Effect of Bariatric Surgery on Obstructive Sleep Apnea and Hypopnea Syndrome, Electrocardiogram, and Pulmonary Arterial Pressure

Background: We evaluated the impact of surgically-induced weight loss on Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS), electrocardiographic changes, pulmonary arterial pressure and daytime sleepiness in morbidly obese patients. Methods: 16 women and 13 men (n=29) underwent bariatric surgery in a 3-year period. The following tests were performed before and 1 year after surgery: nocturnal polysomnography, daytime Multiple Sleep Latency Test (MSLT), and echocardiogram. Results: Mean age was 37.9±11 years (range 20-56). Preoperative body mass index was 56.5±12.3 kg/m² and it was 39.2±8.5 kg/m² at 13.7±6.6 months follow-up. Performed surgical procedures included: vertical banded gastroplasty in 6, Roux-en-Y gastric bypass in 12, and Distal Roux-en-Y gastric bypass in 11. Weight loss induced by surgery eliminated OSAHS in 46% of obese patients with an important improvement in oxygen saturation. Neck, thorax, waist and hip circumferences decreased significantly after surgical intervention but only neck circumference correlated significantly with the apnea/hypopnea index (Spearman rho=0.63, P <0.0001). Electrocardiographic abnormalities were present in 9 patients (31%) before surgery (sinus arrhythmia, ventricular arrhythmias, and sinus arrest). The number of electrocardiographic abnormalities decreased after surgery but new abnormalities appeared in some patients. Systolic pulmonary arterial pressure significantly decreased in the group of patients in whom OSAHS disappeared after surgery. Daytime sleepiness persisted after surgery in most patients. Conclusion: Bariatric surgery effectively reduces respiratory disturbances during sleep and improves pulmonary hypertension. Electro cardiographic abnormalities change after surgery. Daytime sleepiness appeared not to be related to respiratory disturbances during sleep.     

Bioprosthetic Valve Thrombosis and Obstruction Secondary to COVID-19

Patients with COVID-19 may present a hypercoagulable state, with an important impact on morbidity and mortality. Because of this situation pulmonary embolism is a frequent complication during the course of infection. We present the case of a patient recently discharged, after admission with confirmed COVID-19, who developed a pulmonary embolism and thrombosis of a biological mitral valve prosthesis, producing valve obstruction and stenosis. After 15 days of anticoagulant treatment, resolution of the thrombus and normalisation of prosthetic valve function was observed. This case supports current recommendations of administering full-dose anticoagulation therapy to COVID-19 patients with biological heart valve prosthesis, even after the acute phase of infection.     

Identical Presentation of Scapular Osteolysis in Two Patients with Thoracic Kaposiform Hemangioendothelioma

Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor that does not metastasize. We report two unique cases of KHE involving the right hemithorax and the upper ipsilateral extremity. Kasabach–Merrit phenomenon and osteolytic lesions in the scapula were observed in both cases.     

Isolation and characterization of ten nuclear microsatellite loci for the Portuguese dogfish Centroscymnus coelolepis

The Portuguese dogfish Centroscymnus coelolepis is a deepwater squaloid shark with a wide distribution and is also an important fishing resource in parts of its range. Despite concerns about the species’ sustainability, current fisheries management measures have been implemented without a good understanding of the stock structure. The assessment of the population structure of C. coelolepis using molecular markers will provide important information for future management efforts. Here we describe the first attempt at isolating nuclear microsatellite markers for C. coelolepis. Ten polymorphic microsatellite loci were developed and screened in 43–45 individuals collected off western Portugal, showing 3–29 alleles per loci (average: 12.5 alleles/locus) and observed heterozygosities ranging from 0.60 to 0.98. None of the markers exhibited genotypic distributions that deviated from HWE expectations, or showed evidence of linkage disequilibrium or the presence of null alleles.     

Distribution of filamentous fungi causing invasive fungal disease at the Haematological Unit,Hospital de Clínicas de Porto Alegre,Brazil

Very limited data are available in the literature to elucidate the aetiology of invasive mould infections in Latin America. Here we report that Aspergillus species caused only half of such cases in a cohort study conducted over 21 months in a university hospital in Porto Alegre, Southern Brazil. Fusarium spp. were the second most prevalent moulds (20.7%), followed by Zygomycetes (13.8%). The importance of obtaining local epidemiological data for adequately guiding empirical antifungal therapy is reinforced.     

Optimization of DNA extraction in the spiny spider crab <Emphasis Type="Italic">Maja brachydactyla</Emphasis>: determining the best extraction method,sample conservation and starting tissue

Methodological studies are an important previous step in molecular research. We optimize a method for DNA extraction from eggs and a noninvasive extraction method for adult tissues of Maja brachydactyla. Our results show that lyophilized eggs in B developmental stage are the most suitable for DNA extraction. Regarding adult tissues, we propose setae as an alternative tissue for DNA extraction, since prevents mutilation of specimens, which avoids infections and fitness reduction. That is especially relevant in studies with endangered species of crustaceans.