Search

Resveratrol, a natural polyphenol, has shown promising neuroprotective effects in several in vivo and in vitro experimental models. However, the mechanisms by which resveratrol mediates these effects are not fully understood. Glutamate is the major excitatory neurotransmitter in the brain; however, excessive extracellular glutamate levels can affect neural activity in several neurological diseases. Astrocytes are the glial cells that maintain brain homeostasis and can attenuate excitotoxicity by actively participating in glutamate neurotransmission. This study aimed to investigate the glioprotective effects of resveratrol against glutamate-induced cellular dysfunction in hippocampal slices and primary astrocyte cultures, with a focus on the role of heme-oxygenase 1 (HO-1). Glutamate impaired glutamate uptake activity through a glutamate receptor-dependent mechanism, in addition to altering other important astroglial parameters, including glutamine synthetase activity, glutathione levels and cystine uptake, which were normalized by resveratrol. Resveratrol also prevented glutamate-induced disruption in antioxidant defenses, as well as in trophic and inflammatory functions, including the nuclear factor κB (NFκB) transcriptional activity. Most of the effects of resveratrol, mainly in astrocytes, were dependent on the HO-1 signaling pathway, as they were abrogated when HO-1 was pharmacologically inhibited. Resveratrol also increased HO-1 mRNA expression and its transcriptional regulator, nuclear factor erythroid-derived 2-like 2 (Nrf2). Finally, resveratrol prevented glutamate-induced p21 senescence marker, indicating an anti-aging effect. Therefore, we demonstrated that the activation of the Nrf2/HO-1 system in astrocytes by resveratrol represents an astrocyte-targeted neuroprotective mechanism in neurodegeneration, with glutamate excitotoxicity, oxidative stress, and neuroinflammation as common neurochemical alterations., Competing Interests: Declarations. Ethical Approval: Federal University of Rio Grande do Sul Animal Care and Use Committee (process number 21215). Consent to Participate: Not applicable. Consent for Publication: Not applicable. Competing Interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Astrocytes are glial cells that play key roles in neuroinflammation, which is a common feature in diabetic encephalopathy and aging process. Metformin is an antidiabetic compound that shows neuroprotective properties, including in inflammatory models, but astroglial signaling pathways involved are still poorly known. Interferons α/β are cytokines that participate in antiviral responses and the lack of their signaling increases susceptible to viral infections. Here, we investigated the effects of metformin on astrocytes from hypothalamus, a crucial brain region related to inflammatory processes. Astrocyte cultures were derived from interferon α/β receptor knockout (IFNα/βR -/- ) and wild-type (WT) mice. Metformin did not change the expression of glial fibrillary acidic protein but caused an anti-inflammatory effect by decreasing pro-inflammatory cytokines (tumor necrosis factor-α and interleukin-1β), as well as increasing gene expression of anti-inflammatory proteins interleukin-10 and Nrf2 (nuclear factor erythroid derived 2 like 2). However, nuclear factor κB p65 and cyclooxygenase 2 were downregulated in WT astrocytes and upregulated in IFNα/βR -/- astrocytes. AMP-activated protein kinase (AMPK), a molecular target of metformin, was upregulated only in WT astrocytes, while sirtuin 1 increased in both mice models. The expression of inducible nitric oxide synthase was decreased in WT astrocytes and heme oxygenase 1 was increased in IFNα/βR -/- astrocytes. Although loss of IFNα/βR-mediated signaling affects some effects of metformin, our results support beneficial roles of this drug in hypothalamic astrocytes. Moreover, paradoxical response of metformin may involve AMPK. Thus, metformin can mediate glioprotection due its effects on age-related disorders in non-diabetic and diabetic encephalopathy individuals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.)

Iron (Fe) is the fourth most abundant element on the planet, and iron-oxidising bacteria (FeOB) play an important role in the biogeochemical cycle of this metal in nature. FeOB stands out as Fe oxidisers in microaerophilic environments, and new members of this group have been increasingly discussed in the literature, even though their isolation can still be challenging. Among these bacteria is the Gallionellaceae family, mainly composed of neutrophilic FeOB, highlighting Gallionella ferruginea, and nitrite-oxidiser genera. In the previous metagenomic study of the biofilm and sediments of the cooling system from the Irapé hydroelectric power plant (HPP-Irapé), 5% of the total bacteria sequences were related to Gallionellaceae, being 99% unclassified at genus level. Thus, in the present study, a phylogenetic tree based on this family was constructed, in order to search for shared and unique Gallionellaceae signatures in a deep phylogenetic level affiliation and correlated them with geomorphologic characteristics. The results revealed that Gallionella and Ferrigenium were ubiquitous reflecting their ability to adapt to various locations in the power plant. The cave was considered a hotspot for neutrophilic FeOB since it harboured most of the Gallionellaceae diversity. Microscopic biosignatures were detected only in the CS1 sample, which presented abundance of the stalk-forming Ferriphaselus and of the sheath-forming Crenothrix. Further studies are required to provide more detailed insights on Gallionellaceae distribution and diversity patterns in hydroelectric power plants, particularly its biotechnological potential in this industry., (© 2024. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Limnoperna fortunei , the golden mussel, is a bivalve mollusk considered an invader in South America. This species is responsible for ecological and economic damages due to its voluminous fouling capability. Chemical biocides such as MXD-100™ and sodium dichloroisocyanurate (NaDCC) are often used to control L. fortunei infestations in hydraulic systems. Thus, we proposed to investigate the effects of different periods (24, 48 and 72 h) of exposure to MXD-100™ (0.56 mg L -1 ) and NaDCC (1.5 mg L -1 ) on the gills of L. fortunei through morphological and molecular analyses. NaDCC promoted progressive morphological changes during the analyzed periods and only an upregulation of SOD and HSP70 expression during the first 24 h of exposure. MXD-100™ led to severe morphological changes from the first period of exposure, in addition to an upregulation of SOD, CAT, HSP70 and CYP expression during the first 24 h. In contrast, MXD-100™ led to a downregulation of CAT transcription between 24 and 48 h. In static conditions, NaDCC causes lethal damage after 72 h of exposure, and that exposure needs to be continuous to achieve the control of the species. Meanwhile, the MXD-100™ treatment presented several effects during the first 24 h, showing acute toxicity in a shorter period of time.

Microfouling can have significant economic impacts for hydroelectric power plants. However, knowledge concerning the composition and metabolism of microbial biofilm in cooling systems remains scarce. We examined the metagenome present in a cooling system, comprising a filter (F) and heat exchanger (HE), in the Nova Ponte hydroelectric power plant in Brazil, to identify bacteria and pathways that could be targeted to monitor and control biofilm formation. Our data revealed that the microfouling sample from heat exchanger 1 (HEM1), with porous consistency, presented enriched bacterial members not frequently described as biofilm formers in cooling systems, besides it has been shown to be an autoinducer repression pathway. Furthermore, the microfouling sample from heat exchanger 2 (HEM2), with gelatinous consistency, seemed to be an established biofilm, containing enriched bacterial groups such as Desulfotomaculum and Crenothrix and autoinducers, with biotechnological relevance in industrial biofilms. The results demonstrate that biofilm composition will vary depending on different abiotic conditions and the antifouling strategy used, including type of compound, concentration, and frequency of use. Therefore, all these variables must be evaluated when a power plant is affected by microbial slime in the cooling system. Our findings could help to define strategies for efficient and ecofriendly measures to contain microfouling in power plants., (© 2023. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Ovarian cryopreservation is an alternative for the preservation of fertility, and the subcutaneous transplantation site is considered one of the most promising. Studies evaluating the follicular growth and its relationship with gene expression and vascular perfusion are essential for improving this technique and its clinical application. Thus, the aim of this study was to evaluate the effect of subcutaneous autotransplantation and vitrification on follicular growth and atresia and their relationship with vascular perfusion and gene expression. Therefore, female mice were ovariectomized, and the ovaries were divided in two experimental groups (1) vitrified (treatment, n = 97) and (2) not vitrified (control, n = 97) and subsequently were transplanted. Then grafts, from both groups, were recovered after 1, 12, or 23 days (D1, D12, D23) and subjected to follicular quantification, morphometry, and qPCR. Non-transplanted ovaries (D0) were also used. The estrous cycle and vascular perfusion were monitored throughout the experiment. On D9, 100% of the animals had reestablished their estrous cycles (p > 0.05). Blood perfusion at the transplant site was similar for both treatments (p > 0.05), with greater perfusion at the site of vitrified transplants only on D1 (p < 0.05). A drastic reduction in the number of antral follicles and an increased number of atretic follicles were observed on D1 (p < 0.0001), associated with upregulation of Casp3, Fshr, and Igf1r; and downregulation of Bax, Acvr1, Egfr, and Lhcgr (p < 0.05). Our findings indicate that the first day after subcutaneous transplantation is a critical period for follicular survival, with intense follicular atresia independent of Bax upregulation., (© 2023. The Author(s), under exclusive licence to Society for Reproductive Investigation.)

Background: Limnoperna fortunei is a freshwater bivalve mollusc originally from southern Asia that invaded South America in the 1990's. Due to its highly efficient water pumping and filtering, and its capacity to form strong adhesions to a variety of substrates by byssus thread, this invasive species has been able to adapt to several environments across South America, causing significant ecological and economic damages. By gaining a deeper understanding of the biological and ecological aspects of L. fortunei we will be able to establish more effective strategies to manage its invasion. The gills of the mollusc are key structures responsible for several biological functions, including respiration and feeding. In this work, we characterized the ultrastructure of L. fortunei gills and its ciliary epithelium using light microscopy, transmission and scanning electron microscopies. This is the first report of the morphology of the epithelial cells and cilia of the gill of L. fortunei visualized in high resolution., Results: The analysis showed highly organized and abundant ciliary structures (lateral cilia, laterofrontal cirri and frontal cilia) on the entire length of the branchial epithelium. Mitochondria, smooth endoplasmic reticulum and glycogen granules were abundantly found in the epithelial cells of the gills, demonstrating the energy-demanding function of these structures. Neutral mucopolysaccharides (low viscosity mucus) were observed on the frontal surface of the gill filaments and acid mucopolysaccharides (high viscosity mucus) were observed to be spread out, mainly on the lateral tract. Spherical vesicles, possibly containing mucus, could also be observed in these cells. These findings demonstrate the importance of the mucociliary processes in particle capture and selection., Conclusions: Our data suggest that the mechanism used by this mollusc for particle capture and selection could contribute to a better understanding of key aspects of invasion and also in the establishment of more efficient and economically viable strategies of population control., (© 2022. The Author(s).)

Groundwater consumption has become increasingly relevant for urban development. The city of Montes Claros (Minas Gerais, Brazil) is located in the border region of the Brazilian semi-arid polygon and has registered conflicts of water use for decades ago. The study area contains a complex karst system responsible for the heterogeneous permeability of water recharge and groundwater flow. The urban area of Montes Claros is located in the Vieira River watershed and contains different groundwater wells used to agro-industrial and human consumption. Almost groundwater captions have a low specific capacity with a consequent groundwater depletion. On the region, there are significant areas with a negative water balance concerning to water recharge and groundwater exploitation. Groundwater flow has a regional dominant direction of SW-NE, however locally, groundwater flow varies and could be identified some clusters with high hydrological potential. The contrast between hydrogeological features of the outcropping lithotypes added to the geological structures contribute to variations in the potentiometric level and in the productivity of aquifers. The main aim of this study is a reviewer of the regional hydrogeology of the municipality of Montes Claros to evaluate a potential groundwater availability on the urban area and minimize a groundwater overexploitation and scarcity. A detailed characterization of the local hydrogeology from Montes Claros region will be crucial to a definition of more efficient water supply policies on the management of water resources, particularly in a scenario of climate change and water scarcity in semi-arid areas., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Owls are outstanding environmental quality bioindicators due to their position at the top of the food chain and susceptibility to pollutant accumulation. Exposure to chemical contaminants is often a risk for these animals. Moreover, studies addressing the bioaccumulation of trace elements and pesticide residues in tropical nocturnal raptor species are scarce. We analyzed the 26 organs (heart, liver, and kidney) of Tyto furcata (n=3), Megascops spp. (n=5), Pulsatrix koeniswaldiana (n=1), and Asio stygius (n=1) carcasses, collected from June 2018 to May 2019 in the Southern region of Brazil. The original vegetation consisted of areas of Araucaria forests and grassy-woody steppes with gallery forests, which were greatly modified by the introduction of agriculture. In four animals and eight organs, the pesticides abamectin, atrazine, chlorpyrifos-ethyl, and diurom were analyzed through high-performance liquid chromatography coupled with a mass detector. In six animals and eighteen organs, the trace elements cadmium, lead, chromium, and nickel were identified via atomic absorption spectrophotometry. Chlorpyrifos-ethyl was detected in the livers of the genus Megascops. Chromium was found at high concentrations in all matrices analyzed for this trace element. Moreover, P. koeniswaldiana presented lead levels indicative of high exposure. The bioaccumulation of these toxics in owls described here can impact the population levels of these species, impact on its ecological function, and consequently unbalance the ecosystem. Moreover, owls are considered bioindicators; therefore, the occurrence of bioaccumulation indirectly gives us information about the quality of the environment., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The health of family farmers is at risk due to occupational exposure to pesticides. The aims of the current study were to investigate the level of farmers' perception of risks associated with pesticide use and to assess their health condition based on biochemical and immunological tests. Family farmers living in a vegetable-producing region in Southern Brazil were selected to participate in the study. More than 70% of the family farmers were often exposed to more than one type of pesticides; 41.2% were intensively using several pesticides for more than one decade and 74.4% were not using personal protective equipment (PPE) at the time of pesticide handling due to low perception of the risks posed by these chemicals. Enzymatic analysis performed in participants' blood samples showed changes in catalase (CAT) and glutathione reductase (GR) activity, in lipid peroxidation (TBARS) and carbonylated protein levels, as well as in chemoattractant (IL-8) and anti-inflammatory (IL-10) interleukin expression. Low perception of health-related risks posed by pesticides can be attributed to factors such as low schooling and lack of information, which put farmers' health at risk, as evidenced by blood biochemical and immunological changes.

The present study aimed to determine the chemical composition and biological activity of the essential oil obtained from Phyllogonium viride Brid. (Phyllogoniaceae, Bryophyta), whose samples were collected in southern Brazil. For the first time, the cytotoxic activity of the essential oil of P. viride in breast and colorectal tumor cells (MCF-7 and HCT-116) was evaluated, as well as the cytotoxic potential of this oil in non-tumoral cells of human immortalized keratinocytes (HaCaT) via MTT assay. The compounds majorly found in P. viride essential oil were β-bazzanene (20.30 %), β-caryophyllene (17.06 %), β-chamigrene (14.02), and germacrene B (11.72 %). Treatment with P. viride essential oil in the different tested cell lines did not induce any toxicity in most of the tested concentrations. These data contribute to generating new scientific information about this understudied plant species. Furthermore, the chemical characterization of the compounds present in the essential oil of P. viride can lead to greater elucidation of its biotechnological potential., (© 2021 Wiley-VHCA AG, Zurich, Switzerland.)

West Nile virus (WNV) is a mosquito-borne Flavivirus that can affect birds, horses, and humans, and is the only zoonotic Flavivirus that has been identified in six continents. In Brazil, until 2010, there was no evidence of WNV circulation. Recently, the virus was isolated from a horse with encephalitis, and the first human cases were registered in Brazil. Despite that, there is still no information on the enzootic cycle of this virus in birds or wildlife. This study aimed to investigate whether there is evidence of WNV circulation among wild birds from Southern Brazil. For this, we used free-living wild raptors (live-trapped or rescued) as potential sentinels to investigate the presence of WNV antibodies using ELISA and plaque reduction neutralization test (PRNT) assay. In addition, the presence of nucleic acids from Flavivirus family members was investigated. None of the birds sampled presented clinical findings compatible with WNV. Of the 200 serum samples from birds of prey belonging to 21 species, ten (5%) were positive for the presence of WNV antibodies on ELISA testing. The PRNT test did not confirm the ELISA results, but indicated that three birds had possibly been exposed to Saint Louis encephalitis virus (SLEV). All samples were negative for Flavivirus RNA. The results presented here evince the need for permanent surveillance for emerging flaviviruses in Brazil, as well as for a contingency policy in the case of human/animal outbreaks, particularly in high-risk areas.

Microfouling, ie biofilm formation on surfaces, can have an economic impact and requires costly maintenance in water-powered energy generation systems. In this study, the microbiota of a cooling system (filter and heat exchanger) in the Irapé hydroelectric power plant in Brazil was examined. The goal was to identify bacteria that could be targeted to more efficiently reduce biofilm formation. Two sampling campaigns were made corresponding to two well-defined seasons of the Brazilian Cerrado biome: the dry (campaign 1) and the wet (campaign 2). Microfouling communities varied considerably over time in samples obtained at different times after the last clearance of the heat exchanger. The thermophilic bacteria Meiothermus , Thermomonas and Symbiobacterium were exclusive and abundant in the microfouling of the heat exchanger in campaign 2, while methanotrophs and iron-reducing bacteria were abundant only in filter sediments. These findings could help to guide strategies for ecofriendly measures to reduce biofilm fouling in hydroelectric power plants, minimizing environmental and economic losses.

The use of different types of zeolites (X, Na-P1, and 4A) synthesized by different methods and scales were tested in this work to adsorb nutrients present in synthetic solutions and industrial effluents for later application as fertilizer. Modifications with calcium chloride were performed on the zeolite with the best performance to increase its adsorption capacity. The best performing zeolite was type X (ZXH) produced on a pilot scale by the hydrothermal process. Its adsorption capacity without modification was 149 mg P-PO 4 /g zeolite and 349 mg K/g zeolite. With the change, there was a fourfold increase in these results, which were up to threefold higher than reported in the literature. The kinetic model that best characterized the adsorption process was the intraparticle diffusion model, and the equilibrium isotherm was that of Freundlich. The adsorption tests performed with industrial effluent showed high removal of the nutrients of interest (> 90% for PO 4 3- and > 95% for K + ). The desorption tests with zeolites nutrient-loaded from synthetic solutions showed 13 to 24% PO 4 3- and 14 to 47% K + release within 24 h, while for zeolite nutrient-loaded from effluent the release were 7 and 100% for PO 4 3- and K + , respectively. The results we obtained in this work indicated the potential use of zeolites in the treatment of effluent and its application as a fertilizer.

Wild birds carry a number of infectious agents, some of which may have pathogenic potential for the host and others species, including humans. Domestic pigeons (Columba livia) are important targets of study since these increasingly cohabit urban spaces, being possible spillover sources of pathogens to humans. In the present study, two genomes (PiGyV&#95;Tq/RS/Br and PiGyV&#95;RG/RS/Br), representative of Gyrovirus genus, family Anelloviridae, were detected in sera of free-living pigeons collected in Southern Brazil. The genomes exhibit less than 50% identity to previously described members of Gyrovirus genus, suggesting that they constitute a new viral species circulating in pigeons, to which the name "pigeon gyrovirus (PiGyV)" is proposed. The current study characterizes these two PiGyV genomes which, to date, are the first gyrovirus species identified in domestic pigeons., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Unfortunately, the word "evolution" was found missing in title of the original article which is corrected here by this erratum. The original article has been corrected.

Pigeon circovirus (PiCV) is taxonomically classified as a member of the Circovirus genus, family Circoviridae. The virus contains a single stranded DNA genome of approximately 2 kb, with minor length variations among different isolates. The occurrence of PiCV infections in pigeons (Columba livia) has been documented worldwide over the past 20 years; however, in Brazil there were still no reports on PiCV detection. This study identifies seven PiCV genomes recovered from domestic pigeons of South Brazil through high-throughput sequencing and shows a high frequency of PiCV infection, through quantitative real-time PCR. Phylogenetic classification was performed by maximum likelihood analysis of the full genomes, ORF V1 (Rep) and ORF C1 (Cap). The results show that either full genome or Cap based analysis allowed PiCV classification into five major clades (groups A to E), where Brazilian sequences were classified as A, C or D. Recombination analyses were carried out with Simplot and RDP4 and the results show that both Rep and Cap ORFs contain several recombination hotspots, pointing to an important role for such events in PiCV evolution.

Blocks of Bovine bone have shown promising results as implantable scaffolds to promote bone regeneration. Strontium ranelate (SrR) is both an antiresorptive and an anabolic drug that has been indicated for oral administration to treat osteoporosis. Few studies, however, have investigated the local effects of SrR and its use in association with biomaterials thus far. In this work, we investigated SrR effects in cultures of primary osteoblasts (PO, from Wistar rats calvaria) and immortalized osteoblasts (IO, from MC3T3-E1 cell line) cultivated as a monolayer or in association with scaffolds of bovine bone in mineralized (MBB) and demineralized (DBB) forms. The optimum dose to induce SrR effects on cell viability was established as 0.1 mM. Our results suggested that the local administration of SrR is biocompatible and non-cytotoxic. In addition, SrR appeared to accelerate primary osteoblast cell differentiation by enhancing alkaline phosphatase activity, the expression of osteogenic differentiation markers, the synthesis of the organic matrix, and a decrease of Ca 2+ ions in mineralized nodules. DBB was found to be a better scaffold material to promote PO and IO cell proliferation. Exposing the proteins of the demineralized bone matrix might improve scaffold osteoconductive properties. Our results indicated the importance of further investigation of the administration of SrR at sites of bone repair. The association of SrR and bone grafts suggests the possibility of using SrR as a co-adjuvant for bone tissue bioengineering and in bone regeneration therapies.

This study aimed to evaluate the ammonia-nitrogen removal by aluminosilicates, using both standard solutions as pretreated landfill leachate. Three types of commercial clays and one commercial zeolite were initially tested using standard solution; however, only one clay with the best removability and the zeolite were tested with pretreated leachate. The chosen clay sorption capacity with the standard solution reached 83%, while with the pretreated leachate solution has reached 95% and zeolites have reached, respectively, a removal of 73% and 81%. For this two adsorbents' studies of equilibrium and kinetic of the sorption were also performed. The Langmuir model was more adequate to describe the ion exchange equilibrium and the sorption mechanism fit the pseudo-second-order kinetic model. Moreover, the pretreatment used on leachate proved to be essential not only for ammonium detection in solution, but also to facilitate its sorption in aluminosilicates. This alternative of ammonia-nitrogen removal also generates a product derived from treatment that can be used as agricultural feedstock in the form of fertilizer.

Context and Objective: Cerebrovascular disease is one of the most important causes of death and disability worldwide. The patient's inability to identify the warning signs of stroke substantially delays the search for emergency services, which is related directly to a worse outcome. Thus, during the 2011 Stroke Campaign in Brazil, a survey was conducted to identify the lay population's knowledge with regard to the recognition, treatment, and prevention of stroke., Design and Setting: This retrospective, cross-sectional, multicenter study was held in cities throughout southeastern Brazil., Methods: The campaign was conducted by students of several medical schools under the guidance of neurologists (assistants and professors). The students traveled to various public areas in Sao Paulo, Campinas, Sorocaba, Taubaté, and Pouso Alegre, where information about stroke was distributed and a specific questionnaire was administered., Results: A total of 1304 people answered the questionnaire: 43.9% claimed to know what a stroke was, 65% knew someone who has had the disease, 35% knew > 3 risk factors for stroke, and 28.8% knew a preventive measure. Further, 17.9% was able to list at least 3 signs or symptoms of a stroke, 33.6% was aware that they should activate the emergency service, and 3.1% would have checked the time at which the signs and symptoms had developed., Conclusion: Despite the severity of stroke, the population that we analyzed has a low level of knowledge. Campaigns should increase the lay population's understanding of this disease, thus improving its prevention and treatment and contributing to public health politics.

Background and study aims: Palliative treatment of gastric outlet obstruction can be done with surgical or endoscopic techniques. This systematic review aims to compare surgery and covered and uncovered stent treatments for gastric outlet obstruction (GOO). Patients and methods: Randomized clinical trials were identified in MEDLINE, Embase, Cochrane, LILACs, BVS, SCOPUS and CINAHL databases. Comparison of covered and uncovered stents included: technical success, clinical success, complications, obstruction, migration, bleeding, perforation, stent fracture and reintervention. The outcomes used to compare surgery and stents were technical success, complications, and reintervention. Patency rate could not be included because of lack of uniformity of the extracted data. Results: Eight studies were selected, 3 comparing surgery and stents and 5 comparing covered and uncovered stents.The meta-analysis of surgical and endoscopic stent treatment showed no difference in the technical success and overall number of complications. Stents had higher reintervention rates than surgery (RD: 0.26, 95 % CI [0.05, 0.47], NNH: 4). There is no significant difference in technical success, clinical success, complications, stent fractures, perforation, bleeding and the need for reintervention in the analyses of covered and uncovered stents. There is a higher migration rate in the covered stent therapy compared to uncovered self-expanding metallic stents (SEMS) in the palliation of malignant GOO (RD: 0.09, 95 % CI [0.04, 0.14], NNH: 11). Nevertheless, covered stents had lower obstruction rates (RD: - 0.21, 95 % CI [-0.27, - 0.15], NNT: 5). Conclusions: In the palliation of malignant GOO, covered SEMS had higher migration and lower obstruction rates when compared with uncovered stents. Surgery is associated with lower reintervention rates than stents.

Multiple sclerosis (MS) is an inflammatory, demyelinating, neurodegenerative disorder of the central nervous system (CNS) of unknown etiology. The peak onset is between age 20 and 40 years and usually affects more women than men. Although much knowledge has been achieved on the diagnosis and treatment of adult patients with MS, it remains a matter of debate and controversy in childhood. We present a case of MS in 9-year-old girl, review the current state of the knowledge on pediatric MS, and discuss the available tools for the diagnosis and treatment.

Objective: To evaluate the frequency, clinical correlations and prognosis influence of late potentials on the of heart failure patients with different etiologies using the signal averaged electrocardiogram., Methods: A 42 month study of the signal averaged electrocardiograms of 288 heart failure patients with different etiologies was conducted. The group of patients included 215 males (74.65%) and 73 females (25.35%) between the ages of 16 and 70 (mean 51.5, standard deviation 11.24). The heart failure etiologies were: hypertensive heart disease (78 patients, 27.1%); idiopathic dilated cardiomyopathy (73 patients, 25.4%); ischemic cardiomyopathy (65 patients, 22.6%); Chagas disease (42 patients, 14.6%); alcoholic cardiomyopathy (9 patients, 3.1%); peripartum cardiomyopathy (6 patients, 2.1%); valvular heart disease (2 patients, 4.2%) and viral myocarditis (3 patients, 1.04%). The variables included the duration of the standard QRS complex, duration of the filtered QRS complex, duration of the signal below 40 microV and the root mean square of the last 40 ms which were analyzed in regard to age, gender, etiology and mortality as well as the findings of the 12-lead electrocardiogram at rest, echocardiogram and ambulatory electrocardiogram. The statistical analysis tests used were: the Fisher exact probability test, Students t-test, Mann Whitney test, variance analysis, Log-Hank and the Kaplan-Meyer method., Results: Late potentials were diagnosed in 90 patients (31.3%) and there was no association with the etiologies. The presence of this condition is associated with: a lower maximum oxygen uptake during the ergospirometry (p=0.001); sustained and non-sustained ventricular tachycardia during Holter monitoring (p=0.001), sudden death and mortality (p<0.05). Patients that did not present late potentials had a higher overlife rate., Conclusion: The presence of late potentials was not associated with the etiologies and proved to be an indication of a worse prognosis.

We studied the time- and frequency-domain indexes of heart rate variability (HRV) in 653 patients without any evidence of heart disease relative to age, gender, heart rate, body mass index, and functional capacity. There was an inverse correlation of HRV with heart rate (p <0.001). HRV indexes decreased with increasing age, differed by gender, and were higher in patients with higher functional capacity. No correlation was noted between HRV and body mass index.

Objective: Antihypertensive therapy with thiazides decreases coronary events in elderly patients. However, the influence of diuretics on myocardial ischemia has not been fully investigated. The aim of this study was to compare the effect of chlorthalidone and diltiazem on myocardial ischemia., Methods: Following a randomized, double-blind, crossover protocol, we studied 15 elderly hypertensive patients aged 73.6+/-4.6 years with myocardial ischemia. All patients had angiographically documented coronary artery disease. We measured patients using 48- hour ambulatory electrocardiogram monitoring and exercise testing. After a 2-week period using placebo, patients received chlorthalidone or diltiazem for 4 weeks., Results: Both treatments lowered systolic and diastolic blood pressures. The number of ischemic episodes on ambulatory electrocardiogram recordings was reduced with the use of chlorthalidone (2.5+/-3.8) and diltiazem (3.2+/-4.2) when compared with placebo (7.9+/-8.8; p<0.05). The total duration of ischemic episodes was reduced in both treatments when compared with placebo (chlorthalidone: 19.2+/-31.9min; diltiazem: 19.3+/-29.6min; placebo: 46.1+/-55.3min; p<0.05)., Conclusion: In elderly hypertensive patients with coronary artery disease, chlorthalidone reduced myocardial ischemia similarly to diltiazem. This result is consistent with epidemiological studies and suggests that reduction of arterial blood pressure with thiazide therapy plays an important role in decreasing myocardial ischemia.

Purpose: To evaluate the effects of sublingual administration of diazepam, nifedipine, propranolol and the association of nifedipine with propranolol patients with hypertensive crisis., Methods: Eighty patients with hypertensive crisis, DAP greater than 120 mmHg, and mean age of 54 +/- 7.4 years, 33 women and 47 men, were evaluated. The AP was measured with an aneroid sphygmomanometer, in mmHg, in orthostatic position, before and after 10, 20, 30 and 60 minutes of treatment. The heart rate in one minute was also measured at the same intervals. The patients were divided randomly into four groups and treated, respectively, with 10 mg of diazepam, 10 mg of nifedipine, 40 mg of propranolol and 10 mg of nifedipine associated with 40 mg of propranolol., Results: A significant and gradual reduction of SAP and DAP were observed in all groups of patients. The percentage of reduction, after 60 minutes, for SAP was, respectively, 10.1%, 12.9%, 15.4% and 16%, and for DAP 7.7%, 11.3%, 13.6% and 13% in groups I to IV. The heart rate did not change in groups I and II, but significative reduction was observed in groups III (p = 0.002) and IV (p = 0.009)., Conclusion: The drugs used were effective for the treatment of hypertensive crisis, and the sublingual administration is an important and easy way for their administration.