The role of the visceral adiposity index in the assessment of metabolic syndrome of polycystic ovary syndrome patients: a new anthropometric index

PURPOSE

Polycystic ovary syndrome (PCOS) is a common endocrine disorder often linked to metabolic syndrome (MS), raising the risk of cardiovascular disease and type II diabetes. Certain indicators, such as the lipid accumulation product (LAP) and homeostatic model assessment for insulin resistance (HOMA-IR), can predict MS in PCOS patients. This study aimed to assess the predictive power of the visceral adiposity index (VAI) in comparison to LAP and HOMA-IR as predictors of MS in PCOS patients.

METHODS

In this cross-sectional observational study, data from 317 diagnosed PCOS women were analyzed. VAI, LAP, and HOMA-IR were computed as indexes. Participants were categorized into two groups for index accuracy comparison: PCOS patients with and without MS. The data were assessed using a ROC curve.

RESULTS

Among PCOS women with MS, 92.3% had abnormal VAI results, 94.5% had abnormal LAP results, and only 50.5% had abnormal HOMA-IR results. Conversely, the majority of PCOS women without MS had normal HOMA-IR (64.6%). When comparing these indexes using the ROC curve, VAI displayed the highest accuracy, followed by LAP and HOMA-IR.

CONCLUSION

The VAI index proved to be a superior predictor of metabolic MS in PCOS women when compared to other indexes.

Analysis of brazilian paintings of the 20th century: Suspects and authentics through in situ and Non-Invasive techniques

This work studied suspicious and authentic artworks by Brazilian painters Ivan Serpa, Ismael Nery, and Iberê Camargo by XRF, FTIR, OM, and MA-XRF techniques. The studies made it possible to verify that all suspicious artworks are counterfeit artifacts. The analyses were conducted in situ, and different approaches were applied for data treatment. For example, principal component analysis and spectral deconvolution were performed on the XRF data. From these methods, it was possible to verify that the suspect artworks by Ivan Serpa and Iberê Camargo have different materiality than the authentic paintings. Additionally, MA-XRF images did not reveal the presence of a polychrome preparation layer in the suspicious paintings by Ivan Serpa. The suspect artworks from Ismael Nery exhibited a Ca-K/Ti-K ratio that indicates they were created on a low-quality paper support, which is not suitable for paintings. The differences in materials used in the suspicious and authentic artworks are further supported by the FTIR and OM results. In addition to the physicochemical analysis, the paintings were studies graphotechnical examinations, financial evaluations, and artistic analyses that demonstrated they were counterfeit artifacts. The results of the analysis demonstrate how physicochemical techniques can contribute to the forensic investigation of paintings. However, this work highlights the importance of applying distinct treatments to the XRF data in order to accentuate the differences between the suspect and authentic artworks.

Preventive oral kefir supplementation protects mice from ovariectomy-induced exacerbated allergic airway inflammation

Asthma is an inflammatory lung disease that affects more women than men in adulthood. Clinical evidence shows that hormonal fluctuation during the menstrual cycle and menopause are related to increased asthma severity in women. Considering that life expectancy has increased and that most women now undergo menopause, strategies to prevent the worsening of asthma symptoms are particularly important. A recent study from our group showed that re-exposure of ovariectomised allergic mice to antigen (ovalbumin) leads to an exacerbation of lung inflammation that is similar to clinical conditions. However, little is known about the role of probiotics in the prevention of asthma exacerbations during the menstrual cycle or menopause. Thus, our objective was to evaluate the effects of supplementation with kefir, a popular fermented dairy beverage, as a preventive strategy for modulating allergic disease. The results show that the preventive kefir administration decreases the influx of inflammatory cells in the airways and exacerbates the production of mucus and the interleukin 13 cytokine. Additionally, kefir changes macrophage polarisation by decreasing the number of M2 macrophages, as shown by RT-PCR assay. Thus, kefir is a functional food that potentially prevents allergic airway inflammation exacerbations in ovariectomised mice.

Effects of 17β-estradiol on early gonadal development and expression of genes implicated in sexual differentiation of a South American teleost, Astyanax altiparanae

Gonadal sex differentiation in teleost fish shows greater plasticity as compared to other vertebrates, as it can be influenced by a variety of factors such as exogenous sex steroids. Exogenous estrogens, such as 17β-estradiol (E2), can induce feminization when administered during early embryonic development. However, the mechanisms underlying the E2-induced feminization are not fully understood, especially in Neotropical species. Therefore, the aim of this study was to evaluate the effects of E2 administration on the phenotypic sex characteristics, histological assessment of the gonads, and the expression of selected genes in Astyanax altiparanae exposed to dietary E2 prior to gonadal differentiation. At 4 days post-hatch (dph), groups of 30-40 undifferentiated larvae were fed with a diet containing varying amounts of E2 for 28 days, and fish were sampled at 90 dph. Previous studies revealed that ovary formation in A. altiparanae occurred at 58 dph, whereas the first sign of testis formation was found at 73 dph. In relation to the control, E2 exposure increased the proportion of phenotypic females in 120% and 148.4% for 4 and 6 mg E2/Kg, respectively. However, histological analysis revealed that treatments did not affect gonadal sex ratio between males and females, but induced intersex (testis-ova) in the group treated with 6 mg E2/Kg food. Treatment with E2 also altered gonadal transcript levels of a selected number of genes implicated in sexual differentiation. Males overexpressed dmrt1, sox9 and amh following E2 treatment as compared to control. Females showed increased mRNA levels of dmrt1 and sox9, which might be related to the down-regulation of cyp19a1a after E2 exposure. In summary, E2 exposure during early gonadal development affected male secondary characteristics without changing the gonadal sex ratio, and altered expression of genes implicated in sexual differentiation.

Development and chemical characterization of biodegradable polymeric implants containing sirolimus for the treatment of malignant solid tumors

The use of sirolimus and its analogs has been evaluated in studies aimed at combating several types of cancer; however, because of the limited bioavailability of the drug, the search for new forms of administration is required. Biodegradable polymeric implants containing sirolimus were developed and assessed as an alternative method of drug administration. Implants containing 25 % (w/w) sirolimus were prepared employing the polymer matrices chitosan, polycaprolactone and poly(lactic-co-glycolic acid) (PLGA) in two proportions: PLGA 50:50 and PLGA 75:25. Thermal analysis techniques such as thermogravimetry and differential scanning calorimetry, combined with x-ray diffraction were used to characterize and evaluate the compatibility of the constituents of the formulation. No incompatibilities were found between the components, but drug amorphization was observed in all samples. Implants made from the polymers chitosan and PCL may accelerate the degradation of SRL when these polymers are dissolved in methanol at 50 °C. HPLC analysis showed that the implant prepared with PLGA 75:25 did not present degradation products and maintained its appropriate drug content, even when dissolved in methanol and heated to 50 °C. Therefore, it represents the most suitable biodegradable polymer for use in implants developed for the treatment of malignant solid tumors. However, it is still necessary to further study the drug effects after amorphization of the crystal and also to perform stability and solubility analysis.

Reproductive ecology of phorid parasitoids in relation to the head size of leaf-cutting ants Atta sexdens Forel

The leaf-cutting ant Atta sexdens Forel (Hymenoptera: Formicidae) is one of the most damaging agricultural pests in the Neotropics. Management strategies predominantly rely on the use of general insecticides. What is needed are more species-specific and environmentally friendly options. Parasitioids such as phorid flies (Diptera: Phoridae) may be one such option, but a greater understanding of the ecology of the flies and their ant hosts is essential to devise biological control strategies. Here we report parasitism rates, ant host size, parasitoid abundance per host and resultant sex ratios of two phorid species Apocephalus attophilus Borgmeier and Eibesfeldtphora tonhascai Brown parasitizing A.sexdens. The two species achieved parasitism rates of 1.48 and 1.46%, respectively and the pupal period was 14.7 ± 1.1 days and 22.1 ± 2.8 days, respectively. There was no significant difference between the head capsule width of ants parasitized by either A. attophilus or E. tonhascai. Likewise, there was no significant effect between the head capsule width of parasitized and unparasitized ants for both species. A significant positive correlation was found between the head capsule width of the parasitized ants and the number of adult parasitoids A. attophilus emerged. Ants parasitized by E. tonhascai survived significantly longer than those parasitized by A. attophilus. There was no significant effect of ant head width on the sex ratio of the offspring of either parasitoid species and no significant difference in the sex ratio (male: female) of their offspring. In summary, these data addressed here are important steps when considering natural enemies for biological control. Studying survival of the parasitized ants, parasitoid offspring sex ratio and host size preference allows for a better understanding of ant natural biological control in the field and can help in rearing of A. attophilus and E. tonhascai in laboratory.

Directional analysis of cardiac motion field from gated fluorodeoxyglucose PET images using the Discrete Helmholtz Hodge Decomposition

OBJECTIVES

Extract directional information related to left ventricular (LV) rotation and torsion from a 4D PET motion field using the Discrete Helmholtz Hodge Decomposition (DHHD).

MATERIALS AND METHODS

Synthetic motion fields were created using superposition of rotational and radial field components and cardiac fields produced using optical flow from a control and patient image. These were decomposed into curl-free (CF) and divergence-free (DF) components using the DHHD.

RESULTS

Synthetic radial components were present in the CF field and synthetic rotational components in the DF field, with each retaining its center position, direction of motion and diameter after decomposition. Direction of rotation at apex and base for the control field were in opposite directions during systole, reversing during diastole. The patient DF field had little overall rotation with several small rotators.

CONCLUSIONS

The decomposition of the LV motion field into directional components could assist quantification of LV torsion, but further processing stages seem necessary.

Influence of negative dental experiences in childhood on the development of dental fear in adulthood: a case-control study

The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood. This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n = 65) and controls (n = 260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%. The multivariate model showed that students who reported negative dental experiences in childhood (OR = 2·97; 95% CI: 1·44-6·14), toothache in the last 12 months (OR = 11·31; 95% CI: 4·79-26·68), discomfort during dental treatment (OR = 5·36; 95% CI: 2·53-11·36) and poor self-evaluation of oral health (OR = 3·82; 95% CI: 1·61-8·11) were more likely to have high dental fear. Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear.

Input respiratory impedance in mice: comparison between the flow-based and the wavetube method to perform the forced oscillation technique

Objective and approach: In this study, we estimated the constant phase model (CPM) parameters from the respiratory impedance of male BALB/c mice by performing the forced oscillation technique (FOT) in a control group (n  =  8) and in a murine model of asthma (OVA) (n  =  10). Then, we compared the results obtained by two different methods, using a commercial equipment (flexiVent-flexiWare 7.X; SCIREQ, Montreal, Canada) (FXV) and a wavetube method equipment (Sly et al 2003 J. Appl. Physiol. 94 1460-6) (WVT). We believe that the results from different methods may not be comparable. First, we compared the results performing a two-way analysis of variance (ANOVA) for the resistance, elastance and tissue damping.

MAIN RESULTS

We found statistically significant differences in all CPM parameters, except for resistance, when comparing Control and OVA groups. When comparing devices, we found statistically significant differences in resistance, while differences in elastance were not observed. For tissue damping, the results from WVT were observed to be higher than those from FXV. Finally, when comparing the relative variation between the CPM parameters of the Control and OVA groups in both devices, no significant differences were observed for all parameters.

SIGNIFICANCE

We then conclude that this assessment can compensate the effect of using different cannulas. Furthermore, tissue damping differences between groups can be compensated, since bronchoconstrictors were not used. Therefore, we believe that relative variations in the results between groups can be a comparing parameter when using different equipment without bronchoconstrictor administration.

Microglia and neurons in the hippocampus of migratory sandpipers

The semipalmated sandpiper Calidris pusilla and the spotted sandpiper Actitis macularia are long- and short-distance migrants, respectively. C. pusilla breeds in the sub-arctic and mid-arctic tundra of Canada and Alaska and winters on the north and east coasts of South America. A. macularia breeds in a broad distribution across most of North America from the treeline to the southern United States. It winters in the southern United States, and Central and South America. The autumn migration route of C. pusilla includes a non-stop flight over the Atlantic Ocean, whereas autumn route of A. macularia is largely over land. Because of this difference in their migratory paths and the visuo-spatial recognition tasks involved, we hypothesized that hippocampal volume and neuronal and glial numbers would differ between these two species. A. macularia did not differ from C. pusilla in the total number of hippocampal neurons, but the species had a larger hippocampal formation and more hippocampal microglia. It remains to be investigated whether these differences indicate interspecies differences or neural specializations associated with different strategies of orientation and navigation.

Growth performance, carcass and meat quality of lambs supplemented with increasing levels of a tanniferous bush (Cistus ladanifer L.) and vegetable oils

The effects of dietary inclusion of Cistus ladanifer L. (CL) and a vegetable oil blend were evaluated on growth performance,carcass and meat quality of fifty four lambs that were assigned to 9 diets, corresponding to 3 levels of CL(50, 100 and 200 g/kg DM) and 3 levels of oil inclusion (0, 40 and 80 g/kg DM). Treatments had no effects on growth rate. Oil depressed dry matter intake (P = 0.017), carcass muscle (P = 0.041) and increased (P = 0.016) kidney knob channel fat. Chemical and physical meat quality traits were not affected by treatments. Off-flavour perception was higher for 8% of oil (P b 0.001). The level of 100 g/kg DM of CL inclusion improved meat stability after 7 days of storage. Supplementation with linseed and soybean oils (2:1) was a good approach to improve meat nutritional value from feedlot lambs, increasing total n-3 PUFA.

Toll-like receptor 4 inhibition reduces vascular inflammation in spontaneously hypertensive rats

AIMS

Hypertension is associated with increased levels of circulating cytokines and recent studies have shown that innate immunity contributes to hypertension. The mechanisms which hypertension stimulates immune response remain unclear, but may involve formation of neo-antigens that activate the immune system. Toll like receptor 4 (TLR4) is an innate immune receptor that binds a wide spectrum of exogenous (lipopolysaccharide) and endogenous ligands. TLR4 signaling leads to activation of nuclear factor kappa B (NFκB) and transcription of genes involved in inflammatory response. We previously demonstrated that TLR4 blockade reduces blood pressure and the augmented vascular contractility in spontaneously hypertensive rats (SHR). Here we hypothesized that inhibition of TLR4 ameliorates the vascular inflammatory process by a NFκB signaling pathway.

MAIN METHODS

SHR and Wistar rats were treated with anti-TLR4 antibody (1μg/day) or unspecific IgG for 15days (i.p.).

KEY FINDINGS

Anti-TLR4 treatment decreased production of reactive oxygen species and expression of IL-6 cytokine in mesenteric resistance arteries from SHR, when compared with IgG-treated SHR. Anti-TLR4 treatment also abolished the increased vascular reactivity to noradrenaline observed in IgG-treated SHR, as described before, and inhibition of NFκB decreased noradrenaline responses only in IgG-treated SHR. Mesenteric arteries from SHR treated with anti-TLR4 displayed decreased expression of MyD88, but not TRIF, key molecules in TLR4 signaling. Phosphorylation of p38 and NF-κB p65 were decreased in arteries from anti-TLR4-treated SHR versus IgG-treated SHR.

SIGNIFICANCE

Together, these results suggest that TLR4 is a key player in hypertension and vascular inflammatory process by a NFκB signaling pathway.

Effects of eugenol on resting tension of rat atria

In cardiac and skeletal muscle, eugenol (μM range) blocks excitation-contraction coupling. In skeletal muscle, however, larger doses of eugenol (mM range) induce calcium release from the sarcoplasmic reticulum. The effects of eugenol are therefore dependent on its concentration. In this study, we evaluated the effects of eugenol on the contractility of isolated, quiescent atrial trabeculae from male Wistar rats (250-300 g; n=131) and measured atrial ATP content. Eugenol (1, 3, 5, 7, and 10 mM) increased resting tension in a dose-dependent manner. Ryanodine [100 µM; a specific ryanodine receptor (RyR) blocker] and procaine (30 mM; a nonspecific RyR blocker) did not block the increased resting tension induced by eugenol regardless of whether extracellular calcium was present. The myosin-specific inhibitor 2,3-butanedione monoxime (BDM), however, reversed the increase in resting tension induced by eugenol. In Triton-skinned atrial trabeculae, in which all membranes were solubilized, eugenol did not change resting tension, maximum force produced, or the force vs pCa relationship (pCa=-log [Ca²⁺]). Given that eugenol reduced ATP concentration, the increase in resting tension observed in this study may have resulted from cooperative activation of cardiac thin filaments by strongly attached cross-bridges (rigor state).

Movement assessment battery for children-2: translation, reliability, and validity for Brazilian children

The Movement Assessment Battery for Children 2nd edition (MABC-2) is a well-recognized assessment used to identify children with Developmental Coordination Disorder (DCD). Although researchers and practitioners across Brazil have used the MABC-2 to identify children with motor deficits, its validation for this particular population has yet to be investigated. In this study, we translated all MABC-2 items and validated them with respect to content, construct and criteria validity. The validation process involved 13 experts in Motor Development and a total of 844 children (3-13 years old) from two different states in Brazil. A cross-cultural translation method yielded a Brazilian-Portuguese version of the battery. The expert panel confirmed language clarity and pertinence of the items. High intra- and inter-rater reliability and internal consistency for the MABC-2 was established for Brazilian children. A discriminant analysis confirmed the MABC-2 power (.80) to differentiate children with DCD and those at risk for DCD from typically developing children. Predictive validity was observed for the impairment scores and a percentile main effect was found in the repeated measures ANOVA (ICC: .93 and .73, respectively). Although our data are not representative of the entire country, this study is the first to confirm that the original standardized scores established for the MABC-2 are valid in Brazilian children.

The Influence of Formulation on the Dissolution Profile of Diclofenac Sodium Tablets

In attempts to design delayed-release tablets of diclofenac sodium, seven experimental batches were produced. The influence of super-disintegrant croscarmellose sodium (CCS), the granulation process, and the thickness of Eudragit L 100 coating film were evaluated. The values of dissolution efficiency and the similarity factor were used to compare the dissolution profiles of each experimental batch and the reference Voltaren. Both methods appear to be applicable and useful in comparing dissolution profiles. Based on such values four batches were considered similar when contrasted with the reference. The results suggest an optimal relationship between the amount of CCS and the thickness of the coating film, which provides appropriate dissolution rate of diclofenac sodium from the dosage forms.

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled). Uncontrolled asthmatics accounted for higher health care expenditures than controlled patients, US$125.45 and US$15.58, respectively [emergency room visits (US$39.15 vs US$2.70) and hospitalization (US$86.30 vs US$12.88)], per patient over 6 months. The costs with medications in the last month for patients with mild, moderate and severe asthma were US$1.60, 9.60, and 25.00 in the uncontrolled patients, respectively, and US$6.50, 19.00 and 49.00 in the controlled patients. In view of the small proportion of uncontrolled subjects receiving regular maintenance medication (22.2%) and their lack of resources, providing free medication for uncontrolled patients might be a cost-effective strategy for the public health system.

Inhibition of tumor necrosis factor-alpha-induced intercellular adhesion molecule-1 expression in diabetic rats: role of insulin

OBJECTIVE

The effects of insulin on intercellular adhesion molecule (ICAM)-1-mediated leukocyte adhesion and migration were investigated.

METHODS

Diabetic rats (alloxan, 42 mg/kg, i. v., 42 days), matching controls, and insulin (NPH, 2 IU/day for 12 days) treated diabetic rats were used. The internal spermatic fascia of the animals was used for direct vital microscopy of the microcirculation, and for quantitation of ICAM-1 expression by immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR). Experiments were performed 2 h after the local injection of recombinant rat tumor necrosis factor-alpha (5 ng).

RESULTS

Relative to controls (C), diabetic (D) rats exhibited a reduced number of adhered (D: 2.2 +/- 0.4 and C: 14.1 +/- 0.6 cells/100 microm venule length, P < 0.001) and migrated leukocytes (D: 1.1 +/- 0.3 and C: 6.3 +/- 0.6 cells/1,000 microm (2), P < 0.001) accompanied by low expression of ICAM-1 in postcapillary venules (D: 18 +/- 4 and C: 51 +/- 7 arbitrary units, P < 0.001). There were no differences in ICAM-1 mRNA levels (D: 1.01 +/- 0.05 and C: 1.18 +/- 0.09 ICAM-1/GAPDH ratio, P > 0.05). Treatment of diabetic rats with insulin restored the number of adhered (10.9 +/- 1.2 cells/100 microm venule length), and migrated leukocytes (4.0 +/- 0.3 cells/1,000 microm (2)) as well as ICAM-1 expression (45 +/- 3 arbitrary units). Levels of mRNA for ICAM-1 remained unchanged after treatment (1.15 +/- 0.04 ICAM-1/GAPDH ratio).

CONCLUSION

Insulin modulates TNF-alpha-induced ICAM-1 expression on microvascular endothelium controlling, therefore, leukocyte adhesion and migration.

Comparison of four synchronization protocols for fixed-time bovine embryo transfer in Bos indicus × Bos taurus recipients

The objective was to evaluate the effects of 400 IU of eCG given on Days 5 or 8 of an estrus synchronization protocol with progesterone-releasing intravaginal devices (PRID) and estradiol benzoate (EB), in recipients for fixed-time embryo transfer. A secondary objective was to determine the effects of injectable progesterone (given concurrent with EB treatment). Three-hundred-and-four crossbred Bos taurus x Bos indicus beef heifers were randomly assigned to one of four treatment groups (2 x 2 factorial design). At unknown stages of the estrous cycle (Day 0), all heifers received a progesterone-releasing intravaginal device (PRID), plus 2mg of EB i.m., with or without a concurrent treatment of 50mg of progesterone i.m. Heifers were further subdivided to receive 0.15 mg of d-cloprostenol (PGF) i.m. and 400 IU of eCG i.m. on Days 5 or 8. In all heifers, intravaginal devices were removed on Day 8 and 1mg of EB was given i.m. on Day 9 (Day 10 was arbitrarily considered the day of estrus). On Day 17, all heifers with >1 CL or a single CL with a diameter > or =18 mm (based on ultrasonographic examination), received an in vitro produced (IVP) embryo by non-surgical transfer. On Day 17, there was an effect of day of eCG administration on the number of CL (1.35 +/- 0.08 versus 1.13 +/- 0.04, for Day 5 versus Day 8, respectively; P = 0.02) and (in a subset of 154 heifers) mean (+/-S.E.M.) plasma progesterone concentrations (2.41 +/- 0.26 versus 1.74 +/- 0.19 ng/mL; P = 0.03). Although the proportion of recipients transferred/treated and pregnant/transferred did not differ among groups, the proportion of recipients pregnant/treated tended (P = 0.1) to be higher in heifers treated with eCG on Day 5 versus Day 8 (47.0% versus 40.7%, respectively). Progesterone treatment had no significant effect. In conclusion, treatment with eCG (and D-cloprostenol) on Day 5 significantly increased the number of CL and plasma progesterone concentrations and tended to increase pregnancy rates, although progesterone treatment had no significant effect.

[Growth, diarrhea, and breastfeeding: the case of Vila do João]

A prospective study on children under six months old living in an urban area on the periphery of Rio de Janeiro was carried out to examine the possible effect of diarrhea in differentiating the monthly growth rate in weight and height, according to type of nursing. The results seem to indicate that infants show a delay in growth of weight and height as a result of greater incidence and prevalence of diarrhea. It was also shown that human breast milk has a protective effect, reducing weight loss from episodes of diarrhea. The study concludes that the promotion of breastfeeding, together with the control of diarrheal diseases, can provide immediate benefits in improving the nutritional status of the infant population.

[Veterinary Services: how to establish quality assurance in developing countries]

The authors put forward a methodological proposal for introducing quality assurance into animal health service provision in developing countries, based on the experience of Brazil. This proposal is based on three key elements. The first and most important element is the continuing development of those involved in the process, not only from the technical and administrative standpoint (know-how), but also in terms of modelling new forms of behaviour and attitudes for the provision of services (social and personal skills). This requires a culture of ethical values, motivation and team working to ensure that those involved in the process become committed, highly effective employees who identify with the Veterinary Service's objectives as if they were their own. The second key element of this methodology is to consider the various health services to be provided as processes and to treat each of these services as a set of activities, inputs and procedures that are systematically organised for delivering the specified animal health service. Working with processes not only makes it possible to properly plan each service, it also facilitates the identification, analysis and effective resolution of any problems that may arise while the service is being delivered. The third key element of the proposed methodology is the constant control and improvement of the processes making up the various health services, in particular using the Deming cycle (plan--do--check--act). The proposed strategy calls for realism and pragmatism in order to avoid creating false expectations by developing over-ambitious quality systems. It is advisable to avoid major publicity at the start of activities and to create well-defined, localised improvement programmes with anticipated results that are simple, direct and discernible to any observer within a short time frame. In the early stages, the term "quality" needs to be replaced with "better service delivery". It is necessary to ensure that staff is given some type of acknowledgement or feedback when positive results are achieved. Great emphasis must be placed on staff motivation and awareness-raising activities.

A new approach to the study of latissimus dorsi muscle vasoreactivity in rats

In this paper we describe a new approach to the study of changes in latissimus dorsi (LD) muscle microcirculation in rats. The experiments were carried out under anesthesia in normal male Wistar rats (C, n = 6) and in diabetes-induced rats (D, streptozotocin, 50 mg/kg, i.v., n = 6). The left LD muscle was exposed in order to preserve the proximal tendon with its thoracodorsal nerve and artery. The animal was kept in lateral decubitus over a heating board attached to the mechanical stage of the intravital microscope. The ventral surface of the muscle was exposed over a transparent plate and fixing. The image of the LD vascularization was transferred to the camera system, which was connected to a microcomputer equipped with software (KS-300, Kontron Elektronik, Munich, Germany) for image storage. The vasoreactivity of LD was analyzed by changes in arteriole diameter after topically administered noradrenaline (0.3 microg/ml) and acetylcholine (300 microg/ml). The microscopic image provided by the described optical setup permitted clear resolution of capillary vessels and a stable preparation over a period of 3-4 h. D rats showed increased vasodilatation (29 +/- 2% vs. 18 +/- 2.6% in C) and similar vasoconstriction (25.5 +/- 3% vs. 27.5 +/- 3.3% in C) as compared to C rats. The method described in this paper is suitable for the study of changes in responsiveness of LD arterioles, vessels which represent the major site of vascular resistance and are most actively involved in the control of tissue perfusion.

Outbreak of influenza type A (H1N1) in Iporanga, São Paulo State, Brazil

From June to July 1999 an outbreak of acute respiratory illness occurred in the town of Iporanga. Out of a total of 4,837 inhabitants, 324 cases were notified to the Regional Surveillance Service. Influenza virus was isolated from 57.1% of the collected samples and 100% seroconversion to influenza A (H1N1) was obtained in 20 paired sera tested. The isolates were related to the A/Bayern/07/95 strain (H1N1). The percentages of cases notified during the outbreak were 28.4%, 29.0%, 20.7%, 6.2% and 15.7% in the age groups of 0-4, 5-9, 10-14, 15-19 and older than 20 years, respectively. The highest proportion of positives was observed among children younger than 14 years and no cases were notified in people older than 65 years, none of whom had been recently vaccinated against influenza. These findings suggest a significant vaccine protection against A/Bayern/7/95, the H1 component included in the 1997-98 influenza vaccine for elderly people. This viral strain is antigenically and genetically related to A/Beijing/262/95, the H1 component of the 1999 vaccine. Vaccines containing A/Beijing/262/95 (H1N1) stimulated post-immunization hemagglutination inhibition antibodies equivalent in frequency and titre to both A/Beijing/262/95-like and A/Bayern/7/95-like viruses. Thus, this investigation demonstrates the effectiveness of vaccination against influenza virus in the elderly.

Association of periphytic diatom species of artificial substrate in lotic environments in the Arroio Sampaio Basin, RS, Brazil: relationships with abiotic variables

Associations of diatom species were identified, in the Arroio Sampaio Basin, Rio Grande do Sul, Brazil, based on monthly samplings over a year along Arroio Sampaio and its main tributaries, using polyamide thread as an artificial substrate. The species groupings showed four different environments: medium-lower course of Arroio Sampaio; and lower course of Arroio Teresinha; upper course of Arroio Sampaio; and lower course of Arroio Duvidosa. Among the physical and chemical variables measured, water pollution, particularly organic contamination and eutrophication, measured from BOD, and total phosphate concentration, respectively, appeared to be one of the most important environmental factors determining the composition and structure of species associations in the area studied.

Ovarian follicular dynamics of five-eighths Girolando cows

The objective of this study was to examine the follicular dynamics of five-eighths Girolando cows by observing the number of follicular development waves, days of emergence of those waves, diameters of the dominant and largest subordinate follicles and the processes of follicular selection and dominance. Ovarian follicle dynamics were monitored for 24 oestrous cycles in 12 cows, of 4 to 10 years of age, presenting regular oestrous cycles and with body scores between 3 and 4. Ovaries were observed daily for two consecutive oestrous cycles and follicles were measured with ultrasonographic equipment. The dominant follicle was considered to be that which presented a diameter > or = 10 mm for three consecutive days and on the day of wave emergence, when a group of follicles measuring 3-5 mm in diameter would appear. Of the 24 cycles monitored, 62.5% presented two waves of follicular development and 37.5% presented three waves. The cycles presenting two waves had an average duration of 20 days, with the emergence of the waves on days 1 and 9, whereas the cycles presenting three waves had an average duration of 22 days, with emergences on days 1, 10 and 16. For cycles with two waves, both the first and second dominant follicles reached an average size of 13.8 mm, with the first regressing on day 10 and the second ovulating around day 20. For cycles with three waves, the dominant follicles of the first and second waves reached maximum diameters of 11.8 and 12 mm, respectively, with the first regressing on day 11 and the second regressing on day 17. The third dominant follicle reached a maximum diameter of 12.4 mm on day 20, and ovulated on day 22. These results lead to the conclusion that the follicular dynamics of five-eighths Girolando cows are characterized by the presence of two to three waves of follicular growth.

Acylated apigenin glycosides from alfalfa (Medicago sativa L.) var. Artal

Three flavones, including 4'-O-[2'-O-E-feruloyl-O-beta-D-glucuronopyranosyl(1-->2)-O-beta-D-glucuronopyranoside]apigenin, 7-O-beta-D-glucuronopyranosyl-4'-O-[2'-O-E-feruloyl-O-beta-D-glucuronopyranosyl(1-->2)-O-beta-D-glucuronopyranoside]apigenin and 7-O-beta-D-glucuronopyranosyl-4'-O-[2'-O-p-E-coumaroyl-O-beta-D-glucuronopyranosyl(1-->2)-O-beta-D-glucuronopyranoside]apigenin have been identified in alfalfa var. Artal. The known flavone 7-O-[2-O-E-feruloyl-[beta-D-glucuronopyranosyl(1-->3)]-O-beta-D-glucuronopyranosyl(1-->2)-O-beta-D-glucurono-pyranoside] apigenin was also isolated. The structures of these compounds were deduced on the basis of their spectral data.

[AIDS, activism, and the regulation of clinical trials in Brazil: Protocol 028]

This paper examines the politics and practices of drug evaluation in Brazil. It traces the history of AIDS activists' influence on the organization of modern clinical trials and their scientific rationale. Using the Merck indinavir trial as a case study, the authors discuss how organized civil society has developed strategies to intervene in the course of drug evaluation trials, shaping them according to its own interests. Adopting translation sociology as the theoretical framework, the paper describes and analyzes the strategies used by activists from "Grupo PelaVidda/SP" (an AIDS NGO) to build a consensus concerning indinavir monotherapy's lack of efficacy. The study considers the several regulatory forums involved in dealing with the controversy during the trial period.

[Institutionalization and development of nursing in Brazil in view of public health policies]

The paper deals with a historical recovery of the genesis of Nursing and its development in Brazil in order to elucidate its influence in current nursing education and practice. It emphasizes the role played by the Rockefeller Foundation in the organization of public health nursing, the creation of the first school of nursing and the consolidation of nursing education and practice in hospitals. Certain public health policies were also examined, given their influence in the development of the profession. Nursing maintained a scientific and politically neutral position during the implementation of these health policies, possibly because of the non-critical makeup brought about by the adoption of the flexnerian model of teaching, in its link to Medicine.

Biological treatment of wastewater from the cassava meal industry

Biological treatments of cassava meal processing wastewaters were investigated by aerobic and combined anaerobic/aerobic reactors. As a pretreatment, flocculation and sedimentation with aluminum salts and natural polyelectrolytes were employed, in order to change the effluent concentration of organics from 14,000 to 2000 mg/L in the bench scale reactor, with a hydraulic retention time of 37 min and an influent rate of 0.56 L/cm. Biological degradation by an activated sludge process was carried out using a reactor volume of 20 L. The observed organic matter removal rates were 89 to 93%, the cyanide removal was 95 to 99%, and the food to microorganisms ratio was found to be in the range of 0.166 to 0.242/day, with a hydraulic residence time of 1.4 to 4.2 days. As a posttreatment, flocculation and coagulation were employed, resulting in an effluent of good quality, as shown by turbidity measurements and negative tests for fecal and total coliforms.

Immunochemotherapy in American cutaneous leishmaniasis: immunological aspects before and after treatment

In this study, we evaluated the immune response of patients suffering from cutaneous leishmaniasis treated with two distinct protocols. One group was treated with conventional chemotherapy using pentavalent antimonium salts and the other with immunochemotherapy where a vaccine against cutaneous leishmaniasis was combined with the antimonium salt. Our results show that, although no differences were observed in the necessary time for complete healing of the lesions between the two treatments, peripheral blood mononuclear cells from patients treated by chemotherapy showed smaller lymphoproliferative responses at the end of the treatment than those from patients in the immunochemotherapy group. Furthermore, IFN-gamma production was also different between the two groups. While cells from patients in the chemotherapy group produced more IFN-gamma at the end of treatment, a significant decrease in this cytokine production was associated with healing in the immunochemotherapy group. In addition, IL-10 production was also less intense in this latter group. Finally, an increase in CD8+ -IFN-gamma producing cells was detected in the chemotherapy group. Together these results point to an alternative treatment protocol where healing can be induced with a decreased production of a potentially toxic cytokine.

[Monitoring of vegetables sold in Ribeirão Preto, SP, Brazil]

The ingestion of raw vegetables represents an important means of transmission of several infectious diseases. The objective of the present study was to perform a microbiological and parasitological evaluation of the vegetables commercially sold in the municipality of Ribeirão Preto, SP, Brazil. Of a total of 172 commercial concerns analyzed, 115 (67%) presented irregularities in the vegetables they sold, such as elevated concentration of fecal coliforms in 63%, presence of Salmonella in 9%, and presence of enteroparasites in 33%. The commercial concerns with the highest frequencies of vegetables showing inadequate results were: grocery stores (92%), CEAGESP (75%), fruit and vegetables stores (71%), traveling vendors (71%), fairs (69%), supermarkets (52%), and vegetable gardens (18%). The type of contamination was uniformly distributed among these commercial concerns. Most of the contaminated vegetables (61%) were from gardens located in the municipality of Ribeirão Preto. Considering the high frequency of fecal contamination and the potential risk of disease transmitted by vegetables, we suggest greater enforcement in the sanitary surveillance of the food offered to the population.

Role of PAG in the antinociception evoked from the medial or central amygdala in rats

The effects of stimulating the periaqueductal gray (PAG) against the rat tail flick reflex (TFR) was not changed significantly by the microinjection of lidocaine (5%/0.5 microl) into the medial (ME) or central (CE) nuclei of the amygdala. In contrast, lidocaine into the PAG blocked the effects from the ME or CE. The microinjection of naloxone (1 microg), beta-funaltrexamine (2 microg), propranolol (1 microg), or methysergide (1 microg), but not atropine (1 microg) or mecamylamine (1 microg) into the PAG significantly reduced the effects from the CE. The effect from the ME was not altered significantly by microinjecting naloxone into the PAG. Therefore, the ME or CE are unlikely to be intermediary stations for depression of the TFR evoked by stimulating the PAG, but the PAG may be a relay station for the effects of stimulating the ME or CE. The circuitry activated from the CE, but not the ME, utilises opioid mediation in the PAG. The effect from the CE depends at least on mu-opioid, serotonergic, and probably beta-adrenergic mediation in the PAG.

[Nursing in transmissible diseases: how to approach this topic in nursing graduation?]

This study relates the attempts of the discipline Collective Health Nursing with focus in transmissible diseases to reorganize its teaching object, its theoretical and practical content, and its pedagogical atrategics, as a contribution to the formation of a nursing professional compromised with Collective Health. It describes the context of Collective Health in Brazil and the characteristics needed to improve the implementation of the Unified Health Care System in the Country. It also reports the content and the padagogical strategics used in the discipline and makes a critical analysis of its potentialities and limitations to the proposed goal.

The genome sequence of the plant pathogen Xylella fastidiosa. The Xylella fastidiosa Consortium of the Organization for Nucleotide Sequencing and Analysis

Xylella fastidiosa is a fastidious, xylem-limited bacterium that causes a range of economically important plant diseases. Here we report the complete genome sequence of X. fastidiosa clone 9a5c, which causes citrus variegated chlorosis--a serious disease of orange trees. The genome comprises a 52.7% GC-rich 2,679,305-base-pair (bp) circular chromosome and two plasmids of 51,158 bp and 1,285 bp. We can assign putative functions to 47% of the 2,904 predicted coding regions. Efficient metabolic functions are predicted, with sugars as the principal energy and carbon source, supporting existence in the nutrient-poor xylem sap. The mechanisms associated with pathogenicity and virulence involve toxins, antibiotics and ion sequestration systems, as well as bacterium-bacterium and bacterium-host interactions mediated by a range of proteins. Orthologues of some of these proteins have only been identified in animal and human pathogens; their presence in X. fastidiosa indicates that the molecular basis for bacterial pathogenicity is both conserved and independent of host. At least 83 genes are bacteriophage-derived and include virulence-associated genes from other bacteria, providing direct evidence of phage-mediated horizontal gene transfer.

Leishmania sp: comparative study with Toxoplasma gondii and Trypanosoma cruzi in their ability to initialize IL-12 and IFN-gamma synthesis

We compared in vitro and in vivo induction of IL-12 (p40) and IFN-gamma by mouse cells stimulated with Toxoplasma gondii, Trypanosoma cruzi, and different species of Leishmania. Spleen cells cultured in vitro with T. cruzi or T. gondii, but not with Leishmania, produced IL-12 (p40) and IFN-gamma. Accordingly, IL-12 (p40) was produced by macrophages stimulated in vitro with live T. cruzi or T. gondii or membrane glycoconjugates obtained from trypomastigotes or tachyzoites. No IL-12 production was detected when macrophages were stimulated with live parasites or glycoconjugates from Leishmania, regardless of priming with IFN-gamma. In vivo, only T. cruzi and T. gondii induced the synthesis of IL-12 and IFN-gamma by mouse spleen cells after intraperitoneal injection of parasites. When injected subcutaneously, live Leishmania sp. induced IL-12 (p40) and IFN-gamma production by draining lymph node cells, albeit the levels were slightly lower than those induced by infection with T. gondii or T. cruzi using the same route. Together our results indicate that under different conditions, the intracellular protozoa T. gondii and T. cruzi are more potent stimulators of IL-12 and IFN-gamma synthesis by host immune cells than parasites of the genus Leishmania.

Bovine cumulus/oocyte complex: quantification of LH/hCG receptors

LH/hCG receptors of the bovine cumulus/oocyte complex were quantified, and their maximum binding capacities and affinity constants were determined by Scatchard analysis. Specific binding of these gonadotropins to receptors in follicles of different sizes was also determined by radiolabeling techniques. A greater number of receptors was observed to be bound to LH than to hCG (P < 0.05); however, affinity constants did not significantly differ (P > 0.05). The results of specific binding of the gonadotropins presented differences in relation to follicle size. Differences in the specific binding values of LH and hCG were verified (P < 0.05), but when submitted to linear regression analysis, presented similar behaviors in relation to follicle size. It is concluded that receptors of bovine cumulus/oocyte complex cells bind specifically to LH/hCG, that binding capacity is inversely proportional to follicle size, and that the behavior of hCG is similar to that of LH, suggesting that hCG can also promote the maturation of bovine oocytes when used in concentrations greater than LH.

Prevalence of serotypes and antimicrobial resistance of streptococcus pneumoniae strains isolated from Brazilian children with invasive infections. Pneumococcal Study Group in Brazil for the SIREVA Project. Regional System for Vaccines in Latin America

A laboratory surveillance study was developed in Brazil in 1993 to determine capsular types and antimicrobial susceptibility of Streptococcus pneumoniae strains. By studying 360 strains isolated from children with invasive infections in three different cities, 8 out of 34 types were identified as being the most prevalent and considered as the reference group for further analyses. This group comprised 77.7% of all strains studied, and includes the types 1, 5, 6A/B, 9V, 14, 19F, 19A, and 23F. The prevalence of this reference group was significantly higher among strains isolated from children with pneumonia than meningitis. Similarly, this group was more prevalent among strains isolated from children 3 to 6 years of age than from children under 2 years of age. Most strains (78.6%) were found to be susceptible to penicillin and only 1.4% showed high resistance to this antibiotic. However, intermediate resistance to penicillin was detected in 20% of the strains. This laboratory surveillance will be maintained and extended to other cities of Brazil to better define and monitor the trends of pneumococcal infections for proper control and prevention.

Influence of tolrestat on the defective leukocyte-endothelial interaction in experimental diabetes

One of the most devastating secondary complications of diabetes is the blunted inflammatory response that becomes evident even in the very early stages of poorly controlled diabetes mellitus. While the etiology of this diminished response is not clearly understood, it has been linked to a decrease in the respiratory burst of neutrophils, as well as a decrease in microvessel response to inflammatory mediators and defective leukocyte-endothelial interactions. Using video microscopy to visualize vessels of the internal spermatic fascia, we have characterized leukocyte-endothelial interactions in alloxan-induced diabetic and in galactosemic rats by quantitating the number of leukocytes rolling along the venular endothelium and the number of leukocytes sticking to the vascular wall after topical application of zymosan-activated plasma or leukotriene B(4) (1 ng/ml), as well as after the application of a local irritant stimulus (carrageenan, 100 microg). We observed that while 33 days of alloxan-induced diabetes or 7 days of galactosemia had no effect on total or differential leukocyte counts and on the wall shear rate, both treatments significantly (P<0.001) reduced the number of leukocytes rolling along the venular endothelium by about 70% and the number of adhered leukocytes in postcapillary venules by 60%. These effects were not observed in diabetic and galactosemic animals treated with an aldose reductase inhibitor. The results suggest that impaired leukocyte-endothelial cell interactions are a consequence of an enhanced flux through the polyol pathway.

[The historicity of the interpretative theories about health and disease]

The interpretative theories of the health-illness process that can be identified through History have as consequence intervention projects upon the reality, in response to social needs. Until the 19 century, they could be synthesized in two main streams: ontologic and dynamic. In the ontologic conception, illness assumes the character of a natural or supernatural entity, external to the human body, that shows itself when invading it. The dynamic conception sees illness as a product of the disharmony among vital forces, and the re-establishment of the health comes of the restoration of this balance. At the end of the 18 century, the social-environmental paradigms prevailed in Europe as forms of explanation for human illness, linked to the dynamic conception, and the first evidences of the social determination of the health-illness process were formulated. The onset of the Bacteriologic Era made the ontologic conception victorious and its conquests led to the abandon of the social approaches to face the populations health problems. At the present time, one can identify the prevalence of the multicausal theory, with emphasis in the individual conditionings. This paper proposes the articulation of the individual and collective dimensions of the health-illness process, in consonance with the Theory of Nursing Praxical Intervention in Collective Health.

[Monitoring of lettuce crops of Ribeirão Preto, SP, Brazil]

The ingesting of raw vegetables plays an important role in the transmission of several infectious diseases due to the high frequency of irrigation with wastewater. The objective of this study was to evaluate the sanitary conditions of all lettuce producing crops in Ribeirão Preto through microbiological and parasitological analysis of both irrigation water and lettuce together with the implantation of an effective crop monitoring. Laboratory analysis of 129 crops showed irregularities in 26 (20.1%) of these: high concentration of fecal coliforms in 17% of the lettuce, presence of Salmonella in 3.1% and several enteroparasites (Ascaris sp, Ancylostomidae, Strongyloides sp, Hymenolepis nana, and Giardia sp ) in 13.1%. Persistent irregularities determined the definitive closing down of one producer; all of the remaining 128 crops were eventually approved, thus demonstrating the efficacy of lettuce crop monitoring. Crops approved in the laboratory analysis were awarded a Sanitary Inspection Certificate - an unprecedented procedure in our Country - that resulted in a better acceptance of the monitoring.

Crystal structure of human ornithine decarboxylase at 2.1 A resolution: structural insights to antizyme binding

The polyamines spermidine and spermine are ubiquitous and required for cell growth and differentiation in eukaryotes. Ornithine decarboxylase (ODC, EC 4.1.1.17) performs the first step in polyamine biosynthesis, the decarboxylation of ornithine to putrescine. Elevated polyamine levels can lead to down-regulation of ODC activity by enhancing the translation of antizyme mRNA, resulting in subsequent binding of antizyme to ODC monomers which targets ODC for proteolysis by the 26S proteasome. The crystal structure of ornithine decarboxylase from human liver has been determined to 2.1 A resolution by molecular replacement using truncated mouse ODC (Delta425-461) as the search model and refined to a crystallographic R-factor of 21.2% and an R-free value of 28.8%. The human ODC model includes several regions that are disordered in the mouse ODC crystal structure, including one of two C-terminal basal degradation elements that have been demonstrated to independently collaborate with antizyme binding to target ODC for degradation by the 26S proteasome. The crystal structure of human ODC suggests that the C terminus, which contains basal degradation elements necessary for antizyme-induced proteolysis, is not buried by the structural core of homodimeric ODC as previously proposed. Analysis of the solvent-accessible surface area, surface electrostatic potential, and the conservation of primary sequence between human ODC and Trypanosoma brucei ODC provides clues to the identity of potential protein-binding-determinants in the putative antizyme binding element in human ODC.

[Pharmaceutical care in primary health care: the experience of 3 Brazilian States]

In the context of recent changes in the Brazilian drug supply system at the national level, mainly the deactivation of CEME (a government agency under the Ministry of Health that dealt with drug supply policy) and the increasing decentralization of activities under the Unified National Health System (SUS), three Brazilian States - Paraná, São Paulo, and Minas Gerais - have established programs for the distribution of essential drugs for primary health care. A nationwide program for the procurement and supply of 32 drugs for primary health care (the so-called "Basic Pharmacy Program") is currently being implemented by the Ministry of Health, to be decentralized subsequently. This article discusses the establishment of State-level drug policies for primary health care through the analysis of the three pioneering programs encompassing drug selection, procurement, storage, distribution, and use.