Phytochemicals Against Drug-Resistant Bacterial Biofilms and Use of Green Extraction Solvents to Increase Their Bioactivity.

Antimicrobial resistance has become one of the major global public health issues of the twenty-first century. One of the main factors in the limited action of antimicrobials is related to the ability of microorganisms, particularly bacteria, to form biofilms. These complex and well-organized communities allow the colonizing cells to acquire survival advantages over the same cells in suspension, including antibiotic resistance. A huge percentage of bacterial infections in humans are associated with biofilms, and many of them are chronic. Therefore, there is an urgent need to develop new products effective in controlling or eradicating biofilms. Plant secondary metabolites (phytochemicals) have demonstrated their potential as antibacterials against planktonic cells and sessile communities when used alone or in synergy with other molecules. This chapter covers recent advances in the activity of phytochemicals against biofilms, particularly those formed by drug-resistant bacteria. In addition, taking into account that the extraction step is crucial for the successful development of new bioactive compounds, the use of novel solvents that increase the phytochemical effect, such as natural deep eutectic solvents (NADES), as well as the recent applications of these solvents as antimicrobials are discussed.

Accuracy of ultrasound in the diagnosis of acute cholecystitis with coexistent acute pancreatitis.

PURPOSE: Acute cholecystitis and pancreatitis are acute forms of cholecystolithiasis. The presence of acute cholecystitis can lead to important changes in therapy in the early course of acute pancreatitis. The aim of this study was to identify the accuracy of ultrasonography in diagnosing acute cholecystitis with coexistent acute pancreatitis. METHODS: Subjects were all those patients admitted to our hospital with a diagnosis of acute pancreatitis between 1998 and 2015 who underwent cholecystectomy within 15 days of the ultrasonography performed on admittance. Patient data were analyzed retrospectively to compare the ultrasound findings with the pathological findings of the resected gallbladders. Patients were allocated to two groups according to the signs of acute cholecystitis on ultrasonography: group 1 negative and group 2 positive. RESULTS: One hundred and twenty patients were enrolled in the study: 77 in group 1 and 43 in group 2. Similar results were found for the two groups with respect to the pathological diagnosis of acute cholecystitis, i.e., 31.2 % for group 1 and 27.9 % for group 2. Analysis indicated that there was no correlation between the ultrasonography data and pathological findings (p = 0.708). CONCLUSIONS: On the basis of our study, ultrasound findings alone cannot be used to accurately diagnose acute cholecystitis in the setting of acute pancreatitis.

Coronary emergency and diabetes as manifestations of pheochromocytoma.

We report on a woman with refractory hypertension and diabetes suffering from hypertensive crises, one with chest pain suggesting acute coronary syndrome, and another with an abdominal pain, after which a para-aortic abdominal mass was diagnosed, by ultrasound, as pheochromocytoma, later confirmed by an adrenal scintigraphic study with (131)I-labeled metaiodobenzylguanidine. The patient was successfully treated with complete reversal of hypertension and diabetes. Our case illustrates the importance of maintaining a high index of suspicion in patients simultaneously presenting with an acute myocardial event and hypertensive crises.

Desempenho de novilhas leiteiras em pastagem de capim-Xaraés (Brachiaria brizantha cv. Xaraés) suplementadas com dois tipos de misturas minerais / Performance of dairy heifers raised on Xaraés palissadgrass (Brachiaria brizantha cv. Xaraés) pasture supplemented with two types of mineral mixture

The effects of selective (e.g. mineral supplement formulated on the basis of nutritional and clinical examination of the herd) or commercial mineral supplementation of crossbred dairy heifers (Holstein-Mantiqueira), on daily weight gain (DWG), body condition score (BCS), age at first mating (AFM) and the intake of mineral mixture (IMM) managed on Xaraés palissadgrass pasture (Brachiaria brizantha cv. Xaraés) were evaluated from February 2006 to March 2008. Structural characteristics, forage allowance and nutritional value of Xaraés palissadgrass were also evaluated. The structural variables of pasture, allowances and nutritive value of forage, besides the DWG were only affected (p<0.05) by season, with highest results for spring and summer. Throughout the experimental period (730 days), no sign of mineral deficiency was detected in heifers that ingested the selective supplement. The DWG and AFM were not influenced by the mineral mixture offered (0.52 and 0.33 kg/day during the spring/summer and in fall/winter for DWG, respectively, and 813 days of AFM). The IMM was higher for commercial mineral mixture than for selective (61.6 and 51.0g/day respectively). The BCS was slightly higher for selective (3.17) than for the commercial (3.02) mineral mixture. Thus, the selective mineral supplement was a strategy to prevent mineral deficiency in this herd and resulted in similar performance at lower costs (e.g. due to less IMM) of crossbred heifers when compared with the commercial mineral supplementation.

Foram avaliados os efeitos da suplementação mineral seletiva (i.e. aquela feita com base no exame clínico-nutricional do rebanho) ou comercial sobre o desempenho de novilhas leiteiras Holandês-Mantiqueira, com base em seus ganhos de peso diários (GMD), escores da condição corporal (ECC), idades à primeira cobertura (IPC) e consumos de mistura mineral (CMM), criadas em pastagem de capim-Xaraés (Brachiaria brizantha cv. Xaraés), no período de fevereiro de 2006 a março de 2008. Foram também avaliadas as características estruturais do pasto, oferta e valor nutritivo da forragem. Durante todo período experimental (730 dias), nenhum sinal de deficiência mineral foi detectado nas novilhas que ingeriram o suplemento seletivo. As variáveis estruturais do pasto, as ofertas e o valor nutritivo da forragem, além do GMD, somente foram influenciadas (p<0,05) pela estação do ano, com maiores e melhores resultados obtidos para a primavera e verão. O GMD e a IPC não foram influenciados pela mistura mineral ofertada (0,52 e 0,33 kg/dia durante a primavera/verão e outono/inverno para GMD, respectivamente, e 813 dias de IPC). O CMM foi maior para mistura mineral comercial que para seletiva (61,6 e 51,0g/UA/dia, respectivamente). O ECC foi superior para mistura mineral seletiva (3,17) que para comercial (3,02). Esta suplementação mineral seletiva foi uma estratégia que permitiu evitar o aparecimento de estados carenciais no rebanho e obter desempenho similar e com menor custo quando comparada com a suplementação mineral comercial.

Crise hipertensiva: atualização clínico-terapêutica / Hypertensive crisis: clinical-therapeutic updating

Crise hipertensiva é uma situação clínica comum caracterizada por elevação sintomática da pressão arterialque apresenta alta taxa de morbidade e mortalidade e é classificada em emergência e urgência hipertensiva. Oquadro clínico de emergência hipertensiva difere do quadro de urgência por apresentar risco de morte iminentedecorrente de lesão em órgãos-alvo instalada ou em evolução, em particular coração, cérebro e rins. Essa condição requer uma abordagem clínica criteriosa que permita o diagnóstico rápido e correto do comprometimentode órgão-alvo. A intervenção terapêutica deve ser imediata, eficiente e individualizada para cada sistema comprometido, em geral com uso de anti-hipertensivos por via endovenosa em uma unidade de terapia intensiva. Por outro lado, o paciente com urgência hipertensiva não apresenta envolvimento de órgãos-alvo e nem se encontra com risco de morte maior, por isso o tratamento pode ser feito com anti-hipertensivos por via oral na própria sala de urgência. Este artigo revisa as principais causas de crise hipertensiva, a sua fisiopatogênese e a epidemiologia, bem como a sua abordagem clínica e terapêutica com os anti-hipertensivos utilizados e suas indicações.