Aneurysmal Bone Cyst in the Anterior Region of the Mandible.

Aneurysmal bone cyst is a rare osteolytic lesion of uncertain etiology, commonly observed in the lower limbs, with only 1-2% of reports in gnathic bones. We present the case of a 27-year-old male patient referred to the oral and maxillofacial surgery and traumatology service due to complaints of paresthesia in the mental region and increased mandibular volume. Physical examination revealed midline shift and hard consistency. Imaging examinations demonstrated a radiolucent/hypodense lesion with disruption of the mandibular cortices. The histopathological examination of incisional biopsy material led to the diagnosis of a central giant cell lesion. The patient underwent surgical resection, and the histopathological analysis of the specimen revealed a predominantly solid lesion, characterized by blood-filled spaces of varying size, not covered by epithelium or endothelium, with the presence of spindle cells, multinucleated giant cells, and basophilic osteoid material, concluding the diagnosis of mixed-type aneurysmal bone cyst. Despite being uncommon, aneurysmal bone cysts should be considered in the differential diagnosis of volumetric increase in the gnathic bones of young patients.

Purification, bioactivity and application of maltobionic acid in active films.

The objective of this study was to purify sodium maltobionate using Zymomonas mobilis cells immobilized in situ on flexible polyurethane (PU) and convert it into maltobionic acid for further evaluation of bioactivity (iron chelating ability, antibacterial potential and cytoprotection) and incorporation into films based on cassava starch, chitosan, and cellulose acetate. Sodium maltobionate exhibited a purity of 98.1% and demonstrated an iron chelating ability of approximately 50% at concentrations ranging from 15 to 20 mg mL-1. Maltobionic acid displayed minimal inhibitory concentrations (MIC) of 8.5, 10.5, 8.0, and 8.0 mg mL-1 for Salmonella enterica serovar Choleraesuis, Escherichia coli, Staphylococcus aureus, and Listeria monocytogenes, respectively. Maltobionic acid did not exhibit cytotoxicity in HEK-293 cells at concentrations up to 500 µg mL-1. Films incorporating 7.5% maltobionic acid into cassava starch and chitosan demonstrated inhibition of microbial growth, with halo sizes ranging from 15.67 to 22.33 mm. These films had a thickness of 0.17 and 0.13 mm, water solubility of 62.68% and 78.85%, and oil solubility of 6.23% and 11.91%, respectively. The cellulose acetate film exhibited a non-uniform visual appearance due to the low solubility of maltobionic acid in acetone. Mechanical and optical properties were enhanced with the addition of maltobionic acid to chitosan and cassava films. The chitosan film with 7.5% maltobionic acid demonstrated higher tensile strength (30.3 MPa) and elongation at break (9.0%). In contrast, the cassava starch film exhibited a high elastic modulus (1.7). Overall, maltobionic acid, with its antibacterial activity, holds promise for applications in active films suitable for food packaging. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03879-3.

Functional impact on adults and older people after hospitalization by Covid-19.

BACKGROUND AND OBJECTIVES: Hospitalization by Covid-19 can cause persistent functional consequences after hospital discharge due to direct and indirect effects of SARS-COV-2 in several organs and systems of the body added to post-intensive care syndrome and prolonged bed rest. These impacts can lead to dependency in activities of daily living, mainly in older people due to aging process and functional decline. This study aimed to compare the effects of hospitalization by Covid-19 on functional capacity of adults and older people and to identify its associated factors. METHODS: Cross-sectional observational study of 159 survivors of hospitalization by Covid-19 after 1 month from discharge at Hospital das Clínicas of the University of São Paulo, divided into groups: adults (aged < 60 years) and older people (aged ≥ 60 years). Those who did not accept to participate, without availability or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index and patients were classified according to their scores. Data analysis was performed in JASP Statistics program and the sample was compared between the age groups. Wilcoxon test was applied to compare before and after periods, Mann-Whitney test was used for between groups comparison. We adopted alpha = 0.05. RESULTS: The total Barthel Index median score was lower 1 month after hospital discharge than in the pre-Covid-19 period. Older people had worse functional status than adults before and also showed greater impairment after hospital discharge. Both groups showed lower Barthel Index classification than before, and older people presented more functional dependence than adults in both periods. Age, sarcopenia and frailty were associated factors. DISCUSSION: Hospitalization by Covid-19 impacts functional capacity after 1 month from discharge, especially in older people. Age, sarcopenia and frailty are associated factors. These results suggest need for care and rehabilitation of Covid-19 survivors.

High-sodium maltobionate production by immobilized Zymomonas mobilis cells in polyurethane.

The purpose of this study was the production of maltobionic acid, in the form of sodium maltobionate, by Z. mobilis cells immobilized in polyurethane. The in situ immobilized system (0.125-0.35 mm) was composed of 7 g polyol, 3.5 g isocyanate, 0.02 g silicone, and 7 g Z. mobilis cell, at the concentration of 210 g/L. The bioconversion of maltose to sodium maltobionate was performed with different cell concentrations (7.0-9.0 gimobilized/Lreaction_medium), temperature (30.54-47.46 °C), pH (5.55-7.25), and substrate concentration (0.7-1.3 mol/L). The stability of the immobilized system was evaluated for 24 h bioconversion cycles and storage of 6 months. The maximum concentration of sodium maltobionate was 648.61 mmol/L in 34.34 h process (8.5 gdry_cell/Lreaction_medium) at 39 °C and pH 6.30. The immobilized system showed stability for 19 successive operational cycles of 24 h bioconversion and 6 months of storage, at 4 °C or 22 °C.

Effects of physical activity and exercise on well-being in the context of the Covid-19 pandemic.

Coronavirus disease 2019 (COVID-19) was discovered in China and characterized by the World Health Organization as a pandemic in March 2020. Many countries worldwide implemented stringent social isolation as a strategy to contain virus transmission. However, the same physical distancing that protects against the spread of COVID-19 may negatively impact mental health and well-being of the population. The present study sought to shed light on this phenomenon by assessing the relationship between physical activity and subjective well-being (SWB) among individuals who were subjected to social isolation during the COVID-19 pandemic. Data were collected in Brazil between March 31 and April 2, 2020. All of the volunteers agreed to participate by digitally checking the option of agreement after reading consent terms. The inclusion criteria were participants who had been in social isolation for at least 1 week and agreed to the consent terms. Three instruments were applied. A questionnaire was constructed for this study that assessed the participants' exercise routines. The Psychosocial Aspects, Well-being, and Exercise in Confinement (PAWEC) scale was created by researchers of this study that assessed the relationship between well-being and physical activity during social isolation. The Brazilian Portuguese-adapted version of the Positive and Negative Affect Schedule (PANAS) was also used. A total of 592 participants (371 female, 220 male, 1 transgender), 14-74 years old (M = 32.39 years, SD = 10.5 years), reported being in social isolation for an average of 14.4 days (SD = 3.3 days). Well-being that was related to the practice of physical activity during quarantine was linked to an established routine of physical activity before the social isolation period. Participants who already practiced physical exercises previously and reported continuing the practice during the quarantine period had higher positive affect scores. Participants who engaged in physical activity without direct guidance only during the quarantine period had higher negative affect scores. Participants who already practiced physical activity felt more motivated to continue practicing physical activity during the social isolation period, resulting in positive affect, unlike participants who began exercising only during quarantine. Our results suggest that negative affect can occur among individuals who only just begin exercising during social isolation, indicating that physical activity should be habitual and not only occur during periods of social isolation. Engaging in exercise only during social isolation may contribute to an increase in malaise.

Correlated geometric models of order k and its application to intensive care unit and leprosy data.

Geometric models are used to analyse the discrete time until the occurrence of an event of interest (success or consecutive successes). In two real data sets, named leprosy and intensive care unit (ICU), the events correspond, respectively, to abandoning the clinical treatment of leprosy, where abandonment corresponds to four consecutive patient absences from treatment, and the patient's discharge from the ICU. The distribution proposed in this article, called the correlated geometric distribution of order k (or correlated k-order geometric distribution), k≥1 , consists of including a correlation parameter in the geometric distribution of order k, thus considering the dependence between patient responses until the occurrence of the event. This model proves to be a better option for real data analysis where the effect of individual correlation is considered. The model is applied to real leprosy data to estimate the treatment abandonment probability. Bayesian methods are used to determine the parameter estimators of the models and to evaluate regression models. The covariates are related to the probability of the event by an appropriate link function chosen by Bayesian selection criteria. A diagnostic analysis evaluates the models fit by posterior randomized quantile residuals and influential observations by ψ -divergence measures. This methodology is illustrated by simulation studies and real ICU admission data analysis. Studies show a good fit of the proposed model. Real data analyses also find that the probabilities of the event of interest can be overestimated or underestimated when modeled without considering the effect of dependency on the model.

Lessons and challenges for the recycling sector of Brazil from the pandemic outbreak of COVID-19.

Abstract: The 2019-2020 coronavirus pandemic imposed unprecedented challenges in Brazilian governance sectors, mostly in the waste management system. Herein, we analyse the main challenges of the recycling sector in Brazil to cope with this scenario. Understanding difficulties during the pandemic outbreak of COVID-19 can help improve waste recycling in the post-pandemic period in Brazil and other developing nations that face similar issues. The current pandemic exposed the deficiencies of this system, and some important lessons can be learned. Recommendations are drawn to advance the proper management of recyclables in the country. The Government must increase total investments in the recycling industry's infrastructure and support local recycling initiatives during a public health crisis and beyond. In sum, this paper strengthens the idea that waste segregation at the source and selective collection will not be sufficient without massive investments in the recycling sector's infrastructure. The future challenge includes strengthening the economic markets for recycled materials.

Perceptions towards COVID-19 and adoption of preventive measures among the public in Saudi Arabia: a cross sectional study.

BACKGROUND: Effective management of the spread of a novel infectious disease, such as the COVID-19 virus can be achieved through influencing people's behavior to adopt preventive measures. The public's perceptions and attitudes towards the virus, governmental guidance and preventive measures were unknown in Saudi Arabia. OBJECTIVES: 1) investigate the public perception of COVID-19, anxiety level, the COVID-19 information sources sought, adoption of preventive measures, and ability and willingness to self-isolate during and post-lockdown periods of the COVID-19 pandemic in Saudi Arabia; 2) investigate socio-demographic factors associated with adoption of preventive measures against COVID-19 and self-isolation practices. METHOD: Between April 22nd and June 21st 2020, Saudi adults aged ≥18 years voluntarily completed a self-administered web-based cross-sectional survey, distributed through social media (WhatsApp) and emails to representatives in education, health, business, and social sectors across all Saudi Arabian regions. The survey included questions on anxiety level, COVID-19 risk perceptions and adoption of preventive measures. Weighted percentages, Pearson's chi-square tests, and multiple logistic regression were applied to evaluate associations between these factors and socio-demographic variables. RESULTS: A total of 2393 respondents completed the survey. A majority (74%) were worried about the COVID-19 outbreak and of those, 27% reported that it was likely that they would be infected with COVID-19; 16% believed it would be life-threatening or severe. However, only 11% of respondents reported high anxiety level. Adoption of hygiene practices and social distancing were lower among older (> 65 years) compared to younger (18-24 years) respondents (OR: 0.06; 95% CI: 0.01, 0.28 and OR 0.06; 95% CI: 0.01, 0.27 respectively). High percentages of respondents reported being able to (88%) and were willing to (82%) self-isolate. Those with the lowest gross household income and those with at least one flu symptom were less able and willing to self-isolate. A significant increase in levels of anxiety, perceived effectiveness of social distancing and hygiene practices was reported in the post-lockdown compared to during the lockdown. CONCLUSIONS: The study reported high levels of adoption of preventive measures, willingness and perceived ability to self-isolate during the early phase of the pandemic. Vulnerable groups such as the elderly, and those with low socio-economic status reported lower adoption of preventive measures or ability and willingness to self-isolate. Tailored public health messages and interventions are needed to achieve high adherence to these preventive measures in these groups.

Neuroprotective Effects of Acrocomia aculeata Pulp Oil Microcapsules on Rats Subjected to Chronic Stress.

Acrocomia aculeata fruits are rich in monounsaturated fatty acid, ß-carotene, tocopherol, and other antioxidant compounds. The aim of our study was to investigate and compare the protective effects of A. aculeata pulp oil and microencapsulated pulp oil on brain oxidative damage induced by chronic restraint stress (CRS) in rats (cortex, hippocampus, and striatum). Thirty-six Wistar rats were divided into six treatment groups: C, P, and M groups received 1 µL/g of body weight of distilled water, pulp oil, and pulp oil microcapsules by daily gavage, respectively. The SC, SP, and SM groups received 1 µL/g of body weight of distilled water, pulp oil, and pulp oil microcapsules by daily gavage, respectively, and were then subjected to uninterrupted 6 h of CRS. After 21 days of testing, the rats were euthanized and the brain tissue of the groups was removed for evaluation for oxidative damage markers and antioxidant enzymes. Endpoints of oxidative stress (OS) markers (lipid peroxidation, protein carbonylation, and reduced glutathione [GSH]) and antioxidant enzymes (superoxide dismutase and catalase) were evaluated. By imposing chronic stress on rats, pulp oil and microcapsules of pulp oil induced positive antioxidant responses, mainly by increasing the GSH content, increasing the ability of neural tissues to deal with inherent OS, thus protecting against neurodegenerative diseases. The administration of A. aculeata pulp oil and microencapsulated pulp oil made the reversal of the oxidant parameters, which may protect the brain tissue of rats altered by CRS. The Clinical Trial Registration number: n° 1.008/2018 CEUA/UFMS.

Buriti pulp oil did not improve high-fat diet-induced metabolic disorders in c57bl/6 mice.

Metabolic syndrome (MetS) and obesity are growing in many parts of the world, becoming public health problems. It is proposed that foods with functional properties can assist in the treatment of these diseases. Crude buriti pulp oil (BPO) is a food traditionally consumed by residents in the Pantanal, Cerrado and Brazilian Amazon. It is rich in oleic acid, tocopherols and carotenoids, emerging as a potential functional food. Thus, this study aimed to evaluate the effect of the supplementation of BPO on metabolic disorders caused by a high-fat diet. Four groups of C57BL6 mice were used, a lean group with AIN-93M diet and control oil supplementation, an obese group with a high-fat diet and control oil supplementation, and two obese groups with a high-fat diet and BPO supplementation in the amounts of 50 and 100 mg/kg. BPO worsened the metabolic state caused by the high-fat diet, worsening risk factors associated with MetS, as the abdominal circumference and retroperitoneal fat, serum levels of total cholesterol, uric acid, alanine transaminase, glucose and triglycerides, and renal fat, in addition to changes in glycaemic control and oxidative stress markers. C57BL/6 mice fed with a high-fat diet and supplemented with BPO presented a worsening in metabolic risk factors associated with MetS.

Donor hypernatremia and smoking addiction contribute to primary graft failure in heart transplantation

INTRODUCTION: Primary graft failure (PGF) is an important contributor to early mortality, accounting for 41% of deaths within the first 30 days after heart transplantation (HT). Donor hypernatremia has been associated with PGF development. However, controversial data exist regarding the impact of sodium deregulation in patient survival after HT. This study aimed to assess the influence of donor hypernatremia on PGF development and to determine the serum sodium level threshold to assist in decision-making for organ procurement. METHODS: The medical record from 200 HT patients and organ donors were retrospectively assessed and categorized by PGF occurrence. Donor sodium leve were compared and cut-off points obtained by receiver operating characteristic (ROC) curve. A multiple logistic regression model was applied to assess the effects of factors and covariates that influence PGF development. RESULTS: Sodium levels of donors were significantly higher in recipients who developed PGF than those who did not develop PGF (162 vs. 153 mmol/L, p = 0.001). The sodium cut-off value determined by the ROC curve was 159 mmol/L. The group who received organs from donors with a serum sodium concentration >/=159 mmol/L had a higher incidence of PGF (63.3% vs 32.4%, p < 0.001). Furthermore, donor sodium levels >/=159 mmol/L increased the likelihood of recipients developing PGF by 3.4 times. It is also observed that the incidence of donor smoking addiction was significantly higher in the PGF group (28.6% vs. 11.5%, p = 0.004) and donor smoking addiction increased the risk of developing PGF by 2.8 times. CONCLUSION: Smoking addiction and the application of suboptimal organs from donors with hypernatremia contribute to primary graft failure in heart transplantation. (AU)

Donor hypernatremia and smoking addiction contribute to primary graft failure in heart transplantation.

INTRODUCTION: Primary graft failure (PGF) is an important contributor to early mortality, accounting for 41% of deaths within the first 30 days after heart transplantation (HT). Donor hypernatremia has been associated with PGF development. However, controversial data exist regarding the impact of sodium deregulation in patient survival after HT. This study aimed to assess the influence of donor hypernatremia on PGF development and to determine the serum sodium level threshold to assist in decision-making for organ procurement. METHODS: The medical record from 200 HT patients and organ donors were retrospectively assessed and categorized by PGF occurrence. Donor sodium levels were compared and cut-off points obtained by receiver operating characteristic (ROC) curve. A multiple logistic regression model was applied to assess the effects of factors and covariates that influence PGF development. RESULTS: Sodium levels of donors were significantly higher in recipients who developed PGF than those who did not develop PGF (162 vs. 153 mmol/L, P = .001). The sodium cut-off value determined by the ROC curve was 159 mmol/L. The group who received organs from donors with a serum sodium concentration ≥159 mmol/L had a higher incidence of PGF (63.3% vs 32.4%, P < .001). Furthermore, donor sodium levels ≥159 mmol/L increased the likelihood of recipients developing PGF by 3.4 times. It is also observed that the incidence of donor smoking addiction was significantly higher in the PGF group (28.6% vs. 11.5%, P = .004) and donor smoking addiction increased the risk of developing PGF by 2.8 times. CONCLUSION: Smoking addiction and the application of suboptimal organs from donors with hypernatremia contribute to primary graft failure in heart transplantation.

Nonalcoholic Fatty Liver Disease Induced by High-Fat Diet in C57bl/6 Models.

Researchers have a range of animal models in which to study Nonalcoholic fatty liver disease (NAFLD). Induction of NAFLD by a high-fat diet in the C57BL/6 strain is the most widely used among mice. In this study, we review works that performed NAFLD induction by a high-fat diet using the C57BL/6 strain, focusing on experiments on the effects of lipid ingestion. Studies are initially distinguished into researches in which mice received lipids by oral gavage and studies in which lipid was added to the diet, and each of these designs has peculiarities that must be considered. Oral gavage can be stressful for animals and needs trained handlers but allows accurate control of the dose administered. The addition of oils to the diet can prevent stress caused to mice by gavage, but possible changes in the consistency, taste, and smell of the diet should be considered. Regarding the experimental design, some variables, such as animal sex, treatment time, and diet-related variables, appear to have a definite pattern. However, no pattern was found regarding the number of animals per group, age at the beginning of the experiment, time of adaptation, the substance used as a vehicle, and substance used as a control.

Effects of Mat Pilates on Physical Functional Performance of Older Adults: A Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: The present meta-analysis aimed to examine evidence from randomized controlled trials to determine the effects of mat Pilates on measures of physical functional performance in the older population. DESIGN: A search was conducted in the MEDLINE/PubMed, Scopus, Scielo, and PEDro databases between February and March 2017. Only randomized controlled trials that were written in English, included subjects aged 60 yrs who used mat Pilates exercises, included a comparison (control) group, and reported performance-based measures of physical function (balance, flexibility, muscle strength, and cardiorespiratory fitness) were included. The methodological quality of the studies was analyzed according to the PEDro scale and the best-evidence synthesis. The meta-analysis was conducted with the Review Manager 5.3 software. RESULTS: The search retrieved 518 articles, nine of which fulfilled the inclusion criteria. High methodological quality was found in five of these studies. Meta-analysis indicated a large effect of mat Pilates on dynamic balance (standardized mean difference = 1.10, 95% confidence interval = 0.29-1.90), muscle strength (standardized mean difference = 1.13, 95% confidence interval = 0.30-1.96), flexibility (standardized mean difference = 1.22, 95% confidence interval = 0.39-2.04), and cardiorespiratory fitness (standardized mean difference = 1.48, 95% confidence interval = 0.42-2.54) of elderly subjects. CONCLUSIONS: There is evidence that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility, and cardiovascular endurance in elderly individuals. Furthermore, high-quality studies are necessary to clarify the effects of mat Pilates on other physical functional measurements among older adults.

Bilateral Sertoli Cell Tumors in a Patient with Androgen Insensitivity Syndrome.

Androgen insensitivity syndrome is the most common cause of male pseudohermaphroditism and the third most common cause of primary amenorrhea. This genetic alteration is a consequence of inherited defects on the X chromosome causing total or partial damage to the intrauterine virilization process due to functional abnormalities in the androgen receptors. The present report describes a 22-year-old patient with a female phenotype and a 46, XY karyotype, presenting with bilateral inguinal tumors. The tumors were surgically removed at the Santa Casa de Misericórdia Hospital in Vitória, Espírito Santo, Brazil. Pathology revealed bilateral testicles with Sertoli cell tumors. According to the international literature, prophylactic gonadectomy following puberty is recommended due to the progressive risk of neoplastic transformation in the residual gonads.

The Manx shearwater (Puffinus puffinus) as a candidate sentinel of Atlantic Ocean health.

INTRODUCTION: Seabirds have been historically used to monitor environmental contamination. The aim of the present study was to test the suitability of a species belonging to the Procellariiformes group, the Manx shearwater, Puffinus puffinus, as a sentinel of environmental health, by determining contaminant levels (trace metals and organochlorine compounds) from carcass tissues and by isolating Vibrio spp. and Aeromonas spp. from live specimens. To this end, 35 Puffinus puffinus carcasses wrecked on the north-central coast of the state of Rio de Janeiro, Brazil, and two carcasses recovered in Aracruz, on the coast of the state of Espírito Santo, Brazil, were sampled, and fragments of muscle and hepatic tissues were collected for contaminant analyses. Swabs from eleven birds found alive at the north-central coast of Rio de Janeiro were collected for isolation of the aforementioned bacteria. RESULTS: THE AVERAGE CONCENTRATION IN DRY WEIGHT (DW) OF THE TRACE METALS WERE: mercury 7.19 mg kg(-1)(liver) and 1.23 mg kg(-1) (muscle); selenium 34.66 mg kg(-1) (liver) and 7.98 mg kg(-1) (muscle); cadmium 22.33 mg kg(-1) (liver) and 1.11 mg kg(-1) (muscle); and lead, 0.1 mg kg(--1) (liver) and 0.16 mg kg(-1) (muscle). Organochlorine compounds were detected in all specimens, and hexachlorbiphenyls, heptachlorbiphenyls and DDTs presented the highest levels. Regarding microbiological contamination, bacteria from the Vibrio genus were isolated from 91% of the analyzed specimens. Vibrio harveyi was the predominant species. Bacteria from the Aeromonas genus were isolated from 18% of the specimens. Aeromonas sobria was the only identified species. CONCLUSIONS: The results indicate that Puffinus puffinus seems to be a competent ocean health sentinel. Therefore, the monitoring of contaminant levels and the isolation of public health interest bacteria should proceed in order to consolidate this species importance as a sentinel.

Nandrolone decanoate and physical effort: histological and morphometrical assessment in adult rat uterus.

In the past decades, the therapeutic use of anabolic androgenic steroids (AAS) has been overshadowed by illicit abuse of these drugs by athletes and non-athletes. Since that AAS can affect the reproductive tract, resulting in reproduction and fertilization damages, the purpose of this study was to investigate the nandrolone decanoate (ND) effects, associated or not with physical effort, on the uterine histomorphometric parameters. Female Wistar rats, sedentary or not, were exposed to treatment with ND by intraperitoneal injection (5 mg/kg/day, once a week) during four consecutive weeks. Control animals, sedentary or not, received vehicle alone (propylene glycol) in the same manner. The physical activity was forced swimming (20 min/day). During the experiment, all animals were monitored by daily vaginal smears. After 30 days of treatment, the females were sacrificed and their uteri collected and examined under light microscopy techniques. The ND-treated females showed estrus acyclicity and decreased thickness of both the epithelium and endometrial stroma. A reduction in the number and size of blood vessels was also found in ND-treated rats submitted to physical effort when compared to ND sedentary rats. ND-treated rats, regardless of exercise, exhibited stromal fibrosis and reduced gland ducts that displayed high mitotic activity. A remarkable widespread presence of leukocytes occurred in rats receiving ND and submitted to exercise. These results suggest that ND associated or not with physical effort causes histomorphometric changes to the rat uterus.

The long-term course of factor VIII inhibitors in patients with congenital haemophilia A without immune tolerance induction.

The development of alloantibodies that inhibit or neutralise the function of factor VIII is considered the most serious complication of the treatment of congenital haemophilia A. In order to describe their course without immune tolerance induction (ITI), we documented data on all performed inhibitor tests with dates as well as on clotting factor infusions of all consecutive patients who were treated in our centre between 1993 and 2006. Patients were tested every 7.1 months (95% confidence interval [CI], 6.6-7.8). A 'sustained negative inhibitor status' was defined as consistent non-positive inhibitor measurements for two years or longer. A total of 60/486 (12%) patients tested had a positive inhibitor titre in two or more occasions. Most of the patients (56%) with a maximum inhibitor titre of < 5 Bethesda unit (BU)/ml (named "low titre inhibitor") developed a sustained negative inhibitor status. Among patients with high (5-9.9 BU/ml) and very high (≥ 10 BU/ml) inhibitor titres, the proportions were 50% and 3%, respectively. Our findings suggest that ITI might not be needed for all patients with non-transient inhibitors, especially when their maximum inhibitor titre is below 10 BU/ml. Further studies in countries where ITI is not available are needed to examine predictors of the natural sustained negative inhibitor status.

Detection of quinolone-resistance mutations in salmonella spp. Strains of epidemic and poultry origin.

Mutations into codons Aspartate-87 (62%) and Serine-83 (38%) in QRDR of gyrA were identified in 105 Salmonella strains resistant to nalidixic acid (94 epidemic and 11 of poultry origin). The results show a high incidence of mutations associated to quinolone resistance but suggest association with others mechanisms of resistance.