primarily took place in the portal space.

Leptospirosis pulmonary haemorrhage syndrome is associated with linear deposition of immunoglobulin and complement on the alveolar surface.

Leptospirosis is a zoonotic infection associated with severe diseases such as leptospirosis pulmonary haemorrhage syndrome (LPHS). The cause of pulmonary haemorrhage is unclear. Understanding which mechanisms and processes are involved in LPHS will be important in treatment regimens under development for this life-threatening syndrome. In the present study, we evaluated 30 lung specimens from LPHS patients and seven controls using histology and immunohistochemistry (detection of IgM, IgG, IgA and C3) in order to describe the pathological features associated with this syndrome. Immunoglobulin deposits were detected on the alveolar surface in 18/30 LPHS patients. Three staining patterns were observed for the immunoglobulins and C3 in the lung tissues of LPHS patients: AS, delicate linear staining adjacent to the alveolar surface, which was indicative of a membrane covering the luminal surface of type I and II pneumocyte cells; S, heterogeneous staining which was sporadically distributed along the alveolar septum; and IA, weak, focal intra-alveolar granular staining. Human LPHS is associated with individual and unique histological patterns that differ from those of other causes of pulmonary haemorrhage. In the present study, it was found that the linear deposition of immunoglobulins (IgA, IgG and IgM) and complement on the alveolar surface may play a role in the pathogenesis of pulmonary haemorrhage in human leptospirosis.

The effects of human herpesvirus 8 infection and interferon-gamma response in cutaneous lesions of Kaposi sarcoma differ among human immunodeficiency virus-infected and uninfected individuals.

BACKGROUND: Kaposi sarcoma (KS) is associated with human herpesvirus 8 (HHV-8). The cutaneous immune response in this tumour is not well established and a better understanding is necessary. OBJECTIVES: To evaluate the HHV-8 expression and immune response in cutaneous lesions of classic KS (CKS) and AIDS-associated KS (AIDS-KS). METHODS: We performed a quantitative immunohistochemical study of cells expressing HHV-8 latency-associated nuclear antigen (LANA), CD4, CD8 and interferon (IFN)-gamma in skin lesions from patients with CKS and AIDS-KS (with or without highly active antiretroviral therapy, HAART). RESULTS: CKS showed higher LANA expression compared with AIDS-KS, regardless of HAART. We also found higher LANA expression in nodules compared with patch/plaque lesions. The tissue CD4+ cell proportion was lower in AIDS-KS patients without HAART than in patients with CKS. In CKS lesions, CD4+ and CD8+ cells expressed IFN-gamma, as shown by double immunostaining. AIDS-KS presented low numbers of IFN-gamma-expressing cells. CD8+ cell numbers were similar in all groups, which appeared unrelated to the clinical or epidemiological type of KS. CONCLUSIONS: Our quantitative data on the pattern of KS lesions in selected groups of patients, as shown by in situ immune response, demonstrated a CD4+ T-cell involvement associated with IFN-gamma, an environment of immune response-modified human immunodeficiency virus (HIV) infection. In our sample, the promotion of KS in patients without HIV appears to be related to higher HHV-8 load or virulence than in those with AIDS. This higher resistance may be explained by a sustained immune response against this herpesvirus, that is only partially restored but effective after HAART.

Association of insulin resistance and nocturnal fall of blood pressure in GH-deficient adults during GH replacement.

The GH deficiency syndrome in adults is characterized by changes in body composition, metabolic, cardiovascular and psychological profile. Such alterations fit the metabolic syndrome. Changes of blood pressure (BP) levels related to the presence of insulin resistance (IR) may be present in the GH-deficient adult prior to or after therapy with recombinant GH (hGH). The purpose of the study was to assess the relationship between BP and IR in GH-deficient adults after 24 months of replacement with hGH. Thirteen GH-deficient adults were studied [7 men and 6 women, with an average age of 38.6+/-14.14 yr body mass index (BMI) 25.83+/-2.26 kg/m2]. The BP was assessed by means of ambulatory monitoring of BP (AMBP), prior to the treatment and 12 and 24 months after replacement with hGH. Glucose metabolism was assessed by the homeostatic model assessment (HOMA), during the same periods. The average dosage of hGH utilized was 0.67+/-0.15 mg/day. In the analysis of BP levels, we observed a decrease of the diurnal systolic BP (SB P) (p=0.043) and a reduction of the diurnal systolic (p=0.002) and diastolic pressure loads (p=0.038). During the night there were no changes in BP levels. We observed an increase in the percentage of patients with a non-physiological nocturnal fall (non dippers) after replacement with hGH (61.53%). The mean HOMA, insulin and glucose in the fasting state did not present any statistically significant changes. Although the patients within the nondipper group had higher HOMA and insulin levels throughout the study, there were no changes in any of these parameters after GH replacement. All patients with HOMA >2.5 were within the non-dipper group, whereas all dippers had HOMA <2.5. In conclusion, 24 months of therapy with hGH do not seem to have affected glucose homeostasis, and since there is no relationship with the increase of the percentage of non-physiological nocturnal fall, we will need a longer observation time to discover the effects of this finding.

Insulin-like growth factor I levels during growth hormone (GH) replacement in GH-deficient adults: a gender difference.

To evaluate the variation of serum IGF-1 levels during GH replacement and observe gender differences, 29 adults with GH deficiency (mean age 42.5 +/- 10.1 year), were studied. Serum IGF-1 was assessed every 4 weeks during the titration period and afterwards every 3 months of GH therapy. At baseline 77.7% of women and 45.4% of men had serum baseline IGF-1 levels below the lower limit of normal age-related reference range. The time to reach the maintenance dose was lower in men than women (p < 0.05). There was an increase in IGF-1 levels after one year of GH therapy, significant only in men (p < 0.01). IGF-1 concentrations were higher in men than women (p < 0.05), at the 12th and 18th months of GH therapy. GH dose was reduced by 25% in men (p < 0.01). At the end of the study the mean GH dose was lower in men than in women (p < 0.05). The factor responsible for these findings is not known, however a possible role of androgens has been suggested.

Effects of estragole on the compound action potential of the rat sciatic nerve

Estragole, a relatively nontoxic terpenoid ether, is an important constituent of many essential oils with widespread applications in folk medicine and aromatherapy and known to have potent local anesthetic activity. We investigated the effects of estragole on the compound action potential (CAP) of the rat sciatic nerve. The experiments were carried out on sciatic nerves dissected from Wistar rats. Nerves, mounted in a moist chamber, were stimulated at a frequency of 0.2 Hz, with electric pulses of 50-100-æs duration at 10-20 V, and evoked CAP were monitored on an oscilloscope and recorded on a computer. CAP control parameters were: peak-to-peak amplitude (PPA), 9.9 ± 0.55 mV (N = 15), conduction velocity, 92.2 ± 4.36 m/s (N = 15), chronaxy, 45.6 ± 3.74 æs (N = 5), and rheobase, 3.9 ± 0.78 V (N = 5). Estragole induced a dose-dependent blockade of the CAP. At 0.6 mM, estragole had no demonstrable effect. At 2.0 and 6.0 mM estragole, PPA was significantly reduced at the end of 180-min exposure of the nerve to the drug to 85.6 ± 3.96 and 13.04 ± 1.80 percent of control, respectively. At 4.0 mM, estragole significantly altered PPA, conduction velocity, chronaxy, and rheobase (P <= 0.05, ANOVA; N = 5) to 49.3 ± 6.21 and 77.7 ± 3.84, 125.9 ± 10.43 and 116.7 ± 4.59 percent, of control, respectively. All of these effects developed slowly and were reversible upon a 300-min wash-out. The data show that estragole dose-dependently blocks nerve excitability.

Effects of estragole on the compound action potential of the rat sciatic nerve.

Estragole, a relatively nontoxic terpenoid ether, is an important constituent of many essential oils with widespread applications in folk medicine and aromatherapy and known to have potent local anesthetic activity. We investigated the effects of estragole on the compound action potential (CAP) of the rat sciatic nerve. The experiments were carried out on sciatic nerves dissected from Wistar rats. Nerves, mounted in a moist chamber, were stimulated at a frequency of 0.2 Hz, with electric pulses of 50-100-micros duration at 10-20 V, and evoked CAP were monitored on an oscilloscope and recorded on a computer. CAP control parameters were: peak-to-peak amplitude (PPA), 9.9 +/- 0.55 mV (N = 15), conduction velocity, 92.2 +/- 4.36 m/s (N = 15), chronaxy, 45.6 +/- 3.74 micros (N = 5), and rheobase, 3.9 +/- 0.78 V (N = 5). Estragole induced a dose-dependent blockade of the CAP. At 0.6 mM, estragole had no demonstrable effect. At 2.0 and 6.0 mM estragole, PPA was significantly reduced at the end of 180-min exposure of the nerve to the drug to 85.6 +/- 3.96 and 13.04 +/- 1.80% of control, respectively. At 4.0 mM, estragole significantly altered PPA, conduction velocity, chronaxy, and rheobase (P < or = 0.05, ANOVA; N = 5) to 49.3 +/- 6.21 and 77.7 +/- 3.84, 125.9 +/- 10.43 and 116.7 +/- 4.59%, of control, respectively. All of these effects developed slowly and were reversible upon a 300-min wash-out. The data show that estragole dose-dependently blocks nerve excitability.

Misoprostol and congenital anomalies.

Purpose- To evaluate the risk of having a baby with congenital anomalies in mothers who used misoprostol during pregnancy.Methods- Hospital-based case - control study from Hospital Chateaubriand, Fortaleza, Brasil. Cases were 37 babies weighing less than 1500 g with congenital anomalies of various types, and the comparison group included 387 infants also weighing less than 1500 g, and without congenital anomalies.Results- The multivariate odds ratio of having a baby with congenital anomalies was 2.4 (95% confidence interval 1.0 - 6.2) in mothers who reported having used misoprostol compared with those who did not.Conclusions- Misoprostol use during pregnancy might be related to a broad spectrum of congenital anomalies in infants. Copyright (c) 2000 John Wiley & Sons, Ltd.

An optically coupled power stimulus isolation unit with high voltage and fast rise time output.

Recent technological developments have created new devices that could improve and simplify the construction of stimulus isolators. HEXFET transistors can switch large currents and hundreds of volts in nanoseconds. The newer opto-isolators can give a pulse rise time of a few nanoseconds, with output compatible with MOSFET devices, in which delays are reduced to nanoseconds. Integrated DC/DC converters are now available. Using these new resources we developed a new electrical stimulus isolator circuit with selectable constant-current and constant-voltage modes, which are precise and easy to construct. The circuit works like a regulated power supply in both modes with output switched to zero or to free mode through an opto-isolator device. The isolator analyses showed good practical performance. The output to ground resistance was 10(11) ohms and capacitance 35 picofarads. The rise time and fall time were identical (5 microseconds) and constant. The selectable voltage or current output mode made it very convenient to use. The current mode, with higher output resistance values in low current ranges, permits intracellular stimulation even with tip resistances close to 100 megaohms. The high compliance of 200 V guarantees the value of the current stimulus. The very low output resistance in the voltage mode made the device highly suitable for extracellular stimulation with low impedance electrodes. Most importantly, these characteristics were achieved with a circuit that was easy to build and modify and assembled with components available in Brazil.

An optically coupled power stimulus isolation unit with high voltage and fast rise time output

Recent technological developments have created new devices that could improve and simplify the construction of stimulus isolators. HEXFET transistors can switch large currents and hundreds of volts in nanoseconds. The newer opto-isolators can give a pulse rise time of a few nanoseconds, with output compatible with MOSFET devices, in which delays are reduced to nanoseconds. Integrated DC/DC converters are now available. Using these new resources we developed a new electrical stimulus isolator circuit with selectable constant-current and constant-voltage modes, which are precise and easy to construct. The circuit works like a regulated power supply in both modes with output switched to zero or to free mode through an opto-isolator device. The isolator analyses showed good practical performance. The output to ground resistance was 1011 ohms and capacitance 35 picofarads. The rise time and fall time were identical (5 µs) and constant. The selectable voltage or current output mode made it very convenient to use. The current mode, with higher output resistance values in low current ranges, permits intracellular stimulation even with tip resistances close to 100 megaohms. The high compliance of 200 V guarantees the value of the current stimulus. The very low output resistance in the voltage mode made the device highly suitable for extracellular stimulation with low impedance electrodes. Most importantly, these characteristics were achieved with a circuit that was easy to build and modify and assembled with components available in Brazil.

Acromegaly and non-Hodgkin's lymphoma.

OBJECTIVE: To present the fourth case report of development of a non-Hodgkin's lymphoma in a patient with active acromegaly. METHODS: We describe the clinical, laboratory, and imaging findings in a patient with untreated acromegaly in whom a large cell non-Hodgkin's lymphoma developed. RESULTS: Acromegaly is associated with several comorbid conditions. Among these is a higher incidence of several types of visceral malignant lesions, especially carcinoma of the colon. Growth hormone stimulates the hepatic production of somatomedins, such as insulin-like growth factors, which are known promoters of human growth and have also been implicated in tumorigenesis. In recent years, several cases of lymphoproliferative diseases have also been noted in patients with acromegaly. These conditions include multiple myeloma, lymphoma, and leukemia; three previous cases of non-Hodgkin's lymphoma have been described. In our patient, a 57-year-old man with acromegaly, magnetic resonance imaging of the pituitary gland disclosed a large intrasellar mass. Large cell non-Hodgkin's lymphoma was diagnosed. Six months of chemotherapy yielded complete remission. CONCLUSION: An additional case of non-Hodgkin's lymphoma in a patient with acromegaly supports the accumulating evidence of an increased risk for development of cancer in such patients.

An electron microscopic and cytochemical detection of concanavalin A receptors on the cell membrane of Leishmania braziliensis guyanensis.

Promastigotes of Leishmania braziliensis quyanensis cultivated in the NNN medium agglutinate with concanavalin A (con A). The protozoon was agglutinated at different concentrations of con A. Maximal agglutination was obtained with 150 mug/ml. Three types of agglutination were observed: flagellar-flagellar, flagellar-body and body-body. Cell surface polysaccharides, glycoproteins or glycolipids were demonstrated using the periodic acid-thiosemicarbazide-silver proteinate technic. A con A-horseradish peroxidase-diaminobenzidine (DAB) technic was used to detect con A receptors on the cell membrane of the parasite.