Um Caso Único de Hemorragia Digestiva Alta Recorrente Causada por Duas Lesões de Dieulafoy Metácronas: a Importância da Avaliação por Ecoendoscopia

Introduction: Dieulafoy's lesion (DL) is a rare but important cause of acute, severe, life-threatening, and recurrent upper gastrointestinal bleeding (UGIB). It is frequently difficult to diagnose DL with upper GI endoscopy (UGIE), and endoscopic ultrasonography (EUS) may be valuable. There are only 2 reported bleeding cases caused by two synchronous DL but no reported cases of two metachronous DL. Case report: A 28-year-old healthy male presented with acute severe UGIB. UGIE was inconclusive. Systematic EUS mapping identified a gastric DL. After several attempts of EUS-guided hemostasis, DL was marked using a through-the-scope clip and the patient underwent successful transcatheter arterial embolization (TAE). Three years later, a new severe UGIB episode was caused by a second gastric DL in a different location, which was identified and marked by EUS and further successfully treated through TAE. The patient maintained follow-up without evidence of further bleeding. Discussion/conclusion: The authors report a unique case of severe, recurrent UGIB caused by two metachronous gastric DL lesions. The importance of systematic EUS scanning for diagnosis, treatment, and follow-up of DL is emphasized, as well as the potential influence in the outcome of other techniques like angiographic embolization.info:eu-repo/semantics/publishedVersio

Competição de variedades de café conilon (Coffea canephora) para Região Sul do Estado do Espírito Santo.

Os trabalhos de melhoramento de café Conilon da EMCAPER, objetivando disponibilizar variedades melhoradas para os produtores capixabas, abrangeram inicialmente o Norte do Estado do Espírito Santo. Considerando que a área de plantio vem sendo ampliada no Sul, os experimentos de competição passaram a ser conduzidos também nessa região. O Ensaio Regional de Café Conilon foi instalado em maio de 1997, na Fazenda Experimental de Bananal do Norte - FEBN, da EMCAPER, no município de Cachoeiro de Itapemirim, em blocos casualizados, 4 repetições e 8 tratamentos, constituídos de uma variedade de semente, três variedades clonais lançadas pela Ex-EMCAPA, três variedades clonais experimentais e, um Clone Elite, como testemunha. O rendimento médio do experimento variou entre 86 a 118 sc/ben/ha, correspondendo a variedade de semente (EMCAPA 8150) e ao Clone Elite (testemunha), respectivamente. A variedade experimental EMCAPA 8122, de ciclo intermediário, mostrou-se promissora para a região, com rendimento médio de 112 sc/ben/ha

Clinical, cytogenetic and molecular findings of a “de novo” inv dup del (6q)

Introduction: Complex rearrangements resulting in inverted duplications contiguous to a terminal deletion (inv dup del) were first reported for the short arm of chromosome 8 in1976. Since then this type of structural anomaly has been described for an increasing number of chromosomes. In these rearrangements, the concomitant presence of a deletion and a duplication has important consequences in genotype-phenotype correlations. The authors describe the clinical findings and the cytogenetic characterization of a rare inv dup del involving the long arm of chromosome 6. Material and methods: A girl aged 5 was referred for subtelomeric studies with the indication of psychomotor retardation, autistic features and stereotipies. Chromosome analysis with high resolution GTL-banding was performed on metaphases obtained from cultured peripheral blood lymphocytes. Molecular studies included MLPA (Kits P036 and P070, MRC-Holland), FISH with subtelomeric and whole chromosome painting probes specific for chromosome 6, and cCGH techniques. Results: Initial MLPA studies detected a subtelomeric deletion in the long arm of chromosome 6; the subsequent karyotype revealed a structurally abnormal chromosome 6 with additional material in the end of the long arm. FISH analysis showed the deletion and demonstrated that the extra material was derived from chromosome 6; cCGH tecnhiques defined the extension and confirmed the breakpoints of the duplicated segment. Thus this rearrangement was interpreted as an inv dup del (6q). Since parental karyotypes were normal, this anomaly was considered “de novo”. Discussion: As far as we know this is the first description of a patient presenting with a “de novo” inv dup del (6q). We compare the clinical features in this child with the previously reported cases with either an isolated terminal deletion or a duplication of distal 6q. The authors enhance the importance of the combination of high resolution banding with molecular studies in the characterization of this rare rearrangement

Interstitial deletion 15q21 and Prader-Willi like syndrome phenotype: Case report

Introduction: Chromosome 15q interstitial deletions not involving the Prader-Willi/Angelman region are uncommon and poorly characterized. Very few cases of different segmental losses involving the 15q21 region have been reported at cytogenetic level. All the described patients present with moderate to several mental retardation and characteristic facial dysmorphic features. Some authors compare the similarity between the phenotype of these patients with some features of Prader-Willi syndrome (PWS). Methods: We report the case of a girl aged 8 referred for conventional cytogenetics and fluorescence in situ hybridization (FISH) for the PWS region, presenting with mental retardation, almond-shaped eyes, obesity, small hands with short fingers and diminished pigmentation of the hair. Results: The chromosomal analysis revealed an interstitial deletion of the long arm of chromosome 15, apparently between 15q21 and 15q22. Deletion at 15q11.2 (Prader-Willi/Angelman critical region) was excluded by FISH. To establish the exact breakpoints molecular studies were performed using bacterial artificial chromosome (BAC) clones spanning the 15q21.3 region. The absence of signal in this region defines the proband’s final karyotype as: 46,XX,del(15)(q21.3q21.3).ish del(15)(q21.3q21.3)(bA74K1-) Discussion: The authors emphasize the importance of complementary FISH and molecular studies in chromosomal abnormalities and compare the proband’s phenotype with similar cases described in the literature

from in uterus to elderly

Immune system recognize and fight back foreign microorganisms and inner modifications that lead to deficient cell and tissue functions. During a dog's life, the immune system needs to adapt to different physiological conditions, assuring surveillance and protection in a careful and controlled way. Pregnancy alters normal homeostasis, requiring a balance between immunity and tolerance. The embryos and fetus should be protected from infections, while the female dog must tolerate the growing of semi-allografts in her uterus. After birth, newborn puppies are at great risk of developing infectious diseases, because their immune system is in development and immune memory is absent. Passive transfer of immunity through colostrum is fundamental for puppy survival in the first weeks of life, but hampers the development of an active immune response to vaccination. At the end of life, dogs experience a decline in the structure and functional competence of the immune system, compromising the immune responses to novel antigenic challenges, such as infections and vaccines. Therefore, the current article reviews the general processes related to the development of the dog´s immune system, providing an overview of immune activity throughout the dog's life and its implications in canine health, and highlighting priority research goals.publishersversionpublishe

Research into Mercury Exposure and Health Education in Subsistence Fish-Eating Communities of the Amazon Basin: Potential Effects on Public Health Policy

The neurotoxic effects of fish-methylmercury (meHg) consumed regularly are considered hazardous to fetuses and newborn infants; as a result fish consumption advisories are an important asset to control meHg exposure in affluent societies. These concerns are now part of health promotion programs for Amazon subsistence villagers. While urban dwellers in affluent societies can choose an alternative nutritious diet, traditional and subsistence communities are caught up in controversial issues and lifestyle changes with unintended health consequences. Traditional fish-eating populations of industrialized and non-industrialized regions may be exposed to different neurotoxic substances: man-made pollutants and environmentally occurring meHg. Additionally, in non-industrialized countries, pregnant women and infants are still being immunized with thimerosal-containing vaccines (TCVs) which degrade to ethylmercury (etHg). Therefore, the complexity involving fish-meHg associated with wild-fish choices and Hg exposure derived from TCVs is difficult to disentangle and evaluate: are villagers able to distinguish exposure to differently hazardous chemical forms of Hg (inorganic, fish-meHg, and injected etHg)? Is it possible that instead of helping to prevent a plausible (unperceived) fish-meHg associated neurocognitive delay we may inadvertently arouse panic surrounding Hg exposure and disrupt subsistence fish-eating habits (necessary for survival) and life-saving vaccination programs (required by public health authorities)? These questions characterize the incompleteness of information related on the various chemical forms of Hg exposure and the need to convey messages that do not disrupt nutritional balance and disease prevention policies directed at Amazonian subsistence communities