Changes after 12 years of follow-up severe asthma patients cohort: higher obstruction and comorbidities, but significant better quality of life.

BACKGROUND: The Brazilian Cohort of Asthma São Paulo (BRASASP) had a well-characterized severe asthmatic in Brazil, with 12 years of follow-up under standard treatment. METHODS: Sequential assessment of patients with uncontrolled asthma from BRASASP cohort was carried out with 12 years of follow-up, performing exams and comparing with previous measurements. RESULTS: 50 from the 60 initial patients were reevaluated. Twelve years later, FEV1 and the FEV1/FVC ratio have significantly decreased, with a rate of loss of lung function of 11.8 and 14%, respectively, and worsening in small airway parameters such as RV/TLC. BMI, The Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) scores haven't changed. However, exacerbations decreased by 56%. Mean daily inhaled corticosteroid use was similar over time, but daily oral corticosteroid use decreased, in addition to a significant reduction in induced sputum eosinophilic and neutrophilic profile and serum IgE. Rhinitis, sinusitis, and GERD were the main comorbidities. In quality of life according to respiratory questionnaire SGRQ, total score showed a huge improvement (62% of patients). CONCLUSIONS: There was significant decrease in FEV1 and FEV1/FVC. Data of pulmonary functional small airway characteristics show globally affected airways. Although higher doses of medications, patients were still uncontrolled, but with reduction of exacerbations, daily use of oral corticosteroid, less eosinophils and neutrophils in induced sputum and lower levels of IgE. Improvement in quality of life in 62% of patients.

Effects of equal-volume resistance training performed one or two times a week in upper body muscle size and strength of untrained young men.

AIM: The purpose of the present study was to compare the effects of equal-volume resistance training (RT) performed once or twice a week on muscle mass and strength of the elbow flexors in untrained young men. METHODS: Thirty men (23 ± 3 years) without previous resistance training experience were divided into two groups: Group 1 (G1) trained each muscle group only once a week and group 2 (G2) trained each muscle twice a week during 10 weeks. Baseline and 10 weeks post-test elbow flexors muscle thickness (MT) were measured using a B-Mode ultrasound. Peak torque (PT) was assessed by an isokinetic dynamometer before and after the training program. RESULTS: Elbow flexors MT increased significantly (P<0.05) from 31.70 ± 3.31 to 33.43 ± 3.46 mm in G1, and from 32.78 ± 4.03 to 35.09 ± 3.55 mm in G2. Elbow flexors PT also increased (P<0.05) from 50.77 ± 9.26 to 54.15 ± 10.79 N.m in G1, and from 48.99 ± 11.52 to 55.29 ± 10.24 N.m in G2. The results of ANOVA did not reveal group by time interactions for any variable, indicating no difference between groups for the changes in MT or PT. CONCLUSION: The results from the present study suggest that untrained men experience similar gains in muscle mass and strength with equal volume RT performed one or two days per week.

ACE and ACTN3 genotypes in older women: muscular phenotypes.

This study examined the association between ACE I/D and ACTN3 R577X polymorphisms and muscle-related phenotypes and their adaptation to resistance training in older women. Volunteers (n=246;age=66.7 ± 5.5 years) underwent quadriceps strength assessment using isokinetics and fat-free mass by dual energy X-ray absorptiometry. 79 volunteers performed 24 weeks of resistance training and 75 were studied as controls. Genotypes were identified by standard procedures. No associations were observed for muscle strength for either gene, but volunteers carrying the D/D genotype presented higher appendicular fat-free mass compared to the I-allele carriers (6.3 ± 0.1 vs. 6.1 ± 0.1 kg/m (2)). The X-allele carriers presented higher relative fat-free mass when compared to homozygous R/R (16.3 ± 0.1 vs. 15.9 ± 0.1 kg/m (2)). All fat-free mass variables were significantly greater for carriers of both X/X and D/D genotypes. In response to RT, only the I-allele carriers significantly increased fat-free mass and a significant training × genotype interaction was noted. These findings do not support a pivotal role for the studied polymorphisms in determining muscle strength in older women, but suggest a modest role in fat-free mass determination. Of note, the results provide a novel insight that these genetic variations may interact to determine muscle mass in older women.

A multiplex single-base extension protocol for genotyping Cdx2, FokI, BsmI, ApaI, and TaqI polymorphisms of the vitamin D receptor gene.

The well-described role of the vitamin D endocrine system in bone metabolism makes its receptor a widely investigated candidate gene in association studies looking for the genetic basis of complex bone-related phenotypes. Most association studies genotype five polymorphic sites along the gene using PCR-RFLP and allele-specific amplification methods, which may not be the better choice in large case/control or cross-sectional studies. In this case, genotyping SNPs in parallel and using automated allele-calling methods are important to decrease genotyping errors due to manual data handling and save sample in cases where the amount of DNA is limited. The aim of this study was to present a straightforward method based on multiplex PCR amplification followed by multiplex single-base extension as a simple way to genotype five vitamin D receptor gene polymorphisms in parallel, which may be implemented in medium- to large-scale case/control or cross-sectional studies. The results regarding method feasibility and optimization are presented by genotyping eight paternity trios and seven samples of Brazilian postmenopausal women who took part in an ongoing association study carried out by members of our group.

Natural variation of selenium in Brazil nuts and soils from the Amazon region.

Brazil nut tree (Bertholletia excelsa) is native of the Amazon rainforest. Brazil nuts are consumed worldwide and are known as the richest food source of selenium (Se). Yet, the reasoning for such Se contents is not well stablished. We evaluated the variation in Se concentration of Brazil nuts from Brazilian Amazon basin, as well as soil properties, including total Se concentration, of the soils sampled directly underneath the trees crown, aiming to investigate which soil properties influence Se accumulation in the nuts. The median Se concentration in Brazil nuts varied from 2.07 mg kg-1 (in Mato Grosso state) to 68.15 mg kg-1 (in Amazonas state). Therefore, depending on its origin, a single Brazil nut could provide from 11% (in the Mato Grosso state) up to 288% (in the Amazonas state) of the daily Se requirement for an adult man (70 µg). The total Se concentration in the soil also varied considerably, ranging from <65.76 to 625.91 µg kg-1, with highest Se concentrations being observed in soil samples from the state of Amazonas. Se accumulation in Brazil nuts generally increased in soils with higher total Se content, but decreased under acidic conditions in the soil. This indicates that, besides total soil Se concentration, soil acidity plays a major role in Se uptake by Brazil nut trees, possibly due to the importance of this soil property to Se retention in the soil.

Effects of disturbed blood flow during exercise on endothelial function: a time course analysis.

This study aimed to examine the time course of endothelial function after a single handgrip exercise session combined with blood flow restriction in healthy young men. Nine participants (28 ± 5.8 years) completed a single session of bilateral dynamic handgrip exercise (20 min with 60% of the maximum voluntary contraction). To induce blood flow restriction, a cuff was placed 2 cm below the antecubital fossa in the experimental arm. This cuff was inflated to 80 mmHg before initiation of exercise and maintained through the duration of the protocol. The experimental arm and control arm were randomly selected for all subjects. Brachial artery flow-mediated dilation (FMD) and blood flow velocity profiles were assessed using Doppler ultrasonography before initiation of the exercise, and at 15 and 60 min after its cessation. Blood flow velocity profiles were also assessed during exercise. There was a significant increase in FMD 15 min after exercise in the control arm compared with before exercise (64.09% ± 16.59%, P=0.001), but there was no change in the experimental arm (-12.48% ± 12.64%, P=0.252). FMD values at 15 min post-exercise were significantly higher for the control arm in comparison to the experimental arm (P=0.004). FMD returned to near baseline values at 60 min after exercise, with no significant difference between arms (P=0.424). A single handgrip exercise bout provoked an acute increase in FMD 15 min after exercise, returning to near baseline values at 60 min. This response was blunted by the addition of an inflated pneumatic cuff to the exercising arm.

Acute limb ischemia as manifestation of a pheochromocytoma.

A case is described of a woman admitted to the emergency room with myocardial infarction and acute leg ischemia and suspected thromboembolism. Surgical exploration of the common femoral artery and its branches was performed. The surgical outcome and the subsequent clinical course suggested the diagnosis of pheochromocytoma which was supported by isotopic red-cell labelling study and catecholamine measurement. The very high values of catecholamine production explained the marked and persistent arterial vasospasm which led to marked and irreversible ischemia.

Case report: Long-term outcome of class II division 1 malocclusion treated with rapid palatal expansion and cervical traction.

A case of a Class II Division 1 malocclusion with reduced transpalatal width and unfavorable axial inclinations of the posterior teeth is reported. Rapid palatal expansion (RPE) was used for maxillary enhancement and molar distalization therapy to correct the anteroposterior dental discrepancy. This case report illustrates the results of the method of treatment used with a long-term (16-year-posttreatment) follow-up.

[Substituted imidazolidinediones and thiazolidinediones: synthesis, structure and cytotoxic activity]. / Imidazolidinediones et thiazolidinediones substituées: synthèse, étude structurale et activité cytotoxique.

Synthesis and physico-chemical properties of nine 3-(4-fluoro or chlorobenzyl)-5-arylidène-imidazolidine-2,4-diones, four 3-(4-fluoro or bromobenzyl)-5-arylidène-thiazolidine-2,4-diones and three 3-)4-bromophénacyl)-5-arylidène-thiazolidine-2,4- diones has been described. These compounds were synthesized by aldolisation-crotonisation reaction from aromatic aldehydes and 3-substituted imidazolidine-2,4-diones or thiazolidine-2,4-diones. In vitro cytotoxic activity was determined for compounds 8, 17, 18, 21 and 22.

[Cerebral metastasis as the form of presentation of a basaloid carcinoma of the esophagus]. / Metastase cerebral como forma de apresentação de carcinoma basalóide do esófago.

A case of oesophageal basaloid carcinoma is reported. The disease was revealed as a brain metastasis and was found ad initium to be in an advanced stage, with evidence of brain, lung and liver metastasis. The treatment performed was palliative subtotal oesophagectomy followed by roentgen therapy. A year and a half later, the patient is still alive and in home care follow up. The authors end stressing this uncommon presentation for an oesophageal neoplasm and the rarity of its histologic type. They also stress the role of surgery, although palliative, in long survival, very unlike the rapid evolution of the few published cases.

Identification of sarcopenic obesity in postmenopausal women: a cutoff proposal.

Sarcopenic obesity is the combination of reduced fat-free mass (FFM) and increased fat mass (FM) with advancing age but there is lack of clear criteria for its identification. The purposes of the present investigation were: 1) to determine the prevalence of postmenopausal women with reduced FFM relative to their FM and height, and 2) to examine whether there are associations between the proposed classification and health-related variables. A total of 607 women were included in this cross-sectional study and were separated into two subsets: 258 older women with a mean age of 66.8 ± 5.6 years and 349 young women aged 18-40 years (mean age, 29.0 ± 7.5 years). All volunteers underwent body composition assessment by dual-energy X-ray absorptiometry. The FFM index relative to FM and height was calculated and the cutoff value corresponded to two standard deviations below the mean of the young reference group. To examine the clinical significance of the classification, all older participants underwent measurements of quadriceps strength and cardiorespiratory fitness. Values were compared between those who were classified as low FFM or not, using an independent samples t-test and correlations were examined. The cutoff corresponded to a residual of -3.4 and generated a sarcopenic obesity prevalence of 19.8% that was associated with reduced muscle strength and aerobic fitness among the older participants. Also, the index correlated significantly with the health-related fitness variables. The results demonstrated reduced functional capacity for those below the proposed cutoff and suggested applicability of the approach as a definition for sarcopenic obesity.

Effects of disturbed blood flow during exercise on endothelial function: a time course analysis

This study aimed to examine the time course of endothelial function after a single handgrip exercise session combined with blood flow restriction in healthy young men. Nine participants (28±5.8 years) completed a single session of bilateral dynamic handgrip exercise (20 min with 60% of the maximum voluntary contraction). To induce blood flow restriction, a cuff was placed 2 cm below the antecubital fossa in the experimental arm. This cuff was inflated to 80 mmHg before initiation of exercise and maintained through the duration of the protocol. The experimental arm and control arm were randomly selected for all subjects. Brachial artery flow-mediated dilation (FMD) and blood flow velocity profiles were assessed using Doppler ultrasonography before initiation of the exercise, and at 15 and 60 min after its cessation. Blood flow velocity profiles were also assessed during exercise. There was a significant increase in FMD 15 min after exercise in the control arm compared with before exercise (64.09%±16.59%, P=0.001), but there was no change in the experimental arm (-12.48%±12.64%, P=0.252). FMD values at 15 min post-exercise were significantly higher for the control arm in comparison to the experimental arm (P=0.004). FMD returned to near baseline values at 60 min after exercise, with no significant difference between arms (P=0.424). A single handgrip exercise bout provoked an acute increase in FMD 15 min after exercise, returning to near baseline values at 60 min. This response was blunted by the addition of an inflated pneumatic cuff to the exercising arm.

Manganese and limestone interactions during mine water treatment.

Manganese removal from mining-affected waters is an important challenge for the mining industry. Addressed herein is this issue in both batch and continuous conditions. Batch experiments were carried out with synthetic solutions, at 23+/-2 degrees C, initial pH 5.5 and 8.3 g limestone/L. Similarly, continuous tests were performed with a 16.5 mg/L Mn(2+) mine water, at 23 degrees C, initial pH 8.0 and 20.8 g limestone/L. Calcite limestone gave the best results and its fine grinding proved to the most effective parameter for manganese removal. In either synthetic solutions or industrial effluents, the final manganese concentration was below 1 mg/L. A change in limestone surface zeta potential is observed after manganese removal and manganese carbonate formation was suggested by IR spectroscopy. The conclusion is that limestone can remove manganese from industrial effluents for values that comply with environmental regulations.

Catechol cytotoxicity in vitro: induction of glioblastoma cell death by apoptosis.

The exposure to benzene is a public health problem. Although the most well-known effect of benzene is hematopoietic toxicity, there is little information about the benzene and its metabolites effects on the central nervous system (CNS). This study examined the toxic effects of 1,2-dihydroxybenzene (catechol), a benzene metabolite, to human glioblastoma GL-15 cells. GL-15 cell cultures were used as a model to provide more information about the toxic effects of aromatic compounds to the CNS. Catechol induced time- and concentration-dependent cytotoxic effects. Morphological changes, such as the retraction of the cytoplasm and chromatin clumping, were seen in cells exposed to 200 microM catechol for 48 hours. In cells exposed to 600 microM catechol for 48 hours, 78.0% of them presented condensed nuclei, and the Comet assay showed DNA damage. The percentage of cells labeled with annexin V (apoptotic cells) was greater in the group exposed to catechol (20.7%) than in control cells (0.4%). Exposure to catechol at concentrations greater than 100 microM enhanced Bax levels, and a decrease in Bcl-2 level was observed after the exposure to 600 microM catechol for 48 hours. Furthermore, catechol depleted reduced glutathione. Hence, catechol induced cell death mainly by apoptosis.

Physical activity, Cdx-2 genotype, and BMD.

The present study investigated the interaction between Cdx-2 polymorphism and physical activity level over bone mineral density (BMD) variation in Brazilian postmenopausal women. One hundred and ninety women volunteered to participate in the study (66.6 +/- 5.3 years, 64.58 +/- 11.74 kg and 151.94 +/- 6.36 cm). Physical activity level (PAL) was assessed using the international physical activity questionnaire (IPAQ). Lumbar spine (L2 - L4), femoral neck, great trochanter and Wards' triangle bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DXA). The Cdx-2 polymorphism was genotyped by minisequencing, using the SNaPshottrade mark Multiplex System (Applied Biosystems, Foster City, CA, USA). Overall, no significant association was found between Cdx-2 polymorphism and adjusted BMD at any site. However, the results revealed a significant interaction between PAL and Cdx-2 genotype on adjusted femoral neck and Wards' triangle BMD. Active women carrying the Cdx-G/G genotype showed higher adjusted femoral neck and Wards' triangle BMD than inactive women carrying the same genotype, thus suggesting a larger chronic response to physical activity. These results suggest that, in postmenopausal women, the Cdx-2 polymorphism does not influence BMD by itself; however, it seems to affect the BMD response to physical activity since only the Cdx-G/G genotype carriers presented significant differences between active and inactive.

Identification of sarcopenic obesity in postmenopausal women: a cutoff proposal

Sarcopenic obesity is the combination of reduced fat-free mass (FFM) and increased fat mass (FM) with advancing age but there is lack of clear criteria for its identification. The purposes of the present investigation were: 1) to determine the prevalence of postmenopausal women with reduced FFM relative to their FM and height, and 2) to examine whether there are associations between the proposed classification and health-related variables. A total of 607 women were included in this cross-sectional study and were separated into two subsets: 258 older women with a mean age of 66.8 ± 5.6 years and 349 young women aged 18-40 years (mean age, 29.0 ± 7.5 years). All volunteers underwent body composition assessment by dual-energy X-ray absorptiometry. The FFM index relative to FM and height was calculated and the cutoff value corresponded to two standard deviations below the mean of the young reference group. To examine the clinical significance of the classification, all older participants underwent measurements of quadriceps strength and cardiorespiratory fitness. Values were compared between those who were classified as low FFM or not, using an independent samples t-test and correlations were examined. The cutoff corresponded to a residual of -3.4 and generated a sarcopenic obesity prevalence of 19.8 percent that was associated with reduced muscle strength and aerobic fitness among the older participants. Also, the index correlated significantly with the health-related fitness variables. The results demonstrated reduced functional capacity for those below the proposed cutoff and suggested applicability of the approach as a definition for sarcopenic obesity.

Promoting the dignity and rights of people living with HIV / AIDS.

PIP: The Grupo Pela Vidda (GPV) is a network of nongovernmental organizations in Brazil which fights discrimination against people with AIDS, their friends and families. The first GPV group was started in 1989 in Rio de Janeiro and has since multiplied to a total of eight groups forming a focus for social participation where people can unite to cope with the effects of the HIV epidemic. Approximately 100 volunteers are permanently involved in running program activities, but more than 2500 have participated in some way. GPV is not linked to any religious, medical, therapeutic, or political orientations in order to remain nonpartisan and be more directly related to individuals who fight for rights based upon their own experiences. GPV groups also remain independent from each other to best accommodate the specific needs of different cities and regions. Some activities are therefore carried out by almost all the groups, while others have unique projects. Not formed as a federation, the groups do share ideas, experiences, policy strategies, and information on activities and projects through mailings, publications, and national meetings held once or twice yearly. The newest collective project involves the preparation of a data profile concerning the people who consult GPV throughout Brazil and their reasons for doing so. The network is described in sections on outreach through meetings, legal assistance and orientation, workshops, special group activities, information services, collaboration with other organizations, and health promotion.^ieng