Dengue Myocarditis: A Case Report and Major Review

Dengue is a viral disease transmitted by the bite of a female arthropod, prevalent primarily in tropical and subtropical regions. Its manifestations include asymptomatic infections, dengue fever, and a severe form called hemorrhagic dengue or dengue shock syndrome. Atypical manifestations can also occur, called expanded dengue syndrome. We describe the case of a 43-year-old man with an unusual presentation of dengue, demonstrating a workup suggestive of myocardial and pericardial damage. Symptoms and markers indicative of cardiac compromise improved after five days on anti-inflammatory treatment. Dengue myocarditis is considered an uncommon complication of dengue, although its reported incidence is likely an underestimation. In general, most cases of dengue myocarditis are self-limited, with only a minority at risk of progressing to heart failure. In order to improve recognition and prevent progression, healthcare providers should maintain a high degree of suspicion regarding potential cardiac complications in patients with dengue.

Probabilistic Risk Assessment of Polycyclic Aromatic Hydrocarbons in a Colombian Reservoir

The purpose of this research was to evaluate the concentrations, sources and ecological risk assessment of sixteen polycyclic aromatic hydrocarbons (PAHs) present in water from the La Fe reservoir, Colombia in the months of October and November of 2017 and 2018. Concentrations of PAHs in water were measured with semipermeable membrane devices (SPMD) which allow obtaining the dissolved concentrations of the PAHs in the reservoir, emphasizing the reactivity and bioavailability in the environment. The PAHs analyses were carried out by means of gas chromatography, coupled with tandem mass spectrometry (GC/MS-MS) with triple quadrupole (QqQ). The environmental risk assessment using the estimation of risk quotient with deterministic and probabilistic method, the predictive no-effect concentration (PNEC) and environmental exposure concentration (EEC) in water indicate a negligibe risk for probabilistic method for all PAHs evaluated (RQ < 0.1).

The determination of fertiliser quality of the formed struvite from a WWTP

Struvite from nutrient-rich wastewaters has been identified as a potential substitute for commercial mineral fertilisers, with the added benefit of reducing threats to global food security by prolonging phosphate rock reserves. A fertilisation test using grass (Brachiaria brizantha Marandú) and a sand column leaching test was conducted to determine the agronomic effectiveness of struvite precipitates produced from the supernatant of dewatered sewage sludge (centrate) from a municipal Wastewater Treatment Plant (WWTP). The performance of this struvite as a fertiliser was compared with biosolids and commercial fertilisers (Urea and Triple15). The results show that the concentration of heavy metals in struvite was lower than in biosolids and below the limits of Colombia and European fertiliser regulations. Struvite increased the uptake of N and P in grass, resulting in crop yields similar to other treatments tested. Struvite use as an effective slow-release fertiliser is highly dependent on the size of crystal particles, particularly in achieving low P losses, but resulted in high N loss in the sand columns tested; N loses from struvite were higher than in the commercial fertilisers due to the struvite small particle size. Therefore, struvite represents a suitable opportunity to recover and recycle nutrients from municipal sewage sludge, facilitating the effective reuse of P and N in agriculture and uptake by plants.

Psychosocial effects of COVID-19 pandemic in Bolivia. Preliminary results

Introduction

The global health crisis due to Coronavirus Disease 2019 (COVID-19) and related containment measures have led to changes in daily life and, therefore, social and psychological impacts on the population.

Objectives

To explore the psychological and social impact of COVID-19 in the general population of Bolivia.

Methods

Cross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).

Results

A total of 878 adults living in Bolivia answered the questionnaire. Most people considered COVID-19 as a quite/very serious health problem that affects the entire population, without distinction. 65% reported to accomplish lock down measure, however, one of the main reasons for non-compliance is the need to go out to work. Half of participants (50%) reduced worked hours and 18% modified their employment contract. However, 70% reduced household income. A considerable percentage (62%) reported psychological distress (46% with moderate or severe). It was higher in women, young people and among those with lower household income. In addition, social networks and watching series and movies were the main coping strategies reported.

Conclusions

The COVID-19 pandemic has a considerable impact on psychological and social level. The negative impact was greater in some population groups such as women, young people, and those with a lower socioeconomic level, which may further increase inequities.

Psychological well-being and employment status during the COVID-19 pandemic

Introduction

Several restrictive measures have been implemented to reduced COVID- 19 impact with unknown consequences on people daily life.

Objectives

The primary objective is to asses the psychosocial impact and employment status changes since lockdown COVID-19 measures in Chile.

Methods

Cross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).

Results

3102 participants over 18 years answered the questionnaire. 69.9% reported psychological distress mainly women (82.2%), members of the public health system (59%), dependent workers (39.8%), people who suffered income reduction (36.8%)., and those who changed their employment status (26.4%). Participants who presented income reduction were 1.83 times more likely to present psychological distress than those without changes (p <0.001)

Conclusions

Pandemic crisis had impacted population health, especially in some specifics groups that could be targeted for future interventions.

New case of concha bullosa from Bronze Age Iberia (Granada, Spain)

OBJECTIVE

This study aims to expand knowledge of Concha bullosa in a prehistoric population.

MATERIALS

The skull of an adult female from the Bronze Age archeological site ofCastellón Alto (Granada, Spain), dated between 1900 and 1600 BCE.

METHODS

The diagnosis of middle turbinateconcha bullosa was based on macroscopic, radiographic, and computed tomography studies.

RESULTS

This is one of the oldest findings ofconcha bullosa in Europe. Despite the possible obstruction of the osteomeatal complex by the concha bullosa in this individual, no signs of sinusitis were observed in maxillary sinuses.

CONCLUSIONS

The maxillary sinuses of this female showed no signs of sinusitis related to theconcha bullosa.

SIGNIFICANCE

This study provides new evidence on the chronological limits of this condition. The particular funeral rites of these populations have preserved the majority of skeletons at this site in an excellent condition.

LIMITATIONS

The identification ofconcha bullosa continues to be rare in ancient populations, in part due to the poor preservation of nasal bones in archeological collections. Suggestions for further research: Detailed study of the nasal cavity of adequately preserved individuals can be expected to identify further cases of concha bullosa in ancient populations.

Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock

OBJECTIVE

To assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies.

METHODS

Prospective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted.

RESULTS

A total of 705 patients with severe sepsis were included. No differences were found in positive-culture patients (n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics (OR = 0.90; 95% CI = 0.55-1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive (OR = 1.04; 95% CI = 0.99-1.08) or negative cultures (OR = 0.98; 95% CI = 0.92-1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7-18 days for the whole cohort).

CONCLUSIONS

No associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay.

Positive Culture and Prognosis in Patients With Sepsis: A Prospective Cohort Study

PURPOSE

To analyze the prognostic role of positive cultures in patients with sepsis.

METHODS

A prospective cohort study in a tertiary referral hospital in Medellín, Colombia. Adults older than 18 years of age with a bacterial infection diagnosis according to Centers for Disease Control criteria and sepsis (evidence of organ dysfunction) were included. A logistic regression model was used to determine the association between positive cultures and hospital mortality, and a Cox regression with a competing risk modeling approach was used to determine the association between positive cultures and hospital stay as well as secondary infections.

RESULTS

Overall, 408 patients had positive cultures, of which 257 were blood culture, and 153 had negative cultures. Patients with positive cultures had a lower risk of mortality (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.27-0.68), but this association was not maintained after adjusting for confounding factors (OR, 0.56; 95% CI, 0.31-1.01). No association was found with the hospital stay (adjusted subhazard ratio [SHR], 1.06; 95% CI, 0.83-1.35). There was no association between positive cultures and the presence of secondary infections (adjusted SHR, 0.99; 95% CI, 0.58-1.71).

CONCLUSION

Positive cultures are not associated with prognosis in patients with sepsis.

Different Expressivity of two Adjacent Mutations of the APC Gene

Aims and background

The phenotypic expression of different APC mutations in familial adenomatous polyposis (FAP) is variable: two to three variants of the disease have been defined based on the severity of colonic manifestations. Age of onset and number of polypectomies per person-year of postsurgical follow-up were compared in two FAP families with very close mutation sites in the APC gene, in order to ascertain mutation-specific variation of expressivity.

Families and APC mutations

Family A (5 patients) carried a newly characterized mutation, a four bp deletion at codon 843. Family B (5 patients) carried a previously identified mutation at codon 835.

Results

Mean age of onset was 49.7 years in family A and 30.5 years in family B; number of polypectomies per person-year of follow-up was 1.05 for family A and 10.1 for family B (P <0.001).

Conclusions

There is significant variation of expressivity (allelic heterogeneity) in FAP between two mutations separated by only eight codons, located at the 5’ extremity of APC gene exon 15.

Energy distribution of the neutron flux measurements at the Chilean Reactor RECH-1 using multi-foil neutron activation and the Expectation Maximization unfolding algorithm

We present a methodology to obtain the energy distribution of the neutron flux of an experimental nuclear reactor, using multi-foil activation measurements and the Expectation Maximization unfolding algorithm, which is presented as an alternative to well known unfolding methods such as GRAVEL. Self-shielding flux corrections for energy bin groups were obtained using MCNP6 Monte Carlo simulations. We have made studies at the at the Dry Tube of RECH-1 obtaining fluxes of 1.5(4)×10¹³cm^-2s^-1 for the thermal neutron energy region, 1.9(5)×10¹²cm^-2s^-1 for the epithermal neutron energy region, and 4.3(11)×10¹¹cm^-2s^-1 for the fast neutron energy region.

Two-Proton Radioactivity of ^{67}Kr

In an experiment with the BigRIPS separator at the RIKEN Nishina Center, we observed two-proton (2p) emission from ^{67}Kr. At the same time, no evidence for 2p emission of ^{59}Ge and ^{63}Se, two other potential candidates for this exotic radioactivity, could be observed. This observation is in line with Q value predictions which pointed to ^{67}Kr as being the best new candidate among the three for two-proton radioactivity. ^{67}Kr is only the fourth 2p ground-state emitter to be observed with a half-life of the order of a few milliseconds. The decay energy was determined to be 1690(17) keV, the 2p emission branching ratio is 37(14)%, and the half-life of ^{67}Kr is 7.4(30) ms.

Autoimmune rheumatic diseases in the intensive care unit: experience from a tertiary referral hospital and review of the literature

Autoimmune rheumatic diseases (AIRD) are not uncommon in the general population and up to one third of hospitalized patients with AIRD may need admission to intensive care unit (ICU). This paper describes the causes of admission, the clinical features and outcome of 24 AIRD patients admitted to a medical ICU from a third level hospital. Thirteen patients had systemic lupus erythematosus (54.2%), three rheumatoid arthritis (12.5%), three pulmonary renal syndrome (12.5%), two dermatopolymyositis (8.3%), two scleroderma (8.3%) and one antiphospholipid syndrome (4.2%). The main causes for ICU admission were rheumatic disease flare-up (37.5%), infection (37.5%) and complications derived from rheumatic disease (29.1%). Mortality during ICU stay was 16.7% (four patients). Excluding shock requiring vasopressor support, no statistical difference was found between survivors and nonsurvivors; although there was a trend to higher test severity scores (APACHE II, ODIN) in nonsurvivors. Our results reveal a lower mortality rate in AIRD patients admitted to the ICU than reported previously. Severity scores such as APACHE II are predictors of mortality in patients with AIRD in the ICU.

Identification of protective B-cell epitopes of Atroxlysin-I: A metalloproteinase from Bothrops atrox snake venom

Atroxlysin-I (Atr-I) is a hemorrhagic snake venom metalloproteinase (SVMP) from Bothrops atrox venom, the snake responsible for the majority of bites in the north region of South America. SVMPs like Atr-I produce toxic effects in victims including hemorrhage, inflammation, necrosis and blood coagulation deficiency. Mapping of B-cell epitopes in SVMPs might result in the identification of non-toxic molecules capable of inducing neutralizing antibodies and improving the anti-venom therapy. Here, using the SPOT-synthesis technique we identified two epitopes located in the N-ter region of Atr-I (AtrEp1-(22)YNGNSDKIRRRIHQM(36); and AtrEp2-(55)GVEIWSNKDLINVQ(68)). Based on the sequence of AtrEp1 and AtrEp2 a third peptide named Atr-I biepitope (AtrBiEp) was designed and synthesized ((23)NGNSDKIRRRIH(34)GG(55)GVEIWSNKDLINVQ(68)). AtrBiEp was used to immunize BALB/c mice. Anti-AtrBiEp serum cross-reacted against Atr-I in western blot and was able to fully neutralize the hemorrhagic activity of Atr-I. Our results provide a rational basis for the identification of neutralizing epitopes on Atr-I snake venom toxin and show that the use of synthetic peptides could improve the generation of immuno-therapeutics.

Customized Monitoring and Interaction Devices in Virtual Environments for Upper Limb Rehabilitation After Brain Injury

This paper introduces a new approach for upper limb neurorehabilitation based on customized devices for monitoring and interacting with virtual environments. A proof-of-concept test involving eight patients at the Guttmann Neurorehabilitation Hospital shows patient's good acceptance and usability scores and demonstrates the technically feasibility of the devices. The final goal is to achieve a more personalized, monitored, intensive and ecological rehabilitation procedures for ABI patients.

Total Absorption Spectroscopy Study of (92)Rb Decay: A Major Contributor to Reactor Antineutrino Spectrum Shape

The antineutrino spectra measured in recent experiments at reactors are inconsistent with calculations based on the conversion of integral beta spectra recorded at the ILL reactor. (92)Rb makes the dominant contribution to the reactor antineutrino spectrum in the 5-8 MeV range but its decay properties are in question. We have studied (92)Rb decay with total absorption spectroscopy. Previously unobserved beta feeding was seen in the 4.5-5.5 region and the GS to GS feeding was found to be 87.5(25)%. The impact on the reactor antineutrino spectra calculated with the summation method is shown and discussed.

Anti-A2 and anti-A1 domain antibodies are potential predictors of immune tolerance induction outcome in children with hemophilia A

BACKGROUND

Hemophilia A (HA) is a congenital bleeding disorder resulting from factor VIII deficiency. The most serious complication of HA management is the appearance of inhibitory antibodies (Abs) against injected FVIII concentrates. To eradicate inhibitors, immune tolerance induction (ITI) is usually attempted, but it fails in up to 30% of cases. Currently, no undisputed predictive marker of ITI outcome is available to facilitate the clinical decision.

OBJECTIVES

To identify predictive markers of ITI efficacy.

METHODS

The isotypic and epitopic repertoires of inhibitory Abs were analyzed in plasma samples collected before ITI initiation from 15 children with severe HA and high-titer inhibitors, and their levels were compared in the two outcome groups (ITI success [n = 7] and ITI failure [n = 8]). The predictive value of these candidate biomarkers and of the currently used indicators (inhibitor titer and age at ITI initiation, highest inhibitor titer before ITI, and interval between inhibitor diagnosis and ITI initiation) was then compared by statistical analysis (Wilcoxon test and receiver receiver operating characteristic [ROC] curve analysis).

RESULTS

Whereas current indicators seemed to fail in discriminating patients in the two outcome groups (ITI success or failure), anti-A1 and anti-A2 Ab levels before ITI initiation appeared to be good potential predictive markers of ITI outcome (P < 0.018). ROC analysis showed that anti-A1 and anti-A2 Abs were the best at discriminating between outcome groups (area under the ROC curve of > 0.875).

CONCLUSION

Anti-A1 and anti-A2 Abs could represent new promising tools for the development of ITI outcome prediction tests for children with severe HA.

Hindered Gamow-Teller decay to the odd-odd N=Z (62)Ga: absence of proton-neutron T=0 condensate in A=62

Search for a new kind of superfluidity built on collective proton-neutron pairs with aligned spin is performed studying the Gamow-Teller decay of the T=1, J(π)=0+ ground state of (62)Ge into excited states of the odd-odd N=Z nucleus (62)Ga. The experiment is performed at GSI Helmholtzzentrum für Shwerionenforshung with the (62)Ge ions selected by the fragment separator and implanted in a stack of Si-strip detectors, surrounded by the RISING Ge array. A half-life of T1/2=82.9(14)  ms is measured for the (62)Ge ground state. Six excited states of (62)Ga, populated below 2.5 MeV through Gamow-Teller transitions, are identified. Individual Gamow-Teller transition strengths agree well with theoretical predictions of the interacting shell model and the quasiparticle random phase approximation. The absence of any sizable low-lying Gamow-Teller strength in the reported beta-decay experiment supports the hypothesis of a negligible role of coherent T=0 proton-neutron correlations in (62)Ga.

Half-life systematics across the N=126 shell closure: role of first-forbidden transitions in the β decay of heavy neutron-rich nuclei

This Letter reports on a systematic study of β-decay half-lives of neutron-rich nuclei around doubly magic (208)Pb. The lifetimes of the 126-neutron shell isotone (204)Pt and the neighboring (200-202)Ir, (203)Pt, (204)Au are presented together with other 19 half-lives measured during the "stopped beam" campaign of the rare isotope investigations at GSI collaboration. The results constrain the main nuclear theories used in calculations of r-process nucleosynthesis. Predictions based on a statistical macroscopic description of the first-forbidden β strength reveal significant deviations for most of the nuclei with N<126. In contrast, theories including a fully microscopic treatment of allowed and first-forbidden transitions reproduce more satisfactorily the trend in the measured half-lives for the nuclei in this region, where the r-process pathway passes through during β decay back to stability.

Observation of the β-delayed γ-proton decay of (56)Zn and its impact on the Gamow-Teller strength evaluation

We report the observation of a very exotic decay mode at the proton drip line, the β-delayed γ-proton decay, clearly seen in the β decay of the T_{z}=-2 nucleus ^{56}Zn. Three γ-proton sequences have been observed after the β decay. Here this decay mode, already observed in the sd shell, is seen for the first time in the fp shell. Both γ and proton decays have been taken into account in the estimation of the Fermi and Gamow-Teller strengths. Evidence for fragmentation of the Fermi strength due to strong isospin mixing is found.

Observation of low- and high-energy Gamow-Teller phonon excitations in nuclei

Gamow-Teller (GT) transitions in atomic nuclei are sensitive to both nuclear shell structure and effective residual interactions. The nuclear GT excitations were studied for the mass number A = 42, 46, 50, and 54 "f-shell" nuclei in ((3)He, t) charge-exchange reactions. In the (42)Ca → (42)Sc reaction, most of the GT strength is concentrated in the lowest excited state at 0.6 MeV, suggesting the existence of a low-energy GT phonon excitation. As A increases, a high-energy GT phonon excitation develops in the 6-11 MeV region. In the (54)Fe → (54)Co reaction, the high-energy GT phonon excitation mainly carries the GT strength. The existence of these two GT phonon excitations are attributed to the 2 fermionic degrees of freedom in nuclei.

Upper-limb muscular electrical stimulation driven by EEG-based detections of the intentions to move: a proposed intervention for patients with stroke

This study proposes an intervention for stroke patients in which electrical stimulation of muscles in the affected arm is supplied when movement intention is detected from the electroencephalographic signal. The detection relies on the combined analysis of two movement related cortical patterns: the event-related desynchronization and the bereitschaftspotential. Results with two healthy subjects and three chronic stroke patients show that reliable EEG-based estimations of the movement onsets can be generated (on average, 66.9 ± 26.4 % of the movements are detected with 0.42 ± 0.17 false activations per minute) which in turn give rise to electrical stimuli providing sensory feedback tightly associated to the movement planning (average detection latency of the onsets of the movements was 54.4 ± 287.9 ms).

Cerebrospinal Aβ11-x and 17-x levels as indicators of mild cognitive impairment and patients' stratification in Alzheimer's disease

In the present work, the concentrations of Aβ11-x and Aβ17-x peptides (x=40 or 42), which result from the combined cleavages of β-amyloid precursor protein (AβPP) by β'/α or α/γ-secretases, respectively, were assessed in cerebrospinal fluid (CSF) samples from patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI). Specific multiplexed assays were set up using new anti-40 and anti-42 monoclonal antibodies (mAbs) for the capture of these N-truncated Aβ peptides and anti-11 or anti-17 mAbs for their detection. The specificity, sensitivity and reproducibility of such assays were assessed using synthetic peptides and human cell models. Aβ11-x and Aβ17-x were then measured in CSF samples from patients with AD (n=23), MCI (n=23) and controls with normal cognition (n=21). Aβ11-x levels were significantly lower in patients with MCI than in controls. Compared with the combined quantification of Aβ1-42, total Tau (T-Tau) and phosphorylated Tau (P-Tau; AlzBio3, Innogenetics), the association of Aβ11-40, Aβ17-40 and T-Tau improved the discrimination between MCI and controls. Furthermore, when patients with MCI were classified into two subgroups (MCI ≤1.5 or ≥2 based on their CDR-SB (Cognitive Dementia Rating-Sum of Boxes) score), the CSF Aβ17-40/Aβ11-40 ratio was significantly higher in patients with CDR-SB ≤1.5 than in controls, whereas neither Aβ1-42, T-Tau nor P-Tau allowed the detection of this subpopulation. These results need to be confirmed in a larger clinical prospective cohort.

Knowledge of their own allergic sensitizations in asthmatic patients and its impact on the level of asthma control

BACKGROUND

Asthma guidelines recommend the adoption of allergen avoidance measures (AAM). To do so, patients need to know their own allergies. However, this degree of knowledge has not yet been assessed. The aims of this study were to determine, in allergic asthma patients: i)the degree of knowledge of their own allergic sensitizations; ii)the percentage of those who knew all their allergies and, in addition, adopted AAM against all of them, and iii)the possible impact of this degree of knowledge on the level of asthma control.

PATIENTS AND METHODS

Descriptive, prospective and multicentre study, including 147patients from 9 Respiratory Medicine outpatient clinics. After confirming the previous allergic asthma diagnosis, a questionnaire was completed. It included asthma control and severity levels, results of previous allergy tests, and the description and number of allergic sensitizations known by the patients and AAM followed.

RESULTS

Only 72 (49%) patients knew all their allergic sensitizations and only 48 (33%) were also following AAM against all the allergens to which they were allergic. No relationship was established between the degree of knowledge of their own allergies and the level of asthma control (P=.544).

CONCLUSIONS

Overall knowledge about the allergic nature of their disease among asthmatic patients attending Spanish Respiratory Medicine Departments is inadequate. Furthermore, a higher degree of knowledge of their allergies does not seem to lead, by itself, to better asthma control. Both findings seem to question the effectiveness of current educational strategies in this field and consequently, they should be revised.

Prefrontal space ratio: comparison between trisomy 21 and euploid fetuses in the second trimester

OBJECTIVE

To evaluate a novel ultrasound measurement, the prefrontal space ratio (PFSR), in second-trimester trisomy 21 and euploid fetuses.

METHODS

Stored three-dimensional volumes of fetal profiles from 26 trisomy 21 fetuses and 90 euploid fetuses at 15-25 weeks' gestation were examined. A line was drawn between the leading edge of the mandible and the maxilla (MM line) and extended in front of the forehead. The ratio of the distance between the leading edge of the skull and that of the skin (d(1)) to the distance between the skin and the point where the MM line was intercepted (d(2)) was calculated (d(2)/d(1)). The distributions of PFSR in trisomy 21 and euploid fetuses were compared, and the relationship with gestational age in each group was evaluated by Spearman's rank correlation coefficient (r(s) ).

RESULTS

The PFSR in trisomy 21 fetuses (mean, 0.36; range, 0-0.81) was significantly lower than in euploid fetuses (mean, 1.48; range, 0.85-2.95; P < 0.001 (Mann-Whitney U-test)). There was no significant association between PFSR and gestational age in either trisomy 21 (r(s) = 0.25; 95% CI, - 0.15 to 0.58) or euploid (r(s) = 0.06; 95% CI, - 0.15 to 0.27) fetuses.

CONCLUSION

The PFSR appears to be a highly sensitive and specific marker of trisomy 21 in the second trimester of pregnancy.

Mimotopes of mutalysin-II from Lachesis muta snake venom induce hemorrhage inhibitory antibodies upon vaccination of rabbits

Mutalysin-II (mut-II) from Lachesis muta snake venom is an endopeptidase with hemorrhagic activity. A mAb against mutalysin-II that neutralized the hemorrhagic effect was produced previously. To identify the mAb epitopes, sets of 15-mer overlapping peptides covering the mut-II amino acid sequence were synthesized using the SPOT method and tested but failed to react with the mAb. Using a phage-display approach seventeen clones reactive with mAb were identified. Additional immunoassays with the peptides and mAb identified the QCTMDQGRLRCR, TCATDQGRLRCT, HCFHDQGRVRCA, HCTMDQGRLRCR and SCMLDQGRSRCR sequences as possible epitopes. Immunization of rabbits with these peptides induced antibodies that recognize mut-II and protected against the hemorrhagic effects of Lachesis venom.

Upregulation of cardiac NO/NOS system during short-term hypoxia and the subsequent reoxygenation period

Hypoxia/reoxygenation (H/R) reportedly influences nitric oxide (NO) production and NO synthase (NOS) expression in the heart. Nonetheless, a number of works have shown controversial results regarding the changes that the cardiac NO/NOS system undergoes under such situations. Therefore, this study aims to clarify the behaviour of this system in the hypoxic heart by investigating seven different reoxygenation times. Wistar rats were submitted to H/R (hypoxia for 30 min; reoxygenation of 0, 2, 12, 24, 48, 72 h, and 5 days) in a novel approach to address the events provoked by assaults under such circumstances. Endothelial and inducible NOS (eNOS and iNOS) mRNA and protein expression, as well as enzymatic activity and enzyme location were determined. NO levels were indirectly quantified as nitrate/nitrite, and other S-nitroso compounds (NOx), which would act as NO-storage molecules. The results showed a significant increase in eNOS mRNA, protein and activity, as well as in NOx levels immediately after hypoxia, while iNOS protein and activity were induced throughout the reoxygenation period. These findings indicate that, not only short-term hypoxia, but also the subsequent reoxygenation period upregulate cardiac NO/NOS system until at least 5 days after the hypoxic stimulus, implying major involvement of this system in the changes occurring in the heart in response to H/R.