Mari-mari (Cassia leiandra Benth.) is an Amazonian native fruit that is highly appreciated in the northern region of Brazil, but there are few studies regarding its chemical composition and/or biological properties. A phytochemical study was conducted on the extracts of the pulp, peel and seeds; and their antioxidant, cytotoxic and antimicrobial potential were also determined. Methanol and acetone extracts from different fruit parts were subjected to total phenolic, 2,2-diphenyl-1 picrylhydrazyl (DPPH) radical scavenging and FeIII reducing capacity (FRAP) assays. From the peel extracts, the engeletin and astilbin could also be isolated and characterized based on nuclear magnetic resonance spectroscopy and high-resolution mass spectrometry. A quantification using ultra-fast liquid chromatography of acetone dry crude extracts (DCE) of the peel showed that engeletin was the main compound (532.77 mg g-1 DCE). Astilbin content was also determined (131.53 mg g-1 DCE). The antibacterial and antiproliferative activities were evaluated and the methanol extract of the peel showed higher growth inhibition activity against all tested bacteria. Engeletin showed a relevant antimicrobial effect against Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli. Acetone and methanol peel extracts exhibited a relevant inhibitory effect on the proliferation of breast carcinoma cells (MCF-7), with no toxicity to the normal cell line (NIH/3T3).

Abstract Zoonotic spillover is a phenomenon characterized by the transfer of pathogens between different animal species. Most human emerging infectious diseases originate from non-human animals, and human-related environmental disturbances are the driving forces of the emergence of new human pathogens. Synthesizing the sequence of basic events involved in the emergence of new human pathogens is important for guiding the understanding, identification, and description of key aspects of human activities that can be changed to prevent new outbreaks, epidemics, and pandemics. This review synthesizes the connections between environmental disturbances and increased risk of spillover events based on the One Health perspective. Anthropogenic disturbances in the environment (e.g., deforestation, habitat fragmentation, biodiversity loss, wildlife exploitation) lead to changes in ecological niches, reduction of the dilution effect, increased contact between humans and other animals, changes in the incidence and load of pathogens in animal populations, and alterations in the abiotic factors of landscapes. These phenomena can increase the risk of spillover events and, potentially, facilitate new infectious disease outbreaks. Using Brazil as a study model, this review brings a discussion concerning anthropogenic activities in the Amazon region and their potential impacts on spillover risk and spread of emerging diseases in this region.

A adesão a uma alimentação saudável depende de fatores como os preços dos alimentos, sendo que alguns estudos conduzidos em países desenvolvidos apontam para um maior custo de uma alimentação de melhor qualidade nutricional. O objetivo do presente trabalho foi avaliar o custo direto da alimentação de indivíduos adultos com doença cardiovascular no Brasil, investigando a relação entre o custo e a qualidade da dieta. Foram utilizados os dados de um ensaio clínico randomizado, o BALANCE Program. A investigação atual é uma análise transversal no momento inicial dos participantes com alta adesão ao estudo realizado em 35 centros das cinco regiões brasileiras. O consumo alimentar de amostra com 1.160 indivíduos foi coletado pelo recordatório alimentar de 24 horas (R24h), a avaliação da qualidade da dieta pelo Índice da Qualidade da Dieta Revisado (IQD-R) e os custos diretos da alimentação foram estimados por meio de preços de mercado. Não foram observadas diferenças significativas no custo direto da alimentação ou características dos indivíduos entre os tercis de adesão. Quando analisados todos os recordatórios não houve correlação entre custo e qualidade da dieta (r = 0,38; p = 0,17), já a análise por tercis mostrou fraca correlação entre o menor tercil de adesão (r = -0,112; p = 0,03). O presente estudo apontou ausência de diferenças entre os custos diretos da alimentação classificada como saudável e daquela com a pior qualidade nutricional, o que pode ser um incentivo à adesão às orientações alimentares no Brasil, minimizando barreiras à adoção de estilos de vida saudáveis.

Adherence to a healthy diet depends on factors such as food prices, while studies in developed countries have identified higher costs of more nutritional foods. The current study aimed to assess the direct food expenditures by adults with cardiovascular disease in Brazil, investigating the relationship between cost and quality of diet. The study used data from a randomized clinical trial, the BALANCE Program. The current study is a cross-sectional baseline analysis of participants with high adherence to the trial, conducted in 35 sites in all five major geographic regions of Brazil. Food consumption by 1,160 individuals was collected with a 24-hour dietary recall (24HR), quality of diet was measured with the Diet Quality Index Revised (DQI-R), and direct food costs were estimated from market prices. No significant differences were observed between tertiles of adherence in the direct costs of food or individual characteristics. When all the 24HR were analyzed, there was no correlation between cost and quality of diet (r = 0.38; p = 0.17), while analysis by tertiles showed a weak correlation in the lowest tertile of adherence (r = -0.112; p = 0.03). The study showed absence of differences between direct costs of healthy versus unhealthy foods, a finding that can serve as an incentive for adherence to food recommendations in Brazil, thereby minimizing barriers to the adoption of healthy lifestyles.

La adhesión a una alimentación saludable depende de factores como los precios de los alimentos, siendo que algunos estudios realizados en países desarrollados apuntan hacia un mayor coste de una alimentación de mejor calidad nutricional. El objetivo del presente estudio fue evaluar el coste directo de la alimentación en individuos adultos con enfermedad cardiovascular en Brasil, investigando la relación entre el coste y la calidad de la dieta. Se utilizaron los datos de un ensayo clínico aleatorio, el BALANCE Program. La investigación actual es un análisis transversal desde el principio con participantes de alta adhesión al estudio, realizado en 35 centros de las cinco regiones brasileñas. El consumo alimentario de la muestra con 1.160 individuos fue recogido mediante el recordatorio alimentario de 24 horas (R24h), la evaluación de la calidad de la dieta se evaluó mediante el Índice de Calidad de la Dieta Revisado (IQD-R por sus siglas en portugués) y los costes directos de la alimentación se estimaron mediante precios de mercado. No se observaron diferencias significativas en el coste directo de la alimentación o características de los individuos entre los terciles de adhesión. Cuando se analizaron todos los recordatorios no hubo correlación entre coste y calidad de la dieta (r = 0,38; p = 0,17), ya en el análisis por terciles hubo una débil correlación entre el menor tercil de adhesión (r = -0,112; p = 0,03). El presente estudio apuntó una ausencia de diferencias entre los costes directos de la alimentación clasificada como saludable y aquella con peor calidad nutricional, lo que puede ser un incentivo para la adhesión a las orientaciones alimentarias en Brasil, minimizando barreras para la adopción de estilos de vida saludables.

A adesão a uma alimentação saudável depende de fatores como os preços dos alimentos, sendo que alguns estudos conduzidos em países desenvolvidos apontam para um maior custo de uma alimentação de melhor qualidade nutricional. O objetivo do presente trabalho foi avaliar o custo direto da alimentação de indivíduos adultos com doença cardiovascular no Brasil, investigando a relação entre o custo e a qualidade da dieta. Foram utilizados os dados de um ensaio clínico randomizado, o BALANCE Program. A investigação atual é uma análise transversal no momento inicial dos participantes com alta adesão ao estudo realizado em 35 centros das cinco regiões brasileiras. O consumo alimentar de amostra com 1.160 indivíduos foi coletado pelo recordatório alimentar de 24 horas (R24h), a avaliação da qualidade da dieta pelo Índice da Qualidade da Dieta Revisado (IQD-R) e os custos diretos da alimentação foram estimados por meio de preços de mercado. Não foram observadas diferenças significativas no custo direto da alimentação ou características dos indivíduos entre os tercis de adesão. Quando analisados todos os recordatórios não houve correlação entre custo e qualidade da dieta (r = 0,38; p = 0,17), já a análise por tercis mostrou fraca correlação entre o menor tercil de adesão (r = -0,112; p = 0,03). O presente estudo apontou ausência de diferenças entre os custos diretos da alimentação classificada como saudável e daquela com a pior qualidade nutricional, o que pode ser um incentivo à adesão às orientações alimentares no Brasil, minimizando barreiras à adoção de estilos de vida saudáveis.

Adherence to a healthy diet depends on factors such as food prices, while studies in developed countries have identified higher costs of more nutritional foods. The current study aimed to assess the direct food expenditures by adults with cardiovascular disease in Brazil, investigating the relationship between cost and quality of diet. The study used data from a randomized clinical trial, the BALANCE Program. The current study is a cross-sectional baseline analysis of participants with high adherence to the trial, conducted in 35 sites in all five major geographic regions of Brazil. Food consumption by 1,160 individuals was collected with a 24-hour dietary recall (24HR), quality of diet was measured with the Diet Quality Index Revised (DQI-R), and direct food costs were estimated from market prices. No significant differences were observed between tertiles of adherence in the direct costs of food or individual characteristics. When all the 24HR were analyzed, there was no correlation between cost and quality of diet (r = 0.38; p = 0.17), while analysis by tertiles showed a weak correlation in the lowest tertile of adherence (r = -0.112; p = 0.03). The study showed absence of differences between direct costs of healthy versus unhealthy foods, a finding that can serve as an incentive for adherence to food recommendations in Brazil, thereby minimizing barriers to the adoption of healthy lifestyles.

La adhesión a una alimentación saludable depende de factores como los precios de los alimentos, siendo que algunos estudios realizados en países desarrollados apuntan hacia un mayor coste de una alimentación de mejor calidad nutricional. El objetivo del presente estudio fue evaluar el coste directo de la alimentación en individuos adultos con enfermedad cardiovascular en Brasil, investigando la relación entre el coste y la calidad de la dieta. Se utilizaron los datos de un ensayo clínico aleatorio, el BALANCE Program. La investigación actual es un análisis transversal desde el principio con participantes de alta adhesión al estudio, realizado en 35 centros de las cinco regiones brasileñas. El consumo alimentario de la muestra con 1.160 individuos fue recogido mediante el recordatorio alimentario de 24 horas (R24h), la evaluación de la calidad de la dieta se evaluó mediante el Índice de Calidad de la Dieta Revisado (IQD-R por sus siglas en portugués) y los costes directos de la alimentación se estimaron mediante precios de mercado. No se observaron diferencias significativas en el coste directo de la alimentación o características de los individuos entre los terciles de adhesión. Cuando se analizaron todos los recordatorios no hubo correlación entre coste y calidad de la dieta (r = 0,38; p = 0,17), ya en el análisis por terciles hubo una débil correlación entre el menor tercil de adhesión (r = -0,112; p = 0,03). El presente estudio apuntó una ausencia de diferencias entre los costes directos de la alimentación clasificada como saludable y aquella con peor calidad nutricional, lo que puede ser un incentivo para la adhesión a las orientaciones alimentarias en Brasil, minimizando barreras para la adopción de estilos de vida saludables.

Abstract Abstract: This study evaluated the effect of oregano essential oil added to the feed of commercial laying hens. This research was focused on the analysis of biochemical changes linked to hepatic function, and protein and lipid metabolism. It was used 240 laying hens (59 weeks-old) distributed in a completely randomized design of six treatments (five repetitions with eight birds each). The experiments were constituted by a control treatment (CT) with the inclusion of zinc bacitracin and five treatments of oregano essential oil (OEO: 0, 50, 100, 150, and 200 mg.kg-1), respectively. After 28 days of feeding, an increase on serum levels of total proteins and globulins was observed on groups T150 and T200, as well as an increase on albumin levels on group CT. After 84 days of feeding, a significant reduction on total proteins and albumin was observed on group T200, as well as an increase in serum triglycerides. OEO at 200 mg.kg-1 increased globulin levels on day 28, which may be considered an effect in the inflammatory response, which increases serum immunoglobulins and proteins.

ABSTRACT Although the use of vaccines has controlled enteric diseases in dogs in many developed countries, vaccine coverage is still under optimal situation in Brazil. There is a large population of nonimmunized dogs and few studies about the identification of the viruses associated with diarrhea. To address this situation, stool samples from 325 dogs were analyzed by polymerase chain reaction for the detection of common enteric viruses such as Canine adenovirus (CAdV), Canine coronavirus (CCoV), Canine distemper virus (CDV), Canine rotavirus (CRV) and Carnivorous protoparvovirus 1 (canine parvovirus 2; CPV-2). At least one of these species was detected in 56.6% (184/325) of the samples. The viruses detected most frequently in either diarrheic or nondiarrheic dog feces were CPV-2 (54.3% of the positive samples), CDV (45.1%) and CCoV (30.4%), followed by CRV (8.2%) and CAdV (4.9%). Only one agent was detected in the majority of the positive samples (63%), but co-infections were present in 37% of the positive samples and mainly included CDV and CPV-2. The data presented herein can improve the clinical knowledge in regions with low vaccine coverage and highlight the need to improve the methods used to control these infectious diseases in domestic dogs.

Abstract Much of the patients with multiple myeloma present with signs and symptoms related to plasma cells infiltration or by the excess of kappa light chains. Kidney disease is common and has a heterogeneous pathophysiology that may involve different mechanisms. We present the case of a patient with suspected multiple myeloma because of low back pain, renal failure, anemia and hypercalcemia; without hipergammaglobulinemia in the electrophoresis, in whom the diagnosis was confirmed by the presence of kappa chains light in renal tissue; a review of current literature is made.

Resumen Gran parte de los pacientes con mieloma múltiple inician con signos y síntomas relacionados con la infiltración de células plasmáticas o el exceso de cadenas ligeras kappa. La enfermedad renal es común con enfermedad heterogénea que puede involucrar diferentes mecanismos. Se comunica el caso de un paciente con sospecha de mieloma múltiple debido a la existencia de lumbalgia, insuficiencia renal, anemia e hipercalcemia; con electroforesis de proteínas séricas negativa para hipergammaglobulinemia, en quien se confirmó el diagnóstico al demostrar la existencia de cadenas ligeras kappa en tejido renal; se realiza una revisión de la bibliografía actual.

RESUMO O reconhecimento das informações químicas indicando a presença de predadores é muito importante para a sobrevivência da presa. Neste estudo foi testada a resposta comportamental anti-predação de juvenis de jundiás (Rhamdia quelen) a substâncias liberadas por dois predadores potenciais, Hoplias malabaricus e a cobra Helicops infrataeniatus, e substâncias de alarme liberadas por conspecíficos e pelas espécies não predadoras Megaleporinus obtusidens e Astyanax lacustris. Foram usados juvenis de jundiá que não possuíam nenhum contato prévio com predadores. Os testes consistiram em observações de períodos de 10 minutos pré estímulo e 10 minutos pós estímulo. As respostas comportamentais apresentadas pelos jundiás expostos às substâncias de alarme consistiram em diminuição no uso do abrigo, aumento na locomoção e também um longo período de latência antes de ingerir o alimento. Os resultados demonstram que juvenis de jundiá percebem substâncias químicas liberadas por predadores, heterospecíficos e conspecíficos.

ABSTRACT The recognition of chemical information indicating the presence of a predator is very important for prey survival. In this study we tested antipredator behavioral response of juvenile silver catfish (Rhamdia quelen) against predator odor released by two different potential predators, Hoplias malabaricus and the snake Helicops infrataeniatus, and alarm cues and disturbance cues released by conspecifics and by non-predator species, Megaleporinus obtusidens and Astyanax lacustris. We used juvenile catfish that were naive to predators. The trials consisted of a 10-min prestimulus and a 10-min post-stimulus observation period. The behavioral response displayed by silver catfish exposed to alarm cues comprised a decrease in shelter use and an increase in locomotion, and also a longer latency period before feeding. Our results showed that juvenile silver catfish can perceive chemical cues released by predators, heterospecifics and conspecifics.

ABSTRACT The Lu-Hf isotope system is not only an important geo chronometer but also a powerful tool for petrogenetic studies. To determine reliable analytical results of this system from rock and mineral samples, a protocol is established that includes appropriate sample digestion, a three-stage HREE-Hf ion-exchange separation procedure, a data acquisition protocol by MC-ICP-MS, and an R-based data reduction software package (IsotopeHf®) that transforms raw mass spectrome-try data into meaningful isotopie ratios, including all the necessary corrections for spiked samples. Our 176Hf/177Hf results of both mafic and felsic geochemical reference standards agree with those reported by other authors. However, results obtained using PicoTrace® pressure digestion system (DAS®) yield significantly higher 176Lu/177Hf for felsic rocks with high Hf content (> 15 ppm) compared to data obtained by Parr® bomb dissolution, indicating incomplete digestion of HFSE-rich phases like zircon under specific conditions of DAS® digestion. The high degree of Hf purity attained using our chemical procedure, MCI CP-MS measurement protocol, and the IsotopeHf® program yielded accurate data with reliable and reproducible Lu-Hf isotope ratios within typical analytical uncertainties.

RESUMEN El sistema isotópico Lu-Hf no es sólo un geocronómetro importante, también es una poderosa herramienta para estudios petro genéticos. Para determinar resultados analíticos confiables de este sistema a partir de muestras de rocas y minerales, se establece un protocolo que incluye una adecuada digestion de la muestra, un procedimiento de separación HREE-Hf por cromatografia de intercambio iònico en tres etapas, un esquema para adquisición de datos por MC-ICP-MS y un software para la reducción de datos implementado en R (IsotopeHf®), en el que se incluyen todas las correcciones necesarias para muestras con trazador, convirtiendo el conjunto de datos de la espectrometría de masas en relaciones isotópicas significativas. Nuestros resultados en 176Hf/177Hf de los estándares de referencia geoquímica, tanto máficos como félsicos, son concordantes con aquellos reportados previamente por otros autores. Sin embargo, la comparación del sistema de digestión a presión (DAS®) de Picotrace® produce valores 176Lu/177Hf significativamente mayores en rocas félsicas con alta concentración de Hf(> 15 ppm) comparados con los obtenidos mediante bombas Parŕ, indicando digestión incompleta bajo las condiciones específicas en la digestión DAS® para fases ricas en HFSE, como el zircón. La alta purificación de Hf en el procesamiento químico, el protocolo para las mediciones por МС-IСP-MS y el programa IsotopeHf® producen datos exactos con relaciones isotópicas Lu-Hf confiables y reproducibles dentro de las incertidumbres analíticas típicas.

A atividade in vitro de queleritrina e lupeol, dois metabólitos isolados de Zanthoxylumrhoifolium, foram estudados contra o veneno da cobra Bungarus sindanus (Elapidae). O veneno, que é altamente tóxico para os seres humanos, é constituído principalmente pela enzima acetilcolinesterase (AChE). Ambos os compostos apresentaram atividade contra o veneno, e o alcalóide queleritrina apresentou maior atividade do que triterpeno lupeol.

The in vitro activity of chelerythrine and lupeol, two metabolites isolated from Zanthoxylum rhoifolium were studied against the venom of the snake Bungarus sindanus (Elapidae). The venom, which is highly toxic to humans, consists mainly by the enzyme acetylcholinesterase (AChE). Both compounds showed activity against the venom, and the alkaloid chelerythrine presented higher activity than did triterpene lupeol.

Objectives: The primary objective was to expand upon results of a previously piloted patient perception survey with Healthcare Failure Mode and Effect Analysis (HFMEA), to identify areas within pharmacist-managed clinics needing improvement. Methods: The survey was adapted for use in pharmacist-managed clinics. Patients completed the survey following regularly scheduled pharmacist appointments. Data were analyzed with a method adapted from HFMEA. Product scores could range from five to 25. A product of five indicates that pharmacists are doing a good job on the items that patients place the most value on, while a product score of 25 indicates that pharmacists are doing a poor job. A score greater than or equal to ten was used to identify areas for improvement. Results: Seventy-one patients completed surveys. Thirteen components were assessed and no item achieved a mean product greater than or equal to ten. The survey item with the highest mean product pertained to discussion of potential medication side effects (mean: 7.06; interquartile range: 5-10). Analysis of each survey item found that all survey items had multiple individual responses that provided a product score of greater than or equal to ten. The survey items most frequently listed in the overall population as being most valued were "Told you the name of each of your medicines and what they are used for", "Answered your questions fully," and "Explained what your medicines do". Conclusions: Educational components provided during pharmacist-managed clinic appointments are aligned with patients´ needs and are successfully incorporating the components that patients value highly in a patient-healthcare provider interaction. The HFMEA model can be an important teaching tool to identify specific processes in need of improvement and to help enhance pharmacists´ self-efficacy, which may further improve patient care.

Objetivos: El objetivo primario fue profundizar sobre los resultados de un cuestionario pre-pilotado de percepciones de los pacientes con el análisis de modos y efectos de fallos en salud (HFMEA) para identificar áreas en las que las consultas de farmacéuticas necesitan mejorar. Métodos: El cuestionario fue adaptado para su uso en consultas farmacéuticas. Los pacientes cubrieron el cuestionario después de las citas farmacéuticas acordadas. Los datos se analizaron usando un método adaptado del HFMEA. Las puntuaciones de producto podían oscilar de 5 a 25. Un producto de 5 indicaba que el farmacéutico estaba realizando un buen trabajo en los ítems que el paciente valorizaba más, mientras que una puntuación de 25 indicaba que el farmacéutico estaba haciendo un mal trabajo. Se utilizaron las puntuaciones de 10 o más para identificar áreas de mejoría. Resultados: 71 pacientes completaron cuestionarios. Se evaluaron 33 componentes y ningún ítem alcanzó un producto medio mayor o igual a 10. El punto de la encuesta que alcanzó la media más alta trataba de la discusión de los potenciales efectos secundarios de la medicación (media: 7.06; rango intercuartilico: 5-10). El análisis de cada ítem del cuestionario encontró que todos los ítems tenían varias respuestas individuales que proporcionaban una puntuación igual o mayor de 10. Los ítems más frecuentemente considerados por la población total como siendo los más valorados fueron "le dijo el nombre de todos sus medicamentos y para que se usan", "respondió completamente sus preguntas" y "explico lo que hacen los medicamentos". Conclusiones: Los componentes educativos proporcionados en las visitas a las consultas farmacéuticas se alinean con las necesidades de los pacientes e incorporan con éxito los componentes que los pacientes valoran más en la interacción paciente-profesional de la salud. El modelo HFMEA puede ser una importante herramienta educativa para identificar procesos específicos que necesitan mejorar y para ayudar a aumentar la auto-eficacia de los farmacéuticos, lo que podrá en el futuro mejorar la atención a pacientes.

Oxinitreto de zinco e gálio foi sintetizado por meio da nitretação do ZnGa2O4 obtido pelo método dos precursores poliméricos (PP) e por reação no estado sólido (SSR). Foi estudada a influência do método de síntese do óxido precursor (ZnGa2O4) nas características do composto final ZnGaON. A cristalização do ZnGa2O4 foi observada após tratamento térmico a 1100 °C / 12 h para SSR e a 600 °C / 2 h para PP, sem a presença de fases secundárias em ambos os casos. Estas amostras mostraram diferenças no tamanho de cristalito e na área superficial em virtude do método de síntese empregado. Após a nitretação, em ambos os casos, foi obtida a fase oxinitreto ZnGaON com estrutura wurtzita, similar ao GaN. Entretanto esta fase se forma a temperaturas mais baixas quando PP é usado. A microestrutura e a área de superfície específica das amostras nitretadas foram fortemente influenciadas pelo método de síntese do precursor e pela temperatura de nitretação (42 m²g-1e 5 m²g-1 para óxidos obtidos por PP e SSR e tratados a 700 °C, respectivamente). A análise da composição mostrou uma grande perda de Zn para as amostras derivadas de PP, a qual é favorecida tanto pela temperatura de amonólise quanto pela área de superfície específica do precursor.

Zinc-gallium oxynitride powders (ZnGaON) were synthesized by nitridation of ZnGa2O4 oxide precursor obtained by polymeric precursors (PP) and solid state reaction (SSR) methods and the influence of the synthesis route of ZnGa2O4 on the final compound ZnGaON was investigated. Crystalline single phase ZnGa2O4 was obtained at 1100 ºC / 12 h by SSR and at 600 ºC / 2 h by PP with different grain sizes and specific surface areas according to the synthesis route. After nitridation, ZnGaON oxynitrides with a GaN würtzite-type structure were obtained in both cases, however at lower temperatures for PP samples. The microstructure and the specific surface area were strongly dependent on the oxide synthesis method and on the nitridation temperature (42 m²g-1 and 5 m²g-1 for PP and SSR oxides treated at 700 °C, respectively). The composition analyses showed a strong loss of Zn for the PP samples, favored by the increase of ammonolysis temperature and by the higher specific surface area.

A metodologia para amplificação subtipo-específica por PCR da região transmembrana do gene env (gp41) do HIV-1, descrita por Yagyu e colaboradores, foi testada a partir de DNA proviral de 100 pacientes infectados pelo HIV-1 de Itajaí, Sul do Brasil. Setenta indivíduos apresentaram produtos amplificados e correspondentes aos subtipos B, C, D e F de acordo com a metodologia escolhida. Destes indivíduos, 26 (37,1%) apresentaram a amplificação esperada para o subtipo C de acordo com a metodologia; 42 (60%) apresentaram os produtos esperados para os subtipos B e D, sendo que na etapa seguinte de diferenciação destes subtipos, 16 (22,9%) corresponderam ao subtipo D e 26 (37,1%) ao subtipo B. Dois indivíduos (2,9%) mostraram produtos amplificados após a amplificação específica para o subtipo F. O sequenciamento e a comparação com sequências referências confirmou a subtipagem de HIV-1 C e B obtida pela metodologia. No entanto, indivíduos subtipados erroneamente como HIV-1 D e F pela metodologia, foram classificados pela comparação com sequências referências como subtipos C e B, respectivamente. Em relação aos indivíduos que não mostraram produtos amplificados, a baixa carga viral observada no histórico destes pacientes seria em parte responsável pela dificuldade na subtipagem pela metodologia de PCR, como demonstrado pelo resultado significativo no ANOVA ao testar o efeito da carga viral no sucesso da amplificação. O alinhamento das sequências obtidas com sequências referências de HIV-1 correspondentes à região da gp41 demonstrou que há uma alta diversidade intra-subtipo e que as regiões a partir das quais foram desenhados os oligonucleotídeos iniciadores HIV-1 subtipo-específicos não são conservadas nem suficientemente representativas dos subtipos observados nas populações brasileiras para permitir sua correta identificação. Portanto, esta metodologia não é aplicável para populações virais brasileiras.

The method used by YAGYU et al. for the subtype-specific polymerase chain reaction (PCR) amplification of the gp41 transmembrane region of the human immunodeficiency virus type-1 (HIV-1) env gene, was tested. HIV-1 proviral DNA from 100 infected individuals in Itajaí, South Brazil was used to analyze this method. Seventy individuals were determined according to this method as having PCR products at the expected size for subtypes B, C, D and F. Of these individuals, 26 (37.1%) were observed as having the expected amplification for subtype C, and 42 (60%) were observed as having the expected products for subtypes B and D. Of the subtype B and D amplicons, 16 (22.9%) were classified as subtype D, and 26 (37.1%) were classified as subtype B. Two individuals (2.9%) had amplicons that were observed after subtype F-specific amplification was performed. Sequencing and comparing the patient sequences to reference sequences confirmed the classification of sequences of subtypes C and B. However, sequences that were falsely determined as being D and F in the PCR assay were determined as being subtypes C and B, respectively, by sequence analysis. For those individuals from whom no amplified products were obtained, a low viral load that was indicated in their patient history may explain the difficulty in subtyping by PCR methods. This issue was demonstrated by the results of ANOVA when testing the effect of viral load on the success of PCR amplification. The alignment of the obtained sequences with HIV-1 reference sequences demonstrated that there is high intra-subtype diversity. This indicates that the subtype-specific primer binding sites were not conserved or representative of the subtypes that are observed in the Brazilian populations, and that they did not allow the correct classification of HIV-1 subtypes. Therefore, the proposed method by YAGYU et al. is not applicable for the classification of Brazilian HIV-1 subtypes.

Background: One of the major challenge for orthopedic surgery is to create a preoperative plan in a 3D virtual space and reproduce it in a 3D model. Thanks to rapid prototyping (RP) models, we can build a three-dimensional scaled bone model with a tumor inside. Our objective was to obtain segmented images from a tibial bone, with a tumor. Next, determine safe margins inside, in order to create a preoperative 3D plan. Then, print a RP model, with colors inside, and reproduce the surgery (simulation) with a navigation system. The feasibility of such procedure is based on our hypothesis, that it is possible to simulate an in vitro scenario for bone tumor surgery, and apply complex osteotomies with navigation, thus preserving healthy tissue. Methods: An 11-year old patient with knee pain, and proximal tibia osteosarcoma diagnosed by biopsy, was scanned with CT Multislice. The preoperative planning was applied using a 3D simulation platform. Two planes were created into the bone, one near the tumor, in red (3mm of unsafe margin), the other, far from the tumor, in blue (3mm of safe margin). Our RP model was created using Z-printer Spectrum Z- 510 and ZP131 powder in 1hour and 47 minutes. We printed the model in two halves, in order to print the inner colored structures, which were then attached with glue, thus obtaining the final RP bone model. The preoperative plan was masked and exported from our 3D virtual platform to the navigator. The osteotomies were applied with Stryker Navigation System II, using the planned 3D virtual path. After performing the osteotomy, the piece was separated with a saw into the two original halves. Results: The separated RP bone was used as an anatomic pathological simulated model. We could see the correct and wrong paths of the previously planned osteotomy in the 3D virtual scenario, applied with navigation. Conclusions: This novel surgery-reproducing application, is a good training for surgeons, interested in the behavior of the navigation system in oncologic surgery, and in knowing how to perform the preoperative planning in a custom scaled model using a navigated rapid prototyping model. Other interesting benefits are: pre-bending the plates to the bone shape, apply and improve planned osteotomies, plan pins' position for navigation, and check the correct margins in order to avoid mistakes in a real surgery and save OR time with a full 3D preoperative plan, combining CAD software, RP-models and navigation.

Introducción: Una de las promesas de la era informática se suscita desde la investigación in silico (investigación asistida por computadora). En el presente trabajo nos propusimos crear un modelo 3D in silico de un caso clínico real, imprimirlo en 3D y navegar una osteotomía previamente planeada. Materiales y métodos: Se presenta el caso de un paciente de 11 años con diagnóstico de osteosarcoma localizado en la metáfisis proximal de la tibia izquierda. Se practicó la planificación tridimensional a partir del procesamiento de las imágenes correspondientes a la tomografía y la resonancia magnética. La resección y la reconstrucción se practicaron siguiendo el modelo virtual creado. Resultados: La planificación tridimensional pudo ser creada. Fue posible reproducir un modelo 3D en un escenario virtual identificando hueso sano, tumor y márgenes oncológicos planificando y ejecutando una osteotomía biplanar. Conclusiones: Es posible que la aplicación de estas técnicas en la práctica de la ortopedia general permita planificaciones virtuales preoperatorias en múltiples situaciones. De esta forma, contribuiría a disminuir la incidencia de fallas intraoperatorias imprevistas, contribuyendo a obtener procedimientos quirúrgicos predecibles, implementando así una nueva manera de realizar desarrollo, investigación y entrenamiento en ortopedia y traumatología mediante el uso de tecnología in silico.

Introduction: Pandemic Influenza A (H1N1)v infection is the first pandemic in which intensive care units (ICU) play a fundamental role. It has spread very rapidly since the first cases were diagnosed in Mexico with the subsequent spread of the virus throughout the Southern Cone and Europe during the summer season. Objective: This study has aimed to compare the clinical presentation and outcome among the critical patients admitted to the ICU until July 31, 2009 in Spain with some series from Latin America. Material and method: Six series of critically ill patients admitted to the ICU were considered. Clinical characteristics, complications and outcome were compared between series. Results: Young patients (35-45 years) with viral pneumonia as a predominant ICU admission cause with severe respiratory failure and a high need of mechanical ventilation (60-100%) were affected. Obesity, pregnancy and chronic lung disease were risk factors associated with a worse outcome, however there was a high number of patients without comorbidities (40-50%). Mortality rate was between 25-50% and higher in the Latin America series, demonstrating the specific potential pathogenesis of the new virus. The use of antiviral treatment was delayed (between 3 and 6 days) and not generalized, with greater delay in Latin America in regards to Spain. Conclusions: These data suggest that a more aggressive treatment strategy, with earlier and easier access to the antiviral treatment might reduce the number of ICU admissions and mortality.

Introducción: La pandemia de gripe A (H1N1)v es la primera pandemia en la que las unidades de cuidados intensivos (UCI) desempeñan un papel fundamental. Su evolución ha sido muy rápida desde los primeros casos diagnosticados en México y la afectación posterior de países del cono sur hasta su llegada a Europa durante la época estival. Objetivo: Comparar las características clínicas y de evolución de los pacientes críticos ingresados hasta el 31 de julio de 2009 en España con algunas series de Latinoamérica. Material y método: Se consideraron 6 series de pacientes ingresados en la UCI. Se realizaron comparaciones de las características clínicas, complicaciones y evolución entre las series. Resultados: Los datos evidencian una población joven (35-45 años) con predominio de ingresos por neumonía viral con grave insuficiencia respiratoria y una elevada necesidad de ventilación mecánica (60-100%). Si bien algunas determinadas poblaciones, como los obesos, las embarazadas y los pacientes con enfermedad pulmonar crónica, parecen estar expuestas a un riesgo más elevado, la ausencia de comorbilidades alcanza un porcentaje considerable en casi todas las series (40-50%). La mortalidad superior en Latinoamérica osciló entre el 25 y el 50%, y demostró el particular potencial patogénico del nuevo virus. El uso del tratamiento antiviral es tardío (entre 3 y 6 días) y poco generalizado, con mayor retraso en Latinoamérica respecto de España. Conclusiones: Estos datos indican que una estrategia de tratamiento más intensivo con un acceso más precoz y fácil al antiviral podría reducir el número de pacientes que requieren UCI y su mortalidad.