Contemporary pollen and seed dispersal in natural populations of Bertholletia excelsa (Bonpl.).

Due to the nutritional content and commercial value of its seeds, Bertholletia excelsa is one of the most important species exploited in the Amazon region. The species is hermaphroditic, insect pollinated, and its seeds are dispersed by barochory and animals. Because the fruit set is dependent on natural pollinator activity, gene flow plays a key role in fruit production. However, to date, there have been no studies on pollen and seed flow in natural populations of B. excelsa. Herein, we used microsatellite loci and parentage analysis to investigate the spatial genetic structure (SGS), realized pollen and seed dispersal, and effective pollen dispersal for two B. excelsa populations in the Brazilian Amazon forest. Two plots were established in natural forests from which adults, juveniles, and seeds were sampled. Realized and effective pollen flow was greater than realized seed flow. The distance of realized pollen dispersal ranged from 36 to 2060 m, and the distance of realized seed dispersal ranged from 30 to 1742 m. Both pollen and seeds showed a dispersal pattern of isolation by distance, indicating a high frequency of mating among near-neighbor trees and seed dispersal near to mother trees. Both populations present SGS up to 175 m, which can be explained by isolation by distance pollen and seed dispersal patterns. Our results suggested that fragmentation of these forest populations may result in a significant decrease in gene flow, due to the isolation by distance pollen and seed dispersal patterns.

Minimum number of measurements for evaluating Bertholletia excelsa.

Repeatability studies on fruit species are of great importance to identify the minimum number of measurements necessary to accurately select superior genotypes. This study aimed to identify the most efficient method to estimate the repeatability coefficient (r) and predict the minimum number of measurements needed for a more accurate evaluation of Brazil nut tree (Bertholletia excelsa) genotypes based on fruit yield. For this, we assessed the number of fruits and dry mass of seeds of 75 Brazil nut genotypes, from native forest, located in the municipality of Itaúba, MT, for 5 years. To better estimate r, four procedures were used: analysis of variance (ANOVA), principal component analysis based on the correlation matrix (CPCOR), principal component analysis based on the phenotypic variance and covariance matrix (CPCOV), and structural analysis based on the correlation matrix (mean r - AECOR). There was a significant effect of genotypes and measurements, which reveals the need to study the minimum number of measurements for selecting superior Brazil nut genotypes for a production increase. Estimates of r by ANOVA were lower than those observed with the principal component methodology and close to AECOR. The CPCOV methodology provided the highest estimate of r, which resulted in a lower number of measurements needed to identify superior Brazil nut genotypes for the number of fruits and dry mass of seeds. Based on this methodology, three measurements are necessary to predict the true value of the Brazil nut genotypes with a minimum accuracy of 85%.

Diversity and genetic structure of the native Brazil nut tree (Bertholletia excelsa Bonpl.) population.

The present study was carried out in a native Brazil nut tree population (Bertholletia excelsa Bonpl., Lecythidaceae) to assess its genetic diversity and structure. Ten microsatellite markers were used to genotype 198 adult trees (B. excelsa). The population presented high genetic diversity and inbreeding absence rates. The empirical Bayesian method showed three distinct groups in the structure of this population. Molecular analysis of variance showed 98% variability within groups, and 2% between groups. The genetic divergence (FST) indicated little difference between groups; thus, suggesting efficient gene flow between the analyzed B. excelsa adult trees.

Prevention of hernia incision in laparoscopic left colon resection.

AIM: Aim of this study was to assess the rate of incisional hernia in laparoscopic left colectomy comparing two different sites of mini-laparotomy: midline and oblique left iliac fossa. METHODS: The study retrospectively analyzed data from 748 patients who underwent laparoscopic left colectomy, in which we performed a midline 6-7 cm incision of the umbilical pubic tract (438 patients - group A), and an oblique left iliac fossa incision (262 patients - group B). Usually a medial to lateral meso-colon dissection technique with vascular closure was performed as a first step. Electro-thermal bipolar energy was routinely used. The variables compared were operative time, hernia in site of mini-laparotomy, conversion, intraoperative bleeding, 30-day complications, wound infection, length of stay. RESULTS: From early 2004 to April 2012, 748 patients underwent laparoscopic left colectomy, receiving a midline incision for specimen extraction in 438 cases, group A, and off midline in 262, group B. The mean operative time was 135 (90-245) min for group A and 110.5 (40-195) min for group B, and the mean hospital stay was 8 (5-28) days and 6 (4-30) days for group A and B respectively. Forty-eight patients underwent conversion in open surgery and were removed from the study (33 from group A and 15 from group B). Forty-five incisional hernia occurred in group A (10.2%) vs. 3 in group B (1.1%). We shifted to left iliac fossa incision since June 2010. CONCLUSION: This study summarizes our experience in the effort to reduce incisional hernia in laparoscopic left colectomy. There was a significant difference in rate of hernia comparing midline and oblique left iliac fossa incision. We postulate anatomy of abdominal wall, dynamics and the higher rate of infection of umbilicus to be the key.

Gene expression in the lignin biosynthesis pathway during soybean seed development.

The study of gene expression in plants is fundamental, and understanding the molecular mechanisms involved in important biological processes, such as biochemical pathways or signaling that are used or manipulated in improvement programs, are key for the production of high-quality soybean seeds. Reports related to gene expression of lignin in seeds are scarce in the literature. We studied the expression of the phenylalanine ammonia-lyase (PAL), cinnamate 4-hydroxylase, 4-hydroxycinnamate 3-hydroxylase, and cinnamyl alcohol dehydrogenase genes involved in lignin biosynthesis during the development of soybean (Glycine max L. Merrill) seeds. As the endogenous control, the eukaryotic elongation factor 1-beta gene was used in two biological replicates performed in triplicate. Relative quantitative expression of these genes during the R4, R5, R6, and R7 development stages was analyzed. Real-time polymerase chain reaction was used for the gene expression study. The analyses were carried out in an ABI PRISM 7500 thermocycler using the comparative Ct method and SYBR Green to detect amplification. The seed samples at the R4 stage were chosen as calibrators. Increased expression of the cinnamate-4-hydroxylase and PAL genes occurred in soybean seeds at the R5 and R6 development stages. The cinnamyl alcohol dehydrogenase gene was expressed during the final development phases of soybean seeds. In low-lignin soybean cultivars, the higher expression of the PAL gene occurs at development stages R6 and R7. Activation of the genes involved in the lignin biosynthesis pathway occurs at the beginning of soybean seed development.

O impacto do envelhecimento populacional brasileiro para o sistema de saúde sob a óptica da farmacoepidemiologia: uma revisão narrativa / The impact of Brazilian population aging to the health system under the pharmacoepidemiology vision: a narrative review

A população idosa mundial cresce em ritmo acelerado e o Brasil segue esta tendência. Entretanto, diante dos limitados recursos financeiros disponíveis à saúde, e considerando que a população idosa é a faixa etária que mais consome medicamentos - que devem ser utilizados com maior cuidado nesses pacientes devido a alterações fisiológicas que ocorrem com o aumento da idade -, os estudos farmacoepidemiológicos tornam-se fundamentais para traçar o perfil de utilização dos medicamentos a fim de adotar medidas estratégicas para garantir o acesso e o uso racional desse importante recurso terapêutico, principalmente para os pacientes idosos, devido às suas particularidades e necessidades relacionadas ao envelhecimento.

The world’s elderly population grows at a rapid pace and Brazil follows this trend. However, in the face of limited financial resources available to health issues, and considering that the elderly population is the age group that most consumes drugs - that must be used with greater caution by them due to physiological changes that occur with increasing age - pharmacoepidemiological studies become fundamental to perform the profile of drug utilization with the purpose of adopting strategic actions to ensure the access and rational use of this important therapeutic resource, especially for elderly patients, due to their particularities and needs related to aging.

Is laparoscopic fiberoptic choledochoscopy for common bile duct stones a fine option or a mandatory step?

BACKGROUND: Because choledochoscopy often is a challenging maneuver, it would be advantageous to define the real utility of its use. This study aimed to compare blind exploration of the common bile duct (CBD) with choledochoscopy-assisted CBD stone removal in terms of patient outcome and complication rate. METHODS: Two groups of patients were prospectively evaluated in a 4-year period. The study participants were 36 men and 27 women randomized to group A (n = 32) for a blind basket procedure or group B (n = 31) for a choledochoscopy-assisted procedure as the first step of laparoscopic CBD stone removal. Patients with preoperatively suspected CBD stones (n = 51) and those with unsuspected stones (n = 12) were included. The two groups did not differ significantly in terms of anagraphics, American Society of Anesthesiology (ASA) score, or previous surgery. All the procedures were performed by surgeons skilled in this surgical field. Choledochoscopy, when used, was always performed with the instrument connected to a camera monitor that had a wide vision, whether in a single-monitor, in a picture-in-picture manner, or with the use of an additional monitor. RESULTS: From March 2004 to April 2008, 63 patients undergoing CBD exploration for stone removal were enrolled in the study. Five of these patients had undergone previous endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (ES). The mean operative time was 107 min for group A and 122 min for group B. The mean hospital stay was 3 days for group A and 3.6 days for group B. Clearance of CBD stones was achieved laparoscopically in 62 cases. One patient required open combined transduodenal papilloplasty and transcholedochotomy. In seven cases, blind basket exploration was unable to remove the stones according to the cholangiogram, so choledochoscopy was required. Six patients underwent a transversal coledocothomy for stone removal. A Kehr T-tube was placed in four of these patients. In four group A cases, the papilla was inadvertently passed during the procedure. In six group A cases, including the four aforementioned cases, a high level of amylases was found on postoperative day 1. At this writing, no late complications or stone recurrences have been observed in either group. CONCLUSIONS: The laparoscopic basket blind technique and choledochoscopy are safe and effective for CBD stone removal. However, the latter seems to be better in terms of a higher stone removal rate and fewer minor complications despite its longer operation time. In the authors' opinion, it may be preferable to reserve ERCP for very high-risk patients, taking into account that in addition to the related complications, it results in an approximate 10% rate of recurrent or persistent stones.

Suppression of SERK gene expression affects fungus tolerance and somatic embryogenesis in transgenic lettuce.

The Somatic embryogenesis receptor-like kinase (SERK) gene plays an important role in plant somatic and zygotic embryogenesis induction. The gene encodes an LRR-containing receptor-like kinase protein. Studies have been carried out focusing on different aspects of its function, but definitive conclusions on its role are far from being reached. SERK expression is generally detected in cells in which somatic or zygotic embryogenesis has been triggered. Transgenic lettuce lines were produced to silence the endogenous SERK gene using antisense RNA. The average number of seeds per flower in the R(1) and R(2) generations was similar for both transgenic and non-transgenic lines. However, a reduction in the number of viable grained seeds was observed in four studied transgenic lines. Endogenous SERK expression analysis revealed the absence of detectable LsSERK gene transcripts in three transgenic lines, which presented a reduction in their ability to form in vitro somatic embryonic structures. In addition, transgenic lines showed enhanced susceptibility to the pathogenic fungus Sclerotinia sclerotiorum, when compared to control plants. The results support the idea that SERK genes might not only be involved in plant growth and development, but probably also in a general mechanism of biotic and abiotic stress perception.

Does vaginal intraepithelial neoplasia have the same evolution as cervical intraepithelial neoplasia?

BACKGROUND: Vaginal intraepithelial neoplasia is a little known disease which could be related to risk factors different from simple HPV infections. OBJECTIVE: To ascertain wheter vaginal lesions have a natural history similar to cervical lesions. MATERIALS & METHODS: A retrospective study to identify patients with vaginal lesions and synchronous cervical lesions through biopsy. The rate of mild cervical lesions (koilocytosis, warts, CIN I with and without koilocytosis) was compared with the rate of severe cervical lesions (CIN II and III, cervical carcinoma) in patients with mild vaginal lesions (warts and koilocytosis, and low-grade VAIN) and in patients with severe vaginal lesions (high-grade VAIN). Using koilocytosis as a marker, the rate of "active" cervical lesions was compared with the rate of "non active" cervical lesions in patients with "active" versus "non active" vaginal lesions. Finally, the rates of mild and severe cervical lesions were compared among each group of VAIN (low-grade, high-grade, with or without koilocytosis). RESULTS: In patients with mild vaginal lesions, mild cervical lesions were significantly more frequent than severe cervical lesions. In patients with "active" vaginal lesions the rate of "active" cervical lesions was significantly higher than "non active" cervical lesions. The differences in rates of mild cervical lesions and severe cervical lesions among patients with high-grade VAIN and low-grade VAIN (with and without koilocytosis) were not significant. CONCLUSION: These data suggest that CIN and VAIN may have some common features in certain cases, i.e., if an HPV infection is proved.

[Vaginal intraepithelial neoplasia and human papillomavirus infection: a report of 75 cases]. / La neoplasia intraepiteliale vaginale e l'infezione da virus del papilloma umano. Un resoconto di 75 casi.

AIM: Vaginal intraepithelial neoplasia (VaIN) is an uncommon and poorly understood disease. Risk factors other than human papillomavirus (HPV) infection could be linked to the onset and evolution of some VaIN. METHODS: In this paper, the results achieved from the analysis of 75 patients with VaIN are reported. From these cases, women with HIV, previous hysterectomy, autoimmune diseases and radio- and chemotherapy have been excluded. Thus, most of these selected cases should be linked to the HPV infection. They have been examined after a distinction between grade and association with coilocytosis. VaIN preferential localization, mean age of patients and manifestation pattern after vaginal colposcopy have then been examined. RESULTS: Although the population size cannot allow evidences, it seems that VaIN with coilocytosis and VaIN I without coilocytosis have preferential localization in the upper third of the vagina. It does not appear that mean age of patients for each grade of VaIN differs significativly, both associated and not associated with coilocytosis. Finally, after vaginal colposcopy, the pattern of VaIN for each grade is absolutely not typical, and it seems that white thin epithelium or negative Lugol area are usually the manifestation of high grades of VaIN too. CONCLUSIONS: These results, if confirmed, could mean that VaIN due to HPV may have a different natural history relating to the site of localization in the vagina and, moreover, that also VaIN of high grade could appear with an innocent vaginal pattern.

Saliva as a diagnostic matrix for drug abuse.

Scientific interest in saliva as a diagnostic matrix has greatly increased over the last decade. The Triage screening test (Biosite Diagnostics), a rapid immunological test used to detect recreational drugs in the urine, was used to compare two biological matrixes: a non-conventional one, saliva, and a traditional one, urine. Twenty-one drug abusers collected one urine and one saliva specimen, both of which were tested with the Triage kit. Data were validated by gas-chromatography-mass-spectrometry (GC-MS). Results were positive for methadone in 9 saliva and 14 urine specimens, for opiates in 2 and 10, respectively, and for barbiturates in 2 specimens. Saliva specimens were negative for cannabis, THC, benzodiazepines and tricyclic antidepressants, although the GC-MS analysis revealed low concentrations of these drugs in the saliva. The study demonstrates the possibility of using saliva as a diagnostic matrix to test for drug-taking; however, the Triage kit must be improved before being used with saliva.

[Treatment of intraepithelial cervical neoplasia with REP Radiosurgical Excision Procedure)]. / Intervento di REP (Radiosurgical Excision Procedure) nel trattamento della neoplasia cervicale intraepiteliale.

Radiosurgical cervical excision has been performed in 59 patients affected by CIN of various stages. This non-traumatic method uses 3.8 MHz radio waves to cut and/or coagulate without postoperative pain and tissue destruction. The radiosurgical excision has been performed in local anesthesia by a loop electrode or microneedle according to the seat of the lesion. The therapy was "effective" in 98% of cases (58/59) whereas the "incomplete excision" of CIN was observed in 6.7% (4/59). Complications (postoperative and late bleeding) occurred in 3.2% of the patients (2/59). Therefore, the Radiosurgical Excision Procedure (REP) can be considered an easy technique in ambulatory surgery; this method is effective in the treatment of CIN with either therapeutic and economic advantages and guarantee the functional and anatomic integrity of the cervix.

SeCD electronic folder: CADMIO's application for the medical folder of a service for the care of drug addicts.

In this paper we will describe the SeCD (Service for the Care of Drug addicts) electronic folder, a specific application of CADMIO [1] (Computer Aided Design for Medical Information Objects) system. CADMIO is a system for the definition, construction and management of multimedia clinical folders. The Ser.T. (Servizio per la Tossicodipendenza/Service for Drug Addicts) has earned a very special place within the Italian clinical structures as well as any service for drug addicts has done in the rest of the world. Such a structure has special needs and the characteristics of its medical folders are very different from any other folder. Actually, a Ser.T. has to keep updated the patient situation either from the clinical point of view as well as the psychiatric one. Moreover, it must keep track of the clinician subjective considerations about the patient psychic state and his situation in regard of the law. So, we had to redesign some of the features of the existing CADMIO application, to accommodate such highly not structured data into objects easily manipulated by an informative system. The objectives we hope to achieve were mainly two: To show that a well designed adaptive system can be easily exploited to support even very complex and poorly structured data types and actions To design data structures able to accommodate medical, psychiatric and administrative data in an homogeneous manner.

[The possibility of using sulprostone during laparoscopic myomectomy in uterine fibromyomatosis. Preliminary studies]. / Possibilità d'impiego del sulprostone in corso di laparomiomectomia nella fibromiomatosi uterina. Indagini preliminari.

The authors considered sulprostone effects, PGE2 synthetic derivative, on the hematic loss during laparomyomectomy. This drug is been used by intravenous way during the operation in 84 patients affected with uterine myomatosis. The effectiveness and tolerance of the drug is thus evident in the reduction of the hematic intraoperative loss.

[Post-menopausal metrorrhagia. Use of danazol in endometrial hyperplasia]. / Metrorragia post-menopausale. L'uso del danazolo nella iperplasia endometriale.

The Authors, after a careful examination of the literature on endometrial hyperplasias, review the results of a preliminary study on 15 patients affected with postmenopausal metrorrhagia, cured by Danazol (200 mg/die) through 90 consecutive days. Also recognizing the best tolerance to the drug and the low incidence of the side effects, they think the results obtained by Danazol need further confirmation by more protracted controls.

[Lasers and genital (cervico-vulvo-vaginal) pathology]. / Laser e patologia genitale (cervico-vulvo-vaginale).

The authors performed laser vaporization in 240/250 cases for viral pathology of the lower genital tract, obtaining recovery at the first treatment in 232/240 cases and at the second in 238/248 cases.

[Comparative study of short-term antimicrobial chemoprophylaxis in gynecologic surgery: cefotetan versus cefazolin]. / Studio comparativo di chemioprofilassi antimicrobica a breve termine in chirurgia ginecologica: cefoteta versus cefazolina.

The results obtained in 80 patients hospitalized at the University of Obstetrics and Gynecology Clinic in Perugia for abdominal and vaginal hysterectomy are reported and evaluated in a prospective and randomized study of perioperative antibacterial prophylaxis. In the 75 patients available to study a single intravenous dose of 2 g cefotetan was compared with a triple dose of 1 g intravenous cephazolin. A reduction in the incidence of post-operative infections both in abdominal hysterectomy from 24% (cephazolin group) to 11.53% (cefotetan group) and in vaginal hysterectomy from 40% (cephazolin group) to 71.4% (cefotetan group) was noted. These results show that a single intravenous dose of 2 g cefotetan can be considered a valid therapeutic support for antibacterial prophylaxis. In addition the absence of alterations in the parameters considered (haematological, biochemical and urinary) points to the safety, effectiveness and non-toxicity of the drug.

HIV infection and pregnancy: diagnostic and follow-up program for the pregnant woman and newborn child.

The authors take as their starting point the cases of 8 pregnancies in HIV serologically positive women, admitted for their observation from July 1986 to March 1988. They emphasize the importance of clinical, anamnestic and serological screening in order to identify those subjects at risk, and thereby prevent the vertical transmission of the virus. To this end, they propose a protocol to be used for all women at risk, both pregnant and not, both seropositive and seronegative. They also advise repeated clinical and immunological checks of the children of asymptomatic carrier mothers.