Evaluación del control del Asma en República Dominicana: una perspectiva clínica / Evaluation of Asthma Control in the Dominican Republic: a Clinical Perspective

Introducción: El asma es una patología respiratoria caracterizada por inflamación cró-nica y reversible de las vías aéreas. Esta se asocia con factores de riesgo modificables y no modificables que influyen sobre su control y exacerbaciones. En países como Puer-to Rico y Cuba, la prevalencia del asma es significativamente mayor a la global (22,8%, 23% y 6,6%, respectivamente).

Introduction: Asthma is a respiratory pathology characterized by chronic and reversible airway inflammation. It is associated with modifiable and non-modifiable risk factors that influence its control and exacerbations. In countries such as Puerto Rico (22.8 %) and Cuba (23 %), the prevalence of asthma is significantly higher than the global prevalence (6.6 %).

Epstein-Barr virus in gastric cancer and association with 30 bp del-latent membrane protein 1 polymorphism.

OBJECTIVE: This study aimed to determine the frequencies of Epstein-Barr virus, types 1 and 2 infection, and 30 bp del-latent membrane protein 1 viral polymorphism in gastric adenocarcinomas, as well as to investigate the association between Epstein-Barr virus infection and tumor location, type, and the patient's sex. METHODS: Samples were collected from 38 patients treated at a university hospital in Rio de Janeiro, Brazil. Epstein-Barr virus detection and genotyping were performed by polymerase chain reaction, followed by polyacrylamide gel electrophoresis and staining by the silver nitrate method. RESULTS: Overall, 68.4% of patients had Epstein-Barr virus-positive tumors. Of these, 65.4% presented infection by Epstein-Barr virus type 1, 23.1% by Epstein-Barr virus type 2, and 11.5% had coinfection with types 1 and 2. The 30 bp del-latent membrane protein 1 polymorphism was found in 42.3% of Epstein-Barr virus-positive tumors, 23.1% had the wild-type virus, and 23.1% had the wild-type and the polymorphism concomitantly. In 11.5% of Epstein-Barr virus-positive tumors, it was impossible to determine whether there was polymorphism or not. Tumor location in the antrum (22 of 38) and diffuse type (27 of 38) were predominant. There was no significant difference in Epstein-Barr virus infection or the 30 bp del-latent membrane protein 1 polymorphism between men and women. CONCLUSION: Epstein-Barr virus infection was found in 68.4% of tumors investigated in this study. To the best of our knowledge, this is the first article showing the coinfection of Epstein-Barr virus types 1 and 2 in gastric carcinoma in Brazil.

Epstein-Barr virus in gastric cancer and association with 30 bp del-latent membrane protein 1 polymorphism

SUMMARY OBJECTIVE: This study aimed to determine the frequencies of Epstein-Barr virus, types 1 and 2 infection, and 30 bp del-latent membrane protein 1 viral polymorphism in gastric adenocarcinomas, as well as to investigate the association between Epstein-Barr virus infection and tumor location, type, and the patient's sex. METHODS: Samples were collected from 38 patients treated at a university hospital in Rio de Janeiro, Brazil. Epstein-Barr virus detection and genotyping were performed by polymerase chain reaction, followed by polyacrylamide gel electrophoresis and staining by the silver nitrate method. RESULTS: Overall, 68.4% of patients had Epstein-Barr virus-positive tumors. Of these, 65.4% presented infection by Epstein-Barr virus type 1, 23.1% by Epstein-Barr virus type 2, and 11.5% had coinfection with types 1 and 2. The 30 bp del-latent membrane protein 1 polymorphism was found in 42.3% of Epstein-Barr virus-positive tumors, 23.1% had the wild-type virus, and 23.1% had the wild-type and the polymorphism concomitantly. In 11.5% of Epstein-Barr virus-positive tumors, it was impossible to determine whether there was polymorphism or not. Tumor location in the antrum (22 of 38) and diffuse type (27 of 38) were predominant. There was no significant difference in Epstein-Barr virus infection or the 30 bp del-latent membrane protein 1 polymorphism between men and women. CONCLUSION: Epstein-Barr virus infection was found in 68.4% of tumors investigated in this study. To the best of our knowledge, this is the first article showing the coinfection of Epstein-Barr virus types 1 and 2 in gastric carcinoma in Brazil.

Transcriptome-based Phylogeny of the Semi-aquatic Bugs (Hemiptera: Heteroptera: Gerromorpha) Reveals Patterns of Lineage Expansion in a Series of New Adaptive Zones.

Key innovations enable access to new adaptive zones and are often linked to increased species diversification. As such, innovations have attracted much attention, yet their concrete consequences on the subsequent evolutionary trajectory and diversification of the bearing lineages remain unclear. Water striders and relatives (Hemiptera: Heteroptera: Gerromorpha) represent a monophyletic lineage of insects that transitioned to live on the water-air interface and that diversified to occupy ponds, puddles, streams, mangroves and even oceans. This lineage offers an excellent model to study the patterns and processes underlying species diversification following the conquest of new adaptive zones. However, such studies require a reliable and comprehensive phylogeny of the infraorder. Based on whole transcriptomic datasets of 97 species and fossil records, we reconstructed a new phylogeny of the Gerromorpha that resolved inconsistencies and uncovered strong support for previously unknown relationships between some important taxa. We then used this phylogeny to reconstruct the ancestral state of a set of adaptations associated with water surface invasion (fluid locomotion, dispersal and transition to saline waters) and sexual dimorphism. Our results uncovered important patterns and dynamics of phenotypic evolution, revealing how the initial event of water surface invasion enabled multiple subsequent transitions to new adaptive zones on the water surfaces. This phylogeny and the associated transcriptomic datasets constitute highly valuable resources, making Gerromorpha an attractive model lineage to study phenotypic evolution.

Oral Juvenile Xanthogranuloma: A Clinicopathological, Immunohistochemical and BRAF V600E Study of Five New Cases, with Literature Review.

Juvenile xanthogranuloma (JXG) is the most common form of non-Langerhans cell histiocytosis and oral mucosal involvement is exceedingly rare. Histiocytic disorders harbor activating mutations in MAPK pathway, including the report of BRAF V600E in JXG of extracutaneous site. However, no information is available for oral JXG. Herein, the clinicopathological and immunohistochemical features of five new oral JXG were evaluated in conjunction with literature review. Also, we assessed the BRAF V600E in oral samples. Five oral JXG were retrieved from pathology archives. Morphological and immunohistochemical analyses were performed. The BRAF V600E status was determined with TaqMan allele-specific qPCR. The series comprised of three female and two male patients, most of them adults, with a median age of 39 years (range 13-68 years). Clinically, the lesions appeared as asymptomatic solitary nodules, measuring until 2.5 cm, with more incident to the buccal mucosa. Morphologically, most of the cases presented classical histological features of JXG, with histiocytic cells consistent with the non-Langerhans cell immunophenotype. BRAF V600E was not detected in the cases tested. This is the first and largest published series of oral JXG affecting adults and a Brazilian population. The molecular pathogenesis of oral JXG remains unknown. Clinicians and pathologists must recognize JXG to avoid misdiagnoses with oral benign or malignant lesions.

Circulating antioxidant vitamins and copper in Azorean coronary artery disease patients under preventive medication - A case study.

BACKGROUND AND AIM: Oxidative stress and inflammation are conditions that are deeply involved in atherosclerosis and consequent coronary artery disease (CAD). Therefore, the aim of this study was to assess the relationship among circulating antioxidant vitamins (C, A, E), copper, and other pro- or antioxidant/inflammation markers in patients with and without CAD under preventive medication. SUBJECTS AND METHODS: 174 Azorean subjects symptomatic for CAD (age 56 ± 9y; 68 % men) submitted to coronary angiography were split into 2 groups: one formed by CAD patients (≥50 % stenosis in at least one major coronary vessel) and the other by non-CAD patients (<50 % stenosis). Both groups were age-, sex- and BMI-matched. Plasma levels of vitamins or copper were measured by HPLC and AAS, respectively. RESULTS AND CONCLUSIONS: Lower vitamin C levels were observed in CAD patients (mainly in women, who exhibited a high rate of diabetes mellitus) as compared to the non-CAD ones. Also, CAD patients (mainly men) exhibited significantly higher concentrations of plasma copper than their non-CAD counterparts (1.17 ± 0.3 mg/L vs. 1.09 ± 0.3 mg/L, p = 0.030). In bivariate analysis, plasma copper levels were positively associated with serum LDL-cholesterol (r=0.22; p = 0.004) and chiefly with C-reactive protein (r=0.40; p < 0.001). Furthermore, they were significantly lower in recurrent vs. non recurrent CAD patients (1.07±0.2 vs. 1.24±0.3 mg/L, p = 0.004). ROC analysis showed that plasma copper, whenever >1.06 mg/L, was an independent risk factor for CAD in primary prevention for men, which suggests that its levels can fluctuate with medical therapy (such as anti-inflammatory), thus indicating that copper is not a reliable marker for CAD. Moreover, plasma copper concentration was not associated with CAD severity. Yet, results do suggest that, even within its reference concentration range, it could be useful as an acute inflammation marker in CAD management.

Cysteine is a better predictor of coronary artery disease than conventional homocysteine in high-risk subjects under preventive medication.

BACKGROUND AND AIMS: In Portugal, The Azores Archipelago has the highest standardized mortality rate for CAD. Therefore, the aim of this study was to evaluate conventional risk factors, as well as plasma and erythrocyte aminothiol concentration in high-risk Azorean patients undergoing elective coronary angiography and to investigate whether any aminothiol was associated with CAD risk and severity. METHODS AND RESULTS: 174 subjects with symptomatic CAD (age 56±9y; 68% men) submitted to coronary angiography were split into 2 groups: one formed by CAD patients (≥50% stenosis in at least one major coronary vessel) and the other by non-CAD patients (<50% stenosis). Both groups were age-, sex- and BMI-matched. Plasma and erythrocyte aminothiol profiles were evaluated by RP-HPLC/FLD. CAD patients significantly exhibited both higher concentrations of plasma Cys and hypercysteinemia (Cys ≥ 300 µM) prevalence than those in the non-CAD group (261 ± 58 µM vs. 243 ± 56 µM; 22% vs. 10%, respectively). No differences were observed between groups regarding plasma Hcy levels or hyperhomocysteinemia prevalence. After adjustment for several confounders (including Hcy), subjects in the highest quartile of plasma Cys had a 3.31 (95% CI, 1.32-8.30, p = 0.011) fold risk for CAD, compared with those in the lowest quartiles. Furthermore, plasma Cys levels (but not Hcy) tended to increase with the number of stenotic vessels (1VD: 253 ± 64 µM; 2VD: 262 ± 52 µM; 3VD: 279 ± 57 µM, p = 0.129). CONCLUSION: Hypercysteinemia revealed to be a better predictor of CAD than hyperhomocysteinemia. Moreover, plasma Cys showed to be a useful biomarker for CAD both in primary and secondary preventions, seeming to resist better than Hcy to oral medication therapy.

Análise microbiológica da superfície de latas de cerveja: a importância do processo de higienização antes do consumo / Microbiological analysis of beer can: the importance of sanitation before consumption

A produção de bebidas enlatadas segue normas para controle sanitário, porém não é possível estimar as condições higiênicas dessas latas quando chegam ao consumidor. O objetivo do presente trabalho foi analisar externamente latas de cerveja sem selo de proteção, coletadas em prateleiras de supermercado, à temperatura ambiente, quanto à contagem microbiana. As latas foram coletadas, aleatoriamente, em prateleiras de supermercados de Juiz de Fora, MG, à temperatura ambiente e foram submetidas à contagem de micro-organismos aeróbios mesófilos pelo método do esfregaço de suabe. Os resultados demonstraram que as latas testadas sem higienização prévia apresentaram contagem microbiana elevada e que processos de higienização simples, como a lavagem somente com água, podem reduzir consideravelmente a quantidade de micro-organismos na embalagem. A população deve ser esclarecida e instruída a realizar o processo de higienização das latas antes do consumo.

Alterações hepáticas detectadas durante a inspeção post mortem de bovinos abatidos em um frigorífico sob serviço de inspeção federal / Hepatic pathologies detected during bovine post mortem inspection in a slaughterhouse under federal inspection

A inspeção de carnes é um método bastante eficiente na prevenção de problemas de saúde pública, além de diminuir perdas econômicas e aumentar a qualidade dos produtos cárneos que chegam ao consumidor. O objetivo do presente trabalho foi identificar as lesões patológicas que mais acometem o fígado bovino durante o abate dessa espécie em um frigorífico. Para realização desse trabalho foram observados os abates e a inspeção post mortem de 21.045 bovinos, nos meses de dezembro de 2016, janeiro e fevereiro de 2017, em um frigorífico sob Serviço de Inspeção Federal no município de Juiz de Fora, Minas Gerais. As principais alterações encontradas e suas frequências médias, em porcentagem, foram: abscesso 3,17%; cirrose 0,11%; congestão 0,25%; fasciolose 0,44%; telangiectasia 0,19% e tuberculose 0,09%. É possível identificar lesões hepáticas durante a inspeção post mortem de bovinos, sendo, no presente estudo, as alterações mais observadas abscesso e fasciolose.

Levantamento de dados epidemiológicos de surtos de doenças transmitidas por alimentos na cidade de Juiz de Fora, MG, no período de 2007 a 2017 / Data research of foodborne diseases outbreaks from the city of Juiz de Fora, MG, in the period from 2007 to 2017

O perfil epidemiológico das doenças transmitidas por alimentos (DTAs) no Brasil ainda é pouco conhecido, nem todos os estados e/ou municípios dispõem de estatísticas e levantamentos reais sobre as variáveis associadas a essas enfermidades. O objetivo do trabalho foi realizar um levantamento dos dados sobre surtos de origem alimentar ocorridos em Juiz de Fora, MG, no período de 2007 a 2017. Houve 21 notificações de surtos, e em 71,42% desses não se identificou o agente etiológico envolvido. Dos alimentos incriminados, em 66,66% dos casos, estes eram ou continham em sua composição produtos de origem animal. A residência foi o local mais identificado como de início da ocorrência de surtos, representando 28,57% dos casos. Faz-se necessário o desenvolvimento de políticas públicas para a correta notificação das DTAs e, ainda, a conscientização de manipuladores de alimentos quanto aos cuidados na conservação e manipulação dos mesmos, com o objetivo reduzir a ocorrência dessas enfermidades.

Qualidade microbiológica de carne de aves comercializada em feira livre na cidade de Salvador, Bahia, Brasil / Microbiological quality of poultry meat commercialized in street market in the city of Salvador, Bahia, Brazil

Objetivou-se avaliar a qualidade microbiológica de carne de aves comercializada na feira livre de São Joaquim na cidade de Salvador, Bahia, Brasil com base nas análises de presença de Salmonella spp. e contagens de Coliformes totais, Escherichia coli e Staphylococcus spp. Foram analisadas 24 amostras, sendo oito de galinha caipira abatida na hora, oito de frango de corte abatido na hora e oito de frango de corte já abatido comercializado em temperatura ambiente. Dos três tipos de produto analisados, o frango de corte já abatido apresentou os maiores níveis de contaminação pelos microrganismos pesquisados, com três (37,5%) amostras positivas para Salmonella spp. e contagens de Coliformes totais, Escherichia coli, Staphylococcus spp. variando entre 4,0 x 10³ a 7,9 x 10(5) UFC/g, 3,0 x 10² a 6,6 x 10(5) UFC/g e 4,0 x 10² a 3,68 x 10(5) UFC/g, respectivamente. Os resultados alertam para o risco do consumo de produtos de origem animal não inspecionado, reforçando a necessidade de condições higiênico-sanitárias e tecnológicas adequadas durante a obtenção e comercialização da carne de aves.

Qualidade microbiológica de ovos caipiras comercializados em feira livre em Salvador, Bahia / Microbiological quality of hick eggs commercialized in open market places in Salvador, Bahia

Este trabalho objetivou avaliar a qualidade microbiológica de ovos caipiras comercializados na feira livre de São Joaquim na cidade de Salvador – BA. Foram realizadas análises para verificar a presença de Salmonella spp. e, também, a ocorrência e quantificação de bactérias do grupo Coliformes totais, Escherichia coli e Staphylococcus spp. em oito amostras, totalizando 96 ovos, analisados separadamente em casca e conteúdo. A presença de Salmonella spp. não foi verificada na casca de nenhuma das amostras, no entanto em 50% das cascas de ovos analisadas foi verificada a ocorrência de Coliformes totais com contagens entre <10(2) e incontáveis colônias UFC/g, a ocorrência de Escherichia coli foi confirmada em 12,5% das cascas com contagens de <10(2) a 3,0 x 103 UFC/g, já Staphylococcus spp ocorreram na casca de 75% amostras analisadas variando entre <10(2) e incontáveis colônias UFC/g. Não foi verificada a ocorrência dos microrganismos pesquisados no conteúdo dos ovos analisados. Estes resultados indicam a necessidade de melhoria nas práticas de manipulação que visem à redução da incidência desses microrganismos nas cascas dos ovos.

Prejuízo econômico por abscessos vacinais retirados de carcaças de bovinos em um frigorífico sob serviço de inspeção federal em Minas Gerais

Abscessos são formações purulentas que surgem principalmente na região do pescoço das meias carcaças de bovinos em decorrência de reações vacinais. Essas lesões e possíveis partes contaminadas com pus são removidas durante a inspeção post mortem, de acordo com o Regulamento de Inspeção Industrial e Sanitária de Produtos de Origem Animal (RIISPOA), durante o processo de abate e são condenadas. A remoção do abscesso causa perda de porção cárnea, levando a uma redução do peso final da carcaça e consequente prejuízo econômico. Cuidados com o manejo vacinal são importantes para evitar o surgimento desses abscessos. O objetivo do presente estudo foi quantificar as meias carcaças com abscessos vacinais e avaliar o prejuízo econômico proveniente da excisão das partes cárneas contendo as lesões. O presente estudo foi realizado durante um mês em um frigorífico sob Serviço de Inspeção Federal localizado em Minas Gerais. Foram coletados os abscessos retirados pelo agente de inspeção das 100 primeiras carcaças de bovinos abatidos no dia, o que totalizou uma amostra de 20% da média abatida no mês. As carcaças com abscessos foram quantificadas e as partes excisadas foram pesadas diariamente e, no final do período, foi verificado o valor do prejuízo em arrobas. De um total de 2.000 carcaças inspecionadas e avaliadas para fim do estudo, 865 (43,25%) apresentaram um ou mais abscessos vacinais, resultando em um prejuízo de 237,100 kg removidos das carcaças, correspondendo a 0,274 kg por animal lesionado. O valor da perda no final do período de coleta foi de R$ 2.181,37 reais, o que leva a um decréscimo de R$ 2,52 reais por animal. A constatação de significativo prejuízo econômico decorrente da presença de abscessos vacinais nas carcaças inspecionadas demonstra a necessidade de se refletir sobre o manejo vacinal dos animais provenientes da região bem como a qualidade da vacina, com objetivo de diminuir a frequência dessas lesões, evitando assim que o pecuarista tenha prejuízo no abate de seu rebanho

Abscesses are purulent formations that appear mostly in the neck of bovine half-carcasses due to vaccine reactions. Such lesions and possibly pus-infected parts are removed during the post-mortem inspection service, in compliance with the Regulations of Industrial and Sanitary Inspection of Products of Animal Origin (RIISPOA, acronym in Portuguese), during the slaughtering process, and the procedure is condemned. The removal of the abscesses causes loss of meat, leading to a reduction of the final weight of the carcass and consequent economical losses. Safe animal management practices are important to avoid the occurrence of lesions. The aim of this study was to quantify the carcasses with vaccine abscesses and to assess the economic losses from the excision of the parts containing lesions. The present study was carried out over the course of one month in a slaughterhouse in Minas Gerais, under federal inspection. Abscesses were collected by the inspection agents from the first hundred bovine carcasses slaughtered each day, which, at the end of the study, was equivalent to 20% of the monthly slaughter average. The carcasses with abscesses were quantified, the excised parts were weighed daily and, at the end of the period, the loss values were verified in arrobas (one arroba is equivalent to 15 kilos). Out of a total of 2,000 carcasses inspected and evaluated for the purpose of this study, 865 (43,25%) registered one or more vaccine abscesses, resulting in a loss of 237.1 kg removed from the carcasses, corresponding to 0.274 kg per damaged animal. The final value of the losses was R$ 2,181.37, representing a decrease of R$ 2.52 per animal. The verification of significant economical losses due to the presence of abscesses in the inspected carcasses demonstrates the need for consideration about vaccination handling, as well as the quality of the vaccine, with the goal of reducing the frequency of such lesions, avoiding thus, with the procedure, possible losses sustained by the farmer in the slaughter of his/her herd

Prejuízo econômico por abscessos vacinais retirados de carcaças de bovinos em um frigorífico sob serviço de inspeção federal em Minas Gerais

Abscessos são formações purulentas que surgem principalmente na região do pescoço das meias carcaças de bovinos em decorrência de reações vacinais. Essas lesões e possíveis partes contaminadas com pus são removidas durante a inspeção post mortem, de acordo com o Regulamento de Inspeção Industrial e Sanitária de Produtos de Origem Animal (RIISPOA), durante o processo de abate e são condenadas. A remoção do abscesso causa perda de porção cárnea, levando a uma redução do peso final da carcaça e consequente prejuízo econômico. Cuidados com o manejo vacinal são importantes para evitar o surgimento desses abscessos. O objetivo do presente estudo foi quantificar as meias carcaças com abscessos vacinais e avaliar o prejuízo econômico proveniente da excisão das partes cárneas contendo as lesões. O presente estudo foi realizado durante um mês em um frigorífico sob Serviço de Inspeção Federal localizado em Minas Gerais. Foram coletados os abscessos retirados pelo agente de inspeção das 100 primeiras carcaças de bovinos abatidos no dia, o que totalizou uma amostra de 20% da média abatida no mês. As carcaças com abscessos foram quantificadas e as partes excisadas foram pesadas diariamente e, no final do período, foi verificado o valor do prejuízo em arrobas. De um total de 2.000 carcaças inspecionadas e avaliadas para fim do estudo, 865 (43,25%) apresentaram um ou mais abscessos vacinais, resultando em um prejuízo de 237,100 kg removidos das carcaças, correspondendo a 0,274 kg por animal lesionado. O valor da perda no final do período de coleta foi de R$ 2.181,37 reais, o que leva a um decréscimo de R$ 2,52 reais por animal. A constatação de significativo prejuízo econômico decorrente da presença de abscessos vacinais nas carcaças inspecionadas demonstra a necessidade de se refletir sobre o manejo vacinal dos animais provenientes da região bem como a qualidade da vacina, com objetivo de diminuir a frequência dessas lesões, evitando assim que o...

Abscesses are purulent formations that appear mostly in the neck of bovine half-carcasses due to vaccine reactions. Such lesions and possibly pus-infected parts are removed during the post-mortem inspection service, in compliance with the Regulations of Industrial and Sanitary Inspection of Products of Animal Origin (RIISPOA, acronym in Portuguese), during lhe slaughtering process, and the procedure is condemned. The removal of the abscesses causes loss of meat, leading to a reduction of the final weight of the carcass and consequent economical losses. Safe animal management practices are important to avoid the occurrence of lesions. The aim of this study was to quantify the carcasses with vaccine abscesses and to assess the economic losses from the excision of the parts containing lesions. The present study was carried out over the course of one month in a slaughterhouse in Minas Gerais, under federal inspection. Abscesses were collected by the inspection agents from the first hundred bovine carcasses slaughtered each day, which, at the end of the study, was equivalent to 20% of the monthly slaughter average. The carcasses with abscesses were quantified, the excised parts were weighed daily and, at the end of the period, the loss values were verified in arrobas (one arroba is equivalent to 15 kilos). Out of a total of 2,000 carcasses inspected and evaluated for the purpose of this study, 865 (43,25%) registered one or more vaccine abscesses, resulting in a loss of 237.1 kg removed from the carcasses, corresponding to 0.274 kg per damaged animal. The final value of the losses was R$ 2,181.37, representing a decrease of R$ 2.52 per animal. The verification of significant economical losses due to the presence of abscesses in the inspected carcasses demonstrates the need for consideration about vaccination handling, as well as the quality of the vaccine, with the goal of reducing the frequency of such lesions, avoiding thus, with the procedure...

The Effect of a Basic Basket on Tuberculosis Treatment Outcome in the Huambo Province, Angola / Efecto de una cesta básica alimentaria en el resultado del tratamiento de la tuberculosis en la provincia de Huambo, Angola

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Dabigatran reversal with idarucizumab in a patient undergoing heart transplantation: first European report.

BACKGROUND: Dabigatran is a direct thrombin inhibitor with a favorable effectiveness and safety profile when compared to vitamin K antagonists, both in randomized trials and real world registries of atrial fibrillation patients. Yet, physicians' fear of high bleeding risk scenarios in daily clinical practice still precludes a more widespread use of oral anticoagulation. We hereby report a successful case of dabigatran reversal with the novel monoclonal antibody fragment idarucizumab in a patient undergoing heart transplantation. CASE PRESENTATION: A 45-year old male patient on dabigatran for atrial fibrillation thromboprophylaxis was enlisted for heart transplantation due to end-stage ischemic heart failure. Upon donor availability and suitability and following the last intake of the drug 12 h previously, activated partial thromboplastin time was measured and found to be elevated. After general anesthesia and before extracorporeal circulation, idarucizumab was administered as two boluses of 2.5 g. Orthotopic heart transplantation ensued under full heparinization and cardiopulmonary bypass. Total chest tube output was 1125 mL after 3 days and 4 units of fresh frozen plasma and one platelet pool were administered in the operating room without further need for blood products. The post-operative period was uneventful. CONCLUSIONS: Idarucizumab was associated with an effective hemostasis in the setting of heart transplantation. Dabigatran may be considered as an alternative to vitamin K antagonists in heart transplant candidates with an indication for oral anticoagulation.

Reator anaeróbio tipo UASB conjugado com processo Fenton para remoção de cor e demanda química de oxigênio de água residuária sintética de indústria têxtil / Anaerobic reactor type UASB conjunction with process Fenton to remove color and chemical oxygen demand textile industry of synthetic wastewater

RESUMO A contaminação por despejos de efluentes industriais têxteis tem sido uma preocupação emergente de pesquisadores e ambientalistas, pois esses apresentam composição extremamente heterogênea e grande quantidade de material tóxico e recalcitrante, o que dificulta seu tratamento. Durante o processamento têxtil, uma ampla gama de corantes é liberada e alguns desses, como os azo corantes, que se caracterizam pela função azo (-N=N-) ligada a grupos aromáticos e podem ser tóxicos, carcinogênicos e/ou mutagênicos. Em vista disso, esta pesquisa teve como principal objetivo avaliar os benefícios da utilização de um reator anaeróbio tipo reator anaeróbico de fluxo ascendente com manta de lodo (UABS), seguido de processo oxidativo avançado (POA) do tipo Fenton na degradação de cor e demanda química de oxigênio (DQO) de efluente sintético de indústria têxtil. Com os resultados, foram verificadas remoções de DQO em torno de 82,0% para o reator UASB e de 95,6% para o conjunto. A cor alcançou 96,1% de remoção no reator UASB e 100,0% ao final do processo.

ABSTRACT Contamination by textile industrial wastewater discharges has been an emerging concern of researchers and environmentalists, as they have extremely heterogeneous composition and loads of toxic and recalcitrant material, which complicates treatment. In the textile processing, a wide range of dye is released and some of these, such as dyes, azo, characterized by the feature azo (-N=N-) attached to aromatic groups and may be toxic, carcinogenic and/or mutagenic. In view of this, this research aimed to evaluate the benefits of using an anaerobic reactor type anaerobic reactor upflow sludge blanket (UABS), followed by advanced oxidation process (AOP) type Fenton in color degradation and chemical oxygen demand (COD) of synthetic textile industry effluent. From the results of COD removal was observed at around 82.0% for the UASB reactor and 95.6% for the group. The color reached 96.1% removal in UASB reactor and 100.0% at the end of the process.

Matrix metalloproteinase-2 and metalloproteinase-9 activities are associated with blood-brain barrier dysfunction in an animal model of severe sepsis.

There is no description on the mechanisms associated with blood-brain barrier (BBB) disruption during sepsis development. Thus, we here determined changes in permeability of the BBB in an animal model of severe sepsis and the role of matrix metalloproteinase (MMP)-2 and MMP-9 in the dysfunction of the BBB. Sepsis was induced in Wistar rats by cecal ligation and perforation. BBB permeability was assessed using the Evans blue dye method. The content of MMP-2 and MMP-9 in the cerebral microvessels was determined by western blot. The activity of MMP-2 and MMP-9 was determined using zymography. An inhibitor of MMP-2 and MMP-9 or specific inhibitors of MMP-2 or MMP-9 were administered to define the role of MMPs on BBB permeability, brain inflammatory response, and sepsis-induced cognitive alterations. The increase of BBB permeability is time-related to the increase of MMP-9 and MMP-2 in the microvessels, both in cortex and hippocampus. Using an MMP-2 and MMP-9 inhibitor, or specific MMP-2 or MMP-9 inhibitors, the increase in the permeability of the BBB was reversed. This was associated with lower brain levels of interleukin (IL)-6 and lower oxidative damage. In contrast, only the inhibition of both MMP-9 and MMP-2 was able to improve acute cognitive alterations associated with sepsis. In conclusion, MMP-2 and MMP-9 activation seems to be a major step in BBB dysfunction, but BBB dysfunction seems not to be associated with acute cognitive dysfunction during sepsis development.