Transport-Regional Equity Issue Revisited

Almeida E. S. de, Haddad E. A. and Hewings G. J. D. Transport-regional equity issue revisited, Regional Studies. The objective of this paper is to analyse the relationship between transport and regional equity in Minas Gerais, Brazil. Furthermore, the existence of a trade-off between economic performance and regional equity is investigated as well. To do so, the paper develops a spatial computable general equilibrium model based on Brocker and Schneider`s approach of 2002 to implement comparative static analysis, explicitly incorporating iceberg transportation costs. Four activities are modelled, namely production, final demand, transportation and exports. Two production factors are assumed: labour and other factors. The model has 12 domestic regions and three external regions. Four counterfactual experiments are developed based on decreases in transportation costs due to a `distance shortening`. The main findings indicate that if the transport infrastructure improvement is focused only among poor regions, the promotion of regional equity is insignificant. If the transport infrastructure improvement links are concentrated among rich regions, there is an increase in regional income inequalities. However, if the improvements are targeted to the roads linking poor regions and rich ones, there is greater promotion of regional equity. The same result will occur when improvements are made to all road links of the state. [image omitted] Almeida E. S. de, Haddad E. A. et Hewings G. J. D. La question du rapport entre le transport et l`equilibre regional vue sous un jour nouveau, Regional Studies. Cet article cherche a analyser le rapport entre le transport et l`equilibre regional en Minas Gerais au Bresil. En outre, on examine la presence d`un echange entre la performance economoique et l`equilibre regional. Pour le faire, on construit un modele geographique de l`equilibre general a utiliser sur ordinateur fonde sur l`approche de Brockner et Schneider en 2002 afin de mettre en oeuvre une analyse statique comparative qui comprend explicitement les frais de transport iceberg. On modelise quatre activites, a savoir, la production, la demande finale, le transport et l`exportation. On fait deux suppositions quant aux facteurs de production: la main-d`oevre et d`autres facteurs. Le modele embrasse douze regions internes et trois regions externes. On fait quatre experiences paradoxales fondees sur la baisse des frais de transport due a une `reduction des distances`. Les principaux resultats indiquent que si l`amelioration de l`equipement de transport ne porte que sur les regions defavorisees, la promotion de l`equilibre regional s`avere negligeable. Si l`amelioration de l`equipement de transport focalise les regions riches, il s`avere un creusement des ecarts des revenus regionaux. Cependant, si les ameliorations ciblent les routes qui relient les regions defavorisees aux regions riches, il s`avere une plus grande promotion de l`equilibre regional. Il en va de meme pour la situation ou on a apporte des amenagements a toutes les liaisons routieres de l`etat. Modele geographique de l`equilibre general a utiliser sur ordinateur Equilibre regional Peformance economique Frais de transport Almeida E. S. de, Haddad E. A. und Hewings G. J. D. Die Wiederaufnahme der Frage von Verkehrswesen im Verhaltnis zu regionaler Fairness, Regional Studies. Dieser Aufsatz beabsichtigt, die Beziehung zwischen Verkehrswesen und regionaler Fairness in Minas Gerais (Brasilien) zu analysieren und zugleich auch das Vorkommen von Einbussen entweder bei wirtschaftlicher Leistung der regionaler Fairness zu untersuchen. Zu diesem Zwecke wird ein auf dem Ansatz von Brocker und Schneider (2002) aufbauendes raumliches komputables allgemeines Gleichgewichtsmodell entwickelt, um vergleichende statistische Analysen durchzufuhren, wobei verborgene `Eisberg`-Transportkosten ausdrucklich berucksichtigt werden. Es werden vier Unternehmenstatigk eiten aufgefuhrt: Herstellung, Nachfrage, Transportwesen und Exporte, und zwei Produktionsfaktoren vorausgesetzt: Arbeitskrafte und andere Faktoren. Das Modell umfasst zwolf Inlandsregionen und drei externe Regionen. Es werden vier gegensatzliche Experimente entwickelt, die auf einer Abnahme der Transportkosten infolge einer `Verkurzung der Entfernungen` beruhen. Die Hauptbefunde weisen darauf hin, dass die Forderung regionaler Fairness unbedeutend bleibt, wenn die Verbesserungen der Transportinfrastruktur sich nur auf minderbemittelte Regionen konzentrieren; werden die Verbesserungen der Verbindungen der Transportinfrastruktur in wohlhabenden Regionen durchgefuhrt, so nehmen regionale Einkommensunterschiede zu. Wenn die Verbesserungen jedoch auf Strassen abzielen, die wohlhabende Regionen mit weniger bemittelten verbinden, wird regionale Fairness starker gefordert. Das gleiche Ergebnis wird sich einstellen, wenn Verbesserungen an allen Strassenverbindungen des Staates vorgenommen werden. Raumliches, komputables, allgemeines Gleichgewichtsmodell Regionale Fairness Wirtschaftsleistung Transportkosten Almeida E. S. de, Haddad E. A. y Hewings G. J. D. Revisando el tema de la igualdad del transporte en las regiones, Regional Studies. El objetivo de este documento es analizar la relacion entre el transporte y la igualdad regional en Minas Gerais, Brasil. Asimismo investigamos la existencia de una compensacion entre el rendimiento economico y la igualdad regional. Para ello desarrollamos un modelo de equilibrio general computable y espacial basado en el enfoque de Brocker y Schneider en 2002 para hacer un analisis estatico y comparativo, explicitamente incorporando los costes ocultos de transporte. Se modelan cuatro actividades: la produccion, la demanda final, el transporte y las exportaciones. Suponemos que existen dos factores de produccion: mano de obra y otros factores. En este modelo, existen doce regiones internas y tres regiones externas. Desarrollamos cuatro experimentos contrafactuales basados en la disminucion de los costes de transporte debido a una `acortamiento de las distancias`. Los principales resultados indican que si la mejora de la infraestructura del transporte se centra solo entre las regiones mas pobres, el fomento de la igualdad regional es insignificante. Si los enlaces de la mejora de la infraestructura del transporte se concentran en las regiones ricas, aumentan las desigualdades de ingresos regionales. Sin embargo, si se mejoran los enlaces de carreteras entre las regiones pobres y ricas, se fomenta mejor la igualdad regional. El mismo resultado ocurre cuando se mejoran los enlaces de todas las carreteras del estado. Modelo de equilibrio general computable y espacial Igualdad regional Rendimiento economico Costes de transporte.

The juvenile hormone (JH) epoxide hydrolase gene in the honey bee (Apis mellifera) genome encodes a protein which has negligible participation in JH degradation

Epoxide hydrolases are multifunctional enzymes that are best known in insects for their role in juvenile hormone (JH) degradation. Enzymes involved in JH catabolism can play major roles during metamorphosis and reproduction, such as the JH epoxide hydrolase (JHEH), which degrades JH through hydration of the epoxide moiety to form JH diol, and JH esterase (JHE), which hydrolyzes the methyl ester to produce JH acid. In the honey bee, JH has been co-opted for additional functions, mainly in caste differentiation and in age-related behavioral development of workers, where the activity of both enzymes could be important for JH titer regulation. Similarity searches for jheh candidate genes in the honey bee genome revealed a single Amjheh gene. Sequence analysis, quantification of Amjheh transcript levels and Western blot assays using an AmJHEH-specific antibody generated during this study revealed that the AmJHEH found in the fat body shares features with the microsomal JHEHs from several insect species. Using a partition assay we demonstrated that AmJHEH has a negligible role in JH degradation, which, in the honey bee, is thus performed primarily by JHE. High AmJHEH levels in larvae and adults were related to the ingestion of high loads of lipids, suggesting that AmJHEH has a role in dietary lipid catabolism. (C) 2010 Elsevier Ltd. All rights reserved.

The association of Na,K-ATPase subunits studied by circular dichroism, surface tension and dilatational elasticity

Different stoichiometries are observed between alpha and beta subunits of Na,K-ATPase that depend on the method employed to solubilize and purify the enzyme. It is not known whether this variability is due to loss of protein-protein association, or is a result of the replacement of essential phospholipids by detergent molecules. With the aim of understanding the effect of enzyme/surfactant ratio on both the catalytic activity and the enzyme structure, we have investigated the bulk and surface properties of the enzyme. The circular dichroism (CD) spectra, surface tension and dilatational surface elasticity results were compared with the residual ATPase activity of the Na,K-ATPase in different surfactant and protein concentrations. Na,K-ATPase in the (alpha beta)(2) form dissociated to the alpha beta form on dilution, and associated to the (alpha beta)(4) form when concentrated. These different stoichiometries have similar ATPase activities and are in equilibrium at C(12)E(8) concentrations below the CIVIC (0.053 mg mL(-1)). At detergent concentrations above the CIVIC the ATPase activity of all forms was abolished, which is concomitant with the dissociation of the a and subunits. (C) 2008 Elsevier Inc. All rights reserved.

Automated determination of rifampicin in plasma samples by in-tube solid-phase microextraction coupled with liquid chromatography

A sensitive and automated method is described for determination of rifampicin in plasma samples for therapeutic drug monitoring by in-tube solid-phase microextraction coupled with liquid chromatography (in-tube SPME/LC). Important factors in the optimization of in-tube SPME are discussed, such as coating type, sample pH, sample draw/eject volume, number of draw/eject cycles, and draw/eject flow rate. Analyte pre-concentrated in the polyethylene glycol phase was directly transferred to the liquid chromatographic column by percolation of the mobile phase, without carryover. The method was linear over the 0.1-100 mu g/mL range, with a linear coefficient value (r(2)) of 0.998. The inter-assay precision presented coefficient of variation <= 1.7%. The effectiveness and practicability of the proposed method are proven by analysis of plasma samples from ageing patients undergoing therapy with rifampicin. (C) 2011 Elsevier B.V. All rights reserved.

Structural and Biochemical Correlates of Na(+), K(+)-ATPase Driven Ion Uptake Across the Posterior Gill Epithelium of the True Freshwater Crab, Dilocarcinus pagei (Brachyura, Trichodactylidae)

To better comprehend the structural and biochemical underpinnings of ion uptake across the gills of true freshwater crabs, we performed an ultrastructural, ultracytochemical and morphometric investigation, and kinetically characterized the Na(+), K(+)-ATPase, in posterior gill lamellae of Dilocarcinus pagei. Ultrastructurally, the lamellar epithelia are markedly asymmetrical: the thick, mushroom-shaped, proximal ionocytes contain elongate mitochondria (41% cell volume) associated with numerous (approximate to 14 mu m(2) membrane per mu m(3) cytoplasm), deep invaginations that house the Na(+), K(+)-ATPase, revealed ultracytochemically. Their apical surface is amplified (7.5 mu m(2) mu m(-2)) by stubby evaginations whose bases adjoin mitochondria below the subcuticular space. The apical membrane of the thin, distal ionocytes shows few evaginations (1.6 mu m(2) mu m(-2)), each surrounding a mitochondrion, abundant in the cytoplasm below the subcuticular space; basolateral invaginations and mitochondria are few. Fine basal cytoplasmic bridges project across the hemolymph space, penetrating into the thick ionocytes, suggesting ion movement between the epithelia. Microsomal Na(+), K(+)-ATPase specific activity resembles marine crabs but is approximate to 5-fold less than in species from fluctuating salinities, and freshwater shrimps, suggesting ion loss compensation by strategies other than Na(+) uptake. Enzyme apparent K(+) affinity attains 14-fold that of marine crabs, emphasizing the relevance of elevated K(+) affinity to the conquest of fresh water. Western blotting and biphasic ouabain inhibition disclose two alpha-subunit isoforms comprising distinct functional isoenzymes. While enzyme activity is not synergistically stimulated by NH(4)(+) and K(+), each increases affinity for the other, possibly assuring appropriate intracellular K(+) concentrations. These findings reveal specific structural and biochemical adaptations that may have allowed the establishment of the Brachyura in fresh water. J. Exp. Zool. 313A:508-523, 2010. (C) 2010 Wiley-Liss, Inc.

Neoformation of micas in soils surrounding an alkaline-saline lake of Pantanal wetland, Brazil

The mineralogy and origin of micas were investigated in incipient soils surrounding a modem alkaline-saline lake of Nhecolandia, a sub-region of Pantanal wetland. Soils were sampled along a toposequence and analyzed by XRD, TEM-EDS, and ICP-MS. The studied micas, mainly concentrated in a green horizon, are dioctahedral, strongly associated with Fe(3+) and Al, and interstratified with smectite layers. Classification of individual crystals shows that glauconite and Fe-illite are the dominant micas, but one crystal of illite was recognized. Si-rich amorphous materials are associated with small crystallites in the mica-enriched horizon. A recent study shows that water samples from the studied lake and the surrounding water table have high pH, negative Eh, temperatures up to 40 C. high concentration of K. and low concentration of Si(OH)(4). Experimental studies of micas synthesis reported in the literature show that similar water conditions allow for dioctahedral mica crystallization from initial precipitation of amorphous hydroxides. Therefore, water characteristics combined with presence of Si-rich amorphous materials in the mica-enriched horizon suggest that the micas of the study area are neoformed. The alternated origin of illite, glauconite, and Fe-illite mixed-layer minerals probably occurs due to seasonal variations of pH. temperature, and chemical composition of waters in microenvironments, since the changes at this scale are possibly faster and more extreme. (C) 2010 Elsevier B.V. All rights reserved.

Soil morphological control on saline and freshwater lake hydrogeochemistry in the Pantanal of Nhecolandia, Brazil

Joint pedological, geochemical, hydrological and geophysical investigations were performed to study the coexistence or saline and freshwater lakes in close proximity and similar climatic conditions in the Nhecolandia region, Pantanal wetlands in Brazil. The saline lakes are concentrically surrounded by green sandy loam horizons, which cause differential hydrological regimes. Mg-calcite, K-silicates, and amorphous silica precipitate in the soil cover, whereas Mg-silicates and more soluble Na-carbonates are concentrated in the topsoil along the shore of the saline lake. In saline solutions, some minor elements (As, Se) reach values above the water quality recommendations, whereas others are controlled and incorporated in solid phases (Ba, Sr). Locally, the destruction of the sandy loam horizons generates very acidic soil solution (pH similar to 3.5) through a process not yet understood. The soil distributions indicate that some freshwater lakes are former saline lakes. They are invaded by freshwater after destruction of the sandy loam green horizons, then the freshwater becomes enriched in K(+), SO(4)(2-), Fe, Al, and a stream of minor and trace elements. The formation of these green sandy loam horizons in the saline environment and their destruction in the non-saline one emphasizes the dynamic nature of this environment (C) 2008 Elsevier B.V. All rights reserved.

MINERALOGY AND GENESIS OF SMECTITES IN AN ALKALINE-SALINE ENVIRONMENT OF PANTANAL WETLAND, BRAZIL

Smectite formation in alkaline-saline environments has been attributed to direct precipitation from solution and/or transformation from precursor minerals, but these mechanisms are not universally agreed upon in the literature. The objective of this work was to investigate the mineralogy of smectites in the soils surrounding a representative alkaline-saline lake of Nhecolandia, a sub-region of the Pantanal wetland, Brazil, and then to identify the mechanisms of their formation. Soils were sampled along a toposequence and analyzed by X-ray diffraction, transmission electron microscopy-energy dispersive X-ray analysis, and inductively coupled plasma-mass spectrometry. Water was collected along a transect involving the studied toposequence and equilibrium diagrams were calculated using the databases PHREEQC and AQUA. The fine-clay fraction is dominated by smectite, mica, and kaolinite. Smectites are concentrated at two places in the toposequence: an upper zone, which includes the soil horizons rarely reached by the lake-level variation; and a lower zone, which includes the surface horizon within the area of seasonal lake-level variation. Within the upper zone, the smectite is dioctahedral, rich in Al and Fe, and is classified as ferribeidellite. This phase is interstratified with mica and vermiculite and has an Fe content similar to that of the mica identified. These characteristics suggest that the ferribeidellite originates from transformation of micas and that vermiculite is an intermediate phase in this transformation. Within the lower zone, smectites are dominantly trioctahedral, Mg-rich, and are saponitic and stevensitic minerals. In addition, samples enriched in these minerals have much smaller rare-earth element (REE) contents than other soil samples. The water chemistry shows a geochemical control of Mg and saturation with respect to Mg-smectites in the more saline waters. The REE contents, water chemistry, and the presence of Mg-smectite where maximum evaporation is expected, suggest that saponitic and stevensitic minerals originate by chemical precipitation from the water column of the alkaline-saline lake.

Depression in women living with HIV: clinical and psychosocial correlates

The number of Brazilian women living with HIV has increased significantly in past years, rendering studies of their particular care demands including psychiatric issues. This study measures the prevalence of major depression, using the Structured Clinical Interview for DSM-IV Axis I Disorders, in a sample of 120 women living with HIV in treatment at a reference centre in So Paulo. Socio-demographic variables, HIV-related clinical and laboratory data, including CD4+ cell counts and HIV plasma viral loads, as well as psychosocial features (intimate relationships, disclosure of HIV serostatus, partner`s serostatus and patient`s emotional and financial support) were investigated as factors potentially associated with depression. The prevalence of major depression at the time of evaluation was 25.8% (95% CI 18.2-33.4%). Clinical status (p = 0.002), lack of emotional support (p = 0.02), use of antidepressants (p = 0.028) and length of time since HIV diagnosis (p = 0.05) were associated with major depression in univariate analysis. In multivariate multiple-regression model, HIV clinical status, lack of emotional support and higher plasma viral loads were associated with depression. Sixty per cent of the women have a major depression diagnosis during lifetime. We conclude that major depression is highly prevalent among women living with HIV, but it is still underdiagnosed and undertreated.

The effects of plantar fasciitis and pain on plantar pressure distribution of recreational runners

Background: Plantar fasciitis is the third most frequent injury in runners. Despite its high prevalence, its pathogenesis remains inconclusive. The literature reports overload as the basic mechanism for its development. However, the way that these plantar loads are distributed on the foot surface of runners with plantar fasciitis and the effects of pain on this mechanical factor has not yet been investigated. Therefore, the aim of this study was to evaluate and compare the plantar pressure distributions during running in runners with symptom or history of plantar fasciitis and runners without the disease. Methods: Forty-five recreational runners with plantar fasciitis (30 symptomatic and 15 with previous history of the disease) and 60 runners without plantar fasciitis (control group) were evaluated. Pain was assessed by a visual analogue scale. All runners were evaluated by means of the Pedar system insoles during running forty meters at a speed of 12(5%) km/h, using standard sport footwear. Two-way ANOVAS were employed to investigate the main and interaction effects between groups and plantar areas. Findings: No interaction effects were found for any of the investigated variables: peak pressure (P=0.61), contact area (P=0.38), contact time (P=0.91), and the pressure-time integral (P=0.50). Interpretation: These findings indicated that the patterns of plantar pressure distribution were not affected in recreational runners with plantar fasciitis when compared to control runners. Pain also did not interfere with the dynamic patterns of the plantar pressure distributions. (C) 2010 Elsevier Ltd. All rights reserved.

In-shoe plantar pressure distribution during running on natural grass and asphalt in recreational runners

The type of surface used for running can influence the load that the locomotor apparatus will absorb and the load distribution could be related to the incidence of chronic injuries. As there is no consensus on how the locomotor apparatus adapts to loads originating from running Surfaces with different compliance, the objective of this study was to investigate how loads are distributed over the plantar surface while running on natural grass and on a rigid surface-asphalt. Forty-four adult runners with 4 3 years of running experience were evaluated while running at 12 km/h for 40 m wearing standardised running shoes and Pedar insoles (Novel). Peak pressure, contact time and contact area were measured in six regions: lateral, central and medial rearfoot, midfoot, lateral and media] forefoot. The Surfaces and regions were compared by three ANOVAS (2 x 6). Asphalt and natural grass were statistically different in all variables. Higher peak pressures were observed on asphalt at the central (p < 0.001) [grass: 303.8(66.7) kPa; asphalt: 342.3(76.3) kPa] and lateral rearfoot (p < 0.001) [grass: 312.7(75.8) kPa: asphalt: 350.9(98.3) kPa] and lateral forefoot (p < 0.001) [grass: 221.5(42.9) kPa asphalt: 245.3(55.5) kPa]. For natural grass, contact time and contact area were significantly greater at the central rearfoot (p < 0.001). These results suggest that natural grass may be a Surface that provokes lighter loads on the rearfoot and forefoot in recreational runners. (C) 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

AIDS in Latin America: assessing the current status of the epidemic and the ongoing response

Background This article provides a summary of the current status of the HIV/AIDS epidemic in Latin America, as well as an outline of the diverse responses to it. Methods A search of international databases (Pubmed and ISI-Web of Science), regional databases (Scielo and Lilacs), regional and national documents and UNAIDS reports. Data are presented according to subregion. Results In Mexico HIV remains concentrated among urban men who have sex with men (MSM), and has been growing among injecting drug users (IDU) and in rural areas in relation to migration. An increasing proportion of women among those affected is observed in all countries in Central America, the most affected region, as well as increasing the impact on other vulnerable groups, such as indigenous populations. The Andean Countries have urban epidemics concentrated among MSM. In Peru, non-traditional vulnerable populations were identified. In the Southern Cone heterosexual transmission became more relevant, probably in connection with IDU epidemics and is increasingly affecting lower income groups. Incidence rates have been declining since 2002 in Brazil, the first country to guarantee free, universal access to antiretrovirals, where one-third of drug-nave patients are still initiating treatment at an advanced stage. Generally, access to treatment has improved as a result of support from the Global Fund and other initiatives, but there are concerns regarding coverage, equity and sustainability. Conclusions HIV is still concentrated among MSM in Latin America. Non-traditional vulnerable groups such as migrants and lower income populations, usually considered part of the general population, deserve attention. Programmes confronting sexual exclusion are still needed. Access to treatment has improved over time, but inequalities persist.

Forefoot Deformity in Diabetic Neuropathic Individuals and its Role in Pressure Distribution and Gait

Background. Foot deformities have been related to diabetic neuropathy progression but their influence on plantar distribution during dynamic tasks is not completely understood. The purpose of the present study was to investigate the influence of metatarsal head prominence and claw toes on regional plantar pressures during gait in patients with diabetic neuropathy Methods Seventy-one adults participated in this study categorized into three groups: a control group (CG, n = 32), patients with diabetic neuropathy without any foot deformities (DG, n = 20), and patients with diabetic neuropathy with metatarsal head prominence and/or claw toes (DMHG, n = 19). Plantar pressure variables (contact area, peak pressure, and maximum mean pressure) were evaluated during gait on rearfoot, midfoot, and forefoot using capacitive insoles (Pedar-X System, Novel Inc., Munich, Germany). A general linear model was applied to repeatedly measure and analyze variance relationships between groups and areas. Results. DMHG. presented larger contact areas at the forefoot and midfoot along with higher peak pressure at the rearfoot compared to the other two groups The DG showed higher mean pressure at the midfoot compared to:the other two groups. Conclusion. The coexistence of diabetic neuropathy and metatarsal head prominence in addition to claw toes, resulted in overloading the rearfoot and enhancing the contact area of forefoot and midfoot while walking. This plantar pressure distribution is a result of a different coordination pattern adopted in order to reduce plantar loads at the anterior parts of the foot that were structurally altered. Patients with diabetic neuropathy without any forefoot deformities presented a different plantar pressure distribution than patients with deformities suggesting that both neuropathy and structural foot alterations can influence foot rollover mechanisms.

Role of ankle mobility in foot rollover during gait in individuals with diabetic neuropathy

Background: The purpose of this study was to investigate the ankle range of motion during neuropathic gait and its influence on plantar pressure distribution in two phases during stance: at heel-strike and at push-off. Methods: Thirty-one adults participated in this study (control group, n = 16; diabetic neuropathic group, n = 15). Dynamic ankle range of motion (electrogoniometer) and plantar pressures (PEDAR-X system) were acquired synchronously during walking. Plantar pressures were evaluated at rearfoot. midfoot and forefoot during the two phases of stance. General linear model repeated measures analysis of variance was applied to investigate relationships between groups, areas and stance phases. Findings: Diabetic neuropathy patients walked using a smaller ankle range of motion in stance phase and smaller ankle flexion at heel-strike (P = 0.0005). Peak pressure and pressure-time integral values were higher in the diabetic group in the midfoot at push-off phase when compared to heel-strike phase. On the other hand, the control group showed similar values of peak pressure in midfoot during both stance phases. Interpretation: The ankle mobility reduction observed could be associated to altered plantar pressure distribution observed in neuropathic subjects. Results demonstrated that midfoot and forefoot play a different role in subjects with neuropathy by receiving higher loads at push-off phase that are probably due to smaller ankle flexion at stance phase. This may explain the higher loads in anterior areas of the foot observed in diabetic neuropathy subjects and confirm an inadequate foot rollover associated to the smaller ankle range of motion at the heel-strike phase. (C) 2009 Elsevier Ltd. All rights reserved.

Identification of novel mutations of the WFS1 gene in Brazilian patients with Wolfram syndrome

Objective: Wolfram syndrome (WS) is a rare, progressive, neurodegenerative disorder with an autosomal recessive pattern of inheritance. The gene for WS, WFS1, was identified on chromosome 4p16 and most WS patients carry mutations in this gene. However. some studies have provided evidence for genetic heterogeneity and the genotype-phenotype relationships are not clear. Our aim was to ascertain the spectrum of WFS1 mutations in Brazilian patients with WS and to examine the phenotype-genotype relationships in these patients. Design and methods: Clinical characterization and analyses of the WFS1. gene were performed in 27 Brazilian patients with WS from 19 families. Results: We identified 15 different mutations in the WFS1 gene in 26 patients, among which nine are novel. All mutations occurred in exon 8, except for one missense mutation which was located in exon 5. Although we did not find any clear phenotype-genotype relationship in patients with mutations in exon 8, the homozygous missense mutation in exon 5 was associated with a mild phenotype: onset of diabetes mellitus and optic atrophy during adulthood with good metabolic control being achieved with low doses of sulfonylurea Conclusions: Our data show that WFS1 is the major gene involved in WS in Brazilian patients and most mutations are concentrated in exon 8. Also, our study increases the spectrum of WFS1 mutations. Although no clear phenotype-genotype relationship was found for mutations in exon 8, a mild phenotype was associated with a homozygous missense mutation in exon 5.