Internal medicine consultation for high-risk surgical patients: reflection on hospital mortality and readmission rates in a low-income country

OBJECTIVE: The objective of this study was to assess the impact of internal medicine consultation on mortality, 30-day readmission, and length of stay in surgical patients. METHODS: This is a retrospective descriptive study developed in a public Brazilian teaching hospital with 850 beds. RESULTS: A total of 70,245 patients were admitted from 2010 to 2018 to the surgery departments. The main outcomes measured were patients' mortality, 30-day readmission, and length of stay. Mortality of high-risk patients was lower when followed by internal medicine consultation: patients with ASA≥3 (RR 0.89 [95% confidence interval (95%CI) 0.80­0.99], p=0.02), patients with ASA≥3 plus≥65 years (RR 0.88 [95%CI 0.78­0.99], p=0.04), patients with ASA≥3 plus high-risk surgery (RR 0.86 [95%CI 0.77­0.97], p=0.01), and patients with ASA≥4 plus age ≥65 years (RR 0.83 [95%CI 0.72­0.96], p=0.01). The 30-day readmission of high-risk patients was lower when followed by internal medicine consultation: patients with ≥65 years (RR 0.57 [95%CI 0.37­0.89], p=0.01) and patients with high-risk surgery (RR 0.63 [95%CI 0.46­0.57], p=0.005). The Poisson multivariate regression with adjustment in variances showed that all the variables (namely, age, ASA, morbidity index, surgery risk, and internal medicine consultation) were associated with higher mortality of patients; however, internal medicine consultation was associated with a reduction of mortality in high-risk patients (RR 0.72 [95%CI 0.65­0.84], p=0.02) and an increase of mortality in low-risk patients (RR 1.55 [95%CI 1.31­1.67], p=0.01). CONCLUSION: High-risk surgical patients may benefit from perioperative internal medicine consultations, which probably decrease hospital mortality and 30-day hospital readmission.

Somatostatin neuron contributions to cortical slow wave dysfunction in adult mice exposed to developmental ethanol.

Introduction: Transitions between sleep and waking and sleep-dependent cortical oscillations are heavily dependent on GABAergic neurons. Importantly, GABAergic neurons are especially sensitive to developmental ethanol exposure, suggesting a potential unique vulnerability of sleep circuits to early ethanol. In fact, developmental ethanol exposure can produce long-lasting impairments in sleep, including increased sleep fragmentation and decreased delta wave amplitude. Here, we assessed the efficacy of optogenetic manipulations of somatostatin (SST) GABAergic neurons in the neocortex of adult mice exposed to saline or ethanol on P7, to modulate cortical slow-wave physiology. Methods: SST-cre × Ai32 mice, which selectively express channel rhodopsin in SST neurons, were exposed to ethanol or saline on P7. This line expressed similar developmental ethanol induced loss of SST cortical neurons and sleep impairments as C57BL/6By mice. As adults, optical fibers were implanted targeting the prefrontal cortex (PFC) and telemetry electrodes were implanted in the neocortex to monitor slow-wave activity and sleep-wake states. Results: Optical stimulation of PFC SST neurons evoked slow-wave potentials and long-latency single-unit excitation in saline treated mice but not in ethanol mice. Closed-loop optogenetic stimulation of PFC SST neuron activation on spontaneous slow-waves enhanced cortical delta oscillations, and this manipulation was more effective in saline mice than P7 ethanol mice. Discussion: Together, these results suggest that SST cortical neurons may contribute to slow-wave impairment after developmental ethanol.

Do fall armyworm's Metaflumizone resistante populations affect the activity of Trichogramma pretiosum? / Populações da lagarta-do-cartucho resistentes à Metaflumizona afetam a atividade de Trichogramma pretiosum?

The possible interference of resistant pest’s populations to insecticides in natural enemies in the action thas not been clarified yet. Thus, this study aimed to evaluate Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) performance on Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) eggs with resistance frequency to the Metaflumizone over six generations of product exposure. Egg cards (2.0 x 7.0 cm) containing eggs from two populations of S. frugiperda, (resistant to Metaflumizone and the other susceptible), were exposed to T. pretiosum females for 24 hours in free-choice and no-choice testing in three generations (G1, G4, and G6). A completely randomized experimental design was used with 25 replications, each consisting of an egg card (experimental unit) containing 20 eggs. The parameters evaluated were: parasitism (%), emergence (%), sex ratio, number of emerged parasitoids per egg and males/females longevity. ANOVA and Tukey test (P≤ 0.05) were applied on the results. Results showed a reduction in parasitism [41.0% (G1) and 28.4% (G4)], egg emergence (17.5%) and parasitoids/egg [16.2 (G4) and 17.2 (G6)] in eggs originating from the population with resistance frequency. Females emerging from G6 populations eggs without exposure to Metaflumizone had greater longevity (3.5 days more) than the resistant population. The sex ratio and male longevity were not affected. The results indicate a reduction in T. pretiosum activity if S. frugiperda populations have some frequency of resistance to Metaflumizone.

A possível interferência de populações de pragas resistentes na ação de inimigos naturais ainda não foi esclarecida. Assim, este trabalho teve como objetivo avaliar o desempenho de Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) em ovos de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) com frequência de resistência à Metaflumizona ao longo de seis gerações de exposição ao produto. Cartelas (2,0 x 7,0 cm) com ovos de duas populações de S. frugiperda, (resistente à Metaflumizona e outra suscetível), foram expostas às fêmeas de T. pretiosum por 24 horas em condições de livre escolha e sem chance de escolha por três gerações (G1, G4 e G6). O delineamento experimental foi inteiramente casualizado com 25 repetições, sendo cada repetição composta por uma cartela (unidade experimental) contendo 20 ovos. Os parâmetros avaliados foram: parasitismo (%), emergência (%), razão sexual, número de parasitoides emergidos por ovo e longevidade de machos e fêmeas. ANOVA e teste de Tukey (P≤ 0,05) foram aplicados aos dados coletados. Os resultados mostraram redução do parasitismo [41,0% (G1) e 28,4% (G4)], emergência de ovos (17,5%) e parasitoides/ovo [16,2 (G4) e 17,2 (G6)] em ovos oriundos da população com frequência de resistência. As fêmeas emergidas de ovos da população G6 sem exposição à Metaflumizona, tiveram maior longevidade (3,5 dias a mais) do que a população exposta ao inseticida. A razão sexual e a longevidade de machos não foram afetadas. Os resultados indicam uma redução na atividade de T. pretiosum se as populações de S. frugiperda apresentarem alguma frequência de resistência à Metaflumizona.

Do fall armyworms Metaflumizone resistante populations affect the activity of Trichogramma pretiosum?

Abstract The possible interference of resistant pests populations to insecticides in natural enemies in the action thas not been clarified yet. Thus, this study aimed to evaluate Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) performance on Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) eggs with resistance frequency to the Metaflumizone over six generations of product exposure. Egg cards (2.0 x 7.0 cm) containing eggs from two populations of S. frugiperda, (resistant to Metaflumizone and the other susceptible), were exposed to T. pretiosum females for 24 hours in free-choice and no-choice testing in three generations (G1, G4, and G6). A completely randomized experimental design was used with 25 replications, each consisting of an egg card (experimental unit) containing 20 eggs. The parameters evaluated were: parasitism (%), emergence (%), sex ratio, number of emerged parasitoids per egg and males/females longevity. ANOVA and Tukey test (P 0.05) were applied on the results. Results showed a reduction in parasitism [41.0% (G1) and 28.4% (G4)], egg emergence (17.5%) and parasitoids/egg [16.2 (G4) and 17.2 (G6)] in eggs originating from the population with resistance frequency. Females emerging from G6 populations eggs without exposure to Metaflumizone had greater longevity (3.5 days more) than the resistant population. The sex ratio and male longevity were not affected. The results indicate a reduction in T. pretiosum activity if S. frugiperda populations have some frequency of resistance to Metaflumizone.

Resumo A possível interferência de populações de pragas resistentes na ação de inimigos naturais ainda não foi esclarecida. Assim, este trabalho teve como objetivo avaliar o desempenho de Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) em ovos de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) com frequência de resistência à Metaflumizona ao longo de seis gerações de exposição ao produto. Cartelas (2,0 x 7,0 cm) com ovos de duas populações de S. frugiperda, (resistente à Metaflumizona e outra suscetível), foram expostas às fêmeas de T. pretiosum por 24 horas em condições de livre escolha e sem chance de escolha por três gerações (G1, G4 e G6). O delineamento experimental foi inteiramente casualizado com 25 repetições, sendo cada repetição composta por uma cartela (unidade experimental) contendo 20 ovos. Os parâmetros avaliados foram: parasitismo (%), emergência (%), razão sexual, número de parasitoides emergidos por ovo e longevidade de machos e fêmeas. ANOVA e teste de Tukey (P 0,05) foram aplicados aos dados coletados. Os resultados mostraram redução do parasitismo [41,0% (G1) e 28,4% (G4)], emergência de ovos (17,5%) e parasitoides/ovo [16,2 (G4) e 17,2 (G6)] em ovos oriundos da população com frequência de resistência. As fêmeas emergidas de ovos da população G6 sem exposição à Metaflumizona, tiveram maior longevidade (3,5 dias a mais) do que a população exposta ao inseticida. A razão sexual e a longevidade de machos não foram afetadas. Os resultados indicam uma redução na atividade de T. pretiosum se as populações de S. frugiperda apresentarem alguma frequência de resistência à Metaflumizona.

Do fall armyworm's Metaflumizone resistante populations affect the activity of Trichogramma pretiosum? / Populações da lagarta-do-cartucho resistentes à Metaflumizona afetam a atividade de Trichogramma pretiosum?

Abstract The possible interference of resistant pest's populations to insecticides in natural enemies in the action thas not been clarified yet. Thus, this study aimed to evaluate Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) performance on Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) eggs with resistance frequency to the Metaflumizone over six generations of product exposure. Egg cards (2.0 x 7.0 cm) containing eggs from two populations of S. frugiperda, (resistant to Metaflumizone and the other susceptible), were exposed to T. pretiosum females for 24 hours in free-choice and no-choice testing in three generations (G1, G4, and G6). A completely randomized experimental design was used with 25 replications, each consisting of an egg card (experimental unit) containing 20 eggs. The parameters evaluated were: parasitism (%), emergence (%), sex ratio, number of emerged parasitoids per egg and males/females longevity. ANOVA and Tukey test (P≤ 0.05) were applied on the results. Results showed a reduction in parasitism [41.0% (G1) and 28.4% (G4)], egg emergence (17.5%) and parasitoids/egg [16.2 (G4) and 17.2 (G6)] in eggs originating from the population with resistance frequency. Females emerging from G6 populations eggs without exposure to Metaflumizone had greater longevity (3.5 days more) than the resistant population. The sex ratio and male longevity were not affected. The results indicate a reduction in T. pretiosum activity if S. frugiperda populations have some frequency of resistance to Metaflumizone.

Resumo A possível interferência de populações de pragas resistentes na ação de inimigos naturais ainda não foi esclarecida. Assim, este trabalho teve como objetivo avaliar o desempenho de Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) em ovos de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) com frequência de resistência à Metaflumizona ao longo de seis gerações de exposição ao produto. Cartelas (2,0 x 7,0 cm) com ovos de duas populações de S. frugiperda, (resistente à Metaflumizona e outra suscetível), foram expostas às fêmeas de T. pretiosum por 24 horas em condições de livre escolha e sem chance de escolha por três gerações (G1, G4 e G6). O delineamento experimental foi inteiramente casualizado com 25 repetições, sendo cada repetição composta por uma cartela (unidade experimental) contendo 20 ovos. Os parâmetros avaliados foram: parasitismo (%), emergência (%), razão sexual, número de parasitoides emergidos por ovo e longevidade de machos e fêmeas. ANOVA e teste de Tukey (P≤ 0,05) foram aplicados aos dados coletados. Os resultados mostraram redução do parasitismo [41,0% (G1) e 28,4% (G4)], emergência de ovos (17,5%) e parasitoides/ovo [16,2 (G4) e 17,2 (G6)] em ovos oriundos da população com frequência de resistência. As fêmeas emergidas de ovos da população G6 sem exposição à Metaflumizona, tiveram maior longevidade (3,5 dias a mais) do que a população exposta ao inseticida. A razão sexual e a longevidade de machos não foram afetadas. Os resultados indicam uma redução na atividade de T. pretiosum se as populações de S. frugiperda apresentarem alguma frequência de resistência à Metaflumizona.

Patient reported outcomes for phosphomannomutase 2 congenital disorder of glycosylation (PMM2-CDG): listening to what matters for the patients and health professionals.

BACKGROUND: Congenital disorders of glycosylation (CDG) are a growing group of rare genetic disorders. The most common CDG is phosphomannomutase 2 (PMM2)-CDG which often has a severe clinical presentation and life-limiting consequences. There are no approved therapies for this condition. Also, there are no validated disease-specific quality of life (QoL) scales to assess the heterogeneous clinical burden of PMM2-CDG which presents a challenge for the assessment of the disease severity and the impact of a certain treatment on the course of the disease. AIM AND METHODS: This study aimed to identify the most impactful clinical signs and symptoms of PMM2-CDG, and specific patient and observer reported outcome measures (PROMs and ObsROMs, respectively) that can adequately measure such impact on patients' QoL. The most burdensome signs and symptoms were identified through input from the CDG community using a survey targeting PMM2-CDG families and experts, followed by family interviews to understand the real burden of these symptoms in daily life. The list of signs and symptoms was then verified and refined by patient representatives and medical experts in the field. Finally, a literature search for PROMs and ObsROMs used in other rare or common diseases with similar signs and symptoms to those of PMM2-CDG was performed. RESULTS: Twenty-four signs/symptoms were identified as the most impactful throughout PMM2-CDG patients' lifetime. We found 239 articles that included tools to measure those community-selected PMM2-CDG symptoms. Among them, we identified 80 QoL scales that address those signs and symptoms and, subsequently, their psychometric quality was analysed. These scales could be applied directly to the PMM2-CDG population or adapted to create the first PMM2-CDG-specific QoL questionnaire. CONCLUSION: Identifying the impactful clinical manifestations of PMM2-CDG, along with the collection of PROMs/ObsROMs assessing QoL using a creative and community-centric methodology are the first step towards the development of a new, tailored, and specific PMM2-CDG QoL questionnaire. These findings can be used to fill a gap in PMM2-CDG clinical development. Importantly, this methodology is transferable to other CDG and rare diseases with multiple signs and symptoms.

Do fall armyworm's Metaflumizone resistante populations affect the activity of Trichogramma pretiosum?

The possible interference of resistant pest's populations to insecticides in natural enemies in the action thas not been clarified yet. Thus, this study aimed to evaluate Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) performance on Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) eggs with resistance frequency to the Metaflumizone over six generations of product exposure. Egg cards (2.0 x 7.0 cm) containing eggs from two populations of S. frugiperda, (resistant to Metaflumizone and the other susceptible), were exposed to T. pretiosum females for 24 hours in free-choice and no-choice testing in three generations (G1, G4, and G6). A completely randomized experimental design was used with 25 replications, each consisting of an egg card (experimental unit) containing 20 eggs. The parameters evaluated were: parasitism (%), emergence (%), sex ratio, number of emerged parasitoids per egg and males/females longevity. ANOVA and Tukey test (P≤ 0.05) were applied on the results. Results showed a reduction in parasitism [41.0% (G1) and 28.4% (G4)], egg emergence (17.5%) and parasitoids/egg [16.2 (G4) and 17.2 (G6)] in eggs originating from the population with resistance frequency. Females emerging from G6 populations eggs without exposure to Metaflumizone had greater longevity (3.5 days more) than the resistant population. The sex ratio and male longevity were not affected. The results indicate a reduction in T. pretiosum activity if S. frugiperda populations have some frequency of resistance to Metaflumizone.

Lactiplantibacillus plantarum 299v (LP299V®): three decades of research.

This review aims to provide a comprehensive overview of the in vitro, animal, and clinical studies with the bacterial strain Lactiplantibacillus plantarum 299v (L. plantarum 299v; formerly named Lactobacillus plantarum 299v) published up until June 30, 2020. L. plantarum 299v is the most documented L. plantarum strain in the world, described in over 170 scientific publications out of which more than 60 are human clinical studies. The genome sequence of L. plantarum 299v has been determined and is available in the public domain (GenBank Accession number: NZ_LEAV01000004). The probiotic strain L. plantarum 299v was isolated from healthy human intestinal mucosa three decades ago by scientists at Lund University, Sweden. Thirty years later, a wealth of data coming from in vitro, animal, and clinical studies exist, showing benefits primarily for gastrointestinal health, such as reduced flatulence and abdominal pain in patients with irritable bowel syndrome (IBS). Moreover, several clinical studies have shown positive effects of L. plantarum 299v on iron absorption and more recently also on iron status. L. plantarum 299v is safe for human consumption and does not confer antibiotic resistance. It survives the harsh conditions of the human gastrointestinal tract, adheres to mannose residues on the intestinal epithelial cells and has in some cases been re-isolated more than ten days after administration ceased. Besides studying health benefits, research groups around the globe have investigated L. plantarum 299v in a range of applications and processes. L. plantarum 299v is used in many different food applications as well as in various dietary supplements. In a freeze-dried format, L. plantarum 299v is robust and stable at room temperature, enabling long shelf-lives of consumer healthcare products such as capsules, tablets, or powder sachets. The strain is patent protected for a wide range of indications and applications worldwide as well as trademarked as LP299V®.

Epidemiologia e avaliação de risco associado à presença de ácaros hematófagos em galpões de granjas avícolas de postura / [Epidemiological and risk assessment associated with the presence of hematophagous mites in poultry farms]

Este estudo teve como objetivo caracterizar a epidemiologia da presença de ácaros hematófagos em granjas de postura no estado de Minas Gerais. Foi utilizado um banco de dados secundário, com informações de 402 galpões de 42 propriedades comerciais. As variáveis utilizadas para compor o modelo de correspondência foram selecionadas por meio do teste qui-quadrado (P≤0,05). Foi construído um índice para a presença de ácaros hematófagos, considerando alguns fatores de risco. Além disso, um estudo da análise espacial foi realizado para avaliar a presença de ácaros hematófagos em Minas Gerais. Observou-se a presença de ácaros hematófagos em 48% dos galpões, sendo a de O. sylviarum de 45,5%, O. bursa de 17,4% e D. gallinae de 2,7%. Houve associação entre o índice de risco com os intervalos de remoção de fezes e com a presença ou a ausência de aves sinantrópicas. Verificou-se que granjas mais tecnificadas não utilizam acaricida em seus galpões. A presença de ácaros hematófagos foi observada na mesorregião Sul/Sudoeste de Minas Gerais e entre as mesorregiões Oeste de Minas e Metropolitana de Belo Horizonte. Esses resultados fornecem conhecimento sobre a epidemiologia desses ectoparasitos e podem contribuir na tomada de decisões, reduzindo os riscos de possíveis infestações em aves de postura.(AU)

This study aimed to characterize the epidemiology of the presence of hematophagous mites in posture farms in the state of Minas Gerais. Was used a secondary database with information from 402 chicken houses in 42 commercial properties. The variables used to compose the correspondence model were selected through chi-square tests (P≤0.05). A risk index was built to the presence of hematophagous mites considering some risk factors. Additionally, a study of the spatial analysis was done to evaluate the presence of hematophagous mites in Minas Gerais. Was observed the presence of hematophagous mites in 48% of chicken houses, the presence of O. sylviarum was 45.5%, O. bursa 17.4% and D. gallinae 2.7%. There was an association between the risk index with the intervals for the removal of manure and the presence or absence of synanthropic birds. It was verified that more technified farms do not use acaricide in their chicken houses. The presence of hematophagous mites was observed in the Messoregions South/Southwest of Minas Gerais and between the West and Metropolitan Mesoregion of Belo Horizonte. These results provide knowledge about the epidemiology of these ectoparasites and may contribute to decision making by reducing the risks of possible infestations in poultry.(AU)

Influence of minimally invasive endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors.

AIM: To evaluate the influence of the location and design of endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors. METHODOLOGY: After pre-selection using periapical radiographs, forty extracted intact human mandibular incisors were scanned in a micro-computed tomographic device. The teeth were matched based on similar anatomical features of the canals and assigned to four experimental groups (n = 10) according to the endodontic access cavity and root canal preparation protocol: traditional/TRUShape (T/TRU); traditional/MTwo (T/MT); minimally invasive/TRUShape (MI/TRU); and minimally invasive/MTwo (MI/MT). The samples were scanned after root canal instrumentation and filling procedures. The parameters evaluated were as follows: volume and area of the root canal, noninstrumented canal areas, canal transportation and centring ratio, accumulated hard tissue debris, voids in root canal fillings and remnants of root canal filling materials in the pulp chamber. After root canal filling and cavity restoration procedures, the samples were submitted to a fracture resistance test. Data were statistically analysed using Shapiro-Wilk, one-way anova and Bonferroni tests with a significance level of 5% (α = 0.05). RESULTS: There was no difference regarding all parameters evaluated before and after root canal preparation (volume and area of the root canal, noninstrumented canal areas, canal transportation and centring ratio, and accumulated hard tissue debris) amongst the groups (P > 0.05). MI/TRU and MI/MT groups were associated with significantly more voids in root canal fillings when compared to the T/TRU and T/MT groups (P < 0.05). Percentage of root canal filling material remnants in the pulp chamber after cleaning procedures and mean fracture resistance values were not significantly different amongst the four experimental groups (P > 0.05). CONCLUSIONS: The location and design of the endodontic access cavity did not impact on root canal preparation nor resistance to fracture of extracted mandibular incisors, regardless of the instrument used. Minimally invasive access cavities were associated with significantly more voids in root canal fillings.

Difficulty in detecting low levels of polymyxin resistance in clinical Klebsiella pneumoniae isolates: evaluation of Rapid Polymyxin NP test, Colispot Test and SuperPolymyxin medium.

Polymyxins are important therapeutic options for treating infections, mainly those caused by carbapenem-resistant Klebsiella pneumoniae. Specific chemical characteristics of polymyxins make it difficult to perform antimicrobial susceptibility testing, especially within the clinical laboratory. Here we aimed to evaluate the performance of three phenotypic methods: Rapid NP Polymyxin Test, ColiSpot test and the SuperPolymyxin medium. To accomplish this, 170 non-duplicate clinical K. pneumoniae isolates were analysed (123 colistin-resistant and 47 susceptible). The sensitivity and specificity obtained for Rapid Polymyxin NP Test, Colispot and SuperPolymyxin medium were, respectively, 90% and 94%, 74% and 100%, and 82% and 85%. Very major errors occurred more frequently in low-level colistin-resistant isolates (MICs 4 and 8 µg/mL). Rapid Polymyxin NP proved to be a method capable of identifying colistin-resistant strains in acceptable categorical agreement. However, major errors and very major errors of this method were considered unacceptable for colistin-resistance screening. Although the Colispot test is promising and easy to perform and interpret, the results did not reproduce well in the isolates tested. The colistin-containing selective medium (SuperPolymyxin) showed limitations, including quantification of mucoid colonies and poor stability. Nevertheless, Colispot and SuperPolymyxin medium methods did not present acceptable sensitivity, specificity and categorical agreement. It is essential to use analytical tools that faithfully reproduce bacterial resistance in vitro, especially in last-line drugs, such as polymyxins, when misinterpretation of a test can result in therapeutic ineffectiveness.

VPA/PLGA microfibers produced by coaxial electrospinning for the treatment of central nervous system injury.

The central nervous system shows limited regenerative capacity after injury. Spinal cord injury (SCI) is a devastating traumatic injury resulting in loss of sensory, motor, and autonomic function distal from the level of injury. An appropriate combination of biomaterials and bioactive substances is currently thought to be a promising approach to treat this condition. Systemic administration of valproic acid (VPA) has been previously shown to promote functional recovery in animal models of SCI. In this study, VPA was encapsulated in poly(lactic-co-glycolic acid) (PLGA) microfibers by the coaxial electrospinning technique. Fibers showed continuous and cylindrical morphology, randomly oriented fibers, and compatible morphological and mechanical characteristics for application in SCI. Drug-release analysis indicated a rapid release of VPA during the first day of the in vitro test. The coaxial fibers containing VPA supported adhesion, viability, and proliferation of PC12 cells. In addition, the VPA/PLGA microfibers induced the reduction of PC12 cell viability, as has already been described in the literature. The biomaterials were implanted in rats after SCI. The groups that received the implants did not show increased functional recovery or tissue regeneration compared to the control. These results indicated the cytocompatibility of the VPA/PLGA core-shell microfibers and that it may be a promising approach to treat SCI when combined with other strategies.

Gastrointestinal parasites of a population of emus (Dromaius novaehollandiae) in Brazil / Parasitas gastrointestinais de emus Dromaius novaehollandiae de cativeiro no Brasil

Abstract Emus are large flightless birds in the ratite group and are native to Australia. Since the mid-1980s, there has been increased interest in the captive breeding of emus for the production of leather, meat and oil. The aim of this study was to identify gastrointestinal parasites in the feces of emus Dromaius novaehollandiae from a South American scientific breeding. Fecal samples collected from 13 birds were examined by direct smears, both with and without centrifugation, as well as by the fecal flotation technique using Sheather's sugar solution. Trophozoites, cysts and oocysts of protozoa and nematode eggs were morphologically and morphometrically evaluated. Molecular analysis using PCR assays with specific primers for the genera Entamoeba, Giardia and Cryptosporidium were performed. Trophozoites and cysts of Entamoeba spp. and Giardia spp., oocysts of Eimeria spp. and Isospora dromaii, as well as eggs belonging to the Ascaridida order were found in the feces. Three animals were diagnosed with Giardia spp., and three were positive for Entamoeba spp. based on PCR techniques. After analyzing the data, we concluded that emus were infected enzootically by nematode and protozoan species.

Resumo Emus são aves grandes que não voam pertencentes ao grupo das ratitas e são originários da Austrália. Desde meados da década de 1980, aumentou o interesse pela criação de emus em cativeiro para a produção de couro, carne e óleo. O objetivo deste estudo foi identificar parasitas gastrointestinais nas fezes de emus Dromaius novaehollandiae de um criatório científico da América do Sul. Amostras de fezes coletadas de 13 aves foram examinadas por esfregaços diretos, tanto com e sem centrifugação, quanto com a técnica de flutuação fecal utilizando solução de açúcar de Sheather. Trofozoítos, cistos e oocistos de protozoários e ovos de nematóides foram avaliados morfologicamente e morfometricamente. Foram realizadas análises moleculares utilizando ensaios de PCR com primers específicos para os gêneros Entamoeba, Giardia e Cryptosporidium. Trofozoítos e cistos de Entamoeba spp. e Giardia spp., oocistos de Eimeria spp. e Isospora dromaii, bem como ovos pertencentes à ordem Ascaridida foram encontrados nas fezes. Três animais foram diagnosticados com Giardia spp., e três foram positivos para Entamoeba spp. com base em técnicas de PCR. Depois de analisar os dados, concluímos que os emus estavam infectados enzooticamente por espécies de nematóides e protozoários.

Gastrointestinal parasites of a population of emus (Dromaius novaehollandiae) in Brazil.

Emus are large flightless birds in the ratite group and are native to Australia. Since the mid-1980s, there has been increased interest in the captive breeding of emus for the production of leather, meat and oil. The aim of this study was to identify gastrointestinal parasites in the feces of emus Dromaius novaehollandiae from a South American scientific breeding. Fecal samples collected from 13 birds were examined by direct smears, both with and without centrifugation, as well as by the fecal flotation technique using Sheather's sugar solution. Trophozoites, cysts and oocysts of protozoa and nematode eggs were morphologically and morphometrically evaluated. Molecular analysis using PCR assays with specific primers for the genera Entamoeba, Giardia and Cryptosporidium were performed. Trophozoites and cysts of Entamoeba spp. and Giardia spp., oocysts of Eimeria spp. and Isospora dromaii, as well as eggs belonging to the Ascaridida order were found in the feces. Three animals were diagnosed with Giardia spp., and three were positive for Entamoeba spp. based on PCR techniques. After analyzing the data, we concluded that emus were infected enzootically by nematode and protozoan species.

Linking contaminant distribution to hydrodynamic patterns in an urban estuary: The Douro estuary test case.

An increase in anthropogenic activities in coastal regions can put at risk their flora and fauna and their ecosystem services. Therefore, it is important to evaluate possible impacts. In particular, we need to understand the links between contaminants concentrations and the hydrodynamic patterns of these highly productive regions to anticipate the effects of contaminants in the environment. Towards that aim there is the need to carry out regular campaigns to monitor the evolution of the coastal systems. In this work we analyse in-situ measurements of physico-chemical parameters, and look for possible relations between observed contaminants patterns and estuarine hydrodynamics. Data collected in the Douro estuary, one of the main estuarine regions of the Iberian western coast, revealed the presence of 5 hazardous and noxious substances (HNS), 14 polycyclic aromatic hydrocarbons (PAHs) and 6 trace metals in water and sediment samples. Water temperature and salinity analysis revealed a strong variability, which can affect the water solubility properties and the organisms' tolerance to certain toxins. A relationship between the salinity and the HNS and PAHs concentrations was found, caused by the existence of a salt-wedge that triggers the salting-out effect. Sinker contaminants (PAHs and trace metals) can be re-suspended both during low and high flow conditions associated with the salt-wedge and with strong river flows. Floater contaminants (HNS) are completely depended on the tide, which has the capacity to distribute them through the entire estuary, during low river flow regimes. However, strong river flows, with associated river plumes, can distribute both sinker and floater contaminants to the coastal region trapping them over the inner-shelf. The results clearly show that hydrodynamic patterns are a major driver for contaminants dispersion and pathways in coastal areas, inducing harmful effects to the flora and fauna and, consequently, to the ecosystem services of these regions.

VPA/PLGA microfibers produced by coaxial electrospinning for the treatment of central nervous system injury

The central nervous system shows limited regenerative capacity after injury. Spinal cord injury (SCI) is a devastating traumatic injury resulting in loss of sensory, motor, and autonomic function distal from the level of injury. An appropriate combination of biomaterials and bioactive substances is currently thought to be a promising approach to treat this condition. Systemic administration of valproic acid (VPA) has been previously shown to promote functional recovery in animal models of SCI. In this study, VPA was encapsulated in poly(lactic-co-glycolic acid) (PLGA) microfibers by the coaxial electrospinning technique. Fibers showed continuous and cylindrical morphology, randomly oriented fibers, and compatible morphological and mechanical characteristics for application in SCI. Drug-release analysis indicated a rapid release of VPA during the first day of the in vitro test. The coaxial fibers containing VPA supported adhesion, viability, and proliferation of PC12 cells. In addition, the VPA/PLGA microfibers induced the reduction of PC12 cell viability, as has already been described in the literature. The biomaterials were implanted in rats after SCI. The groups that received the implants did not show increased functional recovery or tissue regeneration compared to the control. These results indicated the cytocompatibility of the VPA/PLGA core-shell microfibers and that it may be a promising approach to treat SCI when combined with other strategies.

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background Complex percutaneous coronary intervention (PCI) is associated with higher ischemic risk, which can be mitigated by long-term dual antiplatelet therapy (DAPT). However, concomitant high bleeding risk (HBR) may be present, making it unclear whether short- or long-term DAPT should be prioritized. Objectives This study investigated the effects of ischemic (by PCI complexity) and bleeding (by PRECISE-DAPT [PRE dicting bleeding Complications in patients undergoing stent Implantation and Sub sequent Dual Anti Platelet Therapy] score) risks on clinical outcomes and on the impact of DAPT duration after coronary stenting. Methods Complex PCI was defined as ≥3 stents implanted and/or ≥3 lesions treated, bifurcation stenting and/or stent length >60 mm, and/or chronic total occlusion revascularization. Ischemic and bleeding outcomes in high (≥25) or non-high (<25) PRECISE-DAPT strata were evaluated based on randomly allocated duration of DAPT. Results Among 14,963 patients from 8 randomized trials, 3,118 underwent complex PCI and experienced a higher rate of ischemic, but not bleeding, events. Long-term DAPT in non-HBR patients reduced ischemic events in both complex (absolute risk difference: −3.86%; 95% confidence interval: −7.71 to +0.06) and noncomplex PCI strata (absolute risk difference: −1.14%; 95% confidence interval: −2.26 to −0.02), but not among HBR patients, regardless of complex PCI features. The bleeding risk according to the Thrombolysis In Myocardial Infarction scale was increased by long-term DAPT only in HBR patients, regardless of PCI complexity. Conclusions Patients who underwent complex PCI had a higher risk of ischemic events, but benefitted from long-term DAPT only if HBR features were not present. These data suggested that when concordant, bleeding, more than ischemic risk, should inform decision-making on the duration of DAPT. (AU)

Performance of crossbred lactating cows at grazing in response to nitrogen supplementation and different levels of concentrate feed / Desempenho de vacas mestiças leiteiras a pasto em resposta à suplementação nitrogenada e a diferentes níveis de concentrado

The performance of crossbred (1/2 Holstein x Zebu) cows supplemented on Brachiaria decumbens pasture during the wet-dry transition period was evaluated. Eight cows with 497±50kg, during third and fourth lactations and after the lactation peak were distributed in two 4 x 4 Latin squares. The treatments consisted of a factorial with two types of mineral supplements (nitrogenous and mineral salt) and two levels of concentrate (0.3 and 0.6% body weight (BW)/cow/day), based on corn and soybean meal (60:40), and supplied during the morning and afternoon milking. The experiment lasted 56 days, divided into four periods of 14 days, with seven days for adaptation and seven for data collection. No interaction (P> 0.05) was observed between the supplements and the concentrate levels. The nitrogenous salt and the highest concentrate level increased (P< 0.05) the intake of crude protein, and the highest concentrate level increased (P< 0.05) the intake of non-fibrous carbohydrates and the digestibility of crude protein. No effect (P> 0.05) of supplement and concentrate level was observed on the milk constituents and feed efficiency. Grazing crossbred after the lactation peak during the wet-dry transition period achieve the productive potential with 0.3% BW of concentrate per day and mineral salt.(AU)

Foi avaliado o desempenho de vacas mestiças (1/2 Holandês x Zebu) suplementadas em pastagens de Brachiaria decumbens durante o período de transição águas-seca. Oito vacas com 497±50kg, durante a terceira e a quarta lactação e após o pico de produção, foram distribuídas em dois quadrados latinos 4 x 4. Os tratamentos consistiram de um fatorial com dois tipos de suplementos (sal nitrogenado e sal mineral) e dois níveis de concentrado (0,3 e 0,6% do peso corporal (PC)/vaca/dia), baseado em milho e farelo de soja (60:40) e suprido durante as ordenhas da manhã e da tarde. O experimento durou 56 dias, divididos em quatro períodos de 14 dias, sendo sete dias para adaptação e sete para coletas. Não foi encontrada interação (P>0,05) entre os suplementos e os níveis de concentrado. O sal nitrogenado e o maior nível de concentrado aumentaram (P<0,05) o consumo de proteína bruta, e o maior nível de concentrado aumentou (P<0,05) o consumo de carboidratos não fibrosos e a digestibilidade da proteína bruta. Não foi observado efeito (P>0,05) de suplemento e de nível de concentrado sobre os componentes do leite e a eficiência alimentar. Vacas mestiças após o pico de lactação durante o período de transição águas-seca alcançam seu potencial produtivo com 0,3% do PC/dia de concentrado e sal mineral.(AU)

Soy isoflavones protect against oxidative stress and diminish apoptosis in ovary of middle-aged female rats.

Ovarian aging is characterized by declines in follicular reserve and oocyte quality due, in part, to increased oxidative stress and apoptosis. Soy isoflavones (ISOs) have been shown to improve ovarian lifespan by acting as antioxidant and antiapoptotic agents. We aimed at evaluating whether ISOs could modulate oxidative stress and reduce apoptosis and improve ovarian follicle survival in middle-aged female rats. Twelve ovary-intact female Wistar rats (12-month-old) were divided into groups: control (CTRL) and ISO, daily treated by gavage with vehicle or soy-ISO extract (150 mg/kg b.w), respectively. After 8 weeks, rats were euthanized and their ovaries removed for histomorphometric (% follicles) and apoptosis (cleaved-caspase-3/BCL2 immunostaining) evaluations, or subjected to biochemical assays to survey reactive oxygen species (ROS) and lipid peroxidation levels and total antioxidant capacity (TAC). The frequency of atretic follicles and number of cleaved-caspase-3-positive cells, as well as the ROS and lipid peroxidation levels, were significantly lower in ISO group compared to CTRL. A significantly higher number of BCL2-positive cells and TAC levels were also observed in ISO group. In conclusion, soy ISOs could decrease follicular atresia, apoptosis and oxidative stress, as well as increase the TAC in ovaries of female rats.