Cortical volume abnormalities in schizophrenia: Correlations with symptoms and cognitive impairment

BACKGROUND

Schizophrenic symptoms are known to segregate into reality distortion, negative and disorganization syndromes, but the correlates of these syndromes with regional brain structural change are not well established. Cognitive impairment is a further clinical feature of schizophrenia, whose brain structural correlates are the subject of conflicting findings.

METHODS

165 patients with schizophrenia were rated for symptoms using the PANSS, and cognitive impairment was indexed by estimated premorbid-current IQ discrepancy. Cortical volume was measured using surface-based morphometry in the patients and in 50 healthy controls. Correlations between clinical and cognitive measures and cortical volume were examined using whole-brain FreeSurfer tools.

RESULTS

No clusters of volume reduction were seen associated with reality distortion or disorganization. Negative symptom scores showed a significant inverse correlation with volume in a small cluster in the left medial orbitofrontal gyrus. Larger estimated premorbid-current IQ discrepancies were associated with clusters of reduced cortical volume in the left precentral gyrus and the left temporal lobe. The cluster of association with negative symptoms disappeared when estimated premorbid-current IQ discrepancy was controlled for.

CONCLUSIONS

This study does not provide support for an association between brain structural abnormality and reality distortion or disorganization syndromes in schizophrenia. The cluster of volume reduction found in the left medial orbitofrontal cortex correlated with negative symptoms may have reflected the association between this class of symptoms and cognitive impairment. The study adds to existing findings of an association between cognitive impairment and brain structural changes in the disorder.

Usefulness of autocidal gravid ovitraps for the surveillance and control of Aedes (Stegomyia) aegypti (Diptera: Culicidae) in eastern Colombia

In the past decade, new strategies have been developed to control the Aedes aegypti (Diptera: Culicidae) mosquito vector, as well as a broad range of arboviral agents. Vector control surveillance programmes in Puerto Rico and Australia have implemented the Centers for Disease Control and Prevention autocidal gravid ovitrap (AGO), which has had an impact on vector density and, consequently, the epidemiology of arboviral infections. Colombia intends to establish the AGO as a new tool for the surveillance and control of the A. aegypti vector. AGOs were evaluated in a hyperendemic area for dengue virus during an 8-week period in Villavicencio city, eastern Colombia. The results indicated that the AGOs detect a high density of A. aegypti, with positive results for these traps of over 80% and an average catch of six individuals per trap per week. Acceptance of AGOs in the community exceeded 95%, and adherence was around 89%. This study's results demonstrate, for the first time in Colombia, that traps are a useful tool for the surveillance of A. aegypti. Future studies must consider the implementation of AGOs in the region.

Sodium intake among adolescents who eat inside and outside the home. Campinas-Brazil

Background

Excessive sodium consumption (>2g/day) is one of the risk factors for the development of cardiovascular diseases, which impact the world's public health systems. Rapid urbanization, busy life, the high availability of ultra-processed foods and the short time for meals, especially inside the home, are factors that interfere in the population's food choices.

Objective

To estimate sodium intake according to the place of meal consumption and its association with demographic, socioeconomic and salt-related variables.

Methods

Cross-sectional population-based study, carried out with 901 adolescents aged 10 to 19 years, who answered the Food Consumption and Nutritional Status Survey, ISACamp-Nutri 2015. The mean sodium intake was estimated by the 24-hour recall and the association with the independent variables, using linear regression.

Results

Sodium consumption among adolescents was 3.52 g/day (95% CI 3.42-3.63). Those who consumed at least one meal away from home had an excess of 0.19 g/day (P = 0.012) of sodium, which corresponded to a 6.1% increase compared to adolescents who had eaten exclusively at home. Of the total meals eaten by adolescents, 15.9% are taken outside the home, with 6.6% eating at school and 9.3% in different places. There was a significant increase in sodium consumption among adolescents who had breakfast CR = 0.16g (p = 0.032), afternoon snack CR = 0.09g (p = 0.002) and dinner CR = 0.30g (p = 0.029) outside the home.

Conclusions

sodium consumption by adolescents exceeded the WHO recommendation. Eating at least one meal away from home was associated with a higher sodium intake among these individuals. Regulatory measures in the food industry and strategies for food and nutrition education are relevant to reduce sodium consumption in this age group.

Key messages

High sodium consumption among adolescents, exceeding WHO recommendations. Eating outside the home was associated with a higher sodium intake.

Effects of tenectomy of the medial head of the deep digital flexor on the hindlimbs of healthy horses

ABSTRACT The tenectomy of the medial head of the deep digital flexor (TMHDDF) is a minimally studied surgery used in cases of dorsal subluxation of the proximal interphalangeal joint of the hindlimb in horses. The TMHDDF was evaluated in six healthy horses by the degree of lameness, perimeter of the surgical site, the angle of the distal articular joints, and the linear and angular measures of the hoof. Thus, TMHDDF of the right hindlimb was performed and the contralateral limb was used as a control. Both, right and left limbs were evaluated before surgery, as well as at 15, 30, and 60 days after surgery aiming to evaluate the effects of the surgical procedure in healthy limbs. Data were compared by analysis of variance regarding days and limbs. Values below the significant level (P< 0.05) were analyzed using the Tukey’s test. TMHDDF caused a mild increase of the toe length and the height of lateral heel (0.2cm in both), as well as a decrease of the angle of the proximal interphalangeal joint (2°) when comparing the left hindlimb to the right hindlimb, 30 and 60 days after surgery. Overall, TMHDDF did not cause significant changes in the evaluated variables up to the 60 days of surgery.

Preventive therapy compliance in pediatric tuberculosis - A single center experience

INTRODUCTION

Despite its importance, there are some barriers to patient compliance in preventive therapy (PT) of tuberculosis (TB). The purpose of this study was to evaluate the compliance to appointments, PT and follow-up in a pediatric population after TB exposure, followed in a single TB outpatient center, and the subsequent identification of compliance determinants.

METHODS

Retrospective analysis of all pediatric patients who underwent PT in Gaia TB outpatient center from January 2015 to June 2016. Patients were divided into two groups: compliant and non-compliant, according to adherence to screening, visits and medication. The data collection was based on review of medical records.

RESULTS

A total of 72 patients were enrolled, 33 (45.8%) on chemoprophylaxis and 39 (54.2%) on latent tuberculosis infection (LTBI) treatment. The majority of patients were compliant (63.9%, n=46). Non-compliance was found in 36.1% (n=26): in 12 patients to contact screening, in 11 patients to PT and 22 patients did not attend medical appointments in the first place. In 10 patients, non-compliance was related to social problems/family dysfunction (low socioeconomic status and parent's unemployment). After putting in place several strategies, such as telephone contact, activating social services and direct observation of therapy, a compliance of 98.6% was achieved. Isoniazid was the main drug used (91.7%), during 9 months for LBTI.

CONCLUSION

PT compliance in TB can be challenging, probably related to the lack of risk perception and caregiver's reluctance to undergo a prolonged treatment to an asymptomatic condition. We conclude that implementing interventions can considerably improve treatment compliance and reduce the risk of future tuberculosis development. We emphasize the success in compliance to a 9 month regimen of isoniazid in the vast majority of patients with LTBI.

Synthesis, characterization and applications of maghemite beads functionalized with rabbit antibodies

Magnetic nanoparticles (NPs) have attracted great attention owing to their applications in the biomedical field. In the present work, maghemite (γFe₂O₃) NPs of 6.5 nm were prepared using a sonochemical method and used to prepare magnetic beads through silanization with 3-aminopropyltrimethoxysilane (APTS). Subsequently, amino groups in the resulting APTS-γFe₂O₃ beads were converted to carboxylic acid (CARB-γFe₂O₃) through the succinic anhydride reaction, as confirmed by transmission electron microscopy (TEM), Fourier transform infrared spectroscopy and dynamic light scattering (DLS) measurements. The size of these beads was measured as 12 nm and their hydrodynamic diameter as 490 nm, using TEM analysis and DLS, respectively. The CARB-γFe₂O₃ beads were further functionalized by immobilizing rabbit antibodies on their surfaces; the immobilization was confirmed by flow cytometry and ionic strength. The samples were further characterized by Mössbauer spectroscopy and DC magnetization measurements. Studies on magnetic relaxivities showed that magnetic beads present great potential for application in MR imaging.

Updating national standards for drinking-water: a Philippine experience

The latest version of the Philippine National Standards for Drinking-Water (PNSDW) was issued in 2007 by the Department of Health (DOH). Due to several issues and concerns, the DOH decided to make an update which is relevant and necessary to meet the needs of the stakeholders. As an output, the water quality parameters are now categorized into mandatory, primary, and secondary. The ten mandatory parameters are core parameters which all water service providers nationwide are obligated to test. These include thermotolerant coliforms or Escherichia coli, arsenic, cadmium, lead, nitrate, color, turbidity, pH, total dissolved solids, and disinfectant residual. The 55 primary parameters are site-specific and can be adopted as enforceable parameters when developing new water sources or when the existing source is at high risk of contamination. The 11 secondary parameters include operational parameters and those that affect the esthetic quality of drinking-water. In addition, the updated PNSDW include new sections: (1) reporting and interpretation of results and corrective actions; (2) emergency drinking-water parameters; (3) proposed Sustainable Development Goal parameters; and (4) standards for other drinking-water sources. The lessons learned and insights gained from the updating of standards are likewise incorporated in this paper.

A new combined operative technique using crossed inguinal lymphatic rescue for pediatric patients with mixed lymphatic and venous malformations

Truncular venous malformations and acquired functional or anatomical venous occlusions (or sub-occlusions) can be the cause of secondary lymphedema and even the cause of primary lymphedema when they are associated with lymphatic malformations (lymphangiodysplasia - LAD I, lymphadenodysplasia - LAD II, or a combination of both) in pediatric patients. This understanding recognizes the shared and successive embryogenesis of both systems. These conditions can exhibit hypertension in the venous pedicles intended for lymph-venous anastomosis, and this finding would be a formal contraindication to the procedure. However, this hypertension is a rarely considered condition and is not commonly identified. As a technique to solve this problem, we have combined Nielubowicz, Olszewski, Campisi, and Palma's proposals and created a lymph-venous anastomosis from the side with lymphedema and venous hypertension (lymphatic donor and venous recipient) with an internal suprapubic saphenous venous bridge (from the normal side to the lymphedematous side with venous hypertension) to enable a crossed inguinal lymphatic/venous rescue. We believe this newly synthesized approach will allow better clinical care of pediatric patients with complex and combined lymphatic-venous malformations and is worthy of further investigation.

Left paraduodenal hernia: a rare cause of small bowel obstruction in the elderly

Left paraduodenal hernia is a rarely found condition in which the small bowel herniates through a congenital peritoneal defect located behind the 4th portion of duodenum. It usually courses with non-specific symptoms and a widely variable clinical presentation which makes preoperative diagnosis very difficult. It has been associated with a high rate of complications, including bowel strangulation and even death. Prompt surgical intervention consisting of intraoperative surgeon's awareness and recognition of this condition are crucial in order to improve postoperative morbidity and mortality. The authors present a case of a 73-year-old man with acute intestinal obstruction as the first presentation of a left paraduodenal hernia.

Ileal duplication: an unusual cause of intestinal obstruction in adult life

Gastrointestinal duplications are rare congenital malformations seldom diagnosed in adulthood. They may vary greatly in size and location, with the small intestine being their major focus. Their clinical presentation is widely variable and unspecific, mimicking more common pathologies, thus making preoperative diagnosis very difficult. The intraoperative surgeon's experience and knowledge are crucial in recognising these lesions so that they can be correctly managed. In this report, the authors present a case of a 36-year-old man with an acute intestinal obstruction as the first presentation of ileal duplication.

Applicability of the EULAR recommendations on the role of the nurse in the management of chronic inflammatory arthritis in Portugal

OBJECTIVES

To evaluate the level of agreement and applicability of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis in Portugal.

METHODS

Nurses from all Portuguese rheumatology centers were invited to fill-in a questionnaire addressing the level of agreement (1=strongly disagree to 5=strongly agree) and the level of confidence (1=no confidence to 5=complete confidence) in the applicability of each of the recommendations. Comparisons were established between subgroups of nurses.

RESULTS

A total of 75 nurses (85% female; mean (SD) of 3.9 (4.1) years of practice, 32% with some type of training in rheumatology) participated in the study. The mean level of agreement with the recommendations was 4.8 (SD 0.3). The level of confidence in their full applicability was 3.6 (SD 0.8). Significantly more nurses with rheumatology training totally agreed with recommendations 7 (88% vs 73%, p=0.03) and 3 (96% vs 65% p=0.04) and were fully confident in the applicability of recommendations 2, 3, 7, 9 and 10, comparing with those without specific training.

CONCLUSIONS

The overall level of agreement with EULAR recommendations among Portuguese nurses is high, although rheumatology does not exist as a nursing specialty. Agreement and confidence in the applicability of these recommendations is higher among nurses with specific training, underlining the importance of continuous education for future commitment.

Dechlorane-related compounds in franciscana dolphin (Pontoporia blainvillei) from southeastern and southern coast of Brazil

Concentrations of Dechlorane (Dec) 603 (0.75 ng/g lipid weight (lw); mean) and Dec 602 (0.38 ng/g lw; mean) were quantified in more than 95% of the franciscana (Pontoporia blainvillei) dolphin samples, whereas the frequency of detection decreased to 75% for Dechlorane Plus (DP) (1.53 ng/g lw, mean). The presence of Chlordene Plus (CP) was also observed (0.13 ng/g lw, mean) in half of the samples. On the contrary, Dec 604, decachloropentacyclooctadecadiene (aCl(10)DP), and undecachloropentacyclooctadecadiene (aCl(11)DP) concentrations were below the limit of quantifications in all cases. To the best of our knowledge, this is the first article reporting the presence of Dec 603, Dec 602, and CP in mammals. For comparative purposes, levels of Mirex, polybrominated diphenyl ethers (PBDEs), and decabromodiphenylethane (DBDPE) are also reported. Considering geographic distribution evaluation together with the strong positive correlations found between DP and PBDEs (r(s) = 0.63; p < 0.01), highly anthropogenic areas were identified as potential sources of these chemicals in this dolphin species. However, local sources for Dec 602, 603, Mirex, CP, and DBDPE were not found indicating that in this case historical use and/or atmospheric transport and deposition may play an important role in their fate.

Antimicrobial activity and phytochemical analysis of crude extracts and essential oils from medicinal plants

We aimed to establish a phytochemical analysis of the crude extracts and performed GC-MS of the essential oils (EOs) of Eugenia uniflora L. (Myrtaceae) and Asteraceae species Baccharis dracunculifolia DC, Matricaria chamomilla L. and Vernonia polyanthes Less, as well as determining their antimicrobial activity. Establishment of the minimal inhibitory concentrations of the crude extracts and EOs against 16 Staphylococcus aureus and 16 Escherichia coli strains from human specimens was carried out using the dilution method in Mueller-Hinton agar. Some phenolic compounds with antimicrobial properties were established, and all EOs had a higher antimicrobial activity than the extracts. Matricaria chamomilla extract and E. uniflora EO were efficient against S. aureus strains, while E. uniflora and V. polyanthes extracts and V. polyanthes EO showed the best antimicrobial activity against E. coli strains. Staphylococcus aureus strains were more susceptible to the tested plant products than E. coli, but all natural products promoted antimicrobial growth inhibition.

Estimation of genetic parameters for milk yield in Murrah buffaloes by Bayesian inference

Random regression models were used to estimate genetic parameters for test-day milk yield in Murrah buffaloes using Bayesian inference. Data comprised 17,935 test-day milk records from 1,433 buffaloes. Twelve models were tested using different combinations of third-, fourth-, fifth-, sixth-, and seventh-order orthogonal polynomials of weeks of lactation for additive genetic and permanent environmental effects. All models included the fixed effects of contemporary group, number of daily milkings and age of cow at calving as covariate (linear and quadratic effect). In addition, residual variances were considered to be heterogeneous with 6 classes of variance. Models were selected based on the residual mean square error, weighted average of residual variance estimates, and estimates of variance components, heritabilities, correlations, eigenvalues, and eigenfunctions. Results indicated that changes in the order of fit for additive genetic and permanent environmental random effects influenced the estimation of genetic parameters. Heritability estimates ranged from 0.19 to 0.31. Genetic correlation estimates were close to unity between adjacent test-day records, but decreased gradually as the interval between test-days increased. Results from mean squared error and weighted averages of residual variance estimates suggested that a model considering sixth- and seventh-order Legendre polynomials for additive and permanent environmental effects, respectively, and 6 classes for residual variances, provided the best fit. Nevertheless, this model presented the largest degree of complexity. A more parsimonious model, with fourth- and sixth-order polynomials, respectively, for these same effects, yielded very similar genetic parameter estimates. Therefore, this last model is recommended for routine applications.

Avaliação de características de desempenho e de carcaça de codornas de corte por meio da análise de componentes principais

Foram utilizados dados de 288 codornas de corte (Coturnix coturnix coturnix) para avaliar a possibilidade de resumir a informação contida no complexo de variáveis originais, eliminando-se variáveis inexpressivas por meio da técnica de componentes principais. Foram registrados o peso vivo (PVIVO) e pesos do peito (PPEITO), das coxas (PCOXA), da gordura abdominal (GA), das vísceras comestíveis (fígado, moela e coração) (FIG, MOELA e CORA) e da carcaça eviscerada (PCEVIS). As carcaças foram secas e trituradas para a avaliação do teor matéria seca (MS), gordura (GORD) e proteína bruta (PB). Dos 11 componentes principais, sete (63,6%) apresentaram variância menor que 0,7 (autovalor inferior a 0,7), sendo sugeridas para descarte, respectivamente, em ordem de menor importância, para explicar a variação total das seguintes variáveis: PCEVIS, PPEITO, PCOXA, CORA, FIG MOELA e GORD. Com base nos resultados, recomenda-se manter as seguintes variáveis em experimentos futuros: PVIVO, MS, PB e GA.

Estudo de características de produção de matrizes de corte por meio da análise de componentes principais

Avaliou-se o descarte de variáveis de produção, em análises de componentes principais, de três linhagens de matrizes de corte do Programa de Melhoramento Genético da Universidade Federal de Viçosa, utilizando informações de 270 aves, sendo 90 de cada linhagem. As características analisadas foram dias para postura do primeiro ovo (DPPO), taxa de postura da 22ª a 56ª semana (TP), peso médio individual na 32ª (PMI1), na 40ª (PMI2), na 48ª (PMI3), na 56ª (PMI4) e na 64ª semana (PMI5) e peso médio do ovo, obtido pela média da pesagem de três ovos na 32ª (PMO1), na 40ª (PMO2), na 48ª (PMO3), na 56ª (PMO4) e na 64ª semana (PMO5). Dos 12 componentes principais, sete apresentaram variância menor do que 0,7 (autovalor menor do que 0,7), sugerindo-se sete variáveis para descarte. As variáveis descartadas foram aquelas que apresentaram maiores coeficientes, em valor absoluto, a partir do último componente principal. Observou-se correlação linear simples e significativa entre as variáveis descartadas e as não descartadas, que indica redundância de variáveis, razão do descarte. Recomendam-se as variáveis: DPPO, TP, PM14, PMO1 e PMO4 para o estudo de características da produção de matrizes de frango de corte por meio da análise de componentes principais.

Breastfeeding's protection against illness-induced anorexia is mediated partially by docosahexaenoic acid

OBJECTIVE

To test whether breastfeeding's protection against anorectic responses to infection is mediated by n-3 fatty acids' attenuation of interleukin (IL)-1beta and tumor necrosis factor (TNF)alpha.

DESIGN

Experimental and observational studies.

SETTING

A hospital-based study was conducted.

SUBJECTS

Five groups of infants were followed; three in the experimental and two in the observational study.

METHODS

Breast-fed- (BF-1), DHA-supplemented formula- (SFF-1), and non-DHA-supplemented formula-fed (FF-1) infants were studied before and after immunization against diphtheria, tetanus, pertussis and haemophilus influenzae type b. Pre- and post-immunization energy intakes (EI) and serum IL-1beta and TNFalpha were measured. The two other groups, breast-fed (BF-2) and formula-fed (FF-2) infants with pneumonia were followed throughout hospitalization. EI, IL-1beta and TNFalpha were measured at admission and discharge. Baseline erythrocyte fatty acid contents were determined.

RESULTS

Both cytokines increased following immunization in all feeding groups. Post-immunization reductions in EI of SFF-1 infants (-11.8+/-5%, CI(95)=-23.3, 1.4%, P=0.07) were intermediate to those observed in BF-1 (-5.2+/-4.2%, CI(95)=-15.2, 5.9%, P=0.27) and FF-1 infants (-18+/-4.4%, CI(95)=-29%, -5.4%, P=0.02). In the observational study, TNFalpha (17.2+/-8.3 vs 3.4+/-3.0 ng/l, P=0.001) and decreases in EI (-31+/-43 vs -15+/-31%, CI(95)=-34%, 0.001%, P=0.056) were greater in FF-2 than in BF-2 infants at admission. Breastfeeding duration was associated positively with docosahexaenoic acid (DHA) erythrocyte contents, and negatively with admission TNFalpha. Decreases in EIs were associated with IL-1beta and TNFalpha concentrations.

CONCLUSION

Reductions in EI following immunologic or infectious stimuli were associated with increases in IL-1beta and TNFalpha. Those reductions were attenuated by breastfeeding, and mediated in part by tissue DHA.

Primary culture of the region of the amebocyte-producing organ of the snail Biomphalaria glabrata, the intermediate host of Schistosoma mansoni

Biomphalaria glabrata snails are major hosts for the digenetic trematoda Schistosoma mansoni, the causative agent of human schistosomiasis. The success or failure of the infection will be dependent on the mobilization of the molluskan internal defense system, where a major role will be played by circulating hemocytes produced by the APO (amebocyte-producing organ) of the snail. In this report, the primary culture of the APO region of B. glabrata was obtained for the first time, as well as a control culture of the ovotestis. Three different cell populations migrated easily from the explants in culture, with no need of any dispersion agent. The cells grew in suspension at an incubation temperature of 15 degrees C and the cultures were maintained viable for up to two weeks. Two of these cell populations obtained resembled cell types known to be present in the hemolymph of Biomphalaria. The availability of APO cells in culture may contribute to a better understanding of the internal defense in mollusks, in general, as well as the specific response of B. glabrata to S. mansoni infection.

Resistance to Schistosoma mansoni by transplantation of APO Biomphalaria tenagophila

Transplantation of the haematopoietic organ from Biomphalaria tenagophila (Taim strain, RS, Brazil), resistant to Schistosoma mansoni, to a highly susceptible strain (Cabo Frio, RJ, Brazil) of the same species, showed in the recipient snails resistance against the trematode, when a successful transplant occurred. The success of transplantation could be confirmed by a typical molecular marker of the Taim strain in haemocytes of the recipients (350 bp detected by PCR-RFLP). The recipient snails which did not present the donor marker in haemocytes (unsuccessful transplantation) were infected with the parasite. The use of an atoxic modelling clay for closing the hole in the transplantation site reduced significantly the mortality caused by bleeding after transplantation procedures.

Identification of informative performance traits in swine using principal component analysis

Using principal component analysis, records of 435 animals from an F2 swine population were used to identity independent and informative variables of economically important performance. The following performance traits were recorded: litter size at birth (BL), litter size at weaning (WL), teat number (TN), birth weight (BW), weight at 21 (W21), 42 (W42), 63 (W63) and 77 (W77) days of age, average daily gain (ADG), feed intake (FI) and feed:gain ratio (FGR) from 77 to 105 days of age. Six principal components expressed variation lower than 0.7 (eigen values lower than 0.7) suggesting that six variables could be discarded with little information loss. The discarded variables present significant simple linear correlation with the retained variables. Retaining variables BL, TN, W77, FI and FGR and eliminating all the rest would retain most of the relevant information in the original data set.

Biomphalaria tenagophila/Schistosoma mansoni interaction: premises for a new approach to biological control of schistosomiasis

Biomphalaria tenagophila is very important for schistosomiasis transmission in Brazil. However its mechanisms of interaction with Schistosoma mansoni are still scantly studied. Since this snail displays strains highly susceptible or completely resistant to the parasite infection, the knowledge of that would be a useful tool to understand the mechanism of snail resistance. Particularly, the Taim strain consistently shows absolute resistance against the trematode, and this resistance is a dominant character. A multidisciplinary research group was created aiming at studying B. tenagophila/S. mansoni interaction. The possibility for applying the knowledge acquired to obtain a biological model for the control of S. mansoni transmission in endemic areas is discussed.

Lipoblastoma-lipoblastomatosis associated with unilateral limb hypertrophy: a case report in a newborn

Lipoblastoma is a benign mesenchymal tumor of embryonic adipose tissue, uncommon in infancy. Multicentricity, absence of a capsule and histopathology best defines a lipoblastoma. Synonyms for this lesion are embryonic lipoma, fetal lipoma, lipoblastic tumor, and congenital lipomatoid tumor. Lipoblastoma is more common in males (approximately 80%), is usually located in the subcutaneous soft tissue (benign lipoblastoma) or in the deep interstitium (benign lipoblastomatosis), or sometimes in all corporeal segments. Primary treatment is complete excision. Relapse is between 14-25%, many of which are more "mature," and difficult to differentiate from lipoma. The differential diagnosis includes liposarcoma, which is rare under ten years. Radical excision in children is recommended with relapses, especially with lipoblastomatosis. Chromosomal markers help discriminate between liposarcoma and lipoblastoma.

Cortisol, prolactin, growth hormone and neurovegetative responses to emotions elicited during an hypnoidal state

The present study describes the responses of cortisol, prolactin and growth hormone (GH) to emotions elicited during sessions in which an hypnoidal state was induced. The purpose of the study was to provide answers for the following questions: 1) Do sessions with an emotional content have more hormonal surges than baseline, relaxation-only, sessions? 2) Does the induction of a fantasy of pregnancy and nursing elicit a prolactin response? 3) Are there any associations between surges of different hormones? 4) Are hormonal responses related to the intensity, type, or mode of expression of the emotions? For this purpose, thirteen volunteers and twelve patients with minor emotional difficulties were studied during sessions under hypnosis. The period of observation lasted for about three hours. Heart rate (HR), skin conductance (SC) and vagal tone (VT) were monitored. Serum cortisol, prolactin and growth hormone were sampled every 15 minutes. The volunteers had three types of sessions- "blank", consisting of relaxation only (12 sessions), "breast feeding", in which a fantasy of pregnancy and breast feeding was induced (12 sessions) and "free associations" in which the subjects were encouraged to evoke experiences or feelings (17 sessions). The patients had only sessions of free associations (38 sessions). Sessions of free associations had more hormonal surges than "blank" and "breast feeding" sessions. This was true for cortisol (8/17 v.3/24; p < 0.03), prolactin (7/17 v. 3/24; p < 0.05) and GH (9/17 v. 4/24; p < 0.02). During the 55 sessions of free associations (volunteers plus patients) there were 32 surges of cortisol, 18 of prolactin and 28 of GH. Cortisol and prolactin surges were negatively correlated (p < 0.03). GH had no significant association with either cortisol or prolactin. Visible emotions were positively associated with GH surges (p < 0.05). but not with cortisol or prolactin. Cortisol surges were correlated positively with evocations of real events (p < 0.01) and negatively with evocations containing defensive elements (p < 0.01). Cortisol correlated positively with shock and intimidation (p < 0.02) and negatively with rage (p < 0.04). The AUC of the cortisol peaks during shock and intimidation was significantly higher than that of the pool of all other cortisol peaks (12.4 micromol x min x l(-1) v. 7.1 micromol x min x l(-1); p < 0.005). Rage had a marginally significant positive association with prolactin surges (p=0.07). The distribution of GH surges did not show any significant association with types of emotions. The present study provides evidence that cortisol, prolactin and GH respond to psychological stress in humans. However, they are regulated differently from one another. Cortisol and prolactin surges appear to be alternative forms of response to specific emotions. GH surges depend on the intensity of the emotion, probably as a consequence of the associated muscular activity. The current paradigm of stress, implying corticotrophin-releasing hormone (CRH) as the initial step of a cascade of events, is insufficient to account for the diversity of hormonal changes observed in psychological stress in humans.

Estudo da divergência genética entre seis linhas de aves Legorne utilizando técnicas de análise multivariada

A divergência genética entre seis linhas de aves Legorne (L1, L2, L3, L4, L5 e L6), desenvolvidas pela UFV, foi avaliada utilizando análise de variáveis canônicas e o método de agrupamento de Tocher. Foram incluídas no estudo oito características: peso corporal na 40ª semana (PC40), na 48ª semana (PC48), na 56ª semana (PC56); peso do ovo na 40ª semana (PO40), na 44ª semana (PO44), na 52ª semana (PO52), na 60ª semana (PO60) e taxa de postura da 40ª a 62ª semana (TP). Foi observada diferença entre as linhas quanto às características estudadas. A linha L4 mostrou-se divergente das demais, apresentando a menor média canônica, e foi alocada em grupo distinto das outras pelo teste de Tocher. O desempenho das diferentes linhas foi também avaliado por meio da análise de variância multivariada, usando o teste do maior autovalor de Roy, e por meio do teste de Roy para comparações múltiplas. Verificou-se divergência genética entre as linhas da UFV, sendo PC40 a característica que mais contribuiu para a divergência.

Occurrence of identical hypervariable region 1 sequences of hepatitis C virus in transfusion recipients and their respective blood donors: divergence over time

A total of 240 stored serum specimens from 30 transfusion recipients and 120 blood donors from the Transfusion-Transmitted Viruses Study (TTVS) were evaluated with the objective of establishing transmission of hepatitis C virus (HCV) by specific blood donors. Phylogenetic analysis of hypervariable region 1 (HVR1) and HCV genotyping were performed on the genomic region encoding amino acids 329 to 410. Amino acid distances between HVR1 sequences were calculated by the Kimura formula. Bootstrap analysis of HVR1 sequences provided support for linking recipients to specific donors. Linear regression analysis showed no differences between donor and recipient HVR1 sequences 7.9 weeks posttransfusion, but donor and recipient sequences diverged thereafter (r = 0.690). The initial lag phase in the evolution of HVR1 in the infected recipient was attributed to the time required to mount host immunologic defenses against the virus. Within-recipient divergence in HVR1 was determined from analyses of serial specimens collected within 2 weeks after the alanine transaminase peak, at the end of the original study (1974-1979), and in the follow-up study (1987-present). HVR1 remained invariant over a period of 6.7 to 9.5 days (95% CI) during acute infection. Within-patient divergence in HVR1 increased over a period of 11 to 15 years (r = 0.771), reaching the degree of divergence observed between unlinked subjects. In cases in which transfusion involved more than one HCV subtype, only one of the HCV subtypes established infection in the recipient. Subtype-specific differences in HVR1 were shown.

Long-term mortality and morbidity of transfusion-associated non-A, non-B, and type C hepatitis: A National Heart, Lung, and Blood Institute collaborative study

Persons with non-A, non-B hepatitis (cases) identified in 5 transfusion studies in the early 1970s have been followed ever since and compared for outcome with matched, transfused, non-hepatitis controls from the same studies. Previously, we reported no difference in all-cause mortality but slightly increased liver-related mortality between these cohorts after 18 years follow-up. We now present mortality and morbidity data after approximately 25 years of follow-up, restricted to the 3 studies with archived original sera. All-cause mortality was 67% among 222 hepatitis C-related cases and 65% among 377 controls (P = NS). Liver-related mortality was 4.1% and 1.3%, respectively (P =.05). Of 129 living persons with previously diagnosed transfusion-associated hepatitis (TAH), 90 (70%) had proven TAH-C, and 39 (30%), non-A-G hepatitis. Follow-up of the 90 TAH-C cases revealed viremia with chronic hepatitis in 38%, viremia without chronic hepatitis in 39%, anti-HCV without viremia in 17%, and no residual HCV markers in 7%. Thirty-five percent of 20 TAH-C patients biopsied for biochemically defined chronic hepatitis displayed cirrhosis, representing 17% of all those originally HCV-infected. Clinically evident liver disease was observed in 86% with cirrhosis but in only 23% with chronic hepatitis alone. Thirty percent of non-A, non-B hepatitis cases were unrelated to hepatitis viruses A,B,C, and G, suggesting another unidentified agent. In conclusion, all-cause mortality approximately 25 years after acute TAH-C is high but is no different between cases and controls. Liver-related mortality attributable to chronic hepatitis C, though low (<3%), is significantly higher among the cases. Among living patients originally HCV-infected, 23% have spontaneously lost HCV RNA.

[Acute megaloblastic anemia caused by inhalation of nitrous oxide in a patient with multiple autoimmune pathology]

Although megaloblastic anemias are generally regarded as chronic conditions of insidious appearance, a megaloblastic state can arise over the course of only a few days due to acute folate or vitamin B12 deficiency. One of the most common causes, though seldom reported, is the nitrous oxide (N02) action in tissue. In fact N02, a volatile substance commonly used in anaesthesia, destroys methylcobalamin, leading to the rapid development of a megaloblastic haematopoiesis. This phenomenon may occur in patients without previous vitamin B12 deficit, but is more frequent and severe when there is a pre-existent deficiency state. A case report is described of a patient with femoral fracture who developed acute anemia after surgery and a latent pernicious anemia was revealed upon investigation.

Maternal energy balance and lactation performance of Mesoamerindians as a function of body mass index

The effect of maternal energy balance in conjunction with body energy reserves on lactation performance has not been fully elucidated in humans. Energy balance was computed from changes in weight and body composition over 6 mo postpartum in 21 Otomi Indian women with relatively low postpartum body mass indexes (BMIs; in kg/m2, 21.4 +/- 0.9) and 19 with relatively high BMIs (25.7 +/- 1.9). Body fat was determined by deuterium dilution. Milk production was estimated by 24-h test weighing. Macronutrient content of human milk was measured by standard techniques. In both groups weight declined over the 6 mo postpartum (P = 0.04). In the lower BMI group only, body fat (kg, % of wt) decreased significantly (P = 0.04). Milk fat concentration was positively correlated with body fat at 3 and 6 mo (r = 0.32 and 0.40; P = 0.04 and 0.01, respectively). Energy balance was not associated with milk production or composition, nutrient secretion into milk, or infant growth velocity, except at 6 mo, when energy balance was positively correlated with milk energy and fat concentration in the lower BMI group (r = 0.55; P = 0.01). Fat concentration was lower in the lower BMI group (P = 0.04). Because of the inverse correlation between milk production and milk fat at 3 and 6 mo (r = -0.47 and -0.43, respectively; P = 0.01), fat secretion into milk did not differ between groups. Infant growth velocities did not differ significantly between groups. In conclusion, negative energy balance in conjunction with lower energy reserves did not adversely affect lactation performance or infant growth in this population of Otomi Indians.

Total energy expenditure and physical activity level of lactating Mesoamerindians

Energy-sparing mechanisms may be elicited to meet increased energy requirements imposed by lactation on women who reside in poor, rural communities in developing countries. The objectives of this study were to measure total energy expenditure and its components, basal and activity energy expenditure, and to investigate their relationships with lactation performance in a total of 40 rural Mesoamerindians stratified according to postpartum body mass index. Total energy expenditure and fat-free mass were measured by the doubly labeled water method, and basal metabolic rate was determined by indirect calorimetry at 3 and 6 mo postpartum. Physical activity level was taken as the ratio of total energy expenditure to basal metabolic rate. Milk energy output, which is not included in total energy expenditure, was computed from 24-h milk intake (test-weighing) and energy concentration of milk (bomb calorimetry). Anthropometric measurements revealed negligible mobilization of tissue stores. Mean (+/- SD) total energy expenditures were 8912 +/- 1296 kJ/d and 9253 +/- 1298 kJ/d for the lower and higher body mass index groups, respectively. Adjusted for fat-free mass, total energy expenditure was higher in the lower body mass index group (P = 0.05). Adjusted for fat-free mass, basal metabolic rate did not differ between groups. Physical activity level was significantly higher in the lower body mass index group (P = 0.03). Lactation performance did not differ between groups and was not associated with total energy expenditure or its components. Despite the maintenance of energy balance and heightened energy requirements of lactation, energy-sparing mechanisms were not evident in these lactating Mesoamerindians.

p53 as tumor marker for the early detection of reincidence in lung cancer

To examine the p53 expression in cancer development, we studied the case of a 59-year-old male suffering from squamous cell lung cancer. He was submitted to surgery for resection of the tumoral mass. Through immunoblot and immunohistochemical analysis, the tumor fragment was shown to bear p53 and hsp70 accumulation not detected in the normal lung tissue sample. Six months later, immunohistochemical analysis of a biopsy sample taken from the previous tumor site showed p53 accumulation. Considering the high specificity for p53 detection (100%), this result suggests probable tumor reincidence, not detected by the ordinary H&E staining.

[Stable isotopes in nutrition research]

During the last decades several new techniques have been developed for measuring the utilization of nutrients in humans. The development and potential use of techniques with stable isotopes are discussed. Examples of the different studies are presented for determining whole body aminoacid and protein dynamics like lipids and glucose metabolism in humans. The practical use of these diverse stable isotopically labeled biochemicals provide safe, ethical, noninvasive investigation of nutritional metabolism in humans.