Social support in the healthcare of women submitted to breast cancer treatment

This study aimed to verify the prevalence of low social support (LSS) and associated factors in women submitted to breast cancer (BC) treatment. A cross-sectional study was carried out with 101 female residents of the municipality of Natal (Northeast Brazil), diagnosed with BC and submitted to oncological treatment. Data collection took place between July/2015 and May/2016 from medical records and individuals' interviews, and from the Medical Outcome Study-Social Support Survey. Descriptive, bivariate and multivariate statistics were carried out through Poisson's regression with robust variance and significance level 0.05. Prevalence of LSS in women with BC was 22.8% with confidence interval 14.6-39.94. Type of access to public services (p < .03), prevalence ratio (PR) 1.84 and negative self-rated health (p < .001), PR 4.47 were associated with LSS. These results were obtained after adjustments by the variables age and presence of chronic diseases. The associations established herein could have been mostly related to fragilities of the Brazilian health system, and can contribute to the planning of actions directed to the studied population.

Body Image of Women Submitted to Breast Cancer Treatment

Background: The study of body image includes the perception of women regarding the physical appearance of their own body. The objective of the present study was to verify the prevalence of body image dissatisfaction and its associated factors in women submitted to breast cancer treatment. Methods: A cross-sectional study carried out with 103 female residents of the municipality of Natal (Northeast Brazil), diagnosed with breast cancer who had undergone cancer treatment for at least 12 months prior to the study, and remained under clinical monitoring. The variable body image was measured through the validated Body Image Scale (BIS). Socioeconomic variables and clinical history were also collected through an individual interview with each participant. The Pearson’s chi-squared test (Fisher’s Exact) was utilized for bivariate analysis, calculating the prevalence ratio with 95% confidence interval. Poisson regression with robust variance was utilized for multivariate analysis. The statistical significance considered was 0.05. Results: The prevalence of body image dissatisfaction was 74.8% CI (65%-82%). Statistically significant associations were observed between body image and multi-professional follow-up (p=0.009) and return to employment after treatment (p=0.022). Conclusion: It was concluded that women who reported employment after cancer treatment presented more alterations in self-perception concerning their appearance. Patients who did not receive multi-professional follow-up reported negative body image, evidencing the need for strategies that increase and improve healthcare, aiming to meet the demands of this population.

DRAIN AMYLASE ON THE FIRST POSTOPERATIVE DAY OF WHIPPLE SURGERY: WHAT VALUE IS THE BEST PREDICTOR FOR EARLY DRAIN REMOVAL?

BACKGROUND

The value of drain amylase on the first postoperative day after pancreatic resections has been described as an efficient predictor of pancreatic fistula. In spite of this, the cut-off point below which the drains can be removed early remains controversial.

AIM

Validate the use of the amylase on the 1st postoperative day in the correlation with pancreatic fistula and define the value at which early drain removal is safe.

METHOD

Were included patients undergoing Whipple surgery in the period of 2007 to 2016. Group 1 enrolled the ones who did not develop fistula and those who developed biochemical fistula for less than seven days postoperatively and group 2 included patients who developed persistent biochemical fistula between seven and 21 days and those with grade B and C fistula.

RESULTS

Sixty-one patients were included, 41 comprised group 1 and 20 group 2. The incidence of abdominal collections, need for reoperation and time of hospitalization were for group 1 and 2, respectively: 17.1%, 17.1% and 9.5 days, and 65%, 40% and 21.1 days. The median of the amylase from the drain at 1st postoperative day was in group 1 and 2, respectively: 175 U/l and 3172.5 U/l (p=0.001). Using a cut-off of 180 to predict the group to which the patient would belong there was obtained sensitivity, specificity, positive predictive value and negative predictive value of 100%, 48.8%, 50% and 100% respectively.

CONCLUSION

It was validated the cut-off value of 180 U/l as appropriate to early drain removal.

Functional Disability in Women Submitted to Breast Cancer Treatment

The objective of the study presented herein was to verify the prevalence of functional disability and its associated factors in women submitted to breast cancer treatment. A cross-sectional study was carried out, in 101 women diagnosed with malignant breast cancer neoplasm, who underwent cancer treatment at least 12 months before the study, and remained under clinical monitoring. Functional disability was measured by the DASH instrument. Data collection included variables related to socioeconomic characteristics, life habits, health conditions, clinical tumor characteristics and therapeutic approach. Bivariate analysis was carried out by Pearson’s chi-square test or Fisher’s exact test, calculating the prevalence ratio with a 95% confidence interval. Multivariate analysis utilized Poisson’s Regression with robust variance. A statistical significance of 0.05 was considered. Prevalence of functional disability in the studied sample was 22.8% (CI95% 13.9-31.6). Functional disability was statistically significantly associated with age (p = 0.035) and access to health services (p = 0.028). It was concluded that younger patients suffered higher impact of breast cancer treatment on disability. Regarding access to health services, women that received public clinical monitoring reported higher occurrences of functional disability. This pointed towards the necessity of more organized, less bureaucratic, and effective health services in the assistance network, directed to the minimization of the impacts of cancer treatment on health and life conditions of breast cancer survivors.

Chemical characterization of atmospheric particles and source apportionment in the vicinity of a steelmaking industry

The objective of this work was to provide a chemical characterization of atmospheric particles collected in the vicinity of a steelmaking industry and to identify the sources that affect PM10 levels. A total of 94 PM samples were collected in two sampling campaigns that occurred in February and June/July of 2011. PM2.5 and PM2.5-10 were analyzed for a total of 22 elements by Instrumental Neutron Activation Analysis and Particle Induced X-ray Emission. The concentrations of water soluble ions in PM10 were measured by Ion Chromatography and Indophenol-Blue Spectrophotometry. Positive Matrix Factorization receptor model was used to identify sources of particulate matter and to determine their mass contribution to PM10. Seven main groups of sources were identified: marine aerosol identified by Na and Cl (22%), steelmaking and sinter plant represented by As, Cr, Cu, Fe, Ni, Mn, Pb, Sb and Zn (11%), sinter plant stack identified by NH4(+), K and Pb (12%), an unidentified Br source (1.8%), secondary aerosol from coke making and blast furnace (19%), fugitive emissions from the handling of raw material, sinter plant and vehicles dust resuspension identified by Al, Ca, La, Si, Ti and V (14%) and sinter plant and blast furnace associated essentially with Fe and Mn (21%).

Levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain

The adverse health effects of airborne particles have been subjected to intense investigation in recent years; however, more studies on the chemical characterization of particles from pollution emissions are needed to (1) identify emission sources, (2) better understand the relative toxicity of particles, and (3) pinpoint more targeted emission control strategies and regulations. The main objective of this study was to assess the levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain. Instrumental and biomonitoring techniques were integrated and analytical methods for k0 instrumental neutron activation analysis and particle-induced x-ray emission were used to determine element content in aerosol filters and lichens. Results indicated that in general local industry contributed to the emissions of As, Sb, Cu, V, and Ni, which are associated with combustion processes. In addition, the steelwork emitted significant quantities of Fe and Mn and the cement factory was associated with Ca emissions. The spatial distribution of Zn and Al also indicated an important contribution of two industries located outside the studied area.

Performance assessment of the single photon emission microscope: high spatial resolution SPECT imaging of small animal organs

The single photon emission microscope (SPEM) is an instrument developed to obtain high spatial resolution single photon emission computed tomography (SPECT) images of small structures inside the mouse brain. SPEM consists of two independent imaging devices, which combine a multipinhole collimator, a high-resolution, thallium-doped cesium iodide [CsI(Tl)] columnar scintillator, a demagnifying/intensifier tube, and an electron-multiplying charge-coupling device (CCD). Collimators have 300- and 450-µm diameter pinholes on tungsten slabs, in hexagonal arrays of 19 and 7 holes. Projection data are acquired in a photon-counting strategy, where CCD frames are stored at 50 frames per second, with a radius of rotation of 35 mm and magnification factor of one. The image reconstruction software tool is based on the maximum likelihood algorithm. Our aim was to evaluate the spatial resolution and sensitivity attainable with the seven-pinhole imaging device, together with the linearity for quantification on the tomographic images, and to test the instrument in obtaining tomographic images of different mouse organs. A spatial resolution better than 500 µm and a sensitivity of 21.6 counts·s^-1·MBq^-1 were reached, as well as a correlation coefficient between activity and intensity better than 0.99, when imaging ^99mTc sources. Images of the thyroid, heart, lungs, and bones of mice were registered using ^99mTc-labeled radiopharmaceuticals in times appropriate for routine preclinical experimentation of <1 h per projection data set. Detailed experimental protocols and images of the aforementioned organs are shown. We plan to extend the instrument's field of view to fix larger animals and to combine data from both detectors to reduce the acquisition time or applied activity.

Effect of hydrogen sulfide on growth of sulfate reducing bacteria

A culture of sulfate reducing bacteria (SRB) growing on lactate and sulfate was incubated at different pH values in the range of 5.8-7.0. The effect of pH on growth rate was determined in this pH range; the highest growth rate was observed at pH 6.7. Hydrogen sulfide produced from sulfate reduction was found to have a direct and reversible toxicity effect on the SRB. A hydrogen sulfide Concentration of 547 mg/L (16.1 mM) completely inhibited the culture growth. Comparison between acetic acid and hydrogen sulfide inhibition is presented and the concomitant inhibition kinetics are mathematically described.

Renal disorders involved in the pathophysiology of urinary excretion of a-1 microglobulin in patients with glomerulopathies

AIMS

The protein alpha1-microglobulin (alpha1-microg) is filtered by the glomeruli and fully reabsorbed by the proximal tubules, and tubulointerstitial injury compromises its reabsorption. The aim of this study was to determine which functional, morphological and inflammatory renal disorders associated with tubulointerstitial damage interfere with urinary excretion of alpha1-microg in patients with glomerulopathies.

PATIENTS AND METHODS

38 patients (33.6 +/- 11.3 years) with primary or secondary glomerulopathies diagnosed by renal biopsies were studied. The urinary fractional excretion of alpha1-microg (FEalpha1-microg), the urinary monocyte chemoattractant protein-1/urinary creatinine (UMCP-1) index and 24-h proteinuria were determined. In the cortex of renal biopsies, the number of macrophages/104 microm2 of glomerular tuft (GT) and tubulointerstitial (TI) areas, the relative interstitial area (RCIA), and the relative interstitial fibrosis area (CIF) were measured. Results are reported as median and range and the Spearman non-parametric test was used to determine the correlations.

RESULTS

FEalpha1-microg was 0.165% (0.008% - 14,790.0%) in patients with glomerulopathies and 0.065% (0.010% - 0.150%) in the control group (p < 0.05; Mann-Whitney U-Test). FEalpha1-microg was correlated with creatinine clearance (r = -0.4396; p = 0.0358), UMCP-1 index (r = 0.5978; p < 0.0001), number of macrophages/TI area (r = 0.5634; p = 0.0034) and RCIA (r = 0.7436; p < 0.0001). However, FEa1-microg was not correlated with proteinuria (r = 0.1465; p = 0.5153) or with CIF (r = 0.0039; p = 0.98).

CONCLUSIONS

renal MCP-1 and the expansion and number of macrophages of the tubulointerstitial area participate in the increase of urinary excretion of alpha1-microg in patients with glomerulopathies. Although proteinuria and interstitial fibrosis have not been associated with this effect, the present study does not exclude some of these disorders in the pathophysiology of urinary excretion of alpha1-microg.

High airborne PM2.5 chlorine concentrations link to diabetes surge in Portugal

Since 1995 airborne particles have been sampled near Lisbon and analysed by PIXE at ITN. On the Summer of 2004 extremely high concentrations of 14 microg/m(3) of chlorine in PM2.5 were determined in a week average sample. Later in 2004 and in 2005 similar events occurred. A 12 year database of PIXE data on airborne elemental concentrations (1995 to 2006) compiled on 2007 was then analysed for PM2.5 chlorine concentrations above 1 microg/m(3), and showed that the number of this type of events per year is increasing since 1995 up until the present. A quest for time coincident abnormal health data reports was carried out and revealed a 30% raise in diabetes mellitus incidence from 2003 to 2004 followed by a 20% raise from 2004 to 2005. After a first short publication at the XIth Int. PIXE Conference in 2007 (Reis et al., 2007a) the problem remained live. Taking into account new insights into the problem, recently published data, and biomonitoring data that were previously not considered, it was possible to establish a highly probable link between the abnormally high values of PM2.5 chlorine measured in the Lisbon area and the surge in diabetes mellitus incidence in Portugal in 2004 and 2005. Data, reasoning, possible mechanisms and conclusions regarding this link are reported in the present paper.

Mesenchymal stem cells ameliorate tissue damages triggered by renal ischemia and reperfusion injury

BACKGROUND

Ischemia and reperfusion injury (I/R) is the major cause of acute renal failure (ARF) with high mortality rates. Because alternative therapies are needed, we investigated the use of stem cell therapy to modulate inflammation in a renal I/R model.

METHODS

To study kidney I/R injury, we clamped bilateral pedicles for 60 minutes. Mesenchymal stem cells (MSC), which had been isolated and cultivated in plastic flasks, were administered to mice 6 hours after injury. Real-time polymerase chain reaction was used to quantify interleukin (IL)-4 and IL-1beta mRNAs. Proliferative nuclear cell antigen (PCNA) was used to calculate tubular regeneration.

RESULTS

Administration of MSC attenuated renal injury; serum creatinine and plasma urea levels were significantly reduced 24 hours after reperfusion. PCNA immunohistochemistry showed that regeneration occurred faster in renal tissues of animals that received MSC than in tissues of control animals. Analyses of cytokine expression in renal tissue demonstrated a greater level of anti-inflammatory cytokines in MSC-treated animals.

CONCLUSION

These results showed an antiinflammatory pattern in MSC-treated animals, demonstrating the potential of MSC to modulate I/R, leading to earlier regeneration of damaged renal tissue.

Approaching PM(2.5) and PM(2.5-10) source apportionment by mass balance analysis, principal component analysis and particle size distribution

A chemical characterization was carried out for PM(2.5) and PM(2.5-10) samples collected in a suburban area and the concentrations of 12 elements were determined in 8 size segregated fractions using a Berner Impactor. Two main objectives were proposed in this work: 1) to test for closure among chemical and gravimetric measurements of PM(2.5) and PM(2.5-10) and 2) evaluate the performance of Multilinear Regression Analysis (MLRA) and Mass Balance Analysis (MBA) in the determination of source contribution to Particulate Matter (PM) concentrations. The fraction unaccounted for by chemical analysis comprised on average 17% and 34% of gravimetric PM(2.5) and PM(2.5-10), respectively. The lack of closure in PM(2.5) and PM(2.5-10) mass (i.e., constituent concentrations not adding up to gravimetrically measured) could partly result from the presence of water associated with particles and errors in the estimation of unmeasured species. MLRA and MBA showed very similar results for the temporal variation of the source contributions. However, quantitatively important discrepancies could be observed, principally due to the lack of mass closure in PM(2.5) and PM(2.5-10). Both methods indicated that the major PM(2.5) aerosol mass contributors included secondary aerosol and vehicle exhaust. In the coarse fraction, marine and mineral aerosol contributions were predominant.

Gravimetric and chemical features of airborne PM 10 AND PM 2.5 in mainland Portugal

This paper describes concentration amounts of arsenic (As), particulate mercury (Hg), nickel (Ni) and lead (Pb) in PM(10) and PM(2.5), collected since 1993 by the Technological and Nuclear Institute (ITN) at different locations in mainland Portugal, featuring urban, industrial and rural environments, and a control as well. Most results were obtained in the vicinity of coal- and oil-fired power plants. Airborne mass concentrations were determined by gravimetry. As and Hg concentrations were obtained through instrumental neutron activation analysis (INAA), and Ni and Pb concentrations through proton-induced X-ray emission (PIXE). Comparison with the EU (European Union) and the US EPA (United States Environmental Protection Agency) directives for Ambient Air has been carried out, even though the sampling protocols herein--set within the framework of ITN's R&D projects and/or monitoring contracts--were not consistent with the former regulations. Taking this into account, 1) the EU daily limit for PM(10) was exceeded a few times in all sites except the control, even if the number of times was still inferior to the allowed one; 2) the EU annual mean for PM(10) was exceeded at one site; 3) the EPA daily limit for PM(2.5) was exceeded one time at three sites; 4) the EPA annual mean for PM(2.5) was exceeded at most sites; 5) the inner-Lisbon site approached or exceeded the legislated PMs; 6) Pb levels stayed far below the EU limit value; and 7) concentrations of As, Ni and Hg were also far less than the reference values adopted by EU. In every location, Ni appeared more concentrated in PM(2.5) than in coarser particles, and its levels were not that different from site to site, excluding the control. The highest As and Hg concentrations were found in the neighbourhood of the coal-fired, utility power plants. The results may be viewed as a "worst-case scenario" of atmospheric pollution, since they have been obtained in busy urban-industrial areas and/or near major power-generation and waste-incineration facilities.

Organomercurial removal from vaccine production wastewaters in a supported liquid membrane bioreactor

Vaccine production effluents are strongly polluted with thiomersal, a highly toxic organomercurial compound, for which there is presently no remediation technology available. This work describes a new remediation process based on the extraction of thiomersal from the wastewater to a biological compartment, where it is degraded by a microbial strain. The selective extraction of thiomersal is achieved by using an ionic liquid immobilized in a porous membrane. In the biological compartment, thiomersal is degraded to metallic mercury, under aerobic conditions, by a Pseudomonas putida strain. The utilization of ionic liquids in supported liquid membranes for thiomersal transport, and the kinetics of thiomersal biodegradation by a Pseudomonas putida strain are presented and discussed.

An evaluation of olive-tree bark for the biological monitoring of airborne trace-elements at ground level

There is a need to start looking into the possibility of tree bark for biomonitoring. Bark from olive trees (Olea europaea Linn.) has been collected over an area in northwestern Portugal, featuring a blend of rural lands, industrial towns and coastal environments. Samples were analysed through INAA and PIXE for their elemental contents. Results from both techniques were reconciled and then compared with an extensive database on 46 trace elements in Parmelia spp. thalli from the same sites and mostly from the very bark substrates. Distribution-free, nonparametric statistics show that, despite signal magnitude, variation patterns of bark and lichen concentrations follow one another in a most significant way. Selected elements in bark also correlate to a superior extent. As far as this investigation goes, there is no reason whatsoever for discarding bark as an alternative to lower epiphytes.

Calibration of lichen transplants considering faint memory effects

Biomonitoring, among other purposes, can be used as a tool to study the dispersion of trace elements through the atmosphere and back to the earth's surface again. In this sense it has been used for more than 20 years now. Yet, the calibration of biomonitors elemental contents against other atmospheric element dispersion variables like deposition or airborne concentration is still an open subject. The knowledge of a calibration nevertheless represents a qualitative improvement upon the use of biomonitors. Biomonitors elemental contents are usually assumed to depend in a linear way on the average values of atmospheric element dispersion variables, thus a linear regression is assumed to provide a good calibration. In this work: the element dispersion variables like deposition or airborne concentration will be referred in general as availability variables due to reasons that will be clarified; an uptake experiment using transplants of lichen Parmelia sulcata carried out in Portugal during a 2-year period (1994/1996) is described; and new concepts and calibration methods are presented. Lichen and aerosol samples were analysed by nuclear analytical techniques PIXE and INAA, and total deposition dry residue samples were analysed by ICP-MS. A database of roughly 70,000 values was thus created and biomonitor calibration carried out considering that biomonitors are not mechanical instruments but that they rather describe their exposure with a non-perfect memory. Data shows that surveying lichens four times within 1 year, with a period of 3 months in between sampling campaigns, allows the recovery of availability mean, maxima and standard deviation for many elements.

A comparative study for results obtained using biomonitors and PM10 collectors in Sado Estuary

In 1996 a program was started, financed by the Environmental Ministry of Portugal and IAEA, aiming to study the inorganic atmospheric pollutant dispersion in Sado Estuary. Gent PM10 air samplers were used for air particulate matter sampling. Three sampling sites were chosen, forming a triangle around the fuel power station of Setúbal. Transplants of Parmelia sulcata Taylor were suspended in nylon bags within a rectangle 15 km wide and 25 km long on a 2.5 x 2.5 km grid. Two sets of four transplants were hung in each of the 47 locations, one set facing the wind and the other set opposing the wind. The transplants were suspended in December 1997 for a 1-year period; every 3 months, one transplant of each set was collected. Both lichen transplants and PM10 filters were analysed by INAA and PIXE. A comparative study of results obtained for the two sampling procedures is presented in this work.

In situ corrosion control in industrial water systems

The main objective of this study was to evaluate the efficacy of a biocide and a corrosion inhibitor against the corrosion of a circulating pipe in a cooling tower. Isothiazolone was tested as the industrial biocide. The results showed that the biocide by itself or combined with a dispersant was not efficient to control corrosion in the industrial system. Corrosion rates of 0.324 mm/year were recorded in both the presence and absence of the biocide. Corrosion control was successfully accomplished by using a corrosion inhibitor. In the latter case the maximum corrosion rate of 0.024 mm/year were obtained.

Mechanism of charged pollutants removal in an ion exchange membrane bioreactor: drinking water denitrification

The mechanism of anionic pollutant removal in an ion exchange membrane bioreactor (IEMB) was studied for drinking water denitrification. This hybrid process combines continuous ion exchange transport (Donnan dialysis) of nitrate and its simultaneous bioreduction to gaseous nitrogen. A nonporous mono-anion permselective membrane precludes direct contact between the polluted water and the denitrifying culture and prevents secondary pollution of the treated water with dissolved nutrients and metabolic products. Complete denitrification may be achieved without accumulation of NO3(-) and NO2(-) ions in the biocompartment. Focus was given to the effect of the concentration of co-ions, counterions, and ethanol on the IEMB performance. The nitrate overall mass transfer coefficient in this hybrid process was found to be 2.8 times higher compared to that in a pure Donnan dialysis process without denitrification. Furthermore, by adjusting the ratio of co-ions between the biocompartment and the polluted water compartment, the magnitude and direction of each individual anion flux can be easily regulated, allowing for flexible process operation and control. Synthetic groundwater containing 135-350 mg NO3(-) L(-1) was treated in the IEMB system. A surface denitrification rate of 33 g NO3(-) per square meter of membrane per day was obtained at a nitrate loading rate of 360 g NO3(-) m(-3)d(-1), resulting in a nitrate removal efficiency of 85%.

Magnesium deficiency improves glucose homeostasis in the rat: studies in vivo and in isolated islets in vitro

The serum mineral levels, glucose disappearance rate (kg), total area under the glucose (DeltaG) and insulin (DeltaI) curves, and static insulin secretion were compared among rats fed a Mg-deficient diet for 6 (DF-6) or 11 (DF-11) weeks, and rats fed a control diet for the same periods (CO-6 and CO-11 groups). No change in glucose homeostasis was observed among DF-6, CO-6 and CO-11 rats. DF-11 rats showed an elevated kg and a reduced DeltaG and DeltaI. For evaluating the effect of supplementation, rats fed a control or Mg-deficient diet for 6 weeks were then fed a Mg- supplemented diet for 5 weeks (SCO and SDF groups respectively). The serum Mg levels in SDF rats were similar to those in CO-11 and SCO rats, but higher than in the DF-11 group. SDF rats showed similar kg, DeltaG and DeltaI compared with the CO-11 and SCO groups. However, a significantly lower kg and higher DeltaG and DeltaI were observed in SDF compared with DF-11 rats. Basal and 8.3 mmol glucose/l-stimulated insulin secretion by islets from DF-11 rats were higher than by islets from CO-11 rats. These results indicate that moderate Mg depletion for a long period may increase the secretion and sensitivity to insulin, while Mg supplementation in formerly Mg-deficient rats may prevent the increase in sensitivity and secretion of insulin.

Two-dimensional fluorometry coupled with artificial neural networks: a novel method for on-line monitoring of complex biological processes

The use of two-dimensional scanning fluorometry as an on-line, noninvasive, in situ bioreactor monitoring technique is extended to complex bioprocesses using mixed cultures, with particular attention to biofilm systems. Using the example of spectra subtraction, it is demonstrated that established methods for fluorescence data analysis have a limited capability of utilizing overall fluorometric information. Artificial neural networks (ANNs) are introduced as a novel nonlinear and nonmechanistic technique for interpreting the highly complex fluorescence maps. It is shown that ANNs are able to infer process performance parameters in a pattern recognition approach, based on the entire fluorescence "fingerprint" of the biological system. The studies were carried out using an extractive membrane bioreactor (EMB) for the degradation of chlorinated organic compounds, operating with mixed cultures. Model pollutants em- ployed were 1,2-dichloroethane, 3-chloro-4-methylaniline, and p-toluidine.

Magnesium deficiency modulates the insulin signaling pathway in liver but not muscle of rats

Altered insulin secretion and sensitivity have been observed in Mg-deficient animals. However, the effects of Mg deficiency and supplementation on intracellular signaling events triggered by insulin are unknown. Therefore, we studied the early steps of insulin action in muscle and liver of rats fed Mg-deficient (DF-6, DF-11) or control (CO-6, CO-11) diets for 6 or 11 wk, respectively, and Mg-deficient or control diets for 6 wk, followed by Mg supplementation for 5 wk (SDF and SCO groups, respectively). There were no differences in the glucose disappearance rate (K(itt)) or insulin signaling between CO-6 and DF-6 rats. Between the two groups of rats fed for 11 wk, the DF-11 group had a significantly greater K(itt). SDF and SCO rats had K(itt) that did not differ from CO-11 rats, but that were significantly lower than in DF-11 rats. In the latter rats, insulin receptor and insulin receptor substrate-1 protein and phosphorylation levels were elevated in liver and there was a greater association between the insulin receptor substrate-1 and p85 subunit of phosphatidyl-inositol 3-kinase compared with CO-11 rats. There were no differences in the early steps of insulin action in SDF and control rats. These results suggest that the normal insulin sensitivity maintained by Mg supplementation and the increased insulin sensitivity produced by a long period of Mg deprivation may result, at least in part, from alterations in or maintenance of the early molecular steps of insulin action in hepatic tissue.

[Occurrence of encephalic and cardiac cysticercosis (Cysticercus cellulosae) in necropsy]

OBJECTIVE

To review the incidence and pathologic findings of cysticercosis diagnosed at autopsies, with emphasis on the most common organs affected.

METHODS

Reports of 1.596 autopsies performed between 1974 and 1997 at a school hospital in Uberaba, MG, Brazil were studied. The following data were obtained: age, sex, ethnic group, body mass index, and the site of the cysticercosis.

RESULTS

The study found diagnosis of cysticercosis in 53 autopsies (3.3%). The average age of patients with cysticercosis was 50 (range: 15 to 86 years); 62.3% were male, and 64.1% Caucasian. The most affected organs were: brain (79.2%), heart (22.6%), skeletal muscle (11.3%), and other organs (5.7%). No statistical differences were found comparing age, gender, ethnic group, and body mass index of the affected and the non-affected patients. In two cases of neurocysticercosis the lesions were located in the ventromedial nucleus of the hypothalamus.

CONCLUSION

Both the overall incidence of cysticercosis and the incidence of cardiac cysticercosis were greater in the study than in other autopsy series from the same geographic areas. In two cases there was an association between hypothalamic cysticercosis and obesity

Glucose metabolism and kinetics of phosphorus removal by the fermentative bacterium Microlunatus phosphovorus

Phosphorus and carbon metabolism in Microlunatus phosphovorus was investigated by using a batch reactor to study the kinetics of uptake and release of extracellular compounds, in combination with (31)P and (13)C nuclear magnetic resonance (NMR) to characterize intracellular pools and to trace the fate of carbon substrates through the anaerobic and aerobic cycles. The organism was subjected to repetitive anaerobic and aerobic cycles to induce phosphorus release and uptake in a sequential batch reactor; an ultrafiltration membrane module was required since cell suspensions did not sediment. M. phosphovorus fermented glucose to acetate via an Embden-Meyerhof pathway but was unable to grow under anaerobic conditions. A remarkable time shift was observed between the uptake of glucose and excretion of acetate, resulting in an intracellular accumulation of acetate. The acetate produced was oxidized in the subsequent aerobic stage. Very high phosphorus release and uptake rates were measured, 3.34 mmol g of cell(-1) h(-1) and 1.56 mmol g of cell(-1) h(-1), respectively, values only comparable with those determined in activated sludge. In the aerobic period, growth was strictly dependent on the availability of external phosphate. Natural abundance (13)C NMR showed the presence of reserves of glutamate and trehalose in cell suspensions. Unexpectedly, [1-(13)C]glucose was not significantly channeled to the synthesis of internal reserves in the anaerobic phase, and acetate was not during the aerobic stage, although the glutamate pool became labeled via the exchange with intermediates of the tricarboxylic acid cycle at the level of glutamate dehydrogenase. The intracellular pool of glutamate increased under anaerobic conditions and decreased during the aerobic period. The contribution of M. phosphovorus for phosphorus removal in wastewater treatment plants is discussed on the basis of the metabolic features disclosed by this study.

Distribution in Portugal of some pollutants in the lichen Parmelia sulcata

During the months of July and August 1993 a lichen (Parmelia sulcata Taylor) collection campaign was held in Portugal where samples were obtained from olive tree bark at 228 sites, following a grid of 10 x 10 km along the Atlantic coast and 50 x 50 km in the interior of the country. The samples were analysed by instrumental neutron activation analysis and proton induced X-ray emission techniques. Concentration data patterns for the pollutants As, Cr, Hg, Ni, Pb, S, Sb, Se, and V were obtained for the whole country surface by making use of an extinction rule of 1/r(3), preventing any cut-off distance from being artificially introduced. Some pollution sources were identified: (1) oil-powered plants on the Lisbon-Setúbal axis (V, Ni), (2) coal-power plants in Porto and Sines (S, Se), (3) traffic in the northern area and the Lisbon-Setúbal axis (Pb), (4) a chemical industry south of Porto (Hg, As), and (5) soil influence (Cr, Sb). Arsenic and chromium results largely exceed, in a few areas, the concentrations acceptable to plants, and in a few spots also Hg, Ni, and Pb data.

Environmental assessment in an industrial area of Portugal

The region of Lisbon and south of Lisbon (Sado estuary) is densely industrialized, and, therefore, air pollution should be studied in a more detailed scale there. The topography of the Sado estuary region and the predominant wind direction from the northwest contribute to the influence in this region of the industries located in the north. The region selected includes a fuel-fired power station. Transplants of the lichen Parmelia sulcata Taylor were suspended in nylon bags within a rectangle 15 km wide and 25 km long on a grid 2.5 km x 2.5 km, centered in the power station. In each of the 47 sites, 2 sets of 4 transplants each were hung. Care was taken (1) in covering the two sets with a polyethylene roof to prevent leaching of elements in the lichen, (2) in building a hanging system that could rotate according to the wind direction, and (3) in orienting one set toward the wind and the other set opposite the wind. For a 1-yr period and every 3 mo, one transplant of each set is collected. In this work, the results of the first campaign (after 3 mo suspension) obtained by instrumental neutron activation analysis and proton-induced X-ray emission are shown. Some elemental contents are mapped and discussed.

Protein deficiency and nutritional recovery modulate insulin secretion and the early steps of insulin action in rats

Maternal malnutrition was shown to affect early growth and leads to permanent alterations in insulin secretion and sensitivity of offspring. In addition, epidemiological studies showed an association between low birth weight and glucose intolerance in adult life. To understand these interactions better, we investigated the insulin secretion by isolated islets and the early events related to insulin action in the hind-limb muscle of adult rats fed a diet of 17% protein (control) or 6% protein [low (LP) protein] during fetal life, suckling and after weaning, and in rats receiving 6% protein during fetal life and suckling followed by a 17% protein diet after weaning (recovered). The basal and maximal insulin secretion by islets from rats fed LP diet and the basal release by islets from recovered rats were significantly lower than that of control rats. The dose-response curves to glucose of islets from LP and recovered groups were shifted to the right compared to control islets, with the half-maximal response (EC50) occurring at 16.9 +/- 1.3, 12.4 +/- 0.5 and 8.4 +/- 0.1 mmol/L, respectively. The levels of insulin receptor, as well as insulin receptor substrate-1 and phosphorylation and the association between insulin receptor substrate-1 and phosphatidylinositol 3-kinase were greater in rats fed a LP diet than in control rats. In recovered rats, these variables were not significantly different from those of the other two groups. These results suggest that glucose homeostasis is maintained in LP and recovered rats by an increased sensitivity to insulin as a result of alterations in the early steps of the insulin signal transduction pathway.

[Candidiasis in kidney transplant patients]

The medical records of 620 patients submitted to renal transplant from February 1968 to February 1995 were surveyed for Candida infection. Of these, 87 presented 107 episodes of candidiasis. In 42.9% the infection appeared up to 6 months after the transplant. The most frequent involved sites were: urinary tract, respiratory tract, and gastrointestinal tract. The most frequent etiological agents were: C. albicans, C. tropicalis and C. glabrata. Most urinary tract infections occurred in the first 6 months (61.7%) and manifested clinically as a bacterial infection. In the respiratory tract infections were characterized by isolation of the agent in sputum. In the gastrointestinal infections, 9/16 episodes were esophageal. There were 3 deaths directly related to Candidiasis (one pulmonary and 2 disseminated cases). In the urinary tract, and respiratory tract infections there was association of candidiasis with previous antibiotic treatment (76% and 67%, respectively), and with concomitant bacterial infections (34% and 64%, respectively). The overall prevalence of Candida infections was 14.5%. The predominant location was in the urinary tract (51.0%), followed by the respiratory (26.0%) and gastrointestinal tract (15.0%), with a high rate of association with previous antibiotic treatment and bacterial infections.

Use of ciprofloxacin as a prophylactic agent in urinary tract infections in renal transplant recipients

The most common form of bacterial infection in renal transplant recipients is urinary tract infection (UTI), and some studies have shown that prophylaxis can reduce this incidence. In the present investigation we evaluated 80 patients submitted to renal transplantation at the Renal Transplant Unit of the University Hospital of Ribeirao Preto, SP. The study was prospective, double blind and randomized. The patients were divided into two groups, one receiving placebo and the other ciprofloxacin at the dose of 250 mg twice a day for the first 10 d and 250 mg/d for 6 months after transplantation. Of the 41 patients who received ciprofloxacin 28 completed the study, and of the 39 patients who received placebo 30 completed the study. The largest number of UTI occurred in the placebo group, with a significant difference from the ciprofloxacin group during the first month after surgery (p < 0.05). In the group treated with ciprofloxacin, only 6/40 patients (15%) developed UTI, as opposed to 19/39 (48.7%) for the placebo group. The total number of infectious episodes was higher in the placebo group (26) than in the ciprofloxacin group (12). The medication was well tolerated throughout the study period.

Relationship between Chagas' disease immunoreactivity in pericardial fluid and survival of children

Pericardial fluid (PF) obtained at autopsy has been used for the study of fluid pericardium proteins in noninfectious and infectious diseases such as Chagas' disease. The aim of the present study was to determine the immunoreactivity to Chagas' disease in PF obtained at autopsy from children in an endemic area. A total of 251 autopsy records were surveyed from the files of the Medical School of Uberaba, Brazil, of children ranging in age from stillborn to 14 yr who had died between 1968 and 1992. The reactions for Chagas' disease (immunofluorescence, complement fixation, and hemagglutination) applied to PF were recorded. Thirty-four children (13.5%) showed positive reactions to Chagas' disease. The frequency of immunoreactivity was significantly related to age-group distribution (chi 2 = 13.4; P < 0.005). Children with negative PF tests who had died between 1 and 60 days of age presented a median survival time of 13 days; positive children presented a median survival time of 4 days (Z = 2.1; P = 0.02). These data indicate that the prevalence of Chagas' disease is high among pregnant women in southern Brazil. In addition, they also suggest that "antitrypanosome antibodies" detected in PF may be 1 of the indicators of age of infant death and may possibly play a role in the course of the disease in children born from mothers with Chagas' disease.

Glucose-induced insulin secretion is impaired and insulin-induced phosphorylation of the insulin receptor and insulin receptor substrate-1 are increased in protein-deficient rats

Malnutrition is related to diabetes in tropical countries. In experimental animals, protein deficiency may affect insulin secretion. However, the effect of malnutrition on insulin receptor phosphorylation and further intracellular signaling events is not known. Therefore, we decided to evaluate the rate of insulin secretion and the early molecular steps of insulin action in insulin-sensitive tissues of an animal model of protein deficiency. Pancreatic islets isolated from rats fed a standard (17%) or a low (6%) protein diet were studied for their secretory response to increasing concentrations of glucose in the culture medium. Basal as well as maximal rates of insulin secretion were significantly lower in the islets isolated from rats fed a low protein diet. Moreover, the dose-response curve to glucose was significantly shifted to the right in the islets from malnourished rats compared with islets from control rats. During an oral glucose tolerance test, there were significantly lower circulating concentrations of insulin in the serum of rats fed a low protein diet in spite of no difference in serum glucose concentration between the groups, suggesting an increased peripheral insulin sensitivity. Immunoblotting and immunoprecipitation were used to study the phosphorylation of the insulin receptor and the insulin receptor substrate-1 as well as the insulin receptor substrate-1-p85 subunit of phosphatidylinositol 3-kinase association in response to insulin. Values were greater in hind-limb muscle from rats fed a low protein diet compared with controls. No differences were detected in the total amount of protein corresponding to the insulin receptor or insulin receptor substrate-1 between muscle from rats fed the two diets. Therefore, we conclude that a decreased glucose-induced insulin secretion in pancreatic islets from protein-malnourished rats is responsible, at least in part, for an increased phosphorylation of the insulin receptor, insulin receptor substrate-1 and its association with phosphatidylinositol 3-kinase. These might represent some of the factors influencing the equilibrium in glucose concentrations observed in animal models of malnutrition and undernourished subjects.

Massive intracranial immature teratoma. Report of a case with polyhidramnios and intense pelvic pain

A case of massive intracranial immature teratoma in a female stillborn is reported. She was the product of the second pregnancy of a 25-year-old healthy woman. The pregnancy was unremarkable until the 25th week of gestation when the mother noticed a rapid enlargement of her abdomen and intense pelvic pain. Because of the pain, a cesarean section was indicated, and a stillborn weighing 2750g with macrocephaly was delivered. The cranial contents weighed 1350g and showed a huge tumoral mass with only a rim of normal brain. A histologic diagnosis of immature teratoma was made. Massive intracranial teratomas are rare tumors and their occurrence in intrauterine life is even rarer. Their histogenesis is unknown, and there is no explanation for their continuous growth during embryogenesis. A prenatal diagnosis of this rare condition can be made by ultrasound, computed tomography, or magnetic resonance imaging.

Characterization of representative enzymes from a sulfate reducing bacterium implicated in the corrosion of steel

This communication reports the isolation, purification and characterization of key enzymes involved in dissimilatory sulfate reduction of a sulfate reducing bacterium classified as Desulfovibrio desulfuricans subspecies desulfuricans New Jersey (NCIMB 8313) (Ddd NJ). The chosen strain, originally recovered from a corroding cast iron heat exchanger, was grown in large scale batch cultures. Physico-chemical and spectroscopic studies of the purified enzymes were carried out. These analyses revealed a high degree of similarity between proteins isolated from the DddNJ strain and the homologous proteins obtained from Desulfomicrobium baculatus Norway 4. In view of the results obtained, taxonomic reclassification of Desulfovibrio desulfuricans subspecies desulfuricans New Jersey (NCIMB 8313) into Desulfomicrobium baculatus (New Jersey) is proposed.

Effect of selenium supplementation on polyunsaturated fatty acids in rats

The purpose of this work was to study plasma, adipose tissue, and liver fatty acids percentages of Wistar rats that drank water supplemented with several levels of sodium selenite for 1, 3, and 6 mo. In a general way, percentages of saturated, monounsaturated, and polyunsaturated fatty acids of supplemented groups were not different from those obtained with nontreated animals in the analyzed tissues. However, in rats supplemented with 0.5 ppm Se, mainly in adipose tissue, a polyunsaturated fatty acids increase (p < 0.005) was observed for all times of treatment. This could suggest that 0.5 ppm Se supplement probably exercises a protective role on polyunsaturated fatty acids in that tissue. Supplements of 6.0, 15.0, and 54.0 ppm Se did not change unsaturation levels of fatty acids in the analyzed tissues.

Causes of death in renal transplant recipients: a study of 102 autopsies from 1968 to 1991

A study was conducted on 102 patients submitted to renal transplant who died and were autopsied at the University Hospital, Faculty of Medicine of Ribeirão Preto, Brazil, from 1968 to 1991. The cause of death, based on a review of medical records and autopsy reports, was assigned to one of the following categories: infectious (69.6%); cardiovascular (12.7%); gastrointestinal (7.8%); graft rejection (6.9%); tumoral (2.0%); and undetermined (1.0%). Among the 71 cases of death caused by infection, 28 (39.4%) showed disseminated agents involving two or more organs. Isolated pneumonia involved 17 patients (23.9%), followed by acute pyelonephritis in the transplanted kidney in 10 patients (14.1%). The most frequent agents were: bacteria (58.0%), divided into 'non-classified' (83.0%), Nocardia (10.6%) and Mycobacterium (6.4%); fungi (27.5%) represented by Cryptococcus (22.7%), Aspergillus, Candida and Pneumocystis carinii (18.1% each), Histoplasma (13.6%), Mucor and Paracoccidioides brasiliensis (4.5% each); viruses (6.2%) represented by Herpes simplex (60.0%); metazoa (5.0%, S. stercoralis), and protozoa (2.5%, T. cruzi). Cytomegalovirus (CMV) was identified in the lungs of 12 patients and was not directly correlated with death but was associated with other agents. In conclusion, immunodepressed patients such as renal transplant recipients should be carefully monitored for infection due to the high mortality rate.

Intercomparison of techniques available at INETI in the analysis of two IAEA candidate research materials

Under contract with the IAEA, the epiphytic lichen Evernia prunastri was collected to prepare a multielement lichen reference material for quality assurance of environmental studies. An intercomparison run on trace and minor elements in this candidate research material (IAEA-336) was organized in which six analytical groups of the National Institute of Engineering and Industrial Technology (INETI) took part. INAA, PIXE, XRF, AAS, and ICP-ES were applied. The results obtained by different methods are compared, and their complementarity is discussed. As a quality control, the IAEA cabbage research material (IAEA-359) was analyzed. The results agree quite well with the estimated values given by the IAEA.

Nocardia infection in renal transplant recipient: diagnostic and therapeutic considerations

In the present report the authors discuss the diagnostic difficulties, therapeutic measures and the clinical course of Nocardia infection which occurred among renal transplant recipients at the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (UH-FRP), from 1968 to 1991. Among 500 individuals submitted to renal transplant, 9 patients developed Nocardiosis at varying times after transplant (two months to over two years). All the patients had pulmonary involvement and their most common symptoms were fever, cough and pleural pain. Dissemination of the process is common and three patients presented cutaneous abscesses, four CNS involvement and one had pericarditis due to Nocardia. The diagnostic is quite difficult since there is no specific clinical picture, concomitant infections are frequent and the microorganism presents slow growth in culture (ranging from four to forty days, in our experience). In this report, three cases were only diagnosed by necropsy. The treatment of choice is a combination of Sulfamethoxazole and Trimethoprim (SMX-TMP). In the present series, overall mortality was 77% (7 cases) and in five of the patients who died the diagnosis was late. All the patients who had CNS involvement died.

Middle cerebral artery: determination of flow velocities with MR angiography

A magnetic resonance (MR) angiographic technique for noninvasive measurement of flow velocities in the intracranial cerebral arteries was studied. Velocity measurements were made in a phantom and in the middle cerebral artery of six volunteers. Velocities were assessed in the volunteers before, during, and after finger movement. Average values for mean maximal velocities determined with MR angiography were 69.8 cm/sec before, 77.2 cm/sec during, and 69.6 cm/sec after finger movement. Correlations between values obtained with MR angiography and transcranial Doppler (TCD) sonography were r = .86 and P = .0001 for values obtained at rest and r = .84 and P = .0001 for values obtained during finger movement. The velocity increase during finger movement compared with that at rest was 11% for MR angiography and 11.3% for TCD sonography. Values measured with TCD sonography, however, were less than those measured with MR angiography (P = .001). The results show the feasibility of measuring flow velocities in intracranial arteries with MR angiography.

Flow quantification in the superior sagittal sinus using magnetic resonance

To date, the intracerebral veins and venous sinuses have not been amenable to noninvasive study. We describe a magnetic resonance (MR) technique using "bolus tracking" for rapid imaging and measurement of cerebral venous flow. We specifically applied the technique to the superior sagittal sinus, but it can be used for evaluation of other cerebral venous structures. In 10 healthy subjects and 21 patients referred for MR brain studies, mean flow was 420 ml/min. There was a significant inverse correlation between blood flow and age. There were dynamic changes in cerebral blood flow (CBF) during hyperventilation and hypercapnia. Since the cerebral cortex drains almost exclusively to the superior sagittal sinus, these flow measurements represent an index of global CBF. MR flow quantification provides a new means for assessing dynamic changes in CBF, and may prove useful for monitoring the effects of various disease processes and pharmaceutical agents on CBF.

Role of calcium in the regulation of acetylcholine receptor synthese in cultured muscle cells*

Embroyonic muscles differentiated in vitro were used to study the effects of intracellular Ca2+ ([Ca2+1]i) variations on the amount of acetylcholine receptors ([AChR]) in the cell membrane. 2. Increased Ca2+ concentration in the growth medium ([Ca2+]o) caused a marked elevation of AChR levels, apparently through de novo synthesis. 3. Agents known to increase [Ca2+]i and its accumulation in the sarcoplasmic reticulum (SR), such as ionophore A23187, sodium dantrolene (DaNa), or high [Mg2+]o all enhanced alpha-bungarotoxin (alpha-BGT) binding after 48 h of treatment. 4. Electrical stimulation or caffeine, both affectors of SR calcium release, brought about a decrease in [AChR] probably by suppressing its synthesis. 5. The effects of simultaneous treatment with two AChR-inducing agents, namely, high [Ca2+]o in the presence of tetrodotoxin (TTX) or high [Mg2+]o were not additive, thus suggesting action via a common saturable mediator. 6. Intermediate AChR levels obtained following simultaneous treatments with opposing effects, e.g., electrical stimulation in the presence of high [Ca2+]o or DaNa, suggest contradictory actions on a common mediator. 7. All these observations indicate a strong correlation between SR calcium levels and [AChR] on myotubes; while calcium accumulation in the Sr was followed by increased AChR synthesis, calcium release was accompanied by suppression of receptor synthesis.