Are native microalgae consortia able to remove microplastics from wastewater effluents?

Wastewater Treatment Plants (WWTPs) are potential sources of microplastics (MPs) in the aquatic environment. This study aimed to investigate the potential of wastewater-native microalgae consortia to remove MPs from the effluent of two different types of WWTPs as a dual-purpose solution for MPs mitigation and biomass production. For that purpose, the occurrence of MPs from two types of WWTP effluents was analysed over one year. MPs were characterized in terms of morphology (microbead, foam, granule, irregular, filament and film), colour and size. The wastewater characterisation was followed by the removal of MP loads, using native microalgae consortia, pre-adapted to the wastewater effluent. Microalgae consortia evolved naturally through four mitigation assays, adapted to seasonal conditions, such as temperature, photoperiod, and wastewater composition. MPs were present in all the effluent samples, ranging from 52 to 233 MP L-1. The characterisation of MPs indicated a predominance of white and transparent particles, with irregular and filament shapes, mainly under 500 µm in size. The µFTIR analysis revealed that 43% of the selected particles were plastic, with a prevalence of polypropylene (PP) (34%) and polyethylene terephthalate (PET) (30 %). In the mitigation experiments, substantial biomass production was achieved (maximum of 2.6 g L-1 (d.w.)), with successful removal of MPs, ranging from 31 ± 25% to 82 ± 13%. These results show that microalgae growth in wastewater effluents efficiently promotes the removal of MPs, reducing this source of contamination in the aquatic environment, while generating valuable biomass. Additionally, the strategy employed, requires minimal control of culture conditions, simplifying the integration of these systems in real-world WWTP facilities for improved wastewater management.

Methylation of histone H3 lysine 36 is a barrier for therapeutic interventions of head and neck squamous cell carcinoma.

Approximately 20% of head and neck squamous cell carcinomas (HNSCCs) exhibit reduced methylation on lysine 36 of histone H3 (H3K36me) due to mutations in histone methylase NSD1 or a lysine-to-methionine mutation in histone H3 (H3K36M). Whether such alterations of H3K36me can be exploited for therapeutic interventions is still unknown. Here, we show that HNSCC models expressing H3K36M can be divided into two groups: those that display aberrant accumulation of H3K27me3 and those that maintain steady levels of H3K27me3. The former group exhibits reduced proliferation, genome instability, and heightened sensitivity to genotoxic agents like PARP1/2 inhibitors. Conversely, H3K36M HNSCC models with constant H3K27me3 levels lack these characteristics unless H3K27me3 is elevated by DNA hypomethylating agents or inhibiting H3K27me3 demethylases KDM6A/B. Mechanistically, H3K36M reduces H3K36me by directly impeding the activities of the histone methyltransferase NSD3 and the histone demethylase LSD2. Notably, aberrant H3K27me3 levels induced by H3K36M expression are not a bona fide epigenetic mark because they require continuous expression of H3K36M to be inherited. Moreover, increased sensitivity to PARP1/2 inhibitors in H3K36M HNSCC models depends solely on elevated H3K27me3 levels and diminishing BRCA1- and FANCD2-dependent DNA repair. Finally, a PARP1/2 inhibitor alone reduces tumor burden in a H3K36M HNSCC xenograft model with elevated H3K27me3, whereas in a model with consistent H3K27me3, a combination of PARP1/2 inhibitors and agents that up-regulate H3K27me3 proves to be successful. These findings underscore the crucial balance between H3K36 and H3K27 methylation in maintaining genome instability, offering new therapeutic options for patients with H3K36me-deficient tumors.

Methylation of histone H3 lysine 36 is a barrier for therapeutic interventions of head and neck squamous cell carcinoma.

Approximately 20% of head and neck squamous cell carcinomas (HNSCC) exhibit reduced methylation on lysine 36 of histone H3 (H3K36me) due to mutations in histone methylase NSD1 or a lysine-to-methionine mutation in histone H3 (H3K36M). Whether such alterations of H3K36me can be exploited for therapeutic interventions is still unknown. Here, we show that HNSCC models expressing H3K36M can be divided into two groups: those that display aberrant accumulation of H3K27me3 and those that maintain steady levels of H3K27me3. The first group shows decreased proliferation, genome instability, and increased sensitivity to genotoxic agents, such as PARP1/2 inhibitors. In contrast, the H3K36M HNSCC models with steady H3K27me3 levels do not exhibit these characteristics unless H3K27me3 levels are elevated, either by DNA hypomethylating agents or by inhibiting the H3K27me3 demethylases KDM6A/B. Mechanistically, we found that H3K36M reduces H3K36me by directly impeding the activities of the histone methyltransferase NSD3 and the histone demethylase LSD2. Notably, we found that aberrant H3K27me3 levels induced by H3K36M expression is not a bona fide epigenetic mark in HNSCC since it requires continuous expression of H3K36M to be inherited. Moreover, increased sensitivity of H3K36M HNSCC models to PARP1/2 inhibitors solely depends on the increased H3K27me3 levels. Indeed, aberrantly high H3K27me3 levels decrease BRCA1 and FANCD2-dependent DNA repair, resulting in higher sensitivity to DNA breaks and replication stress. Finally, in support of our in vitro findings, a PARP1/2 inhibitor alone reduce tumor burden in a H3K36M HNSCC xenograft model with elevated H3K27me3, whereas in a H3K36M HNSCC xenograft model with consistent H3K27me3 levels, a combination of PARP1/2 inhibitors and agents that upregulate H3K27me3 proves to be successful. In conclusion, our findings underscore a delicate balance between H3K36 and H3K27 methylation, essential for maintaining genome stability. This equilibrium presents promising therapeutic opportunities for patients with H3K36me-deficient tumors.

Mortalidad materna en Brasil y Cuba: estudio comparativo / Maternal mortality in Brazil and Cuba: comparative study

Introducción: La mortalidad materna constituye un problema de salud pública a nivel internacional. Su comportamiento es expresión del funcionamiento integral de los sistemas de salud, así como, del avance de los derechos sexuales y reproductivos de las mujeres. Objetivo: Comparar los indicadores de mortalidad materna de Brasil y Cuba en el periodo 2005-2017. Métodos: La metodología implementada responde a un análisis de tipo documental. Se utilizaron como fuentes de información las principales bases de datos del Departamento de Informática del Sistema Único de Salud de Brasil, y los anuarios estadísticos publicados por el Ministerio de Salud Pública de Cuba y la Oficina Nacional de Estadística e Información. Resultados: La meta sobre mortalidad materna dentro de los Objetivos de Desarrollo Sustentable es un requisito actualmente cumplido por los dos países. En Cuba, las cifras de la Razón de Mortalidad Materna se mantienen con valores siempre inferiores a los del propio país en el año 2005; no obstante, a partir de 2013 muestran un comportamiento creciente. En Brasil, por su parte, son superiores a las de Cuba y nunca disminuyen en relación con el año 2005, y presentan una marcada tendencia creciente. Conclusiones: Los programas de salud materna analizados para Brasil y Cuba muestran avances y desafíos diferenciados. El comportamiento de los indicadores analizados reafirma la necesidad de intensificar las acciones para la reducción de los óbitos maternos en los dos países, con más urgencia para Brasil(AU)

Introduction: Maternal mortality is a public health problem at the international level. Its behavior is an expression of the comprehensive functioning of health systems, as well as the advancement of women's sexual and reproductive rights. Objective: Compare the maternal mortality indicators of Brazil and Cuba in the period 2005-2017. Methods: The implemented methodology responds to a documentary analysis. The main databases of the Department of Informatics of the Unified Health System of Brazil, and the statistical yearbooks published by the Ministry of Public Health of Cuba and the National Office of Statistics and Information were used as sources of information. Results: The target on maternal mortality within the Sustainable Development Goals is a requirement currently met by both countries. In Cuba, the figures for the Maternal Mortality Ratio remain at values always lower than those of the country itself in 2005; however, as of 2013 they show an increasing behavior. In Brazil, on the other hand, they are higher than those of Cuba and never decrease in relation to 2005, and present a marked growing trend. Conclusions: The maternal health programs analyzed for Brazil and Cuba show differentiated progress and challenges. The behavior of the indicators analyzed reaffirms the need to intensify actions to reduce maternal deaths in both countries, with more urgency for Brazil(AU)

Estimação in-silico do microbioma humano em câncer gástrico / In-silico estimation of the human cancer gastric

O microbioma pode influenciar a fisiologia humana, tanto na saúde quanto na doença. O uso das tecnologias de sequenciamento de última geração ajudou a ampliar o conhecimento a cerca de vários micro-organismos. No entanto, a detecção da diversidade em larga escala ainda apresenta resultados conflitantes devido a heterogeneidade dos protocolos e dos métodos de análise. Aqui, foi projetado e implementado um protocolo computacional para ser incorporado à facility de Bioinformática do A.C. Camargo Cancer Center para a detecção do microbioma humano em câncer gástrico. Avaliamos também os principais aspectos que possam influenciar o resultado final considerando o protocolo de sequenciamento, parametrização e algoritmos de classificação. O pipeline desenvolvido utiliza uma estrutura de gerenciamento de fluxo de trabalho (Snakemake), que permite obter uma análise automatizada e reprodutível, independente do ambiente de execução. Usando os resultados do sequenciamento de uma amostra controle com diversidade conhecida, mostramos que o pipeline proposto identifica com acurácia (TAR =0.89) os organismos a nível de gênero, bem como uma taxa de detecção sem falsos negativos (TDR=1). Como prova de conceito, usamos o pipeline em um conjunto de amostras provenientes de tumor primário e suco gástrico. De importância, ao avaliar como as várias etapas da análise podem influenciar os resultados, observamos que a combinação dos algoritmos deblur e BLAST durante a limpeza das leituras e classificação, respectivamente, apresentam os resultados mais próximos do esperado em relação à amostra controle. Diante da importância do microbioma em estudos de pesquisa básica e translacional, o pipeline proposto será útil na detecção da diversidade de bactérias em um ambiente computacional

The human microbiome has a great potential to influence human physiology, both in health and in disease. The use of state-of-the-art sequencing technologies has helped to extend knowledge about microorganisms. However, diversity detection in large scale basis still presents conflicting results due to the heterogeneity of protocols and analysis methods. Here, a computational protocol was designed and implemented to be incorporated into the A.C. Camargo Cancer Center's Bioinformatics facility in order to detect the human gastric cancer microbiome. We also evaluate the main aspects that can influence final results according to the characteristics of the sequencing protocol, parameterization and classification algorithms. The developed pipeline uses a workflow management structure, called Snakemake, which allows automated and reproducible analysis, regardless of the execution environment. Using the sequencing oa control sample with known diversity, we show that the proposed pipeline accurately identifies organisms at the gender level (TAR = 0.89), as well as a detection rate without false negatvies (TDR = 1). As a proof of concept, we used the pipeline in a set of samples from primary tumor and gastric juice. Of importance, when evaluating how the various stages of the analysis can influence the results, we observed that the combination of the deblur and BLAST algorithms during the denoising and classification steps, respectively, presents the results closer to the expected regarding the control sample. Given the importance of the microbiome in basic and translational research studies, the proposed pipeline will be useful in detecting the microbiome diversity in a computational environment

Muscle degradation, vitamin D and systemic inflammation in hospitalized septic patients.

PURPOSE: To date, the relationship between systemic inflammation and muscle changes observed by ultrasonography in septic patients in clinical studies is not known. Furthermore, the role of vitamin D on muscle changes in these patients needs to be investigated. MATERIALS AND METHODS: Forty-five patients admitted to the ICU due to severe sepsis or septic shock. Blood samples were collected to evaluate systemic inflammation (interleukin (IL)-10, IL-1ß, IL-1α, IL-6, IL-8 and tumor necrosis factor-α(TNF-α)) and vitamin D. Muscle mass was evaluated by ultrasound during hospitalization. Clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip) were performed after the awakening of patients. RESULTS: There was a reduction in day 2 values to hospital discharge on TNF-alpha, IL-8, IL-6 and IL-10 (p < .05). The muscle mass showed a significant decline from day 6 of the ICU. After awakening, the patients had a significant increase in muscle strength (p < .05). There was a positive association between muscle mass variation (day 2 - ICU) with absolute values of IL-8 (r = 0.38 p = .05). For muscle strength, there was a negative association between handgrip strength with IL-8 (r = -0.36 p < .05) on ICU discharge. The vitamin D showed a positive association with the handgrip strength of the day 1 of the awakening (r = 0.51 p < .05). CONCLUSIONS: In septic patients, there is an association between inflammation and changes in muscle mass and strength during ICU stay, which is similar to those observed in experimental studies. In addition, there was an association of vitamin D with recovery of muscle strength during hospitalization.

Genomics and epidemiology for gastric adenocarcinomas (GE4GAC): a Brazilian initiative to study gastric cancer

Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings

Antinociceptive and Anti-Inflammatory Activities of the Ethanolic Extract from Synadenium umbellatum Pax. (Euphorbiaceae) Leaves and Its Fractions.

Synadenium umbellatum Pax., popularly known in Brazil as "cola-nota," "avelós," "cancerola," and "milagrosa", is a plant species used in folk medicine for the treatment of inflammation, pain, and several diseases. This study aimed to investigate the antinociceptive and anti-inflammatory activities of the ethanolic extract from Synadenium umbellatum Pax. leaves (EES) and its hexane (HF), chloroform (CF), and methanol/water (MF) fractions using the acetic acid-induced abdominal writhing test, formalin-induced paw licking test, tail flick test, croton oil-induced ear edema test, and carrageenan-induced peritonitis test. EES and MF reduced the number of acetic acid-induced abdominal writhes, while CF and HF did not. EES effect on acetic acid-induced abdominal writhing was reversed with a pretreatment with naloxone. EES reduced licking time in both phases of the formalin-induced paw licking test, but did not prolong the latency in the tail flick test. These results show that EES presented antinociceptive activity, probably involving the opioid system, anti-inflammatory activity in the croton oil-induced ear edema test, and leukocyte migration into the intraperitoneal cavity. MF also presented anti-inflammatory activity in the croton oil-induced ear edema test. In conclusion, EES and MF have antinociceptive activity involving the opioid system and anti-inflammatory activity.

Oclusão arterial aguda de membros inferiores por êmbolo tumoral em paciente com neoplasia de pulmão / Acute arterial occlusion of lower limbs caused by tumor embolism in a patient with lung neoplasia

A embolia arterial periférica originada de tumores malignos é considerada uma manifestação rara da doença neoplásica, podendo se originar de vários sítios, incluindo coração, aorta e veias pulmonares, sendo estas últimas, fontes massivas de embolia por trombo ou tumores com erosão para seu lúmen. Apesar de infrequente, a neoplasia pulmonar deve ser considerada como uma fonte de êmbolos para as extremidades, principalmente quando há invasão neoplásica para as veias pulmonares. Apresentamos o caso de um paciente do sexo masculino submetido à pneumectomia por neoplasia pulmonar, que evoluiu com oclusão arterial aguda de membros inferiores por êmbolo tumoral " a cavaleiro".

Peripheral arterial embolism (PAE) caused by malignant tumors is a rare manifestation of cancer. PAE may originate from several sites, including heart, aorta, and pulmonary veins. Such veins are a major source of thrombotic embolism or tumors with vascular erosion. Although uncommon, lung cancer should be regarded as a source of emboli in the extremities, especially when there is neoplastic invasion of the pulmonary veins. We report on a case of a male patient who underwent pneumonectomy for lung cancer who developed acute arterial occlusion of the lower extremities caused by saddle tumor embolus.

Auto-anticorpos anti-β2-glicoproteína I e síndrome metabólica / Anti-beta2-glycoprotein I autoantibodies and metabolic syndrome / Anticuerpos anti-β2-glicoproteína I y síndrome metabólico

FUNDAMENTO: A síndrome metabólica (SM) é uma entidade pró-aterogênica. Autoanticorpos tais como β2-glicoproteína I (β2-gpI) podem influenciar o aparecimento de ateromas. Estudos anteriores confirmaram uma associação entre anticorpos IgA anti-β2-gpI e isquemia cerebral, infarto do miocárdio, doença arterial periférica e doença da carótida. OBJETIVO: O objetivo desse estudo de caso-controle foi avaliar uma possível associação entre anticorpos anti-β2-gpI e anticardiolipina (aCL) com SM não-complicada. MÉTODOS: Pacientes com SM sem histórico de eventos vasculares e indivíduos-controle, consistindo em pacientes da Enfermaria de Ortopedia admitidos devido a doenças musculoesqueléticas foram incluídos no estudo. Idade, sexo, etnia, histórico de hipertensão, tabagismo, hipercolesterolemia e diabetes mellitus foram avaliados como fatores de risco em ambos os grupos. Anticorpos IgG, IgM, e IgA anti-β2-gpI e aCL foram detectados através de imunoensaios enzimáticos. RESULTADOS: Um total de 68 pacientes com SM e 82 controles foram estudados. Os pacientes com SM tinham média de idade superior à dos controles (P = 0,001), enquanto homens (P = 0,003; OR 0,31; IC95 por cento: 0,15-0,16) e etnia caucasiana (P = 0,004; OR 0,25; IC95 por cento:0,10-0,60) eram predominantes nos controles. Histórico de hipertensão, hipercolesterolemia e diabetes mellitus foi mais prevalente nos pacientes com SM do que nos controles (P < 0.05). A frequência de anticorpos aCL (todos os isotipos) e do IgG e IgM anti-β2 gpI não diferiu de forma significante nos pacientes com SM e controles. Anticorpos IgA anti-β2-gpI foram significantemente mais frequentes nos pacientes com SM (42,2 por cento) do que nos controles (10,9 por cento) (P < 0,001). O OR ajustado para anticorpos IgA anti-β2-gpI foi 3,60 (IC95 por cento: 1,55-8,37; P = 0,003). CONCLUSÃO: O presente estudo mostra que níveis elevados de autoanticorpos IgA para β2-gpI podem estar independentemente associados com SM.

BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95 percentCI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95 percentCI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2 percent) than controls (10.9 percent) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95 percentCI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.

FUNDAMENTO: El síndrome metabólico (SM) es una entidad pro-aterogénica. Autoanticuerpos tales como β2-glicoproteína I (β2-GPI) pueden influir en la aparición de ateromas. Estudios previos han confirmado una asociación entre anticuerpos IgA anti-β2-GPI y la isquemia cerebral, infarto de miocardio, enfermedad arterial periférica y enfermedad carotidea. OBJETIVO: El objetivo de este estudio de caso-control fue evaluar una posible asociación entre los anticuerpos anti-β2-GPI y anticardiolipina (aCL) con SM complicada. MÉTODOS: Se incluyeron en el estudio a los pacientes con SM sin antecedentes de eventos vasculares y los sujetos control, que consiste en pacientes de la Internación de Ortopedia ingresados debido a enfermedades musculoesqueléticas. Edad, sexo, origen étnico caucásico, antecedentes de hipertensión, tabaquismo, hipercolesterolemia y diabetes mellitus fueron evaluados como factores de riesgo en ambos grupos. Anticuerpos IgG, IgM, e IgA anti-β2-GPI y aCL se detectaron a través de inmunoensayos enzimáticos. RESULTADOS: Un total de 68 pacientes con SM y 82 controles se estudiaron. Los pacientes con SM tenían un promedio de edad superior de los controles (p = 0,001), mientras que los hombres (p = 0,003; OR 0,31; IC95 por ciento: 0,15-0,16) y origen étnico caucásica (p = 0,004; OR 0,25; IC95 por ciento:0,10-0,60) eran predominantes en los controles. Historia de hipertensión, hipercolesterolemia y diabetes mellitus fue más prevalente en los pacientes con SM que en los controles (p < 0,05). La frecuencia de anticuerpos aCL (todos los isotipos) y del IgG e IgM anti-β2 gpI no se distinguió de forma significante en los pacientes con SM y controles. Anticuerpos IgA anti-β2-gpI fueron significantemente más frecuentes en los pacientes con SM (42,2 por ciento) que en los controles (10,9 por ciento) (p < 0,001). El OR ajustado para anticuerpos IgA anti-β2-gpI fue 3,60 (IC95 por ciento: 1,55 a 8,37, p = 0,003). CONCLUSIÓN: El presente estudio muestra que los niveles elevados de autoanticuerpos IgA para β2-gpI pueden estar independientemente asociados con la SM.

Anti-beta2-glycoprotein I autoantibodies and metabolic syndrome.

BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to ß2-gpI might be independently associated to MetS.

Iatrogenic cortical aneurysm post-craniotomy.

Taking into account the number of craniotomies performed every day around the world, iatrogenic aneurysm post-craniotomy is extremely rare with only anecdotal cases reported in literature. We report an iatrogenic aneurysm affecting a cortical vessel which probably developed during dural closure of a conventional craniotomy. The aneurysm was discovered 6 months after surgery on a routine control angiography. The patient was successfully treated by trapping the parent vessel and excising the aneurysm. Histopathological findings were compatible with a true type of traumatic aneurysm. The possibility of this rare condition occurring highlights the risk of arterial injury during craniotomy.

Autoantibodies to the atheroma component beta2-glycoprotein I and risk of symptomatic peripheral artery disease.

Peripheral artery disease (PAD) is mostly related to atherosclerosis. Autoimmunity and, in particular, antibodies to cardiolipin (aCL) and phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) might influence the development of atheroma. Beta2-glycoprotein I (beta2-gpI) has been found in atheroma. It has previously been shown that immunoglobulin A (IgA) anti-beta2-gpI antibodies are associated with a risk of cerebral ischemia and myocardial infarction. This case control study aimed to determine whether elevated levels of aCL/anti-beta2-gpI antibodies are associated with a risk of symptomatic PAD (sPAD). Cases comprised a nonselected population of patients with sPAD (intermittent claudication or critical ischemia). Patient recruitment was based on arteriography changes. Controls were selected from patients admitted to orthopedic wards as a result of fractures or muscle-ligamentous disorders. Age, sex, race, hypertension, smoking, diabetes mellitus, and hypercholesterolemia were evaluated as risk factors in both groups. IgG/IgM/IgA aCL and anti-beta2-gpI were detected by enzyme-linked immunoabsorbant assays (ELISA). To estimate the grade of association of antibodies with sPAD, odds ratios (OR) were calculated. Logistic regression was utilized for adjustment of confounding factors. Seventy-seven cases and 93 controls were studied. The mean age was 61.5 years for cases and 47.5 years for controls (p <0.001). Among the risk factors evaluated, the presence of hypertension showed the strongest association with sPAD (OR 12.1; 95%CI 5.8-30). The presence of IgA anti-beta2-gpI was independently associated with sPAD (OR 5.4; 95%CI 1.8-15.8; p = 0.01). IgA aCL was strongly associated with the outcome (nonadjusted OR 11.5 after Agresti correction). IgA aCL and IgA anti-beta2-gpI antibodies were not associated with any known risk factors for sPAD or with arteriography changes. The occurrence of these autoantibodies might represent one of the links between autoimmunity and atherosclerosis in patients with sPAD.

Síndrome antifosfolipídica e morbidade gestacional / Antiphospholipid syndrome and morbidity gestation

A síndrome antifosfolipídica (SAF) é a mais comum das trombofilias adquiridas do adulto jovem. Ocorre de forma primária ou em associação com doenças do conjuntivo, particularmente o lupus eritematoso. A ocorrência de eventos obstrétricos em pacientes com SAF é assunto de grande interesse entre profissionais da área da Reumatologia e Gineco-Obstetricia. Abordamos, neste artigo, aspectos conceituais da SAF e os eventos obstétricos (abortamentos recorrentes, pré-eclâmpsia) relacionados à presença dos anticorpos contra fosfolípides.

Infarto agudo do miocárdio e Síndrome da Imunodeficiência Adquirida / Acute myocardial infarction in patient with AIDS

Os autores relatam o caso de um paciente com AIDS que apresentou infarto agudo do miocárdio durante internaçäo hospitalar. Além disso, säo feitas consideraçöes sobre a possibilidade do HIV estar relacionado, como fator predisponente, no desenvolvimento de infarto agudo do miocárdio