Indoor radon risk mapping of the Canary Islands using a methodology for volcanic islands combining geological information and terrestrial gamma radiation data.

Within the framework of the recent approval of the National Plan Against Radon by the Council of Ministers of the Spanish Government, one of its five axes focuses on the delimitation of priority action areas. In line with this objective, this paper presents the indoor radon risk maps of the Canary Islands. Due to the volcanic origin of the Canary Islands, there is a great deal of geological heterogeneity in the soils on which buildings settle, making it very difficult to delimit radon-risk areas in the process of creating maps. Following a methodology developed in previous works for a study area formed of a set of representative municipalities, this paper presents radon risk maps of the Canary Islands based on lithostratigraphic information and high-resolution terrestrial gamma radiation maps. The goodness of fit of these maps is verified based on a statistical analysis of indoor radon concentration measurements carried out at representative building enclosures. In order to analyse the level of risk to the population, these maps were combined with built up areas (urban fabric) maps and estimations of the annual effective doses due to radon was obtained by applying a dosimetric model. This methodology improves the capability to delimit indoor radon risk areas, with a greater margin of safety. In this respect, it is estimated that areas classified as low risk have indoor radon concentrations 41 % below the current reference level of 300 Bq/m3 established by national regulations in compliance with the precepts laid down in the European EURATOM Directive.

Language Proficiency and Survival in Pancreatic Cancer: a Propensity Score-Matched Analysis.

BACKGROUND: Limited English proficiency has been shown to negatively affect health outcomes. However, as of now, little is known about survival rates of patients with limited English proficiency (LEP) and pancreatic ductal adenocarcinoma (PDAC) when compared to patients with English proficiency (EP) in an urban, non-safety net setting. We aimed to compare survival rates between patients with LEP and those with EP who had a diagnosis of PDAC. METHODS: A single-institution retrospective propensity-matched cohort study of patients with biopsy-proven PDAC was undertaken. Demographics, clinical characteristics, and language information were collected for all participants. Patients were classified as having LEP or EP based on their preferred speaking language at the time of admission and matched on baseline characteristics using propensity scores. Survival analysis methods were used to study survival rates in patients with PDAC based on their EP status. RESULTS: Of 739 included patients, 71 (9.48%) had LEP, mean age was 68.4 ± 10.9, and 51.8% were female. Both groups of patients were comparable for age, gender, marital status, and time to treatment. LEP status was associated with higher odds of death in both unmatched (HR 1.65, 95% CI 1.22-2.22) and matched (HR 1.60, 95% CI 1.03-2.47) analyses. Additionally, patients with LEP had significantly decreased odds of receiving cancer-directed treatment and increased odds of advanced stage cancer at presentation. CONCLUSIONS: In this cohort of patients with PDAC, LEP predicted worse survival. The results of this study suggest that, after accounting for interpreter use, other factors contribute to this disparity. Such factors, as yet unmeasured, may include health literacy and cultural expectations, for which further investigation is warranted to better understand and limit this survival disparity.

Methodology for determination of radon prone areas combining the definition of a representative building enclosure and measurements of terrestrial gamma radiation.

The recommendations of the European Atomic Energy Community (EURATOM) have recently been incorporated into Spanish regulations in the Basic Document of Health Standards of the Technical Building Code (CTE), section HS6, on protection against radon exposure. This further accentuates the need to delimit radon prone areas as a strategy to address measures which minimise the effects of this gas on the population. In this research, measurements of terrestrial gamma radiation and indoor radon of dwellings have been carried out in the same location to delimit these risk areas. A new methodology has been developed including a definition of a Representative Building Enclosure (RBE) and it is proposed a Building Storey Index (IBS) which allows normalizing measurements of indoor radon activity concentration taken in different levels from the ground to the RBE. The results show the need to consider the type of contact that exists between the building and the ground as a determining factor of radon risk. Terrestrial gamma radiation is used as a proxy for radioisotopic composition of soils to characterise the indoor radon risk at different geological formation.

Use of biometrics in the prediction of body weight in crossbred lambs / [Uso da biometria na predição do peso corporal de cordeiros mestiços]

O objetivo deste trabalho foi propor um modelo matemático para predição do peso corporal de cordeiros com base nas medidas biométricas. Foram utilizados dados de 51 cordeiros, com composição genética de pelo menos 50% da raça Santa Inês. O peso corporal (PC) dos animais foi acompanhado durante 91 dias por meio de pesagens semanais. Após as pesagens, foram tomadas as medidas: altura anterior (AA); altura posterior (AP); comprimento corporal (CC); largura de peito (LP); largura de garupa (LG); perímetro torácico (PT) e perímetro de barril (PB). Essas medidas foram utilizadas como variáveis de entrada do modelo. Foi observado correlações positivas e significativas (P<0,05) entre todas as variáveis biométricas com o PC. No entanto, o PC apresentou uma alta correlação com o PT (0,836), seguido do PB (0,818) e AP (0,740). Dessa forma, essas três medidas foram significativas para estimativa do PC. Portanto, o modelo para predizer o PC dos cordeiros foi: Peso (kg)=0,4455* PT - 0,5794 * PB + 0,0019 * AP2 + 0.0053* PB2. O perímetro torácico, perímetro de barril e altura de posterior podem ser utilizados como variáveis preditoras do peso corporal em ovinos mestiços, independente do sexo.(AU)

Step by step optimization of a sperm cryopreservation protocol for spotted wolffish (Anarhichas minor Olafsen, 1772).

Spotted wolffish Anarhichas minor reproduction in captivity is dependent on in vitro fertilization. However, low sperm volume with relatively low cell concentration and the lack of gametes synchronization (simultaneous availability of mature eggs and sperm) represent a challenge for the industry. Thus, the development of protocols for sperm storage are crucial. Four sequential experiments were conducted to optimize a sperm cryopreservation protocol for this species. First, three different cryoprotectants (DMSO; 1, 2-propanediol; and methanol) at different concentrations (5, 10, and 20%) were tested for their toxicity. No significant differences (p > 0.05) were detected between the control samples and cryoprotectants at concentration up to 10% DMSO, 10% propanediol, and 20% methanol in terms of motility parameters. Second, using the highest non-toxic concentrations of cryoprotectants, sperm was cryopreserved in 0.5 mL straws, at different distances from the liquid nitrogen (1.5, 2.5, 4.5, and 7.5 cm) that correspond to different freezing rates. Motility parameters after freezing/thawing decreased for all the cryoprotectants (p < 0.001), however, methanol had the lowest protective capacity while DMSO the highest. Afterwards, two different thawing rates (1 min at 5 °C; and 25 s at 10 °C) were tested using only 10% DMSO and 10% propanediol. Both for the DMSO and propanediol, there were no significant differences (p > 0.05) between the two thawing rates. The best results were obtained using 10% DMSO. Finally, the fertilization capacity of cryopreserved sperm (10% DMSO and thawed at 5 °C for 1 min) was tested against fresh sperm using two spermatozoa:egg ratios and 4 h gametes contact time. The ratio of eggs with normal cell cleavage, abnormal cleavage or undeveloped were counted at the 2-4 cell stage. Cryopreserved sperm showed lower fertilization capacity at a concentration of 5 × 104 spermatozoa:egg compared with fresh sperm (p < 0.001). At a concentration of 5 × 105 spermatozoa:egg, similar fertilizations rates to the fresh sperm were obtained. The presence of the cryoprotectant DMSO during the 4 h contact time did not affect the fertilization rate or the percentage of embryos with abnormal cleavage (p > 0.05). To cryopreserve spotted wolffish sperm it is recommended to use 10% DMSO, loaded in 0.5 mL straws, freeze at a height between 4.5 (-14.05 °C/min) and 7.5 cm (-5.9 °C/min) from liquid nitrogen for 10 min and thaw for 1 min at 5 °C (177.9 °C/min). In vitro fertilization with cryopreserved sperm should be performed with a concentration of at least 5 × 105 spermatozoa per egg.

Tratamiento quirúrgico o conservador para fracturas de cóndilo mandibular / Surgical or conservative treatment for mandibular condyle fractures

INTRODUCCIÓN: Las fracturas maxilofaciales se asocian a importante morbilidad, pérdida de función y secuelas estéticas, entre otros. Dentro de las fracturas mandibulares, las fracturas de cóndilo mandibular son las más frecuentes. Estas pueden ser tratadas mediante un tratamiento quirúrgico (reducción abierta más estabilización con miniplacas de titanio) o un tratamiento conservador (ortopédico). MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos ocho revisiones sistemáticas que en conjunto incluyen 66 estudios primarios, de los cuales, seis corresponden a ensayos aleatorizados. Concluimos que, en comparación con el tratamiento conservador, el tratamiento quirúrgico en fracturas de cóndilo mandibular probablemente se asocia a menor dolor articular, menor maloclusión y menor desviación lateral en apertura bucal.

INTRODUCTION: Maxillofacial fractures are associated with significant morbidity, loss of function and aesthetic sequelae, among others. Within mandibular fractures, mandibular condylar fractures are the most frequent. These can be treated by surgical treatment or conservative treatment (orthopedic). METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified eight systematic reviews including 66 primary studies overall, of which six were randomized trials. We concluded surgical treatment of mandibular condyle fractures, compared to conservative treatment, is probably associated with less joint pain, less malocclusion and less lateral deviation in buccal opening.

PAI-1 gain-of-function genotype, factors increasing PAI-1 levels, and airway obstruction: The GALA II Cohort.

BACKGROUND: PAI-1 gain-of-function variants promote airway fibrosis and are associated with asthma and with worse lung function in subjects with asthma. OBJECTIVE: We sought to determine whether the association of a gain-of-function polymorphism in plasminogen activator inhibitor-1 (PAI-1) with airway obstruction is modified by asthma status, and whether any genotype effect persists after accounting for common exposures that increase PAI-1 level. METHODS: We studied 2070 Latino children (8-21y) with genotypic and pulmonary function data from the GALA II cohort. We estimated the relationship of the PAI-1 risk allele with FEV1/FVC by multivariate linear regression, stratified by asthma status. We examined the association of the polymorphism with asthma and airway obstruction within asthmatics via multivariate logistic regression. We replicated associations in the SAPPHIRE cohort of African Americans (n=1056). Secondary analysis included the effect of the at-risk polymorphism on postbronchodilator lung function. RESULTS: There was an interaction between asthma status and the PAI-1 polymorphism on FEV1 /FVC (P=.03). The gain-of-function variants, genotypes (AA/AG), were associated with lower FEV1 /FVC in subjects with asthma (ß=-1.25, CI: -2.14,-0.35, P=.006), but not in controls. Subjects with asthma and the AA/AG genotypes had a 5% decrease in FEV1 /FVC (P<.001). In asthmatics, the risk genotype (AA/AG) was associated with a 39% increase in risk of clinically relevant airway obstruction (OR=1.39, CI: 1.01, 1.92, P=.04). These associations persisted after exclusion of factors that increase PAI-1 including tobacco exposure and obesity. CONCLUSIONS AND CLINICAL RELEVANCE: The decrease in the FEV1 /FVC ratio associated with the risk genotype was modified by asthma status. The genotype increased the odds of airway obstruction by 75% within asthmatics only. As exposures known to increase PAI-1 levels did not mitigate this association, PAI-1 may contribute to airway obstruction in the context of chronic asthmatic airway inflammation.

Germinação in vitro de Hyptis leucocephala Mart. ex Benth. e Hyptis platanifolia Mart. ex Benth. / In vitro germination of Hyptis leucocephala Mart. ex Benth. and Hyptis platanifolia Mart. ex Benth

Hyptis leucocephala e Hyptis platanifolia (Lamiaceae) são espécies aromáticas endêmicas do semiárido nordestino e possuem grande importância econômica devido ao seu potencial medicinal. O presente trabalho teve por objetivo obter o protocolo para o estabelecimento inicial in vitro das espécies H. leucocephala e H. platanifolia. O meio de cultura WPM promoveu a maior porcentagem de germinação (96,81%) para H. leucocephala, porém não diferiu estatisticamente dos resultados obtidos no MS½ na última semana de cultivo. Para a germinação de sementes de H. platanifolia, o MS½ foi o meio que proporcionou a maior porcentagem (40,83%). O tipo de esterilização não interferiu na germinação in vitro para as duas espécies. Para a espécie H. platanifolia, quando se utilizou o fechamento dos tubos de ensaio com tampão de algodão, a hiperidricidade foi eliminada; porém, a porcentagem de germinação das sementes foi menor. Avaliando-se o tipo de meio de cultura no crescimento in vitro de H. leucocephala observou-se que este fator não influenciou no número de brotações, nem o comprimento de parte aérea e da matéria seca de raiz. O meio MS proporcionou incremento para o número de folhas, matéria seca da parte aérea, e comprimento da maior raiz, enquanto o meio MS½ foi o que promoveu maior número de raízes. O meio de cultura ideal para a germinação de H. leucocephala e H. platanifolia foi o MS½, podendo ser esterilizado com hipoclorito de sódio, enquanto que o MS foi o melhor meio de cultura para o crescimento in vitro de H. leucocephala.

The Hyptis leucocephala and Hyptis platanifolia (Lamiaceae) are aromatic species, endemic to the Brazilian Semiarid northeast, and they have great economic importance becaude of their pharmacological potential. This study aimed to obtain the protocol for the in vitro establishment of H. leucocephala and H. platanifolia plants. The WPM promoted higher germination percentage (96.81%) for H. leucocephala, but there was no difference between the results obtained in ½MS, in the last week of cultivation. For the germination of H. platanifolia, ½MS was the one that provided the highest percentage (40.83%). The type of sterilization did not affect the in vitro germination of both species. For the H. platanifolia species, when we closed the tubes with a cotton plug, hyperhydricity was eliminated, but the percentage of seed germination was the lowest one. Evaluating the type of culture medium on the in vitro growth of H. leucocephala, it did not influence the number of shoots, length of shoot or root dry matter. The MS medium promoted an increase of the number of leaves, dry shoot and longest root length, and the ½MS medium was more suitable for root induction. The optimal culture medium for the germination of H. leucocephala and H. platanifolia is ½MS, as it can be sterilized with sodium hypochlorite, while the MS was the best culture medium for the in vitro growth of H. leucocephala.

Indução, caracterização bioquímica e ultra-estrutural de calos de aroeira-do-sertão (Myracrodruon urundeuva Fr. All. ) / Induction, biochemical and ultrastructural characterization of the callus of "aroeira-do-sertão" (Myracrodruon urundeuva Fr. All. )

A aroeira-do-sertão (Myracrodruon urundeuva Fr. All.) é espécie arbórea que apresenta grande valor econômico devido às propriedades químicas da casca com elevado teor de taninos. Em decorrência da exploração predatória encontra-se inserida na lista oficial de espécies da flora brasileira ameaçadas de extinção na categoria vulnerável. A micropropagação vem sendo colocada como importante forma de multiplicação dessa espécie, na busca de alternativa para a exploração sustentável. Este trabalho foi realizado com o objetivo de induzir calos a partir de segmentos foliares usando 2,4-D e caracterizá-los quanto aos aspectos morfológicos e bioquímicos. Os resultados obtidos indicam que é possível induzir calos a partir de segmentos foliares de aroeira-do-sertão utilizando-se 2,4-diclorofenoxiacético (2,4-D). Os calos obtidos foram compactos e não-embriogênicos, apresentando valores médios de 43,32 mg g-1 de açúcares solúveis totais; 23,62 mg g-1 de açúcares redutores; 3,157 mg g-1 de proteína total; 3,147 mg g-1 de aminoácidos livres e 0,914 mg g-1 de compostos fenólicos totais na matéria fresca.

"Aroeira-do-sertão" (Myracrodruon urundeuva Fr. All.) is a tree species that has great economic value due to the chemical properties of its bark, which has high tannin content. On account of the predatory exploitation it has been placed in the official list of threatened species of the Brazilian flora, in the vulnerable category. Micropropagation has been considered an important form of multiplication of this species in the search for an alternative for its sustainable exploitation. This study was conducted with the aim of inducing callus from leaf segments using 2,4-D and characterizing them according to their morphological and biochemical aspects. The obtained results indicate that it is possible to induce callus from leaf segments of M. urundeuva using 2,4-dichlorophenoxyacetic (2,4-D). The obtained calluses were compact and non-embryogenic, with average values of 43.32 mg g-1 total soluble sugars, 23.62 mg g-1 reducing sugars, 3.157 mg g-1 total protein, 3.147 mg g-1 free-form amino acids and 0.914 mg g-1 phenolic compounds in the fresh matter.

Dormancy break in seeds of quina (Strychnos pseudoquina A. St.-Hil.) / Superação da dormência de sementes de quina (Strychnos pseudoquina A. St.-Hil.)

"Quina" (Strychnos pseudoquina A. St. Hil) is a medicinal plant species from the Brazilian Cerrado. As its seeds show dormancy, they were subjected to the treatments pre-cooling at 5ºC during 7 days, pre-heating at 40ºC during 7 days, pre-soaking in sulfuric acid PA during 5 and 15 min, pre-soaking in boiling water during 5 and 15 min, pre-soaking in 100 and 200 ppm gibberellic acid during 48 h, pre-soaking in distilled water during 24 and 48 h, and mechanical scarification to break dormancy. Counts were daily conducted from the 2nd day after the experiment implementation until the germination stabilization at the 65th day. The germination speed index (GSI) and the germination percentage were evaluated. Germination rates above 96 percent were reached in seeds pre-soaked in water during 48 h and substrate moistened with water or KNO3.

A quina (Strychnos pseudoquina A. St.-Hil) é espécie medicinal do Cerrado Brasileiro. As sementes apresentam dormência e, por isso, foram submetidas aos tratamentos pré-resfriamento a 5ºC durante 7 dias, pré-aquecimento a 40ºC durante 7 dias, pré-embebição em ácido sulfúrico P.A. durante 5 e 15 minutos, pré-embebição em água fervente durante 5 e 15 minutos, pré-embebição em ácido giberélico a 100 e 200 ppm, durante 48 horas, pré-embebição em água destilada durante 24 e 48 horas e escarificação mecânica, visando à superação da dormência. Foram realizadas contagens diárias entre o 2º dia após a implantação do experimento até a estabilização da germinação, que ocorreu no 65º dia. Foram avaliados o índice de velocidade de germinação (IVG) e a porcentagem de germinação. Taxas de germinação acima de 96 por cento foram atingidas em sementes pré-embebidas em água durante 48 horas e substrato umedecido com água ou KNO3.

Antidipsogenic effects of central adenosine-5'-triphosphate.

Besides other physiological functions, adenosine-5'-triphosphate (ATP) is also a neurotransmitter that acts on purinergic receptors. In spite of the presence of purinergic receptors in forebrain areas involved with fluid-electrolyte balance, the effect of ATP on water intake has not been investigated. Therefore, we studied the effects of intracerebroventricular (icv) injections of ATP (100, 200 and 300 nmol/microL) alone or combined with DPCPX or PPADS (P1 and P2 purinergic antagonists, respectively, 25 nmol/microL) on water intake induced by water deprivation. In addition, the effect of icv ATP was also tested on water intake induced by intragastric load of 12% NaCl (2 mL/rat), acute treatment with the diuretic/natriuretic furosemide (20 mg/kg), icv angiotensin II (50 ng/microL) or icv carbachol (a cholinergic agonist, 4 nmol/microL), on sodium depletion-induced 1.8% NaCl intake, and on food intake induced by food deprivation. Male Holtzman rats (280-320 g, N = 7-11) had cannulas implanted into the lateral ventricle. Icv ATP (300 nmol/microL) reduced water intake induced by water deprivation (13.1 +/- 1.9 vs saline: 19.0 +/- 1.4 mL/2 h; P < 0.05), an effect blocked by pre-treatment with PPADS, but not DPCPX. Icv ATP also reduced water intake induced by NaCl intragastric load (5.6 +/- 0.9 vs saline: 10.3 +/- 1.4 mL/2 h; P < 0.05), acute furosemide treatment (0.5 +/- 0.2 vs saline: 2.3 +/- 0.6 mL/15 min; P < 0.05), and icv angiotensin II (2.2 +/- 0.8 vs saline: 10.4 +/- 2.0 mL/2 h; P < 0.05), without changing icv carbachol-induced water intake, sodium depletion-induced 1.8% NaCl intake and food deprivation-induced food intake. These data suggest that central ATP, acting on purinergic P2 receptors, reduces water intake induced by intracellular and extracellular dehydration.

Antidipsogenic effects of central adenosine-5'-triphosphate

Besides other physiological functions, adenosine-5'-triphosphate (ATP) is also a neurotransmitter that acts on purinergic receptors. In spite of the presence of purinergic receptors in forebrain areas involved with fluid-electrolyte balance, the effect of ATP on water intake has not been investigated. Therefore, we studied the effects of intracerebroventricular (icv) injections of ATP (100, 200 and 300 nmol/µL) alone or combined with DPCPX or PPADS (P1 and P2 purinergic antagonists, respectively, 25 nmol/µL) on water intake induced by water deprivation. In addition, the effect of icv ATP was also tested on water intake induced by intragastric load of 12 percent NaCl (2 mL/rat), acute treatment with the diuretic/natriuretic furosemide (20 mg/kg), icv angiotensin II (50 ng/µL) or icv carbachol (a cholinergic agonist, 4 nmol/µL), on sodium depletion-induced 1.8 percent NaCl intake, and on food intake induced by food deprivation. Male Holtzman rats (280-320 g, N = 7-11) had cannulas implanted into the lateral ventricle. Icv ATP (300 nmol/µL) reduced water intake induced by water deprivation (13.1 ± 1.9 vs saline: 19.0 ± 1.4 mL/2 h; P < 0.05), an effect blocked by pre-treatment with PPADS, but not DPCPX. Icv ATP also reduced water intake induced by NaCl intragastric load (5.6 ± 0.9 vs saline: 10.3 ± 1.4 mL/2 h; P < 0.05), acute furosemide treatment (0.5 ± 0.2 vs saline: 2.3 ± 0.6 mL/15 min; P < 0.05), and icv angiotensin II (2.2 ± 0.8 vs saline: 10.4 ± 2.0 mL/2 h; P < 0.05), without changing icv carbachol-induced water intake, sodium depletion-induced 1.8 percent NaCl intake and food deprivation-induced food intake. These data suggest that central ATP, acting on purinergic P2 receptors, reduces water intake induced by intracellular and extracellular dehydration.

The diagnostic usefulness of AUDIT and AUDIT-C for detecting hazardous drinkers in the elderly.

We compare the diagnostic usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT alcohol consumption questions (AUDIT-C) for detecting hazardous drinkers between the populations over and less than 65 years in primary care settings. To assess weekly alcohol intake an interview on quantity-frequency was administered to 602 patients. Hazardous drinking was defined as a level of consumption of 280 g of alcohol per week for men and 168 g for women. The participants received AUDIT, AUDIT-C and CAGE questionnaires. Gamma-glutamyltransferase (GGT), mean corpuscular volume (MCV), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were also determined. Average weekly alcohol intake among the population aged 65 and older was 83 g, and 10% were hazardous drinkers. In this age group, the sensitivities of AUDIT and AUDIT-C for detecting this type of drinkers were 67% and 100%, whereas specificities were 95% and 81% respectively. In the younger patient group, the sensitivities were 84% and 100% and the specificities 95% and 79% respectively. In conclusion, both AUDIT and AUDIT-C perform well at detecting hazardous drinkers in the group older than 65 years and that their sensitivities and specificities are comparable to those in younger ages.

Assessment of pulmonary function in patients before and after laparoscopic and open esophagogastric surgery.

BACKGROUND: Laparoscopy is a technique used in various surgical procedures. Few studies in the literature compare stress between laparoscopic and open surgery used for esophagogastric surgical procedures. Pulmonary function is known to be significantly affected in open surgeries, increasing postoperative morbidity and mortality. The current study aimed to assess pulmonary function in patients before and after open and laparoscopic esophagogastric surgery. METHODS: For this study, 75 patients were divided into two groups: 50 patients undergoing laparoscopy and 25 patients undergoing open surgery. The following parameters were determined by spirometry before and after surgery: forced expiratory volume in the first second (FEV(1)), forced vital capacity (FVC), and forced expiratory flow in the midexpiratory phase (FEF(25-75%)). RESULTS: A decrease in FEV(1,) FVC, and FEF((25-75%)) was observed in the two groups on postoperative days 2, 3, and 4, as compared with the preoperative period. Likewise, FEV(1) and FVC showed a significant reduction on postoperative days 2, 3, and 4 in the patients who underwent to open surgery, but only on the day 2 in those who underwent to laparoscopic surgery. A significant decrease in FEF((25-75%)) was observed only on postoperative day 2 in the group that underwent open surgery. Significant differences in FEV(1) between the groups were observed on postoperative days 2, 3, and 4. No significant difference in FVC was noted between the groups, and a difference in FEF((25-75%)) was observed only on postoperative day 4. CONCLUSIONS: Postoperative pulmonary dysfunction was more important for the patients undergoing open surgery than for those undergoing laparoscopic surgery.

Clinical challenges and controversies in the management of HIV/HCV-coinfected individuals

The natural history of HIV infection has been dramatically changed by the highly active antiretroviral therapies, reducing complications, morbidity and mortality of the disease. Approximately 25% of persons infected with HIV are co-infected with hepatitis C, and some high risk populations have a prevalence of HCV of more than 75%. Liver disease has become one of the principal causes of morbidity and mortality in this population. Co-infection increases viremia of hepatitis C, with increase in fibrosis progression, cirrhosis and death related to hepatitis C. The permanent state of chronic immune activation related to the persistent hepatitis C virus favors transcription of HIV in infected cells and causes a more rapid destruction of T4 and absolute lymphocytes. In addition, the immunologic response after the start of highly active antiretroviral therapy for HIV is less than in mono-infected patients. The role of liver biopsy in the management of co-infected patients is controversial. Many of these patients, even with normal transaminases, show fibrosis in liver biopsy. Predictive factors for advanced fibrosis include male sex, alcohol consumption in excess of 50 grams per day, age over 35, and HIV infection of more than 15 years with CD4 lymphocytes less than 400/ mm3. The treatment of hepatitis C is limited and sustained viral response is less than 30% for genotypes 1 and 4. This response is even less in the more advanced stages of HIV and hepatitis C. The determination of when to start treatment and the increased toxicity when combining pegylated interferon plus ribavirin and antiretroviral medications makes the management of these patients more difficult. The development of more potent, safe and tolerated medications is required. Management strategies for patients unresponsive to conventional therapy are geared towards improving liver histology and delaying progression to cirrhosis, hepatocellular cancer and liver transplantation.

Intracellular studies of the nucleoside reverse transcriptase inhibitor active metabolites: a review.

Nucleoside reverse transcriptase inhibitors (NRTIs) plasma concentrations do not correlate with clinical efficacy or toxicity. These agents need to be phosphorylated to become active against HIV-infection. Thus, the characterization of the NRTIs intracellular metabolite pharmacological parameters will provide a better understanding that could lead to the development of more rational dose regimens in the HIV-infected population. Furthermore, intracellular measurements of NRTIs may provide a better marker with respect to clinical efficacy and toxicity than plasma concentrations. Thus, in this article we review the latest information regarding the intracellular pharmacological parameters of zidovudine (ZDV) and lamivudine (3TC) active metabolites in HIV-infected patients including the results from our recent clinical studies. We will start the discussion with ZDV and 3TC clinical efficacy, followed by systemic pharmacokinetics studies. We will then discuss the in vitro and in vivo intracellular studies with particular emphasis in the method development to measure these metabolites and we will conclude with the most current data from our clinical trials.

Solubilization of delipidated macrophage membrane proteins for analysis by two-dimensional electrophoresis.

Two-dimensional electrophoresis of proteins is often precluded due to the lack of solubilization of cell membrane extracts in an aqueous medium. Various additives and detergents have been used to circumvent the problem, but their efficacy may not be satisfactory. In this study, the removal of lipidic components of the cell membrane extract with chloroform-methanol was used to achieve solubilization. Optimal delipidation was obtained with acetone washings. This procedure increased solubilization of membrane proteins from a murine macrophage cell line, thus showing a substantial improvement in gel resolution. The two-dimensional gels loaded with delipidated extract proved to be free of smearing and horizontal streaking. In addition, other protein spots were revealed that were not detected in the gels loaded with undelipidated cell membrane extract.

[Systemic talc granulomatosis in a HIV-negative intravenous drug addict]. / Correlação anátomo-clínica: granulomatose sistêmica por talco em drogadicto HIV negativo.

Anatomo-pathological correlation in a case of systemic talc granulomatosis affecting lungs, pleura, liver, spleen and mesenteric lymph nodes resulting in pulmonary arterial hypertension and cor pulmonale is described. The patient, a 26-year-old male HIV-negative intravenous drug addict had no lymphopenia or any histopathologic findings at necroscopy compatible with AIDS, despite of a chronic high-risk behavior favoring this illness.