Antibody-enhanced dengue disease generates a marked CNS inflammatory response in the black-tufted marmoset Callithrix penicillata

Severe dengue disease is often associated with long-term neurological impairments, but it is unclear what mechanisms are associated with neurological sequelae. Previously, we demonstrated antibody-enhanced dengue disease (ADE) dengue in an immunocompetent mouse model with a dengue virus 2 (DENV2) antibody injection followed by DENV3 virus infection. Here we migrated this ADE model to Callithrix penicillata. To mimic human multiple infections of endemic zones where abundant vectors and multiple serotypes co-exist, three animals received weekly subcutaneous injections of DENV3 (genotype III)-infected supernatant of C6/36 cell cultures, followed 24 h later by anti-DENV2 antibody for 12 weeks. There were six control animals, two of which received weekly anti-DENV2 antibodies, and four further animals received no injections. After multiple infections, brain, liver, and spleen samples were collected and tissue was immunolabeled for DENV3 antigens, ionized calcium binding adapter molecule 1, Ki-67, TNFα. There were marked morphological changes in the microglial population of ADE monkeys characterized by more highly ramified microglial processes, higher numbers of trees and larger surface areas. These changes were associated with intense TNFα-positive immunolabeling. It is unclear why ADE should generate such microglial activation given that IgG does not cross the blood-brain barrier, but this study reveals that in ADE dengue therapy targeting the CNS host response is likely to be important.

Hand-assisted laparoscopic nephrectomy versus transperitoneal anterior approach in living donors for renal transplantation

The objective of this study was to compare two surgical approaches for living donor nephrectomy: transperitoneal anterior approach and the hand-assisted laparoscopic nephrectomy. Between January 2001 and October 2003 we performed 63 kidney transplantations from living donors. The transperitoneal anterior approach was used in 36 cases and the hand-assisted laparoscopic nephrectomy in 27. Outcomes were compared in terms of hospital stay, postoperative analgesia, and graft quality. Mean hospital stay was 4.7 days in the transperitoneal anterior approach group and 3.7 days in the hand-assisted laparoscopic group (P < .005). Postoperative analgesia dosage was significantly lower in the hand-assisted laparoscopic group (P < .001). Surgical complications and graft quality were similar. We concluded that hand-assisted laparoscopic nephrectomy patients had shorter hospital stays and less pain in the postoperative period, with better cosmetic results and equivalent graft quality compared to transperitoneal anterior approach patients.

Renal artery aneurysm in hand-assisted laparoscopic donor nephrectomy: case report

We report a living donor who underwent laparoscopic nephrectomy using a hand-assisted device (HALD). At preoperative arteriography the donor showed a renal artery aneurysm. The patient was a 37-year-old female, 166 cm height, white, weighing 87 kg, HLA identical to the recipient. HALD was indicated due to the better visualization of renal pedicle and greater security in an obese patient. Renal artery aneurysm is a rare condition, with many possible complications. The method proved to be adequate and safe for donor nephrectomy, despite a renal artery aneurysm.

Effect of lipids and oleic acid on biomass development in anaerobic fixed-bed reactors. Part I: Biofilm growth and activity

Two similar anaerobic fixed-bed bioreactors which allowed the biomass to be periodically withdrawn were run in parallel. After feeding each digester with synthetic dairy wastes of different lipid content (Period I), both digesters were fed with increasing sodium oleate concentrations with skim milk as co-substrate (Period II) and oleate as the sole carbon source (Period III). In Period I, the digester fed with lipids was more efficient and exhibited lower levels of volatile fatty acids than the digester fed without lipids. The biofilm built up in the presence of lipids was thinner, but more resistant to the presence of oleate than the biofilm formed in the absence of lipids, which lost 53% of its solids after contacting with oleic acid. The specific methanogenic activity with butyrate as substrate was enhanced in the presence of lipids, but no significant effect was detected on the acetoclastic and hydrogenophilic activities, which remained similar for both digesters along the trial period.

Effects of lipids and oleic acid on biomass development in anaerobic fixed-bed reactors. Part II: Oleic acid toxicity and biodegradability

Oleic acid toxicity and biodegradability were followed during long-term operation of two similar anaerobic fixed-bed units. When treating an oleate based effluent, the sludge from the bioreactor that was acclimated with lipids during the first operation period, showed a higher tolerance to oleic acid toxicity (IC50 = 137 mg/l) compared with the sludge fed with a non-fat substrate (IC50 = 80 mg/l). This sludge showed also the highest biodegradation capacity of oleic acid, achieving maximum methane production rates between 33 and 46 mlCH4(STP)/gVS.day and maximum percentages of methanization between 85 and 98% for the range of concentrations between 500 and 900 mg oleate/l. When oleate was the sole carbon source fed to both digesters, the biomass became encapsulated with organic matter, possibly oleate or an intermediate of its degradation, e.g. stearate that was degraded at a maximum rate of 99 mlCH4(STP)/gVS.day. This suggests the possibility of using adsorption-degradation cycles for the treatment of LCFA based effluents. Both tolerance to toxicity and biodegradability of oleic acid were improved by acclimatization with lipids or oleate below a threshold concentration.

An international perspective on the treatment of pediatric shock: the Brazilian experience

Shock in the pediatric population has many preventable causes. Treatment of children in shock will depend on access to health services, training of health personnel, availability of diagnostic procedures, monitoring, and therapeutic measures. Countries will differ among themselves and within themselves in the care provided to children developing shock. In Brazil, the majority of children are cared for in public hospitals, which often lack resources for basic care. Many children in shock do not even reach healthcare services. Investment in training healthcare personnel in a simplified and systematic approach to shock and access to equipped health services are basic to improved outcomes in the treatment of pediatric shock. The Brazilian experience in the treatment of children in shock outside hospital facilities, in the emergency department, and in the ICU is described.

[Anopheles (Culicidae, Anophelinae) and Malaria in Buriticupu-Santa Luzia, pre-Amazonic Maranhao]

Seven species belonging the subgenus Nyssorhyncus were found. Anopheles (N.) darlingi, the principal vector of human malaria, was the most abundant (53.1%) followed by A. (N.) evansae (21.0%, A. (N.) triannulatus (17.4%) e A. (N.) nuñeztovari (4.8%). The others, A. (N.) argyritarsis. A. (N.) oswaldoi and A. (N.) rangeli, were less frequently found, representing only 3.7% of the total sample. The anophelines were most frequent in both the extra (51.7%) and peridomiciles (45.7%). The intradomicile was visited by some specimens of the A. (N.) darlingi and A. (N.) evansae (active in both the rain and dry seasons, especially in the former, when the malaria reached high levels of transmission.