Adaptação digestiva com duodenal switch parcial em pacientes diabéticos e com IMC<35 Kg/m2. Análise da resposta clínica, laboratorial, enterohormonal e da expressão do gene p53 na mucosa intestinal

O diabetes mellitus tipo 2 (DM2) é uma doença de prevalência crescente na população mundial, sendo associado ao aumento de diversas comorbidades. A relação entre o trato digestivo e o DM2 tem sido fortalecida a partir dos resultados das diferentes cirurgias metabólicas frente à remissão do distúrbio endócrino. Alterações morfológicas hipertróficas no epitélio intestinal são percebidas nos estágios iniciais da doença e parece ter papel primordial na instalação da hiperglicemia crônica. O gene p53 participa ativamente dos processos de regulação do crescimento epitelial intestinal e pode sofrer alteração de sua expressão em estados diabéticos. Objetiva-se avaliar os resultados clínicos e laboratoriais de pacientes DM2 e com índice de Massa Corpórea (IMC) >25 e <35 Kg/m2 submetidos a cirurgia metabólica denominada adaptação digestiva com duodenal switch parcial (DSP) e avaliar o comportamento da expressão do gene p53 na mucosa intestinal no período pré e pós-operatório. Nove pacientes DM2, com IMC<35Kg/m2 foram operados pela técnica DSP. Biópsias de duodeno e íleo foram colhidas no estado diabético (pré e transoperatório respectivamente) e, 3 meses após a cirurgia, através de endoscopia digestiva alta. Foram comparados os dados de evolução antropométrica (IMC) e laboratorial no período pré e pós-operatório. Através do método enzyme-linked immunosorbent assay (ELISA) foram determinados os níveis dos entero-hormônios glucagon-like peptide-1 (GLP-1) e glucose-dependent insulinotropic peptide (GIP), no pré e pós-operatório, em jejum e pós-prandial nos períodos 30',60',90' e 120'. A expressão do gene p53, foi avaliada por real time polymerase chain reaction (qrt-PCR) e western blot, nos dois diferentes momentos. As variáveis: glicemia de jejum e pós-prandial (2 horas), trigliceridemia de jejum, hemoglobina glicada (HbAc1) e peptídeo C foram analisadas. As médias dos parâmetros laboratoriais foram comparadas pela análise multivariada ANOVA e após teste-Tukey. A média de expressão relativa do gene p53 foi comparada nos dois períodos pelo teste t-student. Os resultados evidenciaram que entre maio e dezembro de 2010, nove pacientes (4 homens, 5 mulheres) DM2 e com IMC entre 26 e 34Kg/m2 foram submetidos a DSP. A média de IMC do grupo operado foi de 31,3. Houve queda do IMC média de 23% após um ano. Houve queda significativa (p<0,05) nos níveis de triglicerídeos, glicemia de jejum e pós-prandial (2 horas), HbA1c assim como aumento do peptídeo-C (p<0,05), quando comparados os períodos pré e pós-operatório. Os níveis séricos de GLP-1 foram significativamente maiores no pós-operatório (p<0,05), tanto em jejum como pós-prandial sendo que houve diminuição dos níveis de GIP, contudo sem significância estatística. O gene p53 sofreu aumento significativo de sua expressão relativa (qrt-PCR)(p<0,05) no período pós-operatório na mucosa duodenal e uma tendência de aumento no íleo, contudo sem significância estatística. A análise da expressão ao nível proteico foi bem sucedida somente no íleo, também mostrando tendência de aumento. Concluí-se que a DSP foi capaz de controlar satisfatoriamente o DM2 em pacientes com IMC<35 Kg/m2. Houve aumento da secreção de GLP-1 e tendência de diminuição do GIP. Houve aumento da expressão do p53 na mucosa intestinal, no período pós-operatório, após o controle do diabetes, quando comparada ao período pré-operatório.

O avesso da costura: uma análise dos escritos de Gabriel Soares de Sousa (c.1540-1591)

O colono português Gabriel Soares de Sousa apresentou à corte de Felipe II da Espanha, por volta de 1587, um dos mais importantes registros sobre o Brasil quinhentista, o Tratado descritivo do Brasil em 1587, e o bem menos conhecido Capítulos de Gabriel Soares de Sousa contra os padres da Companhia de Jesus no Brasil. Esta tese apresenta uma análise da história destes manuscritos quinhentistas, examinado como chegaram até os seus formatos atuais e as suas leituras através dos tempos.

Custo-efetividade da Terapia Tripla para pacientes adultos portadores do genótipo 1 da hepatite C crônica.

As ações de prevenção, diagnóstico e tratamento da hepatite C crônica integram as agendas das políticas de saúde do Brasil e do mundo, pois se trata de uma doença com grande número de acometidos, com alto custo tratamento e que ocasiona graves desfechos e incapacidade, o que acaba por onerar seu custo social. Os protocolos clínicos e diretrizes terapêuticas demonstram os esforços de inúmeras entidades no combate da hepatite C, pois informam aos profissionais de saúde, pacientes e familiares e cidadãos em geral, qual seria a melhor forma, comprovada cientificamente, de se proceder frente a uma infecção desta natureza. Realizouse uma análise de custoefetividade, sob a perspectiva do SUS, das estratégias: tratamento e retratamento com a terapia dupla, tratamento com a terapia dupla e retratamento com a terapia tripla e tratamento com a terapia tripla. Através de modelo de simulação baseado em cadeias Markov foi criada uma coorte hipotética de 1000 indivíduos adultos, acima de 40 anos, de ambos os sexos, sem distinção declasse socioeconômica, com diagnóstico confirmado para hepatite C crônica, monoinfectados pelo genótipo 1 do VHC e com ausência de comorbidades. A simulação foi iniciada com todos os indivíduos portando a forma mais branda da doença, tida como a classificação histológica F0 ou F1 segundo a escala Metavir. Os resultados demonstram que as duas opções, ou seja, a terapia dupla/tripla e a terapia tripla estão abaixo do limiar de aceitabilidade para incorporação de tecnologia proposto pela OMS (2012) que é de 72.195 (R$/QALY) (IBGE, 2013; WHO, 2012). Ambas são custoefetivas, visto que o ICER da terapia dupla/tripla em relação alinha de base foi de 7.186,3 (R$/QALY) e o da terapia tripla foi de 59.053,8 (R$/QALY). Entretanto o custo incremental de terapia tripla em relação à dupla/tripla foi de 31.029 e a efetividade incremental foi de 0,52. Em geral, quando as intervenções analisadas encontramse abaixo do limiar, sugerese a adoção do esquema de maior efetividade. A terapia tripla, apesar de ter apresentado uma efetividade um pouco acima da terapia dupla/tripla, apresentou custo muito superior. Assim, como seria coerente a adoção de uma ou da outra para utilização no SUS, visto que este sistema apresenta recursos limitados, indicase a realização de um estudo de impacto orçamentário para obterse mais um dado de embasamento da decisão e assim poder apoiar o protocolo brasileiro existente ou sugerir a confecção de novo documento.

Temporal and spatial aspects of bottlenose dolphin occurrence in coastal and estuarine waters near Charleston, South Carolina

The spatial and temporal occurrence of Atlantic bottlenose dolphins (Tursiops truncatus) in the coastal and estuarine waters near Charleston, SC were evaluated. Sighting and photographic data from photo-identification (ID), remote biopsy, capture-release and radio-tracking studies, conducted from 1994 through 2003, were analyzed in order to further delineate residence patterns of Charleston area bottlenose dolphins. Data from 250 photo-ID, 106 remote biopsy, 15 capture-release and 83 radio-tracking surveys were collected in the Stono River Estuary (n = 247), Charleston Harbor (n = 86), North Edisto River (n = 54), Intracoastal Waterway (n = 26) and the coastal waters north and south of Charleston Harbor (n = 41). Coverage for all survey types was spatially and temporally variable, and in the case of biopsy, capture-release and radio-tracking surveys, data analyzed in this report were collected incidental to other research. Eight-hundred and thirty-nine individuals were photographically identified during the study period. One-hundred and fifteen (13.7%) of the 839 photographically identified individuals were sighted between 11-40 times, evidence of consistent occurrence in the Charleston area (i.e., site fidelity). Adjusted sighting proportions (ASP), which reflect an individual’s sighting frequency in a subarea relative to other subareas after adjusting for survey effort, were analyzed in order to evaluate dolphin spatial occurrence. Forty-three percent (n = 139) of dolphins that qualified for ASP analyses exhibited a strong subarea affiliation while the remaining 57% (n = 187) showed no strong subarea preference. Group size data were derived from field estimates of 2,342 dolphin groups encountered in the five Charleston subareas. Group size appeared positively correlated with degree of “openness” of the body of water where dolphins were encountered; and for sightings along the coast, group size was larger during summer months. This study provides valuable information on the complex nature of bottlenose dolphin spatial and temporal occurrence near Charleston, SC. In addition, it helps us to better understand the stock structure of dolphins along the Atlantic seaboard.

Preliminary results from the Caribbean Acoustic Tracking Network (CATn): a data sharing partnership for acoustic tracking and movement ecology of marine animals in the Caribbean Sea

We have recently exchanged and integrated into a single database tag detections for conch, teleost and elasmobranch fish from four separately maintained arrays in the U.S. Virgin Islands including the NMFS queen conch array (St. John nearshore), NOAA’s Biogeography Branch array (St. John nearshore & midshelf reef); UVI shelf edge arrays (Marine Conservation District, Grammanik & other shelf edge); NOAA NMFS Apex Predator array COASTSPAN (St. John nearshore). The integrated database has over 7.5 million hits. Data is shared only with consent of partners and full acknowledgements. Thus, the summary of integrated data here uses data from NOAA and UVI arrays under a cooperative agreement. The benefits of combining and sharing data have included increasing the total area of detection resulting in an understanding of broader scale connectivity than would have been possible with a single array. Partnering has also been cost-effectiveness through sharing of field work, staff time and equipment and exchanges of knowledge and experience across the network. Use of multiple arrays has also helped in optimizing the design of arrays when additional receivers are deployed. The combined arrays have made the USVI network one of the most extensive acoustic arrays in the world with a total of 150+ receivers available, although not necessarily all deployed at all times. Currently, two UVI graduate student projects are using acoustic array data.

Liver genomic responses to ciguatoxin: evidence for activation of Phase I and Phase II detoxification pathways following an acute hypothermic response in mice

Ciguatoxins (CTX) are polyether neurotoxins that target voltage-gated sodium channels and are responsible for ciguatera, the most common fish-borne food poisoning in humans. This study characterizes the global transcriptional response of mouse liver to a symptomatic dose (0.26 ng/g) of the highly potent Pacific ciguatoxin-1 (P-CTX-1). At 1 h post-exposure 2.4% of features on a 44K whole genome array were differentially expressed (p ≤ 0.0001), increasing to 5.2% at 4 h and decreasing to 1.4% by 24 h post-CTX exposure. Data were filtered (|fold change| ≥ 1.5 and p ≤ 0.0001 in at least one time point) and a trend set of 1550 genes were used for further analysis. Early gene expression was likely influenced prominently by an acute 4°C decline in core body temperature by 1 h, which resolved by 8 h following exposure. An initial downregulation of 32 different solute carriers, many involved in sodium transport, was observed. Differential gene expression in pathways involving eicosanoid biosynthesis and cholesterol homeostasis was also noted. Cytochrome P450s (Cyps) were of particular interest due to their role in xenobiotic metabolism. Twenty-seven genes, mostly members of Cyp2 and Cyp4 families, showed significant changes in expression. Many Cyps underwent an initial downregulation at 1 h but were quickly and strongly upregulated at 4 and 24 h post-exposure. In addition to Cyps, increases in several glutathione S-transferases were observed, an indication that both phase I and phase II metabolic reactions are involved in the hepatic response to CTX in mice.

Mass breeding of silver carp in a cement cistern with crude H.C.G.

The paper presents a resume on experiments carried on mass breeding of the silver carp Hypophthalmichthys molitrix in a cement cistern through administration of crude human chorionic gonadotropin. The experiments proves that human chorionic gonadotropin (H.C.G.) can be used for mass breeding of the fish in simple enclosures, with facilities of some input and output of water and a dose of 5 mg/kg and 18 mg/kg of body weight, for males and females respectively are required for the purpose. Observations were made by using pituitary glands in similar way. For successful breeding of about 80 kg female together, the expenditure towards cost of pituitary gland and H.C.G. are respectively 275 and 117 Rs.

Retaining axial-lateral orthogonality in steered ultrasound data to improve image quality in reconstructed lateral displacement data

Ultrasound elastography tracks tissue displacements under small levels of compression to obtain images of strain, a mechanical property useful in the detection and characterization of pathology. Due to the nature of ultrasound beamforming, only tissue displacements in the direction of beam propagation, referred to as 'axial', are measured to high quality, although an ability to measure other components of tissue displacement is desired to more fully characterize the mechanical behavior of tissue. Previous studies have used multiple one-dimensional (1D) angled axial displacements tracked from steered ultrasound beams to reconstruct improved quality trans-axial displacements within the scan plane ('lateral'). We show that two-dimensional (2D) displacement tracking is not possible with unmodified electronically-steered ultrasound data, and present a method of reshaping frames of steered ultrasound data to retain axial-lateral orthogonality, which permits 2D displacement tracking. Simulated and experimental ultrasound data are used to compare changes in image quality of lateral displacements reconstructed using 1D and 2D tracked steered axial and steered lateral data. Reconstructed lateral displacement image quality generally improves with the use of 2D displacement tracking at each steering angle, relative to axial tracking alone, particularly at high levels of compression. Due to the influence of tracking noise, unsteered lateral displacements exhibit greater accuracy than axial-based reconstructions at high levels of applied strain. © 2011 SPIE.

Alternative phosphorus sources for formulated fish feed

An experiment was conducted to evaluate the possibility of using inorganic fertilizer triple super phosphate (TSP), inorganic fertilizer 16:20 (a 16:20 grade fertilizer contains 16 percent N and 20 percent P20 5), rice-bran and duck-manure as phosphorus sources in formulated fish feed for Nile tilapia ( Oreochromis niloticus). Experiment was conducted for a period of 2 months in net-cages suspended in fertilized earthen ponds and all male sex-reversed Nile tilapia (9.39- 10.37 g) were used in the experiment. Seven treatments including one non-feed treatment were used in this experiment. Treatment 1 (non-feed), treatment 2 (-P) where fish fed with phosphorus non-supplemented diet acted as control 1 and treatment 3, 4, 5, 6 and 7 where fish fed with 3% di-calcium phosphate (DCP), 3% triple supper phosphate (TSP), 7% 16:20 inorganic fertilizer, 30% rice-bran and 30% duck-manure supplemented diet, respectively. Results showed that the TSP and 16:20 grade inorganic fertilizer supplementation in diets as phosphorus sources were equivalent to DCP (Di-calcium phosphate) supplementation in terms of growth performance, feed utilization efficiency and final body composition of Nile tilapia. Ricebran and duck-manure were not found as good phosphorus sources.

Seasonal fluctuation in primary production in relation to the physicochemical parameters of two weed-infested ponds of Kalyani, West Bengal

Kalyani lake (P sub(1)), a weed infested recreational water body and a weed chocked derelict water body (P sub(2)) in the heart of Kalyani city of West Bengal were studied for a period of one year for their primary productivity and other physicochemical parameters. Very low primary productivity (GPP=360-1237mg C m super(-2) d super(-1); NPP=157-787 mg C m super(-2) d super(-1)) was recorded in P sub(2) in spite of having a high concentration of nutrients (PO sub(4)–P=0.052-0.260mg l super(- 1); NO sub(3)-N=0.110-0.412mg l super(-1)). On the other hand, moderate primary productivity (GPP=1687-3195mg C m super(-2) d super(-1); NPP=900-2700mg C m super(-2) d super(-1)) was found in P sub(1) with comparatively low range of nutrients (P0 sub(4)-P =0.010-0.058mg l super(-1); NO sub(3)-N=0.032-0.118mg l super(-1)). After studying the other physicochemical parameters (temperature, transparency, dissolved oxygen, free carbon dioxide, pH, alkalinity and macrophytic biomass), it was found that the overall hydro-biological conditions of the weed-chocked derelict water body (P sub(2)) is not congenial for biological production as compared to Kalyani Lake (P sub(1)). Kalyani Lake may be used for fish culture with proper management practices.

Heavy metals in certain commercially important finfish off Mahim in Mumbai coastal waters

The coastal water of the metropolitan city of Mumbai has deteriorated due to the indiscriminate discharge of untreated sewage and industrial waste in huge quantities. Mahim creek is one such locality surrounded by a large number of industrial units discharging heavy metals. The accumulation of the heavy metals Cu, Cd, Zn and Pb in finfishes (Coilia dussumeri, Lepturacanthus savala, Harpodon nehereus and Johnieops elongates) from this locality along with that in the sediment was studied. The rate of accumulation of Cu was high compared to Cd, Zn and Pb. A gradual increase in the bioaccumulation of heavy metals was noticed in fishes with increase in average body weight and length, perhaps due to biomagnification. A declining trend in concentration of heavy metals horizontally from inshore to offshore was observed in these fishes.