Refractive index sensors based on cascaded multimode interference hetero-core optical fibers.

In this work, we demonstrate refractive index (RI) sensors based on the cascade of hetero-core structures using multimode and no-core optical fibers in sequence. The sensor device is engineered to have resonances at different wavelengths using different sensing region lengths. The device fabrication involves simple fiber cleaving and fusion splicing. For the experiments, the two sensor regions are exposed to liquids with different RIs. For the hetero-core fiber insertion length of 45 mm, the transmission valley is centered at 1082.5 nm with 15.1 nm full width at half-maximum (FWHM) for an external medium RI of 1.3370. Additionally, it shifts 4.1 nm towards longer wavelengths as the RI of the external medium increases to 1.3840. For the 30 mm long hetero-core structure, the valley is centered at 1599.7 nm with 23.3 nm FWHM for an external medium RI of 1.3370, which shifts 7.4 nm as the RI increases to 1.3840. The sensor sensitivities are up to -476d B/r e f r a c t i v e index unit (RIU) and 270 nm/RIU. The resolution of the devices is estimated to be 2×10-5 R I U.

SPARC (secreted protein acidic and rich in cysteine) knockdown protects mice from acute liver injury by reducing vascular endothelial cell damage.

Secreted protein, acidic and rich in cysteine (SPARC) is involved in many biological process including liver fibrogenesis, but its role in acute liver damage is unknown. To examine the role of SPARC in acute liver injury, we used SPARC knock-out (SPARC(-/-)) mice. Two models of acute liver damage were used: concanavalin A (Con A) and the agonistic anti-CD95 antibody Jo2. SPARC expression levels were analyzed in liver samples from patients with acute-on-chronic alcoholic hepatitis (AH). SPARC expression is increased on acute-on-chronic AH patients. Knockdown of SPARC decreased hepatic damage in the two models of liver injury. SPARC(-/-) mice showed a marked reduction in Con A-induced necroinflammation. Infiltration by CD4+ T cells, expression of tumor necrosis factor-α and interleukin-6 and apoptosis were attenuated in SPARC(-/-) mice. Sinusoidal endothelial cell monolayer was preserved and was less activated in Con A-treated SPARC(-/-) mice. SPARC knockdown reduced Con A-induced autophagy of cultured human microvascular endothelial cells (HMEC-1). Hepatic transcriptome analysis revealed several gene networks that may have a role in the attenuated liver damaged found in Con A-treated SPARC(-/-) mice. SPARC has a significant role in the development of Con A-induced severe liver injury. These results suggest that SPARC could represent a therapeutic target in acute liver injury.

Reduced LRP6 expression and increase in the interaction of GSK3ß with p53 contribute to podocyte apoptosis in diabetes mellitus and are prevented by green tea.

In diabetes mellitus (DM), podocyte apoptosis leads to albuminuria and nephropathy progression. Low-density lipoprotein receptor-related protein 6 (LRP6) is WNT pathway receptor that is involved in podocyte death, adhesion and motility. Glycogen synthase kinase 3 (GSK3) interaction with p53 (GSK3-p53) promotes apoptosis in carcinoma cells. It is unknown if GSK3-p53 contributes to podocyte apoptosis in DM. In experimental DM, green tea (GT) reduces albuminuria by an unknown mechanism. In the present study, we assessed the role of the GSK3ß-p53 in podocyte apoptosis and the effects of GT on these abnormalities. In diabetic spontaneously hypertensive rats (SHRs), GT prevents podocyte's p-LRP6 expression reduction, increased GSK3ß-p53 and high p53 levels. In diabetic SHR rats, GT reduces podocyte apoptosis, foot process effacement and albuminuria. In immortalized mouse podocytes (iMPs), high glucose (HG), silencing RNA (siRNA) or blocking LRP6 (DKK-1) reduced p-LRP6 expression, leading to high GSK3ß-p53, p53 expression, apoptosis and increased albumin influx. GSK3ß blockade by BIO reduced GSK3ß-p53 and podocyte apoptosis. In iMPs under HG, GT reduced apoptosis and the albumin influx by blocking GSK3ß-p53 following the rise in p-LRP6 expression. These effects of GT were prevented by LRP6 siRNA or DKK-1. In conclusion, in DM, WNT inhibition, via LRP6, increases GSK3ß-p53 and podocyte apoptosis. Maneuvers that inactivate GSK3ß-p53, such as GT, may be renoprotective in DM.

Hepatic connective tissue changes in hepatosplenic schistosomiasis.

Destruction of intrahepatic portal vein branches with dispersion of smooth muscle cells into the periportal fibrosis and preservation of arterial and ductal structures were the main characteristic findings seen in 66 surgical liver biopsies from patients with the hepatosplenic form of schistosomiasis. Besides these diagnostic features, the present histologic, immunocytochemical, and ultrastructural study revealed the presence of a complex matrix forming the portal and septal fibrosis in advanced schistosomiasis. There was marked hyperplasia of elastic tissue, presence of several collagen isotypes (I, III, procollagen III, IV, and V), actin, desmin, fibronectin, and laminin in a richly vascularized connective tissue. Signs of multifocal matrix (collagen) degradation were observed both at light and electron microscopic levels, suggesting a predominance of a fibrolytic process, at the time parasite-related lesions had almost disappeared. The latter findings are related to the involution of periportal fibrosis now being observed in patients who have undergone antischistosomal chemotherapy. They exemplify morphologic changes connected with chronic collagen degradation in human schistosomiasis that are similar to those first seen in experimental material. Evidence of either persistent or active chronic hepatitis was seen in several cases but its etiology could not be determined.

Failure of schistosomiasis to significantly decrease testosterone levels in Brazilian men.

Schistosomes can decrease the reproductive potential or castrate both invertebrate (snail) hosts as well as vertebrate (mouse, rat, and hamster) hosts. To determine if host castration occurs in human males, we examined testosterone levels in the sera of 38 Brazilian males, 16-35 years of age, who had Schistosoma mansoni infections. We found that individuals with intestinal schistosomiasis exhibited serum testosterone levels similar to those of noninfected controls. Four subjects with severe hepatosplenic disease also exhibited testosterone levels within the normal range. We did observe a negative correlation between parasite load (as predicted by fecal egg count) and testosterone levels but could not dissociate this relationship from the effect of age on either parameter. Therefore, in contrast to rodent models, host castration does not appear to be a usual side effect of human schistosomiasis.

Clinical efficacy and safety of cefetamet pivoxil in toddlers.

The safety and efficacy of cefetamet pivoxil, an oral cephalosporin of the third generation, have been studied in open, prospective, randomized comparative, clinical trials including 301 toddlers (children aged 1 to 2 years) with upper and lower respiratory tract infections, and urinary tract infections. Cefetamet pivoxil (CAT) syrup formulation was given to 177 toddlers either in the standard dose of 10 mg/kg b.i.d. [n = 116] or 20 mg/kg b.i.d. [n = 61] and 124 toddlers have been treated with comparator drugs [cefaclor, n = 98; phenoxymethylpenicillin, n = 18; amoxicillin plus clavulanic acid; n = 8]. The treatment period was 7 days mainly, except for pharyngotonsillitis for which the treatment duration was 7 or 10 days. The assessment of treatment was based on clinical signs and symptoms primarily in infections of lower respiratory tract and acute otitis media, whereas in patients with pharyngotonsillitis and acute urinary tract infections the bacteriological findings were the main evaluation criteria. The overall therapeutic outcome was successful in 148 (95.4%) of the 155 toddlers to whom CAT was administered and in 87 (85.3%) out of 102 toddlers receiving standard drugs. Adverse events of mild to moderate severity, mainly of gastro-intestinal type (vomiting or diarrhoea) occurred in 14.7% in the patient group receiving CAT, 11.2% in the toddlers receiving the standard dose of CAT, and in 12.9% with the comparator drugs. From the data presented it is concluded that cefetamet pivoxil is efficient and safe in toddlers presenting with community-acquired respiratory and urinary infections mainly caused by S. pneumoniae, H. influenzae, Group A beta-haemolytic streptococci, M. catarrhalis, E. coli, Proteus spp. and K. pneumoniae.

Histochemistry of the cuticle from proventriculus in stingless bee, Melipona quadrifasciata anthidioides (Hymenoptera, Apidae).

Histochemical study of the proventriculus from stingless bee Melipona quadrifasciata anthidioides revealed for the first time the presence of cysteine-rich proteins in the cuticle that covers the bulb of the proventriculus and its associated hair-like process. The presence of tyrosine-rich proteins was observed in the same structure, but not in hair-like projections. The cuticle of the crop and a small portion of the proventriculus contained no acid carbohydrates or fats and small amounts of neutral carbohydrates. These results are discussed in relation to different composition of insect cuticle depending on its different functions.

Pathology of periportal fibrosis involution in human schistosomiasis.

Optical and electron microscopical evidences of focal matrix degradation were frequently seen in liver sections of periportal fibrosis caused by schistosomiasis mansoni in man. The material came from 14 wedge hepatic biopsies taken from patients with chronic advanced hepatosplenic disease and undergoing operations for the relief of portal hypertension. Besides the presence of focal areas of rarefaction, fragmentation and dispersion of collagen fibers, the enlarged portal spaces also showed hyperplasia of elastic tissue and disarray of smooth muscle fibers following destruction of portal vein branches. Eggs were scanty in the tissue sections, and matrix degradation probably represented involuting changes related to the progressive diminution of parasite-related aggression, which occurs spontaneously with age or after cure by chemotherapy. The changes indicative of matrix degradation now described are probably the basic morphological counterpart of periportal fibrosis involution currently being documented by ultrasonography in hepatosplenic patients submitted to curative chemotherapy.

[Percutaneous balloon mitral valvoplasty. Immediate results, complications and hospital outcome]. / Valvoplastia mitral percutânea por balão. Resultados imediatos, complicações e evolução hospitalar.

PURPOSE: To study the short-term results, complications and in-hospital follow-up of 223 percutaneous mitral balloon valvuloplasty (PMBV) procedures (proc)in 219 patients. METHODS: It was used a single 20mm balloon diameter in 4 proc, double balloon in 7, Inoue balloon in 4 and low profile balloon in 196. The mean-age group was 37.19 years. One hundred eighty three (82.1%) procedures were performed in women (mean age, 36.99 years) and 40 (17.9%) in men (mean age, 38.10 years) (p = 0.63). Patients were in functional class II, (NYHA) in 25 (11.2%) procedures, class III in 165 (74.0%) and class IV in 33 (14.8%). Patients were in sinus rhythm in 182 procedures (81.6%) and in atrial fibrillation in 41 (18.4%). The echocardiographic score range from 4 to 14 (7.4% +/- 1.7). Among 4 and 11 were 98.2% of patients. RESULTS: We had 203 complete proc and success, mitral valve area (MVA) > or = 1.5cm2 after PMBV in 194 proc. Echocardiographic MVA before PMBV was 0.9 +/- 0.2cm2 and after 1.8 +/- 0.3cm2 (p < 0.01). Hemodynamic measures MVA before PMBV was 0.9 +/- 0.2cm2 and after was 1.9 +/- 0.3cm2 (p < 0.01). Mean pulmonary artery pressure decreased from 39 +/- 14mmHg to 27 +/- 11mmHg (p < 0.01) and mitral mean gradient from 20 +/- 9mmHg to 6 +/- 5mmHg (p < 0.01). In the 203 proc, mitral valve (MV) was competent in 176 and there were 1+ mitral regurgitation (MR) in 27. After PMBV, MV was competent in 126, and there were 1+ MR in 60, 2+ in 10.3+ in 6 and 4+ MR in 1. There was complication in 15 proc, severe MR in 7 (3 or 4+), stroke in 3 and cardiac tamponade in 5. Two patients died during emergency cardiac surgery after left ventricular perforation and one by stroke. CONCLUSION: PMBV was an effective procedure with a high grade of success and low rate of complication.

[Percutaneous mitral valvuloplasty with the single balloon technique. Short-term results, complications and in-hospital follow-up]. / Valvoplastia mitral percutânea com a técnica do balão único. Resultados imediatos, complicações e evolução intra-hospitalar.

PURPOSE: To study the short-term results, complication and in-hospital follow-up of 268 percutaneous mitral balloon valvuloplasty (PMBV) procedures performed with the low-profile monofoil balloon (LPMB) technique from 1990 to 1995. METHODS: A single 30mm balloon diameter was used in 247 (92.9%) procedures, a single 25mm balloon diameter in 9 (3.3%), a single 25mm balloon followed by a single 30mm balloon diameter in 7 (2.6%) and in 5 procedures a balloon was not used. The mean age group was 36 +/- 12 years. Two hundred nineteen (81.7%) procedures were performed in women (mean age 36 +/- 12 years) and 49 (18.3%) in men (mean age, 35 +/- 14 years) (p = 0.78). Patients were in functional class II (NYHA) in 39 (14.5%), class III in 198 (73.9%) and class IV in 31 (11.6%). Patients were in sinus rhythm in 228 (85.1%) procedures and in atrial fibrillation in 40 (14.9%). The echocardiographic score ranged from 4 to 14 (mean 7.2 +/- 1.5). RESULTS: There were 256 complete procedures, 249 of which were successful (mitral valve area (MVA) > or = 1.5cm2 after PMBV). Echocardiographic calculated MVA before PMBV was 0.9 +/- 0.2cm2. Hemodynamic calculated MVA before PMBV was 0.9 +/- 0.2cm2 and after was 2.0 +/- 0.4cm2 (p < 0.000001). Mean pulmonary artery pressure decreased from 40 +/- 15mmHg to 28 +/- 10mmHg (p < 0.000001) and mitral mean gradient from 20 +/- 7mmHg to 5 +/- 4mmHg (p < 0.000001). In the 256 complete procedures mitral valve (MV) was competent in 214 and there was 1+ mitral regurgitation (MR) in 42. After PMBV, MV was competent in 166 and there was 1+ MR in 68, 2+ in 16, 3+ in 5 and 4+ MR in 1. There were complications in 14 (5.2%) procedures, severe MR in 6 (3 or 4+), stroke in 2 and cardiac tamponade in 6. Two patients died during emergency cardiac surgery after left ventricular perforation and 1 after stroke. CONCLUSION: PMBV with the LPMB was an effective procedure with a high success rate and a low rate of complications as the more usual double-balloon and Inoue balloon techniques.

[Angioplasty of distal aorta and iliac, femoral, popliteal, renal and subclavian arteries. Early and late results]. / Angioplastia de aorta distal e artérias ilíaca, femoral, poplítea, renal e subclávia. Resultados imediatos e tardios.

PURPOSE: To study the late results of peripheral angioplasty. PATIENTS AND METHODS: In the period of 8 years from August, 1981 until August, 1989, 27 patients were submitted to 33 procedures of peripheral angioplasty. RESULTS: There was success in 29 procedures, an insufficient dilatation in 1 and and failure in 3 (2 new attempts were effective). Success rate was 88% of the procedures; clinical and angiographic success was reached in 25 (93%) of the 27 patients. Thirty four obstructions were successful dilated: 12 in renal artery, 12 in common iliac artery, 4 in external iliac artery, 3 in superficial femoral artery, 1 in distal aorta. In the evolution we had a restenosis of a renal artery that was redilated, a precocious occlusion of a common iliac artery (9% of common iliac artery dilatations and 6% of the total of the iliac dilatations) and a popliteal occlusion. Of the 34 dilatations we had a patency of 91% until 2 months. CONCLUSION: Angioplasty showed to be an effective method with good results in the long term follow-up.

[Clinical and hemodynamic aspects of non-obstructive coronary lesions. A comparative retrospective study]. / Aspectos clínicos e hemodinâmicos das lesões coronárias não-obstrutivas. Estudo retrospectivo comparativo.

PURPOSE: To study the clinical and hemodynamic aspects of a group of patient presenting non-obstructive coronary lesions. METHODS: We reviewed 963 coronary angiographies performed at a same institution. The 52 patients presenting only stenosis < or = 50% after semi-quantitative measurement composed group I, which was compared with two other groups consisted of 52 patients each: one, with patients presenting univascular lesion > 50% (group II) and the other with normal coronary arteriographies (group III). RESULTS: Mean age was similar in groups I and II (49.4 +/- 6.89 and 51.3 +/- 7.86, p > 0.05) and significantly higher than that of group III (44.8 +/- 6.81, p < 0.05). Risk factors did not discriminate group I (GI) from groups II (GII) and III (GIII). During a follow-up period of 63 months, the number of hospital admissions due to cardiac events and repetitions of coronary arteriography were similar in GI and GII, being significantly less frequent in GIII (p < 0.00001 and 0.001; p < 0.01 and 0.05, respectively). By the end of the follow-up period, though angina and heart failure functional classes had been similar in the three groups, patients in groups I and II were using more medications than those in group III (p < 0.0001 and 0.00001). Mean ejection fractions (%) were lower in GI and GII (67.04 +/- 10.13 and 68.90 +/- 11.32) than in GIII (74.69 +/- 6.40, p < 0.01). Lesions were predominantly proximal in GI when compared with GII (p < 0.05). Length, simmetry, ulceration, thrombus and proximal shoulder showed no difference between GI and GII. CONCLUSION: Patients with non-obstructive coronary lesions were similar to those with univascular lesion > 50% regarding several aspects and were considerably different from those with normal coronary arteries.

Influence of the echocardiographic score and not of the previous surgical mitral commissurotomy on the outcome of percutaneous mitral balloon valvuloplasty.

OBJECTIVE: To evaluate prior mitral surgical commissurotomy and echocardiographic score influence on the outcomes and complications of percutaneous mitral balloon valvuloplasty. METHODS: We performed 459 complete mitral valvuloplasty procedures. Four hundred thirteen were primary valvuloplasty and 46 were in patients who had undergone prior surgical commissurotomy. The prior commissurotomy group was older, had higher echo scores, and a tendency toward a higher percentage of atrial fibrillation. RESULTS: When the groups were compared with each other, no differences were found in pre- and postprocedure mean pulmonary artery pressure, mean mitral gradient, mitral valve area, and mitral regurgitation. Because we found no significant differences, we subdivided the entire group based on echo scores, those with echo scores < or =8 and those with echo scores >8 the mitral valve area being higher in the < or =8 echo score group 2.06+/-0.42 versus 1.90+/-0.40 cm2 (p=0.0090) in the >8 echo score group. CONCLUSION: Dividing the groups based on echo score revealed that the higher echo score group had smaller mitral valve areas postvalvuloplasty.

[Percutaneous transluminal renal angioplasty in the treatment of renovascular hypertension]. / Angioplastia renal transluminal percutânea no tratamento da hipertensão renovascular.

PURPOSE: To analyze the effect of percutaneous transluminal renal angioplasty (PTRA) in renovascular hypertension. METHODS: Twenty-three patients with renal artery stenosis and arterial hypertension underwent PTRA. There were 11 male and 12 female, 19 to 78 years old (45.8 +/- 17.41). In 20 lesions the diagnosis was atherosclerosis, in 7 fibromuscular dysplasia and in 1 Takayasu arteritis. Three patients underwent bilateral dilatation and 2 patients repeated the procedure due to restenosis. Two patients presented with acute renal failure and severe bilateral renal artery stenosis. RESULTS: There were 21 technical success in 25 procedures. After 20 satisfactory dilatations, clinical success followed in 17 (100% of cases of fibromuscular dysplasia cases and 77% of atherosclerosis. The fall in diastolic arterial pressure after PTRA was statistical significant (p < 0.001). In two cases acute renal failure the renal function became normal after angioplasty. There were 2 complications and no death attributed to PTRA. CONCLUSION: The method was effective and safe in the management of renovascular hypertension during the short-term follow-up. It was possible in two cases of acute renal failure to normalize renal function.

[Single balloon versus Inoue balloon in percutaneous mitral balloon valvuloplasty. Short-term results and complications]. / Balãco Unico versus balão de Inoue na valvoplastia mitral percutânea por balão. Resultados imediatos e complicações.

PURPOSE: To assess short-term results and complications of percutaneous mitral balloon valvuloplasty (PMBV) performed with Inoue balloon (IB) and single low profile balloon (SB). METHODS: We performed 390 PMBV procedures, 29 with IB and 337 with SB. There were no differences in age, sex, echocardiographic score distribution and echocardiographic mitral valve area (MVA). RESULTS: We performed 29 complete procedures with IB and 330 of 337 in SB group. Comparing IB and pre and pos-PMBV data we obtained: mean pulmonary artery pressure (MPAP) 36 +/- 15 and 39 +/- 14 mmHg, p = 0.2033, mean mitral gradient 17 +/- 6 and 20 +/- 77 mmHg, p = 0.0396 and MVA 0.9 +/- 0.2 and 0.9 +/- 0.2 cm2, p = 0.8043 and pos-PMBV:MPAP 25 +/- 8 and 28 +/- 10 mmHg, p = 0.2881, gradient 5 +/- 3 and 5 +/- 4 mmHg, p = 0.2778 and MVA 2.2 +/- 0.2 and 2.0 +/- 0.4 cm2, p = 0.0362. Mitral valve (MV) was competent in 26 patients in IB and in 280 in SB group and we had +/4 mitral regurgitation in 3 patients in IB and in 57 in SB group (p = 0.3591) pre-PMBV respectively and pos-PMBV there was also no difference in MV competence (p = 0.7439). CONCLUSION: Both techniques were effective. Hemodynamic data were also similar although MVA was greater in IB group after PMBV.

Treatment of refractory amblyopia with levodopa associated with full-time occlusion in the dominant eye / Tratamento da ambliopia refratária com o uso de levodopa associada à oclusão total do olho dominante

Abstract Purpose: To evaluate visual outcomes of levodopa treatment associated with full occlusion of the dominant eye in patients with refractory amblyopia. Methods: A prospective study of 19 attended patients who were subject to treatment with Levodopa and Carbidopa on doses of 0.7mg/kg/day, a ratio of 4:1 divided into three daily doses for 5 weeks, combined with full occlusion (24 hours/day) of the dominant eye. The ophthalmologic exam from previous consultations up to treatment and after 8 weeks of therapy were collected from medical record data. Patients who had completed treatment for more than 12 months were included for complete eye examination. Results: The mean age before treatment with levodopa was 11.0 ± 4.2 years old (varying from 7 to 23 years). The best-corrected visual acuity (Snellen chart) of the amblyopic eye before treatment was 0.24 (0.6 in logMAR) ± 0.16, after 8 weeks of treatment it was 0.47(0.3 in logMAR) ± 0.33, while during the final evaluation it was 0.46 (0.3 in logMAR) ± 0.34. There was a statistically significant improvement in vision after 8 weeks of therapy which was maintained until the final evaluation (p = 0.007). Conclusion: Levodopa/Carbidopa therapyat doses of 0.7 mg/kg/day at a ratio of 4:1 divided in three daily doses, associated with full occlusion of the dominant eye during 5 weeks had a significant improvement on the visual acuity of the amblyopic eye, and persisted up to 1 year after the treatment.

Resumo Objetivo: Avaliar os resultados visuais do tratamento com levodopa associada à oclusão total do olho dominante em pacientes amblíopes. Métodos: Estudo prospectivo de 19 pacientes atendidos e submetidos ao tratamento com levodopa e carbidopa na dose de 0,7 mg/kg/dia e proporção de 4:1, divididos em três doses diárias, durante cinco semanas, combinada a oclusão total (24 horas/dia) do olho dominante. Foram coletados dados do prontuário referentes ao exame oftalmológico da consulta anterior ao tratamento e após 8 semanas de terapia. Os pacientes com término do tratamento com mais de 12 meses foram reconvocados para exame oftalmológico completo. Resultados: A média de idade dos pacientes previamente ao tratamento com levodopa foi de 11,0 ± 4,2 anos (variando de 7 a 23 anos). A acuidade visual melhor corrigida (Snellen) do olho amblíope antes do tratamento foi de 0,24 (0,6 em logMAR) ± 0,16, após 8 semanas de tratamento foi de 0,47 (0,3 em logMAR) ± 0,33 e na avaliação final foi de 0,46 (0,3 em logMAR) ± 0,34. Houve melhora estatisticamente significante da visão após 8 semanas de tratamento que se manteve até a avaliação final (p = 0,007) Conclusão: A terapia com levodopa/carbidopa em doses de 0,7mg/kg/dia na proporção de 4:1 dividida em três doses diárias, associada à oclusão total do olho dominante durante 5 semanas, apresentou uma melhora significativa na acuidade visual do olho ambliópico e persistiu até 1 ano após o tratamento.

Ten years' evaluation of diet, anthropometry, and physical exercise adherence after islet allotransplantation.

Allogeneic islet transplantation (IT) provokes changes in metabolic responses and nutritional behaviors. The durability of these changes needs to be described as well as their impact on the recipients' lifestyle. The goal of this study was to investigate how islet transplantation influenced diet, exercise habits, and body composition during 10 years after IT. A retrospective study performed in 33 (14 males, 19 females) IT recipients used dietary, physical activity open- ended questionnaire and anthropometric measurements. Data were collected before transplantation, every 3 months up to the 18th and every 6 months thereafter. Data were grouped by gender and eras: pre-IT; 0-3 years; 4-6 years, and 7-10 years after IT. Reduction in body mass index (BMI) from pre-IT to 0-3 years was noted: 23.68 ± 2,18 kg/m(2) to 22.07 ± 2.94 kg/m(2) (P < .05). Increased values were observed from 0-3 years to 4-6 years in: waist circumference (WC) (76.68 ± 7.22 to 79.44 ± 7.58 cm), BMI (23,68 ± 2,18 to 22,75 ± 3,11 kg/m(2)) and weight (64.69 ± 11.98 to 67.43 ± 14 kg): (P < .03). WC increased continuously up to 7-10 years (86.33 ± 9.45 cm; P < .05). There was an average of 5.3 ± 5.6 h/wk of exercise during follow-up. From pre-IT to 0-3 years there was a 19% reduction in protein consumption (P < .05) and a 39% increase in calories from saturated fats (P < .05). A trend to reduce carbohydrates intake noted from pre-IT to 0-3 years was progressively inverted from then throughout 7-10 years (not significant). IT was associated with a significantly decreased BMI early on that it was not sustained. The subsequent weight gain and WC increase could be the result of chronic immunosuppressive therapy and/or voluntary change in eating habits. The increased consumption of carbohydrates could be related to an adaptation of a lifestyle or/and reintroduction of insulin after graft dysfunction. Active lifestyle might be result of the intensive clinical care after IT, concomitant awareness of the importance of routine physical exercise on blood glucose control, and diabetes management. Continuous follow-up of IT recipients is needed to better understand these changes and for comparison with subjects with type 1 diabetes mellitus.

Description of atypical pattern in twins with presumed congenital Zika and without microcephaly - Case Report / Descrição de padrão atípico de gemelares com Zika congênita presumida e sem microcefalia - Relato de Caso

INTRODUCTION: Zika virus (ZIKV) infection was a public health emergency of Brazilian national interest until May 2017, due to the sudden increase in newborns with microcephaly and other neurological alterations during the epidemic started in Brazil in November 2015. The manifestations of Intrauterine infections by ZIKV are more severe when they occur in the first and second trimesters of gestation, especially in the first trimester. In this situation, early diagnosis of visual problems is essential for patients to progress in the neurological and motor fields, and there are complications such as refractive errors (myopia, astigmatism and hyperopia), strabismus and hypoactomy. The absence of microcephaly in infants exposed to the zika virus is not indicative of changes in ophthalmology, and it is essential that the ophthalmologist perform the investigations that are relevant to the clinical case. Any and all eye lesions and their consequences are serious. The earlier the diagnosis, the sooner the child can undergo an intervention to enable vision. OBJECTIVE: To analyze atypical pattern in twins with presumed congenital zika and without microcephaly. METHOD: This is a case report, developed in the city of Serra Talhada, in the state of Pernambuco, Northeast Brazil. REPORT: Case of twins whose mother was exposed to zika virus in the second trimester of gestation (eleventh week). The children were born prematurely and without microcephaly. One of the twins had hydrocephalus requiring surgery. The same child was taken for ophthalmologic examination because of convergent strabismus; and hypocortical optic nerve and chorioretinal scar were found in the macular region in both eyes similar to the lesions described by zika virus. A similar scenario, but with less visual impairment was identified in the second twin. Skull tomography demonstrated bilateral calcification foci in the cerebral hemispheres. CONCLUSION: There was presence of convergent deviation and nystagmus to lateroversions. In the funduscopy, the optic nerve was pale and with cicatricial chorioretinal lesion with well delimited edges in the macular area of both eyes.

INTRODUÇÃO: A infecção pelo Zika vírus (VZIK) foi emergência em saúde pública de interesse nacional brasileiro até maio de 2017, devido ao súbito aumento de nascidos com microcefalia e outras alterações neurológicas durante a epidemia iniciada no Brasil em novembro de 2015. As manifestações da infecção intrauterina pelo VZIK são mais graves quando ocorrem no primeiro e segundo trimestres de gestação, principalmente no primeiro trimestre. Nesta situação, o diagnóstico precoce dos problemas visuais é imprescindível para que os pacientes apresentem avanços nos campos neurológicos e até motores, sendo que há complicações como erros refrativos (miopia, astigmatismo e hipermetropia), estrabismo e hipoacomodação. A ausência de microcefalia em lactentes expostos ao Zika vírus não é indicativo de alterações ofatalmológicas, sendo imprescindível ap médico oftalmologista realizar as investigações spertinentes ao caso clínico. Toda e qualquer lesão ocular e em seus anexos são graves. Quanto mais precoce for o diagnóstico, mais cedo a criança pode ser submetida a uma intervenção para habilitação da visão. OBJETIVO: Analisar padrão atípico de gemelares com Zika congênita presumida e sem microcefalia. MÉTODO: Trata-se de um relato de caso, desenvolvido na cidade de Serra Talhada, interior do estado de Pernambuco, Nordeste Brasileiro RELATO: Caso de gemelares cuja mãe foi exposta ao Zika vírus no segundo trimestre de gestação (décima primeira semana). As crianças nasceram prematuras e sem microcefalia. Um dos gemelares apresentou hidrocefalia com necessidade de intervenção cirúrgica. A mesma criança foi levada para exame oftalmológico por possuir estrabismo convergente e foi encontrado nervo óptico hipocorado e cicatriz coriorretiniana em região macular em ambos os olhos semelhantes às lesões descritas pelo Zika vírus. Quadro similar, mas com menor comprometimento visual foi identificado no segundo gemelar. A tomografia de crânio demonstrou focos de calcificação nos hemisférios cerebrais bilateralmente. CONCLUSÃO: Houve presença de desvio convergente e nistagmo às lateroversões. Na fundoscopia, o nervo óptico apresentou-se hipocorado e com lesão coriorretiniana cicatricial com bordos bem delimitados em área macular de ambos os olhos.

Comportamento ingestivo e parâmetros sanguíneos em ovinos que receberam dietas contendo aditivos à base de extratos de própolis em pó / Ingestive behavior and blood profile in sheep fed with diets containing powdered propolis extract additives

Objetivou-se avaliar os efeitos do extrato de própolis (LLOSC2) sobre o comportamento ingestivo e os parâmetros sanguíneos em cordeiros alimentados com dieta concentrada. Foram utilizados quatro cordeiros machos, castrados, sem raça definida e com peso médio inicial de 32±1,92kg, mantidos em gaiolas metabólicas individuais durante todo o período experimental. O delineamento experimental foi em quadrado latino 4x4, com quatro animais, quatro dietas e quatro períodos experimentais. As dietas diferiram em relação à adição ou não de extratos de própolis à ração. As dietas testadas diferiam na adição de zero (controle), 1(88,16mg/g de flavonoides), duas (176,32mg/g de flavonoides) ou três (264,48mg/g de flavonoides) doses de aditivo à base de extrato de própolis LLOSC2. A dieta tinha relação volumoso:concentrado de 40:60 e foi formulada para ganhos de 250g. A ração concentrada era composta de milho e farelo de soja. O comportamento ingestivo dos animais foi observado por 24 horas, divididas em quatro períodos de seis horas. As coletas de sangue eram realizadas no último dia do período. Não houve efeito das doses LLOSC2 sobre o tempo despendido em alimentação, ruminação, ócio e ingestão de água. A duração do ciclo ruminativo foi maior nos animais que receberam duas doses de LLOSC2, e o número de movimentos mastigatórios também tendeu a aumentar no período que compreendia das 13 às 19h. Já a dieta contendo uma dose de LLOSC2 aumentou a duração da ruminação do bolo bem como o seu número total de mastigações no período de uma a sete horas. Houve uma diminuição nos níveis séricos de cortisol com a adição de três doses de LLOSC2. O hemograma, o leucograma, o perfil bioquímico e as imunoglobulinas não foram afetados pela inclusão das doses de LLSOC2. A administração de extrato de própolis LLOSC2 à dieta de ovinos não afetou seu comportamento ingestivo, os parâmetros hematológicos, bioquímicos e imunológicos estudados.(AU)

The objective of this study was to evaluate the effects of propolis extract (LLOS 2) on feeding behavior and blood parameters in lambs fed concentrate diet. Four male lambs were castrated, mongrel and average weight of 32±1.92kg, kept in individual metabolic cages throughout the trial period. The experimental design was a Latin square 4 x 4 with four animals, four treatments and four experimental periods. The diets differed according to addition or not of propolis extracts to feed. The experimental diets differed in addition to zero (control), 1 (88.16mg/g flavonoids) 2 (176.32mg/g flavonoids) or 3 (264.48mg/g flavonoids) Additive doses based on LLOSC2 propolis extract. The diet had a forage:concentrate ratio of 40:60 and was formulated to 250g gains. The concentrate ration was composed based on corn and soybean meal. The feeding behavior of the animals were observed for 24 hours, divided into four periods of 6 hours. Blood collections were made on the last day of the period. There was no effect of LLOSC2 doses on time spent eating, ruminating, leisure and water intake. The duration of the ruminative cycle was higher in animals that received two doses of LLOSC2 and the number of chewing movements also tended to increase in the period comprised from 13 to 19h. Since the diet containing a dose of LLOSC2, increased duration of rumination cake as well as its total number of chewing in the period of 1 to 7 hours. There was a decrease in serum cortisol with the addition of three doses of LLOSC2. The blood count, white blood cell count, biochemical profile and immunoglobulins were not affected by the inclusion of doses of LLSOC2. Administration of LLOSC2 propolis extract the sheep diet did not affect their feeding behavior, hematological, biochemical and immunological studies.(AU)