COVID-19-Associated Encephalitis: Two Case Reports

The infection with SARS-CoV-2 is primarily associated with respiratory symptoms. Since its appearance, several neurological symptoms have been reported, most commonly headache and anosmia, as well as less frequent complications such as COVID-19-associated encephalitis and meningitis. In this case report, we describe two patients, who were 49- and 50-year-old infected with SARS-CoV-2, who presented to the emergency department with altered mental status and behavioral changes. A diagnosis of acute meningoencephalitis associated with COVID-19 was considered, and both patients had a good response to corticosteroid treatment.

Sex-specific thermal tolerance limits in the ditch shrimp Palaemon varians: Eco-evolutionary implications under a warming ocean

As global temperatures continue to rise due to global change, marine heatwaves are also becoming more frequent and intense, impacting marine biodiversity patterns worldwide. Organisms inhabiting shallow water environments, such as the commercially relevant ditch shrimp Palaemon varians, are expected to be the most affected by rising temperatures. Thus, addressing species' thermal ecology and climate extinction-risk is crucial to foster climate-smart conservation strategies for shallow water ecosystems. Here, we estimated sex-specific upper thermal tolerance limits for P. varians via the Critical Thermal Maximum method (CTmax), using loss of equilibrium as endpoint. We further calculated thermal safety margins for males and females and tested for correlations between upper thermal limits and shrimps' body size. To determine sex-biased variation in P. varians' traits (CTmax, weight and length), we compared trait variation between females and males through the coefficient of variation ratio (lnCVR). Females displayed an average CTmax value 1.8% lower than males (CTmax_females = 37.0 °C vs CTmax_males = 37.7 °C). This finding may be related to the larger body size exhibited by females (156% heavier and 39% larger than males), as both length and weight had a significant effect on CTmax. The high energetic investment of females in offspring may also contribute to the differences recorded in thermal tolerance. Overall, organisms with a smaller body-size displayed a greater tolerance to elevated temperature, thus suggesting that smaller individuals may be positively selected in warmer environments. This selection may result in a reduction of size-at-maturity and shifts in sex ratio, given the sexual dimorphism in body size of shrimps. The thermal safety margin of P. varians was narrow (∼2.2 °C for males and ∼1.5 °C for females), revealing the vulnerability of this species to ocean warming and heatwaves.

Could CT abdomen and PET/CT be helpful in early diagnosis of Whipple's disease? A case report

Whipple’s disease is a rare disease, which can be fatal if not treated. It is often diagnosed at a late stage because of the varied disease presentation and its rare incidence. Classic Whipple’s disease presents with arthralgia, abdominal pain, diarrhea and weight loss. CT abdomen may show mesenteric lymphadenopathy with hypodense centers. These CT findings along with clinical presentation should prompt early diagnosis of Whipple’s disease. We present a case of classic Whipple’s disease with interesting CT abdomen and PET scan findings.

Defining the prodromal phase of multiple sclerosis based on healthcare access in a Portuguese population - ProdMS study

BACKGROUND

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system. Prodromal symptoms and higher healthcare use have been suggested in patients who later develop MS.

OBJECTIVES

Assess the healthcare utilization pattern of relapsing-remitting MS (RRMS) patients in the five years prior to MS diagnosis.

METHODS

Retrospective, multicentric study. Demographic and clinical data, drug prescriptions and diagnostic tests were collected from electronic health records five-years previous to MS diagnosis and compared with national data.

RESULTS

Included 168 patients, 112 (66.7%) female, median age 34±11 years. The mean number of healthcare use per patient per year was 3.14±2,69, most of them in primary healthcare (47%). Most frequent symptoms were musculoskeletal (22%), gastrointestinal (17%), sensitive (14%) and sensory organs (14%). Median number of diagnostic tests per patient was 6 (IQR 7), and drug prescriptions per patient was 6 (IQR 9). Most frequently prescribed drugs were analgesic/anti-inflammatories, antibiotics and anxiolytics and there was a high request rate of MRIs.

CONCLUSION

RRMS patients had a high frequency of healthcare utilization when compared to national data. This supports the current evidence showing a prodromal phase in MS.

A New Phenotype of Ataxia With Oculomotor Apraxia Type 4

Ataxia with oculomotor apraxia is a rare neurodegenerative subgroup of diseases with manifestations that include cerebellar ataxia, oculomotor apraxia, extrapyramidal features, and sensorimotor neuropathy. In 2015, ataxia with oculomotor apraxia type 4 was described in 11 Portuguese individuals. The mean age of onset was 4.3 years, with severe extrapyramidal manifestations, neuropathy, rapid progression, and ataxia, being wheelchair-bound during adolescence. The disease is caused by homozygous or compound heterozygous mutations in the PNKP gene. In this case report, we describe two sisters, who were 52- and 58-years-old, with cerebellar dysarthria, oculomotor apraxia, dystonia, and gait ataxia. Two new mutations in the PNKP gene were detected in both sisters, confirming the diagnosis of ataxia with oculomotor apraxia. They were remarkable because they were able to walk unaided during adulthood and had epilepsy. With these clinical cases, we attempt to raise awareness of the possibility of different phenotypes of this rare disease, expanding the spectrum of manifestations of ataxia with oculomotor apraxia type 4.

C1-C2 Injury: Factors influencing mortality, outcome, and fracture healing

BACKGROUND

C1-C2 injury represents 25-40% of cervical injuries and predominantly occurs in the geriatric population.

METHODS

A prospective multicentre study was conducted under the aegis of the french spine surgery society (SFCR) investigating the impact of age, comorbidities, lesion type, and treatment option on mortality, complications, and fusion rates.

RESULTS

A total of 417 patients were recruited from 11 participating centres. The mean ± SD age was 66.6 ± 22 years, and there were 228 men (55%); 5.4% presented a neurological deficit at initial presentation. The most frequent traumatic lesion was C2 fracture (n = 308). Overall mortality was 8.4%; it was 2.3% among those aged ≤ 60 years, 5.0% 61-80 years, and 16.0% > 80 years (p < 0.001). Regarding complications, 17.8% of patients ≤ 70 years of age presented with ≥ 1 complication versus 32.3% > 70 years (p = 0.0009). The type of fracture did not condition the onset of complications and/or mortality (p > 0.05). The presence of a comorbidity was associated with a risk factor for both death (p = 0.0001) and general complication (p = 0.008). Age and comorbidities were found to be independently associated with death (p < 0.005). The frequency of pseudoarthrosis ranged from 0 to 12.5% up to 70 years of age and then constantly and progressively increased to reach 58.6% after 90 years of age.

CONCLUSIONS

C1-C2 injury represents a serious concern, possibly life-threatening, especially in the elderly. We found a major impact of age and comorbidities on mortality, complications, and pseudarthrosis; injury pattern or treatment option seem to have a minimal effect.

Contraction Type Influences Critical Ages for Declines In Lower Body Specific Force in Women Ages 20 to 89 Years

The ability for a muscle to produce force relative to its size, specific force, is an important characteristic for healthy aging. Few studies have identified the influence that different muscle groups or contraction types may have on the onset of declines in specific force. Therefore, the aims of the current study were to identify critical ages for changes in upper (quadriceps and hamstrings) and lower leg (soleus and tibialis anterior) specific force and to determine if the onset of decline is influenced by contraction type (isometric or dynamic) in women aged 20 to 89 years. One-hundred and fifty-two women (47.1±17.7years, 164.2±7.0cm, 67.1±10.7kg) matched for physical activity with approximately 10 participants per five-year interval (20-24, 25-29years, etc.), were included in the present analysis. Specific force was calculated from peak torque values measured from isometric (ISOM) or isokinetic testing (60deg/s and 240deg/s) and made relative to muscle area measured by peripheral quantitative computed tomography. An iterative segmental modelling approach was performed to identify critical age periods for changes in specific force. For the upper leg, ISOM and 60deg/s specific force was maintained across the lifespan, whereas 240deg/s revealed a critical age of 35.2±5.3years. Critical ages were identified for all contraction types for the lower leg and occurred earlier with increasing velocity (ISOM: 63±6.6years, 60deg/s: 53.9±4.5years, and 240deg/s: 49±3.9years). These data suggest that muscle groups of the leg do not display uniform changes across different contraction types and that high velocity contractions display earlier declines across the lifespan.

Associations Between Two Athlete Monitoring Systems Used to Quantify External Training Loads in Basketball Players

Monitoring external training load (eTL) has become popular for team sport for managing fatigue, optimizing performance, and guiding return-to-play protocols. During indoor sports, eTL can be measured via inertial measurement units (IMU) or indoor positioning systems (IPS). Though each device provides unique information, the relationships between devices has not been examined. Therefore, the purpose of this study was to assess the association of eTL between an IMU and IPS used to monitor eTL in team sport. Retrospective analyses were performed on 13 elite male National Collegiate Athletic Association (NCAA) Division I basketball players (age: 20.2 ± 1.2 years, height: 201.1 ± 7.6 cm, mass: 96.8 ± 8.8 kg) from three practices during the off-season training phase. A one-way analysis of variance was used to test differences in eTL across practices. Pearson’s correlation examined the association between the Distance traveled during practice captured by IPS compared to PlayerLoad (PL), PlayerLoad per Minute (PL/Min), 2-Dimensional PlayerLoad (PL^2D), 1-Dimensional PlayerLoad Forward (PL^1D-FWD), Side (PL^1D-SIDE), and Up (PL^1D-UP) captured from the IMU. Regression analyses were performed to predict PL from Distance traveled. The eTL characteristics during Practice 1: PL = 420.4 ± 102.9, PL/min = 5.8 ± 1.4, Distance = 1645.9 ± 377.0 m; Practice 2: PL = 472.8 ± 109.5, PL/min = 5.1 ± 1.2, Distance = 1940.0 ± 436.3 m; Practice 3: PL = 295.1 ± 57.8, PL/min = 5.3 ± 1.0, Distance = 1198.2 ± 219.2 m. Significant (p ≤ 0.05) differences were observed in PL, PL^2D, PL^1D-FWD, PL^1D-SIDE, PL^1D-UP, and Distance across practices. Significant correlations (p ≤ 0.001) existed between Distance and PL parameters (Practice 1: r = 0.799–0.891; Practice 2: r = 0.819–0.972; and Practice 3: 0.761–0.891). Predictive models using Distance traveled accounted for 73.5–89.7% of the variance in PL. Significant relationships and predictive capacities exists between systems. Nonetheless, each system also appears to capture unique information that may still be useful to performance practitioners regarding the understanding of eTL.

Countermovement Jump Inter-Limb Asymmetries in Collegiate Basketball Players

The purpose of the present study was to establish the intrasession and intersession reliability of variables obtained from a force plate that was used to quantitate lower extremity inter-limb asymmetry during the bilateral countermovement jump (CMJ). Secondarily, a comparison was performed to determine the influence of the jump protocol CMJ with or without an arm swing (CMJ AS and CMJ NAS, respectively) on inter-limb asymmetries. Twenty-two collegiate basketball players performed three CMJ AS and three CMJ NAS on dual force platforms during two separate testing sessions. A majority of variables met the acceptable criterion of intersession and intrasession relative reliability (ICC > 0.700), while fewer than half met standards established for absolute reliability (CV < 10%). CMJ protocol appeared to influence asymmetries; Concentric Impulse-100 ms, Eccentric Braking Rate of Force Development, Eccentric Deceleration, and Force at Zero velocity were significantly different between jumping conditions (CMJAS versus CMJ NAS; p < 0.05). The present data establish the reliability and smallest worthwhile change of inter-limb asymmetries during the CMJ, while also identifying the influence of CMJ protocol on inter-limb asymmetries, which can be useful to practitioners and clinicians in order to effectively monitor changes associated with performance, injury risk, and return-to-play strategies.

The Influence of Countermovement Jump Protocol on Reactive Strength Index Modified and Flight Time: Contraction Time in Collegiate Basketball Players

The purpose of the present investigation was to evaluate differences in Reactive Strength Index Modified (RSI_Mod) and Flight Time to Contraction Time Ratio (FT:CT) during the countermovement jump (CMJ) performed without the arm swing (CMJNAS) compared to the CMJ with the arm swing (CMJAS), while exploring the relationship within each variable between jump protocols. A secondary purpose sought to explore the relationship between RSI_Mod and FT:CT during both jump protocols. Twenty-two collegiate basketball players performed both three CMJNAS and three CMJAS on a force plate, during two separate testing sessions. RSI_Mod was calculated by the flight-time (RSI_Mod^FT) and impulse-momentum methods (RSI_Mod^IMP). CMJ variables were significantly greater during the CMJAS compared to CMJNAS (p < 0.001). There were large to very large correlations within each variable between the CMJAS and CMJNAS. There were significant positive correlations among RSI_Mod^FT, RSI_Mod^IMP, and FT:CT during both the CMJAS (r ≥ 0.864, p < 0.001) and CMJNAS (r ≥ 0.960, p < 0.001). These findings identify an increase in RSI_Mod or FT:CT during the CMJAS, that may provide independent information from the CMJNAS. In addition, either RSI_Mod or FT:CT may be utilized to monitor changes in performance, but simultaneous inclusion may be unnecessary.

Association of Vitamin D Status with Chronic Disease Risk Factors and Cognitive Dysfunction in 50⁻70 Year Old Adults

Vitamin D deficiency/insufficiency has been primarily associated with skeletal disorders, however, since vitamin D receptors are found on multiple types of cells, there is also a link to increased chronic disease risk and all-cause mortality. The aim of this study was to examine whether deficient/insufficient vitamin D levels are associated with risk factors of chronic diseases and cognitive dysfunction in 50 to 70 year old adults. Participants completed the health status, three-day dietary record and vitamin D food frequency, sun exposure, and international physical activity questionnaires. Cognitive function of the participants was assessed using the Automated Neuropsychological Assessment Metrics while body composition (percent body fat, android/gynoid ratio) was assessed using Dual Energy X-ray Absorptiometry. Applanation tonometry was used to obtain pressure wave forms at the radial artery to examine arterial stiffness and central pressures. A fasting blood draw was taken to measure vitamin D, blood lipid and glucose levels. Fifty percent of the participants (36/72) were vitamin D deficient/insufficient. Individuals in the low physical activity (PA) group had lower serum vitamin D concentration compared to those in the high PA group (p = 0.04). Moreover, serum vitamin D levels were negatively related to risk factors of chronic diseases; blood glucose (r = -0.38; p = 0.01), triglycerides (r = -0.27; p = 0.02), and android/gynoid ratio (r = -0.32; p = 0.01). Deficient/insufficient vitamin D levels are linked to the risk factors of chronic diseases in men and women aged 50 to 70 years.

Time Course Change in Muscle Swelling: High-Intensity vs. Blood Flow Restriction Exercise

This study determined the time course for changes in muscle swelling and plasma volume following high (HI) and low-intensity resistance exercise with blood-flow restriction (LI-BFR). Ten male participants (22.1±3.0 yrs) completed three experimental conditions: high-intensity exercise (HI - 80% of 1RM), low-intensity exercise with BFR (LI-BFR –20% of 1RM, and 160 mmHg of BFR), and control (CON – no exercise or BFR). Muscle cross-sectional area (mCSA), muscle thickness, thigh circumference, and percentage change in plasma volume (PV%∆) were measured. mCSA was significantly greater than rest values at 15 min post-exercise (p<0.01) for HI and LI-BFR, and at 75 min post-exercise (p<0.01) for HI. Muscle thickness was significantly greater than rest immediately post-exercise (p<0.01) and 30 min post-exercise (p<0.01) for HI and LI-BFR, and at 60 min post-exercise for HI (p=0.01). Muscle thickness was greater for BFR immediately post-exercise compared to HI (p=0.01) post-exercise. Thigh circumference was significantly greater from rest at 15 min post-exercise (p=0.01) and at 75 min post-exercise for both LI-BFR (p=0.03) and HI (p<0.01). PV%∆ significantly decreased from rest immediately post-exercise for both HI (p<0.01) and LI-BFR (p<0.01). In conclusion, BFR exercise induces changes in muscle swelling and plasma volume similar to those observed at high-intensities.

[Surgical correction of post-vertebroplasty kyphosis by pedicle substraction osteotomy. Regarding three cases]

We report a case of three patients treated with pedicle subtraction osteotomy for post-vertebroplasty kyphosis. These patients were initially treated with a vertebroplasty for vertebral fracture (two cases) and spinal lymphoma (1 case). All of these patients worsened progressively on a clinical and radiographic level with progression of the spinal deformity in the form of kyphosis. The surgery consisted of transpedicular osteotomy instrumented at the level of the vertebra cemented with maximum removal of intra-corporeal cement. One of the three patients required a supplementary anterior approach to achieve good quality bone fusion. In all three cases the post-vertebroplasty kyphosis was able to be reduced by at least 50 % emphasizing the feasibility and relevance of the pedicle subtraction osteotomy in a context of cemented vertebra.

Diferentes níveis proteicos no crescimento de juvenis de Macrobrachium pantanalense

O camarão de água doce do Pantanal, Macrobrachium pantanalense, é uma espécie promissora para ser utilizada na aquicultura ornamental. O objetivo deste estudo foi avaliar o crescimento de juvenis de M. pantanalense submetidos a dietas contendo diferentes níveis proteicos. O delineamento experimental foi ao acaso, contendo 4 tratamentos (30, 35, 40 e 45 % PB), com 5 repetições, utilizando 5 animais em cada unidade experimental. Juvenis com peso médio inicial de 0,13±0,02 g e comprimento total médio de 25,44±2,15 mm foram cultivados em 20 tanques de 10 litros em sistema de recirculação fechado dinâmico durante 90 dias. Após o término do cultivo, os animais foram mensurados e os dados submetidos à análise de variância (ANOVA). Não foram encontradas diferenças significativas (p>0,05) entre os tratamentos para comprimento total (mm), peso final (g e %), taxa de crescimento específico (%/dia) e conversão alimentar aparente. Sendo assim, indicamos o nível de 30 % de PB para o cultivo de juvenis de M. Pantanalense, considerando o mesmo crescimento em relação aos demais níveis proteicos avaliados e por apresentar o menor custo para a confecção da ração.

Creatine Supplementation Increases Total Body Water in Soccer Players: a Deuterium Oxide Dilution Study

This study aimed to evaluate changes in total body water (TBW) in soccer athletes using a deuterium oxide dilution method and bioelectrical impedance (BIA) formulas after 7 days of creatine supplementation. In a double-blind controlled manner, 13 healthy (under-20) soccer players were divided randomly in 2 supplementation groups: Placebo (Pla, n=6) and creatine supplementation (CR, n=7). Before and after the supplementation period (0.3 g/kg/d during 7 days), TBW was determined by deuterium oxide dilution and BIA methods. 7 days of creatine supplementation lead to a large increase in TBW (2.3±1.0 L) determined by deuterium oxide dilution, and a small but significant increase in total body weight (1.0±0.4 kg) in Cr group compared to Pla. The Pla group did not experience any significant changes in TBW or body weight. Although 5 of 6 BIA equations were sensitive to determine TBW changes induced by creatine supplementation, the Kushner et al. 16 method presented the best concordance levels when compared to deuterium dilution method. In conclusion, 7-days of creatine supplementation increased TBW determined by deuterium oxide dilution or BIA formulas. BIA can be useful to determine TBW changes promoted by creatine supplementation in soccer athletes, with special concern for formula choice.

Cystatin C, CRP, log TG/HDLc and metabolic syndrome are associated with microalbuminuria in hypertension

BACKGROUND

In patients with systemic hypertension, microalbuminuria is a marker of endothelial damage and is associated with an increased risk for cardiovascular disease.

OBJECTIVE

To determine the factors that may lead to the occurrence of microalbuminuria in hypertensive patients with serum creatinine lower than 1.5 mg/dL.

METHODS

This cross-sectional study included 133 Brazilians with essential hypertension followed up at a hypertension outpatient clinic. Those with serum creatinine higher than 1.5 mg/dL, as well as those with diabetes mellitus, were excluded. Systolic and diastolic blood pressures were measured, and body mass index (BMI) and GFR estimated by using the CKD-EPI formula were calculated. The serum levels of the following were assessed: CysC, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, C-reactive protein (CRP) and fasting glucose. Microalbuminuria was determined in 24-hour urine. Hypertensive patients were classified according to the presence of one or more criteria for metabolic syndrome.

RESULTS

In a multiple regression analysis, the serum levels of CysC and CRP, the atherogenic index log TG/HDLc and the presence of three or more criteria for metabolic syndrome were positively correlated with microalbuminuria (r2: 0.277, p < 0.05).

CONCLUSION

CysC, CRP, log TG/HDLc, and the presence of three or more criteria for metabolic syndrome, regardless of serum creatinine, were associated with microalbuminuria, an early marker of kidney damage and cardiovascular risk in patients with essential hypertension.

Antibacterial activity and synergistic effect between watercress extracts, 2-phenylethyl isothiocyanate and antibiotics against 11 isolates of Escherichia coli from clinical and animal source

To evaluate the possible in vitro interaction between natural extracts of watercress (Nasturtium officinale R. Br.) and 2-phenylethyl isothiocyanate, a natural compound derived gluconasturtiin largely present in watercress tissues, with a standard antibiotic, a synergy study was carried out against 11 isolates of extended-spectrum β-lactamases-Escherichia coli. Aqueous and methanolic watercress extracts and 2-phenylethyl isothiocyanate were combined with the antibiotic, and a disc diffusion assay and minimum inhibitory concentration methods were used to assess the in vitro antibacterial activity. The results of this study showed that there is an increase in antibacterial activity of the antibiotic when it was combined with plants extracts and pure compounds. The most interesting result was the combination between 2-phenylethyl isothiocyanate and the antibiotic. Synergistic effects of the antibiotic with watercress extracts and 2-phenylethyl isothiocyanate suggest the potential of these plants and their natural compounds to improve the performance of the antibiotics and could be an interesting tool for antimicrobial therapy. The results led us to conclude that watercress has important pharmacological substances which can be used for developing new and effective antimicrobial agents.

SIGNIFICANCE AND IMPACT OF THE STUDY

This in vitro study intends to demonstrate the potential use of watercress extracts and 2-phenylethyl isothiocyanate as antimicrobial tools against extended-spectrum β-lactamases-Escherichia coli and to determine their ability to act synergistically with commercial standard antibiotics. We intended to increase the knowledge about different clinical and pharmaceutical approaches to fight against E. coli rather than the traditional use of antibiotics. The results may be useful to those involved in the pharmaceutical, biochemical and microbiology industry and/or academic research in terms of developing alternative control measures and efficient intervention methods.

Humoral immunological profile and parasitological statuses of Leishmune vaccinated and visceral leishmaniasis infected dogs from an endemic area

Dogs represent the major reservoir of Leishmaniao chagasi and vaccination against the canine disease is a potential control strategy. However, seroconversion occurs post-vaccine and hence, there is need to discriminate between the former group and naturally infected dogs. The present study represents a comparison of the humoral immunological profiles of both groups using Leishmania soluble antigen (LSA) and fucose-mannose ligand (FML). For both categories, ear skin samples were evaluated immunohistochemically and through PCR, that was also performed in blood specimens, as well as their ability to infect Lutzomyia (Lutzomyia) longipalpis. All these tests showed negative results for the vaccinated dogs. Differences between groups were observed regarding IgG, IgG2 and IgE absorbances as determined by FML-ELISA, and for IgG1 and IgE absorbances as measured by LSA-ELISA, showing that Leishmune-immunised animals and VL naturally infected dogs present different immunological profiles, even though these differences cannot be used to distinguish between these two groups of dogs.

Upregulation of xCT by KSHV-encoded microRNAs facilitates KSHV dissemination and persistence in an environment of oxidative stress

Upregulation of xCT, the inducible subunit of a membrane-bound amino acid transporter, replenishes intracellular glutathione stores to maintain cell viability in an environment of oxidative stress. xCT also serves as a fusion-entry receptor for the Kaposi's sarcoma-associated herpesvirus (KSHV), the causative agent of Kaposi's sarcoma (KS). Ongoing KSHV replication and infection of new cell targets is important for KS progression, but whether xCT regulation within the tumor microenvironment plays a role in KS pathogenesis has not been determined. Using gene transfer and whole virus infection experiments, we found that KSHV-encoded microRNAs (KSHV miRNAs) upregulate xCT expression by macrophages and endothelial cells, largely through miR-K12-11 suppression of BACH-1-a negative regulator of transcription recognizing antioxidant response elements within gene promoters. Correlative functional studies reveal that upregulation of xCT by KSHV miRNAs increases cell permissiveness for KSHV infection and protects infected cells from death induced by reactive nitrogen species (RNS). Interestingly, KSHV miRNAs simultaneously upregulate macrophage secretion of RNS, and biochemical inhibition of RNS secretion by macrophages significantly reduces their permissiveness for KSHV infection. The clinical relevance of these findings is supported by our demonstration of increased xCT expression within more advanced human KS tumors containing a larger number of KSHV-infected cells. Collectively, these data support a role for KSHV itself in promoting de novo KSHV infection and the survival of KSHV-infected, RNS-secreting cells in the tumor microenvironment through the induction of xCT.

Estabilidade do modelo animal de lesão pulmonar aguda induzida por ácido oleico

OBJETIVO: Avaliar a estabilidade das variáveis hemodinâmicas, da mecânica respiratória e de troca gasosa do modelo animal de lesão pulmonar aguda induzida por ácido oleico. MÉTODOS: Trata-se de um estudo experimental no qual foram utilizados 10 cães de raça indeterminada. As variáveis foram aferidas inicialmente e em 30, 60, 90 e 120 min após a administração do ácido oleico. Para analisar as medidas repetidas, foram testados efeitos lineares e quadráticos e foram utilizados ajustes de modelos lineares mistos com estruturas de variâncias e covariâncias diversificadas, dependendo da variável analisada. RESULTADOS: Observamos estabilidade da pressão arterial média aos 30 min, assim como da frequência cardíaca, da pressão arterial pulmonar e da pressão de capilar pulmonar aos 60 min. Frequência respiratória, volume corrente, volume minuto e trabalho respiratório estabilizaram aos 30 min. Quanto às variáveis de troca gasosa, PaO2, relação PaO2/FiO2 e fração de shunt pulmonar estabilizaram-se aos 30 min. As demais variáveis mantiveram-se em ascensão ou queda contínuas. CONCLUSÕES: O modelo de lesão pulmonar aguda induzida por ácido oleico é estável para algumas das variáveis testadas; porém, a estabilização se dá em momentos diferentes. As variáveis da mecânica respiratória e de troca gasosa estabilizaram em 30 min, e as hemodinâmicas, em 60 min.

Gene expression of divalent metal transporter 1 and transferrin receptor in duodenum of Belgrade rats

Regulation of iron absorption is thought to be mediated by the amount of iron taken up by duodenal crypt cells via the transferrin receptor (TfR)-transferrin cycle and the activity of the divalent metal transporter (DMT1), although DMT1 cannot be detected morphologically in crypt cells. We investigated the uptake of transferrin-bound iron by duodenal enterocytes in Wistar rats fed different levels of iron and Belgrade (b/b) rats in which iron uptake by the transferrin cycle is defective because of a mutation in DMT1. We showed that DMT1 in our colony of b/b rats contains the G185R mutation, which in enterocytes results in reduced cellular iron content and increased DMT1 gene expression similar to levels in iron deficiency of normal rats. In all groups the uptake of transferrin-bound iron by crypt cells was directly proportional to plasma iron concentration, being highest in iron-loaded Wistar rats and b/b rats. We conclude that the uptake of transferrin-bound iron by developing enterocytes is largely independent of DMT1.

Quantitative analysis of the high-affinity binding sites for [3H]ouabain in the rat vas deferens and their immunological identification as the alpha 2 isoform of Na+/K(+)-ATPase

Binding assays were performed with [3H]ouabain to investigate the presence of, and to characterize, a Na+/K(+)-ATPase isoform with high affinity for cardiac glycosides in the rat vas deferens. Nonlinear regression analysis of equilibrium experiments carried out with crude preparations in a Mg-Pi medium indicated the presence of high-affinity sites characterized with good precision (individual coefficients of variation = 11-35%) by their density (Bmax = 0.42 to 0.72 pmol/mg protein) and dissociation constant (Kd = 0.069 to 0.136 microM) values. The values of the dissociation rate constant (kappa-1) and the association rate constant (kappa+1) for these sites were 0.151 to 0.267 min-1 and 2.87 to 3.60 microM-1.min-1, respectively. A higher number of low-affinity sites (Kd around 15 microM), supposed to correspond to the alpha 1 isoform, was also identified, but their Kd and Bmax values were not quantified precisely in this crude preparation. Western blot assays indicated hybridization with specific anti-alpha 1 and anti-alpha 2 isoform antibodies but not with anti-alpha 3 isoform antibody. Taken together, the present results indicate the existence of a low proportion of the alpha 2 isoform of Na+/K(+)-ATPase in the rat vas deferens that can be quantified precisely by [3H]ouabain binding even in a crude membrane preparation that is suitable for studies under conditions of plasticity.

Aortic valve conservation in acute type A dissection

BACKGROUND

We consider operative survival as the primary objective in acute type A dissection and believe that virtually all native aortic valves can be conserved. We sought to answer the question: "Does glue repair improve the long-term stability of proximal aortic repair?"

METHODS

We retrospectively studied 64 patients with an acute type A dissection, an ascending aortic tear, and aortic regurgitation operated on by the same surgeon between 1988 and 1996. Three had Marfan's syndrome and 2 had a bicuspid valve. The valves in all patients without Marfan's syndrome were repaired with gelatin-resorcinol-formol glue. The valve and root were reinvestigated by echocardiography. Some patients underwent nuclear magnetic resonance imaging.

RESULTS

There were four hospital (6%) and three late deaths. Aortic root reoperation was required in 2 of the 60 survivors (3.3%) and operation on the distal aorta in 2. Root reoperations were required within 3 years. The remaining proximal repairs remained stable.

CONCLUSIONS

The native aortic valve can be conserved in most patients, and glue repair is durable. Simple root repair is associated with a low operative mortality.

Primary leiomyosarcoma of the heart: a rare cause of obstruction of the left ventricular outflow tract

Primary cardiac tumours are rare and frequently only diagnosed post-mortem. Recent improvements in non-invasive imaging techniques have led to an increasing number being diagnosed in life, allowing surgical resection. We report a primary leiomyosarcoma presenting with obstruction of the left ventricular outflow tract.

A baseline study of periodontal conditions among youths and adults in Portugal

A study was undertaken in 1979 to obtain baseline data of periodontal disease and treatment needs among rural and urban Portuguese. From Montemor-o-Novo, Alentejo and from Lisbon, 255 persons (121 males, 134 females) aged 15-44 yr were selected by a stratified quota sampling method and examined under field conditions using both Russell's Periodontal Index (P.I.), slightly modified, and components of a proposed new WHO method. The latter formed the basis for estimation of treatment need according to the Community Periodontal Index for Treatment Needs (CPITN). Periodontal disease as assessed by the P.I. exhibited epidemiologic characteristics which in several respects were similar to those reported in other populations. Severity increased with increasing age and there were trends towards more severe disease in males than in females, and more severe disease in rural than in urban districts. Relatively few cases of advanced periodontitis were detected by the P.I. as applied in this study. The underestimation of disease prevalence inherent in the scoring method, the high tooth mortality and the fact that only relatively young individuals were studied may have contributed to this finding. Great need for various types of periodontal therapy were found through CPITN assessments. However, relatively few individuals were in need of "complex periodontal therapy" as assessed by the CPITN.

Bullet embolism into the cardiovascular system

Two clinical case reports of bullet embolism into the cardiovascular system are reported. The patient in the first case sustained a gunshot wound at the right clavicular area with embolism resulting in the right ventricle. In the second case, the patient received a projectile wound to the anterior right shoulder with eventual bullet embolism in the left iliac artery. In both cases, the bullets were removed successfully. Surgical intervention with the aid of extracorporeal circulation is recommended for similar cases.

Pulmonary hydatid cyst: a 25-year experience

This study reviews our experience with 102 patients operated on for pulmonary hydatid cysts during a 25-year period. The sex incidence was approximately equal. All subjects except three were symptomatic. The diagnosis was made on the radiographic findings. Early surgery is advised for complicated cysts in view of their increased postoperative morbidity and mortality. Surgical treatment included Barrett's enucleation for uncomplicated cysts and resection for complicated ones.

Eruption of permanent teeth in Brazilian Whites and Blacks

A total of 302 White and 904 Black children six, nine and 12 years of age were studied for the eruption of their permanent teeth. Differences between the two ethnic groups were not large, but the Black subjects were generally more precocious at the beginning of the process (especially the girls, both in the upper and lower incisors). At nine and 12 years of age, however, these dissimilarities disappear. The latter do not seem to be related to distinct rates of extraction or agenesis of deciduous teeth. No significant differences were observed in the degree of asymmetry present in the permanent dentition of the White and Black individuals studied.