Hypertonic saline and pentoxifylline enhance survival, reducing apoptosis and oxidative stress in a rat model of strangulated closed loop small bowel obstruction

OBJECTIVES: Intestinal obstruction has a high mortality rate when therapeutic treatment is delayed. Resuscitation in intestinal obstruction requires a large volume of fluid, and fluid combinations have been studied. Therefore, we evaluated the effects of hypertonic saline solution (HS) with pentoxifylline (PTX) on apoptosis, oxidative stress and survival rate. METHODS: Wistar rats were subjected to intestinal obstruction and ischemia through a closed loop ligation of the terminal ileum and its vessels. After 24 hours, the necrotic bowel segment was resected, and the animals were randomized into four groups according to the following resuscitation strategies: Ringer’s lactate solution (RL) (RL-32 ml/kg); RL+PTX (25 mg/kg); HS+PTX (HS, 7.5%, 4 ml/kg), and no resuscitation (IO-intestinal obstruction and ischemia). Euthanasia was performed 3 hours after resuscitation to obtain kidney and intestine samples. A malondialdehyde (MDA) assay was performed to evaluate oxidative stress, and histochemical analyses (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling [TUNEL], Bcl-2 and Bax) were conducted to evaluate kidney apoptosis. Survival was analyzed with another series of animals that were observed for 15 days. RESULTS: PTX in combination with RL or HS reduced the MDA levels (nmol/mg of protein), as follows: kidney IO=0.42; RL=0.49; RL+PTX=0.31; HS+PTX=0.34 (po0.05); intestine: IO=0.42; RL=0.48; RL+PTX=0.29; HS +PTX=0.26 (po0.05). The number of labeled cells for TUNEL and Bax was lower in the HS+PTX group than in the other groups (po0.05). The Bax/Bcl-2 ratio was lower in the HS+PTX group than in the other groups (po0.05). The survival rate on the 15th day was higher in the HS+PTX group (77%) than in the RL+PTX group (11%). CONCLUSION: PTX in combination with HS enhanced survival and attenuated oxidative stress and apoptosis. However, when combined with RL, PTX did not reduce apoptosis or mortalit

Serum soluble-Fas and erythropoietin resistance in uremic patients

A resistência a eritropoietina em pacientes com Doença Renal Crônica (ORC) geralmente está ligada a estoques de ferro reduzidos e a inflamação. Em outro estudo demonstramos que Fas solúvel (sFas), uma proteína sérica, está associado com necessidade de doses maiores de eritropoietina recombinante humana (rHuEPO) nos pacientes em diálise. O objetivo do presente estudo, foi investigar se o sFas pode ser um marcador de resistência a eritropoietina e observar se esta associação seria devido a um efeito de resistência a rHuEPO ou simplesmente a um efeito de inibição da síntese de eritropoietina. Este é um estudo de corte-transversal, com 52 pacientes com DRC pré¬ dialítico em tratamento conservador (Cons), 31 pacientes em diálise peritoneal (OP), 30 pacientes em hemodiálise (HD) e 29 controles saudáveis (Contr). Foram dosados, hemoglobina (Hb), hematócrito (Ht), sFas sérico, eritropoietina sérica (Epo), ferro sérico (Fe), ferritina, saturação de transferrina e os marcadores inflamatórios séricos: fator de necrose tumoral alfa (TNF-□, interferon gama (IFN-□, interleucina-1 beta (IL-1□ , interleucina-6 (IL-6), interleucina-10 (IL-10) e proteína C-reativa (PCR). A razão Epo sérica/Ht foi usada como uma medida de resistência à eritropoietina. Encontramos os menores níveis de Hb e Ht nos grupos DP e HD, seguidos do grupo Cons. Comparados ao grupo Contr, os níveis sé ricos de sFas foram maiores nos grupos em diálise, seguidos do grupo Cons ( Contr:1455±844 pg/ml, Cons:3121±1200 pg/ml, DP:4402±1271 pg/ml, HD:4604±790 pg/ml; pBV UNIFESP: Teses e dissertaçõe

Serum soluble-Fas, Inflammation and Anemia in Acute Kidney Injury

Introdução: Anemia é muito comum ocorrer no paciente gravemente enfermo (PGE) com ou sem insuficiência renal aguda (IRA). Os níveis séricos do Fas solúvel (sFas) estão associados com anemia e baixa resposta à eritropoietina (Epo) no paciente com doença renal crônica. Assim, é possível que os níveis séricos de sFas estejam associados com anemia e maior necessidade de níveis séricos de Epo no PGE portador de IRA para manter adequados os níveis de hemoglobina (Hb). Objetivo: Investigar a relação entre os níveis séricos de sFas, Epo, citocinas inflamatórias e os níveis de Hb em PGE com IRA. Métodos: Estudamos 72 PGE com IRA (grupo IRA; n = 53) ou sem IRA (grupo sem IRA; n = 19) e 18 voluntários saudáveis (grupo Contr). Investigamos as relações entre a concentração Hb e os níveis séricos de sFas, Epo, TNF-alfa, IL-6, IL-10 e perfil de ferro (saturação de transferrina, ferro sérico e ferritina) no grupo IRA. Resultados: Os PGEs (grupos IRA e sem IRA) apresentaram maiores níveis séricos de Epo e ferritina (p < 0,001). A concentração de Hb foi menor no grupo IRA (p < 0,001) do que nos outros grupos. Os níveis séricos de IL-6 e IL-10 foram maiores nos grupo IRA e sem IRA do que no grupo Contr (p < 0,001). Os níveis séricos de sFas e TNF-alfa foram maiores no grupo IRA (p < 0,001). Observamos correlações negativas entre a concentração de Hb com os níveis séricos de IL-6 (r = -0,37; p = 0,008), de sFas (r = -0,35; p = 0,01) e de Epo (r = -0,27; p = 0,04) no grupo IRA. No mesmo grupo observamos que os níveis séricos de sFas apresentaram correlação positiva com os níveis séricos de IL-6 (r = 0,28; p = 0,04) e com os níveis de ferro sérico (r = 0,36; p = 0,008). Na análise multivariada, após ajustes para IL-6, TNF-alfa, Epo e ferritina, somente os níveis séricos de sFas (p = 0,03) apresentaram correlação negativa com os níveis de Hb no grupo IRA. Conclusão: Nossos achados demonstram que os níveis séricos de Epo, de citocinas inflamatórias e sFas estão elevados nos PGEs. As concentrações de Hb foram menores, enquanto que os níveis séricos de sFas foram maiores nos PGEs com IRA. A associação independente entre os níveis séricos de sFas com a concentração de Hb sugere que os níveis séricos de sFas possa ser um marcador de anemia nestes pacientes, ou ainda que possa participar de seu processo fisiopatológico. Assim, são necessários mais estudos para entender o papel do sFas no contexto da anemia do paciente portador de IRA.BV UNIFESP: Teses e dissertaçõe

Acute kidney injury outcomes in covid-19 patients: systematic review and meta-analysis

Abstract Background: Acute kidney injury (AKI) is a frequent complication of coronavirus-19 disease (COVID-19). Therefore, we decided to perform a systematic review and meta-analysis with data from the literature to relate the development of COVID-19 associated-AKI with comorbidities, medications, and the impact of mechanical ventilation. Methods: We performed a systematic review using the Newcastle-Ottawa scale and a meta-analysis using the R program. Relevant studies were searched in the PubMed, Medline, and SciELO electronic databases. Search filters were used to include reports after 2020 and cohort studies. Results: In total, 1166 articles were identified and 55 English-written articles were included based on the risk of bias. Of all COVID-19-hospitalized patients presenting with AKI (n = 18029) classified as Kidney Disease Improving Global Outcomes stage 1 to 3, approximately 18% required mechanical ventilation and 39.2 % died. Around 11.3% of the patients required kidney replacement therapy (KRT) and of these, 1093 died and 321 required continuous KRT. Death is more frequent in individuals with AKI [OR 6.03, 95%CI: 5.73-6.74; p<0.01]. Finally, mechanical ventilation is an aggravating factor in the clinical conditions studied [OR 11.01, 95%CI: 10.29-11.77; p<0.01]. Conclusion: Current literature indicates AKI as an important complication in COVID-19. In this context, we observed that comorbidities, such as chronic kidney disease and heart failure, were more related to the development of AKI. In addition, mechanical ventilation was seen as an aggravating factor in this scenario

A retrospective view of the relationship of soluble Fas with anemia and outcomes in chronic kidney disease

Our data contains: Gender; Age_baseline (years); Group_NDD_CKD; BMI; Smoker at that moment; Proteinuria; Creat baseline; eGFR_baseline; CKDstage; eGFR 60; sUrea_basel; DM_cause; Hypetension_cause; Cause of CKD; Hgb_baseline; Hgb_lower10_baseline; Hgb (mg/dl)_baseline; Hgb_baseline (g/l); Hct_b; Hct_basel; VCMb_; HCM_b; Anemia_baseline; ESA; months_to_ESA; rHuEPOU/week; rHuEPO/Kg/week; platelets_baseline; Iron_replacement; Fe_baseline; Trasferrin_sat_basel; Ferritin_baseline; Albumin_baseline; PCR; logPCR; PCR_baseline_LxH; serum_sFas_baseline; sFas/eGFR_at baseline; sFas1000; logsFas; IL-6.b; log_IL_6.b; IFNg.b; logIFNg.b; serum_EPO.basel; logserumEPO_b; EPO/Hb. mg/dl_b_; log_EPO/Hb. mg/dl_b_; Epo/Hgb_baseline; logEpo/Hgb_b; EPO/Hct basel; log EPO/Hct basel; PTH_baseline; logpth; Leuko_b; RAS_blocker; CaXP; LVH; t_CHOLT; Hgb_after 1 year; Hgb_2; Hgb_4; Hgb_6; Hgb_8; Hgb_10; Hgb_12; Hct; Hct1; Hct2; Hct 4; Hct 6; Hct 8; Hct 12; Hgb_last; VCM_last; HCM_last; Hct last; Anemia_end followup; Leuko 2; Leuko 4; Leuko 6; Leuko 8; Leuko 12; Alb_after 2; Alb 4; Alb 6; alb12; Fe 2; Fe 4; Fe 6; Fe 8; Fe 10; Fe 12; Ferrit i; Ferrit 2; Ferrit4; Ferrit 6; Ferrit 8; Ferrit 12; Transf sat_after 2 y ; Transf sat_4; Transf sat_ 6; Transf sat_ 8; Transf sat_10; Transf sat_12; PCR_after 2 y; PCR 4; PCR6; PCR10; PCR12; Weight_after 2 years; Weight_6; Peso12; eGFR_after 1 y; eGFR_2; eGFR_4; eGFR_6; eGFR_8; eGFR_12; eGFR_last; Ant. C.Ca; b-bloq; Diuretic; Vit B; Folate; CVDisease; Time to CVD (years); Hypertens; DM ; NDD_CKD_to_Dialysis; Time to dialysis (months); T to dialysis (years); to_Anemia (years); RBC_Transfus; RBCs units; Time_ RBC_transfusion (months); followup (years); Mortality; Time to mortality (months); Cause_mortality; Year of mortality;</p

Acute kidney injury: Incidence, risk factors, and outcomes in severe COVID-19 patients.

BackgroundCOVID-19 is a multisystemic disorder that frequently causes acute kidney injury (AKI). However, the precise clinical and biochemical variables associated with AKI progression in patients with severe COVID-19 remain unclear.MethodsWe performed a retrospective study on 278 hospitalized patients who were admitted to the ward and intensive care unit (ICU) with COVID-19 between March 2020 and June 2020, at the University Hospital, São Paulo, Brazil. Patients aged ≥ 18 years with COVID-19 confirmed on RT-PCR were included. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. We evaluated the incidence of AKI, several clinical variables, medicines used, and outcomes in two sub-groups: COVID-19 patients with AKI (Cov-AKI), and COVID-19 patients without AKI (non-AKI). Univariate and multivariate analyses were performed.ResultsFirst, an elevated incidence of AKI (71.2%) was identified, distributed across different stages of the KDIGO criteria. We further observed higher levels of creatinine, C-reactive protein (CRP), leukocytes, neutrophils, monocytes, and neutrophil-to-lymphocyte ratio (NLR) in the Cov-AKI group than in the non-AKI group, at hospital admission. On univariate analysis, Cov-AKI was associated with older age (>62 years), hypertension, CRP, MCV, leucocytes, neutrophils, NLR, combined hydroxychloroquine and azithromycin treatment, use of mechanical ventilation, and vasoactive drugs. Multivariate analysis showed that hypertension and the use of vasoactive drugs were independently associated with a risk of higher AKI in COVID-19 patients. Finally, we preferentially found an altered erythrocyte and leukocyte cellular profile in the Cov-AKI group compared to the non-AKI group, at hospital discharge.ConclusionsIn our study, the development of AKI in patients with severe COVID-19 was related to inflammatory blood markers and therapy with hydroxychloroquine/azithromycin, with vasopressor requirement and hypertension considered potential risk factors. Thus, attention to the protocol, hypertension, and some blood markers may help assist doctors with decision-making for the management of COVID-19 patients with AKI

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora