Intra-myocardial dissecting hematoma: late complication of cocaine-induced myocardial infarction

Intra-myocardial dissecting hematoma (IDH) is a rare and unusual form of myocardial rupture that can be secondary to complicate acute myocardail infarction (MI). It is usually caused by a hemorrhagic dissection between the layers of myocardial fibers that can occur during the acute injury or the remodeling process. This case demonstrates a patient with a history of cocaine-induced ischemic cardiomyopathy complicated with an extensive IDH. Case description A 38-year-old man with a past medical history of hypertension, heart failure with reduced ejection fraction (HFrEF), and cocaine abuse disorder, presents to the emergency department complaining of worsening shortness of breath. Six months before the current hospitalization, the patient had been diagnosed with acute myocardial infarction, left heart Cath showed a severe three-vessel coronary artery disease, but it was non-suitable for revascularization. The transthoracic echocardiogram (TTE) showed significant left ventricular dysfunction with an ejection fraction of 28% and a thrombus in the left ventricle. Four days before the current admission, the patient started complaining of worsening exertional dyspnea, orthopnea, and peripheral edema. His vital signs were BP 90 x 62mmhg, HR 104 bpm, SatO2 90% and afebrile. His physical examination revealed an increased jugular venous pressure, significant symmetric peripheral edema (3+/4), and cold extremities. Cardiac auscultation revealed a regular rhythm, S3, without murmrs. A pulmonary exam revealed bilateral crackles on the inferior 1/3 of the lungs. EKG showed sinus tachycardia and prior inferior necrosis. Renal function was normal, but lactate acid was elevated (2.6mg/dL). The patient was started with noninvasive ventilation, along with IV diuretic therapy, vasopressor, and inotropic support (dobutamine). A TTE was performed which showed an intra-myocardial dissecting hematoma in the inferior left ventricle (LV) wall, along with a large thrombus in the LV chamber and severe biventricular dysfunction (ejection fraction was 23%). Our patient responded well to the medical treatment. Due to his severely reduced left ventricular ejection fraction (LVEF), the IDH was managed conservatively. He was discharged on standard medication for HFrEF and oral anticoagulation. Discussion this case demonstrates IDH as a late complication following a cocaine-induced MI. Two-dimensional echocardiography is useful in the diagnosis of IDH as well as in ruling out potential differential diagnoses. Conservative treatment is a viable option, especially for those patients not suitable for cardiac revascularization with severely reduced left ventricular ejection.

Unpredicted, rapid and unintended structural and functional changes occurred during early domestication of Silphium integrifolium, a perennial oilseed.

MAIN CONCLUSION: Selection for increased yield changed structure, physiology and overall resource-use strategy from conservative towards acquisitive leaves. Alternative criteria can be considered, to increase yield with less potentially negative traits. We compared the morphology, anatomy and physiology of wild and semi-domesticated (SD) accessions of Silphium integrifolium (Asteraceae), in multi-year experiments. We hypothesized that several cycles of selection for seed-yield would result in acquisitive leaves, including changes predicted by the leaf economic spectrum. Early-selection indirectly resulted in leaf structural and functional changes. Leaf anatomy changed, increasing mesophyll conductance and the size of xylem vessels and mesophyll cells increased. Leaves of SD plants were larger, heavier, with lower stomatal conductance, lower internal CO2 concentration, and lower resin concentration than those of wild types. Despite increased water use efficiency, SD plants transpired 25% more because their increase in leaf area. Unintended and undesired changes in functional plant traits could quickly become fixed during domestication, shortening the lifespan and increasing resource consumption of the crop as well as having consequences in the provision and regulation of ecosystem services.

Ablação septal com radiofrequência em paciente com obstrução dinâmica na via de saída do ventrículo esquerdo associado a pós operatório de cardiopatia congênita: relato de caso / Septal ablation with radiofrequency in a patient with dynamic obstruction in the left ventricular outflow tract associated with postoperative congenital heart disease: case report

INTRODUÇÃO: A obstrução da via de saída do ventrículo esquerdo (VSVE) é uma condição frequentemente descrita nos casos de cardiomiopatia hipertrófica obstrutiva (CMHO), gerando comprometimento da classe funcional, além de associação com morte súbita. Em pós- -operatório de cardiopatias congênitas com comprometimento da VSVE, podemos observar mecanismo fisiopatológico semelhante aos da CMHO. Atualmente é crescente a aplicação de medidas menos invasivas com objetivo terapêutico, como a ablação endocárdica por radiofrequência (RF) do septo interventricular, que apresenta resultados promissores, sendo uma alternativa à miectomia cirúrgica da VSVE. METODOLOGIA: estudo longitudinal do tipo estudo de caso. RELATO DO CASO: Escolar de 8 anos, portadora de síndrome de Williams, com diagnóstico de base de estenose subvalvar e supravalvar aórtica e ectasia da raiz aórtica, foi submetida aos 6 anos de idade, à ressecção de membrana subaórtica, miectomia da VSVE e ampliação da aorta ascendente. No ano subsequente ao procedimento cirúrgico, evoluiu com sinais de baixo débito cardíaco, associado a achado ecocardiográfico de obstrução dinâmica da VSVE, gerando gradiente sistólico máximo (GSM) inicial de 85mmHg, chegando, até período periprocedimento a 135mmHg. Inicialmente, realizado manejo medicamentoso com betabloqueador, porém paciente manteve sintomatologia a despeito da otimização farmacológica. Desta forma, levando em consideração risco cirúrgico e comportamento anatômico e fisiopatológico, associado a exames de imagem, como tomografia computadorizada com reconstrução tridimensional, optado por realização de procedimento de ablação septal por radiofrequência. Realizadas aplicações de RF em região de maior espessamento. Através da via retroaórtica, foram realizadas aplicações de RF, observando-se modificação do gradiente ecocardiográfico, com GSM final da VSVE de 45 mmHg. Paciente evoluiu com 16 dias após procedimento, com GSM de 13mmHg, ausência de sinais de baixo débito cardíaco e redução significativa da terapia medicamentosa com betabloqueador. Segue atualmente em acompanhamento clínico e ecocardiográfico regular. CONCLUSÕES: O tratamento intervencionista proposto para essa condição parece ser mais seguro. A ablação endocárdica por RF é um procedimento eficaz, seguro em longo prazo, que reduz o tempo de internação hospitalar e morbimortalidade quando comparada à abordagem cirúrgica, com melhora significativa ecocardiográfica e clínica, parecendo ser uma alternativa promissora nas lesões obstrutivas associadas ao pós-operatório de cardiopatias congênitas.

Wine yeast selection in the Iberian Peninsula: Saccharomyces and non-Saccharomyces as drivers of innovation in Spanish and Portuguese wine industries.

Yeast selection for the wine industry in Spain started in 1950 for the understanding of the microbial ecology, and for the selection of optimal strains to improve the performance of alcoholic fermentation and the overall wine quality. This process has been strongly developed over the last 30 years, firstly on Saccharomyces cerevisiae, and, lately, with intense activity on non-Saccharomyces. Several thousand yeast strains have been isolated, identified and tested to select those with better performance and/or specific technological properties. The present review proposes a global survey of this massive ex-situ preservation of eukaryotic microorganisms, a reservoir of biotechnological solutions for the wine sector, overviewing relevant screenings that led to the selection of strains from 12 genera and 22 species of oenological significance. In the first part, the attention goes to the selection programmes related to relevant wine-producing areas (i.e. Douro, Extremadura, Galicia, La Mancha and Uclés, Ribera del Duero, Rioja, Sherry area, and Valencia). In the second part, the focus shifted on specific non-Saccharomyces genera/species selected from different Spanish and Portuguese regions, exploited to enhance particular attributes of the wines. A fil rouge of the dissertation is the design of tailored biotechnological solutions for wines typical of given geographic areas.

Effects of Charcoal Toothpaste on the Surface Roughness, Color Stability, and Marginal Staining of Resin Composites.

OBJECTIVE: This study was designed to evaluate the effects of charcoal toothpaste on the surface roughness, color stability, and marginal staining of resin composite restorations. METHODS: A total of 100 bovine incisors was collected. The crowns were sectioned and randomly divided into 10 groups (n=10) according to two study factors: toothpaste groups and nanoparticle resin composite groups. Five toothpastes-Bianco Pro Clinical (Bianco Oral Care, Uberlândia, MG, Brazil) - Control group; Bianco Carbon (Bianco Oral Care); NAT, Natural Suavetex Carvão Ativado (Suavetex, Uberlândia, MG, Brazil); Nano Action Black Be Emotion (Polishop, Jundiaí, SP, Brazil); and BIW, Black is White (Curaprox, Curaden AG, Kriens, Switzerland)-and two resin composites-Z350XT (Filtek Z350XT, 3M Oral Care) and Vittra (Vittra APS FGM, Joinville, SC, Brazil)-were used. Circular cavities with a diameter of 4 mm and a depth of 1 mm were prepared on the buccal face of the tooth crowns and restored with resin composites. The specimens were subjected to three months of simulated toothbrushing. The surface roughness (right angle [Ra], in micrometers [µm]) of the resin composites was measured before and after toothbrushing in five areas per specimen. The resin composite color and luminosity changes (ΔE and ΔL, respectively) were measured using reflectance spectroscopy (Vita EasyShade). Macro photographs were taken before and after toothbrushing to qualitatively analyze the marginal staining (MSt) of the resin composite restorations. Scanning electron microscopy (SEM) was performed before and after the simulated toothbrushing. Ra data were analyzed using two-way analysis of variance with repeated measures and the Tukey HSD test; MSt was analyzed using Kruskal-Wallis and Dunn tests (α=0.05), and the resin composite color change was analyzed using the clinically unacceptable level of ΔE > 3.3. RESULTS: Simulated brushing increased Ra irrespective of the resin composite or toothpaste used. No significant differences were found in Ra between the control group and all groups on which the charcoal toothpastes were tested. A clinically unacceptable level of resin composite color change (ΔE>3.3) was found after the use of most charcoal toothpastes. Use of Bianco Carbon resulted in marginal staining similar to that of the control group and was lower than that of the other charcoal toothpastes. Vittra brushed with black toothpaste showed the highest marginal staining. CONCLUSION: Use of charcoal toothpaste resulted in Ra values of resin composites similar to those found with conventional toothpastes. Charcoal toothpaste generally resulted in clinical resin composite color changes (ΔE). All charcoal toothpastes, except Bianco Carbon, caused marginal staining of the resin composite restorations.

Correlación genotipo-fenotipo en miocardiopatía hipertrófica: un estudio multicéntrico en Portugal y España sobre la variante p. Arg21Leu de TPM1 / Genotype-phenotype correlations in hypertrophic cardiomyopathy: a multicenter study in Portugal and Spain of the TPM1 p. Arg21Leu variant

Introducción y objetivos: TPM1 es uno de los principales genes en la miocardiopatía hipertrófica (MCH). La información clínica sobre portadores es relativamente escasa, lo cual limita la interpretación de los estudios genéticos. Nuestro objetivo es establecer la correlación genotipo-fenotipo de la variante p.Arg21Leu de TPM1 en una serie de familias. Métodos: Se evaluó el TPM1 mediante secuenciación de nueva generación en 10.561 probandos con cardiopatías hereditarias. Se genotipificó a los familiares mediante Sanger. Se analizaron la cosegregación, las características clínicas y los eventos cardiovasculares. Se estimó la distribuición geográfica de las familias en Portugal y España. Resultados: Se identificó la variente p.Arg21Leu de TPM1 en 25/4.099 (0,61%) casos con MCH y estaba ausente en 6.462 controles con otras cardiopatías familiares (p<0,0001). Se identificó a 83 portadores (31 probandos). La LOD score combinada para cosegregación fue 3,95. La probabilidad acumulada de diagnóstico en portadores a los 50 años fue del 50% para los varones y el 25% para las mujeres. El 17 de los varones y el 46% de las mujeres no estaban afectadas a los 70 años. El grosor medio del ventrículo izquierdo fue 21,4 ±7,65mm. El riesgo de muerte súbita-MCH fue bajo en 34 (77,5%), intermedio en 8 (18%) y alto en 2 (4,5%) de los portadores. La supervivencia libre de eventos cardiovasculares fue del 87,5% a los 50 años. El 6% de los portadores eran homocigotos y el 18% tenían una variante adicional. El origen de las familias se concentró en Galicia, Extremadura y norte de Portugal, lo que indica un efecto fundador. Conclusiones: P.Arg21Leu es una variante patogénica de TPM1 asociada con MCH de penetrancia tardía/incompleta y pronóstico generalmente favorable (AU)

Introduction and objectives: TPM1 is one of the main hypertrophic cardiomyopathy (HCM) genes. Clinical information on carriers is relatively scarce, limiting the interpretation of genetic findings in individual patients. Our aim was to establish genotype-phenotype correlations of the TPM1 p.Arg21Leu variant in a serie of pedigrees. Methods: TPM1 was evaluated by next-generation sequencing in 10 561 unrelated probands with inherited heart diseases. Familial genetic screening was performed by the Sanger method. We analyzed TPM1 p.Arg21Leu pedigrees for cosegregation, clinical characteristics, and outcomes. We also estimated the geographical distribution of the carrier families in Portugal and Spain. Results: The TPM1 p.Arg21Leu variant was identified in 25/4099 (0.61%) HCM-cases, and was absent in 6462 control individuals with other inherited cardiac phenotypes (P<.0001). In total, 83 carriers (31 probands) were identified. The combined LOD score for familial cosegregation was 3.95. The cumulative probability of diagnosis in carriers was 50% at the age of 50 years for males, and was 25% in female carriers. At the age of 70 years, 17% of males and 46% of female carriers were unaffected. Mean maximal left ventricular wall thickness was 21.4 ±7.65mm. Calculated HCM sudden death risk was low in 34 carriers (77.5%), intermediated in 8 (18%), and high in only 2 (4.5%). Survival free of cardiovascular death or heart transplant was 87.5% at 50 years. Six percent of carriers were homozygous and 18% had an additional variant. Family origin was concentrated in Galicia, Extremadura, and northern Portugal, suggesting a founder effect. Conclusions: TPM1 p.Arg21Leu is a pathogenic HCM variant associated with late-onset/incomplete penetrance and a generally favorable prognosis (AU)

Acetylcholinesterase affinity-based screening assay on Lippia gracilis Schauer extracts.

The use of affinity-based protein assay produced by covalently linking acetylcholinesterase to magnetic beads, followed by chemical characterization of the selective binders using Liquid Chromatography with tandem High-Resolution Mass Spectrometry (LC-HRMS) is herein described for profiling crude aqueous natural product extracts. The fishing assay was first modulated using galanthamine as a reference ligand and then, the assay condition was adjusted for the aqueous leaves extracts obtained from Lippia gracilis Schauer (genotype 201) that was used as the natural combinatory library. From the experiments, a selective binder has been undisclosed with an accurate mass of 449.1131 m/z and identified as eriodictyol 2'-O-glucoside or eriodictyol 3'-O-glucoside. The selectivity of the binding assay was demonstrated, as much as, that erydictiol 7-O-glucoside was not fished, although it was present in the crude aqueous extract. The binding assay platform exhibited high specificity and did not require any sample pretreatment, making it appropriate for profiling binders at natural libraries.

Interactions among methylenetetrahydrofolate reductase (MTHFR) and cystathionine ß-synthase (CBS) polymorphisms - a cross-sectional study: multiple heterozygosis as a risk factor for higher homocysteine levels and vaso-occlusive episodes.

High plasma homocysteine (Hcy) ​​levels may be responsible for vaso-occlusive episodes and may have acquired and/or genetic causes. This cross-sectional study aimed to investigate the role of methylenetetrahydrofolate reductase (MTHFR; C677T; A1298C) and cystathionine-ß-synthase (CBS; T833C/844ins68, G919A) polymorphisms in serum levels of folic acid, vitamin B12 and Hcy, and to verify a possible association between these polymorphisms and the clinical variability. Blood samples of Brazilian patients with a diagnosis of thrombosis were submitted to genotyping by PCR-based methods and serum dosages of folic acid, vitamin B12 and Hcy. Except for the CBS G919A polymorphism, all other genetic markers were in Hardy-Weinberg equilibrium. An increased risk for venous thrombosis was found for the MTHFR 1298CC carriers (OR = 1.688; 95%CI = 0.839-3.398, P = 0.018) and those homozygously mutant for the CBS haplotype 844ins68/T833C (OR = 2.488; 95%CI = 0.501-12.363, P = 0.031), while heterozygous for this CBS haplotype showed an increased risk for higher Hcy levels (OR = 5.900; 95%CI = 1.003-34.691, P = 0.030). Significant interactions were observed among the MTHFR C677T, MTHFR A1298C and CBS haplotype 844ins68/T833C polymorphisms in the results for Hcy levels (P = 0.000), where heterozygous had higher values. Interactions among these polymorphisms can affect serum Hcy levels, where multiple heterozygosis could be a risk factor for vaso-occlusive episodes.

Serum n-3 polyunsaturated fatty acids are inversely associated with longitudinal changes in depressive symptoms during pregnancy.

BACKGROUNDS: N-3 polyunsaturated fatty acids (PUFAs) have been hypothesised to be protective for depression during pregnancy. However, there are few data and no consensus regarding this association. In this line, we aim to evaluate if the concentration of n-3 and n-6 PUFAs, and their ratio, are associated with depressive symptoms throughout pregnancy. METHOD: A prospective cohort of 172 Brazilian women was followed at 5-13th, 20-26th and 30-36th weeks of gestation. The presence of depressive symptoms was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) at each pregnancy trimester. Depression was defined as an EPDS score ≥11. The concentrations of n-3 [α-linolenic acid; eicosapentaenoic acid (EPA); docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)] and n-6 PUFAs [linoleic acid; γ linolenic acid; eicosadienoic acid; eicosatrienoic acid; arachidonic acid; docosatetraenoic acid and docosapentaenoic acid] were expressed as absolute (µg/ml) values. The total n-6/n-3 ratio was calculated. Statistical analyses were performed using univariate and adjusted random intercept logistic model for each fatty acid (FA) considering the longitudinal nature of data. Covariates were selected as potential confounders based on their biological plausibility of having an association with the concentration of FA and depressive symptoms during pregnancy. RESULTS: The prevalence of depressive symptoms was high in all pregnancy trimesters (1st = 33.7%; 2nd = 18.9%; 3rd = 17.4%). We did not find differences in means FA concentrations by depressive symptom classification, for each follow-up visit. The women presented a 5% decrease in the odds of having depressive symptoms for each one-week increase in the gestational age. As individual women progressed through pregnancy, higher concentrations of EPA (odds ratio (OR) = 0.92; 95% CI: 0.86-0.99), DHA (OR = 0.96; 95% CI: 0.93-0.99), DPA (OR = 0.87; 95% CI: 0.77-0.99) and total n-3 (OR = 0.98; 95% CI: 0.96-0.99) were associated with a lower odds of depressive symptoms, while higher total n-6/n-3 ratio were associated with greater odds of depressive symptoms (OR = 1.40; 95% CI: 1.09-1.79). We detected a decrease in the probability of depressive symptoms as concentrations of total n-3 FA, α-linolenic acid, DPA, and DHA increased. We also observed a sharper decline for women with initial greater chance of depressive symptoms compared with those with lower chance of having these symptoms. CONCLUSIONS: We found a high prevalence of depressive symptoms in low-income Brazilian pregnant women and no significant associations between n-6 FA and depressive symptoms. Lower serum concentrations of DHA, EPA and DPA and a higher n-6/n-3 ratio at each pregnancy trimester were associated with higher odds of depressive symptoms throughout pregnancy.

Culture of domestic cat ovarian tissue in vitro and in the chick embryo chorioallantoic membrane.

In vitro culture and transplantation procedures are essential protocols employed in the evaluation of ovarian follicle survival and development. Culture in the chorioallantoic membrane (CAM) of chick embryos is an intermediate method that provides important follicle development information and has not been tested for cat ovaries to date. The aim of this study was to investigate if in vitro and CAM culture could be used as short-term systems to study cat ovarian tissue development. The ovaries of eight cats were dissected into 3-mm(3) cubes, cultured in vitro and in CAM for up to 5 days, and stained with hematoxylin-eosin and Gomori trichrome. Cell proliferation was analyzed using anti-Ki67. Possible differences among groups were investigated by analysis of variance or the Kruskal-Wallis test followed by Bonferroni correction. The T-test or Wilcoxon test was used to verify differences between the CAM and IVC. Results revealed that 87.5% of all follicles were primordial during culture. The percentage of primordial follicles in the morphologically normal follicles (MNF) pool was always higher than 80%, with the exception of Day 3 of CAM culture, but the number of MNF reduced significantly from Day 0 (600 out of 777 follicles) to Day 5 in the CAM (91 out of 171) and IVC (296 out of 686). The number of primordial follicles in 1 mm(3) in Days 2, 3, and 5 in the CAM was significantly lower than that in the control (Day 0). No cellular proliferation was observed in culture. Vascularization occurred in the CAM culture, but with no association to follicular viability. In addition, both methods showed an increase in connective tissue during culture. Although no significant differences were observed in the percentage of MNF, there was a reduction in the total number of follicles, both for IVC and CAM-cultured ovarian tissue. Furthermore, anti-Ki67 did not stain any follicle after Day 0 in IVC or in CAM culture. Neither system was capable of promoting follicle growth and/or development. The results show that the CAM is not a suitable system for feline ovarian tissue and highlight the necessity to improve IVC systems in cats.

Effects of 17α-methyltestosterone on the reproduction of the freshwater snail Biomphalaria glabrata.

17-α-methyltestosterone (MT) is a synthetic hormone used in fish hatcheries to induce male monosex. Snails hold promise as possible test models to assess chemicals acting on the endocrine system. Biomphalaria glabrata is an aquatic gastropod mollusk (Pulmonata, Planorbidae) that can be easily maintained in aquaria, predisposing the species for use in ecotoxicological testing. This study evaluated the reproductive effects of MT on B. glabrata by examining histological changes and its reproductive performance. Ten snails per group were exposed for 4 weeks to different concentrations of MT (0.01, 0.1, and 1.0 mg/L). The total number of laid eggs, egg mass per group, size of type V oocytes, and production of spermatozoids were determined. Reproduction of B. glabrata was affected by MT. At the lowest concentration (0.01 mg/L), MT caused a statistically significant increase in the number of egg mass per snail compared with controls unexposed to MT. Histopathology analyses showed an increase in the sperm production at the higher MT concentrations of 0.1 and 1.0 mg/L. Chromatographic analyses of water samples showed that MT concentrations rapidly declined within a 96-h period. These results highlight the importance of giving more support to regulatory authorities, since MT is not registered for use on fish hatcheries in many countries around the world. Wastewater from fish farms discharged into aquatic ecosystems should be monitored for MT residues, since its presence could compromise the reproduction of other native snail species.

An overview of chemical straightening of human hair: technical aspects, potential risks to hair fibre and health and legal issues.

Personal image, as it relates to external beauty, has attracted much attention from the cosmetic industry, and capillary aesthetics is a leader in consumption in this area. There is a great diversity of products targeting both the treatment and beautification of hair. Among them, hair straighteners stand out with a high demand by costumers aiming at beauty, social acceptance and ease of daily hair maintenance. However, this kind of treatment affects the chemical structure of keratin and of the hair fibre, bringing up some safety concerns. Moreover, the development of hair is a dynamic and cyclic process, where the duration of growth cycles depends not only on where hair grows, but also on issues such as the individual's age, dietary habits and hormonal factors. Thus, although hair fibres are composed of dead epidermal cells, when they emerge from the scalp, there is a huge variation in natural wave and the response to hair cosmetics. Although it is possible to give the hair a cosmetically favourable appearance through the use of cosmetic products, for good results in any hair treatment, it is essential to understand the mechanisms of the process. Important information, such as the composition and structure of the hair fibres, and the composition of products and techniques available for hair straightening, must be taken into account so that the straightening process can be designed appropriately, avoiding undesirable side effects for hair fibre and for health. This review aims to address the morphology, chemical composition and molecular structure of hair fibres, as well as the products and techniques used for chemical hair relaxing, their potential risk to hair fibre and to health and the legal aspects of their use.

Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study.

BACKGROUND: Catheter-related infections (CRIs) caused by peripheral intravenous catheters (PIVCs) are an increasingly common iatrogenic complication. To prevent this, recommended timelines for routine replacement of PIVCs have increased from 48 h to 72 h and subsequently to 96 h, despite a lack of supporting scientific evidence. AIM: To compare closed-system (COS) PIVCs with open-system (MOS) PIVCs. METHODS: This prospective, randomized controlled trial compared the indwell time of COS PIVCs without complications with that of MOS PIVCs, removed only by clinical indication. In total, 1199 PIVCs (642 inpatients) were randomized and 283 PIVCs were cultured. Sixteen catheters (11 patients) were lost to the study after randomization. FINDINGS: In total, 104,469 catheter-hours (54,173 h in 584 COS and 50,296 h in 599 MOS) were recorded. The median dwell time was 137.1h for COS PIVCs and 96 h for MOS PIVCs (P = 0.001). Among PIVCs in place for ≥ 24 h, the median dwell time was 144.5h for COS PIVCs [95% confidence interval (CI) 123.4-165.6] and 99 h for MOS PIVCs (95% CI 87.2-110.8). Use of COS PIVCs reduced phlebitis rates by 29% (31 vs 45 cases/1000 catheter-days; P = 0.004). The probability that a MOS PIVC would last for 96 h was 79.9%, and the probability that a COS PIVC would last for 144 h was 80.4%. There were no significant differences in rates of bacterial colonization per 1000 catheter-days (51.1 COS vs 54.1 MOS) or CRI (5.76 COS vs 6.65 MOS). Nevertheless, there was a 20% relative risk reduction in CRI. CONCLUSION: Use of COS PIVCs reduced episodes of phlebitis and risk of infection at a cost of only € 0.09/day. When PIVCs are replaced based on clinical indication, COS PIVCs last for up to 144 h and MOS PIVCs last for up to 96 h without increased risk and with significant cost savings (€ 786,257/year/1000 beds).

Genotoxic evaluation in Oreochromis niloticus (Fish: Characidae) of recombinant spore-crystal complexes Cry1Ia, Cry10Aa and Cry1Ba6 from Bacillus thuringiensis.

Bioinsecticides from Bacillus thuringiensis (Bt) are widely used around the world in biological control against larval stages of many insect species. Bt has been considered a biopesticide that is highly specific to different orders of insects, non-polluting and harmless to humans and other vertebrates, thus becoming a viable alternative for combating agricultural pests and insect vectors of diseases. The family of Bt δ-endotoxins are crystal-protein inclusions showing toxicity to insects' midgut, causing cell lysis leading to starvation, septicemia and death. The aim of this study is to evaluate the genotoxic potential of recombinant Bt spore-crystals expressing Cry1Ia, Cry10Aa and Cry1Ba6 on peripheral erythrocyte cells of Oreochromis niloticus, through comet assay, micronucleus (MN) test and nuclear abnormalities (NA) analysis. Fish (n = 10/group) were exposed for 96 h at 10(7) spores 30 l(-1), 10(8) spores 30 l(-1) or 10(9) spores 30 l(-1) of Bt spore-crystals. Cry1Ia showed a significant increase in comet cells at levels 1 and 2, but not at levels 3 and 4, so it was not mutagenic nor did it induce MN or NA. These three spore-crystals showed some fish toxicity at only the highest exposure level, which normally does not occur in the field.

Lack of genotoxicity in Astyanax bimaculatus and Oreochromis niloticus of 17α-methyltestosterone used in fish hatcheries to produce male monosex populations.

17α-Methyltestosterone (MT) is widely used in fish hatcheries of many countries to produce male monosex populations. Its genotoxic risk to fish species is not well known and studies in other in vivo models are still inconclusive. MT was tested for genotoxicity in the fish species Oreochromis niloticus (tilapia), a target species, and Astyanax bimaculatus (lambari), a native non-target species. Genotoxicity was evaluated by the micronucleus test (MN), nuclear abnormalities (NA), and comet assay using peripheral erythrocytes of both species after a 96-h exposure to MT at concentrations of 0.01, 0.1, and 1.0 mg/L in the water. At the lowest exposure level of 0.01 mg/L, MT induced MN in both species and NA only in O. niloticus. These effects were not observed in the comet assay. Chromatographic analysis of water samples collected from aquariums at the beginning and end of each experiment showed that MT was consumed during the 96-h exposure. At the highest level of exposure (1.0 mg/L), 81.69% of the hormone was consumed during the exposure period. The chromatogram showed that at the lowest concentration level of 0.01 mg/L, 99.56% MT was consumed by the end of the exposure period. Thus, exposure to MT did not cause genotoxicity in either fish species.

Cytogenetic toxicity and gonadal effects of 17 α-methyltestosterone in Astyanax bimaculatus (Characidae) and Oreochromis niloticus (Cichlidae).

The synthetic hormone, 17-α-methyltestosterone (MT), is used in fish hatcheries to induce male monosex. Androgenic effects on various fish species have been reported; however, few studies have assessed possible genotoxic effects, although there are concerns about such effects in target and non-target species. We evaluated genotoxic and gonadal effects of MT in adult tilapia (Oreochromis niloticus) and Astyanax bimaculatus (a common native non-target fish in Brazil). Fish were fed for 28 days with ration containing MT (60 mg/L), a normal dose used in fish farming. Evaluation of MT genotoxicity was carried out through micronucleus test, nuclear abnormality, and comet assay analyses on peripheral erythrocyte cells collected by cardiac puncture. There were no significant differences in micronucleus frequencies and DNA damage in both species; however, MT caused cytogenetic toxicity in the non-target species, A. bimaculatus, with significantly increased erythrocyte nuclear abnormalities. Histopathological analyses of the female gonads of O. niloticus revealed that MT significantly inhibited the development of mature oocytes, while in A. bimaculatus it provoked significant inhibition of spermatozoa production. We concluded that discharge of fish-hatcheries water onto the surface of aquatic ecosystems should be avoided due to risks to reproduction of native species.

Reduction of volatile acidity of acidic wines by immobilized Saccharomyces cerevisiae cells.

Excessive volatile acidity in wines is a major problem and is still prevalent because available solutions are nevertheless unsatisfactory, namely, blending the filter-sterilized acidic wine with other wines of lower volatile acidity or using reverse osmosis. We have previously explored the use of an empirical biological deacidification procedure to lower the acetic acid content of wines. This winemaker's enological practice, which consists in refermentation associated with acetic acid consumption by yeasts, is performed by mixing the acidic wine with freshly crushed grapes, musts, or marc from a finished wine fermentation. We have shown that the commercial strain Saccharomyces cerevisiae S26 is able to decrease the volatile acidity of acidic wines with a volatile acidity higher than 1.44 g L(-1) acetic acid, with no detrimental impact on wine aroma. In this study, we aimed to optimize the immobilization of S26 cells in alginate beads for the bioreduction of volatile acidity of acidic wines. We found that S26 cells immobilized in double-layer alginate-chitosan beads could reduce the volatile acidity of an acidic wine (1.1 g L(-1) acetic acid, 12.5 % (v/v) ethanol, pH 3.12) by 28 and 62 % within 72 and 168 h, respectively, associated with a slight decrease in ethanol concentration (0.7 %). Similar volatile acidity removal efficiencies were obtained in medium with high glucose concentration (20 % w/v), indicating that this process may also be useful in the deacidification of grape musts. We, therefore, show that immobilized S. cerevisiae S26 cells in double-layer beads are an efficient alternative to improve the quality of wines with excessive volatile acidity.

Dual-cured etch-and-rinse adhesive systems increase the bond durability of direct coronal dentin restorations.

This study aimed to evaluate the bond durability of dentin restorations bonded with light- or dual-cured etch-and-rinse adhesive systems. A three-step adhesive system (Scotchbond Multipurpose Plus), an acetone-based two-step adhesive system (Prime & Bond 2.1), and an ethanol-based two-step adhesive system (Excite) were tested. Both the light- and the dual-cured versions were evaluated. High C-factor dentin cavities were prepared on 120 bovine incisors, which were then restored with resin composite (n=10). The samples were stored in water for 24 hours, and half of them were subjected to additional degradation with 10% NaOCl for five hours. The push-out bond strength test was performed in a universal testing machine until failure. Failure modes were evaluated by scanning electron microscopy. Data were analyzed by three-way analysis of variance and Tukey tests (p<0.05). The dual-cured adhesive system presented a higher immediate bond strength and durability than those that were light cured. The three-step adhesive system produced the highest values, whereas the acetone-based adhesive system produced the lowest result. Therefore, the use of dual-cured etch-and-rinse adhesive systems can induce increased bond durability to direct coronal dentin restorations.

Association between methylene tetrahydrofolate reductase and glutathione S-transferase M1 gene polymorphisms and chronic myeloid leukemia in a Brazilian population.

Chronic myeloid leukemia is a hematopoietic stem cell disorder that causes uncontrolled proliferation of white blood cells. Although the clinical and biological aspects are well documented, little is known about individual susceptibility to this disease. We conducted a case-control study analyzing the prevalence of the polymorphisms MTHFR C677T, MTHFR A1298C, del{GSTM1}, del{GSTT1}, and haptoglobin in 105 patients with chronic myeloid leukemia (CML) and 273 healthy controls, using PCR-based methods. A significant association with risk of developing CML was found for MTHFR 1298AA (odds ratio (OR) = 1.794; 95% confidence interval (CI) = 1.14-2.83) and GSTM1 non-null (OR = 1.649; 95%CI = 1.05-2.6) genotypes, while MTHFR 1298AC (OR = 0.630; 95%CI = 0.40-0.99) and GSTM1 null (OR = 0.606; 95%CI = 0.21-0.77) genotypes significantly decreased this risk. There appeared to be selection for heterozygosity at the MTHFR 1298 locus. The considerable range of variation in this and other human populations may be a consequence of distinctive processes of natural selection and adaptation to variable environmental conditions. The Brazilian population is very mixed and heterogeneous; we found these two loci to be associated with CML in this population.

Role of polymorphisms in factor V (FV Leiden), prothrombin, plasminogen activator inhibitor type-1 (PAI-1), methylenetetrahydrofolate reductase (MTHFR) and cystathionine ß-synthase (CBS) genes as risk factors for thrombophilias.

Thrombophilias are defined as a predisposition to thrombosis due to hematological changes which induce blood hypercoagulability; they can be inherited or acquired. They are individually characterized by a large phenotypic variability, even when they occur within the same family. Hereditary thrombophilias are, in most cases, due to changes related to physiological coagulation inhibitors or mutations in the genes of coagulation factors. High levels of plasma homocysteine may also be responsible for vaso-occlusive episodes and may have acquired (nutritional deficiencies of folate and vitamins B6 and B12) and/or genetic causes (mutations in the genes responsible for expression of enzymes involved in the intracellular metabolism of homocysteine). Considering that: (1) thromboses are events of multigenic and multifactorial etiopathology; (2) the presence of mutations in several genes significantly increases the risk of their occurrence; (3) the vascular territory (venous and/or arterial) affected involves different pathophysiological mechanisms and treatments, knowledge of genetic variants that may contribute to the risk and variability of the phenotypic manifestations of these diseases is extremely important. This understanding may provide support for a more individualized and therefore more effective treatment for thrombophilia carriers. Thus, this mini-review aims to address a comprehensive summary of thrombophilias and thrombosis, and discuss the role of polymorphisms in Factor V (FV Leiden), Prothrombin, Plasminogen activator inhibitor type-1 (PAI-1), Methylenetetrahydrofolate reductase (MTHFR) and Cystathionine ß-synthase (CBS) genes as risk factors for thrombophilias.