A dilatação da aorta ascendente é marcador de dilatação da aorta abdominal? Relações entre o diâmetro da aorta torácica avaliada por ecocardiografia e a aorta abdominal estudada por ultrassonografia

ResumoA identificação do aneurisma da aorta abdominal (AAA) e o seu tratamento eletivo, antes da rotura, é importante na redução da mortalidade e está na base dos programas de rastreio. Por outro lado, muitos doentes submetidos a Ecocardiografia Trans-Torácica (ETT) encontramse em grupo etário e apresentam os mesmos fatores de risco que os observados nos portadores de AAA.O objetivo do estudo foi analisar a associação entre a dilatação da aorta ascendente e o diâmetro das restantes partes da aorta no sentido de identificar fatores que pudessem ser usados para identificar um subgrupo de doentes em que pudesse estar indicada por rotina a avaliação da aorta abdominal durante a realização daquele exame.O estudo, mostrou que os doentes que apresentam dilatação da aorta ascendente têm maior risco de apresentarem dilatação da aorta abdominal. Esta observação é concordante com a literatura e reforça o conceito de que todos os pacientes com mais de 60 anos de idade submetidos a ecocardiografia onde é detetada a presença de dilatação da aorta ascendente, deverão fazer estudo ultrassonográfico da aorta abdominal que tem baixo custo, rapidez de execução e elevada fiabilidade.AbstractThe identification of abdominal aortic aneurysms (AAA) and its elective treatment, before rupture, is important to decrease mortality rates and is the basis of screening programs. On the other hand, many patients undergoing Transthoracic Echocardiography (ETT) share with AAA population demographic characteristics like age and risk factors.The aim of the study was to analyze the association between the diameter of the ascending aorta with the diameter of the remaining parts of the aorta in order to identify factors that could be used to select a sub-group of patients at higher risk of AAA on the basis of ETT information.The study showed that patients who present dilatation of the ascending aorta have increased risk of abdominal aorta dilatation. This observation is consistent with the literature and supports the concept that patients with more than 60 years old in which dilation of the ascending aorta on ETT is identified should be also assessed by abdominal in order to screen for AAA

The Nlrc4 Inflammasome Contributes to Restriction of Pulmonary Infection by Flagellated Legionella spp. that Trigger Pyroptosis

The Nlrc4 inflammasome is triggered in response to contamination of the host cell cytoplasm with bacterial flagellin, which induces pyroptosis, a form of cell death that accounts for restriction of bacterial infections. Although induction of pyroptosis has been extensively investigated in response to Salmonella typhimurium and Legionella pneumophila, little is known regarding the role of the inflammasome for restriction of non-pneumophila Legionella species. Here, we used five species of the Legionella genus to investigate the importance of the inflammasome for restriction of bacterial infection in vivo. By infecting mice deficient for inflammasome components, we demonstrated that caspase-1 and Nlrc4, but not Asc, contribute to restriction of pulmonary infection with L. micdadei, L. bozemanii, L. gratiana, and L. rubrilucens. L. longbeachae, a non-flagellated bacterium that fails to trigger pyroptosis, was not restricted by the inflammasome and induced death in the infected mice. In contrast to L. longbeachae, flagellin mutants of L. pneumophila did not induce mice death; therefore, besides bypassing the Nlrc4 inflammasome, L. longbeachae may employ additional virulence strategies to replicate in mammalian hosts. Collectively, our data indicate that the Nlrc4 inflammasome plays an important role in host protection against opportunistic pathogenic bacteria that express flagellin

Biological saline produced water treatment, a sustainable process towards lipids production

Oil and gas industry is responsible for the generation of large volumes of oil-contaminated wastewaters, such as saline produced water (PW), that without proper treatment can cause environmental contamination. Alcanivorax borkumensis SK2 is a biosurfactant producer capable of degrading and converting hydrocarbons into bacterial lipids under nutrient limiting conditions (e.g. nitrogen and/or oxygen). Recently, the industrial interest in biosurfactants and bacterial lipids for biotechnological applications (e.g. bioremediation or biofuels production) is increasing. Pursuing the interest of treating and simultaneously valorizing PW, a sequencing batch airlift reactor (SBAR) strategy consisting of sequential cycles of feast and famine stages was developed. A. borkumensis SK2 was used as bioreactor inoculum and the effect of cycle duration, total petroleum hydrocarbon to nitrogen ratio (TPH/N) and dissolved oxygen (DO) concentration (7-8 mg L-1 and 2-3 mg L-1 (famine and feast stage); and 7-8/1-2 mg L-1 (famine/feast stage)) were investigated. The system provided an efficient PW treatment, achieving TPH removal efficiencies in a narrow range from 90 ± 2.1 to 96 ± 1.8 %. Intracellular lipid production increased from 0.48 to 0.74 g g-1 of cellular dry weight (CDW) with the application of higher feast stage duration and lower TPH/N ratios suggesting that nitrogen availability is the most relevant factor to promote accumulation. Under 2-3 mg L-1 and 7-8/1-2 mg L-1 of oxygen, lipid accumulation dropped to 0.50 g g-1 of CDW. Intracellular lipid profile changed according to the DO concentration. Triacylglycerols (TAG) and wax esters (WE) were accumulated under maximum and limiting DO concentrations, while polyhydroxyalkanoates (PHA) accumulation was triggered by the application of alternated DO conditions, indicating that the type of intracellular compound can be selected by manipulating the oxygen concentration in the SBAR. Extracellular lipid production (TAG and WE) was not significantly affected by none of the operational conditions applied (0.06 g L-1). Moreover, the production of a cell-bound and an extracellular glycolipid biosurfactant capable of reducing the medium surface tension from 65 to approximately 41 mN m-1 was observed. The proposed strategy showed that biological PW treatment in a SBAR can be a sustainable process through the production of added-value compounds contributing to a circular economy model.This research was supported by the Portuguese Foundation for Science and Technology (FCT I.P.) and European Regional Development Fund (ERDF) under the scope of project SaltOil+ (POCI-01- 0145- FEDER-030180) (Portugal 2020, COMPETE 2020); Rita M. Silva PhD grant (SFRH/BD/116154/2016) was funded by FCT.info:eu-repo/semantics/publishedVersio

Percutaneous endoscopic versus surgical gastrostomy in patients with benign and malignant diseases: a systematic review and meta-analysis

To compare the complications and mortality related to gastrostomy procedures performed using surgical and percutaneous endoscopic gastrostomy techniques, this review covered seven studies. Five of these were retrospective and two were randomized prospective studies. In total, 406 patients were involved, 232 of whom had undergone percutaneous endoscopic gastrostomy and 174 of whom had undergone surgical gastrostomy. The analysis was performed using Review Manager. Risk differences were computed using a fixed-effects model and forest and funnel plots. Data on risk differences and 95% confidence intervals were obtained using the Mantel-Haenszel test. There was no difference in major complications in retrospective (95% CI (-0.11 to 0.10)) or randomized (95% CI (-0.07 to 0.05)) studies. Regarding minor complications, no difference was found in retrospective studies (95% CI (-00.17 to 0.09)), whereas a difference was observed in randomized studies (95% CI (-0.25 to -0.02)). Separate analyses of retrospective and randomized studies revealed no differences between the methods in relation to mortality and major complications. Moreover, low levels of minor complications were observed among endoscopic procedures in randomized studies, with no difference observed compared with retrospective studies

High efficacy of ozonated oils on the removal of biofilms produced by methicillin-resistant staphylococcus aureus (MRSA) from infected diabetic foot ulcers

© 2020 by the authors. Ozone has a high wound healing capacity and antibacterial properties and can be used as a complementary treatment in infections. Methicillin-resistant S. aureus (MRSA) is the most common pathogen found in infected diabetic foot ulcers. Most of MRSA are resistant to several classes of antibiotics and, therefore, there is a need for new, effective, and well-tolerated agents. Thus, we aimed evaluate the antimicrobial and antibiofilm potentials of ozonated vegetable oils against MRSA strains isolated from diabetic foot ulcers. Six ozonated oils were produced with concentrations of ozone ranging from 0.53 to 17 mg of ozone/g of oil. The peroxide values were determined for each oil. Ozonated oils content on fatty acid was determined by gas chromatography equipped with a flame ionization detector. The antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method and the effect of ozonated oils on biofilm formation ability and on established biofilms was investigated. In general, the content in identified unsaturated fatty acid in oils decreased with the increase of ozonation time and, consequently, the peroxide value increased. Most bacterial strains were inhibited by ozonated oil at a concentration of 4.24 mg/g. Ozonated oils had moderate to high ability to remove adhered cells and showed a high capacity to eradicate 24 h old biofilms. Our results show promising use of ozonated oils on the treatment of infections, in particular those caused by multidrug-resistant MRSA strains.This work was funded by the R&D Project CAREBIO2—Comparative assessment of antimicrobial resistance in environmental biofilms through proteomics—towards innovative theranostic biomarkers, with reference NORTE-01-0145-FEDER-030101 and PTDC/SAU-INF/30101/2017, financed by the European Regional Development Fund (ERDF) through the Northern Regional Operational Program (NORTE 2020) and the Foundation for Science and Technology (FCT). This work was supported by the Associate Laboratory for Green Chemistry—LAQV, which is financed by national funds from FCT/MCTES (UIDB/50006/2020). Joana S. Amaral is grateful to the Foundation for Science and Technology (FCT, Portugal) for financial support by national funds FCT/MCTES to CIMO (UIDB/00690/2020). Vanessa Silva is grateful to FCT (Fundação para a Ciência e a Tecnologia) for financial support through PhD grant SFRH/BD/137947/2018.info:eu-repo/semantics/publishedVersio

The effect of bevacizumab, 5-fluorouracil, and triamcinolone on the healing modulation of surgical wounds in rats

In this study, we aimed to analyze the effect of 5-fluorouracil, triamcinolone, and bevacizumab on scar modulation in an experimental rat model of surgical lesions. Rats (Rattus norvegicus albinus) were divided into four groups: bevacizumab, 5-fluorouracil + triamcinolone, bevacizumab + 5-fluorouracil + triamcinolone, and control (received no medication) groups. A linear, dorsal incision was created and sutured for the first intention wound healing, mimicking the surgical incision of upper blepharoplasty. Treatments were initiated on day 7, and the rats were euthanized on day 14. Only in the 5-fluorouracil + triamcinolone group was there a difference in the number of infiltrated monocytes. There was 56%, 86%, and 85% decrease in the number of neovessels in the bevacizumab, 5fluorouracil + triamcinolone, and bevacizumab + 5fluorouracil + triamcinolone groups, respectively, compared with the control. Picrosirius red staining showed higher collagen density and more organized collagen in the treatment groups than in the control group. Scar modulation was observed in all groups, but the 5-fluorouracil + triamcinolone group presented the best results. To our knowledge, this is the first study to evaluate the influence of three medications in combination on healing. When used together, these medications can prevent the development of unsightly scars, and are therefore promising alternatives to corticosteroids

Caracterización del limbo de Piper aduncum L. (Piperaceae): Análisis estructurales, histoquímicos y de sus aceites esenciales

Piper aduncum L. is a shrub specie, found mainly in soil with elevated organic matter and humidity. The essential oil containing insecticide and bactericide action, and also has broad application in agricultural and medicinal areas. The objective of this study is to characterize the lamina of P. aduncum. There was realized anatomical and histochemical characterization of paradermic, and anatomical characterization of transversal sections from apical region, median and basal of leaf blade, prepared according to usual technique of light and electronic microscopy of scaning. The mesophyll is dorsiventral with subcelular layer in both epiderms. In the epidermis and subcelular layers, it was only found the presence of total protein. In the palisade and spongyous parenchyma were found starch total and insaturated lipids. In the fundamental parenchyma there were visualized starch, protein, total lipids, ortodihidroxiphenols and terpenoid with carbonil group. There are present unicellular idioblasts in subcelular layers, epiderm or mesophyll. It is hipoestomatic, contains tetracitic stomates. There were observed short trichome tector unicellular with fine cap, pluricelular with fine cap and glandular saclike trichome and perolated glandula. In the basal portion of the tector trichomes there were found total protein. In the oil idioblast there were observed the presence of total lipids, ortodihidroxiphenols, sesquiterpenic lactones and terpenoid with carbonil group, while it was possible to observe in the sac-like trichomes, protein, total lipids and ortodihidroxiphenols.Piper aduncum L. (Piperaceae) es una especie arbustiva umbrófila que se encuentra generalmente en suelos con elevado contenido de materia orgánica y humedad. De las hojas se extrae aceite esencial con acción insecticida, fungicida y bactericida, con una amplia utilización en el sector agrario y medicinal. El objetivo del trabajo fue caracterizar el limbo de P. aduncum. Se efectuó la caracterización anatómica e histoquímica de la sección transversal y la caracterización anatómica de la sección paradérmica apical, mediana y basal del limbo. Para ello las hojas fueron preparadas con las técnicas tradicionales de microscopía de luz y microscopía electrónica. El mesófilo es dorsiventral con capas subcelulares en ambas epidermis. En la epidermis y las capas subcelulares sólo se encontró la presencia de proteínas totales. En el parénquima en empalizada y en el parénquima esponjoso fueron observados almidón, lípidos totales e insaturados. En el parénquima fundamental fueron encontrados almidón, proteína, lípidos totales, ortodihidroxifenoles y terpenoides con grupo carbonilo. Están presentes idioblastos unicelulares en las capas subcelulares de la epidermis del mesófilo hipoestomático, los estomas son tetracíticos y salientes. En los idioblastos oleíferos fue detectada la presencia de lípidos totales, ortodihidroxifenoles, lactonas sesquiterpénicas y terpenoides con grupo carbonilo. Fueron observados tricomas tectores unicelulares cortos, de extremos agudos, pluricelulares de extremos agudos y capitados, y tricomas glandulares saculares y glándulas perladas. En la porción basal de los tricomas tectores fueron encontradas proteínas totales y en los tricomas saculares, proteína, lípidos totales y ortodihidroxifenoles

Tuberculosis Caused by Mycobacterium tuberculosis Complex in a Captive Tapir (Tapirus terrestris)

Background: Tuberculosis is an infectious disease caused by the Mycobacterium tuberculosis complex has already been identified in a great number of wild species. Captive animals may have a potential source for zoonoses, because is related to factors such as cohabitation, direct contact with the public, presence of biological vectors, nutritional deficiencies, absence of sanitary barriers, precautionary hygienic measures and sanitary vigilance. In Brazil, there is little information on tuberculosis in captivity animals, and little attention is given to the risks of disease transmission from humans. The aim of this study was to report the first diagnosed case of tuberculosis Tapirus terrestris in Brazilian Amazon region.Case: One Tapirus terrestris was kept by local zoobotanic foundation in city of Marabá, Southeast of Pará state, Brazilian Amazon, and became ill. Physical examination revealed cough, sneezing, nasal outflow, dyspnea, hyperthermia and lethargy, leading to death. Necropsy demonstrated severe pulmonary alterations: thickening of the inter-alveolar septa, alveolar emphysema, and miliary nodules with dimensions up to 5 mm, which were yellowish-white, caseous, and sometimes calcified. Additionally, large areas of caseous compaction of the parenchyma, characteristic of caseous tuberculosis. Histopathological analysis revealed a process characteristic of mycobacterial infection, with alveoli filled with caseous exudate and thickened septa and fibrocytes, in addition to recently formed tubercles, some with caseous necrosis, calcifications and Langhans cells. In the Ziehl-Neelsen staining, alcohol-acid resistant bacilli were observed in the mesenteric lymph nodes. No mycobacterial growth was observed in Lowenstein-Jensen culture medium. A nested PCR followed by a sequencing assay targeting the hsp65 gene and M. tuberculosis complex member was detected. Water and M. tuberculosis H37Rv were used as negative and positive controls, respectively.Discussion: This article reports the first case of tuberculosis in T. terrestris in Amazonia. The case of infection was caused by a complex of Mycobacterium tuberculosis, as well as reports of other studies described in wild animals. This record presented clinical and pathological similarity with the cases of a tapir and coati at the zoo of Curitiba, and non-human primates in bioteries in Belém. The disease was reported, also, in a T. indicus female in Bangkok, Thailand. In another study with two tapirs there was positivity of tuberculin test result in a Swedish zoo. In necropsy findings of tuberculosis in a Malayan tapir showed multiple white, caseous nodules spread throughout the lungs. Studies have shown that lesions can be in various organs, among them the mediastinal and mesenteric lymph nodes, liver, spleen, kidneys, ovaries, serosa, diaphragm, intestines and uterus. For exemple in a case of disseminated tuberculosis caused by M. tuberculosis in a Malayan tapir were described multiple granulomes, some coalescent, characterized by necrotic caseous centers, with some Langhans giant cells and a discrete fibrotic zone. In the present work, the results of the anatomopathological and molecular assays confirmed the clinical suspicion of respiratory infection and established the conclusive diagnosis of pulmonary tuberculosis caused by M. tuberculosis complex member. It is worth noting that tuberculosis is an important zoonotic disease affecting survival of the species, posing an extinction threat and also a public health concern