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INTRODUCTION: Procurement practices across organ procurement organizations (OPOs) for donation after cardiac death (DCD) transplants have not been evaluated. METHODS: A national telephone survey of all 58 OPOs inquiring about their procurement practices of DCD organs was conducted. Policies concerning maximum donor body mass index (BMI), location of care withdrawal, pre-mortem heparin administration, vasodilator use, wait times after declaration of death before incisions, inclinations between rapid laparotomy and pre-mortem cannulation, and maximum time before aborting DCD procurement were queried. RESULTS: The survey revealed substantial differences across OPOs. Donor BMI restriction was considered by 36 of 58 OPOs, and 23 sites preferred OR for donor withdrawal of care. Pre-mortem heparin was utilized by 53 OPOs. Only 2 recommended vasodilators. Minimum wait time of 5-minutes was implemented by 41 OPOs. Rapid laparotomy was preferred by 57 organizations. 28 OPOs had a 90-minute limit before aborting DCD procurement. CONCLUSION: There are substantial variations across OPO protocols for procuring DCD organs. Current practices do not conform to ASTS guidelines for DCD procurement. Further investigations are needed to quantify the impact of OPO policies on transplant outcomes.
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Obtención de Tejidos y Órganos , Muerte , Humanos , Políticas , Estándares de Referencia , Donantes de TejidosRESUMEN
We report a 41-year-old man with HIV and a chronic obstructive pulmonary disease, treated for seven months with Fluticasone/Salmeterol and antiretroviral therapy (Lamivudine, Tenofovir, Atazanavir and Ritonavir). While using these medications, the patients developed a Cushing syndrome in a period of five months. After performing laboratory and imaging tests, it was concluded that the most probable cause of the syndrome was the interaction of inhaled steroids with Ritonavir. After discontinuing these medications the syndrome reverted in a period of 8 months.
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Broncodilatadores/efectos adversos , Síndrome de Cushing/inducido químicamente , Fluticasona/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/efectos adversos , Xinafoato de Salmeterol/efectos adversos , Adulto , Broncodilatadores/uso terapéutico , Síndrome de Cushing/diagnóstico , Interacciones Farmacológicas , Fluticasona/uso terapéutico , Inhibidores de la Proteasa del VIH/uso terapéutico , Humanos , Masculino , Nebulizadores y Vaporizadores , Xinafoato de Salmeterol/uso terapéuticoRESUMEN
The hydrobiological diversity in the basin depends on biotic and abiotic factors. A predictive model of hydrobiological diversity for periphyton and macrobenthos was developed through multiple linear regression analysis (MLRA) based on the physicochemical parameters of water (PPW) and metal content in sediments (MCS) from eight monitoring stations in the Asana-Tumilaca Basin during the dry and wet seasons. The electrical conductivity presented values between 47.9 and 3617 µS/cm, showing the highest value in the Capillune River due to the influence of geothermal waters. According to Piper's diagram, the water in the basin had a composition of calcium sulfate and calcium bicarbonate-sulfate. According to the Wilcox diagram, the water was found to be between good and very good quality, except for in the Capillune River. The Shannon-Wiener diversity indices (H') were 2.62 and 2.88 for periphyton, and 2.10 and 2.44 for macrobenthos, indicating moderate diversity; for the Pielou's evenness index (J'), they were 0.68 and 0.70 for periphyton, and 0.68 and 0.59 for macrobenthos, indicating similar equity, in the dry and wet seasons, respectively, for both indices. In the model there were three cases, where the first two cases only worked with PPW or MCS, and case 3 worked with PPW and MCS. For case 3, the predicted values for H' and J' of periphyton and macrobenthos concerning those observed presented correlation coefficients of 0.7437 and 0.6523 for periphyton and 0.9321 and 0.8570 for macrobenthos, respectively, which were better than those of cases 1 and 2. In addition, principal component analysis revealed that the As, Pb, and Zn contents in the sediments negatively influenced the diversity, uniformity, and richness of the macrobenthos. In contrast, Cu and Cr had positive impacts because of the adaptation processes.
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Morbidity and mortality from COVID-19 is due to severe inflammation and end-organ damage caused by a hyperinflammatory response. Multiple immunomodulatory agents to attenuate this response have been studied. Corticosteroids, specifically dexamethasone, have been shown to reduce mortality in hospitalized patients who require supplemental oxygen. Interleukin-6 antagonist, tocilizimab, and Janus kinase inhibitors have also been shown to reduce mortality. However, patients who have severe pulmonary end-organ damage requiring mechanical ventilation or extracorporeal membrane oxygenation appear not to benefit from immunomodulatory therapies. This highlights the importance of appropriate timing to initiate immunomodulatory therapies in the management of severe COVID-19 disease.
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COVID-19 , Neumonía , Humanos , Agentes Inmunomoduladores , SARS-CoV-2 , PulmónRESUMEN
The association with Azospirillum brasilense promotes better growth and development in corn plants due to biological N fixation, the capacity to help in the synthesis of phytohormones and to improve the use of nutrients by crop plants. However, there aren't specific recommendations for the use of inoculation in baby corn crop. Thus, this study aimed to evaluate the effects of seed inoculation with A. brasilense, associated with nitrogen fertilization management, on the agronomic performance and chemical quality of baby corn grown in three summer growing seasons (2014/2015; 2015/2016 and 2016/2017). The evaluated treatments consisted of combination of five levels of seed inoculation (0.0, 50, 100, 150 and 200 mL 60,000 seeds-1) based on Azospirillum brasilense, two levels of nitrogen fertilization at sowing time (0.0 and 30.0 kg of N ha-1) and two levels of nitrogen in topdressing (0.0 and 110.0 kg of N ha-1), applied at the V4 stage of the popcorn hybrid IAC 125. The characteristics evaluated were: leaf area index (LAI), leaf nitrogen content (LNC), total husked spikelets yield (HSY) and commercial spikelets yield (CSY), and the chemical characteristics of the commercial spikelets: crude protein content (CPC), starch content (STC) and total sugar content (TSC). The inoculation, when combined with nitrogen fertilization, provided positive responses for LAI and provided an average increment of 6 kg ha-1 to CSY for every 10 mL 60,000 seeds-1 of inoculant added to the seeds. The LNC, CPC, STC and TSC weren't affected by seed inoculation. Nitrogen fertilization provided increments for all characteristics evaluated, except for TSC, which was negatively affected by nitrogen topdressing. The baby corn crop responded positively to seed inoculation with Azospirillum brasilense, combined with Nitrogen fertilization.
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While CD8+ T cells are clearly important in controlling virus replication during HIV and SIV infections, the mechanisms underlying this antiviral effect remain poorly understood. In this study, we assessed the in vivo effect of CD8+ lymphocyte depletion on the lifespan of productively infected cells during chronic SIVmac239 infection of rhesus macaques. We treated two groups of animals that were either CD8+ lymphocyte-depleted or controls with antiretroviral therapy, and used mathematical modeling to assess the lifespan of infected cells either in the presence or absence of CD8+ lymphocytes. We found that, in both early (day 57 post-SIV) and late (day 177 post-SIV) chronic SIV infection, depletion of CD8+ lymphocytes did not result in a measurable increase in the lifespan of either short- or long-lived productively infected cells in vivo. This result indicates that the presence of CD8+ lymphocytes does not result in a noticeably shorter lifespan of productively SIV-infected cells, and thus that direct cell killing is unlikely to be the main mechanism underlying the antiviral effect of CD8+ T cells in SIV-infected macaques with high virus replication.
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Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Citotoxicidad Inmunológica , Síndrome de Inmunodeficiencia Adquirida del Simio/inmunología , Síndrome de Inmunodeficiencia Adquirida del Simio/virología , Replicación Viral/inmunología , Animales , Quimiocinas/sangre , Activación de Linfocitos/inmunología , Macaca mulatta , Modelos Teóricos , Virus de la Inmunodeficiencia de los Simios/fisiología , Carga Viral/inmunologíaRESUMEN
BACKGROUND: Mucormycosis is a life-threatening invasive fungal infection most commonly observed in immunocompromised patients. Throughout the COVID-19 pandemic, a growing number of Mucorales associated infections, now termed COVID-19 associated mucormycosis (CAM), have been reported. Despite an increase in fatality reports, no cases of rhino-orbital CAM complicated with gangrenous bone necrosis have been described in the literature to date. CASE: A 56-year-old male with a recent COVID-19 diagnosis developed rhino-orbital mucormycosis after 22 days of treatment with dexamethasone. Cultures and histopathological assessment of tissue biopsy confirmed the diagnosis. The patient survived after treatment with amphotericin B. CONCLUSIONS: Mucormycosis is an invasive fungal infection affecting mostly immunocompromised patients. Along with the COVID-19 pandemic, the inappropriate use of steroids, in addition to concurrent risk factors, such as diabetes, has led to an increase in the occurrence of these devastating mycoses, leading to the development of severe presentations and complications, as observed in many cases. Early diagnosis and prompt treatment are crucial in order to avoid dissemination and fatal outcomes.
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With the recent breakthrough in genetically expressed voltage indicators (GEVIs), there has been a tremendous demand to determine the capabilities of these sensors in vivo. Novel voltage sensitive fluorescent proteins allow for direct measurement of neuron membrane potential changes through changes in fluorescence. Here, we utilized ArcLight, a recently developed GEVI, and examined the functional characteristics in the widely used mouse somatosensory whisker pathway. We measured the resulting evoked fluorescence using a wide-field microscope and a CCD camera at 200 Hz, which enabled voltage recordings over the entire cortical region with high temporal resolution. We found that ArcLight produced a fluorescent response in the S1 barrel cortex during sensory stimulation at single whisker resolution. During wide-field cortical imaging, we encountered substantial hemodynamic noise that required additional post hoc processing through noise subtraction techniques. Over a period of 28 days, we found clear and consistent ArcLight fluorescence responses to a simple sensory input. Finally, we demonstrated the use of ArcLight to resolve cortical S1 sensory responses in the awake mouse. Taken together, our results demonstrate the feasibility of ArcLight as a measurement tool for mesoscopic, chronic imaging.
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[This corrects the article DOI: 10.1117/1.NPh.4.3.031212.].
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Abstract The objective of this work was to screen sweet cassava accessions collected in smallholding areas in the Midwestern, Southeastern and Southern regions of Brazil, using 15 SSR molecular markers, to determine population structure and genetic diversity. Polymorphism was detected in every loci analyzed, with mean of 6.33 alleles per locus, and mean polymorphism information content (PIC) of 0.6057, pointing out that the primers were highly informative. The observed heterozygosity ranged from 0.0709 (SSRY 101) to 0.9398 (GA 12), with a mean of 0.6511, and mean genetic diversity of 0.6578, ranging from 0.3592 (GA 136) to 0.8116 (SSRY 21). The most dissimilar combinations observed were BGM526PR-BGM596MS, BGM526PR-BGM622MS and BGM526PR-BGM629MS. The traditional cassava cultivars assessed were divided into four distinct groups: two with cultivars from the South, one from the Southeast and one from the Midwestern region of Brazil. The variances among and within groups determined by the analysis of molecular variance were 44 and 56%, respectively. The PhiPT parameter (analogue to Fst) of 0.44 indicates high differentiation among groups. Broad genetic diversity was found among the traditional sweet cassava cultivars assessed, and the most divergent groups were formed by cultivars from the South and the Midwestern regions of Brazil.
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Manihot/genética , Banco de Semillas , Alelos , Hibridación GenéticaRESUMEN
We report a 41-year-old man with HIV and a chronic obstructive pulmonary disease, treated for seven months with Fluticasone/Salmeterol and antiretroviral therapy (Lamivudine, Tenofovir, Atazanavir and Ritonavir). While using these medications, the patients developed a Cushing syndrome in a period of five months. After performing laboratory and imaging tests, it was concluded that the most probable cause of the syndrome was the interaction of inhaled steroids with Ritonavir. After discontinuing these medications the syndrome reverted in a period of 8 months.
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Humanos , Masculino , Adulto , Broncodilatadores/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/efectos adversos , Síndrome de Cushing/inducido químicamente , Xinafoato de Salmeterol/efectos adversos , Fluticasona/efectos adversos , Nebulizadores y Vaporizadores , Broncodilatadores/uso terapéutico , Inhibidores de la Proteasa del VIH/uso terapéutico , Síndrome de Cushing/diagnóstico , Interacciones Farmacológicas , Xinafoato de Salmeterol/uso terapéutico , Fluticasona/uso terapéuticoRESUMEN
N-Thiolated beta-lactams are a new family of antibacterials that inhibit the growth of Staphylococcus bacteria. Unlike other beta-lactam drugs, these compounds retain their full antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) strains and operate through a different mode of action. The structural features, which give these lactams their biological activity, have not yet been completely defined. Earlier efforts in our laboratory established that the N-organothio substituent is essential for antimicrobial activity while other groups at C(3) and C(4) on the lactam ring play a more subtle role. In this present study, we investigate these effects by varying the polar and steric nature of the ring substituents at these two centers. From the data presented herein, it appears that there is a need to balance the lipophilic character of the C(3)/C(4) groups to obtain an optimal anti-MRSA activity. The structure-bioactivity profiles more closely relate to the compound's ability to penetrate the bacterial cell membrane to sites of action within the cytoplasm rather than to any specific non-bonding interactions with a biological target. Based on these results, a model for the compounds' mode of action is presented.