Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries: endoleak analysis and long-term follow-up.

PURPOSE: To report our results of endovascular aneurysm repair (EVAR) over a 10-year period using systematic preoperative collateral artery embolization. METHODS: From 1999 until 2009, 124 patients (117 men; mean age 70.8 years) with abdominal aortic aneurysm (AAA) underwent embolization of patent lumbar and/or inferior mesenteric arteries prior to elective EVAR procedures. Embolization was systematically attempted and, whenever possible, performed using microcoils and a coaxial technique. Follow-up included computed tomography and/or magnetic resonance imaging and abdominal radiography. RESULTS: The technical success for EVAR was 96% (119/124), with 4 patients dying within 30 days (3.2% perioperative mortality) and 1 type III endoleak accounting for the failures. Collateral arteries were occluded spontaneously or by embolization in 60 (48%) of 124 patients. The endoleak rate was 50.9% (74 in 61 patients), most of which were type II (19%). Over a mean clinical follow-up of 60.5±34.1 months (range 1-144), aneurysm sac dimensions decreased in 66 patients, increased in 19 patients, and were stable in 35. The endoleak rate was significantly higher in the patients with increasing sac diameter (p<0.001). Among the patients with patent collateral arteries, 38/64 (59.3%) developed 46 leaks, while 28 leaks appeared in 23 (41%) of 56 patients with collateral artery occlusion (p=0.069). The type II endoleak rate significantly differed between these two groups (47.8% vs. 3.6%, p<0.001). CONCLUSION: Preoperative collateral embolization seems to be a valid method of reducing the incidence of type II endoleak, improving the long-term outcome.

Matéria seca, relação C/N e acúmulo de nitrogênio, fósforo e potássio em misturas de plantas de cobertura de solo

O interesse em consorciar plantas de cobertura no inverno tem aumentado nos últimos anos na região Sul do Brasil. Por ser uma prática agrícola recente, é importante avaliar a produção de matéria seca e o acúmulo de nutrientes de espécies consorciadas ou cultivadas isoladamente. Realizou-se um experimento no período de 1998 a 2000, na UFSM (RS), num Argissolo Vermelho distrófico arênico, consorciando-se aveia preta (Avena strigosa Schieb) + ervilhaca comum (Vicia sativa L.) e aveia preta + nabo forrageiro (Raphanus sativus L. var. oleiferus Metzg.) em diferentes quantidades de sementes. Os nove tratamentos foram: (1) 100 % aveia preta (AP); (2) 100 % ervilhaca comum (EC); (3) 100 % nabo forrageiro (NF); (4) 15 % AP + 85 % EC; (5) 30 % AP + 70 % EC; (6) 45 % AP + 55 % EC; (7) 15 % AP + 85 % NF; (8) 30 % AP + 70 % NF, e (9) pousio invernal (vegetação espontânea). Avaliou-se a produção de matéria seca (MS), bem como as concentrações de nitrogênio, fósforo, potássio e carbono do tecido vegetal. O cultivo consorciado de plantas de cobertura proporcionou produção de matéria seca estatisticamente semelhante àquela da aveia e do nabo em culturas isoladas e superior à da ervilhaca. O acúmulo de N na fitomassa dos tratamentos envolvendo consórcio de aveia + ervilhaca não diferiu daquele da ervilhaca isolada e, na média dos três anos, foi superior ao da aveia isolada em 32 kg ha-1 de N. Consorciando aveia + ervilhaca, houve um aumento médio de 67 % na relação C/N da fitomassa, em relação à ervilhaca. As plantas de cobertura proporcionaram maior produção de MS e foram mais eficientes no acúmulo de N, P e K do que a vegetação espontânea do pousio invernal. Os resultados indicaram que o consórcio de aveia + ervilhaca e de aveia + nabo no outono/inverno proporcionou maior produção de biomassa do que o cultivo isolado de cada espécie, pois combinou a elevada capacidade de produção de fitomassa de aveia e nabo com a fixação de N2 atmosférico da ervilhaca.

Analysis by confocal microscopy of the behavior of heat shock protein 70 within the nucleus and of a nuclear matrix polypeptide during prolonged heat shock response in HeLa cells.

By means of confocal laser scanning microscopy and indirect fluorescence experiments we have examined the behavior of heat-shock protein 70 (HSP70) within the nucleus as well as of a nuclear matrix protein (M(r) = 125 kDa) during a prolonged heat-shock response (up to 24 h at 42 degrees C) in HeLa cells. In control cells HSP70 was mainly located in the cytoplasm. The protein translocated within the nucleus upon cell exposure to hyperthermia. The fluorescent pattern revealed by monoclonal antibody to HSP70 exhibited several changes during the 24-h-long incubation. The nuclear matrix protein showed changes in its location that were evident as early as 1 h after initiation of heat shock. After 7 h of treatment, the protein regained its original distribution. However, in the late stages of the hyperthermic treatment (17-24 h) the fluorescent pattern due to 125-kDa protein changed again and its original distribution was never observed again. These results show that HSP70 changes its localization within the nucleus conceivably because it is involved in solubilizing aggregated polypeptides present in different nuclear regions. Our data also strengthen the contention that proteins of the insoluble nucleoskeleton are involved in nuclear structure changes that occur during heat-shock response.

Adubação nitrogenada na aveia preta. I - Influência na produção de matéria seca e ciclagem de nutrientes sob sistema plantio direto

O desempenho do sistema plantio direto está associado, dentre outros fatores, à quantidade e à qualidade dos resíduos aportados ao solo. A aveia preta é a principal cultura de cobertura utilizada na entressafra das culturas comerciais de verão. Em muitas situações, o desenvolvimento desta gramínea é limitado pela baixa disponibilidade de N do solo. Neste contexto, a adubação nitrogenada pode ser uma alternativa para aumentar a eficiência da aveia preta como cultura de cobertura no sistema plantio direto. O objetivo principal do presente estudo foi verificar a influência de doses de adubação nitrogenada sobre a produção de fitomassa, quantidade de nutrientes acumulados (N, P, K, Ca e Mg) e relação C/N dos resíduos produzidos pela cultura da aveia. O trabalho foi realizado durante os anos de 1998, 1999 e 2000, na área experimental do Departamento de Solos da UFSM, Santa Maria (RS), em um Argissolo Vermelho distrófico arênico com 19 g kg-1 de MO. O delineamento experimental foi de blocos ao acaso, com quatro repetições e sete tratamentos com aveia preta. Nestes, foram aplicadas as seguintes doses de N: 0, 40, 80, 120, 160, 200 e 240 kg ha-1. A fonte de N foi a uréia, aplicada parceladamente e a lanço na cultura da aveia. A adubação com P e K e a correção da acidez foram iguais em todos os tratamentos. A adubação nitrogenada ocasionou resposta quadrática na produção de matéria seca e na quantidade de nutrientes estocados na parte aérea da aveia, exceção ao N cuja resposta foi linear. A recuperação de N desta gramínea foi baixa, alcançando 33 %, na média dos três anos. Na maior dose de N aplicada, a ciclagem de P e K foi aumentada em, respectivamente, 70 e 88 % em relação ao tratamento sem adubação. Para o Ca, a dose estimada de 120 kg ha-1 de N promoveu incremento de 95 % no acúmulo deste nutriente, enquanto, para o Mg, levou a um aumento de 90 %, quando comparada ao tratamento sem adubação nitrogenada. A relação C/N dos resíduos produzidos diminuiu, aproximadamente, em uma unidade a cada 10 kg ha-1 de N aplicados na aveia. Portanto, a adubação nitrogenada, além de proporcionar maior ciclagem de nutrientes, foi uma eficiente estratégia para melhorar a quantidade e a qualidade dos resíduos de aveia preta aportados ao solo no sistema plantio direto.

Soil water storage in an upland forest after selective logging in Central Amazonia

Soil water storage of Central Amazonian soil profiles in upland forest plots subjected to selective logging (in average, 8 trees or 34, 3 m³ of timber per hectare were removed) was measured in four layers, down to a depth of 70 cm. The study lasted 27-months and was divided in two phases: measurements were carried out nearly every week during the first 15 months; in the following year, five intensive periods of measurements were performed. Five damage levels were compared: (a) control (undisturbed forest plot); (b) centre of the clearing/gap; (c) edge of the gap; (d) edge of the remaining forest; and (e) remaining forest. The lowest values for water storage were found in the control (296 ± 19.1 mm), while the highest were observed (333 ± 25.8 mm) in the centre of the gap, during the dry period. In the older gaps (7.5-8.5 year old), soil water storage was similar to the remaining and the control forest, indicating a recovery of hydric soil properties to nearly the levels prior to selective logging.

The effect of fluoxetine on the pharmacokinetics and safety of risperidone in psychotic patients

In this open, 30-day trial, the pharmacokinetics, safety and tolerability of a combination therapy of risperidone (4 or 6 mg/day)and fluoxetine (20mg/day from day 6) were evaluated in 11 psychotic inpatients. CYP2D6 genotyping revealed that 3 and 8 patients were poor metabolizers (PMs) and extensive metabolizers (EMs) of debrisoquine, respectively. The mean (+/- SD) AUC of risperidone increased from 83.1 +/- 46.8 ng.h/ml and 398.3 +/- 33.2 ng.h/ml (monotherapy) to 345.1 +/- 158.0 ng.h/ml (p < 0.05) and 514.0 +/- 144.2 ng.h/ml (p < 0.001) when coadministered with fluoxetine in EMs and PMs, respectively. The AUC of the active moiety (risperidone plus 9-hydroxy-risperidone) increased from 470.0 +/- 170.0 ng.h/ml to 663.0 +/- 243.3 ng.h/ml (p < 0.05)and from 576.3 +/- 19.6 ng.h/ml to 788.0 +/- 89.1 ng.h/ml (ns) in EMs and PMs, respectively. In EMs, the AUC of 9-hydroxy-risperidone remained similar (monotherapy vs. combination therapy: 386.8 +/- 153.0 ng.h/ml vs. 317.7 +/- 125.2 ng.h/ml, ns),whereas it increased in PMs (178.3 +/- 23.5 ng.h/ml vs. 274.0 +/- 55.1 ng.h/ml (p < 0.05)). Ten of the 11 patients showed a clinical improvement (reduction of 20% or more in total PANSS score and 70% on the mean MADRS score compared to baseline). The severity and incidence of extrapyramidal symptoms and adverse events did not significantly increase when fluoxetine was added.

Enhanced expression of 70-kilodalton heat shock protein limits cell division in a sepsis-induced model of acute respiratory distress syndrome.

OBJECTIVE: Fibrotic changes are initiated early in acute respiratory distress syndrome. This may involve overproliferation of alveolar type II cells. In an animal model of acute respiratory distress syndrome, we have shown that the administration of an adenoviral vector overexpressing the 70-kd heat shock protein (AdHSP) limited pathophysiological changes. We hypothesized that this improvement may be modulated, in part, by an early AdHSP-induced attenuation of alveolar type II cell proliferation. DESIGN: Laboratory investigation. SETTING: Hadassah-Hebrew University and University of Pennsylvania animal laboratories. SUBJECTS: Sprague-Dawley Rats (250 g). INTERVENTIONS: Lung injury was induced in male Sprague-Dawley rats via cecal ligation and double puncture. At the time of cecal ligation and double puncture, we injected phosphate-buffered saline, AdHSP, or AdGFP (an adenoviral vector expressing the marker green fluorescent protein) into the trachea. Rats then received subcutaneous bromodeoxyuridine. In separate experiments, A549 cells were incubated with medium, AdHSP, or AdGFP. Some cells were also stimulated with tumor necrosis factor-alpha. After 48 hrs, cytosolic and nuclear proteins from rat lungs or cell cultures were isolated. These were subjected to immunoblotting, immunoprecipitation, electrophoretic mobility shift assay, fluorescent immunohistochemistry, and Northern blot analysis. MEASUREMENTS AND MAIN RESULTS: Alveolar type I cells were lost within 48 hrs of inducing acute respiratory distress syndrome. This was accompanied by alveolar type II cell proliferation. Treatment with AdHSP preserved alveolar type I cells and limited alveolar type II cell proliferation. Heat shock protein 70 prevented overexuberant cell division, in part, by inhibiting hyperphosphorylation of the regulatory retinoblastoma protein. This prevented retinoblastoma protein ubiquitination and degradation and, thus, stabilized the interaction of retinoblastoma protein with E2F1, a key cell division transcription factor. CONCLUSIONS: : Heat shock protein 70-induced attenuation of cell proliferation may be a useful strategy for limiting lung injury when treating acute respiratory distress syndrome if consistent in later time points.

Liver kidney microsomal type 1 antibodies reduce the CYP2D6 activity in patients with chronic hepatitis C virus infection.

Liver kidney microsomal type 1 (LKM-1) antibodies have been shown to decrease the CYP2D6 activity in vitro and are present in a minority of patients with chronic hepatitis C infection. We investigated whether LKM-1 antibodies might reduce the CYP2D6 activity in vivo. All patients enrolled in the Swiss Hepatitis C Cohort Study and tested for LKM-1 antibodies were assessed (n = 1723): 10 eligible patients were matched with patients without LKM-1 antibodies. Patients were genotyped for CYP2D6 variants to exclude individuals with a poor metabolizer genotype. CYP2D6 activity was measured by a specific substrate using the dextromethorphan/dextrorphan metabolic ratio to classify patients into four activity phenotypes. All patients had a CYP2D6 extensive metabolizer genotype. The observed phenotype was concordant with the CYP2D6 genotype in most LKM-negative patients, whereas only three LKM-1 positive patients had a concordant phenotype (six presented an intermediate and one a poor metabolizer phenotype). The median DEM/DOR ratio was sixfold higher in LKM-1 positive than in LKM-1 negative patients (0.096 vs. 0.016, P = 0.004), indicating that CYP2D6 metabolic function was significantly reduced in the presence of LKM-1 antibodies. In chronic hepatitis C patients with LKM-1 antibodies, the CYP2D6 metabolic activity was on average reduced by 80%. The impact of LKM-1 antibodies on CYP2D6-mediated drug metabolism pathways warrants further translational studies.

Informe sobre les X Jornades d'Arxivística de Catalunya: "Els arxivers com (ens) comuniquem?" (Terrassa, 19, 20 i 21 de maig de 2005)

Com ja és costum des de fa vint anys (1985-2005), pel maig l'Associació d'Arxivers de Catalunya (AAC) convoca els seus associats i la comunitat arxivística en general a les Jornades d'Arxivística de Catalunya. Enguany han estat les desenes i amb el títol "Els arxivers com (ens) comuniquem?" s'han dut a terme els dies 19, 20 i 21 de maig a la ciutat de Terrassa. L'objectiu de les X Jornades ha estat doble: en primer lloc, s'ha volgut reflexionar sobre les estratègies de què disposen els arxivers per fer difusió de la seva activitat professional ("com comuniquem") i a continuació s'ha produït el debat sobre la comunicació intraprofessional dels arxivers ("com ens comuniquem").

IL28B polymorphisms, IP-10 and viral load predict virological response to therapy in chronic hepatitis C.

Aliment Pharmacol Ther 2011; 33: 1162-1172 SUMMARY: Background  Hepatitis C virus (HCV) is a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma and the identification of the predictors of response to antiviral therapy is an important clinical issue. Aim  To determine the independent contribution of factors including IL28B polymorphisms, IFN-gamma inducible protein-10 (IP-10) levels and the homeostasis model assessment of insulin resistance (HOMA-IR) score in predicting response to therapy in chronic hepatitis C (CHC). Methods  Multivariate analysis of factors predicting rapid (RVR) and sustained (SVR) virological response in 280 consecutive, treatment-naive CHC patients treated with peginterferon alpha and ribavirin in a prospective multicentre study. Results  Independent predictors of RVR were HCV RNA <400 000 IU/mL (OR 11.37; 95% CI 3.03-42.6), rs12980275 AA (OR 7.09; 1.97-25.56) and IP-10 (OR 0.04; 0.003-0.56) in HCV genotype 1 patients and lower baseline γ-glutamyl-transferase levels (OR = 0.02; 0.0009-0.31) in HCV genotype 3 patients. Independent predictors of SVR were rs12980275 AA (OR 9.68; 3.44-27.18), age <40 years (OR = 4.79; 1.50-15.34) and HCV RNA <400 000 IU/mL (OR 2.74; 1.03-7.27) in HCV genotype 1 patients and rs12980275 AA (OR = 6.26; 1.98-19.74) and age <40 years (OR 5.37; 1.54-18.75) in the 88 HCV genotype 1 patients without a RVR. RVR was by itself predictive of SVR in HCV genotype 1 patients (OR 33.0; 4.06-268.32) and the only independent predictor of SVR in HCV genotype 2 (OR 9.0, 1.72-46.99) or genotype 3 patients (OR 7.8, 1.43-42.67). Conclusions  In HCV genotype 1 patients, IL28B polymorphisms, HCV RNA load and IP-10 independently predict RVR. The combination of IL28B polymorphisms, HCV RNA level and age may yield more accurate pre-treatment prediction of SVR. HOMA-IR score is not associated with viral response.

Fixed bearing for TKR provides better results for individuals aged 70 and above

55 patients, scheduled to undergo total knee replacement, were randomized to receive either fixed or mobile-bearings. The results from a 5 year follow-up indicated that elderly patients (>70 years of age) with fixed bearings had better improvements in gait parameters in comparison to those with mobile bearings. These results was in fact reversed for patients less than 70 years of age, as they performed best with mobile bearings.