Characterisation of TcFUT1, a mitochondrial fucosyltransferase from Trypanosoma cruzi

Previous work has shown that the TbFUT1 and LmjFUT1 genes encode essential fucosyltransferases located inside the single mitochondria of the protozoan parasites Trypanosoma brucei and Leishmania major, respectively. However, nothing was known about the orthologous gene TcFUT1 or its gene product in Trypanosoma cruzi, aetiological agent of Chagas disease. In this study, we describe the overexpression of TcFUT1 with a C-terminal 6xMyc epitope tag in T. cruzi epimastigote cells. Overexpressed and immunoprecipitated TcFUT1-6xMyc was used to demonstrate enzymatic activity and to explore substrate specificity. This defined TcFUT1 as a GDP-Fuc : βGal α1-2 fucosyltransferase with a strict requirement for acceptor glycans with non-reducing terminal Galβ1-3GlcNAc structures. This differs from the specificity of the T. brucei orthologue TbFUT1, which can also tolerate non-reducing terminal Galβ1-4GlcNAc and Galβ1-4Glc acceptor sites. Immunofluorescence microscopy using α-Myc tag antibodies also showed a mitochondrial location for TcFUT1 in T. cruzi epimastigote cells. Collectively, these results are like those described for TbFUT1 and LmjFUT1 from T. brucei and L. major, suggesting that FUT1 gene products have conserved function for across the trypanosomatids and may share therapeutic target potential.

Post-COVID-19 tomographic abnormalities

BACKGROUND: The prevalence of persistent respiratory symptoms tends to be low in patients with a longer recovery time after COVID-19. However, some patients may present persistent pulmonary abnormalities.OBJECTIVE: To evaluate the prevalence of tomographic abnormalities 90 days after symptom onset in patients with COVID-19 and compare two chest high-resolution computed tomography (HRCT) analysis techniques.METHODS: A multicentre study of patients hospitalised with COVID-19 having oxygen saturation <93% on room air at hospital admission were evaluated using pulmonary function and HRCT scans 90 days after symptom onset. The images were evaluated by two thoracic radiologists, and were assessed using software that automatically quantified the extent of pulmonary abnormalities.RESULTS: Of the 91 patients included, 81% had at least one pulmonary lobe with abnormalities 90 days after discharge (84% were identified using the automated algorithm). Ground-glass opacities (76%) and parenchymal bands (65%) were the predominant abnormalities. Both chest HRCT technical assessments presented high sensitivity (95.9%) and positive predictive value (92%), with a statistically significant correlation at baseline (R = 0.80) and after 90 days (R = 0.36).CONCLUSION: The prevalence of pulmonary abnormalities on chest HRCT 90 days after symptom onset due to COVID-19 was high; both technical assessments can be used to analyse the images.

18F-FDG PET/CT images defined the true extent of a urothelial bladder carcinoma

A patient was referred, after neoadjuvant chemotherapy, for pre-surgical evaluation of urothelial bladder carcinoma (single lesion). Two thickenings in the left ureter wall identified on the CT scan were equivocal for malignancy. 18F-FDG PET/CT with delayed pelvic images, hyperhydration, and furosemide showed hypermetabolic ureteral metastases and multifocal bladder tumors. There were no lymph nodes or distant metastases. These 18F-FDG PET/CT findings completely altered the surgical treatment. The patient underwent left nephroureterectomy, radical cystoprostatectomy, and lymphadenectomy, followed by a urinary transit reconstruction. Histopathology confirmed multifocal high-grade urothelial carcinoma in the bladder walls and left ureter and benign lymph nodes.

Antitrypanosomal Activity of Acetogenins Isolated from the Seeds of Porcelia macrocarpa Is Associated with Alterations in Both Plasma Membrane Electric Potential and Mitochondrial Membrane Potential

As part of a drug discovery program aimed at the identification of anti- Trypanosoma cruzi metabolites from Brazilian flora, four acetogenins (1-4) were isolated from the seeds of Porcelia macrocarpa and were identified by NMR spectroscopy and HRESIMS. The new compounds 1 and 2 displayed activity against the trypomastigote (IC₅₀ = 0.4 and 3.6 μM) and amastigote (IC₅₀ = 23.0 and 27.7 μM) forms. The structurally related known compound 3 showed less potency to the amastigotes, with an IC₅₀ value of 58 μM, while the known compound 4 was inactive. To evaluate the potential mechanisms for parasite death, parameters were evaluated by fluorometric assays: (i) plasma membrane permeability, (ii) plasma membrane electric potential (ΔΨ_p), (iii) reactive oxygen species production, and (iv) mitochondrial membrane potential (ΔΨ_m). The results obtained indicated that compounds 1 and 2 depolarize plasma membranes, affecting ΔΨ_p and ΔΨ_m and contributing to the observed cellular damage and disturbing the bioenergetic system. In silico studies of pharmacokinetics and toxicity (ADMET) properties predicted that all compounds were nonmutagenic, noncarcinogenic, nongenotoxic, and weak hERG blockers. Additionally, none of the isolated acetogenins 1-4 were predicted as pan-assay interference compounds.

Antiparasitic activity of new gibbilimbol analogues and SAR analysis through efficiency and statistical methods

Chagas' disease and leishmaniasis are parasitic infections enrolled among the neglected tropical diseases, which urge for new treatments. In the search for new chemical entities as prototypes, gibbilimbols A/B have shown antiparasitic activity against Trypanosoma cruzi and Leishmania infantum, and then a set of analogues (LINS03 series) of this natural product were synthesized and evaluated in vitro against the parasites. In the present paper we reported five new compounds with activity against these protozoan parasites, and quite low cytotoxicity. Moreover, the interference of plasma membrane permeability of these analogues were also evaluated. We found that [(4-methoxyphenyl)methyl]octylamine (4) was noteworthy due to its high activity against the amastigote form of both parasites (IC₅₀ 1.3-5.8 μM) and good selectivity index. In order to unveil the SAR for this chemotype, we also presented a group efficiency analysis and PCA and HCA study, which indicated that the methoxyl provides good activity with lower cytotoxicity to mammalian cells. The results from SAR analyses suggest different mechanisms of action between the neutral and basic compounds. In summary, the analogues represent important activity against these parasites and must be prototypes for further exploitation.

Aspectos Clínicos para a Realização do Procedimento de Moldagem de Trabalho em Prótese Parcial Fixa: Revisão de Literatura

A moldagem é um passo fundamental em um tratamento reabilitador protético oral, quanto melhor a exatidão deste procedimento, mais informações serão alcançadas, possibilitando assim, que se realize um trabalho com sucesso. O objetivo do trabalho é expor os achados na literatura sobre os aspectos clínicos dos materiais e técnicas de moldagem de trabalho em prótese parcial fixa. O levantamento bibliográfico foi realizado através de artigos científicos publicados a partir do ano de 2010 até o ano de 2016, dos bancos de dados SciELO, Bireme e PubMed, por meio dos descritores: Próteses, Impressão e Materiais. Após a leitura do Resumo de trinta artigos, foram selecionados vinte e cinco que apresentavam a temática em questão, sendo cinco artigos excluídos por    não apresentarem de forma concisa e direta o critério esperado, sendo este, uma abordagem dos materiais e técnicas de moldagem de trabalho em prótese parcial fixa. Com base nos artigos avaliados, pode-se observar que os elastômeros são os materiais mais utilizados na execução de moldagens de trabalho em prótese parcial fixa, e em relação as técnicas de moldagem, foi visto que todas as técnicas podem ser utilizadas, não apresentando diferença significativa entre elas. Contudo para se obter sucesso clínico neste procedimento, o mesmo deve ser criteriosamente executado, cabendo aos cirurgiões dentistas respeitar suas limitações e utilizar a técnica de forma precisa para que sua reabilitação oral alcance excelência. Palavras-chave: Próteses. Impressão. Materiais.

Análise Dimensional de Técnicas de Moldagem em Prótese Parcial Fixa

Este trabalho teve como objetivo avaliar quatro técnicas de moldagem de trabalho em prótese fixa, utilizando-se o material de moldagem Zetaplus Orangewash (Zermack), a saber: a técnica em fase única e três técnicas de reembasamento: a primeira, utilizando espaçadores de 1 mm a segunda, espaçadores de 2 mm e a terceira, a técnica com plástico de polietileno (“PVC”). Foi confeccionada uma matriz de aço inoxidável com dois cilindros e estipuladas cinco marcações na matriz: distância entre os centros dos cilindros, diâmetro do cilindro 1, diâmetro do cilindro 2, altura do cilindro 1 e altura do cilindro 2. Foram realizadas cinco moldagens de trabalho para cada grupo, totalizando vinte amostras. Estas foram levadas para se realizarem as medições em uma lupa Askania Variant, com o auxílio de uma câmera e enviadas ao programa Image Pro Plus. Como resultado, verificou-se não ter havido diferença significativa entre os grupos testados, podendo, portanto, se concluir que as quatro técnicas testadas neste estudo podem ser utilizadas em moldagem de trabalho em prótese fixa.Palavras-chave: Modelos Anatômicos. Técnica de Moldagem Odontológica. Prótese Dentária.

Neolignans from leaves of Nectandra leucantha (Lauraceae) display in vitro antitrypanosomal activity via plasma membrane and mitochondrial damages

Chagas disease is a neglected tropical disease, caused by the protozoan parasite Trypanosoma cruzi, which affects more than eight million people in Tropical and Subtropical countries especially in Latin America. Current treatment is limited to nifurtimox and benznidazole, both with reduced effectiveness and high toxicity. In this work, the n-hexane extract from leaves of Nectandra leucantha (Lauraceae) displayed in vitro antitrypanosomal activity against T. cruzi. Using several chromatographic steps, four related neolignans were isolated and chemically characterized as dehydrodieugenol B (1), 1-(8-propenyl)-3-[3'-methoxy-1'-(8-propenyl)-phenoxy]-4,5-dimethoxybenzene (2), 1-[(7S)-hydroxy-8-propenyl]-3-[3'-methoxy-1'-(8'-propenyl)-phenoxy]-4-hydroxy-5-methoxybenzene (3), and 1-[(7S)-hydroxy-8-propenyl]-3-[3'-methoxy-1'-(8'-propenyl)-phenoxy]-4,5-dimethoxybenzene (4). These compounds were tested against intracellular amastigotes and extracellular trypomastigotes of T. cruzi and for mammalian cytotoxicity. Neolignan 4 showed the higher selectivity index (SI) against trypomastigotes (>5) and amastigotes (>13) of T. cruzi. The investigation of the mechanism of action demonstrated that neolignan 4 caused substantial alteration of the plasma membrane permeability, together with mitochondrial dysfunctions in trypomastigote forms. In silico studies of pharmacokinetics and toxicity (ADMET) properties predicted that all compounds were non-mutagenic, non-carcinogenic, non-genotoxic, weak hERG blockers, with acceptable volume of distribution (1.66-3.32 L/kg), and low rodent oral toxicity (LD₅₀ 810-2200 mg/kg). Considering some clinical events of cerebral Chagas disease, the compounds also demonstrated favorable properties, such as blood-brain barrier penetration. Unfavorable properties were also predicted as high promiscuity for P450 isoforms, high plasma protein binding affinity (>91%), and moderate-to-low oral bioavailability. Finally, none of the isolated neolignans was predicted as interference compounds (PAINS). Considering the promising chemical and biological properties of the isolated neolignans, these compounds could be used as starting points to develop new lead compounds for Chagas disease.

Antileishmanial Activity and Immunomodulatory Effects of Tricin Isolated from Leaves of Casearia arborea (Salicaceae)

Bioactivity-guided fractionation of antileishmanial active extract from leaves of Casearia arborea led to isolation of three metabolites: tricin (1), 1',6'-di-O-β-d-vanilloyl glucopyranoside (2) and vanillic acid (3). Compound 1 demonstrated the highest activity against the intracellular amastigotes of Leishmania infantum, with an IC₅₀ value of 56 μm. Tricin (1) demonstrated selectivity in mammalian cells (SI > 7) and elicited immunomodulatory effect on host cells. The present work suggests that tricin modulated the respiratory burst of macrophages to a leishmanicidal state, contributing to the parasite elimination. Therefore, the natural compound tricin could be further explored in drug design studies for leishmaniasis treatment.

New alkenyl derivative from Piper malacophyllum and analogues: Antiparasitic activity against Trypanosoma cruzi and Leishmania infantum

Alkylphenols isolated from Piper malacophyllum (Piperaceae), gibbilimbols A and B, showed interesting activity against the parasites Trypanosoma cruzi and Leishmania infantum. In continuation to our previous work, a new natural product from the essential oil of the leaves of P. malacophyllum was isolated, the 5-[(3E)-oct-3-en-1-il]-1,3-benzodioxole, and also a new set of five compounds was prepared. The antiparasitic activity of the natural product was evaluated in vitro against these parasites, indicating potential against the promastigote/trypomastigote/amastigote forms (IC₅₀ 32-83 μm) of the parasites and low toxicity (CC₅₀  > 200 μm) to mammalian cells. The results obtained to the synthetic compounds indicated that the new derivatives maintained the promising antiparasitic activity, but the cytotoxicity was considerably lowered. The amine derivative LINS03011 displayed the most potent IC₅₀ values (13.3 and 16.7 μm) against amastigotes of T. cruzi and L. infantum, respectively, indicating comparable activity to the phenolic prototype LINS03003, with threefold decreased (CC₅₀ 73.5 μm) cytotoxicity, leading the selectivity index (SI) towards the parasites up to 24.5. In counterpart, LINS03011 has not shown membrane disruptor activity in SYTOX Green model. In summary, this new set showed the hydroxyl is not essential for the antiparasitic activity, and its substitution could decrease the toxicity to mammalian cells.

Metabolomics as a tool to evaluate the toxicity of formulations containing amphotericin B, an antileishmanial drug

Amphotericin B (AmB) is a drug of choice against life-threatening systemic fungal infections and an alternative therapy for the treatment of all forms of leishmaniasis. It is known that AmB and its conventional formulation cause renal damage; however, the lipid formulations can reduce these effects. The aim of the present study was to identify metabolic changes in mice treated with two different AmB formulations, a nanoemulsion (NE) (lipid system carrier) loaded with AmB and the conventional formulation (C-AmB). For this purpose, metabolic fingerprinting represents a valuable strategy to monitor, in a non-targeted manner, the changes that are at the base of the toxicity mechanism of AmB. Plasma samples of BALB-c mice were collected after treatment with 3 alternate doses of AmB at 1 mg kg-1 administered intravenously and analysed with CE, LC and GC coupled to MS. Blood urea nitrogen (BUN) and plasma creatinine levels were also analysed. Kidney tissue specimens were collected and evaluated. It was not observed that there were any alterations in BUN and creatinine levels as well as in histopathological analysis. Approximately 30 metabolites were identified as potentially related to early C-AmB-induced nephrotoxicity. Disturbances in the arachidonic acid, glycerophospholipid, acylcarnitine and polyunsaturated fatty acid (PUFA) pathways were observed in C-AmB-treated mice. In the AmB-loaded NE group, it was observed that there were fewer metabolic changes, including changes in the plasma levels of cortisol and pyranose. The candidate biomarkers revealed in this study could be useful in the detection of the onset and severity of kidney injury induced by AmB formulations.

Assessment of ovarian reserve by antral follicle count in ovaries with endometrioma

OBJECTIVE

To evaluate whether the antral follicle count (AFC) is underestimated in the presence of an endometrioma.

METHODS

This was a retrospective cohort study assessing all women undergoing in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at our clinic between January 2011 and December 2012 who had both ovaries and unilateral endometrioma. The primary outcome of the study was the difference between AFC and the number of oocytes retrieved per ovary.

RESULTS

Within the study period 787 women underwent IVF/ICSI at our clinic. Sixty of these women had at least one endometrioma, but 23 were excluded from the analysis as six had only one ovary and 17 had bilateral endometriomas. Therefore a total of 37 women were included in this study and analysis. Compared with the contralateral ovaries, ovaries with an endometrioma were significantly larger in volume (median, 10.3 (interquartile range (IQR), 4.7-18.9)  cm(3) vs median, 3.6 (IQR, 2.7-6.5)  cm(3); P < 0.001) and presented a significantly lower AFC (median, 3.0 (IQR, 1.0-6.0) vs median, 5.0 (IQR, 2.0-6.5); P = 0.001). However, the median number of oocytes retrieved was similar (P = 0.60) between ovaries with an endometrioma (2.0 (IQR, 0.5-5.0)) and the contralateral ovaries (2.0 (IQR, 0.0-4.0)). Accordingly, the median difference between AFC and number of oocytes retrieved was significantly smaller (P = 0.005) for ovaries with an endometrioma (0.0 (IQR, -1.0 to 1.5) than for those without (2.0 (IQR, 0.0-4.0)).

CONCLUSIONS

Although the AFC is reduced in ovaries with an endometrioma, the number of oocytes retrieved is similar, suggesting that the AFC is underestimated in such ovaries. We believe that this is a consequence of an impaired ability to detect small follicles in the presence of an endometrioma.

Experimental varicocoele in rats affects mechanisms that control expression and function of the androgen receptor

Varicocoele is an important cause of male infertility. Normal male reproductive function and fertility depends on a delicate balance between androgen receptor (AR) and the classic oestrogen receptors ESR1 (ERα) and ESR2 (ERβ). Using a model of surgically induced varicocoele in rats, this study aimed to investigate the effects of varicocoele on the expression of AR, ESR1, ESR2 and G-protein coupled oestrogen receptor (GPER). Varicocoele did not affect the mRNA and protein expression of ESR1 and ESR2 in both testes. Varicocoele did not affect the mRNA and protein expression of GPER in the right testis, but slightly reduced the mRNA and increased the protein levels in the left testis. Varicocoele did not affect the mRNA for AR, but reduced the protein levels in both testes. A proteomic approach was used in an attempt to find differentially expressed targets with possible correlation with AR downregulation. Varicocoele caused the differential expression of 29 proteins. Six proteins were upregulated, including the receptor for activated C kinase 1 (RACK1), and 23 were downregulated, including dihydrolipoamide dehydrogenase, alpha-enolase and pyrophosphatase 1. Western blot analysis confirmed that varicocoele upregulated the expression of RACK1, a protein involved with tyrosine phosphorylation and regulation of AR transcriptional activity, AR metabolism and dynamics of the blood-testis barrier. In conclusion, this study suggests that varicocoele affects mechanisms that control AR expression and function. This regulation of AR may play an important role in the varicocoele-induced testicular dysfunction. Furthermore, varicocoele downregulates several other proteins in the testis that may be useful markers of spermatozoa function and male infertility.

Hippocampal proteomic profile in temporal lobe epilepsy

In this study we used proteomics approaches to obtain the protein profile of human epileptic hippocampi (N=6) and control hippocampi obtained from autopsy (N=6). We used two-dimensional gel electrophoresis (2-D) coupled to HPLC and Mass spectroscopy (MALDI-TOF) to identify proteins differentially expressed. Nine proteins were differentially expressed comparing the hippocampus of patients with the hippocampus of control. Proteins that were increased in the hippocampus of patients with TLE were: isoform 1 of serum albumin, HSP 70, dihydropyrimidinase-related protein 2, isoform 1 of myelin basic protein, proton ATPase catalytic subunit A, and dihydrolipoyllysine-residue acethyltransferase component of pyruvate dehydrogenase complex. The expression of isoform 3 of spectrin alpha chain (fodrin) was down-regulated while the proteins glutathione S-transferase P and the DJ-1 (PARK7) were detected only in the hippocampus of patients with TLE. Taken together, our results provide evidence supporting a direct link between metabolic disturb and oxidative damage related to pathophysiology of TLE. Besides, indicates biomarkers for further investigations as therapies targeted to epilepsy.

Comparative analysis of the performance of various crystalloid cardioplegic solutions on myocardial protection after prolonged cold ischemia

INTRODUCTION

The quality and effectiveness of myocardial protection are fundamental problems to expand the use of and consequently good outcomes of donated hearts for transplantation.

OBJECTIVE

The purpose of this investigation was to compare the cardioprotective effects of Krebs-Henseleit, Bretschneider-HTK, St Thomas, and Celsior solutions using a modified nonrecirculating Langendorff column model of isolated perfused rat heart during prolonged cold storage.

MATERIALS AND METHODS

After removal 36 rat hearts underwent isolated perfusion into a Langendorff apparatus using Krebs-Henseleit solution for a 15-minute period of recovery; we excluded organs that did not maintain an aortic pressure above 100 m Hg. Subsequently, we equally distributed the hearts into four groups according to the cardioprotection solution; group 1, Krebs-Henseleit (control); group II, Bretschneider-HTK; group III, St Thomas; and group IV, Celsior. Each heart received the specific cardioplegic solution at 10°C for 2-hour storage at 20°C, before a 15 minutes perfusion with Krebs-Henseleit solution for recovery and stabilization. After 60 additional minutes of perfusion, every 5 minutes we determined heart rate (HR), coronary flow (CF), left ventricular systolic pressure (LVSP), and positive and negative peak of the first derivative of left ventricular pressure (+dP/dt and -dP/dt, respectively).

RESULTS

Comparative analysis by Turkey's test showed the following performances among the groups at 60 minutes of reperfusion: HR: II = IV > III > I; CF: II = IV > I = III; LVSP: IV > I = II = III; +dP/dt: IV > I = II = III; and -dP/dt: IV = II > I = II.

CONCLUSION

Cardioprotective solutions generally used in clinical practice are not able to avoid hemodynamic alterations in hearts exposed to prolonged ischemia. Celsior solution showed better performance than Bretschneider-HTK, St Thomas, and Krebs-Henseleit.

Teaching of neuroepidemiology in Europe: time for action

Many epidemiological and clinical studies in Europe, especially in Eastern Europe and countries in transition, are of poor methodological quality because of lack of background knowledge in clinical epidemiology methods and study designs. The only way to improve the quality of epidemiological studies is to provide adequate undergraduate and/or postgraduate education for the health professionals and allied health professions. To facilitate this process, the European Federation of Neurological Societies (EFNS) Task Force on teaching of clinical epidemiology in Europe was set up in October 2000. Based on analyses of the current teaching and research activities in neuroepidemiology in Europe, this paper describes the Task Force recommendations aimed to improve these activities.

[Fulfilling of variables in the declarations of external cause of death of children and adolescents in Recife from 1979 to 1995]

This article analyzes the completion of death certificates related to external causes in children and adolescents residing in Recife, Pernambuco State, Brazil, from 1979 to 1995. The analysis focused on the extent to which the following variables were filled in: personal data (occupation, level of schooling, medical care, confirmation of diagnosis by post-mortem, and type of violence) and place (location and municipality of both occurrence and death). Using the chi-squared method, quantitative and/or qualitative flaws were found in most of the variables analyzed. In 1995, the "schooling" and "medical care" variables were recorded in only 5.7% and 17.9% of cases, respectively. Mismatches were observed between data on place of death and medical care, as well as between place of accident and number of accidents. The results suggest a dissociation between the objective of including the variable in the death certificate and its social function. The study provides the public sector with support for improved collecting and critical analysis of data in the mortality information system.

The use of socioeconomic factors in mapping tuberculosis risk areas in a city of northeastern Brazil

In Brazil the challenge of meeting the needs of those living in deprived areas has generated discussions on replacing the existing approach to epidemiological surveillance with an integrated public health surveillance system. This new approach would supplant the traditional focus on high-risk individuals with a method for identifying high-risk populations and the areas where these persons live. Given the magnitude of the problem that tuberculosis (TB) poses for Brazil, we chose that disease as an example of how such a new, integrated public health surveillance system could be constructed. We integrated data from several sources with geographic information to create an indicator of tuberculosis risk for Olinda, a city in the Brazilian state of Pernambuco. In order to stratify the urban space in Olinda and to check for an association between the resulting TB risk gradient and the mean incidence of the disease between 1991 and 1996, we applied two different methods: 1) a "social deprivation index" and 2) principal component analysis followed by cluster analysis. Our results showed an association between social deprivation and the occurrence of TB. The results also highlighted priority groups and areas requiring intervention. We recommend follow-up that would include treating acid-fast bacilli smear-positive pulmonary TB cases, tracing of these persons' contacts, and monitoring of multidrug-resistant cases, all in coordination with local health services.

[Surveillance of endemic diseases in urban areas: the interface between census tract maps and morbidity data]

In this article we discuss the methodological issues associated with the creation of a surveillance system for endemic diseases in urban areas based on analysis of populations at risk and on spatially referenced epidemiological indicators. We comment on the system's basic requirements, selection criteria for socioeconomic variables, and methodological steps to combine these variables so as to construct a census-based deprivation index. We also present the ways we solved some operational problems related to generation of digitized census tracts maps and linkage of morbidity data from different sources. This approach, spatial organization into account in surveillance of endemic diseases, exemplified here by tuberculosis and leprosy, allows for the interaction of several official data sets from census and health services in order to geographically discriminate inner-city risk strata. Criteria for constructing these risk strata were considered a useful tool for health planning and management activities for the control of endemic diseases in cities.

Elevation of prostate specific antigen in cardiac surgery with extracorporeal cardiopulmonary circulation

PURPOSE

We evaluated the correlation of prostate specific antigen (PSA) and cardiac surgery in a group of patients with symptomatic benign prostatic hyperplasia operated on with or without extracorporeal cardiopulmonary circulation.

MATERIALS AND METHODS

A total of 30 men 54 to 72 years old (mean age 62 years) undergoing cardiac surgery had PSA measured preoperatively and postoperatively. To provide the baseline PSA value a first serum sample was obtained before surgery, and PSA measurements were repeated 12 hours and 7 days postoperatively. Cardiac surgery was performed with extracorporeal cardiopulmonary circulation in 20 cases and without cardiopulmonary bypass in 10, constituted the control group. An 18F Foley catheter was left indwelling for the first 24 hours in both groups.

RESULTS

In the study group there was a significant increase in PSA postoperatively (p = 0.01). However, in the control group the PSA was not statistically different before or after surgery (p = 0.16). These results indicate that there was a physiological relationship between the extracorporeal cardiopulmonary circulation and PSA.

CONCLUSIONS

Although the etiology of this elevation is unknown, based on our data we conclude that extracorporeal cardiopulmonary circulation can cause an alteration in serum PSA unrelated to cardiac operation without extracorporeal bypass.

The effects of ejaculation on serum prostate specific antigen

PURPOSE

We evaluated the correlation of prostate specific antigen (PSA) and ejaculation in patients with symptomatic benign prostatic hyperplasia and an active sexual life.

MATERIALS AND METHODS

In a study of 40 patients 50 to 60 years old (mean age 55) with prostatic symptoms serum PSA was evaluated before as well as 1 and 7 days after ejaculation. Due to clinical significance of PSA in diagnosis and monitoring of prostate cancer, we included men at risk age and with an active sex life.

RESULTS

The results were compared to those of a control group of 10 asymptomatic (without coitus) men 50 to 60 years old (mean age 55 years). There were no statistically significant differences in PSA levels before and after ejaculation or between the groups. These results suggested that there was no physiological relationship between ejaculation and PSA level.

CONCLUSIONS

Based on our data we conclude that sexual activity does not preclude the use of PSA to screen men for prostatic cancer.

Antigenic cross-reactivity among the venoms from several species of Brazilian scorpions

The venoms of seven species of scorpions living in different regions of Brazil were analysed with regard to their lethality, antigenic cross-reactivity and ability to induce antibody production. In mice, the tested scorpion venoms can be grouped as: (a) highly toxic: Tityus stigmurus Thorell (LD50 = 0.773 mg/kg), Tityus bahiensis (Perty) (LD50 = 1.062 mg/kg), Tityus serrulatus Lutz and Mello (LD50 = 1.160 mg/kg), and Tityus costatus (Karsch) (LD50 = 1.590 mg/kg); (b) moderately toxic: Tityus cambridgei Pocock (LD50 = 12.136 mg/kg); and (c) practically nontoxic: Rhopalurus agamemnon (Koch) (LD50 = 36.363 mg/kg), and Brotheas amazonicus Lourenço (LD50 = 90.909 mg/kg). On electrophoresis the venoms showed many protein bands displayed along the chromatogram, most of them cross-reacting in immunoelectrophoresis and immunoblotting using horse anti-T. serrulatus, anti-T. bahiensis or anti-T. serrulatus+T. bahiensis sera as probes. The antibodies present in these antivenoms combine with venom components as measured in vitro by the ELISA assay, and neutralize their lethal effects in vivo. These results indicate that horse anti-venoms against a mixture of T. serrulatus and T. bahiensis venoms or only against T. serrulatus venom yield an antibody population able to neutralize the toxic effects found in all venoms studied.

Blood pressure changes after extracorporeal shock wave lithotripsy in normotensive patients

To evaluate the blood pressure changes caused by extracorporeal shock wave lithotripsy 102 patients 5 to 81 years old (mean age 40 years) with normal blood pressure and kidney lithiasis were monitored during a mean period of 22 months. There were 61 male (group 1) and 41 female (group 2) patients. Patients were evaluated by measurement of the diastolic pressure and the average arterial pressure before and after lithotripsy. Hypertension was considered when the diastolic pressure was greater than 90 mm. Hg for 2 weeks. The amount of shock waves applied in each case ranged from 1,250 to 6,000, with a mean of 4,000 shock waves at a median intensity of 18.1 kv. The incidence of hypertension after extracorporeal shock wave lithotripsy was 3.92%, which is similar to that of a normal population, although the diastolic pressure was statistically higher after treatment in both groups. In the male patients the diastolic pressure increased from 79.26 (+/- 9.7) to 81.47 (+/- 10.1) mm. Hg and in female patients it ranged from 76.58 (+/- 8.3) to 79.26 (+/- 9.9) mm. Hg. Similarly, the average arterial pressure was equally higher in the female group, ranging from 89.88 to 91.75 mm. Hg. In the male group the difference was not statistically significant, despite an increase from 94.5 to 95.8 mm. Hg.

[New method for the determination of antivenom sera in suckling mice. I--Determination of Anti-crotalid sera]

A atividade biológica dos soros antipeçonhentos pode ser determinada "in vivo" em pombos, coelhos, cobaios e camundongos adultos, não existindo, entretanto, nenhum método que possa ser recomendado internacionalmente. Estudou-se comparativamente aos métodos tradicionais de dosagem de soros em pombos e camundongos adultos, a validade do uso de camundongos lactentes de 6 a 7 dias, pesando 4 a 5g, inoculados pela via subcutânea. Inicialmente foi determinada a toxidez do veneno de Crotalus durissus terríficus através do estudo da sintomatologia do envenenamento e da atividade letal. O estudo comparativo dos três métodos forneceu maior concordância de resultados em DE100 entre as dosagens realizadas com camundongos lactentes e adultos. A DE100 e DL50 determinadas em camundongos lactentes forneceu resultados mais constantes que os dos métodos de camundongos adultos e pombos. O uso deste novo método permite eliminar a dificuldade de obtenção do atual animal de prova; a utilização de um maior número de animais por ponto de avaliação biológica, possibilitando uma maior precisão e conseguindo-se uma uniformidade nas características exigidas neste tipo de dosagem como peso, idade e linhagem, visando a reprodução sistemática dos resultados.