Treatment of hemorrhagic shock with hypertonic saline solution modulates the inflammatory response to live bacteria in lungs

Shock and resuscitation render patients more susceptible to acute lung injury due to an exacerbated immune response to subsequent inflammatory stimuli. To study the role of innate immunity in this situation, we investigated acute lung injury in an experimental model of ischemia-reperfusion (I-R) followed by an early challenge with live bacteria. Conscious rats (N = 8 in each group) were submitted to controlled hemorrhage and resuscitated with isotonic saline (SS, 0.9% NaCl) or hypertonic saline (HS, 7.5% NaCl) solution, followed by intratracheal or intraperitoneal inoculation of Escherichia coli. After infection, toll-like receptor (TLR) 2 and 4 mRNA expression was monitored by RT-PCR in infected tissues. Plasma levels of tumor necrosis factor α and interleukins 6 and 10 were determined by ELISA. All animals showed similar hemodynamic variables, with mean arterial pressure decreasing to nearly 40 mmHg after bleeding. HS or SS used as resuscitation fluid yielded equal hemodynamic results. Intratracheal E. coli inoculation per se induced a marked neutrophil infiltration in septa and inside the alveoli, while intraperitoneal inoculation-associated neutrophils and edema were restricted to the interseptal space. Previous I-R enhanced lung neutrophil infiltration upon bacterial challenge when SS was used as reperfusion fluid, whereas neutrophil influx was unchanged in HS-treated animals. No difference in TLR expression or cytokine secretion was detected between groups receiving HS or SS. We conclude that HS is effective in reducing the early inflammatory response to infection after I-R, and that this phenomenon is achieved by modulation of factors other than expression of innate immunity components.FAPESPFundação Faculdade de MedicinaCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES

The need for communication between clinicians and pathologists in the context of oral and maxillofacial diseases

Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a lack of research about communication in diagnostic oral and maxillofacial pathology. This narrative review explores different aspects of the quality of communication between clinicians and oral pathologists, with a focus on the diagnosis of oral and maxillofacial diseases. An electronic search was carried out in MEDLINE through the PubMed, Scopus, and Embase databases up to April 2021. No studies reporting communication, its adequacy or the required skills between clinicians and pathologists in oral diagnosis were found. According to studies published in medicine, strategies for improving communication skills include clinician-pathologist collaboration; a well-formatted, clear and thorough report; training in communication skills; and patient-centered care. Further studies evaluating the current practices and quality in oral and maxillofacial pathology are required to identify barriers and encourage optimal communication to facilitate diagnosis, as well as patient safety

Farelo integral de arroz parboilizado submetido a armazenamento prolongado para alimentação de codornas de corte

O objetivo deste trabalho foi avaliar a estabilidade oxidativa do farelo integral de arroz parboilizado (FIAP) durante o armazenamento e os efeitos do seu uso na alimentação de codornas de corte. Foram utilizados 245 animais com sete dias de idade, de ambos os sexos, distribuídos em delineamento inteiramente casualizado, com cinco tratamentos, em arranjo fatorial 2x2+1, e sete repetições de sete aves. Avaliaram-se os seguintes tratamentos: dieta controle, sem adição de FIAP; e níveis de inclusão, na dieta controle, de 10 e 20% de FIAP armazenado por 180 dias (FIAPA) ou de FIAP novo (FIAPN). Houve oxidação lipídica do FIAP durante o armazenamento, e o índice de acidez foi de 4,25 e 63,50 (% em ácido oleico) e o de peróxido foi de 15,64 e 38,28 meq kg-1 para FIAPN e FIAPA, respectivamente. A inclusão do FIAP resultou em menor digestibilidade da matéria seca e do nitrogênio e em maior valor de energia metabolizável da ração, em comparação à ração controle. A inclusão de 20% de FIAPA resultou em menor energia metabolizável da ração do que a adição do FIAPN. As inclusões não influenciaram desempenho, características da carcaça, pesos relativos do fígado e do pâncreas, e crescimento e qualidade óssea. O FIAPA, mesmo com rancidez, pode ser utilizado na alimentação de codornas de corte em níveis de até 20% de inclusão

Relationship between physical attributes, clay fraction mineralogy and aluminum forms in soil

O alumínio (Al) é um dos elementos mais abundantes em massa nos solos brasileiros, estando presente em diferentes minerais e formas. Considerando a carência de informações sobre a sua participação no comportamento físico do solo, buscou-se, no presente estudo, avaliar a relação entre a mineralogia da fração argila, formas de Al e atributos físicos de diferentes solos. Para tanto, foram coletadas amostras deformadas e indeformadas dos horizontes A e B de solos representativos das Zonas Fisiográficas Sul e Campos das Vertentes do estado de Minas Gerais. As amostras foram submetidas às caracterizações física, química e mineralógica. Estudos de correlação mostraram que os atributos físicos dos solos estudados estavam associados às diferentes formas de Al presentes e à mineralogia da fração argila: as formas de Al amorfas e menos cristalinas associaram-se mais aos atributos físicos relacionados com a agregação das partículas do solo, podendo esta associação ser atribuída à afinidade deste elemento com a matéria orgânica, enquanto os componentes cristalinos associaram-se mais aos atributos físicos relacionados com a organização estrutural dos solos._________________________________________________________________________________ ABSTRACT: Aluminum (Al) is one of the most abundant elements in weight in Brazilian soils, found in different minerals and forms. Considering the lack of information about its participation in the physical behavior of soil, the present study aimed to evaluate the relationship between the mineralogy of the clay fraction, different forms of Al and physical attributes of different soils. Disturbed and undisturbed samples of A and B horizons of representative soils from the South and Campos das Vertentes physiographic regions in the State of Minas Gerais were therefore collected. The samples were subjected to physical, chemical and mineralogical characterizations. Correlation studies performed with the resulting data from the different characterizations showed that the physical attributes of the different studied soils are associated to the different forms of Al and to the mineralogy of the clay fraction: the amorphous and less crystalline forms of Al were more associated to physical attributes related with particle aggregation, such association being ascribed to the affinity of this element with organic matter, while the crystalline components were more associated to physical attributes related with the structural organization of the soils

Lung adenocarcinoma promotion by air pollutants

A complete understanding of how exposure to environmental substances promotes cancer formation is lacking. More than 70 years ago, tumorigenesis was proposed to occur in a two-step process: an initiating step that induces mutations in healthy cells, followed by a promoter step that triggers cancer development1. Here we propose that environmental particulate matter measuring ≤2.5 μm (PM2.5), known to be associated with lung cancer risk, promotes lung cancer by acting on cells that harbour pre-existing oncogenic mutations in healthy lung tissue. Focusing on EGFR-driven lung cancer, which is more common in never-smokers or light smokers, we found a significant association between PM2.5 levels and the incidence of lung cancer for 32,957 EGFR-driven lung cancer cases in four within-country cohorts. Functional mouse models revealed that air pollutants cause an influx of macrophages into the lung and release of interleukin-1β. This process results in a progenitor-like cell state within EGFR mutant lung alveolar type II epithelial cells that fuels tumorigenesis. Ultradeep mutational profiling of histologically normal lung tissue from 295 individuals across 3 clinical cohorts revealed oncogenic EGFR and KRAS driver mutations in 18% and 53% of healthy tissue samples, respectively. These findings collectively support a tumour-promoting role for PM2.5 air pollutants and provide impetus for public health policy initiatives to address air pollution to reduce disease burden

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2•72 (95% uncertainty interval [UI] 2•66–2•79) in 2000 to 2•31 (2•17–2•46) in 2019. Global annual livebirths increased from 134•5 million (131•5–137•8) in 2000 to a peak of 139•6 million (133•0–146•9) in 2016. Global livebirths then declined to 135•3 million (127•2–144•1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2•1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27•1% (95% UI 26•4–27•8) of global livebirths. Global life expectancy at birth increased from 67•2 years (95% UI 66•8–67•6) in 2000 to 73•5 years (72•8–74•3) in 2019. The total number of deaths increased from 50•7 million (49•5–51•9) in 2000 to 56•5 million (53•7–59•2) in 2019. Under-5 deaths declined from 9•6 million (9•1–10•3) in 2000 to 5•0 million (4•3–6•0) in 2019. Global population increased by 25•7%, from 6•2 billion (6•0–6•3) in 2000 to 7•7 billion (7•5–8•0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58•6 years (56•1–60•8) in 2000 to 63•5 years (60•8–66•1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens