The venous patterns of the cubital fossa in subjects from Brazil.

Venous punctures are among the most common procedures performed by healthcare professionals. In particular, the cubital fossa is the site where the venous accesses are frequently made due to the number of superficial veins and the numerous anastomoses in this region. The arrangement of these venous connections is of particular interest for clinical application in several areas, thus, the healthcare professional must possess knowledge about these vessels and their anatomical relationships. The present study aims to analyze the venous pattern of the cubital fossa among individuals from Brazil. This study was approved by a Research Ethics Committee. The sample had 100 healthy individuals (50 men and 50 women). The superficial veins of the cubital fossa were analyzed with the aid of a sphygmomanometer. When inflated, the pressure in the forearm increased and the veins became prominent. It was observed that in the selected sample the types with the highest prevalence were the Type I and Type VII, both with 22% in 200 limbs studied. The chi2 test showed a significant statistical difference between the anastomosis pattern and the sex of the studied sample. The anastomotic pattern of the superficial veins of the studies sample is similar to African, European and Asian populations. The study of these variations is necessary to provide scientific basis for the healthcare professional during a venipuncture in order to avoid iatrogenic errors and damages in cutaneous nerves or neighboring arteries.

Pickering emulsion stabilized by cashew gum- poly-l-lactide copolymer nanoparticles: Synthesis, characterization and amphotericin B encapsulation.

In this work, we provide proof-of-concept of formation, physical characteristics and potential use as a drug delivery formulation of Pickering emulsions (PE) obtained by a novel method that combines nanoprecipitation with subsequent spontaneous emulsification process. To this end, pre-formed ultra-small (d.∼10 nm) nanoprecipitated nanoparticles of hydrophobic derivatives of cashew tree gum grafted with polylactide (CGPLAP), were conceived to stabilize Pickering emulsions obtained by spontaneous emulsification. These were also loaded with Amphotericin B (AmB), a drug of low oral bioavailability used in the therapy of neglected diseases such as leishmaniasis. The graft reaction was performed in two CG/PLA molar ratio conditions (1:1 and 1:10). Emulsions were prepared by adding the organic phase (Miglyol 812®) in the aqueous phase (nanoprecipitated CGPLAP), resulting the immediate emulsion formation. The isolation by centrifugation does not destabilize or separate the nanoparticles from oil droplets of the PE emulsion. Emulsions with CGPLAP 1:1 presented unimodal distributions at different CGPLA concentration, lower values in size and PDI and the best stability over time. The AmB was incorporated in the emulsions with a process efficiency of 21-47%, as determined by UV-vis. AmB in CGPLAP emulsions is in less aggregated state than observed in commercial AmB formulation.

Androecia in two Clusia species: development, structure and resin secretion.

Clusia fluminensis and C. lanceolata are dioecious shrubs having resiniferous flowers with strongly distinct androecia. The aim of this study was to investigate the development and anatomy of their androecia and the ultrastructure, histochemistry and secretory process of their androecium resin glands, examining whether the cellular aspects of resin secretion differed between these two morphologically distinct androecia. Stamens differ, being free in C. fluminensis and clustered in a synandrium in C. lanceolata. Staminode sterility is due to the undifferentiated nature of the anthers in C. lanceolata and degeneration of meiocytes and anther indehiscence in C. fluminensis. Resin is produced in subepidermal cavities and canals with wide lumens. In the secretory stage, epithelial cells present sinuous walls, voluminous nuclei, polymorphic plastids associated with periplastidial reticulum, mitochondria, oil bodies, multivesicular bodies, endoplasmic reticulum and dictyosomes. The resin is released through rupture points on the distal surface of stamens and staminodes, associated with disrupted cavities and canals. Our results show morphological diversity associated with functional similarity. Also, a secretion pattern shared by the two species includes initiation of the secretory process in young floral buds, compartmentalisation of the secretion in pre-anthesis buds and release of secretions at anthesis. Cellular aspects of resin secretion in these species are quite similar, as are the chemical identities of the main components of the floral resins of the genus.

Chemically sulfated galactomannan from Dimorphandra gardneriana seed: characterization and toxicity evaluation.

Dimorphandra gardneriana galactomannan (DG) was sulfated in pyridine:formamide using chlorosulfonic acid as the sulfation agent. The degree of substitution was 0.32, determined from the sulfur percentage. Confirmation of sulfation was obtained by FTIR spectroscopy through the presence of an asymmetrical SO stretching vibration at 1,259 cm(-1). NMR data showed that the sulfation occurred on primary hydroxyl groups. NMR and GPC data indicate degradation during reaction with elimination of galactose. At the maximum tested concentration of 1,000 µg/mL, unmodified DG polysaccharide did not show a statistically significant cytotoxicity in Vero cells by the MTT method. Therefore, the CC50>1,000 µg/mL obtained for the sulfated polysaccharides from D. gardneriana in Vero cells point to its lower cytotoxicity than the sulfated galactomannan from Mimosa scabrella.

Contribution of the cashew gum (Anacardium occidentale L.) for development of layer-by-layer films with potential application in nanobiomedical devices.

The search for bioactive molecules to be employed as recognition elements in biosensors has stimulated researchers to pore over the rich Brazilian biodiversity. In this sense, we introduce the use of natural cashew gum (Anacardium occidentale L.) as an active biomaterial to be used in the form of layer-by-layer films, in conjunction with phthalocyanines, which were tested as electrochemical sensors for dopamine detection. We investigated the effects of chemical composition of cashew gum from two different regions of Brazil (Piauí and Ceará states) on the physico-chemical characteristics of these nanostructures. The morphology of the nanostructures containing cashew gum was studied by atomic force microscopy which indicates that smooth films punctuated by globular features were formed that showed low roughness values. The results indicate that, independent of the origin, cashew gum stands out as an excellent film forming material with potential application in nanobiomedical devices as electrochemical sensors.

Development and pathology of Fasciola hepatica in CCL3-deficient mice.

Fasciola hepatica is a parasitic helminth that predominantly infects the liver and bile ducts of cattle and causes great losses of cattle production in the southern and southeastern regions of Brazil. The generation of liver lesions and the consequent inflammatory responses are intimately related to the migration of this parasite. The CC-group of chemokines plays a crucial role in the attraction of several cell types and in the recruitment of additional macrophages to an inflammatory focus in numerous diseases. In order to evaluate the role of CCL3 in the development of F. hepatica, we compared parasitological and pathological parameters in C57Bl/6J mice that were assigned to one of two experimental groups: the first group contained CCL3-producing mice (CCL3(+/+) mice) and the other group contained mice that were genetically deficient in CCL3 production (CCL3(-/-) mice). The mortality rate in the CCL3 non-deficient group was higher than of the deficient animals. In most animals from both experimental groups, the necropsied animals contained hemorrhages in their abdominal cavities. In the genetically modified animals, the lesioned liver areas were less extensive and presented focal and sub-capsular lesions. This work demonstrates that the development of F. hepatica is not affected by the absence of CCL3.

Antiophidian properties of plant extracts against Lachesis muta venom

Snakebites comprise a serious health problem in several countries due to their global incidence, which exceeds 2.5 million per year, and the elevated number of victim fatalities. To counteract envenomations, antivenoms have been used regularly for more than a century. Apart from side effects including anaphylactic reactions, antivenoms are not able to efficiently neutralize local tissue damage, which contributes to increasing the severity and morbidity observed in patients. This fact, in turn, may be responsible for economic hardship, particularly in rural populations of developing countries. In the present work, we evaluated the antiophidian properties of 12 Brazilian plant extracts against the hemolytic, coagulant, hemorrhagic and proteolytic effects of Lachesis muta venom. Taken together, our data revealed that most of these aqueous products were capable of inhibiting those activities at different levels, except for Sapindus saponaria extract. In contrast, Stryphnodendron barbatiman extract completely neutralized all the analyzed biological activities. Thus, we may conclude that Brazilian flora may also be useful against L. muta accidents.

Hematology and blood chemistry parameters differ in free-ranging maned wolves (Chrysocyon brachyurus) living in the Serra da Canastra National Park versus adjacent farmlands, Brazil.

There has been growing interest in the specific impacts of anthropogenic factors on the health of wildlife. This study examined hematology and serum chemistry status of a prominent carnivore, the maned wolf (Chrysocyon brachyurus), living in, on the boundaries to, or on adjacent farmlands to the Serra da Canastra National Park, Brazil. Twenty-eighty wolves were captured, and values were compared 1) between subadults (n=8 animals) and adults (n=20 animals), 2) males (n=12 animals) and females (n=16 animals), and 3) among wolves living inside the park (n=11), near the park border (n=11 animals), and in neighboring farming areas (n=6 animals). Age, gender, and wolf locations influenced (P<0.05) hematology and serum biochemistry values. Specifically, adults had lower (P<0.05) circulating phosphorus than subadults. Males had lower (P<0.05) serum glucose, creatinine phosphokinase, and cholesterol and higher (P<0.05) potassium than females. Erythrocyte count and serum cholinesterase were lower (P<0.05) in wolves living within the park compared with near the park border or on farmlands. Mean corpuscular volume was lower (P<0.05) in wolves living near the park border than those ranging within the park and on farmlands. Aspartate transaminase and chloride were higher (P<0.05) in wolves living inside the park compared with those ranging near the park border. Creatinine phosphokinase was lower (P<0.05) in wolves living on farmland compared with the other two locations. These results clearly reveal a relationship between age and gender on hematology and serum biochemistry values in free-living maned wolves. More importantly, certain traits indicative of health are potentially compromised in wolves living in areas under anthropogenic pressure. These data lay a foundation for examining the influence of farming and local domestic species on disease susceptibility and fitness in the maned wolf.

Opinion of hepatic transplant waiting list patients regarding split liver transplantation.

BACKGROUND: Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethical dilemma between benefiting individual needs or those of society. Barshes and Goss (Am J Transplant 5:2047, 2005) demonstrated that the majority of adult liver transplant candidates are favorable to SLT. The aim of our study was to evaluate the opinions of patients at a Brazilian university hospital regarding SLT. MATERIALS AND METHODS: A questionnaire with 14 questions was applied to 50 patients included in a hepatic transplant waiting list regarding SLT. RESULTS: The overall attitudes of 66% of the participants were classified as utilitarian, 31% were classified as self-preserving, and 3% were undecided. Ninety-one percent of patients would be willing to share even if their expected survival after SLT was shorter than that with OLT. For 77% of patients, children must have priority over adults. However, 83% were unaware of the donors for pediatric transplantations. CONCLUSIONS: SLT is a consistent solution for organ demand despite controversies among transplant physicians. The present study demonstrated that most patients were favorable to SLT. In conclusion, attitudes toward graft sharing are not barriers to SLT.

Degradation of trans-polyisoprene after root filling with thermoplasticized techniques.

AIM: To evaluate ex vivo degradation of gutta-percha following six thermoplastic obturation techniques. METHODOLOGY: Ninety human-extracted mandibular premolars were selected and divided randomly into nine groups for filling. Group 1: thermomechanical compaction for 3 s with Konne gutta-percha points (Konne Ind. e Com. de Mat. Odontol., Belo Horizonte, MG, Brazil); Group 2: thermomechanical compaction for 3 s with Dentsply TP gutta-percha points (Dentsply Indústria e Comércio Ltda, Petrópolis, R.J. Brazil); Group 3: thermomechanical compaction for 10 s with Konne; Group 4: thermomechanical compaction for 10 s with Dentsply TP; Group 5: warm vertical condensation using System B (EIE/Analytic, Richmond, WA, USA) with Konne; Group 6: warm vertical condensation using System B with Dentsply TP; Group 7: vertical condensation with Konne; Group 8: vertical condensation with Dentsply TP; Group 9: Microseal cone (Analytic Endodontics, Glendora, CA, USA). A further four groups were assessed without using teeth, Group 10: Microseal microflow (Analytic Endodontics); Group 11: Obtura (Obtura Corporation, Penton, MO, USA); Group 12: Obtura flow (Obtura Corporation); Group 13: Thermafil (Dentsply Maillefer, Tulsa, OK, USA). The filling material was removed from the root canal and trans-1,4-polyisoprene isolated by solubilization of the root filling remnants in chloroform followed by filtration and centrifugation. By gel permeation chromatography and infrared spectroscopy, the occurrence and degree of degradation were assessed. The results were analysed statistically using the Kruskal-Wallis test. With differential scanning calorimetry, the thermal behaviour of the gutta-percha was determined. RESULTS: A significant decrease in polymer molar mass and the production of carboxyl and hydroxyl groups in the polymer were observed with thermomechanical compaction used for 10 s and vertical condensation filling techniques (P = 0.0001 and P = 0.0005, respectively). Other techniques caused no polymer degradation. CONCLUSION: Polyisoprene degrades with high temperature. Thermomechanical compaction for 10 s and vertical condensation were associated with the greatest degradative process.

Degradation of trans-polyisoprene over time following the analysis of root fillings removed during conventional retreatment.

AIM: To evaluate in vivo degradation of root filling materials over time. METHODOLOGY: Thirty-six root filled teeth with or without periapical lesions were selected. Teeth with poor coronal restoration were not included. The teeth had been root filled 3-30 years previous and were scheduled for conventional retreatment. The association of root canal treatment, age, periapical lesion and root filling degradation was investigated. The filling material was removed from the root canal using files and no solvent. Trans-1,4-polyisoprene was isolated through solubilization of root filling remnants in chloroform followed by filtration and centrifugation. Gel permeation chromatography (GPC) and infrared spectroscopy (FT-IR) were utilized to study the occurrence and degree of degradation. The GPC and FT-IR data were collected for each sample and analysed statistically using the Kruskal-Wallis test. RESULTS: Degradation of trans-1,4-polyisoprene was a slow process. The process was identified as an oxidation reaction through the production of carboxyl and hydroxyl groups. Compared with the control group, significant molar mass decrease was noted after 15 years (P = 0.0146) in teeth with no periapical lesions. However, in teeth associated with periapical lesions the number of years for significant degradation was reduced to 5 (P = 0.0009). CONCLUSION: Polyisoprene degrades inside root canals as an oxidative process. The presence of periapical lesions was associated with a more rapid onset of degradation.

Cytomegalovirus and Toxoplasma gondii seroprevalence in a Brazilian liver transplant waiting

Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplantation. Disseminated toxoplasmosis after liver transplantation is a rare but fatal event. Serologic screening of the donor and the recipient is essential to prophylactic management, early diagnosis and therapeutic strategies to minimize the consequences of these infections. The aim of the present study was to determine the seroprevalence of CMV and Toxoplasma gondii (TG) in a Brazilian liver transplant waiting list (LTWL). Serological data were collected from 44 candidates on the LTWL between May 2003 and November 2004. Serological investigation of antibodies IgM and IgG against CMV (anti-CMV) and TG (anti-T. gondii) was performed using fluorometry commercial kits. IgG anti-CMV was positive in 37 patients (94.9 percent) out of 39 available results. There were not IgM anti-CMV positive results. Out of 36 analyzed patients, 22 (61.1 percent) presented positive IgG anti-T. gondii and none had positive IgM anti-T. gondii. The high CMV seroprevalence among our LTWL reinforces the need for appropriate protocols to avoid related complications, like reactivation and superinfection by CMV. Environmental and drug prophylactic strategies against primary infection and reactivation, as well as early diagnosis and treatment of toxoplasmosis complications, are essential for the good outcome of transplant patients.

Serologic profile in hepatitis B virus and hepatitis C virus in a Brazilian liver transplant waiting list.

UNLABELLED: Chronic viral hepatitis is currently the most common indication for liver transplantation (OLT). Knowing the serological profile of patients on the liver transplant waiting list (LTWL) is essential to manage prophylactic and therapeutic strategies pre- and post-OLT. The aim of this study was to determine the hepatitis B virus (HBV) and hepatitis C virus (HCV) serological profile on the LTWL. METHODS: Serological data were collected from 44 candidates included on the LTWL from May 2003 to November 2004. HBV and HCV serological profiles were performed by microenzyme immunoassay. RESULTS: Twenty-eight patients (66.7%) lacked HBV serological markers. Anti-HBs was detected in 9.5% and was positive for HBsAg, anti-HBc, IgM anti-HBc, or HbeAg in 4.8% of patients, probably related to reactivation of chronic infection. In 7.1% of patients, the markers demonstrated serological cure of infection. In HCV patients, 41.5% were positive. There was HBV and HCV co-infection in 12.2% of patients. CONCLUSION: HBV infection in 21.4% of the patients corroborates the need to use more efficient protocols for prophylactic and therapeutic management pre- and post-OLT. The high prevalence of HCV infection reinforces the need to follow adequate protocols to avoid related complications and guarantee rational and universal use of more efficient drugs.

Chemical and X-ray analyses of five brands of dental gutta-percha cone.

AIM: To determine the chemical composition of five commercially available nonstandardized gutta-percha points. METHODOLOGY: The organic fraction (gutta-percha polymer and wax/resin) of nonstandardized gutta-percha points (Dentsply, Tanari, Konne, Obtura Spartan and Analytic Endodontics) was separated from the inorganic fraction (ZnO and BaSO4) by dissolution in chloroform. Gutta-percha polymer was precipitated with acetone. Zinc oxide was partially separated from barium sulphate by reaction with HCl. Energy-dispersive X-ray microanalysis and X-ray diffraction were employed to identify the chemical elements and compounds (barium sulphate and zinc oxide). The barium sulphate content was calculated by percentage of sulphur from elemental microanalysis. All analyses were repeated three times. RESULTS: The means and standard deviations of the percentage by weight of gutta-percha in the points were: Dentsply (14.5 +/- 0.70%), Tanari (15.6 +/- 0.66%), Obtura (17.7 +/- 0.35%), Konne (18.9 +/- 0.32%) and Analytic (20.4 +/- 0.40%). The mean and SD of the zinc oxide content were: Dentsply (84.3 +/- 0.50%), Tanari (82.0 +/- 0.72%), Obtura (69.5 +/- 0.21%), Konne (78.0 +/- 0.05%) and Analytic (66.5 +/- 0.50%). CONCLUSIONS: The method was appropriate to quantify gutta-percha and resin/wax components of gutta-percha points, but not barium sulphate and zinc oxide. An alternative procedure to determine barium sulphate and zinc oxide contents has been proposed based on elemental microanalysis of sulphur. Some brands of gutta-percha did not contain barium sulphate.

Magnetic resonance imaging study of pituitary morphology in subjects homozygous and heterozygous for a null mutation of the GHRH receptor gene.

OBJECTIVE: Somatotrophs represent the majority of cells in the anterior pituitary, and their numeric reduction can cause anterior pituitary hypoplasia (APH). Small numbers of patients with familial isolated GH deficiency (IGHD) due to bi-allelic mutations in the GHRH receptor (GHRHR) gene (GHRHR) have been reported to have APH. We tested if APH was present in a large cohort of patients homozygous and heterozygous for a GHRHR mutation. DESIGN: We studied pituitary morphology in adult and pediatric age subjects (8 years of age and older) belonging to a large extended Brazilian kindred with a high prevalence of IGHD due to a null GHRHR mutation. METHODS: We performed brain magnetic resonance imaging (MRI) in 38 subjects, divided into four groups: group I: normal adults (five males, four females, age 38+/-11.7 years); group II: heterozygous adults (six males, seven females, age 42.23+/-8.8 years); group III: homozygous GH-naive affected adults (three males, five females, age 41.4+/-15.0 years); group IV: homozygous affected children (three males, five females, age 11.9+/-2.5 years). Results are expressed as means+/-s.d. RESULTS: Pituitary height (mm) was not different between groups II and I (4.61+/-1.55 and 4.41+/-0.62 respectively), but it was significantly reduced in groups III (2.67+/-0.87, P<0.001) and IV (2.87+/-0.79, P<0.001) compared with group I. Pituitary volume (mm(3)) was normal in group II (417.12+/-140.86), but it was significantly reduced in groups III and IV (124.06+/-64.27 and 155.68+/-39.79 respectively vs 414.56+/-71.57; both P<0.001). The volume ratio (calculated by multiplying the pituitary volume by 1000 and dividing it by cranial volume) was significantly lower in the affected subjects (groups III and IV) (0.06+/-0.02) than in unaffected (groups I and II) (0.15+/-0.04; P<0.0001), demonstrating that APH is not due to reduction of cranial volume. CONCLUSIONS: APH is present from childhood in patients homozygous for an inactivating GHRHR mutation, but it does not occur in heterozygous subjects. In our cohort, the presence of normal anterior pituitary size by MRI rules out homozygosity for a GHRHR mutation in subjects who are 8 years of age or older.

Diagnóstico da deficiência de hormônio de crescimento, a rigor de IGF-1 / Diagnosis of growth hormone deficiency, in severity of IGF-1

O diagnóstico da deficiência de IGF-1 por anormalidade do eixo GH-IGF deve utilizar os parâmetros diagnósticos mais adequados para cada faixa etária e estágio puberal. Propomos o diagnóstico da deficiência de GH (DGH) baseado em uma hierarquia de dados clínicos e laboratoriais. A avaliaçäo clínica e os exames laboratoriais gerais, incluindo funçäo tireoideana, permitem excluir etiologias de deficiência de IGF que näo as intrínsecas ao eixo GH-IGF. Nestas, a dosagem do IGF-1 sérico deve ser o primeiro hormônio a ser dosado nos grupos pré-púberes, púberes e idosos. No grupo de adultos jovens, a dosagem do ALS livre é a mais adequada. As concentraçöes de IGF-1 podem caracterizar 4 situaçöes: muito reduzido, reduzido, normal e elevado. IGF-1 menor que 35pg/L ou -2 DP da média para a idade cronológica (EDP-IC) permite o diagnóstico de deficiência de IGF-1. Nesta situaçäo, a realizaçäo de apenas um teste de secreçäo de GH é necessária para diferenciar deficiência e resistência ao GH. O teste de geraçäo de IGF-1 ajuda a confirmar o diagnóstico de resistência ao GH. IGF-1 menor que 70Ng/L em pré-púberes ou adultos e menor que 170pg/L em indivíduos púberes, ou entre -2 e -1 EDP-IC indicam provável deficiência de IGF-1. A realizaçäo de 2 testes de secreçäo de GH é recomendada; resposta sub-normal em ambos indica DGH. Exame de imagem da regiäo hipotáiamo-hipofisária deve ser realizado nos casos de DGH. Resposta normal ao teste de secreçäo do GH frente à forte suspeita clínica e laboratorial de deficiência de IGF-1 indica a realizaçäo de perfil noturno de GH para afastar o diagnóstico de disfunçäo neurossecretora de GH. IGF-1 maior que -1 DP, mas menor que a média para idade cronológica sugere ausência de deficiência de IGF-1. Concentraçöes altas de IGF-1 impöem a dosagem das IGFBPs e consideraçäo da resistência ao IGF-1. Apesar das dificuldades, todo o esforço deve ser feito no sentido de diagnosticar adequadamente as alteraçöes do eixo GH-IGF para instituir a terapia apropriada.