Computed tomography angiography in patients with active gastrointestinal bleeding

Abstract Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding.

Contribuições recentes da reação de hidroformilação na síntese de produtos farmacêuticos: parte II

The hydroformylation reaction represents one of the most important C1-chemistry area in the chemical industry. This catalytic process, which has been developed up to now mainly to the production of commodities chemicals, has shown a remarkable potential for the preparation of several categories of specialty chemicals and in particular pharmaceutical compounds. Arylpropanoic acids, various amines containing aryl groups, and intermediates for the preparation of vitamins, carbocyclic and heterocyclic compounds and many other classes of organic molecules endowed with pharmacological activity are currently accessible in good-to-high yields through hydroformylation of selected olefinic substrates. The asymmetric hydroformylation is going to reach the stage of maturity and hence to contribute in solving many troublesome synthetic problems connected with the preparation of pharmacologically active compounds with very high enantiomeric purity. The present survey emphasizes the usefulness of synthesis gas as a starting material in fine chemistry, which is expected to be important for industry.

Vinte anos de efeito SERS

The Surface Enhanced Raman Scattering (SERS) effect was observed for the first time in 1974, but it was only considered a new effect three years later, hence, nearly twenty years ago. Since its discovery, a significant amount of investigations have been performed aiming at to clarify the nature of the observed enhancement, to improve the surface stability and to establish applications which nowadays range from the study of biomolecules to catalysis. Some of the more relevant aspects of this effect which have been examined across the last two decades are summarized in this paper which presents the introductory aspects of SERS alongside with several of its applications.

Estudos da eletrodeposição de metais em regime de subtensão

This work reviews recent studies of underpotential deposition (UPD) of several metals on Pt and Au substrates performed in the Grupo de Materiais Eletroquímicos e Métodos Eletroanalíticos (IQSC -- USP, São Carlos). The UPD Cu, Cd and Pb on Pt were analysed in terms of their influence in the oxygen evolution reaction. Partial blockage of surface active sites, promoted by Pb ad-atoms, resulted in a change from water to hydrogen peroxide as the final product. The Ag UPD on Pt and Au substrates was also discussed in this work. A detailed model of charge calculation for Ag monolayer was developed and confirmed by the rotating ring-disk data. The partial charge transfer in UPD studies was analysed in the Cd/Pt and Cd/Au systems and a value of 0.5 was found for the adsorption electrovalence of Cd ad-ions. The Sn/Pt UPD systems were studied from the point of view of the valences of metallic ions in solution. The deposition from Sn(IV) generates a full monolayer with a maximum occupation of approximately 40% of the surface active sites (340 µC cm-2) plus 105 µC cm-2 of Hads (half monolayer). Changing the metallic ion for Sn(II), it was possible to deposit a full monolayer (210 µC cm-2) without any detectable Hads. Finally, the effect of anions was discussed in the Zn/Pt and Zn/Au systems. Here, the hydrogen evolution reaction (her) and the hydrogen adsorption/desorption were used in order to investigate the maximum coverage of the surface with Zn ad-atoms. The full monolayer, characterised by the complete absence of Hads, was achieved only in 0.5 M HF solutions.

Potencial de biocatálise enantiosseletiva de lipases microbianas

Microbial lipases have a great potential for commercial applications due to their stability, selectivity and broad substrate specificity because many non-natural acids, alcohols or amines can be used as the substrate. Three microbial lipases isolated from Brazilian soil samples (Aspergillus niger; Geotrichum candidum; Penicillium solitum) were compared in terms of their stability and as biocatalysts in the enantioselective esterification using racemic substrates in organic medium. The lipase from Aspergillus niger showed the highest activity (18.2 U/mL) and was highly thermostable, retaining 90% and 60% activity at 50 ºC and 60 ºC after 1 hour, respectively. In organic medium, this lipase provided the best results in terms of enantiomeric excess of the (S)-active acid (ee = 6.1%) and conversion value (c = 20%) in the esterification of (R,S)-ibuprofen with 1-propanol in isooctane. The esterification reaction of the racemic mixture of (R,S)-2-octanol with decanoic acid proceeded with high enantioselectivity when lipase from Aspergillus niger (E = 13.2) and commercial lipase from Candida antarctica (E = 20) were employed.

Estudo da influência do solvente, carboidrato e ácido graxo na síntese enzimática de ésteres de açúcares

The aim of this work was to gain knowledge of enzymatic processes for the synthesis fatty acid esters of sugar, with the objective to develop an enzymatic process for the preparation of non-toxic biodegradable surface-active agents derived entirely from renewable resources. A wide range of data were collected for reaction conditions involving different sugars (glucose, fructose and sucrose), fatty acids (oleic, palmitic, lauric), solvents (hexane, heptane and t-butanol) and different sources of lipases in both free and immobilized forms. As a solvent t-butanol provided the best conditions to create a catalytic liquid phase in which the reaction occurs. Sugars were preferentially esterified in the following order: fructose > glucose > sucrose, depending on the enzyme preparation. For fructose no influence was found concerning de acyl donor and similar rates were achieved for all tested fatty acids. Ester synthesis was maximized for substrates containing fructose, lauric or oleic acids, t-butanol and lipase from porcine pancreas immobilized on polysiloxane-polyvinyl alcohol particles. Under such conditions molar conversions were higher than 50%.

Electrochemical study about zinc electrodeposition onto GCE and HOPG substrates

We carried out an electrochemical study about zinc electrodeposition onto GCE and HOPG substrates from an electrolytic plating bath containing 0.01M ZnSO4 + 1M (NH4)2SO4 at pH 7. Under our experimental conditions the predominant chemical species was the complex [ZnSO4(H2O)5]. The chronoamperometric study showed that zinc electrodeposition follows a typical 3D nucleation mechanism in both substrates. The average dG calculated for the stable nucleus formation was 6.92 x 10-21 J nuclei"1 and 1.35 x 10-20 J nuclei"1 for GCE and HOPG, respectively. The scanning electron microscopy (SEM) images showed different nucleation and growth processes on GCE and HOPG substrates at same overpotential.

Enantioselective biotransformation of propranolol to the active metabolite 4-hydroxypropranolol by endophytic fungi

The enantioselective biotransformation of propranolol (Prop) by the endophytic fungi Phomopsis sp., Glomerella cingulata, Penicillium crustosum, Chaetomium globosum and Aspergillus fumigatus was investigated by studying the kinetics of the aromatic hydroxylation reaction with the formation of 4-hydroxypropranolol (4-OH-Prop). Both Prop enantiomers were consumed by the fungi in the biotransformation process, but the 4-hydroxylation reaction yielded preferentially (-)-(S)-4-OH-Prop. The quantity of metabolites biosynthesized varied slightly among the evaluated endophytic fungi. These results show that all investigated endophytic fungi could be used as biosynthetic tools in biotransformation processes to obtain the enantiomers of 4-OH-Prop.

OBTAINING ZnO IMMOBILIZED OVER DIFFERENT SUBSTRATES BY HYDROTHERMAL TREATMENT FOR PHOTOCATALYSIS APPLICATION

The aim of this work is to systematically explore the effect of the synthesis conditions of ZnO structures, immobilized on different substrates by hydrothermal treatment, in its photocatalytic activity. A circumscribed central composite design of experiments was used to analyze the effects of reagents stoichiometry, reaction time and temperature, covering a wide range of these variables. The substrates used were etched glass, copper and zinc foils. The photocatalytic activity of the as-obtained ZnO samples was evaluated through photocatalytic degradation of rhodamine B (RhB) in aqueous solution under UV irradiation. Zinc foils presented the best immobilized film quality and the maximum dye removal was 80% in one hour of UV exposure.

Characterization of Citrus tristeza virus isolates from grapefruit (Citrus paradisi Macf.) accessions of Citrus Active Germplasm Bank

Citrus tristeza virus (CTV) isolates from 35 grapefruit accessions belonging to Citrus Active Germplasm Bank of the "Instituto Agronômico de Campinas" located at the "Centro APTA Citros Sylvio Moreira", Cordeirópolis, São Paulo state, Brazil, were characterized and evaluated through symptoms in the trees, biological indexing, immunological diagnosis with different monoclonal antibodies and SSCP analysis (single-strand conformation polymorphism) of the coat protein gene. Symptomatology indicated that, in general, the group of plants with smaller canopy volume and severe stem pitting differed significantly from the group that presented greater vegetative development and mild to moderate stem pitting. However, the isolates from most of the accessions induced mild reaction on Mexican lime. The serological evaluation through the DAS-ELISA using monoclonal antibodies did not reveal any association between virus titer in the plant tissue and symptoms. The reaction with different monoclonal antibodies and the distinct electrophoresis patterns obtained through SSCP showed that there is a high degree of diversity among the isolates that infect these grapefruit accessions. High complexity within the same isolate was also observed in the SSCP profiles. This finding indicates that the CTV isolates from these plants are a complex mixture of CTV haplotypes. Similar SSCP banding patterns were observed among some plants with strong stem pitting symptoms, and among some plants with weak or moderate stem pitting symptoms.

Influence of substrates, light, filter paper and pH on the sporulation of Cercospora sojina

Fungi require special substrates for their isolation, vegetative growth and sporulation. In experiments conducted in the laboratory, the influence of substrates, light, filter paper and pH on the sporulation of Cercospora sojina conidia, the causal agent of soybean frogeye leaf spot, was assessed. The media potato sucrose agar, V-8 agar, tomato extract agar, soybean leaf extract agar, soybean seed extract agar, soybean meal agar, soybean flour agar and wheat flour agar were tested, added on the surface, with and without filter paper and under two light regimes, with 12 h light at 25°± 2°C and in the dark. A triple factorial 8x2x2 (substrates x light/dark x with/without filter paper) design with four replicates was used. V-8 agar medium was employed and the pH was adjusted with HCl 0.1N or NaOH 0.1N before autoclaving to the values: 3, 4, 5, 6, 7 and 8, and the pH of V-8 agar medium is 6.7. The evaluation was done on the seventh day of incubation. Data underwent regression analysis. Sporulation was maximized on the agar media V-8, seed extract, oat flour, tomato extract, and potato sucrose in the presence of filter paper and 12h light. On V-8 medium, maximal sporulation was obtained with pH 6.7.

Active teaching-learning methodologies: medical students' views of problem-based learning

The prevailing undergraduate medical training process still favors disconnection and professional distancing from social needs. The Brazilian Ministries of Education and Health, through the National Curriculum Guidelines, the Incentives Program for Changes in the Medical Curriculum (PROMED), and the National Program for Reorientation of Professional Training in Health (PRO-SAÚDE), promoted the stimulus for an effective connection between medical institutions and the Unified National Health System (SUS). In accordance to the new paradigm for medical training, the Centro Universitário Serra dos Órgãos (UNIFESO) established a teaching plan in 2005 using active methodologies, specifically problem-based learning (PBL). Research was conducted through semi-structured interviews with third-year undergraduate students at the UNIFESO Medical School. The results were categorized as proposed by Bardin's thematic analysis, with the purpose of verifying the students' impressions of the new curriculum. Active methodologies proved to be well-accepted by students, who defined them as exciting and inclusive of theory and practice in medical education.

Learning through role-playing games: an approach for active learning and teaching

This study evaluates the use of role-playing games (RPGs) as a methodological approach for teaching cellular biology, assessing student satisfaction, learning outcomes, and retention of acquired knowledge. First-year undergraduate medical students at two Brazilian public universities attended either an RPG-based class (RPG group) or a lecture (lecture-based group) on topics related to cellular biology. Pre- and post-RPG-based class questionnaires were compared to scores in regular exams and in an unannounced test one year later to assess students' attitudes and learning. From the 230 students that attended the RPG classes, 78.4% responded that the RPG-based classes were an effective tool for learning; 55.4% thought that such classes were better than lectures but did not replace them; and 81% responded that they would use this method. The lecture-based group achieved a higher grade in 1 of 14 regular exam questions. In the medium-term evaluation (one year later), the RPG group scored higher in 2 of 12 questions. RPG classes are thus quantitatively as effective as formal lectures, are well accepted by students, and may serve as educational tools, giving students the chance to learn actively and potentially retain the acquired knowledge more efficiently.

Outplanting performace of eucalyptus clonal cuttings produced in different containers and substrates

The objective of this work was to evaluate the outplanting growth of Eucalyptus grandis e E. saligna clones, produced by cuttings in tubes (50cm³) and in pressed blocks (40x60x07cm) - 175 cm³/ seedlings, with different substrates (BT - sugarcane bagasse+sugarcane filter cake; AR - carbonized rice hull + eucalyptus bark; TF - peat). The experiment was arranged in a randomized block design, in a 2x7 factorial (2 clones and 7 treatments), with four replicates with 25 plants. Survival was evaluated two months later. Plant growth was monitored through height and ground level diameter at 20, 40, 60, 120 and 180 days after outplanting. To evaluate the effect of the containers on stem and root biomass in both clones, 180 days after outplanting, the cuttings grown in BT substrate with fertilizer were selected. One plant per plot of each clone, grown in tubes and in pressed blocks was selected. The E. grandis and E. saligna cuttings grown in pressed blocks with sugarcane bagasse+sugarcane filter cake presented greater height and diameter after out planting. Both clones presented larger root, bark, log and branch biomass production in plants produced in the block system. Cuttings of E. saligna grown in pressed blocks showed 80% most wood biomass 180 days after outplanting, compared to that grown in tubes. In E. grandis, the differences in diameter and height, in function of the cutting production system, decreased along time, while in E. saligna these differences increased along the evaluation period.

Germination and vigor of Dimorphandra mollis benth. seeds under different temperatures and substrates

The Dimorphandra mollis Benth. - Caesalpiniaceae is a native forest species coming from the Cerrado and Caatinga due to its economical and ecological use, which justifies the studies on seed germination. In this work, germinative performance of D. mollis seeds were studied in different conditions of temperature regime and substrate. The experimental delineation used was completely randomized in factorial 4 x 4 (4 substrates -sand, coconut fiber, vermiculite and paper towel; and 4 temperatures: 25, 30, 35 and 20-30ºC), with four replications of 25 seeds each. The following parameters were evaluated: seed moisture content, final germination, first germination count, germination speed index, length and dry matter weight. The best germination and vigor is obtained at 30 and 35ºC. The substrates paper towel and vermiculite allow satisfactory germinative performance of seeds, being suitable to evaluate the physiological quality of D. mollis seeds.