Acetylcysteine for Prevention of Renal Outcomes in Patients Undergoing Coronary and Peripheral Vascular Angiography Main Results From the Randomized Acetylcysteine for Contrast-Induced Nephropathy Trial (ACT)

Background-It remains uncertain whether acetylcysteine prevents contrast-induced acute kidney injury. Methods and Results-We randomly assigned 2308 patients undergoing an intravascular angiographic procedure with at least 1 risk factor for contrast-induced acute kidney injury (age >70 years, renal failure, diabetes mellitus, heart failure, or hypotension) to acetylcysteine 1200 mg or placebo. The study drugs were administered orally twice daily for 2 doses before and 2 doses after the procedure. The allocation was concealed (central Web-based randomization). All analysis followed the intention-to-treat principle. The incidence of contrast-induced acute kidney injury (primary end point) was 12.7% in the acetylcysteine group and 12.7% in the control group (relative risk, 1.00; 95% confidence interval, 0.81 to 1.25; P = 0.97). A combined end point of mortality or need for dialysis at 30 days was also similar in both groups (2.2% and 2.3%, respectively; hazard ratio, 0.97; 95% confidence interval, 0.56 to 1.69; P = 0.92). Consistent effects were observed in all subgroups analyzed, including those with renal impairment. Conclusions-In this large randomized trial, we found that acetylcysteine does not reduce the risk of contrast-induced acute kidney injury or other clinically relevant outcomes in at-risk patients undergoing coronary and peripheral vascular angiography.

Coastal and shelf circulation in the vicinity of Camamu Bay (14 degrees S), Eastern Brazilian Shelf

The Camamu Bay (CMB) is located on the narrowest shelf along the South American coastline and close to the formation of two major Western Boundary Currents (WBC), the Brazil/North Brazil Current (BC/NBC). These WBC flow close to the shelf break/slope region and are expected to interact with the shelf currents due to the narrowness of the shelf. The shelf circulation is investigated in terms of current variability based on an original data set covering the 2002-2003 austral summer and the 2003 austral autumn. The Results show that the currents at the shelf are mainly wind driven, experiencing a complete reversal between seasons due to a similar change in the wind field. Currents at the inner-shelf have a polarized nature, with the alongshore velocity mostly driven by forcings at the sub-inertial frequency band and the cross-shore velocity mainly supra-inertially forced, with the tidal currents playing an important role at this direction. The contribution of the forcing mechanisms at the mid-shelf changes between seasons. During the summer, forcings in the two frequency bands are important to drive the currents with a similar contribution of the tidal currents. On the other hand, during the autumn season, the alongshore velocity is mostly driven by sub-inertial forcings and tidally driven currents still remain important in both directions. Moreover, during the autumn when the stratification is weaker, the response of the shelf currents to the wind forcing presents a barotropic signature. The meso-scale processes related to the WBC flowing at the shelf/slope region also affect the circulation within the shelf, which contribute to cause significant current reversals during the autumn season. Currents at the shelf-estuary connection are clearly supra-inertially forced with the tidal currents playing a key role in the generation of the along-channel velocities. The sub-inertial forcings at this location act mainly to drive the weak ebb currents which were highly correlated with both local and remote wind forcing during the summer season. (C) 2010 Elsevier Ltd. All rights reserved.

The revision of the Brazilian Forest Act: increased deforestation or a historic step towards balancing agricultural development and nature conservation?

Almost two-thirds of the Brazilian territory still has prevalence of natural vegetation. Although not all pristine, much of these areas have high conservation value. 170 million hectare (Mha) of the natural vegetation is located within Federal and State protected areas. Most of the remaining 367 Mha is on private agriculture lands, where the Forest Act is the most important legal framework for conservation. In July 2010, the Brazilian parliament began the analysis of a substitutive legislation for the Forest Act. The main motivations for the revision is that, on the one hand, it has been found ineffective in protecting natural vegetation, and on the other hand, it is perceived as a barrier against development in the agriculture sector. The substitutive Forest Act, as it presently stands, does not represent a balance between existing standpoints and objectives; it may drive development towards either more private protection through market-driven compensation actions, or increased deforestation and less nature protection/restoration. This article uses outcomes from modeling analyses to discuss weaknesses of the substitutive Forest Act and to suggest possible improvements. (C) 2011 Elsevier Ltd. All rights reserved.

Mast cells act as phagocytes against the periodontopathogen Aggregatibacter Actinomycetemcomitans

Background: Evidence to date shows that mast cells play a critical role in immune defenses against infectious agents, but there have been no reports about involvement of these cells in eliminating periodontopathogens. In this study, the phagocytic ability of mast cells against Aggregatibacter actinomycetemcomitans compared with macrophages is evaluated. Methods: In vitro phagocytic assays were conducted using murine mast cells and macrophages, incubated with A. actinomycetemcomitans, either opsonized or not, with different bacterial load ratios. After 1 hour, cells were stained with acridine orange and assessed by confocal laser-scanning electronmicroscopy. Results: Phagocytic ability of murine mast cells against A. actinomycetemcomitans was confirmed. In addition, the percentage of mast cells with internalized bacteria was higher in the absence of opsonization than in the presence of opsonization. Both cell types showed significant phagocytic activity against A. actinomycetemcomitans. However, the percentage of mast cells with non-opsonized bacteria was higher than that of macrophages with opsonized bacteria in one of the ratios (1:10). Conclusions: This is the first report about the participation of murine mast cells as phagocytes against A. actinomycetemcomitans, mainly in the absence of opsonization with human serum. Our results may indicate that mast cells act as professional phagocytes in the pathogenesis of biofilmassociated periodontal disease

Cellular and humoral immune responses against the Plasmodium vivax MSP-119 malaria vaccine candidate in individuals living in an endemic area in north-eastern Amazon region of Brazil

Abstract Background Plasmodium vivax merozoite surface protein-1 (MSP-1) is an antigen considered to be one of the leading malaria vaccine candidates. PvMSP-1 is highly immunogenic and evidences suggest that it is target for protective immunity against asexual blood stages of malaria parasites. Thus, this study aims to evaluate the acquired cellular and antibody immune responses against PvMSP-1 in individuals naturally exposed to malaria infections in a malaria-endemic area in the north-eastern Amazon region of Brazil. Methods The study was carried out in Paragominas, Pará State, in the Brazilian Amazon. Blood samples were collected from 35 individuals with uncomplicated malaria. Peripheral blood mononuclear cells were isolated and the cellular proliferation and activation was analysed in presence of 19 kDa fragment of MSP-1 (PvMSP-119) and Plasmodium falciparum PSS1 crude antigen. Antibodies IgE, IgM, IgG and IgG subclass and the levels of TNF, IFN-γ and IL-10 were measured by enzyme-linked immunosorbent assay. Results The prevalence of activated CD4+ was greater than CD8+ T cells, in both ex-vivo and in 96 h culture in presence of PvMSP-119 and PSS1 antigen. A low proliferative response against PvMSP-119 and PSS1 crude antigen after 96 h culture was observed. High plasmatic levels of IFN-γ and IL-10 as well as lower TNF levels were also detected in malaria patients. However, in the 96 h supernatant culture, the dynamics of cytokine responses differed from those depicted on plasma assays; in presence of PvMSP-119 stimulus, higher levels of TNF were noted in supernatant 96 h culture of malaria patient’s cells while low levels of IFN-γ and IL-10 were verified. High frequency of malaria patients presenting antibodies against PvMSP-119 was evidenced, regardless class or IgG subclass.PvMSP-119-induced antibodies were predominantly on non-cytophilic subclasses. Conclusions The results presented here shows that PvMSP-119 was able to induce a high cellular activation, leading to production of TNF and emphasizes the high immunogenicity of PvMSP-119 in naturally exposed individuals and, therefore, its potential as a malaria vaccine candidate.

Precarização do trabalho e risco de acidentes na construção civil: um estudo com base na Análise Coletiva do Trabalho (ACT)

Este artigo descreve a atividade e a percepção dos trabalhadores da construção civil sobre os riscos e a carga de trabalho. O estudo, com base na Análise Coletiva de Trabalho (ACT), é parte de pesquisa em políticas públicas para aprimoramento do Sistema de Vigilância em Acidentes de Trabalho (SIVAT) de Piracicaba-SP. Priorizou-se a construção civil pela magnitude epidemiológica de ocorrência de acidentes de trabalho e a baixa eficácia das ações tradicionais de vigilância pelas características de informalidade, terceirização e rotatividade do setor. Os trabalhadores revelaram elevada percepção dos riscos de acidentes e que as medidas de segurança dificultam ou impedem a realização do trabalho. Os achados questionam a eficácia dos treinamentos para adesão às medidas de segurança e evidenciam a necessidade de uma pedagogia transformadora nas ações de promoção da saúde e prevenção dos acidentes de trabalho.