[Fibrillary glomerulonephritis]. / La glomérulonéphrite fibrillaire.

Fibrillary glomerulonephritis (FGN) is a glomerular disease described since 1977, with a prevalence in renal biopsies of less than 1%. It presents as renal failure, proteinuria, haematuria and hypertension in middle-aged adults. It is defined histologically, using light microscopy, which reveals organised deposits of fibrils measuring around 20nm, which are negative for Congo red staining. Electron microscopy, the first gold standard for diagnosis, has now been superseded by immunohistochemistry using the anti-DNAJB9 antibody. The discovery of this molecule has revolutionised the diagnosis of GNF, thanks to its excellent sensitivity and specificity (98% and 99% respectively). The association of GNF with hepatitis C virus, autoimmune diseases, neoplasia or haemopathy is debated. Renal prognosis is guarded, with 50% of patients progressing to end-stage renal failure within 2 to 4years of diagnosis. In the absence of randomised controlled trials, the recommended treatment is based on nephroprotective measures, corticosteroid therapy and possibly a second-line immunosuppressant such as rituximab. After renal transplantation, recovery or recurrence is possible. The pathophysiology of the disease is still poorly understood, and further studies are needed.

Triclabendazole and clofazimine reduce replication and spermine uptake in vitro in Toxoplasma gondii.

Toxoplasmosis is a worldwide zoonosis caused by the protozoan parasite Toxoplasma gondii. Although this infection is generally asymptomatic in immunocompetent individuals, it can cause serious clinical manifestations in newborns with congenital infection or in immunocompromised patients. As current treatments are not always well tolerated, there is an urgent need to find new drugs against human toxoplasmosis. Drug repurposing has gained considerable momentum in the last decade and is a particularly attractive approach for the search of therapeutic alternatives to treat rare and neglected diseases. Thus, in this study, we investigated the antiproliferative effect of several repurposed drugs. Of these, clofazimine and triclabendazole displayed a higher selectivity against T. gondii, affecting its replication. Furthermore, both compounds inhibited spermine incorporation into the parasite, which is necessary for the formation of other polyamines. The data reported here indicate that clofazimine and triclabendazole could be used for the treatment of human toxoplasmosis and confirms that drug repurposing is an excellent strategy to find new therapeutic targets of intervention.

Growth regulation of bermudagrass (Cynodon dactylon) and zoysiagrass (Zoysia japonica) with glyphosate.

Glyphosate can generate positive effects on turfgrass maintenance as a form of growth control by decreasing the expenses associated with mowing. However, there is little information about the effects of this herbicide on turfgrasses. This study aimed to evaluate the response of bermudagrass and zoysiagrass to the herbicide glyphosate as a growth regulator. Two studies were performed in a greenhouse and repeated at different times. The treatments involved application of glyphosate at 10 different rates (0, 5.625, 11.25, 22.5, 45, 90, 180, 360, 720, and 1.440 g ae ha-1) with four replicates. Evaluations of green cover by digital analysis, injury, and plant height were performed at 7, 14, 21, and 28 days after application, and shoot dry matter of clippings was determined for the last evaluation period. Bermudagrass and zoysiagrass presented variedtolerance to glyphosate toxicity. Overall, the digital analysis showed that green content was negatively influenced by the increase in visual injury caused by glyphosate application. Moreover, increasing the glyphosate rate decreased plant height and shoot dry matter in both turfgrasses. Glyphosate application rates up to 45 g ae ha-1 for bermudagrass and 90 g ae ha-1 for zoysiagrass decreased plant growth without affecting the factors analyzed in this study.

Bioecological aspects of triatomines and marsupials as wild Trypanosoma cruzi reservoirs in urban, peri-urban and rural areas in the Western Brazilian Amazon.

In the Amazon region, Trypanosoma cruzi transmission cycles involve a great diversity of Triatominae vectors and mammal reservoirs. Some Rhodnius spp. mainly inhabit palm trees that act as microhabitats for hosts and vectors. The current study aimed to describe aspects of the bio-ecology of the vectors and reservoirs of T. cruzi in relation to human populations resident near areas with large quantities of palm trees, in rural, peri-urban and urban collection environments, located in the Western Brazilian Amazon. Rhodnius pictipes and Didelphis marsupialis were respectively the most predominant vector and reservoir, with rates of 71% for R. pictipes and 96.5% for D. marsupialis. The vast majority of T. cruzi isolates clustered with TcI. The most prevalent haplotype was TcI COII1 (69.7%). Mauritia flexuosa and Attalea phalerata were the main ecological indicators of infestation by triatomines. Birds were the most common food source (27,71%). T. cruzi isolated from R. robustus has the haplotype HUM-13, previously detected in a chronic Chagas patient living in the same area. Our results demonstrate the relevance of this study, with the occurrence of elevated infection rates in animals, and suggest the importance of the Amazon zones where there is a risk of infection in humans.

Stimulation action of mefenpyr-diethyl on soybean, wheat, and signal grass plants.

Mefenpyr-diethyl is a safener used for protection of cereal plants under applications of ACCase and ALS inhibitor herbicides. Current studies are describing safeners using a new approach, relating these products to stimulation action on plants. The objective of this work was to evaluate the stimulation action of mefenpyr-diethyl on soybean, wheat, and signal grass plants. The experiment was conducted in a greenhouse, under a completely randomized design, with four replications, in two seasons. Mefenpyr-diethyl (50 g a.i. ha-1) was applied on soybean plants (at V4 stage), and wheat and signal grass plants (both with 15 cm height). The variables evaluated were plant height, dry matter, and lipid content of the three species, and number of tillers of wheat and signal grass plants. The application of mefenpyr-diethyl in the first season increased the number of tillers of wheat and height of soybean plants. The soybean presented 24 and 14% more dry matter than the control in the first and second season, respectively, and 0.5% more lipid content in plants treated with mefenpyr-diethyl. These results show the stimulation action of mefenpyr-diethyl on wheat and soybean plants, denoting its potential for growth promotion and indicating the need for studies with this approach. No effect was found for the signal grass plants.

Diseases and access to treatment by the Peruvian prison population: an analysis according to gender.

OBJECTIVE: In Peru, prisons are spaces with overcrowding, deteriorated infrastructure, poor sanitary conditions and difficult access to medical treatment. The objective of this study is to estimate the burden of disease and access to treatment for different morbidities in the Peruvian inmate population. METHODS: An analysis of secondary data of the First National Penitentiary Census (PCNP) 2016 in Peru was carried out. The absolute frequencies and percentages of each self-reported health condition, the presence of a diagnosis of a disease before entering the prison system and access to treatment were obtained. RESULTS: 74,130 inmates were included in the analysis. The most common diseases in prisons are depression (9.6%), anxiety (8.6%), chronic lung disease (8.4%) and arterial hypertension (6.9%). All diseases included, with the exception of hepatitis, have a diagnostic before the incarceration of less than 60%. Access to medical treatment was higher in women than in men and in general, mental health illnesses had low access to medical treatment. CONCLUSIONS: Chronic and infectious diseases are frequent in those deprived of liberty, with mental health problems being more prevalent in women. In general, access to treatment is low, especially in men and for mental health illnesses. This situation reflects the need to develop intervention programs that promote health and increase the universality of health care in those deprived of liberty.

Enfermedades y acceso a tratamiento de la población penitenciaria peruana: un análisis según el sexo / Diseases and access to treatment by the Peruvian prison population: an analysis according to gender

OBJETIVO: En Perú, las prisiones son espacios con hacinamiento, infraestructura deteriorada, malas condiciones sanitarias y difícil acceso a tratamiento médico. El objetivo de este estudio es estimar la carga de enfermedad y el acceso a tratamiento para diferentes morbilidades en la población peruana privada de libertad. MÉTODOS: Se realizó un análisis de datos secundarios del Primer Censo Nacional de Penitenciarias (PCNP) 2016 en Perú. Se obtuvieron las frecuencias absolutas y los porcentajes de cada condición de salud declaradas por el privado de libertad, de la presencia de un diagnóstico de enfermedad antes de ingresar al sistema penitenciario y del acceso a un tratamiento médico. RESULTADOS: Se incluyeron en el análisis a 74.130 personas privadas de libertad. Las enfermedades más comunes en las prisiones son: depresión (9,6%), ansiedad (8,6%), enfermedad pulmonar crónica (8,4%) e hipertensión arterial (6,9%). Todas las enfermedades incluidas, a excepción de la hepatitis, tienen un porcentaje de diagnóstico inferior al 60% antes de ingresar en el sistema penitenciario. El acceso a tratamiento médico fue mayor en mujeres que en hombres y, en general, las enfermedades de salud mental presentaron un bajo acceso al tratamiento médico. CONCLUSIONES: Las enfermedades crónicas e infectocontagiosas son frecuentes en las personas privadas de libertad, siendo los problemas de salud mental más prevalentes en mujeres. En general, el acceso a tratamiento es bajo, especialmente en hombres y para las enfermedades de salud mental. Esta situación refleja la necesidad de desarrollar programas de intervención que promuevan la salud e incrementen la universalidad del cuidado de la salud de dichas personas

OBJECTIVE: In Peru, prisons are spaces with overcrowding, deteriorated infrastructure, poor sanitary conditions and difficult access to medical treatment. The objective of this study is to estimate the burden of disease and access to treatment for different morbidities in the Peruvian inmate population. METHODS: An analysis of secondary data of the First National Penitentiary Census (PCNP) 2016 in Peru was carried out. The absolute frequencies and percentages of each self-reported health condition, the presence of a diagnosis of a disease before entering the prison system and access to treatment were obtained. RESULTS: 74,130 inmates were included in the analysis. The most common diseases in prisons are depression (9.6%), anxiety (8.6%), chronic lung disease (8.4%) and arterial hypertension (6.9%). All diseases included, with the exception of hepatitis, have a diagnostic before the incarceration of less than 60%. Access to medical treatment was higher in women than in men and in general, mental health illnesses had low access to medical treatment. CONCLUSIONS: Chronic and infectious diseases are frequent in those deprived of liberty, with mental health problems being more prevalent in women. In general, access to treatment is low, especially in men and for mental health illnesses. This situation reflects the need to develop intervention programs that promote health and increase the universality of health care in those deprived of liberty

Respuesta a carta: Investigaciones sobre problemas de salud en la población penitenciaria peruana / Response to the letter: Research on health problems in the Peruvian prison system

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The role of G protein-coupled estrogen receptor 1 on neurological disorders.

G protein-coupled estrogen receptor 1 (GPER) is a membrane-associated estrogen receptor (ER) associated with rapid estrogen-mediated effects. Over recent years GPER emerged has a potential therapeutic target to induce neuroprotection, avoiding the side effects elicited by the activation of classical ERs. The putative neuroprotection triggered by GPER selective activation was demonstrated in mood disorders, Alzheimer's disease or Parkinson's disease of male and female in vivo rodent models. In others, like ischemic stroke, the results are contradictory and currently there is no consensus on the role played by this receptor. However, it seems clear that sex is a biological variable that may impact the results. The major objective of this review is to provide an overview about the physiological effects of GPER in the brain and its putative contribution in neurodegenerative disorders, discussing the data about the signaling pathways involved, as well as, the diverse effects observed.

Characterization of radon levels in soil and groundwater in the North Maladeta Fault area (Central Pyrenees) and their effects on indoor radon concentration in a thermal spa.

Radon levels in the soil and groundwater in the North Maladeta Fault area (located in the Aran Valley sector, Central Pyrenees) are analysed from both geological and radiation protection perspectives. This area is characterized by the presence of two important normal faults: the North Maladeta fault (NMF) and the Tredós Fault (TF). Two primary aspects make this study interesting: (i) the NMF shows geomorphic evidence of neotectonic activity and (ii) the presence of a thermal spa, Banhs de Tredós, which exploits one of the several natural springs of the area and needs to be evaluated for radiation dosing from radon according to the European regulation on basic safety standards for protection against ionizing radiation. The average soil radon and thoron concentrations along a profile perpendicular to the two normal faults - 22 ±â€¯3 kBq·m-3 and 34 ±â€¯3 kBq·m-3, respectively - are not high and can be compared to the radionuclide content of the granitic rocks of the area, 25 ±â€¯4 Bq·kg-1 for 226Ra and 38 ±â€¯2 Bq·kg-1 for 224Ra. However, the hypothesis that the normal faults are still active is supported by the presence of anomalies in both the soil radon and thoron levels that are unlikely to be of local origin together with the presence of similar anomalies in CO2 fluxes and the fact that the highest groundwater radon values are located close to the normal faults. Additionally, groundwater 222Rn data have complemented the hydrochemistry data, enabling researchers to better distinguish between water pathways in the granitic and non-granitic aquifers. Indoor radon levels in the spa vary within a wide range, [7-1664] Bq·m-3 because the groundwater used in the treatment rooms is the primary source of radon in the air. Tap water radon levels inside the spa present an average value of 50 ±â€¯8 kBq·m-3, which does not exceed the level stipulated by the Spanish Nuclear Safety Council (CSN) of 100 kBq·m-3 for water used for human consumption. This finding implies that even relatively low radon concentration values in water can constitute a relevant indoor radon source when the transfer from water to indoor air is efficient. The estimated effective dose range of values for a spa worker due to radon inhalation is [1-9] mSv·y-1. The use of annual averaged radon concentration values may significantly underestimate the dose in these situations; therefore, a detailed dynamic study must be performed by considering the time that the workers spend in the spa.

131I-Induced Graves' disease in patients treated for toxic multinodular goitre: systematic review and descriptive analysis.

BACKGROUND: Graves' disease (GD) arising after the treatment of toxic multinodular goitre (TMNG) with radioiodine has long been described but it remained unclear whether GD was in fact iodine induced, its incidence, risk factors, natural history and treatment outcomes. METHODS: A systematic search using The Cochrane Library, Medline and PubMed Central allowed the pooling of data from 3633 patients with thyroid autonomy, 1340 patients with TMNG, to fill gaps in knowledge, regarding the clinical expression of iodine-induced GD (131I-IGD) in adults. RESULTS: 131I-IGD developed in 0-5.3% of those with thyroid autonomy (first year) and in 5-5.4% of those with TMNG, 3-6 months after treatment. Patients with toxic adenoma were less affected. 131I-IGD was more common in patients with pre-treatment direct or indirect signs of autoimmunity: positive anti-TPO (p < 0.05), glandular hypoechogenicity, TRAbs within reference range, diffuse uptake on 99mTc-pertechnetate scans (p < 0.05), findings that may increase the risk tenfold. 131I-IGD manifested 3 months after 131I, justifying 15.4-29% of cases of relapse. The rate of spontaneous remission was 17-20% (6 months) and the rate of relapse after a second 131I treatment 22-25%. The use of an uptake-based administered 131I activity led to a greater proportion of euthyroid patients (78% compared to 25-50% with the mass-based approach). CONCLUSIONS: GD may be triggered by 131I. The incidence of the condition is low. Several risk factors were consistently identified; some have shown to raise the risk significantly. 131I-IGD seems more treatment resistant than iodine-independent GD and the best resolution rates were achieved with uptake-based selected iodine activities.

Pregnancy rate in dairy cows treated with progesterone for six days during estrus synchronization with PGF2α.

The present study evaluated the effect of progesterone supplementation during a double PGF2α injection synchronization protocol on pregnancy per artificial insemination (P/AI) and on the incidence of twin births. Seven hundred and eighty three dairy cows were synchronized with two injections of PGF2α 14 days apart, starting on day 35 postpartum for their first postpartum insemination. Six days before the second PGF2α injection, cows were treated either with a progesterone-releasing intravaginal device (PRID-Delta) and an intramuscular injection of 500mg of progesterone (n=387) or served as control (n=396) and did not receive progesterone treatment. Cows were inseminated 12h after being detected in estrus. Pregnancy was diagnosed 40-45 days later by transrectal palpation. Progesterone administration improved (P<0.05) the percentage of cows detected in estrus in multiparous [(192/255) 75% vs (161/267) 60%], but not in primiparous cows [93/132 (70%) vs 90/129 (70%)]. Progesterone treatment increased P/AI in multiparous [53/192 (28%) vs 27/161 (17%)] but not in primiparous cows [25/93 (27%) vs 29/90 (32%)]. The incidence of twin births tended to be lower (P=0.09) in cows treated with progesterone [1/74 (1%)] than in the control group [4/53 (7%)]. It is concluded that progesterone administration during estrus synchronization with two PGF2α injections in dairy cows improves estral response and increases P/AI in multiparous, but not in primiparous cows, and tended to decrease the incidence of twin births.

Soil radon dynamics in the Amer fault zone: An example of very high seasonal variations.

Soil radon levels of the Amer fault zone have been measured for a 4 year-period with the aim of checking seasonal fluctuations obtained in previous studies and to understand radon origin and dynamics. In this manuscript additional results are presented: updated continuous and integrated soil radon measurements, radionuclide content of soil materials and a detailed analysis of an urban profile by means of the electrical resistivity imaging technique and punctual soil radon, thoron and CO2 measurements. Integrated and continuous measurements present a wide range of values, [0.2-151.6] kBq m(-3) for radon, [4.5-39.6] kBq m(-3) for thoron and [4.0-71.2] g m(-2) day(-1) for CO2. The highest soil radon levels in the vicinity of the Amer fault (>40 kBq m(-3)) are found close to the fractured areas and present very important fluctuations repeated every year, with values in summer much higher than in winter, confirming previous studies. The highest radon values, up to 150 kBq m(-3), do not have a local origin because the mean value of radium concentration in this soil (19 ± 5 Bq kg(-1)) could not explain these values. Then soil radon migration through the fractures, influenced by atmospheric parameters, is assumed to account for such a high seasonal fluctuation. As main conclusion, in fractured areas, seasonal variations of soil radon concentration can be very important even in places where average soil radon concentration and radium content are not especially high. In these cases the migration capability of the soil is given not by intrinsic permeability but by the fracture structure. Potential risk estimation based on soil radon concentration and intrinsic permeability must be complemented with geological information in fractured systems.

Profile of depressive symptoms in women in the perinatal and outside the perinatal period: similar or not?

PURPOSES: To analyze which Beck Depression Inventory-II (BDI-II) and Postpartum Depression Screening Scores (PDSS) total and dimensional scores, as well as symptomatic answers proportions significantly differ between women in the perinatal period (pregnant/postpartum) without major depression, with major depression and women outside the perinatal period. METHODS: 572 pregnant women in the third trimester completed Beck Depression Inventory-II and Postpartum Depression Screening Scale and were assessed with the Diagnostic Interview for Genetic Studies. 417 of these were also assessed (with the same instruments) at three months postpartum. Ninety non-pregnant women or that did not have a child in the last year (mean age=29.42±7.159 years) also filled in the questionnaires. RESULTS: Non-depressed pregnant women showed lower scores than depressed pregnant women and higher scores than women outside the perinatal period in the BDI-II total score and in its Somatic-Anxiety dimension. Non-depressed postpartum women showed significantly higher scores than women outside the perinatal period only at Sleep/Eating Disturbances. Compared to women outside the perinatal period, pregnant women without depression presented higher scores only in the somatic items. Women with vs. without depression in the postpartum period did not significantly differ and both presented higher scores than women outside the perinatal period in the proportions of loss of energy and sleep changes. LIMITATIONS: Women outside the perinatal period were not diagnosed for the presence of a depressive disorder, but their BDI-II mean score was similar to the figures reported worldwide regarding women in childbearing age. CONCLUSION: In the perinatal period, most particularly at pregnancy, women experience significant somatic changes even if not clinically depressed. Cognitive-affective symptoms are more useful when assessing the presence of perinatal depression.

Análise de crescimento de Bixa orellana L. sob efeito da inoculação micorrízica e adubação fosfatada / Analyses of Bixa orellana L. growth under the effects of mycorrhizal inoculation and phosphate fertilization

Este estudo objetivou avaliar o desenvolvimento de Bixa orellana L. em condições de viveiro sob efeito da inoculação micorrízica e adubação fosfatada. As plantas foram cultivadas em sacos de polietileno com 0,18 X 0,30 m e capacidade de 1,3 kg de substrato. O delineamento experimental utilizado foi inteiramente casualizado com seis tratamentos e trinta repetições. As dosagens de fósforo utilizadas foram 0, 4.200 e 8.400 g m-3 de substrato. O fungo micorrízico arbuscular (FMA) da espécie Glomus clarum, foi utilizado em metade dos tratamentos (com e sem micorrizas) com inoculação de 2 g do fungo. As avaliações ocorreram 30, 60, 90 e 120 dias após a emergência das plântulas. Determinou-se a massa seca de folhas, área foliar, massa seca total, razão de área foliar, área foliar específica, taxa assimilatória líquida, taxa de crescimento relativo e taxa de crescimento absoluto. O fungo micorrízico facilita a absorção de fósforo pelo urucum, atendendo a sua exigência em relação ao nutriente. A dose de fósforo de 4.200 g m-3 em associação com FMA Glomus clarum ou 8.400 g m-3, com ou sem essa associação, são indicadas para o crescimento de plantas de urucum em viveiro, por promoverem adequadas respostas dos índices fisiológicos, contribuindo com seu desenvolvimento.

This study aimed to evaluate the development of Bixa orellana L. under nursery conditions and subjected to the effects of mycorrhizal inoculation and phosphate fertilization. The plants were grown in polyethylene bags with dimensions of 0.18 x 0.30 m and capacity of 1.3 kg substrate. The adopted experimental design was completely randomized with six treatments and thirty replicates. The used phosphorus levels were 0, 4.200 and 8.400 g m-3 substrate. The arbuscular mycorrhizal fungus (AMF) of the species Glomus clarum was used in half of the treatments (with and without mycorrhizae) with inoculation of 2 g of the fungus. Evaluations occurred at 30, 60, 90 and 120 days after the emergence of seedlings. Leaf dry mass, leaf area, total dry mass, leaf area ratio, specific leaf area, net assimilation rate, relative growth rate and absolute growth rate were determined. The mycorrhizal fungus facilitates phosphorus uptake by annatto, fulfilling its requirement for the nutrient. The phosphorus level of 4.200 g m-3 in association with Glomus clarum or 8.400 g m-3, with or without this association, are indicated for annatto plant growth in nurseries since they promote appropriate responses of physiological indexes, contributing to the plant development.

Role of radiology in a national initiative to interdict drug smuggling: the Dutch experience.

OBJECTIVE: The purpose of this pictorial essay is to describe the role of radiology in a national initiative to intercept illegal narcotics concealed within the bodies of human transporters. CONCLUSION: Radiologic examination is increasingly important in identifying intracorporeal drug smuggling as improved wrapping techniques undermine the usefulness of blood and urine testing and clinical observation. Detection rates of high accuracy, sensitivity, and specificity are achieved by experienced radiologists.

[Harvard: historical representation of anesthesia in art]. / Harvard, histórica representación de la anestesia en el arte.

This article is about the use of ether as a general anesthetic that was used for the first time by T. Morton at Harvard University. It was a landmark in future surgical procedures and this discovery was documented by the painting of the Robert Hinckey and it has been used for teaching history of medicine.

[The Ehlers-Danlos syndrome type III and type IV]. / Síndrome de Ehlers-Danlos tipo III y tipo IV.

The Ehlers-Danlos Syndrome (EDS) is a collagen disease characterized by joint hypermobility, skin hyper-extensibility and generalized tissue fragility. It is usually inherited in an autosomal dominant manner and they differ from each other in gene mutation involved in the structure of different types of collagen. We report two female patients with a diagnosis of EDS Type III and Type IV with different clinical manifestations, evolution and prognosis. The first case, EDS Type III, presented marked joint hypermobility and skin hyper-extensibility, and the second case, EDS Type IV, arterial rupture leading to extensive bruising, obstetrics complications and skin hyper-extensibility.