Seroprevalence of Trypanosoma cruzi infection among blood donors in the state of Pará, Brazil

INTRODUCTION

Chagas disease (CD) is a neglected pathology worldwide, considered a public health problem due to the high morbidity and mortality rate and its social impact. Thus, the objective was to estimate the prevalence of reactive serology for T. cruzi in blood donors in the units of the public blood network in the state of Pará (Brazil), as well as to describe the epidemiological profile of these donors.

METHODS

This is a retrospective and descriptive study carried out at the Pará State Center for Hematology and Hemotherapy (HEMOPA) between 2016 and 2021, with analysis of secondary data (epidemiological and serological) of inapt blood donors for CD.

RESULTS

Among the 533,674 screened samples, the reactivity for anti-T. cruzi was detected in 0.1% (548), of which 0.03% (166) were inconclusive and 0.07% (382) were positive. The hemonucleus of the city of Abaetetuba had the highest seroprevalence (0.6%). Regarding epidemiological characteristics, most blood donors were men (63.7%), aged between 31 and 45 (44.7%), racially mixed (79.2%), high school graduate (45.8%), single/widowed/divorced (62%), first-time donors (69%), spontaneous donations (58%) and from the state's countryside (69.9%).

CONCLUSION

Over the years analyzed, we observed an increase in seroprevalence for T. cruzi emphasizing the need to maintain epidemiological control in the region and the application of more accurate serological tests in the screening of donor blood bags.

The GPER1 agonist G1 reduces brain injury and improves the qEEG and behavioral outcome of experimental ischemic stroke

Stroke is one of the principal cerebrovascular diseases in human populations and contributes to a majority of the functional impairments in the elderly. Recent discoveries have led to the inclusion of electroencephalography (EEG) in the complementary prognostic evaluation of patients. The present study describes the EEG, behavioral, and histological changes that occur following cerebral ischemia associated with treatment by G1, a potent and selective G protein-coupled estrogen receptor 1 (GPER1) agonist in a rat model. Treatment with G1 attenuated the neurological deficits induced by ischemic stroke from the second day onward, and reduced areas of infarction. Treatment with G1 also improved the total brainwave power, as well as the theta and alpha wave activity, specifically, and restored the delta band power to levels similar to those observed in the controls. Treatment with G1 also attenuated the peaks of harmful activity observed in the EEG indices. These improvements in brainwave activity indicate that GPER1 plays a fundamental role in the mediation of cerebral injury and in the behavioral outcome of ischemic brain injuries, which points to treatment with G1 as a potential pharmacological strategy for the therapy of stroke.

Convalescent plasma therapy in COVID-19 patients: a non-randomized case-control study with concurrent control

Convalescent plasma therapy has shown controversial results in coronavirus disease-19 (COVID-19) patients. We performed a non-randomized case-control study with contemporaneous controls in a hospital in southern Brazil. Patients were selected for treatment with convalescent plasma by medical decision and compared with patients who did not receive plasma and were hospitalized due to COVID-19 at the same time. The outcomes of interest were intensive care unit (ICU) admission and in-hospital death. Patients that received convalescent plasma had lower in-hospital mortality than patients that did not receive plasma (relative risk (RR) 0.48; 95% confidence interval (CI) 0.29 to 0.79) and these results were consistent after changing the subset of control patients. There were no differences regarding ICU admission between groups (RR=0.80; 95%CI: 0.47 to 1.35). In this study, patients that received convalescent plasma for COVID-19 had lower in-hospital mortality, but this finding requires further confirmation given the retrospective nature of the study.

Parasitic contamination in the soil of public parks from northern Brazil

Public parks are an important source of contamination by parasites due to the high flow of people and animals. We aimed to evaluate the prevalence of intestinal parasites in the soil of public parks from Belém, northern Brazil, as well as compare the degrees of parasitism in squares analyzed, the frequency of parasites found according to parasitological methods and verify the conditions of squares on collection day. This was a cross-sectional analytical study carried out during October 2020. The forty samples from four squares were analyzed by Hoffman, Faust and Baermman modified methods. The results showed that 72.5% of samples were parasitized and 100% of squares were contaminated with intestinal parasites. Moreover, polyparasitism was predominant in contaminated samples and Baermann-Moraes method was the most sensitive in the detection of helminths. Blastocystis hominis (47.2%) and hookworms (52.5%) were the most found species. Thus, this study showed parasitic contamination in all of the squares analyzed, which may be associated with poor sanitary from the city of Belém and reinforce the adoption of preventive measures to reduce the parasitic contamination on squares.

Novas isoflavonas isoladas das folhas de Vatairea guianensis Aubl. e atividade antiprolifetariva

A espécie Vatairea guianensis Aubl, tem grande importância e aplicação na medicina tradicional no tratamento de doenças causadas por fungos dermatofíticos, sendo uma espécie promissora de moléculas bioativas, como antioxidantes, antifúngica dentre outras. Neste contexto, o objetivo deste estudo foi realizar o estudo fitoquímico e testar a atividade citotóxica em linhagens tumorais. O fracionamento do extrato etanólico das folhas levaram ao isolamento e identificação estrutural de cinco metabólicos secundários pertencentes a classe das isoflavonas. Destacam-se dois: Vatairenona A (S1) e Vatairenona B (S2), que são novos produtos naturais. A elucidação estrutural foi realizada utilizando dados espectroscópicos de RMN 1D e 2D, e em comparação com os dados da literatura. A substância Lupiwighteona (S3) apresentou citotoxicidade seletiva nas linhas de mama (MCF-7) e melanoma (SK-MEL-19), com valores IC50 3,971 ± 0,153 e 4,677 ± 0,328 μM, sem causar hemólise em eritrócitos de camundongos, avaliada pelo método MTT in vitro. Os resultados são promissores, sendo o primeiro estudo do gênero Vatairea com atividade citotóxica de isoflavonas de produtos naturais.

Análise de mutações do domínio BCR-ABL quinase em pacientes com leucemia mielóide crônica refratários ao tratamento com mesilato de imatinibe

Objetivo: A Leucemia Mielóide Crônica (LMC) é um distúrbio clonal de células progenitoras hematopoiéticas, caracterizada por uma translocação recíproca entre os cromossomos 9 e 22, que resulta no gene híbrido BCR-ABL1.Mesmo com o progresso no tratamento da doença permitido pelos inibidores de tirosina quinase, mutações pontuais no domínio desse gene são as principais causas de resistência terapêutica, principalmente ao mesilato de imatinibe. O objetivo desse estudo foi analisar as mutações pontuais de alta resistência em paciente com LMC e sua possível correlação com a resposta ao tratamento. Métodos: Estudo transversal com 58 pacientes com LMC em tratamento com imatinibe e com resposta subótima à terapia. As amostras de sangue foram analisadas por PCR em tempo real usando a química TaqMan® para avaliar as seguintes mutações pontuais: T315I, E255V e Y253H. Resultados: Nenhum dos 58 pacientes apresentou alguma das mutações investigadas. Houve uso irregular da medicação em 16% (n = 9), dos quais 44% (n = 4) relataram uso descontínuo e interrupção por conta própria, e 56% (n = 5) apresentaram intolerância ao tratamento e trocaram de fármaco. Conclusão: A ausência das mutações pontuais nos pacientes portadores de LMC analisados neste estudo demonstrou que a falha na terapia não tem correlação molecular com as mutações analisadas e pode estar relacionada à menores taxas de adesão ao tratamento. Estes achados foram demonstrados em um número considerável de pacientes avaliados, apontando a necessidade da edução sobre a importância de seguir as recomendações sobre seu tratamento para evitar complicações futuras.

Prevalence of contamination by intestinal parasites in vegetables (Lactuca sativa L. and Coriandrum sativum L.) sold in markets in Belém, northern Brazil

BACKGROUND

Previous studies have recorded a high prevalence of intestinal parasites in lettuce (Lactuca sativa L.) and coriander (Coriandrum sativum L.) destined for human consumption. This study determined the prevalence of contamination by intestinal parasites in these two plants sold in two street markets and two supermarkets in the city of Belém, northern Brazil.

RESULTS

A total of 200 plant samples were analyzed (100 of each species). The samples were collected randomly between August and October 2018, examined by the spontaneous sedimentation method with two washes, and stored for 24 h. The analysis found that 89% (89/100) of the lettuce samples and 86% (86/100) of the coriander samples were contaminated. Polyparasitism was more frequent in lettuce, but monoparasitism predominated in the coriander. A total of 226 intestinal parasites were found in the lettuce, with a predominance of non-pathogenic parasites in the supermarket samples and more pathogenic parasites in the samples from street markets. In the coriander samples, 172 intestinal parasites were identified, with a predominance of pathogenic parasites in samples from both types of market. In the case of the protozoans, the most prevalent species was Endolimax nana, followed by Blastocystis hominis, in both vegetables. In the helminths, hookworms predominated in the lettuce, and Trichuris trichiura in the coriander.

CONCLUSIONS

These results highlight the need for the monitoring of parasite contamination in vegetables destined for human consumption. Public health initiatives should include educational campaigns on the importance of disinfecting vegetables prior to consumption. © 2020 Society of Chemical Industry.

No effect of acidification or freezing on urinary metanephrine levels

BACKGROUND

Urinary metanephrine is a reliable method to estimate catecholamine secretion. Traditionally, urinary metanephrines are collected into chilled containers containing hydrochloric acid (HCl) and most laboratories freeze urinary samples before analysis. It is uncertain if these pre-analytic procedures alter metanephrine values.

AIM

To evaluate if acidifying and freezing urine samples affect the accuracy of urinary metanephrine measurements.

METHODS

Random urine samples from healthy individuals were collected. Urine samples were distributed into two containers: with HCl 50% homogenized with urine to obtain pH < 2, and without HCl. Each container was divided again into aliquots for immediate measurement or freezing. One aliquot with acid (group 1) and another without acid (group 2) were sent immediately to the laboratory for testing (HPLC), while the other two aliquots, one with acid (group 3) and another without it (group 4) were frozen for 3 months at - 20 °C. Bland-Altman's test was used to analyze inter-assay agreement between measurements.

RESULTS

A total of 15 individuals were included (mean age 27.5 ± 5.9 years, 8 male and 14 white). No difference was observed on mean urinary metanephrine/creatinine ratio between groups: group 1: 0.23 ± 0.11, group 2: 0.22 ± 0.07, group 3: 0.25 ± 0.13, group 4: 0.25 ± 0.15 mg/g creatinine; P > 0.05 for all the comparisons). Bland-Altman's analysis showed agreement between the standard method (group 1) and the experimental method (group 4).

CONCLUSION

Measurement of urinary metanephrines by HPLC method is not influenced by sample acidification nor freezing at - 20 °C for 3 months.

DETECTION OF INTESTINAL PARASITES IN PUBLIC TRANSPORT BUSES IN BELÉM, PARÁ STATE, NORTHERN BRAZIL

The purpose of this study was to investigate the frequency of intestinal parasites in public transport buses in the city of Belém, Pará, Brazil, as well as to compare the frequency of these enteroparasites according to the bus lines, collection sites within the vehicles, and presence of pathogenic and nonpathogenic parasites in the samples. This is a cross-sectional analytical study carried out between February and April 2019, in which 320 samples were analyzed, from 5 bus lines, 8 buses each, collected from 8 different surfaces inside the vehicles, according to Graham’s method. Subsequently, the statistical test was performed to evaluate the differencesbetween the variables, considering p ≤ 0.05. The results indicated that 7.8% of the samples were parasitized and the right handrail presented the highest prevalence of parasites, namely 2.2%. The pathogenic parasites corresponded to 26.7% and the non-pathogenic 73.3%. The non-pathogenic parasite most commonly found was Entamoeba coli totaling 50%, whereas the only pathogenic parasite was Giardia intestinalis in 26.7%. Thus, the presence of pathogenic and non-pathogenic parasites reflects the precarious hygiene of users of this type of transport, presenting a public health issue which needs to be addressed. KEY WORDS: Intestinal Diseases, Fomites, Transmission, Pathogenic parasites, Enteroparasite

Mebendazole induces apoptosis via C-MYC inactivation in malignant ascites cell line (AGP01)

The objective of study was to examine the role of MBZ on malignant ascites cells and the involvement of C-MYC. Comet assay was used to assess the genotoxic effects of MBZ in AGP01 cells and human lymphocytes; differential staining by ethidium bromide and acridine orange, caspase 3/7 and flow cytometry assay was done to access the mechanisms of apoptosis and cell cycle analysis of MBZ in AGP01 cells. C-MYC amplification, C-MYC mRNA and C-MYC protein expression were evaluated by FISH, RT-qPCR and Western blotting, respectively. In addition, cytotoxicity of MBZ was evaluated in AGP01 and AGP01 shRNA MYC by MTT. MBZ significantly increased the damage index and no produced in human lymphocytes. MBZ caused remarkable cell cycle arrest in G0/G1 and G2/M phases at 0.5μM and 1.0 μM, respectively and induced significantly apoptosis in higher concentrations. Additionally, MBZ (0.5 μM and 1.0 μM) increased caspase 3 and 7 activities. MBZ decreased signals, C-MYC mRNA and C-MYC protein expression in AGP01 cells. MBZ induced lower cell viability in AGP01 cells compared AGP01 shRNA MYC in the same concentration. Therefore, our results show the evidence of C-MYC gene as one of the pathways by which MBZ induces cell death in gastric cancer cells.

Isolation of a larvicidal compound from Piper solmsianum C.DC. (Piperaceae)

The Aedes aegypti mosquito is one of the major vectors of arboviruses. These diseases have re-emerged and the insecticides used nowadays are toxic to mammals and environment and have only been effective in the short-term. In this context, natural products are an alternative. The genus Piper has many active compounds against arthropods, including neolignans. The present study evaluated the larvicidal potential of the n-hexanic extract of Piper solmsianum and eupomatenoid-6, identified by GC-MS and NMR techniques, from this extract against Ae. aegypti. The crude extract (100 μg/mL) killed 80% and 98.3% of larvae in the first and third day, respectively. Eupomatenoid-6 exhibited LD₅₀ of 19.33 μM and LD₉₀ of 28.68 μM and was then assayed in human fibroblast cells (MRC5), showing an IC₅₀ of 39.30 μM with estimated LD₅₀ of 42.26 mmol/kg. Our results indicate eupomatenoid-6 as a potent insecticide with relatively low toxicity for mammals.

The anthelmintic drug mebendazole inhibits growth, migration and invasion in gastric cancer cell model

The present study aimed to investigate the effects of MBZ on a human malignant ascites cell line derived from a primary gastric cancer tumor. Our data reveal that MBZ showed high cytotoxicity in vitro, displaying an IC50 of 0.39 μM and 1.25 μM in ACP-02 and ACP-03, respectively. The association between MBZ and 5-FU increased slightly the cytotoxicity when compared to MBZ and 5-FU alone. Furthermore, MBZ disrupted the microtubule structure of AGP-01 cells and inhibited significantly the invasion and migration of these cells. Activity of active MMP-2 significantly decreased at all tested concentration of MBZ compared to negative control. These results support the indication of MBZ in combination with chemotherapeutic agents as a possible adjuvant therapy for the management/treatment of patients with advanced gastric cancer since MBZ is a drug of low cost with acceptable safety profile and reduced toxicity to normal cells. However, clinical trials must be performed in o to evaluate its efficacy in gastric cancer patients.

Effects on DNA repair in human lymphocytes exposed to the food dye tartrazine yellow

Tartrazine is a food additive that belongs to a class of artificial dyes and contains an azo group. Studies about its genotoxic, cytotoxic and mutagenic effects are controversial and, in some cases, unsatisfactory. This work evaluated the potential in vitro cytotoxicity, genotoxicity and effects on DNA repair of human lymphocytes exposed to the dye. We assessed the cytotoxicity of tartrazine by 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide test and the response of DNA repair through comet assay (alkaline version). We used different concentrations of the dye, ranging from 0.25-64.0 mM. The results demonstrated that tartrazine has no cytotoxic effects. However, this dye had a significant genotoxic effect at all concentrations tested. Although most of the damage was amenable to repair, some damage remained higher than positive control after 24 h of repair. These data demonstrate that tartrazine may be harmful to health and its prolonged use could trigger carcinogenesis.

Synthesis and biological evaluation of novel 6-hydroxy-benzo[d][1,3]oxathiol-2-one Schiff bases as potential anticancer agents

With the aim of discovering new anticancer agents, we have designed and synthesized novel 6-hydroxy-benzo[d][1,3]oxathiol-2-one Schiff bases. The synthesis started with the selective nitration at 5-position of 6-hydroxybenzo[d][1,3]oxathiol-2-one (1) leading to the nitro derivative 2. The nitro group of 2 was reduced to give the amino intermediate 3. Schiff bases 4a–r were obtained from coupling reactions between 3 and various benzaldehydes and heteroaromatic aldehydes. All the new compounds were fully identified and characterized by NMR (¹H and ¹³C) and specifically for 4q by X-ray crystallography. The in vitro cytotoxicity of the compounds was evaluated against cancer cell lines (ACP-03, SKMEL-19 and HCT-116) by using MTT assay. Schiff bases 4b and 4o exhibited promising cytotoxicity against ACP-03 and SKMEL-19, respectively, with IC₅₀ values lower than 5 μM. This class of compounds can be considered as a good starting point for the development of new lead molecules in the fight against cancer.

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

The objective of the present cross-sectional study was to assess the prevalence and the clinical and laboratory features of hepatitis C virus (HCV)-positive patients with type 2 diabetes mellitus (DM) attending either an outpatient clinic or hemodialysis units. Serologic-HCV testing was performed in 489 type 2 DM patients (303 outpatients and 186 on dialysis). A structured assessment of clinical, laboratory and DM-related complications was performed and the patients were then compared according to HCV infection status. Mean patient age was 60 years; HCV positivity (HCV+) was observed in 39 of 303 (12.9%) outpatients and in 34 of 186 (18.7%) dialysis patients. Among HCV+ patients, 32 were men (43.8%). HCV+ patients had higher serum levels of aspartate aminotransferase (0.90 ± 0.83 vs 0.35 ± 0.13 μKat/L), alanine aminotransferase (0.88 ± 0.93 vs 0.38 ± 0.19 μKat/L), gamma-glutamyl transferase (1.57 ± 2.52 vs 0.62 ± 0.87 μKat/L; P < 0.001), and serum iron (17.65 ± 6.68 vs 14.96 ± 4.72 μM; P = 0.011), and lower leukocyte and platelet counts (P = 0.010 and P < 0.001, respectively) than HCV-negative (HCV-) patients. HCV+ dialysis patients had higher diastolic blood pressure than HCV- patients (87.5 ± 6.7 vs 81.5 ± 6.0 mmHg; P = 0.005) and a lower prevalence of diabetic retinopathy (75 vs 92.7%; P = 0.007). In conclusion, our study showed that HCV is common among subjects with type 2 DM but is not associated with a higher prevalence of chronic diabetic complications.

Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials

Topiramate was associated with weight loss in clinical trials. We summarize the evidence on the efficacy and safety of topiramate in the treatment of overweight/obesity. The databases Medline, Embase, and Cochrane were searched. Randomized controlled studies with at least 16 weeks of duration that report the effect of topiramate on weight loss and adverse events were eligible for inclusion. Ten studies were included (3320 individuals). Patients treated with topiramate lost an average of 5.34 kg (95% confidence interval [95%CI]-6.12 to -4.56) of additional weight as compared with placebo. According to meta-regression analysis, treatment duration and dosage were associated with the efficacy of topiramate treatment. Evaluating trials using topiramate 96-200 mg day(-1) , the weight loss was higher in trials with >28 weeks of duration (-6.58 kg [95%CI -7.48 to -5.68]) than in trials with ≤28 weeks (-4.11 kg [95%CI -4.92 to -3.30]). Data of 6620 individuals were available for adverse events evaluation and those more frequently observed were paraesthesia, taste impairment and psychomotor disturbances. The odds ratio for adverse events leading to topiramate withdrawal was 1.94 (95%CI 1.64-2.29) compared with the control group. In conclusion, topiramate might be a useful adjunctive therapeutic tool in the treatment of obesity as long as proper warnings about side effects are considered.

Promoter polymorphisms and methylation of E-cadherin (CDH1) and KIT in gastric cancer patients from northern Brazil

The aim of this study was to verify genetic and epigenetic alterations in gastric cancer patients from Pará state, northern Brazil.

MATERIALS AND METHODS

Exon 11 of KIT and two promoter polymorphisms (-160 C/A and -347 G/GA) of the E-cadherin gene (CDH1), and their correlation with the promoter methylation status were analyzed.

RESULTS

No genetic alterations in KIT were found. Promoter polymorphisms revealed an increased probability of developing gastric cancer, especially of the diffuse-type, in patients carrying -160 A and -347 GA alleles. Analyses of CDH1 methylation suggested a significant difference between hypermethylated and non-hypermethylated samples, with a positive association between the -160 A allele and hypermethylation.

CONCLUSION

Our results suggest that -160 A and -347 GA polymorphisms may increase the chance of developing gastric cancer in the studied population and that -160 A polymorphism seems to be related to the hypermethylation pattern of the promoter region of CDH1.

Effects of salivary gland homogenate from wild-caught and laboratory-reared Lutzomyia longipalpis on the evolution and immunomodulation of Leishmania (Leishmania) amazonensis infection

We investigated the effects of Lutzomyia longipalpis salivary glands homogenate of wild-caught and laboratory-reared vectors on the lesion evolution and immunomodulation of the infection caused by Leishmania (Leishmania) amazonensis. To compare the effect of both salivary glands homogenate (SGH), C57BL/6 mice were inoculated subcutaneously into the hind footpads or into the ear dermis with 10(6) promastigotes in the presence or not of SGH from wild-caught and laboratory-colonized sand flies. Comparing SGH groups, the lesion size was lower in mice co-inoculated with wild-caught SGH, as the parasitism and the infiltration of macrophages at the inoculation site. Wild-caught SGH also determined lower production of IL-4 and IL-10 but higher IL-12 levels compared with laboratory-reared SGH. Our findings address a probable bias by using SGH from laboratory-colonized sand flies instead of wild-caught vector SGH in studies concerning saliva effects. A possible mild influence of sand fly saliva in natural infections caused by Leishmania is also speculated, as infection is transmitted by wild and not by laboratory-reared vectors.

In vitro survival and development of goat preantral follicles in two different oxygen tensions

The aim of the present study was to evaluate the effect of two different oxygen (O(2)) concentrations on survival and development of preantral follicles of goats cultured in vitro. Preantral ovarian follicles (> or =150 microm) were isolated from ovarian cortex fragments of goats and individually cultured for 30 days under two different O(2) concentrations (5% and 20% O(2)). Follicle development was evaluated on the basis of antral cavity formation, increase in follicular diameter, presence of healthy cumulus oocyte complexes and fully grown oocytes. Results showed with progression of culture period from 6 to 12 days, a decrease in follicular survival was observed in both O(2) concentrations (P<0.05). When the O(2) tensions were compared to each other in the different days of culture, 20% O(2) was more efficient in promoting an increase in follicular diameter from day 24 of culture onward than 5% O(2) (P<0.05). However, follicles cultured with 5% O(2) had an increased percentage of antrum formation from 12 days to the end of culture, compared with 20% O(2) (P<0.05). Moreover, there was no difference in percentage of fully developed oocytes with the different O(2) tensions. However, only oocytes (16.7%) from follicles cultured in 20% O(2) resumed meiosis. In conclusion, concentration of 20% O(2) was more efficient in promoting follicular growth and oocyte meiosis resumption from preantral follicles of goats when grown in vitro.

Blood pressure means rather than nocturnal dipping pattern are related to complications in Type 2 diabetic patients

AIM

To determine whether systolic and diastolic blood pressure (BP) means, during ambulatory BP monitoring (ABPM), are more strongly correlated with microvascular complications and echocardiographic structural alterations than night-time/daytime (N/D) BP ratio.

METHODS

A cross-sectional study was conducted in 270 Type 2 diabetes mellitus (DM) outpatients who underwent clinical and laboratory investigations, urinary albumin excretion rate (UAER) determination, echocardiography, office and 24-h ABPM (Spacelabs 90207).

RESULTS

UAER, after multivariate adjustments, was associated with office BP (systolic: R(2)(a) 0.162, P < 0.001; diastolic: R(2)(a) 0.124, P < 0.001) and ABPM (24-h systolic: R(2)(a) 0.195, P < 0.001; 24-h diastolic: R(2)(a) 0.197, P < 0.001) but not with N/D BP ratios (systolic: R(2)(a) 0.062, P = 0.080; diastolic: R(2)(a) 0.063, P = 0.069). Similar results were observed for echocardiographic parameters. The presence of retinopathy was associated only with night-time BP values [systolic means: odds ratio (OR) 1.13, 95% confidence interval (CI) 1.03-1.24 and diastolic means: OR 1.21, CI 1.04-1.40 and N/D diastolic BP ratio > 0.90, OR 3.21, CI 1.65-6.25].

CONCLUSIONS

UAER and echocardiographic structural alterations had more consistent correlations of a greater magnitude with systolic BP means than with N/D BP ratios. The nocturnal BP values appear to be more relevant for diabetic retinopathy. BP measurement in patients with Type 2 DM should take into account the 24-h period rather than focusing on a specific time span of BP homeostasis.

Neonatal seizures: background EEG activity and the electroclinical correlation in full-term neonates with hypoxic-ischemic encephalopathy. Analysis by computer-synchronized long-term polygraphic video-EEG monitoring

Between 1994 and 2000, 30 full-term newborns affected by seizures secondary to hypoxic-ischemic encephalopathy, underwent computerised, polygraphic, video-EEG recordings during the first 48 hours of life, in our neonatal intensive care unit. In this longitudinal study, recordings lasted an average of 10.5 hours. We studied EEG ictal discharges that lacked a clinical correlate, the semeiotics, and the electroclinical correlation during seizures, by reviewing the time-synchronised, video-EEG recordings obtained during these six years. The aim of this investigation was to evaluate the relationship between background EEG activity and the electroclinical correlation or dissociation of the seizures. When background activity was depressed and undifferentiated, the seizures were characterised by the electroclinical dissociation except in instances of focal tonic seizures. With all other background patterns, seizures were invariably accompanied by the electrical correlate, the only exception being ocular signs and oral-buccal-lingual movements, which occurred both with and without paroxysmal discharges. Ocular signs and oral-buccal-lingual movements were very frequent and were observed with all patterns of background activity. Only on one occasion were they the sole clinical expression of seizures. In our patients, the electroclinical dissociation was constant only if background EEG activity was depressed and undifferentiated. The constant electroclinical dissociation of seizures was closely correlated with the type of background activity, which, in turn, is indicative of severe cerebral damage. (Published with videosequences.)

HLA antigens and haplotypes in IgA-deficient Brazilian paediatric patients

In the present study we determined the HLA-A, B and DR antigenic and haplotypic frequencies in unrelated Brazilian Caucasian paediatric patients with IgA deficiency (IgA-D). Out of 17 IgA-D subjects typed for HLA A and B specificities, 12 (71%) presented B8 and/or B14; of 15 patients also typed for HLA-DR specificities, 14 (93%) were positive for at least one of the HLA markers previously reported to be associated with IgA-D, i.e. B8, B14, DR1, DR3 or DR7. The haplotypes B8, DR3, B14, DR1 and B13, DR7 were present in 43, 21 and 14% of the cases, respectively, while they have a frequency in the general population of 2, 2 and 1%, respectively. The concomitant association with the three IgA-associated haplotypes found in our study probably reflects the admixture of European genetic influences present in the Brazilian Caucasian population of São Paulo.

Unexplained bilateral occipital calcification and reduced vision

An eight year-old girl, investigated because of convulsions, was found to have isolated bilateral presumably cortical and subcortical calcification, reduced visual acuity and prolonged visual evoked response latencies. There were no clinical manifestations of a phakomatosis.