Multi-analytical characterisation of blotting sands on documents from religious orders in Portugal (16th-19th centuries)

Too little is known about areia de escrever, i.e., blotting sands, the intriguing particles sprinkled on freshly written scripts to accelerate the drying time of the ink. Blotting sands constitute a valuable but underestimated historical source. This work investigated the blotting sands used on the account books of the religious houses scattered across continental Portugal and Madeira Island (16th-19th centuries). The sands were mainly composed of different minerals, predominately black sands, but in a few cases, minerals were found mixed with gums, paper cocoons or bone shavings. The combined use of SEM-EDS, µ-Raman and FT-IR techniques uncovered the materials' chemical or mineralogical composition and morphology. This approach, allied with image analysis and statistics complemented with multivariate analysis, allowed us to look for trends between the samples and hypothesise about their provenance. Heavy minerals, such as ilmenite, hematite and almandine, were identified as major components, together with other silicates (e.g. quartz). Samples were dominated by medium-sized grains with shape features indicating texturally mature sediments resulting from a medium-to-long sedimentary transport. Due to shorter geological transport distances, Madeira Island was the exception, with more angular grains. This work allowed us to uncover blotting sands, value them as historical sources, and establish a roadmap for their use in Portugal, aiming to pave the way towards a more global context in Europe.

Obsessive-compulsive Symptoms in Dementia : Scooping Review of Neurobiological and Cognitive Underpinnings

Introduction

Obsessive-compulsive symptoms (OCS) have been described in many neurological disorders, including dementia. A meta-analysis by the authors (2021) reported a prevalence of OCS in dementia of approx. 35.8%, and a higher percentage in frontotemporal dementia (FTD) (46.7%). The literature also points that obsessive-compulsive disorder with late-life onset is rare, but those cases are frequently associated with neurologic injury, and some authors suggest a role of cognitive disfunction.

Objectives

Our main goal was to describe the neurobiologic and cognitive underpinnings of OCS in patients with dementia.

Methods

MEDLINE, CENTRAL and PsycNet databases were searched for articles about obsessive-compulsive symptoms in dementia. Search terms included “obsessive”, “compulsive”, “OCD”, “cognitive decline”, “cognitive dysfunction” and “dementia”. Titles, abstracts and full texts were screened independently by 2 reviewers.

Results

Correlations between dysfunction / lesions in various circuits in the context of dementia and OCS were found, such as (1) frontal regions (specially the orbitofrontal cortex) and anterior cingulate cortex (2) fronto-striatal-thalamic circuits (3) temporal structures; (4) cerebellar structures; (5) serotoninergic, dopaminergic, and cholinergic neurotransmission. A high proportion of studies concerned FTD. Regarding cognitive mechanisms, there is a focus on the importance subjective concerns about cognitive functioning, which could exacerbate obsessional beliefs and maladaptive responses to intrusions.

Conclusions

The main brain circuits implicated in dementia, specially FTD, and OCS are those involving frontal regions and the fronto-striatal-thalamic circuits, with areas such as the temporal and cerebellar structures algo being studied. The correlation between dysfunctional circuits in dementia and OCS could give us new hints about OCD and its treatment.

Disclosure

No significant relationships.

Concomitant diagnosis of bipolar disorder and tuberous sclerosis - a case report

Introduction

Tuberous sclerosis is a multisystem genetic disorder. It is associated with significant psychiatric comorbidity mainly autistic disorders, hyperkinetic disorders, depression and anxiety. It is rarely associated with psychosis and bipolar disorder.

Objectives

To describe the case of a 34-year-old male with concomitant diagnosis of bipolar disorder and tuberous sclerosis.

Methods

Case report based on clinical records. Brief literature review using articles searched in the PubMed/MEDLINE database using the terms “tuberous sclerosis”, “bipolar disorder” and “neuropsychiatric”.

Results

The patient presented at our Emergency Department 3 years ago with a mixed episode with psychotic symptoms with 1 month of duration. Prior history of two hypomanic episodes, but no depressive episodes. High baseline functionality. Sporadic use of alcohol and cannabis. No family history of psychiatric or neurological diseases. Diagnostic work-up showed no relevant results, aside from small calcifications in brain CT. He was admitted to our ward and medicated with aripiprazol (titrated up to 30 mg), leading to full remission of the clinical picture. The patient was referred to our outpatient clinic and stayed with medication for 1,5 years. One year after, he presented a sudden episode of mutism and perplexity with quick remission. The EEG wielded no relevant results. New brain CT showed signs of tuberous sclerosis. He was referred to Neurology and subsequent assessments, including brain MRI, led to the fulfilment of clinical criteria for tuberous sclerosis.

Conclusions

This case illustrates the possibility of concomitant diagnosis of bipolar disorder and tuberous sclerosis. The possible association between these disorders is discussed.

Disclosure

No significant relationships.

Comparison of clockwise and counterclockwise right atrial flutter using high-resolution mapping

Background

To the best of our knowledge, few studies have been performed that explore the electrophysiological differences between clockwise (CW) and counterclockwise (CCW) right atrial (RA) cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) using the high-resolution Rhythmia mapping system. Objectives. Accordingly, our prospective cohort study, sought to compare CW and CCW CTI-dependent AFL in preselected pure right AFL patients (pts) using the ultra-high-definition (ultra-HD) Rhythmia mapping system. The study also aimed to mathematically develop a cartography model based on automatic velocity RA measurements to identify electrophysiological AFL specificities.

Methods and results

Between October 2019 and July 2020, 33 patients were recruited. The mean age was 71±13 years old. No difference was found concerning clinical variables between CCW AFL and CW AFL or regarding left ventricular ejection fraction (LVEF) (55.5±10 vs. 56.6±12; p=0.76). The AFL cycle length was very similar (248±20 vs. 252±28 ms; p=0.6). The sinus venosus (SV) block line was present in 32/33 of cases (97%) and no significant difference was found between CCW and CW CTI AFL (100% vs. 91%; p=0.7). No line was localized in the region of the crista terminalis (CT). A superior gap was present in the posterior line in 14/31 (45.2%) but this was similarly present in CCW AFL, when compared to CW AFL (10/22 [45.5%] vs. (4/10 [40%]); p=0.9). When present, the extension of the posterior line of block was observed in 18/31 pts (58%) without significant differences between CCW and CW CI AFL (12/22 [54.5%] vs. (6/10 [60%]) (p=.9) The Eustachian ridge line of block was similarly present in both groups (82% [18/22] vs. 45.5% [5/11]; p=0.2). The absence of the Eustachian ridge line of block led to significantly slowed velocity in this area (28±10cm/s; n=8),and the velocities were similarly altered between both groups (26±10 [4/22] vs. 29.8±11cm/s [4/11]; p=0.6). We created mathematical, three-dimensional RA reconstruction-velocity model measurements. In each block localization, when the block line was absent, velocity was significantly slowed (≤20cm/s). A systematic slowdown in conduction velocity was observed at the entrance and exit of the CTI in 100% of cases. This alteration to the conduction entrance was localized at the lateral side of the CTI for the CCW AFL and at the septal side of the CTI for CW AFL. The exit-conduction alteration was localized at the CTI septal side for the CCW AFL and at the CTI lateral side for the CW AFL. The only differences between CW and CCW AFL concerned activation patterns.

Conclusions

The ultra-HD Rhythmia mapping system confirmed the absence of significant electrophysiological differences between CCW and CW AFL. The mechanistic posterior SV and Eustachian ridge block lines were confirmed in each arrhythmia. A systematic slowing down at the entrance and exit of the CTI was demonstrated in both CCW and CW AFL, but in reverse positions.

Funding Acknowledgement

Type of funding sources: None.

The psychological determinants of internet gaming disorder: Vulnerability to stress, psychological well-being, and comorbidity

Introduction

A variety of psychological determinants, such as vulnerability to stress, low levels of psychological well-being and several comorbidities, have been hypothesized to play a role in the development, and maintenance of Internet Gaming Disorder (IGD). However, evidence has been insufficient to sustain an overarching model of the causal pathways leading to IGD.

Objectives

. This study aimed to depict a model of the causal links between vulnerability to stress, psychological well-being, and symptoms of common mental disorders (e.g., depression, generalized anxiety, phobic anxiety, obsessive-compulsive disorder, somatization, and hostility).

Methods

. A community-based sample of Portuguese gamers (N = 153; Mage = 21.92; 15.29% female) completed measures of IGD (IGDS9-SF), mental health (SCL-90-R), psychological well-being (EBEP), and vulnerability to stress (23QVS). A machine learning algorithm – Greedy Fast Causal Inference – was used to infer a model of the causal pathways linking those psychological determinants to IGD.

Results

. Hostility and psychological well-being were directly involved with a subgroup of IGD symptoms (i.e., gaming used as escape, tolerance, withdrawal, and loss of control). Stress vulnerability and symptoms of mental disorders were only indirectly implicated in the causal pathways leading to IGD.

Conclusions

. It is likely that several psychological factors implicated in the causal pathways leading to IGD, have not been yet identified. Future research should directly test specific models of the causal pathways involved in the development and maintenance of IGD symptoms.

Disclosure

No significant relationships.

The forbidden fruit – the thin line between belief, religion, and severe psychopathology: A case report

Introduction

Religious obsessions constitute an interesting component of the phenomenology of obsessive-compulsive disorder(OCD). Scrupulosity can be phenomenologically similar to other OCD subtypes but the ultimate feared consequence is religious or moral in nature.

Objectives

To develop a reflexion about religion, belief and its interaction with psychopathology, focusing on a clinical case.

Methods

Review of the clinical case and literature.

Results

37-year-old female patient with 4 prior psychiatric admissions. Stable until May 2020. After a brief online relationship patient develops subsequent guilt, anxiety and obsessive images with religious/sexual content. Abruptly, on the day of admission to the ER, the patient eats garlic in penitence and self-flagellate. At inpatient-unit she presented in mutism and total oral refusal, needing nasogastric tube for feeding and medication administration. She was medicated with diazepam and olanzapine, being added fluoxetine later on. In later interviews, a primordial idea based on the prevailing religious beliefs was found: “sex before marriage is a mortal sin”. This itself generated doubt “have I been forgiven” with compulsions of verification/purification (eg. repeated confession) and punishment, and this doubt almost reached a delirious character during the acute episode. Partial egodistonia, lived with suffering although with some continuity with her beliefs. At discharge patient showed insight for the unrealism of this dyad, though the primary idea remained immovable.

Conclusions

Although the pharmacological approach managed to control the most disturbing symptoms presented by the patient, it’s worthwhile to review and to reflect on this report in a wider perspective, within in the light of the relevance to the clinical practice.

Disclosure

No significant relationships.

Influenza and schizophrenia: How can we shed a light in the new virus from an old association?

Introduction

COVID-19 raises serious concerns regarding its unknown consequences for health, including psychiatric long term outcomes. Historically, influenza virus has been responsible for pandemics associated with schizophrenia. Epidemiological studies showed increased risk for schizophrenia in children of mothers exposed to the 1957 influenza A2 pandemic. Controversy remains concerning the mechanisms of pathogenesis underlying this risk.

Objectives

We aim to review the evidence for the association between influenza infection and schizophrenia risk, the possible pathogenic mechanisms underlying and correlate these findings with the schizophrenia hypothesis of neurodevelopment.

Methods

We reviewed literature regarding evidence from epidemiological, translational animal models and serological studies using medline database.

Results

The biological mechanisms likely to be relevant account to the effects of infection-induced maternal immune activation, microglial activation, infection-induced neuronal autoimmunity, molecular mimicry of the influenza virus, neuronal surface autoantibodies and psychosis with potential infectious antecedents. Influenza infection may fit into the theory of the neurodevelopment of schizophrenia as a factor that alters the normal maturation processes of the brain (possible second or third hit).

Conclusions

Influenza infection has multiple pathogenic pathways in both pre and post natal processes that might increase the risk of schizophrenia or psychosis. The existing evidence regarding the relationship between influenza virus and psychosis might help us draw similar long-term concerns of COVID-19.

Disclosure

No significant relationships.

An in vivo evaluation of the effects of feed restriction regimens on wooden breast using ultrasound images as a predictive tool

1. Gradual feed restriction was applied to broilers in order to reduce growth rate and, as a consequence, gradually impacts wooden breast myopathy occurrence. Ultrasound (US) images of breast muscle in live birds were correlated with breast fillets presenting wooden breast characteristics (WB). 2. A total of 1800 Cobb × Cobb 500 slow-feathering male chicks were fed one of the six feed restriction treatments with 12 replicates of 25 birds each, in a completely randomised design. Birds were fed ad libitum or were pair-fed to 50%, 60%, 70%, 80% or 90% of normal ad libitum intakes from 8 to 49 d to provide a gradual reduction in growth rate. Ultrasound images were obtained weekly from all birds and, in parallel, one bird per pen was weekly slaughtered and the major breast muscle was weighed and WB graded as 0 (normal), 1 (mild hardening in the upper), 2 (moderate hardening in the upper and/or lower), 3 (severe hardening) and 4 (severe hardening with haemorrhagic lesions and yellow fluid). Blood was taken for analysis of enzymes related to muscle cell breakdown. 3. Feed restriction applied at 50%, 60%, 70%, 80% and 90% of the ad libitum feed intake (FI) resulted in decreased body weight gain (BWG; P ≤ 0.05). 4. From 21 to 49 d, the increasing feed restriction led to linear increases (P ≤ 0.05) in WB scores, fibre density as well as breast depth and breast echogenicity. Creatine kinase, lactate dehydrogenase and aspartate aminotransferase concentration decreased linearly when broilers were feed restricted (P ≤ 0.05). 5. Wooden breast was positively correlated with echogenicity at 21 d (r = 0.510), 28 (r = 0.531), 35 (r = 0.470), 42 (r = 0.430) and 49 d (r = 0.548) (P ≤ 0.001). The use of breast echogenicity can be an additional tool to early detect alterations related to wooden breast.

Health literacy and physical activity as buffers to counter act work related stress

Background

Stress health problems affect 47.8% of the work force in Portugal. It is predicted that, in the next decade, these problems will overcome musculoskeletal disorders, the first cause of employee’s withdrawal from work. Research indicates connections between stress and dimensions of the work place (like job satisfaction). Nevertheless the conceptual understanding of these relationships is sparse. In order to better understand these relationships, this research focus on the use of job–specific models of stress, associating them with health literacy (HL) - in the context of the European Health Literacy Survey framework (HLS-EU) - and physical exercise.

Methods

A total of 748 participants from the different offices of a company in the financial sector (Portugal, main land and autonomous territories) participated in a cross sectional survey (CAWI). Age ranged from 25 to 65 years and HL was measured using the HLS-EU instrument validated to Portuguese (HLS-EU-PT). Each participant was allocated to one of the groups, either of satisfactory HL (when scores ≥30) or insufficient HL (when scores <30).

Results

Out of the 748 participants (58.7% males, average age of 39 years), 80.4% sometimes and very often experience stress and tension in the workplace. Less than one in every two (44.4%) practice physical activity several times a week. Of the participants, 7.1% have inadequate, 39.0% problematic, 36.6% sufficient and 17.3% excellent HL (HLS-EU-PT). Employees that are more active are those who experience lower levels of stress.

Conclusions

The research of the effects of HL combined with physical exercise, as buffer variables to problems related to the effects of work stress, is a new area of research that may help understand patterns of adherence to activities that can help workers deal with everyday working conditions. More research is needed to integrate HL strategies in the work place.

Genome-wide association and epidemiological analyses reveal common genetic origins between uterine leiomyomata and endometriosis

Uterine leiomyomata (UL) are the most common neoplasms of the female reproductive tract and primary cause for hysterectomy, leading to considerable morbidity and high economic burden. Here we conduct a GWAS meta-analysis in 35,474 cases and 267,505 female controls of European ancestry, identifying eight novel genome-wide significant (P < 5 × 10^-8) loci, in addition to confirming 21 previously reported loci, including multiple independent signals at 10 loci. Phenotypic stratification of UL by heavy menstrual bleeding in 3409 cases and 199,171 female controls reveals genome-wide significant associations at three of the 29 UL loci: 5p15.33 (TERT), 5q35.2 (FGFR4) and 11q22.3 (ATM). Four loci identified in the meta-analysis are also associated with endometriosis risk; an epidemiological meta-analysis across 402,868 women suggests at least a doubling of risk for UL diagnosis among those with a history of endometriosis. These findings increase our understanding of genetic contribution and biology underlying UL development, and suggest overlapping genetic origins with endometriosis.

Three-dimensional assessment of lower limb alignment: Accuracy and reliability

INTRODUCTION

Three-dimensional (3D) surgical planning and patient-specific implants are becoming increasingly popular in orthopedics and trauma surgery. In contrast to the established and standardized alignment assessment on two-dimensional (2D) long standing radiographs (LSRs) there is neither a standardized nor a validated protocol for the analysis of 3D bone models of the lower limb. This study aimed to create a prerequisite for pre-operative planning.

METHODS

According to 2D analysis and after meticulous research, 24 landmarks were defined on 3D bone models obtained from computed axial tomography (CT) scans for a 3D alignment assessment. Three observers with different experience levels performed the test three different times on three specimens. Intraobserver and interobserver variability of the landmarks and the intraclass correlation coefficient (ICC) of the resulting axes and joint angles were evaluated.

RESULTS

Overall, the intraobserver and interobserver variability was low, with a mean deviation <5 mm for all landmarks. The ICC of all joint angles and axis deviations was >0.8, except for tibial torsion (ICC = 0.69). All knee joint angles showed excellent ICC (>0.95).

CONCLUSIONS

Using the defined landmarks, a standardized 3D alignment assessment with low intraobserver and interobserver variability and high ICC values for the knee joint angles can be performed regardless of examiner's experience. The described method serves as a reliable standardized protocol for a 3D malalignment test of the lower limb. Three-dimensional pre-operative analysis might enhance understanding of deformities and lead to a new focus in surgical planning.

The effect of hypoxia and flow decrease in macroinvertebrate functional responses: A trait-based approach to multiple-stressors in mesocosms

River ecosystems are most often subject to multiple co-occurring anthropogenic stressors. Mediterranean streams are particularly affected by water scarcity and organic loads that commonly lead to a simultaneous reduction in flow and increasing depletion of dissolved oxygen. In the present study, the single and combined effects of water scarcity (flow velocity reduction) and dissolved oxygen depletion were used to evaluate alterations of drifting macroinvertebrates on a channel mesocosm system, by employing a multiple trait-based approach. Our main findings confirmed that the impact of the two combined stressors can be implicated in alterations of ecosystem functions as result of the changes in proportions of biological traits. Overall, our results showed that, individually, flow velocity reduction and a severe oxygen depletion promoted a shift in community traits. In more detail, biological traits describing the dispersal of organisms and their respiration showed the strongest responses. The respiration mode responded to low flow with drift increase of gill breathers and decrease of individuals with tegument, whereas dispersal was clearly affected by the combination of stressors. Resistance through eggs was higher with the single effect of flow reduction, while swimmers´ relative abundance increased in individuals that drift after exposure to the combination of stressors. Thus, while flow reduction alone is expected to specifically filter out the gill breathers and the egg producers, the combination of stressors will impact more drastically organism's dispersal and swimmers. Such changes in biological traits can result in variations in ecosystem functioning through, for example, local changes in biomass, secondary production, stream metabolism as well as resulting in biodiversity losses or alterations of its distribution patterns.

Mycotic Pseudoaneurysm After Kidney Transplantation: Two Case Reports

BACKGROUND

Vascular complications after kidney transplantation may cause allograft loss. Here, we describe 2 patients with extrarenal mycotic pseudoaneurysm after kidney transplantation.

PATIENTS

Patient 1 was a 54-year-old man who developed pseudoaneurysm 60 days after transplantation, and patient 2 was a 48-year-old woman who was diagnosed with a pseudoaneurysm 5 months after transplantation.

RESULTS

Patient 1 had a deceased-donor kidney transplant with end-to-side external iliac arterial anastomosis that was reconstructed 8 days after transplantation owing to rupture and major bleeding. At 60 days after transplantation, he had high serum creatinine level and Doppler ultrasonography showed a pseudoaneurysm of the arterial graft anastomosis and postanastomotic renal artery stenosis. Treatment included surgical excision of the pseudoaneurysm, vascular reconstruction, and fluconazole, with mycologic culture of the resected pseudoaneurysm showing Candida albicans. Patient 2 developed nondisabling intermittent claudication at 5 months after kidney transplantation, with a pseudoaneurysm subsequently observed on Doppler ultrasonography and computerized tomographic angiography. Treatment included renal artery thrombectomy and common iliac bypass to the hilar donor renal artery with inverted ipsilateral long saphenous vein. Operative samples showed C albicans, and she was treated with fluconazole. Both patients had satisfactory outcomes, and both kidney allografts were preserved.

CONCLUSIONS

Extrarenal mycotic pseudoaneurysms after kidney transplantation require a high index of suspicion for early diagnosis, and preservation of the kidney graft may be achieved with the use of surgical treatment and antifungal therapy.

Total (fumarolic + diffuse soil) CO2 output from Furnas volcano

Furnas volcano, in São Miguel island (Azores), being the surface expression of rising hydrothermal steam, is the site of intense carbon dioxide (CO₂) release by diffuse degassing and fumaroles. While the diffusive CO₂ output has long (since the early 1990s) been characterized by soil CO₂ surveys, no information is presently available on the fumarolic CO₂ output. Here, we performed (in August 2014) a study in which soil CO₂ degassing survey was combined for the first time with the measurement of the fumarolic CO₂ flux. The results were achieved by using a GasFinder 2.0 tunable diode laser. Our measurements were performed in two degassing sites at Furnas volcano (Furnas Lake and Furnas Village), with the aim of quantifying the total (fumarolic + soil diffuse) CO₂ output. We show that, within the main degassing (fumarolic) areas, the soil CO₂ flux contribution (9.2 t day^-1) represents a minor (~15 %) fraction of the total CO₂ output (59 t day^-1), which is dominated by the fumaroles (~50 t day^-1). The same fumaroles contribute to ~0.25 t day^-1 of H₂S, based on a fumarole CO₂/H₂S ratio of 150 to 353 (measured with a portable Multi-GAS). However, we also find that the soil CO₂ contribution from a more distal wider degassing structure dominates the total Furnas volcano CO₂ budget, which we evaluate (summing up the CO₂ flux contributions for degassing soils, fumarolic emissions and springs) at ~1030 t day^-1.

Principais alterações no leite por agentes causadores de mastite no rebanho caprino dos estados de Minas Gerais e Rio de Janeiro

A mastite subclínica caprina ocasiona prejuízos econômicos em decorrência do descarte, dos gastos com medidas terapêuticas e da redução da quantidade e qualidade do leite e seus derivados. Nesse estudo, 129 amostras de leite de cabra in natura, provenientes de 11 propriedades foram avaliadas pelo teste da caneca telada, California Mastitis Test (CMT), exame bacteriológico, pesquisa de Mycoplasma spp. e pela determinação dos parâmetros físico-químicos. No teste da caneca telada e no CMT, 3,1% e 4,6% das amostras foram positivas, respectivamente. No exame bacteriológico, 57,4% das amostras foram positivas e o patógeno mais frequente foi Staphylococcus coagulase negativa com 56% das cepas resistentes à penicilina e 100% de sensíveis à gentamicina. Mycoplasma spp. não foi identificado nas amostras. O diagnóstico da mastite subclínica pelo CMT e pelo exame bacteriológico diferiu de forma significativa e não houve associação entre o número de UFC/mL obtidas no exame microbiológico e o resultado do CMT (Qui-quadrado p < 0,05). Os parâmetros físico-químicos diferiram significativamente entre os rebanhos (ANOVA, Tukey-Kramer, p < 0,05) e a gordura foi o constituinte que demonstrou maior amplitude, sendo que 63,4% dos rebanhos apresentaram os valores abaixo do exigido pela legislação brasileira. Não houve associação significativa entre a presença de mastite diagnosticada pelo exame bacteriológico e os valores obtidos para os parâmetros físico-químicos (t-Student p > 0,05). Com base nos resultados obtidos, recomenda-se a associação do exame bacteriológico quando na utilização do CMT para diagnóstico da mastite subclínica caprina.

Biochemical methane potential of raw and pre-treated meat-processing wastes

Raw and pre-treated greaves and rinds, two meat-processing wastes, were assessed for biochemical methane potential (BMP). Combinations of temperature (25, 55, 70 and 120 °C), NaOH (0.3 g g(-1) waste volatile solids) and lipase from Candida rugosa (10 U g(-1) fat) were applied to promote wastes hydrolysis, and the effect on BMP was evaluated. COD solubilisation was higher (66% for greaves; 55% for rinds) when greaves were pre-treated with NaOH at 55 °C and lipase was added to rinds after autoclaving. Maximum fat hydrolysis (52-54%) resulted from NaOH addition, at 55 °C for greaves and 25 °C for rinds. BMP of raw greaves and rinds was 707±46 and 756±56 L CH4 (at standard temperature and pressure) kg(-1)VS, respectively. BMP of rinds improved 25% by exposure to 70 °C; all other strategies tested had no positive effect on BMP of both wastes, and anaerobic biodegradability was even reduced by the combined action of base and temperature.

Diversity of Campylobacter jejuni and Campylobacter coli genotypes from human and animal sources from Rio de Janeiro, Brazil

To compare the genotypes of Campylobacter jejuni and Campylobacter coli isolates of human and animal origin collected in Rio de Janeiro City, 30 C. jejuni and 35 C. coli isolates from animal sources (n=45) and human patients with gastroenteritis (n=20) were genotyped by PCR-based techniques, namely random amplified polymorphic DNA (RAPD-PCR) and enterobacterial repetitive intergenic consensus sequence (ERIC-PCR). RAPD-PCR identified 50 types and ERIC-PCR identified 22 genotypes, among the 65 Campylobacter isolates. Both PCR methods discriminated the C. jejuni and C. coli groups of isolates. Combining the results of both methods, no single genotype was shared between isolates from human and animal sources. Two groups of two C. coli isolates each with identical genotypes were found among poultry and pig isolates. A high level of genetic diversity observed among the Campylobacter isolates suggests lack of overlap between isolates from different sources.

Exercise training reduces pulmonary ischaemia-reperfusion-induced inflammatory responses

Physical exercise reduces the deleterious effects of cardiovascular and inflammatory disorders. The purpose of the present study was to evaluate the beneficial effects of physical training on the inflammatory responses following lung ischaemia-reperfusion (IR) in rats. Male Wistar rats were divided into sham-operated animals and sedentary and trained animals submitted to lung IR. The run training programme consisted of 5 sessions.week(-1), each lasting 60 min.day(-1), at 66% of maximal oxygen consumption for 8 weeks. The left pulmonary artery, bronchus and pulmonary vein were occluded for 90 min and reperfused for 2 h. Lung protein extravasation was measured as (125)I-human albumin accumulation, whereas lung neutrophil infiltration was measured as myeloperoxidase activity. Lung IR in sedentary rats resulted in marked increases in protein extravasation and neutrophil influx, and in significant elevations of serum tumour necrosis factor (TNF)-alpha and interleukin (IL)-1beta levels. Physical preconditioning attenuated the increased IR-induced protein leakage without affecting neutrophil influx. It also reduced serum TNF-alpha (and IL-1beta) levels, but had no effect on IL-10 levels. Plasma superoxide dismutase activity was significantly increased in trained IR rats. The present data show that physical preconditioning protects the rat lung from ischaemia-reperfusion injury by attenuating the pulmonary vascular permeability that may be a consequence of reduced levels of tumour necrosis factor-alpha and interleukin-1beta and elevated superoxide dismutase activity.

Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale

The study aims to develop and assess metric proprieties of the Portuguese version of the Hospital Anxiety and Depression Scale. A sequential sample includes 1322 participants diagnosed with cancer, stroke, epilepsy, coronary heart disease, diabetes, myotonic dystrophy, obstructive sleep apnoea, depression and a non-disease group, which completed the HADS. The first step includes translation, retroversion, inspection for lexical equivalence and content validity, and cognitive debriefing. Then we reproduce oblique exploratory factor analysis and use confirmatory factor analysis. We explore the sensibility of the questionnaire. The validation process of the Portuguese HADS version shows metric properties similar to those in international studies, suggesting that it measures the same constructs, in the same way, as the original HADS form.

Effect of inhaled racemic and (R)-albuterol on airway vascular smooth muscle tone in healthy and asthmatic subjects

Although the relative effect of racemic and (R)-albuterol on airway smooth muscle tone have been investigated in patients with airflow obstruction, the comparative effectiveness of these drugs in relaxing airway vascular smooth muscle is unknown. Therefore, we determined the actions of inhaled racemic and (R)-albuterol on airway mucosal blood flow (Qaw) normalized for anatomic dead space as an index of airway vascular smooth muscle tone in 11 healthy subjects and 10 subjects with mild asthma. We also monitored the forced expiratory volume in 1 second (FEV1) as an index of airway smooth muscle tone. Mean +/- SE baseline Qaw was 43.1 +/- 1.5 microl x min(-1) x ml(-1) in healthy subjects and 53.4 +/- 2.1 microl x min(-1) x ml(-1) in asthmatic subjects (p < 0.01). The corresponding values for FEV1 were 95.6 +/- 1.4 and 86.8 +/- 2.5% respectively, of predicted (p = 0.01). Racemic and (R)-albuterol caused a transient, dose-dependent increase of Qaw in healthy, but not in asthmatic subjects; the responses were not different between the two drugs. The FEV1 tended to increase more in asthmatics than in healthy subjects, again without a difference between the two drugs. These results show that racemic and (R)-albuterol have comparable effects on airway vascular smooth muscle and suggest that the blunted airway vascular smooth muscle response to albuterol in asthmatics is not related to (S)-albuterol.

Narrow, duplicated internal auditory canal

A narrow internal auditory canal (IAC) constitutes a relative contraindication to cochlear implantation because it is associated with aplasia or hypoplasia of the vestibulocochlear nerve or its cochlear branch. We report an unusual case of a narrow, duplicated IAC, divided by a bony septum into a superior relatively large portion and an inferior stenotic portion, in which we could identify only the facial nerve. This case adds support to the association between a narrow IAC and aplasia or hypoplasia of the vestibulocochlear nerve. The normal facial nerve argues against the hypothesis that the narrow IAC is the result of a primary bony defect which inhibits the growth of the vestibulocochlear nerve.

Longitudinal left ventricular function in a population of healthy adults: a tissue Doppler imaging study

BACKGROUND

Longitudinal left ventricular function is a major determinant of global ventricular function and is probably more sensitive than radial function in the detection of disease. Tissue Doppler imaging of the mitral annulus allows the study of longitudinal left ventricular function.

METHODS

Forty-five healthy volunteers divided into two groups (younger and older than 45 years) were studied with pulsed tissue Doppler imaging of the 4 sides of the mitral annulus (septal, lateral, inferior, anterior) in 4 and 2 apical chamber views. In each wave (systolic-s, rapid filling-e, atrial contraction-a) we analyzed velocities, time intervals and velocity-time integrals, as well as heterogeneity and asynchrony indexes. Data were compared between the different sides in each group, between groups and with conventional Doppler data.

RESULTS

In contrast to the septal side, the lateral side of the annulus shows higher velocities and velocity-time integrals of the s and e waves, with non-significantly shorter isovolumic relaxation time and shorter time to peak e. There is functional agreement between the lateral and inferior sides versus the septal and anterior sides of the annulus. Most systolic parameters remained unchanged with aging; however, aging was associated with decreased e velocity, increased a velocity and inverted e/a ratio. The relation between s and fractional shortening also did not change with aging. Annular isovolumic contraction time and isovolumic relaxation time were shorter than their respective global time intervals.

CONCLUSIONS

This study shows that there are physiological differences in velocities, time intervals and velocity-time integrals between the 4 sides of the mitral annulus, reflecting physiological heterogeneity and asynchrony, and that some of these parameters are age dependent. These data also contribute to a better understanding of longitudinal left ventricular function and may be useful in future studies as reference values in control groups.

Detection of thyroglobulin mRNA transcripts in peripheral blood of individuals with and without thyroid glands: evidence for thyroglobulin expression by blood cells

OBJECTIVE

Recent studies have assigned clinical significance and prognostic value to the detection of thyroglobulin (Tg) mRNA in the blood of patients subjected to total thyroidectomy for a papillary or follicular thyroid carcinoma. In this study, we investigated the diagnostic specificity of Tg mRNA detection, analysing blood samples from healthy volunteers and from patients previously subjected to total thyroidectomy for reasons other than a carcinoma of the follicular epithelium.

DESIGN AND METHODS

Total RNA was extracted from whole blood, reverse-transcribed and the cDNA amplified for Tg and glyceraldehyde-3-phosphate dehydrogenase with specific primers. Expression levels were analysed by using a semi-quantitative PCR. In a few cases, Lymphoprep gradients were used to separate the mononuclear and polymorphonuclear cells prior to further analysis by reverse transcription/PCR.

RESULTS

Our data suggested that all individuals expressed Tg mRNA. Moreover, no differences in the expression levels between subjects with and without thyroid glands were documented. Documentation of Tg expression by the mononuclear and polymorphonuclear layers in patients without thyroid glands support the hypothesis that both lymphocytes and granulocytes express Tg and may justify a background expression in blood, independently of the presence of follicular cells in circulation.

CONCLUSIONS

Tg mRNA expression is not limited to follicular cells of the thyroid gland, and its expression by normal blood cells should be considered in tests performed for diagnostic purposes.

Diaphragmatic function in patients with chronic left ventricular failure

The aim of this paper is to evaluate the function of respiratory muscles in-patients with chronic moderate left ventricular failure (LVF), and its contribution to the pathophysiology of dyspnea and fatigue. We have studied 20 male patients with LVF, classes II and III of New York Heart Association (NYHA), mean age 66.9+/-10 years (GI) and 19 male aged-matched controls without cardiopulmonary disease mean age 64.6+/-8.4 years (GII). The evaluation included (a) methods derived from volitional manoeuvres, maximal inspiratory pressures at Functional Residual Capacity; maximal expiratory pressures at total lung capacity (TLC); nasal sniff; oesophageal sniff and transdiaphragmatic pressures; (b) methods derived from non-volitional manoeuvres, using bilateral cervical magnetic stimulation of the phrenic nerves, measuring the following twitch pressures (oesophageal, gastric and the transdiaphragmatic). With volitional manoeuvres we have not found statistically significant differences between the two groups: maximal expiratory pressures (cmH(2)O), GI 138+/-42; GII 152+/-40; P=NS and maximal inspiratory pressures (cmH(2)O), GI 74.1+/-22; GII 85+/-16; P=NS. However, these values were significantly lower than those obtained with sniff manoeuvres, nasal sniff (cmH(2)O), GI 95.6+/-22; GII 99.6+/-16; P=NS and oesophageal sniff (cmH(2)O), GI 96.2+/-20; GII 97.5+/-18; P=NS. There were no significant differences between nasal sniff and oesophageal sniff. Using cervical magnetic stimulation, we also didn't find a significant difference for transdiaphragmatic twitch between groups, but the contribution of the diaphragm to the transdiaphragmatic pressure was lower in patients with LVF since the oesophageal twitch was lower (cmH(2)O), GI 11.4+/-3.4; GII 16.3+/-6.8; P<0,004. In conclusion, the contribution of the diaphragm to total ventilation in-patients with moderate LVF is preserved. However, its capacity to generate negative intra-thoracic pressures is decreased since there is a significant decrease in oesophageal twitch. So, it seems that the diaphragm is the first inspiratory muscle to be affected in patients with moderate LVF.

[Magnetic resonance imaging of aqueductal flow in patients with normal hydrocephalus pressure]

The treatment of patients with the so-called Normal Pressure Hydrocephalus (NPH) consists of ventricular shunting, but only in some cases is there clinical improvement. The selection of patients for ventricular shunting is usually based on the response to the evacuating lumbar punctures of the cerebrospinal fluid (CSF), but new MRI techniques of flow measurement have been used successfully. In this study, a group of 58 patients, 28 of which with NPH, is presented. Flow quantification of the aqueductal CSF using the MR Phase Contrast technique was performed in all of them. The authors conclude that the method is sensitive and can be a valid criterium in the selection of patients for ventricular shunting.

Tissue Doppler imaging: clinical topics for the new millenium

INTRODUCTION

Tissue Doppler imaging is an echocardiographic technique that allows the selective visualization and quantification of myocardial signals. Its aim is to complement the conventional Doppler study, adding more and better information on specific topics of cardiovascular diseases. During the first seven years of the technique, much scientific work was produced and some clinical applications of the method have emerged.

CLINICAL APPLICATIONS

I--non ischemic heart disease: The technique has been widely used in diastology, in hypertrophic cardiomyopathy, in heart transplant patients and in arrhythmology. II--ischemic heart disease: The quantitative assessment of regional diastolic and systolic function makes the technique very promising during stress echocardiography and during percutaneous transluminal coronary angioplasty.

CONCLUSIONS

In 2000, tissue Doppler echocardiography is still a young, exciting and promising technique. Despite the fact that much has already been done, there is still a long way to go, implying a great amount of time and personal investment. How often do we feel that we are building a small part of the future?

[Diastolic dysfunction and left ventricular hypertrophy in familial amyloidotic polyneuropathy: a cause-effect relationship?]

TTR Met30 Familial Amyloidotic Polyneuropathy of the Portuguese type (FAP) is an incapacitating and lethal hereditary disorder that affects predominantly young adults of both genders. Portuguese type FAP patients have sensory, motor and autonomic polyneuropathy. The generalised systemic amyloid infiltration involves the heart, leading to the characteristic granular bright sparkling echocardiographic pattern. LV wall thickening occurs in the late phases of the disease. LV diastolic dysfunction has been reported in the absence of systolic dysfunction; an abnormal diastolic transmitral flow pattern assessed by pulsed wave Doppler (PW) was described. PW is very much dependent on load conditions. Tissue Doppler imaging (TDI) has been used as a more reliable method to assess long axis diastolic function.

OBJECTIVE

1--To identify the incremental value of TDI in the assessment of diastolic function in FAP. 2--To correlate diastolic pattern abnormalities and left ventricular mass index (LVMI) in FAP patients.

METHODS

We performed a prospective evaluation of 24 consecutive FAP patients and selected 14 (sinus rhythm, age < 45 years). Diastolic function was assessed by PW and classified as normal (GI-E/A > 1) or abnormal (GII-E/A < 1). TDI was performed in 4 sites of the mitral annulus (septum, lateral, inferior, anterior). Velocities of the rapid filling wave (E') and atrial contraction wave (A') were measured and E'/A' calculated. In each site we considered the TDI as normal (E'/A' > 1) or abnormal (E'/A' < 1). The LVMI was calculated by Devereux's formula.

RESULTS

Age, gender and heart rate were similar in both groups. TDI at the septal mitral annulus was normal in all of the GI patients (E'/A': 1.29 +/- 0.19) and suggestive of abnormal LV relaxation in all of the GII patients (E'/A': 0.82 +/- 0.11, p < 0.0001). TDI revealed abnormal diastolic pattern when a restricted number of sites of the mitral annulus were assessed, even in GI patients and before PW abnormalities occurred. Fractional shortening (FS) and LVMI were similar in GI and GII (FS-GI: 45.5 +/- 5.3, GII 43.5 +/- 8.1%, p: NS; LVMI--GI: 66 +/- 9.3, GII: 67 +/- 3.0 g/m2 p: NS).

CONCLUSION

The assessment of mitral annulus motion has introduced new data in the study of diastolic function of FAP patients. An abnormal LV relaxation pattern occurred early in the evolution of the disease in patients with normal LVMI and systolic function.