The enigma of aluminum deposition in bone tissue from a patient with chronic kidney disease: a case report.

About four decades ago, the relationship between dialysis-dementia and aluminum (Al) began to be established. The restriction of drugs containing Al and improvements on water quality used for dialysis resulted in the clinical disappearance of Al intoxication. However, high prevalence of Al deposition in bone tissue from Brazilian dialysis patients is still being detected. Through the case report of a patient on hemodialysis (HD) for one year, presenting significant Al deposition in bone tissue, we speculated if this problem is not being underestimated. We used extensive investigation to identify potential sources of Al exposure with a careful review of medication history and water quality controls. Al concentration was measured by different methods, including mass spectrometry, in poly-electrolyte concentrate solutions and solution for peritoneal dialysis, in an attempt to elucidate the possible sources of contamination. The objective of this case report is to alert the medical community about a potential high prevalence of Al deposition in bone tissue and to discuss the possible sources of contamination in patients with chronic kidney disease (CKD).

The enigma of aluminum deposition in bone tissue from a patient with chronic kidney disease: a case report / O enigma da deposição de alumínio no tecido ósseo de um paciente com doença renal crônica: relato de caso

ABSTRACT About four decades ago, the relationship between dialysis-dementia and aluminum (Al) began to be established. The restriction of drugs containing Al and improvements on water quality used for dialysis resulted in the clinical disappearance of Al intoxication. However, high prevalence of Al deposition in bone tissue from Brazilian dialysis patients is still being detected. Through the case report of a patient on hemodialysis (HD) for one year, presenting significant Al deposition in bone tissue, we speculated if this problem is not being underestimated. We used extensive investigation to identify potential sources of Al exposure with a careful review of medication history and water quality controls. Al concentration was measured by different methods, including mass spectrometry, in poly-electrolyte concentrate solutions and solution for peritoneal dialysis, in an attempt to elucidate the possible sources of contamination. The objective of this case report is to alert the medical community about a potential high prevalence of Al deposition in bone tissue and to discuss the possible sources of contamination in patients with chronic kidney disease (CKD).

RESUMO Cerca de quatro décadas atrás, a relação entre demência relacionada à diálise e alumínio (Al) começou a ser estabelecida. A restrição de medicamentos contendo Al e melhorias na qualidade da água utilizada na diálise resultaram no desaparecimento clínico da intoxicação por Al. Contudo, no Brasil continua a ser identificada uma elevada prevalência de deposição de Al no tecido ósseo de pacientes em diálise. O presente relato de caso de um paciente em hemodiálise (HD) há um ano com deposição significativa de Al no tecido ósseo nos leva a especular se esse problema não tem sido subestimado. Realizamos uma ampla investigação para identificar possíveis fontes de exposição ao Al, com uma revisão cuidadosa do histórico de medicação e dos controles de qualidade da água. A concentração de Al foi medida por diferentes métodos, incluindo espectrometria de massa, nos concentrados polieletrolíticos para hemodiálise e soluções de diálise peritoneal, na tentativa de elucidar as possíveis fontes de contaminação. O objetivo do presente relato de caso é alertar a comunidade médica sobre uma possível elevada prevalência de deposição de Al no tecido ósseo e discutir as possíveis fontes de contaminação nos pacientes com doença renal crônica (DRC).

Elemental fingerprinting of schizophrenia patient blood plasma before and after treatment with antipsychotics.

Antipsychotics are the main line of treatment for schizophrenia, a disorder that affects about 1% of the worldwide population. Considering the poor performance of antipsychotics on patients, this work aimed at detecting alterations in the elemental profile resulting from the use of this type of medication using an elemental fingerprinting strategy. We evaluated 56 plasma samples from schizophrenia patients by inductively coupled plasma mass spectrometry (ICP-MS) before (t0) and after 6 weeks (t6) of treatment. The level of response of the patients (good vs. poor responders) and the medications taken were considered. Zinc, aluminum, phosphorus, and iron levels were found to be increased, whereas sodium, potassium, calcium, and magnesium levels decreased after treatment. Aluminum presented a higher level in poor responders at t0 when compared to good responders. At t6, iron showed an increased level when compared to t0 for good responders; however, its level remained constant in poor responders. The results of this exploratory study provide clues for further investigations on the role of metal ions in the treatment of schizophrenia.

Proteomics strategies for bipolar disorder evaluation: From sample preparation to validation.

Bipolar disorder (BD) is a complex and costly psychiatric disorder, which affects one hundred million people worldwide. Due to its heterogeneity, correct BD diagnosis is still a challenge. In order to overcome this issue, different bioanalytical strategies have been proposed in the literature recently. Among these strategies, proteomic approaches have arisen as some of the most promising in the area. Thus, recent applications suggest protein profiles to further refine the proteome of BD as well as the discovery of novel protein biomarkers to facilitate diagnostics. In this review, the state-of-art of proteomic research in BD is summarized. Furthermore, important aspects of proteomics for understanding of BD, such as sample type and size, sampling, sample preparation, gel-based and gel-free proteomics, proteomic quantitative and protein validation are overviewed.

The importance of evaluating the real metal concentration in nanoparticles post-synthesis for their applications: A case-study using silver nanoparticles.

To determine whether the effect observed in a study is related to the nanoparticle only or to their synergic effect with the "free" metal ions, the real concentration of silver (104±8 and 100±2 mg L(-1)) after AgNP synthesis is obtained through ICP-MS and ICP OES in the solution after the AgNP synthesis and in different fractions after centrifugation (at 8100 g for 40 min). From the resuspension of the AgNP contained in the solution (AgNP-total) after synthesis (AgNP-res), concentrations of 49±3 and 51±3 mg L(-1) are found and concentrations of 50±7 and 47±2 mg L(-1) in the supernatant (Ag-sup) are found using ICP-MS and ICP OES respectively. The characterization of AgNP-total, AgNP-res and Ag-sup is performed by HRTEM and UV-vis, corroborating the results in terms of Ag determination, and indicates that half of the total silver concentration is in the AgNP form and that the other half is in the "free" silver form. The results of the stability test of the NPs indicate a 7% decrease in Ag as NP three months after its synthesis.

Avaliação da atenção primária aos hipertensos cadastrados no HiperDia / Primary care evaluation to hypertensives registered in HiperDia / Evaluación de la atención primaria a los hipertensos registrados en HiperDia

Objetivos: descrever o perfil epidemiológico segundo as informações do HiperDia e avaliar o processo de trabalho prestado a hipertensos e ao seu índice de satisfação. Método: estudo epidemiológico misto associando-se à análise exploratória descritiva de dados do HiperDia a um inquérito com amostra aleatória de 335 hipertensos. Os dados foram analisados à luz da estatística simples e apresentados descritivamente com números absolutos e percentuais. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, sob o Protocolo 261/2009. Resultados: do total de pacientes a maioria é mulher na faixa etária entre 40 e 69 anos, apresentando características como tabagismo e sedentarismo e algumas sequelas, e avaliando a assistência prestada como boa. Exames são realizados com frequência, exceto o de ECG. Conclusão: a falta de vínculo e comunicação entre profissionais e usuários é uma barreira ao acesso à assistência.(AU)

Objectives: describing the epidemiological profile according to HiperDia and evaluating the work process given to hypertensive and their index of satisfaction. Method: a mix epidemiological study associating the exploratory descriptive data analysis in HiperDia to a survey with a random sample of 335 hypertensives. Data were analyzed based on simple descriptive statistics and presented in absolute numbers and percentages. The research project was approved by the Research Ethics Committee, under protocol 261/2009. Results: from the total number of patients the majority is women aged between 40 and 69 years old, exhibiting characteristics, such as smoking and physical inactivity and some sequels, and evaluating the assistance as good. Examinations are performed frequently, except the ECG. Conclusion: the lack of bond and communication among professionals and patients is a barrier to accessing care.(AU)

Objetivos: describir el perfil epidemiológico según informaciones del HIPERDIA y evaluar el proceso de trabajo dado a hipertensos y a su índice de satisfacción. Método: estudio epidemiológico mezclado asociándose al análisis exploratorio y descriptivo de datos del HIPERDIA a una encuesta con una muestra aleatoria de 335 hipertensos. Los datos fueron analizados sobre la base de la estadística simple y presentados descriptivamente en números absolutos y porcentajes. El proyecto de investigación fue aprobado por el Comité Ético de Investigación, bajo protocolo 261/2009. Resultados: del número total de pacientes la mayoría es de mujeres con edad entre 40 y 69 años, presentando características tales como el tabaquismo y la inactividad física y algunas secuelas, y evaluando la asistencia cómo buena. Los exámenes se llevan a cabo con frecuencia, excepto el ECG. Conclusión: la falta de ligación y comunicación entre los profesionales y los pacientes es un obstáculo para el acceso a la atención.(AU)

Metals and (metallo)proteins identification in vitreous humor focusing on post-mortem biochemistry.

This work describes the evaluation of metals and (metallo)proteins in vitreous humor samples and their correlations with some biological aspects in different post-mortem intervals (1-7 days), taking into account both decomposing and non-decomposing bodies. After qualitative evaluation of the samples involving 26 elements, representative metal ions (Fe, Mg and Mo) are determined by inductively coupled plasma mass spectrometry after using mini-vial decomposition system for sample preparation. A significant trend for Fe is found with post-mortem time for decomposing bodies because of a significant increase of iron concentration when comparing samples from bodies presenting 3 and 7 days post-mortem interval. An important clue to elucidate the role of metals is the coupling of liquid chromatography with inductively coupled plasma mass spectrometry for identification of metals linked to proteins, as well as mass spectrometry for the identification of those proteins involved in the post-mortem interval.

Ion mobility spectrometry focusing on speciation analysis of metals/metalloids bound to carbonic anhydrase.

In the present work, traveling wave ion mobility spectrometry-mass spectrometry (TWIMS-MS) was applied to speciation analysis of metalloproteins. The influence of pH on complexation conditions between some metals and bovine carbonic anhydrase was evaluated from pH 6 to 9, as well as the time involved in their complexation (0-24 h). Employing TWIMS-MS, two conformational states of bovine carbonic anhydrase were observed with charge states of +12 and +11; these configurations being evaluated in terms of the folded state of the apo form and this protein (at charge state +11) being linked to barium, lead, copper, and zinc in their divalent forms. Metalloprotein speciation analysis was carried out for copper (Cu(+) and Cu(2+)), lead (Pb(2+) and Pb(4+)), and selenium (Se(4+) and Se(6+)) species complexed with bovine carbonic anhydrase. Mobilities of all complexed species were compared, also considering the apo form of this protein.

Automedicação versus automedicação responsável: uma análise em três escolas de Alfenas-MG / Self-medication versus responsible self-medication: an analysis in three schools of Alfenas-MG

Avaliou-se o uso de medicamentos por conta própria em três escolas estaduais do município de Alfenas-MG. Formulários foram aplicados aos pais para medir os índices de automedicação. Os dados foram processados utilizando o programa epiInfo 6.0. Dos 571 entrevistados, 65% se automedicavam no momento da entrevista, 55,7% se automedicam por falta de recursos financeiros. Os analgésicos e antitérmicos foram as drogas mais utilizadas (91,6%). Verificou-se a prevalência da automedicação semelhante à observada em países desenvolvidos.