Genomic insights into the expansion of carbapenem-resistant Klebsiella pneumoniae within Portuguese hospitals.

Carbapenem-resistant Klebsiella pneumoniae (CR-KP) are a public health concern, causing infections with a high mortality rate, limited therapeutic options and challenging infection control strategies. In Portugal, the CR-KP rate has increased sharply, but the factors associated with this increase are poorly explored. In order to address this question, phylogenetic and resistome analysis were used to compare the draft genomes of 200 CR-KP isolates collected in 2017-2019 from five hospitals in the Lisbon region, Portugal. Most CR-KP belonged to sequence type (ST) 13 (29%), ST17 (15%), ST348 (13%), ST231 (12%) and ST147 (7%). Carbapenem resistance was conferred mostly by the presence of KPC-3 (74%) or OXA-181 (18%), which were associated with IncF/IncN and IncX plasmids, respectively. Almost all isolates were multi-drug resistant, harbouring resistance determinants to aminoglycosides, beta-lactams, trimethoprim, fosfomycin, quinolones and sulphonamides. In addition, 11% of isolates were resistant to colistin. Colonizing and infecting isolates were highly related, and most colonized patients (89%) reported a previous hospitalization. Moreover, among the 171 events of cross-dissemination identified by core genome multi-locus sequence typing data analysis (fewer than five allelic differences), 41 occurred between different hospitals and 130 occurred within the same hospital. The results suggest that CR-KP dissemination in the Lisbon region results from acquisition of carbapenemases in mobile genetic elements, influx of CR-KP into the hospitals by colonized ambulatory patients, and transmission of CR-KP within and between hospitals. Prudent use of carbapenems, patient screening at hospital entry, and improvement of infection control are needed to decrease the burden of CR-KP infection in Portugal.

The Relationship between Photoluminescence Emissions and Photocatalytic Activity of CeO2 Nanocrystals.

In this work, we focus on understanding the morphology and photocatalytic properties of CeO2 nanocrystals (NCs) synthesized via a microwave-assisted solvothermal method using acetone and ethanol as solvents. Wulff constructions reveal a complete map of available morphologies and a theoretical-experimental match with octahedral nanoparticles obtained through synthesis using ethanol as solvent. NCs synthesized in acetone show a greater contribution of emission peaks in the blue region (∼450 nm), which may be associated with higher Ce3+ concentration, originating shallow-level defects within the CeO2 lattice while for the samples synthesized in ethanol a strong orange-red emission (∼595 nm) suggests that oxygen vacancies may originate from deep-level defects within the optical bandgap region. The superior photocatalytic response of CeO2 synthesized in acetone compared to that of CeO2 synthesized in ethanol may be associated with an increase in long-/short-range disorder within the CeO2 structure, causing the Egap value to decrease, facilitating light absorption. Furthermore, surface (100) stabilization in samples synthesized in ethanol may be related to low photocatalytic activity. Photocatalytic degradation was facilitated by the generation of ·OH and ·O2- radicals as corroborated by the trapping experiment. The mechanism of enhanced photocatalytic activity has been proposed suggesting that samples synthesized in acetone tend to have lower e'─h· pair recombination, which is reflected in their higher photocatalytic response.

Synthesis and defect characterization of hybrid ceria nanostructures as a possible novel therapeutic material towards COVID-19 mitigation.

This study reports the synthesis of hybrid nanostructures composed of cerium dioxide and microcrystalline cellulose prepared by the microwave-assisted hydrothermal route under distinct temperature and pH values. Their structural, morphological and spectroscopic behaviors were investigated by X-Rays Diffraction, Field Emission Gun Scanning Electron Microscopy, High-Resolution Transmission Electron Microscopy, and Fourier-Transform Infrared, Ultraviolet-Visible, Raman and Positron Annihilation Lifetime spectroscopies to evaluate the presence of structural defects and their correlation with the underlying mechanism regarding the biocide activity of the studied material. The samples showed mean crystallite sizes around 10 nm, characterizing the formation of quantum dots unevenly distributed along the cellulose surface with a certain agglomeration degree. The samples presented the characteristic Ce-O vibration close to 450 cm-1 and a second-order mode around 1050 cm-1, which is indicative of distribution of localized energetic levels originated from defective species, essential in the scavenging of reactive oxygen species. Positron spectroscopic studies showed first and second lifetime components ranging between 202-223 ps and 360-373 ps, respectively, revealing the presence of two distinct defective oxygen species, in addition to an increment in the concentration of Ce3+-oxygen vacancy associates as a function of temperature. Therefore, we have successfully synthesized hybrid nanoceria structures with potential multifunctional therapeutic properties to be further evaluated against the COVID-19.

Acoustic Radiation Force Impulse (ARFI) elastography imaging of equine distal forelimb flexor structures / [Elastografia Acoustic Radiation Force Impulse (ARFI) das estruturas flexoras da porção distal do membro torácico de equinos]

This study set out to determine normal values for acoustic radiation force impulse (ARFI) elastography of the superficial digital flexor tendon, deep digital flexor tendon, accessory ligament of the deep digital flexor tendon and suspensory ligament in horses. Twenty-four horses were submitted to conventional sonographic assessment and elastography imaging (quantitative ARFI method) of distal forelimb tendons and ligaments at nine anatomical regions. Elastograms depicted tendons and ligaments in orange to red tones consistent with greater stiffness. Shear wave velocity was higher in the longitudinal compared to the cross-sectional plane but did not differ significantly between the left and right forelimbs. The suspensory ligament was stiffer compared to remaining structures in the cross-sectional plane. Ligaments were stiffer than tendons and the deep digital flexor tendon was stiffer than the superficial digital flexor tendon in the longitudinal plane. Target structures were stiffer in male compared to female horses and stiffness tended to increase with age. ARFI elastography proved to be a feasible and reproducible imaging modality for assessment of distal forelimb tendons and ligaments in horses. Qualitative features derived from stiffness quantification in these structures can be applied to horses with musculoskeletal disorders, as well as to other animal species.(AU)

Este trabalho objetivou estabelecer valores de referência por meio da elastografia ARFI ("Acoustic Radiation Force Impulse") do tendão flexor digital superficial, tendão flexor digital profundo, ligamento acessório inferior e ligamento suspensor do boleto em equinos hígidos. Vinte e quatro equinos foram submetidos aos exames ultrassonográfico e elastográfico (método ARFI quantitativo) dos tendões e ligamentos da porção distal do membro torácico, em nove regiões anatômicas diferentes. Os elastogramas mostraram tendões e ligamentos de coloração alaranjada a vermelha, que representam maior rigidez. Não houve diferenças em relação ao membro avaliado; as velocidades de cisalhamento foram maiores nos planos longitudinais. No plano transversal, os ligamentos suspensores foram mais rígidos em comparação aos demais. No plano longitudinal, os ligamentos mostraram-se mais rígidos que os tendões, e o tendão flexor digital profundo, mais rígido que o tendão flexor digital superficial. As estruturas mostraram-se mais rígidas nos machos, e houve uma tendência à maior rigidez em animais mais velhos. A elastografia ARFI comprovou ser um método viável e reprodutível para avaliação dos tendões e ligamentos dos membros torácicos de equinos. As características qualitativas obtidas a partir da rigidez dessas estruturas podem ser utilizadas para testes em equinos com distúrbios musculoesqueléticos e também em outras espécies animais.(AU)

Signs for Early Detection of Dysphagia in Older Adults with Severe Alzheimer's Disease.

OBJECTIVES: The aim of this study was to detect signs of dysphagia in older adults with and without Alzheimer's disease (AD). STUDY DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: A total of 280 institutionalized older adults (with AD = 145; without AD = 135), aged > 70 years, with oral feeding, both sexes were examined. MEASUREMENTS: Modified water-swallowing test determined the dysphagia. Independent variables were dependency level (modified Barthel Index), oral health and function status (residual teeth, occlusal contacts, passive lip sealing, tongue function, rinsing and gargling ability), nutritional status (Body Mass Index, Mini Nutritional Assessment), and diet-related assessments (appetite, storing or stuffing food in the mouth). Statistical analysis was carried out by Fisher´s Exact and chi-square tests. The analyzes of associations with the dysphagia outcome were performed by simple and multiple logistic regression models. RESULTS: Severity of AD was significantly associated with dysphagia. The signs associated with dysphagia were decreased nutritional status, absence of appetite, and storing food in the mouth. CONCLUSION: These signs can be useful tools for early diagnosis of dysphagia in AD older adults.

Muon implantation experiments in films: Obtaining depth-resolved information.

Implanted positive muons with low energies (in the range 1-30 keV) are extremely useful local probes in the study of thin films and multi-layer structures. The average muon stopping depth, typically in the order of tens of nanometers, is a function of the muon implantation energy and of the density of the material, but the stopping range extends over a broad region, which is also in the order of tens of nanometers. Therefore, an adequate simulation procedure is required in order to extract the depth dependence of the experimental parameters. Here, we present a method to extract depth-resolved information from the implantation energy dependence of the experimental parameters in a low-energy muon spin spectroscopy experiment. The method and corresponding results are exemplified for a semiconductor film, Cu(In,Ga)Se2, covered with a thin layer of Al2O3, but can be applied to any heterostructure studied with low-energy muons. It is shown that if an effect is present in the experimental data, this method is an important tool to identify its location and depth extent.

Sequence analysis of 37 candidate genes for male infertility: challenges in variant assessment and validating genes.

BACKGROUND: The routine genetic analysis for diagnosing male infertility has not changed over the last twenty years, and currently available tests can only determine the etiology of 4% of unselected infertile patients. Thus, to create new diagnostic assays, we must better understand the molecular and genetic mechanisms of male infertility. Although next-generation sequencing allows for simultaneous analysis of hundreds of genes and the discovery of novel candidates related to male infertility, so far only a few gene candidates have enough sound evidence to support the gene-disease relationship. OBJECTIVE: Since complementary studies are required to validate genes, we aimed to analyze the presence of potentially pathogenic rare variants in a set of candidate genes related to azoospermia in a hitherto understudied South American population. SUBJECTS AND METHODS: We performed whole exome sequencing in a group of 16 patients with non-obstructive azoospermia from Ribeirão Preto, Brazil. Based on a recent systematic review of monogenic causes of male infertility, we selected a set of 37 genes related to azoospermia, Sertoli-Cell-Only histology, and spermatogenic arrest to analyze. The identified variants were confirmed by Sanger sequencing, and their functional consequence was predicted by in silico programs. RESULTS: We identified potential pathogenic variants in seven genes in six patients. Two variants, c.671A>G (p.(Asn224Ser)) in DMRT1 and c.91C>T (p.(Arg31Cys)) in REC8, have already been described in association with azoospermia. We also found new variants in genes that already have moderate evidence of being linked to spermatogenic failure (TEX15, KLHL10), in genes with limited evidence (DNMT3B, TEX14) and in one novel promising candidate gene that has no evidence so far (SYCE1L). DISCUSSION: Although this study included a small number of patients, the process of rationally selecting genes allowed us to detect rare potentially pathogenic variants, providing supporting evidence for validating candidate genes associated with azoospermia.

The proton and metal binding sites responsible for the pH-dependent green-red bioluminescence color tuning in firefly luciferases.

Firefly luciferases produce yellow-green light under physiological and alkaline conditions, however at acidic pH, higher temperatures or in the presence of heavy metals the color changes to red, a property called pH-sensitivity. Despite many decades of studies, the proton and metal binding sites responsible for pH-sensitivity remain enigmatic. Previously we suggested that the salt bridge E311/R337 keeps a closed conformation of the luciferin phenolate binding site. Here we further investigated the effect of this salt bridge and mutations of the neighbor residues H310 and E/N354, on metal and pH-sensitivity of firefly luciferases emitting distinct bioluminescence colors (Cratomorphus distinctus: 548 nm; Macrolampis sp2: 569 nm). The substitutions of H310 and E/N354 modulate metal sensitivity, whereas the carboxylate of E311 may work as the catalytic base essential for green bioluminescence and pH-sensitivity. Modeling studies showed that H310, E311 and E354 side-chains coordinate Zinc, constituting the metal binding site and the pH-sensor. Electrostatic potential and pKa calculations suggest that the external couple H310/E354 is affected by pH, whereas E311/R337 make a stabilized internal pair which retains excited oxyluciferin ejected proton near its phenolate group into a high energy state, promoting yellow-green bioluminescence. Protonation or metal binding weaken these electrostatic gates and their ability to retain the excited oxyluciferin released proton near its phenolate, promoting red light emission.

The blood mMDSC to DC ratio is a sensitive and easy to assess independent predictive factor for epithelial ovarian cancer survival.

Epithelial ovarian cancer (EOC) may cause abnormal blood levels of leukocytes. This paraneoplastic manifestation is associated with a worse response to therapy and shorter survival. To understand the complexity and nature of these leukocytes, we dissected the different populations of myeloid cells and analyzed their relation to clinical outcome. Therefore, baseline blood samples of 36 EOC patients treated either with carboplatin/doxorubucin or with gemcitabine were analyzed for different subsets of monocytes/macrophages, myeloid derived suppressor cells (MDSC) and dendritic cells (DC) using multiparameter flow cytometry as well as functional assays for myeloid cell mediated suppression of antigen-specific T cell reactivity. Healthy donor blood served as control. EOC patients displayed an increase in monocytes/macrophages, monocytic MDSC (mMDSC) and CD33-CD11b+CD14-CD15- double-negative MDSC (CD33- dnMDSC) and a decrease in the frequency of DC, across all EOC subtypes. A low frequency of DC and high frequencies of monocytes/macrophages and mMDSC, but not CD33- dnMDSC, were associated with poor overall survival. Patient's monocytes/macrophages and mMDSC, but not CD33- dnMDSC, were shown to suppress T cell reactivity in vitro. The mMDSC and DC frequencies were not altered upon treatment. Importantly, the mMDSC to DC ratio was the strongest independent, highly sensitive and specific, predictive factor for survival. This was irrespective of the type of chemotherapy or disease stage and outperformed classical parameters as WHO status or time from last chemotherapy. Thus, the baseline blood mMDSC to DC ratio is a robust, independent and easy to analyze predictive factor for EOC survival, and may assist patient selection for immunotherapy.

Participatory implementation of an antibiotic stewardship programme supported by an innovative surveillance and clinical decision-support system.

BACKGROUND: Antibiotic resistance will cause about 10 million deaths per year by 2050. Fighting antimicrobial resistance is a health priority. Interventions aimed to reduce antimicrobial resistance, such as antibiotic stewardship programmes (ASPs), must be implemented. To be effective, those interventions, and the implementation process, should be matched with social-cultural context. The complexity of ASPs can no longer be developed without considering both organizational and information systems. AIM: To support ASPs through the co-design and implementation, in collaboration with healthcare workers, of a surveillance and clinical decision-support system to monitor antibiotic resistance and improve antibiotic prescription. METHODS: The surveillance and clinical decision-support system was designed and implemented in three Portuguese hospitals, using a participatory approach between researchers and healthcare workers following the Design Science Research Methodology. FINDINGS: Based on healthcare workers' requirements, we developed HAITooL, a real-time surveillance and clinical decision-support system that integrates visualizations of patient, microbiology, and pharmacy data, facilitating clinical decision. HAITooL monitors antibiotic usage and rates of antibiotic-resistant bacteria, allowing early identification of outbreaks. It is a clinical decision-support tool that integrates evidence-based algorithms to support proper antibiotic prescription. HAITooL was considered valuable to support monitoring of antibiotic resistant infections and an important tool for ASP sustainability. CONCLUSION: ASP implementation can be leveraged through a surveillance and clinical decision-support system such as HAITooL that allows antibiotic resistance monitoring and supports antibiotic prescription, once it has been adapted to the context and specific needs of healthcare workers and hospitals.

New objective measurements of semen wave motion are associated with fertility in sheep.

In sheep, wave motion in semen is currently used by AI centres to select ejaculates for insemination. Despite its low cost, convenience and established ability to predict fertility, the subjectivity of this assessment is a limiting factor for its applicability. The aims of the present study were to establish an objective method for the analysis of wave motion and to assess the associations of objective parameters with fertility after cervical insemination. Collective sperm motion in undiluted semen was observed by phase contrast microscopy at low magnification in a 100-µm deep glass chamber. Images of moving dark waves over a grey background were recorded and analysed by the optic flow method, producing several velocity-related parameters. Turbulence was assessed from the motion of fluorescent polystyrene beads. Among objective parameters, optical flow entropy and the average speed of beads were both able to discriminate ejaculates suitable for insemination. Two synthetic variables of optic flow and bead motion and a global objective variable were computed from linear combinations of individual parameters and compared with the subjective motion score for their predictive value. These were as efficient as the wave motion score for assessing fertility and can be proposed for the assessment of ram semen in routine AI procedures.

Pulmonar ARFI elastography and ultrasonography of canine fetal hydrops: case report / Elastografia ARFI e ultrassonografia pulmonar de fetos com hidropsia fetal canina: relato de caso

This case report describes diagnostic and prognostic applicability of pulmonary acoustic radiation force impulse elastography and ultrasonography in canine hydrops fetalis. We also explore these methods' potential in prediction of postnatal respiratory dysfunction. Two pregnant bitches (English bulldog [case 1] and French bulldog [case 2]) were referred for sonographic evaluation in their last week of pregnancy. Ultrasound showed that in each bitch, one fetus presented with lung alterations (hyperechogenicity, irregular surface, and pleural effusion) and anasarca. The other fetuses of the litter were normal, and they were observed as light gray and dark blue on pulmonary elastography. Their shear-wave velocity was 0.75m/s. Fetuses with hydrops were observed as medium gray and dark blue, and the average shear-wave velocities were 1.05m/s (case 1) and 1.12m/s (case 2). Findings were compatible with increased lung rigidity. Six neonates of English bulldog and two of French bulldog showed no signs of clinical abnormalities during neonatal assessment. One puppy in each gestation presented with anasarca and respiratory distress, and died approximately 24 hours after birth. Novel ultrasound techniques (elastography) for assessing pulmonary tissues in abnormal fetuses in veterinary obstetrics can promote early, safe, and non-invasive diagnosis of canine prenatal and neonatal alterations.(AU)

Este relato de caso descreve a aplicabilidade diagnóstica e prognóstica da elastografia ARFI e ultrassonografia pulmonar em fetos caninos com hidropisia, como um método potencial para predizer a disfunção respiratória pós-natal nesses conceptos. Duas cadelas gestantes (Buldogue Inglês - caso 1 e Buldogue Francês - caso 2) foram encaminhadas para avaliação ultrassonográfica na última semana de gestação. Pela ultrassonografia foram observadas, em cada cadela, um feto apresentando alterações pulmonares (hiperecogenicidade, superfície irregular e derrame pleural) e anasarca. Outros fetos não apresentaram anormalidades. Os fetos normais apresentaram elastograma pulmonar cinza-claro e azul-escuro e velocidade de cisalhamento de 0,75m/s. Os fetos com hidropisia apresentaram tonalidades cinza-média e azul-escura e velocidade de cisalhamento de 1,05m/s (caso 1) e 1,12m/s (caso 2). Esses achados são compatíveis com o aumento da rigidez pulmonar. Seis neonatos Buldogue Inglês e dois Buldogues Franceses não mostraram sinais de anormalidades clínicas na avaliação neonatal. Um filhote de cada gestação apresentou anasarca e dificuldade respiratória, vindo a óbito cerca de 24 horas após o nascimento. O uso das novas técnicas de ultrassonografia (elastografia) para avaliação de tecidos pulmonares em feto anormal, em obstetrícia veterinária, pode promover o diagnóstico precoce, seguro e não invasivo de alterações pré-natais e neonatais em conceptos caninos.(AU)

Geriatric nutritional risk index as a nutritional and survival risk assessment tool in stable outpatients with systolic heart failure.

BACKGROUND AND AIMS: Malnutrition is frequent in heart failure (HF). However, the best tool for evaluating malnutrition in geriatric patients with HF with reduced ejection fraction (HFrEF) is unknown. This study aimed to evaluate the incremental prognostic value of the geriatric nutritional risk index (GNRI) in stable geriatric outpatients with HFrEF compared with a clinical/laboratory prognostic model. METHODS AND RESULTS: A total of 143 outpatients with HFrEF, aged >65 years, a LVEF <40%, and who were stable and on optimal therapy were studied. Follow-up lasted 3 years. The outcome was all-cause death. The GNRI was calculated as follows: [(1.489 × serum albumin (g/L)) + (41.7 × (current body weight/ideal weight)]. The 3-year death rate was 36.4% and 16 (11.2%) patients were at risk of malnutrition (GNRI ≤98). Deceased patients had a lower GNRI (113.6 ± 9.1 vs. 105.6 ± 9.2; p < 0.001) than did survivors. Greater values of the GNRI (hazard ratio = 0.93, 95% confidence interval [CI] = 0.90-0.95; p < 0.001) and GNRI >98 (hazard ratio = 0.29, 95% CI 0.15-0.57; p < 0.001) were associated with better survival. These factors remained significant after adjustment of significant confounders. The GNRI was a better discriminator of death than weight and albumin. Adding the GNRI to the clinical/laboratory predictor survival model significantly increased the c-statistics from 0.93 to 0.95 (p < 0.001) and the chi-square likelihood ratio test from 106.15 to 119.9. CONCLUSION: The risk of malnutrition, as assessed by the GNRI, in stable geriatric outpatients with HFrEF is a strong independent predictor of survival. The GNRI adds significant prognostic information to the clinical/laboratory model.

Acoustic radiation force impulse (ARFI) elastography of adrenal glands in healthy adult dogs / Elastografia acoustic radiation force impulse (ARFI) das glândulas adrenais de cães adultos saudáveis

To describe the ARFI elastography in the evaluation of the adrenal glands in adult dogs, to evaluate the stiffness of adrenal parenchyma and to determine the qualitative and quantitative standards of the ARFI technique, which have not yet been described in veterinary medicine. Sixty adrenal glands from thirty healthy adult dogs were evaluated by B-mode and qualitative and quantitative ARFI elastography to assess the stiffness of healthy parenchyma and to determine the quality and quantity (shear velocity) standards of ARFI technique in body, cranial and caudal adrenal poles. Findings of ultrasonography evaluations were normal. Qualitative elastography showed that adrenal glands were not deformable and presented homogeneous middle-gray areas. The results of shear wave velocity were similar statically (P = 0.3087): 1) left adrenal - 1.42 m/s for cranial polar, 1.31 m/s for body region, and 1.71 m/s for caudal polar; 2) right adrenal - 1.42 m/s for cranial polar, 1.74 m/s for body region and 1.63 m/s for caudal pole. Quantitative and qualitative ARFI elastography of dogs' adrenal glands is feasible, well tolerated, easily implemented and may provide baseline data in the study of this structure to allow the use of ARFI.(AU)

Objetivou-se descrever a técnica de elastografia ARFI na avaliação das glândulas adrenais em cães adultos, visando avaliar a rigidez do parênquima adrenal saudável e determinar os padrões qualitativos e quantitativos (velocidade de cisalhamento) da técnica ARFI, ainda não descritos em medicina veterinária. Sessenta glândulas adrenais de 30 cães adultos saudáveis foram avaliadas pela ultrassonografia modo B e pela elastografia ARFI qualitativa e quantitativa para avaliar a rigidez do parênquima saudável e determinar a velocidade de cisalhamento e padrões qualitativos da ARFI no corpo, polos adrenais cranial e caudal. As características ultrassonográficas das glândulas foram normais. A elastografia qualitativa mostrou que glândulas adrenais não se apresentaram deformáveis e homogêneas (coloração cinza médio). Os resultados da velocidade de cisalhamento foram semelhantes (P = 0,3087): 1) adrenal esquerda ( 1,42m/s para polo cranial, 1,31m/s para corpo e 1,71m/s para polo caudal; 2) adrenal direita ( 1,42m/s para polo cranial, 1,74m/s para corpo e 1,63m/s para polo caudal. A elastografia quantitativa e qualitativa (ARFI) das glândulas adrenais de cães é uma ferramenta viável e facilmente implementada, podendo proporcionar valores padrão para o estudo dessa estrutura.(AU)

Influence of bethanechol on salivary parameters in irradiated patients.

BACKGROUND: Some studies have shown evidence that the prophylactic use of bethanechol chloride (BC) may be useful in preventing the incidence and/or severity of xerostomia (XT). However, the indication of BC in irradiated patients with XT needs to be better characterized. The study aimed to evaluate the influence of BC on XT, salivary flow rate, and salivary composition in patients previously submitted to head and neck radiotherapy. MATERIAL AND METHODS: Forty five irradiated patients complaining of XT used 50 mg/day of BC for 3 months, and the salivary parameters were evaluated in 4 Phases (Before BC therapy, after one month of BC, 2 months of BC, and 3 months of BC). Biochemical analysis included buffering capacity; pH; total protein concentration (TP); amylase concentration (AM); catalase (CAT) and peroxidase (PX) activities. In addition, unstimulated and stimulated salivary flow rates were determined and XT was classified. RESULTS: According to the XT grading system used, patients showed improvement in XT between Phase 1, and Phases 2, 3 and 4. In addition, some changes were observed in TP concentration (decreased); AM concentration (increased); and PX and CAT activities (decreased and increased, respectively) after Phase 2, for stimulated saliva collection (p<0.05). CONCLUSIONS: Our results suggested that when BC was used to treat salivary gland dysfunction induced by head and neck radiotherapy, improvement in XT symptoms, and some changes in saliva composition were shown.

Evaluation of the cardiopulmonary and antinociceptive effects of bupivacaine administered epidurally at the first lumbar vertebra in awake dogs / Estudo dos efeitos cardiopulmonares e antinociceptivos da administração epidural de bupivacaína à altura da primeira vértebra lombar em cães acordados

The aim of this study was to evaluate the effect of epidural bupivacaine administration at the first lumbar vertebra on cardiopulmonary variables, arterial blood gases and anti-nociception. Sixteen healthy female dogs were randomly assigned into two groups based on bupivacaine dose: G1 group, 1mg kg-1 or G2 group, 2mg kg-1, diluted in the same final volume (1mL4kg-1). Cardiopulmonary variables were measured and arterial blood gas was collected (T0), it was repeated 10 minutes after intravenous administration of butorphanol 0.4mg kg -1 (T1). Anesthesia was induced with intravenous etomidate at 2mg kg-1 and the epidural catheter was introduced and placed at the first lumbar vertebra. Thirty minutes later, bupivacaine was administered epidurally. Cardiopulmonary measurements and arterial blood gas analysis were recorded at 10 minute intervals (T2 to T6). Evaluation of pre surgical anti-nociception was performed at 5 minute intervals for 30 minutes by clamping the hind limbs, anus, vulva, and tail with the dogs awake. Subsequently, ovariohysterectomy was performed and adequacy of surgical anti-nociception was evaluated at 5 time points. Parametric data were analyzed using the F test with a <0.05 significance. After bupivacaine administration, there were differences between groups just for bicarbonate means (HCO3-) on T6 (P=0.0198), with 18.7±1.3 and 20.4±0.8 for G1 and G2, respectively. After T1, before bupivacaine administration, both groups presented a slightly lower pH, base excess (BE), the end-tidal carbon dioxide tension (PECO2), and partial pressure of carbon dioxide (PaCO2), suggesting mild metabolic acidosis. G2 showed better antinociceptive effect both before and during surgery. It was possible to perform ovariohysterectomy in 87.5% of the G2 bitches and 25% of the G1 bitches. The two doses of bupivacaine evaluated do not cause important alterations in the studied parameters and the dose of 2mg kg-1 results in a better antinociceptive effect.(AU)

O objetivo deste estudo foi avaliar os efeitos da administração epidural de bupivacaína à altura da primeira vértebra lombar sobre variáveis cardiopulmonares, hemogasometria arterial e antinocicepção. Dezesseis cadelas foram separadas aleatoriamente em dois grupos que se diferenciaram pela dose de bupivacaína, 1mg/kg (G1) ou 2mg/kg (G2), diluídas no mesmo volume final (1mL/4kg). As variáveis cardiopulmonares e hemogasometria arterial foram coletadas antes (T0) e após 10 minutos da administração intravenosa de 0,4mg/kg de butorfanol (T1). A anestesia foi induzida com 2mg/kg de etomidato intravenoso para introdução do cateter epidural. Após 30 minutos, a bupivacaína foi administrada e, passados 10 minutos, nova coleta de parâmetros foi feita, sendo repetida a cada 10 minutos (T2 a T6). Após cinco minutos da administração de bupivacaína, iniciou-se a avaliação da antinocicepção pré-cirúrgica, repetida a cada cinco minutos durante 30 minutos. Então, iniciou-se a cirurgia de ovário-histerectomia, na qual se avaliou a antinocicepção transcirúrgica em cinco momentos. Os resultados paramétricos foram analisados pelo software SAS 9.4 (2010), utilizando-se o teste F com significância menor que 0,05. Houve diferença entre as médias dos grupos após administração de bupivacaína apenas para bicarbonato em T6 (P=0.0198), sendo 18,7±1,3 e 20,4±0,8 as médias do G1 e G2, respectivamente. Desde T1, os grupos apresentaram valores de pH, excesso de bases, pressão parcial de gás carbônico no sangue arterial e tensão de dióxido de carbono ao final da expiração pouco abaixo do fisiológico, sugerindo acidose metabólica discreta. O G2 apresentou efeito antinociceptivo pré e transcirúrgico superior ao G1. Foi possível realizar a cirurgia em 87,5% das cadelas do G2 e em 25% das cadelas do G1. Concluiu-se que as duas doses de bupivacaína avaliadas não acarretam alterações importantes nos parâmetros fisiológicos estudados e a dose de 2mg/kg determina melhor efeito antinociceptivo que a dose de 1mg/kg.(AU)

Self-declared ethnicity and genomic ancestry in prostate cancer patients from Brazil.

Some studies of polymorphisms in prostate cancer (PCa) analyze individuals in a uniform manner, regardless of genetic ancestry. However, PCa aggressiveness differs between subjects of African descent and those of European extraction. Thus, genetic ancestry analysis may be used to detect population stratification in case-control association studies. We genotyped 11 ancestry informative markers to estimate the contributions of African, European, and Amerindian ancestries in a case-control sample of 213 individuals from Bahia State, Northeast Brazil, including 104 PCa patients. We compared this data with self-reported ancestry and the stratification of cases by PCa aggressiveness according to Gleason score. A larger African genetic contribution (44%) was detected among cases, and a greater European contribution (61%) among controls. Self-declaration data revealed that 74% of PCa patients considered themselves non-white (black and brown), and 41.3% of controls viewed themselves as white. Our data showed a higher degree of European ancestry among fast-growing cancer cases than those of intermediate and slow development. This differs from many previous studies, in which the prevalence of African ancestry has been reported for all grades. Differences were observed between degrees of PCa aggressiveness in terms of genetic ancestry. In particular, the greater European contribution among patients with high-grade PCa indicates that a population's genetic structure can influence case-control studies. This investigation contributes to our understanding of the genetic basis of tumor aggressiveness among groups of different genetic ancestries, especially admixed populations, and has significant implications for the assessment of inter-population heterogeneity in drug treatment effects.