Machine learning-based risk prediction for major adverse cardiovascular events in a Brazilian hospital: Development, external validation, and interpretability.

BACKGROUND: Studies of cardiovascular disease risk prediction by machine learning algorithms often do not assess their ability to generalize to other populations and few of them include an analysis of the interpretability of individual predictions. This manuscript addresses the development and validation, both internal and external, of predictive models for the assessment of risks of major adverse cardiovascular events (MACE). Global and local interpretability analyses of predictions were conducted towards improving MACE's model reliability and tailoring preventive interventions. METHODS: The models were trained and validated on a retrospective cohort with the use of data from Ribeirão Preto Medical School (RPMS), University of São Paulo, Brazil. Data from Beth Israel Deaconess Medical Center (BIDMC), USA, were used for external validation. A balanced sample of 6,000 MACE cases and 6,000 non-MACE cases from RPMS was created for training and internal validation and an additional one of 8,000 MACE cases and 8,000 non-MACE cases from BIDMC was employed for external validation. Eight machine learning algorithms, namely Penalized Logistic Regression, Random Forest, XGBoost, Decision Tree, Support Vector Machine, k-Nearest Neighbors, Naive Bayes, and Multi-Layer Perceptron were trained to predict a 5-year risk of major adverse cardiovascular events and their predictive performance was evaluated regarding accuracy, ROC curve (receiver operating characteristic), and AUC (area under the ROC curve). LIME and Shapley values were applied towards insights about model interpretability. FINDINGS: Random Forest showed the best predictive performance in both internal validation (AUC = 0.871 (0.859-0.882); Accuracy = 0.794 (0.782-0.808)) and external one (AUC = 0.786 (0.778-0.792); Accuracy = 0.710 (0.704-0.717)). Compared to LIME, Shapley values suggest more consistent explanations on exploratory analysis and importance of features. CONCLUSIONS: Among the machine learning algorithms evaluated, Random Forest showed the best generalization ability, both internally and externally. Shapley values for local interpretability were more informative than LIME ones, which is in line with our exploratory analysis and global interpretation of the final model. Machine learning algorithms with good generalization and accompanied by interpretability analyses are recommended for assessments of individual risks of cardiovascular diseases and development of personalized preventive actions.

Environmentally friendly screen-printed electrodes for the selective detection of 4-bromo-2,5-dimethoxyphenethylamine (2C-B) in forensic analysis.

In response to the growing need for sustainable analytical methods, this study explores the repurposing of screen-printed electrodes (SPEs) that would otherwise be discarded. This involves recoating the working electrode surface with a graphite (Gr) and chitosan (CTS) dispersion, creating a reusable SPE (SPE-Gr/CTS). Demonstrating its utility, SPE-Gr/CTS was employed for the detection of 4-bromo-2,5-dimethoxyphenethylamine (2C-B), a phenylethylamine commonly used for recreational proposes. Identifying 2C-B in fluid oral and seized samples is of great interest for forensic and toxicological applications. The 2C-B detection using SPE-Gr/CTS was optimized in Britton-Robinson buffer solution (0.1 mol L-1) at pH 2.0, employing square-wave adsorptive stripping voltammetry. The electrochemical behavior of 2C-B on SPE-Gr/CTS exhibited one irreversible oxidation and a reversible redox process. The proposed method presented a dynamic linear range for 2C-B determination (0.05 to 7.5 µmol L-1) with a low LOD (0.015 µmol L-1). Moreover, the stability of 2C-B electrochemical responses on SPE-Gr/CTS was confirmed using the same or different electrodes (N = 3), with a relative standard deviation of less than 5.0%. Interference studies with seventeen other illicit drugs and adulterants demonstrated that the proposed method is selective for 2C-B detection even in the presence of these substances. Real seized and oral fluid samples containing 2C-B were analyzed using this method, and the results were confirmed by LC-MS. The proposed device demonstrates to be an environmentally friendly and selective sensor for 2C-B detection in forensic analysis, offering a rapid and straightforward screening method for seized and biological samples. In addition, a portable and sensitive determination of 2C-B in forensic samples is presented with minimal sample consumption (50 µL).

Evidence of a European seed dispersal crisis.

Seed dispersal is crucial for ecosystem persistence, especially in fragmented landscapes, such as those common in Europe. Ongoing defaunation might compromise effective seed dispersal, but the conservation status of pairwise interactions remains unknown. With a literature review, we reconstructed the first European-wide seed dispersal network and evaluated the conservation status of interactions by assessing each interacting partner's IUCN (International Union for Conservation of Nature) conservation status and population trends. We found that a third of the disperser species and interactions face potential extinction and that 30% of the plant species have most of their dispersers threatened or declining. Our study reveals a developing seed dispersal crisis in Europe and highlights large knowledge gaps regarding the dispersers and conservation status of zoochorous plants, urging further scrutiny and action to conserve the seed dispersal service.

A short version of the Alcohol Consumption Consequences Evaluation Scale (ACCE10).

A brief version of the Alcohol Consumption Consequences Evaluation Scale (ACCE) [38] was developed to promptly detect possible risks related to alcohol consumption, such as Binge Drinking (BD), in university students. Using the "snowball" method, a sample of 595 students aged 18 to 20 (65.4% women) from the University of Valencia (Spain) was obtained during the 2019-2020 academic year. Items with the highest values of the discrimination parameter in the original version (ACCE) were selected and the Rasch model was applied. To verify the usefulness of this version, ROC analyses were conducted separately for men and women using the Audit score as the criterion. In the overall sample, the analysis had an area of 0.812 (SE = 0.018). In men, the area was 0.796 (SE = 0.032) and for women, it was 0.823 (SE = 0.021). In addition, a logistic regression analysis was performed, using a cut-off point of 3 based on the ROC analysis, to assess the utility of this version in classifying BD and non-BD. The odds ratio was 3.812 (p = 0.000), correctly classifying 89.2% of the young people and indicating that the probability of engaging in BD is 3.8 times higher for individuals obtaining more than 3 points on this scale. This result confirms the usefulness of this brief version (ACCE10) as a screening tool for early intervention, especially in clinical or university settings, since it allows young people to be situated within a range of severity according to their consumption patterns. Furthermore, it may help stop the progression of the addictive process, create awareness of the need for change, and facilitate access to the most suitable interventions.

Metabolomics and proteomics in occupational medicine: a comprehensive systematic review.

BACKGROUND: Occupational biomonitoring is essential for assessing health risks linked to workplace exposures. The use of 'omics' technologies, such as metabolomics and proteomics, has become crucial in detecting subtle biological alterations induced by occupational hazards, thereby opening novel avenues for biomarker discovery. AIMS: This systematic review aims to evaluate the application of metabolomics and proteomics in occupational health. METHODS: Following the PRISMA guidelines, we conducted a comprehensive search on PubMed, Scopus, and Web of Science for original human studies that use metabolomics or proteomics to assess occupational exposure biomarkers. The risk of bias was assessed by adapting the Cochrane Collaboration tool and the Newcastle-Ottawa Quality Assessment Scale. RESULTS: Of 2311 initially identified articles, 85 met the eligibility criteria. These studies were mainly conducted in China, Europe, and the United States of America, covering a wide range of occupational exposures. The findings revealed that metabolomics and proteomics approaches effectively identified biomarkers related to chemical, physical, biomechanical, and psychosocial hazards. Analytical methods varied, with mass spectrometry-based techniques emerging as the most prevalent. The risk of bias was generally low to moderate, with specific concerns about exposure measurement and confounding factors. CONCLUSIONS: Integrating metabolomics and proteomics in occupational health biomonitoring significantly advances our understanding of exposure effects and facilitates the development of personalized preventive interventions. However, challenges remain regarding the complexity of data analysis, biomarker specificity, and the translation of findings into preventive measures. Future research should focus on longitudinal studies and biomarker validation across diverse populations to improve the reliability and applicability of occupational health interventions.

Sole Stenting versus Stent-Assisted Coiling for Treating Dissecting Posterior Circulation Aneurysms: A Systematic Review and Meta-Analysis.

BACKGROUND: Among the reconstructive methods for treating dissecting posterior circulation aneurysms, there are stent-assisted coiling (SAC), and sole stenting (SS) therapy. Despite SAC being widely employed when compared to SS, no study systematically analyzed the difference in their outcomes. METHODS: The authors conducted a meta-analysis of studies employing both therapies to compare their outcomes. A search was performed in January 2024, including only studies with consecutive patients submitted to SS or SAC. The studies had to have at least one of the following outcomes: complete aneurysm occlusion, complications, mortality, aneurysm recurrence, retreatment, and good clinical outcome. Odds ratio (OR) with 95% confidence interval (CI) were utilized for statistics. RESULTS: In a pooled analysis of 17 studies, comparing 173 SS and 377 SAC procedures for dissecting posterior circulation aneurysms, no significant differences were found in related mortality (OR 1.44; 95% CI 0.49-4.27); total mortality (OR 1.33; 95% CI 0.53-3.37); retreatment (OR 0.45; 95% CI 0.16-1.26); recurrence (OR 1.00; 95% CI 0.43-2.33); postoperative complete aneurysmal occlusion (OR 0.79; 95% CI 0.09-6.77); follow-up complete aneurysmal occlusion (OR 1.57; 95% CI 0.62-3.94); intraoperative complications (OR 1.04; 95% CI 0.29-3.73); postoperative complications (OR 1.22; 95% CI 0.61-2.45); hemorrhagic complications (OR 2.16; 95% CI 0.77-6.06); ischemic complications (OR 1.68; 95% CI 0.68-4.15). Good clinical outcomes significantly favored SAC (OR 0.45; 95% CI 0.23-0.86). CONCLUSIONS: The findings suggest there is no substantial basis for favoring SAC over SS across all cases. Instead, an individualized approach should be considered, according to the patient's characteristics, surgeon skills, and the available material.

Validating alternative oxidase (AOX) gene family as efficient marker consortium for multiple-resilience in Xylella fastidiosa-infected Vitis holobionts.

KEY MESSAGE: AOX gene family in motion marks in-born efficiency of respiration adjustment; can serve for primer screening, genotype ranking, in vitro-plant discrimination and a SMART perspective for multiple-resilient plant holobiont selection. The bacteria Xylella fastidiosa (Xf) is a climate-dependent, global threat to many crops of high socio-economic value, including grapevine. Currently designed breeding strategies for Xf-tolerant or -resistant genotypes insufficiently address the danger of biodiversity loss by focusing on selected threats, neglecting future environmental conditions. Thus, breeding strategies should be validated across diverse populations and acknowledge temperature changes and drought by minimizing the metabolic-physiologic effects of multiple stress-induced oxygen shortages. This research hypothesizes that multiple-resilient plant holobionts achieve lifelong adaptive robustness through early molecular and metabolic responses in primary stress target cells, which facilitate efficient respiration adjustment and cell cycle down-regulation. To validate this concept open-access transcriptome data were analyzed of xylem tissues of Xf-tolerant and -resistant Vitis holobionts from diverse trials and genetic origins from early hours to longer periods after Xf-inoculation. The results indicated repetitive involvement of alternative oxidase (AOX) transcription in episodes of down-regulated transcripts of cytochrome c oxidase (COX) at various critical time points before disease symptoms emerged. The relation between transcript levels of COX and AOX ('relCOX/AOX') was found promising for plant discrimination and primer screening. Furthermore, transcript levels of xylem-harbored bacterial consortia indicated common regulation with Xf and revealed stress-induced early down-regulation and later enhancement. LPS priming promoted the earlier increase in bacterial transcripts after Xf-inoculation. This proof-of-principle study highlights a SMART perspective for AOX-assisted plant selection towards multiple-resilience that includes Xf-tolerance. It aims to support timely future plant diagnostics and in-field substitution, sustainable agro-management, which protects population diversity and strengthens both conventional breeding and high-tech, molecular breeding research. Furthermore, the results suggested early up-regulation of bacterial microbiota consortia in vascular-enriched tissues as a novel additional trait for future studies on Xf-tolerance.

Chemical Profile, Antioxidant and Antimicrobial Activity of Marine Sponge Species Combined with Multivariate Statistical Analyses: Desmapsamma anchorata, Dysidea etheria and Echinodictyum dendroides.

Marine sponges are valuable sources of bioactive compounds, which have attracted pharmacological interest. This study aimed to evaluate the chemical profile, antioxidant, and antibacterial activities of the species Desmapsamma anchorata, Dysidea etheria, and Echinodictyum dendroides. The chemical profile involved identifying and quantifying polyphenols, and antioxidant activity was evaluated using various methods. The antibacterial and modulatory activities were evaluated using microdilution against pathogenic strains. The extracts contained a low amount of polyphenols. In the antioxidant assays, the EACDa and EMDa extracts exhibited better inhibitory results. In the antibacterial evaluation, extracts presented MIC ≥1024 µg mL-1. The modulation of the extracts combined with antibiotics showed significant effects against the multiresistant bacterium Pseudomonas aeruginosa. This study contributes to the deepening of chemical and biological knowledge of sponge species. It indicates that their extracts can act as good modulators of bacterial resistance to aminoglycoside antibiotics, which requires further investigation into their mechanisms of action.

Chemical and Biological Prospection of Marine Sponges Belonging to the Class Demospongiae: A Review.

Marine sponges belonging to the class Demospongiae have shown to be promising sources of bioactive compounds. This review aimed to compile studies on the biological activities and chemical components of sponge species from this class, highlighting the structure/activity relationship. Data collection was conducted using the Science Direct, PubMed, Scielo, Web of Science and Google Scholar databases, employing the following descriptors: antimicrobial marine sponges, antioxidant marine sponges, and biological activity of marine sponges. The inclusion criteria were: (1) publications from the year 2022 onwards; (2) written in English or Portuguese; and (3) that evaluated biological activities. Exclusion criteria included: (1) duplicate studies; (2) studies that were not within the scope; and (3) studies that did not evaluate biological activities. As a result of this survey, it was possible to isolate and identify 262 compounds from different metabolic classes, with terpenes, lipids, and alkaloids being highlighted. The extracts, fractions, and isolates were investigated for their antioxidant, antimicrobial, anti-inflammatory, and cytotoxic properties. The sponges demonstrated broad-spectrum antimicrobial potential and cytotoxic potential against various cancer cell lines. Based on data analysis, it is concluded that the studied compounds show promise for the development of drugs for microorganism control and cancer treatment, acting through different mechanisms of action.

Ferric carboxymaltose-induced hypophosphatemia - a case series.

Hypophosphatemia may cause serious complications. Depending on its severity and duration, signs and symptoms range from fatigue to life-threatening events, like severe rhabdomyolysis and mental status changes. Long-term consequences include osteomalacia. Hypophosphatemia may be secondary to the use of parental iron, mostly associated with ferric carboxymaltose (FCM), with an incidence of around 45% to 70%. We describe three cases of hypophosphatemia in patients with chronic iron deficiency anemia, requiring repeated FCM infusions. The patients' presentation to the Rheumatology department included musculoskeletal symptoms of severe hypophosphatemia and long-term hypophosphatemic osteomalacia, with fractures. We aim to raise awareness for ferric carboxymaltose-induced hypophosphatemia, an entity increasingly described in the literature that can be responsible for severe disability or potentially life-threatening adverse events.

Challenges of Renal Function Assessment in Breast Cancer Patients Treated With Abemaciclib: A Case Report.

Abemaciclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor used for hormone-receptor-positive and human epidermal growth factor receptor 2 (HER-2)-negative breast cancer, can lead to elevated serum creatinine without implications on the true renal function. Although clinical trials have shown no increase in other kidney function biomarkers, this may still represent a challenge in cancer patients. We report a case of a 74-year-old female who presented with creatinine and cystatin-C elevation during treatment with abemaciclib without an equivalent decrease in measured glomerular filtration rate (GFR) with renal scintigraphy. The confirmation of adequate kidney function allowed for the maintenance of treatments that would otherwise be limited by renal impairment. Healthcare providers should be aware of abemaciclib's effect on serum creatinine but should not eliminate the possibility of actual kidney injury. Alternative biomarkers for GFR assessment are recommended, although the usefulness of cystatin-C in patients receiving abemaciclib should be investigated in greater depth.

Determination of drugs of abuse and metabolites in plasma microsamples by LC-MS/MS after microQuEChERS extraction.

Aim: Identifying drugs of abuse and their metabolites in plasma is vital in both forensic and clinical toxicology. While the QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) method offers an efficient approach to sample preparation, its application is complex due to the wide-ranging properties of target analytes and the challenges posed by biological matrix interferences. This study aims to develop a microQuEChERS approach for the quantification of 14 drugs of abuse and metabolites utilizing minimal sample and solvent volumes.Methods: The microQuEChERS method involved using 10 µl plasma samples, 25 mg of a salt mixture and 150 µl of acetonitrile. Extracts were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), with a 7.5 min run. The assay was validated according to bioanalytical guidelines.Results: The accuracy was 96.8-112.4%. The within-assay precision was within 2.0-8.9% and the between-assay precision was within 3.2-8.2%. Matrix effects were found to range from -5.7 to 13.5%. The extraction yield was higher than 74.7%.Conclusion: This study described a microQuEChERS sample preparation approach for determining drugs of abuse and metabolites using plasma microsamples and LC-MS/MS. The approach is efficient, environmentally friendly and suitable for scenarios with limited amounts of biological samples.

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Current management of inherited retinal degenerations in Portugal (IRD-PT survey).

Inherited retinal dystrophies/degenerations (IRDs) are the leading cause of visual impairment and incurable familial blindness in the Western world. Given the clinical and genetic heterogeneity, establishing a molecular diagnosis is especially relevant. The aim of this study was to perform the first nationwide survey to understand the prevalence and current management of IRDs in Portugal. A response was obtained from 26 healthcare providers (HCP) (76.5% response rate). Only 4 respondents reported not managing IRD patients. Most HCPs (68.1%) reported managing up to 100 patients, while three currently manage between 501 and 1000 patients. Based on the Portuguese population, an estimated IRD prevalence of 0.031%, i.e., about 1 in 3000 individuals, was calculated. In most HCPs (86.3%), most patients are adults, and non-syndromic retinitis pigmentosa is the most frequent diagnosis. Only 4 HCPs currently use the national, web-based IRD registry (IRD-PT). However, all but one respondent expressed interest in participating in such a registry. Genetic testing is available in 54.5%, with 58.3% HCPs reporting solved rates between 61-80%, but 4 to 9 months to get a genetic test result in 83.4% of cases. Based on this survey, the prevalence of biallelic RPE65-associated disease in Portugal is 0.00031%, i.e., approximately 1:300,000 individuals. Data from this study provide vital background information on national differences in the diagnosis and management of IRD patients. Nationwide implementation of the IRD-PT registry should be encouraged and supported to provide population-based reference data and to identify patients eligible for current and future therapies.

Kidney transplantation in multiple myeloma in 2023: A short review.

Patients with multiple myeloma (MM) frequently present with kidney involvement, of which a non-negligible proportion will progress to end-stage kidney disease. Kidney transplantation (KT) is the preferred kidney replacement therapy for selected patients; however, there are still many uncertainties regarding its application in MM patients. The risk of hematological relapse and subsequent graft loss or patient death often leads nephrologists to deem these patients unfit for KT. As such, data on KT in MM patients are heterogeneous and originate from individual case reports and small case series. Although MM is still an incurable disease, the addition of newer drugs and autologous hematopoietic stem cell transplant (HSCT) in the standard of care has been increasing patients' overall survival in recent decades. Risk stratification using cytogenetic studies and minimal residual disease detection are helpful in assessing the risk of relapse in patients who attain a complete response after HSCT. The greatest challenges remain the correct identification of patients who will most probably benefit from KT from a survival perspective and the determination of how long relapse-free survival should be before the transplant is performed.

Cytotoxic and Anti-HSV-1 Effects of Caulerpin Derivatives.

Marine organisms represent a potential source of secondary metabolites with various therapeutic properties. However, the pharmaceutical industry still needs to explore the algological resource. The species Caulerpa lamouroux Forssk presents confirmed biological activities associated with its major compound caulerpin, such as antinociceptive, spasmolytic, antiviral, antimicrobial, insecticidal, and cytotoxic. Considering that caulerpin is still limited, such as low solubility or chemical instability, it was subjected to a structural modifications test to establish which molecular regions could accept structural modification and to elucidate the cytotoxic bioactive structure in Vero cells (African green monkey kidney cells, Cercopithecus aethiops; ATCC, Manassas, VA, USA) and antiviral to Herpes simplex virus type 1. Substitution reactions in the N-indolic position with mono- and di-substituted alkyl, benzyl, allyl, propargyl, and ethyl acetate groups were performed, in addition to conversion to their acidic derivatives. The obtained analogs were submitted to cytotoxicity and antiviral activity screening against Herpes simplex virus type 1 by the tetrazolium microculture method. From the semi-synthesis, 14 analogs were obtained, and 12 are new. The cytotoxicity assay showed that caulerpin acid and N-ethyl-substituted acid presented cytotoxic concentrations referring to 50% of the maximum effect of 1035.0 µM and 1004.0 µM, respectively, values significantly higher than caulerpin. The antiviral screening of the analogs revealed that the N-substituted acids with methyl and ethyl groups inhibited Herpes simplex virus type 1-induced cytotoxicity by levels similar to the positive control acyclovir.

Genipa americana L.: A Review on Traditional Uses, Phytochemistry and Biological Activities.

Genipa americana L. (Rubiaceae), genip tree, has therapeutic and nutritional potential. This revision aimed to gather information on botanical characteristics, popular uses, phytochemical, and pharmacological aspects of the tree. The methodology adopted integrated literature published between 2000 and 2024, as well as consultations with the World International Intellectual Property Organization (WIPO); resulting in 39 articles and 11 patents to promote this research. The species, which is native and not endemic to Brazil, is most prevalent in the Amazon biome as it is suitable for reconstructing degraded areas, as well as having various traditional applications. Iridoids are the main secondary metabolites present in the species, especially ginipin, geniposide acid, and geniposide, which are the most prevalent in the fruit. The patents registered with the WIPO indicate its use as a colorant, insecticide, anti-inflammatory, and antioxidant potential, in evidence of its antimicrobial and antioxidant activities. Further studies are needed on the mechanisms of the chemical components' action and on ethnopharmacology.

Punicalagin increases follicular activation, development and activity of superoxide dismutase 1, catalase, and glutathione peroxidase 1 in cultured bovine ovarian tissues.

Context The overproduction of reactive oxygen species (ROS) during in vitro culture of ovarian tissues impairs follicular development and survival. Aims To evaluate the effects of punicalagin on the development and survival of primordial follicles, stromal cell and collagen fibres, as well as on the levels of mRNA for nuclear factor erythroid 2-related factor 2 (NRF2 ), superoxide dismutase 1 (SOD1 ), catalase (CAT ), glutathione peroxidase 1 (GPX1 ) and perirredoxin 6 (PRDX6 ), and activity of antioxidant enzymes in cultured bovine ovarian tissues. Methods Bovine ovarian cortical tissues were cultured for 6days in α-MEM+ alone or with 1.0, 10.0, or 100.0µM punicalagin at 38.5°C with 5% CO2 . Follicle morphology and growth, stromal cell density, and collagen fibres were evaluated by classical histology, while the expression of mRNA was evaluated by real-time PCR. The activity of enzymes was analysed by the Bradford method. Key results Punicalagin improved follicle survival and development, reduced mRNA expression for SOD1 and CAT , but did not influence stromal cells or collagen fibres. Punicalagin (10.0µM) increased the levels of thiol and activity of SOD1, CAT , and GPX1 enzymes. Conclusions Punicalagin (10.0µM) promotes follicle survival and development and activates SOD1, CAT , and GPX1 enzymes in bovine ovarian tissues. Implications Punicalagin improves follicle development and survival in cultured ovarian tissues.

Are vitamin D intake and serum levels in the mid-trimester of pregnancy associated with preeclampsia? Results from a Brazilian multicentre cohort.

OBJECTIVE: To explore the association between serum levels and food intake of Vitamin D (VD) among healthy women in mid-pregnancy and preeclampsia. STUDY DESIGN: In a Brazilian multicentre cohort of healthy nulliparous pregnant women from five maternity centres we developed a nested case-control analysis comparing cases with and without preeclampsia. Women were enrolled and followed during prenatal care, including only singleton pregnancies, without any fetal malformations or previous chronic maternal disease. We matched 87 cases of preeclampsia to eligible controls randomly selected in a 1:1 ratio, by age and region. MAIN OUTCOME MEASURES: Blood samples from these were collected, and a 24-hour recall of food intake was obtained in mid-pregnancy, between 19 and 21 weeks. VD serum levels (25-hydroxyvitamin D) were measured by liquid chromatography-tandem mass spectrometry and were categorized as deficient, insufficient, and sufficient. The dietary intake of VD was estimated with the 24-hour diet recall applied at the same time and from supplementation. Maternal characteristics and VD levels were compared between cases and controls with OR and respective 95 %CI. Multivariate analysis using the Path method was used to assess relationships among VD, PE, BMI, skin colour/ethnicity, and diet. RESULTS: The maternal characteristics of both groups were similar, except for the higher occurrence of obesity among women with preeclampsia (OR 3.47, 95 %CI 1.48-8.65). Dietary intake of VD was similar in both groups, and most of the women in both groups consumed insufficient VD (82.2 vs 79.3 % in the groups with and without PE). CONCLUSIONS: Levels and dietary intake of VD were not associated with PE in this Brazilian sample of healthy pregnant women; however, BMI and skin colour/ethnicity were associated with PE.