Description of four new filamentous cyanobacterial taxa from freshwater habitats in the Azores Archipelago

Simple filamentous cyanobacteria comprise a diverse and polyphyletic group of species, primarily in the orders Leptolyngbyales and Oscillatoriales, that need more sampling to improve their taxonomy. Oceanic islands, such as the Azores archipelago, present unique habitats and biogeographic conditions that harbor an unknown range of diversity of microorganisms. Filamentous cyanobacteria isolated from aquatic habitats in the Azores and maintained in the BACA culture collection were described using morphology, both light and transmission electron microscopy, ecology, and genetic data of the 16S rRNA gene sequences and 16S-23S Internal Transcribed Spacer (ITS) rRNA region secondary structure. Our analyses revealed two new monophyletic genera: Tumidithrix elongata gen. sp. nov. (Pseudanabaenaceae) and Radiculonema aquaticum gen. sp. nov. (Leptolyngbyaceae). In addition, two new species Leptodesmis lacustris sp. nov. (Leptolyngbyaceae) and Pycnacronema lacustrum sp. nov. (Wilmottiaceae) are reported as the first aquatic species for these genera. The description of these new taxa and the genetic study of an isolate of Leptodesmis alaskaensis from the Azores followed the polyphasic approach, identifying diacritical features. Our results reinforce the need for taxonomic studies on cyanobacteria from less-studied habits and geographic regions, which have a potential for new taxa description.

Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal

Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.

Demographic and Clinical Characteristics of Mpox Patients Attending an STD Clinic in Lisbon

Mpox is a viral disease caused by the monkeypox virus, which marked the year of 2022 with a global outbreak. While previously considered to be a zoonosis of almost exclusive animal-to-human transmission, the current outbreak has been attributed to human-to-human transmission, particularly sexual transmission. As a new sexually transmissible disease, we studied the epidemiological and clinical features, as well as the concomitant occurrence of other sexually transmissible diseases, treatment approach, and outcome of our 291 patients, in the current outbreak. We found a total of 169 concomitant sexually transmissible infections of bacterial and viral origins, corresponding to 107 patients. Neisseria gonorrhoeae was the most common agent, particularly in the anal location. With this work, we emphasize the need for a thorough epidemiological and medical history, as well as a concomitant complete laboratorial screening for other STIs in patients with confirmed or suspected mpox.

Distribution and diversity of cyanobacteria in the Azores Archipelago: An annotated checklist

Background

Knowledge about cyanobacteria diversity in the Azores is spread over several publications, dating from 1874, with some of them not generally available to the scientific community due to their restricted access. The dispersion and sometimes inaccessibility of this information hinder a deeper analysis and a better understanding of the biodiversity of the Azores Islands and more general ecological processes in oceanic islands. Here we present the first checklist of cyanobacteria for the Azores Archipelago with updated taxonomy of all recorded taxa.

New information

This work provides a compiled and annotated checklist of all known cyanobacteria from the Azores Archipelago with morphological identification from preserved samples and cultures, based on published literature. All records of taxa known to occur in the Azores were taxonomically updated. The present checklist comprises 225 taxa distributed by six orders (Chroococcales, Nostocales, Oscillatoriales, Pleurocapsales, Spirulinales and Synechococcales). Our literature review reveals that the Azores Archipelago hosts a high diversity of cyanobacteria, despite several overlooked habitats that may present great potential regarding cyanobacteria diversity. Increasing efforts to study these neglected habitats could contribute to the knowledge of cyanobacteria taxonomy. This checklist provides the basis for future works on the taxonomy and taxa richness of cyanobacteria in the Azores and the Atlantic Islands, as also for understanding and monitoring non-indigenous and invasive species.

Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus

The largest monkeypox virus (MPXV) outbreak described so far in non-endemic countries was identified in May 2022 (refs. 1-6). In this study, shotgun metagenomics allowed the rapid reconstruction and phylogenomic characterization of the first MPXV outbreak genome sequences, showing that this MPXV belongs to clade 3 and that the outbreak most likely has a single origin. Although 2022 MPXV (lineage B.1) clustered with 2018-2019 cases linked to an endemic country, it segregates in a divergent phylogenetic branch, likely reflecting continuous accelerated evolution. An in-depth mutational analysis suggests the action of host APOBEC3 in viral evolution as well as signs of potential MPXV human adaptation in ongoing microevolution. Our findings also indicate that genome sequencing may provide resolution to track the spread and transmission of this presumably slow-evolving double-stranded DNA virus.

Ongoing monkeypox virus outbreak, Portugal, 29 April to 23 May 2022

Up to 27 May 2022, Portugal has detected 96 confirmed cases of monkeypox. We describe 27 confirmed cases (median age: 33 years (range: 22-51); all males), with an earliest symptom onset date of 29 April. Almost all cases (n = 25) live in the Lisbon and Tagus Valley health region. Most cases were neither part of identified transmission chains, nor linked to travel or had contact with symptomatic persons or with animals, suggesting the possible previously undetected spread of monkeypox.

Cyanotoxin Screening in BACA Culture Collection: Identification of New Cylindrospermopsin Producing Cyanobacteria

Microcystins (MCs), Saxitoxins (STXs), and Cylindrospermopsins (CYNs) are some of the more well-known cyanotoxins. Taking into consideration the impacts of cyanotoxins, many studies have focused on the identification of unknown cyanotoxin(s)-producing strains. This study aimed to screen strains from the Azorean Bank of Algae and Cyanobacteria (BACA) for MCs, STX, and CYN production. A total of 157 strains were searched for mcy, sxt, and cyr producing genes by PCR, toxin identification by ESI-LC-MS/MS, and cyanotoxin-producing strains morphological identification and confirmation by 16S rRNA phylogenetic analysis. Cyanotoxin-producing genes were amplified in 13 strains and four were confirmed as toxin producers by ESI-LC-MS/MS. As expected Aphanizomenon gracile BACA0041 was confirmed as an STX producer, with amplification of genes sxtA, sxtG, sxtH, and sxtI, and Microcystis aeruginosa BACA0148 as an MC-LR producer, with amplification of genes mcyC, mcyD, mcyE, and mcyG. Two nostocalean strains, BACA0025 and BACA0031, were positive for both cyrB and cyrC genes and ESI-LC-MS/MS confirmed CYN production. Although these strains morphologically resemble Sphaerospermopsis, the 16S rRNA phylogenetic analysis reveals that they probably belong to a new genus.

Quality of life and risk of feminicide in women victims of intimate partner violence in Campinas

Introduction

Violence against women is a public health problem with severe consequences. Most women in situations of domestic violence are emotionally involved and/or economically dependent of their intimate partners contributing to the perpetuation and acceptance of violence.

Objectives

1) To characterize the women who join the Reference and Support Center for Women (Ceamo) in Campinas, Southeast Brazil. 2) To measure the quality of life in women victims of intimate partner violence 3) To determine the risk of feminicide.

Methods

The Ceamo is a public specialized service from the mayor of Campinas, it provides psychological, social and legal guidance to women in situations of gender violence. Inclusion criteria: Women attending Ceamo services, speaking Portuguese, age ≥18 years old and having experienced intimate partner violence. Measure instruments: Danger assessment Scale and WHOQOL-BREF.

Results

During the 11 months of the study, 78 new users were recruited. Average age 38.3 years old, mostly married/stable union, most of them with children (88%). 64% of women do not work and 36% live with the abusive partner. Prevalent types of violence suffered during by the victims in the last year were psychological n = 76, physical n = 62, moral n = 54 and sexual n = 23. The domain most affected in the assessment of quality of life was the environment (average 42% /100%) and psychological domain (42%/100%). 49% of women were classified with increased risk, 22% with severe risk and 1% with extreme risk of femicide. The questions with the most positive answers were those related to believing that the partner can kill her (77%), jealous of the partner (76%) and controlling behavior (73%), being followed/spied by the partner (67%) and threat death (65%).

Conclusions

The service in general receive very vulnerable women with low perception of their own quality of life, precarious material conditions and high risk of femicide.

Key messages

The women in domestic violence situation attended by the Ceamo service are at high risk of femicide. Service users have very low perception of their quality of life and poor social conditions.

Trend of deaths from external causes in Campinas, Brazil (2000-2017): Joint Point Regression Analysis

Introduction

Deaths from external causes are caused by events or acute exposure to physical, chemicals agents or radiation; also due to the lack of essential agents for survival or injuries caused by oneself or others. The preventable nature of deaths from external causes has been pointed out mainly because there are related to violence.

Objective

To describe the trend and characteristics of mortality from external causes in the city of Campinas, São Paulo, Brazil from 2000 to 2017.

Methods

Descriptive, cross-sectional study. Information sources: The death mortality certificates from the Municipal Health Secretariat's Information System included in the chapter XX of the CID-10. Data analysis: External causes were divided into five groups: transportation, falls, suicides, homicides and others. The Standardized Mortality Coefficient (SMC) per 100,000 inhabitants was calculated taking as a reference the populations of the 2000 and 2010 censuses, stratified by age group and sex. The trend analysis for homicide was performed using a joinpoint regression model.

Results

In Campinas during the studied period occurred 12,175 deaths from external causes (80.4% male, 19.6% female). The most important causes of mortality for men were homicides (50%) and traffic accidents (27%) and for women it was falls (35%), traffic accidents (24%) and homicides (22 %). The SMC trend towards homicides shows a decrease in male events and stability in women homicides. It is noteworthy the lack of change in the trend of the female coefficient, regarding the male SMP, we identify three significant changes in the trend.

Conclusions

The decrease in the number of deaths from external causes in Campinas is principally due to the decrease in homicides in male population. The SMP was able to analyze deaths adjusted to the characteristics of the population, being an important tool for the analysis of deaths from external causes.

Key messages

In Campinas deaths from external causes are important causes of mortality. The Standardized Mortality Coefficient and joint point regression method are useful tools for the analysis of deaths from external causes.

Report of simultaneous measles outbreaks in two different health regions in Portugal, February to May 2017: lessons learnt and upcoming challenges

In Portugal, measles vaccination coverage and population immunity are high, and no endemic measles cases had been reported since 2004. The World Health Organization classified measles as eliminated in the country in 2015 and 2016, based on data from the previous 3 years. However, in a context of increasing incidence in several European countries in 2016 and 2017, Portugal experienced two simultaneous measles outbreaks with a total of 27 laboratory-confirmed cases (0.3 cases/100,000 population) in two health regions between February and May 2017. Nineteen cases (70.1%) were adults, of whom 12 were healthcare workers. Overall, 17 cases (63.0%) were not vaccinated, of whom five were infants younger than 12 months of age. One unvaccinated teenager died. Genotype B3 was identified in 14 cases from both regions. Measles virus sequencing identified different possible origins of the virus in each region affected. Although measles transmission was stopped in less than 2 months from the first case being notified, these outbreaks represent an opportunity to reinforce awareness of measles diagnosis. We highlight the intensity of the control measures taken and their impact on the rapid control of the outbreaks and also the fact that high vaccination coverage was crucial to stop transmission.

Cyanobacteria from freshwater lakes in the Azores archipelago, Portugal: data from long term phytoplankton monitoring

BACKGROUND

The Azores are oceanic islands located in the Northern Atlantic Ocean and are particularly rich in aquatic systems, ranging from freshwater, brackish, marine and thermal habitats. Due to the increase in local anthropogenic pressures and global warming, several azorean lakes began to reveal signs of eutrophication that led to the implementation of monitoring programmes and management strategies on the most impacted lakes. Later, the Water Framework Directive (2000/60/EC) demanded the establishment of biomonitoring programmes for European freshwater ecosystems and the limited Azorean monitoring programmes were extended to a larger set of lakes. Since the establishment of the aquatic systems monitoring programme in the Azores archipelago, lakes have been regularly sampled, producing innumerous unpublished records of cyanobacteria that are difficult to access.

NEW INFORMATION

Here we present the occurrences of cyanobacteria in Azorean lakes that result from 22 years of phytoplankton monitoring in a total of 1948 cyanobacteria occurrences from 968 phytoplankton sampling events on Azorean lakes done between 1996 and 2018 as part of regional inland aquatic ecosystems monitoring programmes. Forty two cyanobacteria taxa were identified in those events, 28 species and 14 at genus level. This information is crucial for conservation, biodiversity studies and lake management, as some of the cyanobacteria species present are bloom-forming and have the ability to produce toxins. This will also allow for the identification of invasive species and possible targeted control and mitigation programmes, according to the species present in the Azorean lakes.

Challenging measles case definition: three measles outbreaks in three Health Regions of Portugal, February to April 2018

We report three simultaneous measles outbreaks with 112 confirmed cases in three Health Regions of Portugal, from February to April 2018. The mean age of cases was 30 years, 79% worked in a healthcare setting and 87% were vaccinated. Genotype B3 was identified in 84 cases from the three outbreaks. Primary cases in each outbreak were imported. Several cases presented with modified measles, highlighting the importance of rethinking the measles case definition for vaccinated cases.

Human brucellosis in Portugal-Retrospective analysis of suspected clinical cases of infection from 2009 to 2016

Brucellosis is a zoonosis that is emerging in some regions of the world. Although brucellosis is a disease of obligatory declaration and is not eradicated in Portugal, no prevalence data is available in this country. In this study, we retrospectively analyzed the data available at the Reference Laboratory at the Portuguese National Institute of Health during the past 7 years (2009–2016) in order to get insight into the epidemiological scenario of brucellosis in Portugal. A total of 2313 biological samples from patients with clinical suspicion of brucellosis were subjected to immunological techniques for laboratory diagnosis. From 2010 to 2015, a subset of 259 samples was subjected to molecular methods. According to the available data, 167 out of 2313 (7.2%) samples had positive serology for Brucella spp. and 43 out of 259 samples (16.6%) were positive for B. melitensis by real time PCR, being classified as biovar 1 and 3. This study draws attention to the importance of integrating clinical and laboratory data of human cases in order to increase the efficacy of the response measures in case of outbreaks.

Burkholderia pseudomallei: First case of melioidosis in Portugal

Burkholderia pseudomallei is a Gram-negative bacillus and the causative agent of melioidosis, a serious infection associated with high mortality rate in humans. It can be naturally found as an environmental saprophyte in soil or stagnant water, and rice paddies that predominate in regions of endemicity such as Northeast Thailand. B. pseudomallei is a Biosafety Level 3 organism due to risks of aerosolization and severe disease and is now included in formal emergency preparedness plans and guidelines issued by various authorities in the United States and Europe. Here, we report the first case of imported melioidosis in Portugal. B. pseudomallei was isolated from the patient's blood as well as from a left gluteal abscess pus. The isolate strain showed the unusual resistance profile to first-line eradication therapy trimethroprim/sulfamethoxazole. Whole genome sequencing revealed its similarity with isolates from Southeast Asia, suggesting the Thai origin of this Portuguese isolate, which is in agreement with a recent patient's travel to Thailand.

Influence of sterilization process on cutting effectiveness and durability of ultrasonic tips

Objective: The aim was to evaluate influence of different sterilization methods on cutting effectiveness and durability of cylindrical ultrasonic burs compared with conventional cylindrical diamond-coated burs. Material and Methods: Fifteen conventional cylindrical diamond-coated (1092) (KG Sorensen) coupled to a high-speed turbine, and fifteen cylindrical ultrasonic (8.2137) (CVDentus®) burs coupled to an ultrasound-handpiece were used to perform standardized cavity preparations in healthy bovine tooth fragments, cleaned with rubber cup, pumice stone and water. After every 10 preparations, burs were sterilized 9 times in autoclave (SA), oven (SO), or cleaned with brush, soap and water (C). Fragments were weighed and microphotographs of burs were taken at the beginning and end of experiment. Another 9 conventional diamond-coated and 9 CVD burs underwent the same sterilization cycles in autoclave (SAC), oven (SOC) or washed with soap and water (CC) however, without being used for making cavity preparations, serving as control. Descriptive analyses were made of the values found by weighing and microphotography scores. Results: Statistically significant differences (Paired Student’s-t test) were observed among burs after sterilization (p = 0.0001). SO and SA did not influence cutting effectiveness and durability of ultrasonic and conventional diamond-coated burs. The microphotographs showed morphological differences between the burs used for preparation and the control. Conclusion: Sterilization by oven and autoclave did not influence cutting effectiveness and durability of CVD and conventional diamond-coated burs. Conventional diamond-coated burs presented greater structural alterations after performing cavity preparations and cleaning/sterilization procedures, irrespective of the process used.Keywords: cvdentus, sterilization, dental instruments, infection control.

Role of 13C-urea breath test in experimental model of Helicobacter pylori infection in mice

BACKGROUND

Animal models have been widely used to study Helicobacter pylori infection. Evaluation of H. pylori infection status following experimental inoculation of mice usually requires euthanasia. The (13) C-urea breath test ((13) C-UBT) is both sensitive and specific for detection of H. pylori in humans. Thus, it would be very useful to have such a test with the same accuracy for the follow-up of this infection in animal models of gastric infection. Accordingly, the purpose of this study was to develop and evaluate a (13) C-UBT method for following the course of H. pylori infection in a mouse model.

MATERIAL AND METHODS

A total of 50 female C57BL/6 mice were gavaged three times with either 10(8) colony-forming units of H. pylori (n=29) or saline solution only (n=21). After 2 months of infection, mice were fasted for 14 hours and (13) C-UBT was performed using 300 μg of (13) C-urea. The mice were killed, and the stomach was removed and processed for immunohistochemistry and PCR.

RESULTS

The optimal time for breath sample collection in mice was found to be 15 minutes. The (13) C-UBT cutoff was set at 3.0‰ δPDB. Using PCR as the gold standard, the sensitivity of (13) C-UBT and immunohistochemistry was 96.6 and 72.4%, respectively, while the specificity was 85.7 and 95.2%, respectively.

CONCLUSIONS

(13) C-UBT was shown to be a reliable method for the detection of H. pylori infection in C57BL/6 mice and was even more accurate than immunohistochemistry. The use of (13) C-UBT in the mouse model of H. pylori infection can be very useful to detect the bacterium without the need to kill the animals in long-term time course studies.

Allelic diversity and phylogeny of homB, a novel co-virulence marker of Helicobacter pylori

Background

The homB gene is a Helicobacter pylori disease-marker candidate, strongly associated with peptic ulcer disease, while homA, its paralogue gene with 90% sequence identity, is correlated with non-ulcer dyspepsia. The HomB encoded outer membrane protein was shown to contribute to the proinflammatory properties of H. pylori and also to be involved in bacterial adherence.

This study investigated the distribution of homB and homA genes in 455 H. pylori strains from East Asian and Western countries, and carried out sequence comparison and phylogenetic analyses.

Results

Both homB and homA genes were heterogeneously distributed worldwide, with a marked difference between East Asian and Western strains.

Analysis of homB and homA sequences revealed diversity regarding the number of copies and their genomic localization, with East Asian and Western strains presenting different genotypes. Moreover, homB and homA sequence analysis suggests regulation by phase variation. It also indicates possible recombination events, leading to gene duplication or homB/homA conversion which may as well be implicated in the regulation of these genes. Phylogenetic reconstruction of homB and homA revealed clustering according to the geographic origin of strains. Allelic diversity in the middle region of the genes was observed for both homB and homA, although there was no correlation between any allele and disease. For each gene, a dominant worldwide allele was detected, suggesting that homB/homA allelic variants were independent of the geographical origin of the strain. Moreover, all alleles were demonstrated to be expressed in vivo.

Conclusion

Overall, these results suggest that homB and homA genes are good candidates to be part of the pool of H. pylori OMPs implicated in host-bacteria interface and also contributing to the generation of antigenic variability, and thus involved in H. pylori persistence.

Disease association with two Helicobacter pylori duplicate outer membrane protein genes, homB and homA

Background

homB encodes a Helicobacter pylori outer membrane protein. This gene was previously associated with peptic ulcer disease (PUD) and was shown to induce activation of interleukin-8 secretion in vitro, as well as contributing to bacterial adherence. Its 90%-similar gene, homA, was previously correlated with gastritis. The present study aimed to evaluate the gastric disease association with homB and homA, as well as with the H. pylori virulence factors cagA, babA and vacA, in 415 H. pylori strains isolated from patients from East Asian and Western countries. The correlation among these genotypes was also evaluated.

Results

Both homB and homA genes were heterogeneously distributed worldwide, with a marked difference between East Asian and Western strains. In Western strains (n = 234, 124 PUD and 110 non-ulcer dyspepsia (NUD), homB, cagA and vacA s1 were all significantly associated with PUD (p = 0.025, p = 0.014, p = 0.039, respectively), and homA was closely correlated with NUD (p = 0.072). In East Asian strains (n = 138, 73 PUD and 65 NUD), homB was found more frequently than homA, and none of these genes was associated with the clinical outcome.

Overall, homB was associated with the presence of cagA (p = 0.043) and vacA s1 (p < 0.001), whereas homA was found more frequently in cagA-negative (p = 0.062) and vacA s2 (p < 0.001) strains.

Polymorphisms in homB and homA copy number were observed, with a clear geographical specificity, suggesting an involvement of these genes in host adaptation. A correlation between the homB two-copy genotype and PUD was also observed, emphasizing the role of homB in the virulence of the strain.

Conclusion

The global results suggest that homB and homA contribute to the determination of clinical outcome.

Evaluation of the clinical significance of homB, a novel candidate marker of Helicobacter pylori strains associated with peptic ulcer disease

BACKGROUND

homB codes for a putative Helicobacter pylori outer membrane protein and has previously been associated with peptic ulcer disease (PUD) in children.

METHODS

A total of 190 H. pylori strains isolated from children and adults were studied to evaluate the clinical importance of the homB gene. In vitro experiments were performed to identify HomB mechanisms of bacterial pathogenicity.

RESULTS

Characterization of the isolates demonstrated that homB was significantly associated with PUD in 86 children (odds ratio [OR], 7.64 [95% confidence interval {CI}, 2.65-22.05]) and in 32 adults < or =40 years of age (OR, 11.25 [95% CI, 1.86-68.13]). homB was correlated with the presence of cagA, babA2, vacAs1, hopQI, and oipA "on" genotype (P< .001) The HomB protein was found to be expressed in the H. pylori outer membrane and was noted to be antigenic in humans. H. pylori homB knockout mutant strains presented reduced ability to induce interleukin-8 secretion from human gastric epithelial cells, as well as reduced capacity to bind to these cells. Both of these functions correlated with the number of homB copies present in a strain.

CONCLUSION

homB can be considered a comarker of H. pylori strains associated with PUD. Moreover, results strongly suggest that HomB is involved in the inflammatory response and in H. pylori adherence, constituting a novel putative virulence factor.

Effect of handpiece tip design on the cutting efficiency of an air abrasion system

PURPOSE

The aim of this study was to evaluate the effect of nozzle angle and tip diameter on the cutting efficiency of an air abrasion system.

MATERIALS AND METHODS

Thirty-six extracted human third molars were air-abraded with the PrepStar microabrasion machine using a handpiece with either 80 degrees or 45 degrees nozzle angles with 0.38 or 0.48 mm tip orifice diameters. The following parameters were held constant: abrasive particle size (27 microm), air pressure (80 psi), distance (2 mm) and duration (15 seconds). The cutting efficiency was compared using enamel, dentin and cementum substrates. Width and depth of the cutting patterns were analyzed and measured using scanning electron micrographs.

RESULTS

Statistical analysis using three-way ANOVA and Duncan's Multiple Range test revealed that the width of the cuts was significantly greater when the cavities were prepared using the 45 degrees nozzle angle. Significantly deeper cavities were produced with the 80 degrees nozzle angle. The tip orifice of the nozzle influenced the cutting efficiency in softer substrates, dentin and cementum. Precise removal of hard tissue is best accomplished using the 80 degrees angle nozzle tips for all types of tooth surfaces, enamel, dentin and cementum.

[Inequality of workers' survival in Botucatu, São Paulo State, Brazil]

The aim of this observational study was to estimate the survival function and risk of death in Botucatu, Southeast Brazil, by occupation. The occupational history of inhabitants of Botucatu who died after their 10th birthday from January 1, 1997, to March 31, 1998, was analyzed, as were the occupational histories of workers' spouses. A total of 992 subjects were studied. Data were analyzed by fitting a proportional hazards model where the time variable was age at death or at time of interview and the main co-variable was occupation. Results showed that risk of death increased consistently as the level of occupational specialization decreased, displaying a 12-year increase in life expectancy for professional as compared to unskilled workers.

Enhanced serum glucocorticoid levels mediate the reduction of serosal mast cell numbers in diabetic rats

Rats turned diabetic by treatment with alloxan exhibit a significant reduction in serosal mast cell numbersin parallel with decreased insulin levels in the plasma. Our aim was to investigate the putative involvement of endogenous glucocorticoid hormone in this phenomenon. The findings indicated that rats treated with alloxan responded with an increase in levels of serum corticosterone concomitantly with decreased mast cell numbers in the pleural space. We found that either surgical bilateral adrenalectomy or pretreatment with the steroid antagonist RU 486 (20 mg/kg, i.p.) impaired the drop in pleural mast cell counts in alloxinated rats. Administration of insulin (15 U/kg) prevented the increase in corticosterone levels and restored pleural mast cell levels in diabetic animals. In addition, treatment of naive rats with corticosterone (0.5 mg/kg, s.c.) or dexamethasone (0.1 mg/kg, s.c.), for 3 consecutive days, led to a reduction in the number of mast cells recovered from the pleural cavity as noted in diabetic animals. In contrast, insulin reduced serum corticosterone levels and induced a significant elevation in pleural mast cell numbers in naive rats. We conclude that there is a causative relationship between increased levels of glucocorticoids and down-regulation of mast cell numbers associated with the diabetic state, both phenomena clearly sensitive to insulin.

[Male homicide in the Metropolitan Region of São Paulo between 1979 and 1998: a pictorial approach]

Homicide has become a major social problem in Brazil in the last two decades. In Greater Metropolitan São Paulo, Southeast Brazil, the proportional incidence of male homicides increased from 35 to 121 (x 10-5) from 1979 to 1998. This study presents the trend in this phenomenon using a set of three-dimensional figures. We show both the absolute number and proportional incidence of male deaths by homicide and the natural logarithm of the male/female relative risk of homicide for Greater Metropolitan São Paulo from 1979 to 1998. Seven 3D figures show the homicide trend by age, sex, and year. The figures show the main trends in homicide distribution in the male population during the study period: a clear predominance among adolescents and young adults, a systematic and sharp increase in that same age range, a systematic spread to the lower (below-18) and higher (above-30) age groups, and a non-negligible incidence above the age of 40.

Evaluation of cutting patterns produced with air-abrasion systems using different tip designs

This study assessed cavity preparations produced with different air abrasion tip parameters. Twelve test groups of extracted teeth were prepared to evaluate the parameters of 80 degrees or 45 degrees nozzle angles and 0.38 or 0.48 mm inner tip diameters. All other factors were held constant. A device was made to hold the specimen and air abrasion handpiece that standardized the distance and position relative to the tooth and time of application. The cavities were evaluated by assessing the rounding of the cavosurface margins and cavity floor. Measurements of cavosurface angles and the angle of concavity were made at the deepest portion of the abraded surface using scanning electron micrographs. The cavosurface angles were compared using paired t-test, and the effects of the tip design parameters were analyzed by ANOVA and Duncan's Multiple Range test. From the cavity patterns found in this study, the authors suggest that 80 degrees angle tips are more appropriate than 45 degrees angle tips for making narrow, deep cuts for preventive resin restorations. Conversely, when shallow preparations are needed, as in the case of Class V cavity preparations, cutting patterns of 45 degrees angle tips are more suitable.

[Effect of design in cluster sampling to estimate the distribution of occupations among workers]

OBJECTIVE

To describe the effect of design associated with a sample survey carried out to estimate the distribution of occupations within an economic active population.

METHODS

A cluster sample of households, chosen from a comprehensive directory via systematic random sampling, was performed including 4,782 of all residences in Botucatu, Brazil, between June and July 1997.

RESULTS

Of the 4,782 households, 17,219 subjects were assessed. Due to the loss of distribution heterogeneity of the occupations within the households, the effect of design found ranged from 1.00 to 1.96.

CONCLUSIONS

The results suggest that when planning similar studies aiming at estimating the distribution of occupations among economic active populations, the effect of design should be estimated as e=1.50 for surveys in urban areas, and e=2.00 for surveys in rural areas.

[Validity of occupational histories from proxy respondents]

OBJECTIVE

Occupational studies often use data obtained from proxy respondents. However, few investigations have been conducted on the validity of occupational data provided by workers' surrogates. This study aimed to compare self-reported occupational data to information obtained from next-of-kin, as a contribution to assess the validity of using proxy respondents to obtain information about workers.

METHODS

Worker/next-of-kin pairs, residents in Southeastern Brazil, were interviewed separately in 1998 about worker's occupational past history. The concordance, sensitivity, and specificity of proxy reports about workers' occupations were examined comparing to self-reports.

RESULTS

A total of 2.163 worker/next-of-kin pairs were interviewed. The Kappa statistic for the agreement between worker's and next-of-kin's report about the worker's main occupation was 0.86 (CI95%; 0.85 - 0.88). The sensitivity of proxy reports on occupations ranged from 77.5% (64.6% - 90.4%) to 98.9% (97.3% - 100.0%), and specificity ranged from 96. 9% (96.0% - 97.7%) to 99.9% (99.7% - 100.0%).

CONCLUSIONS

These are encouraging findings for the use of proxy respondents in occupational studies when occupations are considered as categorical variables. However, caution is required when assessing occupational exposition by means of cumulative work time because next-of-kin may underestimates this information.

[Mortality risk measure inequalities among workers in Southeast Brazil]

INTRODUCTION

The main causes of illness and death in Brazil have been migrating backwards into the younger population during the last few years, increasing especially in the more productive age groups. Given the relationship between work and health/disease process, the hypothesis to be considered is that this phenomenon is partially due to the deterioration of workplace conditions. To contribute to investigating this hypothesis, this study estimates mortality risk indicators for the population of Botucatu, in the Southeast region of Brazil, classified according to their occupation.

METHODS

Standardized mortality coefficient, standardized risk ratio, and years of potential life lost were calculated for the inhabitants of Botucatu who died after their 10th birthday, between January 1997 and March 1998, and classified according to their occupation and main cause of death. Occupational and medical information was obtained by interviewing families of the deceased and their doctors, and checking medical files.

RESULTS

The standardized mortality coefficient ranged from 0.6 to 39.9 deaths/1000 workers in different occupations. The years of potential life lost ranged form 33 to 334 years/1000 workers. The ranking of causes of death varied according to occupation and the mortality risk considered.

CONCLUSION

The risk measures analyzed showed a high heterogeneity when associated to occupation and causes of death, which reflects the great social inequality existing in the studied population.

[Validity of information on occupation and principal cause on death certificates in Botucatu, Sao Paulo]

The aim of this paper was to evaluate the accuracy of data on death certificates for occupation and main cause of death. Measure of agreement was assessed comparing data from death certificates with those from both medical records and next-of-kin interviews, analyzing information for 552 residents of Botucatu, Southeast Brazil, who died in 1997. Kappa coefficients of 0.31 (95% C.I. 0. 29-0.34) and 0.76 (95% C.I. 0.75-0.76) were obtained for data on occupation and main cause of death, coded by a Brazilian two-digit classification and the three-digit ICD-10 classification, respectively. One can conclude that, although quality of the main cause of death is acceptable for pilot studies, data on occupation taken only from death certificates is not accurate enough to be used in epidemiological research.

Association between diastolic blood pressure and cumulative work time

Diastolic blood pressure was viewed as a generic indicator of aging, and its association with cumulative work time was studied after controlling for age as a potential confounding factor. The study was conducted among production line workers at a Brazilian tannery in July 1993. The association between diastolic blood pressure and cumulative work time was verified by fitting a second-order linear regression model, where diastolic blood pressure was a function of worker's age and cumulative work time. By fitting the model, one can predict that, from the beginning of working life at the tannery, on average each 1-year period is associated with an increase of about 1. 5 mmHg in diastolic blood pressure. The fit obtained highlights a component directly associated with work as part of the rate of pressure increase in the study group. This component is twice as high as that directly associated with age.

[Blood pressure among tannery workers]

INTRODUCTION

Cardiovascular diseases have been shown to be the leading cause of death in Brazil since the 1970s. High blood pressure has been the major risk factor among the above mentioned diseases. A negative correlation between occupational qualification and blood pressure has been observed among workers. The above mentioned facts bring out the importance of the knowledge of high blood pressure distribution among the different occupational groups. The aim of the present study was to describe the distribution of blood pressure in stable and homogeneous population of unskilled, low wage earning industrial workers. The Prevalence of high blood pressure was established for this specific group. This prevalence was also related to some biological and socio-economical covariates as compared with that among other occupational groups in Brazil.

METHOD

The subjects were 73 active employees at a tannery in Botucatu, state of S. Paulo, Brazil, in July 1993. These subjects underwent blood pressure measurements, anamnesis and clinical examination. The results were compared with those of similar studies carried out in elsewhere Brazil. Age confounding was controlled by different techniques.

RESULT

The crude prevalence of high blood pressure detected in this group of workers was of 56.1%, with 15.8% of isolated systolic hypertension. Alcohol abuse and smoking were associated with high blood pressure and isolated systolic hypertension in the population studied.

DISCUSSION

Prevalence of hypertension in the group studied is significantly higher than that observed in other groups of workers studied in Brazil. Such a finding points to the need for further investigation so as to isolate those factors involved in the increased blood pressure found in this group.

Inhibition by the anti-mitotic drug doxorubicin of platelet-activating-factor-induced late eosinophil accumulation in rats

Platelet-activating factor (PAF) has been shown, in the rat model of pleural inflammation, to induce the generation of an intermediate proteic factor able to cause eosinophil proliferation in vitro. This study was undertaken to investigate the effect of the anti-mitotic compound doxorubicin on PAF-induced eosinophilia in rats, in order to evaluate the contribution of local cell proliferation to this phenomenon. The late eosinophil infiltration caused by another chemoattractant leukotriene B4 was used for comparison. We observed that local treatment with doxorubicin (20 and 40 microg/cavity), given 6 h after PAF (1 microg/cavity), suppressed the eosinophil accumulation within 24 h, whilst only the higher dose was effective when the drug was given 12 h post-PAF. An effect on chemotaxis was ruled out, since local doxorubicin (40 microg/cavity) failed to modify the eosinophil migration noted 24 h after leukotriene B4 (0.5 microg/cavity) and the neutrophil/eosinophil infiltration noted at 6 h after PAF injection. Transfer of the pleural fluids collected 6 h after PAF from donors to recipient rats caused significant eosinophil accumulation in the recipient rats, an effect which was inhibited by the co-administration of doxorubicin (40 microg/cavity). No inhibitory effect was noted when the drug was given 6 h after the pleural fluids were transferred. We also found no change in the number of blood or bone marrow eosinophils after PAF stimulation. We conclude that doxorubicin selectively impaired the late eosinophil accumulation triggered by PAF in the pleural cavity of rats, clearly indicating that local cell proliferation seems to contribute to the development of this inflammatory response.

Desmin and actin filaments in membrane-cytoskeletal preparations of the electric tissue of Electrophorus electricus, L

The electrocyte of the electric organ of the electric eel, Electrophorus electricus, L was investigated by light and electron microscopy as well as immuno-electron microscopy, in order to clarify the fine structures and distribution of cytoskeleton filaments and their relations to proteins, especially desmin and actin. Cytoskeleton-enriched fractions of the electrocytes were analysed with SDS-PAGE. It was verified that a meshwork of filaments was distributed in the electrocytes, more abundantly in the anterior than in the posterior part of the cell, and that this could be associated with membrane invaginations. Desmin and actin were the components of this meshwork, suggesting that desmin intermediate filaments and actin filaments might play a role in the maintenance of the morphology of electrocytes and, as an intracellular filamentous meshwork, they may contribute to the organization of the components of membranes and papillae formation on the anterior face of the electrocytes.

[Neurological disorders in workers with low levels of lead in the blood. II--Neuropsychological disorders]

This is a cross-sectional study with a randomized choice of individuals aiming at studying the validity of the Brazilian biological exposure limits applied to lead level in the blood (PbB) and delta-aminolevulinic acid in the urine (ALAU), which are 60 mu/dl and 10 mg/g.creat., respectively. Thus, twenty workers, whose PbB and ALAU values have been below these limits over the past two years, were selected at random at a battery plant in the State of S. Paulo, Brazil. The workers were submitted to a variation of the WHO Neurobehavioral Core Test Battery. The results were compared with those obtained for workers of a control group also chosen at random. The lead workers showed memory, mood and motor coordination disorders. Comparing these results with those obtained from the control group, a significant difference was observed (p-value < 0.02). The results indicate that the Brazilian biological exposure limits above should be reconsidered.

Pharmacological evidence of a role for platelet activating factor as a modulator of vasomotor tone and blood pressure

The purpose of the present study was to investigate the role of platelet-activating factor (PAF, 1-O-hexadecyl-2-acetyl-sn-glyceryl-3-phosphorylcholine), a phospholipid mediator synthesized by endothelial and smooth muscle cells, in the modulation of vascular tone and blood pressure. In pentobarbitone-anaesthetised rabbits, unloading of the carotid sinus baroreceptors by a bilateral carotid artery occlusion elicited a reflex rise in arterial pressure which was markedly potentiated by pretreating the animals with the PAF receptor antagonists WEB 2086 [3-4-(2-chlorphenyl)-9-methyl-6H-thieno-3,2f-1,2,4-triazolo-4, 3 a-1,4-diazepin-2-yl-(4-morpholinyl)-I-propanone; 2, 5 or 10 mg kg-1, i.v.] or BN 52021 (ginkgolide B; 0.1, 0.3 or 1.0 mg kg-1, i.v.). The increases in systemic vascular resistance induced by noradrenaline (30 micrograms kg-1, i.v.) or by the central activation of the sympathetic nervous system with glutamate (1 mg kg-1, intracerebroventricular) were also significantly potentiated in animals pretreated with WEB 2086 (5 mg kg-1, i.v.). In contrast, pretreatment with the cyclooxygenase inhibitor indomethacin (3 mg kg-1, i.v.) did not affect the haemodynamic actions of noradrenaline, thus excluding the possibility that prostacyclin may modulate the potentiating effect. To further confirm that PAF is released during systemic vasoconstriction, the cardiovascular PAF receptors were desensitized by the daily administration of PAF (3 micrograms kg-1, i.v.) for seven days. This procedure significantly reduced the intensity and duration of the hypotensive response to a subsequent PAF injection (3 micrograms kg-1, i.v.). In desensitized animals, the hypertensive response to bilateral carotid artery occlusion was potentiated to the same extent as in the animals treated with PAF receptor antagonists. Inhibition of PAF biosynthesis by pretreatment of the animals with the phospholipase A2 inhibitor mepacrine (5 mg kg-1, i.v.) also enhanced the increase in blood pressure elicited by carotid artery occlusion. We conclude that PAF is involved in the acute but not basal modulation of vasomotor tone and, hence, arterial pressure, probably by a negative feedback mechanism triggered by important increases in the vascular tone.

[Neurological disorders in workers with low levels of lead in the blood. I: Peripheral neuropathy]

This is a cross-sectional study with a randomized choice of individuals aiming at studying the validity of the Brazilian biological exposure limits applied to lead level in the blood (PbB) and delta-aminolevulinic acid in the urine (ALAU), which are 60 micrograms/dl and 10 mg/g.creat., respectively. For this purpose, twenty workers, whose PbB and ALAU values have been below these limits over the past two years, were selected at random at a battery production plant in the State of S. Paulo, Brazil. The workers were submitted to a peripheral nerve conduction study. The results were compared with those obtained for workers of a control group also chosen at random. The lead workers showed a decrease in the velocity conduction of the radial nerves. Comparing this group with a randomized control group, a significant difference was observed (p-value = 0.0067). The results suggest that the Brazilian biological exposure limits above should be rearranged.

A inadequação dos valores dos limites de tolerância biológica para a prevenção da intoxicação profissional pelo chumbo no Brasil

São revisados os trabalhos que, a partir de 1975,estudaram a ocorrência de manifestações neurológicas centrais e periféricas em trabalhadores ocupacionalmente expostos ao chumbo, que apresentavam níveis de exposição supostamente insuficientes para causarem Saturnismo. A partir da revisão realizada é sugerido que os limites de tolerância biológica utilizados em nosso meio para firmar o diagnóstico de intoxicação profissional pelo chumbo devam ser revistos. Tal sugestão baseia-se na existência de evidências bem estabelecidas que apontam disfunções da condução nervosa periférica e central, além de alterações de várias funções nervosas superiores, em trabalhadores profissionalmente expostos ao chumbo que apresentam indicadores de efeito biológico e indicadores de exposição inferiores aos limites estabelecidos pela legislação brasileira.

Associação da perda auditiva induzida pelo ruído com o tempo acumulado de trabalho entre motoristas e cobradores

Através da técnica da regressão linear múltipla, estudou-se a relação existente entre a perda auditiva induzida pelo ruído e as variáveis "tempo total acumulado de trabalho como condutor de veículos coletivos urbanos", "pressão arterial diastólica" e "idade", em uma população de 278 motoristas e cobradores usuários de um serviço de saúde ocupacional da cidade de Campinas, estado de São Paulo (Brasil). Os principais resultados encontrados foram uma associação positiva entre a perda auditiva e o tempo acumulado de trabalho, bem como a existência de uma interação entre esta variável e a idade dos condutores.

[Diastolic blood pressure associated with accumulated work time among drivers and collectors]

The relationship between diastolic blood pressure and the variables "total cumulative working time" and "age" was examined by regression analysis. The study was carried out among 839 bus drivers and conductors, users of an occupational health center in Campinas, S. Paulo State, Brazil. The main results were a positive association between diastolic blood pressure and cumulative working time, as well as an interaction between this variable and the bus worker's age.