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La muerte fetal es la defunción del feto antes de su expulsión o separación completa del cuerpo de la madre, independientemente de la duración del embarazo. En un alto porcentaje se desconocen sus causas, aunque la literatura ha establecido como factores de riesgo la hipoxia intrauterina y las malformaciones congénitas. Se realizó un estudio retrospectivo, descriptivo, con el objetivo de determinar, a través de revisión de las historias clínicas, las características epidemiológicas de las muertes fetales en la Maternidad Dr. José Luis Facchin de Boni, en el período enero 2007 marzo 2013. La población fue 1236 gestantes con diagnóstico de muerte fetal, determinando una tasa de 56,28 muertes fetales por cada 1000 nacimientos y abortos. La mayoría de dichas muertes fetales (85,03%) ocurrieron por debajo de las 37 semanas, con predominio del sexo masculino. Además los factores médicos como el síndrome anémico, los obstétricos como las malformaciones fetales y las complicaciones hemorrágicas fueron los más frecuentemente encontrados en los casos de muerte fetal. Otro hallazgo importante de la investigación, fue que el peso de los fetos muertos fue menor que el peso de los nacidos vivos de la misma edad gestacional.

Stillbirth is the death of the fetus before their expulsion or complete separation of the body of the mother, regardless of the length of pregnancy. A high percentage of its causes are unknown, although the literature has established as risk factors intrauterine hypoxia and birth defects. A retrospective, descriptive study was conducted in order to determine, through review of medical records, the epidemiological characteristics of stillbirths in the Maternidad Dr. José Luis Facchin Boni, between January 2007 and March 2013. The population was 1236 pregnant women diagnosed with stillbirth, determining a rate of 56.28 stillbirths per 1000 births and abortions. Most of these stillbirths (85.03%) were below 37 weeks, with predominance of males. Medical factors such as anemic syndrome, the obstetric factors such as fetal malformations and hemorrhagic complications were most frequently found in cases of stillbirth. Another important finding of the research was that the weight of dead fetuses was less than the weight of live births of the same gestational age.

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The effect of a mixture of potentially probiotic bacteria (MPPB; Lactobacillus reuteri DDL 19, Lactobacillus alimentarius DDL 48, Enterococcus faecium DDE 39, and Bifidobacterium bifidum strains) on the milk fatty acid (FA) profile, with emphasis on cis-9,trans-11 conjugated linoleic acid (CLA) in the middle stage of goat lactation, was determined. In addition, the effects of MPPB feeding on the FA profile in intestinal content and intestinal morphology in weaned goats were analyzed. The probiotic supplement was able to modify FA composition of milk and intestinal content. The unsaturated FA concentrations in milk (g of FA/L of milk) increased from 4.49 to 7.86 for oleic (18:1), from 0.70 to 1.39 for linoleic (18:2), from 0.063 to 0.187 for linolenic (18:3) acid, and from 0.093 to 0.232 for CLA. The atherogenicity index diminished 2-fold after MPPB ingestion. In the intestinal content of the weaned goats, no significant difference in saturated FA concentration compared with the control was observed. However, oleic acid, linolenic acid, CLA, and docosahexaenoic acid concentrations increased by 81, 23, 344, and 74%, respectively, after probiotic consumption. The ruminal production of CLA was increased by the MPPB. However, bacterial strains of MPPB were unable to produce CLA in culture media. By histological techniques, it was observed that the treated group had intestinally more conserved morphological structures than the control group. The results obtained in this study indicate that the MPPB administration in lactating and weaned goats allows for the production of milk with improved concentrations of beneficial compounds, and also produces a protective effect in the goat intestine. The results obtained in this study reinforce the strategy of probiotics application to enhance goat health with the production of milk with higher concentrations of polyunsaturated FA.

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We investigated the relationship of the positivity for Chlamydophila pneumoniae (Cpn) and Mycoplasma pneumonia (Mpn), inflammatory and metabolic markers, and mRNA expression and polymorphisms of the TLR2, TLR4, IL-6 and TNFA genes with acute myocardial infarction (AMI). Two hundred and eighteen individuals (98 AMI and 120 non-AMI) were selected at two Clinical Centers. Blood samples were drawn to extract DNA and RNA and to measure laboratory variables including anti-Cpn IgM and IgG. Cpn and Mpn genomic DNA as well as TLR2, TLR4, IL-6 and TNFA mRNA expression were evaluated by quantitative real-time PCR (qPCR). Gene polymorphisms were detected by PCR-HRM. AMI patients had higher positivity for Cpn-DNA (17.3%) than non-AMI group (6.7%, p=0.018). In addition, Cpn-DNA positivity was an independent predictor of risk for AMI (OR: 2.56, CI: 1.08 - 6.04, p=0.031). Positivity for anti-Cpn IgG and Mpn-DNA was similar between AMI and non-AMI (> 0.05). TLR4 mRNA expression was higher in AMI than non-AMI individuals (p=0.005). CD14 -260C> T, TNFA -308A> G, TLR2 c.2258G> A, TLR4 c.896A> G and TLR4 c.1196> T variants were not associated with increased risk for AMI (p> 0.05). In the AMI group, individuals carrying CD14 -260CC genotype had higher hsCRP levels than CT/TT carriers (p=0.041). These results are suggestive that Cpn-DNA positivity and increased TLR4 mRNA expression in blood leukocytes may be associated with AMI and could be useful markers to evaluate the severity and progression of the atherosclerotic disease in AMI patients.

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Objetivo: Determinar la expresión del Ki67, p53 y Bcl2 en pacientes con diagnóstico de cáncer de mama en nuestro medio. Métodos: Se realizó un estudio descriptivo, retrospectivo de diseño no experimental de tipo transeccional de la expresión por técnica inmunohistoquímica de los marcadores moleculares Ki67, p53 y Bcl2 de casos con el diagnóstico de carcinoma de mama en un grupo de 110 mujeres que acudieron consecutivamente a una consulta de mama en la Clínica Docente los Jarales (CDLJ) durante el período comprendido 2005 - 2011. La muestra fue intencional y conformada por los casos seleccionados del archivo historias de la consulta que cumplieron los siguientes criterios de inclusión. Resultados: La edad promedio fue de 51,81 años, más del 60 % eran posmenopáusicas. El tumor en la mayoría se localizó en la mama izquierda, Más del 60 % de los tumores tenían un tamaño entre los 2 a 5 cm y más del 80 % metástasis regionales. En más de la mitad de los tumores se observó inmunoexpresión de los receptores hormonales. El 60 % de los tumores correspondieron al subtipo luminal A. El Ki67 se observó en mayor porcentaje de casos en los tumores de pacientes entre 25 a 46 años y el p53 y Bcl2 en aquellos entre 36 a 46 y 58 a 68 años respectivamente. El Ki67, p53 y Bcl2 marcaron en mayor número de casos clasificados estadio clínico II-III, como de tumores entre 2 a 5 cm y con más de 7 ganglios metastásicos. Conclusión: Es necesario generar aún más evidencia sobre las características propias de nuestra población femenina afectada por la neoplasia para comprender su comportamiento en ellas y racionalizar en consecuencia lo correspondiente a su terapéutica.

Objective: To determine the expression of Ki67, p53 and Bcl2 in patients diagnosed with breast cancer in our midst. Methods: A descriptive, retrospective design nonexperimental transeccional expression by immunohistochemistry of molecular markers Ki67, p53 and Bcl2 in cases with a diagnosis of breast cancer in a group of 110 consecutive women attending a breast query the Jarales Teaching Clinic (CDLJ) during the period from 2005 to 2011. The sample was composed of intentional and file cases selected records of the query that met the following inclusion criteria. Results: The mean age was 51.81 years, over 60 % were postmenopausal. The tumor was located in most of the left breast, over 60 % of the tumors had a size between 2-5 cm and over 80 % regional metastases. In more than half of the tumors was observed immunoexpression hormone receptors. 60 % of the tumors corresponded to the luminal subtype A. Ki67 was observed in the highest percentage of cases in tumors from patients aged 25 to 46 years and the p53 and Bcl2 in those between 36 to 46 and 58 to 68 respectively. The Ki67, p53 and Bcl2 marked in more cases classified clinical stage II-III, as tumors between 2-5 cm and more than 7 metastatic nodes. Conclusion: It is necessary to generate further evidence on the characteristics of our female population affected by neoplasia to understand their behavior accordingly rationalize them and what matches your therapy.

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Objetivo: Identificar el diagnóstico definitivo de la imagen probablemente benigna y sospechosa de malignidad del estudio mamográfico en un grupo de mujeres de nuestro medio. Métodos: Se realizó un estudio de las imágenes probablemente benignas y sospechosas de malignidad en las mamografías del grupo de mujeres que acudieron con el estudio a una consulta de mama en la Clínica Docente los Jarales durante junio 2009 a diciembre 2011. Se revisó el archivo de historias de la consulta, seleccionando aquellas de acuerdo a los criterios de inclusión: informe anexo de la mamografía descriptivo de imágenes probablemente benignas y sospechosas de malignidad, sin distinción por el centro que realizó el estudio, nota de lectura de la imagen visualizada durante la valoración, digitalización y archivo de las anteriores, resultado de la biopsia consecutiva, además se evaluó edad, menarquía, paridad, estatus hormonal, tratamiento hormonal, antecedentes de cáncer de mama (familiar y personal), volumen mamario, hallazgo en la evaluación, tiempo de realizado el estudio. Resultados: De los 150 casos estudiados, la edad promedio fue de 42,12 años, 70 % posmenopáusicas, menos del 10 % tenía antecedentes de cáncer de mama. En más de 70 % de las pacientes se palpó un nódulo. En mamografía la densidad nodular definida fue el hallazgo más común. La categoría BIRADS 3 se informó en más del 60 %. El VPP de la mamografía con categoría BIRADS 3 para lesión benigna fue de 99,03 % y en aquellas BIRADS 4 para lesión maligna fue de 90,38 %. Conclusión: Es necesario insistir en el uso del sistema BIRADS para la descripción e informe de las imágenes en la mamografía.

Objective: Identifity the definitive diagnosis of probably benign image and suspicious for malignancy of mammography in a group of women in our country. Methods: We performed a study of images probably benign or suspicious for malignancy on mammograms of women attending group to study a breast query the Jarales Teaching Clinic during June 2009 to December 2011. Revised stories file query, selecting those according to the inclusion criteria: Annex report descriptive mammography images probably benign or suspicious for malignancy, without distinction by the center that conducted the study, note reading image displayed during titration, scanning and archiving of previous consecutive biopsy results also assessed age at menarche, parity, hormonal status, hormone treatment, breast cancer history (family and personal), breast volume, finding in evaluation, the study was conducted time. Results: Of the 150 cases studied, the average age was 42.12 years, 70 % postmenopausal, less than 10 % had a history of breast cancer. In over 70 % of the patients felt a nodule. In defined nodular density mammogram was the most common finding. 3 BIRADS category reported in more than 60 %. The PPV of mammography with BIRADS category 3 for benign lesion was 99.03 % and those BIRADS 4 for malignancy was 90.38 %. Conclusion: It is necessary to insist on using BIRADS system to describe and report on mammography images.

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In order to evaluate the occurrence of Chlamydia trachomatis, we have examined samples of cervical swabs from 189 women (166 of which were symptomatic and the remaining 23 were asymptomatic with regard to chlamydial infection. Two specimens from the endocervical channel were collected and examined by immunofluorescent assay (DIF) and Chlamydia isolation. Detection of IgG and IgA antibodies specific to C. trachomatis was also effected by indirect immunofluorescent assay (IIF), in a cervical secretion sample. We succeeded in isolating chlamydia in 14 (8.4%) symptomatic and 3 (13%) asymptomatic women. The observation that the 152 symptomatic patients with negative results from chlamydia culture presented similar symptoms of disease, indicating that there is no specific symptom for genital infection caused by Chlamydia (p > 0.05). All the 13 (76.5%) positive endocervical specimens, as determined by cell culture and DIF reaction, presented more than 5 epithelial cells in the smears. These cells may represent an interference factor to the positivity of cell culture (p < 0.001). Antibodies of the IgG and/or IgA classes were detected in 11 (64.7%) out of 17 women with positive chlamydia culture, considering as positive the IIF titre of > or = 8. Consequently, this method can not be used as an alternative means of diagnosis, particularly in the earlier stages of chlamydial genital infections, since the presence of the antibodies depends on the phase of the infection and on the individual humoral immune response.

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The diagnosis of spotted fever is based on characteristic signs and symptoms but requires laboratorial confirmation because of the possible differential diagnosis from other diseases like leptospirosis, enterovirus, meningococcemia and typhoid fever. Laboratorial confirmation may be done by detection of specific antibodies which is possible only 5-10 days after the onset of the symptoms or by the isolation of Rickettsiae from blood and/or skin biopsy and from ticks collected in the patient or in the animal reservoir. The isolation of Rickettsiae from blood or skin biopsy results in an early diagnosis of spotted fever since in the rickettsiemic phase of the disease there is no detectable level of antibodies in the serum. With the purpose of facilitating the diagnosis of Spotted Fever we have standardized the isolation of Rickettsiae in cell culture by a method that is less time consuming and that reduces the biological risks than isolation in guinea pigs. Vero cell cultures were inoculated with the Sheyla Smith strain of Rickettsia rickettsii provided by CDC (Atlanta-USA). The identification was performed by indirect immunofluorescence technique. The presence of green fluorescent organisms characterized the growth of the agent. Ulterior confirmation of the methodology was done by isolation of the spotted fever agent from skin biopsy of a patient from an endemic area and from Amblyomma ticks that are the reservoir and vector of the Brazilian spotted fever.

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Shikimic acid has been described as a potent competitive inhibitor of the activity of C4 phosphoenolpyruvate carboxylase (PEPC) from Amaranthus viridis. In the present study, the effects of shikimic acid were examined further with the dephospho (dark-form) and in vitro phosphorylated forms of homogeneous PEPC from A. viridis. Kinetic analysis showed that the inhibitor effect of shikimic acid was dependent on the phosphorylation state of the enzyme. Thus, the I50 value of shikimic acid for dark-form PEPC was six times lower than that for the phosphorylated enzyme (12 vs 71 microM, respectively). When Glc6P, an activator of C4 PEPC, was present in the assay medium, the I50 value increased 2- and 3-times with the phospho and dephospho PEPC-forms, respectively. Shikimic acid also markedly decreased 32P incorporation from Mg[gamma-32P]ATP into the dark-form of C4 PEPC, but not casein, catalyzed by protein kinase A. In this way, shikimic acid mimics the behaviour of L-malate, a well-known inhibitor of PEPC, in that it decreases both the enzyme's activity and phosphorylatability. Based on these data, a possible role for shikimic acid in the regulation of PEPC activity in plants is suggested.

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The inhibitory effects of flavonoids on the activity of two photosynthetic enzymes such as phosphoenolpyruvate carboxylase (PEPCase) and NADP-dependent malic enzyme (NADP-ME) were evaluated. The glycosylation of hydroxyl groups on the flavonoids resulted in compounds that behaved as gradually weaker inhibitors with increased size of the substituent. Quercetin and baicalein showed a competitive inhibition pattern vs. NADP+ for NADP-ME, and a similar model for both flavonoids vs. phosphoenolpyruvate (PEP) was observed when tested on PEPCase. K(i) for NADP-ME inhibition at pH 7.0 were 0.83 microM and 1.54 microM for quercetin and baicalein, respectively. K(i) for PEPCase inhibition were 0.17 microM and 0.79 microM (quercetin and baicalein, respectively), indicating that these compounds are the most potent inhibitors described for this carboxylase. I50 values for these and other flavonoids were in the micromolar range. A tentative physiological role for the inhibitory effects observed on PEPCase is discussed.

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This paper reports the first isolation of a spotted fever group rickettsia from an Amblyomma cooperi ixodid collected from a capybara (Hydrochaeris hydrochaeris) in an endemic area of spotted fever in the County of Pedreira, State of São Paulo, Brazil. Isolation was performed in Vero cell culture and submitted to immunofluorescence, using antibody from Rickettsia rickettsii-positive human serum.

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The effect of structural analogues of L-malate was studied on NADP-malic enzyme purified from Zea mays L. leaves. Among the compounds tested, the organic acids behaved as more potent inhibitors at pH 7.0 than at pH 8.0, suggesting that the dimeric form was more susceptible to the inhibition than the tetrameric form of the enzyme.Oxalate, ketomalonate, hydroxymalonate, malonate, oxaloacetate, tartrate, α-hydroxybutyrate, α-ketobutyrate, α-ketoglutarate and α-hydroxyglutarate exhibited linear competitive inhibition with respect to the substrate L-malate at pH 8.0. On the other hand, glyoxylate and glycolate turned out to be non-competitive inhibitors, while glycolaldehyde, succinate, fumarate, maleate and ß- and γ-hydroxybutyrate had no effect on the enzyme activity, at the concentrations assayed. These results suggest that the extent of inhibition was dependent on the size of the analogues and that the presence of an 1-carboxyl group along with a 2-hydroxyl or 2-keto group was important for binding of the substrate analogue to the enzyme.

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A 2 years old child living in an area of the State of São Paulo, known in the past as endemic for rickettsiosis developed clinical evidences of spotted fever after a tick bite. Rickettsiae were isolated from guinea pigs inoculated with a skin homogenate. In sera tested by indirect immunofluorescence with Rickettsia rickettsii standard antigen, IgG specific antibody titers raised from 1:512 in the first sample to 1:2048 in the third one; IgM specific antibody titer was 1:128 in the three samples. Also positive were sera obtained from the inoculated guinea pigs. In the last 20 years no other case of rickettsial spotted fever has been confirmed by isolation of the agent in Brasil. To our knowledge, there are no previous reports of isolation of Rickettsiae through inoculation of skin biopsy homogenates.

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