Effects of Fabaceae and Poaceae Pollen Accessibility and Traits on the Pollinivory of Adult Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae).

Pollen is a food source for adult Chrysoperla externa (Hagen), whose larvae are biocontrol agents against pests. However, adults may face challenges in foraging for pollen due to differences in pollen accessibility and variability in pollen morphology and chemistry. In the laboratory, we investigated the ability of adult C. externa to consume pollen from flowers of Cajanus cajan, Canavalia ensiformis, Crotalaria juncea, Flemingia macrophylla, Avena strigosa, Pennisetum glaucum, Sorghum bicolor, and Zea mays, and we explored whether adults chose any of these pollens based on their quantitative and qualitative features. Cajanus cajan and F. macrophylla pollen were the only ones not consumed by adults when confined to flowers. Pollen removed from the preanthesis buds was offered simultaneously for 24 and 48 h. In both periods, adults consumed more of the medium-sized P. glaucum (with the second largest exine thickness) and large-sized Z. mays (with the thinnest exine) pollen, even though they had significantly less crude protein than Fabaceae pollen, whose sizes varied from medium (C. juncea, with the thickest exine) to large (C. ensiformis, whose exine thickness was equal to that of P. glaucum). Overall, adults consumed more Poaceae pollen than Fabaceae pollen, but the palynological features and the protein contents did not affect this choice. Our results highlighted that C. juncea, P. glaucum, S. bicolor and Z. mays are good pollen sources for adult C. externa and should be considered promising candidates in the selection of insectary plants to deploy in biocontrol programs aimed at the conservation of this lacewing.

α-Alkylidene δ-lactones inhibit quorum sensing phenotypes in Chromobacterium strain CV026 showing interaction with the CviR receptor.

Disruption of bacterial quorum sensing (QS) is presented as a promising strategy to overcome clinically relevant and phytopathogenic bacteria. This work presents α-alkylidene δ-lactones as new chemical scaffolds that inhibit the biosynthesis of violacein in the biosensor strain Chromobacterium CV026. Three molecules displayed higher than 50% violacein reduction when tested at concentrations lower than 625 µM. The most active α-alkylidene δ-lactone inhibited the hydrolysis of chitin concomitantly with the inhibition of violacein production in CV026, suggesting the disruption of its QS machinery. Further, RT-qPCR and competition experiments showed this molecule to be a transcriptional inhibitor of the QS-regulated operon vioABCDE. Docking calculations suggested a good correlation between binding affinity energies and inhibition effects, with all molecules positioned within the CviR autoinducer-binding domain (AIBD). The most active lactone yielded the best binding affinity energy, most probably due to its unprecedented binding with the AIBD. Our results show α-alkylidene δ-lactones as promising chemical scaffolds for the development of new QS inhibitors affecting LuxR/LuxI-systems.

Faunistic analysis and seasonal fluctuation of ladybeetles in an agro-ecological system installed for organic vegetable production

Plans for an agro-ecological system for agricultural production must consider vegetal diversification in agricultural properties because, among other advantages, it can help the biological control of pests when it focuses on such an end. Predator ladybeetles (Coleoptera: Coccinellidae) can be found in different environments; they play an important role in biological control. The aims of the present study were to feature ladybeetle populations through faunistic analysis and determine their fluctuations in an agro-ecological system comprising seven sub-systems subjected to different cultivation systems in Seropédica County, RJ. The experiment was conducted from December/2018 to December/2019 at Módulo de Cultivo Orgânico Intensivo de Hortaliças (MCOIH), which is located at Sistema Integrado de Produção Agroecológica (SIPA). In total, 1,231 adult ladybeetles were captured, distributed into 13 species, 3 genera and 2 tribes of Coccinellidae, which resulted in S (taxon richness) = 19, Shannon-Wiener diversity index (H') = 0.65 (at 0 to 1 scale) and Margalef diversity index (α) = 2.53 (values lower than 2.0 represent low diversity sites). Equitability was low (E = 0.22), since one of the ladybeetle species has prevailed: Cycloneda sanguinea (most frequent, dominating and constant) in MCOIH, as well as in each of the sub-systems. However, the simplest sub-systems installed for vegetable production (monoculture gardens) were not favorable for ladybeetle diversity, whereas sub-systems installed for polyculture of leafy vegetables recorded the greatest taxa diversity of ladybeetles, including species that predate in aphids that attack vegetables [Coleomegilla maculata, Coleomegilla quadrifasciata, Cycloneda sanguinea, Eriopis connexa, Harmonia axyridis, Hippodamia convergens and Hyperaspis (Hyperaspis) festiva]. The sub-system comprising gliricidia was used to produce fertilization biomass and favored the predominance of C. sanguinea in comparison to the other ladybeetle species in MCOIH. Spring was the season mostly favoring the occurrence of C. sanguinea and H. convergens adults; which were dominant species in ladybeetle assemblage in MCOIH; however, C. sanguinea was constant and H. convergens was accessory.

Intraoperative cholangiography with filling defects: comparative complication analysis of postoperative transcystic duct (TCD) catheter maintenance.

BACKGROUND: This is a retrospective cohort of patients undergoing laparoscopic cholecystectomy with intraoperative cholangiography (IOC) with positive findings for filling defects. We comparatively assessed differences in complication risks for patients that had their cholangiography catheter maintained in its transcystic duct (TCD) position postoperatively. This is a practice proposed to overcome the limited availability of Endoscopic Retrograde Cholangiopancreatography (ERCP) as well as to avoid surgical exploration of the common bile duct. METHODS: Retrospective medical record review of all positive IOC from January 2015 to December 2018 were assessed. Patients' demographic and perioperative data from the hospital stay period in which the cholecystectomy occurred until the last surgical ambulatory visit for perioperative characteristics were compared between groups (with vs. without TCD catheter). Complications were operationalized using the Clavien-Dindo scale. RESULTS: Univariate analysis of complications showed a 2.4-fold risk increase in complications (95% CI 1.13-5.1) between comparison groups. Number of ERCPs (18 vs. 30), and MRCPs (5 vs. 17) were not significantly different between maintaining or not the TCD catheter postop, respectively. Stratified analysis followed by exact logistic regression supported the findings that maintaining the TCD catheter postoperatively increased complication rates (OR = 5.34, 95% CI 1.22, 29.83, p = 0.022), adjusting for potential confounders. CONCLUSION: The maintenance of the TCD catheter postoperatively did not prove to be effective in significantly reducing the number of ERCP nor associated complications. Also, outcomes inherited from the practice caused adverse events that surpassed its potential benefits. Moreover, expectant follow-up is reasonable for patients with evidence of common bile duct stones, even in setting with limited resource availability. We do not recommend this practice, even in settings where there are limited resources of more modern management of choledocholithiasis.

Urgent surgical approach for comminuted mandible fracture and considerations regarding airway risk. Case report / Abordagem cirúrgica urgente para fratura cominutiva da mandíbula e considerações sobre o risco das vias aéreas. Relato de caso

Introduction: Jaw fractures are one of the most common sites of maxillofacial injuries. The location of the jaw makes it very vulnerable to direct impacts. The purpose of treatment is to restore aesthetic function. Case Report: The purpose of this report is to present a case of comminuted mandible fracture in a young male patient, treated urgently due to the need for maintenance of the airways, where fracture osteosynthesis surgery was submitted. Conclusion: The initial assessment of these trauma patients should follow the Trauma Life Support protocol, and structural damage should be investigated. Introduction: Jaw fractures are one of the most common sites of maxillofacial injuries. The location of the jaw makes it very vulnerable to direct impacts. The purpose of treatment is to restore aesthetic function. Case Report: The purpose of this report is to present a case of comminuted mandible fracture in a young male patient, treated urgently due to the need for maintenance of the airways, where fracture osteosynthesis surgery was submitted. Conclusion: The initial assessment of these trauma patients should follow the Trauma Life Support protocol, and structural damage should be investigated

Introdução: As fraturas de mandíbula são um dos locais mais comuns de lesões maxilofaciais. A localização da mandíbula a torna muito vulnerável a impactos diretos. O objetivo do tratamento é restaurar a função estética. Relato de Caso: O objetivo deste relato é apresentar um caso de fratura cominutiva de mandíbula em paciente jovem do sexo masculino, atendido com urgência devido à necessidade de manutenção das vias aéreas, onde foi submetido cirurgia de osteossíntese da fratura. Conclusão: A avaliação inicial desses pacientes com trauma deve seguir o protocolo do Suporte de Vida no Trauma, e devem ser investigados danos estruturais.

Influence of the amount of food resources in the foraging behavior of Nasutitermes corniger (Motschulsky) / Influência da quantidade de madeira no comportamento de forrageamento de Nasutitermes corniger (Motschulsky)

Food scarcity or abundance are factors regulating termites' foraging behavior in general. The aim of the present study is to evaluate the influence of four amounts of Eucalyptus grandis on foraging behavior events shown by worker and soldier of Nasutitermes corniger during laboratory tests. The tests were carried out with adult and active N. corniger colonies found in nests collected in the field, which were stored in glass cubes connected to the test arenas. Four different amounts of wood blocks were used in the tests and each amount concerned a treatment and defined a different experimental group: 1, 2, 3 and 4 blocks/arenas, with 5 repetitions. Each test lasted 60 minutes and consisted in observing, or not, the occurrence of behavioral events shown by foragers when they had contact with the treatment. The duration of each event was recorded, whenever it was observed. The number of recruited foragers and the number of workers consuming the blocks were recorded at the end of each test applied to each treatment. Nasutitermes corniger presented the three behavioral events in all treatments; however, there was not significant difference between treatments in the occurrence of the two first events, in the time taken from test start to the occurrence of a new event, in the number of recruited termites and in the number of gnawing workers. Only workers' mass recruiting was influenced by the amount of wood available. The occurrence of this event was significantly higher in treatments with greater amounts of wood. Thus, N. corniger adjusts its mass recruitment behavior in response to available food amount, which should be considered when developing baiting system for its control. (AU)

A escassez ou abundância de alimento são fatores que regulam o forrageamento do térmitas em geral. No presente estudo, avaliou-se a influência de quatro quantidades de madeira de Eucalyptus grandis em eventos comportamentais do forrageamento exibidos por operárias e soldados de Nasutitermes corniger em testes de laboratório. Os testes foram realizados com colônias maduras e ativas de N. cornigerpresentes em ninhos coletados a campo, os quais foram acondicionados em cubas de vidro conectadas a arenas testes. Blocos de madeira de mesma dimensão foram ofertados aos térmitas em quatro quantidades: 1, 2, 3 e 4 blocos/arena, com 5 repetições. Cada teste durou 60 minutos e consistiu na observação ou não da ocorrência de eventos comportamentais exibidos pelos forrageadores quando foi dado acesso a cada tratamento. Quando cada evento foi observado, o tempo de sua duração foi registrado. Ao final de cada teste registrou-se, em cada tratamento, o número de térmitas forrageadores recrutados e o número de operários consumindo os blocos. Observou-se que N. corniger exibiu os três eventos comportamentais em todos os tratamentos. Todavia, não houve diferença significativa entre os tratamentos com relação à ocorrência dos dois primeiros eventos, aos tempos transcorridos desde o início do teste até a ocorrência de cada evento, aos números de térmitas recrutados e ao número de operários em roedura. Apenas a ocorrência de recrutamento em massa dos operários foi influenciada pela quantidade de madeira ofertada, sendo que foi significativamente superior quando se ofertou os blocos de madeira na maior quantidade. Dessa forma, N. corniger ajusta seu comportamento de recrutamento em massa em resposta a quantidade de alimento disponível, o que deve ser considerado ao se desenvolver um sistema de isca para seu controle. (AU)

Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome.

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.

Nucleosome binding peptide presents laudable biophysical and in vivo effects.

Chromatin state is highly dependent on the nucleosome binding proteins. Herein, we used a multipronged approach employing biophysical and in vivo experiments to characterize the effects of Nucleosome Binding Peptides (NBPeps) on nucleosome and cell activity. We performed a series of structure-based calculations on the nucleosome surface interaction with GMIP1 (a novel NBPep generated in silico), and HMGN2 (nucleosome binding motif of HMGN2), which contains sites that bind DNA and the acid patch, and also LANA and H4pep (nucleosome binding motif of H4 histone tail) that only bind to the acidic patch. Biochemical assays shows that H4pep, but not HMGN2, GMIP1 and LANA, is highly specific for targeting the nucleosome, with important effects on the final nucleosome structure and robust in vivo effects. These findings suggest that NBPeps might have important therapeutic implications and relevance as tools for chromatin investigation.

Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.

System Fertilization: a Viable Practice for Black Oat-soybean Crop

Abstract System fertilization is characterized by partial or total fertilizer application at the predecessor crop; and it can be a viable practice to soybean crop. This study aimed to determine the fertilizer management and fertilizer levels for black oat-soybean cropping system, in high fertility soils and no-tillage system. The field trial was conducted in a bifactorial scheme, consisting of six environments, by combination of locations (Bom Sucesso do Sul - Paraná, Itapejara d'Oeste - Paraná) and fertilization management (all fertilization in black oat; splitting with 50% in black oat and 50% in soybean, all fertilization in soybean), and four fertilizer levels (0, 100, 200 and 300%) defined according to soil analysis and production expected. The evaluated traits were dry mass production, N, P and K nutrient accumulation of straw, dry mass remaining of black oat crop; and plant height, number of pods per plant, thousand grain weight, grain yield for soybean crop. Higher black oat dry mass production was observed at higher fertilization level. The fertilizer anticipation in black oat crop had better performance. Phosphorus and potassium accumulation increased linearly with fertilizer level increase. For N, the highest accumulated value occurred at the 200%, decreasing at the 300% of fertilizer level. The soybean crop had no influence in grain yield considering fertilization management, anticipation or splitting, and fertilizer levels. Thus, the system fertilization can be a viable practice, and favor black oat dry mass production and soybean development.

Fat nucleosome: Role of lipids on chromatin.

Structural changes in chromatin regulate gene expression and define phenotypic outcomes. Molecules that bind to the nucleosome, the complex of DNA and histone proteins, are key modulators of chromatin structure. Most recently, the formation of condensed chromatin regions based on phase-separation in the cell, a basic physical mechanism, was proposed. Increased understanding of the mechanisms of interaction between chromatin and lipids suggest that small lipid molecules, such as cholesterol and short-chain fatty acids, can regulate important nuclear functions. New biophysical data has suggested that cholesterol interacts with nucleosome through multiple binding sites and affects chromatin structure in vitro. Regardless of the mechanism of how lipids bind to chromatin, there is currently little awareness that lipids may be stored in chromatin and influence its state. Focusing on lipids that bind to nuclear receptors, clinically relevant transcription factors, we discuss the potential interactions of the nucleosome with steroid hormones, bile acids and fatty acids, which suggest that other lipid chemotypes may also impact chromatin structure through binding to common sites on the nucleosome. Herein, we review the main impacts of lipids on the nuclear environment, emphasizing its role on chromatin architecture. We postulate that lipids that bind to nucleosomes and affect chromatin states are likely to be worth investigating as tools to modify disease phenotypes at a molecular level.

Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis / Importância dos Achados Clínicos e Laboratoriais no Diagnóstico e Prognóstico Cirúrgico de Pacientes com Pericardite Constritiva

Abstract Background: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. Objective: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. Methods: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant. Results: We studied 84 patients (mean age, 44 ± 17.9 years; 67% male). Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%). Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL) were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%), and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation. Conclusions: Magnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death.

Resumo Fundamento: Estudos internacionais têm relatado o valor de perfil clínico e exames de imagem no diagnóstico e prognóstico da pericardite constritiva. Entretanto, dados da população brasileira são escassos. Objetivo: Avaliar as características clínicas, sensibilidade de exames de imagem e fatores relacionados ao óbito em uma série de casos de pericardite constritiva submetidos à pericardiectomia. Métodos: Pacientes com pericardite constritiva confirmada por cirurgia foram avaliados retrospectivamente quanto a variáveis clínicas e laboratoriais. Dois métodos diagnósticos foram utilizados: ecocardiograma transtorácico e ressonância cardíaca. Preditores de mortalidade foram determinados por análise univariada usando metodologia das proporções de Cox e hazard ratio. Todos os testes foram considerados bicaudais e um erro alfa ≤ 5% foi considerado como significante. Resultados: Foram estudados 84 pacientes com idade média de 44 ± 17,9 anos, sendo 67% do sexo masculino. Sinais e sintomas de insuficiência cardíaca (IC) predominantemente direita estiveram presentes com estase jugular, edema e ascite em 89%, 89% e 62% dos casos, respectivamente. Etiologia idiopática foi observada em 69% dos casos, seguida por tuberculose em 21%. Apesar do grau de IC, encontramos baixos níveis de BNP (mediana de 157 pg/mL). As sensibilidades diagnósticas para constrição do ecocardiograma e da ressonância foram 53,6% e 95,9%, respectivamente. Durante a evolução clínica, houve 9 óbitos (10,7%) e os fatores de risco foram: anemia, elevações de BNP, PCR, hipertensão pulmonar > 55 mmHg e fibrilação atrial. Conclusões: Pericardite constritiva manifesta-se com sinais e sintomas de IC biventricular com predomínio à direita e baixos níveis de BNP. A ressonância magnética apresenta melhor sensibilidade para diagnóstico. Marcadores clínicos, laboratoriais e de imagem estiveram associados ao óbito.

Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis.

BACKGROUND: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. OBJECTIVE: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. METHODS: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant. RESULTS: We studied 84 patients (mean age, 44 ± 17.9 years; 67% male). Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%). Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL) were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%), and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation. CONCLUSIONS: Magnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death.

Biophysical studies of cholesterol effects on chromatin.

Changes in chromatin structure regulate gene expression and genome maintenance. Molecules that bind to the nucleosome, the complex of DNA and histone proteins, are key modulators of chromatin structure. Previous work indicated that cholesterol, a ubiquitous cellular lipid, may bind to chromatin in vivo, suggesting a potential function for lipids in modulating chromatin architecture. However, the molecular mechanisms of cholesterol's action on chromatin structure have remained unclear. Here, we explored the biophysical impact of cholesterol on nucleosome and chromatin fibers reconstituted in vitro and characterized in silico the cholesterol binding to the nucleosome. Our findings support that cholesterol assists 10 and 30 nm chromatin formation and induces folding of long chromatin fibers as a result of direct interaction of the cholesterol to six nucleosomal binding sites.

Excessive daytime sleepiness in patients with chronic kidney disease undergone hemodialysis / Sonolência excessiva diurna em pacientes com doença renal crônica submetidos a hemodiálise

Introduction Approximately 80% of patients with chronic kidney disease complain about sleep disorders, which is a much higher percentage than in the general population. Excessive daytime sleepiness is the third most frequent complaint in these patients, and it is significantly associated with a higher risk of sleep apnea. The aim of this study was to assess the presence of daytime sleepiness in patients with end stage renal disease (ESRD) who were undergoing diurnal hemodialysis. Materials and methods The Epworth Sleepiness Scale (ESS) was applied to patients with ESRD who underwent diurnal hemodialysis in the Centro de Nefrologia da Zona Norte in Sao Paulo, Brazil. Results A total of 168 patients were included in the study. According to the ESS, 31% presented with a mild propensity to sleep, 22% with a moderate propensity, and 17% with a severe propensity. Conclusion Our study concluded that 70% of the sample of patients with ESRD who were undergoing hemodialysis presented with a propensity to sleep in inappropriate circumstances on the ESS. When excessive daytime sleepiness is associated with sleep apnea and other comorbidities, it is essential to carefully assess patients’ complaints.

Introdução Aproximadamente 80% dos pacientes com doença renal crônica (DRC) referem alguma queixa sobre distúrbios do sono, sendo muito maior do que na população em geral. A sonolência excessiva diurna é a terceira queixa mais frequente e está significativamente associada com um maior rico de apneia do sono. O objetivo deste estudo foi avaliar a presença de sonolência excessiva diurna em pacientes com doença renal em estágio final (DREF) submetidos a hemodiálise diurna. Materiais e métodos A escala de sonolência de Epworth (ESE) foi aplicada em pacientes em DREF, que realizam hemodiálise diurna no Centro de Nefrologia da Zona Norte, na cidade de São Paulo. Resultados Cento e sessenta e oito pacientes foram incluídos no estudo. Trinta e um por cento da amostra apresentou uma leve propensão a dormir, de acordo com ESE, enquanto que vinte e dois por cento apresentaram uma moderada propensão e dezessete por cento apresentaram uma grave propensão. Conclusão Nosso estudo concluiu que 70% da amostra em DREF submetidos a hemodiálise apresentaram uma propensão de dormir em circunstâncias inapropriadas, de acordo com a escala de sonolência de Epworth. Uma vez que a sonolência excessiva diurna está associada com a apneia do sono e outras comorbidades é essencial estar atento às queixas desses pacientes.

Peritonite encapsulante: tomografia computadorizada e correlação cirúrgica / Encapsulating peritonitis: computed tomography and surgical correlation

A peritonite esclerosante encapsulante é uma entidade rara, muitas vezes grave, caracterizada pelo envolvimento total ou parcial de alças do intestino delgado por uma membrana de tecido fibroso. Apresenta quadro clínico inespecífico de obstrução intestinal, exigindo diagnóstico por imagem preciso para orientação do tratamento. O presente relato enfatiza a importância da tomografia computadorizada no diagnóstico desta doença, com confirmação por correlação cirúrgica.

Sclerosing encapsulating peritonitis is a rare and frequently severe entity characterized by total or partial involvement of small bowel loops by a membrane of fibrous tissue. The disease presents with nonspecific clinical features of intestinal obstruction, requiring precise imaging diagnosis to guide the treatment. The present report emphasizes the importance of computed tomography in the diagnosis of this condition and its confirmation by surgical correlation.

Encapsulating peritonitis: computed tomography and surgical correlation.

Sclerosing encapsulating peritonitis is a rare and frequently severe entity characterized by total or partial involvement of small bowel loops by a membrane of fibrous tissue. The disease presents with nonspecific clinical features of intestinal obstruction, requiring precise imaging diagnosis to guide the treatment. The present report emphasizes the importance of computed tomography in the diagnosis of this condition and its confirmation by surgical correlation.

A peritonite esclerosante encapsulante é uma entidade rara, muitas vezes grave, caracterizada pelo envolvimento total ou parcial de alças do intestino delgado por uma membrana de tecido fibroso. Apresenta quadro clínico inespecífico de obstrução intestinal, exigindo diagnóstico por imagem preciso para orientação do tratamento. O presente relato enfatiza a importância da tomografia computadorizada no diagnóstico desta doença, com confirmação por correlação cirúrgica.

Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial.

BACKGROUND: Chronic kidney disease (CKD) is one of the most serious public health problems. The increasing prevalence of CKD in developed and developing countries has led to a global epidemic. The hypothesis proposed is that patients undergoing dialysis would experience a marked negative influence on physiological variables of sleep and autonomic nervous system activity, compromising quality of life. METHODS/DESIGN: A prospective, consecutive, double blind, randomized controlled clinical trial is proposed to address the effect of dialysis on sleep, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life in patients with CKD. The measurement protocol will include body weight (kg); height (cm); body mass index calculated as weight/height(2); circumferences (cm) of the neck, waist, and hip; heart and respiratory rates; blood pressures; Mallampati index; tonsil index; heart rate variability; maximum ventilatory pressures; negative expiratory pressure test, and polysomnography (sleep study), as well as the administration of specific questionnaires addressing sleep apnea, excessive daytime sleepiness, depression, anxiety, stress, and quality of life. DISCUSSION: CKD is a major public health problem worldwide, and its incidence has increased in part by the increased life expectancy and increasing number of cases of diabetes mellitus and hypertension. Sleep disorders are common in patients with renal insufficiency. Our hypothesis is that the weather weight gain due to volume overload observed during interdialytic period will influence the degree of collapsibility of the upper airway due to narrowing and predispose to upper airway occlusion during sleep, and to investigate the negative influences of haemodialysis in the physiological variables of sleep, and autonomic nervous system, and respiratory mechanics and thereby compromise the quality of life of patients. TRIAL REGISTRATION: The protocol for this study is registered with the Brazilian Registry of Clinical Trials (ReBEC RBR-7yhr4w and World Health Organization under Universal Trial Number UTN: U1111-1127-9390 [http://www.ensaiosclinicos.gov.br/rg/RBR-7yhr4w/]).

Intracerebroventricular administration of inosine is anticonvulsant against quinolinic acid-induced seizures in mice: an effect independent of benzodiazepine and adenosine receptors.

Inosine (INO) has an anticonvulsant effect against seizures induced by antagonists of GABAergic system. Quinolinic acid (QA) is an agonist NMDA receptors implicated in the neurobiology of seizures. In the present study, we investigated the anticonvulsant effect of intracerebroventricular (i.c.v.) INO administration against QA-induced seizures in adult mice. We also investigated whether the benzodiazepines (BZ) or adenosine (ADO) receptors were involved in the INO effects. Animals were pretreated with an i.c.v. injection of either vehicle or INO before an i.c.v. administration of 4 µl QA (36.8 nmol). All animals pretreated with vehicle followed by QA presented seizures. INO protected against QA-induced seizures in a time and dose dependent manner (up to 60% at 400 nmol, 5 min before QA injection). Diazepam (DZ) and ADO (i.c.v.) also exhibited anticonvulsant effect against QA induced seizures. Additionally, i.p. administration of either flumazenil, a BZ receptor antagonist, or caffeine, an ADO receptor antagonist, did not change the anticonvulsant potency of INO i.c.v. injection, but completely abolished the DZ and ADO anticonvulsant effects, respectively. In conclusion, this study demonstrated that INO exert anticonvulsant effect against hyperactivity of the glutamatergic system independently of BZ or ADO receptors activation.