Race (black-white) and sex inequalities in tooth loss: A population-based study.

The effect of health inequalities is determined by different socioeconomic, sex, and race conditions. This study aimed to analyze the association of tooth loss with race (defined by self-reported skin color) and sex. Based on the hypothesis that the association between tooth loss and race may be modified by sex, we also aimed to evaluate possible interactions between race and sex in association with this event, in a population-based study in the city of Campinas, Brazil. A directed acyclic graph was used to select covariates. The prevalence, of tooth loss was 19% higher in black women compared to white men (Prevalence ratio [PR]: 1.19; 95%CI: 1.05-1.34). Moreover, the prevalence of tooth loss in black women was 26% higher than in white women (PR: 1.26; 95%CI: 1.13-1.42); and, within the strata of black people, black women had 14% higher dental loss (PR: 1.14; 95%CI: 1.02-1.27) compared to black men. This study found a significant interaction between race and sex in tooth loss, with a disadvantage for black women. In addition, this work contributes to the discussion of health inequities and can support policies for the provision of universal dental care.

Strategies for laboratory professionals to drive laboratory stewardship.

Appropriate laboratory testing is critical in today's healthcare environment that aims to improve patient care while reducing cost. In recent years, laboratory stewardship has emerged as a strategy for assuring quality in laboratory medicine with the goal of providing the right test, for the right patient, at the right time. Implementing a laboratory stewardship program now presents a valuable opportunity for laboratory professionals to exercise leadership within health systems and to drive change toward realizing aims in healthcare. The proposed framework for program implementation includes 5 key elements: 1) a clear vision and organizational alignment; 2) appropriate skills for program execution and management; 3) resources to support the program; 4) incentives to motivate participation; and, 5) a plan of action that articulates program objectives and metrics. This framework builds upon principles of change management, with emphasis on engagement with clinical and administrative stakeholders and the use of clinical data as the basis for change. These strategies enable laboratory professionals to cultivate organizational support for improving laboratory use and take a leading role in providing high-quality patient care.

A glycan gate controls opening of the SARS-CoV-2 spike protein

SARS-CoV-2 infection is controlled by the opening of the spike protein receptor binding domain (RBD), which transitions from a glycan-shielded "down" to an exposed "up" state in order to bind the human ACE2 receptor and infect cells. While snapshots of the "up" and "down" states have been obtained by cryoEM and cryoET, details of the RBD opening transition evade experimental characterization. Here, over 130 s of weighted ensemble (WE) simulations of the fully glycosylated spike ectodomain allow us to characterize more than 300 continuous, kinetically unbiased RBD opening pathways. Together with ManifoldEM analysis of cryo-EM data and biolayer interferometry experiments, we reveal a gating role for the N-glycan at position N343, which facilitates RBD opening. Residues D405, R408, and D427 also participate. The atomic-level characterization of the glycosylated spike activation mechanism provided herein achieves a new high-water mark for ensemble pathway simulations and offers a foundation for understanding the fundamental mechanisms of SARS-CoV-2 viral entry and infection.

Quantification of Treg cells in peripheral blood and lymph nodes of dogs with multicentric lymphoma / Quantificação de células Treg no sangue periférico e linfonodos de cães com linfoma multicêntrico

Lymphoma is a malignant tumor characterized by cell proliferation of lymphoid origin and corresponds to 90% of all hematopoietic neoplasms of dogs. Regulatory T cells (Tregs) have been the target of many investigations in oncology due to their potential of down-regulating immune responses, as well as ensuring the maintenance of active mechanisms of tumor suppression. The aims of the present study were to compare the percentage of Tregs in peripheral blood between dogs with multicentric lymphoma and healthy animals, together with the percentage of Tregs in peripheral blood and lymph nodes of dogs with multicentric lymphoma. Twenty-six animals were enrolled in the study: 10 healthy dogs comprised the control group (CG) and 16 dogs with multicentric lymphoma comprised the Lymphoma Group (LG). We observed that dogs in the LG showed a significantly higher Tregs expression in peripheral blood compared to the CG. No significant difference was observed between Tregs expression in lymph nodes and peripheral blood of the LG, however. With these results, it is possible to conclude that multicentric lymphoma is a neoplasm with high Tregs expression, which poses this as a condition of interest when investigating treatments that can suppress Regulatory T cells.(AU)

O linfoma é uma neoplasia maligna caracterizada pela proliferação neoplásica de células originadas de tecido linfoide e corresponde a cerca de 90% das neoplasias hematopoiéticas em cães. Células T reguladoras (Tregs) têm sido alvo de diversas investigações na área da oncologia devido ao potencial de regulação negativa da resposta do sistema imune e à manutenção ativa do mecanismo de imunossupressão tumoral. O objetivo do presente estudo foi a comparação da porcentagem de Tregs no sangue periférico entre cães com linfoma multicêntrico e animais saudáveis e a porcentagem de Tregs no sangue periférico e nos linfonodos de cães com linfoma multicêntrico. Foram utilizados 26 animais: 10 cães saudáveis, como grupo controle (CG), e 16 cães com linfoma multicêntrico, como grupo linfoma (LG). Observou-se maior expressão de Tregs no sangue periférico de cães do LG em comparação ao CG. Entretanto, não foi observada diferença significativa entre as expressões de Treg nos linfonodos e no sangue periférico do LG. Com esses resultados, foi possível concluir que o linfoma multicêntrico apresenta alta expressão de Tregs, tornando-se condição interessante para o estudo de tratamentos capazes de suprimir as células T reguladoras.(AU)

Downregulation of ATM Gene and Protein Expression in Canine Mammary Tumors.

The ataxia telangiectasia mutated (ATM) gene encodes a protein associated with DNA damage repair and maintenance of genomic integrity. In women, ATM transcript and protein downregulation have been reported in sporadic breast carcinomas, and the absence of ATM protein expression has been associated with poor prognosis. The aim of this study was to evaluate ATM gene and protein expression in canine mammary tumors and their association with clinical outcome. ATM gene and protein expression was evaluated by reverse transcription-quantitative polymerase chain reaction and immunohistochemistry, respectively, in normal mammary gland samples (n = 10), benign mammary tumors (n = 11), nonmetastatic mammary carcinomas (n = 19), and metastatic mammary carcinomas (n = 11). Lower ATM transcript levels were detected in benign mammary tumors and carcinomas compared with normal mammary glands (P = .011). Similarly, lower ATM protein expression was observed in benign tumors (P = .0003), nonmetastatic mammary carcinomas (P < .0001), and the primary sites of metastatic carcinomas (P < .0001) compared with normal mammary glands. No significant differences in ATM gene or protein levels were detected among benign tumors and nonmetastatic and metastatic mammary carcinomas (P > .05). The levels of ATM gene or protein expression were not significantly associated with clinical and pathological features or with survival. Similar to human breast cancer, the data in this study suggest that ATM gene and protein downregulation is involved in canine mammary gland tumorigenesis.

Processo de trabalho em enfermagem na saúde da família: revisão da literatura / Nursing work process in family health: literature review

Revisão bibliográfica sobre o processo de trabalho deenfermagem na saúde da família. Foram consultadas asbases de dados LILACS e MedLine em julho de 2012. Osobjetivos foram identificar produção científica nacionalsobre o processo de trabalho em enfermagem na saúde dafamília; caracterizar as publicações segundo a quantidade,o ano, o periódico, o tipo de estudo e o foco das abordagens;relacionar as abordagens dos textos selecionadosem termos de conteúdo e contextualização. Analisaram-seos textos completos de 20 artigos publicados no períodode 2000 a 2011. Foi observado que 35% dos artigosforam publicados recentemente, em 2011, em periódicosdestinados à Enfermagem e Saúde Pública. A maior partedos textos analisados destaca a identificação de um doselementos do processo de trabalho em saúde (40%) seguidada caracterização do processo de trabalho (35%),identificação do processo de trabalho em áreas específicas(20%) e as reflexões sobre o processo de trabalho (5%). Aleitura crítica e aprofundada dos artigos permitiu sinalizarque a produção científica sobre o processo de trabalho daenfermagem em Saúde da Família no período estudado éescassa, diante da importância dessa temática no contextoda saúde.

Literature review on the process of nursing work in familyhealth. The LILACS and MEDLINE databases wereconsulted in July 2012. The goal was to identify scientificproduction in Brazil on the process of nursing work infamily health; characterize the publications accordingto frequency, year, journal, study design, and focus ofapproaches; relate the approaches of the selected textsin terms of content and context. The full texts of 20articles published between 2000 and 2011 were analyzed.It was observed that 35% of the articles were publishedrecently, in 2011, in Nursing and Public Health journals.Most of the articles highlight the identification of theelements of the work process in health (40%); followed bycharacterization of the work process (35%); identificationof the work process in specific areas (20%); and reflectionsabout the work process (5%). The critical in-depth readingof the articles allowed us to conclude that the scientificliterature on the process of nursing work in Family Healthis limited, considering the importance of this theme in thecontext of health.

Colony-stimulating factor 1 receptor inhibition prevents microglial plaque association and improves cognition in 3xTg-AD mice.

BACKGROUND: Microglia are dependent upon colony-stimulating factor 1 receptor (CSF1R) signaling for their survival in the adult brain, with administration of the dual CSF1R/c-kit inhibitor PLX3397 leading to the near-complete elimination of all microglia brainwide. Here, we determined the dose-dependent effects of a specific CSF1R inhibitor (PLX5622) on microglia in both wild-type and the 3xTg-AD mouse model of Alzheimer's disease. METHODS: Wild-type mice were treated with PLX5622 for up to 21 days, and the effects on microglial numbers were assessed. 3xTg-AD mice were treated with PLX5622 for 6 or 12 weeks and effects on microglial numbers and pathology subsequently assessed. RESULTS: High doses of CSF1R inhibitor eliminate most microglia from the brain, but a 75% lower-dose results in sustained elimination of ~30 of microglia in both wild-type and 3xTg-AD mice. No behavioral or cognitive deficits were found in mice either depleted of microglia or treated with lower CSF1R inhibitor concentrations. Aged 3xTg-AD mice treated for 6 or 12 weeks with lower levels of PLX5622 resulted in improved learning and memory. Aß levels and plaque loads were not altered, but microglia in treated mice no longer associated with plaques, revealing a role for the CSF1R in the microglial reaction to plaques, as well as in mediating cognitive deficits. CONCLUSIONS: We find that inhibition of CSF1R alone is sufficient to eliminate microglia and that sustained microglial elimination is concentration-dependent. Inhibition of the CSF1R at lower levels in 3xTg-AD mice prevents microglial association with plaques and improves cognition.

Avaliação da atenção primária aos hipertensos cadastrados no HiperDia / Primary care evaluation to hypertensives registered in HiperDia / Evaluación de la atención primaria a los hipertensos registrados en HiperDia

Objetivos: descrever o perfil epidemiológico segundo as informações do HiperDia e avaliar o processo de trabalho prestado a hipertensos e ao seu índice de satisfação. Método: estudo epidemiológico misto associando-se à análise exploratória descritiva de dados do HiperDia a um inquérito com amostra aleatória de 335 hipertensos. Os dados foram analisados à luz da estatística simples e apresentados descritivamente com números absolutos e percentuais. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, sob o Protocolo 261/2009. Resultados: do total de pacientes a maioria é mulher na faixa etária entre 40 e 69 anos, apresentando características como tabagismo e sedentarismo e algumas sequelas, e avaliando a assistência prestada como boa. Exames são realizados com frequência, exceto o de ECG. Conclusão: a falta de vínculo e comunicação entre profissionais e usuários é uma barreira ao acesso à assistência.(AU)

Objectives: describing the epidemiological profile according to HiperDia and evaluating the work process given to hypertensive and their index of satisfaction. Method: a mix epidemiological study associating the exploratory descriptive data analysis in HiperDia to a survey with a random sample of 335 hypertensives. Data were analyzed based on simple descriptive statistics and presented in absolute numbers and percentages. The research project was approved by the Research Ethics Committee, under protocol 261/2009. Results: from the total number of patients the majority is women aged between 40 and 69 years old, exhibiting characteristics, such as smoking and physical inactivity and some sequels, and evaluating the assistance as good. Examinations are performed frequently, except the ECG. Conclusion: the lack of bond and communication among professionals and patients is a barrier to accessing care.(AU)

Objetivos: describir el perfil epidemiológico según informaciones del HIPERDIA y evaluar el proceso de trabajo dado a hipertensos y a su índice de satisfacción. Método: estudio epidemiológico mezclado asociándose al análisis exploratorio y descriptivo de datos del HIPERDIA a una encuesta con una muestra aleatoria de 335 hipertensos. Los datos fueron analizados sobre la base de la estadística simple y presentados descriptivamente en números absolutos y porcentajes. El proyecto de investigación fue aprobado por el Comité Ético de Investigación, bajo protocolo 261/2009. Resultados: del número total de pacientes la mayoría es de mujeres con edad entre 40 y 69 años, presentando características tales como el tabaquismo y la inactividad física y algunas secuelas, y evaluando la asistencia cómo buena. Los exámenes se llevan a cabo con frecuencia, excepto el ECG. Conclusión: la falta de ligación y comunicación entre los profesionales y los pacientes es un obstáculo para el acceso a la atención.(AU)

Automedicação versus automedicação responsável: uma análise em três escolas de Alfenas-MG / Self-medication versus responsible self-medication: an analysis in three schools of Alfenas-MG

Avaliou-se o uso de medicamentos por conta própria em três escolas estaduais do município de Alfenas-MG. Formulários foram aplicados aos pais para medir os índices de automedicação. Os dados foram processados utilizando o programa epiInfo 6.0. Dos 571 entrevistados, 65% se automedicavam no momento da entrevista, 55,7% se automedicam por falta de recursos financeiros. Os analgésicos e antitérmicos foram as drogas mais utilizadas (91,6%). Verificou-se a prevalência da automedicação semelhante à observada em países desenvolvidos.

Thrombin induces macrophage migration inhibitory factor release and upregulation in urothelium: a possible contribution to bladder inflammation.

PURPOSE: Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine expressed by urothelial cells that mediates bladder inflammation. We investigated the effect of stimulation with thrombin, a Protease Activated Receptor-1 (PAR1) agonist, on MIF release and MIF mRNA upregulation in urothelial cells. MATERIALS AND METHODS: MIF and PAR1 expression was examined in normal human immortalized urothelial cells (UROtsa) using real-time RT-PCR, Western blotting and dual immunostaining. MIF and PAR1 immunostaining was also examined in rat urothelium. The effect of thrombin stimulation (100 nM) on urothelial MIF release was examined in UROtsa cells (in vitro) and in rats (in vivo). UROtsa cells were stimulated with thrombin, culture media were collected at different time points and MIF amounts were determined by ELISA. Pentobarbital anesthetized rats received intravesical saline (control), thrombin, or thrombin +2% lidocaine (to block nerve activity) for 1 hr, intraluminal fluid was collected and MIF amounts determined by ELISA. Bladder or UROtsa MIF mRNA was measured using real time RT-PCR. RESULTS: UROtsa cells constitutively express MIF and PAR1 and immunostaining for both was observed in these cells and in the basal and intermediate layers of rat urothelium. Thrombin stimulation of urothelial cells resulted in a concentration- and time-dependent increase in MIF release both in vitro (UROtsa; 2.8-fold increase at 1 hr) and in vivo (rat; 4.5-fold) while heat-inactivated thrombin had no effect. In rats, thrombin-induced MIF release was reduced but not abolished by intravesical lidocaine treatment. Thrombin also upregulated MIF mRNA in UROtsa cells (3.3-fold increase) and in the rat bladder (2-fold increase) where the effect was reduced (1.4-fold) by lidocaine treatment. CONCLUSIONS: Urothelial cells express both MIF and PAR1. Activation of urothelial PAR1 receptors, either by locally generated thrombin or proteases present in the urine, may mediate bladder inflammation by inducing urothelial MIF release and upregulating urothelial MIF expression.

A terapia de desinfecção total da boca no tratamento periodontal / The full-mouth disinfection on the periodontal treatment

Vários estudos foram feitos para comparar o resultado de diferentes tipos de tratamentos da doença periodontal, sendo encontradas, até então, pequenas diferenças. Mais recentemente, uma nova forma de tratamento foi proposta, a qual visa realizar a desinfecção total da boca do paciente em um intervalo de 24 horas, impedindo, assim, que haja a recolonização dos sítios já tratados por bactérias presentes em outros nichos bucais. Essa técnica de “full-mouth disinfection” tem sido amplamente estudada na literatura. Os trabalhos já desenvolvidos mostram excelentes resultados do tratamento, ao se empregar a técnica de desinfecção total da boca, seja ela utilizada de acordo com o protocolo original ou conforme as suas modificações, que incluem o não-uso de clorexidina, o uso de antibióticos sistêmicos e o uso de aparelho ultrassônico. Os dados presentes na literatura indicam que a desinfecção “full-mouth” é efetiva no tratamento de pacientes com periodontite, por promover uma melhora nos parâmetros clínicos, além de eliminar o risco de contaminação cruzada entre lugares tratados e não-tratados.

Many studies were done to compare the outcomes of different techniques for the treatment of periodontal disease and minor differences were found so far. More recently, a new technique for periodontal disease treatment were recommended which aims to disinfect the whole mouth in a 24 hours period, marking not possible the recolonization of the treated sites by bacteria from other buccal niches. This full-mouth disinfection technique has been largely studied in the literature. The studies done so far show excellent treatment outcomes using the full-mouth disinfection, if it is done as the original protocol or as the modifications that include the non use of chlorhexidine, the use of systemic antibiotics, and the use of ultra-sonic device. The data from literature demonstrate that the full-mouth disinfection is effective for the treatment of patients with periodontitis, promoting an improvement of clinical parameters, eliminating the risk of cross-infection between treated and untreated sites.

Pneumatization of the sphenoid sinus.

This paper describes a case of pneumatization of the sphenoid sinus in the pterygoid process and greater wing of the sphenoid bone, observed on a panoramic radiograph. Conventional radiographs and computerized tomography in axial and coronal sections confirmed the presence of the pneumatization of these structures.

Effect of kosmotropicity of ionic liquids on the enzyme stability in aqueous solutions.

This paper examined the effect of several pyridinium and imidazolium-based ionic liquids (ILs) on the protease stability in aqueous solutions. In general, the enzyme was found quite active at low concentrations of hydrophilic ILs. In aqueous environment, the enzyme was stabilized by the kosmotropic anions (such as CF3COO- and CH3COO-) and chaotropic cations (such as [BuPy]+ and [EMIM]+), but was destabilized by chaotropic anions (such as tosylate and BF4-) and kosmotropic cations (such as [BMIM]+).

A joint TEM-HLEM geophysical approach to borehole sitting in deeply weathered granitic terrains.

The accurate location of aquiferous fracture zones in granite beneath a > 50 m thick weathered mantle in semi-arid regions is a major hydrogeological problem. It is expected that the zone of intensive fracturing will be more susceptible to weathering and thus be characterized by the thickest development of saprolite, a good electrically conductive target for deep-probing electromagnetic systems. The single-loop transient electromagnetic (TEM) technique is well known to have the capability for detecting concealed steep mineralized targets in mining environments and can be adapted to this hydrogeological problem. We propose that combining the conventional frequency-domain horizontal-loop electromagnetic (HLEM) and single-loop TEM is an effective practical approach to locating concealed aquiferous fracture zones. In the supporting case studies presented here, we deployed multifrequency HLEM profiling (with 50 m transmitter-receiver separation) and TEM soundings with contiguous 10 or 20 m sided loops along the survey lines in a granitic terrain affected by deep (> 50 m) weathering in northeast Brazil. A somewhat layered structure consisting of resistive hardpan/leached zone, conductive saprolite, and resistive basement is identifiable in the typical TEM depth sounding data. We obtained coincident HLEM and TEM anomalies at all the sites, enabling a relatively straightforward selection of potential drilling positions. Simple resistivity-depth transformation of the TEM data was done for each site, yielding an approximate section from which drilling depths were estimated. All of the boreholes located were successful. Although our results appear to indicate that the single-loop TEM method could be used independently for borehole sitting in deeply weathered granitic terrains and that the weathering profile over granite can be mapped using TEM depth soundings of appropriate observational bandwidth, we recommend a joint electromagnetic approach for optimal well sitting.

Standardization of the comet assay technique on FRTL5 cells.

The comet assay is a sensitive and rapid method for DNA strand break detection in individual cells. The principle of break detection, using either the alkaline or neutral version of the assay, makes it a good technique for studying both double and single strand DNA breaks. Furthermore, the possibility of following DNA damage at different time moments also makes it possible to investigate the cell repair mechanisms. This explains why in the last few years there has been a tremendous increase in the number of laboratories which started to use this technique. The technique was first created for lymphocyte cells and later on has been used on many other cell types, growing both in suspension and adherent. To date, no one has applied this technique on normal differentiated endocrine cells, such as FRTL5 cells (Fisher Rat Thyroid Cells). The aim of this study has been to standardize the alkaline version of the Comet Assay technique on FRTL5 cells by studying the kinetics of DNA-damage and DNA-repair after different doses of UV-C (254 nm). FRTL-5 cells not only resulted very sensitive to UV-C (p<0.05 at 5 J/m2), but were also able to repair most of their DNA damage very rapidly (within one hour) as shown by a significant exponential regression in comet length. Finally, the successful measurement of biomarkers of UV-C on thyroid cells established the comet assay as a valuable tool in measurement of DNA damage and repair. Any radiation, or other damaging agents, interacting with living organisms could cause DNA damages which, depending upon dosages and kinetics of exposure, may or may not be completely repaired.

Radiation-dependent apoptosis on cultured thyroid cells.

Aim of this investigation is the study of the modifications and the DNA damage occurring in thyroid cells exposed to radiation. The FRTL-5 rat thyroid cell strain has been chosen for this study. Objects of this research are both Ionizing radiation, of fundamental interest for space missions, and the UV radiation, (also mutagen and frequent cause of several cancer forms). The present study of UV radiation represents a preliminarily tool to investigate the biological radiation damage. FRTL-5 cells have been irradiated with doses of UV-C (254 nm wavelength) ranging from 15 to 80 Joule/m2. The DNA damage has been analyzed with the 'DNA ladder by gel electrophoresis' technique. DNA has been extracted at 24 and 48 hours from irradiation. At 24h the apoptotic process is not detectable. At 48 h from irradiation, cells show the characteristic signs of apoptosis. The lower dose to which the apoptotic process is detectable, corresponds to 20 Joule/m2. At the higher doses a bigger percentage of cells undergoes apoptosis. These data confirms that the FRTL-5 biological system is particularly suitable for further studies on the biological mechanisms of radiation damage.

Downregulation of c-Ki-ras promoter activity by triplex-forming oligonucleotides endogenously generated in human 293 cells.

Exogenous triplex-forming oligodeoxynucleotides (TFO) have the capacity to modulate in vivo the expression of individual genes. As the administration of TFO to cells is not without problems, we analyzed the possibility of generating them directly in the cell, using specific expression vectors. We constructed three vectors, mU6-GA, mU6-CA, and mU6-CT, that direct the synthesis in human 293 cells of 76-mer CU, GU, and AG motif TFO (rTFO) potentially capable of binding to a critical poly (R x Y) sequence contained in the promoter of the Ki-ras proto-oncogene. The ability of the CU, GU, and AG motif rTFO to interact with the double helix of the c-Ki-ras target was investigated in vitro by footprinting and band-shift experiments, using both synthetic and endogenously synthesized oligoribonucleotides. The human 293 cells were transfected with DNA mixtures containing a plasmid, which bears the reporter chloramphenicol acetyltransferase (CAT) gene downstream from the c-Ki-ras promoter (pKRS-413), as well as an rTFO-generating vector (mU6-GA, mU6-CA, or mU6-CT). As control, the cells were transfected with DNA mixtures containing vector mU6-C1 or mU6-C2. These generated transcripts unable to form triple helices with the poly (R x Y) sequence of the c-Ki-ras promoter. Intracellular synthesis of the 76-mer CU, GU, and AG rTFO by mU6-GA, mU6-CA, and mU6-CT was checked by Northern blot hybridization. Through beta-gal and CAT ELISA immunoassays, we found that the 293 cells transfected with either mU6-GA, mU6-CA, or mU6-CT showed a significant inhibition of CAT expression compared with cells transfected with control plasmids mU6-C1 or mU6-C2. The results of five separate transient transfection experiments showed that endogenous GU and AG rTFO, generated by mU6-CA and mU6-CT, produce, respectively, 40% (+/- 4% SE) and 47% (+/- 8% SE) CAT inhibition, whereas CU rTFO, generated by mU6-GA, produces 38% (+/- 7% SE) CAT inhibition. In conclusion, this study suggests that it is possible to downregulate the expression of an individual gene through the use of recombinant vectors encoding the information for the intracellular synthesis of short triplex-forming RNA strands.

Formation of triple helices at irregular poly (R.Y) sites located in critical positions in the human bcr promoter.

Two polypurine sequences interrupted respectively by one and two adjacent pyrimidines have been identified in the promoter of the human bcr gene. Although these targets are irregular they are recognised and tightly bound by AG and GT motif triplex-forming oligonucleotides. Thermodynamic and kinetic data are presented.

[Fatal infectious endocarditis in a patient with annulo-aortic ectasia and predominant bicuspid valve aortic stenosis. Anatomoclinical case]. / Endocarditis infecciosa mortal en portadora de anuloectasia aortica asociada a estenosis aortica biscuspide predominante. Caso anatómo clínico.

A 25 year old female with bicuspid aortic valve and aortic stenosis developed infectious endocarditis due to beta hemolytic streptococcus. Specific antibiotic therapy was not successful, the patient developed multiple embolic episodes and platelet dysfunction that prevented surgery. The patient died 5 weeks after admission. Necropsy showed aortic annulo-ectasia, cystic medial necrosis and localized dissection of the proximal aorta. There were multiple aortic valve vegetations and evidence of inflammatory myocardial involvement, coronary embolization and myocardial infarction. Aortic annulo-ectasia should be investigated in patients with aortic valve endocarditis and early surgery would be advised to prevent aortic dissection.