Down-regulation of autophagy proteins is associated with higher mTOR expression in the placenta of pregnant women with preeclampsia.

Autophagy is a lysosomal degradation pathway that removes protein aggregates and damaged organelles maintaining cellular integrity. It seems to be essential for cell survival during stress, starvation, hypoxia, and consequently to the placenta implantation and development. Preeclampsia (PE) is a multisystemic disorder characterized by the onset of hypertension associated or not with proteinuria and other maternal complications. Considering that the placenta seems to play an important role in the pathogenesis of PE, the objective of the present study was to evaluate protein levels of light chain protein (LC3), beclin-1, and the mammalian target of rapamycin (mTOR) in the placenta of pregnant women with PE. Placental tissues collected from 20 women with PE and 20 normotensive (NT) pregnant women were evaluated for LC3, beclin-1, and mTOR expression by qPCR and immunohistochemistry. The mRNA for LC3 and beclin-1 were significantly lower, while mTOR gene expression was significantly higher in the placenta of pregnant women with PE than in the NT group. Placentas of PE women showed significantly decreased protein expression of LC3-II and beclin-1, whereas mTOR was significantly increased compared with the NT pregnant women. There was a negative correlation between protein expression of mTOR and LC3-II in the placental tissue of PE women. In conclusion, the results showed autophagy deficiency suggesting that failure in this degradation process may contribute to the pathogenesis of PE; however, new studies involving cross-talk between autophagy and inflammatory molecular mechanisms might help to better understand the autophagy process in this obstetric pathology.

Plasmodium falciparum Drug Resistance Genes pfmdr1 and pfcrt In Vivo Co-Expression During Artemether-Lumefantrine Therapy.

Background: Artemisinin-based combination therapies (ACTs) are the global mainstay treatment of uncomplicated Plasmodium falciparum infections. PfMDR1 and PfCRT are two transmembrane transporters, associated with sensitivity to several antimalarials, found in the parasite food vacuole. Herein, we explore if their relatedness extends to overlapping patterns of gene transcriptional activity before and during ACT administration. Methods: In a clinical trial performed in Tanzania, we explored the pfmdr1 and pfcrt transcription levels from 48 patients with uncomplicated P. falciparum malaria infections who underwent treatment with artemether-lumefantrine (AL). Samples analyzed were collected before treatment initiation and during the first 24 h of treatment. The frequency of PfMDR1 N86Y and PfCRT K76T was determined through PCR-RFLP or direct amplicon sequencing. Gene expression was analyzed by real-time quantitative PCR. Results: A wide range of pre-treatment expression levels was observed for both genes, approximately 10-fold for pfcrt and 50-fold for pfmdr1. In addition, a significant positive correlation demonstrates pfmdr1 and pfcrt co-expression. After AL treatment initiation, pfmdr1 and pfcrt maintained the positive co-expression correlation, with mild downregulation throughout the 24 h post-treatment. Additionally, a trend was observed for PfMDR1 N86 alleles and higher expression before treatment initiation. Conclusion: pfmdr1 and pfcrt showed significant co-expression patterns in vivo, which were generally maintained during ACT treatment. This observation points to relevant related roles in the normal parasite physiology, which seem essential to be maintained when the parasite is exposed to drug stress. In addition, keeping the simultaneous expression of both transporters might be advantageous for responding to the drug action.

Eudragit® L100/chitosan composite thin bilayer films for intravaginal pH-responsive release of Tenofovir.

The high rate of HIV new infections and AIDS-related deaths each year make prevention tools still necessary today. Different dosage forms - including films - for vaginal administration of antiretroviral drugs have been developed for this purpose. Six batches of Tenofovir-loaded films were formulated based on Eudragit® L100 (EL100) and chitosan, containing triethyl citrate and glycerol. In all the cases films structured in two layers - the upper layer mainly attributed to EL100 and the lower layer to chitosan - were revealed by SEM. A higher content in EL100 and plasticizers improves the mechanical properties and control over drug release in the vaginal medium without affecting mucoadhesion. The EL100-based layer acts as a structuring agent that controls Tenofovir release for days in the vaginal medium while it occurs in a few hours in the presence of seminal fluid. Bilayer films with the highest tested content of EL100 and plasticizers would be the most suitable as vaginal microbicides as they are easier to administer due to their excellent mechanical properties and they offer more comfortable posology and enhanced protection against HIV during intercourse due to their pH-responsive release of Tenofovir.

Pelvic organ prolapse repair-relapse risk factors: A 10-year retrospective study / Reparación del prolapso de órganos pélvicos: factores de riesgo de recaída. Estudio retrospectivo de 10 años

ObjectivesPelvic organ prolapse (POP) is a common problem among older female. The usual treatment for POP is surgery but there are high recurrence rates, with a 29% reoperation rate. This study aims to identify risk factors for both primary prolapse and recurrence after surgical treatment.MethodsRetrospectively assessment of clinical records of patients who underwent surgery for POP in a 10-year period. Statistical analysis was performed using the version 26.0 of Statistical Package for the Social Science (SPSS®) software.Results746 women entered our study. The population was predominantly post-menopausal, multiparous, and obese/overweight. The most affected compartment was the anterior. Almost 90% of the patient presented with major prolapse. Being overweight or obese, having apical compartment POP, major POP or all compartment POP were risk factors for recurrence with statistical significance. The recurrence rate was nearly one-third but the reoperation incidence was low, reaching less than 6%.ConclusionsPOP surgery has a high satisfaction rate. The only modifiable risk factor for recurrence is being overweight/obese and a nutritional plan should be considered before surgery so we can achieve the best possible results.

ObjetivosEl prolapso de órganos pélvicos (POP) es un problema común entre las mujeres. El tratamiento habitual del POP es la cirugía, pero existen altas tasas de recurrencia, con una tasa de reintervención del 29%. Este estudio tiene como objetivo identificar los factores de riesgo tanto para el prolapso primario como para la recurrencia después del tratamiento.MétodosEvaluación retrospectiva de historias clínicas de pacientes intervenidos por POP en un período de 10 años. El análisis estadístico se realizó utilizando la versión 26.0 del software Statistical Package for the Social Science (SPSS®).ResultadosIngresaron a nuestro estudio 746 mujeres. La población era predominantemente posmenopáusica, multípara y obesa/con sobrepeso. El compartimento más afectado fue el anterior. Casi el 90% de los pacientes presentó prolapso mayor. Tener sobrepeso u obesidad, tener POP de compartimento apical, POP mayor o POP de todos los compartimentos fueron factores de riesgo de recurrencia con significación estadística. La tasa de recurrencia fue de casi un tercio, pero la incidencia de reintervención fue baja, alcanzando menos del 6%.ConclusionesLa cirugía POP tiene un alto índice de satisfacción. El único factor de riesgo modificable de recurrencia es el sobrepeso/obesidad y se debe considerar un plan nutricional antes de la cirugía para que podamos lograr los mejores resultados posibles.

A role of Na+, K+ -ATPase in spatial memory deficits and inflammatory/oxidative stress after recurrent concussion in adolescent rats.

Sports-related concussions are particularly common during adolescence, and there is insufficient knowledge about how recurrent concussions in this phase of life alter the metabolism of essential structures for memory in adulthood. In this sense, our experimental data revealed that seven recurrent concussions (RC) in 35-day-old rats decreased short-term and long-term memory in the object recognition test (ORT) 30 days after injury. The RC protocol did not alter motor and anxious behavior and the immunoreactivity of brain-derived neurotrophic factor (BDNF) in the cerebral cortex. Recurrent concussions induced the inflammatory/oxidative stress characterized here by increased glial fibrillary acidic protein (GFAP), interleukin 1ß (IL 1ß), 4-hydroxynonenal (4 HNE), protein carbonyl immunoreactivity, and 2',7'-dichlorofluorescein diacetate oxidation (DCFH) levels and lower total antioxidant capacity (TAC). Inhibited Na+,K+-ATPase activity (specifically isoform α2/3) followed by Km (Michaelis-Menten constant) for increased ATP levels and decreased immunodetection of alpha subunit of this enzyme, suggesting that cognitive impairment after RC is caused by the inability of surviving neurons to maintain ionic gradients in selected targets to inflammatory/oxidative damage, such as Na,K-ATPase activity.

Down-regulation of autophagy proteins is associated with higher mTOR expression in the placenta of pregnant women with preeclampsia

Autophagy is a lysosomal degradation pathway that removes protein aggregates and damaged organelles maintaining cellular integrity. It seems to be essential for cell survival during stress, starvation, hypoxia, and consequently to the placenta implantation and development. Preeclampsia (PE) is a multisystemic disorder characterized by the onset of hypertension associated or not with proteinuria and other maternal complications. Considering that the placenta seems to play an important role in the pathogenesis of PE, the objective of the present study was to evaluate protein levels of light chain protein (LC3), beclin-1, and the mammalian target of rapamycin (mTOR) in the placenta of pregnant women with PE. Placental tissues collected from 20 women with PE and 20 normotensive (NT) pregnant women were evaluated for LC3, beclin-1, and mTOR expression by qPCR and immunohistochemistry. The mRNA for LC3 and beclin-1 were significantly lower, while mTOR gene expression was significantly higher in the placenta of pregnant women with PE than in the NT group. Placentas of PE women showed significantly decreased protein expression of LC3-II and beclin-1, whereas mTOR was significantly increased compared with the NT pregnant women. There was a negative correlation between protein expression of mTOR and LC3-II in the placental tissue of PE women. In conclusion, the results showed autophagy deficiency suggesting that failure in this degradation process may contribute to the pathogenesis of PE; however, new studies involving cross-talk between autophagy and inflammatory molecular mechanisms might help to better understand the autophagy process in this obstetric pathology.

Cystlike Lesions as a Late Sequela of Radiotherapy in Pediatric Patients.

BACKGROUND AND PURPOSE: The developing nervous system is particularly vulnerable to late adverse effects of cranial radiation therapy, such as leukoencephalopathy, microbleeds, and cavernomas. Cystlike lesions have been rarely described and characterized in the literature. We aimed to characterize cystlike lesions, their risk factors, and association with other late adverse effects. MATERIALS AND METHODS: Children treated for brain tumors during a 30-year period (n = 139) were included. We documented imaging findings, focusing on cystlike lesion development and its relationship with clinical history and other imaging findings. Multivariable analysis was performed using logistic regression and negative binomial regression models. RESULTS: Cystlike lesions developed in 16.5% of patients treated with radiotherapy, with a median of 2 years until the development of the first lesion. For every 4-year age increase, there were 50% decreased odds of developing lesions and a 50% decrease in the average count of lesions. Females demonstrated a 4.00 rate ratio of developing a higher number of lesions. Patients who underwent chemoradiotherapy had 3.20 increased odds of developing cystlike lesions compared with patients with radiation therapy alone. A larger proportion of patients treated with methotrexate (25%) developed cystlike lesions, but this was not statistically significant. Cystlike lesions tended to develop in cerebral locations where leukoencephalopathy was worse. A strong relationship was found between the development of cystlike lesions and leukoencephalopathy severity. CONCLUSIONS: Cystlike lesions are frequent and under-reported late adverse effects of cranial radiation therapy in children. Younger age, chemoradiotherapy, and the severity of leukoencephalopathy represent risk factors for the development of cystlike lesions.

Administration of a single dose of 300 IU of human chorionic gonadotropin seven days after the onset of estrus improves pregnancy rate in dairy goats by an unknown mechanism.

This study examined the effects of exogenous hCG administration on ovarian function and pregnancy rates in estrous-induced dairy goats during the transition into the breeding season. Eighty-six Toggenburg does received 60 mg of medroxyprogesterone acetate intravaginal sponge for 6 d plus 200 IU of equine chorionic gonadotropin and 30 µg of d-cloprostenol i.m. 24 h before sponge removal, and were then bred for 96 h. Seven days (D7) after first mating the does received either 1 mL of saline (the control group, n = 43) or 300 IU of hCG (the hCG-treated group, n = 43) i.m. Transrectal ovarian ultrasonography (B-mode and color Doppler) was performed on D7, D13, D17, and D21 and ultrasonographic pregnancy detection on D30. Pregnancy rate was higher (P < 0.05) in hCG-treated goats (90.7%; 39/43) than that in control animals (74.4%; 32/43). Accessory luteal structures (ALSs) were detected in 46.5% (20/43) of hCG-treated does. All hCG-treated does that had ALSs and 82.6% of goats without ALS post-treatment remained pregnant. The total luteal area increased (P < 0.05) from D7 to D13 in pregnant animals of both groups, whereas mean vascular area declined (P < 0.05) by D21 in all nonpregnant does. Serum progesterone concentrations increased (P < 0.05) on D21 in pregnant goats of both groups, but they were related to changes in luteal tissue content only in control does throughout the present study. Mean daily numbers of small- and medium-sized antral follicles decreased (P < 0.05) only in pregnant animals of both groups with a decline in medium follicle numbers occurring earlier in hCG-treated (D13) compared with control does (D17). To summarize, a single dose of hCG given on D7 after estrus was followed by a decrease in the number of medium-sized antral follicles in gestating hCG-treated does, induced the formation of ALSs in ~47% of all hCG-treated does, and significantly increased the pregnancy rate in estrous-induced Toggenburg goats in the transition to the breeding season.

Phosphorus speciation and iron mineralogy in an oxisol after 11 years of pig slurry application.

Application of phosphate fertilizers beyond plants needs favors phosphorus (P) accumulation in soils, which may alter its reactivity and chemical speciation. The objective of this study was to assess the changes in P speciation in a Brazilian oxisol that received consecutive applications of varying rates of pig slurry (PS) over 11 years. The soils were treated with PS at rates of 50, 100 and 200 m3 ha-1 year-1, whereas a control plot received P and potassium (K) to replenish the amounts removed by harvest. The soils were sampled and characterized for its P sorption capacity (PSC) as determined by Langmuir sorption isotherms, P partitioning by sequential chemical fractionation (SCF), P chemical speciation via P K-edge XANES and iron (Fe) mineralogy via Fe K-edge EXAFS spectroscopies. Increases in applied PS rates were accompanied by increases in PSC at the 0 to 2.5 and 0 to 10 cm soil layers. P accumulation was observed to be restricted up to the depth of 20 cm, regardless of the PS rate applied. The P K-edge XANES analysis indicated that P accumulation in the topmost soil layers, occurred predominantly associated with Fe-(hydr)oxide minerals. In this soil layer (0 to 2.5 cm), the organic P pool was of particular importance likely due to no-tillage. A dramatic change in Fe mineralogy in the topmost soil layer was observed across the studied soils, with the predominance of hematite in the reference soil and in the control plot, whereas the occurrence of goethite and ferrihydrite was followed by the application of PS.

Hiloterapia como tratamiento coadyuvante en la extracción quirúrgica de terceros molares. A propósito de un caso clínico / Hilotherapy as a coadyuvant treatment in the third molar surgical extraction. A clinical case report

Introducción: La extracción de los terceros molares es una práctica habitual en la consulta odontológica. Es muy común la aparición postoperatoria de respuestas fisiológicas como el dolor, inflamación, hematomas y trismo, y cuyo tratamiento de elección sigue siendo la farmacología. La hiloterapia es un tratamiento alternativo complementario que forma parte de la medicina física terapéutica. Se trata de una unidad conectada a una máscara preformada de contorno facial que, mediante la reducción de la termperatura tisular de manera constante, persigue conseguir la disminución del flujo sanguíneo, la inflamación, el dolor y el edema. Caso clínico: Se presenta el caso clínico de una mujer de 22 años de edad, sin antecedentes médicos de interés, que acudió al Hospital Virgen de la Paloma por presentar dolor en el tercer molar inferior izquierdo. Una vez realizada la exploración clínica y radiológica de la paciente, se propuso como plan de tratamiento la extracción de los cuatro cordales, bajo anestesia general. Inmediatamente después de la cirugía se colocó a la paciente la máscara facial de Hilotherm(R), programada a una temperatura constante de 15ºC. Se revisó a las 24h y a los 8 días tras la intervención. Conclusiones: La terapia con la máscara facial Hilotherm(R) ha demostrado ser de utilidad en la disminución del dolor y la inflamación postoperatorios derivados de la extracción quirúrgica de los terceros molares, probablemente debido a la posibilidad de un control constante de la temperatura y a la mayor colaboración del paciente. No hay evidencia científica suficiente que respalde su posible participación en la reducción de hematomas. Asimismo, este sistema sugiere un aumento significativo de la calidad de vida de los pacientes, así como una buena aceptación por parte de éstos otorgando más comodidad y satisfacción

Introduction: The extraction of third molars is common practice in the dental practice. The postoperative appearance of physiological responses such as pain, inflammation, bruising and trismus is very common, for which the treatment of choice is still pharmacology. The hilotherapy is a complementary alternative treatment that is part of the therapeutic physical medicine which consists on a unit connected to a preformed face contour mask that, by constantly reducing tissue temperature, aims to achieve decreased blood flow, inflammation, pain and edema. Clinical case: A clinical case of a 22-year-old woman is presented, with no interesting medical record, who went to the Virgen de la Paloma Hospital with pain in the left lower third molar. Once the clinical and radiological examination of the patient had been carried out, a treatment plan for the extraction of the four wisdom teeth, under general anesthesia, was proposed. Immediately after the surgery, the patient was placed the facial mask of Hilotherm(R) on, programmed at a constant temperature of 15ºC. It was reviewed twice, 24h and 8 days after the intervention. Conclusions: Hilotherm(R) facial mask therapy has been shown to be useful in the reduction of postoperative pain and inflammation derived from the surgical extraction of third molars, probably due to the possibility of constant temperature control and greater patient collaboration. There is not enough scientific evidence to support its possible participation in the reduction of bruising. Likewise, this system suggests a significant increase in the quality of life of patients, as well as a good acceptance from patients, providing them with more comfort and satisfaction

Influence of electron acceptors on hexanoic acid production by Clostridium kluyveri.

Clostridium kluyveri was used for chain elongation of C2C4 fatty acids in stirred tank bioreactors. The influence of different electron acceptors (acetic acid, butyric acid and the mixture of both) on C6 fatty acid production was evaluated in presence of ethanol using similar molar alcohol/acid ratios around 3.5. Bottle batch assays without pH regulation and with only acetic acid as electron acceptor yielded a final C6 fatty acid concentration of 6.8 ±â€¯0.6 g L-1. Then, pH-regulated bioreactors were operated at constant pH of 6.8. Under such conditions, the maximum growth rate was 0.039 h-1 obtained using acetic acid and butyric acid as electron acceptors, whereas the lowest growth rate was 0.010 h-1 with only butyric acid as electron acceptor. The maximum growth rate with acetic acid only, was similar, though slightly lower, as with the mixture of C2C4 fatty acids. Besides, the maximum productions of hexanoic acid were 11.8 g L-1, 13.1 g L-1 and 21.2 g L-1 using, respectively, acetic acid, butyric acid and the mixture of both acids as electron acceptors. Thus, the use of a mixture of acetic acid and butyric acid in presence of ethanol for chain elongation, at constant pH, proved to be efficient for hexanoic acid production.

Plasmodium falciparum K13 expression associated with parasite clearance during artemisinin-based combination therapy.

BACKGROUND: Delayed parasite clearance and, consequently, reduced efficacy of artemisinin-based combination therapies have been linked with Plasmodium falciparum K13 gene SNPs in Southeast Asia. In Africa, significantly prolonged clearance has not yet been observed and the presently restricted variation in parasite clearance cannot be explained by K13 polymorphisms. OBJECTIVES: Our aim was to study the in vivo pfK13 transcriptional response in patients treated with artemether-lumefantrine and explore whether the pfk13 transcripts can explain the patients' parasite clearance outcomes. PATIENTS AND METHODS: A total of 47 Tanzanian children with microscopically confirmed uncomplicated P. falciparum malaria were hospitalized and received artemether-lumefantrine treatment (clinical trial ID: NCT00336375). RNA was extracted from venous blood samples collected before treatment initiation and at five more timepoints after treatment. cDNA was synthesized and pfk13 transcripts measured by real-time PCR. RESULTS: A wide range of pfk13 transcript variation was observed throughout all timepoints after artemether-lumefantrine treatment. Taking parasite clearance data together with the pfk13 transcripts profile, we observed a negative correlation inferring that pfk13 down-regulation is associated with longer parasite clearance time. CONCLUSIONS: The findings suggest that a reduced PfK13 transcriptional response may represent a first step towards artemisinin tolerance/resistance.

Lipid-mediated growth of SrCO3/CaCO3 hybrid films as bioactive coatings for Ti surfaces.

SrCO3 is frequently used as Sr2+ source in ceramic cements, but its application as bioactive coating for metallic implants has not been explored yet. Aiming at rapid osteointegration and because of the well-known Sr2+ effects on bone metabolism, researchers have sought to design Sr2+-containing biomaterials. In this context, developing simple techniques to prepare Sr2+-based coatings is a must nowadays. Here, we describe the use of a bioinspired lipid-mediated approach to grow SrCO3 hybrid films on Ti surfaces at room temperature. To obtain these coatings, we applied the Langmuir-Blodgett technique to deposit phospholipid films with high degree of organization on Ti. In this way, we expected that controlled SrCO3 crystal growth could be templated by the array of nucleation points arising from electrostatic interaction between Sr2+ and the phospholipid polar heads. To control surface composition and the amount of Sr2+ released from the coatings, we also promoted CaCO3 co-precipitation in the hybrid films. We characterized the hybrid coatings in terms of morphology, chemical structure, wettability, and ability to release Sr2+ upon immersion in biological medium. In vitro osteoblast culture on mixed SrCO3/CaCO3 films revealed that the osteogenic response depended on surface composition, as indicated by alkaline phosphatase activity overexpression, which is an early indicator of osteoblast differentiation. Results showed that the mixed SrCO3/CaCO3 hybrid film created a synergic environment for osteoblasts, and that proper Sr2+ release associated with a Ca2+-rich environment might have optimized the Sr2+ anabolic effect. In conclusion, we have proposed a bioinspired and versatile technique to grow hybrid films that can control surface composition and Sr2+ release. Our results open an opportunity to explore the use of SrCO3-based coatings for rapid metallic implant osteointegration.

Percutaneous electrical stimulation for overactive bladder in children: a pilot study.

PURPOSE: The purpose of this was to evaluate the efficacy (tolerance and safety) of once-a-week parasacral percutaneous electrical nerve stimulation (PENS) to treat overactive bladder (OAB) in children. MATERIALS AND METHODS: This is a prospective case series of children aged 4-14 years who underwent PENS for OAB. Acupuncture needles were used bilaterally and symmetrically at S3 for sacral nerve stimulation (Figure). Eighteen children with pure OAB underwent PENS weekly for 20 weeks. Frequency was 10 Hz. Intensity varied up to a maximum of 10 mA, as tolerated by the participant, but without reaching the motor threshold. Pulse width was 600 µs Patients' voiding history was assessed before treatment using a structured questionnaire. The dysfunctional voiding scoring system (DVSS) was used before and after treatment to quantify symptoms of lower urinary tract dysfunction. A visual analog scale (VAS) was used to evaluate treatment outcome. RESULTS: Seven boys and eleven girls (mean age, 7.82 ± 2.45 years) were included. According to the VAS, symptoms were resolved in 66% of patients. Urinary urgency, present in all children at baseline, was resolved in 84% (P = 0.001). The proportion of patients with involuntary loss of urine without urgency decreased from 77% before treatment to 27% (P = 0.04). Urge incontinence resolved in 13 of 16 patients after treatment (P = 0.001). Only one of the 12 children with frequent urination at baseline reported this complaint after treatment (P = 0.04). All cases of recurrent urinary tract infection were resolved (P = 0.001). Regarding nocturnal enuresis, treatment was successful in 9 of 14 children (P = 0.004). DISCUSSION: The theory behind this new method is that when skin impedance is overcome through the use of acupuncture needles and greater proximity is attained between the tip of the electrode and the sacral nerves, a more effective stimulus is achieved, with enough energy to provide the same benefits as parasacral transcutaneous electrical nerve stimulation with the advantage that treatment can be given only once a week. CONCLUSIONS: Percutaneous electrical nerve stimulation seems to be an effective and safe treatment for OAB over the short term. Furthers studies with a control group are needed.

Hydrometra in dairy goats: Ultrasonic variables and therapeutic protocols evaluated during the reproductive season.

Hydrometra is characterized by the accumulation of fluid within the uterus due to the persistence of corpus luteum. The diagnosis of this disorder occurs with an ultrasonic exam. This study evaluated uterine drainage and fertility rates in goats after the use of d-cloprostenol in association or not with Gonadotropin-releasing hormone (GnRH) treatment. Twenty Saanen goats, diagnosed with hydrometra, received three 37.5-µg doses of d-cloprostenol laterovulvarly at 10-day intervals. On D5, the goats were assigned into two groups receiving 1 mL of GnRH or saline solution intramuscularly. Ultrasonography (US) was performed from D0 to D25. An US approach was used to rank hydrometra in scores. The pregnancy rate was assessed 45 and 90 days after the end of treatment. The uterine fluid was totally drained after the first and second administration of d-cloprostenol in 50% and 95% of the goats, respectively. In one female, full emptying of the uterus occurred only after D20. US performed at 45 and 90 days after the end of treatment indicated there was a pregnancy rate of 45.0% and 55.0%, respectively. Fertility did not differ between the GnRH-treated and control goats. Those goats not pregnant at 45 days had a follicular cyst, hydrosalpinx or hydrometra. At 90 days, no change was observed in the hydrosalpinx, and four goats had hydrometra. The use of three doses of d-cloprostenol 10 days apart was efficient for induction of draining the contents of the uterus, resulting in a relatively acceptable pregnancy rate. This treatment associated with the US approach can be important when applied in the field.

Bloqueo en el plano del músculo erector de la columna para mastectomía radical: ¿una nueva indicación? / Erector spinae plane block for radical mastectomy: a new indiacation?

El bloqueo de la fascia del músculo erector de la columna es una técnica recientemente descrita por Forero et al. en septiembre de 2016. Tiene aplicaciones en el control del dolor crónico con componente neuropático de la pared torácica, y para el control del dolor en cirugía toracoscópica. En este artículo, describimos el uso de esta técnica como parte de un enfoque analgésico multimodal en una mujer de 40 años, que fue sometida a una mastectomía radical a causa de un cáncer de mama. Al realizar este bloqueo antes de la inducción anestésica, conseguimos un efecto ahorrador de opioides, evitando el posible efecto inmunomodulador, que todavía no está comprobado en humanos. Durante la hospitalización, la paciente no reportó dolor (0/10 en escala numérica), sin recurrir a analgesia de rescate. La ejecución fácil, rápida y segura del bloqueo de la fascia del músculo erector de la columna hace que esta sea una técnica prometedora en el contexto del dolor quirúrgico durante la mastectomía radical (AU)

The erector spinae plane block is a technique recently described by Forero et al. in September 2016. It has applications in the control of chronic pain with neuropathic component of the chest wall, and for pain control in thoracoscopic surgery. In this article, we describe the use of this technique as part of a multimodal analgesic approach in a 40-year-old woman, who underwent radical mastectomy due to breast cancer. By performing this block before anesthetic induction, we have achieved an opioid sparing effect, avoiding a possible immunomodulatory effect, although not yet proven in humans. During hospitalization, the patient reported no pain (0/10 in numeric scale), without resorting to rescue analgesia. The easy, fast and safe execution of erector spinae plane block makes it a promising technique in the context of surgical pain during radical mastectomy (AU)

Maternal left ventricular hypertrophy and diastolic dysfunction and brain natriuretic peptide concentration in early- and late-onset pre-eclampsia.

OBJECTIVE: Pre-eclampsia (PE) is associated with maternal cardiac remodeling and diastolic dysfunction. The aim of this study was to assess and compare maternal left ventricular structure and diastolic function and levels of brain natriuretic peptide (BNP) in women with early-onset (< 34 weeks' gestation) vs those with late-onset (≥ 34 weeks' gestation) PE. METHODS: This was a prospective, cross-sectional, observational study of 30 women with early-onset PE, 32 with late-onset PE and 23 normotensive controls. Maternal cardiac structure and diastolic function were assessed by echocardiography and plasma levels of BNP were measured by enzyme immunoassay. RESULTS: Early- and late-onset PE were associated with increased left ventricular mass index and relative wall thickness compared with normotensive controls. In women with early-onset PE, the prevalence of concentric hypertrophy (40%) and diastolic dysfunction (23%) was also significantly higher (both P < 0.05) compared with women with late-onset PE (16% for both). Maternal serum BNP levels were significantly higher (P < 0.05) in women with early-onset PE and correlated with relative wall thickness and left ventricular mass index. CONCLUSIONS: Early-onset PE is associated with more severe cardiac impairment than is late-onset PE, as evidenced by an increased prevalence of concentric hypertrophy, diastolic dysfunction and higher levels of BNP. These findings suggest that early-onset PE causes greater myocardial damage, increasing the risk of both peripartum and postpartum cardiovascular morbidity. Although these cardiovascular effects are easily identified by echocardiographic parameters and measuring BNP, further studies are needed to assess their clinical utility. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Organic loading rate effect on the acidogenesis of cheese whey: a comparison between UASB and SBR reactors.

Volatile fatty acids (VFA) production and degree of acidification (DA) were investigated in the anaerobic treatment of cheese whey by comparison of two processes: a continuous process using a laboratory upflow anaerobic sludge blanket (UASB) reactor and a discontinuous process using a sequencing batch reactor (SBR). The main purpose of this work was to study the organic loading rate (OLR) effect on the yield of VFA in two kinds of reactors. The predominant products in the acidogenic process in both reactors were: acetate, propionate, butyrate and valerate. The maximum DA obtained was 98% in an SBR at OLR of 2.7 g COD L-1 d-1, and 97% in the UASB at OLR at 15.1 g COD L-1 d-1. The results revealed that the UASB reactor was more efficient at a medium OLR with a higher VFA yield, while with the SBR reactor, the maximum acidification was obtained at a lower OLR with changes in the VFA profile at different OLRs applied.

Transrectal ultrasound evaluation in tropical dairy goats: an indispensable tool for the diagnosis of reproductive disorders.

In Brazil, great milk productivity was achieved after the implementation of a genetic improvement program. However, reproductive efficiency is still far from optimal, possibly due to the high number of undiagnosed disorders that may affect fertility. The aim of this study was to evaluate occurrences of the main reproductive disorders in dairy goats in southeastern Brazil. Data were collected between January 2015 and May 2017 from 23 commercial herds of different breeds, with goats ranging from 8 months to 12 years of age. Transrectal ultrasound exams were performed in 2680 goats. A total of 14.8% of the does showed a disorder in the reproductive tract: hydrometra (10.0%), ovarian follicular cysts (2.3%), gestational loss (1.5%), and hydrosalpinx (1.1%). This was the first study evaluating reproductive disorders in live animals that used a high number of Brazilian dairy goats. Considering that all these diseases affect fertility to different degrees, the performance of transrectal ultrasonography exams twice a year is strongly suggested, in order to guide precocious treatment or discard the animal as soon as possible, thus reducing economic losses in dairy goat farming.

Aeromonas caviae inhibits hepatic enzymes of the phosphotransfer network in experimentally infected silver catfish: Impairment on bioenergetics.

Several studies have been demonstrated that phosphotransfer network, through the adenylate kinase (AK) and pyruvate kinase (PK) activities, allows for new perspectives leading to understanding of disease conditions associated with disturbances in energy metabolism, metabolic monitoring and signalling. In this sense, the aim of this study was to evaluate whether experimental infection by Aeromonas caviae alters hepatic AK and PK activities of silver catfish Rhamdia quelen. Hepatic AK and PK activities decreased in infected animals compared to uninfected animals, as well as the hepatic adenosine triphosphate (ATP) levels. Also, a severe hepatic damage was observed in the infected animals due to the presence of dilation and congestion of vessels, degeneration of hepatocytes and loss of liver parenchyma architecture and sinusoidal structure. Therefore, we have demonstrated, for the first time, that experimental infection by A. caviae inhibits key enzymes linked to the communication between sites of ATP generation and ATP utilization. Moreover, the absence of a reciprocal compensatory mechanism between these enzymes contributes directly to hepatic damage and for a severe energetic imbalance, which may contribute to disease pathophysiology.