Copper molybdate synthesized by sonochemistry route at room temperature as an efficient solid catalyst for esterification of oleic acid.

Copper molybdate nanoplates were synthesized by a sonochemical process at room temperature, which we report as a simple and cost-effective route. Structural analysis of the material by the Rietveld method of X-ray diffraction (XRD) data revealed lindgrenite Cu3(MoO4)2(OH)2 in a single-phase structure. All the vibrational modes characteristic of the space group were identified by Raman vibrational and near-infrared (NIR) spectroscopies. The profile obtained for N2 adsorption/desorption was type III hysteresis, characteristic of mesoporous materials, with a surface area of 70.77(1) m2 g-1. The micrographs of the material obtained by scanning electron microscopy showed nanoplates with nanometric sizes and an anisotropic growth aspect. The catalytic activity of lindgrenite was evaluated by esterifying oleic acid with methanol, showing high conversion rate to methyl oleate and good catalyst stability after seven recycling cycles. Above all, the best catalytic performance was reached when we optimized parameters such as oleic acid:methanol molar ratio of 1:5, 5% of catalyst dosage, and reaction time of 5 h, resulting in 98.38% of conversion at 413 K. Therefore, sonochemically synthesized lindgrenite proved to be a high potential material for biofuel production by oleic acid esterification.

Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis-randomized clinical trial.

This study aims to evaluate the use of assistive devices as a strategy in non-pharmacological treatment for hand osteoarthritis (HOA). This is a randomized, prospective, parallel, assessor-blinded clinical trial, in which patients with a diagnosis of HOA were randomly allocated to an intervention group (IG), where they received assistive devices for daily life activities, or to a control group (CG), where they received a guideline leaflet with information on joint protection and disease features. The primary outcomes considered were occupational performance, measured by the Canadian Occupational Performance Measure (COPM), and hand function was evaluated through the Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (SACRAH). The secondary outcomes were pain, measured by the visual analog scale (VAS), and quality of life, measured by the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). We compared both outcomes before and after interventions and outcomes between groups. Participants from the two groups were assessed at the time of inclusion in the study, 30, and 90 days after initial evaluation. Out of the 39 patients included, 19 were allocated to the IG and 20 to the CG. Only two patients from the CG did not complete the follow-up period. The patients' hand function and occupational performance improved after intervention (30 days-SACRAH-p < 0.05; COPM-p < 0.05; VAS-p < 0.05). When comparing results between the groups, there was a statistical difference in COPM (performance-p < 0.001; and satisfaction-p < 0.001), in the first reevaluation carried out. The use of assistive devices has proved to be an effective alternative in non-pharmacological treatment for HOA. CLINICAL TRIAL REGISTRATION: NCT02667145.

Rheumatic Heart Disease: Pathogenesis and Vaccine.

Rheumatic fever (RF) and rheumatic heart disease (RHD) follow untreated S. pyogenes throat infections in children who present susceptible genes that favor the development of autoimmune reactions. In this review, we focus on the genes that confer susceptibility and on the autoimmune reactions that occur due to molecular mimicry between human-tissue proteins and streptococcal M protein. Polyarthritis is the initial manifestation, which can evolve to carditis and severe valve damage; these culminate in rheumatic heart disease (RHD) or Sydenham's chorea, which affects the central nervous system. A perspective on vaccine development to prevent the disease is also discussed.

Significados do dinheiro e do trabalho; um estudo com operários da construção de edificações de Belo Horizonte / Meaning of money and work: a study with construction workers of buildings in Belo Horizonte

Os significados do dinheiro e do trabalho são fenômenos multidimensionais, imbuídos de aspectoscontraditórios forjados no contexto contemporâneo do sistema capitalista. Objetivamos, então, explorar arelação entre os dois fenômenos na construção de edificações. Desenvolvemos a pesquisa com 302operários, aplicando questionários e realizando entrevistas. Às respostas dos questionários aplicamostécnicas estatísticas descritivas (frequência e médias) e inferenciais (análise de cluster e ANOVA). Ainterpretação das entrevistas apoiou a compreensão dos resultados das análises anteriores. Entre osresultados encontrados, destacamos: os valores coletivistas incorporados aos padrões de significado dodinheiro (PSD); a tendência dos participantes do padrão do significado do trabalho (PST) indiferenteexpressivo em apresentar o PSD coletivista expressivo e dos participantes do PST otimista em apresentarmenos frequentemente o PSD conflitante(AU)

Amlodipine reduces blood pressure during dynamic resistance exercise in hypertensive patients.

This study investigated the effect of the dihydropyridine calcium channel antagonist, amlodipine, on blood pressure (BP) during resistance exercise performed at different intensities in hypertensives. Eleven hypertensives underwent 4 weeks of placebo and amlodipine (random double-blinded crossover design). In each phase, they performed knee extension exercise until exhaustion following three protocols: one set at 100% of 1 RM (repetition maximum), three sets at 80% of 1 RM, and three sets at 40% of 1 RM. Intraarterial BP was measured before and during exercise. Amlodipine reduced maximal systolic/diastolic BP values achieved at all intensities (100% = 225 ± 6/141 ± 3 vs. 207 ± 6/130 ± 6 mmHg; 80% = 289 ± 8/178 ± 5 vs. 273 ± 10/169 ± 6 mmHg; 40% = 289 ± 10/176 ± 8 vs. 271 ± 11/154 ± 6 mmHg). Amlodipine blunted the increase in diastolic BP that occurred during the second and third sets of exercise at 40% of 1RM (+75 ± 6 vs. +61 ± 5 mmHg and +78 ± 7 vs. +64 ± 5 mmHg, respectively). Amlodipine was effective in reducing the absolute values of systolic and diastolic BP during resistance exercise and in preventing the progressive increase in diastolic BP that occurs over sets of low-intensity exercise. These results suggest that systemic vascular resistance is involved in BP increase during resistance exercise, and imply that hypertensives receiving amlodipine are at lower risk of increased BP during resistance exercise than non-medicated patients.

Alpha-tocopherol concentration in serum and colostrum of mothers with gestational diabetes mellitus.

OBJECTIVE: To evaluate and compare the levels of α-tocopherol in colostrum and in the serum of healthy and diabetic mothers. METHODS: This cross-sectional study enrolled 51 volunteer mothers, 20 with the diagnosis of gestational diabetes mellitus and 31 without associated diseases. Serum and colostrum samples were collected in fasting in the immediate postpartum period and α-tocopherol was analyzed by high performance liquid chromatography (HPLC). In order to define the nutritional status of vitamin E, the cutoff point for the serum (697.7µg/dL) was adopted. Student's t-test for independent variables compared the average concentrations of α-tocopherol in the serum and in the colostrum between control and gestational diabetes mellitus groups. Pearson's correlation was used to assess the relationship between the concentration of α-tocopherol in serum and colostrum for both groups. Differences were considered significant when p<0.05. RESULTS: The α-tocopherol concentration in colostrum was 1,483.1±533.8µg/dL for Control Group and 1,368.8±681.8µg/dL for diabetic women, without differences between groups (p=0.50). However, α-tocopherol concentration in the serum was 1,059.5±372.7µg/dL in the Control Group and 1,391.4±531.5µg/dL in the diabetic one (p<0.01). No correlation was found between the concentration of α-tocopherol in the serum and in the colostrum for control and diabetic groups. CONCLUSIONS: The groups had adequate nutritional status of vitamin E. Gestational diabetes was not associated with changes in α-tocopherol concentration in colostrum.

Alpha-tocopherol concentration in serum and colostrum of mothers with gestational diabetes mellitus / Concentración de ?-tocoferol en el suero y calostro de madres con diabetes mellitus gestacional / Concentração de ?-tocoferol no soro e colostro de mães com diabetes melito gestacional

To evaluate and compare the levels of α-tocopherol in colostrum and in the serum of healthy and diabetic mothers. METHODS: This cross-sectional study enrolled 51 volunteer mothers, 20 with the diagnosis of gestational diabetes mellitus and 31 without associated diseases. Serum and colostrum samples were collected in fasting in the immediate postpartum period and α-tocopherol was analyzed by high performance liquid chromatography (HPLC). In order to define the nutritional status of vitamin E, the cutoff point for the serum (697.7µg/dL) was adopted. Student's t-test for independent variables compared the average concentrations of α-tocopherol in the serum and in the colostrum between control and gestational diabetes mellitus groups. Pearson's correlation was used to assess the relationship between the concentration of α-tocopherol in serum and colostrum for both groups. Differences were considered significant when p<0.05. RESULTS: The α-tocopherol concentration in colostrum was 1,483.1±533.8µg/dL for Control Group and 1,368.8±681.8µg/dL for diabetic women, without differences between groups (p=0.50). However, α-tocopherol concentration in the serum was 1,059.5±372.7µg/dL in the Control Group and 1,391.4±531.5µg/dL in the diabetic one (p<0.01). No correlation was found between the concentration of α-tocopherol in the serum and in the colostrum for control and diabetic groups. CONCLUSIONS: The groups had adequate nutritional status of vitamin E. Gestational diabetes was not associated with changes in α-tocopherol concentration in colostrum...

Evaluar y comparar la concentración de α-tocoferol en la leche calostro y en el suero de madres diabéticas y sanas. MÉTODOS: Estudio transversal, realizado con 51 parturientes voluntarias, siendo 20 diagnosticadas con diabetes mellitus gestacional y 31 sin cualquier enfermedad asociada. Se recogieron las muestras de suero y de calostro en ayuno en el postparto inmediato y se analizó el α-tocoferol por cromatografía líquida de alta eficiencia (CLAE). Para definir el estado nutricional de vitamina E, se adoptó el punto de corte sérico (697,7µg/dL). El análisis estadístico se realizó con la prueba t de Student para variables independientes a fin de comparar las concentraciones medianas de α-tocoferol en el suero entre los grupos control y con diabetes mellitus gestacional. Ese análisis también fue realizado para comparar los promedios de α-tocoferol en el calostro en los grupos estudiados. Se utilizó la correlación de Pearson para evaluar la relación entre la concentración de α-tocoferol en el suero y en el calostro para ambos grupos. Las diferencias fueron consideradas significativas cuando p<0,05. RESULTADOS: Las concentraciones de α-tocoferol en el calostro fueron 1.483,1±533,8µg/dL para las mujeres del Grupo Control y 1.368,8±681,8µg/dL para las diabéticas, no habiendo diferencias (p=0,50). Sin embargo, en el suero de las puérperas control, la concentración de α-tocoferol fue 1.059,5±72,7µg/dL y, en las diabéticas, 1.391,4±531,5µg/dL, con p<0,01). No hubo correlación entre la concentración de α-tocoferol en el suero y en el calostro para el Grupo Control. Resultado semejante fue encontrado para el grupo con diabetes mellitus gestacional. CONCLUSIONES: Los grupos presentaron estado nutricional adecuado respecto...

Avaliar e comparar a concentração de α-tocoferol no leite colostro e no soro de mães diabéticas e saudáveis. MÉTODOS: Estudo transversal, realizado com 51 parturientes voluntárias, sendo 20 diagnosticadas com diabetes melito gestacional e 31 sem nenhuma doença associada. Coletaram-se as amostras de soro e de colostro em jejum no pós-parto imediato e o α-tocoferol foi analisado por cromatografia líquida de alta eficiência (CLAE). Para definir o estado nutricional de vitamina E, adotou-se ponto de corte sérico (697,7µg/dL). O teste t de Student para variáveis independentes comparou as concentrações médias de α-tocoferol no soro e no colostro entre os grupos controle e com diabetes melito gestacional. A correlação de Pearson testou a relação entre a concentração de α-tocoferol no soro e no colostro para ambos os grupos. As diferenças foram consideradas significantes quando p<0,05. RESULTADOS: As concentrações de α-tocoferol no colostro foram 1.483,1±533,8µg/dL para as mulheres do Grupo Controle e 1.368,8±681,8µg/dL para as diabéticas, não havendo diferenças (p=0,50). Entretanto, no soro das puérperas controle, a concentração de α-tocoferol foi 1.059,5±372,7µg/dL e, nas diabéticas, 1.391,4±531,5µg/dL, com p<0,01. Não houve correlação entre a concentração de α-tocoferol no soro e no colostro para o Grupo Controle. Resultado semelhante foi encontrado para o grupo com diabetes melito gestacional. CONCLUSÕES: Os grupos apresentaram estado nutricional adequado quanto à vitamina E. Não houve associação entre diabetes melito gestacional e mudanças na concentração de α-tocoferol no colostro...

Pulmonary and hepatic lesions caused by the dehydropyrrolizidine alkaloid-producing plants Crotalaria juncea and Crotalaria retusa in donkeys.

The effects and susceptibility of donkeys to Crotalaria juncea and Crotalaria retusa poisoning were determined at high and low doses. Seeds of C. juncea containing 0.074% of dehydropyrrolizidine alkaloids (DHPAs) (isohemijunceines 0.05%, trichodesmine 0.016%, and junceine 0.008%) were administered to three donkeys at 0.3, 0.6 and 1 g/kg body weight (g/kg) daily for 365 days. No clinical signs were observed and, on liver and lung biopsies, the only lesion was a mild liver megalocytosis in the donkeys ingesting 0.6 and 1 g/kg/day. Two other donkeys that received daily doses of 3 and 5 g seed/kg showed initial respiratory signs 70 and 40 days after the start of the administration, respectively. The donkeys were euthanized following severe respiratory signs and the main lung lesions were proliferation of Clara cells and interstitial fibrosis. Three donkeys ingested seeds of C. retusa containing 5.99% of monocrotaline at daily doses of 0.025, 0.05 and 0.1 g/kg for 365 days. No clinical signs were observed and, on liver and lung biopsies, the only lesion was moderate liver megalocytosis in each of the three donkeys. One donkey that received a single dose of 5 g/kg of C. retusa seeds and another that received 1 g/kg daily for 7 days both showed severe clinical signs and died with diffuse centrilobular liver necrosis. No lung lesions were observed. Another donkey that received a single dose of 2.5 g/kg of C. retusa seeds showed no clinical signs. The hepatic and pneumotoxic effects observed are consistent with an etiology involving DHPAs. Furthermore, the occurrence of lung or liver lesions correlates with the type of DHPAs contained in the seeds. Similarly as has been reported for horses, the data herein suggest that in donkeys some DHPAs are metabolized in the liver causing liver disease, whereas others are metabolized in the lung by Clara cells causing lung disease.

Periacinar liver fibrosis caused by Tephrosia cinerea in sheep.

Tephrosia cinerea has been associated with ascites and liver fibrosis in sheep in Brazil. The dried plant was fed ad libitum to three sheep for 55-80 days. Three additional sheep were used as controls. All the treated sheep presented with hypoalbuminemia and increased γ-glutamyltransferase and aspartate aminotransferase activities. Anorexia, apathy, rough coat, ascites, and emaciation were observed after 45-60 days of feeding with T. cinerea. At necropsy 55-80 days after feeding of the plant commenced, the treated sheep had ascites, hydrothorax and hydropericardium, and their livers were firm and whitish, with a nodular surface. Histologically, the main hepatic lesions were periacinar fibrosis associated with hemorrhages and necrosis. On electron microscopy, a severe swelling of sinusoidal endothelial cells, frequently obstructing the lumen of the sinusoid was observed. The space of Disse was compressed by the swollen endothelial cells and microvilli usually present on the surface of hepatocytes adjacent to the space of Disse were not apparent. Dense bundles of collagen fibers were present in the spaces of Disse and within the sinusoids between profiles of swollen endothelial cells. It is concluded that T. cinerea causes periacinar fibrosis, similar to poisoning by Galenia africana in sheep and goats and veno-occlusive disease in different species.

Dystrophic epidermolysis bullosa in goats.

Clinical, histopathological and ultrastructural findings of caprine dystrophic epidermolysis bullosa (DEB) with autosomal recessive inheritance are reported. The goats presented with exungulation, erosions, crusts and scars on the skin and ulcers in the oral cavity. Microscopically, the skin showed subepidermal separation with clefts filled occasionally with clear eosinophilic fluid, cellular debris or neutrophils. Ultrastructurally, the site of blister formation was the sublamina densa in the epidermal basement membrane zone. In skin with blister formation and in clinically uninvolved skin, the basal lamina was preserved, but the anchoring fibrils were sparse and rudimentary. A twin brother of an affected kid was mated over 5 years with his mother; three out of the 10 kids born presented with epidermolysis bullosa, indicating that the disease has an autosomal recessive mode of inheritance. It is suggested that the disease is similar to human severe generalized recessive DEB.

Shoenfeld's syndrome after pandemic influenza A/H1N1 vaccination.

Recently, reports have suggested grouping different autoimmune conditions that are triggered by external stimuli as a single syndrome called autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This syndrome is characterized by the appearance of myalgia, myositis, muscle weakness, arthralgia, arthritis, chronic fatigue, sleep disturbances, cognitive impairment and memory loss, and the possible emergence of a demyelinating autoimmune disease caused by systemic exposure after vaccines and adjuvants. In the current study, the authors reported the first Brazilian case of a woman who developed ASIA, which was characterized by arthralgia, changes in inflammatory markers, and chronic fatigue, after the pandemic anti-influenza A/H1N1 vaccine without causing any other rheumatic disease, and it had a positive outcome.

Orthopaedic evaluation in children with severe haemophilia A or B submitted to primary prophylaxis therapy in a coagulopathy treatment centre.

There is a lack of publications concerning the use of primary prophylaxis in developing countries. The aim of this study was to evaluate the effectiveness of primary prophylaxis therapy in preventing the development of arthropathy in children with severe haemophilia A or B. From January 1999 to April 2009, a prospective study was carried out involving 39 patients with severe haemophilia A or B. These haemophilia A and haemophilia B patients received 20-40 UI kg(-1) of factors VIII and IX, three and two times per week, respectively. The patients were followed up by a multidisciplinary team. The analysis was carried out in 23 patients who had been on prophylaxis therapy for at least 12 months. The orthopaedic evaluation was performed according to the recommendations of the Orthopedic Advisory Committee of the World Federation of Hemophilia, by evaluating pain and bleeding, and by conducting physical examination and radiological assessment (Pettersson's Joint Score and magnetic resonance): 82.6% of patients who had used the factor regularly did not present any clinical or radiographic changes in the studied joints; 17.4% used the factor irregularly at the beginning of the treatment and of those, most patients presented mild changes in the joints; and 4.3% presented transient knee and ankle pain in spite of regular factor use. The preliminary results of primary prophylaxis confirm its effectiveness in preventing haemophilic arthropathy. Socioeconomic factors did not play a significant role.

Coproparasitological diagnosis of alligators (Caiman latirostris Daudin, 1802) commercially raised in Rio de Janeiro / Diagnóstico coproparasitológico de jacarés (Caiman latirostris Daudin, 1802) criados comercialmente no Rio de Janeiro

The aim of this study was to determine the genera of parasites found in fecal samples of commercially raised (farming system) alligators (Caiman latirostris Daudin, 1802) in Rio de Janeiro state, in the period 2008 to 2009. From the 480 stool samples collected, 300 originated from alligators of a closed farming system (150 hactchlings, 80 grow out phase and 70 breeding animals), while 180 originated from alligators of an open system (100 grow out and 80 breeding animals). The samples were analyzed for fecal floating (Willis-Mollay method) and simple sedimentation (Lutz method), according to methodology described by Hoffman (1987) and observed by optical microscopy. The results showed oocysts of the following genera Eimeria and Isospora and eggs of Acanthostomum, Balantidium, Capillaria, Dujardinascaris and Strongyloides. Statistically, a higher degree of parasitism by coccidia was observed in both systems studied. In conclusion, the parasitism found in commercially raised animals occurs due to factors such as stress and feeding; and parasitism may occur through breeders from breeding regions as well.

O objetivo desta pesquisa foi realizar um diagnóstico qualitativo dos gêneros de parasitos encontrados em amostras fecais de jacarés (Caiman latirostris Daudin, 1802) criados comercialmente (sistema farming de criação), no período de 2008 a 2009, no estado do Rio de Janeiro. Inicialmente foram colhidas 480 amostras, sendo 300 de criatório comercial de sistema fechado (150 filhotes, 80 engorda e 70 reprodução) e 180 de criatório comercial de sistema aberto (100 engorda e 80 reprodução). Em seguida as amostras foram submetidas a análises coproparasitológicas de flutuação (método de Willis-Mollay) e de sedimentação simples (método de Lutz), segundo metodologia descrita por Hoffmann (1987) e visualizadas por microscopia óptica. Os resultados obtidos evidenciaram a presença de oocistos dos gêneros Eimeria e Isospora e ovos de Acanthostomum, Balantidium, Capillaria, Dujardinascaris e Strongyloides. Ao final do experimento foi possível concluir que o parasitismo encontrado em animais de criatórios ocorre devido a fatores como pressão de estresse e alimentação e que a transmissão parasitária pode ocorrer através de matrizes e reprodutores oriundos de regiões nascedouras ou intracriatórias.

Pneumoperitoneum in association with perforated appendicitis in a Brazilian Amazon woman. Case report.

Radiographic findings of free air in the peritoneal cavity secondary to perforation of a acutely inflamed appendix are extremely rare. It accounts for about 0-7% of all patients with pneumoperitoneum. We report on a 58-years-old Brazilian Amazon woman presenting a 1- week history of abdominal pain, tenderness and distension associated with asthenia and without passage of stool or gas. Abdominal percussion revealed a tympanic sound located on the right hypocondrium. Plain chest radiography revealed a large amount of free air beneath the right leaf of the diaphram. The patient was taken immediately to the operation room and, during surgery, a gangrenous appendix with an apex perforation was verified. Appendectomy was performed as routinely. The patient evolved with pneumonia and septic shock that responded well to intravenous antibiotics and vasoactive drugs. She was discharged to home on the twenty-first post-operative day in good clinical conditions. This case highlights that perforated acute appendicitis is rarely associated with pneumoperitoneum, but it must be considered in the differential diagnosis of patients presenting right abdominal pain and free intraperitoneal air.

Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event.

Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP), are related to coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116) were prospectively included if they had suffered a recent acute coronary syndrome (acute myocardial infarction or unstable angina pectoris requiring hospitalization) and if they had metabolic syndrome diagnosed according to the National Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of atherosclerosis was estimated by the Gensini score. The severity of coronary disease was correlated (Spearman's or Pearson's coefficient) with gender (r = 0.291, P = 0.008), age (r = 0.218, P = 0.048), hsCRP (r = 0.256, P = 0.020), ApoB/ApoA ratio (r = 0.233, P = 0.041), and carotid intima-media thickness (r = 0.236, P = 0.041). After multiple linear regression, only male gender (P = 0.046) and hsCRP (P = 0.012) remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of hsCRP, two variables that can be easily obtained, were associated with more extensive coronary disease, identifying patients with the highest potential of developing new coronary events.

Correlates of substance use during adolescent pregnancy in São Paulo, Brazil

Objetive: To investigate the association of cocaina and marijuana use during adolescent pregnancy in são paulo-sp, brazil with psychiatric disorders, social status and sexual history. method: one thousand pregnancy adolescents were assessed by using the composite international diagnostic interview, and sociodemographic and socio-economic questionnaire at the obstetric center of a public hospital in são paulo. Hair samples were collected for analysis. Results: the following data were associated with cocaine and/or marijuana use during the third trimester of the pregnancy: being younger than 14 year of agge, having a history of more than 3 sexual partners, and having psychiatric disorders, specifically, bipolar disordes, post-traumatic stress disorder, and somatoform disorder. Conclusion: in earlt adolescence pregnancy, having 3 or more sexual partners in the life for this population os significantly associated with the use of cocaine or marijuana during gestation. This association suggests that specific intervention programs should target these young women.(au) - en

Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event

Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP), are related to coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116) were prospectively included if they had suffered a recent acute coronary syndrome (acute myocardial infarction or unstable angina pectoris requiring hospitalization) and if they had metabolic syndrome diagnosed according to the National Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of atherosclerosis was estimated by the Gensini score. The severity of coronary disease was correlated (Spearman’s or Pearson’s coefficient) with gender (r = 0.291, P = 0.008), age (r = 0.218, P = 0.048), hsCRP (r = 0.256, P = 0.020), ApoB/ApoA ratio (r = 0.233, P = 0.041), and carotid intima-media thickness (r = 0.236, P = 0.041). After multiple linear regression, only male gender (P = 0.046) and hsCRP (P = 0.012) remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of hsCRP, two variables that can be easily obtained, were associated with more extensive coronary disease, identifying patients with the highest potential of developing new coronary events.

Susceptibility to chemical insecticides of two Brazilian populations of the visceral leishmaniasis vector Lutzomyia longipalpis (Diptera: Psychodidae).

OBJECTIVES: To investigate the insecticide susceptibility of two geographically separated Lutzomyia longipalpis populations (Lapinha and Montes Claros) with different histories of insecticide exposure (i.e. no exposure and repeated exposure, respectively). METHODS: (i) Bioassay monitoring of sand fly survival over time when exposed to a range of insecticides; and (ii) analysis of the level of insecticide detoxification enzymes in individual sand flies caught at both study sites. Insecticides tested were the organophosphates malathion and fenitrothion and the pyrethroids lambda-cyhalothrin, permethrin and deltamethrin. RESULTS: Survival analyses showed that whilst there was no overall significant difference in susceptibility of both populations to organophosphates, Lapinha sand flies were significantly more susceptible to pyrethroids than those from Montes Claros. Multiple regression analyses also showed that insecticide susceptibility in both locations varied with sand fly sex. The relative susceptibilities of the two sand fly populations to tested insecticides were also compared. Thus, Montes Claros sand flies were most susceptible to malathion, followed by fenitrothion, deltamethrin and permethrin. Those from Lapinha were most susceptible to lambda-cyhalothrin, followed by malathion, permethrin, deltamethrin and fenitrothion. Biochemical analyses demonstrated that Montes Claros sand flies had significantly lower insecticide detoxification enzyme activity than Lapinha sand flies. CONCLUSIONS: Our results are the first record of significantly reduced susceptibility to the insecticides used in control of wild populations of Lu. longipalpis. They demonstrate the importance of evaluating chemicals against this species by conventional bioassay and microplate assays before and during spraying programmes.

Contribution of standard oesophageal manometry in sliding hiatal hernia: from the gastro-oesophageal pressure gradient to the diagnosis.

OBJECTIVE: We tested whether gastro-oesophageal pressure gradient is augmented in sliding hiatal hernia and the yield of oesophageal manometry in diagnosing sliding hiatal hernia. METHODS: Patients with equivalent body mass index were categorised according to manometry and endoscopy in groups: (1) no sliding hiatal hernia (n=147); (2) sliding hiatal hernia solely at endoscopy (n=46); and (3) sliding hiatal hernia at manometry (n=22). The yield of manometry was assessed taking endoscopy as referential. RESULTS: Gastro-oesophageal pressure gradient was similar between groups both at inspiration (13.3+/-5.7 mm Hg vs. 13.6+/-5.4 mm Hg vs. 12.6+/-4.4 mm Hg; P=0.874) or expiration (5.1+/-3.8 mm Hg vs. 5.2+/-3.6 mm Hg vs. 5.1+/-3.7 mm Hg; P=0.767). Group 3 patients were older than those of groups 1 and 2 (59+/-10 vs. 42+/-15 vs. 45+/-13 years; P<0.001). Sliding hiatal hernia was larger when characterised by manometry than at endoscopy [4 cm (2.25-4.75) vs. 2 cm (2-3); P<0.001]. Manometry showed sensitivity of 28% (95%CI 19-40%), specificity of 97% (95%CI 93-99%) and positive predictive value of 82% (95%CI 63-92%) in diagnosing sliding hiatal hernia. CONCLUSIONS: By using manometry in patients with equivalent body mass index, sliding hiatal hernia presence and size are related with age rather than gastro-oesophageal pressure gradient. This technique may be clinically useful when positive for sliding hiatal hernia.

Abortion and neonatal mortality in sheep poisoned with Tetrapterys multiglandulosa.

Tetrapterys spp. have been reported as a cause of cardiac fibrosis, status spongiosus of the nervous system, and abortion. To study the intoxication by Tetrapterys multiglandulosa, 24 sheep were divided into 4 experimental groups of 4 sheep each and 1 control group. Groups 1 to 3, respectively, received 1, 1.5, and 3 g/kg body weight of the dry plant daily, starting on the 90th day of pregnancy. Group 4 received 1.5 g/kg from the 120th day of pregnancy to the end of gestation. All sheep from groups 2 and 3, except 1 that was submitted to cesarean delivery, aborted between 110 and 134 days of pregnancy. Seven fetuses had anasarca. Seven lambs from groups 1 and 4 were weak and died or were euthanatized. The other 2 were born weak with mild nervous signs but recovered. Cardiac fibrosis and status spongiosus of the nervous system were observed in newborn lambs and fetuses.