Blueberry Metabolites Attenuate Lipotoxicity-Induced Endothelial Dysfunction

SCOPE

Lipotoxicity-induced endothelial dysfunction is an important vascular complication associated with diabetes. Clinical studies support the vascular benefits of blueberry anthocyanins, but the underlying mechanism is unclear. The hypothesis that metabolites of blueberry anthocyanins attenuate lipotoxicity-induced endothelial dysfunction was tested.

METHODS AND RESULTS

Human aortic endothelial cells (HAECs) were treated for 6 h with either: (i) the parent anthocyanins (malvidin-3-glucoside and cyanidin-3-glucoside); or (ii) the blueberry metabolites (hydroxyhippuric acid, hippuric acid, benzoic acid-4-sulfate, isovanillic acid-3-sulfate, and vanillic acid-4-sulfate), at concentrations known to circulate in humans following blueberry consumption. For the last 5 h HAECs were treated with palmitate or vehicle. HAECs treated with palmitate displayed elevated reactive oxygen species generation, increased mRNA expression of NOX4, chemokines, adhesion molecules, and IκBα, exaggerated monocyte binding, and suppressed nitric oxide production. Of note, the damaging effects of palmitate were ameliorated in HAECs treated with blueberry metabolites but not parent anthocyanins. Further, important translational relevance of these results was provided by our observation that palmitate-induced endothelial dysfunction was lessened in arterial segments that incubated concurrently with blueberry metabolites.

CONCLUSION

The presented findings indicate that the vascular benefits of blueberry anthocyanins are mediated by their metabolites. Blueberries might complement existing therapies to lessen vascular complications.

Dietary Salba (Salvia hispanica L) seed rich in α-linolenic acid improves adipose tissue dysfunction and the altered skeletal muscle glucose and lipid metabolism in dyslipidemic insulin-resistant rats

This work reports the effect of dietary Salba (chia) seed rich in n-3 α-linolenic acid on the morphological and metabolic aspects involved in adipose tissue dysfunction and the mechanisms underlying the impaired glucose and lipid metabolism in the skeletal muscle of rats fed a sucrose-rich diet (SRD). Rats were fed a SRD for 3 months. Thereafter, half the rats continued with SRD while in the other half, corn oil (CO) was replaced by chia seed for 3 months (SRD+chia). In control group, corn starch replaced sucrose. The replacement of CO by chia seed in the SRD reduced adipocyte hypertrophy, cell volume and size distribution, improved lipogenic enzyme activities, lipolysis and the anti-lipolytic action of insulin. In the skeletal muscle lipid storage, glucose phosphorylation and oxidation were normalized. Chia seed reversed the impaired insulin stimulated glycogen synthase activity, glycogen, glucose-6-phosphate and GLUT-4 protein levels as well as insulin resistance and dyslipidemia.

Dietary fish oil normalized glucose-stimulated insulin secretion in isolated pancreatic islets of dyslipemic rats through mechanisms involving glucose phosphorylation, peroxisome proliferator-activated receptor γ and uncoupling protein 2

This study evaluates some possible mechanisms behind the beneficial effects of dietary fish oil (FO) on β cell dysfunction in rats fed a sucrose-rich diet (SRD). Rats were fed a SRD for 6 months. Thereafter, half the rats received a SRD in which corn oil was partially replaced by FO up to 8 months. The other half continued consuming the SRD up to 8 months. A control group was fed a control diet throughout the experimental period. In isolated islets of SRD-fed rats dietary FO normalized the reduced glucose phosphorylation, the altered glucose oxidation, the triglyceride content, the increased protein mass levels of peroxisome proliferator-activated receptor γ (PPARγ) and uncoupling protein 2 without changes in GLUT2 and PPARα. These finding suggest that the changes mentioned above could be involved in the normalization of the altered glucose-stimulated insulin secretion pattern in this nutritional model of dyslipidemia and insulin resistance.

Programme of stepping down from twice daily proton pump inhibitor therapy for symptomatic gastro-oesophageal reflux disease associated with a formulary change at a VA medical center

BACKGROUND

In July 2001, our Veterans' Affairs hospital changed its formulary proton pump inhibitor (PPI) from lansoprazole to rabeprazole. All patients previously receiving lansoprazole 30 mg twice daily were switched to rabeprazole 20 mg once daily.

AIM

To determine if patients with gastro-oesophageal reflux disease (GERD), who were previously managed on lansoprazole 30 mg twice daily, could be maintained on rabeprazole 20 mg once daily.

PATIENTS AND METHODS

Four hundred and thirty-five patients had received lansoprazole 30 mg twice daily for at least 12 months before the formulary change. Medical records were reviewed for 12 months before and after the formulary change.

RESULTS

There were 432 men and three women with a mean age of 66.7 years (range: 38-91). Two hundred and twelve patients were excluded. Of the remaining 223, 111 (50%) were maintained successfully on rabeprazole 20 mg once daily. Twenty-three (10%) stayed off all acid suppression during follow-up. The number of endoscopies and clinic visits did not significantly change during the follow-up. Fifty-six percent who had erosive oesophagitis failed a dose taper compared with 31% of those with endoscopy-negative GERD (P<0.025).

CONCLUSIONS

Most patients receiving twice daily PPI therapy for GERD could be maintained on once daily PPI or no acid suppression for 12 months of follow-up. Dose reduction was more successful in those without erosive oesophagitis.

Programme of stepping down from twice daily proton pump inhibitor therapy for symptomatic gastro-oesophageal reflux disease associated with a formulary change at a VA medical center

BACKGROUND

In July 2001, our Veterans' Affairs hospital changed its formulary proton pump inhibitor (PPI) from lansoprazole to rabeprazole. All patients previously receiving lansoprazole 30 mg twice daily were switched to rabeprazole 20 mg once daily.

AIM

To determine if patients with gastro-oesophageal reflux disease (GERD), who were previously managed on lansoprazole 30 mg twice daily, could be maintained on rabeprazole 20 mg once daily.

PATIENTS AND METHODS

Four hundred and thirty-five patients had received lansoprazole 30 mg twice daily for at least 12 months before the formulary change. Medical records were reviewed for 12 months before and after the formulary change.

RESULTS

There were 432 men and three women with a mean age of 66.7 years (range: 38-91). Two hundred and twelve patients were excluded. Of the remaining 223, 111 (50%) were maintained successfully on rabeprazole 20 mg once daily. Twenty-three (10%) stayed off all acid suppression during follow-up. The number of endoscopies and clinic visits did not significantly change during the follow-up. Fifty-six percent who had erosive oesophagitis failed a dose taper compared with 31% of those with endoscopy-negative GERD (P<0.025).

CONCLUSIONS

Most patients receiving twice daily PPI therapy for GERD could be maintained on once daily PPI or no acid suppression for 12 months of follow-up. Dose reduction was more successful in those without erosive oesophagitis.

The role of inadequate health literacy skills in colorectal cancer screening

Colorectal cancer is ideally suited for early detection strategies that are likely to improve survival rates. Screening with either a fecal occult blood test (FOBT) or flexible sigmoidoscopy has been shown to identify precancerous polyps or cancers in early stages. However, persons with limited education and of lower socioeconomic status infrequently participate in screening programs in general and have very low rates of colorectal screening. Low literacy, which is common among persons with limited education and low income, may be an overlooked factor in understanding patients' decision making about colorectal cancer screening. This article provides information from focus groups about colorectal cancer screening, which we examine in the context of relevant literature on cancer screening and literacy. Using the health belief model, we examine the association between inadequate health literacy skills and low rates of colorectal cancer screening. The theoretical model also provides insights into strategies for improving knowledge, attitudes, and beliefs and screening rates for this challenging patient population.

Shear bond strength of one-bottle dentine bonding systems

The purpose of this in vitro study was to determine the shear bond strength (SBS) of composite resin to human, buccal dentine, using four one-bottle dentine bonding systems. Eighty recently extracted human molar teeth were embedded in metal rings by means of self-curing acrylic resin. The projecting buccal surfaces were ground wet on 600 grit silicone carbide paper in order to expose superficial dentine. The teeth were randomly divided into four groups (N=20): 1=Prime&tBond 2.1 (PB, Dentsply); 2=Scotchbond 1 (SB, 3M); 3=Optibond Solo (OS, Kerr) and 4=Syntac Single Component (SY, Vivadent). The dentine surfaces were etched, treated with one of the four dentine bonding systems, and cylinders of matching composites were then bonded to the surfaces by means of a silicone rubber split mould. All specimens were stored for 24 hours under water at 37 degrees C. The bonds were then stressed to failure with an Instron testing machine, operating at a crosshead speed of 0.5 mm/min. The data were statistically analysed (Kruskall-Wallis). The mean SBS (MPa) were: PB = 12.5 +/- 2.0; SB = 16.2 +/- 1.9; OS = 17.4 +/- 3.1 and SY= 8.1 +/- 1.9. There was a statistically significant difference (P = 0.0001) between the mean of SY and the other 3 groups, and also between PB and the other groups. There was no statistically significant difference (P = 0.244) between the SBS of OS and SB. SY demonstrated the lowest SBS.

Racial variation in the use of laparoscopic cholecystectomy in the Department of Veterans Affairs medical system

BACKGROUND

While studies have found racial differences in the rates of use of established invasive cardiac and cerebrovascular procedures, no study has evaluated racial variation in the rates of adoption of new surgical procedures. For patients undergoing laparoscopic cholecystectomy, the procedure represents a new and safe option that shortens the duration of postoperative hospitalization by almost one week. In this study, we evaluated whether, in the equal access Veterans Affairs (VA) medical system, the rate of adoption of this procedure and improvements in the duration of postoperative hospitalization differed between African-American and Caucasian patients.

STUDY DESIGN

Data were obtained from two sources-administrative claims files and prospectively compiled dinical data from medical records and patient interviews. In both data sets, frequency of use, length of stay, and outcomes for African-American and Caucasian patients undergoing minimally invasive and open gallbladder surgery were analyzed for the first four years of use of the procedure in the VA system (1992 to 1995).

RESULTS

Analyses based on claims files indicated that, after adjustment for potentially confounding variables, African-American patients who underwent cholecystectomy in VA medical centers were 25% less likely to undergo a minimally invasive cholecystectomy during the first 4 years of use of the new procedure (adjusted odds ratio, 0.74; 95% confidence interval, 0.66-0.83). Shortening of the average postoperative length of stay from 9 days or more in the prelaparoscopic era to less than 4.5 days for patients undergoing the laparoscopic procedure occurred in the first year for Caucasian patients, but did not occur until the fourth year for African-American patients (p<0.001). The overall difference in postoperative length of stay between African-American and Caucasian patients more than doubled from 1.7 days before introduction of laparoscopic cholecystectomy to 3.8 days in the fourth year. In comparison, analyses based on nurse-compiled clinical data indicated that, after adjustment for relevant clinical factors, racial variations in the rate of laparoscopic surgery were even larger (adjusted odds ratio for laparoscopic versus open cholecystectomy for African-American versus Caucasian veterans, 0.68; 95% confidence interval, 0.55-0.84).

CONCLUSIONS

Compared to Caucasian patients, African-American patients who underwent cholecystectomy in VA medical centers had an approximately 25% to 32% lower likelihood of undergoing minimally invasive cholecystectomy procedures. The differences in rates of adoption of laparoscopic surgery did not appear to be from more comorbid illnesses among African-American patients. African-American and Caucasian veterans may differ in their preference for new surgical procedures like laparoscopic cholecystectomy. Conversely, VA physicians may have been less likely to recommend laparoscopic cholecystectomies to African-American patients.

Diffusion of laparoscopic cholecystectomy in the Veterans Affairs health care system, 1991-1995

CONTEXT

Laparoscopic cholecystectomy has become the most widely used treatment for gallbladder disease. In HMO, Medicare, and fee-for-service settings, cholecystectomy rates increased 28% to 59% after introduction of laparoscopic cholecystectomy.

OBJECTIVE

To investigate the impact of the introduction of laparoscopic cholecystectomy on cholecystectomy rates and the operative mortality rate in Veterans Affairs (VA) hospitals.

DESIGN

Sequential cross-sectional study.

PATIENTS

All patients who underwent cholecystectomy from 1991 (before introduction of laparoscopic cholecystectomy) to 1995.

SETTING

133 VA hospitals.

OUTCOME MEASURES

Cholecystectomy rates, use of laparoscopic or open cholecystectomy, and operative mortality rate.

RESULTS

The annual number of cholecystectomies in the VA system increased by 10% from 1991 to 1995; the laparoscopic procedure accounted for 25% of the caseload in 1992 and 52% in 1995. Compared with patients having laparoscopic cholecystectomy, those having open cholecystectomy were more likely to be older, be male, and have acute cholecystitis or comorbid illnesses (P < 0.001). The operative mortality rate of open cholecystectomy increased by 46% during this 4-year period (from 2.4% to 3.4%) and was constant for laparoscopic cholecystectomy (about 0.5%). Given the increasing use of the laparoscopic procedure, however, the overall mortality rate of cholecystectomy during surgery decreased by 22% (from 2.4% to 1.8%). Despite increased use of the surgery, the absolute number of deaths decreased by 9%.

CONCLUSIONS

The introduction of laparoscopic cholecystectomy in the VA system was not accompanied by a large increase in cholecystectomy rates, as it was in fee-for-service, Medicare, and HMO systems. Because the rate of operations has changed only slightly, the total number of cholecystectomy-related deaths has decreased.

[The emergence of multiple antimicrobial resistance in Vibrio cholerae isolated from gastroenteritis patients in Ceará, Brazil]

Of 7058 Vibrio cholerae strains recovered from patients suspected of cholera in the State of Ceará between December 1991 and September 1993, two were resistant to antimicrobials (Ampicillin, erythromycin, trimethoprim-sulfamethoxazole, tetracycline) and to vibriostatic agent O/129 (2,4-diamino-6,7-diisopropylpteridine). From the bacteriological standpoint, one strain was identified as V. cholerae serogroup O:1, biotype El Tor, serovar Inaba, and another as V. cholerae serogroup O:22, biochemically classified as Heiberg type II. It was shown that only in the serogroup O:1 strain, multiple resistance was encoded by a plasmid transferrable by conjugation to Escherichia coli K12 and a sensitive strains of V. cholerae O1 and non-O1, with at a frequency between 8 x 10(-2) and 5 x 10(-6). The plasmid, with a molecular weight of 147 Kb, encoded both multiple resistance to antimicrobials and the vibriostatic compound (O/129), compatible with descriptions reported in other parts of world.

Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer

PURPOSE

Diagnosis of advanced prostate cancer is a major health problem, especially among low-income men. Opportunities vary for early detection of prostate cancer for low-income black and white men because of financial, cultural, and social factors. In this study, we evaluated the association of poor literacy skills with higher rates of presentation of advanced stages of prostate cancer among low-income black and white men who received care in equal-access medical systems.

PATIENTS AND METHODS

Literacy and stage at diagnosis of prostate cancer were evaluated in 212 low-income men who received medical care in Shreveport, LA, and Chicago, IL. The patients' literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine (REALM), an individually administered reading screening test designed specifically for use in the medical setting. Logistic regression models were used to evaluate predictors of metastatic disease at presentation as a function of patient age, race, literacy, and city.

RESULTS

Whereas black men were almost twice as likely to present with stage D prostate cancer (49.5% v 35.9%; P < .05), they were significantly more likely to have literacy levels less than sixth grade (52.3% v 8.7%; P < .001). However, after adjustment for differences in literacy, age, and city, race was not a significant predictor of advanced-stage prostate cancer.

CONCLUSION

Low literacy may be an overlooked but significant barrier to the diagnosis of early-stage prostate cancer among low-income white and black men. The development of culturally sensitive, low-literacy educational materials may improve patient awareness of prostate cancer and improve the frequency of diagnosis of early-stage cancer.

Intestinal helminthiasis and anaemia in youngsters from Matriz da Luz, district of São Lourenço da Mata, state of Pernambuco, Brazil

A group of youngsters (4-18 years old) in northeast Brazil was studied to establish the prevalence of anaemia and intestinal parasitism, as well as to analyze the correlation between them. Two criteria were used to determine the state of anaemia, the level of haemoglobin and the mean of corpuscular volume. The first was considered a single criterion and the second an associated criteria, used in an attempt to correlate anaemia with iron deficiency. The prevalence of intestinal parasitism was 93%, while the prevalence of anaemia was 43.1% and 16.1% according to the criteria employed (single or associated respectively). Anaemia was significantly associated with both sex and age. No significant statistical difference was observed when the association was made between each parasite and anaemia even with those more related to anaemia.

Resistance to 3-mercaptopropionic acid-induced seizures in hepatic encephalopathy

BACKGROUND/AIMS

To determine if a model of hepatic encephalopathy (HE) exhibits decreased sensitivity to the neuronal effects of a drug that induces seizures as a consequence of decreasing GABA-mediated inhibitory neurotransmission.

MATERIALS AND METHODS

3-Mercaptopropionic Acid (MPA) is an inhibitor of L-glutamate decarboxylase which catalyzes the synthesis of GABA from glutamate. MPA was administered, either by intraperitoneal or intracerebroventricular injection, into rats with stage III HE due to thioacetamide-induced fulminant hepatic failure and into normal control rats.

RESULTS

When MPA was administered by intraperitoneal injection, seizure-inducing doses were similar for rats with HE and control rats. However, when a constant dose of MPA (330 micrograms) was administered by intracerebroventricular injection, rats with HE took significantly longer to develop seizures than control rats (16.2 vs. 7.3 minutes; p < 0.0005).

CONCLUSIONS

In a model of HE: (i) There is increased resistance to the convulsive effects of MPA; and (ii) This phenomenon is apparent when MPA is given centrally, but not when it is given peripherally. Increased resistance to the development of a complication of reduced GABA-mediated neurotransmission induced by MPA in the model provides support for the hypothesis that HE is associated with increased GABA-mediated inhibitory neurotransmission.

Percentage cure of cement cured through various thicknesses of Cerec porcelain

Highly filled luting resins are recommended for bonding porcelain restorations to tooth structure. This in vitro investigation was undertaken to determine the degree of cure of a 82 per cent filled dual-curing luting resin, after it was cured through various thicknesses of Cerec Vita Mark II porcelain. Infrared, as well as micro-Raman spectroscopy were used to determine the degree of cure of the cement at different time intervals after mixing and exposure to the curing light. The results indicated that Cerec porcelain thicknesses greater than 3 mm adversely affected the degree of cure of the luting resin, even at 24 hours after mixing the cement.

The learning curve for laparoscopic colorectal surgery. Preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomies

BACKGROUND

Laparoscopic-assisted colectomy is an emerging technology for patients with cancer, polyps, inflammation, and other types of pathologic conditions. While previous studies have shown better outcomes for laparoscopic cholecystectomies when surgeons perform more procedures, there is no information on the relationship between surgeon volume and outcomes for laparoscopic-assisted colectomy.

OBJECTIVE

To evaluate whether better clinical outcomes are found for surgeons who perform higher numbers of laparoscopic-assisted colectomies and whether such a relationship, if it exists, applies to both intraoperative and postoperative outcomes.

DESIGN

Analysis of a data set of 1194 patients, operated on by 114 surgeons, from a prospective registry sponsored by the American Society of Colon and Rectal Surgeons, from May 1991 to October 1994.

MAIN OUTCOME MEASURES

Completion rate, intraoperative and postoperative complications, and length of hospital stay.

RESULTS

In 75% of cases, surgery was completed laparoscopically, with no difference between high-volume surgeons (> or = 40 cases) and low-volume surgeons. Length of stay (average, 6 days) did not vary according to surgeon volume. Postoperative complications occurred in 15% of cases, with a significantly lower rate for high-volume surgeons (10% vs 19%; P < .001). Intraoperative complications occurred in 5% of cases, with a nonsignificant trend toward a lower rate for high-volume surgeons (3.7% vs 6.3%). A multivariate regression analysis, adjusting for type of disease (cancer vs inflammation vs polyps) and for level of difficulty of the procedure (high vs low) showed that for high-volume surgeons there is a lower probability of both intraoperative complications (adjusted odds ratio, 0.56; 95% confidence interval, 0.32-0.97; P = .04) and postoperative complications (adjusted odds ratio, 0.48; 95% confidence interval, 0.34-0.68; P < .001).

CONCLUSIONS

There is a learning curve for laparoscopic-assisted colectomy with respect to intraoperative and postoperative outcomes. As with other laparoscopic procedures, surgeons who perform higher volumes of laparoscopic-assisted colectomy have lower rates of intraoperative and postoperative complications.

The effect of the depth of dentine on shear bond strength of adhesive resins

Dentine bonding agents require the use of a conditioner or primer which affects the adjacent dentine and/or smear layer. The appearance of superficial and deep dentine differs and this may affect the bond strength of adhesive systems. The purpose of this in vitro study was to investigate the bonding efficiency of two modern dentine bonding systems (DBS) i.e., Scotchbond Multi-Purpose (SBMP) and Imperva Bond (IB) when bonding composite resin, Z100 and Lite-Fil II, to firstly superficial and secondly to deep dentine. The bond strength values for SBMP to superficial and deep dentine were 24.7 MPa and 23.0 MPa respectively, and that of IB 19.3 MPa and 18.2 MPa. These differences were statistically significant for both products using the paired Student-t test (p < 0.05). Fractures sites were also examined in a SEM. For both products it was found that the samples which were bonded to the deep dentine showed lower bond strengths than those bonded to the superficial dentine.

Allergies to dental materials

Allergies related to dentistry generally constitute delayed hypersensitive reactions to specific dental materials. Although true allergic hypersensitivity to dental materials is rare, certain products have definite allergenic properties. Extensive reports in the literature substantiate that certain materials cause allergies in patients, who exhibit mucosal and skin symptoms. Currently, however, neither substantial data nor clinical experience unequivocally contraindicate the discontinuance of any of the materials, which include dental amalgam and nickel- and chromium-containing metals. The dentist forms a vital link in the team approach to the differential diagnosis of allergenic biomaterials that elicit symptoms in a patient, not only intraorally, but also on unrelated parts of the body.

Shear bond strength of a composite resin to differently silicoated base metal alloys

This study was undertaken to determine the shear bond strength of Charisma composite resin to both thermal and pyrogenic silicoated base metal alloys namely, Duracast MS, Rexillium V and Wironit extra-hard. The bonded specimens were subjected to three stress treatments prior to shear bond testing. The results indicated that both silicoating techniques significantly improved shear bond strengths to sandblasted alloys, whereas wet heat and thermocycling treatments reduced the bond strengths, except for pyrogenic silicoated Wironit. Thermocycling was more detrimental to thermal than to pyrogenic silicoated Rexillium nad Wironit specimens.

[Safety of ciprofibrate. Open study in a Portuguese population]

STUDY OBJECTIVE

To determine the safety of ciprofibrate in portuguese patients with dyslipidaemia.

DESIGN

Open-label study with 6-month therapy.

PARTICIPANTS

Sequential sample of 40 patients, 20 from each hospital, 37 patients (92.5%) completed the study.

METHODS

After at least one month of diet or washout period, all participants were given 100 mg/day of ciprofibrate, taken after the evening meal. Analysis and clinical examinations were performed at weeks (-4), (0), (+8), (+16) and (+24). Glycemia, uric acid, creatine kinase, creatinine and transaminases were determined.

MAIN RESULTS

Thirty-seven patients ended the study (92.5%), three abandoned because of gastrointestinal adverse effects, six other patients also complaint of gastrointestinal side effects. The creatinine and creatine kinase levels increased 9.7% and 19.2%, although kept in the normal range. There were no statistically significant changes in glycemia, uric acid and transaminases levels.

CONCLUSIONS

These results confirm the high safety of ciprofibrate in patients with dislipidaemia. The short term of this study does not allows taking conclusions about long term use of this drug.

Analysis of 8-hydroxy-2'-deoxyguanosine in rat urine and liver DNA by stable isotope dilution gas chromatography/mass spectrometry

A previously developed gas chromatographic/mass spectrometric method was applied to the measurement of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in rat liver DNA and in rat urine. For DNA samples, the method included: (i) fortification of samples with [15N]DNA (internal standard), (ii) enzymatic hydrolysis of DNA to deoxynucleosides, (iii) degradation of native nucleosides by treatment with trifluoroacetic acid and hydrazine, (iv) purification by C18 solid-phase extraction (SPE), (v) derivatization (acetylation followed by pentafluorobenzylation, Ac-PFB), and (vi) GC/MS analysis of the derivatives. For urine, the following methodology was used: (i) fortification of the samples with 8-18OHdG, (ii) prepurification by C18/OH SPE, (iii) derivatization, (iv) high-performance liquid chromatography purification of the Ac-PFB derivatives, and (v) GC/MS analysis. The precision of the method was demonstrated by carrying out replicate analysis of several urine and DNA samples: within-run and between-run variability was less than 5 and 8%, respectively. The analytical approaches were sufficiently sensitive to quantitate the urinary excretion of 8-OHdG (490 +/- 70 pmol/kg/24 h; sample size, 600 microliters urine) and to measure the level of 8-OHdG in liver DNA (20 8-OHdG/10(6) deoxynucleosides; sample size, 30 micrograms DNA) of rats not deliberately exposed to oxidative stress. Major advantages over previous methods are increased precision due to the use of proper isotopically labeled internal standards, and increased sensitivity due to the optimization of cleanup procedures. The simultaneous analysis of standards of three different oxidized nucleosides, namely 8-OHdG, thymidine glycol, and 5-hydroxy-methyl-2'-deoxyuridine, is shown.

[Effectiveness of ciprofibrate. Open study in a Portuguese population]

STUDY OBJECTIVE

To determine the efficacy of ciprofibrate in portuguese patients with hypercholesterolaemia, hypertriglyceridaemia and mixed hyperlipidaemia.

DESIGN

Open-label study with 6-month therapy.

SETTING

Out-patient clinics of two Central Hospitals.

PARTICIPANTS

Sequential sample of 40 patients 20 from each hospital. 37 patients (92.5%) completed the study; 14 had dyslipidaemia type IIa, 12 type IIb and 11 type IV.

METHODS

After at least one month of diet or washout period, all participants were given 100 mg/day of ciprofibrate, taken after the evening meal. Analysis and clinical examinations were performed at weeks (-4), (0), (+8), (+16) and (+24). Total (TC) and HDL (HDL-C) cholesterol, triglycerides (TG), apoproteins A-I, B100, and (a), and fibrinogen were determined. LDL-cholesterol (LDL-C) was calculated by means of the Friedewald formula, whenever TG < or = 400 mg/dl.

MAIN RESULTS

With ciprofibrate, in the whole population, TC, TG, LDL-C, apoB100, and TC/HDL-C ratio diminished, respectively 16.6%, 46.2%, 20.7%, 12.6% and 24.6%. HDL-C and apoA-I increased 10.4% and 4.2%. LDL-C was reduced by 29.5% (p = 0.0001) in type IIa patients, and increased 23% (not statistically significant) in type IV patients. The reduction of TG attained 57.4% in type IIb patients. One type IIb patient received 200 mg/day of the drug from week (+16) on. BMI, waist/hip ratio, hypertension, alcohol consumption and sex didn't affect ciprofibrate activity.

CONCLUSIONS

These results confirm the high efficacy of ciprofibrate in patients with hypercholesterolaemia, hypertriglyceridaemia and mixed hyperlipidaemia. In type IIa dyslipidaemia, the reduction of LDL-C was roughly equivalent to that of the less potent statins. In type IV dyslipidaemia LDL-C may increase moderately. The influence on apoprotein (a) and fibrinogen was positive but modest.

Shear bond strength of a composite resin after delayed bonding to a polymerised dentine bonding system

Polymerised adhesive may serve as a temporary sealant on prepared dentine surfaces and may be used as a precursor to the final bonding of a resin restoration. This procedure may, however, have an adverse effect on the strength of the final bond. This study was undertaken on 40 extracted human molar teeth to assess the effect of delayed bonding on the shear bond strength of a composite resin luted with a luting resin to abraded dentine treated with the Scotchbond Multi-Purpose (SMP) Bonding System (3M). No significant difference (p = 0.969) could be demonstrated between shear bond strengths achieved after immediate and delayed bonding to the polymerised Scotchbond Multi-Purpose adhesive.

[Hematogenic placentitis in chagasic mothers]

Foram estudadas 135 placentas de mães chagásicas que não transmitiram sua infecção ao feto. Em apenas uma destas placentas, encontrou-separasitismo associado a discreta vilosite, crônica e focal. Em outras 24 placentas, observou-se apenas vilosite, na ausência de parasitismo, determinando uma freqüência de 17,9% de vilosite de causa ignorada. Comparou-se esta freqüência com a de um grupo controle, composto de placentas de mães não-chagásicas. A diferença observada foi, estatisticamente, não significante.

Tensile bond strength of dental glazes

Adaptic Glaze and Finite exhibited higher tensile bonds strengths than Concise Enamel Bond and Nuva-Seal. This is probably due to inherent higher viscosity and strength properties of Adaptic Glaze and Finite rather than to differences in adhesive qualities of the various resins. Consequently, the observed occasional early clinical loss of glazes should not be attributed to poor tensile bond strength.