Physical and chemical characterization of drill cuttings: A review.

Drill cuttings comprise a mixture of rocks generated during drilling activities of exploration and production of oil and gas. These residues' properties are variable, depending on several drilling parameters and drilled rock composition. Many scientific studies have been published regarding the characterization of these residues. Articles summarizing these residues' characteristics and toxicity data are poorly explored in the literature. This work reviews the principal methods used to characterize drill cuttings and data about these residues' properties. Some authors have reported the large content of Zn in drill cuttings. These cuttings can be associated with base fluids (as olefins, varying from C11 to C18), and some time crude oil (high range of TPH, unresolved complex mixtures, and PAH compounds). Acute and chronic toxicity tests have shown negative impacts of different types of fluids, the components of these fluids, and cuttings on other marine organisms.

Postnatal women's breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries.

BACKGROUND: Women with COVID-19 experienced numerous concerns and doubts about the safety of breastfeeding their babies, and lack of support may have impacted breastfeeding practices. This study aims to compare breastfeeding beliefs, practices, and contact with healthcare professionals regarding the level of postnatal feeding support provided during the COVID-19 pandemic in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom. METHODS: A multi-country cross-sectional study was conducted with postnatal women in five countries. Women up to six months postpartum were invited to complete an online survey concerning the transmission of preventative measures, beliefs toward breastfeeding, infant feeding practices in the last 24 hours and experiences of postnatal infant feeding support between July to November 2021. Bivariate and multivariate analyses were performed to identify the association. RESULTS: Of the 3,253 eligible responses received, 39.5% of children were aged between one and two months, but in Taiwan (36%) and South Korea (42.8%) they were between three and four months. The mean of the belief score was significantly different among countries (p < 0.0001). Women in Brazil and the UK had a higher rate of breastfeeding at the breast (90.7% and 85.4%, respectively) compared to the three Asian countries (p < 0.0001) while feeding with expressed breastmilk in Thailand (59.9%), Taiwan (52.6%), and South Korea (50.4%) was higher than the others (p < 0.0001). Brazil and UK mothers (mean = 16.0 and 14.5 respectively) had a higher mean score for belief toward breastfeeding during the COVID-19 than the others. These results are inversely associated with breastfeeding but positively related to formula feeding practice. Postnatal feeding support during the COVID-19 pandemic was mainly provided by healthcare professionals (67.1%) and peers / family through face-to-face personal contact (51.6%) in all countries. CONCLUSION: Some differences were found in breastfeeding beliefs during the COVID-19 pandemic in Asian countries. A positive breastfeeding belief was associated with the practice of breastfeeding at the breast. Women from all countries received postpartum infant feeding support from health professionals and peers / family through personal contacts. Governments need to emphasize and disseminate the importance of breastfeeding safety, especially in Asian countries.

Omega-3 Supplementation Prevents Short-Term High-Fat Diet Effects on the α7 Nicotinic Cholinergic Receptor Expression and Inflammatory Response.

The study is aimed at investigating if PUFA supplementation could prevent the effects of a short-term HFD on α7nAChR expression and on the severity of sepsis. Swiss mice were used for the in vivo experiments. For the in vitro experiments, we used a microglia cell line (BV-2) and a hepatoma cell line (Hepa-1c1c7) derived from mice. The animals were either fed standard chow, fed a short-term HFD (60%), or given supplementation with omega-3 fatty acid (2 g/kg or 4 g/kg bw) for 17 days, followed by a short-term HFD. Endotoxemia was induced with an intraperitoneal (i.p.) lipopolysaccharide injection (LPS, 5 or 12 mg/kg), and sepsis was induced by subjecting the animals to cecal ligation and puncture (CLP). BV-2 and Hepa-1c1c7 cells were treated with LPS (100 and 500 ng/mL, respectively) for 3 hours. RT-PCR or Western blotting was used to evaluate α7nAChR expression, inflammatory markers, DNMT1, and overall ubiquitination. LPS and HFD reduced the expression of α7nAChR and increased the expression of inflammatory markers. Omega-3 partially prevented the damage caused by the HFD to the expression of α7nAChR in the bone marrow and hypothalamus, decreased the inflammatory markers, and reduced susceptibility to sepsis-induced death. Exposing the BV-2 cells to LPS increased the protein content of DNMT1 and the overall ubiquitination and reduced the expression of α7nAChR. The inflammation induced by LPS in the BV-2 cell decreased α7nAChR expression and concomitantly increased DNMT1 expression and the ubiquitinated protein levels, indicating the participation of pre- and posttranscriptional mechanisms.

ω-Conotoxina MVIIC e células-tronco mesenquimais promovem recuperação motora em ratos Wistar após trauma medular agudo / ω-Conotoxin MVIIC and mesenchymal stem cells promote motor recovery in Wistar rats after acute spinal cord injury]

O objetivo deste estudo foi avaliar o efeito da ω-conotoxina MVIIC e das células-tronco mesenquimais (CTM) de forma isolada e sua associação nos ratos submetidos ao trauma medular agudo (TMA). Trinta Rattus novergicus, linhagem Wistar, três meses de idade, foram distribuídos igualmente em cinco grupos experimentais: controle negativo (CN), controle positivo (CP), ω-conotoxina MVIIC (MVIIC), células-tronco mesenquimais da medula óssea (CTM-MO) e associação (MVIIC + CTM-MO). O grupo CN foi submetido à laminectomia sem trauma medular, e os grupos CP, MVIIC, CTM-MO e MVIIC + CTM-MO foram submetidos ao trauma medular contusivo. O grupo CP recebeu, uma hora após o TMA, 10µL de PBS estéril, e os grupos MVIIC e MVIIC + CTM-MO receberam 10µL de PBS contendo 20pmol da ω-conotoxina MVIIC, todos por via intratecal. Os grupos CTM-MO e MVIIC + CTM-MO receberam, 24 horas após, 1x106 de CTM via intravenosa. Avaliou-se a recuperação da função locomotora até o sétimo dia pós-trauma. Os animais tratados com MVIIC + CTM-MO obtiveram recuperação motora após o trauma medular agudo (P<0,05). Conclui-se que essa associação apresentou efeito neuroprotetor com melhora na função locomotora em ratos Wistar.(AU)

The objective of this study was to evaluate the effect of isolated ω-conotoxin MVIIC and mesenchymal stem cells (MSCs) and its association in rats submitted to acute spinal cord injury (SCI). Thirty Rattus norvegicus, Wistar strain, three-month-old rats were randomly distributed in five experimental groups with six animals: negative control (CN), positive control (CP), ω-conotoxin MVIIC (MVIIC), bone marrow mesenchymal stem cells (CTM-MO) and the association (MVIIC + CTM-MO). The CN group underwent laminectomy without spinal cord trauma, and groups CP, MVIIC, CTM-MO and MVIIC + CTM-MO were submitted to contusive spinal cord trauma. The CP group received 10µl of PBS one hour after SCI, and groups MVIIC and MVIIC + CTM-MO received 10µl of PBS containing 20pmol of ω-conotoxin MVIIC, both intrathecally. Groups CTM-MO and MVIIC + CTM-MO received 1x106 of MSCs intravenously 24 hours later. The recovery of locomotor function was evaluated up to seven days post-injury. The animals treated with MVIIC + CTM-MO obtained motor recovery after SCI (P<0.05). It is concluded that this association showed neuroprotective effect with improvements in locomotor function in Wistar rats.(AU)

Laser-assisted production of HAp-coated zirconia structured surfaces for biomedical applications.

OBJECTIVES: The aim of this study was to develop a novel design for implants surface functionalization through the production of HAp-coated zirconia structured surfaces by means of hybrid laser technique. The HAp-rich structured surfaces were designed to avoid hydroxyapatite (HAp) coating detachment from the zirconia surface during implant insertion, thus guaranteeing an effective osseointegration. MATERIALS AND METHODS: The functionalization process of zirconia surface started by creating micro-textures using a Nd:YAG laser and subsequent deposition of a HAp coating on the designated locations by dip-coating process. Afterwards, a CO2 laser was used to sinter the HAp coating. The potential of the HAp-coated zirconia structured surfaces was inspected concerning HAp bioactivity preservation, surface wettability, HAp coating adhesion to the textured surfaces and mechanical resistance of zirconia, as assessed by different approaches. RESULTS: The functionalized surfaces exhibited a superhydrophilic behavior (2.30 ± 0.81°) and the remaining results showed that through the hybrid strategy, it is possible to maintain the HAp bioactivity as well as promote a strong adhesion of HAp coating to the textured surfaces even after high energy ultrasonic cavitation tests and friction tests against bovine bone. It was also verified that the flexural strength of zirconia (503 ± 24 MPa) fulfills the strict requirements of the ISO 13356:2008 standard and as such is expectable to be enough for biomedical applications. SIGNIFICANCE: The promising results of this study indicate that the proposed surface design can open the window for manufacturing zirconia-based implants with improved bioactivity required for an effective osseointegration as it avoids the coating detachment problem during the implant insertion.

Cell adhesion evaluation of laser-sintered HAp and 45S5 bioactive glass coatings on micro-textured zirconia surfaces using MC3T3-E1 osteoblast-like cells.

Laser texturing is a technique that has been increasingly explored for the surface modification of several materials on different applications. Laser texturing can be combined with conventional coating techniques to functionalize surfaces with bioactive properties, stimulating cell differentiation and adhesion. This study focuses on the cell adhesion of laser-sintered coatings of hydroxyapatite (HAp) and 45S5 bioactive glass (45S5 BG) on zirconia textured surfaces using MC3T3-E1 cells. For this purpose, zirconia surfaces were micro-textured via laser and then coated with HAp and 45S5 BG glass via dip coating. Afterwards, the bioactive coatings were laser sintered, and a reference group of samples was conventionally sintering. The cell adhesion characterisation was achieved by cell viability performing live/dead analysis using fluorescence stains and by SEM observations for a qualitative analysis of cell adhesion. The in vitro results showed that a squared textured pattern with 100µm width grooves functionalized with a bioactive coating presented an increase of 90% of cell viability compared to flat surfaces after 48h of incubation. The functionalized laser sintered coatings do not present significant differences in cell viability when compared to conventionally sintered coatings. Therefore, the results reveal that laser sintering of HAp and 45S5 BG coatings is a fast and attractive coating technique.

Impacto tardio da hipertensão pulmonar e da insuficiência tricúspide após troca transcateter de valva aórtica / Late impact of pulmonary hypertension and tricuspid regurgitation after transcatheter aortic valve replacement

INTRODUÇÃO: Troca transcateter de valva aórtica (TAVR) é cada vez mais utilizada no tratamento da estenose aórtica (EA) senil. EA é comumente associada a hipertensão pulmonar (HP) e insuficiência tricúspide (IT). Nosso OBJETIVO foi avaliar o impacto tardio no curso da HP e IT. MÉTODOS: Pacientes submetidos a TAVR foram acompanhados quanto aos dados ecocardiográficos da HP e da IT por 24 meses. Todos os ecocardiogramas foram realizados em centro único. Foram divididos em grupos de acordo com IT e HP após 24 meses (pressão sistólica da artéria pulmonar = or < 45 mmHg) com follow-up de até 96 meses. Resultados clínicos e mortalidade foram comparados. RESULTADOS: 156 e 151 pacientes foram selecionados para acompanhamento da HP e da IT respectivamente. Média de follow-up foi de 42,23±17,53 meses e 42,60±17,67 meses para grupos de HP e IT. HP se reduziu após o TAVR (32,7% pre-TAVR vs. 20,5% pos-TAVR, p<0,001), mas não foi encontrada mudança significativa na IT (11,9% pre-TAVR vs. 10,6% pos-TAVR). Aumento de átrio esquerdo (AE) foi associado a manutenção de HP (p=0,002). Além disso, o aumento do diâmetro do AE (p=0,015) e EuroSCORE II elevado (p=0,041) foram correlacionados ao surgimento de nova HP. Na análise multivariada, surgimento de nova HP (HR 6,17, 95% CI 1,71­22,29,p=0,005), disfunção diastólica tipo II ou III (HR 1,06, 95% CI 1,06-1,11, p=0,036) e diâmetro de AE (HR 1,11, 95% CI 1,02­1,21, p=0,02) foram preditores independentes de mortalidade. CONCLUSÃO: TAVR foi capaz de reduzir a gravidade da HP, mas não da IT. Além disso, a sobrevida a longo prazo foi afetada pela HP, disfunção diastólica e tamanho do AE.

Long-term analysis of pulmonary hypertension and tricuspid regurgitation after transcatheter aortic valve replacement

INTRODUCTION: transcatheter aortic valve replacement (TAVR) is increasingly utilized in treatment of aortic stenosis (AS). AS is commonly associated to pulmonary hypertension (PH) and tricuspid regurgitation (TR). We aimed to evaluate the long-term post-TAVR course of PH and TR. METHODS: Patients undergoing TAVR were screened for 24-month echocardiographic data on PH and TR. All echocardiograms were performed by a sing le team. Patients were divided in groups according to TR and PH (pulmonary systolic pressure ≥ or < 45 mmHg) grading at 24 months with follow-up of up to 96 months. Standardized clinical outcomes and survival were compared. RESULTS: 156 and 151 patients were se le cted for PH and TR follow-up, respectively. Mean follow-up was 42.23±17.53 months and 42.60±17.67 months for PH and TR groups. Maximum follow-up was 96 months. PH was reduced post-TAVR (32.7% pre-TAVR vs. 20.5% post-TAVR, p<0.001), but no significant difference in TR was found (11.9% pre-TAVR vs. 10.6% post-TAVR). Increased le ft atrial (LA) diameter (p = 0.002) was associated to maintenance PH. Moreover, increased LA diameter (p=0.015) and increased EuroSCORE II (p=0.041) were correlated to new onset PH. On a multivariab le Cox regression model, new onset PH (HR 6.17, 95% CI 1.71­22.29, p=0.005), diastolic dysfunction type II or III (HR 1.06, 95% CI 1.06-1.11, p=0.036) and LA diameter (HR 1.11, 95% CI 1.02­1.21, p=0.02) were independent predictors of long-term mortality. CONCLUSIONS: TAVR was ab le to reduce the severity of PH, but not TR, in this cohort. Additionally, long-term survival was affected by PH, diastolic dysfunction and LA sizing.

Combined effects of arsenic exposure and diabetes on male reproductive functions.

BACKGROUND: It is known that exposure to either arsenic or hyperglycemia can induce male reproductive damages. However, their combined effects on male reproductive organs are still unclear. Therefore, the present study investigated morphological and functional parameters of the testis, epididymis, and spermatozoa in diabetic rats exposed to arsenate. MATERIALS AND METHODS: Diabetes was induced in male rats by intraperitoneal streptozotocin injection. While a set of healthy and diabetic animals received saline solution (negative control and diabetes control, respectively), the other set received 10 mg/L sodium arsenate (arsenic control and diabetes + arsenic groups, respectively) for 40 days in drinking water. Testosterone concentration, daily sperm production, sperm counts in the testis and epididymis, and sperm parameters were evaluated in the groups. Moreover, testis and epididymis were subjected to antioxidant enzymes analysis, micromineral determination, and histopathological evaluation. RESULTS: Arsenate exposure reduced serum testosterone concentration in healthy animals and worsened this reduction in diabetic rats. In addition, the number of spermatozoa in testis and epididymis tissues, as well as the daily sperm production, was decreased in these groups. Sperm parameters such as motility, morphology, and integrity of acrosomal and plasma membranes were impaired in health animals exposed to arsenate. The combination of diabetes and arsenate, in turn, increased only the percentage of spermatozoa with abnormal morphology. Moreover, the proportion of arsenic increased in the testis and epididymis of both groups receiving arsenate. Its bioaccumulation in these organs caused an imbalance in antioxidant enzymes activities and mineral content in healthy animals, enhancing these changes in diabetic rats. Testicular pathologies occurred mainly in animals co-exposed to diabetes and arsenate. CONCLUSION: Our results indicate that arsenate exposure enhances several damages to male reproductive functions in diabetic rats, mainly by impairing testosterone levels and inducing nitrosative stress in testis and epididymis.

Development of an infectious clone and replicon system of norovirus GII.4.

Human norovirus (HuNoV) is one of the main causes of acute gastroenteritis worldwide and is responsible for at least 20% of all cases. The detailed molecular mechanism of this norovirus remains unknown due to the lack of a suitable in vitro culturing system. An infectious clone of HuNoV would be a useful tool for elucidating the processes of viral infection and the mechanisms of replication. We developed an infectious cDNA clone of HuNoV using the rapid technique of Gibson Assembly. The complete genome of the HuNoV GII.4 Sydney subtype was cloned into a previously modified pcDNA3.1-based plasmid vector downstream from a cytomegaloviral promoter. We monitored the viral infection in vitro by inserting the reporter gene of the green fluorescent protein (GFP) between the NTPase and p22 genes, also by Gibson Assembly, to construct a HuNoV-GFP replicon. Human Caco-2 cells were transfected with the full-length genomic clone and the replicon containing GFP. The gene encoding the VP1/VP2 capsid protein was expressed, which was indirect evidence of the synthesis of subgenomic RNAs and thus the negative strand of the genome. We successfully constructed the infectious clone and its replicon containing GFP for the HuNoV GII.4 Sydney subtype, a valuable tool that will help the study of noroviral infection and replication.

Drought promotes increases in total mercury and methylmercury concentrations in fish from the lower Paraíba do Sul river, southeastern Brazil.

Bioaccumulation of mercury and methylmercury in fish represents a serious risk to human beings. Extreme climate events like droughts may increase the trophic transfer of contaminants and net methylation of mercury. The present study assessed the influence of the 2014 drought on total mercury and methylmercury levels in fish from the lower Paraiba do Sul river basin. Contaminant levels were compared for Pimelodus fur, Pachyurus adspersus, Pimelodella lateristriga, Oligosarcus hepsetus, and Crenicichla lacustris captured in five sites in 2013 (N = 212) and 2014 (N = 231). The results indicate that levels of contaminants were higher during the drought in most species. Rainfall was weakly and negatively correlated with total mercury levels in most of the species. The weak relationship between these two variables was due to the indirect influence of rainfall on mercury bioaccumulation. In summary, drought increased the levels of two contaminants in fish.

Minimally Invasive Bilateral Lung Resections and CABG through 5 Ports.

Minimal access surgery is increasingly popular to reduce postoperative morbidity and enhance recovery. We present a case of a patient who underwent bilateral minimally invasive thoracic and cardiac surgery. An 81-year-old woman was diagnosed with T1aN0M0 left upper lobe small-cell lung cancer and underwent single-port left video-assisted thoracoscopic surgery (VATS) upper lobectomy in 2016. She developed a contralateral right lower lobe nodule and underwent a single-port right VATS wedge resection of the lower lobe nodule, subsequently confirmed as necrotising granulomatous inflammation with acid-fast bacilli, consistent with previous tuberculosis (TB) infection. On postoperative day 1, she had an episode of self-reverting ventricular tachycardia and bradycardia. Subsequent myocardial perfusion scan and coronary angiogram showed significant LV dysfunction and severe coronary artery disease with a left main stem (LMS) lesion. After agreement at MDT, an Endo-ACAB (endoscopic atraumatic coronary artery bypass grafting) was performed, via 3 ports, with the left internal mammary artery anastomosed to left anterior descending artery. She recovered well postoperatively and was discharged. Multiple sequential minimally invasive procedures are now routine and can be performed safely in patients with a complex combination of pathologies. In this case, bilateral single-port (anatomic and nonanatomic) lung resections were undertaken followed by coronary revascularisation with a total of 5 minimal access ports.

Prática assistencial dos enfermeiros em atenção primária à saúde: revisão integrativa / Nurse’s practice in the primary health care: an integrative review

Objetivo: sintetizar a produção científica brasileira sobre a prática assistencial do enfermeiro em atenção primária à saúde (APS). Métodos: realizou-se uma revisão integrativa no período de janeiro a março de 2016, com busca nas bases de dados LILACS, MEDLINE e SCIELO. Foram selecionados 28 artigos que atenderam aos critérios de inclusão. Resultados: evidenciou-se, que as práticas assistenciais dos enfermeiros ocorrem durante as visitas domiciliares, as consultas de enfermagem e as atividades de vigilância em saúde. Os limites para realização das práticas assistenciais apontados referem-se ao reconhecimento profissional, as relações com a equipe, aos protocolos assistenciais e as capacitações. Considerações finais: destaca-se a inexistência de pesquisas nacionais com evidências fortes relacionados ao tema.

Objective: to synthesize the Brazilian scientific production on the nursing care practice in theprimary health care. Methods: this integrative review was carried out from January to March 2016,by searching on the databases LILACS, MEDLINE and SCIELO. Twenty-eight articles that fitted theinclusion criteria were selected. Results: facilities and limits to the development of health carepractices of nurses in the ESF; program activities and evaluation of care practices. Home visits,nursing appointments, and activities surveillance in health accomplish the care practices. The limitsto accomplishment indicated in the articles refer to the lack of recognition at work; difficulty inrelationship with staff; lack of care protocols and lack of training to perform service activities. Finalconsiderations: there’s a lack of national research that stands out strong evidence to the theme.

Phenotypic Variability of the Amazonian Species Rhodnius brethesi (Hemiptera: Reduviidae).

The wild species Rhodnius brethesi (Matta, 1919) (Hemiptera: Reduviidae) is found in areas of piassabais in microregion of Rio Negro, Amazonas, Brazil. Its geographical distribution overlaps the areas of Leopoldinia piassaba palm. In areas where palm trees are found, transmission cycle of Trypanosoma cruzi is related to the extractive activity of the palm fiber, exposing workers to wild vector transmission of this parasite. The close association with the palm tree L. piassaba suggests that this wild triatomine has special features in its sensory system allowing specificity of ecotope. The objective of the study is to identify the antennal sensilla phenotype and morphologically characterize the size and shape of the wings of wild R. brethesi, and to compare with the phenotype present in individuals reared in the laboratory. From the samples taken in the field, the presence of the species R. brethesi was found on both banks of the Rio Negro. The techniques used to verify the morphological patterns are important resources for observations of the triatomine populations, be they in an artificial or natural habitat.

Activity and in vivo tracking of Amphotericin B loaded PLGA nanoparticles.

The development of biocompatible polymeric nanoparticles has become an important strategy for optimizing the therapeutic efficacy of many classical drugs, as it may expand their activities, reduce their toxicity, increase their bioactivity and improve biodistribution. In this study, nanoparticles of Amphotericin B entrapped within poly (lactic-co-glycolic) acid and incorporated with dimercaptosuccinic acid (NANO-D-AMB) as a target molecule were evaluated for their physic-chemical characteristics, pharmacokinetics, biocompatibility and antifungal activity. We found high plasma concentrations of Amphotericin B upon treatment with NANO-D-AMB and a high uptake of nanoparticles in the lungs, liver and spleen. NANO-D-AMB exhibited antifungal efficacy against Paracoccidioides brasiliensis and induced much lower cytotoxicity levels compared to D-AMB formulation in vivo and in vitro. Together, these results confirm that NANO-D-AMB improves Amphotericin B delivery and suggest this delivery system as a potential alternative to the use of Amphotericin B sodium deoxycholate.

Effect of Base and Inlay Restorative Material on the Stress Distribution and Fracture Resistance of Weakened Premolars.

The purpose of this study was to evaluate the influence of direct base and indirect inlay materials on stress distribution and fracture resistance of endodontically treated premolars with weakened cusps. Forty healthy human premolars were selected; five were left intact as controls (group C+), and the others were subjected to endodontic treatment and removal of buccal and lingual cusp dentin. Five teeth were left as negative controls (group C-). The remaining 30 teeth were divided into two groups according to the direct base material (glass ionomer [GIC] or composite resin [CR]). After base placement, each group was subjected to extensive inlay preparation, and then three subgroups were created (n=5): no inlay restoration (GIC and CR), restored with an indirect composite resin inlay (GIC+IR and CR+IR), and restored with a ceramic inlay (GIC+C and CR+C). Each specimen was loaded until fracture in a universal testing machine. For finite element analysis, the results showed that the removal of tooth structure significantly affected fracture resistance. The lowest values were presented by the negative control group, followed by the restored and based groups (not statistically different from each other) and all lower than the positive control group. In finite element analysis, the stress concentration was lower in the restored tooth compared to the tooth without restoration, whereas in the restored teeth, the stress concentration was similar, regardless of the material used for the base or restoration. It can be concluded that the inlay materials combined with a base showed similar behavior and were not able to regain the strength of intact tooth structure.

Uso da vitamina K como rastreador de eventos adversos hemorrágicos por varfarina: um estudo de caso / Use of vitamin K to track hemorrhagic adverse events caused by warfarin: a case study

The medical use of warfarin requires close monitoring because of its narrow therapeutic index. Thus, methods that enable effective monitoring to detect any adverse events (AEs) associated with this drug are necessary to improve the quality of health care. Many authors have proposed the use of triggers to search actively for possibleAEs. The aim of this study was to assess the possible use of vitamin K as a tracker of adverse bleeding events caused by warfarin in a public hospital specialized in cardiology in Rio de Janeiro. We applied the method of trigger tools (Institute for Healthcare Improvement, 2004; Rozichet al., 2003), which retrospectively analyzed the results of the use of vitamin K (phytomenadione), to screen for adverse bleeding events caused by warfarin, from October 2010 to March 2011. From an analysis of 46 medical records, 14 possible AEs were found. In 23 cases, internal bleeding was the cause of hospitalization. Despite difficulties, especially those related to poor access to data and quality of hospital records, the application of vitamin K as a trigger was found to be of great use in detecting hemorrhagic AEs associated with warfarin. This method has potential applications for monitoring the results of interventions, with a view to reducing the incidence of hemorrhagic adverse events...

O uso de varfarina requer monitoramento rigoroso devido a seu índice terapêutico estreito. Da mesma forma, a aplicação de métodos que permitam o monitoramento adequado de eventos adversos a este medicamento é necessária para que se possa contribuir com a qualidade do cuidado em saúde. O uso de marcadores para o processo de busca ativa de eventos adversos tem sido proposto por muitos autores. Neste trabalho, buscou-se avaliar o potencial de utilização do uso da vitamina K como rastreador de eventos adversos hemorrágicos causados por varfarina em um hospital público de alta complexidade em cardiologia do Rio de Janeiro. O método dos rastreadores ou trigger tools foi aplicado para análise retrospectiva da utilização da vitamina K (fitomenadiona) como rastreador de eventos adversos hemorrágicos causados por varfarina, no período de outubro de 2010 a março de 2011. Com base na análise de 46 prontuários, foram encontrados 14 possíveis eventos adversos. Em 23 casos, a hemorragia foi a causa da internação. Apesar das dificuldades, sobretudo relacionadas ao acesso às informações e à qualidade dos registros, a aplicação da vitamina K como rastreador se mostrou bastante útil na detecção de eventos adversos hemorrágicos por varfarina. A aplicação deste método como estratégia de monitoramento de eventos adversos, tem potencial para uso no acompanhamento dos resultados de intervenções visando à redução da incidência dos eventos adversos hemorrágicos...

Is glycated hemoglobin related to other dysmetabolic variables implicated in the increase of cardiovascular risk in polycystic ovary syndrome? A comparative study.

BACKGROUND: In non-PCOS patients the concentration of glycated hemoglobin (HbA1C) has been employed to identify individuals at higher risk for impaired glucose tolerance (IGT) and diabetes mellitus. A few studies have examined the role of HbA1C in PCOS patients and current results are controversial. AIM: To compare the strength of the association between glycated hemoglobin and other predictors of cardiovascular risk in polycystic ovary syndrome (PCOS). METHODS: This cross-sectional study enrolled 197 PCOS patients and 72 non-PCOS women. Transvaginal ultrasound, biochemical and hormone measurement were performed. Glycated hemoglobin (HbA1C) was correlated with other variables related to dysmetabolic/vascular diseases. RESULTS: The HbA1C levels were 6.0±1.4% and 4.9±0.4% in PCOS patients and non-PCOS controls, respectively (p<0.001). The HbA1C levels were≥5.7% in 46.4% of PCOS and in none of the control subjects (OR=90.8). HbA1C was well-correlated with several anthropometric, metabolic and endocrine parameters. Stepwise multiple regression including HbA1C and other known predictors of cardiovascular risk resulted in a significant model in which body mass index (BMI) and free testosterone exhibited the best correlation with HbA1C (adjusted R(2)=0.530; F=39.8; p<0.001). CONCLUSION: HbA1C was elevated and correlated with anthropometric, biochemical and endocrine variables of metabolic/vascular disease risks in PCOS patients. Combined HbA1C, BMI and free testosterone levels provided a significant model with potential use to evaluate metabolic/vascular disease in PCOS patients.

Parameters of the reproductive tract, spermatogenesis, daily sperm production and major seminal plasma proteins of tropically adapted morada nova rams.

This study describes the reproductive parameters of Morada Nova rams, a breed of hair sheep from Brazil and with unique adaption to tropical environments. At 42 weeks of age, 15 rams were subjected to semen collection and, 1 week later, animals were slaughtered for collection of testes, epididymis and accessory sex glands. We conducted 2-D electrophoresis of seminal plasma proteins and major spots of stained gels were identified by LC-MS/MS. Total RNA was isolated from testis, epididymis and vesicular glands and subjected to qPCR. At slaughter, scrotal circumference and testicular weight were 27.5 ± 0.5 cm and 109.5 ± 6.0 g, respectively. Seminiferous tubule (ST) diameter was 188.3 ± 4.0 µm and each testis contained 1.9 ± 0.1 Sertoli cells (×10(9) ). Each Sertoli cell supported 0.1 ± 0.01 A spermatogonia, 3.0 ± 0.2 pachytene spermatocytes and 7.7 ± 0.5 round spermatids/tubule cross section. Daily sperm production reached 5.6 × 10(6)  cells/g of testis parenchyma. Testis size appeared as indicative of ST diameter and associated with epididymal measurements, as well as with the population of round spermatids and Sertoli cells/testis. Rams with heavier testes had greater daily sperm production and more Sertoli cells/testis. We detected 90.9 ± 9.6 spots per 2-D gel of seminal plasma. Major seminal proteins were identified as ram seminal vesicle proteins at 14 and 22 kDa, representing 16.2% and 12.8% of the total intensity of valid spots in the gels, respectively. Expression of both genes was greater in the vesicular glands as compared to testis and epididymis. Pixel intensity for those proteins in the 2-D gels was significantly correlated with seminal vesicle weight. This is the first description of the basic reproductive aspects of Morada Nova rams, including protein profiles of their seminal plasma. These findings will allow a better understanding of their reproductive physiology.