Impact of waitlist time on post-HSCT survival: a cohort study at a hospital in southern Brazil

INTRODUCTION

The time elapsed from diagnosis to hematopoietic stem cell transplantation (HSCT) is influenced by numerous factors. In Brazil, patients using the public health system are also dependent on the availability of HSCT-specific beds in the hematology ward.

OBJECTIVE AND METHODS

We conducted a cohort study of listed patients who underwent allogeneic HSCT at a Brazilian public hospital to investigate the impact of the waitlist time on post-HSCT survival.

RESULTS

The median time from diagnosis to HSCT was 19 months (IQR, 10 - 43), of which 6 months (IQR, 3 - 9) were spent on the waitlist. The time on the waitlist for HSCT appeared to influence mainly the survival of adult patients (≥ 18 years), with an increasing risk according to this time (RR, 3.53 and 95%CI, 1.81 - 6.88 for > 3 and ≤ 6 months; RR 5.86 and 95%CI, 3.26 - 10.53 for > 6 and ≤ 12 months, and; RR 4.24 and 95%CI, 2.32 - 7.75 for > 12 months).

CONCLUSION

Patients who remained on the waitlist for less than 3 months had the highest survival (median survival, 856 days; IQR, 131 - 1607). The risk of reduced survival was about 6-fold higher (95%CI, 2.8 - 11.5) in patients with malignancies.

Antiproliferative, genotoxic and mutagenic potential of synthetic chocolate food flavoring

Flavoring additives are of great technological importance for the food industry. However, there is little information regarding the toxicological properties of these micro-ingredients, especially at the cellular level. The present study used meristematic root cells of Allium cepa L. to evaluate the toxicity of a liquid, aroma and flavor synthetic chocolate additive, manufactured and widely marketed throughout Brazil and exported to other countries in South America. The flavoring concentrations evaluated were 100.00; 50.00; 25.00; 1.00; 0.50 and 0.25 µL/L, where the highest concentration established was one-hundred times lower than that commercially suggested for use. The concentration 100 µL/L substantially reduced cell division of meristems within 24- and 48-hours exposure. Concentrations from 100.00 to 0.50 µL/L resulted in a significant number of prophases to the detriment of the other phases of cell division, indicating an aneugenic activity, and induced a significant number of cellular changes, with emphasis on micronuclei, nuclear buds and chromosomal breaks. Under the established analysis conditions, with the exception of concentration 0.25 µL/L, the flavoring of chocolate caused cytotoxicity, genotoxicity and mutagenicity to root meristems.

Biosynthesis and characterization of gold nanoparticles using Brazilian red propolis and evaluation of its antimicrobial and anticancer activities

Gold nanoparticles (AuNPs) are highlighted due to their low toxicity, compatibility with the human body, high surface area to volume ratio, and surfaces that can be easily modified with ligands. Biosynthesis of AuNPs using plant extract is considered a simple, low-cost, and eco-friendly approach. Brazilian Red Propolis (BRP), a product of bees, exhibits anti-inflammatory, anti-tumor, antioxidant, and antimicrobial activities. Here, we described the biosynthesis of AuNPs using BRP extract (AuNPextract) and its fractions (AuNPhexane, AuNPdichloromethane, AuNPethyl acetate) and evaluated their structural properties and their potential against microorganisms and cancer cells. AuNPs showed a surface plasmon resonance (SPR) band at 535 nm. The sizes and morphologies were influenced by the BRP sample used in the reaction. FTIR and TGA revealed the involvement of bioactive compounds from BRP extract or its fractions in the synthesis and stabilization of AuNPs. AuNPdichloromethane and AuNPhexane exhibited antimicrobial activities against all strains tested, showing their efficacy as antimicrobial agents to treat infectious diseases. AuNPs showed dose-dependent cytotoxic activity both in T24 and PC-3 cells. AuNPdichloromethane and AuNPextract exhibited the highest in vitro cytotoxic effect. Also, the cytotoxicity of biogenic nanoparticles was induced by mechanisms associated with apoptosis. The results highlight a potential low-cost green method using Brazilian red propolis to synthesize AuNPs, which demonstrated significant biological properties.

Androgen receptor mRNA measured by quantitative real time PCR is decreased in the urethral mucosa of patients with middle idiopathic hypospadias

Androgen action is exerted through the androgen receptor. The normal 46,XY genital virilization depends on androgen receptor gene expression, which is tissue specific, and requires normal androgen receptor mRNA levels in androgen sensitive tissues. Hypospadias is a frequent male genital abnormality, potentially related to reduced androgen sensitivity in genital tissues. The aim of this study was to compare, by quantitative real time PCR, the amount of androgen receptor mRNA in cells obtained from the urethral mucosa of patients with middle idiopathic hypospadias with the androgen receptor mRNA levels observed in control phimosis subjects with eutopic urethral opening. Prepubertal individuals were studied, including 41 controls and 17 hypospadias patients with mean (SD) ages of 4.7 (2.1) years and 4.0 (3.0) years, respectively. We observed significantly less androgen receptor mRNA in the urethral mucosa of patients with hypospadias than in the controls (p=0.002). The correlation between the level of androgen receptor mRNA expression and the penile size was almost statistically significant only in hypospadias patients (r=0.47; p=0.053). We also established the number of CAG repeats in exon 1 of the androgen receptor gene by GeneScan analysis. No significant difference was observed in the number of CAG repeats when patients and controls were compared. A negative correlation between the CAG repeats and penile size was detected in patients with hypospadias, but not in controls. Our data suggest that a critical lower level of androgen receptor mRNA expression could be a determining factor in the development of middle hypospadias.

An extended model of phosphorus metabolism in growing ruminants

A major objective of this study was to extend the Vitti-Dias model used to describe P metabolism in ruminants, by adding 2 new pools to the original model to represent the rumen and saliva. An experiment was carried out using 24 male sheep, initial BW of 34.5 kg, aged 8 mo, fed a basal diet supplied with increasing amounts of dicalcium phosphate to provide 0.14, 0.32, 0.49, and 0.65% P in the diet. Sheep were individually housed indoors in metabolic cages and injected with a single dose of 7.4 MBq of (32)P into a jugular vein. Feed intake and total fecal and urinary outputs were recorded and sampled daily for 1 wk, and blood samples were obtained at 5 min, and 1, 2, 4, 6, 24, 48, 72, 96, 120, 144, and 168 h after (32)P injection. Saliva and rumen fluid samples were taken on d 6, 7, and 8. Then, animals were slaughtered and samples from liver, kidney, testicle, muscle, and heart (soft tissue) and bone were collected. Specific radioactivity and inorganic P were then determined in bone, soft tissue, plasma, rumen, saliva, and feces, and used to calculate flows between pools. Increased P intake positively affected total P (r = 0.97, P < 0.01) and endogenous P excretion in feces (r = 0.85, P < 0.01), P flow from plasma to saliva (r = 0.73, P < 0.01), from saliva to rumen (r = 0.73, P < 0.01), and from lower gastrointestinal tract to plasma (r = 0.72, P < 0.01). Urinary P excretion was similar for all treatments (P = 0.35). It was, however, related to plasma P (r = 0.63, P < 0.01) and to net P flow to bone (accretion - resorption; r = -0.64, P < 0.01). Phosphorus intake affected net P flow to soft tissue (P = 0.04) but not net P flow to bone (P = 0.46). Phosphorus mobilized from bone was directed toward soft tissue, as suggested by the correlations between P flow from bone to plasma and net P flow to soft tissue (r = 0.89, P < 0.01), and P flow from plasma to soft tissue and net P flow to bone (r = -0.76, P < 0.01). The lack of effect of dietary P on net P accretion in bone suggests that P demand for bone formation was low and surplus P was partially used by soft tissue. In conclusion, the model resulted in appropriate biological description of P metabolism in sheep and added knowledge of the effects of surplus dietary P on P metabolism. Additionally, the model can be used as a tool to assess feeding strategies aiming to mitigate P excretion into the environment.

Low-level laser therapy, at 830 nm, for pain reduction in experimental model of rats with sciatica

Chronic pain, resulting from nerve compression, is a common clinical presentation. One means of conservative treatment is low-level laser therapy, although controversial. The aim of this study was to evaluate the effects of two doses of low-level laser, at 830 nm, on pain reduction in animals subjected to sciatica. Eighteen rats were used, divided into three groups: GS (n=6), sciatica and simulated treatment; G4J (n=6), sciatica and treatment with 4 J/cm²; and G8J (n=6), sciatica and irradiation with 8 J/cm². The right sciatic nerve was exposed and compressed using catgut thread. Five days of treatment were started on the third postoperative day. Pain was assessed by means of the paw elevation time during gait: before sciatica, before and after the first and second therapies, and the end of the fifth therapy. Low-level laser was effective in reducing the painful condition.

Breast cancer patients with micrometastases in sentinel lymph nodes: differences considering additional metastatic lymph nodes

AIMS

Characterization of breast cancer patients with micrometastases in sentinel lymph node (SLN) and establish differences between micrometastatic breast cancers with additional metastatic lymph nodes (LNS) versus no other lymph node invasion.

METHODS

Analysis of 30 breast cancers, N1mi or pN0(i+), diagnosed and treated in our department from July 2000 to July 2008.

RESULTS

Micrometastases in SLNs were found in 30 patients. Complete axillary dissection revealed other metastatic LNs in 24%. Concerning breast cancers with additional LN invasion versus no other LN invasion, tumors located in the superior-external quadrant were more frequent in the former group. Other characteristics as clinical presentation, histological subtype, focality, cytonuclear grade, hormone receptors and Her2 expression were not significantly different in either group. Regarding SLN invasion, the presence of at least two micrometastatic foci were significantly more relevant in patients with other metastatic LN invasion (p < 0.01). Micrometastases diagnosed only after immunohistochemistry (IHC) were exclusively found in patients without other LN invasion, reaching statistical significance (p < 0.05).

CONCLUSIONS

Complete axillary dissection revealed additional LN invasion in 24% of patients with micrometastases in the SLN. Tumors with additional LN invasion were more frequently found in the superior external quadrant and SLNs harbored at least two micrometastatic foci. Micrometastases diagnosed exclusively by IHC techniques were more relevant in cases without additional lymph node invasion.

Impact of prolonged physical training on the pituitary glucocorticoid sensitivity determined by very low dose intravenous dexamethasone suppression test

The activity of the hypothalamic-pituitary-adrenal axis is usually modulated by several stress factors, including exercise. Different responses are induced by physical training according to duration and intensity of exercise. During prolonged training, cortisol remains normal or decreased as a consequence of altered cortisol secretion, metabolism and excretion, and possibly by changes in glucocorticoid sensitivity. The aim of this study was to evaluate the impact of prolonged physical training on the glucocorticoid sensitivity. Eighteen cadets of the Air Force Academy, mean (SD) age: 18.7 (1.0) years, underwent an intensive 6-week preparatory training-period considered adequate by inducing significant changes on body composition measured by bioelectrical impedance. Measurement of individual's pituitary glucocorticoid sensitivity was done by an intravenous very low dose dexamethasone suppression test (20 microg/m (2)) that was performed before and after the training period. Cortisol levels were obtained at basal condition and 120 minutes after the dexamethasone infusion. Basal cortisol showed a significant decrease after prolonged training. The percent cortisol suppression after dexamethasone tended to be lower after the training period. Overall, our data suggest that prolonged physical training is able to reduce glucocorticoid sensitivity, which can have a beneficial impact in chronic stress conditions.

Seasonal variation in the biomass and agar yield from Gracilaria cervicornis and Hydropuntia cornea from Brazil

Seasonality of biomass and agar yield from two agarophytes (G. cervicornis and H. cornea) was determined. The biomass from G. cervicornis was higher (390 g m-2) during the dry season and lower during the rainy season (129 g m-2). The data analysis for G. cervicornis revealed a significant seasonal variation (P < 0.05). H. cornea did not show a clear seasonal variation and was present only from March to August. The peak in biomass for this species was recorded in April (383 g m-2) and was significantly different from the other months (P < 0.05). The agar yield for G. cervicornis varied from 11% to 20%, with generally higher values recorded during the dry season. The agar yield showed a highly significant variation (P < 0.001). Agar yield from H. cornea ranged from 29% to 41%, with a peak recorded in June. The results above indicate that H. cornea can be considered a good candidate for commercial use.

[A lymphoepithelioma-like type of spinous-cell carcinoma of the cervix uteri]

Lymphoepithelioma-like carcinomas of the cervix uteri are very rare. They are poorly differentiated squamous cell carcinomas with intense stromal lymphocytic infiltration. These histologic features are similar to nasopharyngeal lymphoepithelioma and may have a better prognosis than other tumors of the cervix. A lymphoepithelioma-like lesion of the cervix uteri is described in a 33-year-old Caucasian woman who had an episode of vaginal bleeding. A review of the literature about these types of tumor is also presented.

[Primary lymphoma of the lung]

Primary lymphomas of the lung are rare neoplasias that can be easily diagnosed when enough tissue is available, but are easily mistaken for lung carcinomas or mesotheliomas on clinical evaluation. Two surgical cases are described with reference made to their morphological and immunohistochemical characteristics.