Lifetime maximization for beamforming applications in wireless sensor networks

Energy efficiency is a major design issue in the context of Wireless Sensor Networks (WSN). If data is to be sent to a far-away base station, collaborative beamforming by the sensors may help to dis- tribute the load among the nodes and reduce fast battery depletion. However, collaborative beamforming techniques are far from opti- mality and in many cases may be wasting more power than required. In this contribution we consider the issue of energy efficiency in beamforming applications. Using a convex optimization framework, we propose the design of a virtual beamformer that maximizes the network's lifetime while satisfying a pre-specified Quality of Service (QoS) requirement. A distributed consensus-based algorithm for the computation of the optimal beamformer is also provided

Study about the Problem of Dropping of Subjects by Students During an Academinc Year at the University.

In university studies, it is not unusual for students to drop some of the subjects they have enrolled in for the academic year. They start by not attending lectures, sometimes due to neglect or carelessness, or because they find the subject too difficult, this means that they lose the continuity in the topics that the professor follows. If they try to attend again they discover that they hardly understand anything and become discouraged and so decide to give up attending lectures and study on their own. However some fail to turn up to do their final exams and the failure rate of those who actually do the exams is high. The problem is that this is not only the case with one specific subject, but it is often the same with many subjects. The result is that students arent’s productive enough, wasting time and also prolonging their years of study which entails a great cost for families. Degree courses structured to be conducted and completed in three academic courses, it may in fact take up to an average of six or more academic courses. In this paper, we have studied this problem, which apart from the waste of money and time, produces frustration in the student, who finds that he has not been able to achieve what he had proposed at the beginning of the course. It is quite common, to find students who do not even pass nor 50% of the subjects they had enrolled in for the academic year. If this happens repeatedly to a student, it can be the point when he considers dropping out altogether. This is also a concern for the universities, especially in the early courses. In our experience as professors, we have found that students, who attend lectures regularly and follow the explanations, approach the final exams with confidence and rarely fail the subject. In this proposal we present some techniques and methods carried out to solve in possible, the problem of lack of attendance to lectures. This involves "rewarding students for their assistance and participation in lectures". Rewarding assistance with a "prize" that counts for the final mark on the subject and involving more participation in the development of lectures. We believe that we have to teach students to use the lectures as part of their learning in a non-passive way. We consider the professor's work as fundamental in terms of how to convey the usefulness of these topics explained and the applications that they will have for their professional life in the future. In this way the student see for himself the use and importance of what he is learning. When his participation is required, he will feel more involved and confident participating in the educational system. Finally we present statistical results of studies carried out on different degrees and on different subjects over two consecutive years. In the first year we assessed only the final exams without considering the students attendance, or participation. In the second year, we have applied the techniques and methods proposed here. In addition we have compared the two ways of assessing subjects.

The lethal mutation of the mouse wasted (wst) is a deletion that abolishes expression of a tissue-specific isoform of translation elongation factor 1α, encoded by the Eef1a2 gene

We have identified the mutation responsible for the autosomal recessive wasted (wst) mutation of the mouse. Wasted mice are characterized by wasting and neurological and immunological abnormalities starting at 21 days after birth; they die by 28 days. A deletion of 15.8 kb in wasted mice abolishes expression of a gene called Eef1a2, encoding a protein that is 92% identical at the amino acid level to the translation elongation factor EF1α (locus Eef1a). We have found no evidence for the involvement of another gene in this deletion. Expression of Eef1a2 is reciprocal with that of Eef1a. Expression of Eef1a2 takes over from Eef1a in heart and muscle at precisely the time at which the wasted phenotype becomes manifest. These data suggest that there are tissue-specific forms of the translation elongation apparatus essential for postnatal survival in the mouse.

Role of calpain in skeletal-muscle protein degradation

Although protein degradation is enhanced in muscle-wasting conditions and limits the rate of muscle growth in domestic animals, the proteolytic system responsible for degrading myofibrillar proteins in skeletal muscle is not well defined. The goals of this study were to evaluate the roles of the calpains (calcium-activated cysteine proteases) in mediating muscle protein degradation and the extent to which these proteases participate in protein turnover in muscle. Two strategies to regulate intracellular calpain activities were developed: overexpression of dominant-negative m-calpain and overexpression of calpastatin inhibitory domain. To express these constructs, L8 myoblast cell lines were transfected with LacSwitch plasmids, which allowed for isopropyl β-d-thiogalactoside-dependent expression of the gene of interest. Inhibition of calpain stabilized fodrin, a well characterized calpain substrate. Under conditions of accelerated degradation (serum withdrawal), inhibition of m-calpain reduced protein degradation by 30%, whereas calpastatin inhibitory domain expression reduced degradation by 63%. Inhibition of calpain also stabilized nebulin. These observations indicate that calpains play key roles in the disassembly of sarcomeric proteins. Inhibition of calpain activity may have therapeutic value in treatment of muscle-wasting conditions and may enhance muscle growth in domestic animals.

A second promoter provides an alternative target for therapeutic up-regulation of utrophin in Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is an inherited muscle-wasting disease caused by the absence of a muscle cytoskeletal protein, dystrophin. We have previously shown that utrophin, the autosomal homologue of dystrophin, is able to compensate for the absence of dystrophin in a mouse model of DMD; we have therefore undertaken a detailed study of the transcriptional regulation of utrophin to identify means of effecting its up-regulation in DMD muscle. We have previously isolated a promoter element lying within the CpG island at the 5′ end of the gene and have shown it to be synaptically regulated in vivo. In this paper, we show that there is an alternative promoter lying within the large second intron of the utrophin gene, 50 kb 3′ to exon 2. The promoter is highly regulated and drives transcription of a widely expressed unique first exon that splices into a common full-length mRNA at exon 3. The two utrophin promoters are independently regulated, and we predict that they respond to discrete sets of cellular signals. These findings significantly contribute to understanding the molecular physiology of utrophin expression and are important because the promoter reported here provides an alternative target for transcriptional activation of utrophin in DMD muscle. This promoter does not contain synaptic regulatory elements and might, therefore, be a more suitable target for pharmacological manipulation than the previously described promoter.

Slow and fast dietary proteins differently modulate postprandial protein accretion

The speed of absorption of dietary amino acids by the gut varies according to the type of ingested dietary protein. This could affect postprandial protein synthesis, breakdown, and deposition. To test this hypothesis, two intrinsically 13C-leucine-labeled milk proteins, casein (CAS) and whey protein (WP), of different physicochemical properties were ingested as one single meal by healthy adults. Postprandial whole body leucine kinetics were assessed by using a dual tracer methodology. WP induced a dramatic but short increase of plasma amino acids. CAS induced a prolonged plateau of moderate hyperaminoacidemia, probably because of a slow gastric emptying. Whole body protein breakdown was inhibited by 34% after CAS ingestion but not after WP ingestion. Postprandial protein synthesis was stimulated by 68% with the WP meal and to a lesser extent (+31%) with the CAS meal. Postprandial whole body leucine oxidation over 7 h was lower with CAS (272 ± 91 μmol⋅kg−1) than with WP (373 ± 56 μmol⋅kg−1). Leucine intake was identical in both meals (380 μmol⋅kg−1). Therefore, net leucine balance over the 7 h after the meal was more positive with CAS than with WP (P < 0.05, WP vs. CAS). In conclusion, the speed of protein digestion and amino acid absorption from the gut has a major effect on whole body protein anabolism after one single meal. By analogy with carbohydrate metabolism, slow and fast proteins modulate the postprandial metabolic response, a concept to be applied to wasting situations.

Fas-dependent CD4+ cytotoxic T-cell-mediated pathogenesis during virus infection

β2-Microglobulin-deficient (β2m−) mice generate a CD4+ major histocompatibility complex class II-restricted cytotoxic T-lymphocyte (CTL) response following infection with lymphocytic choriomeningitis (LCM) virus (LCMV). We have determined the cytotoxic mechanism used by these CD4+ CTLs and have examined the role of this cytotoxic activity in pathogenesis of LCM disease in β2m− mice. Lysis of LCMV-infected target cells by CTLs from β2m− mice is inhibited by addition of soluble Fas-Ig fusion proteins or by pretreatment of the CTLs with the protein synthesis inhibitor emetine. In addition, LCMV-infected cell lines that are resistant to anti-Fas-induced apoptosis are refractory to lysis by these virus-specific CD4+ CTLs. These data indicate that LCMV-specific CD4+ CTLs from β2m− mice use a Fas-dependent lytic mechanism. Intracranial (i.c.) infection of β2m− mice with LCMV results in loss of body weight. Fas-deficient β2m−.lpr mice develop a similar wasting disease following i.c. infection. This suggests that Fas-dependent cytotoxicity is not required for LCMV-induced weight loss. A potential mediator of this chronic wasting disease is tumor necrosis factor (TNF)-α, which is produced by LCMV-specific CD4+ CTLs. In contrast to LCMV-induced weight loss, lethal LCM disease in β2m− mice is dependent on Fas-mediated cytotoxicity. Transfer of immune splenocytes from LCMV-infected β2m− mice into irradiated infected β2m− mice results in death of recipient animals. In contrast, transfer of these splenocytes into irradiated infected β2m−.lpr mice does not cause death. Thus a role for CD4+ T-cell-mediated cytotoxicity in virus-induced immunopathology has now been demonstrated.

Cloning and characterization of FGF23 as a causative factor of tumor-induced osteomalacia

Tumor-induced osteomalacia (TIO) is one of the paraneoplastic diseases characterized by hypophosphatemia caused by renal phosphate wasting. Because removal of responsible tumors normalizes phosphate metabolism, an unidentified humoral phosphaturic factor is believed to be responsible for this syndrome. To identify the causative factor of TIO, we obtained cDNA clones that were abundantly expressed only in a tumor causing TIO and constructed tumor-specific cDNA contigs. Based on the sequence of one major contig, we cloned 2,270-bp cDNA, which turned out to encode fibroblast growth factor 23 (FGF23). Administration of recombinant FGF23 decreased serum phosphate in mice within 12 h. When Chinese hamster ovary cells stably expressing FGF23 were s.c. implanted into nude mice, hypophosphatemia with increased renal phosphate clearance was observed. In addition, a high level of serum alkaline phosphatase, low 1,25-dihydroxyvitamin D, deformity of bone, and impairment of body weight gain became evident. Histological examination showed marked increase of osteoid and widening of growth plate. Thus, continuous production of FGF23 reproduced clinical, biochemical, and histological features of TIO in vivo. Analyses for recombinant FGF23 products produced by Chinese hamster ovary cells indicated proteolytic cleavage of FGF23 at the RXXR motif. Recent genetic study indicates that missense mutations in this RXXR motif of FGF23 are responsible for autosomal dominant hypophosphatemic rickets, another hypophosphatemic disease with similar features to TIO. We conclude that overproduction of FGF23 causes TIO, whereas mutations in the FGF23 gene result in autosomal dominant hypophosphatemic rickets possibly by preventing proteolytic cleavage and enhancing biological activity of FGF23.

Altered potassium balance and aldosterone secretion in a mouse model of human congenital long QT syndrome

The voltage-dependent K+ channel responsible for the slowly activating delayed K+ current IKs is composed of pore-forming KCNQ1 and regulatory KCNE1 subunits, which are mutated in familial forms of cardiac long QT syndrome. Because KCNQ1 and KCNE1 genes also are expressed in epithelial tissues, such as the kidneys and the intestine, we have investigated the adaptation of KCNE1-deficient mice to different K+ and Na+ intakes. On a normal K+ diet, homozygous kcne1−/− mice exhibit signs of chronic volume depletion associated with fecal Na+ and K+ wasting and have lower plasma K+ concentration and higher levels of aldosterone than wild-type mice. Although plasma aldosterone can be suppressed by low K+ diets or stimulated by low Na+ diets, a high K+ diet provokes a tremendous increase of plasma aldosterone levels in kcne1−/− mice as compared with wild-type mice (7.1-fold vs. 1.8-fold) despite lower plasma K+ in kcne1−/− mice. This exacerbated aldosterone production in kcne1−/− mice is accompanied by an abnormally high plasma renin concentration, which could partly explain the hyperaldosteronism. In addition, we found that KCNE1 and KCNQ1 mRNAs are expressed in the zona glomerulosa of adrenal glands where IKs may directly participate in the control of aldosterone production by plasma K+. These results, which show that KCNE1 and IKs are involved in K+ homeostasis, might have important implications for patients with IKs-related long QT syndrome, because hypokalemia is a well known risk factor for the occurrence of torsades de pointes ventricular arrhythmia.

Increased mRNA levels for components of the lysosomal, Ca2+-activated, and ATP-ubiquitin-dependent proteolytic pathways in skeletal muscle from head trauma patients.

The cellular mechanisms responsible for enhanced muscle protein breakdown in hospitalized patients, which frequently results in lean body wasting, are unknown. To determine whether the lysosomal, Ca2+-activated, and ubiquitin-proteasome proteolytic pathways are activated, we measured mRNA levels for components of these processes in muscle biopsies from severe head trauma patients. These patients exhibited negative nitrogen balance and increased rates of whole-body protein breakdown (assessed by [13C]leucine infusion) and of myofibrillar protein breakdown (assessed by 3-methylhistidine urinary excretion). Increased muscle mRNA levels for cathepsin D, m-calpain, and critical components of the ubiquitin proteolytic pathway (i.e., ubiquitin, the 14-kDa ubiquitin-conjugating enzyme E2, and proteasome subunits) paralleled these metabolic adaptations. The data clearly support a role for multiple proteolytic processes in increased muscle proteolysis. The ubiquitin proteolytic pathway could be activated by altered glucocorticoid production and/or increased circulating levels of interleukin 1beta and interleukin 6 observed in head trauma patients and account for the breakdown of myofibrillar proteins, as was recently reported in animal studies.

Broad resistance to plant viruses in transgenic plants conferred by antisense inhibition of a host gene essential in S-adenosylmethionine-dependent transmethylation reactions.

S-Adenosylhomocysteine hydrolase (SAHH) is a key enzyme in transmethylation reactions that use S-adenosylmethionine as the methyl donor. Because of the importance of SAHH in a number of S-adenosylmethionine-dependent transmethylation reactions, particularly the 5' capping of mRNA during viral replication, SAHH has been considered as a target of potential antiviral agents against animal viruses. To test the possibility of engineering a broad type of resistance to plant viruses, we expressed the antisense RNA for tobacco SAHH in transgenic tobacco plants. As expected, transgenic plants constitutively expressing an anti-sense SAHH gene showed resistance to infection by various plant viruses. Among those plants, about half exhibited some level of morphological change (typically stunting). Analysis of the physiological change in those plants showed that they contained excess levels of cytokinin. Because cytokinin has been found to induce acquired resistance, there is also a strong possibility that the observed resistance was induced by cytokinin.

Desigualdade social entre as crianças menores de 5 anos em diferentes regiões mundiais

Introdução: A Organização Mundial da Saúde indica que a prevalência do déficit de altura tem diminuído no planeta nas últimas décadas, pouco se sabe ainda sobre os fatores associados a este declínio ou sua associação com a desigualdade social. Objetivo: Descrever a evolução do déficit de altura e da desigualdade socioeconômica em diferentes regiões do mundo. Métodos: A pesquisa foi baseada em dados secundários provenientes do programa Demografic Health Surveys DHS de 6 sub-regiões do mundo representando 24 países em um total de 48 pesquisas na década de 90 e na primeira década do século 21 com 377.151 crianças menores de 5 anos. Foi considerada como variável de interesse o Déficit de altura para idade considerado como a ocorrência deste índice inferior a -2 escore Z da distribuição de referência WHO-2006. Foram imputados através de modelo de regressão os valores faltantes das variáveis água para beber, esgoto sanitário e escolaridade materna. Foi estimado o Índice de Concentração para as variáveis déficit de altura, educação materna deficiente, água para beber insegura, esgoto domiciliar deficiente e ocorrência de doenças, tendo como variável de ranqueamento o Índice de Riqueza. Dados do poder de paridade de compra fornecidos pelo Banco Mundial foram utilizados para verificar as diferenças na evolução da desnutrição. Resultados: Nessa análise acerca da evolução da desigualdade socioeconômica do déficit de altura para idade em países em desenvolvimento constatou-se que: a) a prevalência do déficit de altura para idade decresceu em 87 por cento dos países; b) apenas 8 países (33 por cento ) aumentaram a diferença entre prevalência do déficit de altura nos quintos extremos c) quatorze países (58 por cento ) evoluíram com diminuição do déficit de altura e aumento do índice de concentração; d) Dois países que diminuíram a o déficit de altura e a desigualdade tinham os menores valores de escolaridade materna deficiente; e) 13 países (93 por cento ) daqueles que diminuíram déficit mas aumentaram a desigualdade possuíam indicadores de vulnerabilidade infantil deficientes. Conclusões: Os países em desenvolvimento apresentam redução no déficit de altura em crianças menores de 5 anos. A diminuição da desigualdade na riqueza e na escolaridade materna deficiente explicaram maior parte da melhoria da desigualdade do déficit de altura para idade.

Análise in vitro da expressão de genes de resposta a estresse oxidativo e osmótico da bactéria fastidiosa Leifsonia xyli subsp. xyli

Atualmente, o Brasil é o maior produtor de cana-de-açúcar (Saccharum ssp.), no qual o estado de São Paulo é responsável por mais de 50% da produção. Esta cultura é hospedeira de diversos patógenos que podem limitar sua produção, dentre os quais se destaca a bactéria Leifsonia xyli subsp. xyli (Lxx), agente causal do raquitismo da soqueira (ratoon stunting disease - RSD). Pouco se sabe sobre a fisiologia deste organismo e quais as estratégias utilizadas por este para colonizar seu hospedeiro. No entanto, sabemos que para infectar e colonizar seus hospedeiros, é necessário que bactérias parasíticas superem estresses de diversas naturezas impostas durante estes processos, como os estresses oxidativo e o osmótico. Neste contexto, os objetivos deste trabalho foram identificar in silico e analisar a expressão in vitro, por qPCR, de genes relacionados a estes dois estresses. Uma análise da sequência do genoma de Lxx identificou 35 genes, sendo 8 relacionados ao estresse oxidativo, 9 relacionados ao estresse osmótico e 11 relacionados a estresse gerais, incluindo um cluster de 6 genes envolvidos na síntese de carotenoides. A expressão destes foi avaliada 60 minutos após exposição a 30mM de H2O2 ou 7% (p/v) de polietilenoglicol 6000 (PEG 6000). Sete genes foram avaliados como normalizadores das reações de qPCR. A quantificação do grau de peroxidação lipídica indicou que ambos os tratamentos resultaram em sensível peroxidação, muito embora o efeito do tratamento com PEG 6000 tenha sido maior do que o tratamento com H2O2. A exposição ao H2O2 aumentou a expressão dos genes katA (catalase), sodA (superóxido dismutase), msrA (Sulfóxido de metionina redutase) e msrB (Sulfóxido de metionina redutase) bem como de todos os genes responsáveis pela síntese de carotenoides. Por outro lado, todos os genes relacionados ao estresse osmótico foram menos expressos na presença deste composto. Já quando a bactéria foi exposta a PEG 6000, o oposto ocorreu, ou seja, os genes relacionados ao estresse osmótico, que são otsA (Trealose-6-fosfato sintase), otsB (Trealose fosfatase), treY (Malto-oligosil trealose sintase), treZ (Malto-oligosil trealose trealoidrolase), treS (Trealose sintase), proX (Proteína de ligamento em substrato, tipo ABC glicina betaína transportadora), proW (Proteína permease, tipo ABC glicina betaína transportadora), proZ (Proteína permease, tipo ABC glicina betaína transportadora) e Naggn (Amidotransferase), além dos genes do cluster carotenoide, foram mais expressos, ao passo que alguns dos genes ligados à resposta ao estresse oxidativo foram menos expressos. Verificou-se também, através de PCR convencional utilizando primers para amplificar as regiões entre os genes carotenoides, que estes são expressos como um RNA policistrônico, constituindo assim um operon. Estes resultados validam predições anteriores baseadas na análise in silico da sequência do genoma de Lxx, confirmando que Lxx possui mecanismos responsivos aos estresses osmótico e oxidativo aos quais é submetida durante o processo de infecção de seu hospedeiro.

Limnologia, balneabilidade e impactos ambientais: uma análise temporal e espacial na represa do Lobo (Broa), Itirapina/Brotas - SP

Considerando a importância da represa do Lobo, os indícios de eutrofização encontrados na área e tendo a recreação como seu principal uso, buscou-se, neste trabalho, avaliar a qualidade da água nos rios tributários e na represa, e sua adequação a balneabilidade. Para os afluentes do sistema, estimando-se, ainda, a contribuição dos mesmos ao aporte de materiais à represa, foram amostrados o córrego do Geraldo, a confluência dos córregos Água Branca e Limoeiro, o rio Itaqueri (antes da mineradora), o ribeirão do Lobo, o córrego das Perdizes, avaliando-se parâmetros físicos, químicos e biológicos da água e a vazão dos rios, em dois períodos (agosto/setembro e dezembro) de 2002. Os resultados, com base no índice de estado trófico, indicam que a maioria dos tributários, com exceção do córrego Água Branca (eutrófico), é oligotrófico. Na represa o estudo teve avaliações mensais para alguns parâmetros (nutrientes totais e dissolvidos, clorofila total e material em suspensão) e semanais para outros (pH, condutividade elétrica, temperatura da água, oxigênio dissolvido e coliformes fecais) ao longo de um ano (dezembro de 2001 a dezembro de 2002), em nove pontos, abrangendo a região de foz do rio Itaqueri, córrego do Geraldo e ribeirão do Lobo, quatro pontos distribuídos na praia do balneário Santo Antônio e um ponto a jusante da represa. A foz do rio Itaqueri apresentou-se meso-eutrófica no período, enquanto os outros pontos avaliados, oligotróficos. Apesar da condição favorável apresentada, a análise temporal dos dados (com estudos realizados nos últimos 30 anos), mostra uma evidente e preocupante alteração nas condições originárias desse sistema, indicando um evidente processo de eutrofização do reservatório, associado aos usos e ocupação da bacia hidrográfica (resíduos domiciliares, turismo, agricultura e pecuária). Em relação a balneabilidade os principais pontos de contaminação fecal na represa são as entradas dos tributários, enquanto o corpo da represa foi considerado excelente em todo o período amostrado. O córrego Água Branca, como corpo receptor do esgoto de Itirapina, é o mais comprometido dos corpos de água avaliados, além de ser o principal contribuinte de nutrientes e coliformes fecais para a represa do Lobo, através do rio Itaqueri.

Otimização dos valores de referência da 17OH-progesterona neonatal de acordo com o peso ao nascimento no programa de triagem neonatal da APAE DE SÃO PAULO

Introdução: A Hiperplasia Adrenal Congênita por deficiência da 21-hidroxilase (HAC) é uma doença com mortalidade neonatal elevada sendo elegível para programas públicos de Triagem Neonatal (TN). A HAC é causada por mutações no gene CYP21A2, as quais acarretam diferentes comprometimentos da atividade enzimática e resultam em espectro amplo de manifestações clínicas. Apesar da eficiência da TN para diagnosticar os casos graves, a taxa elevada de resultados falso-positivos (RFP), principalmente relacionados à prematuridade, é um dos maiores problemas. Porém, resultados falso-negativos também podem ocorrer em coletas antes de 24 horas de vida. No Brasil, a coleta da amostra neonatal difere entre os municípios, podendo ser no terceiro dia de vida como após. Objetivo: Avaliar se os valores da 17OH-progesterona neonatal (N17OHP) das coletas no terceiro dia de vida diferem significativamente das coletas a partir do quarto dia. Determinar qual percentil (99,5 ou 99,8) pode ser utilizado como valor de corte para a N17OHP, de acordo com o peso ao nascimento e tempo de vida na coleta, a fim de que proporcione taxa menor de RFP. Métodos: Foi avaliada, retrospectivamente, a N17OHP de 271.810 recém-nascidos (Rns) de acordo com o tempo de vida na coleta (G1: 48 - = 72h) e peso ao nascimento (P1: <= 1.500g, P2: 1.501-2.000g, P3: 2.001-2.500g e P4: >= 2.500g), pelo método imunofluorimétrico. Testes com resultados alterados foram confirmados no soro por Espectrometria de Massas em Tandem - LC-MS/MS. Rns afetados e/ou assintomáticos e com valores persistentemente elevados de 17OHP sérica foram submetidos ao estudo molécular, sequenciamento do gene CYP21A2. Resultados: os valores da N17OHP no grupo G1 foram significativamente menores do que em G2 em todos os grupos de peso (p < 0.001). A taxa de RFP em G1 e G2 foi de 0,2% para o percentil 99,8 e de 0,5% para o percentil 99,5 em ambos os grupos. O percentil 99,8 da N17OHP foi o melhor valor de corte para distinguir os Rns não afetados dos afetados, cujos valores são: G1 (P1: 120; P2: 71; P3: 39 e P4: 20 ng /mL) e em G2 (P1: 173; P2: 90; P3: 66 e P4: 25 ng/mL). Vinte e seis Rns do grupo G1 apresentaram a forma perdedora de sal (PS) (13H e 13M), nestes a N17OHP variou de 31 a 524 ng/mL e vinte Rns no grupo G2 (8H e 12M), nestes a N17OHP variou de 53 a 736 ng/mL. Para ambos os grupos foram encontrados três Rns com a forma virilizante simples (1H e 2M) e os valores da N17OHP variaram de 36 a 51 ng/mL. Resultados falso-negativos não foram relatados. O valor preditivo positivo (VPP) no teste do papel filtro foi de 5,6% e 14,1% nos grupos G1 e G2, respectivamente, ao se utilizar o percentil 99,8, e de 2,3% e 7% nos grupos G1 e G2 ao se utilizar o percentil 99,5. Dentre os casos com TN alterada (RFP), 29 deles também apresentaram 17OHP sérica elevada quando dosada por LC-MS/MS. Os casos assintomáticos foram acompanhados até normalização da 17OHP sérica e/ou submetidos ao estudo molecular, que identificou dois Rns com genótipo que prediz a forma não clássica. Conclusão: a melhor estratégia para otimização do diagnóstico da HAC na triagem neonatal é se padronizar valores de corte da N17OHP em dois grupos de acordo com o tempo de vida na coleta (antes e depois de 72 horas), subdivididos em quatro grupos de peso. A utilização dos valores de corte do percentil 99,8 se mantém eficaz no diagnóstico da HAC-21OH na triagem neonatal, reduzindo de forma significativa a taxa de RFP, sem perda do diagnóstico da forma PS