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Lemes JA, Silva MSCF, Gonçalves BSM, Céspedes IC, Viana MB. Deep Brain Stimulation of the dorsal raphe induces anxiolytic and panicolytic-like effects and alters serotonin immunoreactivity. Behav Brain Res 2023; 449:114462. [PMID: 37121276 DOI: 10.1016/j.bbr.2023.114462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/02/2023]
Abstract
Previously we showed that Deep Brain Stimulation (DBS) of the dorsal region (DRD) and of the lateral wings of the dorsal raphe (lwDR) respectively decreases anxiety and panic-like responses in the elevated T-maze (ETM). This study investigates neurobiological alterations which might respond for these behavioral effects. Male Wistar rats were submitted to high-frequency stimulation (100µA, 100Hz) of the DRD or of the lwDR for 1h, and subsequently tested in the avoidance or escape tasks of the ETM. Since serotonin (5-HT) reuptake inhibitors are first line pharmacological treatment for anxiety disorders, we also tested the effects of chronic fluoxetine administration (10mg/kg, IP, 21 days) on a separate group of rats. An open field was used for locomotor activity assessment. Additionally, we evaluated c-Fos immunoreactivity (Fos-ir) in serotonergic cells of the dorsal raphe (DR). Results showed that DBS of the DRD decreases avoidance reactions, an anxiolytic-like effect, without altering escape or locomotor activity. Both fluoxetine and DBS of the lwDR decreased escape responses in the ETM, a panicolytic-like effect, without altering avoidance measurements or locomotor activity. While DBS of the DRD decreased double immunostaining in the DRD, DBS of the lwDR increased Fos-ir and double immunostaining in the DRD and lwDR. Fluoxetine also increased double immunostaining in the lwDR and in the DRV but decreased it in the DRD. These results suggest that both the anxiolytic and panicolytic-like effects of DBS and fluoxetine are related to 5-HT modulation in different subnuclei of the DR.
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Affiliation(s)
- J A Lemes
- Departamento de Biociências, Federal University of São Paulo (UNIFESP), Santos, Brazil
| | - M S C F Silva
- Departamento de Biociências, Federal University of São Paulo (UNIFESP), Santos, Brazil
| | - B S M Gonçalves
- Departamento de Biociências, Federal University of São Paulo (UNIFESP), Santos, Brazil
| | - I C Céspedes
- Departamento de Morfologia e Genética, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - M B Viana
- Departamento de Biociências, Federal University of São Paulo (UNIFESP), Santos, Brazil.
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Sales RR, Nogueira BL, Belisário AR, Mendes F, Faria G, Viana MB, Luizon MR. HAPLÓTIPOS DE BCL11A E HBS1L-MYB ASSOCIADOS COM CONCENTRAÇÃO ELEVADA DE HEMOGLOBINA FETAL E INTERAÇÃO ENTRE ESTES LOCI NA PREDIÇÃO DE DESFECHOS CLÍNICOS E HEMATOLÓGICOS EM CRIANÇAS COM ANEMIA FALCIFORME. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Nogueira BL, Sales RR, Belisário AR, Faria G, Mendes F, Viana MB, Luizon MR. BCL11A POLYMORPHISMS ASSOCIATED WITH INCREASED FETAL HEMOGLOBIN IN RESPONSE TO HYDROXYUREA TREATMENT IN A COHORT OF PEDIATRIC PATIENTS WITH SICKLE CELL ANEMIA. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Viana MB, Martins RS, Silva MSCF, Xapelli S, Vaz SH, Sebastião AM. Deep Brain Stimulation of the dorsal raphe abolishes serotonin 1A facilitation of AMPA receptor-mediated synaptic currents in the ventral hippocampus. Behav Brain Res 2021; 403:113134. [PMID: 33476685 DOI: 10.1016/j.bbr.2021.113134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/11/2020] [Accepted: 01/11/2021] [Indexed: 11/24/2022]
Abstract
In a previous study we showed that Deep Brain Stimulation (DBS) of the rat dorsal subregion of the dorsal raphe (DRD), which sends serotonergic projections to forebrain areas, such as the ventral hippocampus, induces anxiolytic-like effects. The purpose of the present study was to investigate neurobiological alterations which might underline these behavioral effects. For that, we tested the influence of DBS upon the neuromodulatory action of serotonin on excitatory post-synaptic currents (EPSCs) in the ventral hippocampus. Male Wistar rats were submitted to high-frequency stimulation (100 μA, 100 Hz) of the DRD for 1 h during three consecutive days. On the third day, immediately after the DBS procedure, animals were euthanized. Slices of the ventral hippocampus were processed for whole cell patch clamp recordings of AMPA-receptor (AMPAR) mediated EPSCs in the CA1 area. As reported by others, we confirmed that in pre-weaning rats a high affinity 5-HT1A receptor agonist (8-OH-PIPAT, 0.5-5nM) inhibits EPSCs. However, in adult rats (non-operated or sham-operated), 8-OH-PIPAT (0.5-5 nM) increased EPSC amplitude, an effect blocked by the 5-HT1A antagonist WAY-100,635 (200 nM). Importantly, in adult rats exposed to DBS, the 5-HT1A agonist was devoid of effect. Taken together these results show that: 1) changes in 5-HT1A receptor-mediated hippocampal synaptic transmission occur with age; 2) these changes lead to a facilitatory effect of 5-HT1A receptors; 3) DBS blocks this serotonergic facilitatory action. These observations suggest that an alteration in serotonin modulation of limbic areas may underlie the psychotherapeutic effects of DBS.
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Affiliation(s)
- M B Viana
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil.
| | - R S Martins
- Departamento de Farmacologia e Fisiologia, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - M S C F Silva
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
| | - S Xapelli
- Instituto Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - S H Vaz
- Instituto Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - A M Sebastião
- Instituto Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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Oliveira MCL, Sampaio KC, Brito AC, Campos MK, Murao M, Gusmão R, Fernandes AAL, Viana MB. 30 Years of Experience with Non-Hodgkin Lymphoma in Children and Adolescents: a retrospective cohort study. ACTA ACUST UNITED AC 2020; 66:25-30. [PMID: 32130377 DOI: 10.1590/1806-9282.66.1.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Describe the clinical and demographic characteristics of pediatric patients with non-Hodgkin's lymphoma (NHL) enrolled in a tertiary unit of Pediatric Hematology between 1982-2015. PATIENTS AND METHODS A retrospective cohort study of 140 patients aged 16 years or less with NHL. Demographic characteristics, data on diagnosis, and outcomes were analyzed. The overall survival (OS) analysis and stratification by the most frequent histological subtypes were performed using the Kaplan-Meier method. RESULTS One hundred and thirty-six patients with de novo NHL and four with NHL as a second malignancy were analyzed. The median age at diagnosis was 6.4 years (interquartile range, 4.2 to 11.1 years); 101 patients were males. Four patients had primary immunodeficiency, four had human immunodeficiency virus, two post-liver transplantation, and one had autoimmune lymphoproliferative syndrome. The most frequent histological type was NHL of mature B- cell (B-NHL-B; 67.1%), with Burkitt's lymphoma being the most frequent subtype, and lymphoblastic lymphoma (LBL, 21.4%). The main clinical manifestation at the diagnosis was abdominal tumors (41.4%). During the follow-up time, 13 patients relapsed, but five of them reached a second remission. Thirty-five patients died, and 103 remained alive in clinical remission. No contact was possible for two patients. The OS at 5 years was 74.5% (± 3.8%). The OS estimated for patients with LBL, NHL-B, and the remaining was 80.4%±7.9%, 72.8%±4.7%, and 74.5%±11%, respectively (P = 0.58). CONCLUSION Our results are comparable with cohorts from other middle-income countries.
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Affiliation(s)
- Maria Christina L Oliveira
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Keyla C Sampaio
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Andrea C Brito
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Marcia K Campos
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Mitiko Murao
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Rebeca Gusmão
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Ana Angélica L Fernandes
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marcos B Viana
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
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Vasconcelos EAF, Santaella ST, Viana MB, Dos Santos AB, Pinheiro GC, Leitão RC. Composition and ecology of bacterial and archaeal communities in anaerobic reactor fed with residual glycerol. Anaerobe 2019; 59:145-153. [PMID: 31254652 DOI: 10.1016/j.anaerobe.2019.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/31/2019] [Accepted: 06/26/2019] [Indexed: 11/28/2022]
Abstract
Glycerol, the main residue of biodiesel production, can be used to produce organic acids and energy through anaerobic digestion. This study aimed to assess microbial structure, diversity, productivity, and stability and the influence of these parameters on the performance of an anaerobic reactor. The experimental setup consisted of an upflow anaerobic sludge blanket (UASB) reactor fed residual glycerol and nutrients. The organic loading rate (OLR) was gradually increased through five stages, and sludge samples were collected at each, followed by DNA extraction and PCR denaturing gradient gel electrophoresis (PCR-DGGE). The resulting bands were excised, amplified, and purified. The results showed increased bacterial diversity and richness from the inoculum (Rr 38.72 and H 2.32) and along stages I and II, reaching the highest populational parameters (Rr 194.06 and H 3.32). The following stages promote decreases in richness and diversity, achieving the lowest populational parameters on this study (Rr 11.53 and H 2.04). Biogas production increased along with functional organization due to the specialization of the bacterial community and a decrease in the methanogenic population, both promoted by the increase in OLR.
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Affiliation(s)
- E A F Vasconcelos
- Ecology and Natural Resources, Department of Biology, Federal University of Ceará, Campus Pici, Block 902, 60455-970, Fortaleza, CE, Brazil
| | - S T Santaella
- Institute of Marine Science, Federal University of Ceará, Av Abolição, 3207, 60165-081, Fortaleza, CE, Brazil
| | - M B Viana
- Institute of Marine Science, Federal University of Ceará, Av Abolição, 3207, 60165-081, Fortaleza, CE, Brazil
| | - A B Dos Santos
- Department of Hydraulics and Environmental Engineering, Federal University of Ceará, Campus Pici, Block 713, 60.451-970, Fortaleza, CE, Brazil
| | - G C Pinheiro
- Department of Technology and Environmental Management, Federal Institute of Education, Science and Technology of Ceará, Campus Maracanaú, Avenida Parque Central, Distrito Industrial I, Maracanaú, 61939-140, Brazil
| | - R C Leitão
- Embrapa Agroindústria Tropical, Rua Dra, Sara Mesquita, 2270, 60511-110, Fortaleza, CE, Brazil.
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Carvalho NO, Del Castillo DM, Januário JN, Starling ALP, Arantes RR, Norton RC, Viana MB. Novel mutations causing biotinidase deficiency in individuals identified by the newborn screening program in Minas Gerais, Brazil. Am J Med Genet A 2019; 179:978-982. [PMID: 30912303 DOI: 10.1002/ajmg.a.61137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/24/2019] [Accepted: 02/25/2019] [Indexed: 11/05/2022]
Abstract
Biotinidase deficiency is an autosomal recessive inherited metabolic disorder caused by mutations in the BTD gene. Clinical manifestations can be treated and effectively prevented with pharmacological doses of biotin. Nine novel mutations in BTD are reported in 14 children diagnosed by the newborn screening program in Minas Gerais, Brazil, from June 2013 to December 2017. Serum BTD enzyme activity was determined for all cases and some parents. Two of the mutations are deletions and seven missense mutations located in the exonic region of the BTD gene, mostly in exon 4. Two newborns were profoundly biotinidase-deficient (one homozygous p.A534V [c.1601C > T] and another, double heterozygous for a novel mutation p.R211S [c.631C > A] co-inherited with an already described mutation p.T532 M [c.1595C > T]). Two mutations were associated with a partial deficiency of biotinidase (p.F361 V [c.1081 T > G] in two homozygous children, and p.S311 T [c.932G > C] in a compound heterozygous child who co-inherited a known severe mutation p.Y438X [c.1314 T > A]). The remaining five mutations were found in compound heterozygous children. Hence, a definitive conclusion about the degree of biotinidase deficiency is not possible yet. These results emphasize the importance of sequencing the BTD gene as an important tool to gain a better understanding of the correlation between biochemical phenotype and genotype.
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Affiliation(s)
- Nara O Carvalho
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Dora M Del Castillo
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - José N Januário
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana L P Starling
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rodrigo R Arantes
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil.,University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rocksane C Norton
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Marcos B Viana
- Nupad - Center for Newborn Screening and Genetic Diagnostics, UFMG - Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Rezende PV, Belisário AR, Oliveira ÉL, Almeida JA, Oliveira LMM, Muniz MBSR, Viana MB. Co-inheritance of a-thalassemia dramatically decreases the risk of acute splenic sequestration in a large cohort of newborns with hemoglobin SC. Haematologica 2019; 104:e281-e283. [PMID: 30630972 DOI: 10.3324/haematol.2018.209221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Paulo V Rezende
- Servico de Pesquisa, Fundação Hemominas, Santa Efigênia, Belo Horizonte, MG.,Faculdade de Medicina/Núcleo de Ações e Pesquisa em Apoio Diagnóstico (NUPAD), UFMG, Belo Horizonte, MG
| | - André R Belisário
- Servico de Pesquisa, Fundação Hemominas, Santa Efigênia, Belo Horizonte, MG.,Faculdade de Medicina/Núcleo de Ações e Pesquisa em Apoio Diagnóstico (NUPAD), UFMG, Belo Horizonte, MG.,Centro de Tecidos Biológicos de Minas Gerais, Fundação Hemominas, Belo Horizonte, MG
| | - Érica L Oliveira
- Servico de Pesquisa, Fundação Hemominas, Santa Efigênia, Belo Horizonte, MG
| | - Jéssica A Almeida
- Servico de Pesquisa, Fundação Hemominas, Santa Efigênia, Belo Horizonte, MG
| | | | | | - Marcos B Viana
- Faculdade de Medicina/Núcleo de Ações e Pesquisa em Apoio Diagnóstico (NUPAD), UFMG, Belo Horizonte, MG .,Bolsista do CNPq, Brasilia, DF, Brazil
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Rezende PV, Santos MV, Campos GF, Vieira LL, Souza MB, Belisário AR, Silva CM, Viana MB. Clinical and hematological profile in a newborn cohort with hemoglobin SC. Jornal de Pediatria (Versão em Português) 2018. [DOI: 10.1016/j.jpedp.2017.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Belisário AR, Vieira ÉLM, Almeida JA, Mendes FG, Miranda AS, Rezende PV, Viana MB, Simões e Silva AC. Low urinary levels of angiotensin‐converting enzyme 2 may contribute to albuminuria in children with sickle cell anaemia. Br J Haematol 2018; 185:190-193. [DOI: 10.1111/bjh.15439] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- André R. Belisário
- Centro de Tecidos Biológicos de Minas Gerais Fundação Hemominas Lagoa SantaMG Brazil
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina Universidade Federal de Minas Gerais (UFMG) Belo HorizonteMG Brazil
- Faculdade de Medicina/Núcleo de Ações e Pesquisa em Apoio Diagnóstico (NUPAD) UFMG Belo Horizonte MG Brazil
| | - Érica L. M. Vieira
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina Universidade Federal de Minas Gerais (UFMG) Belo HorizonteMG Brazil
| | - Jéssica A. Almeida
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina Universidade Federal de Minas Gerais (UFMG) Belo HorizonteMG Brazil
| | - Fabíola G. Mendes
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina Universidade Federal de Minas Gerais (UFMG) Belo HorizonteMG Brazil
| | - Aline S. Miranda
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina Universidade Federal de Minas Gerais (UFMG) Belo HorizonteMG Brazil
| | - Paulo V. Rezende
- Faculdade de Medicina/Núcleo de Ações e Pesquisa em Apoio Diagnóstico (NUPAD) UFMG Belo Horizonte MG Brazil
| | - Marcos B. Viana
- Faculdade de Medicina/Núcleo de Ações e Pesquisa em Apoio Diagnóstico (NUPAD) UFMG Belo Horizonte MG Brazil
| | - Ana C. Simões e Silva
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina Universidade Federal de Minas Gerais (UFMG) Belo HorizonteMG Brazil
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Cancela CSP, Assumpcao JG, Paula FDF, Murao M, Viana MB, Oliveira BM. Use of the Polymerase Chain Reaction as a Complementary Method for the Detection of Central Nervous System Involvement in Children and Adolescents with Acute Lymphoblastic Leukemia. Clin Lab 2018; 64:205-209. [PMID: 29479883 DOI: 10.7754/clin.lab.2017.170622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Cytological analysis of the cerebrospinal fluid (CSF) remains the most widely used method for diagnosing central nervous system (CNS) involvement in acute lymphoblastic leukemia (ALL). This study aimed at evaluating the use of polymerase chain reaction (PCR), in comparison to other methods, for the assessment of the presence of blast cells in the CSF at the time of diagnosis of ALL. METHODS This was a prospective, single-centre, study enrolling all patients up to the age of 18 years who were admitted to a university hospital between November 2011 and November 2014 with a diagnosis of ALL and from whom it was possible to draw a sufficient amount of CSF for analysis by conventional cytology (CT), immunophenotyping (IMP), and PCR. RESULTS A total of 46 CSF samples from 44 ALL pediatric patients were included. CT was performed in all samples, IMP in 44, and PCR in 34. Thirteen (28.2%) samples showed positive results: two by CT, four by IMP, four by PCR, and three by both IMP and PCR. CONCLUSIONS The results of this study showed that PCR should be considered a complementary method for the evaluation of the CSF in ALL patients at diagnosis.
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Fernandes APPC, Avendanha FA, Viana MB. Hospitalizations of children with sickle cell disease in the Brazilian Unified Health System in the state of Minas Gerais. J Pediatr (Rio J) 2017; 93:287-293. [PMID: 27932225 DOI: 10.1016/j.jped.2016.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/20/2016] [Accepted: 07/27/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To identify and characterize hospital admissions and readmissions in the Brazilian Unified Public Health System (Sistema Único de Saúde [SUS]) in children with sickle cell disease diagnosed by the Minas Gerais Newborn Screening Program between 1999 and 2012. METHODS Hospital Admission Authorizations with the D57 (International Classification of Diseases-10) code in the fields of primary or secondary diagnosis were retrieved from the SUS Databank (1999-2012). There were 2991 hospitalizations for 969 children. RESULTS 73.2% of children had hemoglobin SS/Sβ0-thalassemia and 48% were girls. The mean age was 4.3±3.2 years, the mean number of hospitalizations, 3.1±3.3, and the hospital length of stay, 5±3.9 days. Hospital readmissions occurred for 16.7% of children; 10% of admissions were associated with readmission within 30 days after discharge; 33% of readmissions occurred within seven days post-discharge. There were 41 deaths, 95% of which were in-hospital. Secondary diagnoses were not recorded in 96% of admissions, making it impossible to know the reason for admission. In 62% of cases, hospitalizations occurred in the child's county of residence. The total number of hospitalizations of children under 14 with sickle cell disease relative to the total of pediatric hospitalizations increased from 0.12% in 1999 to 0.37% in 2012. CONCLUSIONS A high demand for hospital care in children with sickle cell disease was evident. The number of hospitalizations increased from 1999 to 2012, suggesting that the disease has become more "visible." Knowledge of the characteristics of these admissions can help in the planning of care for these children in the SUS.
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Affiliation(s)
- Ana Paula P C Fernandes
- Universidade Federal Minas Gerais (UFMG), Faculdade de Medicina, Núcleo de Ações e Pesquisa em Apoio Diagnóstico (Nupad), Belo Horizonte, MG, Brazil
| | - Fernanda A Avendanha
- Universidade Federal Minas Gerais (UFMG), Faculdade de Medicina, Núcleo de Ações e Pesquisa em Apoio Diagnóstico (Nupad), Belo Horizonte, MG, Brazil
| | - Marcos B Viana
- Universidade Federal Minas Gerais (UFMG), Faculdade de Medicina, Núcleo de Ações e Pesquisa em Apoio Diagnóstico (Nupad), Belo Horizonte, MG, Brazil; Universidade Federal Minas Gerais (UFMG), Departamento de Pediatria, Belo Horizonte, MG, Brazil.
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Brandalise SR, Viana MB, Pinheiro VRP, Mendonça N, Lopes LF, Pereira WV, Lee MLM, Pontes EM, Zouain-Figueiredo GP, Azevedo ACAC, Pimentel N, Fernandes MZ, Oliveira HM, Vianna SR, Scrideli CA, Werneck FA, Álvares MN, Boldrini É, Loggetto SR, Bruniera P, Mastellaro MJ, Souza EM, Araújo RA, Bandeira F, Tan DM, Carvalho NA, Salgado MAS. Shorter Maintenance Therapy in Childhood Acute Lymphoblastic Leukemia: The Experience of the Prospective, Randomized Brazilian GBTLI ALL-93 Protocol. Front Pediatr 2016; 4:110. [PMID: 27800472 PMCID: PMC5066157 DOI: 10.3389/fped.2016.00110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 09/26/2016] [Indexed: 11/29/2022] Open
Abstract
AIM Maintenance therapy is an important phase of the childhood ALL treatment, requiring 2-year long therapy adherence of the patients and families. Weekly methotrexate with daily 6-mercaptopurine (6MP) constitutes the backbone of maintenance therapy. Reduction in the maintenance therapy could overweight problems related with poverty of children with ALL living in limited-income countries (LIC). OBJECTIVE To compare, prospectively, the EFS rates of children with ALL treated according to two maintenance regimens: 18 vs. 24 months duration. MATERIALS AND METHODS From October 1993 to September 1999, 867 consecutive untreated ALL patients <18 years of age were treated according to the Brazilian Cooperative Group for Childhood ALL Treatment (GBTLI) ALL-93 protocol. Risk classification was based exclusively on patient's age and leukocyte count (NCI risk group) and clinical extra medullary involvement of the disease. Data were analyzed by the intention-to-treat approach. RESULTS Fourteen patients (1.6%) were excluded: wrong diagnosis (n = 7) and previous corticosteroid (n = 7). Of the 853 eligible patients, 421 were randomly allocated, at study enrollment, to receive 18-month (group 1) and 432 to receive 24-month (group 2) maintenance therapy. Complete remission rate was achieved in 96% of the patients (817/853). Twenty-eight patients (3.4%) died during the induction phase. Thirty-four patients (4.0%) were lost to follow-up. The overall EFS was 66.1 ± 1.7% at 15 years. No difference was seen according to maintenance: EFS15y was 65.8 ± 2.3% (group 1) and 66.3 ± 2.3% (group 2; p = 0.79). No difference between regimens was detected after stratifying the analyses according to factors associated with adverse prognosis in this study (age group <1 year or >10 years and high WBC at diagnosis). Overall death in remission rate was 6.85% (56 patients). Deaths during maintenance were 13 in group 1 and 12 in group 2, all due to infection. Over 15 years of follow-up, two patients both from group 2 presented a second malignancy (Hodgkin's disease and thyroid carcinoma) after 8.3 and 11 years off therapy, respectively. CONCLUSION Six-month reduction of maintenance therapy in ALL children treated according to the GBTLI ALL-93 protocol provided the same overall outcome as 2-year duration regimen.
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Affiliation(s)
| | - Marcos B Viana
- Federal University of Minas Gerais , Belo Horizonte , Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Flávia Bandeira
- Hematology and Hemotherapy Foundation (HEMOPE) , Recife , Brazil
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de Andrade JS, Céspedes IC, Abrão RO, Dos Santos TB, Diniz L, Britto LRG, Spadari-Bratfisch RC, Ortolani D, Melo-Thomas L, da Silva RCB, Viana MB. Chronic unpredictable mild stress alters an anxiety-related defensive response, Fos immunoreactivity and hippocampal adult neurogenesis. Behav Brain Res 2013; 250:81-90. [PMID: 23644183 DOI: 10.1016/j.bbr.2013.04.031] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/16/2013] [Accepted: 04/20/2013] [Indexed: 12/29/2022]
Abstract
Previous results show that elevated T-maze (ETM) avoidance responses are facilitated by acute restraint. Escape, on the other hand, was unaltered. To examine if the magnitude of the stressor is an important factor influencing these results, we investigated the effects of unpredictable chronic mild stress (UCMS) on ETM avoidance and escape measurements. Analysis of Fos protein immunoreactivity (Fos-ir) was used to map areas activated by stress exposure in response to ETM avoidance and escape performance. Additionally, the effects of the UCMS protocol on the number of cells expressing the marker of migrating neuroblasts doublecortin (DCX) in the hippocampus were investigated. Corticosterone serum levels were also measured. Results showed that UCMS facilitates ETM avoidance, not altering escape. In unstressed animals, avoidance performance increases Fos-ir in the cingulate cortex, hippocampus (dentate gyrus) and basomedial amygdala, and escape increases Fos-ir in the dorsolateral periaqueductal gray and locus ceruleus. In stressed animals submitted to ETM avoidance, increases in Fos-ir were observed in the cingulate cortex, ventrolateral septum, hippocampus, hypothalamus, amygdala, dorsal and median raphe nuclei. In stressed animals submitted to ETM escape, increases in Fos-ir were observed in the cingulate cortex, periaqueductal gray and locus ceruleus. Also, UCMS exposure decreased the number of DCX-positive cells in the dorsal and ventral hippocampus and increased corticosterone serum levels. These data suggest that the anxiogenic effects of UCMS are related to the activation of specific neurobiological circuits that modulate anxiety and confirm that this stress protocol activates the hypothalamus-pituitary-adrenal axis and decreases hippocampal adult neurogenesis.
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Affiliation(s)
- J S de Andrade
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
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15
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Silva MR, Sendin SM, Araujo ICO, Pimentel FS, Viana MB. Clinical and molecular characterization of hemoglobin Maputo [beta 47 (CD6) Asp > Tyr HBB: c.142G > T] and G-Ferrara [beta 57 (E1) Asn > Lys HBB: c.174C > A] in a newborn screening in Brazil. Int J Lab Hematol 2013; 35:e1-4. [PMID: 23279838 DOI: 10.1111/ijlh.12043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M R Silva
- Núcleo de Ações e Pesquisa em Apoio Diagnóstico (Nupad), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Departamento de Pediatria da UFMG, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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16
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Diniz L, dos Santos TB, Britto LRG, Céspedes IC, Garcia MC, Spadari-Bratfisch RC, Medalha CC, de Castro GM, Montesano FT, Viana MB. Effects of chronic treatment with corticosterone and imipramine on fos immunoreactivity and adult hippocampal neurogenesis. Behav Brain Res 2012; 238:170-7. [PMID: 23098799 DOI: 10.1016/j.bbr.2012.10.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 10/10/2012] [Accepted: 10/14/2012] [Indexed: 12/26/2022]
Abstract
In a previous study we showed that rats chronically treated with corticosterone (CORT) display anxiogenic behavior, evidenced by facilitation of avoidance responses in the elevated T-maze (ETM) model of anxiety. Treatment with the tricyclic antidepressant imipramine significantly reversed the anxiogenic effects of CORT, while inhibiting ETM escape, a response related to panic disorder. To better understand the neurobiological mechanisms underlying these behavioral effects, analysis of c-fos protein immunoreactivity (fos-ir) was used here to map areas activated by chronic CORT (200 mg pellets, 21-day release) and imipramine (15 mg/kg, IP) administration. We also evaluated the number of cells expressing the neurogenesis marker doublecortin (DCX) in the hippocampus and measured plasma CORT levels on the 21st day of treatment. Results showed that CORT increased fos-ir in the ventrolateral septum, medial amygdala and paraventricular hypothalamic nucleus and decreased fos-ir in the lateral periaqueductal gray. Imipramine, on the other hand, increased fos-ir in the medial amygdala and decreased fos-ir in the anterior hypothalamus. CORT also decreased the number of DCX-positive cells in the ventral and dorsal hippocampus, an effect antagonized by imipramine. CORT levels were significantly higher after treatment. These data suggest that the behavioral effects of CORT and imipramine are mediated through specific, at times overlapping, neuronal circuits, which might be of relevance to a better understanding of the physiopathology of generalized anxiety and panic disorder.
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Affiliation(s)
- L Diniz
- Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
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17
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de Andrade JS, Abrão RO, Céspedes IC, Garcia MC, Nascimento JOG, Spadari-Bratfisch RC, Melo LL, da Silva RCB, Viana MB. Acute restraint differently alters defensive responses and fos immunoreactivity in the rat brain. Behav Brain Res 2012; 232:20-9. [PMID: 22487246 DOI: 10.1016/j.bbr.2012.03.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 03/21/2012] [Accepted: 03/23/2012] [Indexed: 11/30/2022]
Abstract
Results from a previous study show that rats exposed to acute restraint display anxiogenic-like behavior, evidenced by facilitation of avoidance responses in the elevated T-maze (ETM) model of anxiety. In contrast, escape responses were unaltered by stress exposure. Since ETM avoidance and escape tasks seem to activate distinct sets of brain structures, it is possible that the differences observed with acute restraint are due to particularities in the neurobiological mechanisms which modulate these responses. In the present study, analysis of fos protein immunoreactivity (fos-ir) was used to map areas activated by exposure of male Wistar rats to restraint stress (30 min) previously (30 min) to the ETM. Corticosterone levels were also measured in stressed and non-stressed animals. Confirming previous observations restraint facilitated avoidance performance, an anxiogenic result, while leaving escape unaltered. Performance of the avoidance task increased fos-ir in the frontal cortex, intermediate lateral septum, basolateral amygdala, basomedial amygdala, lateral amygdala, anterior hypothalamus and dorsal raphe nucleus. In contrast, performance of escape increased fos-ir in the ventromedial hypothalamus, dorsolateral periaqueductal gray and locus ceruleus. Both behavioral tasks also increased fos-ir in the dorsomedial hypothalamus. Restraint significantly raised corticosterone levels. Additionally after restraint, fos-ir was predominantly seen in the basolateral amygdala and dorsal raphe of animals submitted to the avoidance task. This data confirms that different sets of brain structures are activated by ETM avoidance and escape tasks and suggests that acute restraint differently alters ETM behavior and the pattern of fos activation in the brain.
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Affiliation(s)
- J S de Andrade
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
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18
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Hatano VY, Torricelli AS, Giassi ACC, Coslope LA, Viana MB. Anxiolytic effects of repeated treatment with an essential oil from Lippia alba and (R)-(-)-carvone in the elevated T-maze. Braz J Med Biol Res 2012; 45:238-43. [PMID: 22358424 PMCID: PMC3854189 DOI: 10.1590/s0100-879x2012007500021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Accepted: 02/01/2012] [Indexed: 11/21/2022] Open
Abstract
Lippia alba (Mill.) N.E. Brown (Verbenaceae) is widely used in different regions of Central and South America as a tranquilizer. The plant's anxiolytic properties, however, merit investigation. The present study evaluated the effects of repeated daily (14 days) intraperitoneal (ip) treatment with an essential oil (EO) from a chemotype of L. alba (LA, chemotype II, 12.5 and 25 mg/kg; N = 6-8) and (R)-(-)-carvone (25 mg/kg; N = 8-12), the main constituent of this chemotype, on male Wistar rats (weighing 250 g at the beginning of the experiments) submitted to the elevated T-maze (ETM). The ETM allows the measurement of two defensive responses: inhibitory avoidance and one-way escape. In terms of psychopathology, these responses have been related to generalized anxiety and panic disorder, respectively. Treatment with the EO impaired ETM avoidance latencies, without altering escape, in a way similar to the reference drug diazepam (P < 0.05) (avoidance 2: control = 84.6 ± 35.2; EO 12.5 mg/kg = 11.8 ± 3.8; EO 25 mg/kg = 14.6 ± 2.7; diazepam = 7 ± 2.1). (R)-(-)-carvone also significantly altered this same response (P < 0.05; avoidance 1: control = 91.9 ± 31.5; carvone = 11.6 ± 1.8; diazepam = 8.1 ± 3.3). These results were not due to motor changes since no significant effects were detected in an open field. These observations suggest that LA exerts anxiolytic-like effects on a specific subset of defensive behaviors that have been implicated in generalized anxiety disorder, and suggest that carvone is one of the constituents of LA responsible for its action as a tranquilizer.
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Affiliation(s)
- V Y Hatano
- Departamento de Biociências, Universidade Federal de São Paulo, Santos, SP, Brazil
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Viana MB, Freitas AV, Leitão RC, Santaella ST. Biodegradability and methane production potential of glycerol generated by biodiesel industry. Water Sci Technol 2012; 66:2217-2222. [PMID: 22949254 DOI: 10.2166/wst.2012.455] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Crude glycerol, the main by-product of the biodiesel industry, is a material containing compounds considered recalcitrant to microorganisms. The aims of this study were to determine the anaerobic biodegradability and the methane production potential (MPP) of different crude glycerols generated from the transesterification of oils from several kinds of seeds and/or beans, and the anaerobic toxicity of crude glycerol obtained from a mixture of soybean and cottonseed oils. All tests were based on specific methanogenic activity assays (SMA). The biodegradability tests and the MPP assays lasted 30 days. Toxicity was evaluated through the statistical technique of factorial design and a response surface was generated in which the concentrations of crude glycerol and glucose were the independent variables and SMA was the dependent variable. The results showed that the type of seed or bean, as well as the transesterification process, affected the anaerobic biodegradability. Biodegradability ranged between 65.9 and 85.6% and MPP, between 0.220 and 0.322 m(3) CH(4)/kg crude glycerol. The toxicity test showed that crude glycerol was not toxic to anaerobic sludge.
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Affiliation(s)
- M B Viana
- Department of Environmental Sanitation, Federal Institute of Education, Science and Technology of Ceará, Sobral, Brazil.
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Pimentel FS, Silva MR, Ferraz MHC, Carvalho NO, Perone C, del Castillo DM, Januario JN, Viana MB. Homozygous Hb Stanleyville-II [alpha2 78(EF7) Asn>Lys; HBA2:c.237C>A, not C>G] associated with genotype -α 3.7/-α 3.7 in two Brazilian families. Int J Lab Hematol 2011; 33:566-9. [PMID: 21470372 DOI: 10.1111/j.1751-553x.2011.01321.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Several hemoglobin variants have electrophoretic behavior similar to hemoglobin S, which may lead to false diagnosis for sickle-cell disorders in newborn screening programs. A homozygous hemoglobin with S mobility was detected in two unrelated babies in Brazil. METHODS Isoelectric focusing and high-performance liquid chromatography assays, gene sequencing, and restriction fragment length polymorphism with AfeI were used to characterize the hemoglobin. RESULTS Hb Stanleyville-II and -α(3.7) /-α(3.7) type I deletion in the α-globin gene was diagnosed. Parents were heterozygous for both Hb Stanleyville-II and α-thalassemia. Hypochromia and microcytosis were probably due to the homozygous α-thalassemia. CONCLUSION Stanleyville-II gene mutation is HBA2:c.237C>A, or C>G, and this information on the Globin Gene Server should be updated; AfeI test is a fast and accurate method to detect it; NBS programs should consider the possibility of Hb Stanleyville-II whenever IEF shows one band in the HbS position, and another one between S and C.
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Affiliation(s)
- F S Pimentel
- Núcleo de Ações e Pesquisa em Apoio Diagnóstico (Nupad), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Viana MB, Oliveira BM, Cancela CSP. Kaplan-Meier method is inappropriate for estimating cumulative incidence of graft-versus-host disease in the presence of competing events. Am J Hematol 2010; 85:458-9; author reply 459. [PMID: 20306544 DOI: 10.1002/ajh.21681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Brandalise SR, Pinheiro VR, Aguiar SS, Matsuda EI, Otubo R, Yunes JA, Pereira WV, Carvalho EG, Cristofani LM, Souza MS, Lee ML, Dobbin JA, Pombo-de-Oliveira MS, Lopes LF, Melnikoff KN, Brunetto AL, Tone LG, Scrideli CA, Morais VL, Viana MB. Benefits of the Intermittent Use of 6-Mercaptopurine and Methotrexate in Maintenance Treatment for Low-Risk Acute Lymphoblastic Leukemia in Children: Randomized Trial From the Brazilian Childhood Cooperative Group—Protocol ALL-99. J Clin Oncol 2010; 28:1911-8. [DOI: 10.1200/jco.2009.25.6115] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeTo describe event-free survival (EFS) and toxicities in children with low-risk acute lymphoblastic leukemia (ALL) assigned to receive either continuous 6-mercaptopurine (6-MP) and weekly methotrexate (MTX) or intermittent 6-MP with intermediate-dose MTX, as maintenance treatment.Patients and MethodsBetween October 1, 2000, and December 31, 2007, 635 patients with low-risk ALL were enrolled onto Brazilian Childhood Cooperative Group for ALL Treatment (GBTLI) ALL-99 protocol. Eligible children (n = 544) were randomly allocated to receive either continuous 6-MP/MTX (group 1, n = 272) or intermittent 6-MP (100 mg/m2/d for 10 days, with 11 days resting) and MTX (200 mg/m2every 3 weeks; group 2, n = 272).ResultsThe 5-year overall survival (OS) and EFS were 92.5% ± 1.5% SE and 83.6% ± 2.1% SE, respectively. According to maintenance regimen, the OS was 91.4% ± 2.2% SE (group 1) and 93.6% ± 2.1% SE (group 2; P = .28) and EFS 80.9% ± 3.2% SE (group 1) and 86.5% ± 2.8% SE (group 2; P = .089). Remarkably, the intermittent regimen led to significantly higher EFS among boys (85.7% v 74.9% SE; P = .027), while no difference was seen for girls (87.0% v 88.8% SE; P = .78). Toxic episodes were recorded in 226 and 237 children, respectively. Grade 3 to 4 toxic events for groups 1 and 2 were, respectively, 273 and 166 for hepatic dysfunction (P = .002), and 772 and 636 for hematologic episodes (P = .005). Deaths on maintenance were: seven (group 1) and one (group 2).ConclusionThe intermittent use of 6-MP and MTX in maintenance is a less toxic regimen, with a trend toward better long-term EFS. Boys treated with the intermittent schedule had significantly better EFS.
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Affiliation(s)
- Silvia R. Brandalise
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Vitória R. Pinheiro
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Simone S. Aguiar
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Eduardo I. Matsuda
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Rosemary Otubo
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - José A. Yunes
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Waldir V. Pereira
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Eny G. Carvalho
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Lilian M. Cristofani
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Marcelo S. Souza
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Maria L. Lee
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Jane A. Dobbin
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Maria S. Pombo-de-Oliveira
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Luiz F. Lopes
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Katharina N.T. Melnikoff
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Algemir L. Brunetto
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Luiz G. Tone
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Carlos A. Scrideli
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Vera L.L. Morais
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
| | - Marcos B. Viana
- From the Serviço de Hematologia/Oncologia Pediátrica, Universidade Estadual de Campinas; Centro Infantil Boldrini, Campinas; Instituto da Criança, Universidade de São Paulo; Grupo de Apoio à Criança com Câncer; Hospital A.C. Camargo; Hospital Brigadeiro; Hospital das Clinicas, Ribeirão Preto, São Paulo; Hospital Universitário, Santa Maria; Instituto de Oncologia, Salvador; Hospital Regional, Campo Grande; Instituto Nacional do Câncer, Rio de Janeiro; Hospital das Clinicas, Porto Alegre; Hospital Oswaldo
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Jotta PY, Ganazza MA, Silva A, Viana MB, da Silva MJ, Zambaldi LJG, Barata JT, Brandalise SR, Yunes JA. Negative prognostic impact of PTEN mutation in pediatric T-cell acute lymphoblastic leukemia. Leukemia 2009; 24:239-42. [PMID: 19829307 DOI: 10.1038/leu.2009.209] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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24
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Scrideli CA, Assumpção JG, Ganazza MA, Araújo M, Toledo SR, Lee MLM, Delbuono E, Petrilli AS, Queiróz RP, Biondi A, Viana MB, Yunes JA, Brandalise SR, Tone LG. A simplified minimal residual disease polymerase chain reaction method at early treatment points can stratify children with acute lymphoblastic leukemia into good and poor outcome groups. Haematologica 2009; 94:781-9. [PMID: 19483156 DOI: 10.3324/haematol.2008.003137] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Minimal residual disease is an important independent prognostic factor in childhood acute lymphoblastic leukemia. The classical detection methods such as multiparameter flow cytometry and real-time quantitative polymerase chain reaction analysis are expensive, time-consuming and complex, and require considerable technical expertise. DESIGN AND METHODS We analyzed 229 consecutive children with acute lymphoblastic leukemia treated according to the GBTLI-99 protocol at three different Brazilian centers. Minimal residual disease was analyzed in bone marrow samples at diagnosis and on days 14 and 28 by conventional homo/heteroduplex polymerase chain reaction using a simplified approach with consensus primers for IG and TCR gene rearrangements. RESULTS At least one marker was detected by polymerase chain reaction in 96.4% of the patients. By combining the minimal residual disease results obtained on days 14 and 28, three different prognostic groups were identified: minimal residual disease negative on days 14 and 28, positive on day 14/negative on day 28, and positive on both. Five-year event-free survival rates were 85%, 75.6%, and 27.8%, respectively (p<0.0001). The same pattern of stratification held true for the group of intensively treated children. When analyzed in other subgroups of patients such as those at standard and high risk at diagnosis, those with positive B-derived CD10, patients positive for the TEL/AML1 transcript, and patients in morphological remission on a day 28 marrow, the event-free survival rate was found to be significantly lower in patients with positive minimal residual disease on day 28. Multivariate analysis demonstrated that the detection of minimal residual disease on day 28 is the most significant prognostic factor. CONCLUSIONS This simplified strategy for detection of minimal residual disease was feasible, reproducible, cheaper and simpler when compared with other methods, and allowed powerful discrimination between children with acute lymphoblastic leukemia with a good and poor outcome.
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Affiliation(s)
- Carlos A Scrideli
- Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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25
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Fagundes EM, Rocha V, Glória ABF, Clementino NCD, Quintão JS, Guimarães JPO, Pedroso ERP, Viana MB. De novo acute myeloid leukemia in adults younger than 60 years of age: Socioeconomic aspects and treatment results in a Brazilian university center. Leuk Lymphoma 2009; 47:1557-64. [PMID: 16966267 DOI: 10.1080/10428190600627055] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We retrospectively studied the outcomes of adults with de novo acute myeloid leukemia treated in a reference center in Brazil and analyzed the association with the human development index (HDI) of the United Nations used as a socioeconomic factor. Among 123 patients, 46 (37%) died during induction, 65 (53%) reached complete remission and 45 (37%) received high-dose cytarabine (Hidac) consolidation. The 5-year overall survival and leukemia-free survival (LFS) were 17 and 26%, respectively, for all patients and 36 and 30%, respectively, for those receiving Hidac. In multivariate analysis, an HDI <0.660 was associated with a lower probability to receive Hidac (P = 0.001), a trend for higher mortality in remission induction (P = 0.062) and a decreased LFS (P < 0.0001). However, it was not associated with outcomes for patients receiving Hidac. In conclusion, survival for patients who received Hidac consolidation is satisfactory; however, socioeconomic factors may have selected patients to receive intensive Hidac consolidation.
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Affiliation(s)
- Evandro M Fagundes
- Hematology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Abstract
OBJECTIVE To analyze acute splenic sequestration (ASS) in children with sickle cell anemia diagnosed through a newborn screening program in the state of Minas Gerais, Brazil, and followed up at the hematology center in the city of Belo Horizonte, Minas Gerais, Brazil. METHODS Retrospective cohort of 255 children with sickle cell anemia (Hb SS/Sbeta(0)) born between January 01, 2000, and December 31, 2004, and followed up until December 31, 2006. Data were abstracted from the patients' medical records. RESULTS A total of 89 patients had 173 episodes of ASS (10.2 first episodes per 100 patient-years); 75% of the first episodes occurred before 2 years of age. The estimated probability of occurrence of the first episode of ASS during the study period was 40%. Recurrence rate reached 57.3%. After the first episode, splenectomy was indicated in only 12.4% of the cases; after the second, in 60.4% of the cases. After the third episode, 41.7% of the patients remained under clinical observation. The median time between indication for splenectomy and the actual surgical procedure was 2 months. During the intervening period, 37.2% of the children suffered a new episode of ASS and one child died. Case-fatality rate was 1.1% for the first episode and 7.8% for the subsequent episodes. Among a total of 255 children, 19 died: 36.8% due to infections and 26.3% after ASS. CONCLUSIONS ASS is relatively common in sickle cell anemia, mainly in the first 2 years of life; relapse occurs in more than half of the cases. Conservative management instead of immediate splenectomy was the method of choice. Although the case-fatality rate was low, ASS was the second most common cause of death. These results disclose some fragilities of the health system in the state of Minas Gerais and the need for better professional education to approach ASS crises.
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Affiliation(s)
- Paulo V Rezende
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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27
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Viana MB, Alvim RC. Painful crises in children with sickle cell disease are not prevented by piracetam. Acta Haematol 2009; 121:9-10. [PMID: 19246889 DOI: 10.1159/000205261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 12/18/2008] [Indexed: 11/19/2022]
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28
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Delgado RB, Viana MB, Fernandes RAF. Púrpura trombocitopênica imune da criança: experiência de 12 anos em uma única instituição brasileira. Rev Bras Hematol Hemoter 2009. [DOI: 10.1590/s1516-84842009005000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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29
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Oliveira MCLA, Rodrigues AR, Sampaio KC, Gomes ACSC, Viana MB. Linfoma não-Hodgkin em crianças com imunodeficiência: relato de cinco casos. Rev Bras Hematol Hemoter 2008. [DOI: 10.1590/s1516-84842008000300015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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30
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Rodrigues PC, Oliveira SN, Viana MB, Matsuda EI, Nowill AE, Brandalise SR, Yunes JA. Prognostic significance of WT1 gene expression in pediatric acute myeloid leukemia. Pediatr Blood Cancer 2007; 49:133-8. [PMID: 16883592 DOI: 10.1002/pbc.20953] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Wilms Tumor gene (WT1) encodes a transcription factor involved in kidney development and malignancy. WT1 expression in a subpopulation of early CD34+ cells has suggested its involvement in hematopoiesis. WT1 is aberrantly expressed in leukemias. High expression of WT1 at diagnosis has been associated with unfavorable prognosis in adult acute myeloid leukemia (AML). The prognostic relevance of WT1 expression in pediatric AML was evaluated in only one study, including 47 patients, which showed that very low levels of WT1 at presentation were associated with an excellent outcome. To test the validity of these findings we measured levels of WT1 in 41 newly diagnosed pediatric AML of the non-M3 FAB subtype. PROCEDURE Patients were treated according to an AML-BFM 83-based protocol in a single institution. Mononucleated cells obtained from presentation BM aspirates were cryopreserved and later thawed and used for total RNA extraction and cDNA synthesis. The quantitative assessment of WT1 transcripts was made by real-time PCR (RQ-PCR). WT1 transcripts values were normalized with respect to the number of ABL transcripts. RESULTS WT1 levels were significantly higher in patients bearing favorable chromosome abnormalities, t(8;21) and inv(16) (P = 0.002). Higher levels of WT1 expression were unexpectedly associated with a higher probability of overall survival by Cox regression analysis (P = 0.002). Multivariate regression analysis could not discriminate between the effects of WT1 and cytogenetics on survival. CONCLUSIONS Higher WT1 expression was associated with favorable cytogenetics subtypes and accordingly with better outcome in children with AML in this study.
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MESH Headings
- Acute Disease
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Brazil/epidemiology
- Child
- Child, Preschool
- Chromosome Inversion
- Chromosomes, Human, Pair 16/ultrastructure
- Chromosomes, Human, Pair 21/ultrastructure
- Chromosomes, Human, Pair 8/ultrastructure
- Cytarabine/therapeutic use
- Daunorubicin/therapeutic use
- Etoposide/therapeutic use
- Female
- Follow-Up Studies
- Gene Expression Regulation, Leukemic
- Genes, Wilms Tumor
- Humans
- Infant
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/mortality
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/mortality
- Male
- Neoplasm Proteins/biosynthesis
- Prognosis
- Proportional Hazards Models
- Reverse Transcriptase Polymerase Chain Reaction
- Survival Analysis
- Translocation, Genetic
- WT1 Proteins/biosynthesis
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Affiliation(s)
- Patricia C Rodrigues
- Laboratório de Biologia Molecular, Centro Infantil Boldrini, Campinas, SP, Brazil
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Ribeiro MD, Onusic GM, Poltronieri SC, Viana MB. Effect of Erythrina velutina and Erythrina mulungu in rats submitted to animal models of anxiety and depression. Braz J Med Biol Res 2006; 39:263-70. [PMID: 16470314 DOI: 10.1590/s0100-879x2006000200013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Erythrina velutina (EV) and Erythrina mulungu (EM), popularly used in Brazil as tranquilizing agents, were studied. The effects of acute and chronic oral treatment with a water:alcohol extract of EV (7:3, plant grounded stem bark; acute = 100, 200, 400 mg/kg; chronic = 50, 100, 200 mg/kg) were evaluated in rats (N = 11-12) submitted to the elevated T-maze (for avoidance and escape measurements) model of anxiety. This model was selected for its presumed capacity to elicit specific subtypes of anxiety disorders recognized in clinical practice: avoidance has been related to generalized anxiety and escape to panic. Additionally, animals were treated with the same doses of EV and EM (water:alcohol 7:3, inflorescence extract) and submitted to the forced swim test for the evaluation of antidepressant activity (N = 7-10). Both treatment regimens with EV impaired elevated T-maze avoidance latencies, without altering escape, in a way similar to the reference drug diazepam (avoidance 1, mean +/- SEM, acute study: 131.1 +/- 45.5 (control), 9.0 +/- 3.3 (diazepam), 12.7 +/- 2.9 (200 mg/kg), 28.8 +/- 15.3 (400 mg/kg); chronic study: 131.7 +/- 46.9 (control), 35.8 +/- 29.7 (diazepam), 24.4 +/- 10.4 (50 mg/kg), 29.7 +/- 11.5 (200 mg/kg)). Neither EV nor EM altered measurements performed in the forced swim test, in contrast to the reference drug imipramine that significantly decreased immobility time after chronic treatment. These results were not due to motor alterations since no significant effects were detected in an open field. These observations suggest that EV exerts anxiolytic-like effects on a specific subset of defensive behaviors which have been associated with generalized anxiety disorder.
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Affiliation(s)
- M D Ribeiro
- Departamento de Psicologia e Educação, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Abstract
OBJECTIVE Autoimmune hemolytic anemia is characterized by the production of autoantibodies against erythrocyte membrane antigens. This study was carried out to identify the clinical, immunological and outcome characteristics of autoimmune hemolytic anemia patients treated at the (HC-UFMG) Pediatric Hematology Unit and the Hemocentro de Belo Horizonte. METHODS We evaluated 17 patients younger than 15 years old admitted from 1988 to 2003 were evaluated. Autoimmune hemolytic anemia diagnosis was based on the presence of acquired hemolysis and confirmed by positive direct Coombs polyspecific test results. Clinical, laboratory, and outcome data were obtained from patient records. RESULTS The median age at diagnosis was 10.5 months. The direct Coombs polyspecific test was positive in 13 and negative in four patients. Monospecific testing was performed for 14 patients. The most frequent red cell autoantibody was IgG (five patients), followed by IgM in two. Thirteen patients had severe anemia and needed blood transfusions. Underlying diseases were identified in four patients: systemic lupus erythematosus, Hodgkin's lymphoma, autoimmune hepatitis and Langerhans cell histiocytosis. The remaining patients were classified as having primary disease. The median follow-up period was 11 months (5 to 23 months). Three children died, two after splenectomy and one with complications of the underlying disease. CONCLUSION Autoimmune hemolytic anemia is rare in children and adolescents. Although patients usually respond to corticosteroids and/or immunoglobulin, fatal cases can occur. Prognosis is worse in patients with chronic underlying diseases.
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Bueno CH, Zangrossi H, Viana MB. The inactivation of the basolateral nucleus of the rat amygdala has an anxiolytic effect in the elevated T-maze and light/dark transition tests. Braz J Med Biol Res 2005; 38:1697-701. [PMID: 16258641 DOI: 10.1590/s0100-879x2005001100019] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pharmacological evidence indicates that the basolateral nucleus of the amygdala (BLA) is involved in the mediation of inhibitory avoidance but not of escape behavior in the elevated T-maze test. These defensive responses have been associated with generalized anxiety disorder (GAD) and panic disorder, respectively. In the present study, we determined whether the BLA plays a differential role in the control of inhibitory avoidance and escape responses in the elevated T-maze. Male Wistar rats (250-280 g, N = 9-10 in each treatment group) were pre-exposed to one of the open arms of the maze for 30 min and 24 h later tested in the model after inactivation of the BLA by a local injection of the GABA A receptor agonist muscimol (8 nmol in 0.2 microL). It has been shown that a prior forced exposure to one of the open arms of the maze, by shortening latencies to withdrawal from the open arm during the test, improves the escape task as a behavioral index of panic. The effects of muscimol in the elevated T-maze were compared to those caused by this GABA agonist in the avoidance reaction generated in the light/dark transition test. This defensive behavior has also been associated with GAD. In the elevated T-maze, intra-BLA injection of muscimol impaired inhibitory avoidance (control: 187.70 +/- 14.90 s, muscimol: 37.10 +/- 2.63 s), indicating an anxiolytic effect, without interfering with escape performance. The drug also showed an anxiolytic effect in the light/dark transition test as indicated by the increase in the time spent in the lighted compartment (control: 23.50 +/- 2.45 s, muscimol: 47.30 +/- 4.48 s). The present findings point to involvement of the BLA in the modulation of defensive responses that have been associated with GAD.
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Affiliation(s)
- C H Bueno
- Laboratório de Psicofarmacologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Alvim RC, Viana MB, Pires MAS, Franklin HMOH, Paula MJ, Brito AC, Oliveira TF, Rezende PV. Inefficacy of piracetam in the prevention of painful crises in children and adolescents with sickle cell disease. Acta Haematol 2005; 113:228-33. [PMID: 15983428 DOI: 10.1159/000084675] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2004] [Accepted: 10/04/2004] [Indexed: 11/19/2022]
Abstract
Analgesia and hydration remain the only safe treatment for painful crises of sickle cell disease; hydroxyurea is effective, but the toxicity is still a problem. Piracetam is a nootropic drug that has reportedly been effective and non-toxic in sickle cell patients, but most studies were not placebo-controlled and included a small number of patients. The present study evaluated the drug in a double-blind crossed placebo-controlled clinical trial in 73 children and adolescents suffering from moderate to severe painful crises for 13 months. Information regarding frequency and severity of pain was acquired through monthly clinical evaluation, visits and house calls, and 4,300 weekly questionnaires filled out by the patients in their domiciles. A monthly pain score was calculated for each patient. Pain was the most frequent adverse manifestation of the disease stressing its significant bio-psycho-social impact. Although nearly all patients and relatives reported a better clinical course throughout the whole study, the drug was ineffective in the prevention of painful crises. This placebo effect may be ascribed to an unplanned and unsystematic 'cognitive-behavioural' management of the children. The pain score in the second semester of the study - both in the experimental and in the control groups - was significantly smaller than that in the first semester. In conclusion, piracetam was found to be ineffective in the prevention of painful crises; a powerful placebo effect due to adequate patient care was demonstrated.
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Affiliation(s)
- R C Alvim
- Department of Paediatrics and Haematology Division of Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil
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de Oliveira BM, Viana MB, de Mattos Arruda L, Ybarra MI, Romanha AJ. [Evaluation of compliance through specific interviews: a prospective study of 73 children with acute lymphoblastic leukemia]. J Pediatr (Rio J) 2005; 81:245-50. [PMID: 15951910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To evaluate compliance in children with acute lymphoblastic leukemia. METHOD Compliance was assessed through specific interviews. RESULTS A total of 73 patients who had concluded the maintenance phase of chemotherapy were enrolled on the study. Eighty-one percent of the interviews were conducted with the patients' mothers; 92% of the families stated that medical instructions had been understood well. Interviews indicated that 27% of the patients did not receive their medication twice or more during the maintenance phase, without medical direction for this. These children were considered non-compliant. Sixteen percent of the children failed to receive their medication three times or more. The main reason for non-compliance was forgetfulness. In ten cases the reported dosage of drugs was not that which was prescribed. No significant associations of non-compliance with parents' schooling level, number of family members or per capita family income were detected. The 8.5-year estimated probability of event free survival was 72.4% (95% CI: 59.2-82.3). The event free survival curves for non-compliant children were not statistically different from those for the compliant group. CONCLUSIONS Results suggest that comprehensive approaches to the problem of non-compliance are urgently needed.
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Affiliation(s)
- Benigna M de Oliveira
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG.
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Abstract
Blood transfusion in patients with sickle cell disease (SCD) is limited by the development of alloantibodies to erythrocytes. In the present study, the frequency and risk factors for alloimmunization were determined. Transfusion records and medical charts of 828 SCD patients who had been transfused and followed at the Belo Horizonte Blood Center, Belo Horizonte, MG, Brazil, were retrospectively reviewed. Alloimmunization frequency was 9.9% (95% CI: 7.9 to 11.9%) and 125 alloantibodies were detected, 79% of which belonged to the Rhesus and Kell systems. Female patients developed alloimmunization more frequently (P = 0.03). The median age of the alloimmunized group was 23.3 years, compared to 14.6 years for the non-alloimmunized group (P < 0.0001). Multivariate analyses were applied to the data for 608 hemoglobin (Hb) SS or SC patients whose number of transfusions was recorded accurately. Number of transfusions (P = 0.00006), older age (P = 0.056) and Hb SC (P = 0.02) showed independent statistical associations with alloimmunization. Hb SC patients older than 14 years faced a 2.8-fold higher (95% CI: 1.3 to 6.0) risk of alloimmunization than Hb SS patients. Female Hb SC patients had the highest risk of developing alloantibodies. In patients younger than 14 years, only the number of transfusions was significant. We conclude that an increased risk of alloimmunization was associated with older patients with Hb SC, specially females, even after adjustments were made for the number of transfusions received, the most significant variable.
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Affiliation(s)
- M Murao
- Fundação Hemominas, Serviço de Hematologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Abstract
AIM To evaluate compliance in children with acute lymphoblastic leukaemia (ALL). METHODS Compliance was assessed through specific interviews, annotations from medical charts, and erythrocytic determination of 6-mercaptopurine metabolites. RESULTS A total of 39 patients who had concluded maintenance phase of chemotherapy were included in the study. Mothers were responsible for delivering 6-MP in 87% of cases. Thirty five interviewees said that medical prescription was well understood and that the main reason for non-compliance was forgetfulness. Non-compliance was detected through interviews (33.3% of the cases), reports from medical charts (30.7%), and drug determination (16.6%); 53.8% of children were found to be non-compliant. Non-compliance was significantly associated with chronic undernourishment. Although not statistically significant, there was a trend for the group of non-compliant children to be associated with low per capita family income. No significant associations of non-compliance with age at diagnosis, gender, parents' schooling level, number of family members, power consumption, and medians of absolute leucocyte or neutrophil blood counts were detected. A short follow up period precluded valid analysis on outcome. In the non-compliant group (n = 21), seven children relapsed, contrasting with three relapses in the compliant group (n = 18). CONCLUSIONS Results suggest that non-compliance is one of the mechanisms which underlies the adverse influence of socioeconomic factors on the outcome of children with ALL. Additional studies are necessary to confirm this hypothesis. Comprehensive approaches to the problem of non-compliance are urgently needed.
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Affiliation(s)
- B M de Oliveira
- Haematology Division, Department of Paediatrics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Oliveira BM, Romanha AJ, Alves TMA, Viana MB, Zani CL. An improved HPLC method for the quantitation of 6-mercaptopurine and its metabolites in red blood cells. Braz J Med Biol Res 2004; 37:649-58. [PMID: 15107925 DOI: 10.1590/s0100-879x2004000500004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A procedure is described for the rapid determination of the intra-erythrocyte concentration of 6-mercaptopurine (6-MP) and its metabolites, 6-thioguanine nucleotides (6-TGN) and 6-methylmercaptopurine (6-MMP). Erythrocytes (8 x 10(8) cells) in 350 microl Hanks solution containing 7.5 mg dithiothreitol were treated with 50 microl 70% perchloric acid. The precipitate was removed by centrifugation (13,000 g) and the supernatant hydrolyzed at 100 degrees C for 45 min. After cooling, 100 microl was analyzed directly by HPLC using a Radialpack Resolve C18 column eluted with methanol-water (7.5:92.5, v/v) containing 100 mM triethylamine. 6-TG, 6-MP and the hydrolysis product of 6-MMP, 4-amino-5-(methylthio)carbonyl imidazole, were monitored at 342, 322 and 303 nm using a Shimadzu SPD-M10A diode array UV detector. The analytes eluted at 5.3, 6.0 and 10.2 min, respectively. The calibration curves were linear (r(2) > 0.998), and the analytical recoveries were 73.2% for 6-TG, 119.1% for 6-MP and 97.4% for 6-MMP. The intra- and inter-assay variations were highest for 6-MP (9.6 and 14.3%, respectively). The lowest detectable concentrations were 3, 3 and 25 pmol/8 x 10(8) erythrocytes for 6-TG, 6-MP and 6-MMP, respectively. The quantification limits (coefficients of variation <15%) were 8, 10 and 70 pmol/8 x 10(8) erythrocytes for 6-TG, 6-MP and 6-MMP, respectively. The method was applied to the analysis of 183 samples from 36 children under chemotherapy for acute lymphoblastic leukemia. The concentrations of the metabolites in the red cells of the patients ranged from 0 to 1934 pmol/8 x 10(8) erythrocytes for 6-TGN, and from 0 to 105.8 and 0 to 45.9 nmol/8 x 10(8) erythrocytes for 6-MP and 6-MMP, respectively. The procedure gave results that were in agreement with those obtained with other methods designed to detect cases of non-compliance with treatment, including patient interviews and medical evaluation, among others, demonstrating its applicability to monitoring the treatment of leukemic children.
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Affiliation(s)
- B M Oliveira
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Viana MB, Cunha KCCMS, Ramos G, Murao M. [Acute myeloid leukemia in childhood: 15-year experience in a single institution]. J Pediatr (Rio J) 2003; 79:489-96. [PMID: 14685445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To investigate the survival of children with acute myeloid leukemia (AML) before and after the introduction of a Berlin-Frankfurt-Munich-83 based protocol. To analyze the prognostic impact of age, gender, nutritional status, initial white blood cell count and use of etoposide in the remission induction phase. METHODS This partly prospective/retrospective study comprised 83 children with AML diagnosed at Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil, between 1986 and 2000. Before 1991, 15 children were treated with 2-3 pulses of cytarabin plus daunomycin, followed by several consolidation/maintenance schemes. From January 1991 to November 1992 a pilot study (n = 15) was carried out to test etoposide toxicity in the induction phase. Etoposide was randomized from December 1992 to June 1999. RESULTS Median follow-up period was 5 years. Initial remission rates were 40 and 66% before or after the introduction of the German protocol, respectively (p = 0.11). Induction failure was largely due to death caused by infection and/or hemorrhage. The 5-year estimated probabilities of survival and of continuous complete remission were 31+/-5.4% and 49.7+/-7.4%, respectively. All 22 relapses involved the bone marrow. Age below 6 years at diagnosis was significantly associated with a poor prognosis. Sex, initial leukocyte count, and nutritional variables were not significant prognostic factors. The randomized addition of etoposide in the induction phase unexpectedly decreased the probability of complete remission at 5 years. CONCLUSIONS The introduction of a German-based protocol in 1991 significantly improved survival and duration of first remission. No plausible explanation for the unfavorable effect of etoposide was found.
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Affiliation(s)
- Marcos B Viana
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Paes CA, Viana MB, Freire RV, Martins-Filho OA, Taboada DC, Rocha VG. Direct association of socio-economic status with T-cell acute lymphoblastic leukaemia in children. Leuk Res 2003; 27:789-94. [PMID: 12804636 DOI: 10.1016/s0145-2126(03)00010-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lymphoblasts from 186 consecutive untreated children <18 years were analysed by flow cytometry in Brazil. Socio-economic status was defined by family income; undernourishment by height and weight for age standardised z scores below -1.28. The observed frequencies were precursor-B (pre-B) CD10 positive acute lymphoblastic leukaemia (ALL) (CD10+) 65%, pre-B CD10 negative (CD10-) 13%, and T-ALL 18%. The typical incidence peak at age 2-5 years was observed among the CD10 positive cases. Nutritional variables were not associated with immunophenotypes. Low monthly per capita income was associated with T-immunophenotype (P=0.024). In conclusion, a direct association between unfavourable socio-economic status and the T-phenotype indicates a potential role of socio-economic factors on the genesis of ALL in children, thus confirming indirect data of the international literature.
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Affiliation(s)
- Cybele A Paes
- Haematology Division, Hospital of Clinics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Oliveira MCLA, Oliveira BM, Queirós E, Viana MB. [Clinical and nutritional aspects of Gaucher disease: prospective study of 13 children at a single center]. J Pediatr (Rio J) 2002; 78:517-22. [PMID: 14647734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE Gaucher disease is an autosomal recessive lysosomal storage disease, caused by mutation to the GBA gene (glucocerebrosidase gene) located on chromosome 1. The objective of the present study was to identify the clinical, nutritional, biochemical and genetic features of the patients with Gaucher disease treated at the Unit of Pediatric Hematology (Hospital das Clínicas-Universidade Federal de Minas Gerais). METHODS Thirteen patients were prospectively followed up. Gaucher disease was confirmed in all patients through the use of an enzyme assay test to measure glucocerebrosidase enzyme activity. Demographic and nutritional data, and biochemical findings obtained on admission, were studied. Genetic testing was performed in seven patients. The median age of follow-up was 5.3 years. Z scores for weight and height on admission and at the end of observation period were calculated. The standardized prevalence for malnutrition was calculated using the Mora method. RESULTS The mean age at diagnosis was 5.8 years. The predominant clinical manifestations at diagnosis were hepatomegaly and splenomegaly, and all patients were classified as clinical type 1. Low platelet count and anemia were detected at diagnosis in eight and six children, respectively. The most frequent genetic mutation was N370S. One child died during follow-up due to septicemia, after splenectomy. The prevalence of malnutrition was 26% at admission and 48% at the end of the observation period. CONCLUSION The analysis of data demonstrates that N370S and clinical type 1 predominate in our Unit, characterizing the milder form of the disease. The irregular enzyme replacement therapy during the study period did not allow valid clinical conclusions on its efficacy.
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Onusic GM, Nogueira RL, Pereira AMS, Viana MB. Effect of acute treatment with a water-alcohol extract of Erythrina mulungu on anxiety-related responses in rats. Braz J Med Biol Res 2002; 35:473-7. [PMID: 11960198 DOI: 10.1590/s0100-879x2002000400011] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We investigated the effect of acute oral treatment with a water-alcohol extract of the inflorescence of Erythrina mulungu (EM, Leguminosae-Papilionaceae) (100, 200 and 400 mg/kg) on rats submitted to different anxiety models: the elevated T-maze (for inhibitory avoidance and escape measurements), the light/dark transition, and the cat odor test. These models were selected for their presumed capacity to demonstrate specific subtypes of anxiety disorders as recognized in clinical practice. Treatment with 200 mg/kg EM impaired avoidance latencies (avoidance 1 - 200 mg/kg EM: 18 +/- 7 s, control group: 40 +/- 9 s; avoidance 2 - 200 mg/kg EM: 15 +/- 4 s, control group: 110.33 +/- 38 s) in a way similar to the reference drug diazepam (avoidance 1: 3 +/- 0.79 s; avoidance 2: 3 +/- 0.76 s), without altering escape. Additionally, the same treatments increased the number of transitions (200 mg/kg EM: 6.33 +/- 0.90, diazepam: 10 +/- 1.54, control group: 2.78 +/- 0.60) between the two compartments and the time spent in the lighted compartment in the light/dark transition model (200 mg/kg EM: 39 +/- 7 s; diazepam: 61 +/- 9 s; control group: 14 +/- 4 s). The dose of 400 mg/kg EM also increased this last measurement (38 +/- 8 s). These results were not due to motor alterations since no significant effects were detected in the number of crossings or rearings in the arena. Furthermore, neither EM nor diazepam altered the behavioral responses of rats to a cloth impregnated with cat odor. These observations suggest that EM exerts anxiolytic-like effects on a specific subset of defensive behaviors, particularly those that have been shown to be sensitive to low doses of benzodiazepines.
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Affiliation(s)
- G M Onusic
- Laboratório de Psicofarmacologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Zangrossi H, Viana MB, Zanoveli J, Bueno C, Nogueira RL, Graeff FG. Serotonergic regulation of inhibitory avoidance and one-way escape in the rat elevated T-maze. Neurosci Biobehav Rev 2001; 25:637-45. [PMID: 11801289 DOI: 10.1016/s0149-7634(01)00047-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
It has been proposed that distinct 5-HT pathways modulate different types of anxiety. Activation of the ascending dorsal raphe (DR)-5-HT pathway, innervating the amygdala and frontal cortex, would facilitate learned defensive behaviors. On the other hand, activation of the DR-periventricular 5-HT pathway, which innervates the dorsal periaqueductal gray matter (DPAG), would inhibit innate flight or fight reactions. Dysfunction of these pathways has been suggested to relate to generalized anxiety disorder (GAD) and panic disorder (PD) in humans, respectively. The elevated T-maze has been developed to separate conditioned (inhibitory avoidance) from unconditioned (escape) defensive responses in the same rat. Pharmacological validation of this model has shown that the GAD-effective serotonergic anxiolytic buspirone or the putative anxiolytic ritanserin selectively impaired inhibitory avoidance while leaving one-way escape unchanged. Chronic injection of the 5-HT/noradrenaline reuptake inhibitor imipramine impaired inhibitory avoidance and prolonged escape, an effect that may be related to the therapeutic action of this drug on both GAD and PD. Like imipramine, intra-DPAG injection of the 5-HT(1A) agonist 8-OH-DPAT impaired both inhibitory avoidance and one-way escape. Intra-DPAG administration of the 5-HT(2A/2C) agonist DOI prolonged escape, without affecting inhibitory avoidance. The reversible inactivation of the DRN by muscimol impaired inhibitory avoidance, while facilitating escape from the open arm. Taken together, these results suggest that 5-HT exerts differential control on inhibitory avoidance and escape response in the elevated T-maze, mobilizing different types of 5-HT receptors in key structures implicated in fear/anxiety.
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Affiliation(s)
- H Zangrossi
- Department of Pharmacology, School of Medicine, University of São Paulo, 14049-901, SP, Ribeirão Preto, Brazil.
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Paixão MC, Cunha Ferraz MH, Januário JN, Viana MB, Lima JM. Reliability of isoelectrofocusing for the detection of Hb S, Hb C, and HB D in a pioneering population-based program of newborn screening in Brazil. Hemoglobin 2001; 25:297-303. [PMID: 11570722 DOI: 10.1081/hem-100105222] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Out of 128,326 newborns in the first 6-month period of a population-based screening program in Minas Gerais, Brazil, a second sample was obtained at the age of 6 months from 4,635 carriers of Hbs AS, AC, and AD which were detected by isoelectrofocusing. Discordance in results occurred in only 27 cases (0.6%): in seven there was a history of hemotransfusion; errors during pipetting or transcription of results occurred in seven cases; it was difficult to differenciate between Hbs S and D in eight patients; and the causes were not elucidated in five patients. The incidence of Hbs FS and FSC for the total population was 1:2,800 and 1:3,450, respectively. Isoelectrofocusing is a very reliable method for distinguishing AS, AC, or AD carriers from patients presenting with [corrected] variant hemoglobin and beta(+)-thalassemia combinations, and may be widely used in massive newborn screening programs.
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Affiliation(s)
- M C Paixão
- Núcleo de Pesquisa em Apoio Diagnóstico, Research Center for Newborn Screening, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Clementino NC, Yamamoto M, Viana MB, Figueiredo MS, Kerbauy J, Saad ST, Costa FF. Lack of association between N-ras gene mutations and clinical prognosis in Brazilian children with acute lymphoblastic leukemia. Leuk Lymphoma 2001; 42:473-9. [PMID: 11699412 DOI: 10.3109/10428190109064604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Point mutations in codons 12, 13 and 61 of the N-ras proto-oncogene have been detected in several human malignancies. We studied 170 patients with acute lymphoblastic leukemia (ALL), treated from 1988 to 1994 according to a protocol derived from BFM-83 studies, in order to evaluate the incidence and prognostic significance of mutations in this gene in childhood ALL. DNA was extracted from bone marrow smears at diagnosis and amplified by polymerase chain reaction (PCR). After screening with SSCP, PCR products were hybridized with allele specific probes and, in some cases, cloned in a pMOS Blue T vector and sequenced. Exon 2 was also studied in 101 children. Our results showed 4% of mutations in codons 12 and 13 and 2% in exon 2. Similar to a previous report, we identified 7% of mutations among children who were studied for both exons. A new mutation in codon 64 of the N-ras gene was detected in one patient. No significant clinical differences between patients with and without mutations were detected (sex, age, leukocyte counts at diagnosis, nutritional status, and risk factor according to the BFM protocol). Children with mutations in codons 12 and 13 showed significantly higher reactivity to PAS staining on blast cells than children with a wild type N-ras gene configuration. Comparison of overall- and recurrence-free survival did not show significant difference between groups with and without mutations. Our results suggest that mutations in the ras gene are infrequent in children with ALL at diagnosis and seem to be of low prognostic value.
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Affiliation(s)
- N C Clementino
- Federal University of São Paulo, UNIFESP-EPM, Federal University of Minas Gerais, UFMG, S. Paulo, Brazil
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Viana MB, Fernandes RA, de Oliveira BM, Murao M, de Andrade Paes C, Duarte AA. Nutritional and socio-economic status in the prognosis of childhood acute lymphoblastic leukemia. Haematologica 2001; 86:113-20. [PMID: 11224478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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Raz T, Labay V, Baron D, Szargel R, Anbinder Y, Barrett T, Rabl W, Viana MB, Mandel H, Baruchel A, Cayuela JM, Cohen N. The spectrum of mutations, including four novel ones, in the thiamine-responsive megaloblastic anemia gene SLC19A2 of eight families. Hum Mutat 2000; 16:37-42. [PMID: 10874303 DOI: 10.1002/1098-1004(200007)16:1<37::aid-humu7>3.0.co;2-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Thiamine responsive megaloblastic anemia (TRMA) is an autosomal recessive disorder with a triad of symptoms: megaloblastic anemia, deafness, and non-type 1 diabetes mellitus. Occasionally, cardiac abnormalities and abnormalities of the optic nerve and retina occur as well. Patients with TRMA often respond to treatment with pharmacological doses of thiamine. Recently, mutations were found in patients with TRMA in a thiamine transporter gene (SLC19A2). We here describe the mutations found in eight additional families. We found four novel mutations and three that were previously described. Of the novel ones, one is a nonsense mutation in exon 1 (E65X), two are missense mutations in exon 2 (S142F, D93H), and another is a mutation in the splicing donor site at the 5' end of intron 4 (C1223+1G>A). We also summarize the state of knowledge on all mutations found to date in TRMA patients. SLC19A2 is the first thiamine transporter gene to be described in humans. Reviewing the location and effect of the disease causing mutations can shed light on the way the protein functions and suggest ways to continue its investigation.
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Affiliation(s)
- T Raz
- Department of Genetics, Tamkin Human Molecular Genetics Research Facility, Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
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Abstract
OBJECTIVES: To report the experience in the treatment of Hodgkińs lymphoma in children at Hospital das Clínicas, UFMG, Brazil.METHODS: 31 children with Hodgkińs lymphoma were retrospectively followed up from 1983 to 1999. Fifteen children were treated according to HD-85, a protocol based on German-Austrian studies; the 16 remaining children were treated otherwise.RESULTS: The age at diagnosis varied from 3 to 15 years (median 9 years). There were 28 male patients. The follow-up period ranged from 2 months to 16 years (median 3 years and 7 months). Mixed cellularity was the predominant (61%) histological subtype; 58% had advanced disease (stages III or IV) at diagnosis. Staging abdominal surgery was necessary in 61%. No reduction in the frequency of staging surgeries was observed after starting standardized HD-85 protocol in 1994. Herpes simplex and zoster infections were the most common complications. The estimated probability of disease-free survival (DFS) was 55.6%-/+11.7% at 5 years. Overall survival probability was 96.5%-/+3.5%. No difference in DFS was apparent between children treated with HD-85 and those treated otherwise.CONCLUSIONS: The overall results in DFS are worse than those reported in the literature. The predominance of mixed cellularity subtype, and early age and advanced disease at diagnosis are commonly reported in developing countries and do not fully explain the observed results. A longer follow-up is necessary to evaluate the influence of treatment standardization on the outcome of these children.
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Affiliation(s)
- B M Oliveira
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Zangrossi H, Viana MB, Graeff FG. Anxiolytic effect of intra-amygdala injection of midazolam and 8-hydroxy-2-(di-n-propylamino)tetralin in the elevated T-maze. Eur J Pharmacol 1999; 369:267-70. [PMID: 10225362 DOI: 10.1016/s0014-2999(99)00075-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The effects of intra-amygdala injection of midazolam (20 nmol) and 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT; 8 and 16 nmol) were investigated in rats submitted to the elevated T-maze, a new animal model of anxiety. This test allows the measurement, in the same rat, of conditioned and unconditioned fear/anxiety responses. Both drugs impaired inhibitory avoidance of the open arms of the T-maze (task representing conditioned fear), indicating an anxiolytic effect, but did not change escape performance from one of the open arms (representing unconditioned fear). The results further implicate gamma-aminobutyric acid (GABA)/benzodiazepine and serotonergic systems within the basolateral/lateral amygdala in the modulation of conditioned anxiety responses.
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Affiliation(s)
- H Zangrossi
- Faculdade de Medicina de Ribeirão Preto, Departamento de Farmacologia, University of São Paulo-Ribeirão Preto, SP, Brazil.
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Viana MB, Fernandes RA, de Carvalho RI, Murao M. Low socioeconomic status is a strong independent predictor of relapse in childhood acute lymphoblastic leukemia. Int J Cancer Suppl 1999; 11:56-61. [PMID: 9876480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The results of the treatment of acute lymphoblastic leukemia (ALL) in children depend not only on the biologic diversity of the leukemia cell, the multi-drug treatment schedule and the individual variability of drug metabolism, but also on the socioeconomic and cultural background of the leukemic child. Social and cultural disparity is very marked in underdeveloped countries and has been increasing in industrialized nations. The prognostic influences of these factors are poorly documented and sometimes mistakenly attributed to differences in ethnic origin. We have investigated in Brazil the relative impact of malnutrition and socioeconomic status on the outcome of ALL, adjusting for the known influence of biologic factors. Children with ALL (n = 167) treated with a Berlin-Frankfurt-Munster-based protocol were studied prospectively. At a median follow-up of 1623 days, the estimated probability of disease-free survival was 43 +/- 4%. The main cause for interruption of remission was bone-marrow relapse. Socioeconomic indicators of poverty (poor housing conditions, low per capita income and energy consumption) were significantly associated with a greater risk of relapse in univariate analysis. They were consolidated in a single index, socioeconomic status (SES), defined by the product of monthly per capita income times mean familial daily energy consumption. Other unfavorable findings included age, z score for the height for age at diagnosis (HAZ) below-1.28 and the z score for weight for age below-1.28. After adjustment in Cox's multivariate model, only HAZ and poor SES remained as predictive factors for relapse. Poor prognosis for leukemic children of low SES is just another indicator of social inequality.
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Affiliation(s)
- M B Viana
- Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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