Perfil epidemiológico de la colelitiasis aguda en pacientes de 0 a 18 años en el Hospital Nacional de Niños Benjamín Bloom durante el período de Enero 2010 a Diciembre 2014

La Colelitiasis biliar se define como la presencia de material sólido, cálculos o lodo, en el tracto biliar, generalmente en la vesícula biliar. El concepto de enfermedad vesicular indica cambios funcionales y/o morfológicos (inflamación o fibrosis) en la vía biliar, secundarios al desarrollo de bilis con capacidad para formar cálculos o asociados a la litiasis vesicular. En el caso de nuestro estudio, definimos como cuadro agudo, el cuadro que se acompaña de dolor de inicio súbito, vómito, diarrea, y / o síntomas dispépticos, así como ictericia, que obligan a consultar de forma inmediata en un centro asistencial. El interés del pediatra por determinar la causa específica del dolor abdominal en niños, ha obligado a ampliar los conocimientos teóricos, a mejorar la sospecha clínica, a la identificación temprana de factores de riesgo, y la mejora en los manejos para la mayor supervivencia de niños con patología que predisponen a la colelitiasis biliar. Con el avance en las exploraciones ultrasonográficas, se ha descrito con mayor frecuencia casos de colelitiasis biliar en la edad pediátrica, con una incidencia mayor a la esperada hasta hace algunos años, para los diferentes grupos poblacionales.

A microestrutura e o desenvolvimento dos órgãos genitais masculinos de preás (Galea spixii) criados em cativeiro

O preá do semiárido nordestino (Galea spixii) é um roedor pertencente à família Caviidae. São encontrados nas regiões da Caatinga e do Cerrado Brasileiro e se reproduz ao longo do ano, apresentando um período de gestação de 48 dias e uma ninhada de 2 a 4 crias. O objetivo deste estudo foi caracterizar histologicamente os componentes estruturais dos órgãos genitais de preás machos relacionando com a evolução cronológica destes órgãos na espécie. Foram utilizados para análise animais ao nascimento e aos 15, 30, 45, 60, 75, 90, 105, 120 e aos 150 dias de idade. Fragmentos do epidídimo, ducto deferente, pênis e glândulas sexuais acessórias foram coletados, fixados e processados para descrição em microscopia de luz. O epidídimo apresentou epitélio colunar simples e em cada fase sexual notou-se diferença quanto ao tamanho do lúmen tubular e à presença de espermatozóides no lúmen aos 45 dias de idade. O epitélio do ducto deferente no preá mostrou-se pseudo-estratificado colunar com crescente presença de estereocilios com o avanço da idade. A glândula vesicular no preá apresentou uma mucosa com pregueamento variado, de acordo com a fase do desenvolvimento sexual. A próstata mostrou-se pouco desenvolvida, com lúmen pequeno nos preás ao nascimento e aos 15 dias de idade; aos 45 dias mostrou-se com um pregueamento do epitélio variável. Os órgãos genitais masculinos do preá passaram por transformações morfológicas no decorrer da idade e com o desenvolvimento sexual, isso colaborou para a determinação do início da fase da puberdade, que na espécie em estudo foi aos 45 dias de idade.

A real-time reverse transcriptase polymerase chain reaction for detection and quantification of Vesiculovirus

Vesiculoviruses (VSV) are zoonotic viruses that cause vesicular stomatitis disease in cattle, horses and pigs, as well as sporadic human cases of acute febrile illness. Therefore, diagnosis of VSV infections by reliable laboratory techniques is important to allow a proper case management and implementation of strategies for the containment of virus spread. We show here a sensitive and reproducible real-time reverse transcriptase polymerase chain reaction (RT-PCR) for detection and quantification of VSV. The assay was evaluated with arthropods and serum samples obtained from horses, cattle and patients with acute febrile disease. The real-time RT-PCR amplified the Piry, Carajas, Alagoas and Indiana Vesiculovirus at a melting temperature 81.02 ± 0.8ºC, and the sensitivity of assay was estimated in 10 RNA copies/mL to the Piry Vesiculovirus. The viral genome has been detected in samples of horses and cattle, but not detected in human sera or arthropods. Thus, this assay allows a preliminary differential diagnosis of VSV infections.

First case reported of Bouveret's syndrome associated to duodenal and biliary perforation to retroperitoneum

We present the case of a 69 year old woman with a history of cholecystitis, who consulted for severe abdominal pain, nausea and vomiting. Abdominal CT showed duodenal obstruction caused by a gallstone, cholecystoduodenal fistula and pneumobilia, what is known as Bouveret's syndrome, a rare form of gallstone ileus. Additionally, she presented free duodenal and vesicular perforation to retroperitoneum at the same level of the cholecystoduodenal transit point. The patient underwent a difficult cholecystectomy, enterolithotomy, repair of the duodenal defect, extensive washing and drainage of the retroperitoneum. The postoperative course was uneventful except for a laparotomy infection.

Prevalência de lesões orais associadas ao hábito de dormir com prótese removível

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Alterações orais na doença celíaca

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Estudo da função da proteína Mob1 na estrutura dos centrossomas

Dissertação de Mestrado, Oncobiologia - Mecanismos Moleculares do Cancro, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 2016

Criterios predictivos de colecistectomía laparoscópica difícil: clínicos, de laboratorio y ecográficos. Hospitales Vicente Corral M. y José Carrasco A. Cuenca 2006

Los objetivos del estudio fueron: determinar si los criterios clínicos: Murphy positivo, fiebre y cirugías previas del abdomen superior, tamaño de cálculo, pared de fondo vesicular más de 3 mm de grosor, distensión vesicular, líquido perivesicular, Murphy ecográfico, cálculo impactado en el cuello vesicular y barro biliar, están asociados significativamente con colecistectomía laparoscópica difícil. Resultados: De los 140 pacientes de ambos sexos realizados colecistectomía laparoscópica: 26 fueron del HVCM Y 114 del hospital José Carrasco (IESS).

Structural and ultrastructural characteristics of interrenal gland and chromaffin cell of matrinxa, Brycon cephalus Gunther 1869 (Teleostei-Characidae)

This work presents the structure and ultrastructure of the interrenal gland and chromaffin cells, as well as the morphology of the head kidney of Brycon cephalus, the head kidney is composed of fused bilateral lobes located anterior to the swim bladder and ventrolateral to the spinal column, the parenchyma revealed lympho-haematopoietic tissue, melano-macrophage centres, interrenal gland and chromaffin cells. The interrenal gland consisted of cords or strands of cells grouped around the posterior cardinal vein and their branches. Chromaffin cells are found in small groups, closely associated with the interrenal gland and/or under the endothelium of the posterior cardinal vein. So far, the ultrastructural analysis has revealed only one interrenal cell type which contained abundant smooth endoplasmic reticulum and numerous mitochondria with tubulo-vesicular cristae, characteristic of steroid-producing cells. Two types of chromaffin cells were observed. The first type was characterized by the presence of vesicles with round, strongly electron-dense granules, which were eccentrically located, Such cells were interpreted as noradrenaline cells, Meanwhile, cells which contained smaller vesicles and electron-lucent granules, with a small halo separating the granule from the vesicular limiting membrane, were identified as adrenaline cells.

Epothilone-d rescues cognition and attenuates alzheimer’s disease-like pathology in APP/PS1 mice

AIMS: Cognitive decline in Alzheimer's disease (AD) patients has been linked to synaptic damage and neuronal loss. Hyperphosphorylation of tau protein destabilizes microtubules leading to the accumulation of autophagy/vesicular material and the generation of dystrophic neurites, thus contributing to axonal/synaptic dysfunction. In this study, we analyzed the effect of a microtubule-stabilizing compound in the progression of the disease in the hippocampus of APP751SL/PS1M146L transgenic model. METHODS: APP/PS1 mice (3 month-old) were treated with a weekly intraperitoneal injection of 2 mg/kg epothilone-D (Epo-D) for 3 months. Vehicle-injected animals were used as controls. Mice were tested on the Morris water maze, Y-maze and object-recognition tasks for memory performance. Abeta, AT8, ubiquitin and synaptic markers levels were analyzed by Western-blots. Hippocampal plaque, synaptic and dystrophic loadings were quantified by image analysis after immunohistochemical stainings. RESULTS: Epo-D treated mice exhibited a significant improvement in the memory tests compared to controls. The rescue of cognitive deficits was associated to a significant reduction in the AD-like hippocampal pathology. Levels of Abeta, APP and ubiquitin were significantly reduced in treated animals. This was paralleled by a decrease in the amyloid burden, and more importantly, in the plaque-associated axonal dystrophy pathology. Finally, synaptic levels were significantly restored in treated animals compared to controls. CONCLUSION: Epo-D treatment promotes synaptic and spatial memory recovery, reduces the accumulation of extracellular Abeta and the associated neuritic pathology in the hippocampus of APP/PS1 model. Therefore, microtubule stabilizing drugs could be considered therapeutical candidates to slow down AD progression. Supported by FIS-PI12/01431 and PI15/00796 (AG),FIS-PI12/01439 and PI15/00957(JV)

Características y perfil microbiológico de pacientes con colecistitis moderada y severa en Mederi de 2014 a 2016

Introducción: Las guías de Tokyo de 2013 lograron un consenso respecto al manejo antibiótico de la infección biliar. Sus recomendaciones están sustentadas en estudios internacionales de la epidemiología bacteriana, pero también recalcan la importancia de conocer la microbiología local para ajustar las guías de manejo. Materiales y métodos: Se diseñó un estudio descriptivo tipo serie de casos de pacientes tratados por colecistitis aguda moderada y severa en Méderi Hospital Universitario Mayor (HUM), describiendo los aislamientos microbiológicos y perfiles de resistencia de los cultivos de bilis tomados durante la cirugía. Resultados: Se analizaron 131 pacientes con una edad promedio de 63 años, la mayoría sin comorbilidades médicas. Se encontró un 48% de positividad en los cultivos, predominantemente enterobacterias siendo la más frecuente Escherichia coli, seguida de especies de Klebsiella y de Enterococcus. Los perfiles de resistencia evidenciaron un 93% de multisensibilidad antibiótica y se aislaron 4 microorganismos multirresistentes. No se encontraron diferencias en comorbilidades, alteraciones paraclínicas, presencia de síndrome biliar obstrutivo, pancreatitis o instrumentación previa de la vía biliar entre los pacientes con cultivo positivo y negativo. Conclusiones: Los resultados concuerdan con los reportes internacionales en cuanto a la flora bacteriana aislada, pero los perfiles de resistencia evidenciados en esta serie son diferentes a los que sustentan las guías de manejo de Tokio revisadas en 2013. Este hallazgo obliga a ajustar las guías de manejo institucionales con base en la epidemiología local.

Efeito do fósforo e da micorriza sobre o crescimento e a absorção de nutrientes por mudas de seringueira (Hevea brasiliensis Muell Arg.).

Avaliaram-se os efeitos da micorriza vesicular-arbuscular e das doses de fósforo sobre o crescimento e a absorção de nutrientes em mudas de seringueira, em casa-de-vegetação. Os tratamentos constaram de três doses de fósforo: 0,9; 1,8 e 2,7 g de P2O5/planta, tendo como fonte o superfosfato triplo, e dois tratamentos de inoculação: não-inoculado e inoculado com Gigaspora margarita, ambos em solo não-esterilizado. Os parâmetros analisados foram infecção radicular, altura das plantas, diâmetro do caule, peso da matéria seca da parte aérea, teor foliar e absorção de N, P, K, Ca, Mg, S, B, Fe, Mn e Zn em materiais coletados nove meses após a instalação do experimento. A aplicação da dose de 2,7 g de P2O5/planta favoreceu a infecção radicular e 2,7 g dc P2O5/planta. O fornecimento de B ao solo, na concentração de 1 mg/kg, induziu níveis do toxicidade nas plantas.

Senecavirus A outbreak affecting piglets and sows in southern Brazil.

2016

The impact of phosphoinositide metabolic enzymes in glioblastoma: a tale of phosphoinositide-specific phospholipase C PLCβ1 and 5-phosphatase SKIP

Background: Glioblastoma multiforme (GBM) is one of the deadliest and most aggressive form of primary brain tumor. Unfortunately, current GBM treatment therapies are not effective in treating GBM patients. They usually experience very poor prognosis with a median survival of approximately 12 months. Only 3-5% survive up to 3 years or more. A large-scale gene profile study revealed that several genes involved in essential cellular processes are altered in GBM, thus, explaining why existing therapies are not effective. The survival of GBM patients depends on understanding the molecular and key signaling events associated with these altered physiological processes in GBM. Phosphoinositides (PI) form just a tiny fraction of the total lipid content in humans, however they are implicated in almost all essential biological processes, such as acting as second messengers in spatio-temporal regulation of cell signaling, cytoskeletal reorganization, cell adhesion, migration, apoptosis, vesicular trafficking, differentiation, cell cycle and post-translational modifications. Interestingly, these essential processes are altered in GBM. More importantly, incoming reports have associated PI metabolism, which is mediated by several PI phosphatases such as SKIP, lipases such as PLCβ1, and other kinases, to regulate GBM associated cellular processes. Even as PLCβ1 and SKIP are involved in regulating aberrant cellular processes in several other cancers, very few studies, of which majority are in-silico-based, have focused on the impact of PLCβ1 and SKIP in GBM. Hence, it is important to employ clinical, in vitro, and in vivo GBM models to define the actual impact of PLCβ1 and SKIP in GBM. AIM: Since studies of PLCβ1 and SKIP in GBM are limited, this study aimed at determining the pathological impact of PI metabolic enzymes, PLCB1 and SKIP, in GBM patient samples, GBM cell line models, and xenograft models for SKIP. Results: For the first time, this study confirmed through qPCR that PLCβ1 gene expression is lower in human GBM patient samples. Moreover, PLCβ1 gene expression inversely correlates with pathological grades of glioma; it decreases as glioma grades increases or worsens. Silencing PLCβ1 in U87MG GBM cells produces a dual impact in GBM by participating in both pro-tumoral and anti-tumoral roles. PLCβ1 knockdown cells were observed to have more migratory abilities, increased cell to extracellular matrix (ECM) adhesion, transition from epithelial phenotype to mesenchymal phenotype through the upregulation of EMT transcription factors Twist1 and Slug, and mesenchymal marker, vimentin. On the other hand, p-Akt and p-mTOR protein expression were downregulated in PLCβ1 knockdown cells. Thus, the oncogenic pathway PI3K/Akt/mTOR pathway is inhibited during PLCβ1 knockdown. Consistently, cell viability in PLCβ1 knockdown cells were significantly decreased compared to controls. As for SKIP, this study demonstrated that about 48% of SKIP colocalizes with nuclear PtdIns(4,5)P2 to nuclear speckles and that SKIP knockdown alters nuclear PtdIns(4,5)P2 in a cell-type dependent manner. In addition, SKIP silencing increased tumor volume and weight in xenografts than controls by reducing apoptosis and increasing viability. All in all, these data confirm that PLCβ1 and SKIP are involved in GBM pathology and a complete understanding of their roles in GBM may be beneficial.

Interrogation of human monoclonal antibodies induced by 4C-MenB to identify protective antigens contained in the OMV component

Neisseria meningitidis is a gram negative human obligated pathogen, mostly found as a commensal in the oropharyngeal mucosa of healthy individuals. It can invade this epithelium determining rare but devastating and fast progressing outcomes, such as meningococcal meningitidis and septicemia, leading to death (about 135000 per year worldwide). Conjugated vaccines for serogroups A, C, W135, X and Y were developed, while for N. meningitidis serogroup B (MenB) the vaccines were based on Outern Membrane Vesicles (OMV). One of them is the 4C-MenB (Bexsero). The antigens included in this vaccine’s formulation are, in addition to the OMV from New Zeland epidemic strain 98/254, three recombinant proteins: NadA, NHBA and fHbp. While the role of these recombinant components was deeply characterized, the vesicular contribution in 4C-MenB elicited protection is mediated mainly by porin A and other unidentified antigens. To unravel the relative contribution of these different antigens in eliciting protective antibody responses, we isolated human monoclonal antibodies (mAbs) from single-cell sorted plasmablasts of 3 adult vaccinees peripheral blood. mAbs have been screened for binding to 4C-MenB components by Luminex bead-based assay. OMV-specific mAbs were purified and tested for functionality by serum bactericidal assay (SBA) on 18 different MenB strains and characterized in a protein microarray containing a panel of prioritized meningococcal proteins. The bactericidal mAbs identified to recognize the outer membrane proteins PorA and PorB, stating the importance of PorB in cross-strain protection. In addition, RmpM, BamE, Hyp1065 and ComL were found as immunogenic components of the 4C-MenB vaccine.