Paracoccidioidomycosis Epidemiological Features of a 1,000-Cases Series from a Hyperendemic Area on the Southeast of Brazil

Paracoccidioidomycosis has been known for over 100 years, and until now, there were only few estimates of the disease`s incidence. We aim to analyze 1,000 cases treated between 1960 and 1999 at Ribeirao Preto city, Sao Paulo, Brazil, where the disease`s incidence range detected was 1.6 to 3.7 cases per 100,000 habitants per year (mean = 2.7 cases/year). We observed a male to female ratio of 6:1 and an age distribution from 3 to 85 years. The acute/subacute form of the disease accounted for 25.4% of cases. Most of the patients (93.5%) had lived or worked in rural areas before the disease development. Smoking and alcoholism were reported by 64.7% and 37.2% of patients, respectively. Comorbidities identified included tuberculosis (8.3%), Chagas` disease (8.6%), and human immunodeficiency virus/acquired immunodeficiency syndrome (4.2%). The present study revealed an area in Brazil where paracoccidioidomycosis is hyperendemic (has the highest reported incidence of this disease); this endemic area is probably caused by geological and climatic conditions as well as intensive agriculture.

Pompe disease in a Brazilian series: clinical and molecular analyses with identification of nine new mutations

Pompe disease (glycogen storage disease type II or acid maltase deficiency) is an inherited autosomal recessive deficiency of acid alpha-glucosidase (GAA), with predominant manifestations of skeletal muscle weakness. A broad range of studies have been published focusing on Pompe patients from different countries, but none from Brazil. We investigated 41 patients with either infantile-onset (21 cases) or late-onset (20 cases) disease by muscle pathology, enzyme activity and GAA gene mutation screening. Molecular analyses identified 71 mutant alleles from the probands, nine of which are novel (five missense mutations c.136T > G, c.650C > T, c.1456G > C, c.1834C > T, and c.1905C > A, a splice-site mutation c.1195-2A > G, two deletions c.18_25del and c.2185delC, and one nonsense mutation c.643G > T). Interestingly, the c.1905C > A variant was detected in four unrelated patients and may represent a common Brazilian Pompe mutation. The c.2560C > T severe mutation was frequent in our population suggesting a high prevalence in Brazil. Also, eight out of the 21 infantile-onset patients have two truncating mutations predicted to abrogate protein expression. Of the ten late-onset patients who do not carry the common late-onset intronic mutation c.-32-13T > G, five (from three separate families) carry the recently described intronic mutation, c.-32-3C > A, and one sibpair carries the novel missense mutation c.1781G > C in combination with known severe mutation c.1941C > G. The association of these variants (c.1781G > C and c.-32-3C > A) with late-onset disease suggests that they allow for some residual activity in these patients. Our findings help to characterize Pompe disease in Brazil and support the need for additional studies to define the wide clinical and pathological spectrum observed in this disease.

Treatment of Brain Arteriovenous Malformations by Double Arterial Catheterization with Simultaneous Injection of Onyx: Retrospective Series of 17 Patients

BACKGROUND AND PURPOSE: The use of Onyx in the treatment of intracranial AVMs has increased the cure rate of endovascular embolization compared with the use of liquid adhesive agents. Inadvertent occlusion of the draining veins before the complete exclusion of the nidus constitutes a major risk of bleeding. We report a case series using the technique of double simultaneous arterial catheterization as an approach to achieve the complete, exclusion of the nidus before reaching the venous drainage, through a more controlled hemodynamic filling. MATERIALS AND METHODS: Between April 2008 and November 2009, 17 patients with brain AVMs were treated by the DACT. The mean age of the patients was 32.7 years (range, 6-54 years), with 9 females and 8 males. The clinical onset was characterized by intracranial hemorrhage in 8 patients and by seizures in 7. The size of the AVMs ranged from 13 to 54 mm (average, 26.2 mm). The DACT was always used with the objective of curing the AVM. RESULTS: All 17 patients completed the EVT. The average number of sessions conducted was 1.4 (range, 1-3 sessions), with the average injection amount of 6.9 mL of Onyx (range, 2-25.2 mL). Sixteen AVMs (94.1%) were angiographically cured by embolization. Clinical complications occurred in 2 patients (11.7%); 1 of these was permanent (5.9%). No deaths were registered. CONCLUSIONS: This preliminary series shows that the DACT presents satisfactory results when used with curative intent.

Time series evaluation of traumatic lesions and airsacculitis at one poultry abattoir in the state of Sao Paulo, Brazil (1996-2005)

Ten year official condemnation records of one officially inspected poultry abattoir in state of Sao Paulo. Brazil, were analyzed. Seasonal and cyclical trends were analyzed in relation to traumatic lesions and airsacculitis. which were the most relevant official condemnation causes Time series analysis of the records, seasonal indexes and moving averages was used to describe the adherence to the mathematical model and to offer preventive management strategies for the slaughter house industry Although cause-effect relationships were not defined, some insight was given into the causal mechanisms that generated the series (C) 2010 Elsevier B V All rights reserved

Developing human minor salivary glands: morphological parallel relation between the expression of TGF-beta isoforms and cytoskeletal markers of glandular maturation

Morphogenesis of salivary glands involves complex coordinated events. Synchronisation between cell proliferation, polarisation and differentiation, which are dependent on epithelial-mesenchymal interactions and on the microenvironment, is a requirement. Growth factors mediate many of these orchestrated biological processes and transforming growth factor-beta (TGF-beta) appear to be relevant. Using immunohistochemistry and immunofluorescence, we have mapped the distribution of TGF-beta 1, 2 and 3 and compared it with the expression of maturation markers in human salivary glands obtained from foetuses ranging from weeks 4 to 24 of gestation. TGF-beta 1 first appeared during canalisation stage in the surrounding mesenchyme and, in the more differentiated stages, was expressed in the cytoplasm of acinar cells throughout the adult gland. TGF-beta 2 was detected since the bud stage of the salivary gland. Its expression was observed in ductal cells and increased along gland differentiation, TGF-beta 3 was detected from the canalisation stage of the salivary gland, being weakly expressed on ductal cells, and it was the only factor detected on myoepithelial cells. The data suggest that TGF-beta have a role to play in salivary gland development and differentiation.

Efficacy of Profile .04 taper series 29 in removing filling materials during root canal retreatment-an in vitro study

Objective. The aim of this study was to compare Profile .04 taper series 29 instruments and hand files for gutta-percha removal. Study design. Twenty maxillary central incisors with a single straight canal were instrumented and filled. The teeth were divided into 2 groups of 10 specimens each, according to gutta-percha removal techniques: Group 1- Profile series 29 and Group 2- hand files and solvent. The amount of time for gutta-percha removal and the number of fractured instruments were evaluated. Radiographs were taken and the teeth were grooved longitudinally and split. The area of residual debris was measured using computer software. Results. The time for filling material removal was significantly shorter when Profile series 29 was used (P = .00). Regarding cleanliness, there were no statistical differences in the teeth halves evaluations (P = .05). Hand instruments cleaned the canals significantly better than Profiles, in the radiographic analysis considering the whole canal. Overall, the radiographic analysis showed a smaller percentage of residual debris than the teeth halves analysis. Conclusion. The Profile series 29 instruments proved to be faster than hand instruments in removing root filling materials; however, hand instruments yielded better root canal cleanliness. Some residual debris was not visualized by radiographs. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e46-e50)

Timing and duration of the last interglacial inferred from high resolution U-series chronology of stalagmite growth in Southern Hemisphere

High-precision Th-230-U-238 ages for a stalagmite from Newdegate Cave in southern Tasmania, Australia define a rare record of precipitation between 100 and 155 ka before the present. The fastest stalagmite growth occurred between 129.2 +/- 1.6 and 122.1 +/- 2.0 ka (similar to 61.5 mm/ka), coinciding with a time of prolific coral growth from Western Australia (128-122 ka). This is the first high-resolution continental record in the Southern Hemisphere that can be compared and correlated with the marine record. Such correlation shows that in southern Australia the onset of full interglacial sea level and the initiation of highest precipitation on land were synchronous. The stalagmite growth rate between 129.2 and 142.2 ka (similar to 5.9 mm/ka) was lower than that between 142.2 and 154.5 ka (similar to 18.7 mm/ka), implying drier conditions during the Penultimate Deglaciation, despite rising temperature and sea level. This asymmetrical precipitation pattern is caused by latitudinal movement of subtropical highs and an associated Westerly circulation, in response to a changing Equator-to-Pole temperature gradient. Both marine and continental records in Australia strongly suggest that the insolation maximum between 126 and 128 ka at 65 degreesN was directly responsible for the maintenance of full Last Interglacial conditions, although the triggers that initiated Penultimate Deglaciation (at similar to 142 ka) remain unsolved. (C) 2001 Elsevier Science B.V. All rights reserved.

Thermal ionization mass spectrometry U-series dating of a hominid site near Nanjing, China

Mass spectrometric U-series dating of speleothems from Tangshan Cave, combined with ecological and paleoclimatic evidence, indicates that Nanjing Man, a typical Homo erectus morphologically correlated with Peking Man at Zhoukoudian, should be at least 580 k.y. old, or more likely lived during the glacial oxygen isotope stage 16 (similar to 620 ka). Such an age estimate, which is similar to 270 ka older than previous electron spin resonance and alpha counting U-series dates, has significant implications for the evolution of Asian H. erectus. Dentine and enamel samples from the coexisting fossil layer yield significantly younger apparent ages, that of the enamel sample being only less than one-fourth of the minimum age of Nanjing Man. This suggests that U uptake history is far more complex than existing models can handle. As a result, great care must be taken in the interpretation of electron spin resonance and U-series dates of fossil teeth.