T2-FLAIR Mismatch Sign in Pediatric Low-Grade Glioma.

BACKGROUND AND PURPOSE: No qualitative imaging feature currently predicts molecular alterations of pediatric low-grade gliomas with high sensitivity or specificity. The T2-FLAIR mismatch sign predicts IDH-mutated 1p19q noncodeleted adult gliomas with high specificity. We aimed to assess the significance of the T2-FLAIR mismatch sign in pediatric low-grade gliomas. MATERIALS AND METHODS: Pretreatment MR images acquired between January 2001 and August 2018 in pediatric patients with pediatric low-grade gliomas were retrospectively identified. Inclusion criteria were the following: 1) 0-18 years of age, 2) availability of molecular information in histopathologically confirmed cases, and 3) availability of preoperative brain MR imaging with non-motion-degraded T2-weighted and FLAIR sequences. Spinal cord tumors were excluded. RESULTS: Three hundred forty-nine patients were included (187 boys; mean age, 8.7 [SD, 4.8] years; range, 0.5-17.7 years). KIAA1549-B-Raf proto-oncogene (BRAF) fusion and BRAF p.V600E mutation were the most common molecular markers (n = 148, 42%, and n = 73, 20.7%, respectively). The T2-FLAIR mismatch sign was present in 25 patients (7.2%). Of these, 9 were dysembryoplastic neuroepithelial tumors; 8, low-grade astrocytomas; 5, diffuse astrocytomas; 1, a pilocytic astrocytoma; 1, a glioneuronal tumor; and 1, an angiocentric glioma. None of the 25 T2-FLAIR mismatch pediatric low-grade gliomas were BRAF p.V600E-mutated. Fourteen of 25 pediatric low-grade gliomas with the T2-FLAIR mismatch sign had rare molecular alterations, while the molecular subtype was unknown for 11 tumors. CONCLUSIONS: The T2-FLAIR mismatch sign was not observed in the common molecular alterations, BRAF p.V600E-mutated and KIAA1549-BRAF fused pediatric low-grade gliomas, while it was encountered in pediatric low-grade gliomas with rare pediatric molecular alterations.

Could paraprobiotics be a safer alternative to probiotics for managing cancer chemotherapy-induced gastrointestinal toxicities?

Clinical oncology has shown outstanding progress improving patient survival due to the incorporation of new drugs. However, treatment success may be reduced by the emergency of dose-limiting side effects, such as intestinal mucositis and diarrhea. Mucositis and diarrhea management is symptomatic, and there is no preventive therapy. Bacterial and fungal-based compounds have been suggested as an alternative for preventing the development of diarrhea in cancer patients. Using probiotics is safe and effective in immunocompetent individuals, but concerns remain during immunosuppressive conditions. Paraprobiotics, formulations composed of non-viable microorganisms, have been proposed to overcome such limitation. The present literature review discusses current evidence regarding the possible use of paraprobiotics as an alternative to probiotics to prevent gastrointestinal toxicity of cancer chemotherapy.

IFITM3 restricts virus-induced inflammatory cytokine production by limiting Nogo-B mediated TLR responses.

Interferon-induced transmembrane protein 3 (IFITM3) is a restriction factor that limits viral pathogenesis and exerts poorly understood immunoregulatory functions. Here, using human and mouse models, we demonstrate that IFITM3 promotes MyD88-dependent, TLR-mediated IL-6 production following exposure to cytomegalovirus (CMV). IFITM3 also restricts IL-6 production in response to influenza and SARS-CoV-2. In dendritic cells, IFITM3 binds to the reticulon 4 isoform Nogo-B and promotes its proteasomal degradation. We reveal that Nogo-B mediates TLR-dependent pro-inflammatory cytokine production and promotes viral pathogenesis in vivo, and in the case of TLR2 responses, this process involves alteration of TLR2 cellular localization. Nogo-B deletion abrogates inflammatory cytokine responses and associated disease in virus-infected IFITM3-deficient mice. Thus, we uncover Nogo-B as a driver of viral pathogenesis and highlight an immunoregulatory pathway in which IFITM3 fine-tunes the responsiveness of myeloid cells to viral stimulation.

Could paraprobiotics be a safer alternative to probiotics for managing cancer chemotherapy-induced gastrointestinal toxicities?

Clinical oncology has shown outstanding progress improving patient survival due to the incorporation of new drugs. However, treatment success may be reduced by the emergency of dose-limiting side effects, such as intestinal mucositis and diarrhea. Mucositis and diarrhea management is symptomatic, and there is no preventive therapy. Bacterial and fungal-based compounds have been suggested as an alternative for preventing the development of diarrhea in cancer patients. Using probiotics is safe and effective in immunocompetent individuals, but concerns remain during immunosuppressive conditions. Paraprobiotics, formulations composed of non-viable microorganisms, have been proposed to overcome such limitation. The present literature review discusses current evidence regarding the possible use of paraprobiotics as an alternative to probiotics to prevent gastrointestinal toxicity of cancer chemotherapy.

Chemical Composition and Antimicrobial Potential of Palm Leaf Extracts from Babaçu (Attalea speciosa), Buriti (Mauritia flexuosa), and Macaúba (Acrocomia aculeata).

Babaçu (A. speciosa), Buriti (M. flexuosa), and Macaúba (A. aculeata) are palm trees typical of the ecotone area between Cerrado and the Amazon rainforest. The purpose of this study was to evaluate the antimicrobial potential of the extracts prepared from the leaves of those palms as well as determine their chemical compositions. The ethanol extracts were prepared in a Soxhlet apparatus and tested by disk diffusion and agar dilution technique against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, and Candida parapsilosis. However, there was no significant activity at concentrations of 25, 50, and 100 mg·Ml(-1). Moreover, the phytochemical analysis revealed the presence of tannins, flavonoids, catechins, steroids, triterpenes, and saponins. Gas chromatography (GC/MS) analysis also identified organic acids, such as capric (decanoic) acid, lauric (dodecanoic) acid, myristic (tetradecanoic) acid, phthalic (1,2-benzenedicarboxylic) acid, palmitic (hexadecanoic) acid, stearic (octadecanoic) acid, linoleic (9,12-octadecadienoic) acid (omega-6), linolenic (octadecatrienoic) acid (omega-3), and the terpenes citronellol and phytol. Based on the chemical composition in the palm leaf extracts, the palms have the potential to be useful in the food, cosmetic, and pharmaceutical industries.

Identification of oxidative coupling products of xylenols arising from laboratory-scale phytoremediation.

Oxidative coupling reactions take place during the passage of xylenols through a laboratory-scale helophyte-based constructed wetland system. Typical coupling product groups including tetramethyl-[1,1'-biphenyl] diols and tetramethyl diphenylether monools as stable organic intermediates could be identified by a combination of pre-chromatographic derivatization and GC/MS analysis. Structural assignment of individual analytes was performed by an increment system developed by Zenkevich to pre-calculate retention sequences. The most abundant analyte turned out to be 3,3',5,5'-tetramethyl-[1,1'-biphenyl]-4,4'-diol, which can be formed by a combination of radicals based on 2,6-xylenol or by an attack of a 2,6-xylenol-based radical on 2,6-xylenol. Organic intermediates originating from oxidative coupling could also be identified in anaerobic constructed wetland systems. This finding suggested the presence of (at least partly) oxic conditions in the rhizosphere.

Structural characterization of organic intermediates arising from xylenol degradation by laboratory-scale constructed wetlands.

A mixture of xylenols (2,6-, 3,4-, 3,5-) was subjected to laboratory-scale constructed wetland treatment using helophytes. Conversion efficiencies under aerobic conditions ranged from 89% to 94%; the corresponding numbers under anaerobic conditions were lower. The studies were focused on the identification of stable organic intermediates. Identification was performed by a combination of GC/MS analysis and pre-chromatographic derivatization of the lyophilizates. In addition to common intermediates including citraconate, succinate and dimethyl benzenediols, an array of α- and ß-ketoadipic acid carboxylates could be identified. The ketoadipic acid carboxylates have not been known to be formed in bioremediation of phenols including xylenols so far. Mechanisms for the formation of ketoadipic acid carboxylates are proposed. Chemotaxonomic considerations using diagnostic fatty acids provided mounting evidence that organic matter originating from plants prevailed over bacterial organic matter. Biomarkers indicated a virtual absence of fungi and algae.

Farmacoeconomia: um instrumento para gestão em drogarias de bairro / Pharmacoeconomy: an instrument for the management of neighborhood drugstores

OBJETIVO: Analisar os conceitos básicos da FarE e sua possível utilização em drogarias de bairro para o incremento financeiro e competitividade destes estabelecimentos. MATERIAIS E MÉTODOS: Trata-se de um estudo teórico dos conceitos básicos da FarE, e análise desta ferramenta para utilização em drogarias de bairro. O levantamento bibliográfico foi realizado através das bases de dados: Scielo, Lilacs, Ibecs, Medline e Google Acadêmico, com os descritores "farmacoeconomia", "economia da saúde" e "farmacoeconomia e drogarias", nos vernáculos inglês e português. Foram incluídos trabalhos sobre análise dos conceitos básicos e formas de análise, e trabalhos experimentais realizados no Brasil que utilizaram a FarE. RESULTADOS E DISCUSSÃO: A comercialização de medicamentos em drogarias alcançam cifras na ordem de bilhões, porém é observada a crescente abertura e interiorização de grandes redes, o que dificulta o mercado para as drogarias conhecidas como "drogarias de bairro". Como estes estabelecimentos geralmente dispõem de baixo capital e estoques, as análises de FarE podem orientar a compra de produtos mais eficazes, menos onerosos e permitem a redução do estoque, a fim de evitar a retenção de grande capital em produtos que não teriam fácil comercialização. Isto possibilitaria ainda uma melhor orientação aos pacientes, o que resulta provavelmente em uma maior fidelização dos mesmos. CONCLUSÃO: Pode-se concluir com este estudo através da análise dos conceitos básicos da FarE que esta ferramenta pode ser utilizada pelas drogarias de bairro para organização tanto financeira da compra e venda de produtos como a uma melhor assistência farmacêutica e fidelização de clientes

OBJECTIVE: to analyze the basic concepts of pharmacoeconomy (PharmE) and its possible use in neighborhood drugstores as a way of enhancing these establishments financially and competitively. MATERIAL AND METHODS: This is a theoretical study on the basic concepts of PharmE and its use in neighborhood drugstores. Literature searches were performed on the databases: SciELO, Lilacs, IBECS, Medline and Google Scholar, using the keywords "pharmacoeconomics", "health economics" and "pharmacoeconomics and drugstores", in English and Portuguese. We included studies addressing basic definitions and analysis tools as well as experimental work carried out in Brazil using PharmE. RESULTS AND DISCUSSION: the sale of medicines in drugstores accounts for billions. There has been an increasing establishment and internalization of big pharmacy chains, which makes difficult the market for drugstores known as "neighborhood drugstores". As these establishments generally have low capital and stock, analysis of PharmE can guide the purchase of more effective, less costly products. In addition, PharmE could drive the reduction of stocks in order to avoid large capital retention in products that would not have rapid commercialization. This would provide an even better orientation for patients, which probably results in increased loyalty. CONCLUSION: PharmE can be used by neighborhood drugstores for financial organization ­ purchase and sale of products ­ as well as for a better pharmaceutical care and customer loyalty

Response of ammonium removal to growth and transpiration of Juncus effusus during the treatment of artificial sewage in laboratory-scale wetlands.

The correlation between nitrogen removal and the role of the plants in the rhizosphere of constructed wetlands are the subject of continuous discussion, but knowledge is still insufficient. Since the influence of plant growth and physiological activity on ammonium removal has not been well characterized in constructed wetlands so far, this aspect is investigated in more detail in model wetlands under defined laboratory conditions using Juncus effusus for treating an artificial sewage. Growth and physiological activity, such as plant transpiration, have been found to correlate with both the efficiency of ammonium removal within the rhizosphere of J. effusus and the methane formation. The uptake of ammonium by growing plant stocks is within in a range of 45.5%, but under conditions of plant growth stagnation, a further nearly complete removal of the ammonium load points to the likely existence of additional nitrogen removal processes. In this way, a linear correlation between the ammonium concentration inside the rhizosphere and the transpiration of the plant stocks implies that an influence of plant physiological activity on the efficiency of N-removal exists. Furthermore, a linear correlation between methane concentration and plant transpiration has been estimated. The findings indicate a fast response of redox processes to plant activities. Accordingly, not only the influence of plant transpiration activity on the plant-internal convective gas transport, the radial oxygen loss by the plant roots and the efficiency of nitrification within the rhizosphere, but also the nitrogen gas released by phytovolatilization are discussed. The results achieved by using an unplanted control system are different in principle and characterized by a low efficiency of ammonium removal and a high methane enrichment of up to a maximum of 72.7% saturation.

Investigation of the toxic potential of crude ethanol extract of Annona coriacea (araticum) seeds in acute exposed mice

In this study, Annona coriacea Mart., Annonaceae, was examined for possible toxic effects on brain, liver and kidney of mice exposed to crude extract of the seeds (CESAN) of this plant. CESAN was administered by gavage for four days at doses of 12.5, 25, 50, and 100 mg/kg/day. Significant changes on liver were observed, which showed reduction in the number of hepatocytes per area and increase the apoptotic index in the exposed groups, and changes in the cytoplasm and nucleus of these cells and reduced consumption of water and feed in these animals. For the other studied areas, brain and kidneys showed no changes in the parameters used in this study. The results suggest hepatotoxic effects of CESAN, but without damage to brain and kidneys in this experiment, showing a toxic potential to this species, as to the Annonaceae family.

Biological activities of sulfated polysaccharides from tropical seaweeds.

Sulfated polysaccharides from 11 species of tropical marine algae (one edible specie of Rhodophyta, six species of Phaeophyta and four species of Chlorophyta) collected from Natal city coast (Northeast of Brazil) were evaluated for their anticoagulant, antioxidant and antiproliverative in vitro activities. In the activated partial thromboplastin time (APTT) test, which evaluates the intrinsic coagulation pathway, seven seaweeds presented anticoagulant activity. Dictyota cervicornis showed the highest activity, prolonging the coagulation time to double the baseline value in the APTT with only 0.01 mg/100 microl of plasma, 1.4-fold lesser than Clexane, a low molecular weight heparin. In the protrombin time (PT) test, which evaluates the extrinsic coagulation pathway, only Caulerpa cupresoides showed anticoagulant activity. All species collected showed antioxidant activities. This screening emphasized the great antioxidant potential (total capacity antioxidant, power reducing and ferrous chelating) of four species: C. sertularioide; Dictyota cervicornis; Sargassum filipendula and Dictyopteris delicatula. After 72 h incubation, HeLa cell proliferation was inhibited (p<0.05) between 33.0 and 67.5% by S. filipendula; 31.4 and 65.7% by D. delicatula; 36.3 and 58.4% by Caulerpa prolifera and 40.2 and 61.0% by Dictyota menstrualis at 0.01-2mg/mL algal polysaccharides. The antiproliferative efficacy of these algal polysaccharides were positively correlated with the sulfate content (r=0.934). Several polysaccharides demonstrated promising antioxidant, antiproliferative an/or anticoagulant potential and have been selected for further studies on bioguided fractionation, isolation and characterization of pure polysaccharides from these species as well as in vivo experiments are needed and are already in progress.

Thoracic textilomas after myocardial revascularisation: typical CT findings.

The objective of this work was to report the tomographic findings in five cases of intrathoracic textilomas. The CT scans of five patients presenting with textilomas after being submitted to thoracotomy for myocardial revascularisation were reviewed retrospectively. Two chest radiologists studied the scans independently, and decisions concerning the CT findings were made by consensus. In each of the five cases, the imaging findings were similar and showed lesions resembling an extrapulmonary mass and well-defined contours situated at the marginal posterior pleural surface. In four of the five cases, a low-density centre and peripheral rim-like enhancement were observed after administration of contrast media. The suspicion of textiloma should be raised when a patient with a history of previous myocardial revascularisation surgery presents with an extrapulmonary mass in close contact with the posterior pleural surface.

Determinantes dietéticos da ingestão alimentar e efeito na regulação do peso corporal / Dietetic determinants on food intake and effects in body weight regulation

Obesity is a multifactorial pathology currently considered one of the main public health problems. Its prevalence is increasing dramatically in the last decades, reaching huge rates in Brazil and many other countries. Regardless of the factors associated with genetic predisposition, this pathology is often associated with abnormal food intake, and also with high consumption of caloric foods and sedentary habits. Thus, obesity is the result of an imbalance between food intake and energy expenditure. One of the greatest research interests in nutrition has currently been the dietetic determinants that may exert an influence on the process of food intake, as well as the role of foods on physiological, physical and chemical factors most related to the processes of satiation and satiety. Based on these aspects, this paper analyzes several research works to gain a better insight of the dietetic factors affecting food intake and body weight regulation.

Falling diarrhoea mortality in Northeastern Brazil: did ORT play a role?

The impact of oral rehydration therapy (ORT) on the recent decline in diarrhoea mortality in the northeast of Brazil was studied. Proportionate infant mortality fell from 32% in 1980 to 17% in 1989 and infant deaths attributed to diarrhoea dropped from 41% to 25%, resulting in an overall reduction of 57%. Similar decreases were observed for children aged 1-4 years. Diarrhoea admissions also fell from 57% of infant hospitalizations in 1980 to 30% in 1990. None of the other major causes of death or admissions showed such decline. ORT was introduced in the early 1980s, being used in 35% of all episodes in 1991 and in 62% of those regarded as severe by the mother. Other changes included a worsening of socioeconomic conditions and increases in water supply, vaccine coverage, breastfeeding duration and nutritional status. A simulation model estimated that changes in factors other than ORT would lead to a 21% reduction in infant diarrhoea mortality, or about one-third of the actual decline. Finally, an ecological analysis showed that ORT use rates were inversely correlated to infant diarrhoea mortality (r=-0.61; p=0.04). Despite the shortcomings of the available data, these findings suggest an important impact of ORT on diarrhoea mortality.

PIP: Proportionate infant mortality in the northeast of Brazil fell from 32% in 1980 to 17% in 1989, with infant deaths attributed to diarrhea falling from 41% to 25%; these declines comprise an overall reduction of 57%. Similar decreases were observed for children aged 1-4 years. Diarrhea admissions also fell from 57% of infant hospitalizations in 1980 to 30% in 1990. No such decline was observed in any of the other major causes of death or admissions. The authors explored the impact of oral rehydration therapy (ORT) upon this recent decline in diarrhea mortality in the region. ORT was introduced in the early 1980s, being used in 35% of all episodes in 1991 and in 62% of those regarded as severe by the mother. Socioeconomic conditions worsened during the 1980s, but the levels of water supply, vaccine coverage, breastfeeding duration, and nutritional status increased. A simulation model estimated that changes in factors other than ORT would lead to a 21% reduction in infant diarrhea mortality, or approximately one third of the actual decline. An ecological analysis found ORT use rates to be inversely correlated with infant diarrhea mortality. These findings suggest that the introduction and use of ORT in northeastern Brazil had an important impact upon diarrhea mortality.

Spinal cord compression due to extramedullary hematopoiesis in the proliferative phase of polycythemia vera.

Extramedullary hematopoiesis is a common accompaniment of a variety of hematologic diseases such as hereditary spherocytosis, thalassemia and myelofibrosis. The association of extramedullary hematopoiesis with polycythemia vera in the proliferative phase is much less usual. We report a patient who presented with paraplegia due to spinal cord compression; clinical investigation revealed a paravertebral hematopoietic tumor, and the diagnosis of polycythemia vera was then established.

Deaths due to dysentery, acute and persistent diarrhoea among Brazilian infants.

In a population-based study, all infant deaths occurring in a one-year period in the metropolitan areas of Porto Alegre and Pelotas, in southern Brazil, were studied. There were 227 infants who presented diarrhoea during the fatal illness, and in 75% of these diarrhoea was considered to be the underlying cause of death. Acute diarrhoea (< 14 days' duration) accounted for 28% of the deaths, persistent diarrhoea for 62% and dysentery for a further 10%. Approximately one-half of the children with persistent diarrhoea were admitted to a hospital in the first two weeks of the episode. Hospital-acquired infections were likely to have contributed to one- to two-thirds of deaths due to dysentery and persistent diarrhoea. A comparison with neighbourhood controls showed that breast milk provided substantial protection against deaths due to either acute or persistent diarrhoea.

[Female mortality in Brazil: the weaker sex or stronger sex?]. / Mortalidade feminina no Brasil: sexo frágil ou sexo forte?

Population ageing in Brazil has been more rapid and more intense among women. This phenomenon is well described in developed countries where mortality rates are higher for men than women. In this regard, the analysis of mortality patterns by cause contributes to elucidate the determinant factors of the present situation in Brazil and provides indications of some future trends in female mortality. This is especially important due to the fact that in Brazil the social role of women has experienced great changes. This study presents data on mortality from ten capital cities in 1985, showing age-standardized overall and cause-specific mortality rates for five of the main groups of causes by sex. Ratios and differences effect estimators were used. The results revealed that regional patterns are associated with the urban and industrial processes with greater differences by sex in more developed regions. External causes and cardiovascular diseases are the main factors responsible for higher mortality among men with special emphasis on violent deaths. It is inferred that the present trend will be maintained, though it is possible that mortality differences by sex could decrease in the near future. The authors discuss that longer survival among women in Brazil does not reveal better life conditions.

[Evaluation of the quality of information on the basic cause of death of infants in Rio Grande do Sul (Brazil)]. / Avaliação da qualidade da informação sobre a causa básica de óbitos infantis no Rio Grande do Sul (Brasil).

The validity of the official information on the cause of infant deaths was studied in the Brazilian cities of Porto Alegre and Pelotas in 1985. Using data collected for a population-based case-control study of infant mortality due to infectious diseases or malnutrition, a comparison was made between the causes of death reported on the death certificates and those obtained after a careful review of case-notes and a medical interview with the parents of the decreased infants. Official death certificates showed an excess of deaths attribute to bronchopneumonia (ICD 485X) and septicemia (ICD 038.9), and an underestimation of the number of deaths due to diarrheal diseases (ICD 009.1) and of sudden infant deaths (ICD 798.0). The overall rate of agreement between official and revised certificates, in terms of groups of causes of death, was only 27.9%. Lower respiratory infections, which were the leading infectious cause of infant death according to official statistics, were superseded by diarrheal diseases after this revision.