Voice and ageing: clinical, endoscopic and acoustic investigation.

Vocal symptoms are frequent in the elderly and are consequences of structural changes in the larynx that occur with ageing. OBJECTIVE: To identify the voice alterations in elderly patients attending a voice clinic. METHODS: Elderly patients of both genders were divided into two groups: 60-75 and above 76 years. All patients completed a questionnaire with identification data, profession, vocal symptoms, hearing, habits and addictions, and systemic diseases. All participants were submitted to video laryngoscopy and acoustic and auditory-perceptual vocal analysis. RESULTS: In this study, women predominated (40 F versus 32 M). Hoarseness was reported by 34.72% of the participants. Other symptoms included singing difficulty (17%) and phonatory effort (15.28%). Maximum phonation time showed lower values and scores 2 and 3 of perceptual analysis were registered in 33% of the elderly participants, but without statistical significance. The fundamental frequency values were inferior in older man and high in women and acoustic parameters showed high values in both groups, but without statistical significance. Videolaryngoscopies demonstrated alterations in 47% of the participants, especially bowed and atrophic vocal folds. CONCLUSIONS: We described the vocal symptoms, vocal perceptual and acoustic analysis and endoscopic findings of an elderly population, characterising the presbyphonia. Therapeutic measures must involve speech therapy and/or surgery to reduce the glottal gap, allowing less air leakage and, consequently, better vocal performance.

Apoptosis: its role in pituitary development and neoplastic pituitary tissue.

Apoptosis, also known as programmed cell death, is a phenomenon in which different stimuli trigger cellular mechanisms that culminate in death, in the absence of inflammatory cell response. Two different activation pathways are known, the intrinsic pathway (or mitochondrial) and extrinsic (or death-receptor pathway), both pathways trigger enzymatic reactions that lead cells to break up and be phagocytized by neighboring cells. This process is a common occurrence in physiological and pathological states, participating in the control of cell proliferation, differentiation and remodeling of organs. In the early steps of pituitary gland formation, numerous apoptotic cells are detected in the separation of Rathke's pouch from the roof of oral ectoderm. In the distal part of the gland, which will form the adenohypophysis, the ratio of apoptosis was significantly lower. However, there is evidence that neoplastic pituitary cells undergo unbalance in genes that control apoptosis leading to uncontrolled cell growth. No direct evidence of apoptosis was found in the drugs used for tumors producing prolactin and growth hormone. In conclusion, an unbalancing in the apoptosis process is the boundary between development and tumor growth.

Exposure to progesterone before an ovulation synchronization protocol increases the follicular diameter and fertility of multiparous suckled Bos taurus cows.

The objective of this study was to evaluate the effect of administering injectable progesterone (P4i) before a timed artificial insemination (TAI) protocol on the follicular growth, ovulation, and pregnancy rate of Bos taurus suckled cows. The effect of P4i administration before the TAI on the pregnancy rate (P/AI) was evaluated in 576 suckled Bos taurus cows at 30-90 days postpartum. In addition, the effect of P4i administration before TAI on follicular dynamics was evaluated in subgroup of 401 suckled Bos taurus cows. On Day -10 (D-10), cows were divided into two experimental groups (Control and P4i). In this moment, P4i cows received i.m. 150 mg of injectable long-action progesterone. After that, both experimental groups received a synchronization protocol (Day 0; D0) that consisted of administration i.m. of 2 mg of estradiol benzoate and a progesterone intravaginal insert on D0. On Day 8 (D8), the progesterone insert was removed, and the cows received 500 µg of cloprostenol, 400 IU of eCG, and 1 mg of estradiol cypionate. TAI was performed 48 h after the removal of the progesterone insert. The ultrasound exams were performed in a subgroup of cows on Days 0, 8, 10 and 12 to evaluate the diameter of the largest follicle, rate of follicular growth and risks of single and double ovulation. The pregnancy diagnosis was performed 30 days after TAI in all cows to determine the pregnancy rate. The diameter of the largest follicle, on D10 (P = 0.84), rate of follicular growth (P = 0.14), ovulation rate (P = 0.40) and double ovulation rates (P = 0.23) did not differ between experimental groups. The pregnancy rate was greater in the P4i group [Control 46.2 % (133/288) vs. P4i 55.6 % (160/288); P = 0.03]. The diameter of the largest follicles (LF) on D0 (Control 11.6 ± 0.2 vs. P4i 13.3 ± 0.3) was greater (P = 0.01) in the P4i group. In conclusion, injectable progesterone before the ovulation synchronization protocol increased the diameter of the largest follicle on the D0 and the pregnancy rate in multiparous Bos taurus suckled beef cows.

Comparison of peri-operative core temperature in obese and non-obese patients.

Our aim was to compare peri-operative core temperatures and the incidence of hypothermia in obese and non-obese women with active forced-air warming. Twenty female patients scheduled for abdominal surgery were allocated to two groups according to body mass index. Ten obese (30.0-34.9 kg.m(-2) ) and 10 non-obese (18.5-24.9 kg.m(-2) ) women received forced-air warming on their lower limbs. At the end of surgery, the mean (SD) core temperatures were 36.7 (0.5) °C in the obese group and 36.0 (0.6) °C in the non-obese group (p < 0.001). Only in the non-obese group was there a significant decrease in the intra-operative core temperature values (p < 0.001). The incidences of intra-operative hypothermia were lower in the obese group (10%) compared with non-obese group (60%; p = 0.019). In the postoperative recovery phase, the mean (SD) core temperature data were higher in the obese group than in the non-obese group (36.2 (0.4) vs 35.6 (0.5) °C, respectively (p < 0.001)). In conclusion, obese female patients have higher peri-operative core temperature and a lower incidence of hypothermia compared with non-obese female patients during abdominal surgery with active forced-air warming.

Ultrasound-guided aspiration of dominant follicles (≥25 mm) followed by luteinization and progesterone production during the estrous cycle in mares.

The present study was designed to evaluate luteinization rates subsequent to aspiration of dominant follicles (≥25 mm) in the absence of a functional CL (progesterone <1 ng/mL) and characterize the temporal changes in plasma concentrations of progesterone following aspiration-induced luteinization during the estrous cycle in mares. A total of 29 estrous cycles involving 15 mares in a cross-over design were randomly assigned to five groups: 1) ASP-F≥25 mm (n = 6; follicle aspiration 25-29 mm), 2) ASP-F≥30 mm (n = 6; follicle aspiration 30-34 mm), 3) ASP-F≥35 mm (n = 6; follicle aspiration 35-40 mm), 4) ASP-F≥40 (n = 6; follicle aspiration ≥40), and 5) Control (n = 5; spontaneous ovulation or no follicle aspiration). Subsequent to ovulation (Day 0), PGF was administered to all groups on Day 5, blood samples were collected daily and aspiration of the dominant follicle was done using ultrasound-guided transvaginal follicle needle puncture. Among the follicle aspirations groups 25-29, 30-34, 35-39, and ≥40 mm, the luteinization rates were not different (P > 0.05) at 83, 67, 83, and 100%, respectively. Correspondingly, progesterone concentrations increased (>2 ng/mL) by approximately 6, 7, 5, and 4 d after aspiration, respectively, which were delayed (P < 0.05) in the 25-29 and 30-34 mm follicle aspiration groups compared to 2 d after ovulation in the control group. Thereafter, progesterone reached maximal concentrations (10-11 ng/mL) as averaged over all aspiration groups but were lower (P < 0.05) compared to the mean maximal concentration (18 ng/mL) in the control group. Subsequently, there was a decrease in progesterone concentrations (<2 ng/mL) in response to luteolysis, which was delayed (P < 0.05) in the aspiration groups over Days 16-20 compared to Day 15 in the control group. Despite this discrepancy, the mean length of the interovulatory intervals were not different (P > 0.05) among groups on Day 23. Thus, the present study provided novel information that the luteinization rate is relatively high (83%) and consistent following aspiration of dominant follicles (≥25 mm) in the absence of a functional CL and that the increase in progesterone reaches sustainable progestational concentrations (≥2 ng/mL) in accord with the length of the estrous cycle that may potentially support development and maintenance of early pregnancy in recipient mares involved in an embryo transfer program.

Evaluation of genotoxic potential of peptides used in nuclear medicine (PSMA -617 and -11, and ubiquicidine 29-41) using a flow-cytometric, semi-automated analysis of micronuclei frequency in cell cultures.

Assays that rely on the assessment of frequency of micronuclei are important standard techniques currently used to quantify potential genotoxic damage after exposure to chemical or physical agents, such as ionizing radiation, or in pre-clinical studies, to assessment of the genotoxic potential of drugs or its components. The experiments are usually performed using conventional microscopy, but currently the protocols are being upgraded to automated approaches based on flow cytometry protocols based on the elimination of the plasma membrane by chemical agents, allowing quantification by flow cytometry. In this work, the genotoxic potential of peptides used as components of radiopharmaceuticals (PSMA-617 and 11 and Ubiquicidine) was evaluated exposing CHO-KI cells to a wide range of concentration (0.1X and 100X the maximum allowed concentration to human adults). Incubation with PSMA-11 or UBI29-41 did not induce genotoxicity. After 24 h of incubation, PSMA-617 induced genotoxicity only in non-practical concentration (100-fold). Results corroborate the safety of the pre-drugs and the wide detection range of technique.

Advances in ultrasound techniques improve early detection of deep vein thrombosis.

AIM: This study aimed at assessing the accuracy of ultrasound (US) in the diagnosis of recent deep vein thrombosis (DVT) in an experimental study in dogs. DESIGN: blinded and randomized experimental study. Twenty dogs were randomly divided in two groups: control group (CG) and thrombosis group (TG). US was performed in the pre- and postoperative period. Phlebography was performed immediately prior to the postoperative US. After the second US, a surgery was performed to detect whether thrombus was present or not. US results were compared to those of phlebography and surgical findings. RESULTS: In all dogs, inferior vena cava (IVC) was compressible. The relations of IVC diameter with the aorta were higher (P<0.005) in TG than in CG. Spectral Doppler in spontaneous breathing, tissue harmonic imaging, power Doppler and B flow showed sensitivity, specificity and accuracy of 1. Phlebography presented sensitivity of 90%, specificity of 80% and accuracy of 85%, when compared to surgical finding. CONCLUSIONS: For the diagnosis of recent DVT in the experimental model used, venous compressibility proved to be inefficient. The ratio of IVC diameter to aorta, when increased, suggests thrombosis. The use of new US technological advances increases accuracy. Phlebography was less accurate than US.

Effects of Ischemic Preconditioning and Postconditioning in a Renal Ischemia-Reperfusion Injury Model: A Comparative Experimental Study in Rats.

BACKGROUND: Ischemia-reperfusion injury is an unavoidable aspect of transplantation, as well as an important cause of acute kidney injury in clinical practice. Pre- and post-ischemic conditioning are strategies that may provide organs with resistance to major ischemic events. This study evaluates the effects of ischemic preconditioning and ischemic postconditioning, either separately or in combination, after an acute ischemia-reperfusion kidney injury. METHODS: Forty Wistar rats received isoflurane anesthesia and were randomized into 5 groups: 1. the sham group underwent laparotomy; 2. the control group underwent laparotomy and 30 minutes of renal ischemia followed by reperfusion; 3. the preconditioning group underwent laparotomy, ischemic preconditioning, and 30 minutes of renal ischemia followed by reperfusion; 4. the preconditioning and postconditioning group underwent laparotomy, ischemic preconditioning, 30 minutes of renal ischemia, and ischemic postconditioning followed by reperfusion; and 5. the postconditioning group underwent laparotomy, 30 minutes of renal ischemia, and ischemic postconditioning followed by reperfusion. Serum analyses of creatinine and neutrophil gelatinase-associated lipocalin (NGAL) were performed, and renal histology was examined 24 hours later. RESULTS: Severe tubular injury and increases in creatinine were observed in all groups except the sham group. The control group and all ischemic conditioning groups were no different in the degree of renal injury and values of NGAL and creatinine after the injury. CONCLUSIONS: Ischemic preconditioning and ischemic postconditioning, together or separately, are unable to preserve kidney function or exert a protective effect against tubular cell injury after an acute ischemia-reperfusion kidney injury.

Ketoconazole Treatment Decreases the Viability of Immortalized Pituitary Cell Lines Associated with an Increased Expression of Apoptosis-Related Genes and Cell Cycle Inhibitors.

Ketoconazole, which was initially developed as an antifungal agent, is a potent inhibitor of adrenal steroidogenesis and has therefore been used in the management of Cushing's disease. Surprisingly, the reduction of cortisol levels during ketoconazole treatment is not accompanied by the expected elevation in plasma adrenocorticotrophic hormone (ACTH) at the loss of negative cortisol feedback from corticotrophic cells, suggesting a direct effect of ketoconazole on these cells. To characterize the direct effects of ketoconazole, we evaluated its in vitro effect on cell viability using the pituitary tumoural cell lines AtT-20 (which secretes ACTH), GH3 (which secretes growth hormone and prolactin) and αT3.1 (which secretes α-subunit) and we also determined the expression levels of genes involved in apoptosis and DNA replication by the quantitative reverse transcription polymerase chain reaction (qRT-PCR). We also evaluated ACTH levels in AtT-20 cells during ketoconazole treatment. We observed a ketoconazole concentration-dependent decrease in pituitary cell viability and reduced ACTH levels in AtT-20 cells after removal of the drug. We also observed increased expression of cell death receptors (e.g. Fas, tumour necrosis factor receptor) and caspases (e.g., caspase-6, caspase-7, caspase-9), suggesting activation of the apoptosis pathway. In addition, we observed increased gene expression of the cell cycle inhibitors p21 and p27 in GH3 cells and increased expression of p21 in αT3.1 cells. In conclusion, our findings suggest that ketoconazole significantly reduces cell viability in a concentration-dependent manner in pituitary tumour cell lines and is associated with an increase in apoptosis- and cell cycle regulation-related gene expression.

Genotoxicity of fractionated organic material in airborne particles from São Paulo, Brazil.

Particulate matter less than 10 microns aerodynamic diameter (PM10) is associated with adverse health effects including increased respiratory problems and mortality. PM10 is also associated with increases in cancer in some urban areas. Identification of toxic compounds in PM10 is a step toward estimating exposure to these compounds and evaluating their public health risk. However, the toxic compounds on PM10 are part of a highly complex mixture of compounds that makes chemical characterization difficult. Before this study, there has been little investigation of genotoxic compounds in particulate matter from Latin American cities. Here, both bioassay (mutagenicity) and chemical analyses were conducted with organic solvent extracts of PM10 collected from São Paulo, a major Brazilian city. Sequential extraction in dichloromethane (DCM) followed by acetone (ACE) yielded 20.3% and 10.2% of the total mass, respectively. Non-polar and moderately polar organic material solubilized in DCM. ACE extracted more polar organic species and some inorganic ions. Both extracts were fractionated separately using cyanopropyl-bonded silica chromatography with organic solvents of increasing polarity. The mass distribution among the fractions was measured. The mutagenic activity of the fractions was assayed using the microsuspension procedure with the Salmonella typhimurium tester strain TA98, with and without addition of metabolic enzymes (S9). The DCM extract had about four times higher mutagenic activity than the ACE extract. In general, addition of S9 resulted in an increase in mutagenicity of DCM fractions, but a decrease for the ACE extract. Most of the activity was concentrated in fractions in the mid-range of polarity within both the DCM and ACE extracts. The fractions were analyzed by gas chromatography with mass selective detection (GC/MS) without derivatization. The most mutagenic fractions in the DCM extract contained ketones, aldehydes, and quinolines. The most mutagenic ACE fraction had ketones, carboxylic acids, and aldehydes.

Effects of fetuin on zona pellucida hardening, fertilization and embryo development in cattle.

Mammalian oocytes can undergo spontaneous meiotic maturation when they are liberated from their follicles and cultured in vitro; however, the zona pellucida (ZP) becomes resistant to chymotrypsin digestion, or hardens, when spontaneous maturation occurs in serum-free medium. Schroeder et al. [Biol. Reprod. 43 (1990) 891] described that fetuin, a component of fetal calf serum (FCS), inhibits ZP hardening during oocyte maturation. The aim of this experiment was to study the effect of the presence of cumulus cells and addition of hormones to maturation media on bovine zona hardening and embryo development in medium with and without fetuin. In Experiment I, different concentrations of fetuin were added to the maturation medium. The time necessary for digestion of 50% of the ZP (d50) was not different when oocytes were matured in presence of 10% FCS, 1mg/ml polyvinyl alcohol (PVA), or 4, 1 and 0.25mg/ml of fetuin; cleavage rates were also similar. However, significantly more blastocysts (P<0.05) were formed when FCS was used compared to PVA and 0.25mg/ml of fetuin. In Experiment II, we examined the influence of the presence of cumulus cells and hormones during the maturation of oocytes in media with PVA, BSA, FCS and fetuin. The d50 was significantly higher (P<0.05) when oocytes were matured in presence of cumulus cells. The cleavage rate of cumulus-intact oocytes was similar for all groups. However, when oocytes were partially stripped before maturation, the cleavage rate was significantly higher (P<0.05) when FCS or fetuin was used. In both stripped and non-stripped groups, significantly more blastocysts (P<0.05) were formed when oocytes were matured with FCS compared to BSA and PVA. These results indicate that zona hardening, as described for mouse and human oocytes, does not have a large effect on bovine cumulus-intact oocytes. Apparently fetuin can be used as a substitute for FCS during bovine oocyte maturation, since it leads to similar developmental rates as FCS in intact and partially stripped oocytes.

Capillary electrophoresis determination of urinary muconic acid as a biological marker for benzene in cigarette smoke.

trans,trans-Muconic acid (MA), a benzene metabolite in urine, has currently been indicated as a biological marker for benzene in cigarette smoke. The available methodologies for MA present a few shortcomings, such as lack of specificity and labor-intensive sample pretreatment. In this work, a capillary electrophoresis method for separation, identification, and quantification of urinary muconic acid has been implemented. The electrolyte consisted of a 60-mM phosphate buffer solution (pH 7), containing 0.1 mM cetyltrimethylammonium bromide (CTAB) as an electroosmotic flow modifier. Urine samples from nonsmokers and smokers were filtered through a 0.22-micron membrane prior to injection in a 75 microns i.d. x 80 cm capillary. The analysis was conducted under constant voltage conditions of -30 kV and direct UV detection at 262 nm. The detection capability of the electrophoresis system was enhanced by employing a high-sensitivity optical cell, positioned at 60 cm from the injection port. The CE methodology presented an overall analysis time of less than 10 min, with 5 min spent for capillary conditioning and approximately 5 min for run completion. The method was found to be sensitive for the determination of MA down to 25 micrograms/L, with a percentage recovery of 100 +/- 8%, and suitable for discriminating urinary MA from nonsmokers and smokers.

[Influence of socioeconomic conditions in the nutritional changes and at rest metabolic rate in school children living in shantytowns of the city of São Paulo, Brazil]. / Influência das condições socioeconômicas nas alterações nutricionais e na taxa de metabolismo de repouso em crianças escolares moradoras em favelas no município de São Paulo.

PURPOSE: A cross-sectional study was carried out to characterize the alterations in the resting metabolic rate (RMR), and socioeconomic conditions of 15 stunted (DP= height/age < 95% and 110% (3) weight/height >90%) and 15 nonstunted (EU= height/age > 95% and 110% (3) weight/height >90%) school girls living in shantytowns of São Paulo. METHODS: Resting metabolic rate was measured using indirect calorimetry. Socioeconomic data was collected during home visits by administration of a questionnaire. RESULTS: The mildly stunted group had a higher RMR when expressed as Kcal/kg body weight (EU= 40,5 Kcal/kg/day; DP=44,4 Kcal/kg/day; p<0.05) and lean body mass (EU= 49, 2 Kcal/kg/day; DP=52,5 Kcal/kg/day; p<0.05). Stunting was associated with maternal illiteracy (EU= 13,3%; DP=57,1%; p<0.05), income per capita (EU=US$107,14; DP=US$54,40; p< 0.05), number of parasites per child (EU=0; DP=1; p<0.05), birth order (EU=2; DP=4; p< 0.05), and number of siblings (EU=4; DP=6; p<0.01). Stunting was best predicted by income per capita and maternal illiteracy by using multiple logistic regression. CONCLUSIONS: Although the two groups had normal weight/height, the group with mild stunting showed socioeconomic and metabolic alterations, typical of a malnourished condition.

Evaluation of renal protection from high doses of melatonin in an experimental model of renal ischemia and reperfusion in hyperglycemic rats.

BACKGROUND: Melatonin is a free radical scavenger with important actions in the study of renal ischemia and reperfusion (I/R). This study evaluated possible renal protection of high doses of melatonin in an experimental model of I/R in which rats were submitted to acute hyperglycemia under anesthesia with isoflurane. METHOD: Forty-four male Wistar rats, weighing more than 300 g, were randomly divided into 5 groups: G1, sham (n = 10); G2, melatonin (n = 10; 50 mg.kg(-1)); G3, hyperglycemia (n = 9; glucose 2.5 g.kg(-1)); G4, hyperglycemia/melatonin (n = 10; 2.5 g.kg(-1) glucose + melatonin 50 mg.kg(-1)); and G5, I/R (n = 5). In all groups, anesthesia was induced with 4% isoflurane and maintained with 1.5% to 2.0% isoflurane. Intraperitoneal injection of melatonin (G1, G4), glucose (G3, G4), or saline (G1, G5) was performed 40 minutes before left renal ischemia. Serum plasma values for creatinine and glucose were determined at baseline (M1), immediately following reperfusion (M2), and 24 hours after completion of the experiment (M3). Histological analysis was performed to evaluate tubular necrosis (0-5). RESULTS: Serum glucose was higher at M2 in the groups supplemented with glucose, hyperglycemia (356.00 ± 107.83), and hyperglycemia/melatonin (445.3 ± 148.32). Creatinine values were higher at T3 (P = .0001) for I/R (3.6 ± 0.37), hyperglycemia/melatonin (3.9 ± 0.46), and hyperglycemia (3.71 ± 0.69) and lower in the sham (0.79 ± 0.16) and melatonin (2.01 ± 1.01) groups, P < .05. Histology showed no necrosis injury in the G1, lesion grade 2 in the G2, and severe acute tubular necrosis in the G3: (grade 4), G4: (grade 5) and G5: (grade 4) groups (P < .0001). DISCUSSION: Melatonin protected the kidneys submitted to I/R in rats without hyperglycemia; however, this did not occur when the I/R lesion was associated with hyperglycemia. CONCLUSIONS: Due to its antioxidant and antiapoptotic action, melatonin was able to mitigate, but not prevent acute tubular necrosis in rats with hyperglycemia under anesthesia by isoflurane.

Perfil epidemiológico da hanseníase em Itabuna - Bahia / Epidemiological profile of leprosy in Itabuna - Bahia

Objetivo: analisar o perfil epidemiológico dos novos registros de hanseníase na cidade de Itabuna,Bahia no período de 2010 a 2014. Métodos: estudo exploratório, descritivo e quantitativo, através dacoleta de dados secundários registrados no Sistema de Informação de Agravos de Notificação.Resultados: houve tendência de decréscimo no número de casos entre 2010 e 2014, predominou osexo masculino (56,1%), a faixa etária entre 50 a 64 anos (23,5%), cor da pele parda (58,7%), ensinofundamental incompleto (40,2%) Conclusão: a Hanseníase em Itabuna-BA ocorre mais comumente emadultos e idosos, prevalecendo indivíduos com mais de 50 anos, de cor de pele parda e com baixaescolaridade, indicando pessoas que geralmente são economicamente ativas e com pouco acesso àinformação.

Objective: to analyze the epidemiological profile of the new records of leprosy in the city of Itabuna,Bahia from 2010 to 2014. Methods: exploratory, descriptive and quantitative study was conductedby collecting secondary data recorded in the Information System Notifiable Diseases. Results: therewas a decrease in the number of cases between 2010 and 2014, the predominance of males (56,1%),age between 50 to 64 years (23,5%), brown skin color (58,7%), incomplete elementary school (40,2%).Conclusions: leprosy in Itabuna-BA occurs most commonly in adults and the elderly, with individualsover 50 years of age, from the brown skin color and with low low schooling, indicating people whoare generally economically active and with little access to information.

Ovarian response to porcine FSH in association with ablation-induced or spontaneous follicular wave development during the estrous cycle in crossbred and Brazilian Warmblood mares.

The primary objective of this study was to examine the follicular and ovulatory responses following treatment with pFSH in association with ablation-induced or spontaneous follicular wave emergence or follicle deviation during diestrus in crossbred (Mangalarga×Arabian) and Brazilian Warmblood mares with a propensity for spontaneous multiple ovulations; secondary considerations were given to the collection of embryos. In Experiment 1, crossbred mares were administered (im) saline (control, n=7) or pFSH (25mg) when the largest follicle of the ablation-induced follicular wave reached ≥13mm (n=7) or ≥20mm (n=7) or, after pre-treatment ovulation (Day 0) on Day 6 (n=7). In Experiment 2, crossbred mares were administered (im) saline (control, n=10) or a larger dose of pFSH (50mg, n=7) when the largest follicle of the ablation-induced follicular wave reached ≥13mm. In Experiment 3, Brazilian Warmblood mares were administered (im) saline (control, n=7), pFSH (25mg, n=7 or 50mg, n=5) or EPE (12.5mg, n=7) as a positive control on Day 6. Ultrasonic technology was used to ablate all follicles ≥8mm and to monitor follicular development and detect ovulation. Treatment with pFSH or EPE was done twice daily until the largest follicle reached ≥32mm; thereafter, hCG (2500IU) was administered (iv) when the largest follicle reached ≥35mm. Artificial insemination was done 12h after hCG and embryo collections were done 8 d after post-treatment ovulations. In Experiments 1 and 2, treatment of crossbred mares with pFSH post-ablation in association with the expected time of wave emergence or follicle deviation did not (P>0.05) enhance the follicular or ovulatory responses or collection of embryos compared to controls. In Experiment 3, although the enhanced ovulatory response of mares to EPE at the expected time of spontaneous wave emergence was not different (P>0.05) from controls, it was greater (P<0.05) than the response to pFSH. In conclusion, the novelty of using follicle ablation prior to pFSH treatment at the time of wave emergence or follicle deviation did not enhance the follicular or ovulatory responses or collection of embryos to treatment in crossbred mares. In addition, the hypothesis that Brazilian Warmblood mares with a greater propensity for spontaneous multiple ovulations are as responsive to pFSH compared to EPE was not supported. Thus, the combined experimental results of the present study continue to support the general consensus that pFSH is relatively ineffective for follicular superstimulation/superovulation in mares.

Comparison of oxidative stress in ASA physical status I patients scheduled for minimally invasive surgery under balanced or intravenous anesthesia.

BACKGROUND: The effects of anesthetics on inflammation and oxidative parameters, evaluated in patients without comorbidities undergoing minor surgery, remain unknown. The present study aimed to investigate the inflammatory and oxidative stress status in adult patients undergoing elective minimally invasive surgery, using different anesthetic techniques. METHODS: Thirty patients classified as ASA physical status I, who were scheduled for minor surgeries (tympanoplasty or septoplasty), were randomly allocated into two groups: balanced (BAL) anesthesia maintained with isoflurane or total intravenous anesthesia (TIVA) with propofol. Blood samples were drawn prior to the induction of anesthesia (baseline), 120 min after the beginning of anesthesia and one day after surgery. The proinflammatory cytokine IL-6 was determined by flow cytometry; DNA oxidation was evaluated by the single cell gel electrophoresis assay, and plasma malondialdehyde (lipid peroxidation biomarker) and antioxidant status were determined through fluorometry. RESULTS: Increased IL-6 was observed one day after surgery in both groups (P=0.0001). Malondialdehyde levels did not change among the time points assessed or between the groups (P>0.05). Whereas BAL anesthesia had no effect on acid nucleic and antioxidant status, TIVA decreased oxidized/alkylated purines (P=0.03) and increased antioxidant status (P=0.002) during anesthesia. The two groups did not differ significantly in DNA oxidation or antioxidant status (P>0.05). CONCLUSION: BAL anesthesia maintained with isoflurane and TIVA maintained with propofol are safe by virtue of not causing oxidative stress status in ASA physical status I patients undergoing minimally invasive surgeries. Moreover, even in minor surgeries, TIVA with propofol produces an antioxidant effect in patients.

Prevalence and antifungal susceptibility of Candida parapsilosis complex isolates collected from oral cavities of HIV-infected individuals.

At present, few data are available on the prevalence and antifungal susceptibility of Candida parapsilosis complex isolates from HIV-infected individuals. The C. parapsilosis complex comprises three species, C. parapsilosis sensu stricto, C. metapsilosis and C. orthopsilosis. Fifteen of 318 Candida isolates were identified as members of the C. parapsilosis complex by PCR and restriction fragment length polymorphism (RFLP). The prevalence of C. parapsilosis complex isolates was 4.7 %, 2.2 % being identified as C. parapsilosis sensu stricto and 2.5 % as C. metapsilosis, while no C. orthopsilosis was isolated. This is believed to be the first study that has identified isolates of C. metapsilosis obtained from the oral cavity of HIV-infected individuals. Antifungal susceptibility tests indicated that all the isolates were susceptible to amphotericin B (AMB), fluconazole (FLC), ketoconazole (KTC), itraconazole (ITC), voriconazole (VRC) and caspofungin (CASPO). Although isolates of C. parapsilosis sensu stricto and C. metapsilosis were susceptible to FLC, isolates of C. metapsilosis showed a tendency for higher MICs (≥1.0 µg ml(-1)). Based upon the frequency of candidiasis and the fact that certain isolates of the C. parapsilosis complex respond differently to FLC therapy, our data may be of therapeutic relevance with respect to susceptibility and potential resistance to specific antifungal agents. Our data suggest that C. metapsilosis can be a human commensal; its importance as a pathogen has yet to be confirmed.

Caffeic acid phenethyl ester effects in the kidney during ischemia and reperfusion in rats anesthetized with isoflurane.

BACKGROUND: The purpose of this investigation was to examine the effect of caffeic acid phenethyl ester (CAPE) in renal ischemia/reperfusion injury in rats anesthetized with isoflurane (iso). METHODS: We randomly assigned 26 male Wistar rats anesthetized with isoflurane, intubated and mechanically ventilated to 3 groups: G1 (controls; n = 8), G2 (CAPE; n = 10), and G3 (ethanol; n = 8). Mean arterial pressure was monitored for anesthetic control. Intraperitoneal CAPE (G2) or ethanol (G3) injections were administered 40 minutes before left renal ischemia. All animals underwent right nephrectomy and the left kidney was submitted to ischemia for 25 minutes. Serum creatinine (cr) values were determined at the beginning (M1), end (M2), and 24 hours after the experiment (M3) upon intracardiac blood samples. The left kidney was removed for histologic analysis, using a scale for tubular necrosis (0-5, injury maximum). Statistical analysis was applied to serum creatinine and histological score injury considering statistical differences to be significant when P < .05. RESULTS: The cr values in the CAPE were significantly higher at M2 (0.8 mg/mL; P = .0012) and M3 (3.7 mg/mL; P = .0014) than the control (0.5 and 0.9 mg/mL) or G3 (0.6 and 1.0 mg/mL), respectively. Histologic examination showed the CAPE group to display more pericapsular tubular necrosis (3.0 [2.0; 3.0]) than the G1 group (2.0 [1.0; 2.0]) or G3 group (1.5 [1.0; 2.0]; P < .001). The CAPE group displayed more medullary tubular necrosis (2.0 [2.0; 3.0] than G1 (2.0 [1.0; 2.0] or G3 (1.0 [0.0; 2.0]; P < .001). CONCLUSION: CAPE promoted greater functional and anatomic renal injury when rats were anesthetized with iso than control or ethanol groups, as demonstrated by histologic analysis and serum values.

Accuracy of routine diagnostic tests used in paracoccidioidomycosis patients at a university hospital.

The identification of appropriate laboratory measures to confirm clinical hypotheses is important in routine paracoccidioidomycosis medical care. The clinical records and laboratory reports of 401 paracoccidioidomycosis patients attended at the Tropical Diseases Area, Faculdade de Medicina de Botucatu, from 1974 to 2008 were reviewed. Direct mycological (DM), cell block (CB), histopathological (HP), and double immunodiffusion (DID) tests were evaluated before treatment. Typical Paracoccidioides brasiliensis yeast forms were observed in clinical specimens of 86% of the patients, but 14% were detected only by serological test. DM of 51 different tissue specimens produced 74.5% sensitivity, and 62.5% sensitivity was observed in 112 sputum samples. CB in 483 sputum samples generated 55.3% sensitivity. HP performed in 239 samples from different tissues revealed 96.7% sensitivity. Serology carried out in 351 patients and 200 healthy controls provided 90.0% sensitivity, 100.0% specificity, 100.0% positive predictive value, 85.1% negative predictive value and 93.6% accuracy. Comparisons of laboratory measurements performed in the same patient showed that sensitivity decreases from HP to DID to CB and DM, with the last two assays providing similar sensitivities. This study demonstrated that P. brasiliensis identification by HP, CB, and/or DM associated with DID is sufficient to establish the laboratorial diagnosis of paracoccidioidomycosis in practically all cases.