Three new species of the family Cirolanidae Dana, 1852 (Isopoda, Cymothoida) from the shallow Brazilian bathyal.

Three new species of isopod crustaceans of the family Cirolanidae-Dolicholana ivanyae spec. nov., Natatolana hadassae spec. nov. and Politolana cleoniceae spec. nov.-are described from the shallow waters of the Brazilian bathyal. The specimens were collected from the shallow bathyal zone of the Potiguar Basin, off the Brazilian state of Rio Grande do Norte, from Pernambuco and Bahia, and the Campos Basin, off Rio de Janeiro and São Paulo states. Dolicholana ivanyae spec. nov. can be distinguished from its congeners by the subrectangular shape of the head, its very long frontal lamina, which surpasses article 2 of the peduncle of antenna 1, and its densely setose pereopod 7. Natatolana hadassae spec. nov. is unique due to the subacute posteroventral angle of epimeron 4, ischial pereopod 3 as produced as those of pereopods 1 and 2, and the distal margin of the pleotelson with 10 robust distal setae. Politolana cleoniceae spec. nov. differs from its congeners based on the combination of the following traits: the pereon-pleon articulation is tight, with pleonite 1 clearly visible, and not covered completely by pereonite 7, while the pleon (in the dorsal-ventral view) is arched in a uniform sequence with the pereon, and the uropodal endopod is shorter than the exopod. In addition to these findings, the known geographical distribution of Dolicholana brucei, which was described recently from Brazil, is extended southward to include Bahia, Brazil. This study increases the number of cirolanid species recorded from Brazilian waters to 23.

Forest disturbance and recovery in Peruvian Amazonia.

Amazonian forests function as biomass and biodiversity reservoirs, contributing to climate change mitigation. While they continuously experience disturbance, the effect that disturbances have on biomass and biodiversity over time has not yet been assessed at a large scale. Here, we evaluate the degree of recent forest disturbance in Peruvian Amazonia and the effects that disturbance, environmental conditions and human use have on biomass and biodiversity in disturbed forests. We integrate tree-level data on aboveground biomass (AGB) and species richness from 1840 forest plots from Peru's National Forest Inventory with remotely sensed monitoring of forest change dynamics, based on disturbances detected from Landsat-derived Normalized Difference Moisture Index time series. Our results show a clear negative effect of disturbance intensity tree species richness. This effect was also observed on AGB and species richness recovery values towards undisturbed levels, as well as on the recovery of species composition towards undisturbed levels. Time since disturbance had a larger effect on AGB than on species richness. While time since disturbance has a positive effect on AGB, unexpectedly we found a small negative effect of time since disturbance on species richness. We estimate that roughly 15% of Peruvian Amazonian forests have experienced disturbance at least once since 1984, and that, following disturbance, have been increasing in AGB at a rate of 4.7 Mg ha-1 year-1 during the first 20 years. Furthermore, the positive effect of surrounding forest cover was evident for both AGB and its recovery towards undisturbed levels, as well as for species richness. There was a negative effect of forest accessibility on the recovery of species composition towards undisturbed levels. Moving forward, we recommend that forest-based climate change mitigation endeavours consider forest disturbance through the integration of forest inventory data with remote sensing methods.

Los bosques amazónicos son reservorios y sumideros de carbono, contribuyendo a la mitigación del cambio climático. Si bien experimentan perturbaciones, el efecto de estas en la biomasa y biodiversidad a través del tiempo no ha sido evaluado a gran escala. En este estudio, evaluamos el grado de perturbación forestal reciente en la Amazonía peruana y los efectos de las perturbaciones, condiciones ambientales y actividad antrópica sobre la biomasa y la biodiversidad en bosques perturbados. Los datos de biomasa aérea y riqueza de especies forestales provenientes de 1,840 subparcelas del Inventario Nacional Forestal y de Fauna Silvestre (INFFS) se analizaron en conjunto con la información de detección de cambios de cobertura forestal derivadas de perturbaciones detectadas a partir de series de tiempo de índices de diferencia de humedad normalizados (NDMI) a partir de imágenes Landsat. Nuestros resultados muestran un claro efecto negativo de la intensidad de las perturbaciones sobre la riqueza de especies arbóreas. Este efecto también fue observado en los valores de recuperación de biomasa aérea y riqueza de especies arbóreas hacia niveles no perturbados, así como en la recuperación de la composición florística. El tiempo transcurrido desde la perturbación tuvo un efecto mayor sobre la biomasa aérea que sobre la riqueza de especies. Mientras el tiempo desde una perturbación forestal tuvo un efecto positivo sobre la biomasa área, se observó un pequeño efecto negativo sobre la riqueza de especies. Estimamos que aproximadamente el 15% de los bosques en la Amazonía peruana han experimentado una perturbación al menos una vez desde 1984, y que, tras esta, han aumentado en biomasa aérea en una tasa de 4.7 Mg ha−1 año−1 durante los primeros 20 años posteriores al evento de perturbación. Además, el efecto positivo de la cubierta forestal circundante fue evidente tanto para la biomasa aérea como para su recuperación hacia niveles no perturbados, así como para los valores de riqueza de especies. La accesibilidad a bosques tuvo un efecto negativo en la recuperación de la composición de especies hacia niveles no perturbados. Recomendamos que los esfuerzos de mitigación de cambio climático basados en bosques tengan en cuenta las perturbaciones forestales mediante el análisis integrado de información de inventarios forestales con métodos de teledetección.

Grain Refinement of Inconel 718 Superalloy-The Effect of Rotating Magnetic Field.

The effect of the application of a rotating magnetic field on the average grain size of IN718 castings was experimentally studied. For the purpose, four parts were produced by investment casting and characterized. The first casting was produced without application of RMF for comparison. The remaining ones were submitted to different RMF frequencies for 15 min and subsequently to the pouring of the nickel-based superalloy. In these three castings, the RMF frequencies applied were, respectively, 15 Hz, 75 Hz and 150 Hz. All the other process parameters were kept constant during the execution of the experimental procedure. The average grain size of the samples was determined according to the ASTM E112-13 standard, using intercept methods. Macro hardness measurements, tensile testing and SEM-EDS analysis were conducted in order to evaluate the casting's mechanical properties and microstructures. The results demonstrate a noticeable grain size reduction in the samples submitted to rotating magnetic field. An average grain area reduction, greater than 96%, was achieved in the castings where RMF frequencies of 75 Hz and 150 Hz were applied. The application of RMF also caused a morphological change in the casting's dendrites from cellular to almost equiaxed. Additionally, it originated the decrease of the size and amount of needle-like δ phase. Regarding mechanical properties of the cast parts, no major differences were verified.

Cytological Screening Model of Normal Oral Mucosa Exposed to Carcinogens: A Pilot Study.

INTRODUCTION: Oral cytopathology is able to detect incipient cellular alterations, but it is not routinely applied to this purpose. We aimed to establish a model to screen individuals with no oral lesion exposed to smoking/alcohol, by means of the nuclear area, cell proliferation rate, and analysis of genetic damage. METHODS: In this cross-sectional pilot study, 90 patients were allocated into 3 groups: oral cancer group (patients with oral squamous cell carcinoma), tobacco/alcohol group (patients without oral lesions and exposed to these risk factors), and control group (individuals with no lesion and not exposed to tobacco and alcohol). The cytological smears performed in these individuals were stained with Papanicolaou, a silver-staining and a Feulgen reaction. The nuclei of cells were measured, and AgNORs/nucleus and micronuclei (MN) were quantified. The cutoff values were stipulated evaluating the healthy mucosa (control group) and the cancerization field mucosa (oral cancer group). RESULTS: Cutoff values for the screening of individuals exposed to carcinogens were ≥8% of nuclei larger than 100 µm2, ≥3.38 AgNOR/nucleus, and ≥3 MN per 1,000 cells. CONCLUSIONS: Nuclear area measurement and AgNORs/nucleus and MN quantification identified the incipient phase of oral carcinogenesis. A screening model for individuals without oral lesion exposed to smoking/alcohol was proposed.

Thermochemical Liquefaction as a Cleaner and Efficient Route for Valuing Pinewood Residues from Forest Fires.

Biomass thermochemical liquefaction is a chemical process with multifunctional bio-oil as its main product. Under this process, the complex structure of lignocellulosic components can be hydrolysed into smaller molecules at atmospheric pressure. This work demonstrates that the liquefaction of burned pinewood from forest fires delivers similar conversion rates into bio-oil as non-burned wood does. The bio-oils from four burned biomass fractions (heartwood, sapwood, branches, and bark) showed lower moisture content and higher HHV (ranging between 32.96 and 35.85 MJ/kg) than the initial biomasses. The increased HHV resulted from the loss of oxygen, whereas the carbon and hydrogen mass fractions increased. The highest conversion of bark and heartwood was achieved after 60 min of liquefaction. Sapwood, pinewood, and branches reached a slightly higher conversion, with yields about 8% greater, but with longer liquefaction time resulting in higher energy consumption. Additionally, the van Krevelen diagram indicated that the produced bio-oils were closer and chemically more compatible (in terms of hydrogen and oxygen content) to the hydrocarbon fuels than the initial biomass counterparts. In addition, bio-oil from burned pinewood was shown to be a viable alternative biofuel for heavy industrial applications. Overall, biomass from forest fires can be used for the liquefaction process without compromising its efficiency and performance. By doing so, it recovers part of the lost value caused by wildfires, mitigating their negative effects.

Peptidylprolyl isomerase C (Ppic) regulates invariant Natural Killer T cell (iNKT) differentiation in mice.

Peptidyl-prolyl cis-trans isomerase C (Ppic) is expressed in several bone marrow (BM) hematopoietic progenitors and in T-cell precursors. Since the expression profile of Ppic in the hematoimmune system was suggestive that it could play a role in hematopoiesis and/or T lymphocyte differentiation, we sought to test that hypothesis in vivo. Specifically, we generated a Ppic-deficient mouse model by targeting the endogenous locus by CRISPR/Cas9 and tested the requirement of Ppic in hematopoiesis. Several immune cell lineages covering BM progenitors, lymphocyte precursors, as well as mature cells at the periphery were analyzed. While most lineages were unaffected, invariant NKT (iNKT) cells were reduced in percentage and absolute cell numbers in the Ppic-deficient thymus. This affected the most mature stages in the thymus, S2 and S3, and the phenotype was maintained at the periphery. Additionally, immature transitional T1 and T2 B lymphocytes were increased in the Ppic-deficient spleen, but the phenotype was lost in mature B lymphocytes. In sum, our data show that Ppic is dispensable for myeloid cells, platelets, erythrocytes, αß, and γδ T lymphocytes in vivo in the steady state, while being involved in B- and iNKT cell differentiation.

The fermented soy beverage Q-CAN® plus induces beneficial changes in the oral and intestinal microbiome.

BACKGROUND: Soy products are associated with many beneficial health consequences, but their effects on the human intestinal microbiome are poorly characterized. OBJECTIVES: To identify the changes in the oral and fecal microbiome in lean and obese participants due to consumption of Q-CAN®, and to assess the expected consequences of these changes based on the published literature. METHODS: Prospective study of lean (10) and obese (9) participants consuming Q-CAN® twice daily for 4 weeks with 8 weeks follow-up. Microbial DNA was extracted from saliva and stool samples, amplified against the V4 region of the 16S ribosomal RNA gene and data analyzed using QIIME 1.9.1 bioinformatics. Four hundred forty-four samples were collected in total, 424 of which were productive and yielded good quality data. RESULTS: STOOL. In the lean population Bifidobacteria and Blautia show a significant increase while taking Q-CAN®, and there was a trend for this in the obese population. ORAL. There were relatively fewer major changes in the oral microbiome with an increase in the family Veillonellaceae in the lean population while on Q-CAN®. CONCLUSION: Q-CAN® consumption induced a number of significant changes in the fecal and oral microbiome. Most notably an increase in the stool microbiome of Bifidobacteria and Blautia, both of which are associated with positive health benefits, and in the saliva an increase in Veillonellaceae. TRIAL REGISTRATION: This trial was registered with Clinicaltrials.gov on January 14th 2016. ClinicalTrials.gov Identifier: NCT02656056.

Fibroma ossificante trabecular juvenil: um relato de caso / Juvenile ossifying fibroma: a case report

Objetivo: o fibroma ossificante trabecular juvenil (FOJT) é uma lesão fibro-óssea incomum, benigna, porém de comportamento agressivo. Ocorre, frequentemente, em crianças e adolescentes, com maior acometimento em maxila e mandíbula. O presente relato aborda os aspectos clínicos, imaginológicos, histopatológicos, imuno-histoquímicos e o tratamento de um caso de FOTJ. Além de discutir suas similaridades com o osteossarcoma de baixo grau e as alternativas para o seu diagnóstico. Relato de caso: paciente do sexo masculino, com 12 anos de idade, apresentando aumento de volume em mandíbula no lado esquerdo, perda de função mastigatória e de fala, com tempo de evolução de seis meses. Radiograficamente, a lesão apresentava aspecto unilocular, com limites definidos e de padrão misto. O tratamento consistiu em cirurgia de enucleação total da lesão, seguida de curetagem sob anestesia geral. A histopatologia e a ausência de marcação para MDM2 e CDK4 na imuno-histoquímica confirmaram o diagnóstico de FOTJ e excluíram o de osteossarcoma de baixo grau. No controle pós-operatório de 20 dias, o paciente relatou melhora da parestesia, da função mastigatória e da fala e ausência de dor. Não se observou recidiva no acompanhamento de 1 ano após a cirurgia. Considerações finais: a similaridade dos aspectos clínico, imaginológico e microscópico entre FOJT e osteossarcoma de baixo grau pressupõe o estudo imuno-histoquímico com os arcadores MDM2 e CDK4, minimizando equívocos no diagnóstico e orientando de forma mais eficiente o plano de tratamento adotado.(AU)

Objective: juvenile Trabecular Ossifying Fibromas (JTOF) are uncommon benign fibro-osseous lesions with a local aggressive behavior. They frequently occur in children and adolescents involving the jaw bones. This report addresses the clinical, imaging, histopathological, and immunohistochemical aspects and the treatment of a case of JTOF. In addition, it discusses similarities between JTOF and low-grade osteosarcomas and alternatives for their diagnosis. Case report: male patient, 12 years old, with a tumor in his left mandible, loss of masticatory function and speech, with a 6-month time course. Radiographically, the lesion had an unilocular aspect, with defined borders and a mixed image pattern. Treatment consisted surgical enucleation, followed by bone curettage, under general anesthesia. Histopathology presented fibrous stroma interspaced with bone trabeculae without signs of cellular malignancy. MDM2 and CDK4 markers in immunohistochemistry, confirmed the diagnosis of JTOF and excluded low-grade osteosarcoma. At the 20-day postoperative follow-up, the patient reported improvement in paresthesia, masticatory function and speech, and the absence of pain. Evaluation 1 year after surgery showed no signs of local recurrence. Final considerations: the similarity of clinical, imaging, and microscopic aspects between JTOF and low-grade osteosarcoma prompts an immunohistochemical study including MDM2 and CDK4 markers in order to improve final diagnosis and guide the treatment plan more efficiently.(AU)

Fermented Soy Beverage Q-CAN Plus Consumption Improves Serum Cholesterol and Cytokines.

Soy-based beverages are well recognized for their rich nutritional contents and positive health benefits. However, there is little information regarding the composition of various commercially available soy-based beverages and uncertainty among patients regarding the utility of fermented soy products. Current study evaluates the health benefits of QCAN® Plus-an easily available fermented soy drink. This study was performed in lean (n = 10) and obese (n = 10) subjects. The subjects were observed during pre-soy (weeks -2, -1, and 0), on-soy (weeks 1, 2, 3, and 4), and post-soy (weeks 6, 8, 10, and 12) periods. The serum samples during these visits were subjected to lipid profile analysis and multiplex assay for cytokines. The results revealed that total cholesterol and low-density lipoprotein (LDL) cholesterol levels were significantly reduced in both lean and obese individuals during on-soy (P ≤ .05). Furthermore, cytokines such as platelet-derived growth factor (PDGF) AA and AB/BB were significantly lowered on-soy compared with pre-soy (P ≤ .05) in lean subjects and PDGF AA, IL-1RA, and GMCSF were significantly reduced on-soy (P ≤ .05) in obese subjects. In addition, a qualitative and quantitative analysis of the Q-CAN Plus by a third-party laboratory confirmed its chemical and microbial safety. Our preliminary study on Q-CAN Plus ensures its safety for consumption and highlights its hypolipidemic and suppressive effect on certain cytokines. These observations and relevant studies in future might guide clinicians in future to consider Q-CAN Plus as a therapeutic nutritional supplement.

Harnessing the power of regulatory T-cells to control autoimmune diabetes: overview and perspective.

Type 1 diabetes (T1D) is a T-cell-mediated autoimmune disease resulting in islet ß-cell destruction, hypoinsulinaemia and severely altered glucose homeostasis. Although the mechanisms that initiate T1D still remain elusive, a breakdown of immune tolerance between effector T-cells (Teff ) and regulatory T-cells (Treg ) is considered to be the crucial component leading to autoimmunity. As such, strategies have been developed to boost the number and/or function of Treg in the hope of specifically hampering the pathogenic Teff activity. In this review, we will summarize the current understanding of biomarkers and functions of both forkhead box protein 3 (FoxP3)+ Treg and type 1 regulatory T (Tr1) cells in health and in T1D, examine the outcome of experimental therapies in both animal models and humans via manipulation of Treg responses and also provide an outlook on the potential of Treg -based immunotherapies in the prevention and treatment of this disease. Discussed immunotherapies include adoptive transfer of ex-vivo expanded FoxP3+ Treg , manipulation of Treg cells via the interleukin (IL)-2/IL-2R pathway and induction of Treg by tolerogenic peptides, tolerogenic dendritic cells or altered gut microbiota.

A new species of Dolicholana Bruce, 1986 (Isopoda, Cymothoidea, Cirolanidae), the first record of the genus from the Atlantic Ocean.

The isopod genus Dolicholana Bruce, 1986, previously known only from the Indo-West Pacific, is recorded for the first time from the Atlantic Ocean. A new species, Dolicholana brucei sp. nov., is described from the northeastern Brazilian coast, and is the first record of the genus Dolicholana Bruce, 1986 for the Atlantic Ocean. The material was collected from the upper part of the continental slope off Rio Grande do Norte (150 m depth). The new species is characterized by pereopod 1 propodal palm being crenulate, ischium of pereopod 1 and 2 with a plumose seta on the anterior margin, peduncle of pleopods 3-5 bearing an accessory lobe acute on the distolateral angle, pleotelson posterior margin being rounded, and the uropodal endopod and the exopod apices distally being rounded. A revised key to the genus is provided.

Th17 cells transdifferentiate into regulatory T cells during resolution of inflammation.

Inflammation is a beneficial host response to infection but can contribute to inflammatory disease if unregulated. The Th17 lineage of T helper (Th) cells can cause severe human inflammatory diseases. These cells exhibit both instability (they can cease to express their signature cytokine, IL-17A) and plasticity (they can start expressing cytokines typical of other lineages) upon in vitro re-stimulation. However, technical limitations have prevented the transcriptional profiling of pre- and post-conversion Th17 cells ex vivo during immune responses. Thus, it is unknown whether Th17 cell plasticity merely reflects change in expression of a few cytokines, or if Th17 cells physiologically undergo global genetic reprogramming driving their conversion from one T helper cell type to another, a process known as transdifferentiation. Furthermore, although Th17 cell instability/plasticity has been associated with pathogenicity, it is unknown whether this could present a therapeutic opportunity, whereby formerly pathogenic Th17 cells could adopt an anti-inflammatory fate. Here we used two new fate-mapping mouse models to track Th17 cells during immune responses to show that CD4(+) T cells that formerly expressed IL-17A go on to acquire an anti-inflammatory phenotype. The transdifferentiation of Th17 into regulatory T cells was illustrated by a change in their signature transcriptional profile and the acquisition of potent regulatory capacity. Comparisons of the transcriptional profiles of pre- and post-conversion Th17 cells also revealed a role for canonical TGF-ß signalling and consequently for the aryl hydrocarbon receptor (AhR) in conversion. Thus, Th17 cells transdifferentiate into regulatory cells, and contribute to the resolution of inflammation. Our data suggest that Th17 cell instability and plasticity is a therapeutic opportunity for inflammatory diseases.

Mortalidade de zero a cinco anos em Uberlândia nos anos de 2000, 2005 e 2009 / Mortality rates in children between birth and five years old in Uberlandia in the years of 2000, 2005, and 2009

Introdução: a mortalidade de crianças de zero a cinco anos é um importante indicador social e o conhecimento dessa taxa permite o desenvolvimento de diversas políticas públicas. Objetivos: conhecer e classificar as mortes de crianças de zero a cinco anos em Uberlândia, suas principais causas e a evolução das taxas de mortalidade nos anosde 2000, 2005 e 2009. Métodos: foram colhidos os dados relativos aos óbitos no Cartório de Registro Civil de Uberlândia, classificando as mortes de acordo com as seguintes variáveis: faixa etária, sexo, causa básica de morte conforme os grandes capítulos da CID-10,1 procedência e mês em que ocorreu o óbito. Resultados: foram relatados 476 óbitos nos anos citados, sendo 159 em 2000, 156 em 2005 e 161 em 2009. Houve predomínio de mortalidade da faixa etária neonatal precoce (zero a seis dias), do sexo masculino e causas de morte relacionadas a afecções do período perinatal (capítulo XVI da CID-10).1 Conclusões: a mortalidade de zero a cinco anos, assim como a infantil (zero a um ano), apresentou-se relativamente estável, com ligeira queda no ano de 2009, em Uberlândia. No entanto, os índices de mortalidade em Uberlândia ainda são mais baixos do que na maioria dos estados brasileiros e em todas as cinco regiões emuito inferior aos índices do país, de forma geral.

Introduction: the mortality rate in children between birth and five years old is an important social indicator that allows the development of various public policies. Objectives: to know and classify the deaths of children from birth to five years of age in Uberlândia, the main causes, and trends in mortality rates in the years of 2000, 2005, and 2009. Methods: data on deaths were collected in the Civil Registry Office of Uberlândia. The deaths were classified according to the following variables: age, gender, basiccause of death according to the CID-10 major chapters 1, origin, and month of death. Results: 476 deaths were reported in the cited years being 159 in 2000, 156 in 2005, and 161 in 2009. There was a predominance of mortality in the early neonatal age group (zero to six days), males, and causes of death related to diseases of the perinatal period (XVI chapter from the CID-10).1 Conclusions: the mortality rate between birth and five years old, as well as that in infants (zero to one year old), was relativelystable, with a slight fall in the year of 2009. These mortality rates in Uberlândia are still lower than in most of the Brazilian States and in all five regions; they are also markedly inferior to those in the country in general.

Avaliação da sensibilidade e especificidade dos exames não invasivos no diagnóstico da estenose de artéria renal / Analysis of the sensitivity and specificity of noninvasive imaging tests for the diagnosis of renal artery stenosis

FUNDAMENTO: O envelhecimento e a aterosclerose estão relacionados à hipertensão renovascular em indivíduos idosos. Independentemente das comorbidades, a estenose de artéria renal é, por si só, importante causa de morbidade e mortalidade cardiovascular. OBJETIVO: Definir a sensibilidade, a especificidade, o valor preditivo positivo e o valor preditivo negativo dos exames não invasivos utilizados no diagnóstico de estenose da artéria renal. MÉTODOS: Um grupo de 61 pacientes recrutados permitiram a análise de 122 artérias e a definição de sensibilidade, especificidade e da contribuição relativa de cada exame realizado (Doppler, cintilografia e angiotomografia, comparados a arteriografia renal). RESULTADOS: A média das idades foi de 65,43 (desvio padrão: 8,7) anos. Das variáveis relacionadas à população do estudo e comparadas à arteriografia, duas estiveram correlacionadas à estenose da artéria renal, à disfunção renal e aos triglicerídeos. A mediana do ritmo de filtração glomerular foi de 52,8 mL/min/m². O Doppler identificou sensibilidade de 82,90%, especificidade de 70%, valor preditivo positivo de 85% e valor preditivo negativo de 66,70%. Para a tomografia, encontraram-se sensibilidade de 66,70%, especificidade de 80%, valor preditivo positivo de 87,50% e valor preditivo negativo de 55,20%. Esses achados permitiram identificar os exames que melhor detectavam a estenose. CONCLUSÃO: A tomografia e o Doppler mostraram qualidade e grande possibilidade no diagnóstico de estenose da artéria renal, com vantagem para o segundo, pois não há necessidade do uso de meio de contraste na avaliação de uma doença que, frequentemente, ocorre em diabéticos e associa-se à disfunção renal e à disfunção ventricular esquerda grave.

BACKGROUND: Aging and atherosclerosis are related to renovascular hypertension in elderly individuals. Regardless of comorbidities, renal artery stenosis is itself an important cause of cardiovascular morbidity and mortality. OBJECTIVE: To define the sensitivity, specificity, positive predictive value, and negative predictive value of noninvasive imaging tests used in the diagnosis of renal artery stenosis. METHODS: In a group of 61 patients recruited, 122 arteries were analized, thus permitting the definition of sensitivity, specificity, and the relative contribution of each imaging study performed (Doppler, scintigraphy and computed tomographic angiography in comparison to renal arteriography). RESULTS: The mean age was 65.43 years (standard deviation: 8.7). Of the variables related to the study population that were compared to arteriography, two correlated with renal artery stenosis, renal dysfunction and triglycerides. The median glomerular filtration rate was 52.8 mL/min/m². Doppler showed sensitivity of 82.90%, specificity of 70%, a positive predictive value of 85% and negative predictive value of 66.70%. For tomography, sensitivity was 66.70%, specificity 80%, positive predictive value 87.50% and negative predictive value 55.20%. With these findings, we could identify the imaging tests that best detected stenosis. CONCLUSION: Tomography and Doppler showed good quality and efficacy in the diagnosis of renal artery stenosis, with Doppler having the advantage of not requiring the use of contrast medium for the assessment of a disease that is common in diabetics and is associated with renal dysfunction and severe left ventricular dysfunction.

Analysis of the sensitivity and specificity of noninvasive imaging tests for the diagnosis of renal artery stenosis.

BACKGROUND: Aging and atherosclerosis are related to renovascular hypertension in elderly individuals. Regardless of comorbidities, renal artery stenosis is itself an important cause of cardiovascular morbidity and mortality. OBJECTIVE: To define the sensitivity, specificity, positive predictive value, and negative predictive value of noninvasive imaging tests used in the diagnosis of renal artery stenosis. METHODS: In a group of 61 patients recruited, 122 arteries were analized, thus permitting the definition of sensitivity, specificity, and the relative contribution of each imaging study performed (Doppler, scintigraphy and computed tomographic angiography in comparison to renal arteriography). RESULTS: The mean age was 65.43 years (standard deviation: 8.7). Of the variables related to the study population that were compared to arteriography, two correlated with renal artery stenosis, renal dysfunction and triglycerides. The median glomerular filtration rate was 52.8 mL/min/m². Doppler showed sensitivity of 82.90%, specificity of 70%, a positive predictive value of 85% and negative predictive value of 66.70%. For tomography, sensitivity was 66.70%, specificity 80%, positive predictive value 87.50% and negative predictive value 55.20%. With these findings, we could identify the imaging tests that best detected stenosis. CONCLUSION: Tomography and Doppler showed good quality and efficacy in the diagnosis of renal artery stenosis, with Doppler having the advantage of not requiring the use of contrast medium for the assessment of a disease that is common in diabetics and is associated with renal dysfunction and severe left ventricular dysfunction.

Recent thymic emigrants are the preferential precursors of regulatory T cells differentiated in the periphery.

Most Forkhead box P3(+) (Foxp3(+)) CD4 regulatory T cell (Treg) precursors are newly formed thymocytes that acquire Foxp3 expression on antigen encounter in the thymus. Differentiation of Treg, however, can also occur in the periphery. What limits this second layer of self- and nonself-reactive Treg production in physiological conditions remains to be understood. In this work, we tested the hypothesis that, similarly to thymic Treg, the precursors of peripheral Treg are immature T cells. We show that CD4(+)CD8(-)Foxp3(-) thymocytes and recent thymic emigrants (RTEs), contrarily to peripheral naïve mature cells, efficiently differentiate into Treg on transfer into lymphopenic mice. By varying donor and recipient mice and conducting ex vivo assays, we document that the preferential conversion of newly formed T cells does not require intrathymic preactivation, is cell-intrinsic, and correlates with low and high sensitivity to natural inhibitors and inducers of Foxp3 expression, such as IL-6, T-cell receptor triggering, and TGF-ß. Finally, ex vivo analysis of human thymocytes and peripheral blood T cells revealed that human RTE and newly developed T cells share an increased potential to acquire a FOXP3(bright)CD25(high) Treg phenotype. Our findings indicating that RTEs are the precursors of Tregs differentiated in the periphery should guide the design of Treg-based therapies.

Sub-optimal CD4+ T-cell activation triggers autonomous TGF-ß-dependent conversion to Foxp3+ regulatory T cells.

Classical in vitro Treg conversion assays, which rely on optimal T-cell activation in the presence of exogenous TGF-ß, induce Foxp3 expression at a frequency far above that which is observed in vivo in Treg-dependent models of oral or transplantation tolerance. We have found that suboptimal murine T-cell activation in vitro results in induction of Foxp3 expression, in the absence of exogenous TGF-ß, at a frequency similar to that which we found in vivo upon anti-CD4-induced transplantation tolerance. We show that TCR triggering with either low-dose anti-CD3 or low-dose agonist peptide, as well as down-modulation of the TCR signal with non-depleting anti-CD4, promotes TGF-ß production by T cells, an event that precedes Foxp3 expression and is Foxp3 independent. These findings support the view that sub-immunogenic regimens lead to dominant tolerance as a result of T-cell intrinsic properties.

Cisto periodontal lateral - relato de caso e revisão de literatura / Lateral periodontal cyst - case report and literature review

Introdução: O cisto periodontal lateral é um tipo de cisto odontogênico, de etiologia desconhecida, cuja prevalência na população não é frequente. Essa lesão ocorre geralmente na região de pré-molares inferiores, é assintomática e, em alguns casos, ocasiona expansão da cortical óssea. Radiograficamente, apresenta radio-lucidez unilocular bem definida. Objetivo e relato de caso: Este estudo tem por objetivo relatar o caso de um paciente do gênero masculino, 44 anos de idade, que procurou atendimento com queixa de aumento de volume associado a desconforto na região do segundo pré-molar inferior direito. Após criterioso processo de diagnóstico, procedeu-se à excisão cirúrgica e o exame microscópico revelou se tratar de cisto periodontal lateral, conforme a hipótese de diagnóstico clínico prévia. Considerações finais: Esse relato de caso clínico discute a importância da utilização de um protocolo de diagnóstico diferencial para estabelecer a conduta terapêutica adequada ao paciente.

Cutting edge: Intrathymic differentiation of adaptive Foxp3+ regulatory T cells upon peripheral proinflammatory immunization.

Thymocytes differentiate into CD4(+) Foxp3(+) regulatory T cells (T(R)) upon interaction between their TCR and peptide-MHC II complexes locally expressed in the thymus. Conversion of naive CD4(+) T cells into T(R) can additionally take place in the periphery under noninflammatory conditions of Ag encounter. In this study, making use of TCR transgenic models naturally devoid of Foxp3(+) cells, we report de novo generation of T(R) upon a single footpad injection of Ag mixed with a classic proinflammatory adjuvant. Abrupt T(R) differentiation upon immunization occurred intrathymically and was essential for robust tolerance induction in a mouse model of spontaneous encephalomyelitis. This phenomenon could be attributed to a specific feature of thymocytes, which, in contrast to mature peripheral CD4(+) T cells, were insensitive to the inhibitory effects of IL-6 on the induction of Foxp3 expression. Our findings uncover a pathway for T(R) generation with major implications for immunity and tolerance induction.