Portuguese validation of the Symptom Inventory of the M.D. Anderson Cancer Center

Objective To analyze the reliability and validity of the psychometric properties of the Brazilian version of the instrument for symptom assessment, titled MD Anderson Symptom Inventory - core. Method A cross-sectional study with 268 cancer patients in outpatient treatment, in the municipality of Ijuí, state of Rio Grande do Sul, Brazil. Results The Cronbach’s alpha for the MDASI general, symptoms and interferences was respectively (0.857), (0.784) and (0.794). The factor analysis showed adequacy of the data (0.792). In total, were identified four factors of the principal components related to the symptoms. Factor I: sleep problems, distress (upset), difficulties in remembering things and sadness. Factor II: dizziness, nausea, lack of appetite and vomiting. Factor III: drowsiness, dry mouth, numbness and tingling. Factor IV: pain, fatigue and shortness of breath. A single factor was revealed in the component of interferences with life (0.780), with prevalence of activity in general (59.7%), work (54.9%) and walking (49.3%). Conclusion The Brazilian version of the MD Anderson Symptom Inventory - core showed adequate psychometric properties in the studied population.

The association of ACE gene D/I polymorphism with cardiovascular risk factors in a population from Rio de Janeiro

Our aim was to determine the frequencies of the angiotensin-converting enzyme (ACE) gene alleles D and I and any associations to cardiovascular risk factors in a population sample from Rio de Janeiro, Brazil. Eighty-four adults were selected consecutively during a 6-month period from a cohort subgroup of a previous large cross-sectional survey in Rio de Janeiro. Anthropometric data and blood pressure measurements, echocardiogram, albuminuria, glycemia, lipid profile, and ACE genotype and serum enzyme activity were determined. The frequency of the ACE*D and I alleles in the population under study, determined by PCR, was 0.59 and 0.41, respectively, and the frequencies of the DD, DI, and II genotypes were 0.33, 0.51, and 0.16, respectively. No association between hypertension and genotype was detected using the Kruskal-Wallis method. Mean plasma ACE activity (U/mL) in the DD (N = 28), DI (N = 45) and II (N = 13) groups was 43 (in males) and 52 (in females), 37 and 39, and 22 and 27, respectively; mean microalbuminuria (mg/dL) was 1.41 and 1.6, 0.85 and 0.9, and 0.6 and 0.63, respectively; mean HDL cholesterol (mg/dL) was 40 and 43, 37 and 45, and 41 and 49, respectively, and mean glucose (mg/dL) was 93 and 108, 107 and 98, and 85 and 124, respectively. A high level of ACE activity and albuminuria, and a low level of HDL cholesterol and glucose, were found to be associated with the DD genotype. Finally, the II genotype was found to be associated with variables related to glucose intolerance.

Fractures of the proximal femur: correlation with vitamin D receptor gene polymorphism

Fractures are the feared consequences of osteoporosis and fractures of the proximal femur (FPF) are those that involve the highest morbidity and mortality. Thus far, evaluation of bone mineral density (BMD) is the best way to determine the risk of fracture. Genetic inheritance, in turn, is one of the major determinants of BMD. A correlation between different genotypes of the vitamin D receptor (VDR) and BMD has been recently reported. On this basis, we decided to determine the importance of the determination of VDR genotype in the presence of an osteoporotic FPF in a Brazilian population. We studied three groups: group I consisted of 73 elderly subjects older than 65 years (78.5 ± 7.2 years) hospitalized for nonpathological FPF; group II consisted of 50 individuals older than 65 years (72.9 ± 5.2 years) without FPF and group III consisted of 98 young normal Brazilian individuals aged 32.6 ± 6.6 years (mean ± SD). Analysis of VDR gene polymorphism by restriction fragment length polymorphism (RFLP) was performed by PCR amplification followed by BsmI digestion of DNA isolated from peripheral leukocytes. The genotype distribution in group I was 20.5% BB, 42.5% Bb and 37% bb and did not differ significantly from the values obtained for group II (16% BB, 36% Bb and 48% bb) or for group III (10.2% BB, 47.6% Bb and 41.8% bb). No differences in genotype distribution were observed between sexes or between the young and elderly groups. We conclude that determination of VDR polymorphism is of no practical use for the prediction of FPF. Other nongenetic factors probably start to affect bone mass, the risk to fall and consequently the occurrence of osteoporotic fractures with advancing age.

Electrophysiological evidence for the presence of NR2C subunits of N-methyl-D-aspartate receptors in rat neurons of the nucleus tractus solitarius

The nucleus tractus solitarius (NTS) plays an important role in the control of autonomic reflex functions. Glutamate, acting on N-methyl-D-aspartate (NMDA) and non-NMDA ionotropic receptors, is the major neurotransmitter in this nucleus, and the relative contribution of each receptor to signal transmission is unclear. We have examined NMDA excitatory postsynaptic currents (NMDA-EPSCs) in the subpostremal NTS using the whole cell patch clamp technique on a transverse brainstem slice preparation. The NMDA-EPSCs were evoked by stimulation of the solitary tract over a range of membrane potentials. The NMDA-EPSCs, isolated pharmacologically, presented the characteristic outward rectification and were completely blocked by 50 µM DL-2-amino-5-phosphonopentanoic acid. The I-V relationship of the NMDA response shows that current, with a mean (± SEM) amplitude of -41.2 ± 5.5 pA, is present even at a holding potential of -60 mV, suggesting that the NMDA receptors are weakly blocked by extracellular Mg2+ at near resting membrane potentials. This weak block can also be inferred from the value of 0.67 ± 0.17 for parameter delta obtained from a fit of the Woodhull equation to the I-V relationship. The maximal inward current measured on the I-V relationship was at -38.7 ± 4.2 mV. The decay phase of the NMDA currents was fitted with one exponential function with a decay time constant of 239 ± 51 and 418 ± 80 ms at a holding potential of -60 and +50 mV, respectively, which became slower with depolarization (e-fold per 145 mV). The biophysical properties of the NMDA receptors observed in the present study suggest that these receptors in the NTS contain NR2C subunits and may contribute to the synaptic signal integration.

Determination of fat soluble vitamins from amazonian fresh-water fishes. I. HPLC analysis of tambaqui, pirarucu and cuiu-cuiu livers .

It was found that fish livers from the Amazon have considerable amounts of vitamins A, D and E compared with the values of the standartized cod-liver oil. Tambaqui liver oil has high concentration of vitamin A1(retinol) and vitamin A2 (degidroretinol) whereas the liver oils of pirarucu and cuiu-cuiu have preferently the vitamin A2. The contents of the vitamins D and E observed in the liver oils of tambaqui and cuiu-cuiu was extremely high.

Presence of the RHD pseudogene and the hybrid RHD-CE-Ds gene in Brazilians with the D-negative phenotype

The molecular basis for RHD pseudogene or RHDpsi is a 37-bp insertion in exon 4 of RHD. This insertion, found in two-thirds of D-negative Africans, appears to introduce a stop codon at position 210. The hybrid RHD-CE-Ds, where the 3' end of exon 3 and exons 4 to 8 are derived from RHCE, is associated with the VS+V- phenotype, and leads to a D-negative phenotype in people of African origin. We determined whether Brazilian blood donors of heterogeneous ethnic origin had RHDpsi and RHD-CE-Ds. DNA from 206 blood donors were tested for RHDpsi by a multiplex PCR that detects RHD, RHDpsi and the C and c alleles of RHCE. The RHD genotype was determined by comparison of size of amplified products associated with the RHD gene in both intron 4 and exon 10/3'-UTR. VS was determined by amplification of exon 5 of RHCE, and sequencing of PCR products was used to analyze C733G (Leu245Val). Twenty-two (11%) of the 206 D-negative Brazilians studied had the RHDpsi, 5 (2%) had the RHD-CE-Ds hybrid gene associated with the VS+V- phenotype, and 179 (87%) entirely lacked RHD. As expected, RHD was deleted in all the 50 individuals of Caucasian descent. Among the 156 individuals of African descent, 22 (14%) had inactive RHD and 3% had the RHD-CE-Ds hybrid gene. These data confirm that the inclusion of two different multiplex PCR for RHD is essential to test the D-negative Brazilian population in order to avoid false-positive typing of polytransfused patients and fetuses.

Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young

OBJECTIVE: To study the in-hospital evolution of patients aged 65 years and older, with acute myocardial infarction, who were treated by direct coronary angioplasty with no fibrinolytic therapy. METHODS: We studied 885 patients divided into 2 groups as follows: group I (GI) - 293 (33.4%) patients aged ³ 65 years (72±5 years), and group II (GII) - 592 patients aged < 65 years (57±9 years). Multivessel disease was more frequent in GI (63.5% x 49.7%; p=0.001). A greater number of GII patients were class I or II of the clinical Killip-Kimball classification (K) (80.2% x 67.2%; p=0.00002), while a significant number of GI patients were KIII and KIV (24.3% x 12.8%; p=0.00003). RESULTS: Group I had a lower index of success (84.6% x 94%; p=0.0002) and a greater in-hospital mortality (12.2% x 4.7%; p=0.00007). The predictors of mortality in GI were as follows: previous infarction (20.5% x 6.3%; p=0.02), anterior location (13.4% x 6.4%; p=0.03), and male sex (10.4% x 4.4%; p=0.007). CONCLUSION: Elderly patients had more severe acute myocardial infarction and more extensive disease, a lower index of success, and greater in-hospital mortality. Previous infarction, anterior location and male sex were identified as predictors of mortality in the elderly group (GI).

Isolation and characterization of a serine proteinase with thrombin-like activity from the venom of the snake Bothrops asper

A serine proteinase with thrombin-like activity was isolated from the venom of the Central American pit viper Bothrops asper. Isolation was performed by a combination of affinity chromatography on aminobenzamidine-Sepharose and ion-exchange chromatography on DEAE-Sepharose. The enzyme accounts for approximately 0.13% of the venom dry weight and has a molecular mass of 32 kDa as determined by SDS-PAGE, and of 27 kDa as determined by MALDI-TOF mass spectrometry. Its partial amino acid sequence shows high identity with snake venom serine proteinases and a complete identity with a cDNA clone previously sequenced from this species. The N-terminal sequence of the enzyme is VIGGDECNINEHRSLVVLFXSSGFL CAGTLVQDEWVLTAANCDSKNFQ. The enzyme induces clotting of plasma (minimum coagulant dose = 4.1 µg) and fibrinogen (minimum coagulant dose = 4.2 µg) in vitro, and promotes defibrin(ogen)ation in vivo (minimum defibrin(ogen)ating dose = 1.0 µg). In addition, when injected intravenously in mice at doses of 5 and 10 µg, it induces a series of behavioral changes, i.e., loss of the righting reflex, opisthotonus, and intermittent rotations over the long axis of the body, which closely resemble the `gyroxin-like' effect induced by other thrombin-like enzymes from snake venoms.

Survival and Predictive Factors of Lethality in Hemodyalisis: D/I Polymorphism of The Angiotensin I-Converting Enzyme and of the Angiotensinogen M235T Genes

Background: End-stage kidney disease patients continue to have markedly increased cardiovascular disease morbidity and mortality. Analysis of genetic factors connected with the renin-angiotensin system that influences the survival of the patients with end-stage kidney disease supports the ongoing search for improved outcomes. Objective: To assess survival and its association with the polymorphism of renin-angiotensin system genes: angiotensin I-converting enzyme insertion/deletion and angiotensinogen M235T in patients undergoing hemodialysis. Methods: Our study was designed to examine the role of renin-angiotensin system genes. It was an observational study. We analyzed 473 chronic hemodialysis patients in four dialysis units in the state of Rio de Janeiro. Survival rates were calculated by the Kaplan-Meier method and the differences between the curves were evaluated by Tarone-Ware, Peto-Prentice, and log rank tests. We also used logistic regression analysis and the multinomial model. A p value ≤ 0.05 was considered to be statistically significant. The local medical ethics committee gave their approval to this study. Results: The mean age of patients was 45.8 years old. The overall survival rate was 48% at 11 years. The major causes of death were cardiovascular diseases (34%) and infections (15%). Logistic regression analysis found statistical significance for the following variables: age (p = 0.000038), TT angiotensinogen (p = 0.08261), and family income greater than five times the minimum wage (p = 0.03089), the latter being a protective factor. Conclusions: The survival of hemodialysis patients is likely to be influenced by the TT of the angiotensinogen M235T gene.

The Adolpho Lutz collection of Tabanidae: (Diptera): I. The described genera and species, condition of the collection, and selection of lectotypes

A study of the Adolpho Lutz Collection of Tabanidae at the Instituto Oswaldo Cruz and of additional Lutz material at the Instituto Butantan in São Paulo is reported. Of the ninety-four species of Tabanidae validly described by Lutz, type material of eighty-four was recognized, either holotypes, allotypes or syntypes. Lectotypes were selected from among syntype series or remaining specimens and all type material was labelled. Of the ten species of which no type material could be found, neotypes were designated in the case of two species, Erephosis nigricans and Erephosis pseudo-aurimaculata. Types of three species, Chrysops ecuadoriensis, Dichelacera salvadorensis and Esenbeckia nigricorpus are believed to have been in Hamburg and destroyed during the last war. Types of two species, Esenbeckia biscutellata and E. dubia, and additional type material of several others are believed to have been in Montevideo. A request for information about them remains unanswered. Types of the remaining three species, Dichelacera intermedia, Dichelacera laceriascia and Esenbeckia distinguenda could not be found, and it is believed that at least the type of the last species was accidentally destroyed. Three specific of subspecific names proposed by Lutz but palaced by others in synonymy have been revalidated, Acanthocera intermedia, Erephosis brevistria and Esenbeckia fenestrata. Generic placement of two names has been changed, Esenbeckia arcuata ricardoae to Proboscoides, and Selasoma giganteum to Stibasoma. Seven specific names proposed by Lutz appear to be synonyms of earlier names, as follows: Bombylopsis juxtaleonina Lutz and Castro, 1936 = B. leonina Lutz, 1909. Bombylopsis pseudoanalis Lutz, 1909 = B. erythronotata (Bigot, 1892). Esenbeckia fuscipennis var. flavescens Lutz, 1909 = Esenbeckia fuscipennis Wied., 1828. Fidena chrysopyga Lutz and Castro, 1936 = F. atra Lutz and Castro, 1936. Laphriomyia longipalpis Lutz and Castro, 1937 = L. mirabilis Lutz, 1911. Stibasoma semiflavum Lutz, 1915 = St. bicolor Bigot, 1892. Tabanus hesperus Lutz, 1912 = Chlorotabanus (Cryptolylus) innotescens (Walker, 1854). Four Lutz names appear to antedate names proposed by others, viz.: Diachlorus angustifrons Kröber, 1930 and D. ochraceus Kröb., 1928 not Macquart, 1850 = Diachlorus fuscistigma Lutz, 1913. Psalidia fairchildi Barretto, 1950 = dicladocera conspicua Lutz and Neiva, 1914. Fidena pseudo-fulvithorax Kröb., 1931 = Erephopsis flavicrinis Lutz, 1909. Esenbeckia lemniscata Enderlein, 1925 = Esenbeckia clari Lutz, 1909. Some comments on Lutz' system of classification are given together with notes on the genotypes and included species of his genera as revaled by his collection and notes.

Competitive interactions between species of freshwater snails. I. Laboratory studies: Ib. Comparative studies of the dispersal and the vagility capabilities of Biomphalaria glabrata and Biomphalaria straminea

Experiments reported in the current paper, carried out under semi-field conditions created in the laboratory, have shown that b. straminea has competitive superiority when compared with B. glabrata. The former species has shown higher capabilities of both dispersal and vagility. In addition, B. straminea was able to compete sucessfully with B. glabrata.

Ultrastructure of the ovary of Dermatobia hominis (Diptera: cuterebridae). I. Development during the 3rd larval instar

The ultrastructure and distribution of gonial and somatic cells in the ovary of Dermatobia hominis was studied during the 3rd larval instar. In larvae weighing between 400 and 500 mg, the ovary is partially divided into basal and apical regions by oblong somatic cells that penetrate from the periphery; these cells show ovoid nucleus and cytoplasm full of microtubules. In both regions, gonial cells with regular outlines, large nucleus and low electron-density cytoplasm are scattered among the interstitial somatic cells. These later cells have small nucleus and electrodense cytoplasm. Clear somatic cells with small nucleus and cytoplasm of very low electron-density are restrict to the apical region of the gonad. Degenerating interstitial somatic cells are seen in the basal portion close to the ovary peduncle. During all this larval period the morphological features of the ovary remain almost the same. At the end of the period there is a gradual deposition of glycogen in the cytoplasm of the somatic cells, increase in the number and density of their mitochondria plus nuclear modification as membrane wrinkling and chromatin condensation in masses.

Calyptrate diptera (Muscidae and Anthomyidae) of the state of Rio de Janeiro: I. Synanthropy

The synanthropy of Muscidae and Anthomyidae was studied in three ecologically distinct areas of the metropolitan region of Rio de Janeiro. Using baits such row fish, decomposing bovine liver, fresh human faeces and mashed banana it was found that Synthesiomyia nudiseta, Atherigona orientalis, and Musca domestica are highly synanthropic in contrast with Neomuscina pictipenis, Phaonantho devia and Morellia maculipenis found exclusively in the forest.

Urban malaria in the Brazilian Western Amazon Region I: high prevalence of asymptomatic carriers in an urban riverside district is associated with a high level of clinical malaria

Cross sectional studies on malaria prevalence was performed in 2001, 2002, and 2004 in Vila Candelária, an urban riverside area of Porto Velho, Rondônia, in the Brazilian Western Amazon, followed by longitudinal surveys on malaria incidence. Vila Candelária is a working class district, provided with electricity, water supply, and basic sanitation. Previous preliminary surveys indicated high malaria incidence in this community. At the end of year 2000 regular diagnostic and treatment measures for malaria were introduced, with active search of febrile cases among residents. Despite of both rapid treatment of cases and relative good sanitary and housing conditions, the malaria incidence persisted at high levels during the following years with an annual parasite index of 150 to 300/1000 inhabitants. Parasite surveys in 2001, 2002, and 2004 achieved through microscopy and polymerase chain reaction to diagnose malaria showed a constant high prevalence of asymptomatic carriers for both Plasmodium falciparum and P. vivax parasites. It was concluded that asymptomatic carriers represent an important reservoirs of parasites and that the carriers might contribute to maintaining the high level of transmission. Comparing our findings to similar geo-demographic situations found in other important urban communities of the Brazilian Amazon, we propose that asymptomatic carriers could explain malaria's outbreaks like the one recently observed in Manaus.