High ankle-brachial index predicts cardiovascular events and mortality in hemodialysis patients with severe secondary hyperparathyroidism / Índice tornozelo-braquial elevado prediz eventos e mortalidade cardiovasculares nos pacientes em hemodiálise com hiperparatireoidismo secundário grave

Abstract Introduction: Vascular calcification related to severe secondary hyperparathyroidism (SHPT) is an important cause of cardiovascular and bone complications, leading to high morbidity and mortality in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD). The present study aimed to analyze whether ankle-brachial index (ABI), a non-invasive diagnostic tool, is able to predict cardiovascular outcomes in this population. Methods: We selected 88 adult patients on HD for at least 6 months, with serum iPTH>1,000pg/mL. We collected clinical data, biochemical and hormonal parameters, and ABI (sonar-Doppler). Calcification was assessed by lateral radiography of the abdomen and by simple vascular calcification score (SVCS). This cohort was monitored prospectively between 2012 and 2019 for cardiovascular outcomes (death, myocardial infarction (MI), stroke, and calciphylaxis) to estimate the accuracy of ABI in this setting. Results: The baseline values were: iPTH: 1770±689pg/mL, P: 5.8±1.2 mg/dL, corrected Ca: 9.7±0.8mg/dL, 25(OH)vit D: 25.1±10.9ng/mL. Sixty-five percent of patients had ABI>1.3 (ranging from 0.6 to 3.2); 66% had SVCS≥3, and 45% aortic calcification (Kauppila≥8). The prospective evaluation (51.6±24.0 months), provided the following cardiovascular outcomes: 11% of deaths, 17% of nonfatal MI, one stroke, and 3% of calciphylaxis. After adjustments, patients with ABI≥1.6 had 8.9-fold higher risk of cardiovascular events (p=0.035), and ABI≥1.8 had 12.2-fold higher risk of cardiovascular mortality (p=0.019). Conclusion: The presence of vascular calcifications and arterial stiffness was highly prevalent in our population. We suggest that ABI, a simple and cost-effective diagnostic tool, could be used at an outpatient basis to predict cardiovascular events in patients with severe SHPT undergoing HD.

Resumo Introdução: A calcificação vascular relacionada ao hiperparatireoidismo secundário (HPTS) grave é uma causa importante de complicações cardiovasculares e ósseas, levando a alta morbidade e mortalidade em pacientes com doença renal crônica (DRC) em hemodiálise (HD). O presente estudo objetivou analisar se o índice tornozelo-braquial (ITB), uma ferramenta diagnóstica não invasiva, pode predizer desfechos cardiovasculares nesta população. Métodos: Selecionamos 88 adultos em HD há pelo menos 6 meses, com PTHi sérico>1.000pg/mL. Coletamos dados clínicos, parâmetros bioquímicos e hormonais, e ITB (sonar-Doppler). A calcificação foi avaliada por radiografia lateral do abdome e por escore de calcificação vascular simples (ECVS). Esta coorte foi monitorada prospectivamente entre 2012 e 2019 para desfechos cardiovasculares (óbito, infarto do miocárdio (IM), acidente vascular cerebral e calcifilaxia) para estimar a precisão do ITB neste cenário. Resultados: Os valores basais foram: PTHi: 1770±689pg/mL, P: 5,8±1,2 mg/dL, Ca corrigido: 9,7±0,8mg/dL, 25(OH)vit D: 25,1±10,9ng/Ml; 65% dos pacientes apresentaram ITB>1,3 (variando de 0,6 a 3,2); 66% tiveram ECVS≥3, e 45% calcificação da aorta (Kauppila≥8). A avaliação prospectiva (51,6±24,0 meses) forneceu os seguintes desfechos cardiovasculares: 11% de óbitos, 17% de IM não fatal, um AVC, 3% de calcifilaxia. Após ajustes, pacientes com ITB≥1,6 tiveram risco 8,9 vezes maior de eventos cardiovasculares (p=0,035), e ITB≥1,8 apresentaram risco 12,2 vezes maior de mortalidade cardiovascular (p=0,019). Conclusão: A presença de calcificações vasculares e rigidez arterial foi altamente prevalente em nossa população. Sugerimos o ITB, uma ferramenta diagnóstica simples e econômica, para ser usada em ambulatório para prever eventos cardiovasculares em pacientes com HPTS grave em HD.

Difference Between the Profiles Presented by Yeasts that Colonize the Vaginal Mucosa or Cause Primary or Recurrent Candidiasis.

Candida yeasts are the most frequent in the vaginal content. This yeast may be a normal microbiota but also causes candidiasis. In symptomatic cases, primary candidiasis (VVC) or recurrence (RVVC) can be considered. This study aims to compare the frequency and in vitro sensitivity profile of Candida species isolated in the vaginal content with the different stages of the presence of yeasts. A total of 258 non-pregnant patients with/without VVC were prospectively screened at a teaching Health Centre of the Faculty of Medicine, in the University of Sao Paulo. The vaginal isolates were identified by traditional and molecular methods. Yeasts were isolated in 160 women. 34% were asymptomatic, 34% with vulvovaginal candidiasis (VVC), and 32% recurrent vulvovaginal candidiasis (RVVC). C. albicans was the most frequent species with 50.1% (82/160), followed by C. parapsilosis 13.7%(22/160), C. glabrata 12.5% (20/160), and C. tropicalis (6.2%). Analysis by the group showed that, in the asymptomatic group, eight yeast species were isolated, C. albicans 44.5% (24/54), C. glabrata 20% (11/54), C. parapsilosis and Rhodotorula rubra being the most frequent. In the VVC group, 11 yeast species were identified. Most isolates were C. albicans 68.5% (37/54), C. tropicalis 7.5% (4/54), and C. parapsilosis 5.5% (3/54). In the RVVC group, ten species were identified, the most frequent being C. albicans 38.5% (20/52), C. parapsilosis 17% (9/52), C. glabrata 4% (8/52), and C. tropicalis 6% (3/52). Less frequent species, such as C. haemulonii and Trichosporon spp, were isolated in the VVC and RVVC groups, C. kefyr was isolated in the three groups studied, and Rhodotorula spp was isolated in the control and RVVC groups. Candida metapsilosis was present in two isolates from the RVVC group. Most isolates were considered sensitive to the tested antifungals. Less sensitivity was seen for caspofungin. In this study, we were able to verify that the most common species of yeasts found in vaginal secretion were isolated in the three groups studied; however, there was the diversity of species in VVC and RVVC. Cryptic species C. haemulonii and were isolated in symptomatic patients. High levels of MICs, some of the antifungals tested, in the control group, draw attention in the group of asymptomatic women. We would like to emphasize that this research aims to assist clinicians and gynecologists, as well as assist in the epidemiological studies of candidiasis, in our country, how to draw attention to the profile of sensitivity/resistance to antifungals.

Yeasts and filamentous fungi in psittacidae and birds of prey droppings in midwest region of Brazil: a potential hazard to human health / Leveduras e fungos filamentosos em excretas de psittacideos e aves de rapina em cativeiro na região centro-oeste do Brasil: um risco potencial para a saúde humana

Abstract Birds of prey and from Psittacidae family are host to fungal microbiota and play an important role in the epidemiology of zoonoses. Few studies in the literature have characterized mycelial and yeast fungi in the droppings of these birds and correlated the isolates with the zoonotic potential of the microorganisms. Droppings from 149 birds were evaluated and divided into two groups: captive: Rhea americana araneipes, Primolius maracana, Ara ararauna, Ara chloropterus, Anodorhynchus hyacinthinus, Amazona aestiva, Ara macao macao, Ramphastos toco, Sarcoramphus papa, Busarellus nigricollis, Bubo virginianus nacurutu, Buteogallus coronatus, Buteogallus urubitinga urubitinga, Spizaetus melanoleucus, Spizaetus ornatus ornatus, Buteo albonotatus, Geranoaetus albicaudatus albicaudatus, Rupornis magnirostris magnirostris and Harpia harpyja, and quarantined birds: Amazona aestiva and Eupsitulla aurea. The fungal isolates were identified according to macroscopic (gross colony appearance), micromorphological and biochemical characteristics. Among birds displayed in enclosures, Aspergillus niger (41.1%) and Candida kefyr (63.8%) were the fungi most frequently isolated in Harpia harpyja and Ramphastos toco, respectively. For quarantined birds, the following percentages were observed in Eupsittula aurea , (76.6%) C. krusei, (84.4%) C. kefyr and (15.2%) C. famata, while in Amazona aestiva, (76.2%) C. krusei was observed. These findings indicate potentially pathogenic species in the bird droppings assessed, which constitute a risk of exposure for keepers and individuals who visit the zoo. Birds of the Cerrado and Pantanal of Mato Grosso (Central Western region of Brazil) could act in the epidemiological chain of important zoonoses.

Resumo Aves de rapina e psitacídeos são hospedeiras de uma rica microbiota fúngica e desempenham um papel importante na epidemiologia de zoonoses. Poucos estudos na literatura têm caracterizado fungos micelianos e leveduras nos excrementos de pássaros e correlacionados estes isolados com o potencial zoonótico dos microrganismos isolados. Excrementos de 149 aves foram divididas e avaliados em dois grupos: Em cativeiro: Rhea americana araneipes, Primolius maracana, Ara ararauna, Ara chloropterus, Anodorhynchus hyacinthinus, Amazona aestiva, Ara macao macao, Ramphastos toco, Sarcoramphus papa, Busarellus nigricollis , Bubo virginianus nacurutu, Buteogallus coronatus, Buteogallus urubutinga urubitinga, Spizaetus melanoleucus, Spizaetus ornatus ornatus, Buteo albonotatus, Geranoaetus albicaudatus albicaudatus, Rupornis magnirostris magnirostris e Harpia harpyja e aves em quarentena: Amazona aestiva e Eupsittula aurea). Os isolados de leveduras e de fungos micelianos foram identificados em observações macroscópicas (aspectos das colônias), características micromorfológicas e bioquímicas. Entre as aves indicadas em compartimentos, Aspergillus niger (41,1%) e Candida kefyr (63,8%) foram os fungos mais isolada em Harpia harpyja e Ramphastos toco, respectivamente. Para as aves em quarentena, os seguintes percentuais foram observados em Eupsittula aurea (76,6%) C. krusei, (84,4%) C. kefyr e (15,2%) C. famata, enquanto em Amazona aestiva (76,2%) de C. krusei foi observada. Estes resultados indicam a presença de espécies potencialmente patogênicos nas excretas das aves avaliadas, constituem um risco a exposição para os criadores e pessoas que visitam o zoológico. Aves do Pantanal e do Cerrado de Mato Grosso (região Centro-Oeste do Brasil) poderia atuar na cadeia epidemiológica das zoonoses importantes.

Yeasts and filamentous fungi in psittacidae and birds of prey droppings in midwest region of Brazil: a potential hazard to human health.

Birds of prey and from Psittacidae family are host to fungal microbiota and play an important role in the epidemiology of zoonoses. Few studies in the literature have characterized mycelial and yeast fungi in the droppings of these birds and correlated the isolates with the zoonotic potential of the microorganisms. Droppings from 149 birds were evaluated and divided into two groups: captive: Rhea americana araneipes, Primolius maracana, Ara ararauna, Ara chloropterus, Anodorhynchus hyacinthinus, Amazona aestiva, Ara macao macao, Ramphastos toco, Sarcoramphus papa, Busarellus nigricollis, Bubo virginianus nacurutu, Buteogallus coronatus, Buteogallus urubitinga urubitinga, Spizaetus melanoleucus, Spizaetus ornatus ornatus, Buteo albonotatus, Geranoaetus albicaudatus albicaudatus, Rupornis magnirostris magnirostris and Harpia harpyja, and quarantined birds: Amazona aestiva and Eupsitulla aurea. The fungal isolates were identified according to macroscopic (gross colony appearance), micromorphological and biochemical characteristics. Among birds displayed in enclosures, Aspergillus niger (41.1%) and Candida kefyr (63.8%) were the fungi most frequently isolated in Harpia harpyja and Ramphastos toco, respectively. For quarantined birds, the following percentages were observed in Eupsittula aurea , (76.6%) C. krusei, (84.4%) C. kefyr and (15.2%) C. famata, while in Amazona aestiva, (76.2%) C. krusei was observed. These findings indicate potentially pathogenic species in the bird droppings assessed, which constitute a risk of exposure for keepers and individuals who visit the zoo. Birds of the Cerrado and Pantanal of Mato Grosso (Central Western region of Brazil) could act in the epidemiological chain of important zoonoses.

Yeasts and filamentous fungi in psittacidae and birds of prey droppings in midwest region of Brazil: a potential hazard to human health

Abstract Birds of prey and from Psittacidae family are host to fungal microbiota and play an important role in the epidemiology of zoonoses. Few studies in the literature have characterized mycelial and yeast fungi in the droppings of these birds and correlated the isolates with the zoonotic potential of the microorganisms. Droppings from 149 birds were evaluated and divided into two groups: captive: Rhea americana araneipes, Primolius maracana, Ara ararauna, Ara chloropterus, Anodorhynchus hyacinthinus, Amazona aestiva, Ara macao macao, Ramphastos toco, Sarcoramphus papa, Busarellus nigricollis, Bubo virginianus nacurutu, Buteogallus coronatus, Buteogallus urubitinga urubitinga, Spizaetus melanoleucus, Spizaetus ornatus ornatus, Buteo albonotatus, Geranoaetus albicaudatus albicaudatus, Rupornis magnirostris magnirostris and Harpia harpyja, and quarantined birds: Amazona aestiva and Eupsitulla aurea. The fungal isolates were identified according to macroscopic (gross colony appearance), micromorphological and biochemical characteristics. Among birds displayed in enclosures, Aspergillus niger (41.1%) and Candida kefyr (63.8%) were the fungi most frequently isolated in Harpia harpyja and Ramphastos toco, respectively. For quarantined birds, the following percentages were observed in Eupsittula aurea , (76.6%) C. krusei, (84.4%) C. kefyr and (15.2%) C. famata, while in Amazona aestiva, (76.2%) C. krusei was observed. These findings indicate potentially pathogenic species in the bird droppings assessed, which constitute a risk of exposure for keepers and individuals who visit the zoo. Birds of the Cerrado and Pantanal of Mato Grosso (Central Western region of Brazil) could act in the epidemiological chain of important zoonoses.

Resumo Aves de rapina e psitacídeos são hospedeiras de uma rica microbiota fúngica e desempenham um papel importante na epidemiologia de zoonoses. Poucos estudos na literatura têm caracterizado fungos micelianos e leveduras nos excrementos de pássaros e correlacionados estes isolados com o potencial zoonótico dos microrganismos isolados. Excrementos de 149 aves foram divididas e avaliados em dois grupos: Em cativeiro: Rhea americana araneipes, Primolius maracana, Ara ararauna, Ara chloropterus, Anodorhynchus hyacinthinus, Amazona aestiva, Ara macao macao, Ramphastos toco, Sarcoramphus papa, Busarellus nigricollis , Bubo virginianus nacurutu, Buteogallus coronatus, Buteogallus urubutinga urubitinga, Spizaetus melanoleucus, Spizaetus ornatus ornatus, Buteo albonotatus, Geranoaetus albicaudatus albicaudatus, Rupornis magnirostris magnirostris e Harpia harpyja e aves em quarentena: Amazona aestiva e Eupsittula aurea). Os isolados de leveduras e de fungos micelianos foram identificados em observações macroscópicas (aspectos das colônias), características micromorfológicas e bioquímicas. Entre as aves indicadas em compartimentos, Aspergillus niger (41,1%) e Candida kefyr (63,8%) foram os fungos mais isolada em Harpia harpyja e Ramphastos toco, respectivamente. Para as aves em quarentena, os seguintes percentuais foram observados em Eupsittula aurea (76,6%) C. krusei, (84,4%) C. kefyr e (15,2%) C. famata, enquanto em Amazona aestiva (76,2%) de C. krusei foi observada. Estes resultados indicam a presença de espécies potencialmente patogênicos nas excretas das aves avaliadas, constituem um risco a exposição para os criadores e pessoas que visitam o zoológico. Aves do Pantanal e do Cerrado de Mato Grosso (região Centro-Oeste do Brasil) poderia atuar na cadeia epidemiológica das zoonoses importantes.

Clinical aspects and dynamics of auricular parasitosis in Gir cattle / Aspectos clínicos e dinâmica de parasitoses auriculares em bovinos da raça Gir

We evaluated the dynamics of ear infestations caused by Rhabditis spp. and Raillietia spp., which were correlated with animal age, intensity of clinical signs and climate factors. Sixty-four Gir cattle were distributed into three groups: GA - 23 calves with 4 to 6 months of age; GB - 18 calves with 7 to 12 months of age; and GC - 23 heifers with 13 to 33 months of age. Five samplings, defined as S1, S2, S3, S4 and S5 were performed every three months from August 2008 to August 2009. The ear secretion was collected using the auricular washing method for the right ear and a swab for the left ear. A clinical assessment of the animals was performed, and they were classified according to the presence and severity of otitis. The highest relative frequency of rhabditosis was 52.2% in GC at the last sampling. In the first sampling, 42.2% of the animals were infested by Raillietia spp. The older cattle were more susceptible to infestations by both parasites. No correlation of Rhabditis spp. and Raillietia spp. parasitism with climate factors was found. The results showed that both parasites could infest Gir cattle, and in most cases, there was no co-infestation. Only older animals parasitized by the nematode showed clinical signs of the disease.

Avaliou-se a dinâmica da infestação auricular causada por Rhabditis spp. e por Raillietia spp., relacionando-a com a idade dos animais, com a intensidade dos sinais clínicos e com os fatores climáticos. Utilizaram-se 64 bovinos Gir, distribuídos em três grupos: GA - 23 bezerros de quatro a seis meses de idade, GB - 18 bezerros de sete a 12 meses e GC - 23 novilhas de 13 a 33 meses. Foram feitas cinco coletas a cada três meses. A secreção auricular foi coletada utilizando o método de lavagem auricular na orelha direita e um swab na orelha esquerda. Fez-se avaliação clínica dos animais classificando-os de acordo com a presença e gravidade da otite. A maior frequência relativa da rhabditiose encontrada foi de 52,2%, no GC na ultima coleta. Na primeira coleta, 42,2% dos animais estavam infestados pela Raillietia spp. Os bovinos mais velhos foram mais suscetíveis às infestações de ambos os parasitos. Não foi encontrada correlação entre o parasitismo por Rhabditis spp. e por Raillietia spp. e os fatores climáticos. Concluiu-se que ambos os parasitas podem infestar bovinos da raça Gir e na maioria dos casos, não ocorreram infestações simultâneas. Apenas os animais mais velhos, parasitados pelo nematóide, apresentaram sinais clínicos da doença.

Stock assessment and fishery management of the pink shrimp Farfantepenaeus brasiliensis Latreille, 1970 and F. paulensis Pérez-Farfante, 1967 in Southeastern Brazil (23° to 28° S)

Quantitative analyses of the pink shrimp (Farfantepenaeus brasiliensis and Farfantepenaeus paulensis) fisheries were carried out using data collected from July 1999 to July 2001 from the trawling operations of the fishing fleet based in Santos/Guarujá, SP. According to classical models, the fishery is at its maximum sustainable yield. Therefore, reduction of the fishing effort and adequate season and area closures seem to be the best management actions for the pink shrimp fishery.

Análises quantitativas do camarão-rosa (Farfantepenaeus brasiliensis e Farfantepenaeus paulensis) foram realizadas com dados coletados de Julho/1999 a Julho/2001, da frota de arrasto sediada em Santos/Guarujá (SP). De acordo com os modelos clássicos de manejo, a pescaria atingiu seu rendimento máximo sustentável. Assim, uma redução no esforço pesqueiro, combinada com a adoção de defesos periódicos e o fechamento de algumas áreas à pesca, parecem ser as melhores medidas de manejo do estoque para o camarão-rosa.

Growth and mortalities of the pink-shrimp Farfantepenaeus brasiliensis Latreille, 1970 and F. paulensis Pérez-Farfante 1967 in Southeast Brazil

From July, 1999 until July, 2001 data from the pink-shrimp Farfantepenaeus brasiliensis Latreille, 1970 and F. paulensis Pérez-Farfante, 1967 fishery were collected from trawling by the fishing fleet based in Santos/Guarujá-SP. Growth and mortalities of these species were studied. F. brasiliensis and F. paulensis have longevity of 2 years and growth estimates of L FONT FACE=Symbol>¥ /FONT> = 29.0 cm and k = 1.24 year-1 for F. brasiliensis and L FONT FACE=Symbol>¥ /FONT> = 27.5 cm and k = 1.34 year-1 for F. paulensis. Females reach bigger lengths than males in both species. Natural mortalities (M) were 1.80 and 1.90 year-1 and fishing mortalities (F) were 4.7 and 6.8 year-1 for F. brasiliensis and F. paulensis, respectively. Survival rates are S = 0.15% and 0.02% for F. brasiliensis and F. paulensis, respectively, which are usually low values for shrimps.

De Julho de 1999 a Julho de 2001, foram coletados dados das pescarias comerciais do camarão-rosa Farfantepenaeus brasiliensis Latreille, 1970 e F. paulensis Pérez-Farfante, 1967, relativos à frota pesqueira de arrasto, sediada em Santos (SP). Estimativas dos parâmetros de crescimento e de mortalidades foram calculadas. Farafantepenaeus brasiliensis e F. paulensis são espécies de crescimento rápido e vida curta, com longevidade de 2 anos (L FONT FACE=Symbol>¥ /FONT> = 29,0 cm e k = 1,24 ano-1 para F. brasiliensis; L FONT FACE=Symbol>¥ /FONT> = 27,5 cm e k = 1,34 ano-1 para F. paulensis). As fêmeas atingem tamanhos maiores que os machos para ambas espécies. As mortalidades naturais foram estimadas em M = 1,80 ano-1 e 1,90 ano-1 e as mortalidades por pesca F = 4,7 ano-1 e 6,8 ano-1 para F. brasiliensis e F. paulensis, respectivamente. As taxas de sobrevivência foram calculadas em S = 0,15% para F. brasilensis e S = 0,02% para F. paulensis, valores usualmente baixos para camarões.

Evidence for phase-separated quantum dots in cubic InGaN layers from resonant raman scattering

The emission of light in the blue-green region from cubic InxGa1-xN alloys grown by molecular beam epitaxy is observed at room temperature and 30 K. By using selective resonant Raman spectroscopy (RRS) we demonstrate that the emission is due to quantum confinement effects taking place in phase-separated In-rich quantum dots formed in the layers. RRS data show that the In content of the dots fluctuates across the volume of the layers. We find that dot size and alloy fluctuation determine the emission wavelengths.