Influenza A infections: predictors of disease severity.

Influenza affects approximately 10% of the world's population annually. It is associated with high morbidity and mortality rates due to its propensity to progress to severe acute respiratory infection, leading to 10-40% of hospitalized patients needing intensive care. Characterizing the multifactorial predictors of poor prognosis is essential for developing strategies against this disease. This study aimed to identify predictors of disease severity in influenza A-infected (IFA-infected) patients and to propose a prognostic score. A retrospective cross-sectional study was conducted with 142 IFA-infected out- and inpatients treated at a tertiary hospital between 2010 and 2018. The viral subtypes, hemagglutinin mutations, viral load, IL-28B SNPs, and clinical risk factors were evaluated according to the patient's ICU admission. Multivariate analysis identified the following risk factors for disease severity: neuromuscular diseases (OR = 7.02; 95% CI = 1.18-41.75; p = 0.032), cardiovascular diseases (OR = 5.47; 95% CI = 1.96-15.27; p = 0.001), subtype (H1N1) pdm09 infection (OR = 2.29; 95% CI = 1.02-5.15; p = 0.046), and viral load (OR = 1.43; 95% CI = 1.09-1.88; p = 0.009). The prognosis score for ICU admission is based on these predictors of severity presented and ROC curve AUC = 0.812 (p < 0.0001). Our results identified viral and host predictors of disease severity in IFA-infected patients, yielding a prognostic score that had a high performance in predicting the IFA patients' ICU admission and better results than a viral load value alone. However, its implementation in health services needs to be validated in a broader population.

Utilização de caneca de alumínio como material alternativo para temperatura de globo de Vernon / Use of aluminum mug as alternative material for Vernon globe temperature

Diversos estudos relacionados à viabilidade e eficiência do uso de materiais alternativos ao globo de Vernon têm sido realizados, principalmente em decorrência ao preço elevado do cobre, componente do instrumento padrão. O objetivo foi avaliar a eficiência da utilização de caneca de alumínio como material alternativo para substituição do globo de Vernon. Para a confecção do protótipo empregou-se uma caneca de alumínio, utilizada em pistola de pintura, com capacidade de 50 ml. A caneca foi pintada com tinta preto-fosca, em duas camadas e um termômetro de mercúrio foi inserido ao centro. Para realização dos testes foram utilizados quatro equipamentos (dois globos de Vernon e dois globos negros alternativos). Foram efetuados testes prévios de comportamento temporal. Estabelecido o tempo, as temperaturas dos globos foram coletadas durante sete dias consecutivos, em três períodos, de 15 minutos cada. Os registros de temperatura foram realizados a cada cinco minutos, num total de 84 por equipamento. Os dados foram submetidos a análise de correlação de Pearson. Os resultados indicaram correlação positiva com o r2 de 0,9927, estabelecendo uma forte correlação entre os resultados de temperatura média do globo negro alternativo e globo de Vernon. Conclui-se que o globo negro alternativo do tipo caneca de alumínio mostrou-se eficiente para aferição da temperatura de globo negro em estudos de ambiência em substituição ao Globo de Vernon.(AU)

Several studies related to the feasibility and efficiency of using alternative materials to Vernon's globe have been carried out, mainly due to the high price of copper, a component of the standard instrument. The objective was to evaluate the efficiency of using an aluminum mug as an alternative material for replacing Vernon's globe. To make the prototype, an aluminum mug was used, used in a paint gun, with a capacity of 50 ml. The mug was painted with matte black paint, in two layers and a mercury thermometer was inserted in the center. Four pieces of equipment were used to carry out the tests (two Vernon globes and two alternative black globes). Previous temporal behavior tests were carried out. Once the time was established, the globes' temperatures were collected for seven consecutive days, in three periods of 15 minutes each. Temperature records were taken every five minutes, a total of 84 per equipment. Data were subjected to Pearson's correlation analysis. The results indicated a positive correlation with the r2 of 0.9927, establishing a strong correlation between the mean temperature results of the alternative black globe and Vernon's globe. It is concluded that the alternative black globe of the aluminum mug type proved tobe efficient for measuring the temperature of the black globe in ambience studies, replacing the Vernon Globe.(AU)

Standardization of a high-performance RT-qPCR for viral load absolute quantification of influenza A.

Influenza is an acute viral infectious respiratory disease worldwide, presenting in different clinical forms, from influenza-like illness (ILI) to severe acute respiratory infection (SARI). Although real-time quantitative polymerase chain reaction (qPCR) is already an important tool for both diagnosis and treatment monitoring of several viral infections, the correlation between the clinical aspects and the viral load of influenza is still unclear. This lack of clarity is primarily due to the low accuracy and reproducibility of the methodologies developed to quantify the influenza virus. Thus, this study aimed to develop and standardize a universal absolute quantification for influenza A by reverse transcription-quantitative PCR (RT-qPCR), using a plasmid DNA. The assay showed efficiency (Eff%) 98.6, determination coefficient (R2) 0.998, linear range 10^1 to 10^10, limit of detection (LOD) 6.77, limit of quantification (LOQ) 20.52 copies/reaction. No inter and intra assay variability was shown, and neither was the matrix effect observed. Serial measurements of clinical samples collected at a 72h interval showed no change in viral load. By contrast, immunocompetent patients have a significantly lower viral load than immunosuppressed ones. Absolute quantification in clinical samples showed some predictors associated with increased viral load: (H1N1)pdm09 (0.045); women (p = 0.049) and asthmatics (p = 0.035). The high efficiency, precision, and previous performance in clinical samples suggest the assay can be used as an accurate universal viral load quantification of influenza A. Its applicability in predicting severity and response to antivirals needs to be evaluated.

Desenvolvimento de plataforma informatizada para o gerenciamento da inspeção e análise laboratorial de produtos de origem animal fornecidos ao exército brasileiro / Development of a computerized platform for inspection management and laboratory analysis of animal products supplied to the Brazilian army

O trabalho propôs o desenvolvimento de plataforma informatizada para apoio ao gerenciamento da inspeção e análise laboratorial de produtos de origem animal fornecidos à tropa do Exército Brasileiro. A pesquisa aplicada corresponde à modalidade de produção tecnológica, em três fases. A fase I foi realizada por meio do levantamento dos arquivos de Laudos Fiscais dos artigos de origem animal, impressos e emitidos pelo LIAB (Laboratório de Inspeção de Alimentos e Bromatologia) do 12º Batalhão de Suprimento, durante o período de janeiro a novembro de 2021, e dos arquivos referentes aos Boletins Técnicos do Exército Brasileiro (BT30.404- EB). A fase II correspondeu ao projeto e desenvolvimento da "Plataforma Alimentar - Rastreabilidade e Confiabilidade Garantida". Toda a programação desenvolvida foi armazenada em um servidor web terceirizado e pode ser acessada pelos LIABs pelo link: www.pmppa.com.br/alimentar. A plataforma informatizada utilizou a linguagem PHP (Hypertext Preprocessor) associada às linguagens CSS (Cascading Style Sheet), HTML (Hyper Text Markup Language), JS (Java script) e bootstrap. A fase III consistiu na realização do teste de Caixa Preta. Os módulos disponíveis para inclusão das informações no sistema são: "cadastro dos artigos de origem animal"; "lançamento das análises"; "cadastro de Boletim Técnico" e "relatórios", os quais permitem atribuir ao artigo de origem animal a qualidade satisfatória ou insatisfatória para o consumo seguro da tropa, de acordo com a avaliação laboratorial das amostras. Houve, com eficácia, o desenvolvimento da plataforma, garantindo ao oficial médico veterinário uma ferramenta segura para apoio ao gerenciamento de qualidade dos produtos destinados à alimentação da tropa do Exército Brasileiro.

The study proposed the development of a computerized platform to support the inspection management and laboratory analysis of animal products supplied to the Brazilian Army troops. The applied research corresponds to the modality of technological production in three phases. Phase I consisted in survey from Fiscal Report Files of animal products, which was printed and issued by the FIBL (Food Inspection and Bromatology Laboratory) from the 12th Supply Battalion, from January to November 2021, and the Brazilian Army's Technical Bulletins (BT30.404-EB) Files. Phase II corresponded to design and development of the "Food Platform - Guaranteed Traceability and Reliability". All the developed programming stored at an outsourced web server by accessing the FIBLS through the link: www.pmppa.com.br/alimentar. The supportive computerized platform used the PHP (Hypertext Preprocessor) language associated with the CSS (Cascading Style Sheet), HTML (Hyper Text Markup Language), JS (Java script) and bootstrap. Phase III consisted in performing a Black Box testing. The available modules for information inclusion in the system are the following issues: "Animal products registration"; "Analyses release"; "Technical Bulletin registration" and "Reports", which allow attributing the satisfactory or unsatisfactory quality to the animal products providing safe consumption for the troops, according to the evaluation of laboratory samples. The platform was effectively developed, guaranteeing the veterinary officer a safe tool to support the quality management of products intended for feeding the Brazilian Army troops.

Subjective time under altered states of consciousness in ayahuasca users in shamanistic rituals involving music.

Ayahuasca is described as a hallucinogenic substance whose property is to alter the subjective experience of time and impair the perception of the passage of time during stimuli of more than two to three seconds. The dose-dependent effects of two concentrations of ayahuasca in the ritualistic context were investigated employing temporal reproduction tasks in participants experienced in shamanistic ayahuasca rituals. The study was conducted on nine healthy volunteers who ingested two doses of ayahuasca at two times during a ritual session. The doses of each session, consumed in amounts ranging from 20 to 60 mL, were either of low concentration or of experimental ayahuasca according to a double-blind procedure. Participants performed the task of immediately listening and reproducing, with a laptop, 20-s musical stimuli during the session. The results showed that significant temporal distortion was triggered by the musical stimulus presented without the ingestion of ayahuasca, with means of 16.33 to 16.52 s. There were minor temporal distortions after ingestion of ayahuasca: a mean of 17.91 s for control ayahuasca and of 18.38 s for experimental ayahuasca. These results with less temporal distortion among participants with ayahuasca intake disagree with other studies of hallucinogens involving temporal reproduction.

Evaluation of the effects of chronic occupational exposure to metallic mercury on the thyroid parenchyma and hormonal function.

INTRODUCTION: Experiments in animals exposed to mercury (Hg) in different chemical states have shown thyroid parenchymal and hormone alterations. However, these experiments did not allow the establishment of dose-response curves or provide an understanding of whether these Hg effects on the thyroid parenchyma occur in humans. OBJECTIVE: To evaluate the association between chronic occupational exposure to metallic Hg and alterations in thyroid hormones and gland parenchyma 14 years after the last exposure. METHODS: A cross-sectional study including 55 males exposed in the past to metallic Hg and 55 non-exposed males, paired by age, was conducted in the Hospital das Clínicas (Brazil) from 2016 to 2017. Serum concentrations of total and free triiodothyronine (TT3 and FT3), free thyroxine (FT4), thyrotropin (TSH), reverse T3 (RT3), selenium and antithyroid antibody titers were obtained. The Hg and iodine concentrations were measured in urine. The thyroid parenchyma was evaluated by B-mode ultrasonography with Doppler. The nodules with aspects suspicious for malignancy were submitted to aspiration puncture with a thin needle, and the cytology assessment was classified by the Bethesda system. The t test or Mann-Whitney test, Chi-square test and Spearman correlation were used to compare the exposed and non-exposed groups and examine the relationships between the variables. Univariate and multivariate logistic regression models were used to trace determinants of the risk of thyroid hormone alteration. Statistical significance was defined by p < 0.05. RESULTS: The urinary Hg average was significantly higher in the exposed group than in the non-exposed group (p < 0.01). The mean TSH serum concentration in the exposed group was higher, with a statistically significant difference between the groups (p = 0.03). Serum concentrations of TSH exceeded the normality limit (4.20 µIU/ml) in 13 exposed individuals (27.3%) and 4 non-exposed individuals (7.3%), with a statistically significant association between the hormonal increase and exposure to Hg (p = 0.02). In the logistic regression model, exposure to Hg (yes or no) showed an odds ratio = 4.86 associated with an increase of TSH above the normal limit (p = 0.04). The serum concentrations of RT3 showed a statistically borderline difference between the groups (p = 0.06). There was no statistically significant difference between the mean TT3, FT3 and FT4 serum concentrations in the Hg-exposed group compared to the non-exposed group. The proportions of the echogenicity alterations were higher in the exposed group compared to the non-exposed group (27.3% versus 9.1%; p = 0.03). Papillary carcinomas were documented in three exposed individuals and one non-exposed individual. A follicular carcinoma was recorded in one non-exposed individual. CONCLUSIONS: Due to the higher serum TSH concentration and the prevalence of parenchymal alterations in the Hg-exposed group, even after cessation of exposure, it is recommended that the thyroid status of exposed workers be followed for a long period.

Subjective time under altered states of consciousness in ayahuasca users in shamanistic rituals involving music

Ayahuasca is described as a hallucinogenic substance whose property is to alter the subjective experience of time and impair the perception of the passage of time during stimuli of more than two to three seconds. The dose-dependent effects of two concentrations of ayahuasca in the ritualistic context were investigated employing temporal reproduction tasks in participants experienced in shamanistic ayahuasca rituals. The study was conducted on nine healthy volunteers who ingested two doses of ayahuasca at two times during a ritual session. The doses of each session, consumed in amounts ranging from 20 to 60 mL, were either of low concentration or of experimental ayahuasca according to a double-blind procedure. Participants performed the task of immediately listening and reproducing, with a laptop, 20-s musical stimuli during the session. The results showed that significant temporal distortion was triggered by the musical stimulus presented without the ingestion of ayahuasca, with means of 16.33 to 16.52 s. There were minor temporal distortions after ingestion of ayahuasca: a mean of 17.91 s for control ayahuasca and of 18.38 s for experimental ayahuasca. These results with less temporal distortion among participants with ayahuasca intake disagree with other studies of hallucinogens involving temporal reproduction.

Genetic progress estimation strategy for upright common bean plants using recurrent selection.

Common bean producers in Brazil tend to grow plants as upright as possible. Because the control of this trait involves a large number of genes, recurrent selection (RS) is the best approach for successful plant improvement. Because plant architecture (PA) is evaluated using scores and usually has high heritability, RS for PA is performed through visual selection in generation S0. The aim of the present study was to evaluate selection progress and investigate whether this progress varies with the number of selected progenies or the generation evaluated. In addition, the effect of RS for the upright (PA) trait on progeny grain yield (GY) was investigated. Data of progenies S0:3 and S0:4 of the fifth, eighth, and twelfth cycles were used. A combined analysis of variance was performed using the adjusted means of the 47 best progenies from each generation and cycle, using two control cultivars as reference. A joint analysis of the two generations used during the evaluation of progenies for the different cycles was also performed. The genetic progress (GP) was estimated by fitting a linear regression equation to the relationship between the adjusted mean of each cycle and the number of cycles. We found that RS was efficient and the estimated GP of the evaluated progenies was 4.5%. Based on the GY heritability estimates, in more advanced generation selection for GY can be successfully performed on progenies. Thus, the selection already done for PA in F2 could be associated to the most productive progenies.

Jump Squat is More Related to Sprinting and Jumping Abilities than Olympic Push Press.

The aim of this study was to test the relationships between jump squat (JS) and Olympic push press (OPP) power outputs and performance in sprint, squat jump (SJ), countermovement jump (CMJ) and change of direction (COD) speed tests in elite soccer players. 27 athletes performed a maximum power load test to determine their bar mean propulsive power (MPP) and bar mean propulsive velocity (MPV) in the JS and OPP exercises. Magnitude-based inference was used to compare the exercises. The MPV was almost certainly higher in the OPP than in the JS. The MPP relative to body mass (MPP REL) was possibly higher in the OPP. Only the JS MPP REL presented very large correlations with linear speed (r>0.7, for speed in 5, 10, 20 and 30 m) and vertical jumping abilities (r>0.8, for SJ and CMJ), and moderate correlation with COD speed (r=0.45). Although significant (except for COD), the associations between OPP outcomes and field-based measurements (speed, SJ and CMJ) were all moderate, ranging from 0.40 to 0.48. In a group composed of elite soccer players, the JS exercise is more associated with jumping and sprinting abilities than the OPP. Longitudinal studies are needed to confirm if these strong relationships imply superior training effects in favor of the JS exercise.

Traditional Periodization versus Optimum Training Load Applied to Soccer Players: Effects on Neuromuscular Abilities.

It is unknown whether traditional periodization of strength-power training involving accumulation, transformation and realization blocks is superior to other simpler and more practical training schemes. The purpose of this study was thus to investigate changes in strength/power/speed characteristics of elite soccer players in response to either classic strength-power periodization (TSP) or optimum power load (OPL). 23 professional soccer players were randomly assigned to TSP or OPL for 6 weeks in-season regular training (3 times per week). TSP involved half squats or jump squats, depending on the respective training block, while OPL involved only jump squats at the optimum power load. Results revealed that both groups presented similar significant (P<0.05) improvements in squat one repetition maximum, squat and countermovement jump heights and change of direction speed. In addition, although both groups reported significant increases in sprinting speed (P<0.05); delta change scores demonstrated a superior effect of OPL to improve 10- and 20-m speed. Similarly, OPL presented greater delta change in mean propulsive power in the jump squat. Therefore, training continuously at the optimum power zone resulted in superior performance improvements compared to training under classic strength-power periodization.

Effects of far infrared rays emitting clothing on recovery after an intense plyometric exercise bout applied to elite soccer players: a randomized double-blind placebo-controlled trial.

The aim was to investigate the effects of far infrared (FIR) ray emitting clothes on indirect markers of exercise-induced muscle damage and physical performance recovery after a plyometric bout applied to soccer players. Twenty-one male players (18.9±0.6 years; 70.8±5.01 kg; 178.3±0.06 cm) performed 100 drop-jumps. Six hours after the bout, athletes put on FIR clothes (FIR) (density of 225 g·m(-2), 88% far infrared rays emitting polyamide 66 Emana yarn (PA66) fibre, 12% Spandex, emissivity of 0.88 and power emitted of 341 W/m2µm at 37°C in the 5-20 µm wavelength range, patent WO 2009/077834 A2) (N = 10) or placebo clothes (PLA) (N = 11). Mid-thigh circumferences, creatine kinase (CK), and delayed-onset muscle soreness (DOMS) were assessed before, immediately after and 24, 48, and 72 h after the bout. Squat (SJ) and countermovement jump (CMJ) heights were measured before and at 24, 48, and 72 h after, while 1RM leg press (maximum strength) was measured before and at 72 h after the plyometrics. No differences between groups were found in mid-thigh circumferences, SJ, CMJ or 1RM. CK increased significantly 24 h after the plyometrics in comparison to before (p < 0.05) in both groups. PLA showed significant DOMS increases at 24, 48, and 72 h, while FIR showed significant increases at 24 and 48 h (p < 0.05). DOMS effect sizes were greater in FIR (moderate at 48 h, ES = 0.737 and large at 72 h, ES = 0.844), suggesting that FIR clothes may reduce perceived DOMS after an intense plyometric session performed by soccer players.

Prevalence of hypertension and its associated factors in contaminated areas of the Santos-São Vicente Estuarine region and Bertioga, Brazil: 2006-2009.

In Brazil, cardiovascular diseases account for 33% of deaths and the prevalence of hypertension is of approximately 22%. The Santos and São Vicente Estuarine System is the most important example of environmental degradation by chemicals from industrial sources. The aim of the present study was to evaluate the prevalence of hypertension and its associated factors in the population of this estuary in the period 2006-2009. A cross-sectional study was conducted to assess the aforementioned prevalence of hypertension in the evaluated areas, as well as risk factors for this disease in four contaminated areas located in the Estuary, and one area outside Estuary, the city of Bertioga. Associations between categorical variables were tested using Pearson's chi-square test incorporating Yates' correction, or Fisher's exact test. Single and multiple logistic regression models were applied to evaluate the risk factors for hypertension. The highest prevalence of hypertension was found in Continental São Vicente (28.4%). The risk factors for hypertension were the following: living in Center of Cubatão (OR: 1.3; IC95%: 1.0 - 1.6) and Continental São Vicente (OR: 1.4; IC95%: 1.1 - 1.8); illiterate (OR: 1.9; IC95%: 1.1 - 3.2); living in the area for more than 20 years (OR: 1.2; IC95%: 1.0 - 1.5); group of people aged 36-60 years (OR: 3.9; IC95%: 3.3 - 4.6) and who have had past occupational exposure (OR: 1.3; IC95%: 1.1 - 1.6). Results indicate that living in contaminated areas, especially for a longer time, is a risk factor for hypertension.

A Correlational Analysis of Tethered Swimming, Swim Sprint Performance and Dry-land Power Assessments.

Swimmers are often tested on both dry-land and in swimming exercises. The aim of this study was to test the relationships between dry-land, tethered force-time curve parameters and swimming performances in distances up to 200 m. 10 young male high-level swimmers were assessed using the maximal isometric bench-press and quarter-squat, mean propulsive power in jump-squat, squat and countermovement jumps (dry-land assessments), peak force, average force, rate of force development (RFD) and impulse (tethered swimming) and swimming times. Pearson product-moment correlations were calculated among the variables. Peak force and average force were very largely correlated with the 50- and 100-m swimming performances (r=- 0.82 and -0.74, respectively). Average force was very-largely/largely correlated with the 50- and 100-m performances (r=- 0.85 and -0.67, respectively). RFD and impulse were very-largely correlated with the 50-m time (r=- 0.72 and -0.76, respectively). Tethered swimming parameters were largely correlated (r=0.65 to 0.72) with mean propulsive power in jump-squat, squat-jump and countermovement jumps. Finally, mean propulsive power in jump-squat was largely correlated (r=- 0.70) with 50-m performance. Due to the significant correlations between dry-land assessments and tethered/actual swimming, coaches are encouraged to implement strategies able to increase leg power in sprint swimmers.

Prevalence of liver diseases as referred by people living in the Santos and São Vicente Estuary.

The Santos and São Vicente Estuary has suffered extensively over the years from irregular industrial deposits. The present study aimed to evaluate liver disease prevalence and potential associated risk factors in four of the Estuary's areas (Pilões and Água-Fria, Cubatão Center, Continental São Vicente, and Guarujá) and a reference area (Bertioga). This study consisted of a cross-sectional study design, in which a questionnaire was used to collect information in 820 households at each of the study areas. The proportion of total liver diseases, hepatitis, cirrhosis, and cancer (liver, biliary tract, and pancreas) per area were estimated. Pearson's chi-square test and two proportion differences test were applied in order to evaluate associations between disease occurrence and areas and to test differences between two proportions, respectively. Single and multiple logistic regression models were applied to assess associations between disease prevalence and the different study areas. Liver disease prevalence was 1.5 % among all inhabitants and 1.4 % among those without any type of exposure. Among those who reported the presence of liver disease, a higher percentage of the participants that reported hepatitis (27.7 %) or other liver disease (48.7 %) did not report occupational or alcohol exposures. Hepatitis (77.8 %) was the most reported disease, and a statistical association between living in Pilões and Água-Fria and the occurrence of hepatitis was observed (Pearson's χ (2): z = 18.1; p = 0.001). The consumption of locally-produced groceries (2.88; CI: 1.24-6.70) and water (5.88; CI: 2.24-15.45) were shown to be risk factors for the occurrence of liver disease. Thus, environmental exposure is still a public health problem present in the estuary region.

Genetic control of inflorescence in common bean.

The number of pods per common bean plant is a primary component of grain yield, which depends on the number of flowers produced and on the flower set. Thus, a larger number of flowers per plant would increase yield. Lines with inflorescences that had a large number of flowers compared to common bean plants now under cultivation were identified. We analyzed the genetic control of this trait and its association with grain yield. The cultivar BRSMG Talismã was crossed with 2 lines, L.59583 and L.59692, which have a large number of flowers. The F1, F2, and F3 generations were obtained. These generations were assessed together with the parents in a randomized block experimental design with 2 replications. The traits assessed included length of inflorescence, number of pods per inflorescence, number of pods per plant, number of grains per plant, 100-grain weight, and grain yield per plant. Mean genetic components and variance were estimated. The traits length of inflorescence and number of pods per inflorescence exhibited genetic control with predominance that showed an additive effect. In the 2 crosses, genetic control of grain yield and of its primary components showed that the allelic interaction of dominance was high. The wide variability in the traits assessed may be used to increase yield of the common bean plant by increasing the number of flowers on the plant.

VEGF receptor expression decreases during lung development in congenital diaphragmatic hernia induced by nitrofen.

Changes in vascular endothelial growth factor (VEGF) in pulmonary vessels have been described in congenital diaphragmatic hernia (CDH) and may contribute to the development of pulmonary hypoplasia and hypertension; however, how the expression of VEGF receptors changes during fetal lung development in CDH is not understood. The aim of this study was to compare morphological evolution with expression of VEGF receptors, VEGFR1 (Flt-1) and VEGFR2 (Flk-1), in pseudoglandular, canalicular, and saccular stages of lung development in normal rat fetuses and in fetuses with CDH. Pregnant rats were divided into four groups (n=20 fetuses each) of four different gestational days (GD) 18.5, 19.5, 20.5, 21.5: external control (EC), exposed to olive oil (OO), exposed to 100 mg nitrofen, by gavage, without CDH (N-), and exposed to nitrofen with CDH (CDH) on GD 9.5 (term=22 days). The morphological variables studied were: body weight (BW), total lung weight (TLW), left lung weight, TLW/BW ratio, total lung volume, and left lung volume. The histometric variables studied were: left lung parenchymal area density and left lung parenchymal volume. VEGFR1 and VEGFR2 expression were determined by Western blotting. The data were analyzed using analysis of variance with the Tukey-Kramer post hoc test. CDH frequency was 37% (80/216). All the morphological and histometric variables were reduced in the N- and CDH groups compared with the controls, and reductions were more pronounced in the CDH group (P<0.05) and more evident on GD 20.5 and GD 21.5. Similar results were observed for VEGFR1 and VEGFR2 expression. We conclude that N- and CDH fetuses showed primary pulmonary hypoplasia, with a decrease in VEGFR1 and VEGFR2 expression.

VEGF receptor expression decreases during lung development in congenital diaphragmatic hernia induced by nitrofen

Changes in vascular endothelial growth factor (VEGF) in pulmonary vessels have been described in congenital diaphragmatic hernia (CDH) and may contribute to the development of pulmonary hypoplasia and hypertension; however, how the expression of VEGF receptors changes during fetal lung development in CDH is not understood. The aim of this study was to compare morphological evolution with expression of VEGF receptors, VEGFR1 (Flt-1) and VEGFR2 (Flk-1), in pseudoglandular, canalicular, and saccular stages of lung development in normal rat fetuses and in fetuses with CDH. Pregnant rats were divided into four groups (n=20 fetuses each) of four different gestational days (GD) 18.5, 19.5, 20.5, 21.5: external control (EC), exposed to olive oil (OO), exposed to 100 mg nitrofen, by gavage, without CDH (N-), and exposed to nitrofen with CDH (CDH) on GD 9.5 (term=22 days). The morphological variables studied were: body weight (BW), total lung weight (TLW), left lung weight, TLW/BW ratio, total lung volume, and left lung volume. The histometric variables studied were: left lung parenchymal area density and left lung parenchymal volume. VEGFR1 and VEGFR2 expression were determined by Western blotting. The data were analyzed using analysis of variance with the Tukey-Kramer post hoc test. CDH frequency was 37% (80/216). All the morphological and histometric variables were reduced in the N- and CDH groups compared with the controls, and reductions were more pronounced in the CDH group (P<0.05) and more evident on GD 20.5 and GD 21.5. Similar results were observed for VEGFR1 and VEGFR2 expression. We conclude that N- and CDH fetuses showed primary pulmonary hypoplasia, with a decrease in VEGFR1 and VEGFR2 expression.

Cultivo in vitro de Brosimum gaudichaudii Tréc. (Moraceae) / In vitro cultivation of Brosimum gaudichaudii Tréc. (Moraceae)

O objetivo desta pesquisa foi avaliar o potencial organogenético de entrenós, discos foliares, e raízes de Brosimum gaudichaudii utilizando 12 diferentes combinações dos fitorreguladores 6-benzilaminopurina e ácido naftaleno acético, em meio MS (diluído à metade), sólido (6,5 g de ágar), e com 20 g.L-1 de sacarose. Independentemente das combinações hormonais testadas verificou-se a formação de calos friáveis (2 a 20 mm de diâmetro) em 90% dos entrenós usados como explantes. No entanto, os tratamentos testados não foram capazes induzir calos ou gemas em raízes e em discos foliares. O estudo anatômico revelou a formação de meristemóides nas regiões mais externa e mais interna dos calos. Os resultados obtidos poderão servir de base para novos testes de indução de calos na espécie.

The objective of this research was to evaluate the organogenic potential of internodes, leaf discs and roots of Brosimum gaudichaudii using 12 different combinations of the plant growth regulators 6-benzylaminopurine and naphthalene acetic acid in MS medium (half strength), solid medium (6.5 g agar) and sucrose medium (20 g.L-1). Regardless the hormonal combination tested, we observed the formation of friable calluses (2 - 20 mm wide) in 90% of the internode explants. However, the treatments were not able to induce callus or buds on roots and leaf discs. The anatomical analysis revealed meristemoid formation in the outer and inner regions of the calluses. The results may serve as the basis for further testing of callus induction in this species.

Consequences of the implementation of the Model for End-stage Liver Disease system for liver allocation in Brazil.

BACKGROUND: In July 2006, the system for liver allocation in Brazil started to rely on the Model for End-stage Liver Disease (MELD) scale, replacing the previous chronological criteria. Under the new system, the score for listing pediatric patients is obtained by multiplication of the calculated PELD score by 3. The current criteria also features extra points for diseases such as hepatocellular carcinoma (HCC). This study sought to analyze the consequences of implementation of the MELD system on waiting list mortality, posttransplant survival rates and characteristics of the transplanted patients. METHODS: We retrospectively studied data from the State Health Secretariat of São Paulo, regarding all patients registered on the waiting list for liver transplantation in the State of São Paulo, in two periods: July 2005 to July 2006 (pre-MELD era) and July 2006 to July 2010 (MELD era). Patient survival rates calculated using the Kaplan-Meier method were compared by the log-rank test. P values <.05 were considered statistically relevant. RESULTS: After implementation of the MELD, waiting list registrations decreased by 39.8%; the percentage of transplants in HCC recipients increased from 2.4% to 23.7%; pediatric transplants increased from 6.5% to 9.3%; deaths on the list fell from 599 in the pre-MELD era to 359 in the last year analyzed; recipients with higher MELD displayed significantly lower posttransplant survival rates; HCC patients, better survival after transplantation (P = .002); No difference was observed comparing survival rates between pre-MELD and MELD eras (P = 474) or between adults and children (P = .867). CONCLUSION: Under the MELD system for liver allocation in Brazil, there was a reduction in waiting list mortality and an increased number of transplantations in pediatric and HCC recipients. Survival rates of patients with higher MELD score were inferior. However, this result was offset by the greater survival in HCC recipients, with no difference in patient survival rates between the pre-MELD and MELD eras.

Testing liver allocation in São Paulo, Brazil: the relationship of model for end-stage liver disease implementation with a reduction in waiting-list mortality.

INTRODUCTION: In 2006, the model for end-stage liver disease (MELD) was launched as a new liver allocation system in Sao Paulo, Brazil. We designed this study to assess the results of the new allocation policy on waiting list mortality. METHODS: We reviewed the state of Sao Paulo liver transplant database from July 2003 through July 2009. Patients were divided in those who were transplanted before (pre-MELD group) and those who were transplanted after (post-MELD group) the implementation of the MELD system. Included were adult liver transplant candidates. Waiting list mortality was the primary endpoint. RESULTS: The unadjusted death rate in patients on the waiting list decreased significantly after the implementation of the MELD system (from 91.2 to 33.5/1000 patients/year, P < .0001). Multivariate analysis has shown a significant drop of the risk of waiting list death for post-MELD patients (odds ration 0.34, P < .0001). CONCLUSION: There was a reduction in waiting time and list mortality after the implementation of the MELD system in Brazil. Patients listed in the post-MELD era had a significant reduction of death risk on the waiting list. Future studies should assess posttransplant outcomes.