Association of Non-host Crop Plants with Mandarin in Host Location and Survival of Diaphorina citri Kuwayama (Hemiptera: Psyllidae).

Research efforts have been made to develop novel tactics, such as those targeting behavioral control, for management of the Asian citrus psyllid Diaphorina citri Kuwayama (Hemiptera: Psyllidae), vector of the causal agent of citrus Huanglongbing. Here, we investigated whether association of "Ponkan" mandarin (Citrus reticulata) with volatiles from non-host crops: avocado, passion fruit or coffee, alters host location by the Asian citrus psyllid; and whether they can be temporary hosts for the Asian citrus psyllid. In wind tunnel assays, we found that the association of mandarin seedling with avocado plant volatiles reduced in 30% the number of psyllids sitting on host plants compared to the mandarin alone. In contrast, passion fruit plant volatiles facilitated host location by psyllids, which found mandarin seedlings faster than when exposed to mandarin alone. The association with coffee volatiles did not alter the attractiveness of mandarin to the Asian citrus psyllid. Survival and half-lethal time (LT50) of D. citri fed on non-host plants were longer than those insects with water only, but shorter than those fed on mandarin. Among the non-host plants, D. citri performed better in coffee, followed by avocado and passion fruit plants. Our results indicate that the association of mandarin with avocado plant can be beneficial for Asian citrus psyllid management.

Predictors of cancer in patients with acute pulmonary embolism.

BACKGROUND: Acute pulmonary embolism (PE) can occur as a manifestation of an underlying cancer and be of paraneoplastic aetiology. A previously unknown cancer is sometimes diagnosed after the acute PE diagnosis. The identification of a group of patients with elevated probability of having an occult cancer underlying PE was never performed. We aimed to determine predictors of occult cancer in acute PE. Our hypothesis was that the D-dimer levels would be a predictor of cancer. PATIENTS AND METHODS: We retrospectively analysed a cohort of patients hospitalized with acute PE. EXCLUSION CRITERIA: <18 years, venous embolism only of veins other than pulmonary territory or when the embolism was considered chronic, and no image confirmation of acute PE. Patients were grouped according to the timing of cancer diagnosis: 1) known concomitant active cancer, 2) cancer diagnosed during acute PE admission or in the following 2 years and, 3) no known cancer during the 2-year follow-up since PE diagnosis. Predictors of concomitant cancer were determined using a logistic regression analysis. Multivariate models were built. RESULTS: We studied 562 patients; median age was 72 years and 219 (39.0 %) were men. In 223 (39.7 %) of the patients the PE was of central arteries and 61.4 % presented with bilateral PE. PE was considered unprovoked at time of discharge in 47.7 %. Median (interquartile range) D-dimer level was 7.98 (3.30-14.99) µg/mL. A total of 126 (22.4 %) patients were in group 1, 47 in group 2 (cancer diagnosed after the diagnosis of acute PE and up to 2 years) and 389 patients were in group 3. Elevated D-dimer levels were independently associated with already known cancer. D-dimer were independent predictors of future cancer diagnosis: OR = 1.07 ((95 % CI: 1.01-1.14) per each 5 ng/mL increase; for patients with D-dimer >15.0 µg/mL the OR of future cancer was 2.10 (1.05-4.18). If only patients with unprovoked PE upon admission (n = 307) were to be considered results were similar considering D-dimer; anaemia also predicted unknown cancer [OR = 2.13 (1.08-4.16)]. CONCLUSIONS: Patients with D-dimer >15 µg/mL presented a >2-fold higher risk of being diagnosed with a cancer condition in the upcoming 2 years. D-dimer may help clinicians in identifying which patients are at higher risk of occult cancer.

Haemophagocytic Lymphohistiocytosis Associated With Anaplastic Large-Cell Lymphoma in a Young Woman.

Haemophagocytic lymphohistiocytosis is a syndrome of excessive immunological activation that can be triggered by various diseases, including haematological cancers. We report a case of a 25-year-old woman presenting with constitutional symptoms and a painful thoracic mass of four months duration. Laboratory exams showed pancytopenia, hypertriglyceridemia and extremely high serum ferritin levels. A whole-body computed tomography (CT) scan revealed splenomegaly and highlighted the mass on the deep tissues of the left breast; the biopsy was compatible with anaplastic large-cell lymphoma. Additionally, a bone marrow biopsy revealed haemophagocytosis, fulfilling the criteria for associated haemophagocytic lymphohistiocytosis. The patient was quickly sent for chemotherapy followed by autologous haematopoietic cell transplantation. She achieved a complete metabolic response and has been in clinical remission after nearly four years of follow-up. We emphasise the benefit of a timely diagnosis and intervention which were the keys to success in this case.

Tratamento de feridas com utilização de fitoterápico em paciente vítima de atropelamento: relato de caso / Treatment of wounds with the use of phytotherapy in a patient victim of training: case report / Tratamiento de heridas con uso de fitoterapia en paciente víctima de entrenamiento: reporte de caso

Objetivo: descrever a utilização do fitoterápico tópico na cicatrização de feridas e demonstrar sua eficácia no tratamento de pacientes com feridas crônicas. Método: Estudo qualitativo, descritivo, retrospectivo, com paciente domiciliar, na cidade de Duque de Caxias, Rio de Janeiro. A coleta de dados ocorreu de 31 de março de 2022 a 29 de junho de 2022, utilizando registros em fichas de avaliação, evolução clínica e evolução de registros de enfermagem focando nos principais aspectos relacionados ao histórico de enfermagem, avaliação de feridas, contexto clínico econduta tópica para o tratamento da ferida. Resultados: Paciente de 19 anos, do sexo feminino, vítima de atropelamento no dia 10/12, previamente hígida, sem nenhuma comorbidade, eutrófica, IMC de 19,7. Manteve 24h de internação, alta em 11/12 com lesão extensa. Lesão com curso desfavorável sendo necessário desbridamento no dia 07/02/2022. Trata-se de ferida traumática, crônica, complexa e de difícil cicatrização. Considerações Finais: O uso de fitoterápicos no tratamento da ferida mostrou-se eficiente e trouxe resultados satisfatórios quanto à cicatrização e o desfecho do caso, durante todo o tratamento. Percebeu-se no desfecho do caso uma completa cicatrização da ferida em um curto período de tempo, durante a utilização do produto não houve nenhuma reação alérgica ou irritabilidade reforçando os benefícios da utilização de componentes naturais no tratamento de feridas.

Objective: to describe the use of a topical herbal medicine in wound healing and to show its effectiveness in treating patients with chronic wounds. Method: a retrospective, descriptive, qualitative study with a home care patient in the city of Duque de Caxias, Rio de Janeiro, Brazil. Data were collected from March 31st, 2022, to June 29th, 2022, from patient assessment charts, clinical course, and evolution of nursing records focusing on the main aspects related to nursing history, wound assessment, clinical context, and topical treatment of the wound. Results: a 19 -year-old female patient, victim of a hit-and-run on December 10th, previously healthy, with no comorbidity, and with normal weight (BMI of 19.7). She remained hospitalized for 24 hours and was discharged on December 11thwith an extensive injury. Due to the unfavorable course of the injury, it was removed on February 07th, 2022. It was a complex, chronic, traumatic, and difficult-to-heal wound. Conclusions: topical herbal medicine was shown to be effective in the treatmentof wounds and had positive results as for both healing and the outcome of the case, throughout the treatment. The outcome of the case has shown a complete wound healing in a short period of time. There was no allergic reaction or irritability while using the herbal medicine, which reinforces the benefits of natural components in the treatment of wounds.

Objetivo: describir el uso de producto fitoterapéutico tópico para cicatrización de heridas y demostrar su eficacia en el tratamiento de pacientes con heridas crónicas. Método: Estudio cualitativo, descriptivo, retrospectivo, con paciente domiciliar, en la ciudad de Duque de Caxias, Rio de Janeiro, Brasil. La recolección de los datos ocurrió durante el período de 31 de marzo a 29 de junio de 2022, utilizando registros de fichas de evaluación, evolución clínica y evolución de registros de enfermería, concentrando en los principales aspectos relacionados al histórico de enfermería, evaluación de heridas, contexto clínico y conducta tópica para el tratamiento de la herida. Resultados: Paciente de 19 años, del sexo femenino, víctima de atropellamiento en el día 10/12, previamente saludable, sin ninguna comorbilidad, eutrófica, IMC de 19,7. Fue hospitalizada por 24h, recibiendo alta el día 11/12 con lesión extensa. Lesión con curso desfavorable, siendo necesario desbridamiento el día 07/02/2022. Se trata de herida traumática, crónica, compleja y de difícil cicatrización. Consideraciones finales: El uso de productos fitoterapéuticos para el tratamiento de la herida demostró ser eficiente y proporcionó resultados satisfactorios con relación a la cicatrización y al resultado final del caso, durante todo el tratamiento. En el resultado del caso fueron observadas que la cicatrización completa de la herida ocurrió en un período corto de tiempo y que no hubo ninguna reacción alérgica o irritabilidad durante la utilización del producto, reforzando los beneficios del uso de substancias naturales en el tratamiento de heridas.

Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review.

Objectives: Patients with laboratory or clinical manifestations suggestive of antiphospholipid syndrome (APS) but not fulfilling the classification criteria constitute a clinical challenge. This study aims to compare non-criteria APS (NC-APS) with definite APS in terms of clinical manifestations, therapies, and outcomes. Methods: A systematic review of observational studies comparing definite and NC-APS was performed searching four electronic databases. Data on clinical manifestations, therapies and clinical outcomes was extracted. Results: Sixteen studies, assessing a total of 3,798 participants, were included. Seven out of 10 studies found no significant difference in the prevalence of arterial or venous thrombosis between definite and NC-APS, with two studies on seronegative APS also finding no difference in thrombosis recurrence. Seven out of 12 studies found no significant difference in the prevalence of obstetric manifestations between groups, with the remaining exhibiting conflicting results. In 9 studies comparing treatment frequency in obstetric patients, all but one described similar treatment frequency, with the percentage of NC-APS treated during pregnancy ranging from 26% to 100%. In 10 studies comparing pregnancy outcomes of NC-APS versus definite APS, 7 found similar successful pregnancies/live births. Additionally, 5 studies described improvement of live births in both groups with treatment, with three signalling aspirin monotherapy as efficacious as combination therapy in NC-APS. Conclusion: This review hints at an absence of marked differences in most evaluated parameters between definite and NC-APS, emphasizing the value of a more active follow-up of these patients. The low-quality available evidence highlights the need for well-defined NC-APS populations in future studies. Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier CRD42020210674.

Sustainable Packaging Material Based on PCL Nanofibers and Lavandula luisieri Essential Oil, to Preserve Museological Textiles.

The connection with textiles is one of the oldest traditions in humanity, and in the historical scenario, textiles and clothing deal with material culture. Therefore, preservation is of the utmost importance to keep this important heritage. Packaging and protection of museological textiles is imperative due to the risks that these articles suffer, mainly concerning the attack of microorganisms that promote the acceleration of their degradation, and it is still necessary to create a proper packing material. In the present work we describe a bibliographic review about the museological scenario, focused on the packaging for preservation of textile articles, as well as the techniques usually used in preventive material conservation. Future perpsctives for the improvement in the conservation of museological textiles are also given. This research aims to produce a sustainable material based on polycaprolactone (PCL), with and without antimicrobial function by incorporating Lavandula luisieri essential oil (EO), in the form of a non-woven substrate for museological packaging. A comparison was made with the most frequently used materials, such as raw cotton and a non-woven polyester. The results demonstrated that both PCL and PCL + EO obtained a good characterization for museological application with good breaking strength and excellent whiteness index. In addition, PCL + EO showed a high bacterial reduction when compared with other protective materials frequently used in museums. Therefore, these findings emphasize the potential use of this material as an innovative protective antibacterial museological packaging solution, able to safeguard and preserve textile museum and clothing collections for longer and for future generations.

The presence of non-criteria manifestations negatively affects the prognosis of seronegative antiphospholipid syndrome patients: a multicenter study.

BACKGROUND: Seronegative antiphospholipid syndrome (SN-APS) is often defined as the presence of APS criteria manifestations, negative antiphospholipid antibodies (aPL), and coexistence of APS non-criteria manifestations. Nevertheless, the impact of these non-criteria features is still unclear. On a different note, the relevance of one single aPL positive determination in patients with APS manifestations is another domain with limited evidence. We aim to compare the course of SN-APS and single-positive aPL (SP-aPL) patients with that of individuals with APS manifestations without non-criteria features/aPL positivity (controls). METHODS: Retrospective analysis of patients with thrombosis/obstetric morbidity assessed in two European hospitals between 2005 and 2020. Patients were divided into SN-APS, SP-aPL, and control groups. Clinical characteristics, comorbidities, and therapies were compared. RESULTS: A total of 82 patients were included in the SN-APS group, 88 in the SP-aPL group, and 185 in the control group. In Cox regression model, SN-APS displayed more thrombosis recurrence than controls (HR 3.8, 95% CI 2.2-6.5, p < 0.001) even when adjusting for the presence of hereditary thrombophilia, systemic lupus erythematosus, or contraceptive hormonal treatment. In SP-aPL, the difference in thrombosis recurrence did not reach statistical significance (p = 0.078). Indefinite anticoagulation (p < 0.001 and p = 0.008, respectively) and vitamin K antagonist (VKA) use (p < 0.001 in both cases) were more common in SN-APS/SP-aPL. CONCLUSION: SN-APS displayed more thrombosis recurrence, indefinite anticoagulation, and VKA use than controls without non-criteria manifestations. The presence of such features in patients with thrombosis and negative aPL may negatively impact their clinical course.

The Ins and Outs of 14C Dating Lead White Paint for Artworks Application.

Lead white is known as one of the oldest pigments in art and can be used as a dating material. Upon production following the Stack process, the 14C isotope of atmospheric carbon dioxide is fixed in the carbonate, and its radiocarbon dating can be used as a proxy for the age of a painting. The previously reported carbonate hydrolysis protocol reaches its limitation when confronted with samples presenting a mixture of carbonates, such as lead carbonate (cerussite or hydrocerussite), calcium carbonate (calcite), and/or calcium magnesium carbonate (dolomite). Thermogravimetric analyses indicate that decomposition of lead carbonate can be achieved at 350 °C in TGA diagrams, as other mineral carbonates only decompose to carbon dioxide at temperatures above 700 °C. Thus, a thermal approach is proposed to separate the various carbonates and isolate the specific 14C signature to the lead carbonate. In practice, however, discrepancies between the measured radiocarbon ages and expected ages were observed. FTIR analyses pointed to the formation of metal carboxylates, an indicator that the organic binder is not inert and plays a role in the dating strategy. Upon drying, oxidation and hydrolysis take place leading to the formation of free fatty acids, which in turn interact with the different carbonates upon heating. Their removal was achieved by introduction of a solvent extraction step prior to the thermal treatment, which was confirmed by GC-MS analyses, and thus, the collected carbon dioxide at 350 °C results can be assigned correctly to the decomposition of the lead white pigment. The proposed procedure was furthermore verified on mixed carbonate-bearing paint samples collected from a Baroque oil painting.

Uncovering modern paint forgeries by radiocarbon dating.

Art forgeries have existed since antiquity, but with the recent rapidly expanding commercialization of art, the approach to art authentication has demanded increasingly sophisticated detection schemes. So far, the most conclusive criterion in the field of counterfeit detection is the scientific proof of material anachronisms. The establishment of the earliest possible date of realization of a painting, called the terminus post quem, is based on the comparison of materials present in an artwork with information on their earliest date of discovery or production. This approach provides relative age information only and thus may fail in proving a forgery. Radiocarbon (14C) dating is an attractive alternative, as it delivers absolute ages with a definite time frame for the materials used. The method, however, is invasive and in its early days required sampling tens of grams of material. With the advent of accelerator mass spectrometry (AMS) and further development of gas ion sources (GIS), a reduction of sample size down to microgram amounts of carbon became possible, opening the possibility to date individual paint layers in artworks. Here we discuss two microsamples taken from an artwork carrying the date of 1866: a canvas fiber and a paint chip (<200 µg), each delivering a different radiocarbon response. This discrepancy uncovers the specific strategy of the forger: Dating of the organic binder delivers clear evidence of a post-1950 creation on reused canvas. This microscale 14C analysis technique is a powerful method to reveal technically complex forgery cases with hard facts at a minimal sampling impact.

Cervical Lymphadenopathy in a Nonagenarian Woman: What to Think?

Tuberculosis remains a worldwide public health problem. Cervical tuberculous lymphadenitis (TBL) or scrofula is the most common form of extrapulmonary tuberculosis, affecting the cervical lymph nodes. We report the case of a 93-year-old woman presenting with cervical adenopathies with 3 months duration. Fine needle aspiration (FNA) biopsy yielded a noncaseous granulomatous process, but was negative for Mycobacterium tuberculosis (MT). As the adenopathies had grown, an excisional biopsy was performed. An extensive study of infectious aetiologies was performed, including for MT, with a negative outcome. Owing to the persistence of cervical lymphadenitis with caseous granulomas, a diagnosis of TBL was strongly suspected and presumptive treatment was initiated. Afterwards, diagnostic confirmation was obtained by isolation of MT in the lymph node culture. The patient presented a favourable clinical outcome. This case highlights that a high index of suspicion is essential for the diagnosis of TBL, especially in the elderly, and emphasizes the importance of pursuing diagnostic confirmation, in which FNA and excisional biopsy plays a key role. LEARNING POINTS: The diagnosis of tuberculous lymphadenitis should be considered in all patients presenting with cervical adenopathies, especially in endemic areas, irrespective of the patient's age.A high index of suspicion is essential for the diagnosis due to the wide range of conditions that can mimic the disease.Fine needle aspiration biopsy is appropriate as an initial diagnostic approach, with excisional biopsy recommended when the former is not diagnostic.

Azathioprine-induced interstitial nephritis in an anti-neutrophil cytoplasmic antibody (ANCA) myeloperoxidase (MPO) vasculitis patient.

Azathioprine (AZA) is used in a wide array of autoimmune diseases, still corresponding to the mainstay maintenance therapy in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Although generally well-tolerated, several side effects are recognized. We report the case of a 50-year-old Caucasian man with kidney-limited ANCA myeloperoxidase (MPO) vasculitis who presented with general malaise, fever, worsening renal function, and elevated inflammatory markers 2 weeks after the initiation of therapy with oral AZA. Although a disease relapse was suspected, renal biopsy revealed an eosinophilic infiltrate, suggestive of acute interstitial nephritis. After suspension of AZA, a sustained improvement of renal function and normalization of inflammatory markers was observed. A diagnosis of allergic interstitial nephritis secondary to AZA was established, corresponding to the first biopsy-proven case described in an ANCA MPO vasculitis patient. Although rare, renal toxicity of AZA must be present in the clinician's mind, avoiding the straightforward assumption of disease relapse in the case of worsening renal function.

Desfecho de Curto e Longo Prazo na Cardiomiopatia Induzida por Estresse: O que Podemos Esperar? / Short and Long-Term Outcome of Stress-Induced Cardiomyopathy: What Can We Expect?

Fundamento: A cardiomiopatia de estresse/Takotsubo (CT) é uma entidade diagnóstica cada vez mais reconhecida. Objetivo: Este estudo teve como objetivo avaliar a prevalência e os preditores clínicos de complicações de curto e longo prazo de pacientes (pts) com CT. Métodos: Foram incluídos todos os pts consecutivamente admitidos no nosso centro, entre novembro de 2006 e agosto de 2011, que preenchiam os critérios diagnósticos da Clínica Mayo. Resultados: Analisaram-se 37 pts (35 mulheres), com idade média de 63 ± 13 anos. A CT foi precipitada na maioria dos casos por eventos de estresse emocional (57%) e dor torácica foi o sintoma de apresentação mais frequente (89%). O electrocardiograma na admissão mostrou supradesnivelamento do segmento ST em 12 pts (32%) e inversão da onda T em 15 casos (41%). Verificou-se disfunção sistólica ventricular esquerda (VE) grave em 16 pts (45%) e a elevação média de troponina I foi de 2,6 ± 1,8 ng/mL. A taxa de complicações intra-hospitalares foi de 30%, sendo o choque cardiogênico a situação mais comum. O estresse físico, a disfunção sistólica grave do VE e o valor de pico do peptídeo natriurético cerebral (BNP) foram preditores de complicações agudas. Não foi encontrada associação entre o pico de troponina I e a apresentação eletrocardiográfica. Trinta e cinco pacientes foram acompanhados por um tempo médio de 482 ± 512 dias, sem recorrência clínica. Conclusão: Na nossa série de pacientes, a CT foi associada a uma alta taxa de complicações intra-hospitalares. O estresse físico, a disfunção sistólica do VE e o valor de pico do BNP foram preditores de desfechos adversos agudos. .

Background: Stress-induced/Takotsubo cardiomyopathy (TC) is an increasingly recognized diagnostic entity. Objective: This study was aimed to assess the prevalence and clinical predictors of short and long-term outcome of patients (pts) diagnosed with TC. Methods: We included all consecutive pts admitted in our department, from November 2006 to August 2011, who met the Mayo Clinic criteria for TC diagnosis. Results: We evaluated 37 pts (35 women) with a mean age of 63 ±13 years. TC was precipitated by a stressful emotional event in the majority (57%) and chest pain was the most common symptom (89%). Twelve pts (32%) had ST-segment elevation and 15 pts (41%) had T-wave inversion on the electrocardiogram at admission. Severe left ventricular (LV) dysfunction was found in 16 pts (43%) and the mean troponin I level was 2.6±1.8 ng/mL. The in-hospital complication rate was 30%, with cardiogenic shock being the most common situation. Physical stress, severe LV systolic dysfunction and peak brain natriuretic peptide (BNP) were predictors of acute complications. On the other hand, we found no association between peak troponin I and electrocardiographic presentation. Thirty-five pts were followed for a mean time of 482 ± 512 days, without clinic recurrence. Conclusion: In our cohort of pts, TC was associated with a high in-hospital complications rate. Physical stress, LV dysfunction and peak BNP could predict acute adverse outcomes. .

Short and long-term outcome of stress-induced cardiomyopathy: what can we expect?

BACKGROUND: Stress-induced/Takotsubo cardiomyopathy (TC) is an increasingly recognized diagnostic entity. OBJECTIVE: This study was aimed to assess the prevalence and clinical predictors of short and long-term outcome of patients (pts) diagnosed with TC. METHODS: We included all consecutive pts admitted in our department, from November 2006 to August 2011, who met the Mayo Clinic criteria for TC diagnosis. RESULTS: We evaluated 37 pts (35 women) with a mean age of 63 ± 13 years. TC was precipitated by a stressful emotional event in the majority (57%) and chest pain was the most common symptom (89%). Twelve pts (32%) had ST-segment elevation and 15 pts (41%) had T-wave inversion on the electrocardiogram at admission. Severe left ventricular (LV) dysfunction was found in 16 pts (43%) and the mean troponin I level was 2.6 ± 1.8 ng/mL. The in-hospital complication rate was 30%, with cardiogenic shock being the most common situation. Physical stress, severe LV systolic dysfunction and peak brain natriuretic peptide (BNP) were predictors of acute complications. On the other hand, we found no association between peak troponin I and electrocardiographic presentation. Thirty-five pts were followed for a mean time of 482 ± 512 days, without clinic recurrence. CONCLUSION: In our cohort of pts, TC was associated with a high in-hospital complications rate. Physical stress, LV dysfunction and peak BNP could predict acute adverse outcomes.

Hypertrophic osteoarthropathy and congenital heart disease: this is not casual.

This case presents a patient with congenital cyanotic heart disease in whom secondary hypertrophic osteoarthropathy was diagnosed. The symptoms of severe bilateral leg pain started 2 months before hospital admission. The presence of clubbing, painful swelling of the lower limbs and his comorbid condition roused the suspicion of hypertrophic osteoarthropathy and a skeleton radiograph of the lower limbs was performed. The last showed changes consistent with periosteal new bone formation, so a non-steroid anti-inflammatory drug was started with complete resolution of the debilitating pain. Hypertrophic osteoarthropathy is an uncommon disease that may be genetically acquired or secondary to other conditions affecting lungs, heart, liver or bowel. Considering it elusive pathogenesis, treatment options are scarce and symptomatic relief is still the main objective.

Valvular lesions in patients with systemic lupus erythematosus and antiphospholipid syndrome: an old disease but a persistent challenge.

Valvular heart disease is common in systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Immunologic insult plays a fundamental role in its pathogenesis but data on the role of antiphospholipid antibodies have been inconsistent, particularly regarding SLE-associated valvular lesions. Although timely diagnosis is essential to prevent progression of valvular lesions, treatment remains a challenge because of the lack of large systematic studies. This article reviews and summarizes recent information relating to valvular damage in these two autoimmune diseases, and highlights some important questions that need to be answered.

Statin-induced low cholesterol is not associated with poor outcome in chronic heart failure.

BACKGROUND: Low cholesterol levels are associated with a worse outcome in patients with heart failure (HF). Use of statins in HF remains controversial. We aimed to assess whether the prognosis of patients with intrinsically low cholesterol levels differed from that of those with pharmacologically induced low cholesterol. MATERIALS AND METHODS: We conducted a retrospective cohort study on 464 ambulatory patients attending a specialized HF clinic. Patients were cross-classified according to statin therapy and admission total cholesterol level (low cholesterol <150 mg/dL and cholesterol ≥150 mg/dL): (1) low total cholesterol level on statin therapy; (2) low total cholesterol level not taking statins; (3) cholesterol ≥150 mg/dL on statin therapy; and (4) cholesterol ≥150 mg/dL not on statin therapy. Patients were followed up to 5 years and the outcome was all-cause death. A Cox regression analysis was used in prognosis assessment. RESULTS: Almost two thirds of the patients were men and the median population age was 69 years; 22.8% of the patients had preserved ejection fraction and 43.5% severe systolic dysfunction. The patients with an intrinsically low cholesterol had a hazard ratio of all-cause death up to 5 years of 2.38 (1.08-7.14) compared to those with low cholesterol induced by statin use. This association was independent of other variables associated with outcome. CONCLUSIONS: Patients with HF with instrisically low cholesterol levels have a double risk of death up to 5 years compared to patients with pharmacologically induced low cholesterol. Clinicians should not limit the use of statins by fear of lowering the cholesterol levels.

Otimização de protocolo para micropropagação da figueira "Roxo de Valinhos" / Protocol otimization for micropropagation of 'Roxo de Valinhos' fig tree

Foram avaliados os efeitos de alterações na concentração de sacarose, do meio WPM - Wood Plant Medium - e da variação no número de gemas por segmento com diferentes doses de cinetina. Os experimentos foram conduzidos no Laboratório de Cultura de Tecidos da Universidade Federal de Lavras, utilizando plântulas previamente estabelecidas in vitro, seguindo o delineamento experimental inteiramente casualizado, em esquema fatorial 5 x 4. Os resultados mostraram que, na multiplicação de brotações de figueira "Roxo de Valinhos", podem-se usar 100 por cento do meio WPM com adição de 10gL-1 de sacarose. Foram obtidos brotos alongados quando foi usado o meio WPM sem adição de cinetina e segmentos com uma ou duas gemas. A adição de cinetina a 0,5mgL-1 e a utilização de segmentos com três gemas promoveu maior número de brotações.

Effects of different concentration of sucrose on Wood Plant Medium -WPM and variations on number of bud/plantlets with different doses of kinetin were evaluated on this research. The experiments were carried out in the Tissue Culture Laboratory at Federal University of Lavras, using plantlets which was already established in vitro. The experimental design adopted was the complete randomized in factorial scheme 5 x 4. The results revealed that better sprouts multiplication of ‘Roxo de Valinhos' fig plants occurred in WPM medium, 100 percent salts, added with 10gL-1 of sucrose and the sprout elongation in WPM medium without kinetin taking explants within one or two buds. Adding 0.5mgL-1 of kinetin and taking explants with tree buds promoted larger sprouts number.

Prolongamento do período de colheita da tangerineira Ponkan com aplicação de GA3 e 2,4-D / Harvest season extent of tangerin 'Ponkan' fruits with the application of GA3 AND 2,4-D

Conduziu-se, este experimento em pomar comercial, dez anos após o plantio, localizado no município de São João Del Rei - MG, visando ampliar o período de colheita de frutos da tangerineira 'Ponkan' (Citrus reticulata Blanco). Foram avaliados os efeitos do ácido giberélico (GA3) à 0, 10, 20 e 30 mg.L-1 e do Ácido 2,4-diclorofenoxiacético (2,4-D) à 0 e 10 mg.L-1 aplicados em duas vezes: 24/4 e 17/5 quando os frutos apresentavam-se com coloração verde da casca e foram realizadas duas avaliações sendo a primeira no dia 25/7, quando já se aproximava a fase final de colheita da região, e a segunda 30 dias após. O delineamento experimental utilizado foi em blocos casualizados, em esquema fatorial 4 x 2 x 2, com quatro repetições em parcelas subdivididas. Os resultados mostraram que o 2,4-D, à 10 mg.L-1 influenciou na textura dos frutos, propiciando o prolongamento da colheita de tangerina 'Ponkan'; ¹ aumentou a acidez dos frutos e reduziu a relação sólidos solúveis totais /acidez; que a utilização de 20 mg.L-1 de GA3 promoveu incremento no diâmetro e no peso dos frutos; que o maior rendimento foi obtido no mês de agosto e que não houve diferença no teor de sólidos solúveis nas diferentes épocas de colheita.

This experiment was carried out on a ten year-old commercial orchard in São João Del Rei county-MG in order to extend the harvest season of tangerine Ponkan (Citrus reticulate Blanco). One evaluated the effects of Giberelic Acid (GA3) at 0, 10, 20 and 30 mg.0L-1 and Diclorofenoxiacetic acid (2,4- D) at 0 and 10 mg.L-1 applied two times: on 4/24 and 5/17 when the fruits still had a green peel color the evaluations were made: the first one on 7/25, when the harvest time in the region was ending, and the second 30 days after. The experimental design adopted was the one of randomized blocks, with a factorial of 4 x 2 x 2, with four split-plot replicates. The results showed that 2,4-D at 10 mg.L-1 influenced fruits texture and extended the harvest and also increased fruit acidity and reduced the ratio; GA3 at 20mg.L-1 increased the diameter and weight of the fruits harvested in August and presented higher juice rate and there was no difference on total soluble sugar in solid solute tenor.