A comparison between diatom inferred ph changes and diatom populations in brownwater and clearwater lakes

The objective of this study was to determine whether clearwater and brownwater lakes differed in their rate of acidification as inferred by subfossil diatoms analyzed in recent downcore sediments. Differences between associations of diatom populations in brownwater and clearwater environments were characterized. Sediment cores were taken from four lakes located north and east of Lake Superior, near Wawa, Ontario. Two of these lakes were humicrich, brownwater lakes ( lakes U1 and CB2). The two other lakes were clearwater lakes ( lakes Xl and CF). The regression of Nygaard log index-alpha for surficial diatom sediments on observed pH ( Inferred pH = 6.57 - 0.82 log index-alpha ), was utilized to infer lake pH in recent sediments of these lakes. Upon analyzing the downcore diatoms, it was discovered that no significant change, in downcore diatom inferred pH, could be detected in the two brownwater lakes. In contrast, the two clearwater lakes showed significant shifts in downcore diatom inferred pH. In one of these lakes, pH had dropped from 5.3 to 4.5, in the top 9.0 cm of the core, while in the second lake, pH had dropped from 5.4 to 5.0 in the top 1.5 cm of the core. These findings suggested that humic substances, found in brownwater lakes, imparted a buffering capacity to these lake waters. In the clearwater lakes, the decrease in pH was very probably a consequence of acid precipitation. The Ambrosia rise ( circa 1890 ) occurred at the same depth in both brownwater lakes ( 11.0 - 12.0 cm). In both clearwater lakes, the Ambrosia rise occurred at a depth of 14.0 - 15.0 cm. This suggested a lower sedimentation rate in the brownwater lakes. pH influenced the total percentage composition of diatom pH indicator groups. Greater numbers of alkaliphilous taxa were found in less acidic lakes ( e.g. Lake Ul ), While greater numbers of acidloving forms were found in highly acidic lakes ( e.g. Lake Xl ). There was a greater abundance of indifferent forms in the brownwater lakes, than in the clearwater lakes. A number of diatom genera and species were found to be associated with either clearwater or brownwater conditions. The centric diatom, ~elosira distans, significantly increased in abundance in the recent sediments of both clearwater lakes. This may be indicating a shift toward a more oligotrophic state within these acidic, clearwater lakes. This study suggested that a pH index based on subfossil diatoms may be a sensitive indicator of changing lake pH. This study also indicated that humic substances may playa more important role, than previously acknowledged, in controlling the pH dynamics of lake waters, and in determining diatom populations.

Revisión sistemática de literatura de la neumonía lipoidea exógena (nle) por exposición laboral

Objetivo Realizar una revisión sistemática de la neumonía lipoidea exógena (NLE) con el propósito de compactar y sintetizar los conocimientos fragmentados, así como el de informar el estado actual de este tema como riesgo laboral. Metodología La neumonía lipoidea es una condición poco común que resulta de la presencia de lípidos en el interior del espacio alveolar, se desconoce su actual incidencia. La neumonía lipoidea exógena se produce por aspiración o inhalación de sustancias oleosas, es una patología rara en pacientes sin enfermedades de base que predispongan a la broncoaspiración y cuando se presenta en individuos sanos se debe sospechar un origen ocupacional. Se realizó una revisión de literatura según la metodología estandarizada, incluyendo en la búsqueda: reporte de casos, descripciones de la enfermedad y el uso de técnicas diagnósticas. Las bases de datos fueron OVID además de GOOGLE ACADÉMICO; buscadores específicos: MEDLINE, CHEST, PUB MED, REDALYC, SCIELO, Europe PubMed Central (Europe PMC) y ELSEVIER. La búsqueda estuvo además, orientada por una serie de preguntas orientadoras sobre la neumonía lipoidea exógena (NLE) como riesgo laboral. Los artículos que cumplieron con los criterios de inclusión, se clasificaron de acuerdo con tipo de estudio, la calidad del artículo y finalmente se evaluaron con base en una lista de chequeo ajustada para este fin. Resultados Se seleccionó un total de 71 estudios incluyendo reporte de casos, descripciones de la enfermedad y técnicas diagnósticas; publicaciones provenientes de 21 países. Un total de 63 casos, 31 en mujeres (49,20%) y 32 en hombres (50,8%) fueron reportados; el 7,93% de los casos fueron atribuidos a la exposición de agentes en el ambiente laboral: combustibles, parafina/pintura/ pulverizaciones oleosas y diésel, ambientes propios de trabajadores de almacenes de pinturas y conductores de vehículos. Los síntomas de la neumonía lipoidea exógena (NLE) descritos fueron muy variables, puede cursar asintomática o con presencia de fiebre, disnea y tos irritativa; dolor torácico, en algunos casos hemoptisis, cianosis y pérdida de peso; El examen físico generalmente es normal, aunque puede revelar sibilancias o roncus. En pruebas de función respiratoria tales como la espirometría, se presenta un patrón restrictivo, además puede hallarse un descenso en la capacidad de difusión para el monóxido de carbono. En el hemograma puede detectarse leucocitosis con predominio de neutrófilos y aumento de la velocidad de sedimentación globular, hallazgos que también pueden ser producidos por una infección concomitante. Conclusiones Se destaca el hallazgo en la literatura de los diferentes agentes causales presentes en el ambiente laboral que pueden incidir en la aparición de la enfermedad: combustibles, parafina/pintura/ pulverizaciones oleosas y diésel, ambientes propios de trabajadores de almacenes de pinturas y conductores de vehículos. Se presentó neumonía lipoidea exógena (NLE) de tipo agudo después de 30 minutos a 24 horas de exposición masiva a aceites y sustancias oleosas, luego de de ocho meses a 9,5 años de inhalación continua secundaria. Los métodos más para de la diagnóstico enfermedad incluyen el lavado broncoalveolar (BAL), la biopsia de pulmón y la con radiografía torácica. Finalmente, es posible que en pacientes con neumonía lipoidea exógena, puedan presentarse complicaciones asociadas tales como: sobreinfección, fibrosis, retracción de las lesiones, cáncer de pulmón, bronconeumonías recurrentes e hipercalcemia.

The fall speeds of sub-100 mu m ice crystals

Estimates for the sedimentation rate of realistic ice crystals at sizes smaller than 100 µm are presented. These calculations, which exploit new results for the capacitance of ice crystals, are compared with laboratory studies and found to be in good agreement. The results highlight a weakness in contemporary ice particle fall speed parametrizations for very small crystals, which can lead to sedimentation rates being overestimated by a factor of two. The theoretical approach applied here may also be useful for calculating the sedimentation rate and mobility of non-spherical aerosol particles.

Analysis and application of ichnofabrics

Bioturbation at all scales, which tends to replace the primary fabric of a sediment by the ichnofabric (the overall fabric of a sediment that has been bioturbated), is now recognised as playing a major role in facies interpretation. The manner in which the substrate may be colonized, and the physical, chemical and ecological controls (grainsize, sedimentation rate, oxygenation, nutrition, salinity, ethology, community structure and succession), together with the several ways in which the substrate is tiered by bioturbators, are the factors and processes that determine the nature of the ichnofabric. Eleven main styles of substrate tiering are described, ranging from single, pioneer colonization to complex tiering under equilibria, their modification under environmental deterioration and amelioration, and diagenetic enhancement or obscuration. Ichnofabrics may be assessed by four attributes: primary sedimentary factors, Bioturbation Index (BI), burrow size and frequency, and ichnological diversity. Construction of tier and ichnofabric constituent diagrams aid visualization and comparison. The breaks or changes in colonization and style of tiering at key stratal surfaces accentuate the surfaces, and many reflect a major environmental shift of the trace-forming biota. due to change in hydrodynamic regime (leading to non-deposition and/or erosion and/or lithification), change in salinity regime, or subaerial exposure. The succession of gradational or abrupt changes in ichnofabric through genetically related successions, together with changes in colonization and tiering across event beds, may also be interpreted in terms of changes in environmental parameters. It is not the ichnotaxa per se that are important in discriminating between ichnofabrics, but rather the environmental conditions that determine the overall style of colonization. Fabrics composed of different ichnotaxa (and different taphonomies) but similar tier structure and ichnoguild may form in similar environments of different age or different latitude. Appreciation of colonization and tiering styles places ancient ichnofabrics on a sound processrelated basis for environmental interpretation. (C) 2002 Elsevier Science B.V. All rights reserved.

Computer modelling and estimation of recruitment patterns of non-branching coral colonies at three sites in Wakatobi Marine Park, S.E. Sulawesi, Indonesia; implications for coral reef conservation

We have studied growth and estimated recruitment of massive coral colonies at three sites, Kaledupa, Hoga and Sampela, separated by about 1.5 km in the Wakatobi Marine National Park, S.E. Sulawesi, Indonesia. There was significantly higher species richness (P<0.05), coral cover (P<0.05) and rugosity (P<0.01) at Kaledupa than at Sampela. A model for coral reef growth has been developed based on a rational polynomial function, where dx/dt is an index of coral growth with time; W is the variable (for example, coral weight, coral length or coral area), up to the power of n in the numerator and m in the denominator; a1……an and b1…bm are constants. The values for n and m represent the degree of the polynomial, and can relate to the morphology of the coral. The model was used to simulate typical coral growth curves, and tested using published data obtained by weighing coral colonies underwater in reefs on the south-west coast of Curaçao [‘Neth. J. Sea Res. 10 (1976) 285’]. The model proved an accurate fit to the data, and parameters were obtained for a number of coral species. Surface area data was obtained on over 1200 massive corals at three different sites in the Wakatobi Marine National Park, S.E. Sulawesi, Indonesia. The year of an individual's recruitment was calculated from knowledge of the growth rate modified by application of the rational polynomial model. The estimated pattern of recruitment was variable, with little numbers of massive corals settling and growing before 1950 at the heavily used site, Sampela, relative to the reef site with little or no human use, Kaledupa, and the intermediate site, Hoga. There was a significantly greater sedimentation rate at Sampela than at either Kaledupa (P<0.0001) or Hoga (P<0.0005). The relative mean abundance of fish families present at the reef crests at the three sites, determined using digital video photography, did not correlate with sedimentation rates, underwater visibility or lack of large non-branching coral colonies. Radial growth rates of three genera of non-branching corals were significantly lower at Sampela than at Kaledupa or at Hoga, and there was a high correlation (r=0.89) between radial growth rates and underwater visibility. Porites spp. was the most abundant coral over all the sites and at all depths followed by Favites (P<0.04) and Favia spp. (P<0.03). Colony ages of Porites corals were significantly lower at the 5 m reef flat on the Sampela reef than at the same depth on both other reefs (P<0.005). At Sampela, only 2.8% of corals on the 5 m reef crest are of a size to have survived from before 1950. The Scleractinian coral community of Sampela is severely impacted by depositing sediments which can lead to the suffocation of corals, whilst also decreasing light penetration resulting in decreased growth and calcification rates. The net loss of material from Sampela, if not checked, could result in the loss of this protective barrier which would be to the detriment of the sublittoral sand flats and hence the Sampela village.

A high resolution late Holocene palaeo environmental record from the central Adriatic Sea

A multi-proxy study of a Holocene sediment core (RF 93-30) from the western flank of the central Adriatic, in 77 m of water, reveals a sequence of changes in terrestrial vegetation, terrigenous sediment input and benthic fauna, as well as evidence for variations in sea surface temperature spanning most of the last 7000 yr. The chronology of sedimentation is based on several lines of evidence, including AMS 14C dates of foraminifera extracted from the core, palaeomagnetic secular variation, pollen indicators and dated tephra. The temporal resolution increases towards the surface and, for some of the properties measured, is sub-decadal for the last few centuries. The main changes recorded in vegetation, sedimentation and benthic foraminiferal assemblages appear to be directly related to human activity in the sediment source area, which includes the Po valley and the eastern flanks of the central and northern Appenines. The most striking episodes of deforestation and expanding human impact begin around 3600 BP (Late Bronze Age) and 700 BP (Medieval) and each leads to an acceleration in mass sedimentation and an increase in the proportion of terrigenous material, reflecting the response of surface processes to widespread forest clearance and cultivation. Although human impact appears to be the proximal cause of these changes, climatic effects may also have been important. During these periods, signs of stress are detectable in the benthic foram morphotype assemblages. Between these two periods of increased terrigeneous sedimentation there is smaller peak in sedimentation rate around 2400BP which is not associated with evidence for deforestation, shifts in the balance between terrigenous and authigenic sedimentation, or changes in benthic foraminifera. The mineral magnetic record provides a sensitive indicator of changing sediment sources: during forested periods of reduced terrigenous input it is dominated by authigenic bacterial magnetite, whereas during periods of increased erosion, anti-ferromagetic minerals (haematite and/or goethite) become more important, as well as both paramagnetic minerals and super-paramagnetic magnetite. Analysis of the alkenone, U37k′, record provides an indication of possible changes in sea surface temperature during the period, but it is premature to place too much reliance on these inferred changes until the indirect effects of past changes in the depth of the halocline and in circulation have been more fully evaluated. The combination of methods used and the results obtained illustrate the potential value of such high resolution near-shore marine sedimentary sequences for recording wide-scale human impact, documenting the effects of this on marine sedimentation and fauna and, potentially, disentangling evidence for human activities from that for past changes in climate.

Paleoenvironmental analysis of a late-holocene subfossil Coleopteran fauna from Starks, Maine

The Sandy River in central Maine Is flanked along much of its length by low terraces. Approximately 100 kg of sediment from one terrace in Starks, Somerset County, Maine was wet-sieved in the field. Over 1100 subfossil Coleoptera were recovered representing 53 individual species of a total of 99 taxa. Wood associated with the fauna is 2000 +/-80 14C Yr in age (1-16,038). The fauna is dominated by species characteristic of habitats apparent in modern central Maine. The subfossil assemblage is indicative of a wide vartety of environments including open ground (e.g., Harpalus pensylvanicus), dense forest (e.g., pterostichus honestus), aquatic environments (e.g., Gyrinus, Helophorus), riparian environments with sand and gravel substrates (e.g., Bembidion inaequale, Schizogenius lineolatus), and moist, organic-rich terrestrial environments (e.g., Micropeplus sculptus). The ecological requirements for each taxon permit an environmental reconstruction suggesting an area vegetationally, climatically, and ecologically similar to that of the Sandy River today. The lowest terraces apparently represent the modern-day floodplain of the Sandy River. An average sedimentation rate of l.00 to 1.04 mm per year has been inferred based on radiocarbon dates here and elsewhere on the Sandy River. The Coleopteran fauna suggests that sand and gravel were distinctly abundant, and that the aggradation of point bars, as seen today, contributed to the flood history. Lateral bank erosion of the modern Sandy River accelerated after the State of Maine mandated cessation of bar removal in 1975: flood severity has dramatically increased since that time. Implications suggest that mining of the bars may be necessary to minimize future flooding problems.

Dinâmica de Sedimentação de Lodo em Lagoas de Estabilização

Stabilization ponds are an effective sewage treatment alternative for the climatic conditions prevailing in Brazil. In the present work, a primary facultative pond was studied, in the city of Natal, Rio Grande do Norte, Northeast Brazil. The aim of this study was to evaluate the sedimentation dynamics in the facultative pond. The pond was divided in three section or zones along its length starting from the inlet end namely A1, A2 and A3. The research was accomplished in three phases. In the first the mapping of the sludge layer was done, sludge core samples were also collected for analysis for total, fixed and volatile solids and the depth of the sludge layer was determined using a portable echo sounder. In the second solids sedimentation rates were measured using traps placed in the inlet and outlet zones and in the third phase resuspension sludge was evaluate using a tracer. The amount accumulated sludge since the start operation was 13.583 m3. The sedimentation constant averages changed between 0.93 to 2.94 and 3.90 to 5.80 for the depths of 0.5 and 1.0 m respectively. The relationship between volatile and fixed solids (SV/SF) increased along the pond. The removal efficiencies were 52.12%, 36.09%, and 37.50% for BOD, COD and SS, respectively. The sludge accumulation model proposed had a good adjustment with 0.17 m3/hab.year rate. The results presented here demonstrated that the wind had a direct influence on the sedimentation of solids in this pond affecting the efficiency and sludge accumulation

Avaliação do Tratamento da Paracoccidioidomicose Com O Ketoconazol

Foram, tratados 12 doentes atendidos na Disciplina de Moléstias Infecciosas e Parasitárias da Faculdade de Medicina de Botucatu com diagnóstico etiológico de paracoccidioidomicose que apresentavam lesões orgânicas múltiplas e evolução prolongada. O tratamento foi realizado por 18 meses, com o ketoconazol, pela via oral, nas doses diárias de 400 mg no primeiro mês e de 200 mg nos meses seguintes. Todos os doentes foram acompanhados durante o tratamento e, em média 4 meses e meio após o mesmo, clínica, radiológica e sorologicamente pelas reações de imunofluorescência indireta, precipitinas e imunodifusão em gel. A competência imunitária foi avaliada em todos os doentes antes do tratamento e repetida em quatro, no final do mesmo. Os resultados mostraram que houve recaída em 5 doentes. A droga foi bem tolerada e a imunodifusão em gel e a hemossedimentação foram as provas que mostraram maior paralelismo com a evolução clínica.

Pulmonary tuberculosis: Hematology, serum biochemistry and the relation with the disease duration

The aim of the present study was to analyze the relationship between hematological and biochemical parameters and tuberculosis process activity time according to clinical complaint duration. It was a retrospective study analyzing medical records from 80 pulmonary tuberculosis patients at Botucatu Medical School University Hospital ( Botucatu, São Paulo State, Brazil), who were divided into 2 groups according to clinical complaint duration: Group 1 ( G1) - up to three months; Group 2 ( G2) - over three months. Parameters included: age, gender, bacilloscopy, erythrocyte sedimentation rate ( ESR), platelet count, alpha1-globulin, alpha2-globulin, gamma globulin, mucoprotein, alpha1-acid glycoprotein values, and the presence of risk factors such as smoking, alcoholism, drug addiction, sexual promiscuity, contact with tuberculosis carriers, and previous treatment. Groups were compared by calculating t and p, and Chi-square (X-2) and p. Comparisons revealed a tendency towards smoking with a higher frequency of smokers in G1 ( 0.05< p< 0.10). G1 also tended to present greater platelet values than G2 ( 0.05< p< 0.10) and presented significantly higher ESR values than G2 ( p< 0.05). Other factors did not show any significantly different behavior between groups ( p> 0.05). A correlation was found between ESR, platelet count, smoking and less than three months clinical duration.

Cytokines and acute-phase serum proteins as markers of inflammatory regression during pulmonary tuberculosis treatment

Tuberculosis is still increasing and was declared a worldwide sanitary emergency by the World Health Organization (WHO) in 1995. Its control is difficult due to long treatment duration and lack of markers of treatment success or failure. Cytokines such as IFN-gamma and TNF-alpha, a central factor in immune response against Mycobacterium tuberculosis, are responsible for the interaction between T lymphocytes and the infected macrophage and are also produced during this interaction. As proinflammatory cytokines have a close relationship with mycobacteria clearance, in fact even preceding it, they could be used as markers for inflammatory activity and response to treatment. Proinflammatory cytokines act in the liver and stimulate a strong local and systemic acute-phase response as a result of homeostatic and physiological responses also induced by them. Acute-phase proteins produced by cytokine activity are useful diagnostic markers that could also be used to monitor treatment response as they can be serially quantified. The objective of this study was to evaluate IFN-gamma, TNF-alpha, IL-10 and TGF-beta production in supernatant of peripheral blood mononuclear cell (PBMC) and monocyte (MO) cultures, as well as serum acute-phase response through total protein, albumin, globulin, C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), and erythrocyte sedimentation rate (ESR) as regression markers of inflammatory response during pulmonary tuberculosis treatment. Twenty blood donors (G1) from the Blood Bank at Botucatu School of Medicine's University Hospital (BSM-UH) were evaluated once and 28 pulmonary tuberculosis patients (G2): 13 from BSM-UH and 15 from the Bauru State Health Secretariat. Patients were evaluated at three moments of treatment: before (M1), at three months (M2), and at the end (M3). Cytokines were determined in 20ml of peripheral blood (ELISA), with or without activation: lipopolysaccharide (LPS) for MO culture and phytohemagglutinin (PHA) for PBMC culture. Acute-phase protein behavior in G2 throughout treatment was: Globulins: M1> M2, M1> M3 (rho < 0.001); CRP: M1> M2> M3 (.< 0.001); AGP for men: M1> M2, M1> M3 (rho < 0.001); ESR for men: M1> M2, M1> M3 (rho < 0.0016) and for women: M1> M2 (.< 0.025). Comparison between cytokine levels found in supernatant of MO and PBMC cultures, with and without stimulus, in G1 and G2 during treatment showed: TNF-alpha (with/ without LPS) at M1: G2> G1; at M2: G2> G1 (rho < 0.001); (without LPS) at M3: G2> G1 (rho < 0.001), (with LPS) at M3: G2> G1 (rho < 0.028); IFN-. (with and without PHA) at M1: G2> G1; at M2: G2> G1 (rho < 0.001); IL-10 (with and without LPS) at M1: G2> G1; at M2: G2> G1; at M3: G2> G1 (rho < 0.001); TGF-beta (with and without LPS) at M1: G2> G1; at M2: G2> G1 (rho < 0.001), (without LPS) at M3: G2> G1 (rho < 0.001). In G2, all cytokines in supernatant of MO and PBMC cultures, with and without stimulus, showed: M1> M2> M3 (rho < 0.01). Levels of globulins, CRP, AGP, and ESR in patients with pulmonary tuberculosis before treatment (M1) were significantly higher than reference values, suggesting their use as diagnostic markers and indicators of treatment. The CRP decreasing values along treatment could be taken as a marker of the regression of inflammatory process and of response to treatment in patients with pulmonary tuberculosis.Regarding cytokines, there was significant increase in TNF-alpha, IFN-gamma, IL-10, and TGF-alpha levels before and at three months treatment, with and without stimulus; in TNF-a and IL-10 lvels, with and without stimulus, as well as in TGF-alpha levels without stimulus at six months. Patients had higher levels of all studied cytokines than controls before treatment, and these values decreased along treatment. In this study, pulmonary tuberculosis patients showed a Th0 cytokine profile before treatment, with the production of both Th1 (IFN-gamma) and Th2 (IL-10) cytokines, in addition to TNF-alpha inflammatory and TGF-alpha regulatory and fibrosis-inducer cytokines. At the end of treatment, all had evolved to Th2 profile, probably in an attempt to reduce the harmful effects of the proinflammatory activity of the Th1 cytokine profile and of the still above-normal levels of TNF-alpha. The high levels of TGF-alpha, also found in these patients, are related to its important role in the extracellular matrix deposition and fibrosis induction that characterize tuberculosis healing process. IFN-gamma was the only cytokine reaching normal levels at the end of treatment, which suggests its use as a marker of response to treatment.

Citocinas e proteínas de fase aguda do soro como marcadores de regressão da resposta inflamatória ao tratamento da tuberculose pulmonar

OBJETIVO: Analisar o padrão de citocinas pró- e antiinflamatórias e da resposta de fase aguda (RFA) como marcadores de resposta ao tratamento da tuberculose pulmonar. MÉTODOS: Determinação dos níveis de interferon-gama (IFN-γ), tumor necrosis factor-alpha (TNF-α, fator de necrose tumoral-alfa), interleucina-10 (IL-10) e transforming growth factor-beta (TGF-β, fator transformador de crescimento-beta), pelo método ELISA, em sobrenadante de cultura de células mononucleares do sangue periférico e monócitos, assim como dos níveis de proteínas totais, albumina, globulinas, alfa-1-glicoproteína ácida (AGA), proteína C reativa (PCR) e velocidade de hemossedimentação (VHS) em 28 doentes com tuberculose pulmonar, em três tempos: antes (T0), aos três meses (T3) e aos seis meses (T6) de tratamento, em relação aos controles saudáveis, em um único tempo. RESULTADOS: Os pacientes apresentaram valores maiores de citocinas e RFA que os controles em T0, com diminuição em T3 e diminuição (TNF-α, IL-10, TGF-β, AGA e VHS) ou normalização (IFN-γ e PCR) em T6. CONCLUSÕES: PCR, AGA e VHS são possíveis marcadores para auxiliar no diagnóstico de tuberculose pulmonar e na indicação de tratamento de indivíduos com baciloscopia negativa; PCR (T0 > T3 > T6 = referência) pode também ser marcador de resposta ao tratamento. Antes do tratamento, o perfil Th0 (IFN-γ, IL-10, TNF-α e TGF-β), indutor de e protetor contra inflamação, prevaleceu nos pacientes; em T6, prevaleceu o perfil Th2 (IL-10, TNF-α e TGF-β), protetor contra efeito nocivo pró-inflamatório do TNF-α ainda presente. O comportamento do IFN-γ (T0 > T3 > T6 = controle) sugere sua utilização como marcador de resposta ao tratamento.

Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil omega-3 fatty acids

OBJECTIVE: the potential pathogenicity of free radicals may have a pivotal role in ulcerative colitis. Fish oil omega-3 fatty acids exert anti-inflammatory effects on patients with ulcerative colitis (UC), but the precise mechanism of the action of fish oil on oxidative stress is still controversial. The aim of the present work was to verify the blood oxidative stress in patients with UC and determine whether the association of sulfasalazine to fish oil omega-3 fatty acids is more effective than isolated use of sulfasalazine to reduce the oxidative stress.METHODS:, Nine patients (seven female and two male; me. an age = 40 +/- 11 y) with mild or moderate active UC were studied in a randomized crossover design. In addition to their usual medication (2 g/d of sulfasalazine), they received fish oil omega-3 fatty acids (4.5 g/d) or placebo for 2-mo treatment periods that were separated by 2 mo, when they only received sulfasalazine. Nine healthy individuals served as control subjects to study the oxidative stress status. Disease activity was assessed by laboratory indicators (C-reactive protein, alpha(1)-acid glycoprotein, alpha(1)-antitrypsin, erythrocyte sedimentation rate, albumin, hemoglobin, and platelet count), sigmoidoscopy, and histology scores. Analysis of oxidative stress was assessed by plasma chemiluminescence and erythrocyte lipid peroxidation, both induced by tert butyl hydroperoxide (t-BuOOH) and by plasma malondialdehyde. Antioxidant status was assayed by total plasma antioxidant capacity (TRAP) and microsomal lipid peroxidation inhibition (LPI). Superoxide dismutase (SOD) and catalase erythrocyte enzymatic activities were also determined.RESULTS: No significant changes were observed in any laboratory indicator or in the sigmoidoscopy or histology scores, with the exception of erythrocyte sedimentation rate, which decreased with both treatments. Oxidative stress was demonstrated by significant decreases in TRAP and LPI levels, increased chemiluminescence induced by t-BuOOH, and higher SOD activity in patients with UC. Treatment with fish oil omega-3 fatty acids reverted the chemiluminescence induced by t-BuOOH and LPI to baseline levels but that did not occur when patients received only sulfasalazine. Levels of plasma malondialdehyde, erythrocyte lipid peroxidation, and catalase were not different from those in the control group.CONCLUSIONS: the results indicated that plasma oxidative stress occurs in patients with UC, and there was a significant decrease when the patients used sulfasalazine plus fish oil omega-3 fatty acids. However, there was no improvement in most laboratory indicators, sigmoidoscopy, and histology scores. The results suggested that omega-3 fatty acids may act as free radical scavengers protecting the patients against the overall effect of oxidative stress. (C)Elsevier B.V. 2003.

Comparison of omega-3 fatty acids and sulfasalazine in ulcerative colitis

Fish oil omega-3 fatty acids exert antiinflammatory effects on patients with ulcerative colitis. However, a comparative study in patients with mild to moderate ulcerative colitis receiving only sulfasalazine or omega-3 fatty acids has not been performed. We sought to detect changes in the inflammatory disease activity with the use of either fish oil omega-3 fatty acids or sulfasalazine in patients with ulcerative colitis. Ten patients (five male, five female; mean age = 48 +/- 12 y) with mild to moderate active ulcerative colitis were investigated in a randomized cross-over design. They received either sulfasalazine (2 g/d) or omega-3 fatty acids (5.4 g/d) for 2 mo. Disease activity was assessed by clinical and laboratory indicators, sigmoidoscopy, histology, and whole-body protein turnover (with N-15-glycine). Treatment with w-3 fatty acids resulted in greater disease activity as detected by a significant increase in platelet count, erythrocyte sedimentation rate, C-reactive protein, and total fecal nitrogen excretion. No major changes in protein synthesis and breakdown were observed during either treatment. In conclusion, treatment with sulfasalazine is superior to treatment with omega-3 fatty acids in patients with mild to moderate active ulcerative colitis. Nutrition 2000;16:87-901 (C) Elsevier B.V. 2000.

Preliminary Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus

Objective. To develop widely acceptable preliminary criteria of global flare for childhood-onset systemic lupus erythematosus (cSLE).Methods. Pediatric rheumatologists (n = 138) rated a total of 358 unique patient profiles with information about the cSLE flare descriptors from 2 consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-double-stranded DNA antibodies, disease activity index scores, protein: creatinine (P:C) ratio, complement levels, and erythrocyte sedimentation rate (ESR). Based on 2,996 rater responses about the course of cSLE (baseline versus followup), the accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the American College of Rheumatology recommendations for the development and validation of criteria sets.Results. The highest-ranked candidate criteria considered absolute changes (Delta) of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) or British Isles Lupus Assessment Group (BILAG), MD-global, P:C ratio, and ESR; flare scores can be calculated (0.5 x Delta SLEDAI + 0.45 x Delta P:C ratio + 0.5 x Delta MD-global + 0.02 x Delta ESR), where values of >= 1.04 are reflective of a flare. Similarly, BILAG-based flare scores (0.4 x Delta BILAG + Delta 0.65 x Delta P:C ratio + 0.5 + Delta MD-global + 0.02 x Delta ESR) of >= 1.15 were diagnostic of a flare. Flare scores increased with flare severity.Conclusion. Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care.