Prevalence of subclinical systolic dysfunction in Takayasu's arteritis and its association with disease activity: a cross-sectional study.

BACKGROUND: Takayasu's arteritis (TA) is a vasculitis that affects the aorta and its branches and causes stenosis, occlusion, and aneurysms. Up to 60% of TA patients are associated with cardiac involvement which confers a poor prognosis. Global longitudinal strain (GLS) analysis is an echocardiographic technique that can detect the presence of subclinical systolic dysfunction. Hence, this study aimed to describe the prevalence of subclinical systolic dysfunction in patients with TA using the GLS method and to correlate this finding with disease activity using the ITAS-2010 (Indian Takayasu Activity Score). METHODS: Thirty patients over 18 years of age who met the American College of Rheumatology (ACR) 1990 criteria for TA were included. The sample was submitted for medical record review, clinical and echocardiographic evaluation, and application of ITAS-2010. The cutoff for systolic dysfunction was GLS > - 20%. RESULTS: Of the 30 patients analyzed, 25 (83.3%) were female, and the mean age was 42.6 years (± 13.2). The median time since diagnosis was 7.5 years [range, 3-16.6 years], and the type V angiographic classification was the most prevalent (56.7%). Regarding echocardiographic findings, the median ejection fraction (EF) was 66% [61-71%] and the GLS was - 19.5% [-21.3 to -15.8%]. Although half of the participants had reduced GLS, only two had reduced EF. Eleven patients (33.%) met the criteria for activity. An association was found between disease activity and reduced GLS in eight patients (P = 0.02) using the chi-square test. CONCLUSION: GLS seems to be an instrument capable of the early detection of systolic dysfunction in TA. The association between GLS and disease activity in this study should be confirmed in a study with a larger sample size.

Past, Present, and Future of Naturally Occurring Antimicrobials Related to Snake Venoms.

This review focuses on proteins and peptides with antimicrobial activity because these biopolymers can be useful in the fight against infectious diseases and to overcome the critical problem of microbial resistance to antibiotics. In fact, snakes show the highest diversification among reptiles, surviving in various environments; their innate immunity is similar to mammals and the response of their plasma to bacteria and fungi has been explored mainly in ecological studies. Snake venoms are a rich source of components that have a variety of biological functions. Among them are proteins like lectins, metalloproteinases, serine proteinases, L-amino acid oxidases, phospholipases type A2, cysteine-rich secretory proteins, as well as many oligopeptides, such as waprins, cardiotoxins, cathelicidins, and ß-defensins. In vitro, these biomolecules were shown to be active against bacteria, fungi, parasites, and viruses that are pathogenic to humans. Not only cathelicidins, but all other proteins and oligopeptides from snake venom have been proteolyzed to provide short antimicrobial peptides, or for use as templates for developing a variety of short unnatural sequences based on their structures. In addition to organizing and discussing an expressive amount of information, this review also describes new ß-defensin sequences of Sistrurus miliarius that can lead to novel peptide-based antimicrobial agents, using a multidisciplinary approach that includes sequence phylogeny.

Past, present, and future of naturally occurring antimicrobials related to snake venoms

This review focuses on proteins and peptides with antimicrobial activity because these biopolymers can be useful in the fight against infectious diseases and to overcome the critical problem of microbial resistance to antibiotics. In fact, snakes show the highest diversification among reptiles, surviving in various environments; their innate immunity is similar to mammals and the response of their plasma to bacteria and fungi has been explored mainly in ecological studies. Snake venoms are a rich source of components that have a variety of biological functions. Among them are proteins like lectins, metalloproteinases, serine proteinases, L-amino acid oxidases, phospholipases type A2, cysteine-rich secretory proteins, as well as many oligopeptides, such as waprins, cardiotoxins, cathelicidins, and β-defensins. In vitro, these biomolecules were shown to be active against bacteria, fungi, parasites, and viruses that are pathogenic to humans. Not only cathelicidins, but all other proteins and oligopeptides from snake venom have been proteolyzed to provide short antimicrobial peptides, or for use as templates for developing a variety of short unnatural sequences based on their structures. In addition to organizing and discussing an expressive amount of information, this review also describes new β-defensin sequences of Sistrurus miliarius that can lead to novel peptide-based antimicrobial agents, using a multidisciplinary approach that includes sequence phylogeny.

In sickness and in health: the intestinal microbiome of dogs / Na saúde e na doença: os efeitos do microbioma intestinal no cão

Studies on the interactions between the intestinal microbiome and its host have strengthened in the last decade. However, publications on this topic in dogs still need to be made available, reinforcing the need for new studies and literary data for consultation. Given this, this review aims to describe the intestinal microbiome and its interactions with the canine host, which can contribute to both health and morbid conditions in these animals. The definition of microbiome encompasses the collective genome of all microorganisms that live in a defined habitat (intestine). It is known that the dog's intestinal microbiota is varied, composed of bacteria, archaea, viruses, fungi, and protozoa. Under normal conditions, there is commensalism between some of these microorganisms and the host, which promotes critical physiological relationships and interactions that contribute to homeostasis and the consequent health of the animal. With this in mind, it is expected that the disturbances associated with the microbiome will result in imbalances in this commensal relationship and thus precipitate the development of diseases and aggravation of other diseases, thus characterizing intestinal dysbiosis.(AU)

Os estudos sobre as interações entre o microbioma intestinal e o seu hospedeiro ganharam força na última década. Entretanto, as publicações acerca de tal temática em cães ainda são escassas, o que reforça a necessidade de novos estudos e dados literários para consultas. Frente a isso, o objetivo da presente revisão é descrever sobre o microbioma intestinal e suas interações e principais efeitos no cão, os quais podem contribuir tanto para a higidez quanto para quadros mórbidos desses animais. A definição de microbioma engloba o genoma coletivo de todos os microrganismos que vivem em habitat definido (intestino). É sabido que a microbiota intestinal do cão é muito variada, sendo composta por bactérias, arqueas, vírus, fungos e protozoários. Em condições normais, há o comensalismo entre alguns desses microrganismos e o hospedeiro, o que promove importantes relações e interações fisiológicas que contribuem sobremaneira para a homeostasia e consequente saúde do animal. Ciente disso, é de se esperar que os distúrbios associados ao microbioma resultarão em desequilíbrios nessa relação comensal e, assim, precipitar o desenvolvimento de doenças e/ou agravamento de outras moléstias, caracterizando, assim, a disbiose intestinal.(AU)

Prevalence of subclinical systolic dysfunction in Takayasu's arteritis and its association with disease activity: a cross-sectional study

Abstract Background Takayasu's arteritis (TA) is a vasculitis that affects the aorta and its branches and causes stenosis, occlusion, and aneurysms. Up to 60% of TA patients are associated with cardiac involvement which confers a poor prognosis. Global longitudinal strain (GLS) analysis is an echocardiographic technique that can detect the presence of subclinical systolic dysfunction. Hence, this study aimed to describe the prevalence of subclinical systolic dysfunction in patients with TA using the GLS method and to correlate this finding with disease activity using the ITAS-2010 (Indian Takayasu Activity Score). Methods Thirty patients over 18 years of age who met the American College of Rheumatology (ACR) 1990 criteria for TA were included. The sample was submitted for medical record review, clinical and echocardiographic evaluation, and application of ITAS-2010. The cutoff for systolic dysfunction was GLS > - 20%. Results Of the 30 patients analyzed, 25 (83.3%) were female, and the mean age was 42.6 years (± 13.2). The median time since diagnosis was 7.5 years [range, 3-16.6 years], and the type V angiographic classification was the most prevalent (56.7%). Regarding echocardiographic findings, the median ejection fraction (EF) was 66% [61-71%] and the GLS was - 19.5% [-21.3 to -15.8%]. Although half of the participants had reduced GLS, only two had reduced EF. Eleven patients (33.%) met the criteria for activity. An association was found between disease activity and reduced GLS in eight patients (P = 0.02) using the chi-square test. Conclusion GLS seems to be an instrument capable of the early detection of systolic dysfunction in TA. The association between GLS and disease activity in this study should be confirmed in a study with a larger sample size.

Reconstrução de palato com malha de polipropileno e prótese acrílica para correção de fístula oronasal adquirida em cão / Palate reconstruction with polypropylene mesh and acrylic prosthesis in dog for correcton of acquired oronosal fistulae

As fístulas oronosais adquiridas são defeitos que permitem a comunicação anormal entre as cavidades oral e nasal. Inúmeras causas podem ser atribuídas à etiologia de tal defeito. O presente trabalho visa relatar o caso de um cão com fístula oronasal adquirida que foi submetido à reconstrução cirúrgica do palato com o uso de malha de polipropileno e prótese acrílica. Após estabilização do quadro clínico e remoção manual das larvas, o paciente foi encaminhado para o desbridamento cirúrgico das lesões orais e correção do defeito no palato. A palatoplastia foi realizada com o uso da malha e resina de polimetilmetacrilato autopolimerizável. A malha foi suturada sobre o defeito palatino com pontos simples separados e fio náilon 3-0 nas extremidades da ferida. Em seguida, a resina foi preparada e, ao atingir consistência adequada, foi aplicada e modelada sobre o a malha de polipropileno com o auxílio de um descolador de Molt, sendo também suturada nas bordas da fístula com pontos simples separados e fio náilon 3-0. No mesmo tempo cirúrgico foi inserida uma sonda esofágica para alimentação enteral. Devido complicações cirúrgicas no pós operatório, o paciente foi submetido a mais duas intervenções cirúrgicas para desfecho satisfatório do tratamento. Conclui-se que associação entre a tela de polipropileno e a prótese acrílica foi uma alternativa exequível para a palatoplastia em cão.

Acquired oronosal fistulae are abnormal communication between the oral and nasal cavities. A oronasal fistula can be the result of different causes, like oral myiasis. The objetctive of these paper is to report the case of a dog with acquired oronasal fistula that underwent surgical reconstruction of the palate using polypropylene mesh and acrylic prosthesis. After stabilization of the patient ́s clinical condition and mecanic removal of the larvae, the dog was referred for surgical debridement of the oral lesions and correction of the defect in the palate. Palatoplasty was performed using a mesh and polymethylmethacrylate resin. The mesh was sutured over the palatal defect with separate simple suture and 3-0 naylon thread at the ends of the wound. Then, the resin was prepared and, upon reaching adequate consistency, it was applied and shaped over the polypropylene mesh with Molt peeler. It was also sutured on the edges of the fistula with separate simple suture and 3-0 nylon suture. At the same surgical time, an esophageal tube was inserted for enteral feeding. Due to complications, the dog underwent two more surgical interventions for a satisfactory treatment outcome. It is concluded that the association between the polypropylene mesh and the acrylic prosthesis was a practical alternative for palatoplasty in dogs after oral myiasis.

Estimation of the aboveground biomass and carbon stocks in open Brazilian Savannah developed on sandy soils.

BACKGROUND: The Cerrado is the second largest biome in Brazil and the most biodiverse tropical savannah in the world and acts as a great sequester of atmospheric carbon. The lack of studies related to the quantification of its total biomass compromises the understanding of the dynamics of CO2 in this biome. Thus, it is relevant to develop studies aiming at obtaining accurate estimates of the carbon stock in the different phytophysiognomies that make the Cerrado, to include them in appropriate forest management models. Based on the hypothesis that the amount of carbon stored can vary according to the vegetation typology and vegetation compartments, the aerial stock of dry biomass and carbon were estimated in different compartments (arboreal, herbaceous-shrub and litter). The study was developed in open Brazilian savannah and soils on the sandstone and discussed the effect of fire on this phytophysiognomy. For the arboreal compartment were adjusted mathematical models to fit the biomass equations to estimate the individual stock of the trees in this compartment. The results of the stocks were discussed considering the effect of fire on the phytophysiognomy. RESULTS: Based on the precision and extra distribution measures, the Schumacher-Hall (non-logarithmic) equation presented better results to estimate the individual biomass and carbon stocks of the open Brazilian savannah trees. The aboveground biomass was 12.88 Mg ha-1, corresponding to a total carbon stock of 5.91 Mg ha-1, where most of the stocks are in the herbaceous-shrub compartment (44%). The arboreal compartment accounts for the smallest part of the stocks, followed by the litter. CONCLUSIONS: The observed values are in the interval verified for other areas of savannah studied in Brazil. The values verified for the open Brazilian savannah in sandy soils are at the lower limit of this range, due to the nutrient-poor nature of this type of soil. The distribution of stocks in the different compartments above the ground points to the fragility of this environment to the random fire effect, common in the region. That shows the need for conservation measures for vegetation maintenance and soil protection to preserve adequate nutrient cycling in the ecosystem.

Bothrops jararaca accessory venom gland is an ancillary source of toxins to the snake.

In Viperidae snakes, it has been attributed to the main venom gland, a component of the venom gland apparatus, the function of synthesizing all venom toxins and storing them inside a basal-central lumen. However, the role of the accessory gland is still unknown. Here, we analyzed the proteome and the transcriptome of the accessory gland during venom production and secretion cycle. We showed that the accessory gland expresses and synthesizes toxins that are similar to those produced by the main venom gland such as C-type lectin/C-type lectin-like proteins, metalloproteinase, phospholipase A2, cysteine rich secretory protein, nerve growth factor, vascular endothelial growth factor, serine proteinase, and l-amino acid oxidase. Our data have shown that toxin synthesis in the accessory gland is asynchronous when compared to the same process in the venom gland. Moreover, this gland also expresses inhibitors of venom phospholipases A2 and metalloproteinases. Transcriptome analysis showed that the transcripts that correspond to toxins in the accessory gland have a good correlation to the main venom gland transcripts. Therefore, it is proposed that the accessory gland is an ancillary source of toxins to the snake, and provides inhibitors that could control venom toxicity (and integrity) during storage. SIGNIFICANCE: In this study, we propose that the accessory venom gland acts as an important ancillary source of toxins to the snake, in lieu of a depleted main venom gland, and provides inhibiting agents that control venom toxicity (and integrity) during its storage.

Bothrops jararaca accessory venom gland is an ancillary source of toxins to the snake

In Viperidae snakes, it has been attributed to the main venom gland, a component of the venom gland apparatus, the function of synthesizing all venom toxins and storing them inside a basal-central lumen. However, the role of the accessory gland is still unknown. Here, we analyzed the proteome and the transcriptome of the accessory gland during venom production and secretion cycle. We showed that the accessory gland expresses and synthesizes toxins that are similar to those produced by the main venom gland such as C-type lectin/C-type lectin-like proteins, metalloproteinase, phospholipase A(2), cysteine rich secretory protein, nerve growth factor, vascular endothelial growth factor, serine proteinase, and L-amino acid oxidase. Our data have shown that toxin synthesis in the accessory gland is asynchronous when compared to the same process in the venom gland. Moreover, this gland also expresses inhibitors of venom phospholipases A(2) and metalloproteinases. Transcriptome analysis showed that the transcripts that correspond to toxins in the accessory gland have a good correlation to the main venom gland transcripts. Therefore, it is proposed that the accessory gland is an ancillary source of toxins to the snake, and provides inhibitors that could control venom toxicity (and integrity) during storage. Significance: In this study, we propose that the accessory venom gland acts as an important ancillary source of toxins to the snake, in lieu of a depleted main venom gland, and provides inhibiting agents that control venom toxicity (and integrity) during its storage.

Bothrops jararaca accessory venom gland is an ancillary source of toxins to the snake

In Viperidae snakes, it has been attributed to the main venom gland, a component of the venom gland apparatus, the function of synthesizing all venom toxins and storing them inside a basal-central lumen. However, the role of the accessory gland is still unknown. Here, we analyzed the proteome and the transcriptome of the accessory gland during venom production and secretion cycle. We showed that the accessory gland expresses and synthesizes toxins that are similar to those produced by the main venom gland such as C-type lectin/C-type lectin-like proteins, metalloproteinase, phospholipase A(2), cysteine rich secretory protein, nerve growth factor, vascular endothelial growth factor, serine proteinase, and L-amino acid oxidase. Our data have shown that toxin synthesis in the accessory gland is asynchronous when compared to the same process in the venom gland. Moreover, this gland also expresses inhibitors of venom phospholipases A(2) and metalloproteinases. Transcriptome analysis showed that the transcripts that correspond to toxins in the accessory gland have a good correlation to the main venom gland transcripts. Therefore, it is proposed that the accessory gland is an ancillary source of toxins to the snake, and provides inhibitors that could control venom toxicity (and integrity) during storage. Significance: In this study, we propose that the accessory venom gland acts as an important ancillary source of toxins to the snake, in lieu of a depleted main venom gland, and provides inhibiting agents that control venom toxicity (and integrity) during its storage.

Proteomic analysis of the rare Uracoan rattlesnake Crotalus vegrandis venom: Evidence of a broad arsenal of toxins.

The investigation of venoms has many clinical, pharmacological, ecological and evolutionary outcomes. The Crotalus spp. venom can cause hemorrhage, neurotoxicity, myotoxicity, coagulopathy and hypotension. Although neurotoxicity and hemorrhage usually does not occur for the same species, the rare Venezuelan species Crotalus vegrandis presents both characteristic. Different from the other species it has a restricted ecological niche and geographical distribution. Nevertheless, it has a raising medical importance as this rattlesnake population is increasing. Few works describe its neurotoxic and hemorrhagic features, but other toxins might play an important role in envenomation. We combined proteomic methods to identify for the first time the main components of it venom: 2D SDS-PAGE and gel-filtration chromatography for protein mixture decomplexation; LC-MS(2) of low molecular mass fractions and tryptic peptides; bioinformatic identification of toxin families and specific protein species based on unique peptide analysis and sequence database enriched with species-specific venom gland transcripts; and finally polyclonal anti-crotamine Western-blotting. Our results point to a broad arsenal of toxins in C. vegrandis venom: PIII and PII metalloproteases, crotoxin subunits, other phospholipases, isoforms of serine proteases and lectins, l-amino-acid oxidase, nerve growth factor, as well as other less abundant toxins.

Interaction of the rattlesnake toxin crotamine with model membranes.

Crotamine is one of the main constituents of the venom of the South American rattlesnake Crotalus durissus terrificus. A common gene ancestry and structural similarity with the antimicrobial ß-defensins (identical disulfide bond pattern and highly positive net charge) suggested potential antimicrobial activities for this snake toxin. Although crotamine demonstrated low activity against both Gram-positive and Gram-negative bacteria, a pronounced antifungal activity was observed against Candida spp., Trichosporon spp., and Cryptococcus neoformans. Crotamine's selective antimicrobial properties, with no observable hemolytic activity, stimulated us to evaluate the potential applications of this polypeptide as an antiyeast or candicidal agent for medical and industrial application. Aiming to understand the mechanism(s) of action underlying crotamine antimicrobial activity and its selectivity for fungi, we present herein studies using membrane model systems (i.e., large unilamellar vesicles, LUVs, and giant unilamellar vesicles, GUVs), with different phospholipid compositions. We show here that crotamine presents a higher lytic activity on negatively charged membranes compared with neutral membranes, with or without cholesterol or ergosterol content. The vesicle burst was not preceded by membrane permeabilization as is generally observed for pore forming peptides. Although such a property of disrupting lipid membranes is very important to combat multiresistant fungi, no inhibitory activity was observed for crotamine against biofilms formed by several Candida spp. strains, except for a limited effect against C. krusei biofilm.

Intervençäo cirúrgica eletiva durante a menstruaçäo: análise de um levantamento / Elective surgery during menstruation: a survey analysis

Faz-se um breve histórico sobre alguns tabus e crenças em relaçäo à menstruaçäo para se chegar à indagaçäo sobre por que se opera ou näo a mulher menstruada. Foi realizado um questionário sobre o tema, o qual foi encaminhado a 57 serviços de ginecologia, obtendo-se 17 respostas. Analisa-se o assunto após revisäo da literatura, concluindo-se que as alteraçöes do sistema de coagulaçäo e o risco de endometriose näo justificam postergar as intervençöes cirúrgicas eletivas durante a menstruaçäo

Fatores envolvidos na associaçäo lúpus eritematoso-neoplasia cervical / Involved factors in the association lupus erythematosus-cervical neoplasia

A partir da observaçäo de vários autores da maior freqüência de neoplasia cervical (NC) em pacientes portadoras de lúpus eritematoso (LE), foram acompanhadas 113 pacientes portadoras de doença do tecido conjuntivo (DTC), sendo 81 portadoras de LE. Este grupo näo era altamente exposto à NC por fatores epidemiológicos prévios; a forma de tratamento näo foi significativamente diferente entre as pacientes afetadas; näo foi evidenciada a participaçäo do HPV nas pacientes com NC de forma relevante; a prevalência de NC em portadoras de DTC foi de 21,24% e de 27,16% nas portadoras de LE; o risco relativo de pacientes portadoras de LE apresentarem NC foi de, aproximadamente, 22 vezes. Säo necessários estudos adicionais para melhor avaliaçäo da influência do tratamento e de fatores próprios do LE capazes de participar na patogenia da NC

Tratamento clínico da incontinência urinária na mulher / Clinical treatment of the female urinary incontinence

O artigo sumariza o tratamento clínico da incontinência urinária na mulher, apresentando a opiniäo dos autores. A síndrome e seu tratamento foram enfocadas segundo sua etiopatogenia

Tratamento cirúrgico da incontinência urinária de esforço por via vaginal: Análise de 5 casos / Surgical treatment of stress urinary incontinence by vaginal route

Foram analisados os resultados do tratamento cirúrgico para incontinência urinária de esforço (IUE) em 55 pacientes, no período de 1979 a 1985. Todas foram submetidas a cirurgia por via vaginal. Em 49 foi realizada colporrafia anterior com pontos de Kelly-Kennedy. Em outras seis pacientes que apresentavam algum grau de prlapso genital associado à IUE, foi realizada em cinco a operaçåo de Manchester-Fothergil e em uma a histerectomia vaginal. Quarenta e cinco pacientes nåo apresentaram recidiva da IUE até a época deste estudo, o que representa um índice de cura de 81,8 por cento, embora algumas tenham apresentado outros sintomas urinários, como urgência e freqüência urinárias. Treze pacientes referiram recidiva da IUE em um período que variou de seis meses a seis anos após a cirurgioa. Em três delas nåo foi evidenciado a perda de urina com o teste de esforço, e foram dadas como curadas

Prenhez ovariana intrafolicular: apresentaçäo de caso / Intrafolicular ovarian pregnancy: a case report

The autors report an uncommon case of ovarian pregnancy in a 31-yearold womam. They comment the differences between the primitive infrafolicular ovarian and the secundary one; the diagnostic difficulties and the role of laparoscopy in management of such cases

Endometriose urinária: evoluçäo após ooforectomia / Urinary endometriosis: evolution post oophorectomia

A endometriose urinária, apesar de näo ser freqüente, é de grande importância, devido à gravidade do seu curso. Há, em geral, obstruçäo das vias urinárias, tendo como conseqüência a hidronefrose e a atrofia renal. Outro aspecto pouco comum é a evoluçäo da endometriose após ooforectomia bilateral. Discutimos três casos, acompanhados no Serviço de Ginecologia do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, de pacientes com endometriose persistente pós-ooforectomia e com comprometimento urinário. A estabilizaçäo do processo evolutivo foi obtida com o uso de danazol e/ou medroxiprogesterona

Fatores de risco no adenocarcinoma do endométrio: experiência do Serviço de Ginecologia do Hospital Universitário da Universidade Federal do Rio de Janeiro / Risk factors of endometrial adenocarcinoma: experience of the Serviço de Ginecologia of the Hospital Universitário of the Universidade Federal do Rio de Janeiro

Foram analisados retrospectivamente 18 casos de adenocarcinoma de endométrio ocorridos no Serviço de Ginecologia do Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, no período de agosto de 1978 a maio de 1986. Devido ao número pequeno de casos, a análise estatística do nosso material näo foi significativa. No entanto, serviu para demonstrar a experiência do Serviço e auxiliar na elaboraçäo de um protocolo desta doença. Foram discutidos aspectos epidemiológicos e verificou-se que o fator de risco mais importante era a obesidade (50 por cento), levando a um estudo de hiperestrogenismo constante. Em relaçäo às queixas referidas pelas 18 pacientes de amostra foram encontradas hemorragia pós-menopausa (12 casos), metrorragia e leucorréia sanguinolenta. A colpocitologia contribuiu para o diagnóstico em sete casos, mas a curetagemm uterina fracionada foi o passo fundamental m todos os sangramentos pós-menopausa. Grande significância tem sido atribuída ao teste de progesterona, como por gambrell, para rastrear pacientes de alto risco assintomáticas na pós-menopausa