Short sleep duration is associated with shorter telomere length in healthy men: findings from the Whitehall II cohort study.

Shorter telomere length and poor sleep are more prevalent at older ages, but their relationship is uncertain. This study explored associations between sleep duration and telomere length in a sample of healthy middle and early old age people

Disfunção tiróidea e amiodarona

Although most patients remain clinically euthyroid, some develop amiodarone-induced hyperthyroidism (HPEAI) or hypothyroidism (HPOAI). The authors present a retrospective analysis of ten patients with amiodarone-induced thyroid dysfunction. Six patients were female and mean amiodarone intake was 17.7 months. HPOIA was more common (six patients). From all the patients with HPEAI, two had type 2, one had type 1, and one had type 3 hyperthyroidism. Symptoms suggestive of thyroid dysfunction occurred in five patients, most of them with HPOAI. In HPEAI, the most frequent symptom was exacerbation of arrhythmia (three patients). Discontinuation of amiodarone and treatment with levothyroxine was chosen in 83.3% of the HPOAI cases, while thyonamide treatment with corticosteroids and without amiodarone was the option in 75% of the HPEAI cases. There were three deaths, all in patients with HPEAI. HPEAI is potentially fatal. The clinical picture may be vague, so the thyroid monitoring is mandatory

Endovascular Treatment of Pediatric Ischemic Stroke: a Single Center Experience and Review of the Literature

Introduction: Mechanical thrombectomy is standard treatment for large vessel occlusion (LVO) in adults. There are no randomized controlled trials for the pediatric population. We report our single-center experience with thrombectomy of LVO in a series of pediatric patients, and perform a review of the literature. Methods: Retrospective review of consecutive pediatric thrombectomy cases between 2011 and 2018. Demographic variables, imaging data, technical aspects and clinical outcome were recorded. Results: In a period of 7 years, 7 children were treated for LVO at our center. Median age was 13 (2-17), and median Ped-NIHSS was 15 (3-24), and the median ASPECTS was 8 (2-10). Five patients had cardiac disease, and 2 of them were under external cardiac assistance. Median time from onset of symptoms to beginning of treatment was 7h06m (2h58m-21h38m). Five patients had middle cerebral artery occlusions. Thrombectomy was performed using a stentriever in 3 patients, aspiration in 3 patients, and combined technique in 1 patient. Six patients had good recanalization (TICI 2 b/3). There were no immediate periprocedural complications. At 3 months, 4 patients (57%) were independent (mRS score <3). Two patients died, one after haemorrhagic transformation of an extensive MCA infarct, and one due to extensive brainstem ischemia in the setting of varicella vasculitis. Discussion: Selected pediatric patients with LVO may be treated with mechanical thrombectomy safely. In patients under external cardiac assistance and under anticoagulation, thrombectomy is the only alternative for treatment of LVO. A multidisciplinary approach in specialized pediatric stroke centers with trained neurointerventionalists are essential for good results.info:eu-repo/semantics/publishedVersio

IL-4-secreting CD4+ T cells are crucial to the development of CD8+ T-cell responses against malaria liver stages.

CD4+ T cells are crucial to the development of CD8+ T cell responses against hepatocytes infected with malaria parasites. In the absence of CD4+ T cells, CD8+ T cells initiate a seemingly normal differentiation and proliferation during the first few days after immunization. However, this response fails to develop further and is reduced by more than 90%, compared to that observed in the presence of CD4+ T cells. We report here that interleukin-4 (IL-4) secreted by CD4+ T cells is essential to the full development of this CD8+ T cell response. This is the first demonstration that IL-4 is a mediator of CD4/CD8 cross-talk leading to the development of immunity against an infectious pathogen

Extended-spectrum beta-lactamase-producing enterobacteriaceae susceptibility to fosfomycin

Introdução: A emergência de enterobacteriáceas produtoras de beta-lactamases de espectro alargado (ESBL) nos últimos anos representa um problema de saúde pública, escasseando alternativas eficazes para o seu tratamento. Vários trabalhos internacionais têm demonstrado uma sensibilidade in vitro muito elevada destas bactérias à fosfomicina, havendo alguns que testaram a eficácia clínica do tratamento de cistites agudas não complicadas no subgrupo das Escherichia coli com resultados promissores. No Hospital Prof. Dr. Fernando Fonseca EPE (HFF) tem havido um aumento anual progressivo do isolamento destes patogéneos. Os autores pretenderam testar a sensibilidade das enterobacteriáceas produtoras de ESBL à fosfomicina no HFF e averiguar o eventual potencial terapêutico. Material e métodos: Estudo prospectivo, durante 6 meses, no qual foi testada a sensibilidade à fosfomicina das enterobacteriáceas produtoras de ESBL isoladas. Foi utilizado o equipamento VITEK 2® para identificação das estirpes. A susceptibilidade à fosfomicina foi determinada através do método de difusão de disco (Oxoid®). O tratamento estatístico foi realizado através do programa Microsoft Excel®. Resultados: Foram identificadas 150 enterobacteriáceas ESBL, das quais 52% corresponderam a Klebsiella pneumoniae e 44% a Escherichia coli. Cerca de 88% das Escherichia coli e 68% das Klebsiella pneumoniae apresentaram sensibilidade à fosfomicina. Conclusões: De acordo com os dados obtidos a nível internacional e no nosso hospital, os autores recomendam a utilização da fosfomicina para tratamento de cistites agudas não complicadas provocadas por Escherichia coli produtoras de ESBL, sugerindo, concomitantemente, a realização de trabalhos futuros de eficácia clínica para consubstanciar esta prática e recomendação.Introduction: The rising frequency of extended spectrum Beta-lactamase (ESBL) producing Enterobacteriaceae in recent years represents an important public health issue, with scarce effective alternatives for treatment. Several international studies have demonstrated very high in vitro susceptibility of these bacteria to fosfomycin. The clinical efficiency of this treatment was tested on acute uncomplicated cystitis due to Escherichia coli subset, with encouraging results. In Hospital Prof. Dr. Fernando Fonseca EPE (HFF) there has been a progressive annual increase in the isolation of these pathogens. The authors’ goal was to test the susceptibility of ESBL-producing Enterobacteriaceae to fosfomycin in HFF and assess its possible therapeutic potential. Material and methods: Prospective study (6 month period), in which the susceptibility to fosfomycin of isolated ESBL-producing Enterobacteriaceae was tested. The VITEK 2® equipment was used to identify the strains. The fosfomycin susceptibility was determined by disk diffusion method (Oxoid®). Statistical analysis was performed using the Microsoft Excel® software. Results: We identified 150 ESBL-producing Enterobacteriaceae, of which 52 % corresponded to Klebsiella pneumoniae and 44% to Escherichia coli. Approximately 88% of Escherichia coli and 68% of Klebsiella pneumoniae were susceptible to fosfomycin. Conclusions: Based on the data obtained at international level and in this study, the authors recommend the use of fosfomycin for the treatment of acute uncomplicated cystitis caused by ESBL-producing Escherichia coli. Future clinical efficacy research is needed in order to substantiate this practice and recommendation

Feeding spectra and activity of the freshwater crab Trichodactylus kensleyi (Decapoda: Brachyura: Trichodactylidae) at La Plata basin

Background: In inland water systems, it is important to characterize the trophic links in order to identify the ‘trophic species’ and, from the studies of functional diversity, understand the dynamics of matter and energy in these environments. The aim of this study is to analyze the natural diet of Trichodactylus kensleyi of subtropical rainforest streams and corroborate the temporal variation in the trophic activity during day hours. Results: A total of 15 major taxonomic groups were recognized in gut contents. The index of relative importance identified the following main prey items in decreasing order of importance: vegetal remains, oligochaetes, chironomid larvae, and algae. A significant difference was found in the amount of full stomachs during day hours showing a less trophic activity at midday and afternoon. The index of relative importance values evidenced the consumption of different prey according to day moments. Results of the gut content indicate that T. kensleyi is an omnivorous crab like other trichodactylid species. Opportunistic behavior is revealed by the ingestion of organisms abundant in streams such as oligochaetes and chironomid larvae. The consumption of allochthonous plant debris shows the importance of this crab as shredder in subtropical streams. However, the effective assimilation of plant matter is yet unknown in trichodactylid crabs. Conclusions: This research provides knowledge that complements previous studies about trophic relationships of trichodactylid crabs and supported the importance of T. kensleyi in the transference of energy and matter from benthic community and riparian sources to superior trophic levels using both macro- and microfauna.Fil: Williner, Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto Nacional de Limnología. Universidad Nacional del Litoral. Instituto Nacional de Limnología; Argentina. Universidad Nacional del Litoral. Facultad de Humanidades y Ciencias; ArgentinaFil: de Azevedo Carvalho, Debora. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto Nacional de Limnología. Universidad Nacional del Litoral. Instituto Nacional de Limnología; ArgentinaFil: Collins, Pablo Agustin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto Nacional de Limnología. Universidad Nacional del Litoral. Instituto Nacional de Limnología; Argentina. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; Argentin