Anthocyanins and reactive oxygen species: a team of rivals regulating plant development?

Anthocyanins are a family of water-soluble vacuolar pigments present in almost all flowering plants. The chemistry, biosynthesis and functions of these flavonoids have been intensively studied, in part due to their benefit for human health. Given that they are efficient antioxidants, intense research has been devoted to studying their possible roles against damage caused by reactive oxygen species (ROS). However, the redox homeostasis established between antioxidants and ROS is important for plant growth and development. On the one hand, high levels of ROS can damage DNA, proteins, and lipids, on the other, they are also required for cell signaling, plant development and stress responses. Thus, a balance is needed in which antioxidants can remove excessive ROS, while not precluding ROS from triggering important cellular signaling cascades. In this article, we discuss how anthocyanins and ROS interact and how a deeper understanding of the balance between them could help improve plant productivity, nutritional value, and resistance to stress, while simultaneously maintaining proper cellular function and plant growth.

Promoter replacement of ANT1 induces anthocyanin accumulation and triggers the shade avoidance response through developmental, physiological and metabolic reprogramming in tomato.

The accumulation of anthocyanins is a well-known response to abiotic stresses in many plant species. However, the effects of anthocyanin accumulation on light absorbance and photosynthesis are unknown . Here, we addressed this question using a promoter replacement line of tomato constitutively expressing a MYB transcription factor (ANTHOCYANIN1, ANT1) that leads to anthocyanin accumulation. ANT1-overexpressing plants displayed traits associated with shade avoidance response: thinner leaves, lower seed germination rate, suppressed side branching, increased chlorophyll concentration, and lower photosynthesis rates than the wild type. Anthocyanin-rich leaves exhibited higher absorbance of light in the blue and red ends of the spectrum, while higher anthocyanin content in leaves provided photoprotection to high irradiance. Analyses of gene expression and primary metabolites content showed that anthocyanin accumulation produces a reconfiguration of transcriptional and metabolic networks that is consistent with, but not identical to those described for the shade avoidance response. Our results provide novel insights about how anthocyanins accumulation affects the trade-off between photoprotection and growth.

[Santa Casa de Misericórdia of Cachoeira: charity and philanthropy in the context of the imperial government's welfare policy]. / Santa Casa de Misericórdia da vila da Cachoeira: a caridade e a filantropia no contexto da política assistencial do governo imperial.

The constitution and operationalization of a religious brotherhood in Cachoeira, Bahia province, during the Brazilian imperial period, is investigated. Deserving of particular attention is the decree issued by Emperor Pedro I, which raised the then centennial São João de Deus Hospital, a royal institution administered by officials designated by the city council, to the status of Santa Casa de Misericórdia. The policy regulating the granting of privileges and provincial monies to all the institutions of this designation in Bahia is also analyzed. The study concludes that the financial policy adopted by the Brazilian State in Bahia constituted a significant stimulus both for the founding and for the financial upkeep of the Cachoeira brotherhood.

O estudo examina o processo de constituição e operacionalização de uma confraria devocional na vila de Cachoeira, província da Bahia, ao longo do período imperial brasileiro. Merecerá destaque o decreto do imperador dom Pedro I que elevou o então centenário Hospital São João de Deus, equipamento do patrimônio régio administrado por dirigentes designados pela Câmara de Vereadores, à condição de Santa Casa de Misericórdia. Além disso, será analisada a política de concessão de privilégios e consignações orçamentárias do governo da província destinada às misericórdias baianas. Conclui-se que a política das finanças públicas do Estado brasileiro, na Bahia, representou um estímulo relevante para a fundação e para a sustentação econômico-financeira da irmandade cachoeirana.

Santa Casa de Misericórdia da vila da Cachoeira: a caridade e a filantropia no contexto da política assistencial do governo imperial / Santa Casa de Misericórdia of Cachoeira: charity and philanthropy in the context of the imperial government's welfare policy

Resumo O estudo examina o processo de constituição e operacionalização de uma confraria devocional na vila de Cachoeira, província da Bahia, ao longo do período imperial brasileiro. Merecerá destaque o decreto do imperador dom Pedro I que elevou o então centenário Hospital São João de Deus, equipamento do patrimônio régio administrado por dirigentes designados pela Câmara de Vereadores, à condição de Santa Casa de Misericórdia. Além disso, será analisada a política de concessão de privilégios e consignações orçamentárias do governo da província destinada às misericórdias baianas. Conclui-se que a política das finanças públicas do Estado brasileiro, na Bahia, representou um estímulo relevante para a fundação e para a sustentação econômico-financeira da irmandade cachoeirana.

Abstract The constitution and operationalization of a religious brotherhood in Cachoeira, Bahia province, during the Brazilian imperial period, is investigated. Deserving of particular attention is the decree issued by Emperor Pedro I, which raised the then centennial São João de Deus Hospital, a royal institution administered by officials designated by the city council, to the status of Santa Casa de Misericórdia. The policy regulating the granting of privileges and provincial monies to all the institutions of this designation in Bahia is also analyzed. The study concludes that the financial policy adopted by the Brazilian State in Bahia constituted a significant stimulus both for the founding and for the financial upkeep of the Cachoeira brotherhood.

The regulation of P700 is an important photoprotective mechanism to NaCl-salinity in Jatropha curcas.

Salinity commonly affects photosynthesis and crop production worldwide. Salt stress disrupts the fine balance between photosynthetic electron transport and the Calvin cycle reactions, leading to over-reduction and excess energy within the thylakoids. The excess energy triggers reactive oxygen species (ROS) overproduction that causes photoinhibition in both photosystems (PS) I and II. However, the role of PSI photoinhibition and its physiological mechanisms for photoprotection have not yet been fully elucidated. In the present study, we analyzed the effects of 15 consecutive days of 100 mM NaCl in Jatropha curcas plants, primarily focusing on the photosynthetic electron flow at PSI level. We found that J. curcas plants have important photoprotective mechanisms to cope with the harmful effects of salinity. We show that maintaining P700 in an oxidized state is an important photoprotector mechanism, avoiding ROS burst in J. curcas exposed to salinity. In addition, upon photoinhibition of PSI, the highly reduced electron transport chain triggers a significant increase in H2 O2 content which can lead to the production of hydroxyl radical by Mehler reactions in chloroplast, thereby increasing PSI photoinhibition.

Proteomic and physiological approaches reveal new insights for uncover the role of rice thylakoidal APX in response to drought stress.

Chloroplast APX isoforms display controversial roles as H2O2 scavengers and signaling players in response to abiotic stress and conclusive results are lacking. We tested the hypothesis that thylakoidal APX displays an important role for drought tolerance, especially by regulating abundance of essential protein species. For this, OsApx8 RNAi-silenced rice (apx8) and non-transformed plants (NT) were exposed to mild water deficit. The drought-sensitivity in apx8 plants was revealed by decreases in shoot growth, relative water content and photosynthesis, which was accompanied by increased membrane damage, all compared to NT plants. This higher sensitivity of apx8 plants to mild drought stress was also related to a lower accumulation of important protein species involved in several metabolic processes, especially photosynthesis, photorespiration and redox metabolism. Despite apx8 plants have displayed an effective induction of compensatory antioxidant mechanisms in well-watered conditions, it was not enough to maintain H2O2 homeostasis and avoid oxidative and physiological disturbances under mild drought conditions. Thus, thylakoidal APX is involved in several phenotypic modifications at proteomic profile level, possibly via a H2O2-induced signaling mechanism. Consequently, this APX isoform is crucial for rice plants effectively cope with a mild drought condition. BIOLOGICAL SIGNIFICANCE: This work provides for the first time an integrative study involving proteomic, physiological and biochemical analyses directed to elucidation of thylakoidal APX roles for drought tolerance in rice plants. Our data reveal that this enzyme is crucial for maintaining of growth and photosynthesis under mild water deficit conditions. This essential role is related to maintaining of H2O2 homeostasis and accumulation of essential proteins involved in several important metabolic pathways. Remarkably, for drought resistance was essential the accumulation of proteins involved with metabolism of photosynthesis, signaling, carbohydrates, protein synthesis/degradation and stress. These results can contribute to understand the role of chloroplast ascorbate peroxidases in drought tolerance, highlighting the physiological importance of key proteins in this process.

Santa Casa de Misericórdia da vila da Cachoeira: a caridade e a filantropia no contexto da política assistencial do governo imperial / Santa Casa de Misericórdia of Cachoeira: charity and philanthropy in the context of the imperial government’s welfare policy

O estudo examina o processo de constituição e operacionalização de uma confraria devocional na vila de Cachoeira, província da Bahia, ao longo do período imperial brasileiro. Merecerá destaque o decreto do imperador dom Pedro I que elevou o então centenário Hospital São João de Deus, equipamento do patrimônio régio administrado por dirigentes designados pela Câmara de Vereadores, à condição de Santa Casa de Misericórdia. Além disso, será analisada a política de concessão de privilégios e consignações orçamentárias do governo da província destinada às misericórdias baianas. Conclui-se que a política das finanças públicas do Estado brasileiro, na Bahia, representou um estímulo relevante para a fundação e para a sustentação econômico-financeira da irmandade cachoeirana

PanCD44 Immunohistochemical Evaluation in Prostatectomies from Patients with Adenocarcinoma.

INTRODUCTION: CD44 has been proposed as a prognostic marker and a stem cell marker but studies in patients with prostate cancer have yielded inconsistent results. PATIENTS AND METHODS: Patients submitted to radical prostatectomy between 2008 and 2013 at a university hospital were followed with biannual serum PSA tests to determine the biochemical recurrence (BR). Archived paraffin blocks with neoplastic and nonneoplastic tissue were evaluated immunohistochemically for a panCD44 and MYC. RESULTS: Sixty-nine patients completed follow-up and were included. CD44 positivity was observed in inflammatory cells (42%), nonneoplastic epithelium (39.7%), and neoplastic tissue (12.3%). In nonneoplastic tissues staining was observed in basal and luminal cells with the morphology of terminally differentiated cells. In neoplastic tissues, CD44 negativity was correlated with higher Gleason scores (Rho = -0.204; p = 0.042) and higher preoperative serum PSA levels when evaluated continuously (p = 0.029). CD44 expression was not associated with tumor stage (p = 0.668), surgical margin status (p = 0.471), or BR (p = 0.346), nor was there any association between CD44 and MYC expression in neoplastic tissue (p = 1.0). CONCLUSION: In the bulk of cells, the minority of cancer stem cells would not be detected by immunohistochemistry using panCD44. As a prognostic marker, its expression was weakly correlated with Gleason score and preoperative PSA level, but not with surgical margin status, tumor stage, or BR.

Impact of testicular sperm extraction and testicular sperm aspiration on gonadal function in an experimental rat model

ABSTRACT Purpose To assess the impact of sperm retrieval on the gonadal function of rats with impaired spermatogenesis by comparing testicular sperm extraction (TESE) to aspiration (TESA). The efficacy of these procedures to sperm obtainment was also compared. Materials and Methods A pilot study showed impaired spermatogenesis, but normal testosterone (T) production after a bilateral orchidopexy applied to 26 rats, which were randomly assigned into four groups: TESE (n=7), TESA (n=7), SHAM (n=6) and Control (n=6). The T levels were measured through comparative analysis after the orchidopexy. Results There was no statistical difference in the animal's baseline T levels after orchidopexy in comparison to the controls: the TESE and TESA groups, 6.66±4.67ng/mL; the SHAM group (orchidopexy only), 4.99±1.96ng/mL; and the Control, 4.75±1.45ng/mL, p=0.27. Accordingly, no difference was found in the postoperative T levels: TESE, 5.35±4.65ng/mL; TESA, 3.96±0.80ng/mL; SHAM, 3.70±1.27ng/mL; p=0.4. The number of sperm cells found through TESE (41.0±7.0) was significantly larger than that found through TESA (21.3±8.1, p=0.001). Moreover, higher tissue weight was found through TESE (0.09±0.02g versus 0.04±0.04g, p=0.04). Conclusions The testicular sperm capture performed in rats through extraction or aspiration, after orchidopexy, did not significantly decrease the T levels. The amount of sperm found through testicular sperm extraction was higher than that through testicular sperm aspiration.

Mandibular Osteonecrosis Associated With Raloxifene.

Osteonecrosis is a disease with diverse pathophysiology, clinical presentation, and management. It may be associated with some medications used to treat systemic issues with bone metabolism. A few cases of jaw bone osteonecrosis have been associated with raloxifene. In this paper, the authors present a clinical report of a 64-year-old woman who presented with a necrosis foci in the right alveolar ridge of the mandible, associated with continued raloxifene use.

Impact of testicular sperm extraction and testicular sperm aspiration on gonadal function in an experimental rat model.

PURPOSE: To assess the impact of sperm retrieval on the gonadal function of rats with impaired spermatogenesis by comparing testicular sperm extraction (TESE) to aspiration (TESA). The efficacy of these procedures to sperm obtainment was also compared. MATERIALS AND METHODS: A pilot study showed impaired spermatogenesis, but normal testosterone (T) production after a bilateral orchidopexy applied to 26 rats, which were randomly assigned into four groups: TESE (n=7), TESA (n=7), SHAM (n=6) and Control (n=6). The T levels were measured through comparative analysis after the orchidopexy. RESULTS: There was no statistical difference in the animal's baseline T levels after orchidopexy in comparison to the controls: the TESE and TESA groups, 6.66±4.67ng/mL; the SHAM group (orchidopexy only), 4.99±1.96ng/mL; and the Control, 4.75±1.45ng/ mL, p=0.27. Accordingly, no difference was found in the postoperative T levels: TESE, 5.35±4.65ng/mL; TESA, 3.96±0.80ng/mL; SHAM, 3.70±1.27ng/mL; p=0.4. The number of sperm cells found through TESE (41.0±7.0) was significantly larger than that found through TESA (21.3±8.1, p=0.001). Moreover, higher tissue weight was found through TESE (0.09±0.02g versus 0.04±0.04g, p=0.04). CONCLUSIONS: The testicular sperm capture performed in rats through extraction or aspiration, after orchidopexy, did not significantly decrease the T levels. The amount of sperm found through testicular sperm extraction was higher than that through testicular sperm aspiration.

Francisco Antonio de Sampaio: a história natural e a cirurgia na Vila de Nossa Senhora do Rosário do Porto da Cachoeira / Francisco Antonio de Sampaio: natural history and surgery in the Village of Our Lady of the Rosary of the Port of Cachoeira

Analisa as atividades de Francisco Antônio de Sampaio, um representante das artes de curar no Brasil, especialmente a partir de sua inserção no campo da história natural e da cirurgia na vila de Nossa Senhora do Rosário da Cachoeira, na segunda metade do século XVIII. Ele estudou plantas e animais, possuía conhecimento sobre anatomia e sobre remédios utilizados para a cura das doenças de enfermos no referido contexto.(AU)

Metabolic syndrome in patients with rheumatoid arthritis followed at a University Hospital in Northeastern Brazil.

INTRODUCTION: Patients with rheumatoid arthritis (RA) are 30-60% more likely to develop cardiovascular disease (CV) than the general population. Metabolic syndrome (MS), defined by a number of cardiovascular risk factors, confers a greater risk of CVdisease and diabetes. The association of MS with RA is not yet fully understood and its prevalence varies from 19 to 63% across studies. OBJECTIVES: To assess the prevalence of MS in a population of RA patients followed in a hospital in Northeastern Brazil and analyze associations of demographic and clinical factors with MS. METHODS: Outpatients with RA were evaluated in a cross-sectional study regarding demographic, clinical, laboratory and anthropometric data. The criteria for defining MS were those adopted by NCEPIII (2005) and IDF (2006). RESULTS: 110 patients with RA were studied; 97.3% were female, with a mean age of 55.5 years (SD=12.9) and duration of illness of 11.2 years (SD=7.3). The MS prevalence from NCEPIII (2005) and IDF (2005) were, respectively, 50% and 53.4%. Advanced age (57.9±11.9 versus 52.9±13.5; p=0.04) and smoking load >20 packs/year (29% versus 9%, p=0.008) were associated with MS. The major components of the metabolic syndrome were abdominal obesity (98.1%), hypertension (80%) and low HDL cholesterol (72.2%). CONCLUSIONS: RA patients in a tertiary center in Northeastern Brazil showed high prevalence of MS. It is worth noting that almost all patients had MS and abdominal obesity, which has important practical implications. In addition to the components of MS, age and smoking were associated with this syndrome.

Metabolic syndrome in patients with rheumatoid arthritis followed at a University Hospital in Northeastern Brazil / Síndrome metabólica em pacientes com diagnóstico de artrite reumatoide acompanhados em um Hospital Universitário do Nordeste brasileiro

ABSTRACT Introduction: Patients with rheumatoid arthritis (RA) are 30-60% more likely to develop cardiovascular disease (CV) than the general population. Metabolic syndrome (MS), defined by a number of cardiovascular risk factors, confers a greater risk of CVdisease and diabetes. The association of MS with RA is not yet fully understood and its prevalence varies from 19-63% across studies. Objectives: To assess the prevalence of MS in a population of RA patients followed in a hospital in Northeastern Brazil and analyze associations of demographic and clinical factors with MS. Methods: Outpatients with RA were evaluated in a cross-sectional study regarding demographic, clinical, laboratory and anthropometric data. The criteria for defining MS were those adopted by NCEPIII (2005) and IDF (2006). Results: 110 patients with RA were studied; 97.3% were female, with a mean age of 55.5 years (SD = 12.9) and duration of illness of 11.2 years (SD = 7.3). The MS prevalence from NCEPIII (2005) and IDF (2005) were, respectively, 50% and 53.4%. Advanced age (57.9 ± 11.9 versus 52.9 ± 13.5; p = 0.04) and smoking load> 20 packs/year (29% versus 9%, p = 0.008) were associated with MS. The major components of the metabolic syndrome were abdominal obesity (98.1%), hypertension (80%) and low HDL cholesterol (72.2%). Conclusions: RA patients in a tertiary center in Northeastern Brazil showed high prevalence of MS. It is worth noting that almost all patients had MS and abdominal obesity, which has important practical implications. In addition to the components of MS, age and smoking were associated with this syndrome.

RESUMO Introdução: Pacientes com artrite reumatoide (AR) têm 30 a 60% mais chances de desenvolver doenças cardiovasculares (DCV) do que a população geral. A síndrome metabólica (SM), definida por um conjunto de fatores de risco cardiovasculares, confere maior risco de DCV e diabete. A associação da SM com AR ainda não está totalmente esclarecida e sua prevalência varia de 19 a 63% entre os estudos. Objetivos: Avaliar a prevalência de SM numa população de pacientes com AR acompanhada num hospital do Nordeste brasileiro e analisar associações de fatores demográficos e clínicos com SM. Pacientes ambulatoriais com AR foram transversalmente avaliados com relação a dados demográficos, clínicos, laboratoriais e antropométricos. Os critérios para definir SM foram os adotados pelo NCEPIII (2005) e IDF (2006). Resultados: Foram estudados 110 pacientes com AR, 97,3% mulheres com média de 55,5 anos (DP = 12,9) e duração da doença de 11,2 anos (DP = 7,3). As prevalências de SM do NCEPIII (2005) e IDF (2005) foram, respectivamente, 50% e 53,4%. Idade avançada (57,9 ± 11,9 versus 52,9 ± 13,5; p = 0,04) e carga tabágica > 20 maços ano (29% versus 9%; p = 0,008) estiveram associadas com SM. Os principais componentes da SM foram obesidade abdominal (98,1%), hipertensão arterial (80%) e HDL baixo (72,2%). Conclusões: Pacientes com AR de um serviço terciário do Nordeste brasileiro apresentaram alta prevalência de SM. Chama atenção a quase totalidade dos pacientes com SM e obesidade abdominal, o que traz implicações práticas importantes. Além dos componentes de SM, idade e tabagismo se mostrarem associados com SM.

Correlação dos índices de atividade da artrite reumatoide (Disease Activity Score 28 medidos com VHS, PCR, Simplified Disease Activity Index e Clinical Disease Activity Index) e concordância dos estados de atividade da doença com vários pontos de corte numa população do nordeste brasileiro / Correlation of rheumatoid arthritis activity indexes (Disease Activity Score 28 measured with ESR and CRP, Simplified Disease Activity Index and Clinical Disease Activity Index) and agreement of disease activity states with various cut-off points in a Northeastern Brazilian population

Resumo Introdução: O Disease Activity Score 28 (DAS28) e versões têm sido usados para medir atividade da artrite reumatoide (AR), mas não existe consenso sobre qual é o melhor. Objetivos: Determinar a correlação entre os índices (DAS28 VHS, DAS28 PCR, SDAI e CDAI) e avaliar a concordância dos estratos de atividade com o uso de diferentes pontos de corte. Métodos: Pacientes com artrite reumatoide foram avaliados transversalmente com coleta de dados para cálculo do DAS28 (VHS e PCR), SDAI e CDAI, com o uso de pontos de cortes diferentes para definição de remissão, atividade leve, moderada e alta. Correlações de Pearson foram calculadas para medidas contínuas e concordância (teste de kappa) para os estratos (remissão, atividade leve, moderada e alta). Resultados: De 111 pacientes incluídos, 108 foram mulheres, média de 55,6 anos, tempo de doença de 11 anos. DAS28 (VHS) foi significantemente maior do que DAS28 (PCR) (4 vs. 3,5; p < 0,001) e os valores permaneceram maiores após estratificação por idade, sexo, tempo doença, fator reumatoide e HAQ. Correlações entre índices variaram de 0,84 a 0,99, com melhor correlação entre SDAI e CDAI. Concordâncias entre estratos de atividade variaram de 46,8% a 95,8%. DAS28 (PCR) com ponto de corte para remissão de 2,3 subestimou atividade da doença em 45,8% quando comparado com DAS28 (VHS). SDAI e CDAI apresentaram concordância de 95,8%. Os quatro índices mostraram associação com tempo de doença e HAQ. Conclusões: Embora os índices de atividade apresentem boa correlação, mostram discrepâncias nos estratos de atividade. Tornam-se necessários mais estudos para definir melhor índice e melhores pontos de corte.

Abstract Introduction: The Disease Activity Score 28 (DAS28) and its versions have been used to measure rheumatoid arthritis activity, but there is no consensus about which one is the best. Objectives: Determine the correlation among indexes (DAS28 ESR, DAS28 CRP, SDAI and CDAI) and evaluate agreement of activity strata using different cut-off points. Methods: Rheumatoid arthritis patients were cross-sectionally evaluated with data collection to calculate the DAS28 (ESR and CRP), SDAI and CDAI, using different cut-offs for defining remission, mild, moderate and high activity. Pearson correlations were calculated for continuous measures and agreement (kappa test) for the strata (remission, mild, moderate and high activity). Results: Of 111 patients included, 108 were women, age 55.6 years, 11-year disease duration. DAS28 (ESR) was significantly higher than DAS28 (CRP) (4.0 vs. 3.5; p < 0.001) and the values remained higher after stratification by age, gender, disease duration, rheumatoid factor and HAQ. Correlations among indexes ranged from 0.84 to 0.99, with better correlation between SDAI and CDAI. Agreements among activity strata ranged from 46.8% to 95.8%. DAS28 (CRP) with cut-off point for the remission of 2.3 underestimated disease activity by 45.8% compared with DAS28 (ESR). SDAI and CDAI showed agreement of 95.8%. The four indexes were associated with disease duration and HAQ. Conclusions: Although the activity indexes show good correlation, they show discrepancies in activity strata, thus requiring more researches to define a better index and better cut-off points.

Correlation of rheumatoid arthritis activity indexes (Disease Activity Score 28 measured with ESR and CRP, Simplified Disease Activity Index and Clinical Disease Activity Index) and agreement of disease activity states with various cut-off points in a Northeastern Brazilian population.

INTRODUCTION: The Disease Activity Score 28 (DAS28) and its versions have been used to measure rheumatoid arthritis (RA) activity, but there is no consensus about which one is the best. OBJECTIVES: Determine the correlation among indexes (DAS28 ESR, DAS28 CRP, SDAI and CDAI) and evaluate agreement of activity strata using different cutoff points. METHODS: Rheumatoid arthritis patients were cross-sectionally evaluated with data collection to calculate the DAS28 (ESR and CRP), SDAI and CDAI, using different cut-offs for defining remission, mild, moderate and high activity. Pearson correlations were calculated for continuous measures and agreement (kappa test) for the strata (remission, mild, moderate and high activity). RESULTS: Of 111 patients included, 108 were women, age 55.6 years, 11-year disease duration. DAS28 (ESR) was significantly higher than DAS28 (CRP) (4.0 vs. 3.5; p<0.001) and the values remained higher after stratification by age, gender, disease duration, rheumatoid factor and HAQ. Correlations among indexes ranged from 0.84 to 0.99, with better correlation between SDAI and CDAI. Agreements among activity strata ranged from 46.8% to 95.8%. DAS28 (CRP) with cut-off point for the remission of 2.3 underestimated disease activity by 45.8% compared with DAS28 (ESR). SDAI and CDAI showed agreement of 95.8%. The four indexes were associated with disease duration and HAQ. CONCLUSIONS: Although the activity indexes show good correlation, they show discrepancies in activity strata, thus requiring more researches to define a better index and better cutoff points.

Effects of chronic administration of tamsulosin and tadalafil, alone or in combination, in rats with bladder outlet obstruction induced by chronic nitric oxide deficiency.

PURPOSE: The aim of this study was to define if tadalafil causes detrusor muscle impairment and to observe the effect of combination of tadalafil with tamsulosin on the lower urinary tract of rats with bladder outlet obstruction (BOO) induced by chronic nitric oxide deficiency. MATERIALS AND METHODS: Thirty-one male rats were randomized to following groups: 1 - control; 2 - L-Nitroarginine methyl ester (L-NAME); 3 - Tamsulosin + L-NAME, 4 Tadalafil+L-NAME; and 5 - Tamsulosin + Tadalafil + L-NAME. At the end of the treatment period (30 days), all animals were submitted to urodynamic study. RESULTS: The administration of L-NAME increased the number of non-voiding contractions (NVC) (1.04 ± 0.22), volume threshold (VT) (1.86 ± 0.35), and micturition cycle (MC) (1.34 ± 0.11) compared with control (0.52 ± 0.06, 0.62 ± 0.06, and 0.67 ± 0.30), respectively. The administration of tamsulosin reduced the number of NVC (0.57 ± 0.42) and VT (0.76 ± 0.24 ) compared with L-NAME group. Co-treatment with tadalafil decreased the number of VT (0.85 ± 0.53) and MC (0.76 ± 0.22) compared with L-NAME group. The combination of tamsulosin with tadalafil improved the number of NVC (0.56 ± 0.18), VT (0.97 ± 0.52) and MC (0.68 ± 0.30) compared with L-NAME group. CONCLUSION: In rats with BOO induced by chronic nitric oxide deficiency, tadalafil did not cause impairment in detrusor muscle and seems to have an addictive effect to tamsulosin because the combination decreased non voiding contractions as well the number of micturition cycles.

Effects of chronic administration of tamsulosin and tadalafil, alone or in combination, in rats with bladder outlet obstruction induced by chronic nitric oxide deficiency

Purpose The aim of this study was to define if tadalafil causes detrusor muscle impairment and to observe the effect of combination of tadalafil with tamsulosin on the lower urinary tract of rats with bladder outlet obstruction (BOO) induced by chronic nitric oxide deficiency. Materials and Methods Thirty-one male rats were randomized to following groups: 1 - control; 2 - L-Nitroarginine methyl ester (L-NAME); 3 - Tamsulosin + L-NAME, 4 Tadalafil+L-NAME; and 5 - Tamsulosin + Tadalafil + L-NAME. At the end of the treatment period (30 days), all animals were submitted to urodynamic study. Results The administration of L-NAME increased the number of non-voiding contractions (NVC) (1.04 ± 0.22), volume threshold (VT) (1.86 ± 0.35), and micturition cycle (MC) (1.34 ± 0.11) compared with control (0.52 ± 0.06, 0.62 ± 0.06, and 0.67 ± 0.30), respectively. The administration of tamsulosin reduced the number of NVC (0.57 ± 0.42) and VT (0.76 ± 0.24 ) compared with L-NAME group. Co-treatment with tadalafil decreased the number of VT (0.85 ± 0.53) and MC (0.76 ± 0.22) compared with L-NAME group. The combination of tamsulosin with tadalafil improved the number of NVC (0.56 ± 0.18), VT (0.97 ± 0.52) and MC (0.68 ± 0.30) compared with L-NAME group. Conclusion In rats with BOO induced by chronic nitric oxide deficiency, tadalafil did not cause impairment in detrusor muscle and seems to have an addictive effect to tamsulosin because the combination decreased non voiding contractions as well the number of micturition cycles. .

Combined liver-kidney transplantation: experience at a Brazilian university hospital.

BACKGROUND: Combined liver-kidney transplant is a routine procedure in many transplant centers. The increase in its number coincided with the introduction in 2002 of the MELD (Model for End-stage Liver Disease) score for allocation of livers, prioritizing patients with renal dysfunction. Aim : To analyze the experience with combined liver-kidney transplantation in a liver transplant center in Brazil. METHOD: A retrospective review was conducted. All transplants were performed using grafts from deceased donors. RESULTS: Sixteen combined liver-kidney transplantations were performed in the same period, which corresponds to 2.7% and 2.5% of the kidney and liver transplants, respectively. Fourteen patients were male (87.5 %) and two were female (12.5%). The average patients and donors age was 57.3 ± 9.1 and 32.7 ± 13.1, respectively. The MELD score mean was 23.6 ± 3.67. The main cause of liver dysfunction were chronic hepatitis C virus (n=9). As for renal dysfunction, diabetic nephropathy (n=4) was the most frequent. There were six deaths, two of them by severe dysfunction of the liver graft and four by infectious causes. The 1, 3 and 5 years survival rate in patients undergoing liver-kidney transplantations was 68.8%, 57.3% and 57.3%, respectively. CONCLUSION: The survival rates achieved in this series are considered satisfactory and show that this procedure has an acceptable morbidity and survival.

Combined liver-kidney transplantation: experience at a brazilian university hospital / Transplante combinado figado-rim: experiencia de um hospital universitario brasileiro

Background: Combined liver-kidney transplant is a routine procedure in many transplant centers. The increase in its number coincided with the introduction in 2002 of the MELD (Model for End-stage Liver Disease) score for allocation of livers, prioritizing patients with renal dysfunction. Aim : To analyze the experience with combined liver-kidney transplantation in a liver transplant center in Brazil. Method : A retrospective review was conducted. All transplants were performed using grafts from deceased donors. Results : Sixteen combined liver-kidney transplantations were performed in the same period, which corresponds to 2.7% and 2.5% of the kidney and liver transplants, respectively. Fourteen patients were male (87.5 %) and two were female (12.5%). The average patients and donors age was 57.3±9.1 and 32.7±13.1, respectively. The MELD score mean was 23.6±3.67. The main cause of liver dysfunction were chronic hepatitis C virus (n=9). As for renal dysfunction, diabetic nephropathy (n=4) was the most frequent. There were six deaths, two of them by severe dysfunction of the liver graft and four by infectious causes. The 1, 3 and 5 years survival rate in patients undergoing liver-kidney transplantations was 68.8%, 57.3% and 57.3%, respectively. Conclusion : The survival rates achieved in this series are considered satisfactory and show that this procedure has an acceptable morbidity and survival. .

Racional: O transplante combinado fígado-rim é procedimento de rotina em muitos centros de transplante. O aumento no seu número coincidiu com a introdução em 2002 do escore MELD (Model for End-stage Liver Disease) para alocar fígados, priorizando pacientes com disfunção renal. Objetivo : Mostrar a experiência em transplante combinado fígado-rim de um centro de transplante hepático. Método : Foi realizado estudo retrospectivo de pacientes adultos tratados com transplante combinado fígado-rim. Todos foram feitos com enxertos de doadores cadáveres. Resultados : Dezesseis transplantes combinados fígado-rim foram realizados no período, correspondendo a 2,7% e 2,5% dos transplantes de rim e fígado, respectivamente. Quatorze eram homens (87,5%) e duas mulheres (12,5%). A média de idade dos pacientes e doadores foi 57,3±9,1 e 32,7±13,1, respectivamente. A média do escore MELD foi 23.6±3.67. A principal causa de disfunção hepática foi hepatite crônica pelo vírus C (n=9). Para a disfunção renal, nefropatia diabética (n=4) foi a mais frequente. Houve seis mortes, duas por disfunção grave do enxerto hepático e quatro por causas infecciosas. A taxa de sobrevida dos pacientes submetidos ao transplante combinado fígado-rim no 1º, 3º e 5º anos foi 68.8%, 57.3% e 57.3%, respectivamente. Conclusão : As taxas de sobrevida alcançadas nesta série são consideradas satisfatórias e mostram que este procedimento tem morbidade e sobrevida aceitáveis. .