Assessment of cellular damage with cytome assay among environmental/occupational triazole

The use of triazole fungicides is common in Minas Gerais, Brazil. However, the risk arising from excessive and often unprotected exposure can be harmful to farmers. Therefore, we evaluated volunteers, exposed to triazole fungicides for cellular damage caused by this pesticide. In the buccal micronucleus cytome assay (BMCyt), cells were analyzed. Urinary triazoles were analyzed by the Liquid-Liquid Extraction coupled with Gas-chromatography/mass-spectrometry (LLE-GC/MS). Statistical differences were found for all cell types evaluated in residents of rural areas (n = 145). Analysis of variance showed statistical difference in kariolytic and pyknotic cells, between the groups of men and women living in rural areas, with higher incidence in the male group. Likewise, higher concentrations triazoles in urine samples in the male group were observed. Greater cellular damage suggests increases in DNA damage, chromossomal instability and cell deaths. The results showed the urgency of the public management with the implementation of measures to minimize the pesticides exposure.

Placental inflammation in pre-eclampsia by Nod-like receptor protein (NLRP)3 inflammasome activation in trophoblasts

Pre-eclampsia is associated with increased levels of cholesterol and uric acid and an inflamed placenta expressing danger-sensing pattern recognition receptors (PRRs). Crystalline cholesterol and uric acid activate the PRR Nod-like receptor protein (NLRP)3 inflammasome to release interleukin (IL)-1β and result in vigorous inflammation. We aimed to characterize crystal-induced NLRP3 activation in placental inflammation and examine its role in pre-eclampsia. We confirmed that serum total cholesterol and uric acid were elevated in pre-eclamptic compared to healthy pregnancies and correlated positively to high sensitivity C-reactive protein (hsCRP) and the pre-eclampsia marker soluble fms-like tyrosine kinase-1 (sFlt-1). The NLRP3 inflammasome pathway components (NLRP3, caspase-1, IL-1β) and priming factors [complement component 5a (C5a) and terminal complement complex (TCC)] were co-expressed by the syncytiotrophoblast layer which covers the placental surface and interacts with maternal blood. The expression of IL-1β and TCC was increased significantly and C5a-positive regions in the syncytiotrophoblast layer appeared more frequent in pre-eclamptic compared to normal pregnancies. In-vitro activation of placental explants and trophoblasts confirmed NLRP3 inflammasome pathway functionality by complement-primed crystal-induced release of IL-1β. This study confirms crystal-induced NLRP3 inflammasome activation located at the syncytiotrophoblast layer as a mechanism of placental inflammation and suggests contribution of enhanced NLRP3 activation to the harmful placental inflammation in pre-eclampsia.

Abstract P6-11-06: Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients: A retrospective, comprehensive review of 330 cases of Brazil

Background: Chemotherapy-induced alopecia (CIA) is a distressing adverse effect of many chemotherapy (CT) agents. New strategies for prevention of CIA have been studied. Scalp cooling has been reported to prevent CIA. We conducted a retrospective study aimed to assess the efficacy of scalp cooling in preventing CIA among women receiveing chemotherapy for breast cancer. Methods: Was included clinical data of breast cancer patients at the Oncoclinicas Group from July/2015 to March/2017. All patients were elected to use scalp cooling to prevent CIA. Cooling started 30 minutes before infusion and was maintained throughout the infusion of the treatment and extended for 90 minutes after infusion. Degree of hair loss was rated by nurse assessment using CTCAE v4.0 scale in grade zero (without alopecia), 1 (<50%) or 2 (>50%), digital photographs and clinical assessment. Assessments were made before each chemotherapy treatment and at a follow up visit between 3 weeks and 3 months after the completion of chemotherapy. Success was defined when there was G0 or G1 alopecia at the end of the treatment, and failure when finished with G2 alopecia and patient withdrawal due to alopecia. Results: 330 patients were included. 283 with localized breast cancer and 47 with metastatic disease. 188 patients (57.0%) completed all tratment with scalp cooling. 72 patients (21.8%) withdrew from cryotherapy for alopecia of any degreee, 51 patients (15.4%) gave up cryotherapy for complaints unrelated to alopecia and 19 patients (5.8%) had their treatment interrupted due to external factors (progression of disease, change of CT protocol, among others). Among patients who completed chemotherapy (n=188), the degree of alopecia at the end was G0 = 27, G1 = 138, G2 = 23. Thus, the overall success rate with cryotherapy was 63.5%. CT protocols initiated with doxorubicin and cyclophosphamide, followed by taxanes, presented a success rate of 50%. The combintation of docetaxel and cyclophosphamide showed success of 71.9%.

Scalp cooling: chemotherapy regimes and alopeciaChemotherapy (CT) regimeCompleted CT G0Completed CT G1Completed CT G2Abandoned SC G1Abandoned SC G2AC02011AC/taxanes65152527AC non sequential11100D alone or combi no AC319221DC6401134EC at 2nd part of CT01000EC at 1rst part of CT00111P alone or combi no AC613014No AC21000AC at 2nd part of CT310310Total27138233438A: doxorubicin; C: cyclophosphamide; D: docetaxel; E: epirubicin; P: paclitaxel; combi: combination

In addition to alopecia, headache and cold sensation were common reasons for cryotherapy withdrawal. Conclusions: Scalp cooling appears to be effective in preventing CIA among breast cancer patients who underwent chemotherapy. Studies involving a psychological approach to the expectation and experience of alopecia with cryotherapy and better management of pain are necessary to increase adherence to treatment.

Citation Format: Silva GB, Moreira RB, Gimenes DL, Silva ACP, Araújo BRC, Pacheco BP, Paiva RdCP, Sutmoller C, Hammermuller LMJ, Lima RO, Pimentel RVIA, Simões ÂAB, Mathias CMC, Lessa ÂMC, Costa MAD, Martins LCA, Ferrari BL. Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients: A retrospective, comprehensive review of 330 cases of Brazil [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-06.

Mercury Concentrations in Tuna (Thunnus albacares and Thunnus obesus) from the Brazilian Equatorial Atlantic Ocean

Average total Hg concentrations measured in muscle of two species of tuna (Thunnus obesus and T. albacares) captured in the Brazilian Equatorial Atlantic Ocean varied from 95 to 1748 ng.g^-1 wet weight in T. obesus and 48 to 500 ng.g^-1 wet weight in T. albacares. Higher concentrations in T. obesus are probably related to foraging on deep water carnivorous fish. Smaller individuals of both species showed the lowest concentrations, but a significant positive relationship between fish weight and length and Hg concentrations was found for T. obesus, but not for T. albacares. Largest individuals (>30 kg) of T. obesus showed Hg concentrations ≥1000 ng.g^-1, surpassing the legal limits for human consumption, although the average concentration for this species was much lower (545 ng.g^-1). Concentrations in T. albacares from the Brazilian Equatorial were lower than those found in the African and in the North Atlantic. No comparison could be made for T. obesus due to few studies for this species in the Atlantic Ocean.

Differences among children, adolescents and adults with severe leptospirosis: A comparative analysis

Leptospirosis is a zoonosis of global importance caused by Leptospira interrogans. The aim of this study was to compare the data between children, adolescents and adults with leptospirosis. This is a retrospective study including a total of 373 consecutive patients with leptospirosis, admitted to tertiary hospitals in Northeast of Brazil, from May 1985 to August 2010. The patients were divided into two groups (age ≤21 years and >21 years). The adults were 304 (81.5%) of the population, with a mean ge of 41 ± 13 (range 22-84) years. The pediatric group was 16 ± 3 (range 9-21) years. Signs and symptoms where similar between the groups, excepting arrhythmia, which was more frequent in adults and vomiting, more common in children (16% vs. 0%, P = 0.04 and 65% vs. 79%, P = 0.02), respectively. Adult group presented with higher serum urea (137 vs. 97 mg/dl, P = 0.002) and creatinine (4.3 vs. 3.0 mg/dl, P = 0.007). Acute kidney injury (AKI) was observed in 80%, mainly in adults (83% vs. 70% P < 0.005). Adults required renal replacement therapy more frequently than children (38% vs. 11%, P < 0.0001). Mortality was higher in adults (14.8% vs. 2.8%, P = 0.005) and in adults with AKI (93% vs. 7%, P < 0.05). There are important differences between the adults and children with leptospirosis. AKI was more frequent in adults and it was associated with increased mortality.

Angiotensin II inhibits ADH-stimulated cAMP: role on O2- and transport-related oxygen consumption in the loop of Henle

Dehydration and acute reductions of blood pressure increases ADH and Ang II levels. These hormones increase transport along the distal nephron. In the thick ascending limb (TAL) ADH increases transport via cAMP, while Ang II acts via superoxide (O2-). However, the mechanism of interaction of these hormones in this segment remains unclear. The aim of this study was to explore ADH/Ang II interactions on TAL transport. For this, we measured the effects of ADH/Ang II, added sequentially to TAL suspensions from Wistar rats, on oxygen consumption (QO2) -as a transport index-, cAMP and O2-. Basal QO2 was 112+-5 nmol O2/min/mg protein. Addition of ADH (1nM) increased QO2 by 227 percent. In the presence of ADH, Ang II (1nM) elicited a QO2 transient response. During an initial 3.1+-0.7 minutes after adding Ang II, QO2 decreased 58 percent (p less than 0.03 initial vs. ADH) and then rose by 188 percent (p less than 0.03 late vs initial Ang II). We found that Losartan blocked the initial effects of Ang II and the latter blocked ADH and forskolin-stimulated cAMP. The NOS inhibitor L-NAME or the AT2 receptor antagonist PD123319 showed no effect on transported related oxygen consumption. Then, we assessed the late period after adding Ang II. The O2- scavenger tempol blocked the late Ang II effects on QO2, while Ang II increased O2- production during this period. We conclude that 1) Ang II has a transient effect on ADH-stimulated transport; 2) this effect is mediated by AT1 receptors; 3) the initial period is mediated by decreased cAMP and 4) the late period is mediated by O2-.

Comparative performance of macrocyclic lactones against large strongyles in horses

Several formulations of macrocyclic lactones (abamectin, ivermectin, moxidectin), including ivermectin combined with pyrantel (tetrahydropyrimidine) and ivermectin combined with praziquantel (pyrazinoisoquinolin derivative), were tested regarding their efficacy to control gastrointestinal nematodes of horses on a stud farm in southern Brazil. In addition, we tested a pharmaceutically produced generic paste containing ivermectin 4%. Similar formulations of avermectins had different efficacies measured by reduction of EPG. Levels of efficacy of the tested drugs varied against Strongylus edentatus, S. equinus and S. vulgaris. The generic paste (ivermectin 4%) was less effective than the conventional drugs.

Leptospirosis-associated acute kidney injury: penicillin at the late stage is still controversial

WHAT IS KNOWN AND OBJECTIVE

Some antimicrobial agents are active in vitro against Leptospiras. The use of penicillins at the late stage of leptospirosis is still controversial. We aimed to evaluate the use of penicillin in patients with leptospirosis-associated acute kidney injury (AKI).

METHODS

A retrospective study was conducted of patients with leptospirosis admitted to two hospitals in Fortaleza city, Brazil, between 1985 and 2008. AKI was defined according to the RIFLE and AKIN classifications. Patients were divided in two groups according to whether they were treated with a penicillin or not.

RESULTS

Two hundred and eighty-seven patients were included, with an average age of 36·8±15·6 years and mostly male (80·8%). One hundred and twelve patients (39%) received a penicillin. Patients treated with a penicillin were younger (32±14 years vs. 39±16 years, P=0·0002) and had a shorter hospital stay (8·4±5·0 vs. 11±7·7 days, P<0·0001). There was no difference in the onset of symptoms before hospital admission between the two groups (6·5±3·0 vs. 7·7±4·7, P=0·33). Systolic blood pressure was lower in the penicillin group (111±21 vs. 119±22 mmHg, P=0·04). AKI, need of dialysis and renal recovery at the time of hospital discharge were more frequent in patients who did not use a penicillin (P<0·05). Mortality was similar in both groups (11·6% vs. 13·7%, P=0·60).

CONCLUSION

Treatment of leptospirosis with antibiotics, including the penicillin, remains controversial. The main benefit of using penicillin in the present study was a reduction in the length of hospital stay and fewer complications, such as AKI, but its use was not associated with a decrease in mortality. On balance of risks and benefits, we recommend the use of penicillin in late-stage leptospirosis.

Creatinine-based equations predicting chronic kidney disease after kidney donation

BACKGROUND

Kidney donation is associated with few adverse outcomes in living donors. The aim of this study was to evaluate the outcomes of living kidney donors and the utility of creatinine-based equations to predict chronic kidney disease.

METHODS

The study population was selected among 154 living kidney donors from 2001 to 2009. Seventy-eight patients underwent medical consultation to review demographic data and perform laboratory evaluations. Estimated glomerular filtration rate (GFR) values were obtained by three equations: Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (C-G) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Receiver operating characteristic (ROC) analysis was performed to determine the area under the curve of each equation to predict evolution to chronic kidney disease.

RESULTS

The overall median age was 39 years including 64% of women subjects. The mean follow-up after kidney donation was 65 ± 34 months. During follow-up, 20.5% of patients developed hypertension. Serum creatinine values above 1.5 mg/dL were detected in 14.1% of cases. Dyslipidemia was present in 33.3% of donors at the last follow-up. According to measured creatinine clearance and the C-G equation, only four and six donors had renal failure (defined as GFR < 60 mL/min), a number that increased to 23 (29.4%) when considering the MDRD or CKD-EPI equations (P < .05). ROC curves performed to explore the GFR measurements to predict renal failure occurrence after donation showed the CKD-EPI to be the only one with a significant area under the curve (0.7442, P = .003).

CONCLUSION

Living kidney donors should receive careful long-term follow-up. Assessment of renal function before donation using CKD-EPI creatinine-based equations must be performed preferentially. A careful approach should be adopted for the detection and treatment of other complications such as hypertension and dyslipidemia.

Transport and recombination in organic light-emitting diodes studied by electrically detected magnetic resonance

We have used electrically detected magnetic resonance (EDMR) to study a series of multilayer organic devices based on aluminum (III) 8-hydroxyquinoline (Alq3). These devices were designed to identify the microscopic origin of different spin-dependent processes, i.e. hopping and exciton formation. The EDMR signal in organic light-emitting diodes (OLEDs) based on Alq3 is only observed when the device is electroluminescent and is assigned to spin-dependent exciton formation. It can be decomposed in at least two Gaussians: one with peak-to-peak line (deltaH(PP)) of 1.6 mT and another with deltaH(PP) of 2.0 to 3.4 mT, depending on bias and temperature. The g-factors of the two components are barely distinguishable and close to 2.003. The broad line is attributed to the resonance in Alq3 anions, while the other line is attributed to cationic states. These attributions are supported by line shape and its electrical-field dependence of unipolar Alq3-based diodes, where hopping process related to dication and dianion formation is observed. In these unipolar devices, it is shown that the signal coming from spin-dependent hopping occurs close to organic semiconductor/metal interfaces. The sign of the magnetic-resonance-induced conductivity change is dominated by charge injection rather than charge mobility. Our results indicate that the probability of singlet exciton formation in our OLEDs is smaller than 25%.

Considerations on the new epidemic outbreak of human leptospirosis in greater recife, brasil, in 1975

Abstract- A brief report was presented on a new outbreak of leptospirosis among the population of Greater Recife in 1975 in the wake of the floods that struck the city and its survivors in July of that year. A total of 107 cases were recorded, of which 105 were identified by sero-agglutination and 2 by hemoculture. Once again the serotype icterohaemorrhagiae was the predominant etiological agent, having been found in 55 cases, followed by ballum in 18, grippotyphosa in 9, and pyrogenes in 8 cases.