Pancreatite em adulto com leucemia linfoblástica aguda usando L-asparaginase e sinvastatina: relato de caso e revisão sistemática

Context: Acute pancreatitis is a inflammatory process of the pancreas. It can be caused by gallstones, metabolic disorders, associated or not with alcohol abuse, or medication. Case Report: A 38-year-old man was admitted to the hospital because of worsening of nausea, abdominal pain, dizziness and white stool. Patient was diagnosed with severe acute pancreatitis. After six days of hospitalization, patient progressed into hypotension and severe bradycardia, and died. The patient used simvastatin chronically, and was in treat with L-asparaginase, both drugs related to the occurence of acute pancreatitis separately. Naranjo´s probability scale of adverse drug reaction established the causality between these medications and acute pancreatitis as probable. However, due to the absence of reports of causality, the acute pancreatitis is associated with to the use of L-asparaginase with possible drug interactions with simvastatin. Conclusion: It is very important to monitor patients treated with L-asparaginase, through careful observation of clinical signs and laboratory follow-up, as well as verification of other medications in use. The AP may have different levels of severity, being indispensable the quick diagnosis and early treatmentContexto: Pancreatite aguda é um processo inflamatório do pâncreas. É causada por cálculos biliares, desordens metabólicas, associadas ou não ao uso abusivo de álcool, ou medicamentos. Relato do Caso: Homem de 38 anos foi admitido no hospital em razão do agravamento de náuseas, dor abdominal, tontura e fezes brancas. O paciente foi diagnosticado com pancreatite aguda. Após seis dias de internação, paciente progrediu com hipotensão e bradicardia severa, evoluindo à óbito. O paciente fazia uso crônico de sinvastatina, e estava em tratamento com L-asparaginase, ambos fármacos, de modo separado, são relacionados com a ocorrência de pancreatite aguda severa. O algoritmo de Naranjo para estabelecimento de reação adversa a medicação classificou a causalidade entre as medicações citadas e a pancreatite aguda como provável. Porém, em razão da ausência relatos dessa causalidade, associa-se a pancreatite aguda ao uso de L-asparaginase, com possível interação medicamentosa com sinvastatina. Conclusão: É de suma importância o acompanhamento clínico e laboratorial de pacientes em uso de Lasparaginase para sinais de pancreatite aguda, sendo imprescindível o rápido diagnóstico e tratamento precoc

Structure and membrane interactions of the homodimeric antibiotic peptide homotarsinin

Antimicrobial peptides (AMPs) from amphibian skin are valuable template structures to find new treatments against bacterial infections. This work describes for the first time the structure and membrane interactions of a homodimeric AMP. Homotarsinin, which was found in Phyllomedusa tarsius anurans, consists of two identical cystine-linked polypeptide chains each of 24 amino acid residues. The high-resolution structures of the monomeric and dimeric peptides were determined in aqueous buffers. The dimer exhibits a tightly packed coiled coil three-dimensional structure, keeping the hydrophobic residues screened from the aqueous environment. An overall cationic surface of the dimer assures enhanced interactions with negatively charged membranes. An extensive set of biophysical data allowed us to establish structure-function correlations with antimicrobial assays against Gram-positive and Gram-negative bacteria. Although both peptides present considerable antimicrobial activity, the dimer is significantly more effective in both antibacterial and membrane biophysical assays.PMC524437

SARS-CoV-2 uses CD4 to infect T helper lymphocytes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as Coronavirus Disease 2019 (COVID-19). SARS-CoV-2 infects mainly lungs and may cause several immune-related complications, such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is still not fully understood. Here, we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS-CoV-2 in T helper cells. This leads to impaired CD4 T cell function and may cause cell death. SARS-CoV-2-infected T helper cells express higher levels of IL-10, which is associated with viral persistence and disease severity. Thus, CD4-mediated SARS-CoV-2 infection of T helper cells may contribute to a poor immune response in COVID-19 patients.</p

SARS-CoV-2 uses CD4 to infect T helper lymphocytes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as Coronavirus Disease 2019 (COVID-19). SARS-CoV-2 infects mainly lungs and may cause several immune-related complications, such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is still not fully understood. Here, we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS-CoV-2 in T helper cells. This leads to impaired CD4 T cell function and may cause cell death. SARS-CoV-2-infected T helper cells express higher levels of IL-10, which is associated with viral persistence and disease severity. Thus, CD4-mediated SARS-CoV-2 infection of T helper cells may contribute to a poor immune response in COVID-19 patients.</p

Glicerina bruta em suplementos para bovinos de corte a pasto no período seco

O objetivo deste trabalho foi avaliar o efeito da substituição do milho pela glicerina bruta (GB) sobre os parâmetros nutricionais e o desempenho de bovinos de corte em pastagem de Urochloa brizantha 'Marandu', no período seco. Para a avaliação dos parâmetros ruminais, foram utilizados cinco bovinos da raça Nelore não fistulados, com peso corporal (PC) inicial de 331,7±29,6 kg, distribuídos em delineamento em quadrado latino 5x5. Para a avaliação do desempenho, foram utilizados 30 bovinos, com PC médio de 312,4±23,3 kg, distribuídos em delineamento inteiramente casualizado. Avaliaram-se suplementos concentrados (20% de proteína bruta) com 0, 33, 66 e 100% de GB em substituição ao milho, fornecidos na quantidade de 4,0 kg por animal por dia. Os consumos de matéria seca (MS) de suplemento, total e de pasto, bem como o de matéria orgânica (MO) digestível, apresentaram comportamento quadrático frente aos níveis de substituição. As digestibilidades aparentes de MS, MO, fibra em detergente neutro e MO digerida, bem como o ganho médio diário, também apresentaram comportamento quadrático. Em suplementos concentrados fornecidos na quantidade de 10 g kg-1 de peso corporal, a substituição total do milho pela glicerina bruta reduz o consumo de suplemento e de matéria orgânica digerida, além do desempenho de bovinos de corte em pastejo