Diagnostic Yield of Endoscopic Ultrasound in Common Bile Duct Dilation: A Real Breakthrough.

BACKGROUND: Endoscopic ultrasound (EUS) is important for the evaluation of patients with common bile duct (CBD) dilation. AIMS: The purpose of this study was to evaluate the diagnostic performance of EUS for CBD dilation in patients with negative initial studies. METHODS: This was a retrospective cohort study that included patients who underwent EUS for CBD dilation (≥ 7 mm if intact anatomy or ≥ 10 mm if prior cholecystectomy) in the absence of pathology on previous ultrasonography (US), computed tomography (CT), and/or magnetic resonance cholangiopancreatography (MRCP). RESULTS: A total of 109 patients were included, among whom 41 had a positive EUS: 33 choledocholithiasis (30.3%), 6 chronic pancreatitis (5.5%), and 2 ampullary cancer (1.8%). If the EUS was negative, no pathology was found during 1-year follow-up. Older age was associated with positive EUS (79 versus 71 years, p = 0.030). Patients with jaundice, cholelithiasis, and altered liver biochemistry were 16.2 (p = 0.002), 3.1 (p = 0.024), and 2.9 (p = 0.009) times more likely to have positive EUS, respectively. A total of 53 patients had a negative MRCP (48.6%); those with biliary abdominal pain and jaundice were 15.5 (p < 0.001) and 20.0 (p = 0.007) times more likely to have positive EUS, respectively. Considering asymptomatic patients with normal liver tests, CBD diameter ≥ 10 mm in US and ≥ 11 mm in CT can predict a positive EUS (AUC 0.754, p = 0.047 and AUC 0.734, p = 0.048). CONCLUSIONS: EUS is a useful diagnostic method for patients with unexplained CBD dilation, even if negative MRCP, and especially in patients with older age, abdominal pain, jaundice, cholelithiasis, and/or altered liver biochemistry. CBD diameter in US and CT had a moderate discriminative ability in predicting positive EUS in asymptomatic patients without altered liver biochemistry.

A prospective study on the efficacy of oral estrogen in female patients with acromegaly.

PURPOSE: To evaluate the efficacy and safety of oral estrogen therapy in female patients of childbearing age with uncontrolled acromegaly and to verify the significance of the presence of estrogen receptor α (ER-α) in somatotropinomas. METHODS: Prospective study in which biochemical and radiological evaluations were performed at baseline and after six months of treatment with an oral formulation of ethinyl-estradiol 0.03 mg and levonorgestrel 0.15 mg. ER-α was assessed by immunohistochemistry and immunopositivity was considered when it was present in ≥ 1% of cells. RESULTS: Eight patients with uncontrolled acromegaly were selected. All patients underwent surgery. Four patients were on octreotide LAR 30 mg, two patients were on lanreotide autogel 120 mg, and two patients had active disease after surgery. At the end of follow-up, IGF-I normalized in 3/8 (37%), 2/8 (25%) patients presented with mean IGF-I reduction of 25% but without IGF-I normalization, and 2/8 (25%) did not respond-one had a 13% increase in IGF-I and IGF-I level remained unchanged after treatment in the other. In one patient, treatment was discontinued after 3 months due to side effects (headache), with an IGF-I reduction of 28% but without normalization. Tumor volume increase (41%) was observed in only one patient (the only tumor with positive ER-α expression). CONCLUSIONS: In uncontrolled patients with acromegaly, a trial with oral estrogen can be an option for young women. Oral estrogen was well tolerated, but the somatotropinoma that presented ER-α expression was the only somatotropinoma that presented growth during treatment.

The beneficial role of exercise in mitigating doxorubicin-induced Mitochondrionopathy.

Doxorubicin (DOX) is a widely used antineoplastic agent for a wide range of cancers, including hematological malignancies, soft tissue sarcomas and solid tumors. However, DOX exhibits a dose-related toxicity that results in life-threatening cardiomyopathy. In addition to the heart, there is evidence that DOX toxicity extends to other organs. This general toxicity seems to be related to mitochondrial network structural, molecular and functional impairments. Several countermeasures for these negative effects have been proposed, being physical exercise, not only one of the most effective non-pharmacologic strategy but also widely recommended as booster against cancer-related fatigue. It is widely accepted that mitochondria are critical sensors of tissue functionality, both modulated by DOX and exercise. Therefore, this review focuses on the current understanding of the mitochondrial-mediated mechanisms underlying the protective effect of exercise against DOX-induced toxicity, not only limited to the cardiac tissue, but also in other tissues such as skeletal muscle, liver and brain. We here analyze recent developments regarding the beneficial effects of exercise targeting mitochondrial responsive phenotypes against redox changes, mitochondrial bioenergetics, apoptotic, dynamics and quality control signalling affected by DOX treatment.

Novel strategies for genomic prediction of untested single-cross maize hybrids using unbalanced historical data.

KEY MESSAGE: Weighted outperformed unweighted genomic prediction using an unbalanced dataset representative of a commercial breeding program. Moreover, the use of the two cycles preceding predictions as training set achieved optimal prediction ability. Predicting the performance of untested single-cross hybrids through genomic prediction (GP) is highly desirable to increase genetic gain. Here, we evaluate the predictive ability (PA) of novel genomic strategies to predict single-cross maize hybrids using an unbalanced historical dataset of a tropical breeding program. Field data comprised 949 single-cross hybrids evaluated from 2006 to 2013, representing eight breeding cycles. Hybrid genotypes were inferred based on their parents' genotypes (inbred lines) using single-nucleotide polymorphism markers obtained via genotyping-by-sequencing. GP analyses were fitted using genomic best linear unbiased prediction via a stage-wise approach, considering two distinct cross-validation schemes. Results highlight the importance of taking into account the uncertainty regarding the adjusted means at each step of a stage-wise analysis, due to the highly unbalanced data structure and the expected heterogeneity of variances across years and locations of a commercial breeding program. Further, an increase in the size of the training set was not always advantageous even in the same breeding program. The use of the two cycles preceding predictions achieved optimal PA of untested single-cross hybrids in a forward prediction scenario, which could be used to replace the first step of field screening. Finally, in addition to the practical and theoretical results applied to maize hybrid breeding programs, the stage-wise analysis performed in this study may be applied to any crop historical unbalanced data.

Effectiveness of contact tracing and quarantine on reducing COVID-19 transmission: a retrospective cohort study.

OBJECTIVES: Contact tracing and quarantine are common measures used in the management of infectious disease outbreaks. However, few studies have measured their impact on the control of the COVID-19 pandemic. This study aimed to assess the effectiveness of those measures on reducing transmission of severe acute respiratory syndrome coronavirus 2 in a community setting. STUDY DESIGN: The study design is a retrospective cohort study. METHODS: A retrospective cohort study of COVID-19 cases notified in Eastern Porto from March 1st to April 30th, 2020 was performed. Intervention and control cohorts were defined based on whether cases were subjected to contact tracing and quarantine measures before the laboratory confirmation of disease. The number of secondary cases per index case and the proportion of cases with subsequent secondary cases were the primary outcomes. Secondary outcomes included the time from symptom onset to specimen collection and the number of close contacts. The analysis was stratified according to whether national lockdown measures had already been implemented. RESULTS: The intervention and control cohorts comprised 98 and 453 cases, respectively. No differences were observed concerning primary outcomes. The intervention group had a shorter time between symptom onset and specimen collection (median: 3 days, interquartile range [IQR]: 1-6, vs. median: 5 days, IQR: 2-7, P-value = 0.004) and fewer close contacts (median: 0, IQR: 0-2, vs. median: 2, IQR: 1-4, P-value<0.001). The stratified analysis returned similar results. CONCLUSION: Local public health measures were effective in reducing the time between symptom onset and laboratory diagnosis and the number of close contacts per case. No effect was apparent on secondary case figures, suggesting that further measures may be required.

A field tool for the aerobic power evaluation of middle-aged female recreational runners.

This study used time to exhaustion (TTE) to predict V̇O2max in female recreational master runners. Forty-two middle-aged women (mean = 40.5 ± 5.9 years) who had trained for recreational running performed two Université de Montréal Track Tests in the facilities of the University of Barcelona (Spain). The first was performed on a treadmill (t), the second, on an athletics track (field: f). After measuring TTE and V̇O2max on the treadmill, a first-order equation was obtained to estimate fV̇O2max from fTTE. No significant difference was observed between the estimated fV̇O2max (46.5 ± 2.9 mL·kg-1·min-1) and the measured tV̇O2max (46.2 ± 5.3), with a mean value of the absolute differences of less than 8% of the tV̇O2max average. High agreement between the two V̇O2max values was also evident, as shown by the low bias of the differences and the Bland-Altman plot. The equation obtained is of interest to evaluate performance in middle-aged female recreational runners. It will allow coaches and runners to set running paces for training and could be used in training routines to determine improvements after a training program. Moreover, these tools could be used in the field to assess the physical fitness of middle-aged women, in efforts to preserve their health and physical function.

Acute lower gastrointestinal bleeding: are STRATE and BLEED scores valid in clinical practice?

AIM: Acute lower gastrointestinal bleeding (ALGIB) is a common gastroenterological emergency. Despite this, outcomes are difficult to predict. Only STRATE and BLEED scores are readily available. The aim of this study was to identify risk factors for severe ALGIB and access the validity of available scores. METHODS: Emergency consecutive admissions for ALGIB in the last 7 years were retrospectively reviewed. Severe ALGIB was defined as transfusion of ≥ 2 units of blood and/or a haematocrit decrease of ≥ 20% within the first 24 h and/or recurrent bleeding after 24 h of stability. STRATE and BLEED scores were calculated and concordance between score and respective severity outcome was accessed. RESULTS: A total of 132 patients were identified. Bleeding presented as haematochezia in 94.7% and was severe in 36.4% of cases. ALGIB was significantly more severe in patients with lower systolic (P = 0.02) and diastolic blood pressures on admission (P < 0.01), lower admission haemoglobin (P < 0.01), diverticular bleeding (P < 0.01), angioectasias (P = 0.02) and radiation colitis (P < 0.02). Severe ALGIB was associated with admission intermediate care units (P < 0.01), increased length of stay (P < 0.01) and volume of blood transfused (P < 0.01). We identified no significant association between outcomes with either the STRATE (P = 0.72) or BLEED scores (P = 0.05). CONCLUSIONS: Severe ALGIB is associated with greater length of stay, volume of blood transfusions and admission to greater level of care units. In our cohort, STRATE and BLEED scores were poor predictors of outcome.

Detection of the antiviral activity of epicatechin isolated from Salacia crassifolia (Celastraceae) against Mayaro virus based on protein C homology modelling and virtual screening.

Mayaro fever, caused by Mayaro virus (MAYV) is a sub-lethal disease with symptoms that are easily confused with those of dengue fever, except for polyarthralgia, which may culminate in physical incapacitation. Recently, outbreaks of MAYV have been documented in metropolitan areas, and to date, there is no therapy or vaccine available. Moreover, there is no information regarding the three-dimensional structure of the viral proteins of MAYV, which is important in the search for antivirals. In this work, we constructed a three-dimensional model of protein C of MAYV by homology modelling, and this was employed in a manner similar to that of receptors in virtual screening studies to evaluate 590 molecules as prospective antiviral agents. In vitro bioassays were utilized to confirm the potential antiviral activity of the flavonoid epicatechin isolated from Salacia crassifolia (Celastraceae). The virtual screening showed that six flavonoids were promising ligands for protein C. The bioassays showed potent antiviral action of epicatechin, which protected the cells from almost all of the effects of viral infection. An effective concentration (EC50) of 0.247 µmol/mL was observed with a selectivity index (SI) of 7. The cytotoxicity assay showed that epicatechin has low toxicity, with a 50% cytotoxic concentration (CC50) greater than 1.723 µmol/mL. Epicatechin was found to be twice as potent as the reference antiviral ribavirin. Furthermore, a replication kinetics assay showed a strong inhibitory effect of epicatechin on MAYV growth, with a reduction of at least four logs in virus production. Our results indicate that epicatechin is a promising candidate for further testing as an antiviral agent against Mayaro virus and other alphaviruses.

The influence of hyperbaric environment on the skeletal muscle mitochondrial energetic of rats after induced muscle contusion.

OBJECTIVE: Analyze the influence of the hyperbaric environment on skeletal muscle mitochondrial bioenergetic end-points of rats submitted to muscle contusion. METHODS: Twelve female Wistar rats were randomly assigned to three groups. All rats were submitted to muscle contusion in the right gastrocnemius through a standard protocol. The control group (C) remained under normobaric conditions without any treatment. The hyperbaric air (HB) and the hyperbaric oxygen (HBO2) groups had four sessions of HBO2 therapy 60 minutes, six, 12, 24 and 48 hours after the injury at 253.25 kPa (2.5 atmospheres absolute/ATA) with air or 100% oxygen, respectively. The animals were sacrificed 48 hours after muscle injury, and both muscles (injured and non-injured) were analyzed. Muscle mitochondrial bioenergetics and mitochondrial permeability transition pore (MPTP) susceptibility were evaluated. RESULTS: Significant differences were found in all parameters between the injured and the non-injured gastrocnemius in the C group. In the HB group, significantly better results concerning bioenergetics-related end points with complex I and II substrates where found in the right gastrocnemius, whereas in the HBO2 group the time to Vmax (time that elapsed until the faster swelling kinetics starts) was significantly higher and the swelling amplitude was significantly smaller than in other groups, which suggest a lower susceptibility to MPTP opening. CONCLUSION: The present data suggest that hyperbaric exposure, particularly with oxygen, positively modulates the efficiency of skeletal muscle mitochondria after muscle contusion.

Cortical bone analysis in a predialysis population: a comparison with a dialysis population.

This study was designed to characterize cortical bone by histomorphometry in a predialysis population, to correlate turnover, mineralization, and volume between cortical and trabecular bone, and to compare the findings with those in patients treated with maintenance dialysis. We evaluated cortical bone by histomorphometry in 16 patients with stage 3 or stage 4 chronic kidney disease and in 16 dialysis patients. Dual-energy X-ray absorptiometry (DXA) of the distal end of the forearm was performed in seven predialysis patients, and the findings correlated with histologic parameters. Predialysis patients compared with dialysis patients showed increased cortical bone thickness (p = 0.027) and decreased osteonal bone formation rate (p = 0.020) and adjusted apposition rate (p = 0.018), mainly for external cortical bone. In this predialysis population, trabecular bone volume positively correlated with external cortical porosity (r = 0.723, p = 0.003), external cortical thickness (r = 0.569, p = 0.034), and external osteonal accumulation (osteonal osteoid thickness, r = 0.530, p = 0.05; osteonal osteoid volume to bone volume ratio, r = 0.921, p < 0.001; and osteonal osteoid surface to bone surface ratio, r = 0.631, p = 0.016). These correlations were not observed in the internal cortical bone. Cortical osteonal mineralization surface negatively correlated with DXA Z and T scores and bone mineral density for the distal end of the forearm. The osteonal bone formation rate of both internal cortical bone and external cortical bone correlated with Z score (r = -0.975, p = 0.005 and r = -0.880, p = 0.021 respectively). We found no significant correlations between cortical thickness or porosity and DXA parameters for either external cortical bone or internal cortical bone. Our results suggest that a greater degree of kidney disease is associated with thinner cortices, eventually contributing to the higher fracture rate observed in the chronic kidney disease population. In predialysis patients, parathyroid hormone seems to have a modulating effect on both trabecular bone and cortical bone, particularly in external cortical bone.

Viability of Yersinia pestis subcultures in agar stabs.

UNLABELLED: Since its identification as the causative agent of plague in 1894, thousands of Yersinia pestis strains have been isolated and stored. Here, we report the ability of Y. pestis to survive up to 47 years in agar stabs, in rubber-stoppered tubes, under refrigeration (+4 to +10°C), although overall subculture recovery rates were poor and inversely related to the length of time stored. Genetic characterization of virulence gene presence among these subcultures was suggestive of significant variation in the genomic stability of Y. pestis subcultures stored under these conditions. Specifically, we found variation in the presence of plasmid and chromosomal virulence markers (genes pla, lcrV, caf1 and irp2) among multiple subcultures of Y. pestis strains in the 'Collection of Yersinia pestis' (Fiocruz-CYP) maintained by the SRP of FIOCRUZ-PE in Brazil. This variation, together with all of the inherent temporal, geographic and other genetic variation represented by all of the recoverable strains in this historical collection was preserved in new frozen culture stocks stored at -70°C as a result of this study. These frozen culture stocks represent a valuable resource for future comparative studies of Y. pestis. SIGNIFICANCE AND IMPACT OF THE STUDY: We report the ability of Yersinia pestis to survive up to 47 years in agar stabs, in rubber-stoppered tubes, under refrigeration (+4 to +10°C), although overall subculture recovery rates were poor and inversely related to the length of time stored. Genetic characterization of virulence gene presence among these subcultures was suggestive of significant variation in the genomic stability of Y. pestis subcultures stored under these conditions. This variation, together with all of the inherent temporal, geographic and other genetic variation represented by all of the recoverable strains in the historical 'Collection of Yersinia pestis' (Fiocruz-CYP) maintained by the SRP of FIOCRUZ-PE in Brazil was preserved in new frozen culture stocks stored at -70°C as a result of this study. These frozen culture stocks represent a valuable resource for future comparative studies of Y. pestis.

Genetic variability in isolates of Chromobacterium violaceum from pulmonary secretion, water, and soil.

Chromobacterium violaceum is a free-living Gram-negative bacillus usually found in the water and soil in tropical regions, which causes infections in humans. Chromobacteriosis is characterized by rapid dissemination and high mortality. The aim of this study was to detect the genetic variability among C. violaceum type strain ATCC 12472, and seven isolates from the environment and one from a pulmonary secretion from a chromobacteriosis patient from Ilhéus, Bahia. The molecular characterization of all samples was performed by polymerase chain reaction (PCR) sequencing and 16S rDNA analysis. Primers specific for two ATCC 12472 pathogenicity genes, hilA and yscD, as well as random amplified polymorphic DNA (RAPD), were used for PCR amplification and comparative sequencing of the products. For a more specific approach, the PCR products of 16S rDNA were digested with restriction enzymes. Seven of the samples, including type-strain ATCC 12472, were amplified by the hilA primers; these were subsequently sequenced. Gene yscD was amplified only in type-strain ATCC 12472. MspI and AluI digestion revealed 16S rDNA polymorphisms. This data allowed the generation of a dendogram for each analysis. The isolates of C. violaceum have variability in random genomic regions demonstrated by RAPD. Also, these isolates have variability in pathogenicity genes, as demonstrated by sequencing and restriction enzyme digestion.

PLGA Implants containing vancomycin and dexamethasone: development, characterization and bactericidal effects.

Post-operative endophthalmitis is an infection and an inflammation of the eye following a surgical procedure. Its treatment is based on drug injections into the eye. However, this treatment can lead to ocular complications. Intraocular implants could substitute the conventional therapy. Poly(lactic-co-glycolic acid) (PLGA) implants comprising on vancomycin and dexamethasone were evaluated as drug delivery system to treat endophthalmitis after cataract surgery. Implants were characterized by drug content uniformity, Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), Wide Angle X-ray Scattering (WAXS), Scanning Electron Microscopy (SEM) and in vitro drug release. The bactericidal effect of vancomycin, eluted from the implants, was demonstrated against Staphylococcus aureus and Staphylococcus epidermidis. The drugs were uniformly distributed in the polymer. The analytical techniques revealed the chemical integrity of the drugs incorporated into the polymer and the modification of dexamethasone semi-crystalline nature. Drugs were controlled released from implants; and the eluted vancomycin showed bactericidal effects. In conclusion, PLGA implants containing vancomycin and dexamethasone may represent a therapeutic alternative to treat post-operative endophthalmitis.

Effect of hydrogen sulfide sources on inflammation and catabolic markers on interleukin 1ß-stimulated human articular chondrocytes.

OBJECTIVE: Hydrogen sulfide (H2S), the third gasotransmitter together with NO and CO, is emerging as a regulator of inflammation. To test if it might offer therapeutic value in the treatment of osteoarthritis (OA) we evaluated the effects of two exogenous sources of H2S, NaSH and GYY4137, on inflammation and catabolic markers that characterize OA. METHOD: Human chondrocytes (CHs) were isolated from OA tissue. Cells were stimulated with a pro-inflammatory cytokine (interleukin-1ß, IL1ß, 5 ng/ml) and the ability of the two H2S sources to ameliorate its effects on the cells was tested. Nitric oxide (NO) production was quantified through the Griess reaction. Protein levels of inducible NO synthase (NOS2) and matrix metalloproteinase 13 (MMP13) were visualized through immunocytochemistry (ICC). Relative mRNA expression was quantified with qRT-PCR. Prostaglandin-2 (PGE-2), interleukin 6 (IL6) and MMP13 levels were measured with specific EIAs. NFκB nuclear translocation was visualized with immunofluorescence. RESULTS: Both H2S sources led to significant reductions in NO, PGE-2, IL6 and MMP13 released by the cells and at the protein level. This was achieved by downregulation of relevant genes involved in the synthesis routes of these molecules, namely NOS2, cyclooxigenase-2 (COX2), prostaglandin E synthase (PTGES), IL6 and MMP13. NFκB nuclear translocation was also reduced. CONCLUSION: NaSH and GYY4137 show anti-inflammatory and anti-catabolic properties when added to IL1ß activated osteoarthritic CHs. Supplementation with exogenous H2S sources can regulate the expression of relevant genes in OA pathogenesis and progression, counteracting IL1ß pro-inflammatory signals that lead to cartilage destruction in part by reducing NFκB activation.

Evaluation of multiplex PCR in first episodes of febrile neutropenia as a tool to improve early yeast diagnosis in leukemic/preleukemic patients.

In febrile neutropenic onco-hematological patients, delayed microbiological diagnosis leads to an increase in morbidity and mortality. Identification of the microorganism changes antibiotic therapy in more than half of cases; however, in only 20-30 % of such cases pathogen isolation is achieved. This study evaluates the frequency of fungus infection and its etiology in onco-hematological patients with febrile neutropenia utilizing blood cultures and non-commercial multiplex polymerase chain reaction (MT-PCR) primers. Fifty-three febrile neutropenia episodes in 35 onco-hematological patients were observed, and the results for the first unique 30 episodes are presented. Blood cultures were positive for Candida tropicalis (one case), gram-positive bacteria (two cases), and gram-negative bacteria (four cases), showing a 23.3 % microbiological isolation rate. Multiplex-PCR pan-fungal sequence was positive in 18 cases (60 %), and further sequencing identified fugal pathogens in 11 cases (Candida glabrata and Candida parapsilosis being the most common). MT-PCR pan-fungal sequence amplification was detected in 13 of 16 patients that later received antifungal treatment for clinical reasons only, while positivity was found in 5 out of 14 patients that did not receive antifungal treatment (p = 0.02). These results show that performing in-house non-commercial MT-PCR is feasible and may provide additional information about fungal infection without the need to wait for culture results. Further research is necessary to incorporate this technology into the decision-making process.

HLA-G 5' URR SNPs and 3' UTR 14-bp insertion/deletion polymorphism in an Afro-Brazilian population from Paraná State.

The present study investigated 23 SNPs in the 5'URR promoter region and the 14 bp ins/del polymorphism at the 3'UTR region of the HLA-G gene in 150 individuals with Afro-Brazilian ancestry. Three haplotypes were found to be the most frequent. Comparing these polymorphisms in other samples, our data suggest that Afro-Brazilians are more similar to the Euro-Brazilians than to Hutterite population.

Selection of sorghum hybrids grown under aluminum saturation.

The purpose of this study was to evaluate 165 hybrids derived from lines previously selected for aluminum (Al) tolerance. Nine check cultivars were used, eight commercial hybrids and one experimental hybrid. Hybrids were evaluated at three levels of Al saturation (0, 20 and 40% on average). The differences between the environments were significant. Environment with 0% Al saturation yielded 29.5% more than that with 40% Al saturation, showing the importance of genotype selection for acid soils. The best check cultivar was the hybrid DKB550. The hybrids AG1020 and AG1040 also performed well, where the latter was more tolerant but the former more responsive to environment improvement. The hybrid BRS304 was susceptible to high levels of Al saturation. The three commercial BRS hybrids (BRS310, BRS330 and BRS332) performed better than BRS304 at high Al saturation. The hybrid BRS330 was the best BRS hybrid to grow on a field with high Al saturation. The hybrid DKB559 performed well at high Al saturation but did not respond to environment improvement. The hybrids 727029, 727039, 729041, 729095, 729109, AG1040, and DKB550 were tolerant to higher levels of Al saturation and responsive to environment improvement, and showed good stability and adaptability at both low and high Al saturation.

[Intrauterine contraception in nulliparous women as a strategy to reduce unplanned pregnancies in Latin America]. / Anticoncepción intrauterina en mujeres nulíparas como estrategia para disminuir los embarazos no planeados en América Latina.

UNLABELLED: Due high rates of unplanned pregnancy and unsafe abortion in young women in Latin America intrauterine contraception, by its great contraceptive efficacy, should be offered by the public services of health in a more generalized way. However, some negative prejudices prevail over the perception of its benefits. The aim of this article was to explore the most relevant myths around this contraceptive method in Latin America and make a review of the literature to allay the fears of their use by young and nulliparous women. METHODS: Descriptive and retrospective study. Search for information in Embase and PubMed with emphasis on clinical randomized studies, studies of cases and controls, meta-analyses and systematic reviews which show risks and benefits of intrauterine contraception. RESULTS: Evidence shows that intrauterine contraception has few contraindications for young women and nulliparous; for this reason it must be as an effective public health strategy to reduce unplanned pregnancies and unsafe abortions. CONCLUSIONS: We identified the major barriers to the use of intrauterine contraception in Latin America and evidence for each one of them in the bibliography. Doctors of first contact in health systems should now recognize that intrauterine contraception is safe and effective.

Neuronal control of microglia through the mitochondria.

The microbial toxin ß-N-methylamino-L-alanine (BMAA), which is derived from cyanobacteria, targets neuronal mitochondria, leading to the activation of neuronal innate immunity and, consequently, neurodegeneration. Although known to modulate brain inflammation, the precise role of aberrant microglial function in the neurodegenerative process remains elusive. To determine if neurons signal microglial cells, we treated primary cortical neurons with BMAA and then co-cultured them with the N9 microglial cell line. Our observations indicate that microglial cell activation requires initial neuronal priming. Contrary to what was observed in cortical neurons, BMAA was not able to activate inflammatory pathways in N9 cells. We observed that microglial activation is dependent on mitochondrial dysfunction signaled by BMAA-treated neurons. In this scenario, the NLRP3 pro-inflammatory pathway is activated due to mitochondrial impairment in N9 cells. These results demonstrate that microglia activation in the presence of BMAA is dependent on neuronal signaling. This study provides evidence that neurons may trigger microglia activation and subsequent neuroinflammation. In addition, we demonstrate that microglial activation may have a protective role in ameliorating neuronal innate immune activation, at least in the initial phase. This work challenges the current understanding of neuroinflammation by assigning the primary role to neurons.

Occurrence and diversity of arbuscular mycorrhizal fungi in yerba mate (Ilex paraguariensis - Aquifoliaceae) cultivation environments.

Yerba mate (Ilex paraguariensis) represents a culture of economic, social, and ecological importance for the cultivation regions. Due to the chemical, physical, and biological variations that occur in the different soils where yerba mate is economically exploited, the symbiotic associations with arbuscular mycorrhizal fungi (AMF) guarantee the plant's ability to absorb nutrients. The purpose of this study was to identify and quantify the occurrence of arbuscular mycorrhizal fungi in different environments of yerba mate cultivation. The research was performed in four areas located in the rural area of the municipality of Seberi/RS: Environment with production of yerba mate in the conventional system, silvopastoral system, organic system, and native forest. The normality of residuals and homogeneity of variances assumptions were verified using the Lilliefors and Chi-square tests and the averages compared by the Tukey's test at 5% probability of error. In addition to calculations of diversity, equivalent species, and evenness indices. The presence of AMF spores showed a direct relationship with the phosphorus (P) availability in each treatment, with a count reduction in the organic system, with P content lower than 3 mg kg-1 of soil. The species with the highest predominance were the Acaulosporaceae (Acaulospora colombiana, A. delicata, and A. tuberculata), followed by the Glomaceae (Glomus ambisporum and Glomus pansihalos) in the conventional and silvopastoral systems. The silvopastoral and conventional systems showed the highest levels of Shannon-Weaver diversity (H') and Pielou's evenness, demonstrating greater diversity and consequently greater richness and uniformity.