Patients treated for acute VTE during periods of treatment-related thrombocytopenia have high rates of recurrent thrombosis and transfusion-related adverse outcomes.

Venous thromboembolism (VTE) is a common complication of hematologic malignancies. Prolonged periods of thrombocytopenia are experienced universally by patients undergoing treatment for these diseases, yet data to guide management of anticoagulation in this setting are lacking. To obtain data on the management and outcomes of VTE in patients with thrombocytopenia related to the treatment of hematologic malignancies. This was an observational cohort study of patients experiencing VTE during periods of treatment-related thrombocytopenia over a 5-year period at the Fred Hutchinson Cancer Research Center. Medical records were reviewed for diagnostic, treatment and outcomes data, including bleeding events (categorized by WHO criteria) and progression or recurrence of VTE. Eighty-two patients meeting inclusion criteria were identified. Forty-eight percent were male and the median age was 55. Sixty-seven patients received anticoagulation, 88% of these were managed with transfusion support for a platelet goal of 50 × 109/L. Thirty-one patients experienced bleeding events, 22 of which were grade 2 and nine of which were grade 3/4. The median platelet count at the time of bleeding event was 54 × 109/L. Seven patients experienced progression of thrombosis and/or recurrence. Eleven patients experienced transfusion reactions and 30 experienced volume overload requiring diuretics or dialysis. While bleeding events were not uncommon, the majority of events were non-major/non-clinically relevant. Most bleeding events occurred while the platelet count was within the 'goal' range of ≥50 × 109/L, and many patients experienced transfusion related adverse events. Prospective studies are urgently needed to identify the optimal transfusion strategy for these patients.

The SOS Chromotest applied for screening plant antigenotoxic agents against ultraviolet radiation.

In this work, we investigated the usefulness of the SOS Chromotest for screening plant antigenotoxic agents against ultraviolet radiation (UV). Fifty Colombian plant extracts obtained by supercritical fluid (CO2) extraction, twelve plant extract constituents (apigenin, carvacrol, ß-caryophyllene, 1,8-cineole, citral, p-cymene, geraniol, naringenin, pinocembrin, quercetin, squalene, and thymol) and five standard antioxidant and/or photoprotective agents (curcumin, epigallocatechin gallate, resveratrol, α-tocopherol, and Trolox®) were evaluated for their genotoxicity and antigenotoxicity against UV using the SOS Chromotest. None of the plant extracts, constituents or agents were genotoxic in the SOS Chromotest at tested concentrations. Based on the minimal extract concentration that significantly inhibited UV-genotoxicity (CIG), five plant extracts were antigenotoxic against UV as follows: Baccharis nítida (16 µg mL-1) = Solanum crotonifolium (16 µg mL-1) > Hyptis suaveolens (31 µg mL-1) = Persea caerulea (31 µg mL-1) > Lippia origanoides (62 µg mL-1). Based on CIG values, the flavonoid compounds showed the highest antigenotoxic potential as follows: apigenin (7 µM) > pinocembrin (15 µM) > quercetin (26 µM) > naringenin (38 µM) > epigallocatechin gallate (108 µM) > resveratrol (642 µM). UV-genotoxicity inhibition with epigallocatechin gallate, naringenin and resveratrol was related to its capability for inhibiting protein synthesis. A correlation analysis between compound antigenotoxicity estimates and antioxidant activity evaluated by the oxygen radical absorbance capacity (ORAC) assay showed that these activities were not related. The usefulness of the SOS Chromotest for bioprospecting of plant antigenotoxic agents against UV was discussed.

Prevalencia de ventilación mecánica en pacientes pediátricos con sepsis internados en Cuidados Intensivos / Prevalence of ventilation Mechanics in patients pediatric patients with sepsis interned in Intensive Care

Objetivo: Describir las características sociodemográficas y clínicas de niños con sepsis y ventilación mecánica. Métodos: Estudio observacional, transversal, multicéntrico, de un año de duración, en 19 Unidades de Cuidados Intensivos Pediátricos. Los datos se recolectaron a través de la página www.sepsisencolombia.com. Los pacientes fueron clasificados por diagnósticos, según tuvieran criterios de sepsis, sepsis grave, choque séptico y falla orgánica múltiple, y la necesidad o no de ventilación mecánica. Resultados: Se incluyeron 1051 pacientes con sepsis y el 67,7% de ellos requirió ventilación mecánica. El 43,1% eran niñas, la mediana de la edad era de 12 meses (rango intercuartílico 1-59). La mediana de estancia en la Unidad de Cuidados Intensivos Pediátricos de los pacientes ventilados fue de 8 días (rango intercuartílico 5-15) y de 4 días (rango intercuartílico 3-6) de los no ventilados. En el 97,1%, se conoció el origen de la sepsis, el más frecuente fue el aparato respiratorio. Se encontró relación entre tener sepsis y no requerir ventilación mecánica (rango intercuartílico 0,279-0,439) (p = 0,0000) y de requerirla, si había choque séptico (rango intercuartílico 0,694-0,781) (p = 0,0000). Los pacientes que requirieron ventilación mecánica tuvieron más probabilidad de morir (odds ratio 30,0; rango intercuartílico 11,5-78,6). Conclusiones: La sepsis y desarrollar choque séptico hacen más probable la necesidad de ventilación mecánica y hay una asociación entre ésta y mayor probabilidad de muerte.(AU)

Objective: To describe the sociodemographic and clinical characteristics of children with sepsis and mechanical ventilation. Methods: Observational, cross-sectional, multicenter study in 19 pediatric intensive care units. Data were collected through the website www. sepsisencolombia.com. Patients were classified by diagnosis, according to the following criteria: sepsis, severe sepsis, septic shock and multiple organ failure, with or without mechanical ventilation. Results: 1051 patients with sepsis were included and 67.7% of them required mechanical ventilation. 43.1% were female, median age: 12 months (interquartile range 1-59). The median stay in the PICU of ventilated patients was 8 days (interquartile range 5-15) and 4 days (interquartile range 3-6) of those without ventilation. The origin of sepsis was known in 97.1%, the most frequent source was the respiratory system. Relationship was found between having sepsis and not requiring mechanical ventilation (interquartile range 0.279 to 0.439) (p = 0.0000) and requiring it was found, if there was septic shock (interquartile range 0.694 to 0.781) (p = 0.0000). Patients who required mechanical ventilation were more likely to die (odds ratio 30.0; interquartile range 11.5 to 78.6. Conclusions: Sepsis and the development of septic shock make it more likely to need mechanical ventilation and there is an association between this and increased probability of death.(AU)

Seleção de características morfofuncionais de cavalos da raça Mangalarga Marchador por meio da análise de componentes principais / Identification of morphofunctional traits in Mangalarga Marchador horse using principal component analysis

Dados de 14.288 animais da raça Mangalarga Marchador, nascidos de 1990 a 2005, foram utilizados para avaliar a redução da dimensionalidade do espaço multivariado para características morfofuncionais, por meio da análise de componentes principais. Foram consideradas as características: altura na cernelha, altura na garupa, comprimento da cabeça, comprimento do pescoço, comprimento do dorso, comprimento da garupa, comprimento da espádua, comprimento do corpo, largura da cabeça, largura das ancas, perímetro do tórax, perímetro da canela e a pontuação da marcha. Para tais características, obtiveram-se sete componentes principais, a partir da matriz de correlação, que apresentaram variância inferior a 0,7 (autovalor inferior a 0,7). Isso sugere sete variáveis para descarte, por apresentarem maiores coeficientes de ponderação, em valor absoluto, a partir do último componente principal. A razão para isso é que variáveis altamente correlacionadas com os componentes de menor variância representam variação praticamente insignificante. Com base nesses resultados, recomendam-se as seguintes características para serem mantidas em trabalhos futuros com esta base de dados: pontuação da marcha, altura na garupa, comprimento do dorso, comprimento da garupa, largura da cabeça e perímetro da canela.

Records from 14,288 animals of the Mangalarga Marchador breed, born from 1990 to 2005, were used to discard morphofunctional traits in a principal component analysis. The following traits were used: height at withers, height at croup, lengths of head, neck, back, croup, hip length and body, widths of head, hip width, thorax perimeter, cannon bone circumference and gait score. For the traits considered it was observed that 7 principal components showed variation lower than 0.7; suggesting that seven variables could be discarded. The reason is that when variable are highly correlated with the principal components of smaller variance, their variation is practically insignificant. Based on those results the recommendation is to maintain the following traits for future research with this database: gait score, height at croup, length of back, length of croup, width of head and cannon bone circumference.

Modelos lineares generalizados mistos na avaliação genética da prenhez precoce na raça Nelore / Generalized linear mixed models on genetic evaluation of early pregnancy in Nellore breed

Utilizaram-se os modelos lineares generalizados com as funções de ligação probit e logit na avaliação da prenhez precoce, e observaram-se os efeitos na variabilidade genética e na seleção de reprodutores quando diferentes idades são adotadas na definição dessa característica. A prenhez precoce foi estudada aos 15 (PP15) e 21 meses (PP21). Correlações entre os valores genéticos preditos e a porcentagem de touros em comum, considerando 10% dos touros com maiores valores genéticos (TOP10), entre a classificação dos modelos com função de ligação logit e probit e em cada modelo entre PP15 e PP21, foram calculadas. As herdabilidades para PP15 e PP21 foram próximas entre os modelos, exceto para PP15 utilizando a função de ligação probit. Aquelas entre os modelos e a TOP/10 foram altas. Os critérios de Akaike e Bayesiano apresentaram-se semelhantes entre os modelos. As correlações entre PP15 e PP21 e a TOP10, considerando o mesmo modelo, foram de média magnitude.

This study aimed to use the generalized linear models with probit and logit link function to evaluate early pregnancy, and to observe the effects on genetic variability and on sire selection when different ages are adopted in the definition of this trait. Early pregnancy was studied at 15 (EP15), and 21 (EP21) months. The analysis was done in R software. Pearson correlations (PC), between genetic predicted values and percentage of bulls in common considering only 10% of bulls with higher genetic values (TOP 10), between classification by logit and probit models and in each model among EP15 and EP21, were calculated. The heritability for EP15 and EP21 were close between models, except for EP15 using probit link function. PC and TOP10 among models were high. The Akaike and Bayesian criteria reported was similar between models. TOP10, considering the same model, among EP15-EP21 were moderated between EP15-EP21.

Avaliação genética para peso corporal em um rebanho Nelore / Genetic evaluation for body weight in a Nellore herd

Estimaram-se as herdabilidades para os efeitos genéticos direto e materno e as correlações genéticas entre essas variáveis para os pesos ao desmame (P205), ao ano (P365) e ao sobreano (P550) em um rebanho Nelore do norte de Minas Gerais. O modelo estatístico incluiu os efeitos aditivos direto e materno, os efeitos fixos de grupo de contemporâneos (fazenda, sexo, regime alimentar, estação (seca e água) e ano de nascimento do animal) e o efeito da covariável idade da vaca ao parto (linear e quadrático). Os componentes de variância e os valores genéticos foram estimados utilizando-se o método REML. A tendência genética foi obtida utilizando-se a regressão do valor genético médio anual em relação ao ano de nascimento dos animais. As estimativas de herdabilidade do efeito aditivo direto () para P205, P365 e P550 foram 0,60, 0,69 e 0,75, respectivamente. Estes coeficientes de são de alta magnitude, indicando que o rebanho apresenta variabilidade genética aditiva relativa e, portanto, espera-se progresso genético considerável utilizando a seleção. Pela análise da tendência genética, verificou-se que houve evolução nos valores genéticos dos animais ao longo dos anos estudados.

The heritabilities for direct and maternal genetic effects and genetic correlations between these effects were estimated for weight at 205 (P205), 365 (P365), and 550 days (P550) in a Nelore herd in northern Minas Gerais. The statistical model included direct and maternal additive effects, in addition to the fixed effects of contemporary group (farm, gender, diet, season - dry and water -, and year of birth) and the covariate age of cow at calving (linear and quadratic effects). The variance components and genetic values were estimated by REML method. The genetic trend was obtained using the regression of the annual mean genetic value in relation to the year birth. The heritability estimates for the direct additive effect () for P205, P365, and P550 were equal to 0.60, 0.69, and 0.75, respectively. These coefficients showed high magnitude, indicating that the herd in question presents a great additive genetic variability and therefore it is expected a great progress using genetic selection. By the analysis of genetic trend, it was verified a development in animals genetic values over the years studied.

Incidence and predictors of bleeding or thrombosis after polypectomy in patients receiving and not receiving anticoagulation therapy.

BACKGROUND AND AIMS: To assess the effect of warfarin anticoagulation therapy (AC) on the incidence of colon bleeding after elective colonoscopy with polypectomy and to identify independent predictors of post-polypectomy colon bleeding. METHODS: This was a retrospective cohort analysis. Patients interrupting warfarin AC therapy for polypectomy (AC group) were matched on age (+/- 3 years) with up to two patients who underwent polypectomy but were not receiving AC (non-AC group). Data were extracted from electronic medical, pharmacy and laboratory claims and records and manual medical chart review. Incidence rates of colon bleeding requiring hospitalization, other gastrointestinal bleeding, thrombosis and death in the 30 days post-polypectomy were compared between groups. Multivariate regression techniques were used to identify independent predictors of post-polypectomy colon bleeding. RESULTS: A total of 425 AC group patients were matched to 800 non-AC group patients. Post-polypectomy colon bleeding occurred more often in AC group patients (2.6% vs. 0.2%, P = 0.005). There were no differences in the rates of other outcomes (P > 0.05). Independent predictors of colon bleeding included AC group status [adjusted odds ratio (AOR) = 11.6; 95% confidence interval (CI) = 2.3-57.3], number of polyps removed (AOR = 1.2; 95% CI = 1.1-1.4) and male gender (AOR = 9.2, 95% CI = 1.1-74.9). CONCLUSIONS: The incidence of post-polypectomy colon bleeding was higher in patients receiving AC even although warfarin was interrupted for the procedure. Independent predictors of colon bleeding were identified as: receiving AC, removal of multiple polyps and male gender. Our findings suggest that additional methods to reduce the likelihood of post-polypectomy colon bleeding in AC patients should be investigated.

Anxiogenic-like effects of Tagetes minuta L essential oil on T-maze and tonic immobility behaviour in domestic chicks.

In a first experiment, four doses (ranging between 0.04 and 0.45 mg/kg of body weight) of the essential oil from Tagetes minuta L. were subcutaneously injected in two-day-old chicks and a dose-response curve assessed for escape performance in a T-maze test. The 0.1, 0.25 and 0.45 mg/kg doses impaired the first escape performance suggesting an anxiogenic-like effect of the essential oil. After 3 h the same chicks were tested for a second escape performance, without being injected again, and no differences were observed compared to controls, suggesting that the essential oil did not affect retention. Furthermore, the effects of the essential oil were observed in the three sections of the T-maze apparatus. So, the performance was impaired in the isolation chamber section, suggesting the induction of increased anxiogenic behaviour, and also in the mirror section, suggesting that the social reinstatement behaviour was modified by an increased anxiety level. Changes in the principal corridor section were not observed, suggesting that the locomotor activity was not affected by these oil doses. The second escape performance was not affected in any of the T-maze sections, confirming that these doses did not affect learning ability. In a second experiment, a middle dose of the essential oil (0.25 mg/kg) increased the tonic immobility reaction in 15 days old chicks similarly to an anxiogenic dose of FG 7142 (1 mg/kg), while an anxiolytic dose of diazepam (0.08 mg/kg) did not affect this behaviour. Taken together, the present results suggest that the essential oil from Tagetes minuta L. may exert a negative modulation on the GABAergic function without affecting the learning ability.

The essential oil from Tagetes minuta L. modulates the binding of [3H]flunitrazepam to crude membranes from chick brain.

The hypothesis that the essential oil from Tagetes minuta L. can interact with biological membranes was investigated by assessing its ability of perturbing the binding of a benzodiazepine [flunitrazepam (FNTZ)] to crude members from chick brains. The essential oil from T. minuta L. inhibited [3H]FNTZ specific binding to chick brain members. These values were obtained from the analysis of the saturation curve for the kinetic parameters: dissociation equilibrium constant (Kd) = 2.47 +/- 0.32 nM, maximal binding (Bmax) = 556 +/- 5 fmoles/mg protein, and Hill coefficient (n) = 1.00 +/- 0.07 in the absence, and Kd = 6.73 +/- 1.4 nM, Bmax = 583 +/- 69 fmoles/mg protein, and n = 1.02 +/- 0.08 in the presence of 29 microgram/mL of essential oil. The essential oil could self-aggregate with a critical micellar concentration (CMC) of 60 microgram/mL. The marked increase in [3H]FNTZ nonspecific binding starting at 60 micrograms of essence per mL was due to that phenomenon and revealed the ability of self-aggregated structures to interact with members. [3H]FNTZ specific binding decrement as a function of essence concentration cannot be ascribed merely to oil's micelles ability of trapping the lipophilic radioligand molecules, because the discontinuous behavior that characterizes a monomer-aggregate phase transition was not shown. Oil's components might behave as competitive inhibitors or allosteric modulators of FNTZ specific binding. However, their ability to increase FNTZ nonspecific binding at concentrations below oil's CMC suggests that this effect may be due to oil's partitioning into the lipid bilayer. This latter phenomenon would induce an increment in membrane fluidity and a change on FNTZ binding site toward a lower affinity conformation. Therefore, the essential oil components can interact with brain membranes either as monomers, by partitioning into the lipid bilayer, or as self-aggregated structures, through an adsorption to the membrane surface.

An experimental evaluation of endodontic procedures and filling materials.

Radionuclide imaging was evaluated as a diagnostic tool in predicting the outcomes of endodontic procedures. Endodontic techniques intended to produce successful or unsuccessful results were performed on the molars of six dogs, and the effects on apical tissues were followed radiographically and by imaging over a 14-week period. Abnormally high uptake of radionuclides was observed during the first month following treatment in all teeth, regardless of the technique used. Persistent high uptake beyond that time was found to be associated with a failing course of therapy. Various root canal filling materials were also tested for their effects on bone formation in a rabbit model of healing bone. Experimental bone formation was inhibited by two commercial canal cements but not by either gutta-percha or silver points. It was tentatively concluded that the inhibitory effect of cements may serve to suppress heightened bone turnover associated with apical breakdown.

The appearances of common dental diseases on radionuclide bone images of the jaws.

Radionuclide images of hospital patients were examined for abnormal areas within the jaws. Fourteen of 25 subjects studied showed one or more abnormal image areas, most of which were attributable to common dental lesions revealed by oral examinations. The lesions detectable on images included healing bone sites, periodontal and pulpal disease, residual osteitis and irritations caused by ill-fitting dentures.

Relative accretion of 99mTc-polyphosphate by forming and resorbing bone systems in rats: its significance in the pathologic basis of bone scanning.

The relative roles of osteogenesis andd osteolysis in the production of positive radionuclide images of skeletal lesions were investigated. The uptake of 99mTc-polyphosphate (Tc-PP) by each process was measured in an animal model that permitted bone formation and resorption to be studied independently. Ten rats received intramuscular implants of bone-forming demineralized matrix (DM) and resorbing devitalized bone (DV). Radiographs and Tc-PP scintiscans were made each week thereafter. At 6-10 weeks, the implants and normal bone samples were removed, counted for 99mTc, and examined histologically. The uptake of Tc-PP BY DM implants was first detected on images made 3 weeks after implanatation, and by DV implants, 1-2 weeks later. Serial radiography showed progressive calcification of DM an resorption of DV implants. Microscopic examinations of undecalcified sections, stained with a modified Goldner preparation, revealed vital-bone formation in the DM implants and osteoclastic resorption in the DV. Activity counts per gram of DM and DV implants were, respectively, 200% and 90% that of normal bone. Since only the bone-forming system (DM) accumulated Tc-PP at greater than normal concentrations, this study indicates that positive bone images of osteolytic lesions solely reflect compensatory osteogenic responses.