Growth hormone deficiency and other endocrinopathies after childhood brain tumors: results from a close follow-up in a cohort of 242 patients

PURPOSE

Brain tumors are the most common solid tumor in children. The prevalence of survivors from these cancers has been increasing, presenting endocrine sequelae in more than 40% of the cases. Our aim was to characterize the endocrinopathies diagnosed in this population, exploring the outcomes of growth hormone treatment.

METHODS

We have performed a retrospective analysis of the survivors that were followed-up through a close protocol at our endocrine late-effects clinic.

RESULTS

242 survivors, followed during 6.4 (0-23.4) years, were considered. The median age at tumor diagnosis was 6.7 (0-18) years and pilocytic astrocytoma was the most frequent neoplasm (33.5%). The prevalence of endocrinopathies was of 71.5%, with growth hormone deficiency being the most frequent (52.9%). An indirect correlation between the age at the beginning of somatropin and growth velocity in the first year of treatment was observed. Those treated with craniospinal radiotherapy presented a smaller final upper/lower segments ratio comparing with those that only received cranial radiotherapy. However, their final height was not compromised when compared to their family height target. We found pubertal delay in 12%; accelerated/precocious puberty in 13.2%; central and primary hypogonadism in 21.9% and 3.3%, respectively; primary and central hypothyroidism in 23.6% and 14.5%, respectively; thyroid nodules in 7.4%; ACTH deficiency in 10.3% and diabetes insipidus in 12%.

CONCLUSION

This study reveals a higher prevalence of endocrinopathies in brain tumors survivors and explores the influence of craniospinal irradiation in the adult body proportions. It reinforces the importance of routine follow-up among survivors.

Biochemical assessment of the neurotoxicity of gold nanoparticles functionalized with colorectal cancer-targeting peptides in a rat model

The application of gold nanoparticle-peptide conjugates as theranostic agents for colorectal cancer shows much promise. This study aimed at determining the neurotoxic impact of 14 nm gold nanoparticles (AuNPs) functionalized with colorectal cancer-targeting peptides (namely p.C, p.L or p.14) in a rat model. Brain tissue samples, obtained from Wistar rats that received a single injection of citrate-capped AuNPs, polyethylene glycol-coated (PEG) AuNPs, p.C-PEG-AuNPs, p.L-PEG-AuNPs or p.14-PEG-AuNPs, and sacrificed after 2- and 12-weeks, respectively, were analysed. Inflammation marker (tumour necrosis factor-α, interleukin-6, interleukin-1β), oxidative stress (superoxide dismutase, catalase, glutathione peroxidase) and apoptotic biomarker (cytochrome c, caspase-3) levels were measured. Gold nanoparticle-treated groups sacrificed after 2-weeks did not exhibit any significant inflammatory, oxidative stress or apoptotic effects in brain tissue compared to the untreated control group. In brain tissue from rats that were exposed to citrate-capped AuNPs for 12-weeks, tumour necrosis factor-α and interleukin-6 levels were significantly increased compared to the untreated control. Exposure to PEG-AuNP, p.C-PEG-AuNP, p.L-PEG-AuNP and p.14-PEG-AuNP did not elicit significant toxic effects compared to the control after 12-weeks, as evidenced by the absence of inflammatory, oxidative stress and apoptotic effects in brain tissue. We thus report on the safety of PEG-coated AuNP-peptide conjugates for potential application in the diagnosis of colorectal cancer; however, exposure to citrate-capped AuNPs could induce delayed neuro-inflammation, and as such, warrants further investigation.

Quercetin lipid nanoparticles functionalized with transferrin for Alzheimer's disease

Quercetin was encapsulated in lipid nanoparticles (SLN and NLC) to take advantage of its neuroprotective properties in Alzheimer's disease. The nanoparticles were functionalized with transferrin to facilitate the passage across the blood-brain barrier through the transferrin receptors overexpressed in brain endothelial cells. NMR and FTIR confirmed the functionalization of the nanoparticles with transferrin. TEM results showed all nanoparticles presented spherical morphology. Nanoparticles exhibited size around 200 nm and zeta potential values higher than -30 mV. Quercetin entrapment efficiency was around 80-90%. LDH cytotoxicity assays in hCMEC/D3 cell line demonstrated that even for the highest concentration (30 μM) nanoparticles did not reveal cytotoxicity after 4 h of incubation. Permeability studies across hCMEC/D3 cell monolayers showed NLC permeate more the blood-brain barrier, while amyloid-beta studies demonstrated NLC-transferrin have the capacity to inhibit fibril formation. Nanoparticles seem to be suitable for brain applications, mainly for Alzheimer's disease due to inhibition of amyloid-beta aggregation.

Reversible Endoscopic Medial Maxillectomy: Endonasal Approach to Diseases of the Maxillary Sinus

Introduction  The endoscopic access has reduced the morbidity associated with external approaches in diseases of the maxillary sinus. A reversible endoscopic medial maxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases.

Objective  To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach.

Methods  The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMM approach. The same technique was performed on four consecutive patients with benign maxillary sinus disease.

Results  The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course.

Conclusion  The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.

Physical performance, quality of life and sexual satisfaction evaluation in adults with cystic fibrosis: An unexplored correlation

OBJECTIVE

Quality of life (QOL), sexual satisfaction (SS) and physical performance have been assessed in the management of numerous chronic diseases.

METHODS

In this study, the following tests and surveys were applied: (i) QOL questionnaire [Cystic Fibrosis Questionnaire (CFQ)]; (ii) SS questionnaire (SSQ) [female sexual quotient (FSQ) and male sexual quotient (MSQ)]; (iii) 6-minute walk test (6MWT). Spearman's correlation was used for comparison between the data; the Mann-Whitney test was applied to analyze the difference between genders. A total of 52 adult patients with CF were included in this study.

RESULTS

There was a positive correlation between CFQ domains and SSQ questions. The CFQ showed a positive correlation with peripheral oxygen saturation of hemoglobin (SpO₂) and the distance walked in the 6MWT, and a negative correlation with the Borg scale. The SSQ showed positive correlation with the distance walked and a negative correlation with the Borg scale. For some markers evaluated in the 6MWT, there was sometimes association with the evaluated domains and questions. Male patients showed better scores in the emotional CFQ domain, better performance in SSQ and physical performance.

CONCLUSIONS

There was a correlation between CFQ, SSQ and 6MWT in CF. Finally; we believe that QOL surveys should assess the domain "sexuality" as well as physical performance tests.

Testis Morphology and Dichotomic Spermatogenesis in the Sugarcane Borer Diatraea saccharalis (F.) (Lepidoptera: Crambidae)

In the present study, we describe the testis morphology and spermatogenesis of the sugarcane borer, one of the most destructive pests of sugarcane, using light, transmission, and scanning electron microscopies. Diatraea saccharalis (F.) larvae have paired, kidney-shaped testes that are limited externally and divided into four follicles by tunica cells. The adults have two fused whitish and spherical testes that are divided into eight follicles and are composed of spermatogonia, spermatocyte, spermatid, and sperm bundles. The spermatogonia and spermatocyte cysts are located at the apical extremity of the follicle, while the spermatid cysts and sperm bundles are located at the basal extremity of the follicle. Inside of the cysts, which are formed by the somatic cells, the germ line cells develop synchronously and are interconnected by cytoplasmic bridges. Each cyst contains only apyrene or eupyrene, and none of the cysts contain both of the cells. The inner part of the apyrene cyst consists of an electron-dense cap as opposed to a nucleus. The eupyrene sperm contains a nucleus, acrosome, and reticular and lacinate appendages. Both of the sperm types have a "9 + 9 + 2" axoneme and two mitochondrial derivatives at the tail region. The spermatogenesis process and spermatozoa morphology are similar to that of other Lepidoptera.

Polycyclic aromatic hydrocarbons: levels and phase distributions in preschool microenvironment

This work aims to characterize levels and phase distribution of polycyclic aromatic hydrocarbons (PAHs) in indoor air of preschool environment and to assess the impact of outdoor PAH emissions to indoor environment. Gaseous and particulate (PM1 and PM(2.5)) PAHs (16 USEPA priority pollutants, plus dibenzo[a,l]pyrene, and benzo[j]fluoranthene) were concurrently sampled indoors and outdoors in one urban preschool located in north of Portugal for 35 days. The total concentration of 18 PAHs (ΣPAHs) in indoor air ranged from 19.5 to 82.0 ng/m(3) ; gaseous compounds (range of 14.1-66.1 ng/m(3)) accounted for 85% ΣPAHs. Particulate PAHs (range 0.7-15.9 ng/m(3)) were predominantly associated with PM1 (76% particulate ΣPAHs) with 5-ring PAHs being the most abundant. Mean indoor/outdoor ratios (I/O) of individual PAHs indicated that outdoor emissions significantly contributed to PAH indoors; emissions from motor vehicles and fuel burning were the major sources.

Assessment of ultrafine particles in Portuguese preschools: levels and exposure doses

The aim of this work was to assess ultrafine particles (UFP) number concentrations in different microenvironments of Portuguese preschools and to estimate the respective exposure doses of UFP for 3-5-year-old children (in comparison with adults). UFP were sampled both indoors and outdoors in two urban (US1, US2) and one rural (RS1) preschool located in north of Portugal for 31 days. Total levels of indoor UFP were significantly higher at the urban preschools (mean of 1.82 × 10(4) and 1.32 × 10(4) particles/cm(3) at US1 an US2, respectively) than at the rural one (1.15 × 10(4) particles/cm(3) ). Canteens were the indoor microenvironment with the highest UFP (mean of 5.17 × 10(4) , 3.28 × 10(4) , and 4.09 × 10(4) particles/cm(3) at US1, US2, and RS1), whereas the lowest concentrations were observed in classrooms (9.31 × 10(3) , 11.3 × 10(3) , and 7.14 × 10(3) particles/cm(3) at US1, US2, and RS1). Mean indoor/outdoor ratios (I/O) of UFP at three preschools were lower than 1 (0.54-0.93), indicating that outdoor emissions significantly contributed to UFP indoors. Significant correlations were obtained between temperature, wind speed, relative humidity, solar radiation, and ambient UFP number concentrations. The estimated exposure doses were higher in children attending urban preschools; 3-5-year-old children were exposed to 4-6 times higher UFP doses than adults with similar daily schedules.

PRACTICAL IMPLICATIONS

This study reports information on ultrafine particles (UFPs) in various indoor and outdoor microenvironments (canteens, classrooms, gymnasiums, and outdoor) of urban and rural preschools. It identifies the potential sources and origins, characterizes the influence of meteorological parameters on UFP levels, and performs a comparison with other existing international studies. To this date, relatively few studies have investigated UFP in preschools (none in Portugal) and none assessed exposure dose for different age-groups. The obtained findings showed that levels of UFP in various microenvironments of schools differed significantly. Therefore, to obtain an accurate representation of child’s overall preschool exposure profiles, the exposures occurring in these different microenvironments should be always accounted for.

PAH air pollution at a Portuguese urban area: carcinogenic risks and sources identification

This study aimed to characterize air pollution and the associated carcinogenic risks of polycyclic aromatic hydrocarbon (PAHs) at an urban site, to identify possible emission sources of PAHs using several statistical methodologies, and to analyze the influence of other air pollutants and meteorological variables on PAH concentrations.The air quality and meteorological data were collected in Oporto, the second largest city of Portugal. Eighteen PAHs (the 16 PAHs considered by United States Environment Protection Agency (USEPA) as priority pollutants, dibenzo[a,l]pyrene, and benzo[j]fluoranthene) were collected daily for 24 h in air (gas phase and in particles) during 40 consecutive days in November and December 2008 by constant low-flow samplers and using polytetrafluoroethylene (PTFE) membrane filters for particulate (PM10 and PM2.5 bound) PAHs and pre-cleaned polyurethane foam plugs for gaseous compounds. The other monitored air pollutants were SO2, PM10, NO2, CO, and O3; the meteorological variables were temperature, relative humidity, wind speed, total precipitation, and solar radiation. Benzo[a]pyrene reached a mean concentration of 2.02 ng m(-3), surpassing the EU annual limit value. The target carcinogenic risks were equal than the health-based guideline level set by USEPA (10(-6)) at the studied site, with the cancer risks of eight PAHs reaching senior levels of 9.98 × 10(-7) in PM10 and 1.06 × 10(-6) in air. The applied statistical methods, correlation matrix, cluster analysis, and principal component analysis, were in agreement in the grouping of the PAHs. The groups were formed according to their chemical structure (number of rings), phase distribution, and emission sources. PAH diagnostic ratios were also calculated to evaluate the main emission sources. Diesel vehicular emissions were the major source of PAHs at the studied site. Besides that source, emissions from residential heating and oil refinery were identified to contribute to PAH levels at the respective area. Additionally, principal component regression indicated that SO2, NO2, PM10, CO, and solar radiation had positive correlation with PAHs concentrations, while O3, temperature, relative humidity, and wind speed were negatively correlated.

Spirometric tests to assess the prevalence of childhood asthma at Portuguese rural areas: influence of exposure to high ozone levels

The study here reported aimed to: i) evaluate the prevalence of childhood asthma at a Portuguese rural area with high ozone concentrations through lung function tests, validating the previously estimated one assessed through questionnaires (similar to those of the ISAAC); ii) compare the achieved prevalence with the one reported at an unexposed area (with low ozone concentrations), aiming to evaluate the influence of exposure to high ozone levels; and iii) determine potential risk factors. Ninety-five of the original 478 children that completed the questionnaires, mentioned to have at least one of asthma symptoms (wheeze, dyspnea or cough) and were therefore evaluated by spirometry. FEV(1) was in average 89.7% for asthmatics and 102.8% for non-asthmatics. For the studied sample the risk was higher for girls with a tendency to be higher from 8 to 10 years old. Lifetime prevalence of childhood asthma at the exposed area was 9.2%. Children living at the exposed area had 3 times higher risk of having asthma than those living at the unexposed area. Considering that ozone concentrations were the main difference between both areas, it can be suggested that ozone pollution increased asthma prevalence. Nevertheless, it should be remarked that further studies should be done to confirm these results.

Biofouling control using microparticles carrying a biocide

This study presents a new technological approach to minimize the use of antimicrobial (AMB) agents and their deleterious effects, based on the principle of drug-delivery systems whereby the AMB chemicals are transported on microparticles. The efficacy of microparticles carrying the quaternary ammonium compound (QAC), benzyldimethyldodecyl ammonium chloride (BDMDAC), was assessed against Pseudomonas fluorescens in both the planktonic and the biofilm state. The microparticles were prepared using a layer-by-layer (LBL) self-assembly technique. Oppositely charged molecules of polyethyleneimine (PEI), sodium polystyrene sulfonate (PSS), and BDMDAC were assembled on polystyrene (PS) cores. BDMDAC-coated particles were observed by CryoSEM and their composition analyzed by X-ray microanalysis. Zeta potential measurements indicated that changes in surface charge were compatible with a BDMDAC/particle interaction. This biocidal carrier structure had significant stability, verified by the release of only 15% of the BDMDAC when immersed in water for 18 months. Biocidal carrier activity was evaluated by determining the survival ratio of P. fluorescens planktonic and biofilm cells after different exposure periods to BDMDAC-coated particles. Tests with biofilm cells were also performed with the free QAC. An efficient AMB effect (minimum bactericidal concentration) against suspended cells was found for a concentration of 9.2 mg l(-1) of BDMDAC on coated particles after incubation for 30 min and 6.5 mg l(-1) of BDMDAC on coated particles after 60 min. Exposure of biofilms to PS-PEI/PSS/BDMDAC (0.87 mg l(-1)) resulted in a decrease in viability of 60.5% and 66.5% of the total biofilm population for 30 and 60 min exposure times, respectively. Exposure for 60 min to 6.33 mg l(-1) and 11.75 mg l(-1) of BDMDAC in PS-PEI/PSS/BDMDAC particles promoted inactivation of 80.6% and 87.2% of the total population, respectively. The AMB effects obtained with the application of free BDMDAC were statistically similar to those promoted by the application of BDMDAC coated particles. The overall results indicate that this novel AMB strategy has potential for the control of microbial growth of planktonic cells and biofouling. Moreover, the technique allows the reuse of AMB molecules and consequently reduces the environmental risks associated with excessive use of AMB agents, thereby providing real benefits to public health.

Discordant nadir GH after oral glucose and IGF-I levels on treated acromegaly: refining the biochemical markers of mild disease activity

Biochemical markers for remission on acromegaly activity are controversial. We studied a subset of treated acromegalic patients with discordant nadir GH levels after oral glucose tolerance test (oGTT) and IGF-I values to refine the current consensus on acromegaly remission. We also compared GH results by two GH immunoassays. From a cohort of 75 treated acromegalic patients, we studied 13 patients who presented an elevated IGF-I despite post-oGTT nadir GH of < or =1 microg/l. The 12-h daytime GH profile (GH-12 h), nadir GH after oGTT, and basal IGF-I levels were studied in patients and controls. Bland-Altman method showed high concordance between GH assays. Acromegalic patients showed higher mean GH-12 h values (0.71+/-0.36 vs. 0.31+/-0.28 microg/l; p<0.05) and nadir GH after oGTT (0.48+/-0.32 vs. 0.097+/-0.002 microg/l; p<0.05) as compared to controls. Nadir GH correlated with mean GH-12 h (r=0.92, p<0.05). The mean GH-12 h value from upper 95% CI of controls (0.54 microg/l) would correspond to a theoretical normal nadir GH of < or =0.27 microg/l. Patients with GH nadir < or =0.3 microg/l had IGF-I between 100-130% ULNR (percentage of upper limit of normal range) and mean GH-12 h of 0.35+/-0.15, and patients with GH nadir >0.3 and < or =1 microg/l had IGF-I >130% ULNR and mean GH-12 h of 0.93+/-0.24 microg/l. Our data integrate daytime GH secretion, nadir GH after oGTT, and plasma IGF-I concentrations showing a continuum of mild residual activity in a subgroup of treated acromegaly with nadir GH values < or =1 microg/l. The degree of increased IGF-I levels and nadir GH after oGTT are correlated with the subtle abnormalities of daytime GH secretion.

Ozone exposure and its influence on the worsening of childhood asthma

BACKGROUND

It is well documented that high levels of many airborne pollutants can adversely affect many systems of the human body. The aim of this study was to evaluate the specific impact of ozone (O(3)) on the worsening of childhood asthma, comparing children living at regions with high and low O(3) concentrations (reference site) without the confounding effects of other pollutants.

METHODS

Pollutant concentrations were monitored and data concerning asthma prevalence were collected through a questionnaire. The studied population consisted of 478 children aged 6-13 years old enrolled in four schools of the municipalities where monitoring was performed. Remote sites were identified with very low concentrations of nitrogen dioxide and volatile organic compounds and high concentrations of O(3).

RESULTS

The prevalence of wheeze for lifetime period and in the past year was 15.9% and 6.3%, respectively. Asthmatic children were identified when dyspnoea and wheezing were simultaneously mentioned in the absence of upper respiratory infections; according to that, the lifetime prevalence of asthmatic symptoms at the remote sites was 7.1%. The comparison with other previous studies was difficult because the criteria for analysis are not conveniently established.

CONCLUSION

The prevalence of childhood asthmatic symptoms was about 4% higher at the high O(3) site than at the low O(3) site.

Efeito da mitomicina-C tópica sobre os depósitos de colágeno total na submucosa das pregas vocais íntegras de suínos

OBJETIVO: Estudar o efeito da aplicação tópica de Mitomicina-C em diferentes concentrações sobre os depósitos de colágeno total na submucosa de pregas vocais íntegras de suínos. MÉTODOS: Os animais foram divididos em três grupos de acordo com o conteúdo da solução tópica aplicada sobre as pregas vocais: solução fisiológica 0,9 % (grupo controle); Mitomicina-C tópica 4 mg/mL (grupo 1); e Mitomicina-C 8 mg/mL (Grupo 2). Após 30 dias da aplicação, os animais foram submetidos à eutanásia, coletado amostras das pregas vocais e coradas pela técnica do picrosirius red com polarização para a quantificação computadorizada da deposição do colágeno, através do programa Image Pro plus 4.5Ò. Compararam-se as médias de área do colágeno depositado na submucosa das pregas vocais dos três grupos através do teste não paramétrico de Mann-Whitney. RESULTADOS: As médias das áreas de depósito colágeno na submucosa das pregas vocais foram de 3.110,44 micrômetros quadrados (mm²); 3.115,98 mm² e 3.105,78 mm² nos grupos controle, 1 e 2 respectivamente. Não houve diferença significativa nas áreas de depósitos de colágeno total da submucosa das pregas vocais entre os três grupos estudados (p>0,05). CONCLUSÃO: A mitomicina-C aplicada topicamente em pregas vocais suínas íntegras não alterou significativamente a deposição de colágeno na submucosa.

Effect of topical mitomycin-C on total collagen deposits on the submucosa of intact vocal folds in swine

OBJECTIVE

To compare the effects of topical mitomycin-C at different concentrations on submucosal collagen deposition on the vocal folds of swine.

METHODS

The animals were divided into three groups according to the composition of the topical solution to be applied to the vocal folds: 0.9% saline solution (control group); 4 mg/ml mitomycin-C (group 1) and 8 mg/ml mitomycin-C (group 2). Thirty days after the application, all animals were sacrificed, their vocal folds were collected and stained by the picrosirius red technique, and submucosal collagen deposition areas were estimated by the Image Pro Plus 4.5 software. Mann-Whitney test was used to compare differences between parameters of each group.

RESULTS

The means of the areas of submucosal collagen deposits on vocal folds were 3110.44 square micrometers (microm(2)), 3115.98 microm(2) and 3105.78 microm(2) for groups control, 1 and 2, respectively. There were no statistical differences across the three groups (p>0.05).

CONCLUSION

Mitomycin-C topically applied to intact vocal folds of swine did not alter submucosal collagen deposition.

Novel highly reactive and regenerable carbon/iron composites prepared from tar and hematite for the reduction of Cr(VI) contaminant

Highly reactive carbon/Fe composites were prepared from tar used as a carbon source, and hematite (alpha-Fe(2)O(3)), a widespread naturally available iron oxide. Tar was impregnated on hematite and thermally treated under N(2) atmosphere. Mössbauer, powder X-ray diffraction and magnetization data suggested that treatment at 400 and 600 degrees C produced only magnetite (Fe(3)O(4)) whereas at 800 degrees C mainly metallic iron (Fe(0)) was produced. Raman, TG and XRD analyses of the different composites revealed the presence of amorphous and graphitic carbon highly dispersed on the iron oxide surface. The composites obtained at 800 degrees C were very efficient in reducing aqueous Cr(VI), as CrO(4)(2-), even compared to finely ground commercial Fe(0). XPS and Mössbauer data showed that after five consecutive reuses, the composites deactivated, due to the surface oxidation of Fe(0). A simple treatment at 800 degrees C completely regenerated the composite by reducing Fe(3+) species allowing several reuses.

Catalytic effect of magnetic nanoparticles over the H2O2 decomposition reaction

This paper compares the rate of decomposition of hydrogen peroxide when controlled nano-sized magnetite powders are used as catalysts. Two different nano-sized powders and a Fe0/Fe3O4 composite have been used. The nanoparticle samples were synthesized by: (i) a chemical reduction-precipitation method and, (ii) by reduction under H2 atmosphere at 250 degrees C, of a hematite sample previously prepared. The composite, Fe0/Fe3O4, was prepared by thermal controlled reduction of nanoparticles of Fe2O3 obtained from hematite under H2 at 300 degrees C. The samples were characterized by Fourier-transform infrared, X-ray diffraction, and Mössbauer spectroscopy at room temperature, and surface area. The catalytic effect was studied in the decomposition reaction of H2O2 by measuring the formation of gaseous O2. The results showed the presence of pure Fe3O4 for nano magnetite samples and Fe0 and Fe3O4 for the composite sample. The average particle sizes of the magnetite, calculated from reflection 311 by using Scherrer equation were about 33 and 10 nm for the samples obtained by hematite reduction and reduction-precipitation, respectively. Kinetic studies of the decomposition of peroxide showed a higher decomposition rate for the hydrogen peroxide reaction when nanoparticles prepared by reduction-precipitation method were used as catalysts. The high catalytic activity associated to nanoparticles is discussed in terms of the high surface area of these samples.

Oral mucositis in acute lymphoblastic leukaemia: analysis of 169 paediatric patients

Chemotherapy-induced oral mucositis is a frequent therapeutic challenge in cancer patients. The purpose of this retrospective study was to estimate the prevalence and risk factors of oral mucositis in 169 acute lymphoblastic leukaemia (ALL) patients treated according to different chemotherapeutic trials at the Darcy Vargas Children's Hospital from 1994 to 2005. Demographic data, clinical history, chemotherapeutic treatment and patients' follow-up were recorded. The association of oral mucositis with age, gender, leucocyte counts at diagnosis and treatment was assessed by the chi-squared test and multivariate regression analysis. Seventy-seven ALL patients (46%) developed oral mucositis during the treatment. Patient age (P = 0.33), gender (P = 0.08) and leucocyte counts at diagnosis (P = 0.34) showed no correlation with the occurrence of oral mucositis. Multivariate regression analysis showed a significant risk for oral mucositis (P = 0.009) for ALL patients treated according to the ALL-BFM-95 protocol. These results strongly suggest the greater stomatotoxic effect of the ALL-BFM-95 trial when compared with Brazilian trials. We concluded that chemotherapy-induced oral mucositis should be systematically analysed prospectively in specialized centres for ALL treatment to establish the degree of toxicity of chemotherapeutic drugs and to improve the quality of life of patients based on more effective therapeutic and prophylactic approaches for prevention of its occurrence.

Air quality improvements using European environment policies: a case study of SO2 in a coastal region in Portugal

The European Union (EU) has defined several efforts for preventing and controlling air pollution that have led to a generalized reduction of health risks and environmental effects. One example of these efforts was the establishment of legislation that imposed a reduction of sulfur content in fuels, switching to cleaner fuels for industry and motor vehicles (Auto-Oil Directives). The goal of this study was to evaluate the first trends in the air quality of Oporto Metropolitan Area (Oporto-MA) related to implementation of these directives in Portugal since 2000. Therefore, sulfur dioxide (SO2) concentration data from air quality monitoring sites were analyzed for the period 1999 through 2003. It was observed that daily SO2 concentrations in the industrial area are much higher than those of the urban and rural areas, reflecting the influence of the industrial sector. The annual SO2 concentrations for the consecutive years of analysis decreased considerably for all the monitoring sites. A considerable decrease in SO2 emissions was also observed for the same period. According to EU legislation, the exceedances of the SO2 recommended limit values decreased significantly. In conclusion, this analysis shows evidence that SO2 concentrations are decreasing, and that this is consistent with the implementation of the legislation and control of the sources of pollution. Nevertheless, the potential for human health risks still persists, particularly in industrialized areas. It is expected that SO2 concentration levels in ambient air of Oporto-MA will continue to decrease in the coming years, following the present European trends.

Prediction of ozone concentrations in Oporto city with statistical approaches

The performance of three statistical methods: time-series, multiple linear regression and feedforward artificial neural networks models were compared to predict the daily mean ozone concentrations. The study here reported was based on data from one urban site with traffic influences and one rural background site. The studies were performed for the year 2002 and the respective four trimesters separately. In the multiple linear regression and feedforward artificial neural network models, the concentrations of ozone, the concentrations of its precursors (nitrogen oxides) and some meteorological variables for one and two days before the prediction day were used as predictors. For the application of these models in the validation step, the inputs of ozone concentration for one and two days before were replaced by the ozone concentrations predicted by the models. The results showed that time-series modelling was not profitable. In the development step, similar performances were obtained with multiple linear regression and feedforward artificial neural network. Better performance indexes were achieved with feedforward artificial neural network models in validation step. Concluding, feedforward artificial neural network models were more efficient to predict ozone concentrations.

Contribution of anthropogenic pollutants to the increase of tropospheric ozone levels in the Oporto Metropolitan Area, Portugal since the 19th century

The main purpose of this study was to evaluate the contribution of anthropogenic pollutants to the increase of tropospheric ozone levels in the Oporto Metropolitan Area (Portugal) since the 19th century. The study was based on pre-industrial and recent data series, the results being analyzed according to the atmospheric chemistry. The treatment of ozone and meteorological data was performed by classical statistics and by time-series analysis. It was concluded that in the 19th century the ozone present in the troposphere was not of photochemical origin, being possible to consider the respective concentrations as reference values. For recent data a cycle of 8h for ozone concentrations could be related to traffic. Compared to the 19th century, the current concentrations were 147% higher (252% higher in May) due to the increased photochemical production associated with the increased anthropogenic emissions.

Ovariectomy reduces the gelatinolytic activity and expression of matrix metalloproteinases and collagen in rat molar extraction wounds

Osteoporosis is commonly associated with estrogen deficiency. However, the mechanisms by which the lack of this hormone causes bone loss are poorly understood. The bone structure of the oral cavity seems to be affected by estrogen deficiency, since a delayed healing process after tooth extraction has been observed after ovariectomy in rats. The aim of this study was to describe the effect of the absence of estrogen on the expression and activity of matrix metalloproteinases (MMC)-2 and -9 and expression of types I and III collagens in the alveolar granulation tissue of young female rats after tooth extraction. Sixty-six, four-week-old female rats underwent bilateral ovariectomies (OVX) or sham operations. Three weeks later, both first and second mandibular molars were extracted and the animals were killed by cervical dislocation 3, 5, or 7 days after tooth extraction. The granulation tissues were collected from the extracted alveolar sockets and used for zymographic, Western blot, or reverse transcription polymerase chain reaction (RT-PCR) analysis. There was a gradual increase on the expression of all studied proteins as well as MMP-2 and -9 activities in the periods after surgery. In contrast, OVX animals showed a significant decrease in the gelatinolytic activities and expression of MMP-2 and -9 and types I and III collagens. The results presented here in suggest that the absence of estrogen may possibly contribute to the delayed alveolar wound healing by interfering with the extracellular matrix turnover.

Relevant aspects of air quality in Oporto (Portugal): PM10 and O3

The air quality Framework Directive (FWD) and the correspondent Daughter Directives defined the new strategy for air quality management in Europe. In general, the new standards are more restrictive than those established by the previous legislation. In Portugal, some difficulties can be previewed to achieve those new standards. Thus, this paper aims at evaluating the impact of application of the FWD to Oporto Metropolitan Area in what concerns to the most critical air pollutants in the area (PM10 and O3). The specific objectives were: (i) to analyse the concentration exceedances between 1999 and 2001; (ii) to identify the main emission sources; (iii) to evaluate the possibility of a new redistribution of the existing monitoring sites; (iv) to contribute to the definition of a new strategy for air quality management. The results showed that; (i) the standard values for PM10 and O3 were largely surpassed, possibly concluding that the FWD application implies a strong impact on the air quality management strategies; (ii) the main emission sources (road traffic and the neighbour stationary sources localised upwind) affect all the Metropolitan area through intra-region pollutant transport; (iii) it is safer maintaining the site localisation to avoid previewing exceedances through mathematical correlations; (iv) the reduction of PM10 and of ozone precursors must be performed considering new technologies for 'cleaner production' and gaseous depuration, a rigorous urban and territory planning, the creation of an efficient public transport network and the definition of strict measures for car maintenance.

[Motivation in nursing team work]

This is a descriptive study conducted in a university hospital with the purpose to apprehend some aspects influencing human motivation and their implications to work results. A recorded semi-structured interview was used for data collection which was applied to 18 members of a nursing team, of whom 6 were nurses and 12 were nursing auxiliaries and technicians. The apprehended material was submitted to the content analysis technique, which enabled the identification of "Work Itself" as the most frequently cited category considered to be motivating and "Work Organization" as the most unmotivating. The most cited suggestions referred to "Work Organization" and to "Interpersonal Relationship".

[Difficulties in multi-organ harvesting]

Planning in transplantation is always a difficult process mainly due to the difficulty presented in attaining the required estimated, as well as the problems inherent in transplant units. According to data from European Countries and USA, the ideal number of donors is 50/1 million inhabitants per year, 90% of whom will be multiorgan donors. In 1999 Portugal climbed to 19.2 donors/1 million inhabitants per year, 80 of whom were kidney and liver donors. A data comparison with European Countries, particularly France shows that Portugal is well placed in terms of the number of transplants units per million of population (p.m.p.). In fact, the problem lies in the area of heart and lung transplantation where the annual figures are well below requirements. Estimates for the year 2000 forecast 18 heart transplantation, % the 1999 figure.

Experimental skin lesions from larvae of the bot fly Dermatobia hominis

Skin biopsies from larvae of Rattus norvegicus, experimentally infested with Dermatobia hominis (Linnaeus Jr) (Diptera: Cuterebridae), were processed for histopathological studies. Two days after infestation, the first-stage larvae (L1) were located deep in the dermis, surrounded by an inflamed area infiltrated predominantly by neutrophils. On the fourth day a thin necrotic layer could be seen close to the larvae, surrounded by large numbers of neutrophils, lymphocytes, macrophages with a few eosinophils and mast cells. A small warble was formed after the fourth day, increasing in size until the seventh day, when the L1 moulted to the second-stage larva (L2). The inflammatory process continued with increasing numbers of neutrophils, macrophages, lymphocytes, eosinophils and mast cells invading the area, as well as the proliferation of fibroblasts and endothelial cells and the appearance of a few localized haemorrhages. After 18-20 days, the L2 moulted to the third-stage larva (L3), when a few plasma cells could be seen in the inflamed area. At 25-30 days there was a reduction in the necrotic layer, as well as in the number of neutrophils and lymphocytes, although large amounts of eosinophils, plasma cells, and collagen fibres were seen. The L3 usually left the host after 30 days. Two days later, the larval cavity was reduced, mast cells infiltrated the region and collagen fibre production were increased. After 7 days, an intense infiltration of plasma cells and scattered necrotic areas could be seen. A scar formed after 10 days. This study showed the laboratory rat to be a suitable model for studies of D. hominis infestation.

Ticks associated with wild animals in the Nhecolândia Pantanal, Brazil

A study of ticks associated with wild animals was carried out from September 1996 to April 1998 at the Fazenda Alegria (21,000 ha), in the Nhecolândia Pantanal, State of Mato Grosso do Sul, Brazil, a sunken plain bordering the upper Paraguay river, located 19 x 08'S; 56 x 46'W. A total of 81 wild animals (13 species, 6 orders) were captured with the aid of nets, and ticks were found on 63 (78%). Tick species identified included Boophilus microplus (Canestrini), Amblyomma cajennense (F.), A. parvum (Aragão), A pseudoconcolor (Aragão), A. scalpturatum (Neumann), A. nodosum (Neumann), A. ovale (Koch), and A. tigrinum (Koch). Dragging from grasslands (campos) yielded negative results compared to the high concentration of ticks, mainly nymphs, that were collected from leaves in the forests (capão). Predominance of immature instars (Amblyomma genera) was observed in the end of winter (August-September). Ticks were associated mainly with coatis, deer (Mazama gouazoubira) and anteater, and these animals may play a role in the epidemiology of tick-transmitted pathogens in the Pantanal if one considers their co-existence with local domestic animals.

Trypanosoma cruzi-cardiomyocytes: new contributions regarding a better understanding of this interaction

The present paper summarizes new approaches regarding the progress done to the understanding of the interaction of Trypanosoma cruzi-cardiomyocytes. Mannose receptors localized at the surface of heart muscle cell are involved in binding and uptake of the parasite. One of the most striking events in the parasite-heart muscle cells interaction is the disruption of the actin cytoskeleton. We have investigated the regulation of the actin mRNA during the cytopathology induced in myocardial cells by the parasite. T. cruzi invasion increases calcium resting levels in cardiomyocytes. We have previously shown that Ca2+ ATPase of the sarcoplasmic reticulum (SERCA) is involved in the invasion of T. cruzi in cardiomyocytes. Treating the cells with thapsigargin, a drug that binds to all SERCA ATPases and causes depletion of intracellular calcium stores, we found a 75% inhibition in the T. cruzi-cardiomyocytes invasion.

Trypanosoma cruzi infection affects actin mRNA regulation in heart muscle cells

We have previously described alterations in the cytoskeletal organization of heart muscle cells (HMC) infected with Trypanosoma cruzi in vitro. Our aim was to investigate whether these changes also affect the regulation of the actin mRNAs during HMC differentiation. Northern blot analysis revealed that alpha-cardiac actin mRNA levels increased during cell differentiation while beta-actin mRNA levels declined. Nonmuscle cells displayed beta-actin mRNA signal localized at the cell periphery, while alpha-cardiac actin mRNA had a perinuclear distribution in myocytes. Trypanosoma cruzi-infected cells showed 50% reduction in alpha-cardiac actin mRNA expression after 72 h of infection. In contrast, beta-actin mRNA levels increased approximately 79% after 48 h of infection. In addition, in situ beta-actin mRNA was delocalized from the periphery into the perinuclear region. These observations support the hypothesis that Trypanosoma cruzi affects actin mRNA regulation and localization through its effect on the cytoskeleton of heart muscle cells.

Ultrastructural distribution of poly (A)+ RNA during Trypanosoma cruzi-cardiomyocyte interaction in vitro: a quantitative analysis of the total mRNA content by in situ hybridization

Ultrastructural in situ hybridization was used to visualize the spatial distribution of poly (A)+ RNA and quantitate its relative amount within different cellular compartments of cardiomyocytes after T. cruzi infection. The amount of poly (A)+ RNA remained about the same up to 24 h post-infection. In contrast, its content was reduced 65% after 72 h of interaction, showing a marked decrease in the cell cytoplasm. This decline in poly (A)+ RNA level in host cell cytoplasm was concomitant with intracellular proliferation of T. cruzi amastigotes. Thus, T. cruzi may affect host cell cytoplasmic mRNA stability, associated with the parasite's intracellular multiplication.

Application of stripping voltammetry and microelectrodes in vitro biocompatibility and in vivo toxicity tests of AISI 316L corrosion products

Adsorptive stripping voltammetric procedures, using mercury film microelectrodes, were optimised and applied to quantify total iron, chromium and nickel in samples of osteoblast-like cells culture medium and mice organs (liver, kidney and spleen) obtained from, respectively, in vitro and in vivo 316L stainless steel corrosion products biocompatibility and toxicity studies. The methods were based on the pre-concentration of the iron-catechol complex by adsorption at the potential of -1.80 V (vs. Ag/AgCl), of the chromium-diethylenetriaminepentaacetic acid complex at -1.00 V or -1.15 V (vs. Ag/AgCl) and of the nickel-dimethylglyoxime complex at -0.70 V (vs. Ag/AgCl). The detection limits achieved for each metal ion (i) in the culture medium were 1.93x10(-8) mol/L Fe, 2.80x10(-10) mol/L Cr and 7.70x10(-9) mol/L Ni for a collection time of 30 s, 40 s and 10 s, respectively, and (ii) in the mice organ solutions were 1.37x10(-8) mol/L Fe, 1.54x10(-8) mol/L Cr and 1.58x10(-9) mol/L Ni for an adsorption time of 25 s, 25 s and 15 s, respectively. The accuracy of the proposed procedures was verified by comparison of the results obtained by adsorptive stripping voltammetry with those attained by atomic absorption spectrometry for the same set of samples and good agreement was found. The in vitro study showed that stainless steel corrosion products affect the expression of the osteogenic phenotype. The in vivo mice model, used to investigate the systemic effects provoked by the corrosion products per se, indicated that Fe, Cr and Ni are partially accumulated in the organs studied and that Ni induced the more significant morphological alterations.

[Iatrogenic vascular injuries]

Iatrogenic vascular injuries include an extremely broad group of lesions with multiple etiology and polymorphic manifestations. We present a series of 44 patients with iatrogenic vascular lesions that result from arterial and venous catheterizations and surgical interventions. The arterial catheterization for coronariography and arteriography and orthopaedic surgery were the agents that most frequently caused vascular injury. Arterial and venous reconstructive surgery were the predominant treatment procedures. In our series, morbidity and mortality were 4.6% and 2.3%, respectively.

Spontaneously occurring anti-PTH autoantibodies must be considered in the differential diagnosis of patients with elevated serum PTH levels

We investigated the cause of elevated immunoreactive circulating parathyroid hormone (PTH) levels in two females of 41 (case 1) and 39 (case 2) years of age with low/normal serum calcium levels and hypocalcemia, respectively, and, in the latter case, hyperprolactinemia. Serum samples from both patients were fractionated by Sephadex G-100 Superfine chromatography. Fractions were assayed for PTH and prolactin (PRL) by immunoradiometric assays (IRMA) and for immunoglobulin G (IgG) by radial immunodiffusion. Sera from both patients were incubated with protein A and protein G Sepharose, centrifugated and the supernatant was assayed for PTH by IRMA. Sera were also subjected to affinity chromatography with an anti-human-IgG-agarose column. IgG and PTH or PRL were measured in the fractions by radial immunodiffusion and IRMA, respectively. In both cases the majority of serum PTH immunoreactivity eluted in the same fractions of IgG after gel filtration and was precipitated by protein A (89% in patient 1 and 96% in patient 2) and protein G (83% in patient 1 and 100% in patient 2), thus, behaving as IgG. In case 1, 79% of PTH was also retained by an anti-hIgG agarose column. High PRL levels in patient 2 were due to macroprolactinemia since most of PRL eluted as big,big (40%) and big-PRL (45%) after gel filtration. Forty-eight percent of PRL from patient 2 was retained by the anti-hIgG column indicating the presence of an anti-PRL autoantibody. These data suggest that spontaneously occurring anti-PTH autoantibodies must be considered in the differential diagnosis of patients with elevated serum PTH levels.

Bone mineral density and androgen levels in elderly males

To clarify the relationship of sex male hormones and bone in men, we studied in 140 healthy elderly men (aged 55-90 years) the relation between serum levels of androgens and related sex hormones, bone mineral density (BMD) at different sites, and other parameters related to bone metabolism. Our results show a slight decrease of serum-free testosterone with age, with an increase of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in a third of the elderly subjects studied. BMD decreased significantly with age in all regions studied, except in the lumbar spine. We found a positive correlation between body mass index (BMI) and BMD at the lumbar spine and femoral neck (P < 0.001). No relationship was found (uni- and multivariate regression analysis) between serum androgens or sex hormone-binding globulin (SHBG) and BMD. We found a positive correlation of vitamin D binding protein (DBP) and osteocalcin with lumbar spine BMD and with BMI, DBP, IGF-1, and PTH with femoral neck BMD. In conclusion, there is a slight decline in free testosterone and BMD in the healthy elderly males. However, sex male hormones are not correlated to the decrease in hip BMD. Other age-related factors must be associated with bone loss in elderly males.

Histological effects of iron accumulation on mice liver and spleen after administration of a metallic solution

Special attention has been focused on the toxicity of some metallic species released from implanted materials, which accumulate in vital organs over long periods of time. A set of experiments with mice was designed to investigate the individual effects caused by iron in the liver and spleen. Histological features of these organs were evaluated and slight morphological changes were observed during the treatment time suggesting a negative correlation with the duration of the iron treatment. In addition, to associate the histological changes in the organs with iron accumulation an electrochemical method, adsorptive stripping voltammetry, was chosen to quantify the iron levels in these mentioned organs. The accuracy of the proposed method was checked by atomic absorption spectrometry. Both organs showed elevated concentrations of iron, nearly twofold, 7 days after iron administration compared to control organs.

Control of equine piroplasmosis in Brazil

The importance of equine piroplasmosis control in endemic countries has increased in recent years and plays an important role to maintain the international market open to the horse industry. The purpose of this study was to demonstrate the occurrence of equine piroplasmosis (Babesia equi or Theileria equi and Babesia caballi) in Brazil--a country where the disease occurs endemically--in different climatic conditions, and to evaluate the results of a strategy for tick control in order to decrease infection rates. Blood samples were taken from 720 horses on 28 farms from different regions and subjected for complement fixation testing. The strategy was based on the control of the tick population by spraying the horses with acaricides, treating positive horses and preventing cattle and horses from grazing together. A significant association was found in the prevalence of antibody titres in tropical and subtropical areas. A significantly lower prevalence rate occurred on those farms where measures to control tick population were established. Farms in endemic countries may significantly reduce the prevalence of equine piroplasmosis by establishing measures to control the tick population and treating chronic carrier horses. Additional measures for controlling ticks in tropical areas are also discussed.

Mapping the gene causing hereditary primary hyperparathyroidism in a Portuguese kindred to chromosome 1q22-q31

A Portuguese kindred with autosomal dominant isolated primary hyperparathyroidism (HPT) that was associated with parathyroid adenomas and carcinomas was investigated with the aim of determining the chromosomal location of this gene, designated HPTPort. Leukocyte DNA from 9 affected and 16 unaffected members and 7 parathyroid tumors from 4 patients was used in comparative genomic hybridization (CGH), tumor loss of heterozygosity (LOH), and family linkage studies. The CGH studies revealed abnormalities of chromosomes 1 and 13, and the results of LOH studies were consistent with the involvements of tumor suppressor genes from these regions. Family segregation studies mapped HPTPort to chromosome 1q22-q31 by establishing linkage with eight loci (D1S254, D1S222, D1S202, D1S238, D1S428, D1S2877, D1S422, and D1S412) (peak two-point LOD scores = 3. 46-5.14 at 0% recombination), and defined the location of HPT Port to a 21 cM region flanked centromerically by D1S215 and telomerically by D1S306. Thus, HPTPort has been mapped to chromosome 1q22-q31, and a characterization of this gene will help to elucidate further the mechanisms that are involved in the development of parathyroid tumors.