Prescription patterns for diabetes mellitus and therapeutic implications: a population-based analysis

Objective: To analyze drug prescriptions for insulin and oral antidiabetic drugs in type 1 and type 2 diabetes mellitus patients seen in the Brazilian Public Healthcare System (Unified Health System - SUS) in Ribeirao Preto, SP, Brazil. Subjects and methods: All the patients with diabetes seen in the SUS in the western district of Ribeirao Preto, SP, Brazil between March/2006 and February/2007 were included in the study. Results: A total of 3,982 patients were identified. Mean age of the patients was 60.6 years, and 61.0% were females. Sixty percent of the patients were treated with monotherapy. Doses of oral antidiabetic drugs were lower in monotherapy than in polytherapy. Ten patients received doses of glibenclamide or metformin above the recommended maximum doses, and in elderly patients there was no reduction in drug doses. Conclusion: Monotherapy with oral antidiabetic drugs was the predominant procedure, and the doses were not individualized according to age. Arq Bras Endocrinol Metab. 2012;56(2):120-7

Intervalo hídrico ótimo e grau de compactação de um latossolo vermelho após 30 anos sob plantio direto

A qualidade física do solo é um dos fatores determinantes da sustentabilidade agronômica, econômica e ambiental no sistema plantio direto (SPD). A compactação do solo tem sido apontada como um dos fatores de redução da qualidade física em solos sob SPD. Contudo, com a utilização do SPD, pode haver o incremento de matéria orgânica do solo e o desenvolvimento de um sistema poroso contínuo e estável, que atenuam os impactos negativos da compactação. O objetivo deste trabalho foi avaliar a qualidade física de um Latossolo Vermelho distroférrico sob SPD durante 30 anos, utilizando o intervalo hídrico ótimo (IHO) e o grau de compactação do solo (GC). Em uma área comercial com histórico de altas produtividades sob SPD, foram coletadas amostras de solo com estrutura preservada e deformada, para determinação da densidade do solo (Ds), do IHO e do GC. As amostras com estrutura preservada foram obtidas em três posições, relativas às linhas (L), entrelinhas (E) e posição intermediária entre as linhas e entrelinhas (PI) da cultura do milho. Foram determinadas as curvas de retenção de água e resistência do solo à penetração, bem como a Ds. A amostra de solo com estrutura deformada foi usada para obter a curva de compactação, utilizando o teste de Proctor. A Dmax foi obtida a partir da curva de compactação, e o GC foi determinado pela razão entre a Ds e a Dmax. Independentemente dos limites críticos de resistência à penetração (RP), verifica-se redução do IHO com o aumento da Ds. Os maiores valores do IHO foram verificados na posição de amostragem L, e a utilização de RP crítica maior que 2,0 MPa resultou em IHO condizente com a qualidade física desse solo sob SPD de longo tempo. A Dmax foi de 1,52 kg dm-3, e o GC variou de 64 a 87 %, sendo os maiores valores obtidos nas posições E e PI. Os valores de IHO e GC obtidos neste estudo indicam que a qualidade física desse solo não é limitante à produção das culturas após 30 anos de utilização do SPD.

Assessing Pathogenicity for Novel Mutation/Sequence Variants: The Value of Healthy Older Individuals

Improvement in DNA technology is increasingly revealing unexpected/unknown mutations in healthy persons and generating anxiety due to their still unknown health consequences. We report a 44-year-old healthy father of a 10-year-old daughter with bilateral coloboma and hearing loss, but without muscle weakness, in whom a whole-genome CGH revealed a deletion of exons 38-44 in the dystrophin gene. This mutation was inherited from her asymptomatic father, who was further clinically and molecularly evaluated for prognosis and genetic counseling (GC). This deletion was never identified by us in 982 Duchenne/Becker patients. To assess whether the present case represents a rare case of non-penetrance, and aiming to obtain more information for prognosis and GC, we suggested that healthy older relatives submit their DNA for analysis, to which several complied. Mutation analysis revealed that his mother, brother, and 56-year-old maternal uncle also carry the 38-44 deletion, suggesting it an unlikely cause of muscle weakness. Genome sequencing will disclose mutations and variants whose health impact are still unknown, raising important problems in interpreting results, defining prognosis, and discussing GC. We suggest that, in addition to family history, keeping the DNA of older relatives could be very informative, in particular for those interested in having their genome sequenced.

Top spoilage losses in maize silage sealed with plastic films with different permeabilities to oxygen

The quality of plastic films used for horizontal silos is important to limit losses in the upper silage layer. The aim of this work was to study the effectiveness of different plastic films in reducing the top losses in maize silage. The following treatments were evaluated: (i) coextruded polyethylene/polyamide oxygen barrier film (OB), (ii) polyethylene film (PE), (iii) polyvinyl chloride film (PVC), and (iv) coextruded PE/polyvinyl alcohol film (PVOH). These treatments differed according to oxygen permeability with values of 75, 722, 982 and 289 cm(3) m(-2) per 24 hour respectively. OB and PVOH films had better temperature and fermentation profiles than the more permeable films. The OB film was effective in reducing the dry-matter (DM) losses during storage (82 g kg(-1)), and the PVOH film had an intermediate value of DM loss (101 g kg(-1)). PE and PVC films had higher losses (138 and 145 g kg(-1) respectively). Oxygen permeability of the films promoted a positive correlation with DM losses (P < 0.05; r2 = 0.945). The results indicate that O2 permeability through the plastic film is a crucial factor for maintaining silage quality in the upper layer of the silo when it is perfectly sealed.

Consanguineous unions and the burden of disability: A population-based study in communities of Northeastern Brazil

Objectives: The aim of this study was to identify communities at high risk of transmitting recessive genetic disorders by measuring levels of endogamy and offspring's rate of disabilities. Methods: In a house-to-house population based-survey in the state of Paraiba, 20,462 couples were interviewed regarding kinship relation, number of siblings and offspring affected by mental or physical disabilities. Results: The rate of consanguineous unions in the communities ranged from 6.0% to 41.14%, showing an average value of 20.19% +/- 9.13%. The overall average inbreeding coefficient (F) was 0.00602 +/- 0.00253, ranging from 0.00134 to 0.01182. Communities situated on the backlands had an increased average value of F compared to those closer to the seashore (P = 0.024). The average rate of disabled offspring varied from 2.96% +/- 0.68% for unrelated unions to 10.44% +/- 16.86% for related couples at the level of double first cousins or uncleniece. The Spearman correlation coefficient between the overall rate of disabled offspring from all couples together and F was 0.510 (P < 0.01). Conclusion: Inbreeding increases the risk of disability which is unevenly distributed, varying considerably even in neighboring communities with similar Human Development Index and population density. Higher inbreeding communities are mostly located on the more economically underdeveloped backlands than on the coastal region. The identification of communities at high risk for genetic disorders could serve as basis for the establishment of Community Genetics programs. Am. J. Hum. Biol., 2012. (C) 2012 Wiley Periodicals, Inc.

On the stability of the Higher Manganese Silicides

We investigated in this work the stability of the Higher Manganese Silicides (HMS). Several alloys in the composition range 62-66 at.% Si were prepared from their constitutive elements by arc-melting. The prepared alloys were then analysed by in situ X-ray diffraction measurements and Electron Probe Micro-Analyser (EPMA). The whole results allow us to suggest that whatever the composition is, only Mn(27)Si(47) is stable for the temperatures 500 degrees C and 800 degrees C. At higher temperatures, the studied samples undergo two phase transformations which consecutively lead to the formation of Mn(15)Si(26) and Mn(11)Si(19). Mn(4)Si(7) was never evidenced in the present work. It is shown for the first time in this work that Mn(27)Si(47) is the only HMS stable phase at room temperature. (C) 2011 Elsevier B.V. All rights reserved.

Gene expression profile during coffee fruit development and identification of candidate markers for phenological stages

The objective of this work was to identify genes that could be used as suitable markers for molecular recognition of phenological stages during coffee (Coffea arabica) fruit development. Four cultivars were evaluated as to their differential expression of genes associated to fruit development and maturation processes. Gene expression was characterized by both semi-quantitative and quantitative RT-PCR, in fruit harvested at seven different developmental stages, during three different seasons. No size polymorphisms or differential expression were observed among the cultivars for the evaluated genes; however, distinct expression profiles along fruit development were determined for each gene. Four out of the 28 evaluated genes exhibited a regular expression profile in all cultivars and harvest seasons, and, therefore, they were validated as candidate phenological markers of coffee fruit. The gene a-galactosidase can be used as a marker of green stage, caffeine synthase as a marker of transition to green and yellowish-green stages, and isocitrate lyase and ethylene receptor 3 as markers of late maturation.

Li-Fraumeni-like syndrome associated with a large BRCA1 intragenic deletion

Background: Li-Fraumeni (LFS) and Li-Fraumeni-like (LFL) syndromes are associated to germline TP53 mutations, and are characterized by the development of central nervous system tumors, sarcomas, adrenocortical carcinomas, and other early-onset tumors. Due to the high frequency of breast cancer in LFS/LFL families, these syndromes clinically overlap with hereditary breast cancer (HBC). Germline point mutations in BRCA1, BRCA2, and TP53 genes are associated with high risk of breast cancer. Large rearrangements involving these genes are also implicated in the HBC phenotype. Methods: We have screened DNA copy number changes by MLPA on BRCA1, BRCA2, and TP53 genes in 23 breast cancer patients with a clinical diagnosis consistent with LFS/LFL; most of these families also met the clinical criteria for other HBC syndromes. Results: We found no DNA copy number alterations in the BRCA2 and TP53 genes, but we detected in one patient a 36.4 Kb BRCA1 microdeletion, confirmed and further mapped by array-CGH, encompassing exons 9-19. Breakpoints sequencing analysis suggests that this rearrangement was mediated by flanking Alu sequences. Conclusion: This is the first description of a germline intragenic BRCA1 deletion in a breast cancer patient with a family history consistent with both LFL and HBC syndromes. Our results show that large rearrangements in these known cancer predisposition genes occur, but are not a frequent cause of cancer susceptibility.

Influence of Helmet Use in Facial Trauma and Moderate Traumatic Brain Injury Victims of Motorcycle Accidents

Objective: The objective of this research was to study the influence of the use of helmet in facial trauma victims of motorcycle accidents with moderate traumatic brain injury. Methods: We retrospectively reviewed the incidence of facial injuries in helmeted and nonhelmeted victims with moderate traumatic brain injury at a referral trauma hospital. Results: The sample consisted of 272 patients predominantly men (94.5%) and between 21 and 40 years old (62.9%). The majority of patients were using helmet (80.1%). The occurrence of facial fractures was most frequent for zygomatic bone (51.8%), followed by mandible (18.8%) and nasal bones (9.2%). Conclusions: Individuals in the most productive age group are most affected, which causes a great loss to financial and labor systems. It is important to take measures to alert the public regarding the severity of injuries likely to occur in motorcycle-related accidents and ways to prevent them.

Exercise training in juvenile dermatomyositis

Objective. To investigate the effects of a supervised exercise training program on health parameters, physical capacity, and health-related quality of life in patients with mild and chronic juvenile dermatomyositis (DM). Methods. This was a prospective longitudinal study following 10 children with mild and chronic juvenile DM (disease duration >1 year). The exercise program consisted of twice-a-week aerobic and resistance training. At baseline and after the 12-week intervention, we assessed muscle strength and function, aerobic conditioning, body composition, juvenile DM scores, and health-related quality of life. Results. Child self-report and parent proxy-report Pediatric Quality of Life Inventory scores were improved after the intervention (-40.3%; P = 0.001 and -48.2%; P = 0.049, respectively). Importantly, after exercise, the Disease Activity Score was reduced (-26.9%; P = 0.026) and the Childhood Muscle Assessment Scale was improved (+2.5%; P = 0.009), whereas the Manual Muscle Test presented a trend toward statistical significance (+2.2%; P = 0.081). The peak oxygen consumption and time-to-exhaustion were increased by 13.3% (P = 0.001) and 18.2% (P = 0.003), respectively, whereas resting heart rate was decreased by 14.7% (P = 0.006), indicating important cardiovascular adaptations to the exercise program. Upper and lower extremity muscle strength and muscle function were also significantly improved after the exercise training (P < 0.05). Both the whole-body and the lumbar spine bone mineral apparent density were significantly increased after training (1.44%; P = 0.044 and 2.85%; P = 0.008, respectively). Conclusion. We showed for the first time that a 12-week supervised exercise program is safe and can improve muscle strength and function, aerobic conditioning, bone mass, disease activity, and health-related quality of life in patients with active and nonactive mild and chronic juvenile DM with near normal physical function and quality of life.

Nanosized precipitates in H13 tool steel low temperature plasma nitriding

A comprehensive study of pulsed nitriding in AISI H13 tool steel at low temperature (400 degrees C) is reported for several durations. X-ray diffraction results reveal that a nitrogen enriched compound (epsilon-Fe2-3N, iron nitride) builds up on the surface within the first process hour despite the low process temperature. Beneath the surface, X-ray Wavelength Dispersive Spectroscopy (WDS) in a Scanning Electron Microscope (SEM) indicates relatively higher nitrogen concentrations (up to 12 at.%) within the diffusion layer while microscopic nitrides are not formed and existing carbides are not dissolved. Moreover, in the diffusion layer, nitrogen is found to be dispersed in the matrix and forming nanosized precipitates. The small coherent precipitates are observed by High-Resolution Transmission Electron Microscopy (HR-TEM) while the presence of nitrogen is confirmed by electron energy loss spectroscopy (EELS). Hardness tests show that the material hardness increases linearly with the nitrogen concentration, reaching up to 14.5 GPa in the surface while the Young Modulus remains essentially unaffected. Indeed, the original steel microstructure is well preserved even in the nitrogen diffusion layer. Nitrogen profiles show a case depth of about similar to 43 mu m after nine hours of nitriding process. These results indicate that pulsed plasma nitriding is highly efficient even at such low temperatures and that at this process temperature it is possible to form thick and hard nitrided layers with satisfactory mechanical properties. This process can be particularly interesting to enhance the surface hardness of tool steels without exposing the workpiece to high temperatures and altering its bulk microstructure. (c) 2012 Elsevier B.V. All rights reserved.

Root and Root Canal Morphology of Four-rooted Maxillary Second Molars: A Micro-Computed Tomography Study

Introduction: This study examined the anatomy of 4-rooted maxillary second molars by using micro computed tomography. Methods: Twenty-five 4-rooted maxillary second molars were scanned to evaluate the size and curvature of the roots; the distance and spatial configuration between some anatomical landmarks; the number of root canals and the position of apical foramina; the occurrence of fusion of roots and enamel pearls; the configuration of the canal at the apical third; the cross-sectional appearance, the volume, and surface area of the root canals. Data were compared by using analysis of variance post hoc Tukey test (alpha = 0.05). Results: The specimens were classified as types I (n = 16), II (n = 7), and III (n = 2). The size of the roots was similar (P > .05), and most of them presented straight with 1 canal, except the mesiobuccal that showed 2 canals in 24% of the samples. The configuration of the pulp chamber was mostly irregular quadrilateral-shaped. The lowest mean distance of the orifices was observed between the buccal roots (P < .05). Accessory canals were present mostly in the apical third. Location of the apical foramina varied considerably. Fusion of roots and enamel pearls occurred in 44% and 8% of the samples, respectively. Mean distance from the pulp chamber floor to the furcation was 2.15 +/- 0.57 mm. No statistical differences were found in the bi-dimensional and 3-dimensional analyses (P > .05). Conclusions: All analyzed parameters showed differences between roots, except for the length of the roots, the configuration of the canals at the apical third, cross-sectional appearance, volume, and surface area of the canals. (J Endod 2012;38:977-982)

Comparison of microsatellites and isozymes in genetic diversity studies of Oryza glumaepatula (Poaceae) populations

The study of the genetic structure of wild plant populations is essential for their management and conservation. Several DNA markers have been used in such studies, as well as isozyme markers. In order to provide a better comprehension of the results obtained and a comparison between markers which will help choose tools for future studies in natural populations of Oryza glumaepatula, a predominantly autogamous species, this study used both isozymes and microsatellites to assess the genetic diversity and genetic structure of 13 populations, pointing to similarities and divergences of each marker, and evaluating the relative importance of the results for studies of population genetics and conservation. A bulk sample for each population was obtained, by sampling two to three seeds of each plant, up to a set of 50 seeds. Amplified products of eight SSR loci were electrophoresed on non-denaturing polyacrylamide gels, and the fragments were visualized using silver staining procedure. Isozyme analyses were conducted in polyacrylamide gels, under a discontinuous system, using six enzymatic loci. SSR loci showed higher mean levels of genetic diversity (A=2.83, p=0.71, A(P)=3.17, H-o=0.081, H-e=0.351) than isozyme loci (A=1.20, p=0.20, A(P)=1.38, H-o=0.006, H-e=0.056). Interpopulation genetic differentiation detected by SSR loci (R-ST=0.631, equivalent to F-ST=0.533) was lower than that obtained with isozymes (F-ST=0.772). However, both markers showed high deviation from Hardy-Weinberg expectations (F-IS=0.744 and 0.899, respectively for SSR and isozymes). The mean apparent outcrossing rate for SSR ((t) over bar (a)=0.14) was higher than that obtained using isozymes ((t) over bar (a)=0.043), although both markers detected lower levels of outcrossing in Amazonia compared to the Pantanal. The migrant number estimation was also higher for SSR (Nm=0.219) than isozymes (Nm=0.074), although a small number for both markers was expected due to the mode of reproduction of this species, defined as mixed with predominance of self fertilization. No correlation was obtained between genetic and geographic distances with SSR, but a positive correlation was found between genetic and geographic distances with isozymes. We conclude that these markers are divergent in detecting genetic diversity parameters in O. glumaepatula and that microsatellites are powerful for detecting information at the intra-population level, while isozymes are more powerful for inter-population diversity, since clustering of populations agreed with the expectations based on the geographic distribution of the populations using this marker. Rev. Biol. Trop. 60 (4): 1463-1478. Epub 2012 December 01.

Carlosbarbosaite, ideally (UO2)(2)Nb2O6(OH)(2)center dot 2H(2)O, a new hydrated uranyl niobate mineral with tunnels from Jaguaracu, Minas Gerais, Brazil: description and crystal structure

Carlosbarbosaite, ideally (UO2)(2)Nb2O6(OH)(2)center dot 2H(2)O, is a new mineral which occurs as a late cavity filling in albite in the Jaguaracu pegmatite, Jaguaracu municipality, Minas Gerais, Brazil. The name honours Carlos do Prado Barbosa (1917-2003). Carlosbarbosaite forms long flattened lath-like crystals with a very simple orthorhombic morphology. The crystals are elongated along [001] and flattened on (100); they are up to 120 mu m long and 2-5 mu m thick. The colour is cream to pale yellow, the streak yellowish white and the lustre vitreous. The mineral is transparent (as individual crystals) to translucent (massive). It is not fluorescent under either long-wave or short-wave ultraviolet radiation. Carlosbarbosaite is biaxial(+) with alpha = 1.760(5), beta = 1.775(5), gamma = 1.795(5), 2V(meas) = 70(1)degrees, 2V(calc) = 83 degrees. The orientation is X parallel to a, Y parallel to b, Z parallel to c. Pleochroism is weak, in yellowish green shades, which are most intense in the Z direction. Two samples were analysed. For sample I, the composition is: UO3 54.52, CaO 2.07, Ce2O3 0.33, Nd2O3 0.49, Nb2O5 14.11, Ta2O5 15.25, TiO2 2.20, SiO2 2.14, Fe2O3 1.08, Al2O3 0.73, H2O (calc.) 11.49, total 104.41 wt.%; the empirical formula is (square 0.68Ca0.28Nd0.02Ce0.02)(Sigma=1.00)[U-1.44 square O-0.56(2.88)(H2O)(1.12)](Nb0.80Ta0.52Si0.27Ti0.21Al0.11Fe0.10)(Sigma=2.01) O-4.72(OH)(3.20)(H2O)(2.08). For sample 2, the composition is: UO3 41.83, CaO 2.10, Ce2O3 0.31, Nd2O3 1.12, Nb2O5 14.64, Ta2O5 16.34, TiO2 0.95, SiO2 3.55, Fe2O3 0.89, Al2O3 0.71, H2O (calc.) 14.99, total 97.43 wt.%; the empirical formula is (square 0.67Ca0.27Nd0.05Ce0.01)(Sigma=1.00)[U-1.04 square O-0.96(2.08)(H2O)(1.92)] (Nb0.79Ta0.53Si0.42Ti0.08Al0.10Fe0.08)(Sigma=2.00)O-4.00(OH)(3.96)(H2O)(2.04). The ideal endmember formula is (UO2)(2)Nb2O6(OH)(2)center dot 2H(2)O. Calculated densities are 4.713 g cm(-3) (sample 1) and 4.172 g cm(-3) (sample 2). Infrared spectra show that both (OH) and H2O are present. The strongest eight X-ray powder-diffraction lines [listed as d in angstrom(I)(hkl)] are: 8.405(8)(110), 7.081(10)(200), 4.201(9)(220), 3.333(6)(202), 3.053(8)(022), 2.931(7)(420), 2.803(6)(222) and 2.589(5)(040,402). The crystal structure was solved using single-crystal X-ray diffraction (R = 0.037) which gave the following data: orthorhombic, Cmem, a = 14.150(6), b = 10.395(4), c = 7.529(3) angstrom, V = 1107(1) angstrom(3), Z = 4. The crystal structure contains a single U site with an appreciable deficiency in electron scattering, which is populated by U atoms and vacancies. The U site is surrounded by seven 0 atoms in a pentagonal bipyramidal arrangemet. The Nb site is coordinated by four 0 atoms and two OH groups in an octahedral arrangement. The half-occupied tunnel Ca site is coordinated by four 0 atoms and four H2O groups. Octahedrally coordinated Nb polyhedra share edges and comers to form Nb2O6(OH)(2) double chains, and edge-sharing pentagonal bipyramidal U polyhedra form UO5 chains. The Nb2O6(OH)(2) and UO5 chains share edges to form an open U-Nb-phi framework with tunnels along [001] that contain Ca(H2O)(4) clusters. Carlosbarbosaite is closely related to a family of synthetic U-Nb-O framework tunnel structures, it differs in that is has an (OH)-bearing framework and Ca(H2O)(4) tunnel occupant. The structure of carlosbarbosaite resembles that of holfertite.

Formation of thin luminescent Eu3+-LB films by in situ coordination with 2,3,5,6-tetra(2 '-pyridyl)pyrazine and 1-octadecanol in pure and mixed Langmuir monolayers

The in situ complexation between 2,3,5,6-tetra(2-pyridyl)pyrazine (tppz) molecules and europium ions at the air-liquid interface by means of mixed 1-octadecanol Langmuir films is reported. These films were transferred to solid supports by means of the Langmuir-Blodgett (LB) technique. The EDS maps attested the homogeneity of the LB films as well as the presence of the europium ions. The mixed alcohol/tppz LB film contained a larger amount of europium ions as compared to the pure octadecanol LB film. This work reports the production of a thin luminescent Eu3+ film containing europium ions using only alcohol molecules as ligands an unexpected result, since it is well known that there is an occurrence of non-radiative deactivation of excited europium by hydroxyl groups. Europium ion multiple binding sites were detected from lifetime decay measurements of these films in the presence of tppz molecules. (C) 2012 Elsevier B.V. All rights reserved.