Analysis of the diagnostic presentation profile, parathyroidectomy indication and bone mineral density follow-up of Brazilian patients with primary hyperparathyroidism

Primary hyperparathyroidism is an endocrine disorder with variable clinical expression, frequently presenting as asymptomatic hypercalcemia in Western countries but still predominantly as a symptomatic disease in developing countries. The objective of this retrospective study was to describe the diagnostic presentation profile, parathyroidectomy indication and post-surgical bone mineral density follow-up of patients with primary hyperparathyroidism seen at a university hospital. We found 115 patients (92 women, median age 56 years) with primary hyperparathyroidism diagnosed during the last 20 years. We defined symptomatic patients based on the presence of any classical symptom affecting bone, kidney or the neuromuscular system. Surgical criteria followed the guidelines of the National Institutes of Health regarding asymptomatic primary hyperparathyroidism. Symptomatic patients and patients meeting surgical criteria for parathyroidectomy were 66 and 93% of the sample, respectively. Median calcium and parathyroid hormone values were 11.9 mg/dL and 189 pg/mL, respectively. After surgical treatment, 97% of patients were cured, with increases in bone mineral density of 19.4% in the lumbar spine and 15.7% in the femoral neck 3 years after surgery. Greater bone mass increases were detected in pre-menopausal women, men, and in symptomatic and younger patients, both in the lumbar spine and femoral neck. Our results support the previous findings of a predominantly symptomatic disease with a presentation profile that could be mainly related to a delayed diagnosis. Nevertheless, genetic and racial backgrounds, and nutritional factors such as calcium and vitamin D deficiency may play a role in the clinical presentation of primary hyperparathyroidism of Brazilian patients.

A majority of Brazilian patients with rheumatoid arthritis HLA-DRB1 alleles carry both the HLA-DRB1 shared epitope and anti-citrunillated peptide antibodies

The objective of the present study was to evaluate the contribution of the shared epitope (SE), the rheumatoid arthritis (RA) protection model, and the occurrence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in RA patients from a genetically diverse population. One hundred and forty Brazilian RA patients and 161 matched controls were typed for HLA-DRB1 alleles using amplified DNA hybridized with sequence-specific oligonucleotide probes or primers. Patients were stratified according to the presence or absence of SE (DRB1*0401, *0404, *0405, *0101, *1001, and *1402), of the DERAA alleles (DRB1*0103, *0402, *1102, *1103, *1301, *1302, and *1304), and X (all other alleles). Anti-CCP antibodies were measured by ELISA. The combined frequency of SE-positive alleles was significantly greater (76.4 vs 23.6%, P < 0.0001) than the controls. The SE/SE and SE/X genotypes were over-represented (P < 0.0001, OR = 6.02) and DERAA/X was under-represented in RA patients (P < 0.001, OR = 0.49), whereas the frequencies of the SE/DERAA, X/X and X/DERAA genotypes were not significantly different from controls. The frequency of anti-CCP antibodies was higher in SE-positive patients than in SE-negative patients (64.6 vs 44.7%, P = 0.03; OR = 2.25). Although the Brazilian population is highly miscegenated, the results of this study support the findings observed in most genetically homogeneous populations with RA; however, they are not mutually exclusive but rather complementary. The participation of DRB1-DERAA alleles in protection against RA was also observed (OR = 0.4; 95%CI = 0.23-0.68).

HFE gene mutations and iron status of Brazilian blood donors

Mutations of the HFE and TFR2 genes have been associated with iron overload. HFE and TFR2 mutations were assessed in blood donors, and the relationship with iron status was evaluated. Subjects (N = 542) were recruited at the Hemocentro da Santa Casa de São Paulo, São Paulo, Brazil. Iron status was not influenced by HFE mutations in women and was independent of blood donation frequency. In contrast, men carrying the HFE 282CY genotype had lower total iron-binding capacity (TIBC) than HFE 282CC genotype carriers. Men who donated blood for the first time and were carriers of the HFE 282CY genotype had higher transferrin saturation values and lower TIBC concentrations than those with the homozygous wild genotype for the HFE C282Y mutation. Moreover, in this group of blood donors, carriers of HFE 63DD plus 63HD genotypes had higher serum ferritin values than those with the homozygous wild genotype for HFE H63D mutation. Multiple linear regression analysis showed that HFE 282CY leads to a 17.21% increase (P = 0.018) and a 83.65% decrease (P = 0.007) in transferrin saturation and TIBC, respectively. In addition, serum ferritin is influenced by age (3.91%, P = 0.001) and the HFE 63HD plus DD genotype (55.84%, P = 0.021). In conclusion, the HFE 282Y and 65C alleles were rare, while the HFE 63D allele was frequent in Brazilian blood donors. The HFE C282Y and H63D mutations were associated with alterations in iron status in blood donors in a gender-dependent manner.

Evaluation of the immune humoral response of Brazilian patients with Rubinstein-Taybi syndrome

Rubinstein-Taybi syndrome (RTS) is a rare developmental disorder characterized by craniofacial dysmorphisms, broad thumbs and toes, mental and growth deficiency, and recurrent respiratory infections. RTS has been associated with CREBBP gene mutations, but EP300 gene mutations have recently been reported in 6 individuals. In the present study, the humoral immune response in 16 RTS patients with recurrent respiratory infections of possible bacterial etiology was evaluated. No significant differences between patients and 16 healthy controls were detected to explain the high susceptibility to respiratory infections: normal or elevated serum immunoglobulin levels, normal salivary IgA levels, and a good antibody response to both polysaccharide and protein antigens were observed. However, most patients presented high serum IgM levels, a high number of total B cell and B subsets, and also high percentiles of apoptosis, suggesting that they could present B dysregulation. The CREBBP/p300 family gene is extremely important for B-cell regulation, and RTS may represent an interesting human model for studying the molecular mechanisms involved in B-cell development.

Cytogenetic studies of Brazilian pediatric myelodysplastic syndrome cases: challenges and difficulties in a large and emerging country

Myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) are rare hematopoietic stem cell diseases affecting children. Cytogenetics plays an important role in the diagnosis of these diseases. We report here the experience of the Cytogenetic Subcommittee of the Brazilian Cooperative Group on Pediatric Myelodysplastic Syndromes (BCG-MDS-PED). We analyzed 168 cytogenetic studies performed in 23 different cytogenetic centers; 84 of these studies were performed in patients with confirmed MDS (primary MDS, secondary MDS, JMML, and acute myeloid leukemia/MDS+Down syndrome). Clonal abnormalities were found in 36.9% of the MDS cases and cytogenetic studies were important for the detection of constitutional diseases and for differential diagnosis with other myeloid neoplasms. These data show the importance of the Cooperative Group for continuing education in order to avoid a late or wrong diagnosis.

Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men

This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG) was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V˙O2)peak(predicted)and V˙O2peak(real)(nonparametric Wilcoxon test). In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V˙O2peak(real)was 40% lower than V˙O2peak(predicted)(nonparametric Wilcoxon test). There was no agreement between the real and predicted measurements as analyzed by Lin’s coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer.

Provitamin a activity of Brazilian carrots: leaves and roots, raw and cooked and their chemical composition

The purpose of this study was to determine through carotenoid analysis, the provitamin A value of two carrots (Daucus carota L.) cultivars (Brasilia and Beta3), leaves and roots, raw and submitted to two ways of cooking: boiling and microwave. Proximate analysis results are also presented for a better characterization of these vegetables (moisture, ash, lipids, proteins, fiber and total carbohydrates). The main carotenoids sources of provitamin A in this vegetable, both in leaves or roots was β-carotene and α-carotene. α-carotene shows half of the provitamin A value of β-carotene. Samples of the Brasilia cultivar presented the better provitamin A value both for leaves and roots. The results for raw samples of the Brasilia cultivar were 464.48 RE/100g for leaves and 606.42 RE/100g for roots. There were no significant losses of provitamin A with the boiling or microwave cooking methods used.

Lead and cadmium content of Brazilian beers

The elements called heavy metals when ingested are not completely eliminated from animal bodies and are responsible for chronic and acute intoxications. Sixty-three samples of beer, produced in the states of São Paulo, Paraná, Rio de Janeiro, Rio Grande do Sul, Minas Gerais, and Pará, were analysed for lead and cadmium content by atomic absorption spectrometry with graphite furnace atomization and Zeeman correction. The concentrations of Pb and Cd of dark differed significantly from light beers, being higher in the former. No significant difference was found between the beers produced in predominantly rural areas and the ones produced in industrialized areas. The concentrations of lead and cadmium in all samples were bellow the maximum accepted by present Brazilian regulations and ranged from not detected to 290mugPb/L and from not detected to 14.3mugCd/L. The average concentrations were 37mugPb/L and 1.6mugCd/L.

Evaluation of Brazilian light ketchups II: quantitative descriptive and physicochemical analysis

Samples of ketchup available on the Brazilian market, one traditional (sweetened with sucrose) and three light versions (sweetened with aspartame, acesulfame-K and a blend of cyclamate, saccharin and stevia) were evaluated for their physicochemical characteristics and sensory profile (Quantitative Descriptive Analysis). Four main groups of attributes were generated: appearance, oral texture, aroma and flavor. The samples presented significant differences in all attributes, except for syneresis and overripe tomato flavor. The highest means for sweetener and bitter tastes and aftertastes were observed for the samples sweetened with acesulfame-K and the blend of sweeteners. Although different characteristics were observed among the products evaluated and, despite the differences in the formulations, the light ketchup sweetened with aspartame was the one that presented properties most similar to those of the traditional ketchup.

Analysis of Brazilian consumer preference of filled chocolate

Chocolate is the most popular product made from cocoa. It is mainly consumed with fillings, such as fondant, hydrogenated fat or fruits. This work aimed at assessing the sensory acceptability of chocolate filled with strawberry, orange or passion fruit pulps, mixed in fondant, in a hydrogenated fat base and as truffles. Ninety four consumers participated in the test using a 10 cm hedonic scale to rate the overall liking of the samples. Two-way analysis of variance and the Internal Preference Mapping technique were used to analyze the data. Results showed a good overall liking for almost all samples, especially for strawberry and passion fruit truffles, which obtained 8.4 and 8.8 global means, respectively (p < 0.05), in liking ratings, followed by the hydrogenated fat and fondant fillings. The Internal Preference Map presented two dimensions explaining 72.5% of the variation found. Regarding the flavors, strawberry - traditional in chocolate and confectionary in Brazil - and passion fruit obtained better acceptance, unlike the orange fillings, which showed significantly lower ratings (p < 0.05). The orange fondant filling obtained a global mean of 6.5.

Discrimination of Brazilian red wines according to the viticultural region, varietal, and winery origin

This work evaluated the physicochemical composition of 171 red Brazilian wines from the 2006 vintage, which were represented by 21 varietals. These wines were produced by 58 Brazilian wineries in different regions of the country, with latitudes varying from 9º to 31º South. Physicochemical wine analysis was performed in the same year and discrimination in the viticultural regions, varietal wines, and wineries was performed by means of the principal component analysis (PCA). The main results show that wines from São Joaquim had higher values of A420, A520, A620, color intensity, total phenolic compounds, anthocyanins, and dry extracts, while those from Toledo had lower values of these variables; those from Vale do São Francisco had higher values of potassium, pH, density, and volatile acidity; from Serra do Nordeste A, they had higher titratable acidity; and from Planalto Superior B, higher hue. Regarding the varietal wines, PCA mainly discriminated the wines produced from the varieties Ancellotta, Teroldego, Egiodola, Refosco, Marselan, Cabernet Sauvignon, Pinotage, Pinot Noir, Malbec, Arinarnoa, Barbera, and Alfrocheiro. In relation to wineries, twenty two of them were discriminated by their higher values of some variables, i.e., three were characterized by color intensity; three by hue; eight by alcohol content; six by potassium, dry extract, density, and pH; and two by titratablel acidity.

Comparative antiproliferation of human prostate cancer cells by ethanolic extracts of two groups of Brazilian propolis

Two groups of propolis, group 12, which was collected in the southeastern Brazil and group 13, which was collected in the northeastern Brazil, were examined for antiproliferation of primary malignant tumor (RC-58T/h/SA#4)-derived human prostate cancer cells and human prostate epithelial cells. The strongest inhibition of RC-58T/h/SA#4 cells was observed in propolis group 13 extracts, whereas moderate growth inhibition was observed in human prostate epithelial cells in comparison with group 12. It can be said that the Brazilian propolis of group 13 contains important chemical ingredients.

Chemical pattern of brazilian apples: a chemometric approach based on the Fuji and Gala varieties

The chemical composition of apple juices may be used to discriminate between the varieties for consumption and those for raw material. Fuji and Gala have a chemical pattern that can be used for this classification. Multivariate methods correlate independent continuous chemical descriptors with the categorical apple variety. Three main descriptors of apple juice were selected: malic acid, total reducing sugar and total phenolic compounds. A chemometric approach, employing PCA and SIMCA, was used to classify apple juice samples. PCA was performed with 24 juices from Fuji and Gala, and SIMCA, with 15 juices. The exploratory and predictive models recognized 88% and 64%, respectively, as belonging to a mixed domain. The apple juice from commercial fruits shows a pattern related to cv. Fuji and Gala with boundaries from 0.18 to 0.389 g.100 mL-1 (malic acid), from 8.65 to 15.18 g.100 mL-1 (total reducing sugar) and from 100 to 400 mg.L-1 (total phenolic compounds), but such boundaries were slightly shorter in the remaining set of commercial apple juices, specifically from 0.16 to 0.36 g.100 mL-1, from 9.25 to 15.5 g.100 mL-1 and from 180 to 606 mg.L-1 for acidity, reducing sugar and phenolic compounds, respectively, representing the acid, sweet and bitter tastes.

Characterization of Brazilian wheat cultivars for specific technological applications

Functional and technological properties of wheat depend on its chemical composition, which together with structural and microscopic characteristics, define flour quality. The aim of the present study was to characterize four Brazilian wheat cultivars (BRS Louro, BRS Timbauva, BRS Guamirim and BRS Pardela) and their respective flours in order to indicate specific technological applications. Kernels were analyzed for test weight, thousand kernel weight, hardness, moisture, and water activity. Flours were analyzed for water activity, color, centesimal composition, total dietary fiber, amylose content and identification of high molecular weight glutenins. The rheological properties of the flours were estimated by farinography, extensography, falling number, rapid visco amylography, and glutomatic and glutork equipment. Baking tests and scanning electron microscopy were also performed. The data were subjected to analysis of variance and principal component analysis. BRS Timbauva and BRS Guamirim presented results that did not allow for specific technological application. On the other hand, BRS Louro presented suitable characteristics for the elaboration of products with low dough strength such as cakes, pies and biscuits, while BRS Pardela seemed suitable for bread and pasta products.

Fatty acids profile of pulp and nuts of Brazilian fruits

Fruits and nuts from the North and Northeast regions of Brazil were collected to determine the fatty acid profile of their oils. The species studied were Brazil (Bertholletia excelsa H.B.K.), Mucajá (Couma rigida M.), Inajá (Maximiliana maripa D.), Jenipapo (Genipa Americana L.), and Buriti (Mauritia flexuosa L.) nuts. Fatty acid methyl esters were analyzed by gas chromatography with flame ionization detection (GC-FID). Brazil nut major fatty acid was 18:3n-3 (α-linolenic acid), and Buriti nut had approximately 23 times more 18:3n-3 than the pulp. Mucajá nut presented high content of 12:0 (lauric acid) and 16:0 (palmitic acid), and Mucajá pulp showed significant levels of 18:2n-6 (linoleic acid). Considering the PUFA (polyunsaturated fatty acid) sum values, almost all fruits and nuts analyzed presented very high levels of these compounds. Regarding n-6/n-3 ratio, only Brazil Nut, Buriti Nut, Inajá pulp, and Jenipapo pulp corresponded to the desired profile. These Brazilian fruits and nuts could be of potential interest due to their high nutritive value and lipid content.