Avaliação do valor prognóstico da detecção do status quimérico de pacientes após o transplante alogênico de células progenitoras hematopoéticas

Este trabalho teve por objetivo correlacionar o status quimérico de pacientes pós -TCPH alogênico com parâmetros clínicos, para avaliar o valor preditivo dos achados laboratorias de quimerismo. Amostras de sangue de 98 pacientes (67 em seguimento e 31 novos casos) foram submetidas à análise do status quimérico pós-TCPH. Os locianalisados por biologia molecular foram CS1PO, TPOX, F13A1, FESFPS, HUMTH01, VWA, SE33, HUMARA, HUMD21S11 e Amelogenina. Precocidade da evidência laboratorial de quimerismo misto (QM), em relação ao aparecimento dos sintomas clínicos de recaída, foi observada em 9 dos 12 pacientes nas LA, ou seja, nesses casos, a primeira manifestação de QM foi detectada pelo exame laboratorial antes de qualquer evidência citológica ou clínica de recaída. em todos eles, houve uma mudança terapêutica relacionada com esse momento do aparecimento do QM. em 100% dos pacientes com QM na LMC, a detecção do quimerismo pelo exame laboratorial foi anterior a qualquer evidência citológica ou clínica de recaída. de uma maneira geral, o exame laboratorial da avaliação do status quimérico pós-TCPH alogênico pela análise dos locihipervariáveis do genoma, mostrou ser um exame sensível, com detecção de até 1% de QM e precoce, visto que, muitas vezes, foi a primeira manifestação de doença residual antes de qualquer evidência citológica ou clínica da mesma. A associação da existência de QM e a recaída clínica e/ou óbito fica mais evidente nos casos de LA do que nos casos de LMC e AAS.

Anatomopathological analysis of sentinel and nonsentinel lymph nodes in breast cancer: Hematoxylin-eosin versus immunohistochemistry

The authors compare the detection of metastases in sentinel lymph nodes (SLNs) and nonsentinel lymph nodes (NSLNs) using hematoxvlin-eosin (HE) staining versus immunohistochemistry (IHC). Thirty-six patients with breast carcinoma undergo exeresis of the primary tumor and of 50 SLNs and 491 NSLNs. Sentinel lymph nodes are sectioned into transverse slices of 2- to 3-mm thickness, and a cytologic smear and a frozen section were obtained from each slice. The slices are completely cut into serial sections at 100-mu m intervals. Two consecutive 4-mu m-thick sections are then obtained from each level and were prepared for HE staining and IHC. Nonsentinel lymph nodes are evaluated similarly to SLNs. The authors obtain 4076 SLN sections and 32 012 NSLN sections, fora total of 36 088 sections. A comparison of HE staining versus IHC based on the total number of sections shows a sensitivity of 93.8%, a negative predictive value of 98.9%, and an accuracy of 99.1 %. The values obtained by HE staining are similar to those obtained by IHC.

Response to Treatment in a Prospective Cohort of Patients with Large Ulcerated Lesions Suspected to Be Buruli Ulcer (Mycobacterium ulcerans Disease)

Background: The World Health Organization (WHO) advises treatment of Mycobacterium ulcerans disease, also called Buruli ulcer'' (BU), with a combination of the antibiotics rifampicin and streptomycin (R+S), whether followed by surgery or not. In endemic areas, a clinical case definition is recommended. We evaluated the effectiveness of this strategy in a series of patients with large ulcers of >= 10 cm in longest diameter in a rural health zone of the Democratic Republic of Congo (DRC).Methods: A cohort of 92 patients with large ulcerated lesions suspected to be BU was enrolled between October 2006 and September 2007 and treated according to WHO recommendations. The following microbiologic data were obtained: Ziehl-Neelsen (ZN) stained smear, culture and PCR. Histopathology was performed on a sub-sample. Directly observed treatment with R+S was administered daily for 12 weeks and surgery was performed after 4 weeks. Patients were followed up for two years after treatment.Findings: Out of 92 treated patients, 61 tested positive for M. ulcerans by PCR. PCR negative patients had better clinical improvement than PCR positive patients after 4 weeks of antibiotics (54.8% versus 14.8%). For PCR positive patients, the outcome after 4 weeks of antibiotic treatment was related to the ZN positivity at the start. Deterioration of the ulcers was observed in 87.8% (36/41) of the ZN positive and in 12.2% (5/41) of the ZN negative patients. Deterioration due to paradoxical reaction seemed unlikely. After surgery and an additional 8 weeks of antibiotics, 98.4% of PCR positive patients and 83.3% of PCR negative patients were considered cured. The overall recurrence rate was very low (1.1%).Interpretation: Positive predictive value of the WHO clinical case definition was low. Low relapse rate confirms the efficacy of antibiotics. However, the need for and the best time for surgery for large Buruli ulcers requires clarification. We recommend confirmation by ZN stain at the rural health centers, since surgical intervention without delay may be necessary on the ZN positive cases to avoid progression of the disease. PCR negative patients were most likely not BU cases. Correct diagnosis and specific management of these non-BU ulcers cases are urgently needed.

Low caloric value of ethanol itself increases alveolar bone loss in ligature-induced periodontitis in male rats

This study aimed at morphometrically evaluating the influence of variable caloric values of ethanol consumption on alveolar bone loss in periodontitis in male rats. Thirty-six male rats were randomized into four groups of nine rats each, as follows: Test group A (low) - rats were fed an ethanol-containing liquid diet (ethanol representing 22% of total caloric value); Control group A - rats were fed a pair-fed control diet (ethanol replaced by isocaloric amounts of carbohydrate); Test group B (high) - rats were fed an ethanol-containing liquid diet (ethanol representing 36% of total caloric value); Control group B - rats were fed a pair-fed control diet for Test B. Following anesthesia, cotton ligatures were placed around the cervix of the right upper second molar. At eight weeks, the maxillary bones were removed and alveolar bone loss was analyzed by measuring the distance between the cementoenamel junction and the alveolar bone crest at buccal and palatal sites of the upper second molar. The unligated groups showed no significant differences between the bone loss values observed for the low and high caloric values of ethanol (p > 0.05). In the ligated groups, the rats receiving low caloric values of ethanol showed significantly greater bone loss compared to the isocaloric rats (p < 0.05); however, the rats receiving high caloric values of ethanol showed no significant differences compared to the controls. Analysis of the results demonstrated that, in male rats, ethanol itself affected ligature-induced bone loss when representing a low value in the total caloric value.

Dry matter yield and nutritional value of Marandu grass under nitrogen fertilization and irrigation in cerrado in São Paulo

The aim of this study was to evaluate dry matter yield and nutritional value of palisade grass (Brachiaria brizantha cv. Marandu) using nitrogen doses and sprinkler irrigation in two periods of the year, aiming at reducing seasonality of forage production. It was used a randomized block design in a split-plot scheme, with five doses of nitrogen (0, 50, 100, 150, and 200 kg/ha/cut), and the sub-plots were defined by the seasons of the year (wet and dry season), with and without irrigation. During the wet season, in the plots with and without irrigation, doses of 175 and 161 kg/ha/cut promoted the highest dry matter yields. During the dry season, 171 kg ha -1N with irrigation resulted in the highest dry matter yield. During the same season, there was no response to N fertilization in the lack of irrigation. Average contents of CP were 10% with and without irrigation. Contents of neutral detergent fiber decreased with nitrogen doses, while acid detergent fiber was not affected by fertilization. Plots under irrigation reached the maximal acid detergent fiber content at N dose of 60 kg ha -1. Irrigation promotes increase of 15% increase in dry matter yield and it increases contents of neutral detergent fiber. © 2010 Sociedade Brasileira de Zootecnia.

The taxonomic value of floral characters in Rapateaceae (Poales-Monocotyledons)

The floral anatomy of Cephalostemon, Monotrema, Rapatea, Spathanthus, and Stegolepis was studied for taxonomic purposes. All species studied share colleters between the floral parts; sepals, petals, anthers, and style covered by an ornamented cuticle; short epidermal cells with sinuous walls on the abaxial surface of the petals; tetrasporangiate anthers with phenolic idioblasts in the epidermis; endothecium with spiral thickenings; incompletely septate ovary; and anatropous, bitegmic ovules. The floral anatomy is useful not only for characterizing the family, but also for delimiting the subfamilies and genera. Sepals with silica bodies in the epidermal cells; mature anther wall composed of epidermis, endothecium, and middle layer; absence of phenolic idioblasts in the sepals, filaments, and ovary; and stylar epidermal cells with thickened external periclinal wall support Rapateoideae. Cephalostemon and Rapatea show a great number of similarities, corroborating their close relationship indicated in the phylogenetic analyses of the family. Monotrema shares few characters with the genera of Rapateoideae, corroborating its placement in Monotremoideae. Stegolepis shows several distinctive characters, probably related to the greater diversity found in this genus. © 2012 Springer-Verlag Wien.

The value of intraocular pressure asymmetry in diagnosing glaucoma

PURPOSE

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Introduction Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identified during the hospital stay and after discharge. Results Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.

Predictive capacity of anthropometric indicators for abdominal fat in the oldest old

Cardiovascular diseases are a growing public health problem that affects most people over the age of 65 years and abdominal obesity is one of the risk factors for the development of these diseases. There are several methods that can be used to measure body fat, but their accuracy needs to be evaluated, especially in specific populations such as the elderly. The aim of this study was to assess the accuracy of anthropometric indicators to estimate the percentage of abdominal fat in subjects aged 80 years or older. A total of 125 subjects ranging in age from 80 to 95 years (83.5 ± 3), including 79 women (82.4 ± 3 years) and 46 men (83.6 ± 3 years), were studied. The following anthropometric indicators were used: body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-to-height ratio (WHtR). The percentage of abdominal fat was measured by DEXA. Sensitivity and specificity were analyzed using an ROC curve. The sensitivity, specificity and AUC were 0. 578, 0. 934 and 0. 756 for BMI, respectively; 0.703, 0.820 and 0.761 for WC; 0.938, 0.213 and 0.575 for WHR, and 0.984, 0.344 and 0.664 for WHtR. BMI and WC were the anthropometric indicators with the largest area under the curve and were therefore more adequate to identify the presence or absence of abdominal obesity.

Chemical Composition, Rumen Fermentation Kinetics, Digestibility and Energy Value of Cassava Leaves Hay at Different Storage Times

Cassava leaves have been widely used as a protein source for ruminants in the tropics. However, these leaves contain high level of hydro-cyanic acid (HCN) and condensed tannins (CT). There are evidences that making hay can eliminate more than 90% of HCN and that long-term storage can reduce CT levels. A complete randomized design with four replicates was conducted to determine the effect of different storage times (0-control, 60, 90 and 120 days) on chemical composition, in vitro rumen fermentation kinetics, digestibility and energy value of cassava leaves hay. Treatments were compared by analyzing variables using the GLM procedure (SAS 9.1, SAS Institute, Inc., Cary, NC). Crude protein (CP) and ether extract (EE) of the cassava hay were not affected (P > 0.05) by storage time (17.7% and 3.0%, respectively). Neutral detergent fiber, acid detergent fiber, total carbohydrate and non-fiber carbohydrate were not affected either (P>0.05) by storage time (47.5, 32.6, 72.3 and 25.8% respectively). However, other parameters were influenced. CT was lower (P<0.05) in hay after 120 days of storage compared with control (1.75% versus 3.75%, respectively). Lignin and insoluble nitrogen in neutral detergent, analyzed without sodium sulfite, were higher (P<0.01) after 120 days of storage, compared with the control (11.22 versus 13.57 and 1.65 versus 3.81% respectively). This suggests that the CT has bound to the fiber or CP and became inactive. Consequently, the in vitro digestibility of organic matter (50.36%), total digestible nutrients (44.79%) and energy (1.61 Mcal/KgMS), obtained from gas production data at 72 h of incubation, has increased (P<0.05) with storage times (56.83%, 51.53% and 1.86 Mcal/KgMS, respectively). The chemical composition and fermentative characteristics of cassava hay suffered variations during the storage period. The best values were obtained after 90 days of storage. This is probably due to the reduction in condensed tannins.

Nutritional value of high moisture corn silage in the diet of Holstein cows

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Heating value of eucalypt wood grown on SRC for energy production

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Predictive Usefulness of Urinary Biomarkers for the Identification of Cyclosporine A-Induced Nephrotoxicity in a Rat Model

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)