Combined effect of physical exercise and hormone replacement therapy on cardiovascular and metabolic health in postmenopausal women: A systematic review and meta-analysis

The cardioprotective effect of postmenopausal hormone replacement therapy (HRT) has been demonstrated in several studies. Similarly, physical exercise has yielded positive results. However, the effects of their combination remain inconclusive. This review describes the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We searched the Scopus, Web of Science, PubMed, and Embase databases and included randomized controlled trials published up to December 2021 on the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We identified 148 articles, of which only seven met the inclusion criteria (386 participants; 91 [23%] HRT + exercise; 104 [27%] HRT; 103 [27%] exercise; 88 [23%] placebo). The combined treatment further decreased systolic blood pressure (SBP) compared to the isolated effect of aerobic training (AT) (mean difference [MD]=-1.69; 95% confidence interval [CI]=-2.65 to -0.72, n=73). Nevertheless, it attenuated the decrease in diastolic blood pressure (DBP) (MD=0.78; 95%CI: 0.22-1.35, n=73), and the increase in peak oxygen consumption (VO2 peak) promoted by exercise (AT + HRT=2.8±1.4 vs AT + placebo=5.8±3.4, P=0.02). The combination of AT and oral HRT improved SBP. However, AT alone seemed to have a better effect on physical fitness and DBP in postmenopausal women.

RuBPY decreases intracellular calcium by decreasing influx and increasing storage

RuBPY is a ruthenium complex NO donor that presents a nitrite in its moiety and has been shown to induce vasodilation in various arteries, as well as arterial pressure reduction with no changes in heart rate. Since vascular tone is highly dependent on the cytosolic calcium concentration ([Ca²⁺ ]c), the current study aimed to investigate the effects of RuBPY on the intracellular mobilization of calcium stores of rat aortic vascular smooth muscle cells. Vascular reactivity experiments were performed in isolated aortic rings that were contracted with a high concentration of KCl or phenylephrine (Phe). Moreover, primary cultured vascular smooth muscle cells were used to measure [Ca²⁺ ]c by confocal microscopy. The NO donor RuBPY decreased the [Ca²⁺ ]c and reduced KCl and Phe -induced contractile responses. The selective inhibitor of sarco-endoplasmic Ca-ATPase (SERCA) with thapsigargin impaired the effect of RuBPY on Phe -induced contractile response. RuBPY also reduced caffeine-induced contraction, and the contraction dependent on the capacitive Ca²⁺ influx. Therefore, our results suggest that NO released from RuBPY decreased [Ca²⁺ ]c by calcium influx blockade, and activation of guanylyl-cyclase-cGMP-GK pathway. These results indicate that RuBPY increases Ca²⁺ storage in the sarcoplasmic reticulum by SERCA activation, and also by capacitive Ca²⁺ influx inhibition, which is dependent on the intracellular release of nitric oxide from this compound. This article is protected by copyright. All rights reserved.

Gene-educational attainment interactions in a multi-ancestry genome-wide meta-analysis identify novel blood pressure loci

Educational attainment is widely used as a surrogate for socioeconomic status (SES). Low SES is a risk factor for hypertension and high blood pressure (BP). To identify novel BP loci, we performed multi-ancestry meta-analyses accounting for gene-educational attainment interactions using two variables, "Some College" (yes/no) and "Graduated College" (yes/no). Interactions were evaluated using both a 1 degree of freedom (DF) interaction term and a 2DF joint test of genetic and interaction effects. Analyses were performed for systolic BP, diastolic BP, mean arterial pressure, and pulse pressure. We pursued genome-wide interrogation in Stage 1 studies (N = 117 438) and follow-up on promising variants in Stage 2 studies (N = 293 787) in five ancestry groups. Through combined meta-analyses of Stages 1 and 2, we identified 84 known and 18 novel BP loci at genome-wide significance level (P < 5 × 10-8). Two novel loci were identified based on the 1DF test of interaction with educational attainment, while the remaining 16 loci were identified through the 2DF joint test of genetic and interaction effects. Ten novel loci were identified in individuals of African ancestry. Several novel loci show strong biological plausibility since they involve physiologic systems implicated in BP regulation. They include genes involved in the central nervous system-adrenal signaling axis (ZDHHC17, CADPS, PIK3C2G), vascular structure and function (GNB3, CDON), and renal function (HAS2 and HAS2-AS1, SLIT3). Collectively, these findings suggest a role of educational attainment or SES in further dissection of the genetic architecture of BP.

SCN5A compound heterozygosity mutation in Brugada syndrome: Functional consequences and the implication for pharmacological treatment

AIMS

SCN5A gene encodes the α-subunit of Na_v1.5, mainly found in the human heart. SCN5A variants are the most common genetic alterations associated with Brugada syndrome (BrS). In rare cases, compound heterozygosity is observed; however, its functional consequences are poorly understood. We aimed to analyze the functional impact of de novo Na_v1.5 mutations in compound heterozygosity in distinct alleles (G400R and T1461S positions) previously found in a patient with BrS. Moreover, we evaluated the potential benefits of quinidine to improve the phenotype of mutant Na⁺ channels in vitro.

MATERIALS AND METHODS

The functional properties of human wild-type and Na_v1.5 variants were evaluated using whole-cell patch-clamp and immunofluorescence techniques in transiently expressed human embryonic kidney (HEK293) cells.

KEY FINDINGS

Both variants occur in the highly conservative positions of SCN5A. Although all variants were expressed in the cell membrane, a significant reduction in the Na⁺ current density (except for G400R alone, which was undetected) was observed along with abnormal biophysical properties, once the variants were expressed in homozygosis and heterozygosis. Interestingly, the incubation of transfected cells with quinidine partially rescued the biophysical properties of the mutant Na⁺ channel.

SIGNIFICANCE

De novo compound heterozygosis mutations in SNC5A disrupt the Na⁺ macroscopic current. Quinidine could partially reverse the in vitro loss-of-function phenotype of Na⁺ current. Thus, our data provide, for the first time, a detailed biophysical characterization of dysfunctional Na⁺ channels linked to compound heterozygosity in BrS as well as the benefits of the pharmacological treatment using quinidine on the biophysical properties of Na_v1.5.

Evening preference correlates with regional brain volumes in the anterior occipital lobe

Chronotype or diurnal preference is a questionnaire-based measure influenced both by circadian period and by the sleep homeostat. In order to further characterize the biological determinants of these measures, we used a hypothesis-free approach to investigate the association between the score of the morningness-eveningness questionnaire (MEQ) and the Munich chronotype questionnaire (MCTQ), as continuous variables, and volumetric measures of brain regions acquired by magnetic resonance imaging (MRI). Data were collected from the Baependi Heart Study cohort, based in a rural town in South-Eastern Brazil. MEQ and anatomical 1.5-T MRI scan data were available from 410 individuals, and MCTQ scores were available from a subset of 198 of them. The average MEQ (62.2 ± 10.6) and MCTQ (average MSFsc 201 ± 85 min) scores were suggestive of a previously reported strong general tendency toward morningness in this community. Setting the significance threshold at P > .002 to account for multiple comparisons, we observed a significant association between lower MEQ score (eveningness) and greater volume of the left anterior occipital sulcus (β = -0.163, p = .001) of the occipital lobe. No significant associations were observed for MCTQ. This may reflect the smaller dataset for MCTQ, and/or the fact that MEQ, which asks questions about preferred timings, is more trait-like than the MCTQ, which asks questions about actual timings. The association between MEQ and a brain region dedicated to visual information processing is suggestive of the increasingly recognized fluidity in the interaction between visual and nonvisual photoreception and the circadian system, and the possibility that chronotype includes an element of masking.

Determinants of neonatal, postneonatal and maternal mortality on models of primary health

Background

The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil.

Methods

In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%.

Results

The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates.

Conclusions

It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model.

Key messages

Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.

Development and validation of the dental vulnerability scale in the primary health care setting

Background

Offering equitable access to dental care remains a challenge and methods to risk-stratify individuals to prioritize care could help to attain that goal. The interaction of multiple risk factors associated with oral disease vulnerability can outweigh protective factors conferring resilience and resistance to individuals and their communities; however, there is no validated instrument for measuring oral disease vulnerability. Hence, the objective of this study was to develop a Dental Vulnerability Scale (EVO) for primary health care (PHC) and evaluate its content validity and internal structure.

Methods

This was a psychometric study conducted in São Paulo, Brazil, in 2019. During content validation, 172 items were evaluated by a panel of 40 judges with diverse background and with the application of the Content Validity Ratio (CVR), considering a critical CVR value&gt; 0.26. During the internal structure evaluation, the EVO was applied to a sample of 1227 individuals in the PHC setting and the results were analyzed using Exploratory and Confirmatory Factor Analysis, in addition to the application of 3 reliability indicators (Cronbach's alpha, McDonald's Omega and Greatest Lower Bound).

Results

The CVR was 0.33 for relevance and 0.39 for clarity, resulting in 41 items. The final EVO was composed of 4 dimensions (general health, oral health, infrastructure and health services) with a total of 15 items. Factor loadings ranged from 0.37 to 0.96, with R-squared values ranging from 0.14 to 0.91. The reliability indicators values were α = 0.64, ω = 0.99 and GLB=0.82. The Goodness of fit were NNFI = 0,95, CFI = 0,98, GFI = 0,96 and AGFI = 0,97. The EVO instrument was considered valid to be used among oral health professionals in the PHC setting.

Conclusions

The EVO showed satisfactory psychometric properties and could be employed by health professionals and managers to plan actions and*inform* policies related to oral health.

Key messages

The EVO could be used to risk-stratify individuals in the PHC setting. The EVO could help to inform oral health policies.

Mitochondria, endoplasmic reticulum and innate immune dysfunction in mood disorders: Do Mitochondria-Associated Membranes (MAMs) play a role?

Mood disorders like major depression and bipolar disorder (BD) are among the most prevalent forms of mental illness. Current knowledge of the neurobiology and pathophysiology of these disorders is still modest and clear biological markers are still missing. Thus, a better understanding of the underlying pathophysiological mechanisms to identify potential therapeutic targets is a prerequisite for the design of new drugs as well as to develop biomarkers that help in a more accurate and earlier diagnosis. Multiple pieces of evidence including genetic and neuro-imaging studies suggest that mood disorders are associated with abnormalities in endoplasmic-reticulum (ER)-related stress responses, mitochondrial function and calcium signalling. Furthermore, deregulation of the innate immune response has been described in patients diagnosed with mood disorders, including depression and BD. These disease-related events are associated with functions localized to a subdomain of the ER, known as Mitochondria-Associated Membranes (MAMs), which are lipid rafts-like domains that connect mitochondria and ER, both physically and biochemically. This review will outline the current understanding of the role of mitochondria and ER dysfunction under pathological brain conditions, particularly in major depressive disorder (MDD) and BD, that support the hypothesis that MAMs can act in these mood disorders as the link connecting ER-related stress response and mitochondrial impairment, as well as a mechanisms behind sterile inflammation arising from deregulation of innate immune responses. The role of MAMs in the pathophysiology of these pathologies and its potential relevance as a potential therapeutic target will be discussed.

P1940Reciprocal regulation of Endothelial-Mesenchymal Transition by MAPK7 and EZH2 activity in Intimal Hyperplasia and Coronary Artery Disease

Introduction

Endothelial cells play a pivotal role in the formation of neointimal lesions by the acquisition of a fibro-proliferative phenotype through endothelial-to-mesenchymal transition (EndMT). Uniform laminar shear stress activates the mitogen-activated protein kinase 7 (MAPK7) which suppresses EndMT. It is elusive how MAPK7 activity is regulated in fibroproliferative disease. We recently found in intimal hyperplasia the signaling activity of MAPK7 is rapidly lost through the activation microRNA-374b.

The histone methyltransferase Enhancer of Zeste Homolog 2 (EZH2), which is the catalytic subunit of the Polycomb Repressive Complex 2, plays a pivotal role in endothelial dysfunction. EZH2 trimethylates lysine 27 on histone 3, which silences gene expression and is elevated in endothelial cells in atherosclerotic lesions. Here, we found the reciprocity that exists between MAPK7 and EZH2 in the regulation of EndMT and in human coronary artery stenosis.

Materials and results

In endothelial cells, activation of MAPK7 increases the expression of microRNA-101, which represses the expression of EZH2. Reciprocally, the loss of EZH2 coincides with a decreased expression of the Dual Specificity Phosphatase (DUSP)-1 and DUSP-6 – the phosphatases responsible for the dephosphorylation of MAPK7 - which facilitates the activation of MAPK7.

H3K27Me3, the repressive histone mark placed by EZH2, is abundantly present in the promoter regions of the miR-200b/a/429 and miR-200c/141 gene clusters, which are responsible for the loss of DUSP-1 and DUSP-6 expression. Endothelial cells deficient in EZH2 have reduced levels of H3K27Me3 at these gene promoters, which associates with the increased expression of miR-200b and miR-200c and concurrent increased MAPK7 activation. In endothelial cells with constitutively active MAPK7 signaling (MEK5D), the enrichment of H3K27Me3 at the promoter regions of miR-200b/a/429 (1.6-fold, p=0.034) and miR-200c/141 (1.9-fold, p=0.035) is decreased, suggesting that MAPK7 activation results in a decreased EZH2 activity. Disbalances in this reciprocal signaling circuit culminate in the induction of EndMT and associate to the severity of human coronary artery stenosis.

Conclusion

In summary, we show that in endothelial cells there is reciprocity between MAPK7 signaling and EZH2 expression and that disturbances in this reciprocal signaling circuit associate with the induction of EndMT and severity of human coronary artery stenosis. The reciprocity between MAPK7 and EZH2 is governed by a complex mechanism involving microRNAs and the phosphatases DUSP-1 and DUSP-6. Our study contributes to a better understanding of the molecular and epigenetic cascades that underlie EndMT during coronary artery stenosis and might identify novel targets for therapy.

Acknowledgement/Funding

Mongolian Government Scholarship #621

Thyrotropin and free thyroxine levels and coronary artery disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Data on the association between subclinical thyroid dysfunction and coronary artery disease (CAD) is scarce. We aimed to analyze the association between thyroid function and CAD using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We included subjects with normal thyroid function (0.4-4.0 mIU/L, and normal free thyroxine, FT4, or 0.8 to 1.9 ng/dL), subclinical hypothyroidism (SCHypo; TSH>4.0 mIU/L and normal FT4), and subclinical hyperthyroidism (SCHyper; TSH<0.4 mIU/L and normal FT4) evaluated by coronary computed tomography angiography. We excluded individuals using medications that interfere in thyroid function or with past medical history of cardiovascular disease. Logistic regression models evaluated the presence of CAD, segment involvement score (SIS) >4, and segment severity score (SSS) >4 of coronary arteries as the dependent variables, and quintiles of TSH and FT4 as the independent variables, adjusted for demographical data and cardiovascular risk factors. We included 767 subjects, median age 58 years (IQR=55-63), 378 (49.3%) women, 697 euthyroid (90.9%), 57 (7.4%) with SCHypo, and 13 (1.7%) with SCHyper. No association between TSH and FT4 quintiles and CAD prevalence was noted. Similarly, no association between TSH levels and the extent or severity of CAD, represented by SIS>4 and SSS>4 were seen. Restricting analysis to euthyroid subjects did not alter the results. TSH levels were not significantly associated with the presence, extent, or severity of CAD in a middle-aged healthy population.

-318C/T polymorphism of the CTLA-4 gene is an independent risk factor for RBC alloimmunization among sickle cell disease patients

Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) molecule is expressed on T-lymphocyte membrane and negatively influences the antigen-presenting process. Reduced expression of CTLA-4 due to gene polymorphisms is associated with increased risk of autoimmune disorders, whose physiopathology is similar to that of post-transfusion red blood cell (RBC) alloimmunization. Our goal was to evaluate if polymorphisms of CTLA-4 gene that affect protein expression are associated with RBC alloimmunization. This was a case-control study in which 134 sickle cell disease (SCD) patients and 253 non-SCD patients were included. All patients were genotyped for the polymorphisms 49A/G and -318C/T of CTLA-4 gene. The genotype frequency of -318C/T differed significantly between alloimmunized and nonalloimmunized SCD patients, irrespective of clinical confounders (p = .016). SCD patients heterozygous for -318T allele presented higher risk of alloantibody development (OR: 5.4, CI: 1.15-25.6). In conclusion, the polymorphism -318C/T of CTLA-4 gene is associated with RBC alloimmunization among SCD patients. This highlights the role played by CTLA-4 on post-transfusion alloantibody development.

A computational framework to characterize and compare the geometry of coronary networks

This work presents a computational framework to perform a systematic and comprehensive assessment of the morphometry of coronary arteries from in vivo medical images. The methodology embraces image segmentation, arterial vessel representation, characterization and comparison, data storage, and finally analysis. Validation is performed using a sample of 48 patients. Data mining of morphometric information of several coronary arteries is presented. Results agree to medical reports in terms of basic geometric and anatomical variables. Concerning geometric descriptors, inter-artery and intra-artery correlations are studied. Data reported here can be useful for the construction and setup of blood flow models of the coronary circulation. Finally, as an application example, similarity criterion to assess vasculature likelihood based on geometric features is presented and used to test geometric similarity among sibling patients. Results indicate that likelihood, measured through geometric descriptors, is stronger between siblings compared with non-relative patients. Copyright © 2016 John Wiley & Sons, Ltd.

Subclinical hypothyroidism is associated with higher carotid intima-media thickness in cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

BACKGROUND AND AIM

Although subclinical hypothyroidism (SCH) is associated with cardiovascular risk, there is scarce data about subclinical atherosclerosis in subjects with SCH. We aimed to analyze the association between SCH and carotid intima-media thickness (IMT) using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

METHODS AND RESULTS

We included subjects with normal thyroid function (TSH: 0.4-4.0 mIU/l, and normal free thyroxine (FT4): 0.8-1.9 ng/dl) and SCH (TSH ≥ 4.0 mIU/l and normal FT4) evaluated for IMT in a cross-sectional analysis. We excluded individuals using medications that affect thyroid function and those with a history of cardiovascular disease. We performed logistic and linear regression models to evaluate the association with IMT (mean values and categorized at the 75th percentile) as a dependent variable and SCH as an independent variable, adjusted for other cardiovascular risk factors. From 8623 subjects (median age of 50 years; interquartile range: 44-57), 4624 (53.6%) were women, 8095 (93.9%) were euthyroid, and 528 (6.1%) had SCH. Groups varied in age, body mass index, Framingham risk score, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), C-reactive protein, as well as, IMT, that were all higher in SCH compared to euthyroid participants. SCH is associated with IMT as a continuous variable (β = 0.010, P = 0.036) and IMT >75th percentile: OR = 1.30 (95% CI = 1.06-1.59) in logistic models.

CONCLUSION

Individuals with SCH presented higher IMT compared with euthyroid subjects, even after adjustment for potential confounders. IMT was independently associated with SCH in the baseline of the ELSA-Brasil study.

Stocking rate and monensin supplemental level effects on growth performance of beef cattle consuming warm-season grasses

The objective of this study was to evaluate the effects of monensin supplementation on animals receiving warm-season grass with limited supplementation. In Exp. 1, treatments were a factorial combination of 2 stocking rates (1.2 and 1.7 animal unit [AU] [500 kg BW]/ha) and supplementation with monensin (200 mg/d) or control (no monensin) distributed in a complete randomized design with 3 replicates. Thirty Angus × Brahman crossbred heifers (Bos taurus × Bos indicus) with initial BW of 343 ± 8 kg were randomly allocated into 12 bahiagrass (Paspalum notatum) pastures and supplemented with 0.4 kg DM of concentrate (14% CP and 78% TDN) daily for 86 d. Herbage mass (HM) and nutritive value evaluations were conducted every 14 d, and heifers were weighed every 28 d. There was no effect (P ≥ 0.97) of monensin on HM, herbage allowance (HA), and ADG; however, animals receiving monensin had greater (P = 0.03) plasma urea nitrogen (PUN) concentrations. The stocking rate treatments had similar HM in June (P = 0.20) and July (P = 0.18), but the higher stocking rate decreased (P < 0.01) HM and HA during August and September. Average daily gain was greater (P < 0.01) for the pastures with the lower stocking rate in August but not different in July and September (P ≥ 0.15). Gain per hectare tended to be greater on pastures with the higher stocking rate (P ≤ 0.06). In Exp. 2, treatments were 3 levels of monensin (125, 250, and 375 mg/animal per day) and control (no monensin) tested in a 4 × 4 Latin square with a 10-d adaptation period followed by 5 d of rumen fluid collection and total DMI evaluation. Blood samples were collected on d 4 and 5 of the collection period. Ground stargrass (Cynodon nlemfuensis) hay (11.0% CP and 52% in vitro digestible organic matter) was offered daily. The steers received the same supplementation regimen as in Exp. 1. Total DMI was not different among treatments (P = 0.64). There was a linear increase (P ≤ 0.01) in propionate and a tendency for decreased acetate (P ≤ 0.09) concentrations in the rumen with increasing levels of monensin; however, there was no effect (P ≥ 0.19) of monensin levels on ruminal pH and ruminal concentrations of butyrate and ammonia. In addition, there was no effect (P ≥ 0.73) of monensin levels on plasma concentrations of glucose, insulin, IGF-1, and PUN. In summary, monensin supplementation effects were not detected at either stocking rate and may not be effective in increasing performance of beef cattle grazing low-quality warm-season grasses with limited supplementation.

Mitochondrial and genomic ancestry are associated with etiology of heart failure in Brazilian patients

There is a high prevalence of heart failure (HF) in the general population, but it is more common in black people. We evaluated the association between genomic ancestry and mitochondrial haplogroups (mt-haplogroups) with HF etiology in 503 Brazilian patients. We elicited Mt-haplogroups by analyzing the control region of mitochondrial DNA, and genomic ancestry, by using 48 autosomal insertion-deletion ancestry informative markers. Hypertensive (28.6%, n=144) and ischemic (28.4%, n=143) etiologies of HF were the most prevalent herein. Our results showed that 233 individuals (46.3%) presented African mitochondrial (mt)-haplogroups, and the major contribution in the genomic ancestry analysis was the European ancestry (57.5% (±22.1%)). African mt-haplogroups were positively associated with a diagnosis of hypertensive cardiomyopathy (odds ratio, OR 1.55, confidence interval, CI 95% 1.04-2.44, P=0.04) when compared with European mt-haplogroups. Regarding the genomic ancestry, the African ancestry variant had higher risks (OR 7.84, 95% CI 2.81-21.91, P<0.001), whereas the European ancestry variant had lower risks (OR 0.14, 95% CI 0.04-5.00, P<0.001) for developing the hypertensive etiology. In addition, European ancestry showed an OR of 4.05 (CI 95% 1.53-10.74, P=0.005), whereas African ancestry showed an OR of 0.17 (CI 95% 0.06-0.48, P=0.001) for developing ischemic etiology. In conclusion, this study supports the importance of using ancestry informative markers and mitochondrial DNA to study the genetics of complex diseases in admixed populations to improve the management, treatment and prevention of these illnesses. Therefore, the ancestry informative markers and mt-haplogroups could provide new biomarkers to be associated with HF etiologies and be used as a premise for more specific management.

Diet and cannibalism in plainfin midshipman Porichthys notatus

The macroscopic and microscopic diversity of potential food items available in the nests of plainfin midshipman Porichthys notatus were quantified and compared with items that were found in the stomach and intestine (digestive tract) of the guarding males. In this species, males occur as one of two possible reproductive morphs: guarder males that care for young and sneaker males that parasitize the courtship and care of guarder males. Although it was predicted that guarder males would have fewer feeding opportunities due to their confinement to the nest, they in fact had more food items in their digestive tracts than did sneaker males and females. Date in the breeding season (a proxy of care duration) and body condition were not correlated with the amount of food consumed by guarder males. The main type of food consumed was P. notatus embryos; 69% of all guarder males sampled had cannibalized offspring. By comparing the diet of both sexes and tactics, this study sheds light on some of the strategies designed to cope with the costs of providing parental care.

Temporal variability of radon in a remediated tailing of uranium ore processing--the case of Urgeiriça (central Portugal)

Radon monitoring at different levels of the cover of the Urgeiriça tailings shows that the sealing is effective and performing as desired in terms of containing the strongly radioactive waste resulting from uranium ore processing. However, the analysis of the time series of radon concentration shows a very complex temporal structure, particularly at depth, including very large and fast variations from a few tens of kBq m(-3) to more than a million kBq m(-3) in less than one day. The diurnal variability is strongly asymmetric, peaking at 18 h/19 h and decreasing very fast around 21 h/22 h. The analysis is performed for summer and for a period with no rain in order to avoid the potential influence of precipitation and related environmental conditions on the radon variability. Analysis of ancillary measurements of temperature, relative humidity, wind speed and wind direction, as well as atmospheric pressure reanalysis data shows that the daily averaged radon concentration in the taillings material is anti-correlated with the atmospheric pressure and that the diurnal amplitude is associated with the magnitude of atmospheric pressure daily oscillations.

Effect of particles of ashes produced from sugarcane burning on the respiratory system of rats

The practice of burning sugarcane obtained by non-mechanized harvesting exposes workers and the people of neighboring towns to high concentrations of particulate matter (PM) that is harmful to health, and may trigger a series of cardiorespiratory diseases. The aim of this study was to analyze the chemical composition of the micro-particles coming from sugarcane burning residues and to verify the effects of this micro-particulate matter on lung and tracheal tissues. Micro-particulate matter (PM10) was obtained by dissolving filter paper containing burnt residues in NaCl solution. This material was instilled into the Wistar rats' nostrils. Histological analyses (hematoxylin and eosin - HE) of cardiac, lung and tracheal tissues were performed. Inflammatory mediators were measured in lung tissues by using ELISA. The chemical composition of the particulate material revealed a large quantity of the phthalic acid ester, high concentrations of phenolic compounds, anthracene and polycyclic aromatic hydrocarbons (PAH). Histological analysis showed a reduction in subjacent conjunctive tissue in the trachea, lung inflammation with inflammatory infiltrate formation and reduction of alveolar spaces and a significant increase (p<0.05) in the release of IL-1α, IL-1β, IL-6, and INF-γ in the group treated with PM10 when compared to the control group. We concluded that the burning sugarcane residues release many particles, which have toxic chemical compounds. The micro-particulate matter can induce alterations in the respiratory system.

Haplotype diversity in mitochondrial DNA hypervariable region in a population of southeastern Brazil

Brazilian population derives from Native Amerindians, Europeans, and Africans. Southeastern Brazil is the most populous region of the country. The present study intended to characterize the maternal genetic ancestry of 290 individuals from southeastern (Brazil) population. Thus, we made the sequencing of the three hypervariable regions (HV1, HV2, and HV3) of the mitochondrial DNA (mtDNA). The statistical analyses were made using Arlequin software, and the median-joining haplotype networks were generated using Network software. The analysis of three hypervariable regios showed 230 (79.3 %) unique haplotypes and the most common haplotype was "263G" carried by 12 (4.1 %) individuals. The strikingly high variability generated by intense gene flow is mirrored in a high sequence diversity (0.9966 ± 0.0010), and the probability of two random individuals showing identical mtDNA haplotypes were 0.0068. The analysis of haplogroup distribution revealed that 36.9 % (n = 107) presented Amerindian haplogroups, 35.2 % (n = 102) presented African haplogroups, 27.6 % (n = 80) presented European haplogroups, and one (0.3 %) individual presented East Asian haplogroup, evidencing that the southeastern population is extremely heterogeneous and the coexistence of matrilineal lineages with three different phylogeographic origins. The genetic diversity found in the mtDNA control region in the southeastern Brazilian population reinforces the importance of increased national database in order to be important and informative in forensic cases.

Relação entre a etnia auto-declarada, haplogrupo mitocondrial e ancestralidade genômica em indivíduos do sudeste brasileiro

Em populações onde há um alto grau de miscigenação, como no Brasil, o uso exclusivo de informações da etnia auto-declarada não é um bom método de classifi cação étnica. Neste trabalho, nós avaliamos a relação entre as etnias auto-declaradas com ancestralidade genômica e haplogrupos mitocondriais em 492 indivíduos do Sudeste Brasileiro. Haplogrupos mitocondriais foram obtidos pela análise das regiões hipervariáveis do DNA mitocondrial (mtDNA) e a ancestralidade genômica foi obtida utilizando 48 marcadores autossômicos informativos de ancestralidade (AIM). Dos 492 indivíduos, 74,6% se auto-declararam brancos, 13,8% pardos e 10,4% pretos. Em relação aos haplogrupos mitocondriais, 46,3% apresentaram mtDNA Africano e a maior contribuição de ancestralidade genômica foi Europeia (57,4%). Quando realizamos a distribuição do mtDNA e ancestralidade genômica de acordo com as etnias auto-declaradas, dos 367 indivíduos auto-declarados brancos, encontramos 37,6% com mtDNA Africano, sendo observado maior contribuição de ancestralidade Europeia (63,3%). Dos 68 indivíduos auto-declarados pardos, 25% apresentaram mtDNA Ameríndio e pouca diferen-ça na contribuição de ancestralidade Europeia e Africana. Dos 51 indivíduos auto-declarados pretos, 80,4% apresentaram mtDNA Africano e maior contribuição de ancestralidade Africana (55,6%). A população brasileira apresenta uma uniformidade de ancestralidade genômica Ameríndia, e apenas o uso de marcadores genéticos (autossômico e mitocondrial) foi capaz de capturar essa informação. Sugerimos que estudos epidemiológicos façam o uso associado destes métodos, pois poderiam fornecer informações complementares.

Role of serotonin 1A receptors in the median raphe nucleus on the behavioral consequences of forced swim stress

Despite the intense research on the neurobiology of stress, the role of serotonin (5-HT)1A receptors still remains to be elucidated. In the hippocampus, post-synaptic 5-HT1A receptors activation induces anxiolytic effects in animals previously exposed to stressful situations. However, little is known about somatodendritic 5-HT1A receptors in the median raphe nucleus (MRN). Therefore, the aim of this study was to investigate the role of 5-HT1A receptors located in the MRN in rats exposed to forced swim stress. After recovering from surgery, rats were forced to swim for 15 min in a cylinder. Intra-MRN injections of saline, 8-OH-DPAT (3 nmol/0.2 µL) and/or WAY-100635 (0.3 nmol/0.2 µL) were performed immediately before or after pre-exposure or 24 h later (immediately before test). Non-stressed rats received the same treatment 24 h or 10 min before test. Our data showed that 8-OH-DPAT increased latency to display immobility while decreasing time spent immobile in almost all experimental conditions. These effects were not prevented by previous treatment with WAY-100635. No effects of different treatments were described in non-stressed animals. Taken together, our data suggest that in addition to activation of 5-HT1A, 5-HT7 receptors may also be involved in the behavioural consequences of exposure to swim stress.

Enantiomeric HPLC resolution and absolute stereochemistry assignment of a new poligamain derivative

A new aryltetralin lignan derivative, 1, was obtained by reacting dimethyl succinate and piperonal, furnishing the lactone 4-(3',4'-methylenedioxybenzyl)-4,5-dihydro-2(3H)-furanone, which was reacted once again with piperonal and LDA to give the dibenzylbutirolactone 7-hydroxyhinokinin. The cyclization of 7-hydroxyhinokinin into polygamain occurred in the presence of trifluoroacetic acid. The reduction of the furanic ring of polygamain was done by its reaction with DIBAL in THF, furnishing the diol functionalized lignin derivative 1 as single diastereomer. The enantiomeric fractions of 1 were obtained by preparative enantioselective HPLC. The absolute stereochemistry was assigned by electronic circular dichroism (ECD) and nuclear magnetic resonance (NMR) spectroscopy. An all-trans relative configuration was determined by NMR on the bases of ¹H coupling constants and nuclear Overhauser effect (n.O.e.) experiments. The absolute configuration at C1 was assigned on the basis of the ECD sign at 296 nm by comparison to the ECD spectra of structural analogues with defined stereochemistry. The assignment of the absolute configuration was confirmed by applying the exciton chirality method to the well-defined ECD couplets at 285 and 200 nm allied to the two electronic transitions L(b) and B(b) of the aromatic moieties, respectively. Rac-1 and its enantiomeric isomers were evaluated against important bacteria responsible for dental caries. The best results obtained for the (1R,2S,3S) isomer were against Streptococcus mutans (250 μM), Streptococcus salivarius (250 μM), Streptococcus sobrinus (280 μM) and Streptococcus mitis (280 μM). The (1S,2R,3R) isomer was active only against Streptococcus sanguinis (280 μM). The enantiomeric mixture was less active than the (1R,2S,3S) isomer.

CYBA C242T polymorphism is associated with obesity and diabetes mellitus in Brazilian hypertensive patients

AIMS

The CYBA C242T polymorphism has been associated with cardiovascular phenotypes such as hypertension and atherosclerosis, but available data are conflicting. This report investigated the impact of this variant on hypertension and metabolic determinants of cardiovascular risk in a large Brazilian sample.

METHODS

We cross-sectionally evaluated 1856 subjects (826 normotensive subjects and 1030 hypertensive patients) by clinical history, anthropometry, laboratory analysis and genotyping of the CYBA C242T polymorphism.

RESULTS

Genotype frequencies in the whole population were consistent with the Hardy-Weinberg equilibrium and genotype distributions were not different between hypertensive and normotensive subjects. Hypertensive patients with the CC genotype presented lower fasting plasma glucose levels (5.9 ± 0.1 vs. 6.2 ± 0.1 mmol/l, P = 0.020) and waist circumference (94.5 ± 0.6 vs. 96.3 ± 0.6 cm, P = 0.028) than CT + TT ones. Similarly, the prevalence of diabetes mellitus and obesity was also lower in hypertensive patients carrying the CC genotype (16% vs. 21%, P = 0.041; 36% vs. 43%, P = 0.029, respectively). In addition, multiple and logistic regression analysis demonstrated that the CYBA C242T polymorphism was associated with glucose levels, waist circumference, obesity and diabetes mellitus in hypertensive patients independently of potential confounders. Conversely, in normotensive subjects, no significant difference in studied variables was detected between the genotype groups.

CONCLUSIONS

These data suggest that the T allele of the CYBA C242T polymorphism may be used as a marker for adverse metabolic features in Brazilian subjects with systemic hypertension.

Variations in caries diagnoses and treatment recommendations and their impacts on the costs of oral health care

OBJECTIVE

To evaluate the reproducibility of caries detection and treatment planning among public health dentists and estimate the possible impact of their decisions on financial costs. RESEARCH DESIGN AND SETTINGS: Thirty nine dentists working in the public health service of Piracicaba, São Paulo, Brazil made a combined visual-radiographic caries examination of 40 occlusal surfaces of extracted permanent teeth mounted on two dental mannequins and proposed treatment plans for each tooth. Histological validation then evaluated the diagnoses validity and the suitability of the treatment plans.

OUTCOME MEASURES

Inter-examiner agreement was calculated by Cohen's Kappa statistics. The sensitivity and specificity of caries detection and treatment decision were calculated. The costs of dental treatment plans for public health system were calculated from a Brazilian public health service fee scale.

RESULTS

Inter-examiner agreement for caries detection was moderate (kappa = 0.42) while for treatment decisions it was fair (kappa = 0.29). The sensitivity and specificity were 0.69 and 0.65 for caries detection and 0.56 and 0.65 for treatment decision respectively. Dentists overestimated the presence and depth of carious lesions and there was a tendency to treat enamel lesions using invasive therapeutic procedures. Mean treatment cost across the two cases was 32US$ (range 9-65) while the histologically validated cost was 23US$.

CONCLUSION

The variability in caries detection and treatment decision negatively affected the cost of the dental treatment.

Anthropization on the Cerrado biome in the Brazilian Uruçuí-Una Ecological Station estimated from orbital images

In this study we analysed the dynamics of deforestation and burnings during the dry seasons from 2003 to 2008 in the Uruçuí-Una Ecological Station (UUES) and its buffer zone, located in the Cerrado biome of the southwest of Piauí, a Brazil's State, based on images from the orbital sensors CCD/CBERS-2 and TM/Landsat-5. Two dates from each of the years were interpreted and analysed: one in the middle of the dry season and one at the end. The deforested areas were expanded through the period analysed and were larger in the buffer zone, suggesting a relative protection of the UUES. New cut-offs were predictable because of the early opening of roads that would become their limits. The burning scars were larger at the end of the dry season as a consequence of the management and implementation of agricultures and pastures. In 2004 and 2007 these scars were larger probably because of the increase of dry phytomass that every three years is big enough to spread the fire originated in the anthropogenic burnings through the native vegetation. This scenario reaffirms the need for: stronger enforcement in order to stop anthropisation in the UUES and a management plan, absent for this unit so far. These proceedings are urgent also because the UUES is located in one of the most preserved regions of the Cerrado and controversially where intense anthropisation in ongoing, which stresses the lack, need and urgency of biological conservation proceedings for the Piauí's southeastern Cerrado.

Schistosomicidal and trypanocidal structure-activity relationships for (±)-licarin A and its (-)- and (+)-enantiomers

(±)-Licarin A (1) was obtained by oxidative coupling, and its enantiomers, (-)-licarin A (2) and (+)-licarin A (3), were resolved by chiral HPLC. Schistosomicidal and trypanocidal activities of these compounds were evaluated in vitro against Schistosoma mansoni adult worms and trypomastigote forms of Trypanosoma cruzi. The racemic mixture (1) displayed significant schistosomicidal activity with an LC₅₀ value of 53.57 μM and moderate trypanocidal activity with an IC₅₀ value of 127.17 μM. On the other hand, the (-)-enantiomer (2), displaying a LC₅₀ value of 91.71 μM, was more active against S. mansoni than the (+)-enantiomer (3), which did not show activity. For the trypanocidal assay, enantiomer 2 showed more significant activity (IC₅₀ of 23.46 μM) than enantiomer 3, which showed an IC₅₀ value of 87.73 μM. Therefore, these results suggest that (±)-licarin A (1) and (-)-licarin A (2) are promising compounds that could be used for the development of schistosomicidal and trypanocidal agents.

Development of an auxiliary resource for diagnosis of dental caries in epidemiological surveys

OBJECTIVE

Early dental caries diagnosis within the changing global pattern of dental caries development requires the use of auxiliary resources and adjuncts to diagnosis. The aim of this study was to introduce an alternative resource for drying teeth to enable early diagnosis of dental caries in epidemiological surveys.

METHODS

Polyurethane tips and three-in-one syringes were fitted to nebulizers and non-professional portable compressors for dental surface drying. The output air pressure of these sets was compared with the output pressure from the three-in-one syringe in a dental office.

RESULTS

Although the output pressure from the alternative resources was lower than the output pressure from the dental office equipment, the dental surfaces were dried satisfactorily, allowing the early diagnosis of the dental caries.

CONCLUSION

When a dental setting is not available, these alternative resources for drying teeth can be used satisfactorily.

Productivity, utilization, and nutritive quality of dallisgrass (Paspalum dilatatum) as influenced by stocking density and rest period under continuous or rotational stocking

Dallisgrass (Paspalum dilatatum) is well adapted to the Black Belt physiographic region of the southeastern United States, and information on its productivity and nutritive quality as influenced by grazing management is needed. In a 2-yr grazing experiment, replicate 0.40-ha paddocks in established dallisgrass pasture were continuously stocked, or replicate 0.40-ha paddocks were subdivided into two 0.20-ha (RS2), three 0.13-ha (RS3), or four 0.10-ha (RS4) cells and rotationally stocked with yearling beef steers. Individual cells within the RS2, RS3, and RS4 treatments were stocked for 7 d followed by 7, 14, or 21 d of rest, respectively. In 2007, 3 Angus × Simmental crossbred steers (initial BW, 354 ± 6 kg) were assigned randomly to each paddock on July 16; in 2008, 3 Angus × Simmental crossbred steers (initial BW, 310 ± 6 kg) were assigned randomly to each paddock on July 14. In 2007, there was no effect (P = 0.25) of stocking treatment on ADG. Steers grazing RS4, RS2, and continuously stocked paddocks had 106 (P = 0.01), 86 (P = 0.03), and 83 (P = 0.03) kg greater total BW gain per ha, respectively, than steers grazing RS3 paddocks. In 2008, there were no differences among treatments in ADG (P = 0.43) or total BW gain per ha (P = 0.90). Correlation and regression analyses revealed positive associations between steer performance and forage concentration of CP, areal mass (kg/ha) of forage DM, and areal mass of forage CP. Results indicate that productivity and quality of dallisgrass for stocker cattle production were comparable between continuous and rotational-stocking methods.

IFNG +874 T>A single nucleotide polymorphism is associated with leprosy among Brazilians

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, a low virulence mycobacterium, and the outcome of disease is dependent on the host genetics for either susceptibility per se or severity. The IFNG gene codes for interferon-γ (IFN-γ), a cytokine that plays a key role in host defense against intracellular pathogens. Indeed, single nucleotide polymorphisms (SNPs) in IFNG have been evaluated in several genetic epidemiological studies, and the SNP +874T>A, the +874T allele, more specifically, has been associated with protection against infectious diseases, especially tuberculosis. Here, we evaluated the association of the IFNG locus with leprosy enrolling 2,125 Brazilian subjects. First, we conducted a case-control study with subjects recruited from the state of São Paulo, using the +874 T>A (rs2430561), +2109 A>G (rs1861494) and rs2069727 SNPs. Then, a second study including 1,370 individuals from Rio de Janeiro was conducted. Results of the case-control studies have shown a protective effect for +874T carriers (OR(adjusted) = 0.75; p = 0.005 for both studies combined), which was corroborated when these studies were compared with literature data. No association was found between the SNP +874T>A and the quantitative Mitsuda response. Nevertheless, the spontaneous IFN-γ release by peripheral blood mononuclear cells was higher among +874T carriers. The results shown here along with a previously reported meta-analysis of tuberculosis studies indicate that the SNP +874T>A plays a role in resistance to mycobacterial diseases.

The effects of dimensionality on electrochemical sensors based on carbon nanotubes and metallic nanowires

Electrochemistry based unidimensional nanoelectrodes, such as carbon nanotubes and metallic nanowires, is now a reality that is leaving the academy and reaching a broad range of high-tech companies around the world. The intrinsic properties of electron-electron interactions, sizes and geometries significantly differentiate those nanostructures from conventional macroelectrodes or electrodes with sizes in a millimetric range. The inherent properties as well as the configuration of carbon nanotubes and metallic nanowires as electrochemical sensors are the main focus of this review. Applications and some future trends on developing of a clear pathway for assembly and integration of these into functional materials, are summarized as well.

Optimization of (131)I doses for the treatment of hyperthyroidism

Several methods can be used to determine the activity of (131)I in the treatment of hyperthyroidism. However, many of them do not consider all the parameters necessary for optimum dose calculation. The relationship between the dose absorbed by the thyroid and the activity administered depends basically on three parameters: organ mass, iodine uptake and effective half-life of iodine in the thyroid. Such parameters should be individually determined for each patient in order to optimize the administered activity. The objective of this work is to develop a methodology for individualized treatment with (131)I in patients with hyperthyroidism of the Grave's Disease. A neck-thyroid phantom developed at the IRD was used to calibrate a scintillation camera and a uptake probe SCT-13004 at the Nuclear Medicine Center of the University Hospital of Rio de Janeiro and a uptake probe SCT-13002, available at the Nuclear Medicine Institute in Goiânia. The biokinetic parameters were determined based on measurements performed in eight voluntary patients. It is concluded that the use of the equipment available at the hospital (scintillation camera and uptake probe) has shown to be a suitable and feasible procedure for dose optimization in terms of effectiveness, simplicity and cost.

Further delineation of the 15q13 microdeletion and duplication syndromes: a clinical spectrum varying from non-pathogenic to a severe outcome

BACKGROUND

Recurrent 15q13.3 microdeletions were recently identified with identical proximal (BP4) and distal (BP5) breakpoints and associated with mild to moderate mental retardation and epilepsy.

METHODS

To assess further the clinical implications of this novel 15q13.3 microdeletion syndrome, 18 new probands with a deletion were molecularly and clinically characterised. In addition, we evaluated the characteristics of a family with a more proximal deletion between BP3 and BP4. Finally, four patients with a duplication in the BP3-BP4-BP5 region were included in this study to ascertain the clinical significance of duplications in this region.

RESULTS

The 15q13.3 microdeletion in our series was associated with a highly variable intra- and inter-familial phenotype. At least 11 of the 18 deletions identified were inherited. Moreover, 7 of 10 siblings from four different families also had this deletion: one had a mild developmental delay, four had only learning problems during childhood, but functioned well in daily life as adults, whereas the other two had no learning problems at all. In contrast to previous findings, seizures were not a common feature in our series (only 2 of 17 living probands). Three patients with deletions had cardiac defects and deletion of the KLF13 gene, located in the critical region, may contribute to these abnormalities. The limited data from the single family with the more proximal BP3-BP4 deletion suggest this deletion may have little clinical significance. Patients with duplications of the BP3-BP4-BP5 region did not share a recognisable phenotype, but psychiatric disease was noted in 2 of 4 patients.

CONCLUSIONS

Overall, our findings broaden the phenotypic spectrum associated with 15q13.3 deletions and suggest that, in some individuals, deletion of 15q13.3 is not sufficient to cause disease. The existence of microdeletion syndromes, associated with an unpredictable and variable phenotypic outcome, will pose the clinician with diagnostic difficulties and challenge the commonly used paradigm in the diagnostic setting that aberrations inherited from a phenotypically normal parent are usually without clinical consequences.

TCF7L2 variant genotypes and type 2 diabetes risk in Brazil: significant association, but not a significant tool for risk stratification in the general population

Background

Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population.

Methods

We genotyped the single nucleotide polymorphisms (SNP) rs7903146 of the TCF7L2 gene in 560 patients with known coronary disease enrolled in the MASS II (Medicine, Angioplasty, or Surgery Study) Trial and in 1,449 residents of Vitoria, in Southeast Brazil. The associations of this gene variant to diabetes risk and metabolic characteristics in these two different populations were analyzed. To access the potential benefit of using this marker for diabetes risk prediction in the general population we analyzed the impact of this genetic variant on a validated diabetes risk prediction tool based on clinical characteristics developed for the Brazilian general population.

Results

SNP rs7903146 of the TCF7L2 gene was significantly associated with type 2 diabetes in the MASS-II population (OR = 1.57 per T allele, p = 0.0032), confirming, in the Brazilian population, previous reports of the literature. Addition of this polymorphism to an established clinical risk prediction score did not increased model accuracy (both area under ROC curve equal to 0.776).

Conclusion

TCF7L2 rs7903146 T allele is associated with a 1.57 increased risk for type 2 diabetes in a Brazilian cohort of patients with known coronary heart disease. However, the inclusion of this polymorphism in a risk prediction tool developed for the general population resulted in no improvement of performance. This is the first study, to our knowledge, that has confirmed this recent association in a South American population and adds to the great consistency of this finding in studies around the world. Finally, confirming the biological association of a genetic marker does not guarantee improvement on already established screening tools based solely on demographic variables.

Risk indicators of dental caries in 5-year-old Brazilian children

OBJECTIVE

To report the prevalence and severity of dental caries and to identify caries risk indicators among gender, clinical and socioeconomic variables in 5-year-old children attending preschools in Piracicaba, Brazil, in 2005.

METHOD

The random sample consisted of 728 subjects attending public and private preschools that were examined by a calibrated dentist. Dental caries was measured using WHO criteria. The socioeconomic variables (type of school, monthly family income, number of people living in the household, parents' educational level and home ownership) were collected by means of a parental semi structured questionnaire.

RESULTS

The mean dmft was 1.30 (SD=2.47); 62.2% were caries-free. The multiple logistic regression analyses showed that the risk indicators of caries were father's incomplete college education and presence of initial lesion.

CONCLUSIONS

The prevalence of dental caries in 5-year-old preschool attenders in Piracicaba was moderate, and father's educational status below undergraduate level, as well as presence of initial lesions, were risk indicators of the disease.

Frequency of 22q11.2 microdeletion in sporadic non-syndromic tetralogy of Fallot cases

BACKGROUND

Tetralogy of Fallot (TOF) is a congenital conotruncal heart defect commonly found in DiGeorge (DGS) and velocardiofacial (VCFS) syndromes. The deletion of chromosome 22q11 has also been demonstrated in sporadic or familial cases of TOF. The aim of the present study was to investigate the frequency of del22q11 in patients with non-syndromic TOF seen at a tertiary Pediatric Cardiology care center.

METHOD

One hundred and twenty three non-syndromic TOF patients were selected and evaluated by history, physical examination and review of medical records. Venous blood was drawn for genomic DNA extraction after informed consent 22q11 microdeletion diagnosis was conducted through a standardized SNP genotyping assay and consecutive homozygosity mapping. Phenotype-genotype correlations regarding cardiac anatomy were conducted.

RESULTS

We evaluated 123 non-syndromic TOF patients for a 22q11 deletion. 105 (85.4%) patients presented pulmonary stenosis and 18 (14.6%) had pulmonary atresia. Eight patients (6.5%) were found to have a deletion. Of the deleted patients, three (37.5%) presented pulmonary atresia. We have verified a tendency towards a higher prevalence of pulmonary atresia when comparing TOF patients with and without 22q11 microdeletion.

CONCLUSIONS

22q11.2 deletion in non-syndromic TOF patients is present in approximately 6% of patients. We suggest a tendency towards a higher prevalence of pulmonary atresia in non-syndromic TOF patients with 22q11 microdeletion. Molecular genetic screening of non-syndromic TOF patient may be important for the correct care of these patients and a more specific genetic diagnostic and counseling.