Comparação da evolução do transplante hepático em receptores com MELD alto e baixo

OBJECTIVE: To compare low and high MELD scores and investigate whether existing renal dysfunction has an effect on transplant outcome. METHODS: Data was prospectively collected among 237 liver transplants (216 patients) between March 2003 and March 2009. Patients with cirrhotic disease submitted to transplantation were divided into three groups: MELD &gt; 30, MELD < 30, and hepatocellular carcinoma. Renal failure was defined as a ± 25% decline in estimated glomerular filtration rate as observed 1 week after the transplant. Median MELD scores were 35, 21, and 13 for groups MELD &gt; 30, MELD < 30, and hepatocellular carcinoma, respectively. RESULTS: Recipients with MELD &gt; 30 had more days in Intensive Care Unit, longer hospital stay, and received more blood product transfusions. Moreover, their renal function improved after liver transplant. All other groups presented with impairment of renal function. Mortality was similar in all groups, but renal function was the most important variable associated with morbidity and length of hospital stay. CONCLUSION: High MELD score recipients had an improvement in the glomerular filtration rate after 1 week of liver transplantation

Oil palm monoculture induces drastic erosion of an Amazonian forest mammal fauna

Oil palm monoculture comprises one of the most financially attractive land-use options in tropical forests, but cropland suitability overlaps the distribution of many highly threatened vertebrate species. We investigated how forest mammals respond to a landscape mosaic, including mature oil palm plantations and primary forest patches in Eastern Amazonia. Using both line-transect censuses (LTC) and camera-trapping (CT), we quantified the general patterns of mammal community structure and attempted to identify both species life-history traits and the environmental and spatial covariates that govern species intolerance to oil palm monoculture. Considering mammal species richness, abundance, and species composition, oil palm plantations were consistently depauperate compared to the adjacent primary forest, but responses differed between functional groups. The degree of forest habitat dependency was a leading trait, determining compositional dissimilarities across habitats. Considering both the LTC and CT data, distance from the forest-plantation interface had a significant effect on mammal assemblages within each habitat type. Approximately 87% of all species detected within oil palm were never farther than 1300 m from the forest edge. Our study clearly reinforces the notion that conventional oil palm plantations are extremely hostile to native tropical forest biodiversity, which does not bode well given prospects for oil palm expansion in both aging and new Amazonian deforestation frontiers

Ação do ácido trissódio-cálcio-dietileno-triaminopentaacético (CaNa3DTPA) nas lesões de isquemia-reperfusão em membro posterior de rato

OBJETIVO: Ação do ácido trissódio-cálcio-dietileno-triaminopentaacético (CaNa3DTPA), quelante de ferro com ação ainda anti-viral, antiinflamatória e imunológica, na atenuação de lesões de reperfusão em músculos esqueléticos de ratos. MÉTODOS: 52 ratos Wistar, pesando 188±22g, foram anestesiados e submetidos a semi-amputação de membro posterior direito (MPD), poupando-se o fêmur, artéria e veia femorais. Foram então randomizados e distribuídos: G1-CTAN - controle anestesia, sem cirurgia e sem isquemia; G2-CTCIR - controle cirurgia, sem isquemia; G3-IRCT e G3-IRDTPA - com isquemia (4 hora) e reperfusão ( 2 horas). O G3-IRCT foi tratado, ao final da isquemia, com cloreto de sódio 0,9% e G3-IRDTPA com (CaNa3DTPA).Parâmetros: Circunferência do pé direito e peso do rato, dosagem sérica de CPK, dosagem de malonaldeído e microscopia óptica de músculos soleus bilateral. RESULTADOS: Aumento da circunferência nos G3-IRCT e G3-IRDTPA (significante no G3-IRCT quando comparado ao G1-CTAN); CPK elevado nos G3-IRCT e G3-IRDTPA comparados aos controles; MDA mais alto no membro contralateral do G3-IRDTPA, comparado ao MPD do G3-IRDTPA e ao G1-CTAN; maior edema intersticial em G3-IRCT, maior infiltrado inflamatório em G3-IRDTPA e recuperação dos níveis de glicogênio semelhantes em G3-IRCT e G3-IRDTPA. CONCLUSÃO: Apesar do menor edema no G3-IRDTPA comparado ao G3-IRCT, o CaNa3DTPA não alterou CPK sérico, MDA muscular e morfologia muscular dos animais.OBJECTIVE: Our purpose was to elucidate whether calcium trinatrium diethylenetriaminepentaacetic acid (CaNa3DTPA), a hydrophilic extracelular chelator with some imunological and anti-inflammatory properties, protects skeletal muscle submitted to ischemia/reperfusion. METHODS: Fifty two male Wistar rats were randomly allocated in the following groups:G1-CTAN- control anesthesia whithout surgery. G2-CTCIR - control surgery without ischemia. G3-IRCT and G3-IRDTPA: four hours ischemia and two hours reperfusion. The animals of group 3 were treated with saline and those of the group 4, treated with CaNa3DTPA. Parameters were: foot circumference, rats weight, plasmatic creatine-phosphokinase (CPK), muscular malondialdehyde (MDA), and optic microscopy of muscle cells. RESULTS: There was a significant post-ischemic increase in foot circumference in G3-IRCT. CPK measurements were significantly increased in G3-IRCT and G3-IRDTPA, when compared to G1-CTAN and G2-CTCIR, but there were no differences between G3-IRCT and G3-IRDTPA. MDA was increased in the left no-ischemic muscles in G3-IRCT, when compared to contralateral muscles of G3-IRCT and of G1-CTAN.The histological evaluation showed inflammatory cell infiltrate in G3-IRDTPA and edema in G3-IRCT. The glycogen recovery was similar in both groups. CONCLUSION: There was less edema in the animals with ischemia-reperfusion treated group, but CaNa3DTPA don't protect muscle cells from injury in relations with CPK, MDA managements and histological alterations

Liver transplant outcome: a comparison between high and low MELD score recipients

OBJECTIVE: To compare low and high MELD scores and investigate whether existing renal dysfunction has an effect on transplant outcome. METHODS: Data was prospectively collected among 237 liver transplants (216 patients) between March 2003 and March 2009. Patients with cirrhotic disease submitted to transplantation were divided into three groups: MELD &gt; 30, MELD < 30, and hepatocellular carcinoma. Renal failure was defined as a ± 25% decline in estimated glomerular filtration rate as observed 1 week after the transplant. Median MELD scores were 35, 21, and 13 for groups MELD &gt; 30, MELD < 30, and hepatocellular carcinoma, respectively. RESULTS: Recipients with MELD &gt; 30 had more days in Intensive Care Unit, longer hospital stay, and received more blood product transfusions. Moreover, their renal function improved after liver transplant. All other groups presented with impairment of renal function. Mortality was similar in all groups, but renal function was the most important variable associated with morbidity and length of hospital stay. CONCLUSION: High MELD score recipients had an improvement in the glomerular filtration rate after 1 week of liver transplantation

Linfoma cutâneo de células B: relato de caso Cutaneous B-cell lymphoma: a case report

Os linfomas cutâneos são classificados em linfomas de células B ou de células T, sendo os primeiros menos freqüentes. O linfoma cutâneo de células B (LCCB) pode ser primário ou secundário, tendo o último história natural mais agressiva, com pior prognóstico. Os autores apresentam um caso de LCCB secundário com três anos de evolução, curso indolente, sem envolvimento de outros órgãos além da pele, com ótima resposta ao tratamento quimioterápico. A distinção entre LCCB primário e secundário é muito difícil de ser realizada, uma vez que eles são clínica e histopatologicamente indistinguíveis. Deve-se sempre pesquisar o acometimento de órgãos internos para então definir o prognóstico.<br>Cutaneous lymphomas are classified as either type B cell or T cell lymphoma, the former type being less frequent. Cutaneous B cell lymphoma (CBCL) may be primary or secondary. The latter has a more aggressive natural history with a worse prognostic. In this paper, the authors present a secondary CBCL case with a three-year evolution, indolent course, without involvement of other organs beside the skin and with optimal response to chemotherapeutic treatment. The distinction between primary and secondary CBCL is very difficult to determine insofar as they are clinically and histopathologically indistinguishable. It is always necessary to investigate whether internal organs have been affected prior to defining the prognosis

Subdoses of 17DD yellow fever vaccine elicit equivalent virological/immunological kinetics timeline

Submitted by Nuzia Santos ([email protected]) on 2015-03-02T18:59:13Z No. of bitstreams: 1 2014_133.pdf: 1767507 bytes, checksum: 7391488fb6c7b01f4d8694e5da140f58 (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2015-03-02T18:59:19Z (GMT) No. of bitstreams: 1 2014_133.pdf: 1767507 bytes, checksum: 7391488fb6c7b01f4d8694e5da140f58 (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2015-03-02T19:12:15Z (GMT) No. of bitstreams: 1 2014_133.pdf: 1767507 bytes, checksum: 7391488fb6c7b01f4d8694e5da140f58 (MD5)Made available in DSpace on 2015-03-02T19:12:15Z (GMT). No. of bitstreams: 1 2014_133.pdf: 1767507 bytes, checksum: 7391488fb6c7b01f4d8694e5da140f58 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro,RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Instituto de Biologia do Exército. Rio de Janeiro, RJ, Brasil.Instituto de Biologia do Exército. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, Minas Gerais, Brasil.Background: The live attenuated 17DD Yellow Fever vaccine is one of the most successful prophylactic interventions for controlling disease expansion ever designed and utilized in larger scale. However, increase on worldwide vaccine demands and manufacturing restrictions urge for more detailed dose sparing studies. The establishment of complementary biomarkers in addition to PRNT and Viremia could support a secure decision-making regarding the use of 17DD YF vaccine subdoses. The present work aimed at comparing the serum chemokine and cytokine kinetics triggered by five subdoses of 17DD YF Vaccine. Methods: Neutralizing antibody titers, viremia, cytokines and chemokines were tested on blood samples obtained from eligible primary vaccinees. Results and discussion: The results demonstrated that a fifty-fold lower dose of 17DD-YF vaccine (587 IU) is able to trigger similar immunogenicity, as evidenced by significant titers of anti-YF PRNT. However, only subdoses as low as 3,013 IU elicit viremia kinetics with an early peak at five days after primary vaccination equivalent to the current dose (27,476 IU), while other subdoses show a distinct, lower in magnitude and later peak at day 6 post-vaccination. Although the subdose of 587 IU is able to trigger equivalent kinetics of IL-8/CXCL-8 and MCP-1/CCL-2, only the subdose of 3,013 IU is able to trigger similar kinetics of MIG/CXCL-9, pro-inflammatory (TNF, IFN-γ and IL-2) and modulatory cytokines (IL-5 and IL-10). Conclusions: The analysis of serum biomarkers IFN-γ and IL-10, in association to PRNT and viremia, support the recommendation of use of a ten-fold lower subdose (3,013 IU) of 17DD-YF vaccine