Introduction: Mature circulating endothelial cells (CEC) and circulating endothelial progenitor cells (EPC) have been described in several conditions associated with endothelial injury. Their role in deep vein thrombosis (DVT) has not been previously evaluated. Patients and Methods: In this pilot study we evaluated the time course of CEC and EPC release after vena cava experimental DVT in mice, using the FeCl3 model. We also evaluated their presence in patients with DVT at different phases of the disease (acute and chronic phase). CEC and EPC were evaluated by Flow Cytometry. Results: In mice, both CEC and EPC were increased 24 hours after DVT induction, peaking 48 hours thereafter. After 72 hours, CEC counts decreased sharply, whereas EPC counts decreased less substantially. In DVT patients we observed a significant increase in CEC counts immediately after DVT compared to healthy individuals. Patients with chronic disease also presented a significant elevation of these cell count. In a subgroup of patients for whom serial samples were available, CEC counts decreased significantly after 9-15 months of the acute event. Conclusions: Our results suggest the participation of these cells in the reparative processes that follows DVT, both at immediate and late time-points. The different kinetics of CEC and EPC release in experimental DVT suggests a heterogeneous role for these cells in the reparative events after DVT.

The aim of this study was to determine the prevalence of alpha (ESR1: c.454-397T>C and c.454-351A>G) and beta (ESR2: 1082G>A and 1730G>A) estrogen receptor gene polymorphisms in 2 Brazilian ethnic groups (Caucasian, African Brazilian) and to investigate their association with recurrent miscarriage (RM) in 75 women with a history of 3 or more consecutive pregnancy losses and 139 controls with at least 2 live births and no history of pregnancy loss. Polymerase chain reaction and restriction fragment length polymorphism were used to identify gene polymorphisms. Coagulation methods were used to measure protein C, protein S, and fibrinogen, and a chromogenic method was used for antithrombin quantification. Significantly higher prevalences of 1082G>A and 1730G>A polymorphisms were seen in African Brazilian and Caucasian controls, respectively. There was no association between RM and ESR polymorphisms. There was a difference in the genotype prevalence in the c.454-39T>C polymorphism between RM and control Caucasians, but this finding was not associated with an increased risk of miscarriage. There was no synergistic or additive effect between ESR polymorphisms and thrombophilia in RM patients. A difference in the prevalence of ESR polymorphisms was observed, according to ethnic origin. ESR polymorphisms could not be considered a risk factor for RM.

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Enoxaparin is an anticoagulant widely used in the treatment and prophylaxis of deep vein thrombosis (DVT). The subcutaneous route of administration, sometimes in repeated doses during 24 hours, represents a limitation to its use. Thus, the development of a product that can be administered either subcutaneously, in a smaller number of applications becomes a major challenge, with interesting clinical applications. The use of a system for sustained release of drugs can help to meet that goal, by protecting and enabling a gradual released of the agent. This study consisted of the evaluation of in vivo anticoagulant and antithrombotic activity of biodegradable nanoparticles of poly (ε-caprolactone) (PCL) with enoxaparin after subcutaneous injection. The nanoparticles were prepared by the method of double emulsion (w/o/w) and solvent evaporation. Subcutaneous enoxaparin encapsulated in PCL nanoparticles (1000 IU/kg) showed a sustained release in vivo for up to 12 hours (Cmax 0.62 IU/mL) a significantly longer period (P < 0.01) when compared to free enoxaparin (1000 IU/Kg) that disappeared after 9 hours (Cmax 1.50 IU/mL), however with lower anti-Xa activity. The antithrombotic action of enoxaparin-nanoparticles was tested in a DVT model by stasis in rats. There were virtually no formation of venous thrombosis in any of the rats that received enoxaparin encapsulated in nanoparticles (0.03 mg), with a significant difference when compared to groups that received saline (17.2 mg, P < 0.001) and free enoxaparin (2.87 mg, P = 0.001). In summary, enoxaparin-encapsulated in polymeric nanoparticles showed a sustained release for a greater period than that of enoxaparin, and with excellent antithrombotic action. These results corroborate the promising use of pharmacological nanoparticles in clinical practice.

Studies evaluating circulating endothelial cells by flow cytometry are faced by a lack of consensus about the best combination of monoclonal antibodies to be used. The rarity of these cells in peripheral blood, which represent 0.01% of mononuclear cells, drastically increases this challenge.ObjectiveThe aim of this study is to suggest some combinations of markers that would safely and properly identify these cells.MethodsFlow cytometry analysis of circulating endothelial cells was performed applying three different panels composed of different combinations of the CD144, CD146, CD31, CD133, CD45 and anti-Vascular endothelial growth factor receptor-2 antibodies.ResultsIn spite of the rarity of the events, they were detectable and presented similar inter-person numbers of circulating endothelial cells.ConclusionThe combination of markers successfully identified the circulating endothelial cells in healthy individuals, with the use of three different panels confirming the obtained data as reliable.

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Introduction: Syphilis is a disease transmitted mainly sexually and vertically. Congenital syphilis is preventable when a pregnant woman is treated, warning about the importance of prenatal screening. Objective: To describe the epidemiological profile of gestational and congenital syphilis in the state of Mato Grosso - Brazil. Methodology: A descriptive cross-sectional study with a quantitative approach, using secondary data from the Notifiable Diseases Information System (SINAN), from 2011 to 2020. Results: 5120 cases of gestational syphilis and 2320 cases of syphilis were reported congenital in the state of Mato Grosso. The induced cases increased over the years, with notification peak of gestational syphilis in the year 2019 with 942 (18%) cases and congenital syphilis in the year of 2018 with 322 (14%) cases. Most women affected by gestational syphilis were young, with low education, mixed race, who underwent prenatal care, did not have their partners treated concomitantly and had a late diagnosis after the first trimester. Patients with congenital syphilis were mostly diagnosed early. Conclusion: The findings change flaws in prenatal care and the need for greater investments in innovative actions in order to reduce vertical transmission of syphilis.

A trombose venosa profunda é uma importante causa de morbimortalidade no mundo, principalmente no âmbito intra-hospitalar, justificando seu tratamento e também profilaxia quando necessário. Os métodos de indução de trombose venosa profunda em animais são fundamentais para o estudo da fisiopatologia da doença, assim como para testes de drogas antitrombóticas. Os objetivos do trabalho foram avaliar e comparar dois métodos de indução de trombose venosa profunda em ratos: o modelo por estase venosa, amplamente descrito na literatura, e o modelo por lesão endotelial, com poucos estudos, principalmente em ratos. Foram usados ratos machos Wistar para indução da trombose venosa profunda. Para estase foi dissecada e ligada a veia cava inferior por 3 horas e após retirado o segmento com a veia contendo o trombo. Para o modelo de lesão endotelial, foi aplicado por 1 minuto um pedaço de papel filtro embebido em FeCl3 e avaliado o segmento após 1 hora. Em ambos os modelos foram avaliados o peso úmido e a área de oclusão. Para o peso úmido obteve-se comparando os métodos de lesão endotelial e estase respectivamente: 17,7mg (±3,0mg) vs. 2.34mg (±1,8mg) com P<0,001. Para a área de oclusão obteve-se comparando os métodos de lesão endotelial e estase respectivamente: 85,11% (±9,67%) vs. 40,83% (±33,14%), com P<0,05. Em todas as variáveis o método de lesão endotelial possuiu resultados superiores ao método de estase venosa, mostrando ser mais reprodutível.