Cardiac arrest following sugammadex administration.

A 68-year-old man underwent elective surgical repair of an abdominal wall hernia under general anaesthesia. The operation required muscle relaxation, for which we used rocuronium. Following completion of surgery, 180 mg sugammadex was administered intravenously. Shortly afterwards, the patient became severely bradycardic with hypotension, refractory to treatment with ephedrine. This progressed to a pulseless electrical activity cardiac arrest. After 4 min of cardiopulmonary resuscitation, there was return of spontaneous circulation and, following a period of haemodynamic stability in which general anaesthesia was maintained, the patient emerged from anaesthesia without incident. He remained haemodynamically stable until discharge. Post-resuscitation investigations including the serum tryptase level were unremarkable except for a mild respiratory acidosis and slightly elevated D-dimers. Sugammadex-induced bradycardia has previously been described, but its mechanism remains unknown. We believe that sugammadex was the cause of cardiac arrest in this case because of the timing and sequence of events, the evolution to pulseless electric activity and the relatively uneventful post-arrest clinical course. We hope that our report will help to promote awareness about this potential complication of a now commonly-used drug.

Cardiomiopatia de Takotsubo ­ diagnóstico diferencial de síndrome coronariana aguda: relato de caso / Takotsubo cardiomyopathy - differential diagnosis of acute coronary syndrome: case report

INTRODUÇÃO: A Cardiomiopatia de Takotsubo (CT), ou Cardiomiopatia por Estresse (entre outras denominações), descrita em 1990, é cada vez mais reconhecida em todo o mundo como importante diagnóstico diferencial da Síndrome Coronariana Aguda (SCA). Sua apresentação, bem como achados de exames complementares são variados e sua evolução, frequentemente reversível, pode ser trágica se não for prontamente reconhecida. Este trabalho tem como objetivo relatar o caso de uma paciente do gênero feminino, atendida em um serviço terciário como um Infarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST (IAMCSST), com achados sugestivos de CT e com evolução à óbito apesar das medidas otimizadas instituídas. MÉTODOS: Trabalho realizado no formato de relato de caso. A revisão de literatura foi realizada utilizando a base de dados online Pubmed. Projeto submetido à aprovação do Comitê de Ética e Pesquisa com solicitação de dispensa do termo de consentimento livre e esclarecido. RELATO DE CASO: Paciente do gênero feminino, 69 anos. Apresentou quadro de dor precordial, em aperto, de início súbito, progressiva e de forte intensidade, com irradiação para região cervical e mandibular, que a fez procurou atendimento na Unidade de Pronto Atendimento da sua cidade de origem. Eletrocardiogramas seriados sugeríam IAMCSST. Realizadas então a terapia antiplaquetária dupla, terapia antitrombótica e a trombólise química com tenecteplase. Encaminhada ao serviço de referência para terapia fármaco-invasiva. No hospital terciário, enquanto aguarda estratificação invasiva, evoluiu com quadro de choque cardiogênico. Eletrocardiograma evidenciava supradesnivelamento difuso do segmento ST. Ecocardiograma trasntorácico evidenciava disfunção do ápice do ventrículo esquerdo, bem como derrame pericárdico moderado sem repercussão hemodinâmica. Cineangiocoronariografia não mostrou lesão obstrutiva única cupável em arterias coronarianas. Ventriculografia exibia acinesia anterior e discinesia septo-apical com déficit contrátil global importante. Feita então a hípotese de CT. Apesar das medidas intensivas instituídas, a paciente evoluiu com choque refratário e óbito. CONCLUSÃO: A CT, descrita há mais de 30 anos, permanece com sua fisiopatologia pouco conhecida, necessitando ser melhor estudada e entendida, uma vez que pode se apresentar como diagnóstico diferencial de SCA, evoluindo em alguns casos de forma trágica.

Infrared spectroscopy refines chronological assessment, depositional environment and pyrolysis conditions of archeological charcoals.

Based on infrared spectral characteristics, six archeological sample sets of charcoals from German (5) and Brazilian (1) sites, covering the time span from the nineteenth century CE to 3950 BCE, were compared to a chronological (present to the fifteenth century BCE) series of Austrian charcoals. A typical chronological trend of several bands (stretch vibrations: O-C-O of carboxylates at 1,585-1,565 and 1,385-1,375 cm-1, C-O carboxylic acids at 1,260-1,250 cm-1) that indicate oxidation and subsequently increasing hydrophilicity (O-H stretch vibration at about 3,400 cm-1) was also contained in the archive samples. Three sample sets fit in the typical band development according to their age. For three sample sets this conformity was not observed. Despite the age of two sample sets (3950-2820 BCE), most charcoals were assigned to the Modern Period. Apart from the high degree of carbonization, anaerobic depositional conditions over a longer period of time seem to contribute to the surprising conservation. Non-removable mineral components in charcoals, as observed in a third sample set, strongly influence infrared band intensities and positions of organic compounds. The role of inorganic components in terms of charcoal aging, and the information we can obtain from spectral characteristics in an archeological context, are discussed.

Performance of rapid prescreening and 100% rapid review as internal quality control methods for cervical cytopathology.

BACKGROUND: An objective of quality control for cervical cytopathology is reducing high rates of false-negative results of laboratory tests. Therefore, methods to review smears such as rapid prescreening and 100% rapid review, which have shown better performance detecting false-negative results, have been widely used. The performance of rapid prescreening and the performance of 100% rapid review as internal quality control methods for cervical cytology examinations were evaluated. METHODS: For 24 months, 9318 conventional cervical cytology smears underwent rapid prescreening and routine screening. The 100% rapid review method was performed for 8244 smears classified as negative during routine screening. Any discordant results underwent detailed review to define the final diagnosis. This was considered the gold standard for evaluating the performance of rapid prescreening and 100% rapid review. RESULTS: Routine screening showed increases of 13.3% and 11.5% in the detection of abnormal smears with rapid prescreening and 100% rapid review, respectively. The relative percentage variation showed a 38.1% increase in the diagnosis of atypical squamous cells of undetermined significance with routine screening and rapid prescreening and a 12.5% increase in the diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion with both rapid prescreening and 100% rapid review. Sensitivity rates of rapid prescreening and routine screening were 48.2% and 83.2%, respectively. Sensitivity rates of rapid prescreening and 100% rapid review were 65.7% and 57.8%, respectively, for detecting false-negative results. CONCLUSIONS: Inclusion of rapid prescreening and/or 100% rapid review improved the diagnostic sensitivity of the cervical cytology examination and reduced false-negative results of routine screening and can provide good quality control.

Cytokine expression in response to root repair agents.

AIM: To evaluate the expression of TNF-α, IL-6, IFN-γ, TGF-ß, IL-4, IL-10, RANKL, RANK and OPG on mouse calvarial bone treated with MTA, Geristore® and Emdogain® . METHODOLOGY: Bone wounds were made on the heads of C57BL/6 mice, breaking the periosteum and the cortical surface of the calvaria. Each repair agent was inserted into sectioned Eppendorf microtubes and placed on the bone wound, and soft tissues were sutured. At 14 and 21 days, animals were sacrificed and the treated region was dissected. The calvaria bone was removed, and RNA was extracted. mRNA expression of the aforementioned cytokines was assessed using real-time PCR. Data were analysed by nonparametric methods, including the Mann-Whitney and Kruskal-Wallis tests (P < 0.05). RESULTS: Following treatment with Emdogain® and MTA, mRNA expression of RANKL, RANK and OPG increased significantly (P < 0.05) between days 14 to 21. Geristore® did not alter the basal expression of these mediators during the same period of evaluation. Whilst treatment with Emdogain® did cause a significant increase in TNF-α mRNA expression between days 14 and 21 (P < 0.05), treatment with MTA did not alter the basal expression of this cytokine at either experimental time point. However, TNF-α mRNA expression was down-regulated significantly at day 21 (P < 0.05) when Geristore® was applied. A significant increase in the mRNA expression of IL-6, TGF-ß, IL-10, IL-4 and IFN-γ was observed with Emdogain® and MTA treatment between days 14 to 21, whereas Geristore® reduced significantly the expression of IL-6, TGF-ß and IL-4 (P < 0.05). CONCLUSION: The clinical indication of these repair agents depends on the root resorption diagnosis. Whilst MTA and Emdogain® induce a pro- and anti-inflammatory response early and late, respectively, Geristore® was not associated with an inflammatory reaction when compared with both repair agents.

Determinação do caseinomacropeptídeo em leite UAT por espectroscopia no infravermelho próximo e regressão por mínimos quadrados parciais / Determination of caseinomacropeptide in uht milk using near infrared spectroscopy and pls regression

O presente trabalho foi realizado com o objetivo de desenvolver um método para a determinação de CMP em leite UAT por meio da aplicação da espectroscopia de infravermelho próximo. Leites UAT de oito marcas diferentes foram utilizados para a construção dos modelos de calibração. Os resultados demonstram que, para o desenvolvimento de um modelo de calibração adequado para a determinação de CMP em leite UAT, deve-se utilizar, juntamente com o método de regressão PLS, o método de seleção de espectros máxima distância e os pré-tratamentos 2ª derivada e variável normal padronizada. Além disso, pôde-se determinar que as regiões do infravermelho próximo mais correlacionadas com os movimentos vibracionais dos aminoácidos presentes no CMP foram: 1100-1310; 1400-1430; 1490-1550; 1640-1680; 1780-1970; 2020-2100 e 2310-2350nm. Conclui-se que a espectroscopia de infravermelho próximo pode ser uma alternativa para a determinação de CMP em leite UAT, desde que haja um conjunto de calibração com amostras representativas da população a ser predita no futuro.(AU)

his work´s objective was to develop an UHT milk caseinomacropeptide determination method trough NIR spectroscopy application. Eight UHT milk trademarks are used to produce a mathematical calibration model. The results of NIR analysis suggested that to produce a suitable calibration model, partial least-square regression (PLSR) must be used, with maximum distance in wavelenght space to select spectra, pre - treatment with 2nd derivative and standard normal variant (SNV). Also, suitable near-infrared regions more correlated with CPM aminoacids vibrational movements: 1100-1310; 1400-1430; 1490-1550; 1640-1680; 1780-1970; 2020-2100; and 2310-2350nm. Therefore, NIR spectroscopy can be an alternative to caseinomacropeptide determination of UHT milk, since there was a representative calibration set with a large enough and representative sample of entire population to be predicted in the future.(AU)

Analysis of trace metal concentrations in raw cow's milk from three dairy farms in North Gondar, Ethiopia: chemometric approach.

Concentrations of essential (Cu, Mn, and Zn) and toxic (Cr, Cd, and Pb) trace metals in 30 raw cow's milk samples were quantified using flame atomic absorption spectrometry. The samples were collected from the Nara-Awudarda, Tana-Abo, and Kosoye Amba-Rass sites in North Gondar, Ethiopia, preserved in a deep freezer (-20 °C), and then digested by Kjeldahl apparatus with HNO3/H2O2 (5:2; v/v) at 300 °C for 2.5 h. The data were subject to principal component analysis (PCA) and partial least square-discriminant analysis (PLS-DA). Overall hazard quotient (HQ) and carcinogenic risk (CR) values were also estimated to assess metal-related health risks. The mean concentrations of Cr, Mn, Cu, Zn, Cd, and Pb in the milk samples ranged 0.468-0.828, 1.614-2.806, 0.840-1.532, 1.208-5.267, ND-0.330, and ND-0.186 mg/kg, respectively. The lowest values were obtained for Kosoye Amba-Rass milk samples, while the highest were found for those collected from Nara-Awudarda milk samples, probably due to high mineral enrichment and metal leaching (especially Cd and Pb) from coal deposits. PCA revealed clustering of samples with respect to their geographic origin. Validation of PLS-DA model showed 100% classification efficiency using external validation samples and detected Cd and Cu as trace metal markers. The HQ and CR values were within the safe level; however, the former is close to the alert threshold level for Nara-Awudarda milk samples. Thus, further studies on common foodstuffs, constituting a higher proportion in the local diet, are required in this area to provide a complete risk assessment.

Ontogenetic shifts in fishes between vegetated and unvegetated tidepools: assessing the effect of physical structure on fish habitat selection.

The aim of this study of tidepool fishes was analyse variation in their use of intertidal habitats (rocky shore, mangrove and salt marsh). Specimens were collected during wet and dry periods from 18 tidepools in the three habitats. A total of 7690 specimens, belonging to 19 families and 30 species, was captured. The fish assemblage in rocky shore pools was clearly distinct from that of vegetated habitats (mangrove and salt marshes). The rocky shore fauna was dominated by permanent resident species, whereas pools in mangrove and salt marsh habitats were inhabited primarily by opportunistic and transient species. Habitat segregation by ontogenetic stage (e.g. smaller individuals in mangroves, intermediate size classes in salt marsh and sub-adults/adults on rocky shores) indicates age-related migration in response to the physical structure of these habitats and to the natural history of each fish species. These findings are important for the development of effective conservation and management plans for intertidal fishes.

Pre-transplant shedding of BK virus in urine is unrelated to post-transplant viruria and viremia in kidney transplant recipients.

BK virus-(BKV) associated nephropathy (BKVN) is a major cause of allograft injury in kidney transplant recipients. In such patients, subclinical reactivation of latent BKV infection can occur in the pre-transplant period. The purpose of this study was to determine whether urinary BKV shedding in the immediate pre-transplant period is associated with a higher incidence of viruria and viremia during the first year after kidney transplantation. We examined urine samples from 34 kidney transplant recipients, using real-time quantitative polymerase chain reaction to detect BKV. Urine samples were obtained in the immediate pre-transplant period and during the first year after transplant on a monthly basis. If BKV viruria was detected, blood samples were collected and screened for BKV viremia. In the immediate pre-transplant period, we detected BKV viruria in 11 (32.3%) of the 34 recipients. During the first year after transplantation, we detected BKV viruria in all 34 patients and viremia in eight (23.5%). We found no correlation between pre-transplant viruria and post-transplant viruria or viremia (p = 0.2). Although reactivation of latent BKV infection in the pre-transplant period is fairly common among kidney transplant recipients, it is not a risk factor for post-transplant BKV viruria or viremia.

Levels of Candidate Periodontal Pathogens in Subgingival Biofilm.

In recent years, several new periodontal taxa have been associated with the etiology of periodontitis. A recent systematic review provides further support for the pathogenic role of 17 species/phylotypes. Thus, the aim of this study was to assess the prevalence and levels of these species in subjects with generalized chronic periodontitis (GChP; n = 30), generalized aggressive periodontitis (GAgP; n = 30), and periodontal health (PH; n = 30). All subjects underwent clinical and microbiological assessment. Nine subgingival plaque samples were collected from each subject and analyzed for their content of 20 bacterial species/phylotypes through the RNA-oligonucleotide quantification technique. Subjects from the GChP and GAgP groups presented the highest mean values for all clinical parameters in comparison with the PH group (P < 0.05). Subjects with GChP and GAgP showed significantly higher mean levels of Bacteroidetes sp. human oral taxon (HOT) 274, Fretibacterium sp. HOT 360, and TM7 sp. HOT 356 phylotypes, as well as higher mean levels of Filifactor alocis, Fretibacterium fastidiosum, Porphyromonas gingivalis, Tannerella forsythia, and Selenomonas sputigena species than PH subjects (P < 0.05). GAgP subjects presented higher mean levels of TM7 sp. HOT 356 and F. alocis than GChP subjects (P < 0.05). A significantly higher mean prevalence of Bacteroidales sp. HOT 274, Desulfobulbus sp. HOT 041, Fretibacterium sp. HOT 360, and Fretibacterium sp. HOT 362 was found in subjects with GChP and GAgP than in PH subjects. Mean levels of P. gingivalis (r = 0.68), T. forsythia (r = 0.62), F. alocis (r = 0.51, P = 0.001), and Fretibacterium sp. HOT 360 (r = 0.41) were correlated with pocket depth (P < 0.001). In conclusion, Bacteroidales sp. HOT 274, Desulfobulbus sp. HOT 041, Fretibacterium sp. HOT 360, Fretibacterium sp. HOT 362, and TM7 sp. HOT 356 phylotypes, in addition to F. alocis, F. fastidiosum, and S. sputigena, seem to be associated with periodontitis, and their role in periodontal pathogenesis should be further investigated.

Short Communication An efficient method for simultaneous extraction of high-quality RNA and DNA from various plant tissues.

Determination of gene expression is an important tool to study biological processes and relies on the quality of the extracted RNA. Changes in gene expression profiles may be directly related to mutations in regulatory DNA sequences or alterations in DNA cytosine methylation, which is an epigenetic mark. Correlation of gene expression with DNA sequence or epigenetic mark polymorphism is often desirable; for this, a robust protocol to isolate high-quality RNA and DNA simultaneously from the same sample is required. Although commercial kits and protocols are available, they are mainly optimized for animal tissues and, in general, restricted to RNA or DNA extraction, not both. In the present study, we describe an efficient and accessible method to extract both RNA and DNA simultaneously from the same sample of various plant tissues, using small amounts of starting material. The protocol was efficient in the extraction of high-quality nucleic acids from several Arabidopsis thaliana tissues (e.g., leaf, inflorescence stem, flower, fruit, cotyledon, seedlings, root, and embryo) and from other tissues of non-model plants, such as Avicennia schaueriana (Acanthaceae), Theobroma cacao (Malvaceae), Paspalum notatum (Poaceae), and Sorghum bicolor (Poaceae). The obtained nucleic acids were used as templates for downstream analyses, such as mRNA sequencing, quantitative real time-polymerase chain reaction, bisulfite treatment, and others; the results were comparable to those obtained with commercial kits. We believe that this protocol could be applied to a broad range of plant species, help avoid technical and sampling biases, and facilitate several RNA- and DNA-dependent analyses.

Use of cholesterol-loaded cyclodextrin in donkey semen cryopreservation improves sperm viability but results in low fertility in mares.

The use of cholesterol-loaded cyclodextrin (CLC) on semen cryopreservation has been related with better sperm viability in several species; however, the effect on fertility is not known in donkey semen. Ejaculates (n = 25) from five donkeys were diluted in S-MEDIUM with 0, 1, 2 or 3 mg of CLC/120 × 10(6) spermatozoa. Semen was frozen, and thawed samples were evaluated by computer-assisted sperm analyser system (CASA), supravital test, hyposmotic swelling test and fluorescent dyes to assess the integrity of sperm membranes. Mares (n = 60) were inseminated with frozen-thawed semen treated with the doses of 0 or 1 mg CLC. Percentages of sperm with progressive motility and with functional plasma membrane were greater (p < 0.05) in the CLC-treated groups than in the control. Percentages of intact plasma membrane and intact plasma membrane and acrosome detected by fluorescent dyes were also greater (p < 0.05) in CLC-treated groups. Although no difference (p > 0.05) in conception rates was detected between groups (control, 3/30, 10%; CLC-treated, 1/30, 3.3%), fertility was low for artificial insemination programs in mares. Therefore, we firstly demonstrated that frozen semen treated with CLC in S-MEDIA extender before freezing improves the in vitro sperm viability, but semen treated or not with CLC in S-MEDIUM extender results in a very low conception rate in mares inseminated with thawed donkey semen.

First Report of Leaf Spot Caused by Cladosporium perangustum on Syagrus oleracea in Brazil.

Syagrus oleracea (Mart.) Becc. (bitter coconut), a palm tree species that is native to central Brazil, has been increasingly cultivated in this country for heart-of-palm production. Epidemics of a necrotic leaf spot of unknown etiology have been recorded on bitter coconut plants in transplant nurseries and plantation since 2008. The first symptoms appear as small, yellow, hydrotic flecks on young or mature leaves that evolve to necrotic brown streaks that run parallel to the leaf veins. Usually, yellow halos occur around the lesions and hydrosis is common during lesion expansion. Necrotic lesions can reach up to 40 mm in length and 10 mm in width, and the lesions often coalesce, causing extensive tissue damage. During a survey in a 3-year-old bitter coconut plantation in Maringá County (coordinates: 23°23'51.25″ S, 51°57'02.09″ W; elevation: 507 m) in the state of Parana, a dozen symptomatic leaves were collected with the aim of elucidating the etiology of this disease. Conidia and conidiophores typical of Cladosporium were frequently observed on the diseased leaf tissue under natural field conditions as well on the surfaces of disinfected leaf tissues kept in a humid chamber for 48 h at 25 ± 2°C with a 12-h photoperiod. Five monoconidial cultures growing on potato dextrose agar (PDA) medium were obtained from different leaves showing leaf spot symptoms. The cultures were grown on PDA to induce sporulation. At 7 days after incubation at 25 ± 2°C and a 12-h photoperiod, gray to gray-olive colonies were observed. The conidiophores were macronematous, erect, oblong, branched, 1 to 5 septate, and 75.0 to 120.0 × 1.90 to 3.20 µm. The ramoconidia were cylindrical or oblong, 0 to 2 septate, and 28.0 to 40.0 × 2.8 to 3.6 µm, with a truncate base of 1.9 to 2.2 µm; secondary ramoconidia were cylindrical or oblong, 0 to 2 septate, 8.0 to 31.0 × 2.2 to 3.1 µm, with 3 to 5 distal conidial hila; intercalary 1-septate conidia were 5.5 to 17.0 × 2.1 to 3.4 µm, with 1 to 3 distal conidial hila; terminal 1-septate conidia were catenulate and 2.2 to 4.2 × 1.8 to 3.1 µm. Species identification was performed based on morphology and DNA sequence data (1). Portions of the elongation factor 1α (551 bp; TEF) and actin (213 bp; ACT) genes were amplified by PCR. A BLAST search of the GenBank database revealed that the TEF (KC484658 to KC484662) and ACT (KC484663 to KC484667) sequence fragments from isolates Gua1, Gua2, Gua3, Gua4, and Gua5 had 100% identity with the accessions HM148616 and HM148371 of Cladosporium perangustum (1). Isolates were tested for pathogenicity against bitter coconut. Ten potted plants with 4 to 6 fully expanded leaves were inoculated with each isolate by spraying a suspension of conidia (105 spores per ml) onto leaves until runoff using a handheld spray bottle. Non-inoculated controls (10 plants) were sprayed with distilled water. The plants were kept in a humid plastic chamber at 20 to 26°C. All examined isolates were pathogenic to bitter coconut, causing symptoms identical to those described above 12 days after inoculation. All inoculated tissues were plated onto PDA to confirm the presence of the pathogen. Live cultures are being maintained at the Micoteca/URM/UFPE ( www.ufpe.br/micoteca ), Brazil. To our knowledge, this is the first report of a disease caused by C. perangustum on S. oleracea worldwide, and the study provides valuable plant disease diagnostic information for the palm hearth industry in Latin America. Reference: (1) K. Bensch et al. Stud Mycol. 67:1, 2010.

The effects of a mineral trioxide aggregate-based sealer on the production of reactive oxygen species, nitrogen species and cytokines by two macrophage subtypes.

AIM: To test the effects of a mineral trioxide aggregate-based sealer (MTA Fillapex(®)) and MTA (MTA-Ângelus(®)) on viability and on the production of cytokines, reactive oxygen species (ROS) and nitrogen species (NO) by M1 and M2 inflammatory macrophages. METHODOLOGY: M1 (from C57BL/6 mice) and M2 (from BALB/c mice) peritoneal inflammatory macrophages were obtained and cultured in vitro in the presence of original and diluted extracts of MTA and MTA Fillapex (FLPX). The cell viability, ROS release and the release of tumour necrosis factor-a, interleukin (IL)-12, IL-10 and NO in response to stimulation with interferon-γ and Fusobacterium nucleatum or Peptostreptococcus anaerobius were evaluated. The data were analysed using the Mann-Whitney test and Student's t-test. RESULTS: Fillapex was cytotoxic at the highest concentrations (1:1;1:2) and decreased the viability (P < 0.05) of both macrophage types (<20%). MTA did not interfere with cellular viability. FLPX inhibited the release of ROS and decreased NO release in F. nucleatum and P. anaerobius -stimulated M1 and M2 macrophages (≤25 µ mol L(-1)). F. nucleatum-stimulated M2 macrophage cultures released lower levels of TNF-α when FLPX was added (≤1 ng mL(-1)). M2 macrophages released higher (>5 ng mL(-1)) levels of IL-10 than M1 macrophages. Only M1 macrophage cultures produced IL-12p70. CONCLUSIONS: Fillapex impaired effector immune responses during inflammation (M1 macrophages), as well as during healing (M2 macrophages) responses.

Adult worm-specific IgE/IgG4 balance is associated with low infection levels of Schistosoma mansoni in an endemic area.

Field studies have suggested an immune-mediated mechanism associated with resistance to Schistosoma mansoni infection. Overall, levels of specific IgE have been correlated with resistance to infection, whereas levels of IgG4 have been associated with susceptibility. This study aimed to evaluate serum levels of soluble adult worm antigen preparation (SWAP)-specific IgE and IgG4 in relation to current infection in a large casuistic of individuals living in an endemic area of schistosomiasis in Bahia, Brazil. The prevalence of S. mansoni infection was 37·7% and the mean parasite burden was 55·4 (0-2100) epg/faeces. There was no significant difference in the levels of SWAP-specific IgE in individuals with different parasite burden, whereas high producers of parasite-specific IgG4 presented higher parasite burden when compared to low IgG4 producers. Additionally, S. mansoni parasite load was positively correlated with the levels of specific IgG4 or total IgE. No significant correlation was observed between parasite burden and SWAP-specific IgE. Nevertheless, SWAP-specific IgE/IgG4 ratio was higher in uninfected or lightly infected individuals (1-99 epg/faeces) than in heavily infected ones (≥400 epg/feces). These findings highlight the important role of IgE/IgG4 ratio in the resistance to infection, which could be useful for further studies in schistosomiasis vaccine candidates.

Septin localization in the dimorphic fungus Paracoccidioides brasiliensis.

Septins are evolutionarily conserved proteins that contain a GTPase domain and are capable of forming filaments at the cell periphery. Septins are involved in many essential cellular processes, such as cytokinesis and cell polarization, and are used as markers of morphogenesis in several fungi. Dimorphism in fungi enables cells to switch between morphologies (yeast or filament forms), due to changes in the temperature of the environment. We analysed the localization of septin proteins in yeast and filamentous cells of the dimorphic fungus Paracoccidioides brasiliensis, a common cause of granulomatous mycosis. In order to determine septin localization, we first cloned Cdc12p, a septin homolog from P. brasiliensis, and expressed it in Escherichia coli. Following PbCdc12p purification, specific serum against PbCdc12p were raised for use in immunofluorescence assays. We observed the hourglass and ring forms of septin filaments during cell division in yeast. Septin filaments were also simultaneously localized in the necks of multiple budding cells. A distinctive pattern of punctuate and/or diffuse localization was also seen in the periphery of multinucleate yeast cells and at the tips and septa of filamentous cells. A more diffuse and punctuate pattern of localization observed in P. brasiliensis cells seems to be unique to filamentous and dimorphic fungi and may be related to their specialization in cell wall deposition, morphogenesis and cell cycle control.

Alterations of tendons in patients with diabetes mellitus: a systematic review.

AIMS: To perform a systematic review of observational studies which analyse tendon alterations in patients with diabetes mellitus compared with healthy individuals. METHODS: Data collection was performed, with no language restriction, using the databases of PubMed/Medline, BIREME, CINAHL, LILACS and Cochrane, as well as the references found in these studies. Three reviewers performed independent extractions of articles. Subsequently, these reviewers analysed the articles, focusing on their methodological quality, using the appropriate scale to evaluate observational studies from the Agency for Healthcare Research and Quality. RESULTS: Six articles were included in the analysis. Of these, four had used ultrasonographic diagnostics, one computed tomography and one magnetic resonance imaging. The patient pool comprised 396 individuals. All the articles evaluated tendon thickness and presented heterogeneous results. Two articles stated thickening or increased volume of the tendons in diabetic people, one article did not report any alteration, the fourth failed to determine any alterations and the fifth showed thinning of the tendons. The arrangement of collagen fibrils and the presence of calcification were analysed in only one article (n = 80), showing that 88.10% (n = 68) of individuals with diabetes presented disorientation of collagen fibril arrangement, while only 10% (n = 1) of healthy individuals presented this condition. Regarding tendon calcification, the article showed diabetic individuals with higher values than healthy individuals. CONCLUSIONS: All the articles indicated some relation between diabetes mellitus and tendon alterations in human beings, but due to methodological drawbacks, this association could not be sustained.