Determination of CYP2D6 *3, *4, and *10 frequency in women with breast cancer in São Luís, Brazil, and its association with prognostic factors and disease-free survival

The CYP2D6 enzyme is crucial for the metabolism of tamoxifen. The CYP2D6 gene is highly polymorphic, and individuals can be extensive, intermediate, or poor tamoxifen metabolizers. The aim of this study was to determine the frequencies of the CYP2D6 *3, *4, and *10 alleles in women with breast cancer who were treated with tamoxifen and analyze the association of enzyme activity with prognostic factors and disease-free survival. We observed a high frequency of CYP2D6 *10, with an allelic frequency of 0.14 (14.4%). The *3 allele was not present in the studied population, and *4 had an allelic frequency of 0.13 (13.8%). We conclude that patients with reduced CYP2D6 activity did not present worse tumor characteristics or decreased disease-free survival than women with normal enzyme activity, as the difference was not statistically significant. We also observed a high frequency of CYP2D6 *10, which had not been previously described in this specific population. This study is the first in north-northeastern Brazil that aimed to contribute to the knowledge of the Brazilian regional profile for CYP2D6 polymorphisms and their phenotypes. These findings add to the knowledge of the distribution of different polymorphic CYP2D6 alleles and the potential role of CYP2D6 genotyping in clinical practice prior to choosing therapeutic protocols.

Possible benefit of consolidation therapy with high-dose cytarabine on overall survival of adults with non-promyelocytic acute myeloid leukemia

In adults with non-promyelocytic acute myeloid leukemia (AML), high-dose cytarabine consolidation therapy has been shown to influence survival in selected patients, although the appropriate doses and schemes have not been defined. We evaluated survival after calculating the actual dose of cytarabine that patients received for consolidation therapy and divided them into 3 groups according to dose. We conducted a single-center, retrospective study involving 311 non-promyelocytic AML patients with a median age of 36 years (16-79 years) who received curative treatment between 1978 and 2007. The 131 patients who received cytarabine consolidation were assigned to study groups by their cytarabine dose protocol. Group 1 (n=69) received <1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles. The remaining patients received high-dose cytarabine (≥1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles). The actual dose received during the entire consolidation period in these patients was calculated, allowing us to divide these patients into 2 additional groups. Group 2 (n=27) received an intermediate-high-dose (<27 g/m2), and group 3 (n=35) received a very-high-dose (≥27 g/m2). Among the 311 patients receiving curative treatment, the 5-year survival rate was 20.2% (63 patients). The cytarabine consolidation dose was an independent determinant of survival in multivariate analysis; age, karyotype, induction protocol, French-American-British classification, and de novo leukemia were not. Comparisons showed that the risk of death was higher in the intermediate-high-dose group 2 (hazard ratio [HR]=4.51; 95% confidence interval [CI]: 1.81-11.21) and the low-dose group 1 (HR=4.43; 95% CI: 1.97-9.96) than in the very-high-dose group 3, with no significant difference between those two groups. Our findings indicated that very-high-dose cytarabine during consolidation in adults with non-promyelocytic AML may improve survival.

More than 10 years survival with sequential therapy in a patient with advanced renal cell carcinoma: a case report

Although radical nephrectomy alone is widely accepted as the standard of care in localized treatment for renal cell carcinoma (RCC), it is not sufficient for the treatment of metastatic RCC (mRCC), which invariably leads to an unfavorable outcome despite the use of multiple therapies. Currently, sequential targeted agents are recommended for the management of mRCC, but the optimal drug sequence is still debated. This case was a 57-year-old man with clear-cell mRCC who received multiple therapies following his first operation in 2003 and has survived for over 10 years with a satisfactory quality of life. The treatments given included several surgeries, immunotherapy, and sequentially administered sorafenib, sunitinib, and everolimus regimens. In the course of mRCC treatment, well-planned surgeries, effective sequential targeted therapies and close follow-up are all of great importance for optimal management and a satisfactory outcome.

Transplantation and survival of mouse inner ear progenitor/stem cells in the organ of Corti after cochleostomy of hearing-impaired guinea pigs: preliminary results

In mammals, damage to sensory receptor cells (hair cells) of the inner ear results in permanent sensorineural hearing loss. Here, we investigated whether postnatal mouse inner ear progenitor/stem cells (mIESCs) are viable after transplantation into the basal turns of neomycin-injured guinea pig cochleas. We also examined the effects of mIESC transplantation on auditory functions. Eight adult female Cavia porcellus guinea pigs (250-350g) were deafened by intratympanic neomycin delivery. After 7 days, the animals were randomly divided in two groups. The study group (n=4) received transplantation of LacZ-positive mIESCs in culture medium into the scala tympani. The control group (n=4) received culture medium only. At 2 weeks after transplantation, functional analyses were performed by auditory brainstem response measurement, and the animals were sacrificed. The presence of mIESCs was evaluated by immunohistochemistry of sections of the cochlea from the study group. Non-parametric tests were used for statistical analysis of the data. Intratympanic neomycin delivery damaged hair cells and increased auditory thresholds prior to cell transplantation. There were no significant differences between auditory brainstem thresholds before and after transplantation in individual guinea pigs. Some mIESCs were observed in all scalae of the basal turns of the injured cochleas, and a proportion of these cells expressed the hair cell marker myosin VIIa. Some transplanted mIESCs engrafted in the cochlear basilar membrane. Our study demonstrates that transplanted cells survived and engrafted in the organ of Corti after cochleostomy.

Salmonella Typhimurium, Infantis, Derby, and Enteritidis survival in pasty dulce de leche

Dulce de leche is a food obtained by concentration and heating of milk with the addition of sucrose. The common practice of opening the dulce de leche containers in retail markets can lead to food contamination by Salmonella. The objective of this study was to evaluate the survivability of Salmonellaenterica subsp. enterica serotypes Typhimurium, Enteritidis, Infantis and Derby in pasty dulce de leche. Aliquots of this sweet were experimentally contaminated with these microorganisms and later analyzed to evaluate microorganism viability after storage for 0, 1, 2, 3, 5, 10, and 20 days. Salmonella was recovered up to the 20th day. These results are a warning about the need to adopt proper sanitary-hygienic measures for handling and packaging this food aiming at food safety.

Survival of Lactobacillus rhamnosus probiotic strains in peach jam during storage at different temperatures

The survival of six probiotic wild strains of Lactobacillus rhamnosus was compared with that of a type strain during 78 days of storage at 25 and 5 ºC in peach synthetic medium (PSM) and commercial peach jam (PJ). Changes in viable cell counts, pH values, sugar content, and colour parameters were monitored. All strains exhibited better performances in PJ than in PSM, showing count values higher than 7 Log cfu g-1 up to 78 days of storage at 5 ºC. Almost all wild strains remained above the critical value of 6 Log cfu g-1 in samples stored at 25 ºC up to 45 days, while the Lb. rhamnosus GG type strain, used as control, was not able to survive later than 15 days. In the synthetic medium used, the strains showed better survival in the samples incubated at 25 ºC, remaining viable above the critical level up to 45 days of storage, except for the strain H12. The probiotic cultures added to jam did not significantly change the colour parameters of the product; however the metabolism of lactobacilli did cause changes in the pH and in the composition of sugars.

Survival of Shiga toxin-producing Escherichia coli O157:H7 in Minas frescal cheese

Shiga toxin-producing Escherichia coli (STEC) O157:H7 strains (isolated by cattle’s faeces and a reference strain, EDL933), were inoculated into pasteurized milk (102 and 103 cells.mL–1) to prepare the Minas frescal cheese. As control was used uninfected milk. Physicochemical and microbiological analyses were performed to milk and elaborated cheese. The O157:H7 strains were quantified in the stages of cheese processing and during 0, 2, 4, 5, 7, 10 and 15 storage days at 8 °C onto Sorbitol MacConkey Agar supplemented with potassium tellurite and cefixime (CT-SMAC). O157:H7 was not present in the pasteurised milk prior to the artificial inoculation. At the end of the processing the cheese had 10 to 100 times more STEC O157:H7 than the initial inoculum. During the storage, the Minas frescal cheese exhibited the largest population increase on the 4th and 5th day when inoculated with 102 and 103 cells.mL–1, respectively. Additionally, viable cells were found up to the 10th and 15th day, according to the amount of initial inoculum. This number of cells is able to cause infection in humans, and therefore, Minas frescal cheese, even when stored under refrigeration, is a potential vehicle of disease caused by STEC O157:H7.

Construction of a supercritical fluid extraction (SFE) equipment: validation using annatto and fennel and extract analysis by thin layer chromatography coupled to image

Abstract The present work describes setting up a laboratory unit for supercritical fluid extraction. In addition to its construction, a survey of cost was done to compare the cost of the homemade unit with that of commercial units. The equipment was validated using an extraction of annatto seeds’ oil, and the extraction and fractionation of fennel oil were used to validate the two separators; for both systems, the solvent was carbon dioxide. The chemical profiles of annatto and fennel extracts were assessed using thin layer chromatography; the images of the chromatographic plates were processed using the free ImageJ software. The cost survey showed that the homemade equipment has a very low cost (~US$ 16,000) compared to commercial equipment. The extraction curves of annatto were similar to those obtained in the literature (yield of 3.8% oil). The separators were validated, producing both a 2.5% fraction of fennel seed extract rich in essential oils and another extract fraction composed mainly of oleoresins. The ImageJ software proved to be a low-cost tool for obtaining an initial evaluation of the chemical profile of the extracts.

Assessment of a five-year survival on hemodialysis in Brazil: a cohort of 3,082 incident patients

Brazil has the third largest contingent of patients on maintenance hemodialysis (HD) worldwide. However, little is known regarding survival rate and predictors of mortality risk in that population, which are the purposes of this study. A total of 3,082 patients incident on HD, from 2000 to 2004, at 25 dialysis facilities distributed among 7 out of 26 states of Brazil were followed-up until 2009. Patients were 52 ± 16 years-old, 57.8% men, and 20.4%, diabetics. The primary outcome was all causes of mortality. Data were censored at five years of follow-up. The global five-year survival rate was 58.2%. In the Cox proportional model, variables associated with risk of death were: age (hazard ratio - HR = 1.44 per decade, p < 0.0001), diabetes (HR = 1.51, p < 0.0001), serum albumin (HR = 0.76 per g/dL, p = 0.001), creatinine (HR = 0.92 per mg/dL, p < 0.0001), and phosphorus (HR = 1.06 per mg/dL, p = 0.04). The present results show that the mortality rate on HD in this Brazilian cohort was relatively low, but the population is younger and with a lower prevalence of diabetes than the ones reported for developed countries.

Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation

Introduction: Pre-implantation kidney biopsy is a decision-making tool when considering the use of grafts from deceased donors with expanded criteria, implanting one or two kidneys and comparing this to post-transplantation biopsies. The role of histopathological alterations in kidney compartments as a prognostic factor in graft survival and function has had conflicting results. Objective: This study evaluated the prevalence of chronic alterations in pre-implant biopsies of kidney grafts and the association of findings with graft function and survival in one year post-transplant. Methods: 110 biopsies were analyzed between 2006 and 2009 at Santa Casa de Porto Alegre, including live donors, ideal deceased donors and those with expanded criteria. The score was computed according to criteria suggested by Remuzzi. The glomerular filtration rate (GFR) was calculated using the abbreviated MDRD formula. Results: No statistical difference was found in the survival of donors stratified according to Remuzzi criteria. The GFR was significantly associated with the total scores in the groups with mild and moderate alterations, and in the kidney compartments alone, by univariate analysis. The multivariate model found an association with the presence of arteriosclerosis, glomerulosclerosis, acute rejection and delayed graft function. Conclusion: Pre-transplant chronic kidney alterations did not influence the post-transplantation one-year graft survival, but arteriosclerosis and glomerulosclerosis is predictive of a worse GFR. Delayed graft function and acute rejection are independent prognostic factors.

Survival competencies in SMEs in changing business environments

The thesis examines the competencies that enable business survival in changing business environments from the perspective of Russian and Finnish micro, small, and medium-sized enterprises in the field of forest industry. Additionally, it studies the competence transformation necessary in SMEs for successful continuation of business operations when a firm considers transferring its business to another industry. The dissertation builds a holistic firm-level view of survival competencies for SMEs facing changes in their business environments. The holistic firm-level view of competencies includes both the individual-level and the firm-level perspectives, regardless of the position of the person in a firm. The findings highlight the importance of high-level individual competencies and the ability to perform versatile tasks in a firm. In addition, continuous business environment scanning, self-evaluation of personal competencies, willingness to renew and change, open-mindedness, and a readiness to network, are competencies that belong to and need to be taken care of by everybody – employees and employers - in a firm. In addition to previous competencies, an ability to manage every-day business also needs to be embedded in SME owners/managers. Furthermore, Russian SMEs seem to be more proactive in change situations, when compared with Finnish SMEs, which are used to operate in a more stable business environment. In conclusion, it can be said that the thesis adds to SME literature by introducing the concept of ‘SME-level competencies’, a combination of previously discussed organisational and networking competencies which are needed in order to survive through change. Furthermore, the thesis concludes with new competence classifications, such as operational and change competencies, which offer new information concerning the required competencies by which a firm may reduce the resistance to change that can hinder business renewal. For SME practitioners, the study suggests proper preparation and proactive operations in their business to reduce the influence of endless changes, and reminds SME owners/managers that changes are, however, a significant source of new business opportunities. For educational players, the study suggests upgrading educational and training systems by improving the training as regards attitudes towards work, and especially training in the comprehensive working abilities needed in SMEs to master diverse tasks. Finally, for public actors the study suggests providing stronger support to entrepreneurs by boosting SMEs entrepreneurial conditions and the existing business possibilities in change situations. This can be done by encouraging a legislative and entrepreneurial climate that responds better to the demands of SMEs.

Survey, survival and control of Alternaria alternata in wheat seeds

The fungus Alternaria alternata was quantified in 75 wheat seed samples collected from three different regions of southern Brazil for Cropping and Use Value (CUV) I, II and III. Fungal presence was evaluated in two hundred disinfested seeds per sample before sowing in a potato-dextrose-agar medium + antibiotic (PDA+A). Fungus survival was evaluated every 45 days for 180 days for three seed batches from six wheat cultivars stored in propylene bags in a storehouse, with air temperature varying between 18 to 22 °C and relative air humidity around 60%. The efficacy of carboxin+thiram, difenoconazol, thiram, triadimenol, triticonazol and triticonazol + iprodione fungicides to control A. alternata was determined. A. alternata was detected in all the samples with an incidences of 39.6 %, 38.8% and 35.9% for the CUV I, CUV II and CUV III regions, respectively. The highest mean incidence of the fungus was found in the CUV I region, the coolest and most humid, and was significantly different from the other two regions. The average reduction in A. alternata viability in the wheat cultivar seeds was 49.5% during the 180 days of storage (inter-harvest period), demonstrating that infected seeds are the primary inoculum source for the fungus. The triticonazol + iprodione fungicide mixture efficiently controls A. alternata.

Information management in aircraft maintenance

Well managed information promotes competitive advantage and economic value for the company. The challenge is to use information effectively in complex networks. Decision making in network is complicated due to many independent sources of information. The aim of the present study was to identify and map the internal information flows and used information resourced by functions and roles, to make proposals to the case organization to improve the information management and to improve the situational awareness and process flows. In the present study, an inductive approach was applied, with the aim to find out gaps and bottlenecks of information flow of an aircraft maintenance organization and its network. The empirical part was conducted with observing the processes and with questionnaires. Theoretical part of this study consists on reviewing relevant literature on maintenance management in aviation and information management in aviation. Together with empirical evidence and the literature used in the study the gaps were found and suggestions for improvements were done. The outcome of this study contributes the organization in its bigger goal to improve the productivity. The information management of the network is one actor in the field and will pave the way to smoother operation and situational awareness. The lack of rules and requirements for information management and spreading is a challenge in information management. The excessive data overburden may cause problem in the actors’ situation-awareness due to non-availability of the right information.