Surgeon experience in second-look transurethral resection of bladder cancer - a prospective study

INTRODUCTION AND OBJECTIVES

Transurethral resection of bladder tumor (TURBT) is crucial in the treatment of bladder tumors and when incorrectly performed can cause staging mistakes. To avoid these errors, a second resection is recommended in selected cases. The aim of this study is to evaluate the surgeon's ability to predict histologically complete primary resection of newly diagnosed bladder tumors avoiding the need for a second TURBT.

METHODS

This is a prospective, observational study involving 47 consecutive patients with newly diagnosed bladder tumors who had previously undergone primary TURBT, and met EAU criteria for second-look TURBT. Second-look TURBT specimens were analyzed for routine histological assessment and compared with the surgeon's impression of the tumor at initial resection.

RESULTS

Of 91 patients submitted to primary TURBT, 47 met the criteria for second-look TURBT. Second-look specimens revealed residual disease in 20.9% of patients and 3 (6.4%) of patients showed upstaging disease. The sensitivity of a senior to detect disease on second-look TURBT in relation to muscle invasion was 75%, and the specificity was 85%.

CONCLUSIONS

Second-look TURBT is crucial in the treatment of bladder cancer and cannot be replaced by a surgeon's opinion, so international recommendations should be followed. Supervision of less experienced surgeons is a cornerstone.

Enoxaparin improves COVID-19 by reducing Neutrophils Extracellular Traps (NETs) production

BACKGROUND

COVID-19 causes consequences such as imbalance of the immune system and thrombotic events. During the infection process, NETs in excess induce a pro-inflammatory response and disseminated intravascular coagulation. We evaluated the role of enoxaparin as a potential inhibitor of NETs.

METHODS

K18-hACE2 animals infected with the SARS-CoV-2 virus and a group of 23 individuals admitted to the hospital with COVID-19 treated with enoxaparin or without treatment and controls without the disease were included.

RESULTS

Enoxaparin decreased the levels of NETs, reduced the signs of the disease and mitigated lung damage in the animals infected with SARS-CoV-2. These effects were partially associated with prevention of SARS-CoV-2 entry and NETs synthesis. Clinical data revealed that treatment with enoxaparin decreased the levels of inflammatory markers, the levels of NETs in isolated neutrophils and the organ dysfunction.

CONCLUSION

This study provides evidence for the beneficial effects of enoxaparin in COVID-19 in addition to its anticoagulant role.

Pathogens and microorganisms in the mangrove oyster Crassostrea gasar cultivated in an estuarine environment in Northeast Brazil

Estuaries are important ecosystems due to the ecological services they provide, acting as nurseries for many species of fish and invertebrates, and are also used as environments for the extraction and cultivation of mollusks. Oysters are animals that filter water to obtain oxygen and nutrients. In this process, they can bioaccumulate microorganisms and chemical substances in their tissues. The growth of mollusk culture in Northeastern Brazil requires the health identification of cultivated oysters through the quantification of the potentially harmful microbiota accumulated in the animals. Therefore, the present work aims to quantify and identify bacteria and possible pathogens found in the tissues of cultivated oysters and their culture waters. The Most Probable Number of Coliforms (MPN) in oysters and water were considered suitable according to the Brazilian current legislation, Vibrio sp. obtained low colonization and Salmonella sp. was not observed. The prevalence of microorganisms potentially pathogenic to oysters was 33.7%, highlighting metazoans and Nematopsis sp., however, the intensity of the infestation of these organisms was moderate. The low contamination of oysters demonstrates that this culture environment is promising for this activity. However, continuous environmental and sanitary monitoring is fundamental to guarantee the safety of the culture waters and the sustainability of aquaculture activities.

Filter cake increases sugarcane yield

Sugarcane cultivation stands out in Brazilian agribusiness, covering more than eight million hectares for the production of sugar, ethanol, and by-products. Fertilization is one of the limiting factors in sugarcane yield, for which filter cake is a viable solution to meet plant nutritional needs. This study aimed to assess the effect of enriched filter cake on gas exchange and yield in RB041443 sugarcane, cultivated in soils of the coastal tablelands of Paraíba, Brazil. The experiment was conducted in the Monte Alegre S/A sugarcane mill, in the municipality of Mamanguape, using a randomized blocks experimental design, with 12 treatments (T1- cake, T2- cake + MAP, T3- cake + gypsum, T4 - cake + phosphate, T5- cake + bagasse, T6- cake + MAP + gypsum, T7- cake + MAP + phosphate, T8- cake + MAP + bagasse, T9- cake + gypsum + phosphate, T10- cake + gypsum + bagasse, T11- cake + phosphate + bagasse, and T12- control (only MAP)), and 4 replications, totaling 48 plots. A significant effect (5% probability) was also observed for the variables number of leaves and tons of stem per hectare (TSH). T1- cake, T4- cake + phosphate, T6- cake + MAP + gypsum and T10- cake + gypsum + bagasse, had the best results for TSH, with yields greater than 140 t ha-1. Regarding stomatal conductance, the highest values were obtained in T6 and T8, which, together with T11, had the highest gs values. Concerning the internal carbon concentration, T1, T2, T6, and T8 stood out. T6 also had a significant effect on transpiration. From this study, it was concluded that the use of enriched filter cake as a base fertilizer in sugarcane culture contributes to increasing the yield of the RB041443 variety, generating positive responses for plant gas exchange, being T1 and T10 indicated to increase the production in the sugar-energy sector.

Efferocytosis of SARS-CoV-2-infected dying cells impairs macrophage anti-inflammatory functions and clearance of apoptotic cells

COVID-19 is a disease of dysfunctional immune responses, but the mechanisms triggering immunopathogenesis are not established. The functional plasticity of macrophages allows this cell type to promote pathogen elimination and inflammation or suppress inflammation and promote tissue remodeling and injury repair. During an infection, the clearance of dead and dying cells, a process named efferocytosis, can modulate the interplay between these contrasting functions. Here, we show that engulfment of SARS-CoV-2-infected apoptotic cells exacerbates inflammatory cytokine production, inhibits the expression of efferocytic receptors, and impairs continual efferocytosis by macrophages. We also provide evidence supporting that lung monocytes and macrophages from severe COVID-19 patients have compromised efferocytic capacity. Our findings reveal that dysfunctional efferocytosis of SARS-CoV-2-infected cell corpses suppresses macrophage anti-inflammation and efficient tissue repair programs and provides mechanistic insights for the excessive production of pro-inflammatory cytokines and accumulation of tissue damage associated with COVID-19 immunopathogenesis.

SARS-CoV-2 productively infects primary human immune system cells in vitro and in COVID-19 patients

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a hyperinflammatory state and lymphocytopenia, a hallmark that appears as both signature and prognosis of disease severity outcome. Although cytokine storm and a sustained inflammatory state are commonly associated with immune cell depletion, it is still unclear whether direct SARS-CoV-2 infection of immune cells could also play a role in this scenario by harboring viral replication. We found that monocytes, as well as both B and T lymphocytes, were susceptible to SARS-CoV-2 infection in vitro, accumulating double-stranded RNA consistent with viral RNA replication and ultimately leading to expressive T cell apoptosis. In addition, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from coronavirus disease 2019 (COVID-19) patients. The rates of SARS-CoV-2-infected monocytes in peripheral blood mononuclear cells from COVID-19 patients increased over time from symptom onset, with SARS-CoV-2-positive monocytes, B cells, and CD4⁺ T lymphocytes also detected in postmortem lung tissue. These results indicated that SARS-CoV-2 infection of blood-circulating leukocytes in COVID-19 patients might have important implications for disease pathogenesis and progression, immune dysfunction, and virus spread within the host.

Barriers to the preceptor’s role in interprofessional education: scoping review

Background

With the expansion of interprofessional health education, preceptors are increasingly working with learners from several professions to promote collaborative practice. It is unclear what are the challenges toward interprofessional education in preceptor's learning environment. A scoping review was conducted to map the barriers to preceptorship role in interprofessional health education. The following research question was formulated: What are the barriers to preceptor's role in interprofessional education?

Methods

The research question was defined with the framework PCC: Population - preceptors; Concept - barriers to preceptorship role; Context - interprofessional health education initiatives. A systematic search in 8 databases was conducted in April 2020 to identify primary research studies published in Portuguese, Spanish or English. Independent screenings of titles/abstracts followed by full texts were performed using pre-defined criteria. This review followed the Institute Joanna Briggs Manual of Evidences (2020) and the PRISMA-ScR guideline.

Results

A total of 28 studies from the United States, Brazil, Canada, Australia, Sweden and the United Kingdom remained to extract barriers. Barriers were summarized in five main aspects: limited resources, preceptorship regulation, patients participation, teaching-service integration, local culture for interprofessional teamwork and preceptor development. Some of the barriers were: lack of coordination between educational institutions and health services, hierarchical relationship among professionals, unfavorable working environment for interprofessional collaboration, unclear professional roles and need of preceptor development.

Conclusions

Many barriers have been identified at the macro and microstructural levels of health systems. Discussing and analyzing such barriers is fundamental for advancing the debate on the skills and roles of preceptors, with a view to strengthen the Interprofessional Health Education.

Key messages

Preceptorship is important to development interprofessional collaboration. The results make it possible to plan strategies that contribute to professional recognition and professional development.

Photodynamic control of Aedes aegypti larvae with environmentally-friendly tetra-platinated porphyrin

This work evaluated the photosensitizing activity of isomeric tetra-cationic porphyrins with peripheral [Pt(bpy)Cl]⁺ to control the larval population of Aedes aegypti by photodynamic action. The photolarvicidal activity of the tetra-platinated porphyrins at meta and para position (3-PtTPyP and 4-PtTPyP) was evaluated under blue (450 nm), green (525 nm), and red (625 nm) light illumination at 55.0 J cm^-2. The meta isomer presented an efficient photolarvicidal activity even at a low concentration (1.2 ppm) in the presence of light, while the para counterpart was inactive regardless of the concentration and illumination. The different responses were related to the improved optical features and higher water solubility of 3-PtTPyP compared to 4-PtTPyP. Additionally, the potential environmental toxicity of 3-PtTPyP was tested in a plant model (Allium cepa test), with no toxicity detected for all used concentrations (1.2 to 12 ppm). Hence, this work reveals that 3-PtTPyP has a great potential to be employed to photodynamically control the insect vector population in an environmentally safe way.

Manganese requirements of broiler breeder hens

The present research was conducted to assess Mn requirements of broiler breeder hens. One hundred and twenty Cobb 500 hens, 22 wk of age, were individually allocated in cages. After fed a Mn-deficient diet (22.2 ppm), hens were randomly placed in treatments having 6 increments of 30-ppm Mn. All trace minerals were from laboratory grade sources being Mn from Mn sulfate (MnSO₄H₂O). Treatments were fed for 4 periods of 28 d. There were no interactions between dietary Mn and period for any evaluated response (P > 0.05). Requirements of Mn for hen day egg production and settable egg production were 115.8 and 56.6 ppm and 122.1 and 63.6 ppm (P < 0.05), respectively, using quadratic polynomial (QP) and broken line quadratic (BLQ) models, whereas total eggs and total settable eggs per hen had Mn requirements estimated at 115.7 and 56.6 and 121.8 and 61.7 ppm (P < 0.05), respectively. Number of cracked, defective, and contaminated eggs decreased, whereas hatchability, hatchability of fertile eggs, eggshell percentage, and eggshell palisade layer increased when hens were fed diets having 48.5 to 168.2-ppm Mn (P < 0.05). Maximum responses for egg weight and eggshell percentage were 117.7 and 63.6 ppm as well as 131.6 and 71.0 ppm (P < 0.05), respectively, using QP and BLQ models. Breaking strength and egg specific gravity had Mn requirements estimated at 140.2 and 112.7 ppm as well as 131.3 68.5 ppm (P < 0.05), whereas eggshell palisade layer and eggshell thickness were maximized with 128.8 and 68.8 ppm and 140.2 134.2 ppm, respectively, for QP and BLQ models (P < 0.05). Maximum yolk Mn content values were obtained using 118.0- and 118.4-ppm Mn by QP and BLQ models, respectively. The average Mn requirements estimated for QP and BLQ models is 128.4 and 92.3 ppm Mn (18.7 and 13.5 mg/hen/d), respectively, which is much lower than what has been currently recommended in commercial production.

Neutrophil extracellular traps (NETs) exacerbate severity of infant sepsis

Background

Neutrophil extracellular traps (NETs) are innate defense mechanisms that are also implicated in the pathogenesis of organ dysfunction. However, the role of NETs in pediatric sepsis is unknown.

Methods

Infant (2 weeks old) and adult (6 weeks old) mice were submitted to sepsis by intraperitoneal (i.p.) injection of bacteria suspension or lipopolysaccharide (LPS). Neutrophil infiltration, bacteremia, organ injury, and concentrations of cytokine, NETs, and DNase in the plasma were measured. Production of reactive oxygen and nitrogen species and release of NETs by neutrophils were also evaluated. To investigate the functional role of NETs, mice undergoing sepsis were treated with antibiotic plus rhDNase and the survival, organ injury, and levels of inflammatory markers and NETs were determined. Blood samples from pediatric and adult sepsis patients were collected and the concentrations of NETs measured.

Results

Infant C57BL/6 mice subjected to sepsis or LPS-induced endotoxemia produced significantly higher levels of NETs than the adult mice. Moreover, compared to that of the adult mice, this outcome was accompanied by increased organ injury and production of inflammatory cytokines. The increased NETs were associated with elevated expression of Padi4 and histone H3 citrullination in the neutrophils. Furthermore, treatment of infant septic mice with rhDNase or a PAD-4 inhibitor markedly attenuated sepsis. Importantly, pediatric septic patients had high levels of NETs, and the severity of pediatric sepsis was positively correlated with the level of NETs.

Conclusion

This study reveals a hitherto unrecognized mechanism of pediatric sepsis susceptibility and suggests that NETs represents a potential target to improve clinical outcomes of sepsis.

Electronic supplementary material

The online version of this article (10.1186/s13054-019-2407-8) contains supplementary material, which is available to authorized users.

LETTER Partial diallel crosses for predicting yield of semiexotic maize populations

In Brazil, the total production of maize has increased continuously due to the advances in technology but also to the new frontiers for the maize crop, including the expansion of the second crop (safrinha; usually maize after soybean). Therefore, the exploitation of new sources of germplasm seems to be imperative to attend the actual and future demands for modern cultivars adapted to the greatly variable environments available to the maize crop. The present study was based on a partial diallel (intergroup) cross to provide quantitative information on the potential of two groups of varieties (NAP - exotics and HG - local) and their combining abilities to direct the synthesis of new populations to be used in hybrid crosses or as a base for breeding programs. The experiments were carried out in two planting seasons (safra - 1st crop; safrinha - 2nd crop) following the completely randomized block design with four replications of plots 5 m long spaced 0.9 m with 25 plants per plot after thinning. The following traits were analyzed: male flowering (days), stalk diameter (mm), plant height (m), ear height (m), tassel length (cm), tassel branch number, ear length (cm), ear diameter (cm), ear yield (t/ha), and grain yield (t/ha). The populations under study presented acceptable levels for yield potential and agronomic traits, thus assuring good perspectives for their use in breeding programs. The prediction for the new populations to be synthesized from the cross between the two groups of varieties contributed positively and HG-3 population was the most appropriate, in both eras, as the parent variety most promising in Group II (HG to be used as a base) for incorporation of varieties of Group I (NAP).

Fractionation of sulphite spent liquor for biochemical processing using ion exchange resins

Sulphite spent liquor (SSL) is a side product from acidic sulphite pulping of wood, which organic counterpart is composed mainly by lignosulphonates (LS) and sugars. The last are a prominent substrate for the bioprocessing although a previous purification step is necessary to eliminate microbial inhibitors. In this study a fractionation of hardwood SSL (HSSL) has been accomplished employing ion exchange resins in order to separate sugars fraction from concomitant inhibitors: LS, acetic acid, furan derivatives, phenolics, acetic acid and excess of inorganic salts. The fractionation of HSSL has been carried out using two fixed-bed ion exchangers in series (cationic+anionic). The first cation exchange column packed with Dowex 50WX2 resin was able to eliminate free cations and partially separate sugars from high molecular weight LS and furan derivatives. The second anion exchange column packed with Amberlite IRA-96 sorbed remaining LS, phenolics and acetic acid. Overall, the series arrangement under investigation has removed 99.99% of Mg(2+), 99.0% of Ca(2+), 99.6% of LS, and 100% of acetic acid, whereas the yield of recovered sugars was at least 72% of their total amount in HSSL.

Precalcaneal congenital fibrolipomatous hamartoma: report of 2 cases

Precalcaneal congenital fibrolipomatous hamartoma is a benign condition of infancy that is possibly underdiagnosed because of the lack of reports in the literature. Lesions become evident after the first months of life and may be troublesome to parents and physicians. Patients are frequently referred to the pediatric surgeon for evaluation. We report and discuss 2 typical cases.

Lead poisoning risk for dairy cows in the semi-arid region of Pernambuco, Brazil

The lead (Pb) isotopes ²⁰⁶Pb and ²⁰⁸Pb are the final products of the radioactive decay of ²³⁸U and ²³²Th, respectively. Soils in the municipalities of Pedra and Venturosa, Brazil, present high levels of these radionuclides. We hypothesized that forage plants growing in these soils may take up high amounts of Pb and, consequently, intoxicate dairy cows. To test this, we quantified Pb concentrations in 23 forage samples from this region. Pb concentrations varied from 5 to 344 mg kg⁻¹. The highest values are one order of magnitude above the reported limit, therefore, indicating high risk of Pb contamination for dairy cows.

Estimation of dose due to ingestion of (210)pb in milk from dairy cattle in the semi-arid region of Pernambuco, Brazil

(210)Pb is widely distributed in the environment. In this context, the aim of this research has been: (1) to determine (210)Pb concentrations in milk and dairy products from farms located in the cities of Pedra and Venturosa in Pernambuco, Brazil; and (2) to calculate the dose due to the ingestion of (210)Pb in these products. The ion exchange resin method was used and the concentration of (210)Pb varied from 62 to 650 mBq l(-1) in fresh milk, from 202 to 1,494 mBq kg(-1) in curdled cheese and from 11 to 253 mBq l(-1) in milk whey. The estimated dose due to ingestion of milk and dairy products in this region was 0.2 Sv, which is at least two orders of magnitude above the maximum recommended levels.

Antimicrobial susceptibility of Escherichia coli isolated from shrimp (Litopenaeus vannamei) and pond environment in northeastern Brazil

This study aimed to test the susceptibility of Escherichia coli strains isolated from the water, bottom sediments and individuals cultivated in shrimp farm ponds, to antibiotics belonging to different families, namely B-Lactams: Imipenem (IPM; 10 micro g), Ampicillin (AMP; 10 micro g), Cephalothin (CEP; 30 micro g), Cefoxitin (FOX; 30 micro g), Ceftriaxone (CRO; 30 micro g); Tetracycline: Tetracycline (TCY; 30 micro g); Aminoglycosides: Gentamicin (GEN; 10 micro g), Amikacin (AMK; 30 micro g); Chloramphenicol: Chloramphenicol (CHO; 30 micro g); Fluoroquinolones: Ciprofloxacin (CIP; 5 micro g); Nitrofurans: Nitrofurantoin (NIT; 300 micro g); Sulfonamides: Trimethoprim-Sulfamethoxazole (SXT; 30 micro g); Quilononas: Nalidixic Acid (NAL; 30 micro g). In the laboratory, the method of dissemination (Test Kirby-Bauer) was performed in order to fulfill the antibiogram tests. The results showed high indices of resistance to Imipenem, Cephalothin and Ampicillin. Chloramphenicol, Nitrofurantoin, Cefoxitin, Ceftiaxone and Ciprofloxacin have displayed the highest index of sensitive strains. The antibiotic resistance index (ARI) and the multiple resistance index (MAR) varied within the ranges of 0.068-0.077 and 0.15-0.39, respectively. More than 90.5% of strains of Escherichia coli showed a variety of resistance profiles to the tested antibiotics. The high indices of resistance may be a consequence of indiscriminate use of antibiotics, but also the transfer of resistance through mobile genetic elements found in shrimp farms.

Irrigation of eucalyptus plantation using treated bleached kraft pulp mill effluent

The use of treated pulp mill effluent on eucalyptus plantation appears to be an attractive option for plant nutrition and water supply. It also constitutes a supplementary treatment process and a final disposal option for the mill effluent. This study aimed at the investigation and evaluation of the effects of bleached kraft pulp mill treated effluent on three typical Brazilian soils used for eucalyptus plantation. The effluent was characterized and five different application rates, defined according to the load of sodium, were tested in controlled environment experiments (greenhouse). After effluent application over a six month period an increase in the salinity of the studied soils was observed, although no soil dispersion was detected. The low content of some nutrients in the treated effluent indicated the need for fertilizer complementation. In general, the best biomass productivity and plant growth results were obtained in fine textured soil at a loading rate of 6.49 t Na ha(-1). The good response of the soil-plant system under different effluent application rates showed the feasibility for the eucalyptus irrigation if adequate management practices and monitoring are carried out.

210Pb in forage consumed by dairy cows

The aim of this research was to determine (210)Pb concentrations in forage from farms located in the municipalities of Pedra and Venturosa, in the Brazilian state of Pernambuco, where rolled blocks of mafic rock with a high percentage of U(3)O(8) were found. The concentrations of (210)Pb varied from 2 to 503 Bq kg(-1) in the forage dry matter samples evaluated. Due to the elevated levels of (210)Pb in the forage samples, it is concluded that this radionuclide is highly available to be ingested by dairy cows and this could represent a hazard to the human population due to possible milk contamination.

Radium-228 as an indicator of thorium-232 presence in a soil in Pernambuco, Brazil

Radiometric measurements were taken in a small area of Pernambuco, Brazil, with the objective of monitoring the radium of the soil. For this, 78 soil samples were collected. The gamma analyses of the samples were carried out using HPGe. The values obtained for the (226)Ra varied from 14 to 367 Bqkg(-1) and for the (228)Ra from 73 to 429 Bqkg(-1). The ratio (228)Ra/(226)Ra varied from 1.0 to 7.0. Therefore, it is an indicator of an additional radioactivity source in this soil, maybe (232)Th, which will be further investigated in future studies.

Pb-210 in rock and soils of the semi-arid agreste region of Pernambuco, Brazil

The aim of this research was to determine (210)Pb concentrations in rocks and soils of farms located in the municipalities of Pedra and Venturosa. In these farms, rolled blocks of mafic rock with a high percentage of U(3)O(8) were found. The concentrations of (210)Pb varied from 3.2 to 201 kBq kg(-1) in rock samples and from 195 to 86,400 Bq kg(-1) in soil samples. The high levels of radioactivity found in the samples, indicate the need to conduct more detailed studies to evaluate the risk of radionuclide ingestion due to milk consumption by the population in the state of Pernambuco.

Craniofacial abnormalities, obesity, and hormonal alterations have similar effects in magnitude on the development of nocturnal hypoxemia in patients with acromegaly

BACKGROUND

In patients with acromegaly, sleep apnea-related hypoxemia results in considerable morbidity and mortality.

AIMS

To evaluate the relative weight of pathogenic factors in predicting such hypoxemia.

METHODS

In this cross-sectional study, 34 acromegaly patients were submitted to clinical evaluation, nocturnal oximetry, and nasolaryngeal airway tomography. GH, IGF-I, and its upper limit normal value were measured. Nocturnal hypoxemia was defined as >5 episodes of desaturation/h of sleep. Craniofacial abnormalities were expressed using a linear parameter index (LPI). Nocturnal hypoxemia was predicted using logistic regression, including the variables markers of craniofacial abnormality, hormonal alteration, and obesity. Coefficients were standardized in order to determine their effect magnitudes relative to the outcome. The best model included the variables gender, age, LPI, body mass index (BMI), and IGFI upper limit normal value.

MAIN RESULTS

In the absence of the age and gender variables, the odds ratio for the LPI (1.60) was slightly higher than those found for BMI (1.49) and upper limit normal value (1.40). When the data were adjusted for age, the hormone upper limit normal value presented little alteration (1.49), although the decrease in the LPI was considerable (1.21), as was the increase in the BMI (2.18). The relative weight of the LPI was age-dependent. The gender variable did not alter the relevance of the others.

CONCLUSIONS

The effects that craniofacial aspect, obesity, and hormonal alterations have on nocturnal hypoxemia are of similar magnitude.

Radium-226 in sugar cane, Saccharum officinarum, products in the state of Pernambuco, Brazil

The objective of this study was to determine the 226Ra concentrations in samples of sugar cane juice, which is sold for human consumption in the city of Recife, capital of the state of Pernambuco, Brazil. The sample collections were carried out in seventeen commercial establishments where high quantities of the juice are usually sold. The methodology used to determine the concentrations of 226Ra in the juice was based on 222Rn emanation classical technique. Concentrations of 226Ra in the samples varied from 18 to 89 mBqL(-1).

Unicystic ameloblastoma in a child: a differential diagnosis from the dentigerous cyst and the inflammatory follicular cyst

Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws with an aggressive potential that commonly occurs in children. This cystic odontogenic neoplasm is generally asymptomatic and found during routine radiographs. The purposes of this report were to describe a case of UA involving the crown of the unerupted right mandibular second premolar in an 11-year-old girl under orthodontic treatment, and discuss its diagnosis and radiographic and microscopic findings, emphasizing its distinction from the dentigerous cyst and the inflammatory follicular cyst.

Determination of 226Ra in cheese produced in the rural area of Pernambuco-Brazil

This work is aimed at determining (226)Ra concentration in cheese produced by dairy manufacturers from Pedra and Venturosa, which are two districts in the rural region of Pernambuco-Brazil. Analyses showed concentrations of (226)Ra in cheese samples varying from 54 to 2,080 mBq kg(-1) (wet matter). Using the cumulated risk method, the excess carcinoma and bone sarcoma were estimated for chronic ingestion of cheese containing this radioisotope. In this context, this report discusses the methodology of sample analyses as well as possible consequences of the (226)Ra intake for human health.

Potential for enhancement of aerobic biological removal of recalcitrant organic matter in bleached pulp mill effluents

Increasingly stringent effluent quality limits for bleached kraft pulp mills pose a great challenge to mill wastewater system managers since these limits can require levels of chemical oxygen demand (COD) removal efficiency rarely reported for biological treatment of these types of effluents. The present study was therefore undertaken to better understand the nature of recalcitrant COD in bleached kraft pulp effluents that persists through the biological treatment system. Bleaching effluents from a Brazilian eucalypt bleached kraft pulp mill were collected and treated in a bench-scale sequencing batch reactor. Organic matter in raw and treated effluents was characterized before and after separation into low and high molecular mass fractions. Biological treatment removed 71% of the COD, with 83% removal of the low molecular mass COD but only 36% removal of the high molecular mass COD. Microorganisms capable of degrading the recalcitrant COD were isolated from enrichment cultures of the original activated sludge fed on fractions of the bleaching effluent that presented low biodegradabilities. Use of a microbial consortium composed of ten of these isolates to treat the biologically treated effluent removed a further 12% of the effluent COD, all from the high molecular mass fraction. Results of this research indicate that microorganisms with potential for degrading recalcitrant COD are present in activated sludge, but that these are not metabolically active during normal activated sludge treatment of mill effluents. The use of biological selectors in the treatment system to promote growth of such microorganisms may enhance removal of recalcitrant organic matter.

Effect of hot acid hydrolysis and hot chlorine dioxide stage on bleaching effluent biodegradability

The hot acid hydrolysis followed by chlorine dioxide (A/D*) and hot chlorine dioxide (D*) technologies have proven very useful for bleaching of eucalyptus kraft pulp. Although the characteristics and biodegradability of effluents from conventional chlorine dioxide bleaching are well known, such information is not yet available for effluents derived from hot acid hydrolysis and hot chorine dioxide bleaching. This study discusses the characteristics and biodegradability of such effluents. Combined whole effluents from the complete sequences DEpD, D*EpD, A/D*EpD and ADEpD, and from the pre-bleaching sequences DEp, D*Ep, A/D*Ep and ADEp were characterized by quantifying their colour, AOX and organic load (BOD, COD, TOC). These effluents were also evaluated for their treatability by simulation of an activated sludge system. It was concluded that treatment in the laboratory sequencing batch reactor was efficient for removal of COD, BOD and TOC of all effluents. However, colour increased after biological treatment, with the greatest increase found for the effluent produced using the AD technology. Biological treatment was less efficient at removing AOX of effluents from the sequences with D*, A/D* and AD as the first stages, when compared to the reference D stage; there was evidence of the lower treatability of these organochlorine compounds from these sequences.

The responsibility of the pulp and paper sector with regard to sustainable development: how much is enough?

Pulp and paper companies all over the world certify their environmental management systems assuming public commitments for the continuous improvement of their relationship with the environment. Once certified, they consider themselves having done their part. But is this enough? This work has been carried out with the clear intention of provoking the professionals who can give the much needed answers for the construction of environmental sustainability in the pulp and paper sector.

Application of ultrafiltration in the pulp and paper industry: metals removal and whitewater reuse

In the pulp and paper industry, the water use minimization is a constant target. One way to reduce water use is to recycle the effluent in a closed-cycle concept. In paper mills, the main source of liquid effluent is the so-called whitewater, which is the excess water, originated from pulp stock dewatering and other fibre contaminated water. This research studied the reuse of paper mill whitewater after membrane ultrafiltration (UF) in the paper machine and in the pulp bleach plant of an integrated mill. Contaminant removal and flux behaviour of the UF system were evaluated. The treatment by ultrafiltration was technically feasible and the treated whitewater had good potential to be reused in some processes in the paper machine. The reuse of ultrafiltered whitewater in the bleaching plant was not recommended because of the high level of soluble calcium present in this stream. Therefore, a combined treatment of the whitewater using the principle of precipitation and ultrafiltration was proposed showing good results and enabling the use of the treated whitewater in the bleach plant.

A tank-to-wheel analysis tool for energy and emissions studies in road vehicles

Currently, oil based fuels are the primary energy source of road transport. The growing need for oil independence and CO(2) mitigation has lead to the increasing importance of alternative fuel usage. CO(2) is produced not only as the fuel is used in the vehicle (tank-to-wheel contribution), but also upstream, from the fuel extraction to the refueling station (well-to-tank contribution), and the life cycle of the fuel production (well-to-wheel contribution) must be considered in order to analyse the global impact of the fuel utilization. A road vehicle tank-to-wheel analysis tool that may be integrated with well-to-tank models was developed in the present study. The integration in a demonstration case study allowed to perform a life cycle assessment concerning the utilization of diesel and natural gas fuels in a specific network line of a bus transit company operating in the city of Porto, Portugal.

Co-occurrence of aflatoxins B1, B2, G1, G2, zearalenone and fumonisin B1 in Brazilian corn

Two hundred and fourteen unprocessed corn samples (1997-98 harvest), collected at wholesale markets in different regions in Brazil, were surveyed for the occurrence of mycotoxins. The samples were analysed for aflatoxins B1, B2, G1, G2, zearalenone and fumonisin B1 using in-house validated methods. The occurrence of aflatoxin B1, zearalenone and fumonisin B1 was found in 38.3, 30.4 and 99.1% of the samples, respectively. Aflatoxin B1, zearalenone and fumonisin B1 contamination levels varied from 0.2 to 129, 36.8 to 719, and 200 to 6100 microg/kg, respectively. The co-occurrence of the two carcinogenic mycotoxins aflatoxin B1 and fumonisin B1 was observed in 100% of the aflatoxin-contaminated samples (82 samples). Co-occurrences of aflatoxin B1: zearalenone: fumonisin B1 and aflatoxin B1: aflatoxin B2: fumonisin B1 were found in 18 and 43 samples, respectively.

Long-term prognosis of cirrhosis after spontaneous bacterial peritonitis treated with ceftriaxone

Spontaneous bacterial peritonitis (SBP) is a frequent infection in cirrhotic patients with ascites, with a poor prognosis. The aims of this study were to determine the long-term survival of cirrhotic patients with SBP treated with ceftriaxone and to identify predictive factors related to survival. We studied 47 first episodes of SBP treated with ceftriaxone with a mean follow-up of 272 days. Nineteen variables were recorded to evaluate their relation to survival. The most frequent organism that caused SBP was Escherichia coli (40%). Spontaneous bacterial peritonitis resolution was achieved in 67% of patients. After resolution, SBP recurrence was observed in 44% of patients. The cumulative probability of survival was 68.1% at 1 month and 30.8% at 6 months. After uni-and multivariate analyses of all cases, SBP resolution ( p = 0.0001) and international normalized ratio (INR) ( p = 0.0057) were found to be related to survival. Another analysis performed after SBP resolution and SBP recurrence showed that ascitic fluid-positive culture ( p = 0.0344) and INR ( p = 0.0218) had statistical significance as variables predictive of long-term survival. We conclude that the survival of cirrhotic patients is very short after the first episode of SBP, a fact probably related to advanced liver disease, as liver dysfunction (INR) is the most important factor related to long-term patient survival.

[Predictive value of reactive strips in urinary infection]

The microbiologic method to confirm or not the diagnosis of urinary tract infection is usually the culture and Gram-stain of the clean-catch midstream urine. Nevertheless, this is a costly and time-consuming method. We tried to evaluate the positive and negative predictive value of the nitrite and leucocyte-esterase reactive strips as an alternative method. When both the two parameters are negative it is fairly safe to exclude the urinary tract infection.

Action of selective serotonin reuptake inhibitor on aggressive behavior in adult rat submitted to the neonatal malnutrition

The effect of the malnutrition during suckling on the aggressiveness was investigated in adult rats treated or not with citalopram, a selective serotonin reuptake inhibitor (SSRI). The animals were divided into two groups according to the diet used: nourished group - the rats received the control diet with 23% protein during the life; and malnourished group - the rats had its mothers submitted to diet with 7.8% protein during suckling. At 120 days of age, each group was sub-divided according to the treatment: acute - consisting a single i.p. injection of saline solution or 20-mg/Kg citalopram; chronic - consisting the single injections (1 per day during 14 days) of saline or 20 mg/Kg citalopram. The acute or chronic treatment with SSRI reduces aggressive response in nourished rats, but not in malnourished ones. Thus, the malnutrition during the critical period of brain development seems to induce durable alterations in the function of the serotoninergic neurotransmission

A survey of zearalenone in corn using Romer Mycosep 224 column and high performance liquid chromatography

A survey of zearalenone (ZEA) in corn from various regions of Brazil was carried out by the analysis of 380 corn samples, of which 30 samples (7.8%) were found to be contaminated in the range of 46.7-719 micrograms/kg. ZEA was extracted with acetonitrile-water (84:16, v/v), cleaned-up on a Romer Mycosep 224 column, separated, detected and quantified by high performance liquid chromatography (HPLC). The in-house method characteristics of linearity, accuracy, precision, and detection limit were defined by means of recovery tests with spiked corn samples in the range of 35.8-716 micrograms/kg and the analysis of a naturally-contaminated sample (n = 7). The mean recovery for ZEA was 99.4% and the relative standard deviation (RSD) varied from 0.7 to 26.6% in the range studied. The method has been shown to be accurate, quick and reliable for determination of zearalenone in corn.

Antioxidants in medicinal plant extracts. A research study of the antioxidant capacity of Crataegus, Hamamelis and Hydrastis

The antioxidant capacity of extracts of Crataegus oxyacantha, Hamamelis virginiana, Hydrastis canadensis, plants native to Europe and North America which have long been used in herbal medicine for the treatment of cardiac and circulatory functions, has been investigated. The total antioxidant potential conferred by all hydrogen donating antioxidants present in these extracts has been assessed by the ABTS assay and the relative order of antioxidant potential has been established. Gas chromatography coupled to mass spectrometry (GC-MS) has been used for the chemical identification of the antioxidant volatile compounds present in the extracts. The GC-MS data were related to the results obtained using the ABTS assay.

Anticonvulsant activity of essential oils and active principles from chemotypes of Lippia alba (Mill.) N.E. Brown

In the present work we studied the anticonvulsive effects of the essential oils (EOs) from three chemotypes of Lippia alba (Mill.) N.E.Brown (Verbenaceae). Animals (female Swiss mice, 25 g) were treated with the EO and, 30 or 60 min after intraperitoneal (i.p.) or oral (p.o.) administration, respectively, injected with pentylenetetrazole (80 mg/kg, i.p.) and observed for 30 min. The results showed that EO I (200 and 400 mg/kg), EO II (100, 200 and 400 mg/kg), and EO III (400 mg/kg), i.p., produced an increased latency time for the first convulsion as related to controls. Death latency was greater in the groups receiving EO I (50 and 100 mg/kg), EO II (100 and 200 mg/kg), and EO III (200 mg/kg), i.p. Orally, while no effect was demonstrated with EOs at doses of 200 or 400 mg/kg, significant increases in the latency of convulsion and latency of death were observed with EO I at the highest dose (800 mg/kg). Similarly, EO III at this dose was also effective as far as latency of convulsion is concerned. Animals treated with citral (100 mg/kg, i.p.), beta-myrcene or limonene (200 mg/kg, i.p.), EOs chemical constituents, presented significant increases in the latency of convulsion and percentage of survival as compared to controls. After oral administration these effects were observed only with a higher dose (400 mg/kg). The association of EOs with diazepam significantly potentiated their effects, suggesting a similar mechanism of action and indicating that citral, beta-myrcene, and limonene are probably the EOs active compounds.

Available pathways database (APD): an essential resource for combinatorial biology

A relational database, the Available Pathways Database (APD), has been constructed of microbial natural products, their producing strains, and their biosynthetic pathways. The database allows the ready selection of donor strains for combinatorial biology experiments. It provides the same type of resource for combinatorial biology as the Available Chemicals Directory (ACD) does for combinatorial chemical library generation. Its cataloging ability can also provide insight into novel aspects of biosynthetic routes. In particular, no 10-unit Type I polyketides were found in the compilation of this edition of the APD (Version I).

Six novel beta-galactosidase gene mutations in Brazilian patients with GM1-gangliosidosis

GM1-gangliosidosis is a lysosomal storage disease caused by a deficiency of acid beta-galactosidase. Three clinical forms are recognized-infantile, juvenile, and adult-based on age of onset and severity of the symptoms. We have performed molecular analysis of a large cohort of GM1 patients (19 Brazilian and one Uruguayan), using nonradioactive single-strand conformation polymorphism (SSCP) and restriction enzyme analysis of genomic DNA. Six novel mutations (R121S, V240M, D491N, 638-641insT, 895-896insC, 1622-1627insG) and two previously described point mutations (R59H, R208C) were identified. Together they accounted for 90% of the disease alleles of the patients. Two mutations, 1622-1627insG and R59H, were present in 18 of 20 patients. In addition, four polymorphisms (L10P, L12L, R521C, S532G) were identified. All cases reported are infantile GM1 gangliosidosis. This report constitutes the most comprehensive molecular study to date of this disorder in infantile patients. Since GM1-gangliosidosis is the most common lysosomal storage disorder in Southern Brazil, molecular diagnosis will be important for genetic counseling, carrier detection and prenatal diagnosis in index families.

[Characterization of the cases of domestic violence against women assisted in 2 public hospitals of Rio de Janeiro]

This paper aims at: (a) to analyze the distribution of the cases of domestic violence against women (adolescent and adult) in relation to emergency care due to external causes; (b) to characterize the victims and the rendered care; (c) to analyze the circumstances in which events happened. In methodological terms, it tries to articulate the quantitative and qualitative approaches. The study was developed in two public hospitals of reference placed in the city of Rio de Janeiro. Of the 72 assisted women, most referred to the husband, the partner or the boyfriend as the aggressor (69.4%) and were beaten (70.4%) especially on the face and on the head. The study comes to the conclusion that the health services should provide a good clinical care and promote prevention's actions.

Genetic and environmental influences on atopic immune response in early life

The purpose of our study was to carry out a prospective follow-up of 114 newborns at term (including three pairs of twins), regarding clinical manifestations for atopy during the first year of life. Their IgE levels in cord blood samples, at 3, 6, 9 and 12 months of age were measured and the influence of race, sex, breast-feeding, maternal smoking, family income, month of birth, family history and personal manifestations of atopic disease were evaluated. Total serum immunoglobulin E was quantified by microparticle enzyme immuno-assay (MEIA). The study group consisted of 60 (53%) male neonates, 67 (59%) Caucasians and 47 (41%) blacks. In the clinical follow-up, 32 (28.1%) infants developed obvious atopic disease: 29 infants presented recurrent wheezing, two had cow's milk allergy and one had atopic dermatitis. Probable atopic disease developed in 12 (10.5%) infants, whereas 70 (61.4%) infants showed no manifestations. Cord blood IgE levels in infants with obvious atopic disease was higher when compared to those without (p = 0.024), with 70.97% sensitivity and 46.2% specificity. IgE levels were also significantly different up to 12 months in these groups (p = 0.0001), when the sensitivity was 82.1% and the specificity 54.1%. At this age, the IgE levels were higher in infants with obvious atopy than nonatopic disease in relation to male sex (p = 0.015), black race (p = 0.009), breast-feeding for less than 6 months (p = 0.011) and when the family income was less than three times the minimum wage (about US $300) (p = 0.006). There was no association between IgE levels and family history of atopy. We concluded that immune response for atopy was in a large degree influenced by environmental factors and serum IgE at 12 months was a good marker for identifying infants with risk of atopic disease in early life.

[Evaluation of outpatient care for people with HIV/AIDS in Rio de Janeiro, from the user's perspective]

This article analyzes perceptions by people with HIV/AIDS towards five specialized units under the State Health Department, Rio de Janeiro, concerning the care provided there. The research was based on both quantitative and qualitative methods. Data from 228 questionnaires and 19 semi-structured interviews were analyzed. The results generally indicated a positive evaluation on the part of this group of health care users. One conclusion was that the positive evaluation was actually related to the quality of the services available to them. However, users seem to have low expectations toward the level of services public clinics generally provide.

Copper and iron interactions with angiotensin-converting enzyme inhibitors. A study by fast-atom bombardment tandem mass spectrometry

Fast atom bombardment, combined with high-energy collision-induced tandem mass spectrometry, has been used to investigate gas-phase metal-ion interactions with captopril, enalaprilat and lisinopril, all angiotensin-converting enzyme inhibitors.Suggestions for the location of metal-binding sites are presented. For captopril, metal binding occurs most likely at both the sulphur and the nitrogen atom. For enalaprilat and lisinopril, binding preferably occurs at the amine nitrogen. Copyright 1999 John Wiley & Sons, Ltd.

Effect of growth hormone and induced IGF-I release on germ cell population and apoptosis in the bovine testis

Bovine growth hormone has been used in dairy cattle to increase milk production,but it also increases the twin parturition rate. This effect is mediated by insulin-like growth factor-I (IGF-I), which prevents follicular atresia by hindering apoptosis of granulosa cells. The action of GH and IGF-I on testicular function remains unclear. The goal of this study, therefore, was to verify the effects of short-term administration of GH and induced IGF-I release on the number of testicular germ cells, testicular morphology, and apoptosis in the bovine testis. Twenty Zebu bulls were split into 2 groups. The bulls in Group 1 (n = 10) were treated with 2 subcutaneous injections of bovine GH (500 mg/bull) 7 d apart. Group 2 bulls (n = 10) received placebos under the same protocol. All of the bulls were slaughtered 14 d after the start of treatment. Fragments of the testis were collected, fixed in Bouin's solution, embedded in paraffin, and the sections stained with hematoxilin and eosin. The paraffin-embedded sections were also used for in situ detection of apoptotic cells. Blood samples were collected at slaughter to measure serum levels of IGF-I, FSH and LH. Neither the number of Stage I seminiferous epithelium germ cells and the morphometric parameters (tubular diameter, seminiferous epithelium height, and volumetric proportions of structural components) nor the blood levels of FSH and LH showed a significant difference between the 2 groups. However, the treated animals showed an increase in serum IGF-I (P<0.01). Apoptotic germ cells were detected in the testis of both groups, showing the same pattern and a stage-specific apoptosis pattern. Most of the labeled cells were spermatocytes. The localization of apoptotic germ cells did not differ between groups. These results suggest that short-term administration of GH does not affect bovine spermatogenesis in adult bulls.

Signal transduction defects in growth hormone insensitivity

Growth hormone (GH) insensitivity is a heterogeneous condition that can result from mutations within the GH receptor (GHR) and that can be inherited as both an autosomal recessive and a dominant trait. However, evidence from a small number of growth hormone binding protein (GHBP)-positive families indicates that their GH insensitivity is independent of GHR mutations. Two of these families appear to have distinct abnormalities in GH signal transduction. Studies suggest that one family (classic Laron syndrome phenotype; designated family H) have a signalling defect close to the GHR, preventing activation of both the STAT and MAPK pathways, whereas the other family (less marked phenotype; family M) have a defect in activating MAPK but not the STAT pathway. The children studied here are specifically insensitive to GH and their defect must be exclusive to this signalling system. Thus, families with GHBP-positive GH insensitivity without GHR mutations are likely to be important models in which to study the specificity of GH signal transduction and the relationship between GH insensitive phenotype and signalling defect.