Diabetes and necrotizing soft tissue infections-A prospective observational cohort study: Statistical analysis plan.

BACKGROUND: Necrotizing soft tissue infections (NSTIs) are rare but carry a high morbidity and mortality. The multicenter INFECT project aims to improve the understanding of the pathogenesis, clinical characteristics, diagnosis, and prognosis of NSTIs. This article describes the study outline and statistical analyses that will be used. METHODS: Within the framework of INFECT project, patients with NSTI at 5 Scandinavian hospitals are enrolled in a prospective observational cohort study. The goal is to evaluate outcome and characteristics for patients with NSTI and diabetes compared to patients with NSTI without diabetes. The primary outcome is mortality at 90 days after inclusion. Secondary outcomes include days alive and out of ICU and hospital, SAPS II, SOFA score, infectious etiology, amputation, affected body area, and renal replacement therapy. Comparison in mortality between patients with diabetes type 1 and 2 as well as between insulin-treated and non-insulin-treated diabetes patients will be made. Clinical data for diabetic patients with NSTI will be reported. CONCLUSION: The study will provide important data on patients with NSTI and diabetes.

Qualitative analysis of the vaginal microbiota of healthy cattle and cattle with genital-tract disease.

The microbial community of the reproductive appara-tus, when known, can provide information about the health of the host. Metagenomics has been used to characterize and obtain genetic infor-mation about microbial communities in various environments and can relate certain diseases with changes in this community composition. In this study, samples of vaginal surface mucosal secretions were col-lected from five healthy cows and five cows that showed symptoms of reproductive disorders. Following high-throughput sequencing of the isolated microbial DNA, data were processed using the Mothur soft-ware to remove low-quality sequences and chimeras, and released to the Ribosomal Database Project for classification of operational taxo-nomic units (OTUs). Local BLASTn was performed and results were loaded into the MEGAN program for viewing profiles and taxonomic microbial attributes. The control profile comprised a total of 15 taxa, with Bacteroides, Enterobacteriaceae, and Victivallis comprising the highest representation of OTUs; the reproductive disorder-positive profile comprised 68 taxa, with Bacteroides, Enterobacteriaceae, His-tophilus, Victivallis, Alistipes, and Coriobacteriaceae being the taxa with the most OTU representation. A change was observed in both the community composition as well as in the microbial attributes of the profiles, suggesting that a relationship might exist between the patho-gen and representative taxa, reflecting the production of metabolites to disease progression.

Impact of housing system on intestinal microbiota of laying hens - A systematic review.

Studies on the housing system's impact on laying hens' intestinal microbiota were retrieved from the Web of Science, PubMed, and Scopus (between 2017 and 2022). Inclusion criteria were studies that discussed measurable effects related to the topic written in English, Portuguese, and Spanish. Of 3281 articles in the identification stage, 12 studies were used in the systematic review. Asia developed most research relating to the subject. Most studies compared the intestinal microbiota of laying hens from conventional cages versus Cage-Free or Free-Range. However, no study has evaluated the intestinal microbiota of laying hens maintained in an organic system. Greengene and Silva were the most used reference in the studies. According to the results observed in the studies included in the systematic review, there is greater alpha diversity in the alternative system and a high dissimilarity between the conventional and alternative systems. Exposure to environmental factors such as soil, vegetation, natural lighting, access to pastures, and ingesting fibrous foods can lead to changes in the intestinal microbiota. A brief outline of published scientific evidence demonstrates that the housing system can change the gut microbiome of hens. This study summarises the relationship between the housing system and the intestinal microbiome of laying hens and provides a roadmap for future research regarding the gut microbiome of hens.

Monitoring macroplastics in aquatic and terrestrial ecosystems: Expert survey reveals visual and drone-based census as most effective techniques.

Anthropogenic litter, such as plastic, is investigated by the global scientific community from various fields employing diverse techniques. The goal is to assess and finally mitigate the pollutants' impacts on the natural environment. Plastic litter can accumulate in different matrices of aquatic and terrestrial ecosystems, impacting both biota and ecosystem functioning. Detection and quantification of macroplastics, and other litter, can be realized by jointly using visual census and remote sensing techniques. The primary objective of this research was to identify the most effective approach for monitoring macroplastic litter in riverine and marine environments through a comprehensive survey based on the experiences of the scientific community. Researchers involved in plastic pollution evaluated four litter occurrence and flux investigation methods (visual census, drone-based surveys, satellite imagery, and GPS/GNSS trackers) through a questionnaire. Traditional visual census and drone deployment were deemed as the most popular approaches among the 46 surveyed researchers, while satellite imagery and GPS/GNSS trackers received lower scores due to limited field validation and short performance ranges, respectively. On a scale from 0 to 5, visual census and drone-based surveys obtained 3.5 and 2.0, respectively, whereas satellite imagery and alternative solutions received scores lower than 1.2. Visual and drone censuses were used in high, medium and low-income countries, while satellite census and GPS/GNSS trackers were mostly used in high-income countries. This work provides an overview of the advantages and drawbacks of litter investigation techniques, contributing i) to the global harmonization of macroplastic litter monitoring and ii) providing a starting point for researchers and water managers approaching this topic. This work supports the selection and design of reliable and cost-effective monitoring approaches to mitigate the ambiguity in macroplastic data collection, contributing to the global harmonization of macroplastic litter monitoring protocols.

Two women with cerebral venous thrombosis: oral contraceptives?

Two cases of cerebral venous thrombosis are reported. Patients were apparently healthy 39 and 28-year old females with non-specific presenting features. Image findings were characteristic of cerebral sinus thrombosis. The younger patient received progesterone to treat placental abruption eight years previously; she had cerebral venous thrombosis while using oral contraception. Both patients had used contraceptive pills for a long time. Oral hormonal contraceptives may increase the risk of vascular events, even in people without personal or family history of venous thrombosis. Modern imaging methods have contributed to early diagnosis, but the possibility of under diagnosis still persists. This report aims to increase the awareness of health-workers about cerebral venous thrombosis in women, an entity often misdiagnosed, under diagnosed and under-reported.

A 10-year unsuspected lumbar schwannoma: a case report.

One case of unsuspected schwannoma is reported in a 69-year old man with chronic lumbosacral pain. The tumour had been mistaken for a lumbar lipoma for a decade. The definitive diagnosis was established after surgery based on the characteristic histopathological findings. The purpose of this report is to alert primary care physicians to peripheral sheath nerve tumours, in addition to highlight the role of pain and image features in the suspicion of tumours with long-term evolution.

Massive pleural effusion due to metastasis of prostate cancer.

We describe the case of a 72-year old male with pleural effusion associated with prostate cancer. There was a previous history of tobacco smoking (pack/year: 47) and of total prostatectomy followed by external beam radiation therapy seven years previously for prostate cancer. Furthermore, he was submitted to orchiectomy plus non-steroidal anti-androgen blockage, in addition to docetaxel-based chemotherapy and prednisone. After the beginning of chemotherapy, a progressive elevation in prostate specific antigen (PSA) levels was observed. On admission, he presented with fever, weight loss, and respiratory symptoms due to a massive right pleural effusion. Fluid samples obtained by needle aspiration showed haemorrhagic exudates without malignant cells. Pleural metastasis were detected by thorax imaging studies, and biopsy samples revealed prostate adenocarcinoma as the origin of his pleural effusion. Pleural fluid was drained and talc pleurodesis was performed. This report aims to describe the occurrence of massive pleural effusion due to metastasis of prostate cancer and emphasizes the role of pleural biopsy with immunohistochemical studies to characterize this diagnosis.

Skin eruption and thrombocytopaenia in a woman with glaucoma: a case report.

Antibiotic and non-antibiotic sulphonamides are often prescribed. Although chemical differences make cross-reactivity rare, reactions may be severe in patients allergic to sulphur. Adverse reactions are common with sulphonamides but low platelets and skin changes are rarely associated with eye-drops for glaucoma. A woman treated with dorzolamide and timolol presented with disseminated eruption. On admission, her physical examination was unremarkable except for the skin changes and severe thrombocytopaenia was detected. Skin biopsy showed hyperkeratosis, acanthosis, perivascular and periadnexal infiltrates with no vasculitis. After discontinuation of eye-drops, the eruption improved but low platelets persisted. Skin changes reappeared with use of dapsone which suggested sulphonamide cross-reactivity.

Antiproliferative and photoprotective activities of the extracts and compounds from Calea fruticosa.

In this paper, we complement our previous study on the antiproliferative activity of Calea fruticosa (Asteraceae) by isolating the compounds apigenin-4',7-dimethyl ether (1), budlein A (2), quercetin (3), and cichoriin (4) from the plant's aerial parts. The antiproliferative activity of these compounds was evaluated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method against human tumor cell lines. Compound 3 displayed moderate antiproliferative activity in three cell lines (HCT-116, PC-3, and SF-295, with cell growth inhibition values of 72.97, 74.55, and 68.94%) and high antiproliferative activity (90.86%) in the HL-60 cell line. The in vitro sun protection factor (SPF) of the extracts and compound 4, with and without sunscreen, was determined by a spectrophotometric method. The ethanol extract exhibited the highest SPF (9.67) at a concentration of 0.100 mg/mL, while compound 4, isolated from this extract, showed a SPF of 13.79 at the same concentration. A relative increased efficacy of SPF was observed for the extracts and compound 4 when sunscreen was also used. Compound 4 has not been reported previously from any species within the genus Calea. Compounds 1-4 were obtained from this species for the first time.

Severe oral infection caused by Pseudomonas aeruginosa effectively treated with methylene blue-mediated photodynamic inactivation.

P. aeruginosa is a gram-negative bacterium present in nosocomial infections with high morbidity and mortality. This microorganism is frequently resistant to antibiotics, leading to clinical complications. In the present report, we described a clinical case of a patient with severe oral lesions caused by P. aeruginosa, which was refractory to antibiotics treatment and presented positive clinical outcomes after some sessions of antimicrobial photodynamic inactivation (API) mediated by methylene blue dye. We discuss the potential of API for P. aeruginosa refractory infections and possible resistance mechanisms of this microorganism to different API protocols.

Late-onset postpartum eclampsia: still a diagnostic dilemma?

Eclampsia is still a major cause of perinatal morbidity and mortality in developing countries but postpartum eclampsia has rarely been described. We present a case in which a 22-year-old Brazilian woman without a typical history of pre-eclampsia presented with eclampsia after the fourth postpartum day. The clinical diagnosis was corroborated by angiography and magnetic resonance imaging of the brain. The findings of nine similar cases reported in the literature are reviewed to compare data and highlight possible diagnostic pitfalls when managing this condition.

Quantitative analysis of fibrosis and mast cells in the tongue of chronic chagasic patients: autopsy study.

OBJECTIVE: Recently, an orally transmitted outbreak of Chagas disease was reported in Santa Catarina, Brazil, after ingestion of sugar cane juice (garapa). This disease is caused by Trypanosoma cruzi, a parasite that stimulates the development of chronic inflammatory response, characterized by fibrous connective tissue neoformation (fibrosis). As the density of tissue mast cells (MC) may be an index of fibroblast proliferation and development of local fibrosis, the purpose of this autopsy study was to quantify the fibrosis rate and the number of MC in the tongues of chronic chagasic (CC) patients, compared with a non-chagasic (NC) control group. METHODOLOGY: Twenty-four evaluations, with a quantitative assessment of fibrosis percentage and MC density were performed. RESULTS: The percentage of fibrosis in the tongue was higher among CC than in the control group. In the CC group, a positive and significant correlation was found when the fibrosis rate was compared with the MC density. CONCLUSIONS: These morphometric findings suggest that tongue biopsy may be useful to study specific changes associated with Chagas disease. They also suggest that the systematic analysis of oral cavity, including tongue histopathology changes, could be useful in forensic pathology of the orally acquired chronic Chagas disease.

Laying hens behave differently in artificially and naturally sourced ammoniated environments.

Laying hens are chronically exposed to high levels of ammonia (NH3), one of the most abundant aerial pollutants in poultry houses. Tests for aversion to NH3 in laying hens have used artificially sourced NH3/air mixtures (i.e., from a gas cylinder) showing that birds prefer fresh air to NH3. However, artificially sourced NH3/air mixtures may not accurately reflect barn air conditions, where manure emits a variety of gases. Herein, we investigated whether laying hens differentiate between artificially and naturally sourced NH3/air mixtures and how exposure to NH3 affects foraging and aversive behavior. A total of 20 laying hens was exposed to artificially sourced [A] (from an anhydrous NH3 cylinder) and naturally sourced [N] (from conspecific laying hen excreta) gas mixtures. Hens were exposed to A and N mixtures with NH3 concentrations of 25 and 45 ppm, as well as fresh air [FA]. During the experiment, all birds were exposed to each treatment 3 times using a custom-built polycarbonate chamber, containing a foraging area (containing raisins, mealworms, and feed mix) and a gas delivery system. All testing sessions were video recorded, analyzed with INTERACT® software, and subjected to a GLIMMIX procedure in SAS. Our results showed that the laying hens spent less time foraging overall (P < 0.001) and were slower to commence foraging (P = 0.004) in ammoniated environments compared to the fresh air. Laying hens were more likely to forage for a longer time (with fewer interruptions) in N than in A treatments (P < 0.001). Laying hens also reacted with greater aversion towards treatment A compared to treatment N (P < 0.001). These findings suggest that the laying hens of our study preferred fresh to ammoniated air and that they behaved differently in artificially and naturally sourced NH3/air mixtures, possibly due to the presence of familiar stimuli from the excreta. These findings have implications for new developments in methodological approaches for behavioral testing and for recommendations regarding NH3 levels inside poultry barns.

Biological properties of disturbed and undisturbed Cerrado sensu stricto from Northeast Brazil.

The aim of this study was to measure soil microbial biomass and soil surface fauna in undisturbed and disturbed Cerrado sensu stricto (Css) from Sete Cidades National Park, Northeast Brazil. The following sites were sampled under Cerrado sensu stricto (Css) at the park: undisturbed and disturbed Css (slash-and-burn agricultural practices). Total organic and microbial biomass C were higher in undisturbed than in disturbed sites in both seasons. However, microbial biomass C was higher in the wet than in the dry season. Soil respiration did not vary among sites but was higher in the wet than in the dry season. The densities of Araneae, Coleoptera, and Orthoptera were higher in the undisturbed site, whereas the densities of Formicidae were higher in the disturbed site. Non-metric multidimensional scaling analysis separated undisturbed from disturbed sites according to soil biological properties. Disturbance by agricultural practices, such as slash-and-burn, probably resulted in the deterioration of the biological properties of soil under native Cerrado sensu stricto in the Sete Cidades National Park.

Effects of season and distance during transport on broiler chicken meat.

This research aims to evaluate the microclimate of commercial loads of broiler chickens at different distances in the summer (rainy) and winter (dry) seasons and their effects on meat quality. Twelve broiler loads were monitored with a total of 24 crates per load. Data loggers were used to record temperature and relative humidity. The experiment followed a completely randomized design with 48 treatments in a factorial scheme (2 seasons: rainy and dry) x 2 (distances: short and long) x 12 (positions), with 3 replicates per experimental group. In the rainy season, meat quality was influenced by transport distance. For longer distances, it recorded the highest enthalpy comfort index (ECI), suggesting a tendency of dark, firm, and dry meat (DFD-like) and lower cooking losses (CL). The lowest ECI was recorded during the transport in dry season. Broiler chickens transported and slaughtered in the winter presented meat pH and L* (lightness) classified as "normal," but with higher cooking losses. For the shear force (SF), the seasons and distances had no significant influence on tenderness of the meat. Regarding the crate positioning in the load, no effect was observed during transport on this variable, given the meat quality characteristics of pH, L*, CL, and SF. These results suggest that the distance and the seasons present more influence on broiler meat quality than crate position in the truck.

Pithomycotoxicosis (facial eczema) in ruminants in the Azores, Portugal.

Outbreaks of pithomycotoxicosis (facial eczema), a hepatogenous photosensitisation caused by the mycotoxin sporidesmin, have affected ruminants in the Azores Islands of Portugal after warm, humid periods during late summer and autumn. Twenty-two outbreaks were recorded in cattle between 1999 and 2001, affecting 11.4 per cent of the animals in the affected herds, and in 2000 there was an outbreak in one sheep flock in which more than 20 per cent of the sheep died. The clinical signs included decreases in milk production, weight loss, photosensitisation and its sequelae, including death. The animals had high activities of gamma glutamyltransferase in their serum, and icterus and severe liver disease, including biliary hyperplasia and fibrosis, were found postmortem. The characteristic spores of the toxigenic saprophytic fungus Pithomyces chartarum were found on grass; all 381 isolates of the fungus were toxigenic for sporidesmin by elisa, and the results were confirmed by high-performance liquid chromatography analysis. Cattle from farms at greatest risk of pithomycotoxicosis were protected by supplementing their concentrate feed with zinc oxide, or using a slow-release intraruminal zinc bolus.

Antiproliferative and photoprotective activities of the extracts and compounds from Calea fruticosa

In this paper, we complement our previous study on the antiproliferative activity of Calea fruticosa (Asteraceae) by isolating the compounds apigenin-4',7-dimethyl ether (1), budlein A (2), quercetin (3), and cichoriin (4) from the plant's aerial parts. The antiproliferative activity of these compounds was evaluated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method against human tumor cell lines. Compound 3 displayed moderate antiproliferative activity in three cell lines (HCT-116, PC-3, and SF-295, with cell growth inhibition values of 72.97, 74.55, and 68.94%) and high antiproliferative activity (90.86%) in the HL-60 cell line. The in vitro sun protection factor (SPF) of the extracts and compound 4, with and without sunscreen, was determined by a spectrophotometric method. The ethanol extract exhibited the highest SPF (9.67) at a concentration of 0.100 mg/mL, while compound 4, isolated from this extract, showed a SPF of 13.79 at the same concentration. A relative increased efficacy of SPF was observed for the extracts and compound 4 when sunscreen was also used. Compound 4 has not been reported previously from any species within the genus Calea. Compounds 1-4 were obtained from this species for the first time.

Food intake of a typical Brazilian diet among hospitalized malnourished patients.

AIM: To verify whether malnourished inpatients receiving a typical Brazilian diet meet their food requirements. METHODS: Thirty-five consecutive surgical and medical hospitalized adults, able to feed themselves, received rice and beans based diets for 3 consecutive days. All served food was weighed before and after the meals. Nutrient intake was determined and results compared to American Recommended Dietary Allowances (RDA). Malnutrition was defined by the presence of at least one of these criteria: body mass index &lE 18.5 kg/m(2); height-creatinine index << 70%; or albumin level << 3. 5 g/dl. RESULTS: Malnourished and non-malnourished patients were paired in relation to age, gender, diagnoses and clinical parameters. Despite showing distinct anthropometric parameters and laboratory data, malnourished patients ingested enough quantities of food and met or exceeded RDA for energy and other nutrients. CONCLUSIONS: Clinically-stable malnourished inpatients, supplied with rice- and beans based diets have adequate energy and nutrient intake, the same occurring for non-malnourished ones.

Headache in chagasic women.

The aim of this study was to compare the frequency of headache between Chagasic and Non-chagasic women. The cross-sectional study comprised 647 female > or = 40 years old, Chagasic (n = 362) and Controls (n = 285) at a Brazilian University Hospital. Chagasic were classified as Cardiac (n = 179), Megas (n = 58) or Indeterminate (n = 125) clinical forms. Headache was ascertained according to Headache International Society diagnostic criteria. The age (57.0 +/- 11.3 versus 57.3 +/- 10.4 years), and the percentage of white women (75.8% versus 77.1%) were similar between Chagasic and Controls, respectively. Headache was more prevalent among Chagasic (32.9%) than Controls (16.1%), mainly in Cardiac form (odds ratio, 2.41; 95% confidence interval, 1.38-4.23), phenomenon possibly related to parasympathetic denervation and cerebral vessels changes.