Treatment with metformin glycinate reduces SARS-CoV-2 viral load: An in vitro model and randomized, double-blind, Phase IIb clinical trial.

The health crisis caused by the new coronavirus SARS-CoV-2 highlights the need to identify new treatment strategies for this viral infection. During the past year, over 400 coronavirus disease (COVID-19) treatment patents have been registered; nevertheless, the presence of new virus variants has triggered more severe disease presentations and reduced treatment effectiveness, highlighting the need for new treatment options for the COVID-19. This study evaluates the Metformin Glycinate (MG) effect on the SARS-CoV-2 in vitro and in vivo viral load. The in vitro study was conducted in a model of Vero E6 cells, while the in vivo study was an adaptive, two-armed, randomized, prospective, longitudinal, double-blind, multicentric, and phase IIb clinical trial. Our in vitro results revealed that MG effectively inhibits viral replication after 48 h of exposure to the drug, with no cytotoxic effect in doses up to 100 µM. The effect of the MG was also tested against three variants of interest (alpha, delta, and epsilon), showing increased survival rates in cells treated with MG. These results are aligned with our clinical data, which indicates that MG treatment reduces SARS-CoV2-infected patients´ viral load in just 3.3 days and supplementary oxygen requirements compared with the control group. We expect our results can guide efforts to position MG as a therapeutic option for COVID-19 patients.

Structure of the gonoduct of the viviparous teleost Cnesterodon decemmaculatus (Jenyns, 1842) (Poeciliidae).

During embryogenesis, teleost females do not develop Müllerian ducts, which form the oviducts in all other vertebrates. Thus, when they reach sexual maturity they do not have oviducts. In viviparous teleosts, the lack of oviducts means that the development of the embryos occurs as an intraovarian gestation, unique among vertebrates. The ovary is an unpaired hollow organ whose cavity is continuous with the caudal portion, the gonoduct, characterized by the absence of germinal cells, which opens to the exterior at the gonopore. The gonoduct attains essential function as a barrier between the germinal region of the ovary and the exterior during all reproductive stages. This study describes the functional morphology of the gonoduct in the viviparous teleost Cnesterodon decemmaculatus during non-gestation (previtellogenesis and vitellogenesis) and gestation. The ovaries were processed using histological techniques and stained with hematoxylin-eosin, and periodic acid Schiff. The gonoduct has two regions: cephalic and caudal, and is formed by three histological layers, which are, from inside to the periphery: (a) tunica mucosa; (b) tunica muscularis; and (c) tunica serosa. In the cephalic region there are mucosal folds extending into the lumen and forming a structure similar to a cervix. The histology of the gonoduct indicates essential functions, that is, (a) the control of the luminal diameter in the limit to the germinal region of the ovary by the presence of a cervix; (b) during insemination the gonoduct receives the spermatozoa, may store and transport them to the germinal region; (c) the presence of melano-macrophage centers indicates support of immunological processes, especially during gestation when these centers increase in size; (d) production of exocrine secretions; and (e) it is the birth canal, internally lined by an ciliated epithelium and surrounded by smooth musclesboth tissues supposedly supporting the birth process.

Lymphoma Heterogeneity: Three Different Histological Pictures and One Unique Clone.

We report a patient who developed up to three different lymphomas with the same clonal IGH rearrangement. She was first diagnosed of splenic zone marginal lymphoma and relapsed for the first time with Hodgkin lymphoma histology and later with diffuse large B-cell lymphoma histology. Subsequent biopsies and analysis of clonally rearranged IGH genes helped to elucidate the clonal relationship between the three histologies and to confirm a common origin from the three tissue histologies. An integrated diagnosis should always be performed in order to achieve the most accurate diagnosis and be able to choose the best therapeutic options for our patients.

Acute graft-versus-host disease and bronchiolitis obliterans after autologous stem cell transplantation in a patient with multiple myeloma.

Sixty-seven-year-old patient, diagnosed with multiple myeloma who had received autologous stem cell transplantation, following bortezomib, dexamethasone and thalidomide conventional regimen, achieving complete response, developed rash, diarrhea, and severe respiratory failure, 80 days after the transplantation procedure. He was diagnosed with graft-versus-host disease and bronchiolitis obliterans syndrome.

A cirurgia da catarata com microincisão e lente intra-ocular ultrafina / MICS - Microincision Cataract Surgery with ultrathin IOL

Objetivo: Apresentar resultados com a técnica de microincisão bimanual denomiada de MICS - Microincision Cataract Surgery com implante de lente intra-ocular ultrafina. Local: IMO - Instituo de Moléstias Oculares - São Paulo - Brasil Método: Estudo prospectivo, consecutivo de 10 olhos submetidos à cirurgia de catarata com utilização de anestesia peribulbar, microincisção bimanual, facoemulsificação, implante de LIO enrolável e acompanhados por 4 a 12 semanas. Resultados: 90 por cento dos olhos apresentaram a melhor acuidade visual (MAVC)corrigida de 20/40 ou melhor no 30° dia de pós-operatório. A acuidade visual sem correção para longe e perto foram 20/40 e J5 ou melhor em 90 por cento e 60 por cento, respectivamente. A refração foi plana em 30 por cento dos olhos e entre -0.50D e +0.50D em 90 por cento dos casos. Não houve complicações per ou pós-cirúrgicas. Conclusão: A utilização da nova técnica demonstrou confiabilidade, previsibilidade e reproduzibilidade, devendo ter acompanhamento a longo prazo para avaliar possíveis efeitos colaterais de LIO.

Pupila pequena e facoemulsificaçäo / Small pupil and phacoemulsification

O objetivo dos autores é analisar a incidência e o número de complicaçöes pré e pós-operatórias em pacientes submetidos à facoemulsificaçäo com pupilas medindo 4mm ou menos. Dentre 1.517 olhos submetidos à, facoemulsificaçäo endocapsular, através de pequena incisäo (3,2mm) sem sutura. Foram utilizados dilatadores mecânicos em 26 olhos (81,2 p/cento) e a esfincterotomia em 6 olhos (18,7 p/c). A incidência de pupila pequena foi de 2,1 p/c. A incidência de complicaçöes foi de 0,13 p/c (2/1517). A ruptura de cápsula posterior foi a complicaçäo constatada nos dois casos. Os autores concluem que a facoemulsificaçäo para pequenas pupilas é uma técnica segura e eficiente

Angiografia fluoresceínica e suas complicaçöes: relato de um caso de óbito / Fluorescein angiography complication survey

Relato das complicaçöes mais frequentemente encontradas durante a realizaçäo da angiofluoresceinografia. Num período de 3 anos foram realizadas 5626 angiografias. Säo citadas todas complicaçöes ocorridas. Conclue-se que angiografia fluoresceínica é um exame extremamente confiável apesar de näo ser totalmente inócuo