Vitamin D deficiency is associated with cortical bone loss and fractures in the elderly.

INTRODUCTION: The role of vitamin D on bone microarchitecture and fragility is not clear. OBJECTIVE: To investigate whether vitamin D deficiency (25(OH)D <20 ng/mL) increases cortical bone loss and the severity of fractures. DESIGN: Cross-sectional study of 287 elderly women with at least one prevalent low-impact fracture. METHODS: Biochemistry, X-rays to identify vertebral fractures (VFs) and to confirm non-vertebral fractures (NonVFs), and high-resolution peripheral quantitative computed tomography (HR-pQCT) to evaluate bone microstructure. RESULTS: Serum 25(OH)D levels were associated with body mass index (BMI: r = -0.161, P = 0.006), PTH (r = -0.165; P = 0.005), CTX (r = -0.119; P = 0.043) and vBMD at cortical bone (Dcomp: r = 0.132; P = 0.033) and entire bone (D100: r = 0.162 P = 0.009) at the distal radius, but not at the tibia. Age and PTH levels were potential confounding variables, but in the multiple linear regressions only BMI (95% CI: 0.11-4.16; P < 0.01), 25(OH)D (95% CI: -0.007 to 1.70; P = 0.05) and CTX (95% CI: -149.04 to 21.80; P < 0.01) predicted Dcomp, while BMI (95% CI: 1.13-4.18; P < 0.01) and 25(OH)D (95% CI: 0.24-1.52; P < 0.01) predicted D100. NonVFs predominated in patients with 25(OH)D <20 ng/mL (P = 0.013). Logistic regression analysis showed a decrease in the likelihood of presenting grade 2-3 VFs/NonVFs for every increase in 25(OH)D (OR = 0.962, 95% CI: 0.940-0.984; P = 0.001), BMI (OR = 0.932, 95% CI: 0.885-0.981; P = 0.007) and D100 at radius (OR = 0.994, 95% CI: 0.990-0.998; P = 0.005). CONCLUSION: In elderly patients with prevalent fractures, vitamin D deficiency was associated with cortical bone loss and severity of fractures.

Hepatitis C Virus Eradication in Kidney Transplant Recipients: A Single-Center Experience in Portugal.

INTRODUCTION: Hepatitis C (HCV) is a major cause of liver impairment post-kidney transplantation (KT). Anti-HCV direct-acting antivirals (DAA) made viral eradication possible. METHODS: We performed a retrospective review of KT patients (n = 23) who received DAA at our hospital. Sustained viral response (SVR) was defined as absence of viral detection 12 weeks after cessation of therapy. RESULTS: From 1985 to September 2017, 1440 patients underwent transplantation at Hospital Santa Cruz. From a total of 32 HCV RNA+ KT recipients on follow-up, we describe the first 23 patients treated with DAA. They were 56.7 ± 9.1 years old; 22 were white, 52.2% were males, they underwent transplantation 18.8 ± 9.0 years ago, and 13 had genotype 1B, 21 were naïve, and 9 had stages F3/F4. All but 2 patients, treated with grazoprevir/elbasvir, received sofosbuvir (18 with ledispasvir, 2 with daclastavir, and 4 with simultaneous ribavirin). Pretreatment, intra-treatment, and post-treatment creatinine clearances were 61.4, 60.6, and 60.7 mL/min/1.73 m2, respectively (not significant [NS]). Cyclosporine A was the basis of immunosuppression in the majority [(n = 14); pretreatment and intra-treatment levels were 79.5 ± 23.0 and 91.8 ± 26.0 ng/mL, respectively (P = .08)]; tacrolimus (n = 8) and mammalian target of rapamycin (mTOR) levels (n = 5) were also similar. One patient interrupted ribavirin after 7 weeks due to anemia; all other patients completed the treatment course without major side effects. Only 3 patients presented positive viral RNA at the fourth week of treatment and SVR was achieved in 100% of the patients 12 weeks after treatment. CONCLUSIONS: DAA therapy was well tolerated and effective in 100% of our treated patients, without significant impact on the renal function or on the immunosuppression.

The venous patterns of the cubital fossa in subjects from Brazil.

Venous punctures are among the most common procedures performed by healthcare professionals. In particular, the cubital fossa is the site where the venous accesses are frequently made due to the number of superficial veins and the numerous anastomoses in this region. The arrangement of these venous connections is of particular interest for clinical application in several areas, thus, the healthcare professional must possess knowledge about these vessels and their anatomical relationships. The present study aims to analyze the venous pattern of the cubital fossa among individuals from Brazil. This study was approved by a Research Ethics Committee. The sample had 100 healthy individuals (50 men and 50 women). The superficial veins of the cubital fossa were analyzed with the aid of a sphygmomanometer. When inflated, the pressure in the forearm increased and the veins became prominent. It was observed that in the selected sample the types with the highest prevalence were the Type I and Type VII, both with 22% in 200 limbs studied. The chi2 test showed a significant statistical difference between the anastomosis pattern and the sex of the studied sample. The anastomotic pattern of the superficial veins of the studies sample is similar to African, European and Asian populations. The study of these variations is necessary to provide scientific basis for the healthcare professional during a venipuncture in order to avoid iatrogenic errors and damages in cutaneous nerves or neighboring arteries.

Epicardial adipose tissue and metabolic syndrome An update protocol for systematic review and meta-analysis

BACKGROUND: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia, and an increased risk of cardiovascular events. However, there are no systematic analyses, or well conducted meta-analyses to evaluate the relationship between epicardial adipose tissue (EAT) and (MetS). The aim of this study is to examine this association of EAT with MetS in different ages and sex. METHODS: The update systematic review, and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar. Studies that firstly, examined the association between EAT and MetS, secondly, focus on cohort, case-control, and cross-sectional studies, thirdly, were conducted among in adults aged between 40 and 70 years, fourth, provided sufficient data for calculating ORs or relative risk with a 95% CI, fifth, were published as original articles written in English or other languages, and sixth, have been published until January year 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. RESULTS: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. This study will provide a high quality synthesis on the association of EAT and MetS. CONCLUSION: This systematic review will provide evidence to assess whether there is a strong association of EAT and MetS, and its components.

Accessory subscapularis muscle - A forgotten variation?

The quadrangular space is a space in the axilla bounded by the inferior margin of the teres minor muscle, the superior margin of the teres major muscle, the lateral margin of the long head of the triceps brachii muscle and the surgical neck of the humerus, medially. The axillary nerve (C5-C6) and the posterior circumflex humeral artery and veins pass through this space in order to supply their territories. The subscapularis muscle is situated into the scapular fossa and inserts itself into the lesser tubercle of the humerus, thus helping stabilize the shoulder joint. A supernumerary muscle known as accessory subscapularis muscle originates from the anterior surface of the muscle and usually inserts itself into the shoulder joint. It is a rare variation with few reports of its existence and incidence. We present a case of the accessory subscapularis muscle in a male cadaver fixated with a 10% formalin solution. The muscle passed anteriorly to the axillary nerve, thus, predisposing an individual to quadrangular space compression syndrome. We perform a review of the literature and address its clinical, anthropological and anatomical significance.

Lack of impact of hepatitis C virus infection on graft survival after kidney transplantation--a Portuguese single-center experience.

BACKGROUND: Hepatitis C virus infection (HCV) is a common problem among kidney transplant (KT) recipients. The long-term burden of HCV infection on graft survival after kidney transplantation is controversial. METHODS: We performed a retrospective study including all renal transplant recipients with HCV infection (n = 34) compared with a control group (n = 80). The prevalence of HCV infection was 2.7%. The median follow-up period was 134 months (11 years). Graft survival and associated risk factors were assessed by means of Cox proportional hazard analysis. RESULTS: We found that HCV-positive patients remained on dialysis for longer periods (P = .001) and received transplants at a younger age (P = .03). Actuarial graft survival rates at 1, 5, and 10 years after KT were, respectively, 94.1%, 78.1%, and 66.9%, in the HCV-positive group and 94.9%, 89.1%, and 80.4% in the HCV-negative group. Graft survival did not differ significantly between groups (P = .154). A higher incidence of major cardiovascular disease among HCV-positive patients (P = .004) was noted. Multivariate analysis showed that HCV infection was not an important risk factor for graft loss (adjusted hazard ratio, 2.810; 95% confidence interval, 0.925-8.541; P = .069). Among the HCV-positive population, immunosuppression with cyclosporine or azathioprine conveyed better graft survival. CONCLUSIONS: Our findings suggest that the long-term impact of HCV infection on graft survival after KT is not significant. KT remains a safe and effective modality of renal replacement in HCV-infected patients with end-stage renal disease.

Effect of simulated tooth temperature on the degree of conversion of self-adhesive resin cements exposed to different curing conditions.

OBJECTIVES: This study evaluated the degree of conversion (DC) of two commercial, self-adhesive resin cements (SARCs) using Fourier transform infrared analysis (FTIR) polymerized at simulated prepared tooth surface temperatures and under different curing conditions. MATERIALS AND METHODS: RelyX U100 (U100, 3M ESPE) and Maxcem Elite (MX, Kerr Corporation) were mixed at 25°C and applied to the surface of a horizontal attenuated total reflectance (ATR) unit, which was near room temperature (RT, control) (25°C) or heated to simulate prepared tooth surface temperatures (28°C and 32°C) and then attached to an infrared spectrometer. The products were polymerized using one of three conditions: direct light exposure through a glass slide (DLE), exposure through a 1.5-mm thick ceramic disc overlay (CO) (A2 shade, IPS e.max, Ivoclar Vivadent), or self-curing (SC). FTIR spectra were recorded for 12 minutes (1 spectrum/s, 16 scans/spectrum, resolution 4 cm(-1)) immediately after application to the ATR. The DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios before and 12 minutes after curing, as well as during each 1-second interval. DC data (n=7) were analyzed by two-way analysis of variance and Tukey's post-hoc test (p=0.05). RESULTS: Both simulated tooth temperatures significantly increased DC in all groups of MX and in the CO and SC groups of U100 compared with the RT control. For MX, the self-cure groups exposed to tooth temperatures showed DC values similar to those of the CO groups. For U100, the CO groups showed higher DC values than SC groups regardless of temperature. Time-based conversion profiles ranged according to product, temperature, and curing mode. CONCLUSIONS: Causing SARCs to polymerize at simulated tooth temperatures increases DC of SARCs compared with room-temperature curing values, mainly in the SC mode.

Reduction of vitamin A deficiency and anemia in pregnancy after implementing proposed prenatal nutritional assistance / Reducción de avitaminosis A y anemia en el embarazo después de la implementación propuesta de asistencia nutricional prenatal

Introduction: Micronutrient deficiency is an unquestionable public health problem, specially anemia and vitamin A deficiency (VAD). This is due to the collective dimension of these carencies, which reflects on morbimortality rates in the maternal and infant group. Objective: to evaluate the impact of a proposal for prenatal nutritional assistance, comparing the prevalence of anemia and VAD, in pre-intervention (GI) and intervention(GII) groups. Methods: this is a prospective intervention study in a cohort of pregnant women. The GI group was made up of 225 the GII group of 208 pregnant adults and their respective newborns, attended a Public Maternity Wardin Rio de Janeiro, Brazil. Concentration of hemoglobin was used to diagnose anemia and a standardized interview to diagnose night blindness (XN) .Results and conclusion: after adjusting for confounding variables, through logistic regression, the protective effect of intervention at the on set of anemia (OR = 0.420;IC 95% = 0.251-0.702), with a significant reduction in prevalence, of 28.4% in the GI to 16.8% in the GII, also observed at the on set of XN (OR = 0.377; IC95% = 0.187-0.759), with a reduction in prevalence of 18.7 % in the GIto 6.2% in the GII. Nutritional intervention has a beneficial effect on maternal health, reducing nutritional deficiencies most prevalent during pregnancy and the impact of these on the obstetric ailment (AU)

Introducción: La deficiencia de micronutrientes es un problema de indudable de salud pública, especialmente la anemia y deficiencia de vitamina A (DVA). Esto es debido a la dimensión colectiva de estos carencies, que se refleja en las tasas de morbi-mortalidad en el grupo materno infantil. Objetivo: Evaluar el impacto de un proyecto de atención nutricional prenatal, comparando la prevalencia de anemia y DVA, en la pre-intervención (GI) y la intervención (GII).Métodos: se trata de una intervención prospectiva de un grupo de mujeres embarazadas. El GI consistió de 225 mujeres en el posparto y GII en 208 mujeres embarazadas y sus recién nacidos inscritos en una maternidad pública de Rio de Janeiro, Brasil. Se utilizó la concentración de hemoglobina en el diagnóstico de la anemia durante el embarazo y la entrevista estandarizada para diagnosticar la ceguera nocturna (XN). Resultados y conclusión: Tras ajustar por variables de confusión, por la regresión logística, se verificó el efecto protector de la intervención sobre la anemia (OR = 0,420,95% CI = 0.251-0.702), con reducción significativa en la prevalencia, 28,4 en el GI y 16,8% en el GII, que también se observó en los resultados XN (OR = 0,377, IC del 95%desde 0,187 hasta 0,759), con una reducción en la prevalencia, el 18,7% al 6,2% en el GI y GII. La intervención dietética tiene efectos beneficiosos sobre la salud materna, reducir las deficiencias nutricionales más prevalentes durante el embarazo y el impacto de estos sobre el resultado del embarazo (AU)

Reduction of vitamin A deficiency and anemia in pregnancy after implementing proposed prenatal nutritional assistance.

INTRODUCTION: Micronutrient deficiency is an unquestionable public health problem, specially anemia and vitamin A deficiency (VAD). This is due to the collective dimension of these carencies, which reflects on morbimortality rates in the maternal and infant group. OBJECTIVE: to evaluate the impact of a proposal for prenatal nutritional assistance, comparing the prevalence of anemia and VAD, in pre-intervention (GI) and intervention (GII) groups. METHODS: this is a prospective intervention study in a cohort of pregnant women. The GI group was made up of 225 the GII group of 208 pregnant adults and their respective newborns, attended a Public Maternity Ward in Rio de Janeiro, Brazil. Concentration of hemoglobin was used to diagnose anemia and a standardized interview to diagnose night blindness (XN). RESULTS AND CONCLUSION: after adjusting for confounding variables, through logistic regression, the protective effect of intervention at the onset of anemia (OR = 0.420; IC 95% = 0.251-0.702), with a significant reduction in prevalence, of 28.4% in the GI to 16.8% in the GII, also observed at the onset of XN (OR = 0.377; IC95% = 0.187- 0.759), with a reduction in prevalence of 18.7 % in the GI to 6.2% in the GII. Nutritional intervention has a beneficial effect on maternal health, reducing nutritional deficiencies most prevalent during pregnancy and the impact of these on the obstetric ailment.

Birth weight variation according to maternal characteristics and gestational weight gain in Brazilian women.

OBJECTIVES: This study aims to identify birth weight variation according to maternal characteristics and gestational weight gain. METHODS: It is a cross-sectional descriptive study with 433 puerperal women (> or = 20 years old) who attended a public maternity hospital in Rio de Janeiro. The data were collected through interviews with the women and access to their medical records. Several models were tested using linear regression, using the stepwise method to identify the predictive variables of birth weight. RESULTS: The mean maternal age and gestational age at the end of pregnancy were 27 years old (+/- 5.09 years) and 39 weeks (+ 1.68 weeks), respectively. The data shows that the mean number of prenatal and nutritional prenatal care appointments were 8.24 (+/- 2.98) and 2.26 (+/- 2.33), respectively. Among the predictor variables of birth weight, total gestational weight gain (beta = 25.29; p = 0.000), pre-gestational BMI (beta =13.02; p = 0.037), and the number of pre-natal care appointments (beta = 28.21; p = 0.007) were highlighted. The association of weight gain in the three trimesters was also verified. CONCLUSIONS: This study confirms the interface between adequacy of the pre-gestational and gestational nutritional status and some maternal characteristics with birth weight. Nutritional care should be recognised as part of the actions during pre-natal assistance.

Birth weight variation according to maternal characteristics and gestational weight gain in Brazilian women / Variación del peso corporal en función de las características maternas y la ganancia de peso gestacional en mujeres brasileñas

Objective: This study aims to identify birth weight variation according to maternal characteristics and gestational weight gain. Methods: It is a cross-sectional descriptive study with 433 puerperal women (beta 20 years old) who attended a public maternity hospital in Rio de Janeiro. The data were collected through interviews with the women and access to their medical records. Several models were tested using linear regression, using the stepwise method to identify the predictive variables of birth weight. Results: The mean maternal age and gestational age at the end of pregnancy were 27 years old (± 5.09 years) and39 weeks (+ 1.68 weeks), respectively. The data shows that the mean number of prenatal and nutritional prenatal care appointments were 8.24 (± 2.98) and 2.26 (± 2.33), respectively. Among the predictor variables of birthweight, total gestational weight gain (beta= 25.29; p = 0.000), pre-gestational BMI (beta=13.02; p = 0.037), and the number of pre-natal care appointments (beta= 28.21; p = 0.007)were highlighted. The association of weight gain in the three trimesters was also verified. Conclusions: This study confirms the interface between adequacy of the pre-gestational and gestational nutritional status and some maternal characteristics with birth weight. Nutritional care should be recognised as part of the actions during pre-natal assistance (AU)

Objetivo: Este estudio tiene por objeto identificar la variación de peso al nacimiento en función de las características maternas y la ganancia de peso gestacional. Métodos: Se trata de un estudio transversal y descriptivo con 433 mujeres puérperas (beta 20 años de edad) que acudieron a un hospital maternal de Río de Janeiro. Se recogieron los datos mediante entrevistas con las mujeres y acceso a sus historiales clínicos. Se ensayaron diversos modelos utilizando la regresión linear y el método por pasos para identificar las variables predictivas del peso al nacimiento. Resultados: La edad media materna y la edad gestacional al final del embarazo fueron 27 años (± 5,09 años) y 39semanas (± 1,68 semanas), respectivamente. Los datos muestran que el número medio de visitas prenatales y de educación nutricional prenatal fue de 8,24 (± 2,98) y 2,26 (± 2,33), respectivamente. Entre las variables predictivas del peso al nacimiento, destacaban la ganancia total de peso gestacional (beta= 25,29; p = 0.000), el IMC pre-gestacional(beta= 13,02; p = 0,037) y el número de visitas prenatales (beta= 28,21; p = 0,007). También se verificó la asociación de ganancia de peso en los tres trimestres del embarazo. Conclusiones: Este estudio confirma la interrelación entre un estado nutricional pre-gestacional y gestacional adecuado y algunas características maternas con el peso al nacimiento. Debería reconocerse la atención nutricional como parte de las acciones de la asistencia prenatal (AU)

Stromal cells play a role in cervical cancer progression mediated by MMP-2 protein.

Metalloproteinases, especially metalloproteinase-2 (MMP-2), are known for their role in the degradation of the extracellular matrix. Nevertheless, a thorough understanding of MMP-2 expression in neoplastic lesions of the uterine cervix has yet to be accomplished. This study aimed to analyze the MMP-2 expression in cervical intraepithelial neoplasia III (CIN3) and in cervical squamous cell carcinoma, in tumor cells and adjacent stromal cells. MMP-2 expression was assessed by an immunohistochemical technique. MMP-2 expression was greater in the stromal cells of invasive carcinomas than in CIN3 (p < 0.0001). MMP-2 expression in stromal cells correlates with the clinical stage, gradually increasing as the tumor progresses (p = 0.04). This study corroborates that stromal cells play an important role in tumor invasion and progression, mediated by the progressive enhancement of MMP-2 expression from CIN3 to advanced invasive tumor. The intense MMP-2 expression most probably is associated with poor tumor prognosis.

Natural infection of Alternanthera tenella (Amaranthaceae) by a new potyvirus.

A virus was isolated from joyweed (Alternanthera tenella Colla-Amaranthaceae), a common weed in tropical and sub-tropical regions. Examination by electron microscopy showed long flexuous particles with an average length of 756 nm in crude sap. Serological results showed positive reaction with antisera to PVY-O. A fragment of 1772 nucleotides was sequenced. The CP sequence shares 76% of identity with the CP of Potato virus Y strain NTN. These results confirm that the virus is a new potyvirus infecting A. tenella, and the name Alternanthera mild mosaic virus (AltMMV) is proposed.

Comparison of immunoexpression of 2 antibodies for estrogen receptors (1D5 and 6F11) in breast carcinomas using different antigen retrieval and detection methods.

The importance of in situ immunodetection of hormone receptors for therapy planning and prognostic evaluation in patients with breast carcinoma is well established. Sensitive detection methods are of utmost importance, especially in poorly fixed tissues, which are not uncommon in routine pathologic practice. The purpose of the present study is to compare immunoexpression of estrogen receptors in 20 cases of invasive ductal carcinoma using two antibodies, 1D5 and 6F11, and to verify the effect of different antigen retrieval solutions and detection systems. Immunoperoxidase was performed on paraffin sections using 1D5 and 6F11 as primary antibodies. Heat-induced antigen retrieval was performed using citrate buffer (pH 6.0) or Tris-EDTA buffer (pH 8.9). Detection was achieved using the following systems: EnVision, EnVision Plus, and labeled streptavidin-biotin peroxidase complex. Reaction was semiquantified from 0 to 4. There were no differences between the two markers, 1D5 and 6F11, except when 6F11 was used with EnVision and citrate buffer, in which case weaker reactivity was observed. Only in this combination (6F11/EnVision) was EDTA buffer significantly better than citrate. Labeled streptavidin-biotin peroxidase complex presented the best results, followed by EnVision Plus.

Immunoexpression of CD95 in chronic gastritis and gastric mucosa-associated lymphomas

CD95 (Fas/APO-1)-mediated apoptosis plays an important role in immunological regulation and is related to the pathogenesis of autoimmune diseases. Immunoexpression of CD95 has been reported to frequently occur in low grade non-Hodgkin lymphomas, especially of post-germinal center histogenesis, among which those originating in mucosa-associated lymphoid tissue (MALT lymphomas). However, there is no report comparing in situ immunoexpression of this marker in lymphomas and the hyperplastic lymphoid reaction (chronic gastritis) related to Helicobacter pylori infection. The purpose of the present research was to compare the intensity of lymphoid CD95 immunoexpression in 15 cases of H. pylori-related chronic gastritis and 15 gastric MALT lymphomas. CD95 (anti-CD95) was detected by an immunoperoxidase technique in paraffin sections using the catalyzed amplification system. Graduation of reaction intensity (percentage of CD95-positive cells) was semiquantitative, from 1+ to 4+. Nine cases of chronic gastritis were 4+, five 2+ and one 1+. Three lymphomas were 4+, three 3+, four 2+, four 1+, and one was negative. Although 14 of 15 lymphomas were positive for CD95, the intensity of the reaction was significantly weaker compared to that obtained with gastric tissue for patients with gastritis (P = 0.03). The difference in CD95 immunoexpression does not seem to be useful as an isolated criterion in the differential diagnosis between chronic gastritis and MALT lymphomas since there was overlapping of immunostaining patterns. However, it suggests the possibility of a pathogenetic role of this apoptosis-regulating protein in MALT lymphomas.

Immunoexpression of CD95 in chronic gastritis and gastric mucosa-associated lymphomas.

CD95 (Fas/APO-1)-mediated apoptosis plays an important role in immunological regulation and is related to the pathogenesis of autoimmune diseases. Immunoexpression of CD95 has been reported to frequently occur in low grade non-Hodgkin lymphomas, especially of post-germinal center histogenesis, among which those originating in mucosa-associated lymphoid tissue (MALT lymphomas). However, there is no report comparing in situ immunoexpression of this marker in lymphomas and the hyperplastic lymphoid reaction (chronic gastritis) related to Helicobacter pylori infection. The purpose of the present research was to compare the intensity of lymphoid CD95 immunoexpression in 15 cases of H. pylori-related chronic gastritis and 15 gastric MALT lymphomas. CD95 (anti-CD95) was detected by an immunoperoxidase technique in paraffin sections using the catalyzed amplification system. Graduation of reaction intensity (percentage of CD95-positive cells) was semiquantitative, from 1+ to 4+. Nine cases of chronic gastritis were 4+, five 2+ and one 1+. Three lymphomas were 4+, three 3+, four 2+, four 1+, and one was negative. Although 14 of 15 lymphomas were positive for CD95, the intensity of the reaction was significantly weaker compared to that obtained with gastric tissue for patients with gastritis (P = 0.03). The difference in CD95 immunoexpression does not seem to be useful as an isolated criterion in the differential diagnosis between chronic gastritis and MALT lymphomas since there was overlapping of immunostaining patterns. However, it suggests the possibility of a pathogenetic role of this apoptosis-regulating protein in MALT lymphomas.

Cd(II) determination in the presence of aqueous micellar solutions.

The equilibrium constants and molar absorptivities for the fast formation of a 1:3 complex between cadmium(II) (Cd(II)) and dithizonate anion, in the presence of cationic and non-ionic surfactants, allowed a simple and fast spectrophotometric determination of total cadmium. Indeed, the molar absorptivities of the Cd(II)-dithizone (Dz) complex formed in the presence of the neutral Triton X-100 and cationic cetyltrimethylammonium bromide (CTAB) surfactants are almost twice the value observed in the standard method and the maxima of absorption are shifted by about 40nm when compared with the standard method. Clearly, the use of neutral and cationic surfactants promotes a higher value of the molar absorptivities of the complex, resulting in an increase in the sensitivity of the method. Application of the method to the desorption of Cd(II) ions from clays is illustrated.

Identification of sentinel node in breast cancer: comparison between peritumoral and periareolar injection of the radiopharmaceutical contrast medium.

Axillary node status is the most important prognostic factor for patients with primary breast carcinoma. The sentinel node biopsy (SN) technique has received much attention as a possible alternative to axillary lymph node dissection. The aim of this study is to identify the sentinel node by periareolar and subdermal injection of the radiopharmaceutical in four points, independent of tumor topography and the presence of biopsies and/or previous surgery. The peritumoral injection technique was carried out for comparison purposes. This study was performed on 115 patients, divided into 2 groups: Group A (25 patients, peritumoral injection) and Group B (90 patients, injection in four points). All the SN biopsies were studied by both imprint cytology and H&E staining. Control axillary lymph-node dissection was followed in all patients from Group A and in these positive cases from Group B. Twenty-two out of the twenty-five (88%) SNs were identified in Group A. There was no false negative; the sensitivity and specificity were 100%. Eighty-two of the ninety (91.1%) SNs were identified in Group B. Lymphoscintigraphy showed radiopharmaceutical migration to axilla in 93.7% of the cases. Hotspot area was 10 to 100 times the intensity of the background radiation. Among the 92 cases with negative sentinel nodes at intraoperative examination (TP), the SN histopathology confirmed the absence of cancer cells in 89 patients, whereas 3 were positive for metastatic cells. This study shows that periareolar injection in four points seems to be a good lymphatic mapping method for SN identification. We suggest standardizing this site of injection to identify the SNs. More studies to confirm these findings are ongoing.

Brevipalpus-transmitted plant virus and virus-like diseases: cytopathology and some recent cases.

An increasing number of diseases transmitted by Brevipalpus mite species (Acari: Tenuipalpidae) is being identified that affect economically important plants such as citrus, coffee, passion fruit, orchids, and several ornamentals. All of these diseases are characterized by localized lesions (chlorotic, green spots, or ringspots) on leaves, stems, and fruits. Virus or virus-like agents are considered to be the causal agents, possibly transmitted in a circulative-propagative manner by Brevipalpus mites. The virus or virus-like particles are short, rod-like, or bacilliform, that induce two characteristic types of cell alteration: (1) 'Nuclear type'--nuclei of parenchyma and epidermal cells in the lesions often contain a large electron lucent inclusion. Short, naked, rod-like (40-50 nm x 100-110 nm) particles may be seen in the viroplasm or nucleoplasm and in the cytoplasm. These particles are commonly arranged perpendicularly on the membranes of the nuclear envelope or endoplasmic reticulum (ER). In a very few instances, they were found to be membrane-bound, within the ER cavities. (2) 'Cytoplasmic type'--short bacilliform particles (60-70 nm x 110-120 nm) are present within the cisternae of the ER and often have electron dense viroplasm of varied shapes present in the cytoplasm. Bacilliform particles may be seen budding into the ER lumen near the viroplasm. These particles resemble those of members of the Rhabdoviridae, but are shorter. The only sequenced virus of this group, orchid fleck virus (OFV), has a negative sense (bipartite) type ssRNA genome, but its organization is similar to known rhabdoviruses, which are monopartite. Both types of cytopathological effects have been found associated with citrus leprosis. In orchids, OFV has a 'nuclear type' of cytopathology, but in some species the 'cytoplasmic type' has been found associated with ringspot symptoms. In Hibiscus and Clerodendron, green spot symptoms have been associated with the cytoplasmic type of cell alteration, while chlorotic spots, in the same species, are associated with the nuclear type. In a few cases, both types of cytopathological effects have been found in the same tissue and cell.

Citrus leprosis virus vectored by Brevipalpus phoenicis (Acari: Tenuipalpidae) on citrus in Brazil.

Citrus leprosis is caused by Citrus leprosis virus (CiLV) that is transmitted by mites in the genus Brevipalpus (Acari: Tenuipalpidae). This disease directly reduces production and the life span of the citrus plant. The main symptoms of the disease include lesions on fruits, leaves, and twigs or small branches, causing premature fruit drop, defoliation, and death of the twigs or branches leading to serious tree decline. Leprosis is a highly destructive disease of citrus, wherever it occurs. The Brazilian citrus industry spends over 100 million US dollars annually on acaricides to control the vector, Brevipalpus phoenicis (Geijskes). This review contains information about the history of the etiology of citrus leprosis, its geographical distribution, host range, the role of the mite vectors, viral morphology and relationships with the infected cell, and transmissibility of the virus by the mite. In addition, data on the mite-virus-plant relationship, disease damage, and strategies for controlling disease spread are presented.