Diversity and probiotic characterisation of yeast isolates in the bovine gastrointestinal tract.

The use of yeasts as a feed supplement for cattle can promote animal development and performance. However, for the positive results to be consistent, strains with probiotic properties must be selected. The objective of this study was to isolate and identify yeasts present in the bovine feces and evaluate their probiotic potential together with strains previously isolated from the rumen (preliminary study). A total of 193 isolates were studied, including 139 isolates (19 species) from fecal samples from 11 different animals (Bos taurus and Bos indicus) and 54 strains previously isolated from rumen fluid (Bos taurus). The yeast population in the feces ranged from 3.51 to 4.99 log CFU/g, with Candida pararugosa being the most abundant (isolated from the feces of six samples analysed). Isolates were selected that had negative results in the safety tests (hemolytic activity, DNAse, and gelatinase) and had percentages greater than 35 and 70% for hydrophobicity and auto-aggregation, respectively. In addition, selected isolates had percentages greater than 77.7 and 74.7% for coaggregation with pathogenic strains of Escherichia coli and Clostridium perfringens, respectively. The isolates with percentage growth at 39 °C greater than 64.6% and viability greater than 96.7% were selected for survival testing under bovine gastrointestinal conditions. After the tests, the seven best isolates were selected, belonging to the species Candida pararugosa (L60, CCMA 928 and CCMA 930) and Pichia kudriavzevii (L97, L100, CCMA904, CCMA 907). The selected isolates were exopolysaccharide producers. Based on the results of the evaluated properties, the seven selected isolates were classified as potential probiotics for cattle.

Low dose rate γ-irradiation protects fruit fly chromosomes from double strand breaks and telomere fusions by reducing the esi-RNA biogenesis factor Loquacious.

It is still continuously debated whether the low-dose/dose-rate (LDR) of ionizing radiation represents a hazard for humans. Model organisms, such as fruit flies, are considered valuable systems to reveal insights into this issue. We found that, in wild-type Drosophila melanogaster larval neuroblasts, the frequency of Chromosome Breaks (CBs), induced by acute γ-irradiation, is considerably reduced when flies are previously exposed to a protracted dose of 0.4 Gy delivered at a dose rate of 2.5 mGy/h. This indicates that this exposure, which is associated with an increased expression of DNA damage response proteins, induces a radioadaptive response (RAR) that protects Drosophila from extensive DNA damage. Interestingly, the same exposure reduces the frequency of telomere fusions (TFs) from Drosophila telomere capping mutants suggesting that the LDR can generally promote a protective response on chromatin sites that are recognized as DNA breaks. Deep RNA sequencing revealed that RAR is associated with a reduced expression of Loquacious D (Loqs-RD) gene that encodes a well-conserved dsRNA binding protein required for esiRNAs biogenesis. Remarkably, loss of Loqs mimics the LDR-mediated chromosome protection as it decreases the IR-induced CBs and TFs frequency. Thus, our molecular characterization of RAR identifies Loqs as a key factor in the cellular response to LDR and in the epigenetic routes involved in radioresistance.

Criteria for lactic acid bacteria screening to enhance silage quality.

The main challenge of ensiling is conserving the feed through a fermentative process that results in high nutritional and microbiological quality while minimizing fermentative losses. This challenge is of growing interest to farmers, industry and research and involves the use of additives to improve the fermentation process and preserve the ensiled material. Most studies involved microbial additives; lactic acid bacteria (LAB) have been the focus of much research and have been widely used. Currently, LABs are used in modern and sustainable agriculture because of their considerable potential for enhancing human and animal health. Although the number of studies evaluating LABs in silages has increased, the potential use of these micro-organisms in association with silage has not been adequately studied. Fermentation processes using the same strain produce very different results depending on the unique characteristics of the substrate, so the choice of silage inoculant for different starting substrates is of extreme importance to maximize the nutritional quality of the final product. This review describes the current scenario of the bioprospecting and selection process for choosing the best LAB strain as an inoculant for ensiling. In addition, we analyse developments in the fermentation process and strategies and methods that will assist future studies on the selection of new strains of LAB as a starter culture or inoculant.

Carbapenem-resistant Klebsiella pneumoniae in ICU-admitted COVID-19 patients: Keep an eye on the ball.

Here we report on seven intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS) who developed positive rectal swabs and invasive infections due to carbapenemase-producing Klebsiella pneumoniae (CP-Kp). Notwithstanding the infection prevention measures introduced during the COVID-19 pandemic and changes in the hospitalised population, attention to CP-Kp infections must remain high, especially in the critically ill setting.

Violacein antimicrobial activity on Staphylococcus epidermidis biofilm.

The aim of this study was to evaluate the antimicrobial potential of violacein (VIO) on Staphylococcus epidermidis biofilm. The minimum biofilm inhibition concentration (MBIC) and minimum biofilm eradication concentration (MBEC) were determined, as well as the effect of VIO exposure time on microbial viability in mature biofilm. Violacein showed good antibiofilm action, inhibiting biofilm formation and eradicating mature biofilm of S. epidermidis at concentrations of 20 µg.mL-1 and 160 µg.mL-1, respectively. At concentrations equal to MBEC and 2x MBEC, the biofilm was eradicated in 3 h and 2h30min of incubation, respectively.When evaluating VIO modulating effect on the action of clinically-used drugs (vancomycin, cefepime, ciprofloxacin and meropenem), especial synergism was observed in the violacein-ciprofloxacin association, it can completely erradicated the mature biofilm at the concentration of 1/2xMBEC and 1/4xMBEC, respectively. VIO shows good antimicrobial action on S. epidermidis biofilm and has the potential to synergistically modulate the activity of clinically-used antimicrobials.

In vitro assessment of the probiotic potential of lactobacilli isolated from Minas artisanal cheese produced in the Araxá region, Minas Gerais state, Brazil / Avaliação in vitro do potencial probiótico de lactobacilos isolados de queijo minas artesanal produzido na região de Araxá, estado de Minas Gerais, Brasil

Minas artisanal cheese is made from endogenous starter cultures, including lactic acid bacteria (LAB). Some LAB may possess probiotic potential. Thus, this study aimed to evaluate the in vitro probiotic properties of lactobacilli isolated from Minas artisanal cheeses produced in Minas Gerais. Ten samples of lactobacilli, formerly isolated from those cheeses, were submitted to the following assays: antimicrobial susceptibility, tolerance to artificial gastric juice and biliary salts, production of hydrogen peroxide and antagonism against pathogenic and non-pathogenic micro-organisms. Only L. plantarum (C0) was sensitive to all tested antimicrobials, while the other LAB samples were resistant to at least one drug. Six samples were tolerant to artificial gastric juice, and L. brevis (A6) even grew in that medium. Three samples were tolerant to biliary salts. Only L. brevis (E35) produced hydrogen peroxide. Difference (P< 0.05) was observed among the means of inhibition haloes of lactobacilli against Enterococcus faecalis ATCC 19433 and Lactobacillus plantarum C24 in spot-on-the-lawn assay. All samples of lactobacilli inhibited Escherichia coli ATCC 25922, Salmonella enterica var. Typhimurium ATCC 14028 in co-culture antagonism test (P< 0.0001). Most lactobacilli samples showed in vitro probiotic potential. From the tested samples, L. brevis (A6) presented the best results considering all in vitro probiotic tests.(AU)

O queijo minas artesanal é produzido por culturas starters endógenas, incluindo bactérias ácido-láticas (BAL). Algumas BAL podem possuir potencial probiótico. Com isso, este estudo teve como objetivo avaliar as propriedades probióticas in vitro de lactobacilos isolados de queijo minas artesanal produzido no estado de Minas Gerais. Dez amostras de lactobacilos, previamente isoladas desses queijos, foram submetidas aos seguintes testes: susceptibilidade aos antimicrobianos, tolerância ao suco gástrico artificial e aos sais biliares, produção de peróxido de hidrogênio e antagonismo contra micro-organismos patogênicos e não patogênicos. Apenas L. plantarum (C0) foi sensível a todos os antimicrobianos testados, enquanto as outras amostras de BAL foram resistentes a, pelo menos, uma droga testada. Seis amostras foram tolerantes ao suco gástrico artificial, e L. brevis (A6) apresentou crescimento nesse meio. Três amostras foram tolerantes aos sais biliares. Apenas L. brevis (E35) produziu peróxido de hidrogênio. Diferença (P<0,05) foi observada entre as médias dos halos de inibição de lactobacilos contra Enterococcus faecalis ATCC 19433 e Lactobacillus plantarum C24 no teste do spot-on-the-lawn. Todas as amostras de lactobacilos inibiram Escherichia coli ATCC 25922, Salmonella enterica var. Typhimurium ATCC 14028 no teste de antagonismo em cocultura (P<0,0001). A maioria das amostras de lactobacilos apresentou potencial probiótico in vitro. Com base nas amostras testadas, L. brevis (A6) apresentou os melhores resultados, considerando-se todos os testes probióticos in vitro.(AU)

Violacein antimicrobial activity on Staphylococcus epidermidis and synergistic effect on commercially available antibiotics.

AIMS: The study aimed to assess whether violacein has antimicrobial activity on Staphylococcus epidermidis and synergistically modulates the action of commercially available antimicrobial drugs. METHODS AND RESULTS: Violacein showed excellent antimicrobial activity on biofilm-forming and nonbiofilm-forming S. epidermidis strains (ATCC 35984) (ATCC 12228), with bacteriostatic (MIC = 20 µg ml-1 and 10 µg ml-1 respectively) and bactericidal effects (MBC = 20 µg ml-1 for both strains), observed in short periods of exposure. The violacein bactericidal concentration led to S. epidermidis death after 2-3 h of exposure. Additionally, violacein synergistically modulated the activity of different antimicrobial classes on S. epidermidis ATCC 12228 (81·8%; n = 9) and on S. epidermidis ATCC 35984 (54·5%; n = 6), reducing the MIC of these antibiotics by up to 16-fold. CONCLUSION: Violacein shows excellent antimicrobial activity on S. epidermidis strains. SIGNIFICANCE AND IMPACT OF THE STUDY: Violacein shows the potential for the development of a new drug for the treatment of infections caused by S. epidermidis.

Low-dose Spinal Block With Continuous Epidural Infusion for Renal Transplantation in a Patient With Alport Syndrome: A Case Report.

OBJECTIVE: We aim to describe management of a patient receiving renal transplantation for chronic renal failure due to Alport syndrome with low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. CASE REPORT: A 38-years-old man with chronic renal failure secondary to Alport syndrome underwent kidney transplantation. Because of a high risk of respiratory and cardiovascular complications related to the patient's baseline lung disease and abnormalities in heart conduction, we selected combined spinal-epidural anesthesia. The block was ultrasound-guided and performed at the T12-L1 interspace with 4.5 mg of 0.5% intrathecal hyperbaric bupivacaine followed by a continuous epidural infusion of 0.5% levobupivacaine mixed with 25 µg of Fentanyl at the initial rate of 8 mL/h. Sensory block to T5-T6 was obtained within 10 minutes. The patient then received mild sedation with Propofol and Remifentanil. Methylprednisolone and diuretics were administered before vascular unclamping according to our internal protocol. Surgery lasted 3 hours with no clinical or procedural complication. CONCLUSIONS: Although renal transplantation is usually performed under general anesthesia, in a particularly complex patient with chronic renal failure, chronic obstructive pulmonary disease and a worsened respiratory mechanics, we applied a combined approach with a low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. The technique did not affect hemodynamics while having a positive impact on recovery of function of the transplanted organ with rapid improvement of urine output, serum creatinine, and blood urea nitrogen levels.

A data-driven network model of primary myelofibrosis: transcriptional and post-transcriptional alterations in CD34+ cells.

microRNAs (miRNAs) are relevant in the pathogenesis of primary myelofibrosis (PMF) but our understanding is limited to specific target genes and the overall systemic scenario islacking. By both knowledge-based and ab initio approaches for comparative analysis of CD34+ cells of PMF patients and healthy controls, we identified the deregulated pathways involving miRNAs and genes and new transcriptional and post-transcriptional regulatory circuits in PMF cells. These converge in a unique and integrated cellular process, in which the role of specific miRNAs is to wire, co-regulate and allow a fine crosstalk between the involved processes. The PMF pathway includes Akt signaling, linked to Rho GTPases, CDC42, PLD2, PTEN crosstalk with the hypoxia response and Calcium-linked cellular processes connected to cyclic AMP signaling. Nested on the depicted transcriptional scenario, predicted circuits are reported, opening new hypotheses. Links between miRNAs (miR-106a-5p, miR-20b-5p, miR-20a-5p, miR-17-5p, miR-19b-3p and let-7d-5p) and key transcription factors (MYCN, ATF, CEBPA, REL, IRF and FOXJ2) and their common target genes tantalizingly suggest new path to approach the disease. The study provides a global overview of transcriptional and post-transcriptional deregulations in PMF, and, unifying consolidated and predicted data, could be helpful to identify new combinatorial therapeutic strategy. Interactive PMF network model: http://compgen.bio.unipd.it/pmf-net/.

A prognostic regulatory pathway in stage I epithelial ovarian cancer: new hints for the poor prognosis assessment.

BACKGROUND: Clinical and pathological parameters of patients with epithelial ovarian cancer (EOC) do not thoroughly predict patients' outcome. Despite the good outcome of stage I EOC compared with that of stages III and IV, the risk assessment and treatments are almost the same. However, only 20% of stage I EOC cases relapse and die, meaning that only a proportion of patients need intensive treatment and closer follow-up. Thus, the identification of cell mechanisms that could improve outcome prediction and rationalize therapeutic options is an urgent need in the clinical practice. PATIENTS AND METHODS: We have gathered together 203 patients with stage I EOC diagnosis, from whom snap-frozen tumor biopsies were available at the time of primary surgery before any treatment. Patients, with a median follow-up of 7 years, were stratified into a training set and a validation set. RESULTS AND CONCLUSIONS: Integrated analysis of miRNA and gene expression profiles allowed to identify a prognostic cell pathway, composed of 16 miRNAs and 10 genes, wiring the cell cycle, 'Activins/Inhibins' and 'Hedgehog' signaling pathways. Once validated by an independent technique, all the elements of the circuit resulted associated with overall survival (OS) and progression-free survival (PFS), in both univariate and multivariate models. For each patient, the circuit expressions have been translated into an activation state index (integrated signature classifier, ISC), used to stratify patients into classes of risk. This prediction reaches the 89.7% of sensitivity and 96.6% of specificity for the detection of PFS events. The prognostic value was then confirmed in the external independent validation set in which the PFS events are predicted with 75% sensitivity and 94.7% specificity. Moreover, the ISC shows higher classification performance than conventional clinical classifiers. Thus, the identified circuit enhances the understanding of the molecular mechanisms lagging behind stage I EOC and the ISC improves our capabilities to assess, at the time of diagnosis, the patient risk of relapse.

Atividade antifúngica e possível mecanismo de ação do óleo essencial de folhas de Ocimum gratissimum (Linn. ) sobre espécies de Candida / Antifungal activity and potential action mechanisms of essential oil of Ocimum gratissimum (Linn. ) leaves against Candida species

RESUMO A espécie Ocimum gratissimum (Linn.), popularmente conhecida como alfavaca-cravo, é muito utilizada na medicina popular. A planta apresenta inúmeros compostos, sendo o eugenol o constituinte majoritário do seu óleo essencial e o provável responsável pela sua atividade antimicrobiana. O objetivo deste estudo foi determinar o potencial antifúngico e o possível mecanismo de ação do óleo essencial extraído das folhas de O. gratissimum L. (OEOg) sobre cepas-padrão de Candida. Para avaliação da atividade antimicrobiana foi determinada a Concentração Inibitória Mínima (CIM), o efeito do tempo de exposição, o efeito modulador na atividade de antifúngicos (ATF) de uso clínico e a ação do OEOg nas fases de crescimento exponencial e estacionário de leveduras do gênero Candida. O mecanismo de ação do OEOg foi verificado por captação do cristal violeta e avaliação da morfologia microbiana pela técnica de microcultivo. Também foi avaliada a toxicidade do OEOg sobre hemácias humanas. O OEOg apresentou boa atividade antifúngica sobre cepas de Candida, sendo capaz de reduzir a taxa de crescimento das cepas de Candida a partir de quatro horas de exposição, além de ter modulado positivamente a atividade do cetoconazol para C. tropicalis ATCC 13803 e reduzir o número de células viáveis em todas as fases de crescimento microbiano. O OEOg foi capaz de promover o aumento discreto da captação do cristal violeta e provocou alterações na micromorfologia das células de Candida spp., sugerindo que seu alvo de ação seja o envoltório celular. Observou-se baixa toxicidade do OEOg sobre hemácias humanas. Os resultados encontrados mostraram que o OEOg possui boa atividade sobre o gênero Candida, com mecanismo de ação mediado possivelmente pela ocorrência de danos no envoltório celular, além de ter sido observada baixa toxicidade, indicando do OEOg é promissor no desenvolvimento e elaboração de um novo fármaco com potencial atividade para o tratamento de doenças fúngicas.

ABSTRACT Ocimum gratissimum (Linn.) is a medicinal plant popularly known as “wild basil” widely used in traditional medicine. The plant has numerous compounds, and eugenol is the major constituent of its essential oil and likely responsible for its antimicrobial activity. The aim of this study was to determine the antifungal activity and the potential mechanism of action of the essential oil extracted from the leaves of O. gratissimum L. (OEOg) against standard strains of Candida. The following experiments were performed: determination of Minimum Inhibitory Concentration (MIC), determination of the effect of exposure time to OEOg; evaluation of the modulating effect of OEOg in antifungal (ATF) activity for clinical use; determination of the effects of the OEOg on different growth phases of Candida spp; determination of crystal violet (CV) uptake and the microculture of yeast technique. OEOg showed good antifungal activity against Candida, being able to reduce microbial growth during 24 hours of contact and also the number of viable cells at all stages of growth. OE positively modulates the activity of ketoconazole for C. tropicalis ATCC 13803. Increased uptake of CV and also the inhibition of Candidavirulence factors were also observed, which indicates the occurrence of damage in the cell envelope. These findings, coupled with the low toxicity of OEOg on human erythrocytes, indicate that “wild basil” is a promising plant for the development of a new drug with a potential activity to treat fungal diseases.

[Treating iatrogenic pneumothorax with small-bore chest tube]. / Drenaje de neumotórax iatrogénico con catéter de calibre pequeño.

OBJECTIVE: To evaluate the feasibility of small-bore chest tube placement to treat pneumothorax caused by percutaneous procedures. MATERIAL AND METHODS: Between November 2004 and July 2006 we performed 151 interventional chest procedures (127 biopsies and 24 radiofrequency ablations) in 131 patients (25 women and 106 men; mean age, 63 years, range, 36-83 years). Fine needles (21-25 G) were used in 70 procedures and large core needles (14-20 G) were used in the remaining 81. Pneumothorax occurred in 16 diagnostic procedures (13 of these were treated with small-bore catheter placement) and in two radiofrequency procedures (both cases were treated with small-bore catheter placement). Chest tubes were placed immediately after pneumothorax occurred in all cases because the pneumothorax was greater than 20% or caused symptoms or occurred in patients with emphysema. RESULTS: Chest tubes were successfully placed without incidents in all cases and a Heimlich valve evacuated the air completely. Mean hospital stay was 43 hours (range, 24-72 hours). It was not necessary to place a larger-bore chest tube in any case. CONCLUSION: Small-bore chest tube placement is the treatment of choice for iatrogenic pneumothorax greater than 20% or less than 20% when symptomatic or occurring in patients with emphysema. The procedure is easy, effective, and well tolerated; furthermore, it shortens the hospital stay. The effectiveness of the procedure makes it possible to safely perform percutaneous procedures on patients with emphysema or difficult lesions and to finish an interventional procedure when pneumothorax occurs.

Drenaje de neumotórax iatrogénico con catéter de calibre pequeño / Treating iatrogenic pneumothorax with small-bore chest tube

Objetivo: evaluar la utilidad del drenaje de neumotórax con catéter de calibre pequeño tras la punción de lesiones torácicas. Material y métodos: desde noviembre de 2004 hasta julio de 2006 se realizaron 151 punciones torácicas en 131 pacientes (106 varones y 25 mujeres) con una media de edad de 63 años (36-83 años). Con fines diagnósticos se hicieron 127 punciones y los restantes 24 fueron tratamientos de termocoagulación con radiofrecuencia (RF). Se realizaron 70 punciones con aguja fina (21-25G) y 81 con aguja gruesa (14-20G). En los procedimientos diagnósticos se produjeron 16 neumotórax y se drenaron 13, y en los de RF hubo 2 neumotórax, y se drenaron ambos. El drenaje en todos los casos se realizó inmediatamente después de producirse, porque eran 20 % o presentaban síntomas, o siendo 20 % eran pacientes con enfisema. Resultados: en todos los pacientes pudo colocarse el catéter de drenaje sin incidencias, resolviendo el neumotórax con una válvula de Heimlich. El tiempo máximo de ingreso fue de 72 h, con una media de 43 h. En ningún caso se precisó colocar posteriormente un catéter de mayor calibre. Conclusión: el drenaje de neumotórax con catéter de calibre pequeño tras un procedimiento intervencionista torácico, es la técnica de elección cuando un neumotórax es 20 %, o el paciente está sintomático o tiene enfisema, porque su colocación no es difícil, es resolutivo, bien tolerado y acorta la estancia hospitalaria. Su resolución rápida permite puncionar pacientes con enfisema o lesiones difíciles con mayor seguridad y posibilita finalizar un procedimiento intervencionista si durante su realización se produce el neumotórax (AU)

Objective: to evaluate the feasibility of small-bore chest tube placement to treat pneumothorax caused by percutaneous procedures. Material and methods: between November 2004 and July 2006 we performed 151 interventional chest procedures (127 biopsies and 24 radiofrequency ablations) in 131 patients (25 women and 106 men; mean age, 63 years, range, 36-83 years). Fine needles (21-25 G) were used in 70 procedures and large core needles (14-20G) were used in the remaining 81. Pneumothorax occurred in 16 diagnostic procedures (13 of these were treated with small-bore catheter placement) and in two radiofrequency procedures (both cases were treated with small-bore catheter placement). Chest tubes were placed immediately after pneumothorax occurred in all cases because the pneumothorax was greater than 20 % or caused symptoms or occurred in patients with emphysema. Results: chest tubes were successfully placed without incidents in all cases and a Heimlich valve evacuated the air completely. Mean hospital stay was 43 hours (range, 24-72 hours). It was not necessary to place a larger-bore chest tube in any case. Conclusion: small-bore chest tube placement is the treatment of choice for iatrogenic pneumothorax greater than 20 % or less than 20 % when symptomatic or occurring in patients with emphysema. The procedure is easy, effective, and well tolerated; furthermore, it shortens the hospital stay. The effectiveness of the procedure makes it possible to safely perform percutaneous procedures on patients with emphysema or difficult lesions and to finish an interventional procedure when pneumothorax occurs (AU)

Morcegos capturados no município de Belo Horizonte, 1999-2003 / Bats found in the city of Belo Horizonte, MG, 1999-2003

Entre os anos de 1999 e 2001, realizaram-se 18 capturas de morcegos em Belo Horizonte, sendo uma na estacão seca e uma na estacão chuvosa em cada regional administrativa. Foram capturados 316 exemplares, com predominância de Artibeus lituratus (Olfers, 1818), 55,1 por cento, Platyrrhinus lineatus (Geoffroy, 1810), 24,4 por cento e Glossophaga soricina (Pallas, 1766), 10,1 por cento, além de Sturnira lilium (Geoffroy, 1810), Phyllostomus discolor (Wagner, 1843), Carollia perspicillata (Linnaeus, 1758), Myotis nigricans (Schinz, 1821) e Anoura caudifer (Geoffroy, 1818), totalizando oito espécies, pertencentes às famílias Phyllostomidae e Vespertilionidae. Observou-se concentracão de partos próximos à estacão chuvosa, coincidindo com a maior disponibilidade de alimento para os períodos de prenhez e lactacão. Partos esporádicos ocorreram durante todo o ano. Entre 2002 e 2003, foi feita uma busca em diversos tipos de abrigos nas mesmas regionais. Os abrigos foram registrados, e as espécies encontradas foram somadas às já observadas na primeira parte deste estudo, bem como às citadas em diversas fontes bibliográficas e disponíveis em colecões acadêmicas, gerando um relato atualizado das espécies de morcegos já encontrados no município.

Comparison of the oestrogenic effects of infant milk formulae, oestradiol and the phytoestrogen coumestrol delivered continuously in the drinking water to ovariectomised mice.

The potential oestrogenic effects of infant milk formulae, coumestrol and oestradiol delivered in the drinking water were investigated in ovariectomised mice. None of the infant formulae tested (three soya, two cow's milk) produced any uterotrophic or mitotic responses in the reproductive tract, although the soya milks displayed weak oestrogenic activity in vitro. Studies of the interactions between coumestrol and oestradiol were undertaken to investigate claims that phytoestrogens may act as oestrogen antagonists. The responses to coumestrol (100 g/ml drinking water) and 17-oestradiol (100 ng/ml) given separately were similar. Combined administration begun simultaneously produced only additive effects on uterine weight and cell proliferation in the vagina and uterus. While pretreatment with coumestrol for 24 h reduced the mitotic response of the uterus 48 h after placement of an oestradiol implant, the uterine weight increase was unaffected and the apparent reduction in mitoses reflected the natural fluctuations in the underlying cycle of cell proliferation. These studies indicate that coumestrol acts as a typical oestrogen and shows only additive effects with oestradiol. The results also indicate that infant soya milk formulae do not constitute a large enough source of oestrogenic compounds to invoke oestrogenic effects in the reproductive tract of mature mice.

[Application of selection criteria in sequential double lung transplantation]. / Ampliación de los criterios de selección en el trasplante bipulmonar secuencial. Grupo de Trasplante Pulmonar de Valencia.

Since the first sequential double lung transplant was performed in 1986, such procedures have been increasing in number and the criteria used as indications for this type of surgery have broadened. Our aim was to reflect on the application of selection criteria and to describe the anesthetic and surgical techniques and postoperative follow-up of 72 patients who underwent this type of transplant surgery between March 1993 and December 1998. Actuarial survival five years after surgery was 74.4%. Among patients requiring transplantation after septic disease, actuarial survival was 90.8% for cystic fibrosis and 88.2% for bronchiectasis. Of the preoperative risk factors analyzed (prior surgery, pachypleuritis, multiresistant germs, poor nutrition, mechanical ventilation and corticoid therapy), only prior treatment with high doses of corticoids proved significant. Eleven patients have been diagnosed of bronchiolitis obliterans, four have died and only two continue to experience difficulties in daily living. The high survival rate and the restriction-free life after recovery lead us to consider sequential double lung transplantation to be the treatment of choice for all pulmonary diseases.