Biological effects of the antihypertensive losartan under different ocean acidification scenarios.

Since the last decade, several studies have reported the presence and effects of pharmaceutical residues in the marine environment, especially those of the antihypertensive class, such as losartan. However, there is little knowledge about the physiological effects of losartan in marine invertebrates regarding its behavior under possible coastal ocean acidification scenarios. The objective of this study was to evaluate biological effects on marine organisms at different levels of the biological organization caused by the compound losartan in water and sediment under coastal ocean acidification scenarios. Water and sediment samples were collected at five sites around the Santos Submarine Sewage outfall (SSO) and two sites around the Guarujá Submarine Sewage Outfall (GSO). Losartan was found in concentrations ranging from

Pubertal development in children diagnosed with diabetes mellitus type 1 before puberty.

STUDY OBJECTIVE: To investigate an association between pubertal development and timing of menarche with glycemic control, disease duration, and body mass index (BMI) in patients diagnosed with diabetes mellitus type 1 (DM1) before puberty. DESIGN: Retrospective study. SETTING: The study was performed at the diabetes outpatient clinic of Instituto de Puericultura e Pediatria Martagão Gesteira--IPPMG of the Federal University of Rio de Janeiro--UFRJ. PARTICIPANTS: A total of 131 children, 61 girls and 70 boys, diagnosed with DM1 before puberty participated in the study. MAIN OUTCOME MEASURES: The study investigated how age at puberty onset relates to mean glycated hemoglobin (HbA1c) before puberty, BMI percentile, and disease duration; how puberty duration relates to mean HbA1c before and during puberty and to disease duration; and how timing of menarche relates to mean HbA1c before puberty, BMI percentile, and disease duration. RESULTS: Age at puberty onset was positively correlated with mean HbA1c before puberty (r = 0.204, R(2) = 0.042; P = .019) and disease duration (r = 0.451, R(2) = 0.203; P < .0001), and negatively correlated with BMI percentile (r = -0.289, R(2) = 0.084; P = .001). Timing of menarche was negatively correlated with BMI percentile (r = -0.556, R(2) = 0.310; P < .001). CONCLUSIONS: Children with longer disease duration began puberty later than those diagnosed more recently. Girls in higher BMI percentiles reached menarche sooner.

Evaluation of post-surgical cognitive function and protein fingerprints in the cerebro-spinal fluid utilizing surface-enhanced laser Desorption/Ionization time-of-flight mass-spectrometry (SELDI-TOF MS) after coronary artery bypass grafting: review of proteomic analytic tools and introducing a new syndrome.

Cognitive dysfunction following surgery is a common complication, which increases the incidence of other co-morbid conditions, hospital and health-care costs. The reported rate of the occurrence of post-operative cognitive decline varies with different studies, depending on population profile, type of surgery, definition of cognitive disorder and detection methods, design of study, etc. It remains unclear whether these psychiatric signs and symptoms are direct results of the effects of surgery or general anesthesia. Nonetheless they are more frequent after cardiac surgery and are likely to be multi-factorial, but the patho-mechanisms are not yet fully characterized. This communication provides a synopsis of proteomics tools and delineates novel SELDI-TOF results to evaluate biomarkers in this regard. Presented for the first time is a classification of the clinically relevant forms of post-operative cognitive decline with the advent of a novel subclass.

Coronary heart disease risk assessment in HIV-infected patients: a comparison of Framingham, PROCAM and SCORE risk assessment functions.

OBJECTIVES: The aim of this was to compare the performance of the Framingham, Systematic Coronary Risk Evaluation (SCORE) and Prospective Cardiovascular Munster (PROCAM) scoring systems in the risk assessment of HIV-infected patients with no overt vascular disease. METHODS: A cross-sectional study of 220 HIV-infected patients was conducted at the outpatient clinic of a referral and training centre in infectious and parasitic diseases in Belo Horizonte, Brazil. The Framingham, SCORE and PROCAM equations were calculated. Patients were classified as having low, moderate or high risk, which according to the Framingham and PROCAM equations corresponded to < 10%, 10-20% and > 20% respectively, and according to SCORE corresponded to < 3%, 3-4% and > or = 5% respectively. Cohen's kappa coefficient was used to assess agreement between the methods. RESULTS: Of a total of 220 HIV-infected patients, 56 were antiretroviral (ARV)-naïve while 164 had already been treated with ARV. The prevalence of patients with a high 10-year cardiovascular risk was 3.7%, 2.5% and 1.9% according to the Framingham, PROCAM and SCORE equations respectively. The degree of agreement was moderate between the Framingham and PROCAM risk estimates (kappa = 0.433; p < 0.001), poor-to-fair between the Framingham and SCORE estimates (kappa = 0.220; p < 0.001) and moderate between the PROCAM and SCORE systems (kappa = 0.478; p < 0.001). CONCLUSIONS: There are differences in risk assessment and in the identification of high risk individuals between the three risk functions under evaluation and only a prospective study will be capable of assessing which offers the best current sensitivity, specificity and predictive values for the population under investigation.

Modulation of muscarinic signaling in PC12 cells overexpressing neuronal Ca2+ sensor-1 protein.

It has been suggested that overexpression of neuronal Ca2+ sensor-1 (NCS-1) protein is implicated in the pathophysiology of neurodisorders such as schizophrenia, bipolar disturbance and X-linked mental retardation. The mechanism by which NCS-1 would be involved in the causes and/or consequences of these neurodisorders is still far from elucidation. Independent evidence has pointed NCS-1 as a key regulator of synaptic efficacy by altering the expression and activity of voltage-gated channels, inhibiting internalization of dopaminergic receptors, and altering phosphoinositide metabolism. In this study, we examined the possible participation of NCS-1 protein in signal transmission dependent on muscarinic receptor activation, using PC12 cells stably expressing NCS-1 (PC12-NCS-1). Carbachol (CCH; 300 microM) was able to evoke glutamate release more efficiently from PC12-NCS-1 (15.3+/-1.0nmol/mg of protein) than wild type cells (PC12-wt; 8.3+/-0.9nmol/mg of protein). This increase of glutamate release induced by CCH was independent on extracellular Ca2+ influx. Additionally, a larger increase of cytoplasmic levels of InsP3 (663.0+/-63.0 and 310.0+/-39.0% of fluorescence in A.U.) and [Ca2+]i (766.4+/-40.0 and 687.8+/-37.1nmol/L) was observed after CCH stimulus of PC12-NCS-1 compared with PC12-wt. Clearly distinction between intracellular Ca2+ dynamics was also observed in PC12-NCS-1 and PC12-wt. A larger increase followed by fast decay of [Ca2+]i was observed in PC12-NCS-1. A plateau with a delayed decay of [Ca2+]i was characteristic of PC12-wt [Ca2+]i response. Both enhancement of InsP3 production and glutamate release observed in PC12-NCS-1 were blocked by atropine (10 microM). Together, our data show that overexpression of NCS-1 in PC12 cells induces an enhancement of intracellular second messenger and transmitter release dependent on CCH response, suggesting that muscarinic signaling is "up-regulated" in this cell model.

Caracterização postural da jovem praticante de ginástica olímpica / Postural characterization of young participants in Olympic gymnastics

OBJETIVO: Identificar as alterações posturais em crianças praticantes de ginástica olímpica, com idade entre 8 e 12 anos. MÉTODOS: Foram avaliadas 84 estudantes, 38 praticantes de ginástica olímpica e 46 não praticantes, com idade entre 8 e 12 anos. Foram realizadas fotografias de cada criança nos planos frontal anterior e posterior e plano sagital. As fotos foram analisadas através do software Corel Draw, v. 11.0, utilizando as ferramentas linhas-guia e dimensão (dimensão angular, dimensão vertical e dimensão horizontal), visando determinar os parâmetros das 19 variáveis qualitativas e 5 variáveis quantitativas. RESULTADOS: Ao comparar os sujeitos do grupo teste (GT) com os sujeitos do grupo controle (GC), observa-se diferença estatisticamente significante nas variáveis rotação medial de fêmur (GC 56,52 por cento; GT 39,47 por cento), antepulsão de pelve (GC 43,48 por cento; GT 76,32 por cento) e rotação de tronco (GC 67,39 por cento; GT 23,68 por cento). Observa-se também diferença significante em relação às medidas de valgo de joelho (GC 4,06 ± 2,32 cm; GT 3,14 ± 1,49cm), desnível de pelve (GC 0,69 ± 0,39 cm; GT 0,53 ± 0,33cm) e ângulo tíbio-társico (GC 86,93 ± 2,90 cm; GT 87,11 ± 4,17 cm). CONCLUSÃO: Ao analisar os resultados, nota-se uma tendência ao melhor alinhamento dos membros inferiores no grupo teste quando comparado ao grupo controle. Há um aumento da inclinação pélvica anterior e uma tendência ao aumento da hiperlordose lombar no grupo teste, fatores que podem predispor a praticante de ginástica olímpica a um desalinhamento sobre as estruturas esqueléticas, levando a quadros dolorosos, limitando a sua vida esportiva.

OBJECTIVE: To identify the postural alterations among children aged 8 to 12 years who perform Olympic gymnastics. METHOD: Eighty-four students aged 8 to 12 years were assessed: 38 who were participating in Olympic gymnastics and 46 who were not. Each child was photographed in the anterior and posterior frontal planes and in the sagittal plane. The photos were analyzed using the CorelDraw v. 11.0 software. The line-guide and dimension tools (angular, vertical and horizontal dimensions) were used to determine the parameters of the nineteen qualitative and five quantitative variables. RESULTS: Comparison between the test group subjects (TG) and control group subjects (CG) showed significant differences in the variables of medial rotation of the femur (CG 56.52 percent; TG 39.47 percent), antepulsion of the pelvis (CG 43.48 percent; TG 76.32 percent) and trunk rotation (CG 67.39 percent; TG 23.68 percent). There were also found significant differences in the measurements of knee valgism (CG 4.06 ± 2.32 cm; TG 3.14 ± 1.49 cm), pelvic inclination (CG 0.69 ± 0.39 cm; TG 0.53 ± 0.33 cm) and tibiotarsal angle (CG 86.93 ± 2.90 cm; TG 87.11 ± 4.17 cm). CONCLUSION: Analysis of the results showed a tendency towards better alignment of the lower limbs in the test group than in the control group. There was greater anterior pelvic inclination and a tendency towards lumbar hyperlordosis in the test group. These factors may predispose individuals participating in Olympic gymnastics to misalignment of skeletal structures, thereby leading to painful conditions that may limit their sports activities.

Familial suicide behaviour: association with probands suicide attempt characteristics and 5-HTTLPR polymorphism.

OBJECTIVE: There is compelling evidence that a serotonergic dysfunction may play a major role in suicide behaviour and it has also been demonstrated that suicide is, at least partially, genetically determined. Thus, the serotonin-related genes are the major candidates. Previously a functional polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) was identified and the presence of the short allele (S) was found to be associated with a lower level of expression of the gene and lower levels of 5-HT uptake when compared with the long allele (L). The purpose of this study was to evaluate the association between family suicide behaviour history and probands' suicide attempt (SA) history, SA characteristics and 5-HTTLPR genotype. METHOD: We genotyped 237 probands (major depressed or schizophrenic patients) and used a semistructured interview to determine probands' SA characteristics and first- and second-degree family suicidal behaviour. RESULTS: An association between suicidal family history and proband's SA but not with SA characteristics and probands genotype was found. CONCLUSION: Our results suggest that multiple biological and environmental factors underlie familial transmission of suicidal behaviour.

Gonadotropin levels in Turner's syndrome: correlation with breast development and hormone replacement therapy.

We conducted a study of the basal levels of gonadotropins in 38 patients with Turner's syndrome, 14 of whom were using hormone replacement therapy (HRT). The gonadotropin levels were compared with pubertal development and HRT. Seven patients had presented spontaneous menarche; five patients maintained their periods and normal gonadotropin levels, and two developed secondary amenorrhea and high gonadotropin levels. The majority of patients on HRT had high gonadotropin levels. Follicle stimulating hormone (FSH) levels were significantly lower (p = 0.001) in patients with breast development at stage 5, regardless of whether the patient had undergone a spontaneous or a hormonally induced puberty. We concluded that gonadotropin levels are normal in those patients with spontaneous periods, and are high in most patients on HRT; and that FSH levels are significantly lower in those patients with breasts at stage 5.

The relationship between ovarian structure and hyperandrogenism in premature pubarche.

The aim of this study was to describe the ovarian structure (OS) and its relationship with hyperandrogenism in girls with premature pubarche (PP). A pelvic ultrasound was carried out in 23 girls with PP and in 57 prepubertal age-matched controls (C), and the OS was subdivided into five classes (c): 1-homogeneous; 2-microcystic, 3-multicystic, 4-polycystic and 5-follicular. In the girls with PP, an ACTH test was performed, and the presence of hormonal levels >3 SD of postpubertal normal levels and not compatible with late-onset congenital adrenal hyperplasia were considered an exaggerated response. The fasting levels of glucose (G) and insulin (I) were measured and the fasting I to G ratio (FIGR) was calculated. FIGR >22 was suggestive of I resistance (IR). The microcystic structure (c2) was more frequently found in the PP than in the C group (63% vs 35%, p=0.03). In the PP group, we observed the following OS: cl (n=6), c2 (n=15), c3 (n=1) and c4 (n=1). 11-Deoxycortisol--both basal and after ACTH--was greater in the PPc2 group than in PPc1 (p=0.04, p=0.0008, respectively). We also observed an exaggerated response to ACTH in 87% of the girls with PP, greater in the PPc2 group than in PPc1 (p=0.04). The FIGR showed IR in 44% of girls with PP, but I levels and FIGR were similar between PPc1 and PPc2. These findings suggest generalized adrenocortical hyperresponsiveness in girls with PP, which is more accentuated in PPc2. Long-term follow-up of girls with PP into adulthood is warranted to ascertain whether microcystic ovarian structure precedes functional ovarian hyperandrogenism.

Linear growth and zinc supplementation in children with short stature.

Physical growth retardation is an early and prominent feature of zinc deficiency, but the effect of zinc supplementation in children is still not completely clear. This study investigated the impact of zinc supplementation on linear growth, growth velocity, IGF-I levels, and skeletal maturation of short children during and after mineral supplementation. The study was designed as a double-blind, randomized, controlled trial of zinc supplementation during a 6-month period, with a subsequent 6-month follow-up. Anthropometric data were collected at 0, 6, and 12 months. Measurements included plasma Zn, IGF-I, height, weight, triceps skinfold thickness, and body mass index. Eighteen healthy pre-pubertal short children (z-score -2.0) 7 to 10 years old with normal GH and IGF-I levels were randomized to two groups, one with zinc supplementation (5 mg/kg/d of ZnSO4) and the other with placebo. In the first 6 months, only height velocity increased significantly, 5.99+/-0.80 cm/yr vs 5.05+/-0.85 cm/yr (p=0.03). After 12 months, height velocity returned to the initial values, 3.92+/-0.59 cm/yr vs 4.19+/-1.08 cm/yr (p=0.29). This study indicates that zinc supplementation increased growth velocity, but these effects did not persist after supplementation was discontinued.

[Congenital hypothyroidism screening: seasonal variations of TSH levels] / Variação sazonal nos níveis deTSH em testes de rastreamento para hipotireoidismo congênito.

OBJECTIVE: To evaluate the seasonal differences in newborn TSH levels. METHOD: A restrospective study was performed using normal blood TSH measurements collected in a neonatal screening program for congenital hypothyroidism, during the extremes of temperature (summer/winter) in order to verify the seasonal influence on that exam. Blood samples were collected from baby feet on filter paper in health care public institutions in Rio de Janeiro city and TSH were analyzed by immunofluorimetric method. For this study we considered samples with TSH levels less then 20 micro U/ml. The factors age, birth weight and prematurity were all observed.RESULTS: We evaluated 388 measurements: 159 in the summer and 229 in the winter. Newborn and infants aged from 2 days to 3 months were included. The time of collection of the exam was significant in the measurement of TSH and the mean levels of TSH collected in the summer were somewhat higher than those collected in the winter (p = 0,0001), when analyzed by the t-test, even so when the age was taken into account. Using F-test (p=0,0234) we observed differences between TSH levels in age groups. TSH levels in the newborn with 2 to 7 days of age differ significantly from those of higher age. Birth weight and prematurity do not show interference with the TSH measurement.CONCLUSIONS: Newborn and infant TSH levels were significantly higher in the summer than in the winter.

[Study of true precocious puberty in girls using clinical, laboratorial and imaging techniques]. / Estudo clínico, laboratorial e por métodos de imagem da puberdade precoce verdadeira em meninas.

This paper reviews the clinical findings, pituitary gonadotrophin reserve, plasma estradiol and androgens, radiological findings and pelvic ultrasound appearance in 17 girls with true precocious puberty (PP), and attempts to asses the value of these tests diagnosis in the clinical management of such patients and better understanding of the pathogenesis of this disorder. As noted in other series, acceleration of growth is one of the earliest features of PP and at the time of diagnosis bone age can be already significantly advanced. In 3 (18%) patients intracranial abnormalities were present. Ultrasound examination showed changes similar to those seen during normal puberty. To conclude, the introduction of high-resolution methods (CT scan and RM) and techniques for ultrasound examination have greatly simplified the clinical investigation of female precocious puberty.