[Is endovenous thrombolysis safety and efficacy in ischemic stroke comparable between patients aged over and above 80 years? Experience from an Argentinean cohort]. / Es comparable la seguridad y eficacia del uso de tromboliticos en el ictus isquemico en mayores y menores de 80 años? Experiencia en una cohorte argentina.

INTRODUCTION: Enrollment of patients aged above 80 years in trials assessing endovenous thrombolysis (rt-PA) was scarce. The goal of this study is to compare safety and efficacy of endovenous rt-PA between patients aged above 80 and those below 80 years. PATIENTS AND METHODS: A cohort of patients who received rt-PA was prospectively followed. Length of hospital stay, bleeding incidence, in-hospital mortality and 90 days' clinical outcome was compared between patients aged above 80 and those below 80 years. RESULTS: Of 1996 patients admitted at our hospital with ischemic stroke between October 2005 and January 2016, 180 received rt-PA (9%). Mean age was 77 ± 10 years, being 55% of the women. Comparing patients aged above 80 with those below 80 years, in the latter the length of hospital stay was longer with a median length of 15 days (IQR: 6-19) vs 7 days (IQR: 4-12; p = 0.001) and 90 days' clinical outcome was worse (modified Rankin scale 0-1 of 24% vs 41%; p = 0.001). Admission ASPECTS score, bleeding incidence and in-hospital mortality showed no significant differences between both groups. Patients aged over 80 arrived to the hospital earlier (97 ± 34 vs 113 ± 45 min; p = 0.01), however door-to-needle time was longer. CONCLUSIONS: Endovenous thrombolysis in patients aged above 80 years was safe, although its efficacy in assuring a better clinical outcome was not as pronounced as in patients below 80 years.

TITLE: Es comparable la seguridad y eficacia del uso de tromboliticos en el ictus isquemico en mayores y menores de 80 años? Experiencia en una cohorte argentina.Introduccion. La inclusion de mayores de 80 años fue escasa en los estudios que evaluaron la terapia trombolitica. El objetivo de este estudio es comparar la seguridad y eficacia del uso de activador del plasminogeno tisular recombinante en pacientes mayores y menores de 80 años. Pacientes y metodos. Estudio prospectivo de pacientes que recibieron tratamiento trombolitico. Se comparo el tiempo de estancia, la incidencia de sangrado, la mortalidad hospitalaria y la evolucion a 90 dias en pacientes mayores y menores de 80 años. Resultados. De 1.996 pacientes con ictus ingresados entre octubre de 2005 y enero de 2016, 180 recibieron tratamiento trombolitico (9%). La edad media fue de 77 ± 10 años, con un 55% de mujeres. Cuando se compararon los menores y mayores de 80 años, en estos ultimos la estancia hospitalaria fue prolongada, con una mediana de 15 dias (rango intercuartilico: 6-19) frente a siete dias (rango intercuartilico: 4-12; p = 0,001), y la discapacidad a los tres meses fue mayor (escala de Rankin 0-1 del 24% frente al 41%; p = 0,001). La puntuacion ASPECTS de ingreso, la incidencia de sangrado y la mortalidad hospitalaria no mostraron diferencias entre mayores y menores de 80 años. Los pacientes mayores de 80 años tuvieron menor tiempo de demora para llegar al hospital (97 ± 34 frente a 113 ± 45 min; p = 0,01); sin embargo, el tiempo puerta-aguja fue superior en los mayores de 80 años. Conclusion. La terapia trombolitica en los mayores de 80 años fue segura, aunque el grado de beneficio para reducir la discapacidad resulto menor.

Differential susceptibility of triatomines of the genus Rhodnius to Trypanosoma rangeli strains from different geographical origins.

The susceptibility of four Rhodnius species to different Trypanosoma rangeli strains was evaluated using both intracoelomic inoculation and oral infection. Rhodnius prolixus, Rhodnius domesticus, Rhodnius neglectus and Rhodnius nasutus were infected with Trypanosoma rangeli Macias (Venezuela), Choachi (Colombia) and SC-58 (Brazil) strains, revealing distinct haemolymph and salivary glands infection rates. The obtained infection rates were revealed to be dependent on the method of infection and the triatomine species. Our results suggest the existence of a high adaptation between the strain and the local vector.

Age-related changes of glutathione content, glutathione reductase and glutathione peroxidase activity of human erythrocytes.

1. In order to investigate the effect of aging on the erythrocyte glutathione system, total glutathione (GSH), glutathione reductase (GSH-red) and glutathione peroxidase (GSH-px) levels were measured in erythrocytes from 33 young (mean age = 30.5 +/- 9.7 years) and 28 aged (mean age = 68.9 +/- 11.4 years) healthy individuals. 2. GSH was 3.5 +/- 1.8 microM/g Hb for the young group, a value significantly greater (P less than 0.01) than 2.3 +/- 0.9 microM/g Hb found for the aged group. Similarly, GSH-red activity, 5.5 +/- 1.8 IU/g Hb, was higher (P less than 0.05) for the young group than 3.4 +/- 0.9 IU/g Hb found for the aged group. The GSH-px activity levels for the young group, 21.1 +/- 5.9 IU/g Hb, were significantly greater (P less than 0.01) than 12.0 +/- 3.3 IU/g Hb for the aged group. The lower activity detected in the aged group for all of these parameters of the glutathione redox system was not related to low levels of hematocrit or hemoglobin. 3. There was no statistical difference in the activation coefficient (AC) of reductase (+FAD/-FAD) between groups, which seems to indicate that the lower activity of glutathione reductase observed in the aged group was not due to riboflavin deficiency. 4. Additional information is required to determine the mechanisms controlling the glutathione redox system and its role in the aging process.

Lipid peroxidation, antioxidant enzymes and glutathione levels in human erythrocytes exposed to colloidal iron hydroxide in vitro.

The free form of the iron ion is one of the strongest oxidizing agents in the cellular environment. The effect of iron at different concentrations (0, 1, 5, 10, 50, and 100 microM Fe3+) on the normal human red blood cell (RBC) antioxidant system was evaluated in vitro by measuring total (GSH) and oxidized (GSSG) glutathione levels, and superoxide dismutase (SOD), catalase, glutathione peroxidase (GSH-Px) and reductase (GSH-Rd) activities. Membrane lipid peroxidation was assessed by measuring thiobarbituric acid reactive substance (TBARS). The RBC were incubated with colloidal iron hydroxide and phosphate-buffered saline, pH 7.45, at 37 degrees C, for 60 min. For each assay, the results for the control group were: a) GSH = 3.52 +/- 0.27 microM/g Hb; b) GSSG = 0.17 +/- 0.03 microM/g Hb; c) GSH-Px = 19.60 +/- 1.96 IU/g Hb; d) GSH-Rd = 3.13 +/- 0.17 IU/g Hb; e) catalase = 394.9 +/- 22.8 IU/g Hb; f) SOD = 5981 +/- 375 IU/g Hb. The addition of 1 to 100 microM Fe3+ had no effect on the parameters analyzed. No change in TBARS levels was detected at any of the iron concentrations studied. Oxidative stress, measured by GSH kinetics over time, occurs when the RBC are incubated with colloidal iron hydroxide at concentrations higher than 10 microM of Fe3+. Overall, these results show that the intact human RBC is prone to oxidative stress when exposed to Fe3+ and that the RBC has a potent antioxidant system that can minimize the potential damage caused by acute exposure to a colloidal iron hydroxide in vitro.

Cytomorphological and immunocytochemical evaluation of fine needle aspirates from high grade non-Hodgkin's lymphomas.

1. Fine needle aspirates from ten patients with high-grade malignant non-Hodgkin's lymphomas were analyzed by cytomorphology and immunocytochemistry. 2. The following morphologic diagnoses were made: lymphoblastic lymphoma (3 cases), Burkitt's lymphoma (3 cases), mixed small and large cell lymphomas with predominance of large cells (2 cases), and centroblastic lymphoma (2 cases). Immunocytochemistry showed a B-cell phenotype in five cases and a T-cell phenotype in four. One case of lymphoblastic lymphoma was negative for the T and B cell markers used. 3. The results of histological and immunohistochemical analyses performed on surgical biopsies from 8 patients confirmed the morphological diagnosis in all cases. Two cases of Burkitt's lymphoma were submitted only to cytological and immunological diagnosis. 4. The high diagnostic accuracy of combined cytomorphology and immunocytochemical assessment of fine needle aspirate samples validates the use of the technique in the diagnostic work-up of high-grade non-Hodgkin's lymphomas.

Influence of diabetes mellitus on the glutathione redox system of human red blood cells.

Several components of the erythrocyte-dependent glutathione redox system (reduced glutathione, GSH; oxidized glutathione, GSSG; glutathione peroxidase, GSH-Px; glutathione reductase, GSH-Red) were determined in patients with types I and II diabetes mellitus (DM). All groups studied were male subjects: G1, 20 young healthy individuals (aged 23.7 +/- 4.2 years); G2, 15 young insulin-treated type I DM patients; G3, 20 older insulin-treated type II DM patients; G4, 21 older oral hypoglycemic agent-treated type II DM patients; G5, 28 aged healthy individuals (aged 68.9 +/- 11.5 years). There were no differences between G1 and G2, G3 or G4 regarding erythrocyte GSH, GSSG, and GSH-Red (without FAD) levels. GSH-Px activity was significantly lower in G2 when compared to G1 (15.2 +/- 4.9 vs 20.6 +/- 6.6 IU/g Hb). The GSH-Red and GSH-Px activities and GSH levels were significantly higher in G3 (4.6 +/- 1.7 IU/g Hb, 20.2 +/- 8.7 IU/g Hb and 3.5 +/- 1.3 microM/g Hb) and G4 (5.0 +/- 2.2 IU/g Hb, 16.9 +/- 6.1 IU/g Hb and 5.0 +/- 2.3 microM/g Hb) when compared to G5 (3.4 +/- 0.9 IU/g Hb, 12.0 +/- 3.6 IU/g Hb and 2.3 +/- 0.9 microM/g Hb). The findings suggest that treatment of DM can stimulate the redox activity of red blood cells in aged subjects.

Simultaneous occurrence of Hb C trait and polycythaemia vera.

A slow abnormal haemoglobin was found in a 27 year-old Negro man who had polycythaemia vera. Chemical and structural analysis showed it to be Hb C. The oxygen affinity showed a normal P50 value. Clinical and haematological investigations are described and discussed.

[Pisa syndrome associated with codeine]. / Sindrome de Pisa asociado a codeina.

TITLE: Sindrome de Pisa asociado a codeina.

The first report of the human platelet alloantigen 4b allele in a Brazilian.

The human platelet alloantigen (HPA) 4b allele is rarely observed in Caucasians and the observed incidence in Asians is usually lower than 1.0%. We report the first Brazilian with the allele HPA-4b, and were able to determined that he inherited it from his father.

Characterization of the hemoglobins and globins of Synbranchus marmoratus Bloch, 1795 (Pisces, Synbranchidae).

Total hemolysates of Synbranchus marmoratus Bloch, 1795, captured in Vitoriana, district of Botucatu, State of São Paulo, Brazil, were submitted to agar-starch gel electrophoresis on glass slides using 42 mM-Tris 1.7 mM EDTA-6.1 mM borate buffer, pH 8.8, for the gel and 10 mM borate-1.7 mM NaOH buffer, pH 8.6, for the cuvette. Three distinct hemoglobin bands were detected, with Hb I being of the cathodic type. Cellulose acetate electrophoresis in 800 mM Tris-2.1 mM EDTA buffer, pH 8.9, containing 6 M urea and 2.25 mM beta-mercaptoethanol indicated the presence of four globin chains denoted alpha 1, alpha 2, beta and gamma. It is suggested that the probable tetrameric constitution of the hemoglobin of Synbranchus marmoratus Bloch, 1795 is Hb I (alpha (2)2 gamma 2), Hb II (alpha (1)2 gamma 2) and Hb III (alpha (1)2 beta 2).

Hemoglobin patterns in different populations of Synbranchus marmoratus Bloch, 1795 (Pisces, Synbranchidae).

Total hemolysates of Synbranchus marmoratus Bloch, 1795 captured at four different sites in the State of São Paulo, Brazil, showed two different hemoglobin phenotypes when submitted to agar-starch gel electrophoresis on glass slides in basic buffer. Phenotype I was characterized by 3 hemoglobin bands. When the total hemolysate was submitted to cellulose acetate electrophoresis in basic buffer containing 6 M urea and beta-mercaptoethanol, Phenotype I showed four globins of the alpha 1, alpha 2, beta and gamma types, with 11.9 +/- 1.9 g% total hemoglobin, 45.3 +/- 3.6% globular volume, and 26.8 +/- 4.4% mean corpuscular hemoglobin concentration (MCHC). Phenotype II showed three groups of hemoglobins, with a total of up to 12 hemoglobin bands. When the total hemolysate was submitted to cellulose acetate electrophoresis in basic buffer containing 6 M urea and beta-mercaptoethanol, phenotype II showed five types of globins, denoted types alpha 1, alpha 2, gamma 1, gamma 2 and beta, having electrophoretic positions different from those of Phenotype I globins, with 18.1 +/- 3.3% total hemoglobin, 47.9 +/- 6.4% globular volume, and 37.8 +/- 4.4% MCHC. The distribution of the specimens having the two hemoglobin phenotypes is associated with the different geomorphological provinces of the State of São Paulo, suggesting the existence of at least two populational groups of Synbranchus marmoratus.