Photochemical and microbial alterations of DOM spectroscopic properties in the estuarine system Ria de Aveiro

The chromophoric dissolved organic matter (CDOM) of marine (MZ) and brackish water (BZ) zones of Ria de Aveiro showed different spectral characteristics and susceptibility to photochemical alterations, reflecting the different amounts and prevailing sources of organic matter.

Nonequilibrium quantum magnetism in a dipolar lattice gas

We report on the realization of quantum magnetism using a degenerate dipolar gas in an optical lattice. Our system implements a lattice model resembling the celebrated t-J model. It is characterized by a nonequilibrium spinor dynamics resulting from intersite Heisenberg-like spin-spin interactions provided by nonlocal dipole-dipole interactions. Moreover, due to its large spin, our chromium lattice gases constitute an excellent environment for the study of quantum magnetism of high-spin systems, as illustrated by the complex spin dynamics observed for doubly occupied sites.

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

Background:

High risk of recurrence/progression bladder tumours is treated with Bacillus Calmette-Guérin (BCG) immunotherapy after complete resection of the tumour. Approximately 75% of these tumours express the uncommon carbohydrate antigen sialyl-Tn (Tn), a surrogate biomarker of tumour aggressiveness. Such changes in the glycosylation of cell-surface proteins influence tumour microenvironment and immune responses that may modulate treatment outcome and the course of disease. The aim of this work is to determine the efficiency of BCG immunotherapy against tumours expressing sTn and sTn-related antigen sialyl-6-T (s6T).

Methods:

In a retrospective design, 94 tumours from patients treated with BCG were screened for sTn and s6T expression. In vitro studies were conducted to determine the interaction of BCG with high-grade bladder cancer cell line overexpressing sTn.

Results:

From the 94 cases evaluated, 36 had recurrence after BCG treatment (38.3%). Treatment outcome was influenced by age over 65 years (HR=2.668; (1.344–5.254); P=0.005), maintenance schedule (HR=0.480; (0.246–0.936); P=0.031) and multifocallity (HR=2.065; (1.033–4.126); P=0.040). sTn or s6T expression was associated with BCG response (P=0.024; P<0.0001) and with increased recurrence-free survival (P=0.001). Multivariate analyses showed that sTn and/or s6T were independent predictive markers of recurrence after BCG immunotherapy (HR=0.296; (0.148–0.594); P=0.001). In vitro studies demonstrated higher adhesion and internalisation of the bacillus to cells expressing sTn, promoting cell death.

Conclusion:

s6T is described for the first time in bladder tumours. Our data strongly suggest that BCG immunotherapy is efficient against sTn- and s6T-positive tumours. Furthermore, sTn and s6T expression are independent predictive markers of BCG treatment response and may be useful in the identification of patients who could benefit more from this immunotherapy.

Acute hepatitis E complicated by Guillain-Barre syndrome in Portugal, December 2012--a case report

Autochthonous hepatitis E virus (HEV) infection has been increasingly reported in Europe and the United States, mostly arising from genotype 3 and less frequently genotype 4. We report here on a patient with HEV genotype 3a infection complicated by Guillain-Barré syndrome in Portugal in December 2012. We draw attention to the diagnosis of autochthonous HEV infection and to its rare, but important, neurological complications.

New-onset diabetes after transplantation: drug-related risk factors

INTRODUCTION

New-onset diabetes after transplantation (NODAT), an important complication of renal transplantation leads to reduced graft function and increased patient morbidity and mortality. Because of its high incidence and immense impact on clinical outcomes, prevention of NODAT is highly desirable. Several modifiable and nonmodifiable risk factors for NODAT have been described. The aim of this study was to analyze the influence of various drugs on the development of NODAT during the first year.

METHODS

A retrospective analysis was performed on 303 adult kidney transplant recipients free of previously known diabetes. NODAT was defined as a fasting plasma glucose level ≥ 126 mg/dL confirmed by repeat testing on a different day. We excluded patients with transiently elevated fasting plasma glucose during the first 3 months.

RESULTS

NODAT was diagnosed in 37 recipients (12.2%). Univariate analysis identified several variables related to NODAT: recipient age (P < .001), body mass index (P < .001), donor age (P = .005), family history of diabetes (P < .001), statin use (P = .005), diuretic use (P = .040) and tacrolimus therapy (P = .029). After multivariate analysis, recipient age (relative risk [RR] = 1.060, 95% confidence interval [CI] 1.019- 1.102, P = .004), family history of diabetes (RR = 3.562, 95% CI 1.574-8.058, P = .002), smoking habit (RR 2.514, 95% CI 1.118-5.655, P = .026) and diuretic use (RR = 2.496, 95% CI 1.087-5.733, P = .031) were independently associated with NODAT development.

CONCLUSIONS

In our population of kidney transplant recipients, the main nonmodifiable risk factors for NODAT were recipient age and a family history of diabetes. Diuretic use was a modifiable risk factor associated with the development of NODAT. To reduce NODAT incidence, it is necessary to consider not only immunosuppressive therapy, but also concomitant drugs such as diuretics.

Trabalho e educação em saúde no Brasil: tendências da produção científica entre 1990-2010

O objetivo deste artigo é analisar as características da produção científica sobre educação e trabalho em saúde no Brasil no período de 1990 a 2010. Realizou-se um estudo de síntese a partir de resumos de artigos publicados em revistas brasileiras selecionados nas bases bibliográficas Scielo e Lilacs. Foram selecionados 532 trabalhos, categorizados a partir do ano de publicação, temática abordada e tipo de estudo. Observa-se o crescimento da produção de artigos no período analisado, mais especialmente a partir do ano de 2007. A principal temática investigada é a formação e a capacitação de profissionais de saúde, sendo que a maioria dos trabalhos nesta área analisa reformas curriculares, metodologias de ensino-aprendizagem e experiência de articulação ensino-serviço. Além deste tema, outras questões são estudadas tais como a configuração e as tendências do mercado de trabalho em saúde e as características do processo de trabalho em diversos espaços, a exemplo de unidades de atenção primária à saúde. Chama a atenção o número reduzido de estudos relacionados à formulação de políticas, planejamento e gestão do trabalho no âmbito das instituições públicas e privadas, bem como a escassez de trabalhos que apresentem reflexões de caráter teórico-conceitual acerca do tema.

[Work and education in health in Brazil: trends in scientific output between 1990-2010]

The scope of this article is to analyze the characteristics of scientific literature on work and education in health in Brazil from 1990 to 2010. A synthetic study was conducted from abstracts published in Brazilian journal articles selected from the SCIELO and LILACS databases. Five hundred and thirty-two articles were selected, categorized according to their origin, year of publication, theme, and type of study. The publication of these scientific articles increased during the period analyzed, particularly from 2007 onwards. The main areas researched were education and training of health professionals, and the majority of works in these areas examine curriculum reform, methods of learning and teaching, and teaching in-service experiences. Besides these issues, others questions were addressed such as the labor market configuration and trends in health, and characteristics of the work process in several areas, like primary healthcare units. It was also observed that there are only a small number of studies related to policy, planning and management of work in public and private health institutions, as well as a scarcity of studies presenting reflections on theoretical and conceptual aspects of this theme.

Biodegradable stent for the treatment of a colonic stricture in Crohn’s disease

Biodegradable polydioxanone stents were developed for the treatment of refractory benign esophageal strictures but have been suggested as a new therapeutic option for intestinal strictures. The primary advantage of biodegradable stents over self-expandable metallic stents is that removal is not required. There are, however, few data available on their use in the small or large bowel. We herein describe the case of a 33-year-old patient with long-standing Crohn’s disease (CD) who developed a fibrotic stricture of the sigmoid too long to be amenable to balloon dilation. The use of a biodegradable polydioxanone stent was chosen to avoid surgery. Combined endoscopic and fluoroscopic placement of the stent was technically simple, safe and clinically successful, and no recurrence of obstructive symptoms occurred during a 16-mo follow-up. Further studies are needed to evaluate the long-term efficacy and safety of biodegradable stents in the treatment of intestinal strictures, particularly in the context of CD.

Conversion to everolimus in kidney transplant recipients: to believe or not believe?

INTRODUCTION

Immunosuppression with calcineurin inhibitors (CNI) in renal transplantation is associated with chronic graft dysfunction, increased cardiovascular risk, and malignancies. Everolimus (EVR) appears to permit a CNI-sparing regimen among stable kidney recipients.

AIM

The aim of this study was to analyze the efficacy and safety of conversion from CNI to EVR.

MATERIAL AND METHODS

This was a retrospective registry-based study of all kidney transplant recipients converted from CNI to EVR between 2006 and 2010. One hundred fifty-one patients, including 69.5% males and with an overall mean age of 50.2 ± 12.7 years, underwent conversion to EVR at 37.0 ± 49.8 (16) months after transplantation with 33.7% during the first 6 months. Reasons for conversion included: CNI nephrotoxicity prevention (54.3%), chronic graft dysfunction (25.8%), malignant tumors (10.6%), CNI-adverse reactions (6.6%), and biopsy-proven CNI nephrotoxicity (2.6%). During a follow-up of 17.9 ± 9.9 months (range, 6-58.5), 18 patients (11.9%) were reconverted to CNI, 2 died with functioning grafts, and 2 lost kidney function.

RESULTS

We observed a significant (P < .001) increase in estimated glomerular filtration rate-Modification of Diet in Renal Disease (eGFR-MDRD) by 11.3% within 6 months: 56.7 ± 22.1 to 64.1 ± 23.4 mL/min/1.73 m(2). At final evaluation it was 13.7%, namely, to 65.5 ± 23.0 mL/min/1.73 m(2). At the end of follow-up the proportion of patients with >300 mg/d proteinuria increased from 7.9% to 23.3% (P = .001). Dyslipidemia prevalence increased from 69.5% to 77.5% (P = not significant [NS]) and arterial hypertension increased from 49% to 65.9% (P < .001) at the end of follow-up. Other reported side effects included oral ulcers (2.6%), edema (5.3%), interstitial pneumonitis (1.3%), and toxic hepatitis (1.3%), some of them leading to EVR discontinuation.

CONCLUSION

In our population, renal function improved significantly after conversion from CNI to EVR. Although side effects were common, most were mild, withdrawal of EVR was necessary in a low percentage of cases. EVR appears to be an effective, safe alternative to CNI for maintenance therapy in selected kidney transplant recipients.

In vitro effect of some fungicides used in cultivation of Capsicum spp. on growth and ochratoxin A production by Aspergillus species

The present study aimed to assess the effect of some pre-harvest fungicides commonly used in Capsicum fruit production on growth and ochratoxin A production of three Aspergillus species found in Capsicum powder. Aspergillus tubingensis, Aspergillus ochraceus and Aspergillus westerdijkiae, previously isolated from paprika and chilli, were inoculated on yeast extract sucrose agar and paprika extract agar supplemented with different fungicides at their recommended dosage rates, and incubated at 20 and 30 °C during 7 days. Radial growth was measured after 3, 5 and 7 days and ochratoxin A production was determined by high-performance liquid chromatography with fluorescence detection on day 7. Dodine 40% and mancozeb 80% were the most effective fungicides in inhibiting growth and ochratoxin A production, regardless of the fungal strain tested or temperature conditions. Whereas the application of fungicides could be very attractive in reducing the mycotoxigenic fungal load, it can also stimulate ochratoxin A production in some cases.

E-cadherin and β-catenin expression during urothelial carcinogenesis induced by N-butyl-N-(4-hydroxybutyl) nitrosamine in mice

BACKGROUND

E-cadherin and β-catenin are adhesion molecules that promote integrity and stability of the urothelium. A decrease in their expression is associated with more aggressive tumour phenotypes with the ability to invade and metastasize.

MATERIAL AND METHODS

45 ICR male mice were used, of which 25 received N-butyl-N-(4-hydroxybutyl)nitrosamine (0.05%) in drinking water for a period of 12 weeks. Immunohistochemical expression was evaluated in all urinary bladder preparations for E-cadherin and for β-catenin.

RESULTS

Preneoplastic lesions showed staining patterns similar to normal urothelium. In simple and nodular hyperplasia, membrane staining was dominant (66.7-78.6 and 50-100%, respectively). In dysplasia a cytoplasmic pattern was prevalent (86.7-100%). Neoplastic lesions exhibit an abnormal staining pattern (100%) with heterogeneous staining (cytoplasmic, nuclear and membrane staining). A strong correlation was observed between both adhesion molecule staining patterns (r = 0.83; p = 0.039).

CONCLUSIONS

In mice, as in humans, E-cadherin and β-catenin are valuable tools to investigate cellular adhesion status of urothelium and can be considered as indicators of tumour aggressiveness and evolution.

Simulating an interacting gauge theory with ultracold Bose gases

We show how density dependent gauge potentials can be induced in dilute gases of ultracold atoms using light-matter interactions. We study the effect of the resulting interacting gauge theory and show how it gives rise to novel topological states in the ultracold gas. We find in particular that the onset of persistent currents in a ring geometry is governed by a critical number of particles. The density-dependent gauge potential is also found to support chiral solitons in a quasi-one-dimensional ultracold Bose gas.

Biomechanical properties of vaginal tissue in women with pelvic organ prolapse

BACKGROUND/AIMS

To compare biomechanical properties of vaginal tissues between women with and without pelvic organ prolapse (POP) and investigate factors that may influence these properties.

METHODS

Forty patients submitted to POP surgery and 15 non-POP cadavers were evaluated. The tissue was excised from anterior and posterior middle third vagina. The biomechanical properties considered were stiffness (E) and maximum stress (S), and they were evaluated by means of uniaxial tension tests.

RESULTS

POP patients were associated with higher values of E (13.1 ± 0.8 vs. 9.5 ± 0.7 MPa; p < 0.001) and S (5.3 ± 0.5 vs. 3.2 ± 0.9 MPa; p < 0.001) in the anterior vaginal wall compared to the posterior wall. In contrast, non-POP women presented lower values of E (6.9 ± 1.1 vs. 10.5 ± 1.0 MPa; p = 0.01) and S (2.6 ± 0.4 vs. 3.5 ± 0.4 MPa; p = 0.043) in the anterior wall. The occurrence of POP was the only independent predictor of higher values of E and S in anterior vaginal samples (p = 0.003 and p = 0.008, respectively). Women with severe anterior vaginal prolapse presented higher levels of E and S in the anterior sample compared to those with lower POP stages (p = 0.001 and p = 0.01; respectively).

CONCLUSION

Women with POP present significant changes of biomechanical properties in the vagina.

Acute histoplasmosis in three Mexican sewer workers

We report the detection of high-titre anti-Histoplasma capsulatum IgM in the serum of three young adult males occupationally exposed to bat guano. Multidrug treatment with trimethoprim- sulfamethoxazole was started, followed by ciprofloxacin, clarithromycin, metamizole sodium, rifampicin/isoniazid/pyrazinamide, moxifloxacin and lastly amphotericin B and ceftriaxone. Despite treatment the condition of one patient deteriorated, and he died 23 days after exposure. The other two patients recovered after receiving similar therapy with the addition of voriconazole. They are currently being treated with itraconazole for a 1-year period.

C4d deposits in acute "cell-mediated" rejection: a marker for renal prognosis?

BACKGROUND

Accumulation of C4d along peritubular capillaries (PTC) of renal allografts is normally attributed to antibody-mediated rejection. The prognostic implication of these deposits associated with "cell-mediated" rejection on graft survival remains uncertain. Our study aims to evaluate the impact of C4d deposits along PTC of patients with acute cell- mediated rejection on graft function and survival.

METHODS

We retrospectively analyzed patients transplanted between 2005 and 2010 with histopathologic diagnosis of acute rejection (AR). Eleven patients with "pure" antibody-mediated rejection were excluded. The remaining 79 patients were divided into two groups according to type of AR by Banff 2003 criteria: type I (69.6%) versus type II (30.4%). In each group, comparisons were made between C4d-negative (-) and C4d-positive (+) biopsies.

RESULTS

Fifty-five patients presented with type I AR: 35 (63.6%) C4d- and 20 (36.4%) C4d+. Twenty-four patients presented with type II AR: 13 (54.2%) C4d- and 11 (45.8%) C4d+. In the type I AR group, graft survival at the first and second years was similar in C4d- and C4d+ patients (94% and 91% versus 75% and 75%, respectively, log-rank P = .26). No differences were encountered in estimated glomerular filtration rate (eGFR) between subgroups at the first, second, and final years of follow-up. Graft loss occurred in 14.7% of C4d- patients versus 25% in C4d+ patients (P = NS). In the type II AR group, graft survival at the first and second years was similar in C4d- and C4d+ patients (85% and 85% versus 72% and 61%, respectively, log-rank P = .50). No differences were encountered in eGFR between subgroups at the first, second, and final years of follow-up. Graft loss occurred in 30.8% of C4d- patients versus 45.5% in C4d+ patients (P = NS).

CONCLUSION

Our results suggest that detection of C4d staining in acute "cell-mediated" rejection does not imply a worse renal prognosis.