Hemorragia digestiva baixa - principais doenças associadas, diagnóstico e manejo terapêutico

O sangramento no trato gastrointestinal inferior (LGIB) é uma importante causa de morbimortalidade ao redor do mundo, principalmente em idosos, caracterizado por sangramentos originados distalmente ao ligamento de Treitz. Responsável por aproximadamente 36 casos a cada 100.000 internações anuais, o LGIB apresenta uma taxa de mortalidade variando de 2,4% a 3,9%. Em grande parte, é autolimitado, resolvendo-se espontaneamente, permitindo uma avaliação não urgente. No entanto, casos graves exigem intervenção rápida. Etiologicamente ligado a pólipos, tumores, diverticulose e doença inflamatória crônica, o LGIB afeta predominantemente pessoas de 65 a 80 anos, com incidência aumentando com a idade. A apresentação clínica varia de acordo com a localização, gravidade do sangramento e condições do paciente, sendo crucial avaliar além dos sintomas, a duração do sangramento e outras condições associadas. Fatores de risco, como Colite Isquêmica, Câncer de Cólon, Hemorróidas e Doença Diverticular, contribuem significativamente para o LGIB. A diverticulose é a principal causa, seguida por hemorróidas e neoplasias. As hemorróidas, comuns e muitas vezes assintomáticas, podem causar complicações hemodinâmicas. Neoplasias gastrointestinais e colite isquêmica também são fatores de risco importantes. Para diagnóstico, a endoscopia gastrointestinal é essencial, especialmente a colonoscopia no LGIB agudo. A angiografia e a angiotomografia são úteis para identificar a origem do sangramento. O tratamento, incluindo técnicas endoscópicas e radiologia intervencionista, evoluiu, mas os princípios do tratamento não operatório permanecem. O manejo consiste em reconhecimento inicial, localização do sangramento e intervenção terapêutica, incluindo várias técnicas de hemostasia endoscópica. A cirurgia é reservada para casos específicos e de emergência, como o LGIB contínuo sem diagnóstico claro após intervenções não cirúrgicas. A laparotomia é realizada quando as técnicas não operatórias falham. A colectomia subtotal é eficaz, mas sua morbidade limita seu uso

Honey physicochemical properties of three species of the brazilian Melipona

Physicochemical analyses were carried out to evaluate 27 samples of honeys from three species of the Brazilian genus Melipona (M. capixaba, M. rufiventris and M. mondury) from Espírito Santo and Minas Gerais States. The parameters water activity (Aw), percentage of soluble solids (Brix %), pH, acidity (meq/Kg) and moisture (%) were evaluated. The honey characteristics obtained from these samples were very similar to the ones from other Melipona species. However, regarding the honey from Apis (honey bee), only the pH values were similar. The low pH value and the high acidity detected in Melipona honey are potential factors for increasing the honey shelf life because they do not provide favorable conditions for the microbial development. On the other hand, the high level of water activity favors the growth of microorganisms, especially yeast, which demands a more careful handled and storage. The observed differences between Melipona and Apis honey reinforce the need for specific quality settings for stingless bee honey

Pollen sources for Melipona capixaba Moure & Camargo: an endangered Brazilian stingless bee

Pollen samples were collected in three different periods from 11 Melipona capixaba Moure & Camargo hives and analyzed with melissopalynological methodology. A total of 33 pollen types were identified, of which 23 genera and 15 families were identified. The following families showed the highest pollen richness: Fabaceae (7), Myrtaceae (3), Solanaceae (3), Arecaceae (2), Asteraceae (2), Euphorbiaceae (2), Melastomataceae/Combretaceae (2), Rubiaceae (2), and Sapindaceae (2). The most frequent pollen types (>45%) were Eucalyptus, which generated great similarities between the samples, except one in which the Tibouchina was predominant. Although the majority of the pollen types showed low percentage values, the results demonstrated that M. capixaba has taken advantage of the polliniferous sources available in the Atlantic Rainforest as well as in the “Capoeira” (brushwood, secondary forest) and “ruderal” (field) plants, probably implying its importance as a pollinator of the native flora and of the exotic species

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved