Different degrees of malnutrition and immunological alterations according to the aetiology of cirrhosis: a prospective and sequential study

Abstract Objectives In this work we investigated how immunological dysfunction and malnutrition interact in alcoholic and viral aetiologies of cirrhosis. Methods To investigate the matter, 77 cirrhotic patients divided in three aetiologies [Alcohol, HCV and Alcohol + HCV) and 32 controls were prospectivelly and sequentially studied. Parameters of humoral immunity (Components 3 and 4 of seric complement and immunoglobulins A M, G and E) and of cellular immunity (total leukocytes and lymphocytes in peripheral blood, T lymphocytes subpopulations, CD4+ and CD8+, CD4+/CD8+ ratio and intradermic tests of delayed hypersensitivity), as well as nutrititional parameters: anthropometric measures, serum albumin and transferrin were evaluated. Results Multiple statistical comparisons showed that IgM was higher in HCV group; IgG was significantly elevated in both HCV and Alcohol + HCV, whereas for the Alcohol group, IgE was found at higher titles. The analysis of T- lymphocytes subpopulations showed no aetiologic differences, but intradermic tests of delayed hypersensitivity did show greater frequency of anergy in the Alcohol group. For anthropometric parameters, the Alcohol +HCV group displayed the lowest triceps skinfold whereas creatinine – height index evaluation was more preserved in the HCV group. Body mass index, arm muscle area and arm fat area showed that differently from alcohol group, the HCV group was similar to control. Conclusion Significant differences were found among the main aetiologies of cirrhosis concerning immunological alterations and nutritional status: better nutrition and worse immunology for HCV and vice-versa for alcohol.

Value of adenosine infusion for infarct size determination using real-time myocardial contrast echocardiography

Abstract Background Myocardial contrast echocardiography has been used for determination of infarct size (IS) in experimental models. However, with intermittent harmonic imaging, IS seems to be underestimated immediately after reperfusion due to areas with preserved, yet dysfunctional, microvasculature. The use of exogenous vasodilators showed to be useful to unmask these infarcted areas with depressed coronary flow reserve. This study was undertaken to assess the value of adenosine for IS determination in an open-chest canine model of coronary occlusion and reperfusion, using real-time myocardial contrast echocardiography (RTMCE). Methods Nine dogs underwent 180 minutes of coronary occlusion followed by reperfusion. PESDA (Perfluorocarbon-Exposed Sonicated Dextrose Albumin) was used as contrast agent. IS was determined by RTMCE before and during adenosine infusion at a rate of 140 mcg·Kg-1·min-1. Post-mortem necrotic area was determined by triphenyl-tetrazolium chloride (TTC) staining. Results IS determined by RTMCE was 1.98 ± 1.30 cm2 and increased to 2.58 ± 1.53 cm2 during adenosine infusion (p = 0.004), with good correlation between measurements (r = 0.91; p < 0.01). The necrotic area determined by TTC was 2.29 ± 1.36 cm2 and showed no significant difference with IS determined by RTMCE before or during hyperemia. A slight better correlation between RTMCE and TTC measurements was observed during adenosine (r = 0.99; p < 0.001) then before it (r = 0.92; p = 0.0013). Conclusion RTMCE can accurately determine IS in immediate period after acute myocardial infarction. Adenosine infusion results in a slight better detection of actual size of myocardial damage.

Morphometric analysis of the placenta in the New World mouse Necromys lasiurus (Rodentia, Cricetidae): a comparison of placental development in cricetids and murids

Background: Stereology is an established method to extrapolate three-dimensional quantities from two-dimensional images. It was applied to placentation in the mouse, but not yet for other rodents. Herein, we provide the first study on quantitative placental development in a sigmodontine rodent species with relatively similar gestational time. Placental structure was also compared to the mouse, in order to evaluate similarities and differences in developmental patterns at the end of gestation. Methods: Fetal and placental tissues of Necromys lasiurus were collected and weighed at 3 different stages of gestation (early, mid and late gestation) for placental stereology. The total and relative volumes of placenta and of its main layers were investigated. Volume fractions of labyrinth components were quantified by the One Stop method in 31 placentae collected from different individuals, using the Mercator® software. Data generated at the end of gestation from N. lasiurus placentae were compared to those of Mus musculus domesticus obtained at the same stage. Results: A significant increase in the total absolute volumes of the placenta and its main layers occurred from early to mid-gestation, followed by a reduction near term, with the labyrinth layer becoming the most prominent area. Moreover, at the end of gestation, the total volume of the mouse placenta was significantly increased compared to that of N. lasiurus although the proportions of the labyrinth layer and junctional zones were similar. Analysis of the volume fractions of the components in the labyrinth indicated a significant increase in fetal vessels and sinusoidal giant cells, a decrease in labyrinthine trophoblast whereas the proportion of maternal blood space remained stable in the course of gestation. On the other hand, in the mouse, volume fractions of fetal vessels and sinusoidal giant cells decreased whereas the volume fraction of labyrinthine trophoblast increased compared to N. lasiurus placenta. Conclusions: Placental development differed between N. lasiurus and M. musculus domesticus. In particular, the low placental efficiency in N. lasiurus seemed to induce morphological optimization of fetomaternal exchanges. In conclusion, despite similar structural aspects of placentation in these species, the quantitative dynamics showed important differences.

Expression, purification and molecular analysis of the human ZNF706 protein

Background: The ZNF706 gene encodes a protein that belongs to the zinc finger family of proteins and was found to be highly expressed in laryngeal cancer, making the structure and function of ZNF706 worthy of investigation. In this study, we expressed and purified recombinant human ZNF706 that was suitable for structural analysis in Escherichia coli BL21(DH3). Findings: ZNF706 mRNA was extracted from a larynx tissue sample, and cDNA was ligated into a cloning vector using the TOPO method. ZNF706 protein was expressed according to the E. coli expression system procedures and was purified using a nickel-affinity column. The structural qualities of recombinant ZNF706 and quantification alpha, beta sheet, and other structures were obtained by spectroscopy of circular dichroism. ZNF706's structural modeling showed that it is composed of α-helices (28.3%), β-strands (19.4%), and turns (20.9%), in agreement with the spectral data from the dichroism analysis. Conclusions: We used circular dichroism and molecular modeling to examine the structure of ZNF706. The results suggest that human recombinant ZNF706 keeps its secondary structures and is appropriate for functional and structural studies. The method of expressing ZNF706 protein used in this study can be used to direct various functional and structural studies that will contribute to the understanding of its function as well as its relationship with other biological molecules and its putative role in carcinogenesis.

Prospective surveillance study of acute respiratory infections, influenza-like illness and seasonal influenza vaccine in a cohort of juvenile idiopathic arthritis patients

Background Acute respiratory infections (ARI) are frequent in children and complications can occur in patients with chronic diseases. We evaluated the frequency and impact of ARI and influenza-like illness (ILI) episodes on disease activity, and the immunogenicity and safety of influenza vaccine in a cohort of juvenile idiopathic arthritis (JIA) patients. Methods Surveillance of respiratory viruses was conducted in JIA patients during ARI season (March to August) in two consecutive years: 2007 (61 patients) and 2008 (63 patients). Patients with ARI or ILI had respiratory samples collected for virus detection by real time PCR. In 2008, 44 patients were immunized with influenza vaccine. JIA activity index (ACRPed30) was assessed during both surveillance periods. Influenza hemagglutination inhibition antibody titers were measured before and 30-40 days after vaccination. Results During the study period 105 ARI episodes were reported and 26.6% of them were ILI. Of 33 samples collected, 60% were positive for at least one virus. Influenza and rhinovirus were the most frequently detected, in 30% of the samples. Of the 50 JIA flares observed, 20% were temporally associated to ARI. Influenza seroprotection rates were higher than 70% (91-100%) for all strains, and seroconversion rates exceeded 40% (74-93%). In general, response to influenza vaccine was not influenced by therapy or disease activity, but patients using anti-TNF alpha drugs presented lower seroconversion to H1N1 strain. No significant differences were found in ACRPed30 after vaccination and no patient reported ILI for 6 months after vaccination. Conclusion ARI episodes are relatively frequent in JIA patients and may have a role triggering JIA flares. Trivalent split influenza vaccine seems to be immunogenic and safe in JIA patients.

Stimulation of peripheral Kappa opioid receptors inhibits inflammatory hyperalgesia via activation of the PI3Kγ/AKT/nNOS/NO signaling pathway

Abstract Background In addition to their central effects, opioids cause peripheral analgesia. There is evidence showing that peripheral activation of kappa opioid receptors (KORs) inhibits inflammatory pain. Moreover, peripheral μ-opioid receptor (MOR) activation are able to direct block PGE2-induced ongoing hyperalgesia However, this effect was not tested for KOR selective activation. In the present study, the effect of the peripheral activation of KORs on PGE2-induced ongoing hyperalgesia was investigated. The mechanisms involved were also evaluated. Results Local (paw) administration of U50488 (a selective KOR agonist) directly blocked, PGE2-induced mechanical hyperalgesia in both rats and mice. This effect was reversed by treating animals with L-NMMA or N-propyl-L-arginine (a selective inhibitor of neuronal nitric oxide synthase, nNOS), suggesting involvement of the nNOS/NO pathway. U50488 peripheral effect was also dependent on stimulation of PI3Kγ/AKT because inhibitors of these kinases also reduced peripheral antinociception induced by U50488. Furthermore, U50488 lost its peripheral analgesic effect in PI3Kγ null mice. Observations made in vivo were confirmed after incubation of dorsal root ganglion cultured neurons with U50488 produced an increase in the activation of AKT as evaluated by western blot analyses of its phosphorylated form. Finally, immunofluorescence of DRG neurons revealed that KOR-expressing neurons also express PI3Kγ (≅ 43%). Conclusions The present study indicates that activation of peripheral KORs directly blocks inflammatory hyperalgesia through stimulation of the nNOS/NO signaling pathway which is probably stimulated by PI3Kγ/AKT signaling. This study extends a previously study of our group suggesting that PI3Kγ/AKT/nNOS/NO is an important analgesic pathway in primary nociceptive neurons.

Probabilistic failure modelling of reinforced concrete structures subjected to chloride penetration

Structural durability is an important criterion that must be evaluated for every type of structure. Concerning reinforced concrete members, chloride diffusion process is widely used to evaluate durability, especially when these structures are constructed in aggressive atmospheres. The chloride ingress triggers the corrosion of reinforcements; therefore, by modelling this phenomenon, the corrosion process can be better evaluated as well as the structural durability. The corrosion begins when a threshold level of chloride concentration is reached at the steel bars of reinforcements. Despite the robustness of several models proposed in literature, deterministic approaches fail to predict accurately the corrosion time initiation due the inherent randomness observed in this process. In this regard, structural durability can be more realistically represented using probabilistic approaches. This paper addresses the analyses of probabilistic corrosion time initiation in reinforced concrete structures exposed to chloride penetration. The chloride penetration is modelled using the Fick's diffusion law. This law simulates the chloride diffusion process considering time-dependent effects. The probability of failure is calculated using Monte Carlo simulation and the first order reliability method, with a direct coupling approach. Some examples are considered in order to study these phenomena. Moreover, a simplified method is proposed to determine optimal values for concrete cover.

Increased expression of miR-221 is associated with shorter overall survival in T-cell acute lymphoid leukemia

Background: CD56 expression has been associated with a poor prognosis in lymphoid neoplasms, including T-cell acute lymphoblastic leukemia (T-ALL). MicroRNAs (miRNAs) play an important role in lymphoid differentiation, and aberrant miRNA expression has been associated with treatment outcome in lymphoid malignancies. Here, we evaluated miRNA expression profiles in normal thymocytes, mature T-cells, and T-ALL samples with and without CD56 expression and correlated microRNA expression with treatment outcome. Methods: The gene expression profile of 164 miRNAs were compared for T-ALL/CD56+ (n=12) and T-ALL/CD56- (n=36) patients by Real-Time Quantitative PCR. Based on this analysis, we decided to evaluate miR-221 and miR-374 expression in individual leukemic and normal samples. Results: miR-221 and miR-374 were expressed at significantly higher levels in T-ALL/CD56+ than in T-ALL/CD56- cells and in leukemic blasts compared with normal thymocytes and peripheral blood (PB) T-cells. Age at diagnosis (15 or less vs grater than 15 years; HR: 2.19, 95% CI: 0.98-4.85; P=0.05), miR-221 expression level (median value as cut off in leukemic samples; HR: 3.17, 95% CI: 1.45-6.92; P=0.004), and the expression of CD56 (CD56- vs CD56+; HR: 2.99, 95% CI: 1.37-6.51; P=0.006) were predictive factors for shorter overall survival; whereas, only CD56 expression (HR: 2.73, 95% CI: 1.03-7.18; P=0.041) was associated with a shorter disease-free survival rate. Conclusions: miR-221 is highly expressed in T-ALL and its expression level may be associated with a poorer prognosis.

Ornithodoros guaporensis (Acari, Ixodida: Argasidae), a new tick species from the Guaporé River Basin in the Bolivian Amazon

The soft tick Ornithodoros guaporensis n. sp. (Acari: Ixodida: Argasidae) is described from larvae and adults. Morphological analysis and 16S rDNA sequences are provided. Adults were collected from a rocky fissure inhabited by bats located in the Amazonian forest in north-eastern Bolivia (Beni Department) close to the Guaporé River. Larvae were obtained from eggs laid by females collected in the field, and which were fed on rabbits in the laboratory. Larvae of O. guaporensis are morphologically closely related to Ornithodoros rioplatensis, Ornithodoros puertoricensis and Orni-thodoros talaje. Larvae of O. guaporensis and O. rioplatensis can be separated from O. puertoricensis and O. talaje by the number of pairs of dorsal setae (20 in O. guaporensis and O. rioplatensis, 18 in O. puertoricensis and 17 in O. talaje). Larvae of O. guaporensis and O. rioplatensis can be differentiated by the medial dental formula (2/2 in O. guaporensis and 3/3 in O. rioplatensis) and the apex of the hypostome, which is more pointed in O. rioplatensis than in O. guaporensis. The Principal Component Analysis performed with morphometric characters of larvae showed a clear separation among O. guaporensis, O. rioplatensis, O. puertoricensis and O. talaje. Significant morphological differences among adults of these four species were not found. The analysis of the 16S rDNA sequences allowed for the differentiation between O. guaporensis and the remaining Neotropical species of the family Argasidae.

The 1872 Baltic Sea storm surge

On 13 November 1872, the Baltic Sea coast from Denmark to Pomerania was devastated by an extreme storm surge caused by high winds. This is still the strongest surge on record, and understanding its development can contribute to improved risk assessment and protection. In this paper we trace this event in sea-level pressure and wind data from the “Twentieth Century Reanalysis” (20CR) and compare the results with other observation-based data sources. The analysis shows that, in the ensemble mean of 20CR, the general development is qualitatively well depicted, but with much reduced strength compared to other data sets. The same is true when selecting the ensemble member with maximum wind speeds.

Desarrollo y caracterización de un material celular de alta porosidad con base cementicia activada mediante agentes inorgánicos

Esta tesis ha estudiado los morteros celulares, centrándose en la experimentación con pastas de cemento aireadas (PCA) con polvo de aluminio como agente expansor. El objetivo es el desarrollo de un material cementicio con una baja conductividad térmica que sirva como aislamiento térmico. La naturaleza inorgánica del material lo hace incombustible, en contraste con las espumas poliméricas existentes en el mercado, cuya aplicación en cámaras ventiladas ha sido prohibida por normativas de construcción tanto a nivel nacional como internacional. Las posibles aplicaciones son con proyección neumática o en paneles prefabricados. Se han ensayado dos series de pastas de cemento con polvo de aluminio: - Serie WPC/CAC/CH. Mezcla de referencia con cemento blanco (WPC), cemento de aluminato cálcico (CAC) y cal aérea (CH) en proporción 5:1:4. - Serie OPC/CH. Mezcla de referencia con cemento portland con cenizas volantes (OPC) y cal aérea (CH) en proporción OPC/CH de 4:1 A las mezclas de referencia se le han añadido adiciones de metacaolín (MK) (10 y 20%) o sepiolita (SP) (1 y 2%) para observar el efecto que producen tanto en el mortero fresco como en el mortero endurecido. Se ha estudiado la reología de las pastas en estado fresco, analizando el proceso de expansión de las pastas, registrando los valores de tensión de fluencia, aire ocluido y temperatura durante la expansión. Con los valores obtenidos se ha discutido la influencia de las adiciones utilizadas en la cinética de corrosión del polvo de aluminio que genera la expansión, concluyendo que las adiciones puzolánicas (CV y MK) y la SP reducen mucho el periodo de inducción, lo que provoca poros más grandes y mayor cantidad de aire ocluido. Asimismo se ha analizado la relación entre la tensión de fluencia y el contenido de aire ocluido, deduciendo que a mayor tensión de fluencia en el momento de iniciarse la expansión, menor tamaño de poros y contenido de aire ocluido. Finalmente, se han obtenido las densidades y capacidades de retención de agua de los morteros frescos. Para caracterizar la red porosa de las pastas aireadas endurecidas, se obtuvieron tanto las densidades reales, netas, aparentes y relativas como las porosidades abiertas, cerradas y totales con ensayos hídricos. Finalmente se obtuvieron imágenes de los poros con tomografía axial computerizada para obtener las porosimetrías de las muestras. La caracterización de la red porosa ha servido para terminar de analizar lo observado en la evolución de la expansión del mortero fresco. Se ha analizado la influencia de la red porosa en la conductividad térmica, obtenida con caja caliente, comparándola con la existente en la literatura existente tanto de morteros celulares como de espumas poliméricas. Se concluye que los valores de conductividad térmica conseguida están en el mínimo posible para un material celular de base cementicia. La microestructura se ha estudiado con microscopía electrónica de barrido, difracción de rayos X y ensayos térmicos TG/ATD, observando que los productos de hidratación encontrados coinciden con los que se producen en morteros sin airear. Las imágenes SEM y los resultados de ultrasonidos han servido para analizar la presencia de microfisuras de retracción en las pastas aireadas, observando que en las muestras con adiciones de MK y SP, se reduce la presencia de microfisuras. ABSTRACT This thesis has studied cellular mortars, focusing in testing aerated cement pastes with aluminum powder as expansive agent. The purpose is the development of a cementitious material with low thermal conductivity that can be used as thermal isolation. Inorganic nature of this material makes it non-combustible, in contrast with polymeric foams in market, whose application in ventilated double skin façade systems has been banned by building standards, both domestically and internationally. Possible uses for this material are pneumatically sprayed applications and precast panels. Two series of batches with aluminum powder have been tested: - WPC/CAC/CH series. Reference paste with white portland cement (WPC), calcium aluminate cement (CAC) and lime (CH) with 5:1:4 ratio. - OPC/CH series. Reference paste with portland cement with fly ash (OPC) and lime (CH) with 4:1 ratio. Metakaolin (MK) (10 and 20%) or sepiolite (SP) (1 and 2%) additions were used in reference pastes to characterize the effect in fresh and hardened mortar. Rheology in fresh pastes was studied, expansion process of pastes was analyzed, recording yield stress, entrained air and temperature values during expansion. Recorded values were used to discuss influence of additions on reaction kinetics of aluminum powder corrosion, that produces expansion.. Conclusion is that pozzolanic additions (FA and MK) and SP greatly reduce induction period, producing bigger pores and more entrained air. Relation between yield stress and entrained air has been also analyzed, observing that the bigger yield stress at beginning of expansion, the smaller pores size and the lower entrained air values. Finally density and water retention of fresh mortars were obtained. Pore network in hardened aerated cement pastes was characterized by imbibition methods providing true, bulk and relative density, and providing also open, closed and total porosity. Finally, pore system imaging were obtained with computerized axial tomography to study porosimetry of specimens. Pore network characterization was useful to complete facts analysis observed in expansion of fresh mortars. Influence of pore network in thermal conductivity, checked in hot box, was analyzed comparing with those existing values in cellular mortar and polymeric foams researches. It was concluded that thermal conductivity values achieved are close to minimum possible in a cementitious cellular material. Microstructure was studied with Scanning Electron Microscopy, X-Ray Diffractometry and TG-DTA analysis, observing that hydration phases found, are those produced in non aerated mortar. SEM imaging and ultrasound results were useful to analyze shrinkage microcracks in aerated cement pastes, concluding that microcrack presence in specimens with MK and SP additions were reduced.

Multi-component assessment of chronic obstructive pulmonary disease : an evaluation of the ADO and DOSE indices and the global obstructive lung disease categories in international primary care data sets

Funding The International Primary Care Respiratory Group (IPCRG) provided funding for this research project as an UNLOCK group study for which the funding was obtained through an unrestricted grant by Novartis AG, Basel, Switzerland. The latter funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Database access for the OPCRD was provided by the Respiratory Effectiveness Group (REG) and Research in Real Life; the OPCRD statistical analysis was funded by REG. The Bocholtz Study was funded by PICASSO for COPD, an initiative of Boehringer Ingelheim, Pfizer and the Caphri Research Institute, Maastricht University, The Netherlands.