Frequency of Cardiovascular Involvement in Familial Amyloidotic Polyneuropathy in Brazilian Patients

Background:Familial amyloidotic polyneuropathy (FAP) is a rare disease diagnosed in Brazil and worldwide. The frequency of cardiovascular involvement in Brazilian FAP patients is unknown.Objective:Detect the frequency of cardiovascular involvement and correlate the cardiovascular findings with the modified polyneuropathy disability (PND) score.Methods:In a national reference center, 51 patients were evaluated with clinical examination, electrocardiography (ECG), echocardiography (ECHO), and 24-hour Holter. Patients were classified according to the modified PND score and divided into groups: PND 0, PND I, PND II, and PND > II (which included PND IIIa, IIIb, and IV). We chose the classification tree as the statistical method to analyze the association between findings in cardiac tests with the neurological classification (PND).Results:ECG abnormalities were present in almost 2/3 of the FAP patients, whereas ECHO abnormalities occurred in around 1/3 of them. All patients with abnormal ECHO also had abnormal ECG, but the opposite did not apply. The classification tree identified ECG and ECHO as relevant variables (p < 0.001 and p = 0.08, respectively). The probability of a patient to be allocated to the PND 0 group when having a normal ECG was over 80%. When both ECG and ECHO were abnormal, this probability was null.Conclusions:Brazilian patients with FAP have frequent ECG abnormalities. ECG is an appropriate test to discriminate asymptomatic carriers of the mutation from those who develop the disease, whereas ECHO contributes to this discrimination.

Prevalence of Risk for Obstructive Sleep Apnea Syndrome and Association With Risk Factors in Primary Care

Abstract Background: Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive disease with high morbidity and mortality. It is underdiagnosed, especially among women. Objective: To study the prevalence of high risk for OSAS globally and for the Berlin Questionnaire (BQ) categories, and to evaluate the reliability of the BQ use in the population studied. Methods: Observational, cross-sectional study with individuals from the Niterói Family Doctor Program, randomly selected, aged between 45 and 99 years. The visits occurred between August/2011 and December/2012. Variables associated with each BQ category and with high risk for OSAS (global) were included in logistic regression models (p < 0.05). Results: Of the total (616), 403 individuals (65.4%) reported snoring. The prevalence of high risk for OSA was 42.4%, being 49.7% for category I, 10.2% for category II and 77.6% for category III. Conclusion: BQ showed an acceptable reliability after excluding the questions Has anyone noticed that you stop breathing during your sleep? and Have you ever dozed off or fallen asleep while driving?. This should be tested in further studies with samples mostly comprised of women and low educational level individuals. Given the burden of OSAS-related diseases and risks, studies should be conducted to validate new tools and to adapt BQ to better screen OSAS.

Estudos sobre a nutrição mineral e a adubação do siratro (Macroptilium atroporpureum D.C., cv. siratro), da galactia (Galactia striata (Jacqu.) Urb.) e da soja perene (Glycine wightii Willd). II: exigências nutricionais

O siratro, a galactia e a soja perene foram cultivados em vasos contendo dois tipos de solos, PVA de Araçatuba e AQD de São Pedro, ambos do Estado de São Paulo, sob diferentes tratamentos, de acordo com a técnica da diagnose por subtração. As plantas foram colhidas e analisadas obtendo-se dados que permitem avaliar as exigências de macro e micronutrientes das três espécies e bem assim o seu estado nutricional.

Estudos sobre o comportamento dos planorbídeos: II - enterramento de Biomphalaria glabrata (Say, 1818) como meio de proteção contra a dessecação

Os a.a confirmaram em laboratório a ocorrência de enterramento no repertório comportamental de Biomphalaria glabrata. Verificaram que os indivíduos enterrados se recuperaram com maior rapidez, depois de um período de 20 dias de dessecação, do que os outros que permaneceram sobre o solo. Estudos mais detalhados a respeito são necessários para avaliar a importância epidemiológica desse comportamento.

Aspectos da ecologia dos flebótomos do Parque Nacional da Serra dos Orgãos, Rio de Janeiro: II. Distribuição vertical (Diptera, Psychodidae, Phlebotominae)

Durante um ano completo efetuamos capturas de flebótomos em isca humana, simultaneamente no solo e na copa da floresta em plataforma a dez metros de altura. Lutzomyia fischeri foi a espécie mais numerosa na copa. L.sp. 1 (espécie ainda não descrita) também foi mais freqüente neste nivel; L.shannoni, apesar de ser mais ativa ao nivel do solo, compareceu várias vezes na copa; L.pessoai, L.ayrozai, L.davisi. L.sp.2 (espécie também não identificada), L.microps e L.monticola só picaram iscas situadas no solo; L.hirsuta esteve pouco representada na copa, porém sua maior densidade foi no solo, onde figura como espécie dominante nos meses mais frios e secos do ano. Dois aspectos devem ser enfatizados com relação à distribuição vertical: a acrodendrofilia de L. fischeri e, ao contrário, o fato de L.ayrozai alimentar-se exclusivamente ao nível do solo. Este comportamento de L.ayrozai e sua preferência em sugar nas partes mais baixas do corpo fazem supor que seus abrigos naturais sejam as folhas caídas no solo florestal. Dentre os fatores mesológicos que influenciam na estratificação dos flebótomos consideramos que a luminosidade seja preponderante, pois em noites mais claras (lua crescente ou cheia) a atividade foi nula, todos os flebotomíneos capturados na copa das árvores foram obtidos em noites mais escuras (lua nova ou minguante).

Ectoparasitos de roedores da região urbana de Belo Horizonte, MG: II. Oscilações dos índices de infestação em Rattus norvegicus norvegicus

Os índices de infestação proporcionados pelo ácaro Echinolaelaps echidninus e Laelaps nuttalli, pelo piolho Polyplax spinulosa e pela pulga Xenopsylla cheopis, obtidos mensalmente no período de junho de 1980 a setembro de 1982, em Rattus norvegicus da região urbana de Belo Horizonte, Minas Gerais, Brasil, foram relacionados com períodos estacionais, sexo dos hospedeiros e áreas de captura. Acaros e insetos apresentaram comportamento diferente face a estas variáveis, já que apenas as pulgas e os piolhos exibiram associações significativas entre a infestação nos roedores e os períodos estacionais, ou entre a infestação e o sexo dos roedores, ou ainda uma variação da distribuição pelas áreas onde as capturas foram mais freqüentes. Enquanto as pulgas infestaram um maior número de roedores na estação chuvosa-quente (outubro a março), a infestação proporcionada pelo piolho foi mais intensa na estação seca-fria. Os fatores climáticos mais relacionados com a infestação nos hospedeiros foram, em ordem decrescente, a precipitação pluviométrica, a temperatura e a umidade relativa do ar. Tanto pulgas como piolhos apresentaram infestações preferenciais por roedores machos, sendo a proporcionada por X. cheopis, altamente significativa.

Behavior of triatomines (Hemiptera, Reduviidae) vectors of Chagas' disease. II. Influence of feeding, lighting and time of day on the number of mating, mating speed and duration of copulation of Panstrongylus megistus (Burm, 1835) under laboratory conditions

To determine in influence of feeding, lighting and time of day on the copulating behavior of Panstrongylus megistus, 480 insect pairs were divided into four groups of 120 each and tested in the following respective situations: without food deprivation (F.D.), with five days of F.D., with ten days of F.D., and with 20 days of F. D. The tests were performed between 9:00 a.m. to 12:00a.m. and 7:00 p.m. to 10:00 p.m., with light (700-1400 lux) and in the dark (1.4-2.8 lux) and behavior was recorded by the time sampling technique. Mating spped (MS) and duration of copulation (DC) were also calculated for each situation. The maximum frequency of copulation was observed after five days of F.D., at night, in the dark (n = 16), and the minimum was observed for recently-fed pairs, at night, with light (n = 4). Males approached females more often than females approached males. MS was lowest in pairs with twenty days of F.D., at night, with light (X = 23.0 ± 16.0 minutes), and highest in recently-fed pairs, during the day, with light (X = 2.9 ± 2.5 minutes). DC was shortest in recently-fed insects, during the day, in the dark (X = 23.5 ± 6.7 minutes), and longest in recently-fed animals, at night, in the dark (X = 38.3 ± 6.9 minutes).

Rac2 GTPase activation by angiotensin II is modulated by Ca2C/calcineurin and mitogen-activated protein kinases in human neutrophils

Angiotensin II (Ang II) highly stimulates superoxide anion production by neutrophils. The G-protein Rac2 modulates the activity of NADPH oxidase in response to various stimuli. Here, we describe that Ang II induced both Rac2 translocation from the cytosol to the plasma membrane and Rac2 GTP-binding activity. Furthermore, Clostridium difficile toxin A, an inhibitor of the Rho-GTPases family Rho, Rac and Cdc42, prevented Ang II-elicited O2-/ROS production, phosphorylation of the mitogen-activated protein kinases (MAPKs) p38, extracellular signal-regulated kinase 1/2 (ERK1/2) and c-Jun N-terminal kinase 1/2, and Rac2 activation. Rac2 GTPase inhibition by C. difficile toxin A was accompanied by a robust reduction of the cytosolic Ca(2)(+) elevation induced by Ang II in human neutrophils. Furthermore, SB203580 and PD098059 act as inhibitors of p38MAPK and ERK1/2 respectively, wortmannin, an inhibitor of phosphatidylinositol-3-kinase, and cyclosporin A, a calcineurin inhibitor, hindered both translocation of Rac2 from the cytosol to the plasma membrane and enhancement of Rac2 GTP-binding elicited by Ang II. These results provide evidence that the activation of Rac2 by Ang II is exerted through multiple signalling pathways, involving Ca(2)(+)/calcineurin and protein kinases, the elucidation of which should be insightful in the design of new therapies aimed at reversing the inflammation of vessel walls found in a number of cardiovascular diseases.

Lipoprotein lipase activity and mass, apolipoprotein C-II mass and polymorphisms of apolipoproteins E and A5 in subjects with prior acute hypertriglyceridaemic pancreatitis

BACKGROUND Severe hypertriglyceridaemia due to chylomicronemia may trigger an acute pancreatitis. However, the basic underlying mechanism is usually not well understood. We decided to analyze some proteins involved in the catabolism of triglyceride-rich lipoproteins in patients with severe hypertriglyceridaemia. METHODS Twenty-four survivors of acute hypertriglyceridaemic pancreatitis (cases) and 31 patients with severe hypertriglyceridaemia (controls) were included. Clinical and anthropometrical data, chylomicronaemia, lipoprotein profile, postheparin lipoprotein lipase mass and activity, hepatic lipase activity, apolipoprotein C II and CIII mass, apo E and A5 polymorphisms were assessed. RESULTS Only five cases were found to have LPL mass and activity deficiency, all of them thin and having the first episode in childhood. No cases had apolipoprotein CII deficiency. No significant differences were found between the non-deficient LPL cases and the controls in terms of obesity, diabetes, alcohol consumption, drug therapy, gender distribution, evidence of fasting chylomicronaemia, lipid levels, LPL activity and mass, hepatic lipase activity, CII and CIII mass or apo E polymorphisms. However, the SNP S19W of apo A5 tended to be more prevalent in cases than controls (40% vs. 23%, NS). CONCLUSION Primary defects in LPL and C-II are rare in survivors of acute hypertriglyceridaemic pancreatitis; lipase activity measurements should be restricted to those having their first episode during childhood.

Second-order Møller-Plesset perturbation theory without basis set superposition error : II : open-shell systems

The basis set superposition error-free second-order MØller-Plesset perturbation theory of intermolecular interactions was studied. The difficulties of the counterpoise (CP) correction in open-shell systems were also discussed. The calculations were performed by a program which was used for testing the new variants of the theory. It was shown that the CP correction for the diabatic surfaces should be preferred to the adiabatic ones

Tomografia computadorizada na análise dos padrões de calcificações nos tumores ósseos da bacia em pediatria: nova abordagem

OBJETIVO: No grupo pediátrico, o diagnóstico radiológico dos tumores dos ossos ilíacos, ísquios e púbis apresenta dificuldades e peculiaridades próprias, mas a literatura revisada não trata especificamente desse tema. Este trabalho pretende investigar a existência de padrões radiológicos confiáveis para o diagnóstico diferencial desses tumores. MATERIAIS E MÉTODOS: Foram revistos os achados radiológicos de tumores dos ossos do quadril em dez pacientes com idades entre 8 e 19 anos. RESULTADOS: Reação óssea (esclerose ou lise), reação periosteal (lamelar em camada única, múltiplas camadas ou radial), extensão do tumor no osso e grau de invasão das partes moles revelaram baixa especificidade. As calcificações nas partes moles, consideradas em conjunto, foram inespecíficas. Contudo, separando as próximas do osso comprometido, que apresentam formas e tamanhos variados - padrão I -, daquelas afastadas do osso, finas e amorfas - padrão II -, observamos que o padrão I foi totalmente inespecífico e o padrão II foi identificado nos três casos de osteossarcoma (100%) e em apenas um dos casos de Ewing (16,6%). CONCLUSÃO: Neste material, as calcificações padrão II revelaram sensibilidade de 100% e especificidade de 90% para osteossarcoma. Contudo, sua importância pode não se limitar ao diagnóstico radiológico. As calcificações padrão II indicam, provavelmente, os sítios ideais para biópsia.

Minimum-uncertaity states and pseudoclassical dynamics. II

The set of initial conditions for which the pseudoclassical evolution algorithm (and minimality conservation) is verified for Hamiltonians of degrees N (N>2) is explicitly determined through a class of restrictions for the corresponding classical trajectories, and it is proved to be at most denumerable. Thus these algorithms are verified if and only if the system is quadratic except for a set of measure zero. The possibility of time-dependent a-equivalence classes is studied and its physical interpretation is presented. The implied equivalence of the pseudoclassical and Ehrenfest algorithms and their relationship with minimality conservation is discussed in detail. Also, the explicit derivation of the general unitary operator which linearly transforms minimum-uncertainty states leads to the derivation, among others, of operators with a general geometrical interpretation in phase space, such as rotations (parity, Fourier).