LRP5 gene polymorphisms and radiographic joint damage in rheumatoid arthritis patients.

Rheumatoid arthritis (RA) is characterized by increased bone resorption and impaired bone formation. Osteoblast function is regulated by the canonical LRP5/Wnt/ß-catenin pathway. Bone mineral density and RA joint destruction are partially inherited. In line with this, we found significant associations between LRP5 SNPs (p.A1330V, p.N740N, p.V667M) and RA radiographic damage severity. INTRODUCTION: Increased bone resorption and impaired bone formation characterize rheumatoid arthritis (RA). Canonical Wnt/ß-catenin pathway, signalled by lipoprotein receptor-related protein-5 (LRP5), regulates osteoblast function. Since bone mineral density (BMD) and RA joint destruction are partially inherited, we studied their association with LRP5 single nucleotide polymorphisms (SNPs). METHODS: Clinical data and peripheral blood for biomarkers assessment and LRP5 genotyping were collected from 208 RA patients. Hands and feet X-rays were scored [modified Sharp/van der Heijde Score (SHS), joint space narrowing (JSN), and erosion scores]. Lumbar spine, total left proximal femur, and left hand BMD were assessed by dual-energy X-ray absorptiometry (DXA). RESULTS: TT genotypes for p.A1330V and p.N740N LRP5 SNPs associated with total SHS, erosion score, and hands erosion score; the same for p.A1330V with feet JSN score and p.N740N with hands total score. AG genotype for p.V667M associated with sclerostin and hands JSN score. Femoral BMD associated with TC genotype for p.N740N. Multiple test correction precluded a few of these associations. Among V667M-N740N-A1330V haplotypes: GTT associated with higher feet JSN score (OR = 3.80; p = 0.016) and ATT with higher JSN score (OR = 4.60; p = 0.032), hands total score (OR = 5.65; p = 0.022), and total SHS (OR = 6.74; p = 0.024). CONCLUSION: Significant associations between LRP5 SNPs (p.A1330V, p.N740N, and p.V667M) and the severity of radiographic damage reinforce the evidence of bone destruction heritability in RA.

Assessing the potential biological implications of recreational inshore fisheries on sub-tidal fish communities of Azores (north-east Atlantic Ocean) using catch and effort data.

Recreational inshore fishing activities practiced on Faial and Pico Islands (Azorean archipelago) were surveyed between October 2004 and September 2005. Recreational inshore fishers employ three main methods of fishing (shore angling, spear fishing and intertidal collecting). The method that demanded the highest fishing effort (number of fishing operations) was shore angling, followed by intertidal collecting and spear fishing. Shore angling produced the highest diversity of catch composition (38), which is in part explained by the seven fishing techniques used by shore anglers. The estimates of annual catch were higher for shore angling than spear fishing (51·2 and 6·3 t) even though they were lower than commercial artisanal fishing (442 t). The weighted mean trophic level and vulnerability index values in the fish catch were higher for spear fishing (3·4 and 50·9) than for shore angling (3·1 and 44·5). Cumulative pressure by different recreational fishing activities was detected on species already subject to a heavy pressure from Azorean commercial fishing, and on vulnerable and top-predator species. There are important biological and ecological implications whereby fishery managers should implement additional regulations such as prohibiting catches of the most vulnerable species.

Association between rainfall and Escherichia coli in live bivalve molluscs harvested in Sardinia, Italy.

Rainfall is generally accepted as one of the most important factors associated with an increased level of E. coli in bivalve molluscs. Performing microbiological risk assessment is relevant to official control authorities to determine the sanitary status of harvesting areas and, therefore, develop monitoring strategies and identify management practices that could be used to improve the quality and safety of the final product. The present study aimed to investigate the impact of rainfall on the content of E. coli in bivalve molluscs farmed in Sardinia (Italy). Enumeration of E. coli was performed according to the Most Probable Number (MPN) method (ISO 16649-3) on 1,920 bivalve samples collected from 7 regional counties between 2018 and 2020. Bivalve molluscs samples included 955 mussels (Mytilus galloprovincialis), 500 oysters (Crassostrea gigas), 325 clams (Ruditapes decussatus), 94 warty venus (Venus verrucosa), and 46 lagoon cockles (Cerastoderma glaucum). Rainfall data were obtained by the Department of Meteorology of the ARPA Sardegna. For each sampling site, GPS coordinates were used to identify gauge stations within catchment areas. Cumulative rain (mm) was recorded 1, 3, 5, 7, and 15 days before sampling, among which the 7-day cumulative rain was the strongest predictor of E. coli counts. Several thresholds of 7-day cumulative rain (from <10 mm up to >300 mm) before sampling were used to estimate the chances of a non-compliant sample (E. coli levels above the limit for sanitary class A; 230 MPN/100 g). The 7-day cumulative rain was positively associated with the chances of non-compliance. When the 7-day cumulative rain before sampling was >300 mm, 80.5 % of the samples were non-compliant, and the odds of a non-compliant sample were 23.6 times higher, as compared to samples harvested when the 7-day cumulative rainfall was <10 mm. Precipitation data could be a useful tool for interpreting anomalous results from official control authorities and reduce the costs that originate from closure of production areas.

Sex estimation by maxillary sinus using computed tomography: a systematic review.

Sex estimation is an important part of forensic human identification, and when primary methods cannot be applied, forensic anthropology becomes an important auxiliary method of identification. The maxillary sinus may remain intact even if the skull is severely damaged and could thus be used in forensic investigations. The objective of this study was to verify the effectiveness of the evaluation of the maxillary sinus as a technique for sex estimation. Articles published in the past 10 years were searched using PubMed, Web of Science, Scopus, and Cochrane databases, including those that used computed tomography to perform maxillary sinus measurements with the purpose of sex estimation. Studies that used radiographs to perform the measurements were excluded because they do not allow for a three-dimensional analysis. Studies that did not provide information regarding the origin of the analyzed population were also excluded. The selected articles were evaluated for methodological quality according to the indication of the objective, studied population, inclusion and exclusion criteria, parameters for obtaining the computed tomography image, measurements evaluated, bias discussion, and ethical authorization. From the 52 articles found, 18 were included. The populations studied included Indians, Iraqis, Iranians, Egyptians, Brazilians, French, Dutch, and Turkish. Height, width, length, and volume of the maxillary sinus were measured. The maxillary sinus can act as an auxiliary tool for sex estimation in forensic investigations.

Applicability of forensic facial approximation in the recognition process of unclaimed victims.

BACKGROUND: Identifying bodies in a state of putrefaction, skeletonization or mutilation is often difficult. In these cases, it is possible to use auxiliary methods such as forensic facial approximation, considering the possibility of recognition by a relative or acquaintance, helping to obtain ante-mortem data for the identification process. The aims of the present study were to evaluate the capacity of recognition of individuals from digital facial approximation and to verify the association between the level of understanding of the issue by evaluators and the recognition success index. METHODS: 16 skulls with previous photographic records were selected and then utilized for three-dimensional approximation using the digital technique, scanned by photogrammetry, and reconstructed by computerized method using open-source software. Twenty evaluators tried to recognize the facial approximation performed from images present in the photospreads. RESULTS: The mean overall score was 23.75%, and it was observed that in only five approximations (31.24%) the option of correct recognition of the victim was the one that obtained the highest number of selections. False positives and negatives corresponded, respectively, to 11.56% and 12.5%. CONCLUSIONS: It can be concluded that the methodology can provide recognition albeit in low numbers, and permitting the acquisition of ante-mortem data for the proper process of human identification through primary methods.

Assessment of relative uptake by mandibular condyles in a "normal" population.

Hyperplasia of the mandibular condyle is self-limiting, but can lead to facial asymmetry, malocclusion, pain, and dysfunction of the temporomandibular joint (TMJ). Bone scintigraphy, particularly with single photon emission computed tomography (SPECT), is effective in assessing relative condylar uptake, but we know of no standardised methods or values. Our aim, therefore was to validate the values currently used to measure relative condylar uptake in our population. Between December 2015 and June 2018 44 patients had skull SPECT (15 male and 29 female patients, whose ages ranged from 4-33 years). They were having bone scans (hydroxydiphosphonate (HDP) -99MTc, 740 MBq ev) for unrelated reasons and had no known abnormalities of the head, facial asymmetry, or symptoms of the TMJ. Two research workers measured the relative uptake between the condyles using the summed transaxial images. The Hospital Ethics Committee approved the investigation. The maximum difference in condylar uptake was 8.33% with research worker 1 and 8.77% with research worker 2, and the mean (SD) differences were 3.03 (0.17) % and 3.29 (0.18) %, respectively. Data were tested for normality, and the t test and one-way ANOVA were used to assess the significance of differences. None was found in total counts either between sexes or age groups, and there were none between the total counts measured by the two research workers. We conclude that our results are within the published ranges, and the variation in condylar uptake was less than 5% in 37/44 patients, and in none was it 9% or more. When the results indicate less than 10%, but there is a high clinical suspicion of active hyperplasia, surgeons should use their clinical judgement to decide whether condylar surgery is required.

Incidental finding of a monostotic form of Paget Disease of the scapula in a lung cancer patient.

Paget Disease of the bone is a metabolic disorder which leads to a profound alteration of the bone's architecture. It may be asymptomatic and, since its radiological features mimic those of bone metastases, may present a diagnostic dilemma during the evaluation of a cancer patient. We illustrate an uncommon monostotic form of the disease, affecting solely the scapula, diagnosed during the staging of a lung cancer patient.

Forensic odontology education:from undergraduate to PhD - a Brazilian experience.

BACKGROUND: Forensic Odontology is a topic present in the majority of Dental Schools in Brazil, and due to this reality, some universities develop activities related to undergraduate and graduate students, from the Dentistry course until the Ph.D. degree. AIM: To present the education experience related to Forensic Odontology at School of Dentistry of Ribeirão Preto (USP - University of São Paulo), showing the strategies and activities in the different degrees (Dental course, Forensic Odontology Specialization Program, Specific Professional Training, Master, and Ph.D.). RESULTS: To the undergraduate students, many activities are developed in order to demonstrate all the possibilities that Forensic Dentistry allow, including theoretical and practical activities; in the Forensic Odontology Specialization Program, the dentists are trained to act as Forensic Odontologists in all its amplitude; in the Specific Professional Training, some courses are available, related to specific topics as DVI, Forensic Facial Reconstruction, Auditor in Dental Care Insurance and others; and in the Master and Ph.D. Programs, the professionals receive training in skills like teaching, research, student's guidance and others. CONCLUSION: In Brazil, Forensic Odontology is a well-known field in Dentistry and universities develop an important role in training a qualified workforce.

Profile of the Illegal Import of Products of Animal Origin to Brazilian Cities at the Border with Argentina and Uruguay.

International food transit is a risk to public and animal health when not subject to legal importation sanitation procedures. Due to the extensive border area, illegal food import in Brazil is a common practice, especially in Rio Grande do Sul (RS), a state that borders with Argentina and Uruguay. The objective of this study was to evaluate the profile of Brazilians living in cities in RS that border with Argentina (BR-AR) or Uruguay (BR-UR) regarding the practice of illegal import of products of animal origin and to determine associations between the population characteristics and illegal import. A questionnaire with information related to the personal profile, habits of acquisition of imported food, and knowledge of health risks deriving from the consumption of the imported products was elaborated. The questionnaire was administered in six cities in RS (three cities bordering Argentina and three cities bordering Uruguay) and responses were obtained from 744 individuals. The variables city, sex, level of education, and knowledge were subjected to the chi-square test to verify the association between these variables and food import. Part of the interviewees admitted to illegally importing products of animal origin at both BR-AR (65.17%) and BR-UR (76.28%) borders. Dairy products were the main imported goods, followed by raw and processed meat. The study revealed that illegal import is common at the frontier region of RS, especially that of products of animal origin, dairy, and raw and processed meat. Although illegal importation occurs at all the cities under study, it was higher at the BR-UR border. Also, knowledge of the health risks influences the decision to import food or not.

[Multiple vertebro-basilar infarcts and cardio-embolism]. / Infartos múltiples en el territorio vertebrobasilar y cardioembolismo.

INTRODUCTION: Stroke characteristics do not inform much about its etiology, even if they can suggest a specific mechanism. We thought that multiple vertebrobasilar infarcts could be related with embolism, namely cardioembolism. PATIENTS AND METHODS: From a hospital prospective registry of stroke we retrieved 73 cases of acute non-lacunar vertebrobasilar infarcts, without previous episodes of stroke in any territory or vertebrobasilar transient ischemic accidents (TIA). Two groups were compared: patients with single cerebral posterior artery infarct (49) and patients with multiple vertebrobasilar infarcts (24), in respect to conventional risk factors for cerebrovascular disease, ancillary procedures performed, and associated pathologic conditions, as possible infarct pathogenesis. RESULTS: Proportions of risk factors and ancillary procedures performed were similar in both groups, except for hypercholesterolemia, which was more frequent in multiple infarcts, and for transcranial Doppler, which was performed more frequently in multiple infarcts. In multiple infarct group, cardioemboligenic pathology was more frequent, as were medium-high emboligenic risk cardiac diseases and atrial fibrillation, although the difference did not reach statistical significance. CONCLUSIONS: Our results support the hypothesis that multiple non-lacunar vertebrobasilar infarcts, from a first ever stroke event, suggest cardioembolic etiology, and recommend performing an exhaustive cardiac investigation.

Cleaning conveyor belts in the chicken-cutting area of a poultry processing plant with 45°c water.

Conveyor belts are widely used in food handling areas, especially in poultry processing plants. Because they are in direct contact with food and it is a requirement of the Brazilian health authority, conveyor belts are required to be continuously cleaned with hot water under pressure. The use of water in this procedure has been questioned based on the hypothesis that water may further disseminate microorganisms but not effectively reduce the organic material on the surface. Moreover, reducing the use of water in processing may contribute to a reduction in costs and emission of effluents. However, no consistent evidence in support of removing water during conveyor belt cleaning has been reported. Therefore, the objective of the present study was to compare the bacterial counts on conveyor belts that were or were not continuously cleaned with hot water under pressure. Superficial samples from conveyor belts (cleaned or not cleaned) were collected at three different times during operation (T1, after the preoperational cleaning [5 a.m.]; T2, after the first work shift [4 p.m.]; and T3, after the second work shift [1:30 a.m.]) in a poultry meat processing facility, and the samples were subjected to mesophilic and enterobacterial counts. For Enterobacteriaceae, no significant differences were observed between the conveyor belts, independent of the time of sampling or the cleaning process. No significant differences were observed between the counts of mesophilic bacteria at the distinct times of sampling on the conveyor belt that had not been subjected to continuous cleaning with water at 45°C. When comparing similar periods of sampling, no significant differences were observed between the mesophilic counts obtained from the conveyor belts that were or were not subjected to continuous cleaning with water at 45°C. Continuous cleaning with water did not significantly reduce microorganism counts, suggesting the possibility of discarding this procedure in chicken processing.

Microbiological evaluation of chicken carcasses in an immersion chilling system with water renewal at 8 and 16 hours.

Since 2004, Brazil has been the leading exporter of chicken. Because of the importance of this sector in the Brazilian economy, food safety must be ensured by control and monitoring of the production stages susceptible to contamination, such as the chilling process. The goal of this study was to evaluate changes in microbial levels on chicken carcasses and in chilling water after immersion in a chilling system for 8 and 16 h during commercial processing. An objective of the study was to encourage discussion regarding the Brazilian Ministry of Agriculture Livestock and Food Supply regulation that requires chicken processors to completely empty, clean, and disinfect each tank of the chilling system after every 8-h shift. Before and after immersion chilling, carcasses were collected and analyzed for mesophilic bacteria, Enterobacteriaceae, coliforms, and Escherichia coli. Samples of water from the chilling system were also analyzed for residual free chlorine. The results do not support required emptying of the chiller tank after 8 h; these tanks could be emptied after 16 h. The results for all carcasses tested at the 8- and 16-h time points indicated no significant differences in the microbiological indicators evaluated. These data provide both technical and scientific support for discussing changes in federal law regarding the management of immersion chilling water systems used as part of the poultry processing line.

Contribution to the study of diaphragm innervation in Nelore bovines.

The phrenic nerves, in Nelore bovines, divide more frequently (60%) in a dorsal branch and a ventrolateral trunk, in both left and right sides. Another division, in trifurcation, giving off dorsal, lateral and ventral branches occurred in 23.3% of cases in the right side and in 30% left side. The division in ventral branch and dorsolateral trunk was observed in 16.6% of cases in the right side and 10% left side. The dorsal branches, both left and right, were distributed among their corresponding lumbar portions in all the cases verified. In 3% of the muscles studied, the right dorsal branch sent a nervous twig to caudal vena cava, and in 73.3% of the muscles, the left dorsal branch innervated the left lumbar portion and also sent some twigs which, after crossing the middle line, distributed in the right lumbar portion, ventral to esophageal hiatus. The lateral and ventral branches, in both left and right sides, innervated corresponding parts of the muscle. Connections (anastomosis) were observed between left lateral and dorsal branches in 10% of cases, and between dorsal left and right branches in 6.7% of cases.

Freqüência de cães reagentes para Neospora caninum em São Luís, Maranhão / Frequency of Neospora caninum in dogs from São Luís, Maranhão

The frequency of antibodies to Neospora caninum (Protozoa: Apicomplexa) in dog sera was investigated. Blood samples from 100 mongrel dogs, captured in the streets of São Luís, State of Maranhão, were analized using imunofluorescent antibody test. Forty five percent of the dogs were positive, and the titers ranged from 1:50 to 1:800. No sex difference was observed for frequency of N. caninum (60 percent in males and 40 percent in females). This is the first report of antibodies to N. caninum in dogs from Maranhão.

Avaliação de prescrições de medicamentos para pacientes com Diabetes Mellitus atendidos por uma Unidade Básica de Saúde / Evaluation of the prescriptions of medicines to subjects with Diabetes Mellitus assisted by a basic Unit of Health

O Diabetes Mellitus (DM) é uma síndrome decorrente da falta de insulina e/ou da incapacidade da insulina de exercer adequadamente seus efeitos, devido à redução da sensibilidade dos tecidos a este hormônio.O Diabetes Mellitus tipo 2 (DM2), atinge entre 80 a 90 por cento da população diabética, sendo que cerca de 7,6 por cento dos indivíduos com idade entre 30 e 69 anos são portadores de DM, aumentando para 20 por cento nos pacientes com idade superior a 70 anos.Além da obesidade, o aumento da mortalidade nos pacientes com DM2 está relacionado à agregação de vários fatores de risco, como hipertensão arterial sistêmica, dislipidemia e ausência de informações do paciente em relação à sua patologia.O tratamento do DM baseia-se no aumento da atividade física, suspensão do fumo, hábitos alimentares corretos e, se necessário, uso de insulina e antidiabéticos orais.Esse trabalho realizou um levantamento farmacoepidemiológico com 130 pacientes portadores de DM atendidos pela UBS São José em Ribeirão Preto, SP.Foram avaliadas as 130 prescrições medicamentosas indicadas aos usuários, com relação aos fármacos prescritos, bem como as doses e o tipo de DM de cada paciente.Os pacientes diagnosticados com DM2 utilizaram para o tratamento quatro esquemas terapêuticos distintos:monoterapia com glibenclamida(38,5 por cento),monoterapia com metformina (24,6por cento), metformina associada com glibenclamida (19,2 por cento) e metformina associada com insulina (5,4 por cento).Dos usuários, 12,3 por cento eram portadores de DM1 e utilizaram apenasinsulina.Concluiu-se que a prescrição racional e o seguimento farmacoterapêutico podem diminuir a incidência de comorbidades e melhorar a adesão dos pacientes portadores de DM.

Utilizacao do residuo de fermentacao industrial do glutamato monossodico em racoes. Ensaio com ratos. / Utilization of industrial residue of fermentation of monosodiu glutamate in rations assay with rats

O liquido resultante da fermentacao industrial para obtencao do glutamato monossodico, procedente da Ajinomoto Interamericana, foi analizado encontrando-se os valores, 52,93% de umidade, 10,04% de residuo fixo, 4,06% de nitrogenio amoniacal, 1,38% de nitrogenio proteico, 7,04% de aminoacidos livres e 14,48% de sulfatos. O aminograma revelou baixos teores de aminoacidos essenciais. No ensaio com ratos foram oferecidas racoes com 0% de residuo integral e 8% de residuo tratado. Apos 28 dias, os animais dos grupos experimentais apresentaram menor coeficiente de eficacia proteica e, ao completar 60 dias seus rins mostraram um aumento de peso relativo comparando-se com os od grupo controle