Addressing differences in cancer: a framework for synergistic programming in cancer prevention and control

Background

Cancer remains a leading cause of death worldwide and continues to disproportionately impact certain populations. Several frameworks have been developed that illustrate the multiple determinants of cancer. Expanding upon the work of others, we present an applied framework for cancer prevention and control designed to help clinicians, as well as public health practitioners and researchers, better address differences in cancer outcomes.

Methods

The framework was developed by the Cancer Prevention and Control Research Network's Health Behaviors Workgroup. An initial framework draft was developed based on workgroup discussion, public health theory, and rapid literature review on the determinants of cancer. The framework was refined through interviews and focus groups with Federally Qualified Health Center providers (n=2) and cancer patients (n=2); participants were asked to provide feedback on the framework's causal pathways, completeness, and applicability to their work and personal life.

Results

The framework provides an overview of the relationships between sociodemographic inequalities, social and structural determinants, and key risk factors associated with cancer diagnosis, survivorship, and cancer morbidity and mortality across the lifespan. The framework emphasizes how health-risk behaviors like cigarette smoking interact with psychological, psychosocial, biological, and psychosocial risk factors, as well as healthcare-related behavior and other chronic diseases. Importantly, the framework emphasizes addressing social and structural determinants that influence health behaviors to reduce the burden of cancer and improve health equity. Aligned with previous theory, our framework underscores the importance of addressing co-occurring risk factors and disease states, understanding the complex relationships between factors that influence cancer, and assessing how multiple forms of inequality or disadvantage intersect to increase cancer risk across the lifespan.

Conclusions

This paper presents an applied framework for cancer prevention and control to address cancer differences. Because the framework highlights determinants and factors that influence cancer risk at multiple levels, it can be used to inform the development, implementation, and evaluation of interventions to address cancer morbidity and mortality.

Effects of an 11-Week Detraining, Imposed by the COVID-19 Confinement, on Handball Players' Shoulder Rotator Isokinetic Profile, Shoulder Range of Motion, and Ball Release Velocity

Background and Objectives: The COVID-19 confinement significantly impacted the physical condition of athletes. However, the detraining impacts of this period on the shoulder rotator and range of motion in handball players have not been studied. Thus, the main aim of this study was to investigate the effect of this 11-week detraining period, imposed by the COVID-19 pandemic confinement, on the shoulder rotator isokinetic profile (peak torque, ratio, fatigue index), shoulder rotator and flexion range of motion, and ball release velocity in handball players. Materials and Methods: A total of 16 handball players, with a mean age of 22.38 (5.28) years, participated in this study. The isokinetic strength was assessed using two protocols (three repetitions at an angular velocity of 60°/s and 20 repetitions at an angular velocity of 180°/s). In addition, the range of motion and ball release (at jump and standing shots) were measured. All these measurements were assessed before and after the COVID-19 confinement. Results: The results showed a significant reduction in the peak torque of the external rotation of their dominant and non-dominant shoulders. In addition, confinement significantly increased the fatigue index of external rotation and internal rotation and reduced the range of motion of internal rotation. Additionally, the ball release velocity during standing and jump shots was significantly reduced. Conclusions: These results suggested that strengthening external and internal rotation as well as recovering the internal rotation range of motion may be necessary after a detraining period in order to prevent shoulder injuries.

First report of cucumber mosaic virus infecting Azorina vidalii in Azores Islands

Virus diseases that occur in crops pose a major threat not only to global food security but also to wild plant communities growing in natural ecosystems (Jones, 2020, and references therein). In Azores (Portugal) little is known about viruses present on native flora and therefore, they have not been taken into consideration in conservation programs. Considering this, we selected Azorina vidalii (Campanulaceae), an endangered (IUCN) plant, endemic to Azores (Bilz, 2011), to survey for plant viruses. A. vidalii, the sole species of its genus, is often found in crevices with no soil accumulation on coastal cliffs, exposed to storms and sea spray, and is used as an ornamental. Leaves from 53 plants of A. vidalii from three populations from Terceira Island and three populations from Flores Island were randomly collected without obvious symptoms of virus infection, between the summer of 2021 and fall of 2022. RNA extraction was performed using the Plant/Fungi Total RNA Purification Kit (Norgen Biotek, Canada). RNA extracts from each population were pooled into six distinct composite samples (AvT1, AvT2, AvT3, AvF1, AvF4 and AvF5) and sent to Lexogen (Austria) for small RNA library preparation and High-Throughput Sequencing. Single-end RNA sequencing using Illumina NextSeq2000 system yielded between 10.1 M and 33.8 M raw reads. Adaptors and low-quality reads were removed with Trim Galore! and PRINSEQ. Trimmed reads were mapped to the genome phylogenetically nearest to A. vidalii available at the NCBI database (Adenophora triphylla). The resulting 2.5 M - 13.5 M unmapped reads were analysed with VirusDetect online version (database v248) (Zheng et al., 2017) for virus detection and identification. Sequences of cucumber mosaic virus (CMV) (contigs of up to 3045 nt for RNA1, 2917 nt for RNA2 and 2086 nt for RNA3) were identified in five (AvT1, AvT2, AvT3, AvF1 and AvF5) of the six composite samples and CMV satellite sequences (two contigs with 145 and 197 nt) were identified in only one (AvT1) of the composite samples. To confirm the presence of CMV, all samples were tested by two-step RT-PCR using primers targeting CMV-specific RdRp gene (513 bp) (Grieco et al., 2000), which retrieved 18 positive samples (34%). Nine samples were selected for Sanger sequencing (six out of 13 from Terceira and three out of five from Flores) based on digestion profile obtained with AluI and MboI. The resulting sequences (OQ176229-OQ176233, OQ732757-OQ732760) share an identity of 97.2-100% and BLASTn showed them to have 98.3-99.6% identity to CMV strain TN (AB176848). A Neighbour-Joining tree (Supplementary material) inferred in MEGA11 (Tamura et al., 2021) with 237 additional CMV-RdRp sequences, showed that A. vidalii CMV-derived isolates clustered together with reference strains of subgroup II, as those used by Roossinck (2002) for phylogenetic analysis of the 2a ORF. Besides CMV, tomato spotted wilt virus and polerovirus-associated RNAs sequences were found in one of the A. vidalii populations, but with lower coverage, and need to be further investigated. To the best of our knowledge, this is the first report of CMV infecting A. vidalli. CMV, genus Cucumovirus, is an agriculturally important virus and one of the most successful viruses known, infecting over 1,200 species of plants (Palukaitis & García-Arenal, 2003). In addition to A. vidalii being a CMV reservoir, which may have implications on adjacent crop fields, further research is needed to investigate the impact of CMV on A. vidalli fitness.

OC-072 SYSTEMATIC REVIEW AND META-ANALYSIS OF PREOPERATIVE ADMINISTRATION OF BOTULINUM TOXIN AS ADJUNCT TO VENTRAL HERNIA REPAIRS

Aim

Preoperative application of botulinum toxin (BTX), with or without preoperative progressive pneumoperitoneum (PPP), is an adjunct to complex ventral hernia repairs, causing flaccid paralysis. We aim to evaluate the benefit of BTX in the advancement of the lateral musculature and decrease hernia defect width.

Material & Methods

It was elaborated a systematic review and meta-analysis following PRISMA guidelines and registered at PROSPERO. “Ventral hernia”, “incisional hernia”, “abdominal wall” and “botulinum toxin” were searched. PubMed (Medline), EMBASE (OVID) and LILACS databases research.

Results

Five studies (235 patients) showed tha BTX significantly increases the lateral abdominal wall muscles length (4,07cm) (95%CI (3.65;4.49), p<0,1 I2=47%). Two studies (113 patients) showes that hernia defect width raised 1.24 cm (95%CI (-3.06;5.53), p<0,05, I2=76%) after BTX with or without PPP.

Conclusions

Increase in the volume of the abdominal cavity after BTX and PPP by enlargement of abdominal wall muscles may be related to improve outcomes such as decreasing abdominal compartiment syndrome and surgical site occurrences.

Despite the Increase in the lateral abdominal wall after BTX, the decrease in hernia defect width was not obseved. Insted, meta-analysis showed a tendency of width increasing, taking into account considerable heterogeneity, witch may be related to PPP association.

BTX in complex ventral hernias increases lateral abdominal muscles length and, thus, is suposed to decrease poor surgical outcomes, although the transverse diameter of the defect does not reduced as expected. Futher studies are necessary to evaluate benefits of BTX in complete fascial closure.

P-131 SHORT TERM RESULTS OF PREOPERATIVE TOXIN BOTULINUM A IN PREPARATION FOR ABDOMINAL WALL RECONSTRUCTION

Aim

to report short term outcomes of preoperative toxin botulinum A (TBA) in preparation for abdominal wall reconstruction (AWR).

Material and Methods

Patient with a hernia width>10cm and/or loss of domain who underwent elective AWR from April 2021 through March 2022 were included. All patients received ultrasound-guided administration of 300 units of TBA prior the surgery. Outcomes of interest included: changes in hernia dimensions and CT-Scan volumetric measurements after treatment, rates of complete fascial closure, postoperative intraabdominal hypertension, unplanned readmission and hernia recurrence.

Results

Fifteen patients were included (53% males; mean age 61years, mean body mass index 28.9kg/m2). Median hernia width decreased by 2cm (before 15cm [IQR 14–18.5], after 13cm [IQR 10.3–15]; p=0.002) and median abdominal cavity volume increased by 1.4L (before 4.8L [IQR 3.8–11.1], after 6.2L [4.2–9.2]; p=0.594). Thickness of lateral abdominal wall muscles decreased (before 2cm [IQR 1.6–3], after 1.1cm [IQR 1–1.3]; p=0.008 and the Tanaka Index decreased (12% [IQR 3.6–24.2] and 5% [IQR 1.4–16.8]; p=0.066)

Complete fascial closure was achieved in 13cases(87%). Three patients did not require component separation. Mean endotracheal pressure was 19mmHg. There were no intraabdominal hypertension. At a median 9months follow-up [range 6.2–11.5] wound morbidity rate was 20%(N=3), N=1 recurrence, N=1 unplanned readmission.

Conclusions

TBA promotes changes to the lateral abdominal wall with decrease on defect width and thickness of lateral muscles and increase in cavity volume and Tanaka index. Randomized clinical trials are needed to determine the clinical implication of preoperative TBA in preparation for AWR.

Multisensory Stimulation Improves Cognition and Behavior in Adult Male Rats Born to LT4-treated Thyroidectomized Dams

Gestational hypothyroidism can impair development, cognition, and mood. Here, we tested whether multisensory stimulation (MS) improves the phenotype of rats born to surgically thyroidectomized (Tx) dams suboptimally treated with LT4. 8-week-old female Tx Wistar rats were kept on daily LT4 (0.7 µg/100 g body weight) dosed by gavage (serum TSH and T4 levels indicated moderate hypothyroidism) and 3 weeks later placed for breeding. MS of the litter started at age 60 days and lasted for 8 weeks. It consisted of twice per week of physical, cognitive, sensorial, and food stimuli. The offspring were assessed before and after MS for standardized tests of locomotor activity, cognition, and mood. Gestational hypothyroidism resulted in reduced litter size and increased offspring mortality. The pups exhibited delayed physical development, impairment of short- and long-term memory, and anxiety- and depressive-like behaviors. Nonetheless, ambulatory activity, social memory, and social preference were not affected by gestational hypothyroidism. MS restored short-term memory and anxiety while improving depressive like-behaviors. MS did not improve long-term memory. MS also did not modify the performance of control litter born to intact dams. We conclude that cognition and mood impairments caused by moderate gestational hypothyroidism were reversed or minimized in rats through MS. Further studies should define the molecular mechanisms involved.

REDUÇÃO DE CO2 EM HIDROCARBONETOS E OXIGENADOS: FUNDAMENTOS, ESTRATÉGIAS E DESAFIOS

CO2 REDUCTION TO HYDROCARBONS AND OXYGENATES: FUNDAMENTALS, STRATEGIES AND CHALLENGES. The development of renewable energy sources (e.g., solar and wind) moves foward, the tendance for replacing fossil fuels increases. However, these technologies have as primary barriers to industrial processes’ efficiency and especially storage. Thus, CO2 reduction routes using these energy sources could chemically store part of the energy as fuels or chemicals, offering alternatives to current oil and gas industry. This process is inspired by photosynthesis, e.g., photochemical or electrochemical processes, using homogeneous or heterogeneous catalysts. Nevertheless, this reaction is thermodynamically unfavorable and has very slow kinetics, given the high stability of the CO2 molecule and the complexity of the redox reactions involved. Therefore, this review addresses this process’s kinetic and thermodynamic challenges, and the fundamental concepts of the photo(electro)chemical processes for CO2 reduction, besides presenting and discussing the materials with the potential to act as catalysts. The main reaction mechanisms and advances in the understanding of such processes are discussed, as well as future perspectives

Ecophysiological traits of highly mobile large marine predators inferred from nucleic acid derived indices

Nucleic acid-derived indices such as RNA/DNA ratios have been successfully applied as ecophysiological indicators to assess growth, nutritional condition and health status in marine organisms given that they provide a measure of tissue protein reserves, which is known to vary depending on changes in the environment. Yet, the use of these biochemical indices on highly mobile large predators is scarce. In this study, we tested the applicability of using nucleic acids to provide insights on the ecophysiological traits of two marine mammal species (common bottlenose dolphins and short-finned pilot whales) and explored potential related factors (species, sex, season, and residency pattern), using skin tissue (obtained from biopsy darts) of apparently healthy and adult free-ranging animals. Significantly higher RNA/DNA ratios were obtained for bottlenose dolphins (p < 0.001), and for visitor pilot whales when compared with resident pilot whales (p = 0.001). No significant changes were found between the sexes. Based on the percentile approach, the samples contain individuals in a general good condition (as the 10^th percentile is not closer to the mean than the 75^th percentile), suggesting that the studied region of Macaronesia may be considered an adequate habitat. The combination of this effective tool with genetic sexing and photographic-identification provided an overall picture of ecosystem health, and although with some limitations and still being a first approach, it has the applicability to be used in other top predators and ecosystems.

Quantitative Determination of Paralytic Shellfish Poisoning Toxins in Shellfish Using Prechromatographic Oxidation and Liquid Chromatography with Fluorescence Detection: Collaborative Study

A collaborative study was conducted for the determination of paralytic shellfish poisoning (PSP) toxins in shellfish. The method used liquid chromatography with fluorescence detection after prechromatographic oxidation of the toxins with hydrogen peroxide and periodate. The PSP toxins studied were saxitoxin (STX), neosaxitoxin (NEO), gonyautoxins 2 and 3 (GTX2,3; together), gonyautoxins 1 and 4 (GTX1,4; together), decarbamoyl saxitoxin (dcSTX), B-1 (GTX5), C-1 and C-2 (C1,2; together), and C-3 and C-4 (C3,4; together). B-2 (GTX6) toxin was also included, but for qualitative identification only. Mussels, both blank and naturally contaminated, were mixed and homogenized to provide a variety of PSP toxin mixtures and concentration levels. The same procedure was followed with clams, oysters, and scallops. Twenty-one test samples in total were sent to 21 collaborators who agreed to participate in the study. Results were obtained from 18 laboratories representing 14 different countries. It is recommended that the method be adopted First Action by AOAC INTERNATIONAL.

Interactive 3D geodesign tool for multidisciplinary wind turbine planning

Wind turbine site planning is a multidisciplinary task comprising of several stakeholder groups from different domains and with different priorities. An information system capable of integrating the knowledge on the multiple aspects of a wind turbine plays a crucial role on providing a common picture to the involved groups. In this study, we have developed an interactive and intuitive 3D system (Falcon) for planning wind turbine locations. This system supports iterative design loops (wind turbine configurations), based on the emerging field of geodesign. The integration of GIS, game engine and the analytical models has resulted in an interactive platform with real-time feedback on the multiple wind turbine aspects which performs efficiently for different use cases and different environmental settings. The implementation of tiling techniques and open standard web services support flexible and on-the-fly loading and querying of different (massive) geospatial elements from different resources. This boosts data accessibility and interoperability that are of high importance in a multidisciplinary process. The incorporation of the analytical models in Falcon makes this system independent from external tools for different environmental impacts estimations and results in a unified platform for performing different environmental analysis in every stage of the scenario design. Game engine techniques, such as collision detection, are applied in Falcon for the real-time implementation of different environmental models (e.g. noise and visibility). The interactivity and real-time performance of Falcon in any location in the whole country assist the stakeholders in the seamless exploration of various scenarios and their resulting environmental effects and provides a scope for an interwoven discussion process. The flexible architecture of the system enables the effortless application of Falcon in other countries, conditional to input data availability. The embedded open web standards in Falcon results in a smooth integration of different input data which are increasingly available online and through standardized access mechanisms.

Abstract P164: The Role of the Adrenoreceptors Beta 3 on Metabolic Syndrome Induced by Fructose

The aim of this study was to evaluate the role of the adrenoreceptor beta 3 (ARβ3) in the cardiovascular function on Metabolic Syndrome (MS) induced by fructose overload. Male mice after weaning (8-10g) were divided into 4 groups (n=7/group): FVB Control (C) and ARβ3 Knockout Control (Kβ3C), with free access to food and water for 8 weeks; FVB fructose (F) and ARβ3 Knockout fructose (Kβ3F), with free access to food and fructose added to the drinking water (10%) for 8 weeks. At the end of the protocol, intraperitoneal glucose tolerance test was performed. Triglycerides and HDL fractions were evaluated by colorimetric methods. The animals were submitted to catheterization of carotid artery. This catheter was connected to a transducer and continuous signals of blood pressure (BP) was recorded. The variability of the resultant signal was evaluated in frequency domain. Visceral fat deposits were collected, weighted and normalized as fat (mg)/body weight (g). Results: fructose increased the fasting glycemia in the knockout group (Kβ3C=93±3 vs. Kβ3F=122±7 mg/dL) and decreased the glucose tolerance in both fructose groups. Fructose increased the triglycerides and decreased HDL cholesterol. The uric acid increased in the knockout animals. There was an increase on visceral fat deposits only in FVB animals (C=10±2 vs. F=16±1 mg/g), as well as on blood pressure (C=123±4 vs. 136±2 mmHg) There was an increase on blood pressure variability for all experimental groups compared to Control (C=10.7±1 vs. F=36±11; Kβ3C=50±7; Kβ3F=24±4 mmHg 2 ) as well as on peripheral sympathetic modulation (C=3.3±0.4 vs. F=8.1±0.1; Kβ3C=22.9±3; Kβ3F=9.2±2 mmHg 2 ). Furthermore, Kβ3F showed a decrease on blood pressure variability and peripheral sympathetic modulation. Our data suggest that the hypertension induced by fructose is related with adiposity. Moreover, the blood pressure variability and its sympathetic modulation are dependent of the ARB3. The association between fructose and ARβ3 knockout leads to the loss of the sympathetic modulation.

Treatment of diabetic foot complications with hyperbaric oxygen therapy: a retrospective experience

BACKGROUND

The aim of this study is to evaluate the role of hyperbaric oxygen in the treatment of diabetic foot ulcers.

METHODS

We performed a retrospective observational study of all patients with diabetic foot ulcers treated at the Institution's hyperbaric chamber between January 2010 and August 2012. Patient data was obtained upon patient hospital visit and prospective clinical record consultation.

RESULTS

Twenty-six foot lesions including 13 foot ulcers Wagner grade 2 or greater and 13 amputation stump ulcers were submitted to hyperbaric oxygen therapy between January 2010 and August 2012 in our Institution. Of these, 23 foot lesions completed treatment and complete epithelialization of the primary lesion was achieved in 15 (65%). The mean healing period since the first hyperbaric oxygen therapy session was 16 weeks. Above-ankle amputations were performed in 3 limbs and transmetatarsal amputations in 2 limbs.

CONCLUSION

Hyperbaric oxygen may be associated with ulcer healing in selected diabetic foot ulcers with impaired cicatrization.

An LC-MS assay for the screening of cardiovascular medications in human samples

Cardiovascular drugs are the most commonly prescribed medications. Some prior assays successfully detect cardiovascular drugs among multiple classes using a single sample. Here, we develop an assay to detect a broad range of cardiovascular drug classes to include commonly used cardiovascular drugs and evaluate the assay's analytical and statistical properties in a clinical setting. We describe a protocol for drug detection that encompasses 34 commonly prescribed cardiovascular drugs or drug metabolites with a single LC-MS/MS method using 100μL of serum or plasma. Drug classes monitored by this assay include: anticoagulants, angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, calcium channel blockers, diuretics, statins, and vasodilators, as well as digoxin, fenofibrate, and niacin. Analytical accuracy and precision for each drug were evaluated by repeating the assay on spiked samples at low, medium, and high concentrations. In 294 clinical samples obtained from hospitalized patients for whom medication administration was recorded, we evaluated the assay's statistical sensitivity, specificity, and accuracy. For the 34 drugs or drug metabolites, the assay was statistically sensitive (>0.90) for all drugs except captopril (0.25), isosorbide (0.81), and niacin (0.89). The assay was statistically specific for all drugs, with a minimum specificity of 0.94 (aspirin). To our knowledge, this method is the first method of simultaneous analysis of 34 cardiovascular drugs or drug metabolites from nine drug classes evaluated using clinical samples from hospitalized patients.

An unusual case of foreign body aspiration in an infant

Inhalation of foreign body is a serious condition in childhood and may result in acute respiratory distress, lung injury or death. A nine month old baby with history of severe respiratory distress, cyanosis and gasping breathing diagnosed as foreign body aspiration due to a balloon which was recovered post mortem during the removal of the endotracheal tube.

Compressed domain topographic classification for capsule endoscopy

In this paper we compare the classification accuracy of using compressed domain color (CDC) descriptors versus traditional full decoded images, for the purposes of topographic classification of wireless capsule endoscopy images. Results using a dataset of 26469 images, divided into stomach, small intestine and large intestine show a difference in classification accuracy below 1%. We also show that errors are mostly located near zone transitions (the pylorus and the ileocecal valve) and motivate the need for other visual descriptors (e.g. shape, motion) for addressing these specific areas. We conclude we can use the advantages of CDC in this type of classification with minor accuracy sacrifice.

Autologous transplantation of bone marrow mononuclear stem cells by mini-thoracotomy in dilated cardiomyopathy: technique and early results

CONTEXT AND OBJECTIVES

There are few studies concerning bone marrow mononuclear cell (BMMC) transplantation in cases of nonischemic dilated cardiomyopathy. This study describes a novel technique of BMMC transplantation and the results up to one year after the procedure.

DESIGN AND SETTING

This was a case series to evaluate the safety and viability of the procedure, at Instituto de Cardiologia do Rio Grande do Sul.

METHODS

Nine patients with symptomatic dilated cardiomyopathy, functional class III/IV and left ventricular ejection fraction (LVEF) < 35% received BMMC (9.6 +/- 2.6 x 107 cells) at 20 sites in the ventricular wall, by means of thoracotomy of length 5 cm in the fifth left intercostal space. Echocardiograms and nuclear magnetic resonance (NMR) were performed.

RESULTS

There were no major complications. The functional class results for the first six patients (preoperatively and at two, four, eight and twelve-month follow-ups, respectively) were: [IV-2, III-4] to [I-5, II-1] to [I-3, II-3] to [I-2, II-3] and [I-2, II-3]. Echocardiograms showed LVEF: 25.9 +/- 8.2; 32.9 +/- 10.4; 29.4 +/- 7.2; 25.1 +/- 7.9; 25.4 +/- 6.8% (p = 0.023); and % left ventricular (LV) fiber shortening: 12.6 +/- 4.4; 16.4 +/- 5.4; 14.3 +/- 3.7; 12.1 +/- 4.0; 12.2 +/- 3.4% (p = 0.021). LV performance variation seen on NMR was non-significant.

CONCLUSION

Intramyocardial transplantation of BMMC in dilated cardiomyopathy cases is feasible and safe. There were early improvements in symptoms and LV performance. Medium-term evaluation revealed regression of LV function, although maintaining improved functional class.

Factors predicting intermediate endpoints of cervical cancer and exposure to human papillomavirus (HPV) infections in young women screened as potential targets for prophylactic HPV vaccination in south of Brazil

OBJECTIVE

To explore the predictors of intermediate endpoints of cervical cancer in 500 women living in Porto Alegre.

STUDY DESIGN

Five hundred randomly selected women (mean age 20.3 years, range 15-25) were screened using PCR detecting 25 HPV types (HPV6, 11, 16, 18, 31, 33, 34, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 66, 68, 70, and 74). Women were interviewed and serum samples were analysed for antibodies to HPV16 and HPV18 VLPs. Regression models were constructed to analyse predictive factors for (a) HPV PCR status, (b) HPV16-seropositivity, (c) HPV18-seropositivity, and (d) SIL in the PAP smear, used as intermediate endpoints of cervical cancer.

RESULTS

Specific HPV types were identified in 137 (27.4%) of the 157 (31.4%) PCR-positive women. PAP test result was the most powerful independent predictor of HPV status in PCR (p = 0.0001), followed by the sexual activity started (p = 0.001) (adjusted OR 34.075, 95% CI: 4.650-249.715). PAP test SIL was independently predicted only by the HPV PCR status (p = 0.0001) (OR 7.561, 95% CI: 2.787-20.514). HPV16 and HPV18 serostatus were the most significant predictors of each other (p=0.0001), and the life-time number of sexual partners was more significant (p=0.001) predictor of HPV16 than HPV18 serostatus (p = 0.049).

CONCLUSION

These data are useful in evaluating the exposure status of the women to the risk factors of cervical cancer in south of Brazil.

Risk of human exposure to paralytic toxins of algal origin

The most significant neurotoxins produced by harmful algal blooms (HABs) are paralytic shellfish toxins (PSTs) found in shellfish and freshwater. Human exposure to neurotoxins through the food consumption represents a severe hazard to human health and the exposure through contaminated water represents an added risk often difficult to recognize. Furthermore, there is an insufficient knowledge of toxicokinetics of these complex toxins produced by HABs. If human acute exposure occurs, the diagnosis of intoxication is typically based upon symptomatology and analysis of shellfish tissue by mouse bioassay, HPLC-FLD analysis and mouse neuroblastoma assay. However, the health risks due to chronic exposure should also be considered and its prevention could be reached with a better understanding of sub-lethal doses of these toxins. In this context, information required for development of a diagnostic protocol should include knowledge about toxicokinetics and toxicodynamics of these neurotoxins. We emphasise the importance of research on biomarkers to prevent, predict and diagnose acute and chronic human exposure to PST.

The ultrastructure of the intestinal epithelium in Oreochromis niloticus on a diet with different concentrations of zinc

The effects of diets with variable zinc levels on the midgut epithelial cells were studied in Oreochromis niloticus L. One hundred and twenty fry of tilapia were apportioned into 4 experimental groups (I, II, III and IV groups), with 30 fish in each treatment, 5 replicate aquaria per treatment containing 6 fish each. The animals of the 4 groups were fed with isonitrogenous (30% crude protein) and isoenergetic (3000 Kcal/Kg of digestible energy) diets with increasing quantities of zinc (44.59; 149.17; 309.93; 599.67 mg Zn/kg of diet), twice a day, for 93 days. Three fish from each group were sacrificed at 36, 66 and 93 days and samples of midgut were removed for ultrastructural analysis. After 93 days of treatment, 3 animals of each experimental group were used for the analysis of zinc concentration by atomic absorption spectrophotometry. The comparative relative index (CRI) revealed that the animals in groups II, III and IV contained, respectively, 1.99%, 34.67% and 22.78% more zinc than the mean concentration in animals from group I. The ultrastructural analysis showed enterocytes with swelling of smooth surfaced endoplasmic reticulum and dilated mitochondria with variable matrix rarefaction and cristae number reduction in the fish exposed to 599.67 mg Zn/Kg of diet at 66 and 93 days of treatment.

Cervical Cancer Screening in Porto Alegre, Brazil: Alternative Methods for Detecting Cancer Precursors in a Developing Country

OBJECTIVE

This study was conducted to test the performance characteristics of cervical cancer screening by visual inspection of the cervix with acetic acid and iodine solution.

METHODS

A total of 100 women were screened for cervical cancer by Pap smear and naked eye inspection of the cervix after application of acetic acid and iodine solution.

RESULTS

Comparing visual inspection to the Pap test, a sensitivity of 85.7%, specificity of 78.5%, and concordance of 79% (p < .0011) was established. Comparing the Pap test with colposcopy, the corresponding figures were 42.9%, 92.3%, and 66.6% (p < .077), respectively. Visual inspection compared to colposcopy showed corresponding figures of 100%, 7.7%, and 55.5% (p = .48), respectively. Colposcopy and biopsy had an agreement of 100%.

CONCLUSIONS

Visual inspection with acetic acid and iodine solution proved to be a reasonable method of screening for cervical cancer precursors.

Synthesis and herbicidal activity of N-oxide derivatives

As part of an ongoing program on the chemistry and biological activity of N-oxide-containing molecules, a number of novel 1,2, 5-oxadiazole N-oxide, benzo[1,2-c]1,2,5-oxadiazole N-oxide, and quinoxaline N,N'-dioxide derivatives were synthesized and evaluated for their herbicidal activity. Many of these compounds exhibited moderate to good herbicidal pre-emergence activity against Triticum aestivum. Dose-response studies were done on the more representative compounds (12, 20, and 26). The most active compound, butylcarbamoylbenzo[1,2-c]1,2,5-oxadiazole N-oxide, 26, displayed herbicidal activity at concentrations as low as 24 g/ha.

An integrated strategy for the process development of a recombinant antibody-cytokine fusion protein expressed in BHK cells

Recombinant fusion proteins offer important new therapeutic approaches for the future. This report describes the use of three different genetic strategies (i.e. "mono-", "bi-" and "tri-cistronic" vectors) to achieve stable secretion from BHK cells of a glycosylated antibody-cytokine fusion protein designed for use in antitumour therapy. It describes selection of a robust and effective production cell line based on stability of secretion of the product, quality of mRNA and protein products and performance in in vitro bioassays for potency. The data obtained at this stage were utilised in the selection of a suitable candidate production cell line. The relative productivity and general performance of the cells in stirred tank and fixed bed culture systems indicated that a variety of cell culture technologies provided robust tools for production of a highly selected cell clone. Consistency of the product glycosylation was determined by analysis of released oligosaccharides using matrix-assisted laser desorption ionisation-time of flight mass spectrometry and high-performance anion exchange chromatography. These investigations showed consistent expression of three glycoforms of the fusion protein which varied in their relative proportions in different culture systems and at different time points in a fixed bed reactor with continuous perfusion. In conclusion, this study dealt with a range of important scientific and technical issues which are essential for regulatory approval and commercial success of a recombinant protein and elucidates some useful markers for process development for similar recombinant biologicals.

[The Internet as a solution facilitating the identification of patients with a suspected acute myocardial infarct]

The current steps for diagnosing heart disease are very time consuming, delaying the correct identification of the problem, therefore, delaying the right treatment. In this study we have developed an experimental method using e-mail in order to identify patients with "rule out myocardial" condition and reduce the time lag for thrombolysis or coronary angioplasty in this clinical setting. Three different locations linked to the Internet by ISDN lines were used. Each line was connected with a computer. A pager and a dedicated phone line were also used. The following steps were performed for each situation: filling out of a questionnaire, ECG recording, questionnaire mailing and ECG by e-mail as attachment, pager warning that an urgent cardiology consultation was requested, including the doctor and patient's phone number, time to open the message and reply by e-mail, phone call for additional comments. A total of 24 attempts of interactive communication were performed. In 22 of those, an answer was obtained in less than 30 minutes. Two failures were recorded. One was due to a delay in the pager message, which did not arrive within the first hour; the second was due to a computer break down. This report shows that it is possible to establish a fast communication between the out patient clinic and the hospital (less than 30 minutes in most cases) at a very low cost and in a simple manner.

Synthesis and biological evaluation of 1,2,5-oxadiazole N-oxide derivatives as hypoxia-selective cytotoxins

Synthesis and biological evaluation of new 1,2,5-oxadiazole N-oxide derivatives with potential cytotoxic effects are described. From the series of compounds tested, compounds 2 and 6 proved to be very active, although non-selective.

[Thrombolytic therapy in acute myocardial infarct--is it being used to the fullest?]

OBJECTIVE

To evaluate the experience with thrombolytic therapy (TT) in the treatment of patients with the discharge diagnosis of acute myocardial infarction (AMI).

DESIGN

Retrospective analysis of the clinical records of patients with the discharge diagnosis of AMI, between May 1988 and December 1995.

SETTING

Intensive Cardiac Care Unit (UCIM-Medicina IV) of Santa Maria University Hospital, Lisbon, Portugal.

PATIENTS

1319 patients, 958 men (73%) and 361 women, mean age 64 +/- 12 years.

MAIN RESULTS

Thrombolytic therapy was administered in 391 patients (30%). Female patients received less thrombolytic therapy compared with male (17% vs. 34%; p < 0.001). Anterior wall infarction was more frequent (38%). Patients in Killip class I-II (77%) received more thrombolytic therapy than class III-IV (33% vs. 17%). The utilization rate of thrombolytic therapy increased from 25% in 1988 to 34% in 1995. Two major categories of patients were not treated with thrombolysis: 1) patients presented more than 12 hours after pain onset (38%); 2) patients without ST segment elevation or LBBB on the ECG presented (37%). Overall hospital mortality was 15.6%. The mortality in patients receiving thrombolytic therapy was significantly lower than in those excluded (9.4% vs. 18.2%; p < 0.001).

CONCLUSION

Only 30% of patients with AMI receive TT. Of those excluded from this important therapeutic intervention, 75% had no ECG criteria or were outside the standard therapeutic "window". This significant group of patients need new diagnostic and intervention strategies.

[Dobutamine stress echocardiography in patients after an acute myocardial infarct: what is the significance of arterial patency related to the infarct?]

BACKGROUND

Dobutamine stress echocardiography is a very promising technique for assessing myocardial viability, ischemia and prognosis in patients with a recent acute myocardial infarction. Recent studies have shown that the type of perfusion in the infarct-related artery also plays a role in the prognosis of these patients.

PURPOSE

To evaluated in patients with non complicated infarction the ability of low-dose and high-dose dobutamine stress echocardiography to assess the presence of both viability and inducible ischemia and correlate the results with the patency of the infarct related artery and the accuracy to predict cardiac events during one year follow-up.

PATIENTS AND METHODS

Fifty one consecutive in-hospital patients (47 male and four female, mean age 52 +/- 11 years, range 31-75 years) with acute myocardial infarction were evaluated both by dobutamine stress echocardiography and by coronary angiography and followed-up for a mean of 12 +/- 8 months.

RESULTS

With low-doses of dobutamine, the incidence of myocardial viability was 33% and with high-doses, the incidence of residual inducible ischemia was 41%. The patency of infarct-related artery showed significant correlation with score wall motion index for viability and for myocardial ischemia. Twenty four (47%) patients suffered cardiac events. Dobutamine stress echocardiography showed a positive predictive value of 67% and a negative of 70% and identified high and low risk patients.

CONCLUSIONS

Dobutamine stress echocardiography in patients with acute myocardial infarction is a safe and well tolerated test, and provides in a single test useful information regarding viability, ischemia and prognosis.