A 3D printed hydrogel to promote human keratinocytes' spheroid-based growth

Tissue engineering uses cells and biomaterials to develop bioartificial tissue substitutes for different purposes. For example, although several skin models have been developed for pharmaceutical and cosmetic research and skin wound healing, there are few studies on 3D cultures of keratinocytes in 3D printed scaffolds. So, this work aimed to develop a 3D-printed hydrogel scaffold to promote human keratinocyte growth. Mesh 3D scaffolds were printed using an extrusion-based method with a 20% gelatin/5% alginate hydrogel, where HaCaT cells were cultured for 7 days. Scaffolds kept their structure for over 1 week, and their stiffness only decreased after 7 days, showing good mechanical and structural characteristics and biodegradability (27% weight lost). Viable keratinocytes (MTT assay) are aggregated into spheroids, a 3D model capable of mimicking in vivo cell properties and phenotypes. Spheroids were formed on 47% of scaffolds pores and grew over time, showing promising cell proliferation. F-actin staining showed cells' irregular and interconnected shapes and organization over time. This method offers an easy and inexpensive solution for keratinocyte spheroid formation, which may be helpful in tissue engineering as a cell delivery system, for pharmacological or basic research, or wound healing medical applications.

A review of bioengineering techniques applied to breast tissue: Mechanical properties, tissue engineering and finite element analysis

Female breast cancer was the most prevalent cancer worldwide in 2020, according to the Global Cancer Observatory. As a prophylactic measure or as a treatment, mastectomy and lumpectomy are often performed at women. Following these surgeries, women normally do a breast reconstruction to minimize the impact on their physical appearance and, hence, on their mental health, associated with self-image issues. Nowadays, breast reconstruction is based on autologous tissues or implants, which both have disadvantages, such as volume loss over time or capsular contracture, respectively. Tissue engineering and regenerative medicine can bring better solutions and overcome these current limitations. Even though more knowledge needs to be acquired, the combination of biomaterial scaffolds and autologous cells appears to be a promising approach for breast reconstruction. With the growth and improvement of additive manufacturing, three dimensional (3D) printing has been demonstrating a lot of potential to produce complex scaffolds with high resolution. Natural and synthetic materials have been studied in this context and seeded mainly with adipose derived stem cells (ADSCs) since they have a high capability of differentiation. The scaffold must mimic the environment of the extracellular matrix (ECM) of the native tissue, being a structural support for cells to adhere, proliferate and migrate. Hydrogels (e.g., gelatin, alginate, collagen, and fibrin) have been a biomaterial widely studied for this purpose since their matrix resembles the natural ECM of the native tissues. A powerful tool that can be used in parallel with experimental techniques is finite element (FE) modeling, which can aid the measurement of mechanical properties of either breast tissues or scaffolds. FE models may help in the simulation of the whole breast or scaffold under different conditions, predicting what might happen in real life. Therefore, this review gives an overall summary concerning the human breast, specifically its mechanical properties using experimental and FE analysis, and the tissue engineering approaches to regenerate this particular tissue, along with FE models.

A Review on the Biological Activity of Camellia Species

Medicinal plants have been used since antiquity to cure illnesses and injuries. In the last few decades, natural compounds extracted from plants have garnered the attention of scientists and the Camellia species are no exception. Several species and cultivars are widespread in Asia, namely in China, Japan, Vietnam and India, being also identified in western countries like Portugal. Tea and oil are the most valuable and appreciated Camellia subproducts extracted from Camellia sinensis and Camellia oleifera, respectively. The economic impact of these species has boosted the search for additional information about the Camellia genus. Many studies can be found in the literature reporting the health benefits of several Camellia species, namely C. sinensis, C. oleifera and Camellia japonica. These species have been highlighted as possessing antimicrobial (antibacterial, antifungal, antiviral) and antitumoral activity and as being a huge source of polyphenols such as the catechins. Particularly, epicatechin (EC), epigallocatechin (EGC), epicatechin-3-gallate (ECG), and specially epigallocatechin-3-gallate (EGCG), the major polyphenols of green tea. This paper presents a detailed review of Camellia species’ antioxidant properties and biological activity.

The Role of Physical Frailty Independent Components on Increased Disabilities in Institutionalized Older Women

The purpose of this study was to identify the independent components of physical frailty that most influence disability indicators in institutionalized older women. A cross-sectional study with 319 participants (81.96±7.89 years old) was performed. Disability was assessed through dynamic and static balance tests, activities of daily life and falls risk screen. Fried physical frailty protocol was used to access physical frailty. The frail subgroup displayed the weakest results for all disability indicators (p < 0.05). Regression analysis showed that in the two models tested, low physical activity levels and slowness were the physical frailty independent components that better associated with the disability indicators. More studies with larger samples will help to better understand the independent relationship of each physical frailty component with disability outcomes and assist to design a co-adjuvant treatment to reverse physical frailty.

Building Bridges for Innovation in Ageing: Synergies between Action Groups of the EIP on AHA

The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).

Changes of Hematological Markers during a Multi-stage Ultra-marathon Competition in the Heat

This study examined the changes in resting hematological variables in ultra-endurance runners throughout a multi-stage ultra-marathon competition, and compared athletes that completed all stages with those that failed to complete at least one stage within the cut-off time of competition. 19 ultra-endurance runners competing in a 230 km multi-stage ultra-marathon, conducted over 5 consecutive days in hot ambient conditions (32-40°C T(max)), volunteered to participate in the study. Each day, whole blood samples were collected prior to stage commencement and analyzed for full cell counts by Coulter counter. Linear increases were observed for leukocytes, monocytes and lymphocytes; with increases until Stage 3 and a decrease thereafter. Granulocytes showed a cubic growth exponent, indicating decrements to baseline after the significant increments until Stage 3. Hemoglobin and hematocrit showed linear decrements throughout the multi-stage ultra-marathon. No changes in erythrocytes and platelets were observed throughout the multi-stage ultra-marathon. Granulocytes, erythrocytes, hemoglobin and hematocrit changes along the multi-stage ultra-marathon differed in runners that completed all stages compared to those who failed to complete at least one stage within the cut-off time. Multi-stage ultra-marathon in the heat has a large impact on hematological responses of ultra-endurance runners associated with altered performance.

Production, Nutritional Quality and In vitro Methane Production from Andropogon gayanus Grass Harvested at Different Maturities and Preserved as Hay or Silage

Andropogon gayanus is an important grass due to its high biomass production, drought tolerance and favorable growth on low fertility acidic soils. Currently, there is little research on the impact of growth stage on the nutritional quality or the degree of CH4 production that may arise from this forage during ruminal fermentation. The objectives of this study were to determine the effects of regrowth stage of A. gayanus on its chemical composition, in vitro production of gas and CH4, as well as in vitro dry matter (DM) digestibility when grown under tropical Brazilian conditions and conserved as hay or as silage. The nutritional value of A. gayanus grass declined with increasing maturity; however digestible DM yield linearly increased. After 112 d of regrowth, A. gayanus produced higher quality silage (higher lactate and lower pH and butyrate content) and higher DM yield. However, the low levels of crude protein at this time would make protein supplementation a necessity for proper rumen fermentation. No differences in CH4 kinetic parameters were found with advancing maturity or preservation method (hay or silage).

Moderate hypoxia is able to minimize the manganese-induced toxicity in tissues of silver catfish (Rhamdia quelen)

The aim of this study was to compare the effects of manganese (Mn) on silver catfish exposed to different levels of dissolved oxygen. Silver catfish (Rhamdia quelen) were exposed to increasing concentrations of Mn (4.2, 8.4 or 16.2mgL(-1)) under either normoxia (100 percent saturation) or moderate hypoxia (51.87 percent saturation) for 15 days. Under normoxia, Mn exposure increased lipid peroxidation (LP) in brain and kidney; it increased gluthatione (GSH) levels in brain and decreased catalase (CAT) activity in both tissues. Moderate hypoxia was able to prevent Mn-induced LP in brain and to reduce this oxidative parameter in kidney; GSH level was increased in brain, while CAT activity was reduced in both tissues. Activity of isolated mitochondria of liver and gills was reduced by Mn exposure under both levels of dissolved oxygen, but this effect was more prominent in normoxia. As expected, liver, kidney and gills showed an increase of Mn accumulation according to waterborne levels, and these parameters presented positive relationship. The highest waterborne Mn (8.4 and 16.2mgL(-1)) resulted in greater accumulation under normoxia, indicating that moderate hypoxia can stimulate mechanisms capable of reducing Mn accumulation in tissues (though not in blood). Moderate hypoxia can be considered a stress factor and Mn an aquatic anthropogenic contaminant. Therefore we hypothesized that these two conditions together are able to invoke defense mechanisms in juvenile silver catfish, acting in a compensatory form, which may be related to adaptation and/or hormesis.

Fractions composition study of the pyrolysis oil obtained from sewage sludge treatment plant

In this work the parameters of Low Temperature Conversion--LTC were applied in a centrifuged sludge from a sewage treatment plant located in Rio de Janeiro, Brazil. Before the conversion, the sludge was dried and analyzed by TGA to observe its behavior with increasing temperature. The chemical composition of the crude pyrolysis oil was analyzed by FTIR, 1H NMR and GC-MS. The results showed that the oil is a mixture of hydrocarbons, oxygenated and nitrogenated compounds. Using a catalytic treatment it was possible to fractionate the oil where the predominant constituents were hydrocarbons showing that the cracking was effective. An important result was the difference between the calorific value of dry sludge (10 MJ kg(-1)), the pyrolysis oil (36 MJ kg(-1)) and one of the fractions separated by catalytic cracking (40 MJ kg(-1)) when compared with commercial diesel (45 MJ kg(-1)).

Could dietary trans fatty acids induce movement disorders? Effects of exercise and its influence on Na⁺K⁺-ATPase and catalase activity in rat striatum

The influence of trans fatty acids (FA) on development of orofacial dyskinesia (OD) and locomotor activity was evaluated. Rats were fed with diets enriched with 20% soybean oil (SO; n-6 FA), lard (L; saturated FA) or hydrogenated vegetable fat (HVF; trans FA) for 60 weeks. In the last 12 weeks each group was subdivided into sedentary and exercised (swimming). Brains of HVF and L-fed rats incorporated 0.33% and 0.20% of trans FA, respectively, while SO-fed group showed no incorporation of trans FA. HVF increased OD, while exercise exacerbated this in L and HVF-fed rats. HVF and L reduced locomotor activity, and exercise did not modify. Striatal catalase activity was reduced by L and HVF, but exercise increased its activity in the HVF-fed group. Na(+)K(+)-ATPase activity was not modified by dietary FA, however it was increased by exercise in striatum of SO and L-fed rats. We hypothesized that movement disorders elicited by HVF and less by L could be related to increased dopamine levels in striatum, which have been related to chronic trans FA intake. Exercise increased OD possibly by increase of brain dopamine levels, which generates pro-oxidant metabolites. Thus, a long-term intake of trans FA caused a small but significant brain incorporation of trans FA, which favored development of movement disorders. Exercise worsened behavioral outcomes of HVF and L-fed rats and increased Na(+)K(+)-ATPase activity of L and SO-fed rats, indicating its benefits. HVF blunted beneficial effects of exercise, indicating a critical role of trans FA in brain neurochemistry.

Oxidative stress and anxiety-like symptoms related to withdrawal of passive cigarette smoke in mice: beneficial effects of pecan nut shells extract, a by-product of the nut industry

The present study evaluated the role of pecan nut (Carya illinoensis) shells aqueous extract (AE) against oxidative damage induced by cigarette smoke exposure (CSE) and behavioral parameters of smoking withdrawal. Mice were passively exposed to cigarette smoke for 3 weeks (6, 10, and 14 cigarettes/day) and orally treated with AE (25 g/L). CSE induced lipid peroxidation in brain and red blood cells (RBC), increased catalase (CAT) activity in RBC, and decreased plasma ascorbic acid levels. AE prevented oxidative damage and increased antioxidant defenses of mice exposed to cigarette smoke. In addition, AE reduced the locomotor activity and anxiety symptoms induced by smoking withdrawal, and these behavioral parameters showed a positive correlation with RBC lipid peroxidation. Our results showed the beneficial effects of this by-product of the pecan industry, indicating its usefulness in smoking cessation.

Recombinant human erythropoietin treatment protects the cardio-renal axis in a model of moderate chronic renal failure

Chronic kidney disease (CKD) patients develop anemia because of the low kidney erythropoietin (EPO) production, thus promoting cardiovascular complications. The degree of renal insufficiency might determine the moment to start recombinant human erythropoietin (rhEPO) therapy, but the molecular basis for these options deserves better elucidation. This study aimed to clarify the cardio-renal effects of earlier rhEPO therapy in rats with moderate chronic renal failure (CRF). Four groups of rats were evaluated for 15 weeks (control; rhEPO - 50 IU/kg/week; CRF - 3/4 nephrectomy; CRF + rhEPO) to assess renal and hematology data, EPO levels, blood pressure, heart rate, peripheral catecholamines contents, serum-transforming growth factor-β1 (TGF-β1), kidney gene expression of EPO, Caspase 9 (Casp9), and vascular endothelial growth factor (Vegf). This model of moderate CRF showed moderate and corrected anemia, hypertension, tachycardia, sympathetic overactivity, and increased serum TGF-β1 content. The remnant kidney showed a proliferative profile, with hypertrophy, downregulated gene expression of EPO, and upregulated gene expression of Vegf and Casp9. rhEPO treatment promoted erythrocytosis and prevented tachycardia and catecholamines increment, with a rise of serum TGF-β1. Furthermore, the decreased kidney gene expression of EPO and the overexpression of Casp9 were prevented, demonstrating a renoprotective action on the remnant kidney. In conclusion, rhEPO therapy promotes a protective effect on the cardio-renal axis, which might be mainly attributed to its pro-proliferative and anti-apoptotic properties. These findings might recommend its use in earlier stages of CRF, acting as an erythropoiesis stimulating agent, to efficiently correct not only the anemia, one of the major complications in these patients, but also the succeeding adverse cardio-renal effects.

Effects of aerobic conditioning on salivary IgA and plasma IgA, IgG and IgM in older men and women

As people age, they experience a decline in immune responses. Unusually heavy acute or chronic exercise could increase the risk of upper respiratory tract infection (URTI) whereas regular moderate physical activity may reduce URTI symptomatology. The purpose of the present study was to determine whether an aerobic exercise program would promote chronic adaptations in plasma IgA, IgG and IgM, and salivary IgA (Sal-IgA) in both elderly women and men. Forty-three independently living men and women, aged between 65 and 96 years, were randomly assigned to an aerobic exercising or a control group. Each participant underwent three evaluations (pre, post at 16 weeks and follow-up at 32 weeks). The aerobic exercise group increased resting plasma IgA concentration from 1.08 g. L (-1)+/-0.50 g. L (-1) to 2.29 g. L (-1)+/-0.93 g. L (-1), whereas salivary IgA concentration was unchanged. The control group maintained the plasma IgA values but experienced a decrease in Sal-IgA. The IgG and IgM plasma concentrations increased in both groups, however, only the exercise group maintained higher values in the final follow-up evaluation. Regular aerobic exercise may be effective in promoting IgA immunity and protecting against the deterioration in Sal-IgA values observed in the control group. No gender differences in the immunoglobulin responses to aerobic training were observed.

Constrained next-to-minimal supersymmetric standard model

We consider the fully constrained version of the next-to-minimal supersymmetric extension of the standard model (cNMSSM) in which a singlet Higgs superfield is added to the two doublets that are present in the minimal extension (MSSM). Assuming universal boundary conditions at a high scale for the soft supersymmetry-breaking mass parameters as well as for the trilinear interactions, we find that the model is more constrained than the celebrated minimal supergravity model. The phenomenologically viable region in the parameter space of the cNMSSM corresponds to a small value for the universal scalar mass m_{0}: in this case, one single input parameter is sufficient to describe the model's phenomenology once constraints from collider data and cosmology are imposed.

Homophilic adhesion of human CEACAM1 involves N-terminal domain interactions: structural analysis of the binding site

CEACAM1 on leukocytic, endothelial, and epithelial cells functions in homophilic adhesion, tumor suppression, regulating cell adhesion and proliferation, and in heterophilic adhesion as a receptor for E-selectin and Neisseria meningiditis, Neisseria gonorrhoeae, Haemophilus influenzae, and murine coronaviruses. The 8 transmembrane isoforms of human CEACAM1 possess an extracellular N-terminal IgV domain, followed by variable numbers of IgC2 domains. To establish which key amino acids contribute specifically to CEACAM1 homophilic adhesion, exposed amino acids in the N-terminal domain of a soluble form of CEACAM1 were subjected to mutagenesis. Analyses of mutant proteins with conformationally dependent antibodies indicated that most mutations did not substantially affect the structural integrity of CEACAM1. Nevertheless, decreased adhesion was observed for the single mutants V39A or D40A (single-letter amino acid codes) in the CC' loop and for the triple mutants located in the GFCC'C" face of the N-terminal domain. Interestingly, whereas single mutations in R64 or D82 that are predicted to form a salt bridge between the base of the D and F beta strands close to the critical V39 and D40 residues also abolish adhesion, an amino acid swap (R64D and D82R), which maintains the salt bridge was without significant effect. These studies indicate that the CC' loop plays a crucial role in the homophilic adhesion of CEACAM1. They further predict that specific hydrophobic amino acid residues on the nonglycosylated GFCC'C" face of CEACAM1 N-terminal domain are not only involved in heterophilic interactions with Opa proteins and H influenzae, but are also critical for protein-protein interactions between 2 CEACAM1 molecules on opposing cells.

[Neonatal tetanus]

OBJECTIVE: Neonatal tetanus is an infection with high mortality, constituting a problem in underdeveloped countries, where there is faulty prenatal attendance. In spite of this and of the decreasing incidence of the disease in the state of Rio Grande do Sul, we report a case of neonatal tetanus identified in 1997. METHOD: We interviewed the infantacute;s mother and verified her vaccination history. We conducted a clinical examination of the newborn, anaerobic culture of umbilical stump and review of medical records. We also reviewed the literature and verified the epidemic profile of neonatal tetanus in Rio Grande do Sul.RESULTS: Healthy mother, with complete outline of tetanus vaccination 4 years ago, prenatal uncomplicated and hospital delivery. Family of good socioeconomic level, differing from the other cases notified in the State, in that most did not have prenatal care nor hospital delivery. The patient is a boy. In the 24th day of life he presented fever, cyanosis, lower and upper limbs muscle hypertonia and opisthotonos episodes. An anaerobic culture of the umbilical stump grew Clostridium tetani. He was treated with penicillin G, gentamicin, sedation and tetanus immunoglobulin. He left hospital in good conditions.CONCLUSIONS: Faulty prenatal care in underdeveloped countries is the largest risk factor for high incidence of this disease in these areas. However, in pregnant women with good socioeconomic level and prenatal care, as in the case described here, this diagnosis should not be excluded if there are suggestive signs of it.

Critical determinants of host receptor targeting by Neisseria meningitidis and Neisseria gonorrhoeae: identification of Opa adhesiotopes on the N-domain of CD66 molecules

The human pathogens Neisseria meningitidis and Neisseria gonorrhoeae express a family of variable outer membrane opacity-associated (Opa) proteins that recognize multiple human cell surface receptors. Most Opa proteins target the highly conserved N-terminal domain of the CD66 family of adhesion molecules, although a few also interact with heparan sulphate proteoglycans. In this study, we observed that at least two Opa proteins of a N. meningitidis strain C751 have the dual capacity to interact with both receptors. In addition, all three Opa proteins of C751 bind equally well to HeLa cells transfected with cDNA encoding the carcinoembryonic antigen [CEA (CD66e)] subgroup of the CD66 family, but show distinct tropism for CGM1- (CD66d) and NCA (CD66c)-expressing cells. Because the C751 Opa proteins make up distinct structures via the surface-exposed hypervariable domains (HV-1 and HV-2), these combinations appear to be involved in tropism for the distinct CD66 subgroups. To define the determinants of receptor recognition, we used mutant proteins of biliary glycoprotein [BGP (CD66a)] carrying substitutions at several predicted exposed sites in the N-domain and compared their interactions with several Opa proteins of both N. meningitidis and N. gonorrhoeae. The observations applied to the molecular model of the BGP N-domain that we constructed show that the binding of all Opa proteins tested occurs at the non-glycosylated (CFG) face of the molecule and, in general, appears to require Tyr-34 and Ile-91. Further, efficient interaction of distinct Opa proteins depends on different non-adjacent amino acids. In the three-dimensional model, these residues lie in close proximity to Tyr-34 and Ile-91 at the CFG face, making continuous binding domains (adhesiotopes). The epitope of the monoclonal antibody YTH71.3 that inhibits Opa/CD66 interactions was also identified within the Opa adhesiotopes on the N-domain. These studies define the molecular basis that directs the Opa specificity for the CD66 family and the rationale for tropism of the Opa proteins for the CD66 subgroups.

Analysis of surface markers on CD34+ cells, isolated from cord blood and G-CSF primed peripheral blood

We report a comparative study of the expression of multilineage and adhesion molecules on CD34+ cells isolated from human umbilical cord blood (CB) and G-CSF-mobilized peripheral blood progenitor cells (PBPC) from healthy volunteers. The major difference found between the two sources of CD34+ populations was the expression of CD54 molecule, which was higher in CB in comparison to PBPC.

[Suicide, self-mutilation and poisoning in adolescents: an epidemiological study]

This is an epidemiological study on Self-Inflicted Suicide and Lesions (E950 to E959) that we do not know if they are accidentally or intentionally inflicted (E980 to E989) among adolescents attended in a Psychiatric Ward at an Emergency Service in Ribeirão Preto, S.P., Brazil, from 1988 to 1991. The diagnoses were grouped according to CID-9. Data were obtained from the Hospital Statistics Service. The feminine sex predominated in the 4 years and in both diagnoses. It was observed that the occurrence of E950 to E959 increased during the period, while the occurrence of E980 to E989 decreased among the adolescents.

[Prescription of herbal teas for children under six months of age: the opinion of physicians from a middle size city in Southern Brazil]

A cross sectional study survey was carried out among physicians who work at children's clinics in Pelotas. The doctors were interviewed by medical students about the prescription of tea for children under six months, risk factors and breastfeeding. About half of the interviewed physicians prescribed tea. The main reasons for that were: intestinal colic (35%), diet supplementation (21%), and oral rehydration (18%). The relationship between tea and diarrhoea, tea and malnutrition, tea and weanning was acknowledged by 19%, 47% and 83% of them, respectively. These association remained significant (p<0.05) even after adjustments were allowed for graduation time and pos-graduation courses. The conclusion is that some common aspects of children's diet are not well managed by most of these doctors.

[Promotion of breast-feeding in urban localities of southern Brazil: a randomized intervention study]

A randomized intervention trial to promote breast-feeding was carried out in southern Brazil. A group of 450 mothers and babies was visited at home 5, 10 and 20 days after birth and compared to a non-visited control group of the same size. Ninety-two per cent of the families visited received the three home visits planned. The evaluation of breast-feeding patterns and reasons for weaning took place 6 months after birth for both groups. Ninety-four per cent of the group visited and 92% of the non-visited controls group were traced on the occasion of the assessment. The intervention increased the duration of breast-feeding (median duration of 120 days in the group visited and 105 days in the controls; p = 0.03) and delayed the introduction of milk bottles (median age of introduction of 90 days in the group visited and 60 days in the controls; p = 0.01). Causes of weaning were classified as underlying, intermediate and immediate. The most common underlying cause of weaning was "the baby cried too much", which suggests that mothers should be taught about normal patterns of infant behaviour in the first weeks of life, particularly the need for crying, and the fact that this not necessarily reflects hunger.

The N-domain of the biliary glycoprotein (BGP) adhesion molecule mediates homotypic binding: domain interactions and epitope analysis of BGPc

The biliary glycoproteins (BGPs) represent a group of at least eight differentially spliced molecules belonging to the carcinoembryonic antigen (CEA) subgroup of the CEA family. These molecules are recognized by the CD66 monoclonal antibodies (MoAbs) and function as homotypic and heterotypic adhesion molecules. The extracellular region of the BGPc splice variant comprises an N-terminal IgV-like domain and three IgC2-set domains (A1, B1, and A2). Using soluble recombinant BGP domain variants, we demonstrate in this report that the N-terminal domain mediates homotypic adhesion. Furthermore, this adhesion is both temperature- and cation-dependent. The soluble domain variants of BGP are ideal molecules for epitope mapping. Using these constructs, we have mapped 11 MoAbs that react with the CEA family to different domains of BGPc and have shown that the CD66 MoAbs, YTH71.3.2 and CLBgran 10 (M38), recognize epitopes in the N-terminal domain.

CD66 identifies the biliary glycoprotein (BGP) adhesion molecule: cloning, expression, and adhesion functions of the BGPc splice variant

Within the hematopoietic lineage, the monoclonal antibody (MoAb) CD66 reacts with cells of the granulocyte lineage, but not with the majority of progenitor cells from human bone marrow. Our previous studies have shown that CD66 binds specifically to at least three carcinoembryonic antigen (CEA) superfamily members, ie, CEA itself, nonspecific cross-reacting antigen (NCA), and CGM1, but not to CGM6 (NCA-95). In this report, we show that CD66 will also identify the biliary glycoproteins (BGP). A full-length cDNA for the BGPc molecule (a cytoplasmic splice variant of BGPa) was isolated by expression cloning using the CD66 MoAbs. This protein has an identical extracellular and transmembrane sequence to BGPa with one N-terminal IgV like domain, three IgC-like extracellular domains (A1, B1, and A2), plus a transmembrane domain, but the cytoplasmic domain is spliced by 53 nucleotides. Reverse transcriptase-polymerase chain reaction experiments show that this splice variant can be detected in colonic carcinoma cell lines, in primary colonic adenocarcinomas, and in myeloid and B-cell lines to varying degrees. Quantitative analyses of BGPc RNA expression by RNase protection indicate that abundant levels occur only in the colonic, but not in the hematopoietic, cell lines tested. Studies presented here show that BGPc mediates homotypic adhesion and suggest that the cytoplasmic splicing does not alter the initial homotypic adhesion properties of BGPa.

Early childhood mortality in a Brazilian cohort: the roles of birthweight and socioeconomic status

The deaths of children aged 1-4 years were studied in a cohort of 5914 Brazilian liveborns. A total of 29 early childhood deaths were recorded (cumulative mortality risk of approximately 6 per 1000), 17 of which (59%) were due to infectious diseases. The death rate was highest in the second year. Deaths were highly concentrated in children from low income (< US $50/month) families, where the cumulative risk of early childhood death was about 10 per 1000; on the other hand, there were no deaths among the 616 children from families with a monthly income of US $300 or more. Birthweight was also associated with mortality: the cumulative risk of children weighing less than 2000 g at birth was 21 per 1000, compared to 4 per 1000 among those with birthweights of 3500 g or more. Simultaneous adjustment for income and birthweight did not substantially change these differentials. These findings confirm the strong association between early childhood mortality and socioeconomic conditions, but also make evident the long-term effects of low birthweight.

[Stapling in surgery of cancer of the rectum. Experience with 100 cases]

The authors relate their experience with 100 cases of anterior resections operated using stapling techniques, 43 with double stapling. Fifty three were males and forty seven females, the youngest being 35 year's old and the oldest 87. The tumour was located at the upper third in 54 cases, at the middle third in 41 and at the lower third in five cases. One hundred anterior resections were executed, fifty of the low type. As to the Dukes classification, 15 were A type, 45 type B, 35 type C and 5 type D. There were no operative mortality until the 30th post operative day. As early post-operative complications there were one case of hemorrhage, two pneumopathies, one urinary retention, one cardio-respiratory insufficiency three cases of fistulae and 6 wound infections. In the last 65 cases only one wound infection and two pneumopathies were found. As late complications there were three anastomotic stenosis (all of them satisfactorily solved with dilatation) and six cases with small degree incontinence for gas and faeces recovering spontaneously. The recurrence rate was 14%; in three it has been possible to proceed with its excision by means of abdominoperineal amputation. They conclude stating that mechanical suturing specially is a good alternative to manual suturing in patients with low rectal tumours.

The timing of nutritional status determination: implications for interventions and growth monitoring

A population-based birth cohort of 1226 urban Brazilian children underwent anthropometric examinations at, on average, ages 11, 23 and 47 months. Multiple regression analyses showed that while birth weight was the single most important factor in predicting nutritional status at age 11 months, a wide range of other social, biological and morbidity factors also appeared to play a significant role. Environmental and dietary factors, however, showed no significant association. Nutritional status at age 11 months was a very strong predictor of nutritional status at ages 23 and 47 months and the other explanatory factors made a minimal additional contribution to the regression models. These results suggest that, in this population, childhood nutritional status is primarily determined before the end of the first year of life. These findings have implications for the timing and nature of nutritional interventions and for mechanisms for identifying those children who will suffer from poor nutritional status later in childhood.

[Evaluation of the quality of information on the basic cause of death of infants in Rio Grande do Sul (Brazil)]

The validity of the official information on the cause of infant deaths was studied in the Brazilian cities of Porto Alegre and Pelotas in 1985. Using data collected for a population-based case-control study of infant mortality due to infectious diseases or malnutrition, a comparison was made between the causes of death reported on the death certificates and those obtained after a careful review of case-notes and a medical interview with the parents of the decreased infants. Official death certificates showed an excess of deaths attribute to bronchopneumonia (ICD 485X) and septicemia (ICD 038.9), and an underestimation of the number of deaths due to diarrheal diseases (ICD 009.1) and of sudden infant deaths (ICD 798.0). The overall rate of agreement between official and revised certificates, in terms of groups of causes of death, was only 27.9%. Lower respiratory infections, which were the leading infectious cause of infant death according to official statistics, were superseded by diarrheal diseases after this revision.

Infant feeding and deaths due to diarrhea. A case-control study

The association between infant feeding habits and infant mortality from diarrhea was investigated in a population-based case-control study in two urban areas in southern Brazil during 1985. Each of 170 infants who died due to diarrhea was compared with two neighborhood controls. After allowance was made for confounding variables, infants who received powdered milk or cow's milk, in addition to breast milk, were at 4.2 times (95% confidence interval (CI) 1.7-10.1) the risk of death from diarrhea compared with infants who did not receive artificial milk, while the risk for infants who did not receive any breast milk was 14.2 times higher (95% CI 5.9-34.1). Similar results were obtained when infants who died from diarrhea were compared with infants who died from diseases that were presumed to be due to noninfectious causes. Each additional daily breast feed reduced the risk of diarrhea death by 20% (95% CI 2-34%), but the increase in risk associated with each bottle feed was not significant after allowance was made for the number of breast feeds. The only other consumption variable associated with diarrhea mortality was the frequency with which tea, water, or juice were drunk with each feed (increase in risk, 42% (95% CI 4-93%]. The odds ratios associated with nonbreast milk were highest in the first two months of life. Possible biases were investigated, including the interruption of breast-feeding as an early consequence of the terminal illness, but the strong protective effect of breast-feeding persisted after these adjustments.

Water supply, sanitation and housing in relation to the risk of infant mortality from diarrhoea

In a population-based case-control study in the metropolitan areas of Porto Alegre and Pelotas in southern Brazil children dying in infancy from diarrhoea were compared to neighbourhood controls in terms of several social and environmental variables. Factors found to be significantly associated with an increased risk of death from diarrhoea included the non-availability of piped water, the absence of a flush toilet, residence in a poorly built house and household overcrowding. When adjustment was made for confounding variables and the mutual confounding effect of the environmental variables on each other, the only association that remained statistically significant was that with the availability of piped water. The association with poor housing was almost significant (p = 0.052). Compared to those with water piped to their house, those without easy access to piped water were found to be 4.8 times more likely to suffer infant death from diarrhoea (95% confidence interval 1.7 to 13.8) and those with water piped to their plot but not to their house had a 1.5 times greater risk (95% confidence interval 0.8 to 3.0).

[Operationalization of the concept of social class in epidemiologic studies]

Procura-se demonstrar que é possível operacionalizar o conceito de classe social de forma a utilizá-lo em estudos epidemiológicos. Foi adaptado às características da formação social de Pelotas, RS (Brasil), modelo de classificação desenvolvido para o México e comparado com o desenvolvido para Ribeirão Preto, SP (Brasil). Mediu-se o poder discriminatório das duas classificações em termos do processo saúde-doença, tendo como variável dependente o crescimento de 5.384 crianças nascidas em 1982. As duas classificações estão associadas com diferenças significativas (P<0,001) no crescimento infantil, mas o modelo do México mostra melhor poder discriminatório do que a classificação de Ribeirão Preto. Quando ambas foram incluídas em uma análise multivariada do peso e da altura das crianças, o efeito do modelo do México foi altamente significativo (P<0,001), ao contrário do efeito da classificação, modelo Ribeirão Preto.

Influence of birth weight on mortality from infectious diseases: a case-control study

The association between birth weight and infant mortality from infectious diseases was investigated in a population-based case-control study in two urban areas in southern Brazil. All deaths of children, seven to 364 days of age, occurring in a year were studied and the parents of the 357 infants dying of an infectious cause were interviewed, as were the parents of two neighborhood control infants for each case. Low birth weight infants (less than 2,500 g) were found, after allowing for confounding factors, to be 2.3 (90% confidence interval = 1.6 to 3.4) times more likely to die of an infection than those of higher birth weight. The odds ratios were 2.0 (1.1 to 3.6) for deaths due to diarrhea, 1.9 (1.0 to 3.6) for respiratory infections, and 5.0 (1.3 to 18.6) for other infections. These estimates of the risks associated with low birth weight are considerably lower than those from studies in developed countries.

Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil

In a population-based case-control study of infant mortality in two urban areas of southern Brazil, the type of milk in an infant's diet was found to be an important risk factor for deaths from diarrhoeal and respiratory infections. Compared with infants who were breast-fed with no milk supplements, and after adjusting for confounding variables, those completely weaned had 14.2 and 3.6 times the risk of death from diarrhoea and respiratory infections, respectively. Part-weaning was associated with corresponding relative risks (RR) of 4.2 and 1.6. The risk of death from infections other than diarrhoea or respiratory infection was less clearly associated with breast-feeding (completely weaned, RR = 2.5; partly weaned, RR = 0.4). Cow's and formula milk seemed to be equally hazardous. For deaths due to diarrhoea the increased risk associated with not breast-feeding was greatest in the first two months of life (RR for completely weaned vs breast-fed without supplementary milk = 23.3).

Birthweight and infant mortality: a longitudinal study of 5914 Brazilian children

In a population-based cohort study in Southern Brazil, 87.3% of 5914 liveborn infants were followed for over 12 months. The 215 infant deaths occurring in this cohort were studied in relation to birthweight, gestational age and socioeconomic status. Causes of death were ascertained through the review of case notes and interviews with the parents. As predicted, there was a strong inverse association between birthweight and neonatal and postneonatal mortality. Preterm infants with an adequate weight for their gestational age, despite being slightly heavier than small-for-dates, showed an IMR which was twice as large as the latter. The relative risk associated with low birthweight for deaths due to respiratory infections was over twice as large as that for diarrhoea deaths, but there were only 25 deaths in each category and the estimates are therefore not very precise. There was an interaction between birthweight and socioeconomic status, with the relative risk of mortality associated with low birthweight being much larger among rich than among poor infants. Estimates of the magnitude of the reduction in infant mortality which would accompany a given improvement in the birthweight distribution, which have been mostly based on data from developed countries, may prove to be overoptimistic.

Infant mortality in southern Brazil: a population based study of causes of death

The causes of 215 infant deaths occurring in a population based cohort of 5914 infants from southern Brazil were determined. Perinatal problems were responsible for 43% of these deaths and infectious diseases for 32%. In the group who died of infectious diseases, respiratory infections and diarrhoea were equally important, each accounting for 12% of all deaths. A total of 87% of the deaths occurred in the first six months of life, and this proportion remained high (77%) even after perinatal causes had been excluded. On the other hand, 53% of the infants who died were of low birth weight, as opposed to 7.9% of the survivors. This suggests that low birthweight infants need to be carefully followed by health workers at primary level, especially during the first six months. It was estimated that if the incidence of low birth weight was reduced from the present 8.8% to 5% the likely reduction in infant mortality would be 20%. This reduction would be 33% for deaths due to perinatal causes, 14% for respiratory infections, and only 5% for diarrhoea. Efforts for the prevention of infant deaths in southern Brazil are more likely to be effective if they concentrate on improving perinatal health care and environmental conditions.

Chagas' achalasia treated by a jejunal interposed segment

Resection of the achalasic area and replacement by a segment of jejunal loop, associated with vagotomy and pyloroplasty, has been performed in 21 patients. The majority of these patients had Chagas' disease, with a dilated esophagus wider than 7 cm. This surgical procedure offered symptomatic relief in 20 of our 21 cases. One patient died, but the death was not necessarily related to the operation. Although disphagia and regurgitation did not disappear entirely in all cases the decrease in severity of these symptoms was such to allow the few symptomatic patients to lead an entirely normal life after the operation.