Almeida Memorial Hospital

Objective: There is increasing research interest on the impact of ischemic stroke on organs beyond the central nervous system, and it is now widely recognized that cerebral ischemia induces multiple alterations in peripheral systems. Therefore, it is necessary to elucidate the systemic consequences of cerebral ischemia. Serine protease inhibitor a3 (SERPINA3), a secretory immune-related molecule produced primarily in the liver and brain under normal conditions, is upregulated in response to inflammation. Here, we examined Serpina3n gene expression in the brain and liver and evaluated plasma SERPINA3N protein concentrations following cerebral ischemia using a mouse model. Methods: We examined changes in SERPINA3N levels in the brain, liver, and blood over time using a mouse model of focal cerebral ischemia induced by middle cerebral artery (MCA) occlusion for 4 h followed by reperfusion. Brain, liver, and blood samples were collected on days 1, 3, and 7 after MCA occlusion (MCAo). Serpina3n gene expression levels in the brain and liver were measured by quantitative real-time polymerase chain reaction (qPCR), and plasma SERPINA3N levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: Serpina3n gene expression levels in the brain and liver were increased on day 1 after MCAo. Plasma SERPINA3N protein levels were increased and peaked on day 1 after MCAo. Conclusion: A mouse model of cerebral ischemia showed increased Serpina3n gene expression in the liver and SERPINA3N protein level in plasma. This is the first study of the effects of plasma SERPINA3N protein levels using a mouse model of cerebral ischemia.

Patient 1 was a 70-year-old woman with refractory diffuse large B-cell lymphoma who received allogeneic peripheral blood stem cell transplantation from an HLA-haploidentical related donor. Upper back pain appeared on day63, and Th8-Th9 pyogenic spondylitis was diagnosed based on magnetic resonance imaging (MRI). Blood culture on day14 identified Corynebacterium striatum as the causative bacteria of blood stream infection (BSI). The pyogenic spondylitis resolved after treatment with daptomycin for 2 months. Patient 2 was a 65-year-old man with relapsed angioimmunoblastic T-cell lymphoma who received bone marrow transplantation from an HLA-DR single-antigen-mismatched unrelated donor. Lower back pain appeared on day30, and L4-L5 pyogenic spondylitis was diagnosed based on MRI. Blood culture was negative. Daptomycin and clindamycin were selected for treatment based on the drug susceptibility of bacteria that had caused pre-engraftment BSI (Escherichia coli on day3 and Corynebacterium striatum on day9), and the pyogenic spondylitis resolved after 6 months of this treatment. Pyogenic spondylitis should be considered in the differential diagnosis of back pain accompanied by BSI before engraftment in allogeneic hematopoietic stem cell transplant recipients.

This study aimed to investigate which factors have a great impact on coagulopathy after cardiopulmonary bypass (CPB) using rotational thromboelastometry (ROTEM). Ninety-eight patients undergoing cardiovascular surgery using CPB were enrolled. Data of amplitude 10min after clotting time (A10) of ROTEM measured routinely before and after CPB were retrospectively collected. ROTEM has some assays by which we can evaluate the capacity of extrinsic coagulation (EXTEM), intrinsic coagulation (INTEM), fibrin polymerization (FIBTEM), and the effect of heparin (HEPTEM). The platelet component, defined as PLTEM, can be calculated by subtracting FIBTEM from EXTEM. Age, sex, total plasma volume, pre-CPB A10, lowest body temperature, in-out balance during CPB, intraoperative bleeding amount, and type of pumps were considered as possible factors. Univariate and multivariate analyses were performed for the rate of change of A10. The change rate of each A10 had a significant negative correlation with bleeding amount (p < 0.01 for EXTEM, p < 0.01 for INTEM, p = 0.02 for FIBTEM, p < 0.01 for PLTEM). Female sex was a significant contributive predictor for the greater decline of EXTEM (p < 0.01) and INTEM (p < 0.01), positive balance for EXTEM (p < 0.01), FIBTEM (p = 0.01), and PLTEM (p < 0.01), long CPB time for INTEM (p = 0.01), centrifugal pump for FIBTEM (p < 0.01), and large pre-CPB A10 for PLTEM (p < 0.01). In perioperative hemostatic management using ROTEM, attention should be given to the effects of these multiple factors.

壊死型虚血性大腸炎は残存腸管壊死（on-going ischemia：OGI）のリスクがあり，今回OGIをきたした3症例を経験したので報告する．

With the objective of serving the academic and external community, the PET group, Tutorial Education Program, of Computer Engineering (COMPET) of CEFET -MG located at the Nova Gameleira Campus in Belo Horizonte, includes introducing themes that involve information technologies, promoting an event, which, through lectures, sought to highlight issues that involve the labor market, as well as to update participants on new technologies.The event was named IT CAMP, with lectures on game development; creation of wordpress website; back-end development and machine learning.Thus, COMPET finds a partnership with Commit Jr, a junior company in the Work Engineering course at CEFET-MG, to carry out the activities of the event that took place between June 24th and July 1st, 2020, on the youtube jr commit channel.

Artificial Intelligence, although at its infancy, is progressing at a fast pace. Its potential applications within the business structure, have led economists and industry analysts to conclude that in the next years, it will become an integral part of the boardroom. This paper examines how AI can be used to augment the decision-making process of the board of directors and the possible legal implications regarding its deployment in the field of company law and corporate governance. After examining the three possible stages of AI use in the boardroom, based on a multidisciplinary approach, the advantages and pitfalls of using AI in the decision-making process are scrutinised. Moreover, AI might be able to autonomously manage a company in the future, whether the legal appointment of the AI as a director is possible and the enforceability of its action is tested. Concomitantly, a change in the corporate governance paradigm is proposed for Smart Companies. Finally, following a comparative analysis on company and securities law, possible adaptations to the current directors’ liability scheme when AI is used to augment the decisions of the board is investigated and future legal solutions are proposed for the legislator.

A 68-year-old woman was referred to our hospital due to widespread purpura on her legs. A diagnosis of IgA vasculitis was made based on the findings of a skin biopsy. However, after being admitted to our hospital, abdominal pain and lower gastrointestinal hemorrhaging developed. The purpura disappeared gradually, whereas the abdominal pain migrated and persisted. Treatment with prednisolone was initiated, and the clinical course improved temporarily. However, her severe abdominal symptoms recurred while, in addition, the intestinal tract lesions migrated after the prednisolone dosage was tapered. Therefore, intravenous high-dose methylprednisolone was administered followed by oral steroids. The dose was thereafter carefully tapered, and the steroid dose reduction was successful with this treatment. We herein report the clinical course of the case along with a review of the relevant literature.

O objetivo deste projeto foi identificar os efeitos do treinamento de handebol e rugby em cadeira de rodas desenvolvido de forma recreativa, na forca muscular e capacidade aerobia de individuos com lesao da medula espinhal (LME). Para atingir o objetivo tracado os participantes foram avaliados pre e pos aproximadamente cinco meses de pratica esportiva e desta forma podemos identificar que nao houveram melhoras significativas nas variaveis estudadas.