Low Doses of G-CSF Prevent Cerebral Infarction and Maintain Muscle Strength in an Experimental Model of Global Ischemic Stroke.

BACKGROUND: Stroke is a major cause of severe and long-term disability in adult individuals. Treatment of this disease is limited by the narrow therapeutic window in which intervention is crucial. An alternative therapy for stroke could be cellular growth factors, which participate in several pathways that mediate neuronal cell death. METHODS: We evaluated the neuroprotective ability of different doses of granulocyte colonystimulating factor (G-CSF; 5, 50 and 100 µg/kg/day) in the mouse model of global cerebral ischemia induced by bilateral occlusion of the common carotid arteries for 80 minutes. The control group received vehicle (5% glucose solution) and the treated group was administered with G-CSF at two postsurgery time-points: immediately after and 24 hours after. Subsequently, muscle strength, leukocyte count, infarcted cortical area, and apoptosis/TUNEL were evaluated. RESULTS: The global ischemia promoted an impairment of the strength (16%) and a cerebral infarction (0.437±0.08 cm2) which were accompanied by apoptosis evaluated by TUNEL in control mice. In mice treated with G-CSF the strength function was maintained, the infarcted area (~70%) and apoptosis were decreased in a similar magnitude in all treated groups. Accordingly, the cytokine activities were confirmed by blood leukocyte count that was increased approximately 2-fold than that observed in the control group. CONCLUSION: The results indicate a neuroprotective effect of G-CSF, even in small doses, in mice subjected to global cerebral ischemia, thereby reducing the neurofunctional impairment caused by stroke, when considering the maintenance of muscle strength in the treated animals.

Positivity for HLA DR1 is associated with basal cell carcinoma in renal transplant patients in southern Brazil.

BACKGROUND: Renal transplant patients have a higher incidence of non-melanoma skin cancer (NMSC). Previous studies hypothesized that human leukocyte antigen (HLA), especially types DR1, DR4, and DR7, may influence the incidence of these tumors. This study investigates the association between NMSC and the presence of HLA DR1, DR4, and DR7 in renal transplant patients in southern Brazil. METHODS: In a historical cohort study, 1032 patients who underwent renal transplantation during the period from January 1993 to December 2006 were examined to identify occurrences of NMSC and HLA status prior to transplant. RESULTS: Of the 1032 patients examined, 59 (5.71%) developed NMSC (squamous cell carcinoma [SCC]: 2.42%; basal cell carcinoma [BCC]: 1.74%; both: 1.55%). The presence of HLA DR1 was associated with a higher probability of developing any NMSC and particularly with developing BCC (P < 0.05). There was no statistically significant association between the presence of HLA DR4 or DR7 and the occurrence of NMSC in this sample. CONCLUSIONS: HLA DR1 appears to be associated with the development of BCC, as well as with the higher number of NMSC lesions in renal transplant patients. This study supports the trend to associate the DR1 allele with BCC and not with SCC.

[Development of a multidimensional system for classification and management of health information: applying to clinical information]. / Desenvolvimento de um sistema multidimensional para classificação e gestão de informação em saúde: aplicabilidade à informação clínica.

INTRODUCTION: The large amount of information in the medical area creates management problems, being necessary systematic methods for filing and retrieval. With information on the context of clinical records, methods must integrate controlled biomedical terminologies and desirable characteristics oriented to the structure, content and clinical results. The objective is to test the applicability and capacity for retrieval of a multidimensional system developed for classification and management of health information. METHODS: Three hundred questions were randomly selected, by computerized method, from the questions received in six years (Medicine Information Service, Pharmaceutical Department, Coimbra University Hospitals). They were characterized and applicability evaluated by classified amount and need to alter the system, which is composed of various independent dimensions, incorporating concepts sometimes hierarchical. Questions retrieval was tested searching information in a dimension or between dimensions. RESULTS: All questions were classified: 53% are clinical cases with illnesses incidence in the genitourinary system; metabolic, nutritional and endocrine disease; cancer; infections and nervous system. In 81%, the object is a drug, mostly anti-infectious and anti-neoplastic agents. The therapeutic and safety areas had been the most requested, regarding the subjects: use, adverse reactions, drug identification and pharmaceutical technology. As to applicability, it was necessary to add some concepts and modify same hierarchical groups, that didn't modify the basic structure, nor had collided with the desirable characteristics. The limitations were related with the incorporated external classification systems. The search in the subject dimension of the concept drug administration retrieved 19 questions. The search between two dimensions: antiinfectious (external) and teratogenicity (subject) retrieved three questions. In the two examples, it was possible to retrieve information from any one of the levels of the hierarchy, from the most general to the most specific and even from external dimensions. CONCLUSIONS: The use of the system in this sample showed its applicability in clinical information classification and filing, retrieval capacity and flexibility, supporting modifications without interfering with desirable characteristics. This tool allows retrieval of patient-oriented evidence that matters.