Waist Circumference as a Tool for Identifying Visceral Fat in Women with Non-Metastatic Breast Cancer

Abdominal adiposity is associated with tumor development and poor clinical outcomes in breast cancer (BC) and can be identified by the measurement of waist circumference (WC) and visceral adipose tissue (VAT). This study aimed to evaluate the association between waist circumference (WC) and imaging measurement of central adiposity according to age group in women with BC. Abdominal adiposity was assessed by WC and VAT, obtained by dual-energy X-ray absorptiometry (DXA). Body mass index (BMI) was assessed. The presence of inflammation was investigated by measuring C-Reactive Protein (CRP) levels. Multivariate linear regression models were applied to verify the association between WC and VAT. The significance level adopted for all tests was 5%. This study included 112 women with a mean age of 55.5 ± 11.4 years. After adjusted models, WC remained associated with VAT and for every centimeter increase in WC, there was an increase of 3.12 cm2 (CI: 2.40 - 3.85; p < 0.001) in VAT. WC was associated with VAT in women with breast cancer, proving to be a simple, fast, and noninvasive approach that can be used as a proxy to identify visceral fat.

Giant lactating adenoma

Lactating adenoma is a rare benign breast lesion that most often presents as a small (up to 3 cm), solid, well-circumscribed, solitary, painless, mobile, lobulated mass. The highest incidence occurs in primiparous women (20 to 40 years old) during the third trimester of pregnancy. However, in the rare case presented herein, in addition to its giant size (more than 10 centimeters on palpation), this lactating adenoma is distinctive due to the presence of multiple nodules, poorly defined ultrasonographic margins, worrisome radiologic features, growth since early pregnancy, presence of infarction and association with chronic mastitis. From the clinical-radiologic perspective, the differential diagnoses included abscess associated with puerperal mastitis, phyllodes tumor, and galactocele. Biopsy was performed, and pathologic examination revealed the classic characteristics of lactating adenoma with multiple infarcted areas, leading to an unexpected confirmed case of giant lactating adenoma.

Routine libraries for pattern recognition in quasispecies

The results obtained through biological research usually need to be analyzed using computational tools, since manual analysis becomes unfeasible due to the complexity and size of these results. For instance, the study of quasispecies frequently demands the analysis of several, very lengthy sequences of nucleotides and amino acids. Therefore, bioinformatics tools for the study of quasispecies are constantly being developed due to different problems found by biologists. In the present study, we address the development of a software tool for the evaluation of population diversity in quasispecies. Special attention is paid to the localization of genome regions prone to changes, as well as of possible hot spots.

Does toxoplasmosis cause DNA damage? An evaluation in isogenic mice under normal diet or dietary restriction

Toxoplasmosis is an anthropozoonotic widespread disease, caused by the coccidian protozoan parasite Toxoplasma gondii. Since there are no data regarding the genotoxicity of the parasite in vivo, this study was designed to evaluate the genotoxic potential of the toxoplasmosis on isogenic mice with normal diet or under dietary restriction and submitted to a treatment with sulfonamide (375 microg/kg per day). DNA damage was assessed in peripheral blood, liver and brain cells using the comet assay (tail moment). The results for leucocytes showed increases in the mean tail moment in mice under dietary restriction; in infected mice under normal diet; in infected, sulfonamide-treated mice under normal diet; in infected mice under dietary restriction and in infected sulfonamide-treated mice under dietary restriction. In liver and brain cells, no statistically significant difference was observed for the tail moment. These results indicated that dietary restriction and T. gondii were able to induce DNA damage in peripheral blood cells, as detected by the comet assay.

Chemical safety and governance in Brazil

Chemical safety is recognized in Agenda 21(UNCED--Rio 92), as one of the most serious problems to be faced worldwide being a problem not just of governability, restricted more to the role of states and governments, but of governance at the national and international levels. It poses greater challenges for countries like Brazil where the issues of democracy, security, sustainability and equity, which are fundamental to governance, are merely incipient and still far from solved. Taking as references the analysis of four cases in the Brazilian context, we illustrate the situation from less densely populated areas (as in the cases of mercury use by gold miners in the Amazon and pesticides in agricultural producing areas), through medium-sized towns (as in the accident with cesium 137 in Goiânia), to the major urban and industrial centers (as in the cases of lead from battery renovators and benzene in the oil and steel industries and oil refineries). What can be seen is a situation where problems connected with chemical safety have grown in intensity and extent far more than the capacity to deal with them. In industrializing countries, the formulation of chemical safety policies must take into account not only the complexity and uncertainties involved in understanding the problems, but also the aspects relating to the different modes and levels of vulnerability. This is necessary in order to attempt to build better contextualized and more participatory knowledge and decision-making processes at the local and global levels, which we take as basic prerequisites for governance.

[Biological monitoring: concepts and applications in public health]

This study provides an overview of the theoretical discussion on potential uses for biological monitoring of exposure to chemical substances as related to human health, considering different concepts: definitions, uses, and limitations of internal dose and biological effect indicators and their availability for the substances to be quantified; knowledge of reference values, action levels, and limits based on health and negotiated patterns in biological monitoring interpretation and perspectives; and ethical and social problems in practice and within different preventive practices and their use in public health. Biological monitoring is the result of an exposure situation with conclusions based on scientific and consensus values, rules, and legislation. Biological monitoring as a continuous process and related to actually observed cases has helped establish technological exposure reference values and consensus levels as indicators for improving the environment and the workplace. As a step in the decision-making process in risk analysis, biological monitoring needs to be critically assessed as to its ethical aspects in light of the end use of results and values, which are references for application of this methodology.

[Work-related accidents on oil drilling platforms in the Campos Basin, Rio de Janeiro, Brazil]

The offshore oil industry is characterized by complex systems in relation to technology and organization of work. Working conditions are hazardous, resulting in accidents and even occasional full-scale catastrophes. This article is the result of a study on work-related accidents in the offshore platforms in the Campos Basin, Rio de Janeiro State. The primary objective was to provide technical back-up for both workers' representative organizations and public authorities. As a methodology, we attempt to go beyond the immediate causes of accidents and emphasize underlying causes related to organizational and managerial aspects. The sources were used in such a way as to permit classification in relation to the type of incident, technological system, operation, and immediate and underlying causes. The results show the aggravation of safety conditions and the immediate need for public authorities and the offshore oil industry in Brazil to change the methods used to investigate accidents in order to identify the main causes in the organizational and managerial structure of companies.

[Human fascioliasis. Tomodensitometric aspects. Apropos of 2 cases]

The authors report two cases of hepatic fascioliasis in which the CT scans of the liver revealed multiple hepatic low density lesions, better seen after intravenous bolus injection of contrast material. This CT signs may help in the diagnosis, follow up and to access the efficacy of hepatobiliary fascioliasis treatment.

Isoniazid acetylating phenotype in patients with paracoccidioidomycosis and its relationship with serum sulfadoxin levels, glucose-6-phosphate dehydrogenase and glutathione reductase activities

The authors evaluated the isoniazid acetylating phenotype and measured hematocrit, hemoglobin, glucose-6-phosphate dehydrogenase and glutathione reductase activities plus serum sulfadoxin levels in 39 patients with paracoccidioidomycosis (33 males and 6 females) aged 17 to 58 years. Twenty one (53.84%) of the patients presented a slow acetylating phenotype and 18(46.16%) a fast acetylating phenotype. Glucose-6-phosphate-dehydrogenase (G6PD) activity was decreased in 5(23.80%) slow acetylators and in 4(22.22%) fast acetylators. Glutathione reductase activity was decreased in 14(66.66%) slow acetylators and in 12(66.66%) fast acetylators. Serum levels of free and total sulfadoxin were higher in slow acetylator (p less than 0.02). Analysis of the results permitted us to conclude that serum sulfadoxin levels are related to the acetylator phenotype. Furthermore, sulfadoxin levels were always above 50 micrograms/ml, a value considered therapeutic. Glutathione reductase deficiency observed in 66% of patients may be related to the intestinal malabsorption of nutrients, among them riboflavin, a FAD precursor vitamin, in patients with paracoceidioidomycosis.

Evaluation of acetylator phenotype, renal function and serum sulfadiazine levels in patients with paracoccidioidomycosis treated with cotrimazine (a combination of sulfadiazine and trimethoprim)

The authors evaluated the relationships among renal function, acetylator phenotype and serum sulfadiazine levels in 22 patients with paracoccidioidomycosis treated with 1 tablet of cotrimazine (a combination of 820 mg sulfadiazine and 180 mg trimethoprim) administered orally every 12 hours. Fifteen patients (68.18%) presented free sulfadiazine levels above 50 micrograms/ml, 6(27.28%) presented serum levels above 40 micrograms/ml, and 1(4.54%), levels lower than 40 micrograms/ml, this being the patient in which treatment failed. The highest free sulfadiazine levels were obtained in slow acetylator patients with reduced renal function. One patient with neuroparacoccidioidomycosis presented free sulfadiazine levels in cerebrospinal fluid corresponding to 55% of the serum levels. Finally, the authors consider cotrimazine to be an important therapeutic alternative for neuroparacoccidioidomycosis and conclude that administration every 12 hours can provide therapeutic sulfadiazine levels. They also suggest that when the sulfadiazine-trimethoprim combination is used, the therapeutic levels of sulfadiazine should be above 40 micrograms/ml.

Neurocysticercosis: treatment with albendazole and dextrochloropheniramine

We evaluated the use of albendazole in combination with dextrochloropheniramine for the treatment of neurocysticercosis. Forty patients were treated from September 1984 to December 1987; each was diagnosed on the basis of clinical, epidemiological, cerebrospinal fluid and tomographic data. Patients were divided into 3 groups according to the albendazole treatment schedule. Group I received 10-15 mg/kg albendazole daily; group II received 15-25 mg/kg/d; group III received 15-30 mg/kg/d. Each patient also received simultaneously 18 mg/d of dextrochloropheniramine. Clinical improvement was observed in 4 patients in group I (50.0%), 10 patients in group II (83.3%) and 18 patients in group III (94.7%). Three patients in group II, and one in group III, died. Group III patients showed a significant improvement in quality of life compared to the other 2 groups. Side effects were insignificant in all groups. The combination of albendazole and dextrochloropheniramine seems to be a promising treatment for neurocysticercosis, especially at the doses used for group III, i.e. 15 mg/kg/d of albendazole for 21 d followed by 20-30 mg/kg/d for 30 d after a one-week interval, in combination with 18 mg/d of dextrochloropheniramine.

A retrospective study of 40 victims of crotalus snake bites. Analysis of the hepatic necrosis observed in one patient

Forty patients with a diagnosis of snake bite were studied at the Infectious and Parasitic Disease Service of the Faculty of Medicine of Botucatu. Thirty were males and 10 females, ranging in age from 16 to 70 years. All were farm laborers and 35 of them were bitten in the lower limbs. Two of the 9 patients seen more than 6 hours after the bite died. The low mortality rate (5%) observed could be explained by the early care provided, by the use of appropriate doses of anti-crotalus serum, parenteral hydration, urine alkalinization with sodium bicarbonate and induction of osmotic diuresis with a mannitol solution. Anatomopathological examination of one of the patients who died revealed extensive hepatic necrosis. The authors discuss the possibility of the effect of a factor of snake venom in the genesis of hepatic necrosis and in the increased transaminase levels.

Measurement of glucose-6-phosphate dehydrogenase and glutathione reductase activity in patients with paracoccidioidomycosis treated with ketoconazole

Hemoglobin rates, hematocrit and glucose-6-phosphate dehydrogenase (G6PD) and glutathione reductase activities were measured in 38 patients with paracoccidioidomycosis treated with ketoconazole or sulfadoxin, and in 13 normal individuals. Ketoconazole-treated patients showed reduced G6PD and glutathione reductase activities. One of these patients was found to be G6PD-deficient and suffered a hemolytic episode during treatment, which, however, did not require interruption of therapy. The authors suggest that patients showing an erythrocyte enzyme defect should be monitored hematologically during treatment with ketoconazole. They also suggest that ketoconazole is an oxidant drug in addition to being a possible inhibitor of antioxidant erythrocyte enzymes.

Paracoccidioidomycosis in the region of Botucatu (state of São Paulo, Brazil). Evaluation of serum thyroxine (T4) and triiodothyronine (T3) levels and of the response to thyrotropin releasing hormone (TRH)

T4, T3 and TSH serum levels were measured in 25 patients with paracoccidioidomycosis. Thyroid T3 reserves were measured on the basis of the increase in T3 (delta T3) 2 h after intravenous injection of 200 micrograms TRH, and pituitary TSH reserves were measured on the basis of TSH increase (delta TSH) 20 min after the same injection. Twenty healthy volunteers with no history of thyroid disease were used as controls. When the two groups were compared, the following results were obtained: (a) there was no significant difference in mean T4, T3, delta TSH between groups; (b) reduced T3 levels were detected more frequently in patients with paracoccidioidomycosis, especially among those with the acute form of the disease or with the severely disseminated chronic form. The results suggest the occurrence of a reduction in peripheral conversion of T4 to T3, but do not indicate the occurrence of hypothyroidism in any of its forms (thyroid, pituitary or hypothalamic).