Energy metabolism and behavioral parameters in female mice subjected to obesity and offspring deprivation stress

This study aimed to evaluate the behavioral and energy metabolism parameters in female mice subjected to obesity and offspring deprivation (OD) stress. Eighty female Swiss mice, 40 days old, were weighed and divided into two groups: Control group (control diet, n = 40) and Obese group (high-fat diet, n = 40), for induction of the animal model of obesity, the protocol was based on the consumption of a high-fat diet and lasted 8 weeks. Subsequently, the females were subjected to pregnancy, after the birth of the offspring, were divided again into the following groups (n = 20): Control non-deprived (ND), Control + OD, Obese ND, and Obese + OD, for induction of the stress protocol by OD. After the offspring were 21 days old, weaning was performed and the dams were subjected to behavioral tests. The animals were humanely sacrificed, the brain was removed, and brain structures were isolated to assess energy metabolism. Both obesity and OD led to anhedonia in the dams. It was shown that the structures most affected by obesity and OD are the hypothalamus and hippocampus, as evidenced by the mitochondrial dysfunction found in these structures. When analyzing the groups separately, it was observed that OD led to more pronounced mitochondrial damage; however, the association of obesity with OD, as well as obesity alone, also generated damage. Thus, it is concluded that obesity and OD lead to anhedonia in animals and to mitochondrial dysfunction in the hypothalamus and hippocampus, which may lead to losses in feeding control and cognition of the dams.

Genome-wide association study and pathway analysis for carcass fatness in Nellore cattle measured by ultrasound

Identifying genes or genomic regions influencing carcass-quality traits such as fatness (FTN) is essential to optimize the genetic selection processes in beef cattle. The aim of this study was to identify genomic regions associated with FTN in Nellore cattle as well as to elucidate the metabolic pathways related to the phenotypic expression. Ultrasound-based measurements of FTN were collected in 11 750 animals, with 39 903 animals in the pedigree file. Additionally, 1440 animals were genotyped using the GGP-indicus 35K SNP panel, which contained 33 623 SNPs after quality control. Twenty genes related to FTN were found on 11 chromosomes, explaining 12.96% of the total additive genetic variance. Gene ontology revealed seven genes: NR1L2, PKD2, GSK3β, EXT1, RAD51B, SORCS1 and DPH6, associated with important processes related to FTN. In addition, novel candidate genes (MAATS1, LYPD1, CDK5RAP2, RAD51B, c13H2Oorf96 and TRAPPC11) were detected and could provide further knowledge to uncover genetic regions associated to carcass fatness in beef cattle.

Treatment of keloids and hypertrophic scars. Position statement of the Brazilian expert group GREMCIQ

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines.

Tuberculosis in a township in southern Bahia: epidemiological and operational indicators

Tuberculosis is an important public health problem of global magnitude. Although it has had diagnostic and therapeutic support for decades, its control requires attention in several points from the health system. In this context, epidemiological and operational indicators allow evaluating the effectiveness of the Tuberculosis Control Program. A retrospective epidemiological study was conducted with a quantitative approach, referring to the period from 2014 to 2018, in the township of Ilhéus, using secondary data from the Information System of Notifiable Diseases of the State Secretariate of Bahia (SINAN/SESAB). During the analyzed period, 678 cases of tuberculosis were identified in the information system, with an average annual incidence coefficient of 71.32 cases/100,000 inhabitants and a mortality coefficient with an average of 4.45 deaths/100,000 inhabitants. The test rate of these HIV patients was 56.64%. Regarding the directly observed treatment (DOT), the annual average was 10.19% cases that underwent this follow-up, with a reduction of 28.57% of cases in 2014 followed up with DOT for only 8.11% of cases in 2018. Regarding the closure situation, in 2018 there was a higher proportion of individuals who presented cure (77.61%), lower proportion of treatment abandonment (18.30%), as well as a lower number of cases with closure due to death (2.99%). Thus, it is perceived that tuberculosis in the township of Ilhéus presents values far from what is recommended and remains an important public health problem. In view of this scenario, highlights the importance of decentralization of the service, with its management guided by the evaluation of indicators and the consolidation of primary health care.

Key messages

This study is relevant because it allows the assessment of the tuberculosis profile. The analysis of the indicators makes it possible to adopt appropriate prevention and control strategies.

Anti-inflammatory and antinociceptive effects of phonophoresis in animal models: a randomized experimental study

The aim of this study was to evaluate the therapeutic effects of ultrasound (US)-mediated phonophoresis alone or in association with diclofenac diethylammonium (DCF) administered topically in animal models of inflammation. A pre-clinical, prospective, and randomized experimental study of quantitative and qualitative nature was carried out. Phonophoresis was performed using a therapeutic ultrasound apparatus in two distinct models of acute inflammation. Edema was induced by an intraplantar injection of carrageenan and measured by plethysmography. The Hargreaves test was used to evaluate the antinociceptive activity and investigate the action of phonophoresis on tumor necrosis factor (TNF)-α production. A histological analysis with hematoxylin-eosin was used to evaluate tissue repair, and the expression of COX-2 was determined by immunohistochemical analysis. At the peak of inflammatory activity (3 h), treatment with US, US+DCF, and DCF significantly reduced edema formation compared to the control group. Treatment with US+DCF was more effective than treatment with US alone at both analyzed times. In the analysis of the antinociceptive activity, the treatments significantly increased the latency time in response to the thermal stimulus. Histopathological analysis revealed a reduction of the inflammatory infiltrates and immunohistochemistry demonstrated that the association was effective in reducing COX-2 expression compared to the control group. The association of DCF with US produced anti-inflammatory and antinociceptive effects in rat models of inflammation, which may be associated with inhibition of COX-2 and TNF-α production.

Real-time three-dimensional jaw tracking in temporomandibular disorders

When a dysfunction occurs in any component of the stomatognathic system, temporomandibular disorders (TMD) may originate. The aim of this study was to compare the deviations, displacement and the execution speed of mandibular movements among asymptomatic participants and those with TMD. Convenience sampling was used; forty participants diagnosed by clinical evaluation following the Research Diagnostic Criteria for Temporomandibular Disorders were divided into three groups: arthropathy (GART, 10 participants, 40% men), myopathy (GMYO, 10 participants, 30% men), and the control group (CG, 20 asymptomatic participants, 25% men). Participants were asked to perform the movements of free maximal mouth opening and closing, right and left lateral excursions, and protrusion with sliding teeth contacts. The mandibular trajectory was recorded using opto-electronic devices tracking reflective markers placed in front of the 'soft tissue pogonion point'. The movements were analysed on the following axis: x - medial-lateral, y - vertical, z - antero-posterior. Significative differences were found in CGxGART - unassisted maximal mouth opening and closing projection on y-axis (OCY), CGxGMYO - unassisted maximal mouth opening and closing projection on x-axis (OCX), and in the measures Opening lateral deviation on x-axis (OLDX), closing lateral deviation on x-axis (CLDX) and in the measures of speed for both. In regard to GARTxGMYO, a significative difference was found in Protrusion lateral deviation on x-axis (PLDX) 'Conover-Iman Test of Multiple Comparisons Using Rank Sums' using Bonferroni correction (P < 0·05). In conclusion, the total opening movements in individuals with TMD tended to have higher deviation than in those asymptomatic individuals and a reduction in the speed of movements.

Assessing the genotoxicities of sparteine and compounds isolated from Lupinus mexicanus and L. montanus seeds by using comet assay

The genus Lupinus is widely distributed. Its seeds are used for animal and human food, and Lupinus possesses pharmacological potential because of its high content of quinolizidine alkaloids and flavonoids; however, there is little available information about its genotoxicity. We used the comet assay and staminal nuclei of Tradescantia (clone 4430) to evaluate the in vitro genotoxicity of 4 concentrations (0.01, 0.1, 0.5, and 1.0 mM) of alkaloid extracts of Lupinus mexicanus and Lupinus montanus, flavonoids of L. mexicanus, and commercial sparteine; nitrosodiethylamine was used as a positive control and untreated nuclei were used as a negative control. All concentrations of L. mexicanus and L. montanus showed significant genotoxic activity (P ≤ 0.05). A similar behavior was observed for flavonoid extracts of L. montanus except the 1.0 mM concentration. Sparteine showed genotoxic activity only at 0.5 mM. The order of genotoxicity of the compounds studied was as follows: L. mexicanus > L. montanus > flavonoids of L. montanus > sparteine. There is evident genotoxic activity in the compounds that were studied, particularly at lower concentrations (0.01 and 0.1 mM). Given the limited information about the genotoxicity of the compounds of L. mexicanus and L. montanus, further studies are necessary.

Validation of two real-time PCRs targeting the PE-PGRS 20 gene and the region of difference 4 for the characterization of Mycobacterium bovis isolates

This study aimed to develop and validate real-time PCR for the diagnosis of Mycobacterium bovis isolates. Two hundred and seventy-four M. bovis isolates and 156 M. tuberculosis isolates were tested. Both qPCRs amplified all of the 274 M. bovis samples, but none of the 156 M. tuberculosis samples. The qPCR for PE-PGRS 20 had 91% efficiency and a detection limit of 0.32 ng (sensitivity and specificity for qPCR "Mbovis.100" were 99.64 and 100%, respectively). The qPCR for RD4 had 100% efficiency, and a detection limit of 4 pg (diagnostic sensitivity and specificity were 100 and 100%. The qPCR tests were performed using 4 extraction sets, 3 qPCR kits, and with a range of equipment; yet, all combinations produced similar results in a diagnostic test, demonstrating the robustness of this method. The techniques proved to be efficient, robust, sensitive, and specific for the diagnosis of M. bovis.

Short communication: Viable Mycobacterium avium subspecies paratuberculosis in retail artisanal Coalho cheese from Northeastern Brazil

Mycobacterium avium ssp. paratuberculosis (MAP) is the etiologic agent of paratuberculosis and it potentially plays a role in Crohn's disease. In humans, the main route of transmission of MAP might be the intake of contaminated milk and dairy products. Considering that MAP has already been detected in many types of cheese in different counties, and that Coalho cheese is an important dairy product in northeastern Brazil, the aim of this study was to report the first detection of MAP in retail Coalho cheese in Brazil by PCR and culture. Of 30 retail Coalho cheese samples, 3 (10%) amplified fragments of a similar size to that expected (626 bp) were obtained and viable MAP was recovered by culture from 1 (3.3%) sample. The DNA from the positive culture sample was sequenced and showed 99% identity with the insertion sequence IS900 deposited in GenBank. It was possible to identify the presence of MAP-specific DNA in the analyzed samples for the first time in Brazil, and to recover viable cells from retail Coalho cheese.

A versatile apparatus for on-line emission channeling experiments

The concept and functionality of an apparatus dedicated to emission channeling experiments using short-lived isotopes on-line at ISOLDE∕CERN is described. The setup is assembled in two functional blocks - (a) base stand including beam collimation, implantation and measurement chamber, cryogenic extension, and vacuum control system and (b) Panmure goniometer extension including maneuvering cradle and sample heating furnace. This setup allows for in situ implantation and sample analysis in the as-implanted state and upon cooling down to 50 K and during annealing up to 1200 K. The functionality of the setup will be illustrated with the example of establishing the lattice location of (56)Mn probes implanted into GaAs.

Role of the extracellular matrix in variations of invasive pathways in lung cancers

Among the most common features of highly invasive tumors, such as lung adenocarcinomas (AD) and squamous cell carcinomas (SqCC), is the massive degradation of the extracellular matrix. The remarkable qualitative and quantitative modifications of hyaluronidases (HAases), hyaluronan synthases (HAS), E-cadherin adhesion molecules, and the transforming growth factor β (TGF-β) may favor invasion, cellular motility, and proliferation. We examined HAase proteins (Hyal), HAS, E-cadherin, and TGF-β profiles in lung AD subtypes and SqCC obtained from smokers and non-smokers. Fifty-six patients, median age 64 years, who underwent lobectomy for AD (N = 31) and SqCC (N = 25) were included in the study. HAS-1, -2 and -3, and Hyal-1 and -3 were significantly more expressed by tumor cells than normal and stroma cells (P < 0.01). When stratified according to histologic types, HAS-3 and Hyal-1 immunoreactivity was significantly increased in tumor cells of AD (P = 0.01) and stroma of SqCC (P = 0.002), respectively. Tobacco history in patients with AD was significantly associated with increased HAS-3 immunoreactivity in tumor cells (P < 0.01). Stroma cells of SqCC from non-smokers presented a significant association with HAS-3 (P < 0.01). Hyal, HAS, E-cadherin, and TGF-β modulate a different tumor-induced invasive pathway in lung AD subgroups and SqCC. HAases in resected AD and SqCC were strongly related to the prognosis. Therefore, our findings suggest that strategies aimed at preventing high HAS-3 and Hyal-1 synthesis, or local responses to low TGF-β and E-cadherin, may have a greater impact in lung cancer prognosis.

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

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.

Direct evidence for projectile charge-state dependent crater formation due to fast ions

We report on craters formed by individual 3 MeV/u Au (q(ini)+) ions of selected incident charge states q_(ini) penetrating thin layers of poly(methyl methacrylate). Holes and raised regions are formed around the region of the impact, with sizes that depend strongly and differently on q_(ini). Variation of q_(ini) of the film thickness and of the angle of incidence allows us to extract information about the depth of origin contributing to different crater features.

Thyroid suppression test with a single oral dose of levothyroxine in the diagnosis of functional thyroid autonomy

OBJECTIVE

To propose a modified form of thyroid suppression test with use of a single oral dose of levothyroxine (35 mg/kg).

METHODS

After a baseline scintigram, 23 patients with nodular goiter suspected of autonomous function (warm or hot nodules, subnormal or undetectable thyrotropin levels, or both findings) and 14 normal subjects underwent a repeated scintigram 4 days after administration of levothyroxine. We evaluated triiodothyronine (T(3)), free thyroxine, and thyrotropin before and on the first, second, third, fourth, and seventh days after administration of the individualized dose of levothyroxine.

RESULTS

The 99th percentile of postsuppression uptake in normal subjects was determined, and an uptake >12.4%, a 131 I concentration restricted to the nodule, or both factors were adopted as the criteria for diagnosis of an autonomously functioning thyroid nodule. Twelve patients were considered to have autonomously functioning nodules, and 11 patients were considered to have nonautonomous nodules. Baseline thyrotropin levels in patients with autonomous nodules did not differ significantly from those in patients with nonautonomous nodules. No signs or symptoms of toxicity were detected during the test, but all study subjects had increased free thyroxine values, and seven had high levels of T(3).

CONCLUSION

The thyroid suppression test with 35 mg/kg of levothyroxine is an effective method for the diagnosis of an autonomously functioning thyroid nodule, is nontoxic, and avoids the inaccurate use of the medication occasionally observed with T(3). Even sensitive methods of thyrotropin determination cannot replace this test in the evaluation of autonomous thyroid function.

Analysis of networks based on styrene and divinylbenzene containing iron anchored using variable pressure scanning electron microscopy

There is great demand for the development of composite materials containing small metal or metal oxides particles, owing to their variable properties and wide application. However, microscopic evaluation of these materials using high-vacuum scanning electron microscopy is difficult because the samples must undergo a series of preparation steps to reach a high image quality and to avoid becoming shrunk inside the microscope vacuum chamber. Thus, in this study, we used variable pressure scanning electron microscopy to evaluate the morphology and iron distribution on the surface of magnetic microspheres based on poly(styrene-co-divinylbenzene). These materials were obtained by suspension copolymerization of styrene and divinylbenzene in the presence of fine iron particles. Energy-dispersive X-rays were also used to analyse distribution of the iron particles. The results indicate that, under the conditions used, magnetic microspheres with a relatively narrow size distribution were formed. Moreover, the micrographs show that agglomerated iron particles appeared only on the microsphere surface.

Paracoccidioidomycosis associated with human immunodeficiency virus infection. Report of 10 cases

We describe here the epidemiological and clinical characteristics of 10 HIV-infected patients with paracoccidioidomycosis. All patients were adult males from small towns in Brazil and had a previous history of work or residence in a rural area. The two infections were diagnosed concomitantly in six of the ten patients, and for six of the patients, the mycosis was the first clinical manifestation of HIV infection. Risk factors for HIV infection were injection drug use in some patients and multiple sexual partners in others. Six patients died and autopsy revealed severe disseminated paracoccidioidomycosis in three. Exuberant and severe clinical pictures suggest an alteration in the natural history of this mycosis as a result of HIV immunosuppression. The frequency of paracoccidioidomycosis in the HIV-infected population is not known to differ from that reported for this mycosis in non-HIV patients.

Assessment of maturity degree of composts from domestic solid wastes by fluorescence and Fourier transform infrared spectroscopies

Methods of assessment of compost maturity are needed so the application of composted materials to lands will provide optimal benefits. The aim of the present paper is to assess the maturity reached by composts from domestic solid wastes (DSW) prepared under periodic and permanent aeration systems and sampled at different composting time, by means of excitation-emission matrix (EEM) fluorescence spectroscopy and Fourier transform infrared spectroscopy (FT-IR). EEM spectra indicated the presence of two different fluorophores centered, respectively, at Ex/Em wavelength pairs of 330/425 and 280/330 nm. The fluorescence intensities of these peaks were also analyzed, showing trends related to the maturity of composts. The "contour density" of EEM maps appeared to be strongly reduced with composting days. After 30 and 45 days of composting, FT-IR spectra exhibited a decrease of intensity of peaks assigned to polysaccharides and in the aliphatic region. EEM and FT-IR techniques seem to produce spectra that correlate with the degree of maturity of the compost. Further refinement of these techniques should provide a relatively rapid method of assessing the suitability of the compost to land application.

Cytokeratin 20 is not a reliable molecular marker for occult breast cancer cell detection in hematological tissues

Cytokeratins are potential markers for epithelial cell detection in hematological tissues. Thus, we developed a nested reverse transcriptase-polymerase chain reaction (RT-PCR) strategy to detect cytokeratin 20 (CK20) mRNA and studied its sensitivity and specificity as a molecular marker of occult breast cancer cells. In cell dilution experiments with human breast cancer cell lines, the limit of detection was 1 tumor cell in 1,000 hematological cells. In RNA dilution experiments of breast cancer cells' RNA in E. Coli tRNA, the CK20 transcript was only detectable when at least 1 ng of total tumor RNA was present in a total of 1 microg of RNA mixture. In parallel experiments using colorectal cancer specimens, CK20 mRNA was detected with as little as 1 pg of total tumor RNA, suggesting a low level of CK20 mRNA expression in breast cancer cells. The CK20 transcript was detected in all six tumors and five hematological samples of breast cancer patients but in none of nine hematological cell lines. However, CK20 transcript was also detected in unfractionated nucleated cell population of hematological samples from 23 of 31 (74%) healthy volunteers and from 12 of 24 (50%) patients with hematological malignancies. When mononucleated and polymorphonucleated cell populations of hematological samples from these control groups were screened separately, CK20 expression was detected in 94% of polymorphonucleated cell fractions and in 44% of mononucleated cell subpopulations. Thus, we conclude that the low sensitivity and specificity of RT-PCR detection of CK20 mRNA limits its usefulness for breast cancer cell detection in hematological products.

Pemphigus vulgaris: environmental factors. Occupational, behavioral, medical, and qualitative food frequency questionnaire

BACKGROUND

There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. Factors suggested include exposure to pesticides or certain drugs.

OBJECTIVE

To analyze the association of pemphigus with environmental exposure to various agents, including smoking, recreational and occupational insults, drugs, and food.

DESIGN AND SETTING

In-person interviews of pemphigus patients and control subjects were conducted by trained medical investigators using a structured questionnaire. Questions included occupational, behavioral, medical, and qualitative food frequency details. The multicenter study was conducted at outpatient services of teaching hospitals in Bulgaria, Brazil, India, Israel, Italy, Spain, and the USA.

PARTICIPANTS

A total of 126 pemphigus patients (55 men, 71 women; age, 54 +/- 17 years) and 173 healthy controls (87 men, 86 women; age 50 +/- 19 years) were interviewed in the period between October 1, 1999 and March 31, 2000. The diagnosis of pemphigus was based on clinical, histologic, immunohistologic, and immunohistochemical criteria. The disease duration was 2-27 years (8.4 +/- 7.2 years). Individuals with skin diseases other than pemphigus were selected as control subjects.

MAIN OUTCOME MEASURE

Information on drugs, foods, and occupational, environmental, constitutional, and other possible risk factors was analyzed by t-tests and chi-squared tests as applicable. A multivariate logistic regression model was applied to the data to study simultaneously the independent relationship between each risk factor and pemphigus vulgaris.

RESULTS

The risk for pemphigus vulgaris was lower for ex-smokers and current smokers than for patients who had never smoked. Exposure to pesticides and occupational exposure to metal vapor were associated with an increased risk of pemphigus. Pemphigus patients had more pregnancies than controls. There were differences in environmental factors between countries, with exposure to gardening materials and pesticides being highest among patients from Bulgaria, followed by Israel. Disease characteristics also exhibited differences between countries. Bulgarian patients less frequently had oral mucous membrane lesions: 66% compared to 92% for Israeli patients and 83% for Italians. The distribution of the disease in skin and mucous membranes was similar among patients from all countries. Exclusive skin involvement was seen in 50% of patients, mucous membranes alone in 23% of patients, and both skin and mucous membranes in 27% of patients.

CONCLUSIONS

The beneficial effect of smoking on pemphigus might be explained by its effect on the immune system. In addition, smoking has an antiestrogenic effect, while pesticides have an estrogenic effect. The lower numbers of smokers among patients, the higher exposure rates to pesticides, and the higher number of female patients who had been pregnant may point to the contribution of estrogens to the disease process. It remains to be determined whether measures, such as avoiding exposure to pesticides or metal vapor, may be beneficial in the clinical context. As the present study was a survey, more definitive studies should be conducted to validate the results.

[Prognosis value of p53, C-erB-2 and Ki67 proteins in ovarian carcinoma]

The prognosis in ovarian carcinoma remains poor. We need to identify patients who are less likely to respond to treatment. In order to evaluate the prognostic value of C-erb-B2, p53 and Ki 67 expression and correlate these markers with classic prognostic factors, we studied paraffin-embedded tumor tissue from 81 patients with epithelial ovarian cancer and made a quantitative evaluation of C-erb-B2, p53 and Ki 67 expression by immunohistochemistry. The results were: age 5.4 +/- 15(22-88); 66% with normal physical activity; 48.2% with residual disease < 2 cm; initial stage--42% and advanced stage--58%. Age, performance status, residual disease and stage were correlated with 2 and 5 years survival. Positive immunostaining: p53--87%, C-erb B-2--51% and Ki67--100%. P53 and C-erb B-2 were associated with residual disease and stage; patients with no C-erbB-2 staining had a significantly better survival. A direct and significant correlation was found between p53 and Ki67 and between C-erb B-2 and p53. We conclude that these markers have a high expression in ovarian carcinoma and p53 and C-er B-2 correlate with stage and residual disease. Although C-erb B-2 was associated with better survival, it was not found to be an independent prognostic factor.

N-[tris(hydroxymethyl)methyl]glycine(tricine)

The title compound, C(6)H(13)NO(5), adopts a zwitterionic form where the carboxylic acid H atom is transferred to the amino group. The methyl-glycine backbone is planar. The tris(hydroxymethyl)methyl group is rotated as a rigid group around the amino-methyl bond by 22 (1) degrees and the carboxylic acid plane is rotated by 19.76 (12) degrees from the plane of the main skeleton. Apart from their H atoms, the three hydroxymethyl groups adopt a propeller-like conformation around the amino-methyl bond, close to C(3) symmetry.

Effects of dopamine receptor antagonists on ongoing maternal behavior in rats

The effects of different peripheral doses of four dopamine (DA) receptor antagonists on general activity and maternal behavior were examined in lactating female rats. Administration of the classic D1-like and D2-like DA receptor blocker haloperidol (0.1 and 0.05 mg/kg) disrupted pup retrieval and nest-building behaviors and reduced motor activity. Pimozide (0.5 and 0.2 mg/kg), which has more affinity for DA D2-like receptors, mildly disrupted pup retrieval while showing no significant influence on open-field behaviors. The putative DA D(4) receptor blocker, clozapine (1.5 and 1.0 mg/kg) reduced motor activity significantly, while only 1.0 mg/kg dose significantly decreased percent of rats displaying nest building. The DA D1-like receptor blocker SKF-83566 (0.2 and 0.1 mg/kg) significantly reduced pup retrieval, nest building and motor activity. These results suggest a role for DA receptors in ongoing maternal behavior that correlates directly with general activity.

Effects of the green algae Chlorella vulgaris on the response of the host hematopoietic system to intraperitoneal ehrlich ascites tumor transplantation in mice

Chlorella vulgaris extract (CVE) was examined for its effects on the Ehrlich ascites tumor-induced suppression in the numbers of bone marrow and spleen granulocyte-macrophage progenitor cells (CFU-GM) in mice. No effects on bone marrow and spleen CFU-GM, as compared to controls, were observed in normal mice given 50, 100 and 200 mg/kg CVE orally for 5 days. In tumor-bearing mice, myelosuppression concomitant with increased number of spleen CFU-GM were observed. The number of CFU-GM in the bone marrow was restored to control levels after the administration of CVE (50, 100 and 200 mg/kg) to tumor-bearing mice, and a slight reduction in spleen colony formation was observed in these animals. In addition, CVE significantly prolonged the survival of mice inoculated with the Ehrlich ascites tumor. These results suggest a protective antitumor effect of CVE which might be attributable, at least in part, to the stimulation of the production and, possibly, maturation of granulocytes and macrophages.

Competence of the human host as a reservoir for Leishmania chagasi

The failure of control programs for visceral leishmaniasis (VL) that depend on elimination of infected dogs suggests that other reservoir hosts may participate in the transmission cycle. To determine whether persons infected with Leishmania chagasi can infect the vector sand fly, laboratory-reared Lutzomyia longipalpis were allowed to feed on Brazilian subjects with active, cured, and asymptomatic VL and on asymptomatic residents of houses of persons with active VL. Of 3747 insects that had fed, 26 acquired infection from 11 of the 44 persons with active VL, but none acquired infection from the 137 asymptomatic persons. Among persons <4 years old with active VL, a history of diarrhea and higher peripheral blood neutrophil counts were independent predictors of infectivity. Further experiments using larger numbers of insects are necessary to evaluate the reservoir competence of persons with asymptomatic infections, who represent a large segment of the population of several Brazilian cities.

Prognosis related to staging systems for chronic lymphocytic leukemia

CONTEXT

Chronic lymphocytic leukemia (CLL) is a clonal lymphoproliferative disorder, characterized by B lymphocytic proliferation. CLL is the most frequent adult leukemia in Western countries, accounting for 25 to 30% of all white leukemic patients.

OBJECTIVE

To evaluate clinical and staging characteristics in prognosis of chronic lymphocytic leukemia.

DESIGN

Evaluation of clinical-staging data.

SETTING

Universidade Federal de São Paulo - Escola Paulista de Medicina / Universidade de Alfenas.

SAMPLE

73 patients diagnosed from 1977 to 1994.

MAIN MEASUREMENTS

Sex, ethnic origin, age, lymphadenopathy, splenomegaly, hepatomegaly, three or more areas of lymphoid enlargement, hemoglobin (g/dl), lymphocytes/mm3, Platelets/mm3

RESULTS

Mean survival of patients was 76 months, median age was 65 years, ranging from 33 to 87. Forty-four patients (60.3%) were male and 29 (39.7%) female.

CONCLUSION

The Binet system determined a better prognosis than Rai.

[Biliary microcrystals in idiopathic acute pancreatitis: clue for occult underlying biliary etiology]

The main causes of pancreatic inflammation worldwide are biliary lithiasis and alcoholism. However, 10 to 30% of patients have been considered to have "idiopathic" acute pancreatitis. Recently, some studies showed that a significant rate of the so called idiopathic pancreatitis are caused by microlithiasis and/or biliary sludge, identified by the presence of cholesterol monohidrate and/or calcium bilirubinate microcrystals in the biliary sediment. In the present study, the analysis of microcrystals from bile obtained during endoscopic retrograde cholangiopancreatography was done in patients with pancreatitis (idiopathic, biliary or alcoholic--20 in each group). Patients with idiopathic pancreatitis and microcrystals in the bile underwent cholecystectomy whenever possible. Those who refused or were inapt to surgery underwent endoscopic sphincterotomy or received continuous therapy with ursodeoxycholic acid. Patients with idiopathic pancreatitis without biliary crystals did not receive any specific treatment. The prevalence of biliary microcrystals in patients with idiopathic pancreatitis (75%) and biliary pancreatitis (90%) was significantly higher than in those with alcoholic pancreatitis (15%). In the identification of the etiology of biliary pancreatitis, the presence of microcrystals had a sensitivity of 90%, specificity of 85%, positive predictive value of 85.7%, negative predictive value of 89.4% and accuracy of 87.5%. In the patients with recurrent idiopathic pancreatitis, with biliary crystals, there was an statistically significant reduction in the number of pancreatitis episodes after specific treatment. In the follow-up of this group during 23.3 +/- 4.8 months, recurrence of pancreatitis occurred only in patients with "persistent biliary factor" (choledocholithiasis and/or persistence of cholesterol monohidrate). All patients with idiopathic pancreatitis who underwent cholecystectomy had chronic cholecystitis. Moreover, cholelithiasis was present in one case. In the ultrassonographic follow-up of the patients with idiopathic acute pancreatitis with microcrystals in the bile, cholelithiasis was detected in one case. In the subgroup of five patients with idiopathic pancreatitis without biliary microcrystals recurrence occurred in one case. Ultrassonographic study during follow-up did not reveal biliary stones in any of these patients. We concluded that the detection of biliary microcrystals in "idiopathic" pancreatitis suggested an underlying biliary etiology, even if occult. What's more, early specific therapeutic procedure (cholecystectomy, endoscopic sphincterotomy or ursodeoxycholic acid) in patients with recurrent idiopathic pancreatitis with microcrystals in the bile reduced significantly the recurrence during the follow-up. Finally, acute pancreatitis (specially recurrent) should not be called idiopathic before the microscopic analysis of the bile, aiming to detect or exclude the presence of microcrystals.

Effects of short-term glucocorticoid deprivation on growth hormone (GH) response to GH-releasing peptide-6: studies in normal men and in patients with adrenal insufficiency

There are no data in the literature about the effects of glucocorticoid deprivation on GH-releasing peptide-6 (GHRP-6)-induced GH release. The aims of this study were to evaluate GH responsiveness to GHRP-6 1) after metyrapone administration in normal men, and 2) in patients with chronic hypocortisolism after glucocorticoid withdrawal for 72 h. In normal subjects, metyrapone ingestion did not alter significantly GH responsiveness to GHRP-6 [n = 8; peak, 39.3 +/-7.1 microg/L; area under the curve (AUC), 1958.8 +/- 445.7 microg/min x L; mean +/- SE] compared to placebo (n = 8; peak, 21.9 +/- 4.5; AUC, 1131.0 +/- 229.6). In patients with chronic hypocortisolism (n = 8), GH responses to GHRP-6 were similar both during replacement therapy (peak, 11.8 +/- 3.9; AUC, 563.2 +/- 208.7) and after withdrawal of prednisone (peak, 14.4 +/- 4.5; AUC, 695.6 +/- 272.9) and did not differ from those in controls. Interestingly, after glucocorticoid withdrawal, GH responsiveness to GHRP-6 in patients with chronic hypocortisolism was significantly lower than that in normal subjects pretreated with metyrapone. Our data suggest that short term glucocorticoid deprivation does not have a major impact on GHRP-6-dependent GH-releasing mechanisms. However, in long standing hypocortisolism, subtle changes in GHRP-6 secretory pathways may be present.

[Intestinal parasite infections and schistosomiasis in a poor urban area, in townships of the sugar cane belt and in villages of the semi-arid area of North-East Brazil]

We determined the prevalence of intestinal parasite infections between 1993 and 1998 in the populations of a poor quarter of Recife (Pernambuco), in two townships in the sugar cane belt and in three villages of the semi-arid area far from the coast. Intestinal schistosomiasis was present in the sugar-growing area but was not observed in the populations inland that use dams to provide irrigation and fishing. Ascaris was very common in the city and the sugar cane belt and large numbers of hookworms were observed, especially in the sugar-growing area. These nematodes were very rare in the semi-arid area. This distribution probably results from both climatic conditions and human behavior. The high frequency of Amoeba cysts demonstrates that the peasants, farmers and fisherman living in these areas have poor hygiene practices. There are probably many, complex relationships between education, income, lifestyle and intestinal parasite infections.

Prognostic factors in non-Hodgkin lymphomas

CONTEXT

In Hodgkin's disease, each clinical or pathologic stage can be related to the extent of the area involved and predicts the next anatomical region at risk for tumor dissemination.

OBJECTIVE

To determine the best prognostic factors that could predict survival in non-Hodgkin lymphoma cases.

DESIGN

A retrospective study.

LOCATION

Department of Hematology and Transfusion Medicine, Universidade Federal de São Paulo - Escola Paulista de Medicina.

PARTICIPANTS

142 patients with non-Hodgkin lymphoma diagnosed between February 1988 and March 1993.

MAIN MEASUREMENTS

Histological subset, Sex, Age, Race, B symptoms, Performance status, Stage, Extranodal disease, Bulk disease, Mediastinal disease, CNS involvement, BM infiltration, Level of DHL, Immunophenotype.

RESULTS

In the first study (113 patients), the following variables had a worse influence on survival: yellow race (P<0.1); ECOG II, III e IV (P<0.1) and extranodal disease (P<0.1) for high grade lymphomas; constitutional symptoms (P<0.1), ECOG II, III e IV (P<0.1) and involvement of CNS (P<0.1) for intermediate grade and the subtype lymphoplasmocytoid (P=0.0186) for low grade lymphomas. In the second survey (93 patients), when treatment was included, the variables related to NHL survival were: CNS involvement (P<0.1) for high grade lymphomas, constitutional symptoms (P<0.1), ECOG II, III, IV (P=0.0185) and also CNS involvement (P<0.1) for the intermediate group. There were no variables related to the survival for low-grade lymphomas.

CONCLUSIONS

The intermediate grade lymphomas were more compatible with data found in the literature, probably because of the larger number of patients. In this specific case, the treatment did not have an influence on the survival.

[The use of peripheral blood progenitor cells as an autologous hematopoietic support in high-dose chemotherapy. I. The rationale and results]

We review the rationale for PBPC transplantation and the results reported in the literature. In order to prolong complete remissions and increase cure rates, high-dose chemotherapy is frequently used in the treatment of selected neoplasias. Hematological toxicity can be overcome by the infusion of autologous hemopoietic progenitors. Recently, peripheral blood is being used as the preferred source for hemopoietic progenitors, since it allows faster hematopoietic recoveries when compared to progenitors harvested from bone marrow. An adequate graft is defined by its content in clonogenic progenitors (mainly CFU-GM) and CD34 positive cells; these two parameters need to be accurately determined by specific laboratory methods. PBPC grafts are harvested using cell separators during leukaphereses; to increase efficiency, hemopoietic progenitors are first mobilized into the circulation with growth factors and or chemotherapy. PBSC transplantation may have procedure-associated toxicity related to the mobilization, harvest or reinfusion of the graft.

[The use of peripheral blood progenitor cells as an autologous hematopoietic support in high-dose chemotherapy. II. The experience of the Hematological Intensive Care Unit of the IPOFG. Franciso Gentil Portuguese Institute of Oncology]

We report the results of PBPC collection by large-volume leukaphereses and the hematologic recovery after high-dose chemotherapy supported by autologous PBPC reinfusion in a series of cancer patients treated at the Hematological Intensive Care Unit (UCHI) (Portuguese Institute of Oncology, Lisbon). Large volume leukaphereses were used to increase the efficacy of the PBPC collection. This modification of the standard apheresis technique allowed the harvesting, in only one session, of enough progenitors to proceed to transplantation in nearly 2/3 of patients and without significant toxicity. From December 1993 until September 1997, 95 autologous PBSC transplants were performed at the UCHI; 45% were performed in solid tumor patients and 55% in patients with hematologic malignancies. Hematologic recovery was similar to that published in the literature and related to the number of CD34+ cells infused. Patients supported with bone marrow in addition to PBPC showed delayed hematopoietic recovery, probably because the bone marrow harvest was only performed when an insufficient number of PBPC had been collected (2 x 10(6) CD34+ cells/Kg). The speed of hematological recovery differed per diagnosis, being higher in multiple myeloma and solid tumor patients and lower in Hodgkin's disease patients.

Expression of vitamin D receptor (VDR) in HL-60 cells is differentially regulated during the process of differentiation induced by phorbol ester, retinoic acid or interferon-gamma

The effects of three inducers of differentiation, phorbol myristate acetate (PMA), retinoic acid (RA) and interferon-gamma (IFN-gamma), on the temporal regulation of vitamin D receptor (VDR) expression in HL-60 cells were analyzed by Northern blotting and immunofluorescence assays. VDR, at the protein level, expressed by 81% of uninduced cells, was reduced to 57% after 48 h of PMA or 96 h of RA treatment, preceded by growth inhibition and cell differentiation, evaluated by CD11b expression. Sorted CD11b positive cells in G0/G1 phase exhibited 53% the VDR content of CD11b negative cells (distributed throughout the cell cycle). PMA also induced an increase in PKC beta and PKC alpha mRNA and protein. Simultaneous exposure to PMA and sphingosine blocked stimulation of CD11b and PKC expression without affecting growth arrest and VDR down regulation. Similar effects were observed during sphingosine treatment. In IFN-gamma differentiated cells, the proportion of cells in G0/G1 phase was unchanged and VDR protein was unaltered as compared to uninduced cells. Control cells in G0/G1 expressed less VDR than cells in S and G2/M phases (74% and 59% respectively). All results suggest that in HL-60 cells, reduction of VDR expression is related to growth inhibition rather than to the differentiation process.

Perinatal treatment with picrotoxin induces sexual, behavioral, and neuroendocrine changes in male rats

The effects of maternal exposure to picrotoxin (PT) during the prenatal and postnatal periods of sexual brain differentiation were studied. Behavioral (sexual behavior), physical (sexual maturation, body, and organ weights) and neurochemical (striatal and hypothalamic monoamine and respective metabolite levels) data were assessed in the offspring of PT-treated dams. The following results were obtained: 1) sexual maturation as measured by the day of testis descent and testis weight comparison was unchanged; 2) a decrease in male sexual behavior occurred, as well as a decrease in body, ductus deferens, and seminal vesicle weights and in plasma testosterone levels of adult male offspring; 3) striatal dopamine (DA) and homovanillic acid (HVA) levels were decreased and hypothalamic norepinephrine (NE) levels were increased. These results indicate that perinatal exposure to PT during the critical periods of male brain sexual differentiation has long-term effects on the reproductive physiology and behavior of male rats.

Risk factors for the occurrence of bancroftian filariasis infection in children living in endemic areas of northeast of Brazil

The objective of this study was to identify biological and social risk factors for the occurrence of microfilaraemia in a population of 1464 children of both sexes aged 5-14 years, living in two highly endemic areas of Recife a city in the northeast of Brazil. A survey was performed from December 1990 to July 1991 and the microfilaraemia was examined by the thick-drop technique using 45 microliters of peripheral blood. Information was obtained about use of bednet, length of time living in area and number of occupants per household. Risk was quantified by the crude and adjusted Odds Ratio. The 95 per cent confidence interval, Likelihood Ratio Statistics, and P value were used to test the statistical significance. An association was established between microfilaraemia in children and adolescents, and age, number of individuals per household, the presence of microfilaraemic adults in the household, length of time living in the area, and bednet use. Maternal microfilaraemia was not found to be a risk factor for the occurrence of microfilaraemia in offspring. These results allow the identification of children with a greater risk of microfilaraemia. In addition, these findings highlight the role of the household environment in the transmission process.

[Role of the process of endothelium formation on the wall of the aortic prosthesis in protection against infection. Experimental study in dogs]

An experimental canine model was developed in order to evaluate the role of endothelialization of aortic prostheses for protection against septicemic infection and the utilization of 131I radiolabeled bacteria for vascular experimentation. Two groups of dogs were submitted to insertion of a dacron prosthesis segment in the abdominal aorta with subsequent infusion of inert 131I radiolabeled bacteria. In the first group ("A"), formed by five dogs, the infusion was made 30 minutes after the insertion of the prosthesis and in the second group ("B"), formed by four dogs, in a new surgery performed 12 weeks after. Fragments of the animals' prostheses and aortas were collected after 30 minutes of septicemia and analyzed by scan electron microscopy and submitted to reading of radioactivity uptake by a well-type counter. The microscopy recognized a complete endothelialization of the prostheses of dogs of group "B" 12 weeks after their insertion. Statistical analysis comparing fragments of non-endothelialized prostheses, of endothelialized prostheses and aortas demonstrated that the lower radioactivity uptake of the endothelialized prostheses in relation to non-endothelialized ones was significant (p = 0.0143) and that there was no significant statistical difference in uptake in the aortas and in endothelialized prosthesis (p = 0.3173). It was, therefore, concluded that prosthesis endothelialization fully protected them against septicemic infection; bacteremia contaminated all the non-endothelialized prostheses; there was no bacterial adhesion in the endothelialized prostheses and the use of bacteria labeled with radioisotope 131I is appropriate for the study of infections in vascular prosthetic devices.

Large-volume leukaphereses may be more efficient than standard-volume leukaphereses for collection of peripheral blood progenitor cells

To overcome the need for multiple leukaphereses to collect enough PBPC for autologous transplantation, large-volume leukaphereses (LVL) are used to process multiple blood volumes per session. We compared the efficiency of CD34+ cell collection by LVL (n = 63; median blood volumes processed 11.1) with that of standard-volume leukaphereses (SVL) (n = 38; median blood volumes processed 1.9). To achieve this in patients with different peripheral blood concentrations of CD34+ cells, we analyzed the ratio of CD34+ cells collected per unit of blood volume processed, divided by the number of CD34+ cells in total blood volume at the beginning of apheresis. For LVL, 30% (9%-323%) of circulating CD34+ cells were collected per blood volume compared with 42% (7%-144%) for SVL (p = 0.02). However, in LVL patients, peripheral blood CD34+ cells/L decreased a median of 54% during LVL (similar data for SVL not available). The number of CD34+ cells collected per blood volume processed after 4 and 8 blood volumes and at the end of LVL were 0.32 (0.01-2.05), 0.24 (0.01-1.68), and 0.22 (0.01-2.40) x 10(6) CD34+ cells/kg, respectively (p = 0.0007), despite the 54% decrease in peripheral blood CD34+ cells/L throughout LVL. A median 66% decrease in the platelet count was also observed during LVL. Thus, LVL may be more efficient than SVL for PBPC collection, allowing, in most patients, the collection in one LVL of sufficient PBPC to support autologous transplantation.

Myelodysplastic syndromes (MDS): prognostic factors and scoring systems

OBJECTIVE

To evaluate the score systems of Cassano and Sanz and suggest a new one.

DESIGN

Case series.

LOCATION

Teaching hospitals: EPM UNIFESP and Faculdade de Medicina de Botucatu.

PARTICIPANTS

59 patients diagnosed from 1979 to 1992.

INTERVENTION

Evaluation of clinical-laboratorial data.

MEASUREMENT

Statistical comparison, uni and multivariate analysis and actuarial survival curves.

RESULTS

Cassano's system divided the patients into high and low risk (p = 0.0966) while Sanz's gave high, intermediate and low risk (p = 0.0108). The univariate analysis showed hemoglobin, WBC count, E/M ratio, liver size and blast percentage in BM as statistically significant. The multivariate analysis showed blast percentage in BM (p = 0.004) and Hb (p = 0.050) as significant. Our system, considering the multivariate analysis data, divided the patients into high, intermediate and low risk (p = 0.0038).

CONCLUSIONS

Sanz's system was more functional than Cassano's, while ours showed predictive survival value and ease of use in clinical practice.