Systematic endoscopic assessment of bleeding sites in severe epistaxis: the role of the S-point and the superior epistaxis.

BACKGROUND: Systematic endoscopic assessment (SEA) of bleeding sites is critical for topodiagnosis and treatment of severe epistaxis, which is not limited to the posterior region. A bleeding site originating from the ethmoidal vasculature, the S-point, has recently been described. The aim of this study is to ascertain the prevalence of each bleeding site in severe epistaxis using a SEA protocol that includes the S-point. METHODOLOGY: Prospective longitudinal study of 51 severe epistaxis patients who underwent 53 SEA under general anesthesia from April 2018 through March 2019. SEA consisted of use of a rigid nasal endoscope; no reduction in blood pressure; no use of topical vasoconstrictor; systematic search of all regions of the nose. Bleeding sites were assigned to either superior or posterior epistaxis. RESULTS: At least one bleeding site was identified in 37 evaluations (69.8%). The S-point was the most common bleeding site (28.3%), followed by the lateral middle turbinate (9.4%), non-S-point upper septum (7.5%), nasal roof (7.5%), and upper lateral wall (7.5%). Superior epistaxis was identified in the most of cases (27 SEA, 50.9%), whereas only 14 SEA (26.4%) identified posterior epistaxis â€" fewer than the 16 SEA that did not identify any bleeding sites (30.2%). There were two recurrences (3.8%). CONCLUSIONS: Systematic endoscopic assessment effectively identified bleeding sites in 69.8% of severe epistaxis. The S-point was the most common bleeding site identified (28.3%). Finally, superior epistaxis corresponded to more than half of the identified bleeding sites, demonstrating the importance of examining this region judiciously in patients with severe epistaxis.

Recombinant protein purification in baculovirus-infected Rachiplusia nu larvae: An approach towards a rational design of downstream processing strategies based on chromatographic behavior of proteins.

Expression of recombinant proteins with baculovirus-infected insect larvae is a scarcely investigated alternative in comparison to that in insect cell lines, a system with growing popularity in the field of biotechnology. The aim of this study was to investigate the chromatographic behavior and physicochemical properties of the proteome of Rachiplusia nu larvae infected with recombinant Autographa californica multiple nucleopolyhedrosis virus (AcMNPV), in order to design rational purification strategies for the expression of heterologous proteins in this very complex and little-known system, based on the differential absorption between target recombinant proteins and the system's contaminating ones. Two-dimensional (2D) gel electrophoresis showed differences in the protein patterns of infected and non-infected larvae. Hydrophobic interaction matrices adsorbed the bulk of larval proteins, thus suggesting that such matrices are inappropriate for this system. Only 0.03% and 2.9% of the total soluble protein from the infected larval extract was adsorbed to CM-Sepharose and SP-Sepharose matrices, respectively. Immobilized metal ion affinity chromatography represented a solid alternative because it bound only 1.4% of the total protein, but would increase the cost of the purification process. We concluded that cation-exchange chromatography is the best choice for easy purification of high-isoelectric-point proteins and proteins with arginine tags, since very few contaminating proteins co-eluted with our target protein.

Relevant aspects of radiation protection in oil and gas well logging.

Radiation sources have being widely used in industrial applications, but their inappropriate use presents a large potential for hazards to human health and the environment. These hazards can be minimised by development of specific radiation protection rules and adequate procedures for the handling, use and storage of radiation sources, which should be established in a national normative framework. Recently, due to discovery of new oil and gas reservoirs on the Brazilian continental shelf, especially in deep water and the pre-salt layer, there has been a large and rapid increase in the use of radiation sources for well logging. Generic radiation protection regulations have been used for licensing the use of radiation sources for well logging, but these are not comprehensive or technically suitable for this purpose. Therefore it is necessary to establish specific Brazilian safety regulations for this purpose. In this work, an assessment is presented of the relevant radiation protection aspects of nuclear well logging not covered by generic regulations, with the aim of contributing to the future development of specific safety regulations for the licensing of radioactive facilities for oil and gas well logging in Brazil. The conclusions of this work relate to four areas, which include the specific requirements to control (1) radiation sources, (2) radiation survey meters and (3) access to radiation workplaces and (4) to control and identify the workers who are occupationally exposed.

Erectile dysfunction association with physical activity level and physical fitness in men aged 40-75 years.

The aim of this study is to evaluate the association between physical activity level and physical fitness with erectile dysfunction in men aged 40-75 years. We examined 180 men aged 40-75 years. The individuals were evaluated for age, presence of dyslipidemia and smoking and for anthropometric parameters for the characterization of body mass index. For assessing the level of physical fitness, a test was performed to measure the indirect maximum oxygen consumption. The evaluation of erectile function was made by the International Index of Erectile Function questionnaire and assessment of physical activity level by the International Physical Activity questionnaire in its short version. This study showed that younger men with higher physical activity and better physical fitness are less likely to suffer from erectile dysfunction. Multivariable analysis through logistic regression showed that age (odds ratio (OD)=1.15; 95% confidence interval (95% CI)=1.07-1.23), physical activity (OD=10.38; 95% CI=3.94-27.39) and physical fitness (OD=4.62; 95% CI=1.75-12.25) were independent variables associated with erectile dysfunction. This study reinforces the concept that healthy habits have a direct effect on erectile function.

Rapid affinity purification processes for cyclodextrin glycosyltransferase from Bacillus circulans.

Two rapid and easy-to-scale-up methods for the purification of cyclodextrin glycosyltransferase (CGTase) from Bacillus circulans were developed: affinity precipitation with starch and aqueous two-phase partition. The first method, optimised by a factorial design, gave an 80% CGTase adsorption at 11% starch and 1.6% ammonium sulphate, and a 65% recovery after elution with 10 mM alpha-cyclodextrin. The purification factor was 17. Aqueous two-phase partition yielded a 72% CGTase recovery in a two-step procedure; CGTase was obtained in the bottom phase with a purification factor of 37.

Purification of a lipase from Acinetobacter calcoaceticus AAC323-1 by hydrophobic-interaction methods.

The performance of hydrophobic-interaction chromatography (HIC) for the purification of Acinetobacter calcoaceticus AAC323-1 lipase was compared with that of various aqueous two-phase systems. While a 42% lipase yield with a purification factor of 140 could be recovered by HIC, higher yields were achieved by using aqueous two-phase systems, either those formed by poly(ethylene glycol) and dextran or those based upon the use of a detergent. Triton X-114-based aqueous two-phase partition showed the best performance, with a yield of 81% and a purification factor of 68. Further detergent removal was easily achieved with an adsorbent, with no significant decrease in yields. Owing to its simplicity, the method should be easy to scale-up.