Computed tomography bone density variations in oncological patients undergoing antiresorptive medication.

BACKGROUND: The purpose of this study was to compare jaw and cervical vertebrae bone density in computed tomography (CT) analyses of oncological patients undergoing antiresorptive medication with control patients, aiming to find information that may assist the radiologist and clinician in predicting risks and monitoring osteonecrosis in the jaw. MATERIAL AND METHODS: Thirty-one patients treated with zoledronic acid and 37 control were included in the study. Two areas in regions of interest were chosen and standardized, one in the lower portion of the mandible and another in the axial cervical vertebra (C2) of patients undergoing antiresorptive drug treatment (experimental group) and the control group. Density analysis was performed using Hounsfield scale grayscale values obtained from multislice CT exams. Interclass correlation coefficient test (ICC) was performed to assess reproducibility and repeatability. The test of normality of the samples was demonstrated using the Shapiro-Wilk test and the comparison performed using Mann-Whitney U non-parametric test. RESULTS: When compared to patients in the control group, patients undergoing antiresorptive medication depicted an increase in bone density in both jaw bone (p=0.021) and cervical vertebrae (p=0.002). The same pattern could be observed in patients who used the medication on a monthly basis for analysis of jaw bone (p=0.021), the cervical vertebrae (p=0.002), and the cervical vertebrae of the patients who used the medication on a quarterly basis (p=0.003). CONCLUSIONS: CT can be a potentially useful method for detecting alterations associated with antiresorptive therapy, serving as a possible tool in the prediction of the disease progression.

Alternative Th17 and CD4+ CD25+ FoxP3+ cell frequencies increase and correlate with worse cardiac function in Chagas cardiomyopathy.

Immune homeostasis has been suggested to play an important role in the clinical evolution of chronic Chagas disease; however, the immunopathologic factors involved have not been fully elucidated. Therefore, our study aimed to analyse the frequency of CD4+ CD25+ FoxP3+ cells, classic Th17 cells, alternative Th17 cells and IL-17+ B cells from peripheral blood of chronic cardiac patients after in vitro stimulation with Trypanosoma cruzi soluble EPI antigen. Patients were selected and classified according to clinical evaluation of cardiac involvement: mild, B1 (CARD1) (n = 20) and severe, C (CARD2) (n = 11). Patients with the indeterminate form of CD were included as the control group A (IND) (n = 17). Blood samples were collected and cultured in the presence of EPI antigen. Cells frequency and median fluorescence intensity (MFI) were obtained by flow cytometry. Our results showed that only CD4+ CD25+ FoxP3+ , CD4+ CD25high FoxP3+ , CD4+ IL-17+ IFN-γ- and CD4+ IL-17+ IFN-γ+ cells are more frequent in patients with severe cardiac disease and correlate with worse global cardiac function. However, while indeterminate patients demonstrated a positive correlation between CD4+ CD25+ FoxP3+ and CD4+ IL-17+ IFN-γ- Th17 cells, this relationship was not observed in cardiac patients. IL-17 expression by Th17 cells and B cells correlated with disease progression. Altogether our results suggest that the clinical progression of Chagas cardiomyopathy involves worsening of inflammation and impairment of immunoregulatory mechanisms.

Genetic variation in PTX3 and plasma levels associated with hepatocellular carcinoma in patients with HCV.

Hepatitis C virus (HCV) is the main cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC) worldwide. The risk to develop HCC increases with the severity of liver inflammation and fibrosis. Long pentraxin 3 (PTX3) is a soluble pattern-recognition receptor produced by phagocytes and nonimmune cells at sites of inflammation or injury. The aim of the present study was to determine the association of PTX3 polymorphisms and its plasma levels with HCC occurrence among patients with HCV. Samples from 524 patients with chronic hepatitis C were evaluated in this study. Two polymorphisms (rs1840680 and rs2305619) in the PTX3 gene were determined by real-time PCR. PTX3 plasma levels were measured by Enzyme-linked Immunosorbent Assay (ELISA). Our data show a significant association between PTX3 polymorphisms and HCC occurrence in univariate and multivariate analysis (P = 0.024). Patients with HCC had higher PTX3 plasma levels compared to individuals with mild or severe fibrosis (P < 0.0001 and P = 0.002, respectively). In addition, PTX3 rs2305619 polymorphism and plasma levels were correlated with Child-Pugh scores B and C in HCC individuals. PTX3 seems to be a risk factor for HCC occurrence in chronic hepatitis C. This is the first study that evaluates PTX3 in the context of hepatitis C.

miR-2861 is involved in osteogenic commitment of human periodontal ligament stem cells grown onto 3D scaffold.

miR-2861 endorsing osteoblast differentiation through the overexpression of Runt-related transcription factor 2 (RUNX2) protein has been recently described. In this study we evaluated: the performance of living construct, composed by human Periodontal Ligament Stem Cells (hPDLSCs) and 3D scaffold (EXg), and the behaviour of miR-2861/RUNX2 expression pathway on the osteogenic commitment. Human PDLSCs were seeded with and without EXg scaffold and cultured under basal and osteogenic conditions. Morphological features, adhesiveness and differentiation abilities were analysed using scanning electron and confocal laser scanning microscopy. Time-course of RUNX2, ALP, OPN and miR-2861 were evaluated through RT-PCR analysis. Our results highlighted that the osteogenic differentiation was mostly obvious in the hPDLSCs, grown onto 3D scaffold in presence of osteoinductive medium. Moreover, the overexpression of miR-2861 and RUNX2 in hPDLSCs cultured in presence of EXg under osteogenic and standard conditions was demonstrated. In synthesis, the increased expression of miR-2861/RUNX2 provides new insights regarding miRNA signaling network in the presence of scaffold providing an additional method to evaluate the performance of biomaterial in bone regeneration.

Interleukin-10 and tumour necrosis factor-alpha serum levels in chronic Chagas disease patients.

In Chagas disease, chronically infected individuals may be asymptomatic or may present cardiac or digestive complications, and it is well known that the human immune response is related to different clinical manifestations. Different patterns of cytokine levels have been previously described in different clinical forms of this disease, but contradictory results are reported. Our aim was to evaluate the serum levels of interleukin-10 and tumour necrosis factor-alpha in patients with asymptomatic and cardiac Chagas disease. The serum interleukin-10 levels in patients with cardiomyopathy were higher than those in asymptomatic patients, mainly in those without heart enlargement. Although no significant difference was observed in serum tumour necrosis factor-alpha levels among the patients, we found that cardiac patients also present high levels of this cytokine, largely those with heart dilatation. Therefore, these cytokines play an important role in chronic Chagas disease cardiomyopathy. Follow-up investigations of these and other cytokines in patients with chronic Chagas disease need to be conducted to improve the understanding of the immunopathology of this disease.

Knowledge, behavior and practices of the population during the pandemic against the transmission of SARS-CoV-2 in the state of Alagoas, Brazil.

The World Health Organization (WHO) declared an international state of emergency in order to contain the rapid spread of COVID-19. To ensure that there is adherence to preventive measures by the population aimed at controlling the pandemic in Alagoas, it is expected that knowledge, behavior and practices play an important role in preventing and controlling the disease. In this sense, it becomes relevant to understand the knowledge of the population about the disease. To evaluate the knowledge, behavior and practices of social media users during social isolation to prevent the transmission of the SARS-CoV-2 in the state of Alagoas, Northeast, Brazil. A probabilistic sample was carried out across the entire territory of the state of Alagoas with those who have access to a device that accesses the internet and a cross-sectional study was carried out using an online questionnaire applied to a convenience sample, recruited between August 2021 and July 2022 by snowball sampling. The questionnaire consisted of seven sessions, the first collecting data on the socioeconomic and sociodemographic profile of the participants, and the other sessions involving knowledge, attitudes and practices, including topics related to the vaccination that had to be administered at that time. High popular knowledge about signs and symptoms, means of transmission and risk groups. Low knowledge about seeking health services. Based on the results obtained, information from official channels became relevant to better teach the population in order to reduce the impact of COVID-19.

High tumor necrosis factor-α/interleukin-10 ratio is associated with hepatocellular carcinoma in patients with chronic hepatitis C.

Hepatitis C virus (HCV) is the main cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC) worldwide. The risk for the development of HCC increases with the severity of liver inflammation and fibrosis. The hepatic inflammation caused by HCV involves host regulatory immune response, which is mediated by cytokines with anti-viral role upon the interaction of viral polypeptides with innate and adaptive immunity. Two cytokines; tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) play key roles in the regulation of cellular immune response in HCV infection. The aim of the present study was to determine the levels of IL-10 and TNF-α, as well as the ratio of TNF-α and IL-10 serum levels in patients with HCV and HCC caused by HCV (HCC-HCV). The study included 173 patients with chronic HCV. TNF-α and IL-10 serum levels were measured by ELISA (R&D Systems, Inc.). In the present study, 54 patients presented liver mild fibrosis, 68 had severe fibrosis and 51 patients had HCC. After adjustment in the multivariate regression analysis, the following variables remained significantly associated with HCC-HCV occurrence: diabetes (p=0.012 OR 10.44 CI 1.66-65.60), IL-10 lower levels (p<0.0001 OR 0.83 CI 0.78-0.89) and TNF-α higher levels (p<0.0001 OR 1.19 CI 1.11-1.28). Individuals with HCC presented higher TNF-α/IL-10 ratio than those with fibrosis grade F4, F3 or F0+F1+F2 (p=0.0003, p<0.0001, p<0.0001, respectively). Patients with HCC were associated to higher index TNF-α/IL-10 ratio, suggesting that the unbalanced production of these cytokines may represent progression to the liver disease severity in HCV infected patients.

Radiology-Pathology and Surgical Correlation in Astroblastoma.

Astroblastoma is a rare astrocytic glial neoplasm that affects mainly young girls, peaking between 10 and 30 years of age, with low- and high-grade manifestations. Imaging characteristics are well-described, but histopathologic and, more recently, molecular analysis is fundamental to establish the diagnosis, now based on MN1 alterations. We describe a case with typical imaging and histologic features of an MN1-altered astroblastoma.

Uncommon Glioneuronal Tumors: A Radiologic and Pathologic Synopsis.

Glioneuronal tumors are characterized exclusively by neurocytic elements (neuronal tumors) or a combination of neuronal and glial features (mixed neuronal-glial tumors). Most of these tumors occur in young patients and are related to epilepsy. While ganglioglioma, dysembryoplastic neuroepithelial tumor, and desmoplastic infantile tumor are common glioneuronal tumors, anaplastic ganglioglioma, papillary glioneuronal tumor, rosette-forming glioneuronal tumor, gangliocytoma, and central neurocytoma are less frequent. Advances in immunohistochemical and molecular diagnostics have improved the characterization of these tumors and favored the description of variants and new subtypes, some not yet classified by the World Health Organization. Not infrequently, the histologic findings of biopsies of glioneuronal tumors simulate low-grade glial neoplasms; however, some imaging findings favor the correct diagnosis, making neuroimaging essential for proper management. Therefore, the aim of this review was to present key imaging, histopathology, immunohistochemistry, and molecular findings of glioneuronal tumors and their variants.

Quality of life of women from a quilombola community in northeastern Brazil.

Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire - bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices.

Physicochemical, microbiological and parasitological analysis of water for human consumption in a quilombola community in Alagoas.

Water is the indispensable natural resource for all living beings. For human consumption, it must be potable, so as not to pose a risk to health, and can be used for ingestion, food preparation and personal hygiene. Knowing this importance, this study aimed to carry out physical-chemical, microbiological and parasitological analyzes of water for human consumption in a quilombola community of Santa Luzia do Norte in Alagoas. A cross-sectional, experimental and quantitative study was carried out between January and December 2019. The physical-chemical parameters of residual chlorine, turbidity, fluoride, fluoridation, color and pH were analyzed, microbiological analyses were based on the research of total and thermotolerant coliforms (E. coli) and parasitological analyses were performed based on the research of protozoa and intestinal helminths. Some physical-chemical parameters (turbidity and pH) were observed outside the limits required by the Ministry of Health, and the presence of total coliforms in some of the analyzed samples (17.85%), characterizing this community at risk related to waterborne diseases. The samples analyzed did not present infecting forms of parasitic species. Regarding the variables evaluated, the results found showed that the lack of adequate basic sanitation affects the quality of water used for human consumption by the quilombola population of Santa Luzia do Norte-AL.

Epidemiological, clinical and laboratory aspects of Angiostrongylus cantonensis infection: an integrative review.

This integrative literature review study analyzes the findings of the last 5 years of the parasite Angiostrongylus cantonensis. It is known that this nematode is found in the pulmonary arteries of rats, where it remains as a definitive host. From mice, the cycle spreads to animals, such as snails, which in contact with humans can trigger the disease. In humans, the parasite causes several neurological, abdominal manifestations and mainly meningitis. Based on the review of studies, its epidemiology shows worldwide distribution, although there are endemic cases for this parasite, such as asian countries. Laboratory findings generally showed altered CSF with turbidity, increased protein and eosinophilia, which generated meningeal signs in the patient, moreover MRI exams showed multiple alterations. Rare findings of the nematode in the eyeball, lung and signs of peritoneal inflammation were reported, which requires further studies to understand the whole pathophysiology. Finally, conservative treatment based on anthelmintics and anti-inflammatories brought good responses, although there are reports of deaths, which demonstrates the importance in the prevention and therapy of this disease.

Spatio-temporal analysis of the visceral leishmaniasis in the state of Alagoas, Brazil.

Visceral leishmaniosis is a neglected tropical disease. We evaluated the spatial distribution of cases of visceral leishmaniosis in the state of Alagoas, Brazil. All cases of VL, registered by the health department, were analyzed and georeferenced. Results: Between 2008 and 2017, 97.1% of the municipalities presented sporadic classification of transmission. With temporal evolution, the incidence of cases of visceral leishmaniosis was concentrated in most municipalities in the microregion of Santana do Ipanema-AL. Space-time analysis, if considered, may promote the improvement of surveillance and control actions of visceral leishmaniosis.

Apoptotic gene expression in potentially fertile and subfertile men.

Human sperm contain similar amounts of protamine-1 (P1) and protamine-2 (P2). Although an aberrant protamine ratio have been observed in subfertile men, functional evidence is provided by protamine knockout mice exhibiting male infertility. As sperm DNA integrity is known to be linked with DNA fragmentation and apoptosis, we investigated whether the DNA fragmentation factor 40 (DFF40) ratio or caspase (Casp4, Casp6) and tumor necrosis factor superfamily member 10 (TNFSF10) ratio together with the P1/P2 ratio represents a reliable biomarker to discriminate between fertile and subfertile men. Real-time quantitative RT-PCR was used for amplification of P1, P2 and DFF40 in 49 testicular biopsies. Casp4, Casp6 and TNFSF10 have been selected from a PCR apoptosis array and were further investigated in another group of testicular biopsies (22 subfertile men versus 11 potentially fertile men). Using Spearman's rank correlation coefficient analysis, we did not find a correlation between DFF40 and P1, P2, P1/P2, score, fertilization rate and age. In addition, logistic regression analysis demonstrated no statistically significant effect of the analyzed variables on pregnancy. A two-way analysis of variance with repeated measures of relative expression of Casp4, Casp6 and TNFSF10 versus P1 or P2 in potentially fertile men and subfertile patients demonstrated statistically significant differences between both groups, all tested gene combinations and the interaction between two genes and both groups in all cases analyzed. Furthermore, significant differences in the expression of Casp4 and TNFSF10 between the groups of potentially fertile and subfertile men could be demonstrated. In addition, the means of differences of selected gene combinations revealed that the protamine to apoptotic gene ratio is statistically different between both groups. Our data suggest that Casp4, Casp 6 and TNFSF10 are differentially expressed in potentially fertile and subfertile men and represent useful biomarkers for predicting male fertility in combination with P1 and P2.

Prognostic markers for competent human spermatozoa: fertilizing capacity and contribution to the embryo.

Management of male infertility largely depends on our understanding of cellular and molecular aspects of spermatogenesis as well as sperm function. Apart from standardized and comprehensive semen analysis, prognostic markers estimating the fertilizing capacity of either ejaculated spermatozoa or testicular spermatids are required. While there is general agreement that correct replacement of DNA-binding histones by protamines represents a prerequisite for achieving competent spermatozoa, especially in intracytoplasmic sperm injection (ICSI) where natural selection mechanisms are bypassed, the function of a variety of transcripts within the spermatozoa's cytoplasm and of remaining highly acetylated histones is still a matter of debate. Hence, this review brings the up-to-date research on mammalian spermatozoal chromatin composition into focus, which is discussed in conjunction with the paternal role on epigenetic reprogramming of the zygote following fertilization. As paternal transcripts have been demonstrated to be transmitted to the oocyte, it is now accepted that they represent more than solely remnants of previous transcriptional activity. Acetylation of histones, normaly a characteristic of transcriptional activity, was for a long time a miracle, as spermatozoa are transcriptionally inactive cells, but is now suggested to represent epigenetic marks that are transmitted to the oocyte and play an important role in the regulation of early gene expression in the developing embryo.

Protamine-1 represents a sperm specific gene transcript: a study in Callithrix jacchus and Bos taurus.

Spermatozoa are transcriptionally inactive cells, but contain acetylated histones, normally a characteristic of transcriptionally active cells. Acetylgroups are thought to represent epigenetic marks that are transmitted to the oocyte and are involved in starting gene expression in the zygote and in regulating gene expression during early embryogenesis. We performed reverse transcription polymerase chain reaction (RT-PCR) in the common marmoset monkey (Callithrix jacchus) and in bovine spermatozoa, oocytes, zygotes, two- and four-cell embryos to evaluate the presence of specific transcripts known to play a role during fertilisation and early embryo development, namely protamine-1 (PRM1), protamine-2 (PRM2), histone H1 (H1), histone H3 (H3), histone H4 (H4), cAMP-responsive element modulator (CREM), DNA methyltransferase-1 (DNMT1), TATA box-binding protein (TBP). All transcripts tested were present in spermatozoa of the common marmoset, while bull spermatozoa lack PRM2. Marmoset oocytes exhibited transcripts for H1, H3, H4 and TBP, whereas bovine oocytes revealed H1, H3, H4, CREM, DNMT and TBP mRNAs. In zygotes, we amplified H1, H4, TBP (marmoset) and PRM1, H1, H3, H4, CREM, DNMT1 and TBP (bovine). Two-cell embryos showed PCR products for H1, H3 and TBP in the marmoset. In the bovine, all transcripts could be observed except PRM2. In four-cell embryos, PCR signals were obtained for PRM1, H1, H3, H4 and TBP in the marmoset. In the bovine, all transcripts were detected except PRM2. Our data suggest that, in both C. jacchus and Bos taurus, PRM1 transcripts are delivered by the spermatozoon to the oocyte.

Validation of reference genes in human testis and ejaculate.

Beta-actin (ACTB), glyceraldehyde-3-phosphate-dehydrogenase (GAPD), Heat Shock Protein 1, beta (HSPCB) and Adenosine Triphosphate subunit 5 beta (ATP5B) with distinct functional characteristics and expression patterns were investigated as suitable references for gene expression studies. We determined the expression stability of the four reference genes in ejaculates, cryopreserved as well as fixed and paraffin-embedded testicular tissue (from fertile and subfertile men) applying real-time qRT-PCR and statistical analysis. The mean gene expressions (mean Ct value) were compared for each gene between the fertile and subfertile donors by using the Wilcoxon-Mann-Whitney test. We did not observe significant statistical differences between variability of genes. To detect random effects, we used the two-way analysis of variance with a hierarchical model. The results show no significant statistical differences between proband and repetition within the probands. Taken together, we concluded that ACTB, GAPD, HSPCB and ATP5B have a variable expression within these samples, but this variability is not statistically significant. This finding demonstrated that all these genes could be appropriated for further studies on gene expression in ejaculate and testis tissue. Therefore, the selection of the suitable reference genes is highly specific for a particular experimental model and validation for each situation, on an individual basis, is a crucial requirement.

American visceral leishmaniasis in a state of northeastern Brazil: clinical, epidemiological and laboratory aspects.

In Brazil, American visceral leishmaniasis (AVL) has become a public health concern due to its high incidence and lethality. This study aimed to analyze the clinical, epidemiological, and laboratory aspects of AVL in a state of Brazil. This descriptive, cross-sectional, retrospective, and quantitative study of notified cases of AVL was carried out in Alagoas between 2008 and 2017 from data obtained from DATASUS/SINAN. Sociodemographic, clinical, and laboratory variables were analyzed. A descriptive analysis was performed using absolute values ​​and valid percentages, using tables and/or graphs. Data processing was performed using Stata 12.0®. Results with P <0.05 were considered statistically significant. During the study period, 352 cases of AVL were reported, of which 6.82% died and 38.92% had met a cure criterion. Male patients were predominant (66.76%). Of the total infected patients, 16.76% had attended only the 1st to the 4th grades, with those most affected aged 1 to 4 years (28.69%). Laboratory diagnostic criteria were most commonly used to confirm the notified cases (76.42%), whereas 51.70% and 8.52% of the cases had positive parasitological and immunofluorescence diagnoses, respectively. Finally, the study showed a higher prevalence of the disease in children, men and in rural residents. Although with low lethality, the expressive frequency of AVL in the State of Alagoas was still verified, since there was an increase in the number of cases during the years of the study.

Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas.

Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.

Microbiological characteristics of bloodstream infections in a reference hospital in northeastern Brazil.

Routine blood culture is used for the detection of bloodstream infections by aerobic and anaerobic bacteria and by common pathogenic yeasts. A retrospective study was conducted in a public hospital in Maceió-AL, by collecting data of all medical records with positive blood cultures. Out of the 2,107 blood cultures performed, 17% were positive with Staphylococcus coagulase negative (51.14%), followed by Staphylococcus aureus (11.21%) and Klebsiella pneumoniae (6.32%). Gram-positive bacteria predominated among positive blood cultures, highlighting the group of Staphylococcus coagulase-negative. While Gram-negative bacteria had a higher number of species among positive blood cultures.