Application of clinical indexes in ulcerative colitis patients in regular follow-up visit. correlation with endoscopic 'mucosal healing' and implication for management

OBJECTIVE: Ulcerative Colitis (UC) is a chronic inflammatory disease of the colon of unknown etiology. Several clinical indexes have been proposed for UC disease activity evaluation, but none have been properly validated. Moreover, the reference parameter for the scores and their prognostic value is not clear. Mucosal healing has been recently proposed as an important end-point. Aim of the present study was to evaluate the correlation of four clinical indexes with objective diagnostic tools for UC evaluation, the discriminative ability in identifying patients with endoscopic mucosal healing, and to analyze the possible prognostic indication for disease course in 1 year of follow-up. PATIENTS AND METHODS: We analyzed data of 75 patients recorded in regular follow-up visit in IBD clinic at S. Andrea Hospital, Rome, between 2007-2011. We recorded clinical data and lab tests at the time of the visit, and endoscopic/ histological repor ts performed within 1 month. Clinical indexes (Seo' activity index, Simple Clinical Colitis Activity Index, partial Mayo score and Endoscopic-Clinical Correlation Index) were calculated and correlation to endoscopic and histologic activity, and to C-reactive protein increment, was assessed by mean of Spearman's rank correlation. Discriminative ability of the indexes for patients with and without endoscopic mucosal healing was tested by calculation of area under ROC curve (AUC). Patients with low and high clinical scores were compared for number of flares and increment of therapy during 1 year of follow-up. RESULTS: Clinical indexes had a good correlation with endoscopic activity (mean r = 0.73 ± 0.06), a fair correlation with CRP-increment (mean r = 0.55 ± 0.01) and a poor one with histologic activity (mean r = 0.35 ± 0.01). The discriminatory ability of the indexes for endoscopic mucosal healing was good for all the indexes (mean AUC = 0.87 ± 0.05). Patients with high clinical score had more flares and required more frequently increase of therapy at 1 year of follow up compared with patients with low score. CONCLUSIONS: Clinical indexes have a good correlation with endoscopic activity and can discriminate patients with and without mucosal healing. Patients with low and high score have different risk of disease flare and of need to increase therapy at 1 year. Clinical indexes may represent a useful tool for disease assessment in clinical practice in UC outpatients with mildmoderate disease

Treatment of venous thromboembolism

Deep vein thrombosis (DVT) is defined as an episode of thrombosis involving deep veins, usually of the lower limbs. DVT is frequently accompanied by pulmonary embolism (PE). Venous thromboembolism (VTE) is the generic term commonly used to refer to both clinical conditions indistinctly. In this paper, we present a brief review of current concepts in the treatment of VTE. Use of unfractionated and low molecular weight heparin is approached, and special attention is given to its transition to long term use of oral anticoagulants. In addition, specific therapeutic measures in special clinical conditions and in the supportive management of patients with VTE are also discussed.A trombose venosa profunda (TVP) é definida como um episódio de trombose, envolvendo as veias profundas dos membros inferiores. A TVP é freqüentemente acompanhada por embolia pulmonar (EP). Tromboembolismo venoso (TEV) é o termo empregado para designar ambas as eventualidades indistintamente. No presente artigo, oferecemos uma breve revis ão dos conceitos atualmente preconizados para o tratamento do TEV. São abordados aspectos relativos à utilização da heparina não fracionada, aos novos esquemas terapêuticos com as heparinas de baixo peso molecular e à transição para o tratamento clássico com anticoagulantes orais a longo prazo. Adicionalmente, são discutidas condutas em situações clínicas especiais, além de medidas terapêuticas que se mostraram eficazes no tratamento de pacientes com TEV

Diagnostic investigation of bleeding disorders

Na presente revisão, discutimos as ferramentas clínicas e laboratoriais, utilizadas na investigação de distúrbios hemorrágicos.In this review we discuss the importance of several clinical and laboratory tools currently used in the investigation of bleeding disorders

Lewis X antigen mediates adhesion of human breast carcinoma cells to activated endothelium. Possible involvement of the endothelial scavenger receptor C-Type lectin

Lewis x (Lex, CD15), also known as SSEA-1 (stage specific embryonic antigen-1), is a trisaccharide with the structure Galβ(1–4)Fucα(1–3)GlcNAc, which is expressed on glycoconjugates in human polymorphonuclear granulocytes and various tumors such as colon and breast carcinoma. We have investigated the role of Lex in the adhesion of MCF-7 human breast cancer cells and PMN to human umbilical endothelial cells (HUVEC) and the effects of two different anti-Lex mAbs (FC-2.15 and MCS-1) on this adhesion. We also analyzed the cytolysis of Lex+-cells induced by anti-Lex mAbs and complement when cells were adhered to the endothelium, and the effect of these antibodies on HUVEC. The results indicate that MCF-7 cells can bind to HUVEC, and that MCS-1 but not FC-2.15 mAb inhibit this interaction. Both mAbs can efficiently lyse MCF-7 cells bound to HUVEC in the presence of complement without damaging endothelial cells. We also found a Lex-dependent PMN interaction with HUVEC. Although both anti-Lex mAbs lysed PMN in suspension and adhered to HUVEC, PMN aggregation was only induced by mAb FC-2.15. Blotting studies revealed that the endothelial scavenger receptor C-type lectin (SRCL), which binds Lex-trisaccharide, interacts with specific glycoproteins of Mr␣∼␣28 kD and 10 kD from MCF-7 cells. The interaction between Lex+-cancer cells and vascular endothelium is a potential target for cancer treatment.Fil: Elola, Maria Teresa. Fundación Instituto Leloir; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Capurro, Mariana Isabel. University of Toronto; CanadáFil: Barrio, Maria Marcela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Investigación, Docencia y Prevención del Cáncer; ArgentinaFil: Coombs, Peter J.. Imperial College London; Reino UnidoFil: Taylor, Maureen E.. Imperial College London; Reino UnidoFil: Drickamer, Kurt. Imperial College London; Reino UnidoFil: Mordoh, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Investigación, Docencia y Prevención del Cáncer; Argentin

Physiological quality, content and activity of antioxidants in soybean seeds artificially aged.

ABSTRACT - The objective of this study was to evaluate physiological quality, content, and activity of antioxidants, in soybean seeds subjected to accelerated aging during different periods. Seeds of cultivars BRS 258, BRS 262 and BRS 268, subjected to accelerated aging during 12, 24, 36 and 48 hours and non-aged seeds were used. After each aging period, the seed were evaluated by tests of: germination; first count and tetrazolium. The total of phenolic compounds, total flavonoides, total of isoflavones, and activity for eliminating ABTS°+ radicals were quantified. There were differences among cultivars according to vigor and viability only after seeds were aged. Cultivars BRS 158 and BRS 268 have shown better seed physiological quality in each aging period; however, not presenting higher amounts of isoflavones and efficiency in removing free radicals. For all cultivars, the values for total of phenolic compounds, as well as total of flavonoids have shown quadratic positive behavior; the values for isoflavones remained constant and the vigor and viability showed contrary trend to activity of antioxidant agents. RESUMO: Qualidade fisiológica, conteúdo e atividade de antioxidantes presentes em sementes de soja envelhecidas artificialmente. O objetivo deste trabalho foi avaliar a qualidade fisiológica, o conteúdo e a atividade de agentes antioxidantes presentes em sementes de soja envelhecidas durante diferentes períodos. Foram utilizadas sementes das cultivares BRS 258, BRS 262 e BRS 268, envelhecidas durante 12, 24, 36 e 48 h e sementes não envelhecidas. Após cada período de envelhecimento, as sementes foram avaliadas pelo testes de: germinação; primeira contagem e tetrazólio. Foram quantificados: compostos fenólicos totais; flavonóides totais; total de isoflavonas e atividade eliminadora do radical ABTS°+. Houve diferença entre as cultivares em relação ao vigor e viabilidade somente quando foram envelhecidas. BRS 158 e BRS 268 apresentaram melhor qualidade fisiológica de sementes em cada período de envelhecimento, porém, não apresentaram maior quantidade de isoflavonas e eficiência no sequestro dos radicais livres. Para todas as cultivares, os valores de compostos fenólicos totais, assim como os flavonóides totais, apresentaram comportamento quadrático positivo; os valores das isoflavonas permaneceram constantes e o vigor e a viabilidade apresentaram tendência contrária à atividade dos agentes antioxidantes

A novel xylan degrading β-D-xylosidase: purification and biochemical characterization

Aspergillus ochraceus, a thermotolerant fungus isolated in Brazil from decomposing materials, produced an extracellular b-xylosidase that was purified using DEAE-cellulose ion exchange chromatography, Sephadex G-100 and Biogel P-60 gel filtration. b-xylosidase is a glycoprotein (39 % carbohydrate content) and has a molecular mass of 137 kDa by SDS-PAGE, with optimal temperature and pH at 70 C and 3.0–5.5, respectively.b-xylosidase was stable in acidic pH (3.0–6.0) and 70 C for 1 h. The enzyme was activated by 5 mM MnCl2 (28 %)and MgCl2 (20 %) salts. The b-xylosidase produced by A. ochraceus preferentially hydrolyzed p-nitrophenyl-b- D-xylopyranoside, exhibiting apparent Km and Vmax values of 0.66 mM and 39 U (mg protein)-1 respectively, and to a lesser extent p-nitrophenyl-b-D-glucopyranoside. The enzyme was able to hydrolyze xylan from different sources,suggesting a novel b-D-xylosidase that degrades xylan. HPLC analysis revealed xylans of different compositions which allowed explaining the differences in specificity observed by b-xylosidase. TLC confirmed the capacity.This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), and the Conselho de Desenvolvimento Científico e Tecnológico (CNPq). J. A. J. and M. L. T. M. P are Research Fellows of CNPq. M. M. was a recipient of a FAPESP fellowship and this work is part of her Doctoral Thesis. It is also part of the project SISBIOTA CNPq: 563260/2010-6 and FAPESP: 2010/52322-3

Human toxocariasis: contribution by Brazilian researchers

In the present paper the main aspects of the natural history of human infection by Toxocara larvae that occasionally result in the occurrence of visceral and/or ocular larva migrans syndrome were reviewed. The contribution by Brazilian researchers was emphasized, especially the staff of the Tropical Medicine Institute of São Paulo (IMT)