Carlos Alberto Basílio de Oliveira

The Pathology of Severe Dengue in Multiple Organs of Human Fatal Cases: Histopathology, Ultrastructure and Virus Replication

Dengue is a public health problem, with several gaps in understanding its pathogenesis. Studies based on human fatal cases are extremely important and may clarify some of these gaps. In this work, we analyzed lesions in different organs of four dengue fatal cases, occurred in Brazil. Tissues were prepared for visualization in optical and electron microscopy, with damages quantification. As expected, we observed in all studied organ lesions characteristic of severe dengue, such as hemorrhage and edema, although other injuries were also detected. Cases presented necrotic areas in the liver and diffuse macro and microsteatosis, which were more accentuated in case 1, who also had obesity. The lung was the most affected organ, with hyaline membrane formation associated with mononuclear infiltrates in patients with pre-existing diseases such as diabetes and obesity (cases 1 and 2, respectively). These cases had also extensive acute tubular necrosis in the kidney. Infection induced destruction of cardiac fibers in most cases, with absence of nucleus and loss of striations, suggesting myocarditis. Spleens revealed significant destruction of the germinal centers and atrophy of lymphoid follicles, which may be associated to decrease of T cell number. Circulatory disturbs were reinforced by the presence of megakaryocytes in alveolar spaces, thrombus formation in glomerular capillaries and loss of endothelium in several tissues. Besides histopathological and ultrastructural observations, virus replication were investigated by detection of dengue antigens, especially the non-structural 3 protein (NS3), and confirmed by the presence of virus RNA negative strand (in situ hybridization), with second staining for identification of some cells. Results showed that dengue had broader tropism comparing to what was described before in literature, replicating in hepatocytes, type II pneumocytes and cardiac fibers, as well as in resident and circulating monocytes/macrophages and endothelial cells.

A Customized Evolutionary Algorithm for Multiobjective Management of Residential Energy Resources

Dynamic tariffs are expected to become a relevant pricing scheme in the context of smart grids. In this framework, active management of residential loads can play an important role to optimize the usage of end-use energy resources while minimizing energy cost. This paper presents an evolutionary algorithm to optimize the integrated usage of multiple residential energy resources (local generation, shiftable loads, thermostatically controlled loads, and storage systems) considering a large set of management strategies. Customized solution encoding and operators are developed for different groups of loads. The multiobjective model considers as objective functions the minimization of the energy cost and the minimization of end-users dissatisfaction associated with management strategies. Results have shown that significant savings can be achieved mainly through demand response actions implemented over thermostatically controlled loads. Savings are also dependent on the end-users preferences and degree of willingness to accept automated control.

Detection of dengue NS1 and NS3 proteins in placenta and umbilical cord in fetal and maternal death.

In Brazil, dengue is a public health problem with the occurrence of explosive epidemics. This study reports maternal and fetal deaths due to dengue and which tissues of placenta and umbilical cord were analyzed by molecular methods and immunohistochemistry. The dengue NS3 and NS1 detection revealed the viral presence in different cells from placenta and umbilical cord. In the latter, DENV‐2 was detected at a viral titer of 1,02 × 104 amounts of viral RNA. It was shown that the DENV markers analyzed here may be an alternative approach for dengue fatal cases investigation, especially involving maternal and fetal death. J. Med. Virol. 88:1448–1452, 2016.

An Energy Management System Aggregator Based on an Integrated Evolutionary and Differential Evolution Approach

The increasing penetration of renewable generation in the electric power system has been leading to a higher complexity of grid management due to its inherent intermittency, also with impact on the volatility of electricity prices. Setting the adequate operating reserve levels is one of the main concerns of the System Operator (SO), since the integration of a large share of intermittent generation requires an increased amount of reserve that is needed to balance generation and load. At the same time, the energy consumption in households has been steadily growing, representing a significant untapped savings potential due to consumption waste and load flexibility (i.e., the possibility of time deferring the use of some loads).

Comparative study of the different degrees of risk of gastrointestinal stromal tumor

OBJECTIVE To evaluate the applicability of the main categories of risk and morphological factors in the prognosis of gastrointestinal stromal tumors. METHODS we retrospectively studied fifty-four cases of GIST, assessing the main prognostic factors of this neoplasis: risk levels, topography, size, mitotic index, necrosis, histological subtype and immunophenotype. We also verified their association and the reduction of overall survival. RESULTS Univariate analysis showed that tumors with mitoses number greater than 5 per 50CGA (high-power fields), the presence of necrosis and a high risk for both the systems proposed by Fletcher and Miettinen had a significant association with reduced survival (p = 0.00001, 0.0056, 0.03 and 0.009, respectively). The remaining analyzed factors (size, histological subtype, topography and immunophenotype) had no such association. Multivariate analysis (Jacard index) showed that the Miettinen degree of risk was the one that best correlated with prognosis. CONCLUSION the risk criteria of Fletcher and Miettinen are important in assessing the prognosis of patients with gastrointestinal stromal tumors, especially the latter, which adds to the mitotic index and the presence of tumor necrosis.

Enterocyte ultrastructural alterations following intestinal obstruction in rats

PURPOSE To analyze the small intestinal mucosa ultrastructure, and to characterize the enterocyte lesion severity caused by mechanical intestinal obstruction combined or not with an ischemia of the mesenteric marginal vessels arch. METHODS It was used 47 Wistar rats divided into 4 groups as follows: Group 1- Control rats (C), Group 2- sham rats (S), Group 3- rats submitted to intestinal obstruction excluding marginal vessel (OEV), Group 4- Intestinal obstruction including marginal vessels (OIV). Rats of groups 3 and 4 were allotted into two subgroups for the removal of small intestinal tissue samples, one at the proximal (P), and the other at the distal (D) segments from the obstruction site. Samples of groups 2, 3, 4 were obtained 24, 48, and 72 hours after post operation care. Small intestinal tissue samples of group 1 were excised following laparotomy. Imaging in Light and Transmission Electronic Microscopy were used for morphological and morphometric studies. The results were analyzed by using the ANOVA and Newman-Keuls tests. RESULTS No irreversible lesion was observed. In the 24 hours microvilli volume of group 3 turned down at the proximal site henceforth enlarging very slowly within the next 72 hours. At the distal site significant microvilli shrinkage was observed up to 48 hours. Then they recovered their volume after 72 hours. In the 24 hours microvilli volume of group 4 grew twice in comparison with the microvilli of group 1 rats but after 72 hours there was drastic volume shrinkage, shape alterations, and severe flatness, especially in the distal segments of the obstruction site. CONCLUSIONS Terminal ileum mechanical obstruction with mesenteric marginal arch ischemia led to reversible ultrastructural alterations after 72 hours, and the injury is proportional to the persistence of the obstructive process. Furthermore the mesenteric vessels of the marginal arcade play an important role in the maintenance of mucosal integrity, when such obstructive disorder is present.

Effects of alpha-tocopherol associated with lovastatin on brain tissue and memory function in SHRSPs

Strokes are preceded by oxidative stress and inflammation, two processes linked to atherosclerosis and hypertension. Statins have been widely employed to control atherosclerosis; however, there could be neurological implications to its use—including cognitive impairment. Thus,we aimed to determine whether alpha-tocopherol is capable of reversing the neurological side effects of statins and enhancing its anti-inflammatory properties. To assess these effects, 15-week-old stroke-prone spontaneously hypertensive rats (SHRSPs) were divided into four groups (n = 6, each): alpha-tocopherol (AT), lovastatin (LoV), alpha-tocopherol + lovastatin (AT + LoV), and control (C).We administered 120 IU of alpha-tocopherol diluted in 0.1 ml of coconut oil,whereas the dose of lovastatin was administered at a ratio of 1 mg/kg of rat body weight. The control group received 0.1 ml coconut oil. All animals received the treatments via orogastric gavage.We assessed body weight, diuresis, food and water intake, oxidative stress (malondialdehyde levels), the total cellular injury marker (lactate dehydrogenase), short and long-term memory, cognition, and histopathological changes in the hippocampus. The results demonstrated that lovastatin treatment did not negatively affect the memory of our animal model. In fact, the animals treated with AT and LoV showed improvement in memory and cognition. Additionally, both treatments decrease lactate dehydrogenase and oxidative stress levels. Furthermore, our study also demonstrated hippocampal tissue preservation in the treated groups.

The effects of supraphysiological supplementation of b-carotene in spontaneously hypertensive rats (SHR and SHR-sp)

OBJECTIVE To investigate the effect of administration of supraphysiological β carotene on biological, laboratory and histological parameters of spontaneously hypertensive rats prone to stroke (SHR-sp). METHODS we used 36 male rats divided into three groups, each containing 12 rats of the types Wistar SHR and SHR-sp, subdivided into six control animals and six animals treated with supraphysiological doses of β carotene for two ten-week periods, interspersed by a one-week interruption. We carried out daily physical examination and blood pressure assessment. We collected blood for measurement of serum malondialdehyde; the liver and carotid arteries were subsequently harvested for histological examination. RESULTS there was a temporary change in the color of hair, a significant decrease (p <0.0001) in blood pressure (20 mg β carotene supplementation) and serum levels of malondialdehyde (p<0.05) and increased amount of elastic fibers in the carotid wall of SHR and SHR-sp. CONCLUSION β carotene supraphysiological supplementation caused no toxic effects, showed positive response in the modulation of blood pressure and lower serum malondialdehyde. No significant morphological changes were observed in the groups studied, except for an increase in the number of elastic fibers in the carotid muscular layer, suggesting elastosis in SHR and SHR-sp.

Duplicação uretral em homem adulto

Urethral duplication is a rare congenital anomaly. The clinical presentation and treatment varies because of the different anatomical patterns of this abnormality. We report a case of this entity in the adult male patient. The clinical, radiological and endoscopic findings, as well as the treatment are discussed.