Early Cerebrovascular Ultrasonography as a Predictor of Hemorrhagic Transformation After Thrombectomy.

OBJECTIVES: To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion. MATERIALS AND METHODS: Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings. RESULTS: We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806). CONCLUSION: TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.

Impact of NADPH oxidase functional polymorphisms in acute myeloid leukemia induction chemotherapy.

Efficacy and toxicity of anthracycline treatment in acute myeloid leukemia (AML) is mediated by reactive oxygen species (ROS). NADPH oxidase is the major endogenous source of ROS and a key mediator of oxidative cardiac damage. The impact of NADPH oxidase polymorphisms (CYBA:rs4673, NCF4:rs1883112, RAC2:rs13058338) was evaluated in 225 adult de novo AML patients. Variant alleles of NCF4 and RAC2 were related to higher complete remission (P=0.035, P=0.016), and CYBA homozygous variant showed lower overall survival with recessive model (P=0.045). Anthracycline-induced cardiotoxicity was associated to NCF4 homozygous variant (P=0.012) and CYBA heterozygous genotype (P=0.027). Novel associations were found between variant allele of CYBA and lower lung and gastrointestinal toxicities, and a protective effect in nephrotoxicity and RAC2 homozygous variant. Moreover, RAC2 homozygous variant was related to delayed thrombocytopenia recovery. This study supports the interest of NADPH oxidase polymorphisms regarding efficacy and toxicity of AML induction therapy, in a coherent integrated manner.

Artepillin C and phenolic compounds responsible for antimicrobial and antioxidant activity of green propolis and Baccharis dracunculifolia DC.

AIMS: This study investigates the antimicrobial activity in Staphylococcus aureus isolates (methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA)) and antioxidant activity of green propolis, Baccharis dracunculifolia DC extracts and Artepillin C™. METHODS AND RESULTS: The amount of Artepillin C in different extracts was determined by high performance liquid chromatography analysis. Minimum inhibitory concentration 90 (MIC90) was determined using 40 isolates of S. aureus inoculated in Müeller-Hinton agar culture medium containing the green propolis and B. dracunculifolia DC extracts. PVEE (green propolis ethanolic extract) and BDEH (B. dracunculifolia hexanic extract) showed the greatest antimicrobial activity with MIC90 values of 246·3 and 295·5 µg ml-1 respectively. Green propolis ethanolic and hexanic extracts (PVEE and PVEH respectively) showed the greatest antioxidant activity assessed by DPPH (1,1-diphenyl-2-picryl hydrazyl radical) with IC50 values of 13·09 and 95·86 µg ml-1 respectively. CONCLUSIONS: Green propolis ethanolic displays better antimicrobial and antioxidant activities compared to other extracts. These activities may be related to the presence of Artepillin C in synergism with the other constituents of the extracts. SIGNIFICANCE AND IMPACT OF THE STUDY: In this study, the antimicrobial activity of the extracts of green propolis and B. dracunculifolia DC demonstrated in MRSA and MSSA clinical isolates indicated that they can be important tools to treat infections caused by these bacteria.

Durability assessment of external thermal insulation composite systems in urban and maritime environments.

External Thermal Insulation Composite Systems (ETICS) are multilayer solutions which provide an enhanced thermal performance to the building envelope. However, significant anomalies can be detected on ETICS facades, in some cases shortly after the application of these systems. This study intends to evaluate and compare the durability of six commercially available ETICS after two years of outdoor exposure at both urban and maritime conditions in Portugal. The systems were characterized by means of non-destructive testing (i.e., visual and microscopic assessment, water transport properties, thermal conductivity, surface roughness), thus allowing to evaluate the performance loss throughout natural aging. The bio-susceptibility and aesthetic properties (color and gloss) were also investigated. Results showed that the performance and durability of the complete system is significantly affected by the rendering system formulation. The lime-based specimens obtained the highest rate of mold development after one year of aging in a maritime environment, becoming considerably darker and with lower surface gloss. Fungal analysis of this darkish stained area indicated the presence of mold species of the genera Alternaria, Didymella, Cladosporium and Epicoccum, and yeasts of the genera Vishniacozyma and Cystobasidium. An increase of both capillary water absorption and water vapor permeability was also registered for the aged lime-based specimens. Acrylic-based systems obtained lower capillary water absorption after aging and greater dirt deposition on their surfaces, especially in urban conditions. These systems had also higher color variation and surface gloss decrease and slightly higher mold growth, when compared with those aged in a maritime environment. Finally, no mold growth was detected on the silicate-based specimens after two years of aging. However, these specimens obtained higher capillary water absorption and lower vapor permeability after aging, possibly leading to moisture accumulation within the system. Results contribute towards the development of ETICS with enhanced performance and durability.

Investigating the kinetics of the formation of a C Cottrell atmosphere around a screw dislocation in bcc iron: a mixed-lattice atomistic kinetic Monte-Carlo analysis.

We present a mixed-lattice atomistic kinetic Monte-Carlo algorithm (MLKMC) that integrates a rigid-lattice AKMC approach with the kinetic activation-relaxation technique (k-ART), an off-lattice/self-learning AKMC. This approach opens the door to study large and complex systems adapting the cost of identification and evaluation of transition states to the local environment. To demonstrate its capacity, MLKMC is applied to the problem of the formation of a C Cottrell atmosphere decorating a screw dislocation in α-Fe. For this system, transitions that occur near the dislocation core are searched by k-ART, while transitions occurring far from the dislocation are computed before the simulation starts using the rigid-lattice AKMC. This combination of the precision of k-ART and the speed of the rigid-lattice makes it possible to follow the onset of the C Cottrell atmosphere and to identify interesting mechanisms associated with its formation.

Quenching of local magnetic moment in oxygen adsorbed graphene nanoribbons.

The electronic and magnetic properties of oxidized zigzag and armchair graphene nanoribbons, with hydrogen passivated edges, have been investigated from ab initio pseudopotential calculations within the density functional scheme. The oxygen molecule in its triplet state is adsorbed most stably at the edge of a zigzag nanoribbon. The Stoner metallic behavior of the ferromagnetic nanoribbons and the Slater insulating (ground state) behavior of the antiferromagnetic nanoribbons remain intact upon oxygen adsorption. The formation of a spin-paired C-O bond drastically reduces the local atomic magnetic moment of carbon at the edge of the ferromagnetic zigzag ribbon.

Interaction between interstitial carbon atoms and a ½ 〈1 1 1〉 self-interstitial atoms loop in an iron matrix: a combined DFT, off lattice KMC and MD study.

A static and kinetic study of the interaction between a 19 ½ 〈1 1 1〉 self-interstitial atoms loop and C atoms in body-centred cubic iron is presented in this work. An empirical potential matching the density functional theory calculations is used to study the static properties of the system. The usual kinetic Monte-Carlo (KMC) on-lattice restriction is not valid when the material is highly distorted, especially in the presence of a dislocation loop. Therefore, the dynamics of the system are investigated using both molecular dynamics simulations and k-ART, a self-learning/off-lattice atomic kinetic monte-carlo. The presented work is thus a full study of the C-loop and the C2-loop systems. A good agreement is observed between the statics and the kinetics (e.g. the discovery of a zone of stability of the C atom around the Fe cluster where the C can almost freely move), even though the kinetics show some unexpected behaviours of the studied systems. The pinning time of the loop induced by the C atoms is also estimated.

Radiocesium contamination behavior and its effect on potassium absorption in tropical or subtropical plants.

The accumulation and long-term decline of radiocesium contamination in tropical plant species was studied through measurements of gamma-ray spectra from pomegranate (Punica granatum) and chili pepper (Capsicum fructescens) trees. The plants were originally grown at a (137)Cs contaminated site (where a radiological accident occurred in the city of Goiânia, Brazil, in 1987), and transplanted to uncontaminated soil, so that the main source of contamination of the new leaves and fruits would be the fraction of the available radiocesium in the body of the plants. Measurements of (137)Cs and (40)K concentrations along the roots, main trunk, twigs, leaves and fruits before and after the transplant process of both plant species indicated a direct competition between Cs and K ions, suggesting that these elements could have a common accumulation mechanism. Cesium transfer factors from soil to pomegranate, green and red chili pepper fruits were evaluated as 0.4 +/- 0.1, 0.06 +/- 0.01 and 0.05 +/- 0.01, respectively. Biological half-life values due to (137)Cs translocation from the tree reservoir (BHL(T)) were calculated as 0.30 years for pomegranate, 0.12 years and 0.07 years for red and green peppers, respectively.

Poisoning by Enterolobium contortisiliquum pods in calves showing photosensitization and digestive lesions / [Lesões digestivas e fotossensibilização em bezerros intoxicados pelas favas de Enterolobium contortisiliquum]

Este trabalho descreve um surto de rumenite e abomasite decorrente de sobrecarga de carboidratos em um rebanho de 238 bezerros, com idades entre 12 e 15 meses, causada pela ingestão dos frutos de Enterolobium contortisiliquum. As taxas de morbidade, mortalidade e letalidade foram de, respectivamente, 12,7%, 5,2% e 42,1%. Clinicamente, os bovinos apresentaram fotossensibilização, salivação e diarreia. Os achados de necropsia foram semelhantes nos dois bezerros necropsiados e consistiram de fotodermatite e rumenite ulcerativa multifocal, subaguda a crônica, e abomasite. A relevância deste relato é que, pela primeira vez, foi possível associar a ocorrência da rumenite devido à sobrecarga de carboidratos com a intoxicação espontânea por E. contortisiliquum em bovinos, confirmando achados anteriormente descritos em experimentos realizados com ovinos.(AU)

Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving oral azoles prophylaxis.

Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to construct a post-engraftment IFD risk score. The 1-year CI of IFD was 11%. The non-relapse mortality was 40% in those developing IFD and 16% in those who did not. The intent-to-treat analysis showed that 17% of patients abandoned the assigned prophylaxis. Age >40 years, ⩾1 previous SCT, pre-engraftment neutropenia >15 days, extensive chronic GVHD and CMV reactivation were independent risk factors. The post-engraftment IFD score stratified patients into low risk (0-1 factor, CI 0.7%), intermediate risk (2 factors, CI 9.9%) and high risk (3-5 factors, CI 24.7%) (P<0.0001). The antifungal prophylaxis strategy failed to prevent post-engraftment IFD in 11% of alloSCT. Our risk score could be useful to implement risk-adapted strategies using antifungal prophylaxis after engraftment.

Beta blockers, hypertension, and blacks--is the answer really in?

It has been reported that beta blockers are not effective antihypertensives in black populations. A review of the literature revealed that, for the most part, studies drawing this conclusion were of small sample size, lacked controls, and did not represent the demographics of the US black population. The largest US study (Veterans Administration Cooperative Study) showed propranolol to be effective in at least one half of the black patients, with white patients responding better, but diuretics were more effective in both races. More recent studies show beta blockers with alpha-antagonistic properties to be effective in black hypertensives. The question is raised whether enough data have been analyzed to suggest these drugs are ineffective for black hypertensives.

Investigational drugs for treatment use: an avenue of hope for minority populations.

The Food and Drug Administration in its efforts to facilitate the drug approval process so that promising treatments may be offered to seriously ill or dying patients has established an innovative regulation, commonly known as the Treatment Investigational New Drugs (TIND). The benefits of this new policy should prove to be particularly appealing to black Americans. Traditionally blacks, due to numerous social, political, economic, and cultural factors, have had the poorest health status of any other population in the United States. The implementation of strategies to eradicate such factors will ultimately provide considerable improvement of the health status of blacks. Until then, the utilization of the TIND may prove to be one of the most significant influences in the advancement of our health care. Barriers to the use of the TIND regulation in the black community must be addressed as well.

[Nasofacial zygomycosis. Report of a case of Para state, Brazil]. / Zigomicose nasofacial. Relato de um caso do estado do Pará, Brasil.

A case of nasofacial zygomycosis in a 64-year-old female patient from Barcarena, State of Pará, is reported. This is the second time that the disease is recognized in Northern Brazil. The diagnosis was initially suspected by the direct observation of broad coenocytic hyphae in biopsy specimens of the nasal cavity mucosa. Later, the cause of the disease was confirmed by the mycologial and histopathological findings. Rapid response to the therapy with potassium iodide was achieved, without however a complete resolution of the lesions. The patient still remains under treatment, with itraconazole and iodide.

Atomistic modeling of carbon Cottrell atmospheres in bcc iron.

Atomistic simulations with an EAM interatomic potential were used to evaluate carbon-dislocation binding energies in bcc iron. These binding energies were then used to calculate the occupation probability of interstitial sites in the vicinity of an edge and a screw dislocation. The saturation concentration due to carbon-carbon interactions was also estimated by atomistic simulations in the dislocation core and taken as an upper limit for carbon concentration in a Cottrell atmosphere. We obtained a maximum concentration of 10 ± 1 at.% C at T = 0 K within a radius of 1 nm from the dislocation lines. The spatial carbon distributions around the line defects revealed that the Cottrell atmosphere associated with an edge dislocation is denser than that around a screw dislocation, in contrast with the predictions of the classical model of Cochardt and colleagues. Moreover, the present Cottrell atmosphere model is in reasonable quantitative accord with the three-dimensional atom probe data available in the literature.

Application of radiometric analysis in the study of provenance and transport processes of Brazilian coastal sediments.

Natural gamma radiation of beach sand deposits was measured along the south coast of Rio de Janeiro State, Brazil, with the aim of studying the provenance and transport processes of sediments in this area. Concentrations of thorium, uranium and potassium were evaluated using γ-ray spectrometry and a behavioral study of eTh/eU and eTh/K cross plots was performed, reflecting the mineralogical properties of beach sands, as well as their history of transport and sorting processes. The results show that such technique can be efficiently used to map heavy mineral distributions and to distinguish the different origins of coastal sediments disclosing the influence of nearby rivers.

Superficial siderosis of the central nervous system.

Superficial siderosis of the central nervous system (CNS) is a rare entity characterized by the deposition of hemosiderin in the leptomeninges. In most cases it is caused by chronic and recurrent bleeding into the subarachnoid space as a subclinical form and for long periods of time. The cases described in the literature are associated with tumors, aneurysms, arteriovenous malformations, changes in post-surgical, traumatic cervical and brachial plexus injuries. However, the cause of bleeding is unclear in 40-50% of cases. This report describes the case of a 38-year-old man with a history of trauma with a complete lesion of the left brachial plexus. The patient presented progressively worsening gait imbalance, bilateral deafness, tinnitus and memory loss over two years. Neurological examination disclosed bilateral hearing loss, left upper limb plegia with atrophy of muscle mass, spastic paraparesis with pyramidal signs and gait ataxia. The analytical/genetic study was consistent with hereditary hemochromatosis. In addition to typical findings of siderosis, MR disclosed pseudomeningocele while CT angiography and angiography revealed an aneurysm of the internal carotid artery. Although rare, we should be aware of superficial siderosis especially in imaging studies in patients with deafness or ataxia and in those with lesions of the brachial plexus. The imaging signals are subtle and can easily go unrecognized. The radiological investigation must be extensive to find the primary cause.

Oocyst ingestion as an important transmission route of Toxoplasma gondii in Brazilian urban children.

Toxoplasmosis is a cosmopolitan protozoan infection. Data regarding risk factors for the post-natal acquisition of Toxoplasma gondii infection in childhood are limited. We conducted a serological survey for T. gondii IgG antibodies and associated risk factors in 1,217 children 4-11-yr-old from Salvador, Brazil, using a commercial ELISA kit; antibodies were found in 17.5% of the children. Age (OR  =  2.18; 95% CI: 1.50-3.17) and maternal schooling level (OR  =  0.62; 95% CI: 0.42-0.92) were negatively associated with infection. A greater number of siblings (OR  =  1.53; 95% CI: 1.12-2.09), cat at home (OR  =  1.54; 95% CI: 1.06-2.24), house with non-treated piped water (OR  =  2.54; 95% CI: 1.22-5.31), and the absence of a flush toilet at home (OR  =  1.45; 95% CI: 1.04-2.01) were positively associated with T. gondii infection. Our data suggest that low socioeconomic levels and poor hygiene habits are important factors in favoring T. gondii infection.

Correlations between radiometric analysis of Quaternary deposits and the chronology of prehistoric settlements from the southeastern Brazilian coast.

Natural gamma radiation measurements of sand deposits were carried out in order to study the chronology of prehistoric colonization of the Brazilian coast during the Holocene. The method employs thorium, uranium and potassium as tracers of the geological provenance of Quaternary deposits, where artificial shellmounds are found. The so-called sambaquis are archaeological settlements, characteristic of fisher-gatherers, specialized in the exploitation of shellfish. Our results show a considerable positive correlation between the formation of coastal deposits, based on cross plots of eTh/eU and eTh/K, and the antiquity of its prehistoric human occupation.

The effect of swimming in asthmatic children--participants in a swimming program in the city of Baltimore.

Forty-five asthmatic children were enrolled in a swimming program in Baltimore. After participating in a 2-month swimming session, the children showed significant improvement in all clinical variables including symptoms, hospitalizations, emergency room visits, and school absenteeism compared with their previous medical history or to those of age-matched controls. These health benefits continued to be observed even 12 months after the session had been completed. The implications of these findings and the potential usefulness of adding sports programs as adjunct therapy in the comprehensive care of asthma in children are discussed.