Variable protection against experimental broiler necrotic enteritis after immunisation with the C-terminal fragment of Clostridium perfringens alpha-toxin and a non-toxic NetB variant

Necrotic enteritis toxin B (NetB) is a pore-forming toxin produced by Clostridium perfringens and has been shown to play a key role in avian necrotic enteritis (NE), a disease causing significant costs to the poultry production industry worldwide. The aim of this work was to determine whether immunisation with a non-toxic variant of NetB (NetB W262A) and the C-terminal fragment of C. perfringens alpha-toxin (CPA247–370) would provide protection against experimental NE. Immunised animals with either antigen or a combination of antigens developed serum antibody levels against NetB and CPA. When CPA247–370 and NetB W262A were used in combination as immunogens, an increased protection was observed after oral challenge by individual dosing, but not after in-feed challenge

Extended right hepatectomy with partial resection of the vena cava from colorectal metastases: case report

Introduction: Hepatectomy has been standard treatment for metastases from colorectal origin (CR). Metastases with inferior vena cava (IVC) involvement may require combined resection of the liver and IVC. This approach may present high surgical risk, Both profuse bleeding and gas embolism are letal intraoperative complications. Case: The authors present a case of single hepatic CR metastasis that was treated by means extended right hepatectomy with partial inferior vena cava resection and primary reconstruction. Patient present good postoperative course without neoplasm recurrence (one year follow-up period). Conclusion: Resection of VCI and combined reconstruction with hepatectomy may be satisfactorily done in selected cases. Lack of alternative treatments associated poor prognosis of untreated cases has justified this aggressive conduct. Therefore, this approach should be realized by hepatic surgery expertise team.Introdução: A hepatectomia tem sido o tratamento padrão para metástase de origem colorretal (CR). Metástase com invasão da veia cava inferior (VCI) pode requerer ressecção combinada do fígado e VCI. Esta abordagem pode apresentar alto risco cirúrgico. Sangramento profuso e embolia gasosa são complicações intra-operatorias letais. Relato de Caso: Os autores relatam um caso de metástase colorretal única tratada com hepatectomia direita ampliada e ressecção parcial da veia cava com reconstrução primaria. Paciente apresentou boa evolução pós-operatória sem recidiva (um ano de seguimento). Conclusão: Ressecção da VCI e reconstrução combinada com hepatectomia pode ser satisfatoriamente realizada em casos selecionados. A falta de tratamentos alternativos e o prognostico reservado nos casos não operados justificam esta conduta agressiva. No entanto, esta abordagem deve ser realizada por equipe especializada em cirurgia hepática.UNIFESPHospital Regional da Asa Norte Serviço de Cirurgia GeralUFPRUSP-RPUNIFESPSciEL

Thermal body patterns for healthy Brazilian adults (male and female)

The aim of this study was to establish the skin temperature (Tsk) thermal profile for the Brazilian population and to compare the differences between female and male Brazilian adults. A total of 117 female and 103 male were examined with a thermographic camera. The Tsk of 24 body regions of interest (ROI) were recorded and analyzed. Male Tsk results were compared to female and 10 ROI were evaluated with respect to the opposite side of the body (right vs. left) to identify the existence of significant contralateral Tsk differences (?Tsk). When compared right to left, the largest contralateral ?Tsk was 0.3 °C. The female vs. male analysis yielded significant differences (p menor que0.05) in 13 of the 24 ROI. Thigh regions, both ventral and dorsal, had the highest ?Tsk by sex (? 1.0 °C). Tsk percentile below P5 or P10 and over P9o or P95 may be used to characterize hypothermia and hyperthermia states, respectively. Thermal patterns and Tsk tables 2 were established for Brazilian adult men and women for each ROI. There is a low Tsk variation between sides of the body and gender differences were only significant for some ROIs

Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

BACKGROUND AND AIM: The durability of the sustained virologic response (SVR) in patients with chronic hepatitis C after treatment and the ideal follow-up time for these patients remains undefined. The objective of the study was to evaluate the durability of the virologic response in patients with chronic hepatitis C followed up for at least 12 months after SVR at HCFMRP-USP. METHODS: The study was conducted on 174 patients with chronic hepatitis C treated with different antiviral regimens who had achieved SVR. Qualitative serum HCV-RNA was determined by the commercial kit (COBAS AMPLICOR HCV, v2.0). RESULTS: There was predominance of male (73%) with a mean age of 45.6 ± 10 years. Liver cirrhosis was present in 16.1% of the study subjects. Mean follow-up time after SVR was 47 months (12-156 months). Twenty-two patients received monotherapy with interferon; 94 received interferon plus ribavirin, and 58 received pegylated interferon plus ribavirin. A total of 134 patients (77.0%) received one treatment course, 29 (16.7%) received two courses, and 11 (6.3%) received three courses. The distribution of HCV genotypes was: genotype 1 (40.2%), genotype 3 (40.8%) and genotype 2 (10.3%). Genotype was undetermined in 8.7% of cases. None of the 174 patients had recurrence of HCV infection. Two cirrhotic patients developed hepatocellular carcinoma (HCC) during follow-up. CONCLUSIONS: Among patients with SVR there was no recurrence of HCV infection or evidence of liver disease progression in any patient followed up for a mean of 47 months after SVR, except for patients with advanced hepatic disease before treatment, who may develop HCC despite SVR. Therefore, one can assume that SVR is associated with long term good prognosis.(FAEPA) Fundação de Apoio ao Ensino Pesquisa e Assistênci

Fibroblasts and osteoblasts behavior after contact with different titanium surfaces used as implant abutment: An in vitro experimental study

Background: The goal of this in vitro study was to compare three different surfaces: two types of implant surfaces commercially available ([a] smooth/machined and [b] acid-treated surface) versus (c) anodized surface. Discs were manufactured with commercially pure titanium (CP) grade IV, which were subsequently analyzed by scanning microscopy and fibroblastic and osteoblastic cell cultures. Methods: Ninety-nine discs (5 ×2 mm) were manufactured in titanium grade IV and received different surface treatments: (i) Mach group: machined; (ii) AA group: double acid etch; and (iii) AN group: anodizing treatment. Three discs from each group were analyzed by Scanning Electron Microscopy (SEM) to obtain surface topography images and qualitatively analyzed by EDS. Balb/c 3T3 fibroblasts and pre-osteoblastic cells (MC3T3-E1 lineage) were used to investigate each group’s biological response (n =10/cellular type). The data were compared statistically using the ANOVA one-way test, considered as a statistically significant difference p Mach >AN). There was similar behavior for cell adhesion for the test groups (Mach and AN), with greater adhesion of Balb/c 3T3 fibroblast

Time required to stabilize thermographic images at rest

Thermography for scientific research and practical purposes requires a series of procedures to obtain images that should be standardized; one of the most important is the time required for acclimatization in the controlled environment. Thus, the objective of this study was to identify the appropriate acclimatization time in rest to reach a thermal balance on young people skin. Forty-four subjects participated in the study, 18 men (22.3 ± 3.1 years) and 26 women (21.7 ± 2.5 years). Thermographic images were collected using a thermal imager (Fluke ®), totaling 44 images over a period of 20 minutes. The skin temperature (TSK) was measured at the point of examination which included the 0 minute, 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20. The body regions of interest (ROI) analyzed included the hands, forearms, arms, thighs, legs, chest and abdomen. We used the Friedman test with post hoc Dunn?s in order to establish the time at rest required to obtain a TSK balance and the Mann-Whitney test was used to compare age, BMI, body fat percentage and temperature variations between men and women, considering always a significance level of pmenor que0.05. Results showed that women had significantly higher temperature variations than men (pmenor que0.01) along the time. In men, only the body region of the abdomen obtained a significant variance (pmenor que0.05) on the analyzed period, both in the anterior and posterior part. In women, the anterior abdomen and thighs, and the posterior part of the hands, forearms and abdomen showed significant differences (pmenor que0.05). Based on our results, it can be concluded that the time in rest condition required reaching a TSK balance in young men and women is variable, but for whole body analysis it is recommended at least 10 minutes for both sexes

Cytomegalovirus infection in transplant recipients

Cytomegalovirus infection is a frequent complication after transplantation. This infection occurs due to transmission from the transplanted organ, due to reactivation of latent infection, or after a primary infection in seronegative patients and can be defined as follows: latent infection, active infection, viral syndrome or invasive disease. This condition occurs mainly between 30 and 90 days after transplantation. In hematopoietic stem cell transplantation in particular, infection usually occurs within the first 30 days after transplantation and in the presence of graft-versus-host disease. The major risk factors are when the recipient is cytomegalovirus seronegative and the donor is seropositive as well as when lymphocyte-depleting antibodies are used. There are two methods for the diagnosis of cytomegalovirus infection: the pp65 antigenemia assay and polymerase chain reaction. Serology has no value for the diagnosis of active disease, whereas histology of the affected tissue and bronchoalveolar lavage analysis are useful in the diagnosis of invasive disease. Cytomegalovirus disease can be prevented by prophylaxis (the administration of antiviral drugs to all or to a subgroup of patients who are at higher risk of viral replication) or by preemptive therapy (the early diagnosis of viral replication before development of the disease and prescription of antiviral treatment to prevent the appearance of clinical disease). The drug used is intravenous or oral ganciclovir; oral valganciclovir; or, less frequently, valacyclovir. Prophylaxis should continue for 90 to 180 days. Treatment is always indicated in cytomegalovirus disease, and the gold-standard drug is intravenous ganciclovir. Treatment should be given for 2 to 3 weeks and should be continued for an additional 7 days after the first negative result for viremia

Suplementação pós-natal com cacau melhora a qualidade óssea de ratas submetidas ao desmame precoce / Postnatal cocoa supplementation improves bone quality in early weaning rats

O desmame precoce causa efeitos deletérios na saúde óssea. O cacau, devido à sua composição rica em polifenóis, pode ser capaz de reduzir esses efeitos deletérios. O objetivo deste estudo foi avaliar os efeitos da suplementação com cacau em pó nos parêmetros ósseos da prole de ratas Wistar submetidas ao desmame precoce. No nascimento, as mães e suas ninhadas foram separadas em 4 grupos: a) Controle (C); b) Controle suplementado com Cacau (C+Ca); c) Desmame precoce (DP); d) Desmame precoce suplementado com cacau (DP+Ca). Os filhotes separados da mãe no 21º dia (controle) e no 18º dia (desmame precoce) permaneceram nos grupos de origem (n=6/grupo). Massa corporal e consumo foram aferidos em balança de precisão. Após 90 dias, foram anestesiados e eutanasiados. Análises ósseas, composição óssea e propriedades biomecânicas do fêmur foram determinados. Resultados expressos como média±desvio padrão. Avaliados quanto sua normalidade utilizando teste Kolmogorov-Smirnov. Utilizado teste Kruskal-Wallis com pós-teste de Dunn ou ANOVA one way com pós-teste de Bonferroni quando apropriado. Resultados significativos quando p?0,05. Utilizou-se o software GraphPadPrisma versão 5.0. O consumo foi significativamente menor nos grupos C+Ca e DP+Ca (p<0,0001). Os grupos C+Ca e DP+Ca apresentaram massa corporal inical menor (p<0,0001) e, aos 90 dias de vida, o grupo C+Ca apresentou a massa corporal significativamente maior (p=0,002). Nos parâmetros ósseos observou-se que o grupo C+Ca apresentou largura do ponto médio da diáfise (p=0,008) e massa óssea (p=0,03) significativamente maiores que o grupo C. Em relação às propriedades biomecânicas, a força de ruptura do grupo DP+Ca foi significativamente menor quando comparado com C+Ca (p=0,05). Já o grupo DP apresentou módulo elástico significativamente menor que o C, e o grupo DP+Ca significativamente menor que o C+Ca e maior que o DP (p=0,016). Conclui-se que a suplementação com 10% de cacau em pó é capaz de melhorar a estrutura femoral em ratas em idade reprodutiva

Brazilian recommendations on the safety and effectiveness of the yellow fever vaccination in patients with chronic immune-mediated inflammatory diseases

Background: In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to prevent YF. In special situations, such as patients with chronic immune-mediated inflammatory diseases (CIMID), undergoing immunosuppressive therapy, as a higher risk of severe adverse events may occur, assessment of the risk-benefit ratio of the yellow fever vaccine (YFV) should be performed on an individual level. Main body of the abstract: Faced with the scarcity of specific orientation on YFV for this special group of patients, the Brazilian Rheumatology Society (BRS) endorsed a project aiming the development of individualized YFV recommendations for patients with CIMID, guided by questions addressed by both medical professionals and patients, followed an internationally validated methodology (GIN-McMaster Guideline Development). Firstly, a systematic review was carried out and an expert panel formed to take part of the decision process, comprising BRS clinical practitioners, as well as individuals from the Brazilian Dermatology Society (BDS), Brazilian Inflammatory Bowel Diseases Study Group (GEDIIB), and specialists on infectious diseases and vaccination (from Tropical Medicine, Infectious Diseases and Immunizations National Societies); in addition, two representatives of patient groups were included as members of the panel. When the quality of the evidence was low or there was a lack of evidence to determine the recommendations, the decisions were based on the expert opinion panel and a Delphi approach was performed. A recommendation was accepted upon achieving ≥80% agreement among the panel, including the patient representatives. As a result, eight recommendations were developed regarding the safety of YFV in patients with CIMID, considering the immunosuppression degree conferred by the treatment used. It was not possible to establish recommendations on the effectiveness of YFV in these patients as there is no consistent evidence to support these recommendations. Conclusion: This paper approaches a real need, assessed by clinicians and patient care groups, to address specific questions on the management of YFV in patients with CIMID living or traveling to YF endemic areas, involving specialists from many areas together with patients, and might have global applicability, contributing to and supporting vaccination practices. We recommended a shared decision-making approach on taking or not the YFV