Diet quality, asthma and airway inflammation in school-aged children

Summary

Background. Asthma is a major public health problem, with increasing prevalence in most countries, particularly among children. Poor dietary quality is also increasing in children, and evidence of the overall quality of children's food patterns effects on asthma is scarce. Methods. This cross-sectional analysis (660 children: 49.1% females, aged 7-12years) evaluated the association between diet quality and asthma (n = 56) and airway inflammation among school-aged children according to body mass index (BMI). Diet quality was assessed through the Healthy Eating Index (HEI)-2015, and categorized by tertiles. Higher scores represent a healthier diet. A questionnaire was used to enquire about self-reported medical diagnosis of asthma and asthma under medication. Lung function and airway reversibility were measured, and airway inflammation assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/obese (p less than 85^th), (n = 491), and overweight/obese (p ≥ than 85^th), (n = 169). The associations between diet quality and asthma and airway inflammation were estimated using logistic regression models. Results. Non-overweight/obese children in 2^nd tertile of HEI-2015 score had decreased odds of having eNO ≥ 35ppb (OR 0.43, 95%CI 0.19-0.98), medical diagnosis of asthma (OR 0.18; 95%CI 0.04-0.84), and asthma treatment (OR 0.12; 95%CI 0.01-0.95), compared to children in the 1^st tertile. Conclusions. Our findings suggest that a higher diet quality associates with lower levels of airway inflammation and reduced prevalence of asthma among non-overweight/obese school-aged children.

POS0781 PERFORMANCE OF MAJOR SALIVARY GLAND ULTRASOUND FOR THE DIAGNOSIS OF SJÖGREN’S SYNDROME IN CLINICAL PRACTICE

Background:

There is no specific test to diagnose Sjögren’s Syndrome (SS) although available classification criteria intended for research purposes help guide the diagnosis. Major salivary gland ultrasound (MSGUS) may contribute to SS diagnosis.

Objectives:

To study the performance of MSGUS for the clinical diagnosis of SS and its relationship with other relevant markers of disease.

Methods:

We included patients with a clinical suspicion of SS that underwent MSGUS evaluation at our Department. Parotid and submandibular glands were classified bedside on a 0-4 scale, based on tissue inhomogeneity. The score of the highest graded gland was considered and a score ≥2 was defined as a positive MSGUS. Minor salivary gland biopsy (mSGB) was considered positive if a focus score ≥1 was reported. We compared MSGUS findings across diagnoses and against mSGB result and anti-SSA status. Categorical variables were compared using the chi-square test. Continuous variables were compared using Student’s t-test, Mann-Whitney U test, or ANOVA. P-value was considered significant at <0.05.

Results:

A total of 219 patients were included (Table 1). MSGUS was positive in a higher proportion of patients with primary and secondary SS, in comparison to non-Sjögren’s sicca syndrome (nSSS) and undifferentiated connective tissue disease (UCTD; p<0.001). Mean MSGUS score was higher in SS patients in comparison to nSSS and UCTD (p<0.001). A positive MSGUS was associated with anti-SSA positivity (61.4% vs 38.6% in anti-SSA negative patients; p<0,001). Patients positive for anti-SSA had a higher mean MSGUS score (2.12 ± 1.03) in comparison with anti-SSA negative patients (1.31 ± 0.97, p<0.001). While MSGUS and mSGB were not significantly associated (p=0.237), the mean MSGUS score was higher in patients with a positive mSGB (1.95 ± 1.17) in comparison with those with a negative mSGB (1.61 ± 0.99; p=0.027).

Table 1.

General sample characteristics

Overall(n=219)pSS(n=131)sSS(n=17)nSSS(n=62)UCTD(n=9)p-valueAge, years (mean ± sd)60 ± 1458 ± 1756 ± 1960 ± 1348 ± 160.07Female, n (%)210 (95.9)127 (97.0)15 (88.2)59 (95.2)9 (100)<0.001Anti-SSA positive, n (%)105 (47.9)91 (69.5)10 (5.8)3 (4.8)1 (11.1)<0.001Positive mSGB, n (%)85 (46.4)69 (63.3)7 (46.7)8 (15.7)1 (12.5)<0.001MSGUS score, mean ± sd1.70 ± 1.091.98 ± 1.091.76 ± 1.111.13 ± 1.091.44 ± 1.12<0.001Grade 0, n (%)35 (16.0)17 (13.0)3 (17.7)15 (24.2)0 (0.0)<0.001Grade 1, n (%)62 (28.3)25 (19.1)4 (23.5)27 (43.6)6 (66.7)Grade 2, n (%)62 (28.3)39 (29.8)4 (23.5)17 (27.5)2 (22.2)Grade 3, n (%)54 (24.7)44 (33.6)6 (35.3)3 (4.9)1 (11.1)Grade 4, n (%)6 (2.7)6 (4.6)0 (0.0)0 (0.0)0 (0.0)MSGUS score ≧ 2, n (%)122 (55.7)89 (67.9)10 (58.8)20 (32.3)3 (33.3)<0.001

Conclusion:

MSGUS is a valuable resource in the investigation of SS. It is associated with clinical diagnosis, anti-SSA and MSGB findings. Together with these other complementary exams, it can be used to assist in the diagnosis of patients presenting with sicca features suggestive of SS.

References:

[1]Jousse-Joulin S, Milic V, Jonsson MV, Plagou A, Theander E, Luciano N, et al. Is salivary gland ultrasonography a useful tool in Sjögren’s syndrome? A systematic review. Rheumatology (Oxford). 2016 May;55(5):789–800.

[2]Zhou M, Song S, Wu S, Duan T, Chen L, Ye J, et al. Diagnostic accuracy of salivary gland ultrasonography with different scoring systems in Sjögren’s syndrome: a systematic review and meta-analysis. Sci Rep. 2018 Dec;8(1):17128.

[3]Cornec D, Jousse-Joulin S, Pers J-O, Marhadour T, Cochener B, Boisramé-Gastrin S, et al. Contribution of salivary gland ultrasonography to the diagnosis of Sjögren’s syndrome: toward new diagnostic criteria? Arthritis Rheum. 2013 Jan;65(1):216–25.

Disclosure of Interests:

Maria Catarina Tenazinha: None declared, Vasco C Romão: None declared, Joaquim Polido-Pereira: None declared, Nikita Khmelinskii Speakers bureau: GSK, Rita Barros: None declared, FERNANDO MANUEL DIAMANTINO SARAIVA: None declared, Joao Eurico Fonseca: None declared

Allogenic platelet-rich plasma in induced ulcers in rat’s cornea

ABSTRACT The objective in this study was to evaluate the clinic effect of applying allogenic platelet-rich plasma (PRP) heated or not, for treating cornea ulcers, including the dosage of PDGF-BB in the cornea. The ulcers were induced, standardizing the left eye from 81 rats (Ratus norvegicus, albinus variety), assigned randomly into three groups (N=27): control group (CG) which did not receive any topic treatment; heated PRP group (GA) and PRP group (GP), which received topical treatment every eight hours for five days. Each group underwent evaluation at 24 hours (M1), three days (M3) and five days (M5). The clinical exam evaluated the opacity, vascularization and corneal repair. The corneal PDGF-BB was dosed through the ELISA method. The corneal opacity was decreased in PRP-treated animals (GA and GP) and corneal repair time reduced when compared to CG at M1 and M5. Furthermore, GP showed greater vascularization at M3 compared to M1. Applied allogenic PRP eye drops, heated or not, speed up corneal healing, and reduce corneal repair time. However, the corneal PDGF concentration was not altered in any of the treatments.

AB0044 ESTABLISHED RHEUMATOID ARTHRITIS PATIENTS HAVE INCREASED FREQUENCIES OF FOLLICULAR REGULATORY T CELLS IN PERIPHERAL BLOOD

Background:

Several studies have demonstrated that an immune dysregulation affecting both B and T cells occurs in rheumatoid arthritis (RA). Follicular helper T (Tfh) cells are crucial for B cell maturation, activation and class-switching as well as for germinal center (GC) formation, whereas follicular regulatory T (Tfr) cells can modulate the GC reaction by suppressing Tfh and B cells.

Objectives:

The main goal of this study was to analyze the phenotype and frequency of circulating follicular T cell subsets in established RA patients.

Methods:

Blood samples were collected from established RA patients with active disease, treated with methotrexate (n=32) and from a group of age and sex-matched healthy donors (n=11). Peripheral blood mononuclear cells (PBMC) were isolated and Tfh (CD4+CXCR5+CD45RO+) and Tfr (CD4+ CXCR5+CD25+FoxP3+) cells, as well as their three major subsets [CXCR3+CCR6- (Th1-like), CXCR3-CCR6- (Th2-like) and CXCR3-CCR6+ (Th17-like)] were evaluated by flow cytometry.

Results:

The frequency of circulating Tfh cells was similar between established RA patients and controls. Nonetheless, RA patients had a decreased frequency of Th1-like Tfh cells, and an increased frequency of Th2-like Tfh cells when compared to controls. No significant differences were observed in the frequencies of Th17-like Tfh cells between both groups. The frequency of circulating Tfr cells was significantly increased in RA patients in comparison to controls. Furthermore, Tfr cells from RA patients had significantly increased CD69 median fluorescence intensity (MFI) values when compared to controls. No significant differences were found in the percentages and MFI values of PD-1, ICOS, CD28, CTLA-4, CD40-L and HLA-DR expressed by Tfh and Tfr cells in RA patients when compared to controls.

Conclusion:

Established RA patients have increased circulating frequencies of Tfr cells, with higher CD69 expression levels, when compared to healthy controls. These results suggest a pre-activation state of Tfr cells in RA and a potential role in the disease physiopathology.

*RA Moura, JE Fonseca and L Graca are joint senior authors.

Disclosure of Interests:

None declared

Primary urethral reconstruction results in penile fracture

Objective This study assessed primary urethral reconstruction results in patients with a penile fracture. Materials and methods Between January 2005 and April 2016, patients who underwent primary urethral reconstruction due to penile fracture were called for a follow-up. Epidemiological and clinical presentation data and operative findings were reviewed retrospectively. Partial urethral lesions were primarily treated with interrupted absorbable sutures over urethral catheter. In cases of complete urethral lesion, tension-free end-to-end anastomosis was performed. From the third month after surgery, all patients were interviewed using the International Prostate Symptom Score questionnaire and uroflowmetry. Retrograde urethrocystography was used in patients with urinary symptoms or altered uroflowmetry to rule out or confirm urethral stenosis. Results Of 175 patients with penile fractures, 27 (15.4%) had associated urethral injury. All patients were diagnosed with penile fracture by means of clinical history and physical examination. No subsequent examinations were conducted. Ages varied from 30 years to 58 years old (mean 39.2 years). All fractures resulted from sexual activity. Reported sexual positions were 'doggy style' position in eight cases (61.5%) and with the 'man on top' in five cases (38.4%). Ten patients (76.9%) experienced haematuria, ten (76.9%) had urethral bleeding and four (30.7%) suffered urinary retention. Unilateral and bilateral injury of the corpus cavernosum was observed in four (30.7%) and nine (69.2%) patients, respectively; partial injury was found in nine cases (69.3%) and complete urethral injury was noticed in four cases (30.7%). All cases of complete urethral injury were associated with bilateral lesion of the corpus cavernosum. Six patients who had uroflowmetry with maximum urinary flow rate below 15 ml/s and/or had IPSS above 7 underwent retrograde urethrocystogram, and this was normal in all cases, excluding the possibility of urethral stenosis. Two patients (15.3%) experienced surgical postoperative complications represented by an urethrocutaneous fistula and a subcutaneous abscess adjacent to the end-to-end anastomosis area. Conclusions Penile fracture is a rare urological emergency, especially when it is associated with a urethral lesion. This must be suspected when the clinical picture is suggestive or in cases of high-energy trauma, especially in bilateral lesions of the corpus cavernosum. Complementary imaging methods are not needed in these cases and immediate exploration should not be delayed. Primary urethroplasty produces satisfactory results with low complication levels. Nonetheless, prospective studies with larger samples should be conducted.

Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update

BACKGROUND

Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007.

METHODS

SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey.

RESULTS

The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.

Ceratoconjuntivite nodular em um caso de leishmaniose visceral canina: relato de caso

RESUMO Relata-se um caso de leishmaniose visceral canina com ceratoconjuntivite nodular como queixa exclusiva do proprietário. O diagnóstico se deu pela observação de formas amastigotas de Leishmania sp. no exame parasitológico direto de citologia aspirativa conjuntival. Lesões oculares raramente são queixas principais únicas de cães com leishmaniose, como o caso em questão, o que demonstra a variabilidade de apresentação clínica da doença e a importância da realização de testes laboratoriais diagnósticos para leishmaniose como triagem para pacientes de áreas endêmicas.

Alternative food sources for the ladybird Brumoides foudrasii (Mulsant) (Coleoptera: Coccinellidae)

The predator Brumoides foudrasii (Mulsant) (Coleoptera, Coccinellidae) has been naturally found in plants infested by mealybugs. In this study, the striped mealybug Ferrisia dasylirii (Cockerell) (Hemiptera, Pseudococcidae) and Anagasta kuehniella Zeller (Lepidoptera, Pyralidae) eggs were evaluated as diets for the development and reproduction of B. foudrasii. Brumoides foudrasii immatures developed faster when fed with A. kuehniella eggs than when fed with F. dasylirii. However, the survival and longevity of B. foudrasii adults were not affected by the diets. Oviposition was more frequent when B. foudrasii females were fed with F. dasylirii (95%) than those fed with A. kuehniella eggs (65%). Brumoides foudrasii females fed with F. dasylirii were 2.5 times more fecund than those fed with A. kuehniella eggs. Although both diets may be considered proper for B. foudrasii, A. kuehniella eggs were more suitable for immature development, while F. darsyrili provided more nutritious resources for adult biological parameters as oviposition period, egg viability and fecundity. These results suggests that this predator can play an important role in regulating populations of the stripped mealybug F. dasylirii in the field.

Relationship between sexual position and severity of penile fracture

The objective of the study was to evaluate the relationship between the sexual position and severity of penile fracture (PF). We studied 90 patients with PF. The mechanism of injury and the sexual position was assessed. We divided our sample by the etiology of the fracture in six groups: (a) masturbation or penile manipulation; (b) 'man-on-top' position; (c) 'doggy style' position; (d) 'woman-on-top' position; (d) blunt trauma; and (e) 'rolling over' fracture. We used the χ²-test for contingency analysis of the populations under study (P<0.05). The patient's age ranged from 18 to 66 years (mean 39 years). Investigation of the injury mechanism identified sexual trauma as the main etiological factor, involved in 69 cases (76.5%). The sexual position at the time of injury varied, with 23 cases (25.5%) occurring in the 'man-on-top', 37cases (41%) in the 'doggy style' and 9 cases (10%) in the 'woman-on-top'. We do not observe differences between the severity of the PF between the 'doggy style' and 'man-on-top' (P=0.9595), but the 'doggy style' had more severity of PF when compared with 'woman-on-top' (P=0.0396) and penile manipulation (P=0.0026). The 'man-on-top' and 'doggy style' positions showed more associations with bilateral fractures of the corpus cavernosum and urethral lesions.

Stability of thin liquid curtains

We investigate the stability of thin liquid curtains with respect to two-dimensional perturbations. The dynamics of perturbations with wavelengths exceeding (or comparable to) the curtain's thickness are examined using the lubrication approximation (or a kind of geometric optics). It is shown that, contrary to the previous theoretical results, but in agreement with the experimental ones, all curtains are stable with respect to small perturbations. Large perturbations can still be unstable, however, but only if they propagate upstream and, thus, disrupt the curtain at its outlet. This circumstance enables us to obtain an effective stability criterion by deriving an existence condition for upstream propagating perturbations.

Food allergy: practical approach on education and accidental exposure prevention

Food allergies are a growing problem and currently the primary treatment of food allergy is avoidance of culprit foods. However, given the lack of information and education and also the ubiquitous nature of allergens, accidental exposures to food allergens are not uncommon. The fear of potential fatal reactions and the need of a proper avoidance leads in most of the cases to the limitation of leisure and social activities. This review aims to be a practical approach on education and accidental exposure prevention regarding activities like shopping, eating out, and travelling. The recommendations are focused especially on proper reading of food labels and the management of the disease, namely in restaurants and airplanes, concerning cross-contact and communication with other stakeholders. The implementation of effective tools is essential to manage food allergy outside home, avoid serious allergic reactions and minimize the disease's impact on individuals' quality of life.

Dietary patterns and asthma prevalence, incidence and control

BACKGROUND

The increased asthma prevalence in westernized societies has been suggested to be related to environment exposures and lifestyle changes, particularly diet. We aimed to explore the association between dietary patterns and asthma prevalence, incidence and control in a nationally representative population.

METHODS

Data from 32,644 adults, 53% female, from the 4th Portuguese National Health Survey were analysed. Prevalence of asthma was 5.3%; 'current asthma', defined by asthma symptoms within previous year, 3.5%; 'current medicated asthma' defined by use of asthma medication within previous year, 3.0%; 'current severe asthma' defined by emergency visit because of asthma within previous year, 1.4%; and 'incident asthma', 0.2%. Dietary patterns (DP) were identified by latent trait models based on dietary intake. Unconditional logistic regression models were performed to analyse association between DP and asthma. Age, gender, education, family income, proxy reporting information, smoking, body mass index and physical activity level were analysed as confounders.

RESULTS

Two of the five identified DP were associated with asthma: 'high fat, sugar and salt' DP (positively correlated with pastry, chocolate and sweet desserts, candies, salty snacks, chips, fruit juices, soft drinks and alcoholic beverages consumption at snacks) was associated with asthma prevalence (OR = 1.13, 95% CI = 1.03, 1.24) and current severe asthma (OR = 1.23, 95% CI = 1.03, 1.48), while 'fish, fruit and vegetables' DP (positively correlated with fish, vegetables and fruit intake at meals) was negatively associated with current (OR = 0.84, 95% CI = 0.73, 0.98), and current medicated asthma (OR = 0.84, 95% CI = 0.72, 0.98), after adjustment for confounders.

CONCLUSION & CLINICAL RELEVANCE

Our results suggest a protective association between 'fish, vegetables and fruit' DP and current asthma and current medicated asthma, and a detrimental association between 'high fat, sugar and salt' DP and severe asthma prevalence, further supporting the rational for diet and lifestyle intervention studies in asthma based on whole dietary patterns and physical activity.

Obesity increases the prevalence and the incidence of asthma and worsens asthma severity

BACKGROUND & AIMS

We aimed to explore the association between obesity and asthma prevalence, incidence and severity.

METHODS

The study included 32,644 adults, 52.6% female, from a representative sample of the 4th Portuguese National Health Survey. The following asthma definitions were used: ever asthma (ever medical doctor asthma diagnosis), current asthma (asthma within the last 12 months), current persistent asthma (required asthma medication within the last 12 months), current severe asthma (attending an emergency department because of asthma within the last 12 months), and incident asthma (asthma diagnosis within the last 12 months). Body mass index was calculated based on self-reported weight and height and categorised according to WHO classification. Logistic regression models adjusted for confounders were performed.

RESULTS

Prevalence of ever asthma was 5.3%, current asthma 3.5%, current persistent asthma 3.0%, current severe asthma 1.4%, and incident asthma 0.2%. Prevalence of obesity was 16%, overweight 37.6%, normal weight 44.6% and underweight 0.2%. Being overweight, obesity class I and II, and obesity class III were associated with an OR (95% CI) with ever asthma 1.22 (1.21-1.24), 1.39 (1.36-1.41), 3.24 (3.08-3.40) respectively; current asthma 1.16 (1.14-1.18), 1.86 (1.82-1.90), 4.73 (4.49-4.98) respectively; current persistent asthma 1.08 (1.06-1.10), 2.06 (2.01-2.10), 5.24 (4.96-5.53), and current severe asthma 1.36 (1.32-1.40), 1.50 (1.45-1.55) and 3.70 (3.46-3.95), respectively. Considering the incidence of asthma, obesity more than quadrupled the odds (OR = 4.46, 95% CI 4.30, 4.62).

CONCLUSION

Obesity is associated in a dose dependent way with an increase of prevalent and incident asthma, and it seems to increase the odds of a more persistent and severe asthma phenotype independently of socio-demographic determinants, physical activity, and dietary patterns. Our results provide rational for future lifestyle intervention studies for weight reduction in the obesity-asthma phenotype.

A diagnosis of disseminated tuberculosis based on knee arthroscopic guided synovial biopsy in the context of monoarthritis

Accounting for 2.2-4.7% of all tuberculosis cases in Europe and USA and around 10-15% of extra-pulmonary tuberculosis cases, osteoarticular tuberculosis tends to be chronic, slowly progressive and destructive. We report the case of an 81-year-old male with 3 weeks of progressively worsening pain, swelling and limited range of motion of the left knee. A knee arthroscopy was performed for synovial biopsy at our department revealing diffuse synovitis with scarce villi formation. The positive polymerase chain reaction assay for Mycobacterium tuberculosis in the synovial tissue allowed the establishment of the diagnosis and synovium histology showed caseating granulomas. A lengthy delay between first symptoms of osteoarticular tuberculosis and the beginning of treatment has been reported. A high index of suspicion, synovial membrane biopsy and appropriate microbiologic testing are fundamental to avoid a delay in diagnosis.

Mensurações do bulbo ocular e cálculo do poder dióptrico da lente intraocular em miniporcos

Objetivou-se com este trabalho determinar o poder dióptrico da lente intraocular (LIO) em miniporco e as dimensões do bulbo do olho. Foram utilizados 17 miniporcos, sadios, adultos, machos e fêmeas, com peso médio de 70kg. Em todos os olhos foram realizadas a ultrassonografia modo A, a ceratometria e a medida da distância limbo a limbo. O cálculo do poder dióptrico da LIO foi obtido utilizando-se as fórmulas Haigis, Hoffer Q, SRK/T, Holladay I e Holladay II e o software Holladay IOL Consultant(r). Na comparação entre o sexo e a lateralidade do olho, não houve diferença nas variáveis biométricas e poder da LIO. A aplicação das fórmulas (Haigis, Holladay II, Holladay I, SRK/T e Hoffer Q) possibilitou o cálculo do poder da LIO. A Holladay II, fórmula que melhor individualiza o bulbo do olho do miniporco, estima valor dióptrico ao redor de 41 D. Os miniporcos têm potencial como modelo experimental em oftalmologia, relacionado ao seu menor porte e à facilidade no manejo, especialmente em experimentos de longa duração.

Cry Proteins from Bacillus thuringiensis Active against Diamondback Moth and Fall Armyworm

Biopesticides based on Bacillus thuringiensis and genetically modified plants with genes from this bacterium have been used to control Plutella xylostella (L.) and Spodoptera frugiperda (J.E. Smith). However, the selection pressure imposed by these technologies may undermine the efficiency of this important alternative to synthetic insecticides. Toxins with different modes of action allow a satisfactory control of these insects. The purpose of this study was to characterize the protein and gene contents of 20 B. thuringiensis isolates from soil and insect samples collected in several areas of Northeast Brazil which are active against P. xylostella and S. frugiperda. Protein profiles were obtained by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Polymerase chain reaction assays were used to determine toxin genes present within bacterial isolates. The protein profile of the majority of the isolates produced bands of approximately 130 kDa, suggesting the presence of Cry1, Cry8 and Cry9 proteins. The gene content of the isolates of B. thuringiensis investigated showed different gene profiles. Isolates LIIT-4306 and LIIT-4311 were the most actives against both species, with LC50 of 0.03 and 0.02 × 10(8) spores mL(-1), respectively, for P. xylostella, and LC50 of 0.001 × 10(8) spores mL(-1) for S. frugiperda. These isolates carried the cry1, cry1Aa, cry1Ab, cry1Ac, cry1B, cry1C, cry1D, cry1F, cry2, cry2A, cry8, and cry9C genes. The obtained gene profiles showed great potential for the control of P. xylostella and S. frugiperda, primarily because of the presence of several cry1A genes, which are found in isolates of B. thuringiensis active against these insects.

Adsorbed fibrinogen leads to improved bone regeneration and correlates with differences in the systemic immune response

Designing new biomaterials that can modulate the inflammatory response instead of attempting just to reduce it constitutes a paradigm change in regenerative medicine. This work aimed to investigate the capacity of an immunomodulatory biomaterial to enhance bone regeneration. For that purpose we incorporated a molecule with well-established pro-inflammatory and pro-healing roles, fibrinogen, in chitosan scaffolds. Two different incorporation strategies were tested, leading to concentrations of 0.54±0.10mg fibrinogen g(-1) scaffold immediately upon adsorption (Fg-Sol), and 0.34±0.04mg fibrinogen g(-1) scaffold after washing (Fg-Ads). These materials were implanted in a critical size bone defect in rats. At two months post-implantation the extent of bone regeneration was examined by histology and the systemic immune response triggered was evaluated by determining the percentages of myeloid cells, T and B lymphocytes in the draining lymph nodes. The results obtained indicate that the fibrinogen incorporation strategy conditioned the osteogenic capacity of biomaterials. Fg-Ads scaffolds led to more bone formation, and the presence of Fg stimulated angiogenesis. Furthermore, animals implanted with Fg-Ads scaffolds showed significant increases in the percentages of B lymphocytes and myeloid cells in the draining lymph nodes, while levels of T lymphocytes were not significantly different. Finally, a significant increase in TGF-β1 was detected in the plasma of animals implanted with Fg-Ads. Taken together the results presented suggest a potential correlation between the elicited immune response and biomaterial osteogenic performance.

ESTUDO SOBRE A APLICAÇÃO FOLIAR DE ACIBENZOLAR-S-METIL PARA INDUÇÃO DE RESISTENCIA À FERRUGEM ASIÁTICA EM SOJA E CERCOSPORIOSE EM MILHO

RESUMO A resistência sistêmica adquira pode apresentar benefícios promissores para o manejo de diversas enfermidades de plantas. Nas culturas da soja e milho esta tática poderia trazer benefícios como a redução de danos e também de custos de produção. Com o intuito de avaliar os efeitos da aplicação do acibenzolar-S-metil (ASM) em plantas de soja e milho sobre o controle de Phakopsora pachyrhizi H. Sydow & P. Sydow e de Cercospora spp. (C. zeae-maydis Tehon & Daniels, C. zeina Crous & U. Braun e C. sorghi var. maydis Ellis & Everh), foram conduzidos quatro experimentos em campo com estas culturas. Em soja, foi realizado um experimento em Maracaju, MS, na variedade CD 219 RR com a aplicação de cinco tratamentos em diferentes programas de pulverização de herbicida, inseticidas e fungicidas com e sem a associação do ASM em diferentes estádios da cultura. Em milho, dois experimentos foram conduzidos na safrinha 2008 em Aral Moreira, MS, (híbrido Somma) e Maracaju, MS, (híbrido 2B710) com a aplicação de ASM isolado e em associação com azoxistrobina + ciproconazole em dois diferentes estádios de desenvolvimento das plantas. Outro ensaio com milho foi conduzido no verão de 2008/2009 com o híbrido AG 9040, em Maracaju, MS, também com a aplicação de ASM isoladamente e em mistura com azoxistrobina + ciproconazole com pulverizações em até três estádios diferentes das plantas de milho. Em nenhum dos experimentos conduzidos detectou-se benefícios da utilização do ASM tanto isoladamente quanto em mistura com fungicidas para o controle da ferrugem asiática em soja e da cercosporiose do milho, tendo havido controle apenas quando da utilização de fungicida químico independentemente da adição do ASM.

[Rearing technique and biological traits of Atheloca subrufella (Hulst) (Lepidoptera: Phycitidae) in coconut fruits]

Rearing Technique and Biological Traits of Atheloca subrufella (Hulst) (Lepidoptera: Phycitidae) in Coconut Fruits. Larvae of the coconut moth Atheloca subrufella (Hulst) develop in flowers and fruits of coconut, Cocos nucifera, causing precocious abscission of these structures and, hence, yield decrease. This work studied a feasible and suitable rearing technique for A. subrufella using fruits of coconut. We first determined the appropriate density of larvae to be reared per coconut fruit (among two, three, four or five larvae) and later tested the suitability of this rearing technique for three successive generations. The storage of egg and pupal stages during 0, 5, 10 and 20 days was also studied at 12ºC. Based on the fertility life table parameters, the best results were achieved by rearing two or three larvae per fruit as they yielded the best net reproductive rate and intrinsic rate of population increase. In addition, eggs and pupae of A. subrufella can be stored at 12ºC up to five days with viability higher than 90%. Adult moths emerged from pupae stored for five days at 12ºC produced an average of 219.4 eggs and lived 18.8 days. Storage periods for eggs and pupae over 10 days significantly reduced egg viability and adult fecundity, respectively. Thus, the technique in here described was shown to be suitable for the continuous rearing of A. subrufella in laboratory conditions.

COMPARAÇÃO DA REPRODUTIBILIDADE DAS ESTIMATIVAS DE SEVERIDADES DE MANCHAS FOLIARES EM ALGODOEIRO FEITAS POR AVALIADORES UTILIZANDO DIFERENTES ESCALAS DIAGRAMÁTICAS

RESUMO A adoção de escalas diagramáticas que viabilizem estimar a severidade de doenças no algodoeiro é fundamental para a tomada de decisão do momento mais correto de se fazer o controle químico destas enfermidades na cultura. Nas safras 2000/2001 e 2001/2002 foram realizados experimentos a campo, com cinco repetições, em delineamento de blocos ao acaso, objetivando comparar a reprodutibilidade da estimativa das severidades das manchas foliares causadas por Stemphylium spp., Alternaria spp., Ramularia areola e por Xanthomonas axonopodis pv. malvacearumpor meio de escalas diagramáticas: uma desenvolvida pelos autores deste trabalho, a de ANDRADE et al. (1999), a de CIA et al. (1999) e a de CIA; SALGADO (1997) na cultivar Delta Opal. As avaliações foram realizadas por quatro diferentes avaliadores aos 66, 81, 100 e 114 dias após a emergência no ano agrícola 2000/2001 e aos 71, 86, 106 e 124 dias após a emergência na safra 2001/2002 em 40 plantas marcadas por parcela. As escalas propiciaram aos avaliadores estimarem as severidades das manchas foliares com graus diferentes de sintomas, em planta, apresentando resultados mais uniformes quando a severidade das doenças era baixa. A escala de CIA; SALGADO (1997) exigiu maior competência dos avaliadores para a sua utilização adequada na determinação da severidade das manchas do complexo Stemphylium/Alternaria. As escalas 1 (elaborada pelos autores deste trabalho) e de CIA et al. (1999) demonstraram-se mais adequadas para a detecção dos sintomas iniciais da mancha de ramulária.

Undifferentiated connective tissue disease: a seven-center cross-sectional study of 184 patients

The purpose of this study was to characterize the clinical and serological features of a large cohort of patients with antinuclear antibody (ANA) positive undifferentiated connective tissue disease (UCTD). Consecutive patients with UCTD, followed up at the Rheumatology Clinic of the participating centers, were included. Data from these patients were obtained by clinical evaluation and chart review. All patients were diagnosed as having UCTD on basis of the following criteria: positive ANA plus at least one clinical feature of connective tissue disease, but not fulfilling classification criteria for any differentiated connective tissue disease. One hundred eighty-four patients were studied (female patients-94.5%; mean age at time of evaluation-47 years). The most prevalent manifestations were arthralgia (66%), arthritis (32%), Raynaud's phenomenon (30%), sicca symptoms (30%), and leukopenia (19%). The prevalence of ANA was 100%, anti-SSA 20%, anti-dsDNA 14%, and anti-SSB 7%. Patients with anti-dsDNA/anti-Sm, anticentromere/anti-Scl70, or anti-SSA/anti-SSB antibodies more frequently presented a set of manifestations close to systemic lupus erythematosus (SLE), systemic sclerosis, or Sjögren syndrome, respectively. We analyze a large cohort of UCTD. Seventy-two percent of these UCTD patients present lupus-, scleroderma-, or Sjögren-like features but do not fulfill classification criteria and mostly present a mild disease.

Key elements of the BMP/SMAD pathway co-localize with CDX2 in intestinal metaplasia and regulate CDX2 expression in human gastric cell lines

Helicobacter pylori infection induces intestinal metaplasia of the stomach, a preneoplastic lesion associated with an increased risk for gastric cancer development. Intestinal metaplasia is induced by the intestine-specific transcription factor CDX2 but the mechanisms responsible for this ectopic expression have never been described. We hypothesized that the BMP/SMAD pathway has a role in CDX2 regulation, in this context, for the following reasons: (1) the BMP pathway is crucial for normal intestinal differentiation and (2) there is an influx of BMP2 and BMP4-producing cells to the stomach upon Helicobacter pylori infection. We evaluated the expression of key elements of the BMP pathway in human stomach specimens with IM. Growth factor treatments, with BMP2 and BMP4, were performed in cultured cells and a knock-down experiment of SMAD4 was done using RNAi. We showed overexpression in IM of BMP2/4, BMPR1A, and SMAD4 in 56% of IM foci, and pSMAD1/5/8 in 100% of IM foci as compared to adjacent mucosa. In vitro, treatment of AGS cells with BMP2 and BMP4 increased endogenous CDX2 expression as well as the intestinal differentiation markers MUC2 and LI-cadherin. On the other hand, SMAD4 knock-down led to decreased endogenous CDX2, MUC2, and LI-cadherin in AGS. Treatment of the SMAD4 knock-down cells had no influence on CDX2 expression as opposed to wild-type cells. A 9.3 kb CDX2 promoter could be transactivated by SMAD4 and SMAD1 in a cell-dependent manner. In conclusion, we identified for the first time that the BMP pathway is active in intestinal metaplasia and that BMP2 and BMP4 regulate CDX2 expression and promote intestinal differentiation through the canonical signal transducers.

New insights of HLA class I association to Behçet's disease in Portuguese patients

Human leukocyte antigen (HLA)-B*51 is a well-known genetic factor associated with Behçet's disease (BD). To analyse the influence of HLA-B*51 and other HLA class I alleles in BD susceptibility in a Portuguese population and its association with disease severity, we studied 78 BD patients and 208 healthy controls. The patients were classified into two severity groups as described by Gul et al. As expected, a higher frequency of HLA-B*51 was found. The frequency of HLA-Cw*16 alleles was significantly higher in patients. Regarding severity, HLA-B*27 frequency was higher in the severe group compared with controls and with the mild group. Thus, HLA-B*51 and HLA-Cw*16 seem to confer susceptibility to BD in this patients. HLA-B*27 may be important as a prognostic factor.

Adherence to the Mediterranean diet and fresh fruit intake are associated with improved asthma control

BACKGROUND

The traditional Mediterranean diet is claimed to possess antioxidant and immune-regulatory properties in several chronic diseases. Typical Mediterranean foods have recently been associated with improvement of symptoms of asthma and rhinitis in children. However the effect of adherence to Mediterranean diet on adult asthma outcomes is unknown. We aimed to investigate the association between adherence to Mediterranean diet and asthma control.

METHODS

Cross sectional study of 174 asthmatics, mean (SD) age of 40 (15) years. The patients were defined as controlled, in contrast to noncontrolled, if they showed FEV1 >or= 80% of predicted, exhaled nitric oxide (NO) <or=35 ppb, and Asthma Control Questionnaire score <1. Dietary intake was obtained by a food frequency questionnaire, and Mediterranean diet was assessed by alternate Mediterranean Diet (aMED) Score. Logistic regression models adjusting for confounders were performed to estimate the association between Mediterranean diet and asthma control.

RESULTS

Controlled asthmatics (23%) had significantly higher aMED Score, intake of fresh fruit, and lower intake of ethanol compared to noncontrolled (77%). High adherence to Mediterranean diet reduced 78% the risk of noncontrolled asthma after adjusting for gender, age, education, inhaled corticosteroids and energy intake (OR = 0.22; 95% CI = 0.05-0.85; P-trend = 0.028). The higher intake of fresh fruit decreased the probability of having noncontrolled asthma (OR = 0.29; 95% CI = 0.10-0.83; P-trend = 0.015), while the higher intake of ethanol had the opposite effect (OR = 3.16; 95% CI = 1.10-9.11; P-trend = 0.035).

CONCLUSION

High adherence to traditional Mediterranean diet increased the likelihood of asthma to be under control in adults. The study introduces a novel link between diet and asthma control, as measured by symptoms, lung function and exhaled NO.

DINÂMICA HEMOCITÁRIA EM DIATRAEA SACCHARALIS F. (LEPIDOPTERA: CRAMBIDAE) DESAFIADA IMUNOLOGICAMENTE PELOS FUNGOS BEAUVERIA BASSIANA (BALS.) VUILL. E METARHIZIUM ANISOPLIAE (METSCH.) SOROK

RESUMO A pesquisa objetivou analisar, morfológica e quantitativamente, os tipos de hemócitos em lagartas do terceiro ínstar de Diatraea saccharalis F., desafiadas imunologicamente por Metarhizium anisopliae (Metsch.) Sorok. e Beauveria bassiana (Bals.) Vuill., nas concentrações 103, 105 e 107 conídios mL-1, em comparação a lagartas não tratadas. Foram coletados 10 µL de hemolinfa de cinco lagartas por tratamento, nos intervalos de 24, 36, 48, e 60 horas pós-inoculação, sendo contadas 300 células em campos aleatórios da lâmina, utilizando-se a objetiva de imersão (100X). Os hemócitos mais freqüentes foram os esferulócitos (34,8%), plasmatócitos (29,7%) e granulócitos (22,2%), enquanto os menos freqüentes foram os prohemócitos (8,3%), adipohemócitos (2,6%) e oenocitóides (2,4%). B. bassiana promoveu interferência efetiva na população de granulócitos na concentração de 107 conídios mL-1 (24 e 36h) e plasmatócitos nas concentrações 103 conídios mL-1 (60h) e 107 conídios mL-1 (24 e 36h), onde ocorreu aumento do número de granulócitos e redução do número de plasmatócitos na maior concentração e, ainda, o aumento do número de plasmatócitos na concentração 103 conídios mL-1. M. anisopliae não interferiu quantitativamente nos granulócitos e plasmatócitos. No que se refere aos esferulócitos, verificou-se maior tendência de redução do número dessas células no intervalo de 36h para ambos os fungos, porém, diferença significativa só ocorreu na concentração de 105 conídios mL-1 no intervalo de 60h, apresentando a menor média. Conclui-se que B. bassiana tem ação mais efetiva sobre a dinâmica populacional dos granulócitos e plasmatócitos em lagartas de D. saccharalis em relação ao M. anisopliae.

High rates of fluoroquinolone-resistant Campylobacter in Portugal - need for surveillance

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