Distinctive features of positive anti-cell antibody tests (indirect immunofluorescence on HEp-2 cells) in patients with non-autoimmune diseases.

OBJECTIVE: The objective of this study was to determine whether characteristics of positive results in the indirect immunofluorescence assay on HEp-2 cells for anti-cell antibodies (HEp-2 IFA) differ between patients with non-autoimmune diseases (NADs) and patients with systemic autoimmune rheumatic diseases (SARDs). METHODS: Cross-sectional observational study comparing HEp-2 IFA test results in three groups: (a) 558 NAD patients comprising four subgroups (cancer ( n = 95), infectious diseases ( n = 148), psychiatric diseases ( n = 163), common non-infectious chronic diseases ( n = 152)); (b) 194 SARD patients; (c) 1217 healthy individuals (HIs). Sera were tested at 1:80 dilution and diluted to the end titer. Slides were analyzed by two independent blinded examiners. RESULTS: A positive HEp-2 IFA test occurred in 102 (18.3%) NAD patients, 170 (87.6%) SARD patients and 150 (12.3%) HIs. The four NAD subgroups did not differ regarding HEp-2 IFA frequency, titer or pattern. HEp-2 IFA titer was higher in NAD patients than in HIs and both had lower titer than SARD patients. Nuclear dense fine speckled pattern was more frequent in NAD patients and HIs than in SARD patients ( p < 0.001). Nuclear homogeneous and nuclear coarse speckled patterns were more frequent in SARD patients than in the other groups ( p < 0.001). The nuclear fine speckled pattern was prevalent in all three groups, but presented a gradient in titer across them; HIs and NAD patients had low and intermediary titers, which were significantly lower than in SARD patients ( p < 0.001). CONCLUSION: Positive HEp-2 IFA frequency, pattern and titer present differential features in NAD and SARD patients, and this attribute adds value to the test in the diagnosis of SARDs.

Circulating miRNAs as biomarkers in cardiovascular diseases.

Cardiovascular diseases (CVDs) have shown a high prevalence every year, presenting arterial hypertension as prime factor for their development, also driven by population growth, the aging of population and epidemiologic changes in disease. One of the main challenges in the study of CVD is the identification of reliable biomarkers that can be used in clinical practice and, in this context, microRNAs (miRNAs) have attracted much attention recently. MiRNAs are small non-coding RNAs, identified as post-transcriptional regulators of the expression of several genes both in physiologic and pathologic conditions. They have been studied as possible biomarkers, since they are highly expressed in the vascular system and are crucial modulators for the differentiation, contraction, migration and apoptosis of vascular cells, so modifications in their expression can cause several vascular alterations. Thus, this review aimed to compile the main studies regarding the role of miRNAs in the development of cardiac diseases, their potential applicability in the diagnosis, prognosis and treatment of these disorders. It was possible to verify that alterations in miRNAs expression are present in almost all cardiovascular diseases, such as the development of cardiac hypertrophy, coronary heart disease, heart failure and other conditions. Furthermore, growing evidence indicates that circulating miRNAs may become a potential tool for rapid and easy tests, since they are detected in peripheral blood, also allowing new therapeutic possibilities.

Validation of a food frequency questionnaire for children and adolescents aged 4 to 11 years living in Salvador, Bahia.

OBJECTIVE: To assess the validity of a food frequency questionnaire (FFQ) by applying it to children and adolescents living in Salvador, Bahia. METHODS: The validity of this FFQ with 98 food items was investigated among 108 children and adolescents who were selected from a sample of 1445 that had been planned for a study on the risk factors for asthma and other allergic diseases. The adults responsible for these children and adolescents gave responses for a 24-hour recall (R24h) and an FFQ. The average energy and nutrient values from the FFQ were compared with those from the R24h by means of the paired t test and Pearson correlation coefficients. The concordance was evaluated using the Bland-Altman method and kappa statistics. RESULTS: The energy and nutrient intake estimated using the FFQ was significantly higher than what was obtained using the R24h. The correlation coefficients adjusted for energy were statistically significant for protein, fat, vitamin C and zinc. The weighted kappa values ranged from 0.06 for vitamin A (p = 0.24) to 0.34 for energy (p < 0.00). The results from the Bland-Altman plots for lipid, protein and zinc showed the most significant validity parameters, and zinc was found to show the best concordance. CONCLUSION: The results suggest that the FFQ showed satisfactory validity for use in studies involving children and adolescents.

Individual and contextual determinants of the duration of diarrhoeal episodes in preschool children: a longitudinal study in an urban setting.

This study investigated individual and contextual factors associated with the duration of diarrhoeal episodes in 693 young children living in a large Brazilian city who were followed-up for at least 3 months. The outcome is analysed as a continuous variable, by means of a hierarchical conceptual model organizing the factors in meaningful blocks. A total of 2397 episodes were recorded (median duration 2 days, interquartile range 1-3 days). Low percentage of households connected to the sewerage system in the neighbourhood, low family purchasing power, high agglomeration, mother aged <19 years, low zinc content in child's diet, and episode severity were significantly associated with longer duration (0·26-0·69 days more). Purchasing power effect was largely mediated by environmental conditions, characteristics of the child, and hygienic behaviour. Environmental conditions acted as a possible effect modifier, enhancing the effect on duration of diarrhoea of the child not having being vaccinated against measles or breastfed for >6 months.

Separação e identificação de ácidos graxos em formulações cosméticas contendo óleo de castanha do Brasil por eletroforese capilar / Separation and identification of fatty acids in cosmetic formulations containing Brazil nut oil by capillary electrophoresis

An analytical method based on capillary electrophoresis (CE) with a partially aqueous electrolyte system was developed to enable the free fatty acids of Brazil nut oil to be identified in cosmetic formulations. In this study, a gel cream formulation was developed and its oil phase was extracted with a mixture of chloroform-methanol-water (1:2:0.8 v/v/v). The chloroform layer was saponified with a methanolic solution of NaOH (0.5 mol L-1) at 75-80 °C for 25 minutes. Experiments were carried out on a Beckman PACE/MDQ CE system (Fullerton, CA, USA) equipped with an on-column, diode-array detection system set at 254 nm and at 25ºC. The electrolyte consisted of 12.5 mmol L-1 sodium tetraborate buffer pH 7.0, 12.5 mmol L-1 polyoxyethylene 23-lauryl ether, 7.5 mmol L-1 sodium dodecylbenzenesulfonate (used as chromophore for indirect UV detection) and acetonitrile (35% v/v). The proposed method allowed the separation and identification of the fatty acids of Brazil nut oil in a cosmetic gel cream, as well as enabling possible interference by the oily phase components in the formulation to be identified.

Um método de análise por eletroforese capilar com sistema de eletrólito parcialmente aquoso foi desenvolvido para identificar os ácidos graxos livres do óleo de Castanha do Brasil em formulações cosméticas. No presente trabalho foi desenvolvida uma formulação cosmética (gel creme) cuja fase oleosa foi extraída com uma mistura de clorofórmio-metanol-água (1:2:0.8 v/v/v). A camada de clorofórmio, foi saponificada com solução de NaOH em metanol (0,5 mol L-1) a 75-80 °C durante 25 minutos. Os experimentos foram realizados em sistema de eletroforese capilar Beckman PACE/MDQ (Fullerton, CA, USA), com detecção de arranjo de diodos a 254 nm e a 25 ºC. O eletrólito utilizado foi 12,5 mmol L-1 de tetraborato de sódio tampão a pH 7,0, 12,5 mmol L-1 de éter de polioxietileno 23-lauril, 7,5 mmol L-1 de dodecilbenzenosulfonato de sódio (utilizado como agente cromóforo para detecção UV indireta) e acetonitrila (35% v/v). O método proposto permitiu a separação e a identificação dos ácidos graxos do óleo de Castanha do Brasil em formulações cosméticas, bem como possibilitou a identificação de interferências presentes na fase oleosa da formulação.

Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire for brazilian children / Adaptação transcultural do Questionário de Transtorno do Desenvolvimento da Coordenação para crianças brasileiras

BACKGROUND: Developmental Coordination Disorder (DCD) is considered a major health problem among school-aged children worldwide. Although there are several instruments to identify children with DCD, none of them are translated into Portuguese and validated to be used in Brazil. OBJECTIVES: Considering that a parent questionnaire is a simple and effective method to screen children with DCD, this study describes the adaptation of the Developmental Coordination Disorder Questionnaire (DCDQ) and the pilot testing with Brazilian children. METHODS:Translation of the DCDQ into Portuguese was conducted according to current guidelines for cross-cultural adaptation of instruments. The questionnaire was completed by parents of 15 children with motor coordination problems and parents of 30 children who were typically developing, matched for age. Five parents randomly selected from each group completed the questionnaire twice, to examine test-retest reliability. The parent's opinion regarding the quality of the questionnaire was recorded. RESULTS: 91 percent of Brazilian parents reported no difficulty in completing the DCDQ. Examination of psychometric properties revealed that two items had limitations due to cultural differences. After item substitution, sensitivity increased from 0.66 to 0.73 and test-retest reliability from 0.95 to 0.97. Internal consistency also increased from 0.91 to 0.92. CONCLUSIONS:The translated instrument shows potential as a screening tool for children in Brazil and should be further examined. Research with a larger sample is needed in order to define cut-off scores and verify the instrument's validity and clinical utility. The use of the DCDQ will allow the comparison of epidemiological data from different countries.

CONTEXTUALIZAÇÃO: O transtorno do desenvolvimento da coordenação (TDC) é considerado, em vários países, um grande problema de saúde para crianças. Apesar de existirem vários instrumentos para identificar o TDC, nenhum deles foi traduzido e validado para uso no Brasil. OBJETIVOS: Considerando que um questionário de pais é um método simples e eficiente para fazer triagem de crianças com TDC, este estudo descreve a adaptação do Developmental Coordination Disorder Questionnaire (DCDQ) e o teste piloto com crianças brasileiras. MÉTODOS: A tradução do DCDQ para o português foi feita de acordo com normas atuais para adaptação transcultural de instrumentos. O questionário foi respondido pelos pais de 15 crianças com problemas de coordenação motora e 30 crianças com desenvolvimento típico, emparelhadas por idade. Cinco pais de cada grupo, selecionados aleatoriamente, responderam ao questionário duas vezes para examinar a confiabilidade teste-reteste. A opinião dos pais sobre a qualidade do questionário foi registrada. RESULTADOS: 91 por cento dos pais brasileiros reportaram que não tiveram dificuldade para responder ao DCDQ. Exame das propriedades psicométricas revelou que dois itens apresentavam limitações devido a diferenças culturais. Após a substituição desses itens, a sensibilidade aumentou de 0,66 para 0,73, e a confiabilidade teste-reteste passou de 0,95 para 0,97. A consistência interna aumentou de 0,91 para 0,92. CONCLUSÕES: O questionário final mostrou bom potencial para ser examinado como instrumento de triagem no Brasil e deve ser melhor examinado. É necessário coletar mais dados para definir o ponto de corte e verificar a validade e a utilidade clínica. O uso do DCDQ vai contribuir para a comparação de dados epidemiológicos de diferentes países.

Asymptomatic giardiasis and growth in young children; a longitudinal study in Salvador, Brazil.

This study sought to assess the effect of giardiasis on growth of young children. In Salvador, northeast Brazil, 597 children initially aged 6 to 45 months were followed for a year in 1998/9, measured anthropometrically thrice, every 6 months, and monitored for diarrhoea prevalence twice weekly. Stool samples were collected and examined during the second round of anthropometry, and infected children were treated 39 days later, on average (S.D. 20 days). For each 6-month interval, the gains in z-scores of infected and uninfected children were compared, after adjustment for potential confounding factors, including longitudinal prevalence of diarrhoea. No significant difference was found for the first interval but in the second, the gain in adjusted height-for-age z-score was 0.09 less in infected than uninfected children, equivalent to a difference in height gain of 0.5 cm. The shortfall in growth was greater in children who remained free of diarrhoea, and was significantly correlated with the proportion of the second interval during which the child had remained untreated. We conclude that Giardia can impede child growth even when asymptomatic, presumably through malabsorption. This finding challenges the view that young children found to have asymptomatic giardiasis in developing countries should not be treated.

Childhood stunting in Northeast Brazil: the role of Schistosoma mansoni infection and inadequate dietary intake.

OBJECTIVE: To evaluate the relationship between stunting, Schistosoma mansoni infection and dietary intake in schoolchildren. DESIGN: This is a cross-sectional study. Two stool samples were obtained from each child and examined quantitatively for the presence of S. mansoni, Ascaris lumbricoides and Trichuris trichiuria eggs. Information on dietary intake, and demographic, biologic and socioeconomic variables was elicited during the in-home survey. Logistic regression was used to evaluate the association between stunting (height for age < -2s.d.), parasitic infection and food consumption. SETTING: The study was carried out in the city of Nazaré, located in the Recôncavo region of the State of Bahia, Northeastern Brazil. SUBJECTS: The sample consisted of 461 children 7-14 y old, 228 boys and 233 girls, recruited from public schools. RESULTS: Of the children studied, 55.1% presented with S. mansoni infection and 22.1% were stunted. The median protein, lipid and carbohydrates intake were 47.8, 36.0 and 248.2 g/day, respectively. The median caloric consumption was 1527.0 kcal (6388.97 kJ/day). The analysis indicated that children heavily infected (> or = 400 eggs/g of stool) with S. mansoni had a 2.74-fold (95% CI: 1.32-5.67) higher risk of stunting than uninfected children, and those with inadequate intake of lipid (< 36 g/day) had a 1.83-fold (95% CI: 1.05-3.20) increased risk of stunting compared to those with adequate diets. CONCLUSION: Heavy S. mansoni infection and inadequate dietary intake of fat in schoolchildren play a significant and independent role in the development of stunting. This meaning that nutritional interventions in this age group in S. mansoni endemic areas must include the diagnosis and treatment of the infection associated with dietary measures. SPONSORSHIP: This study was supported by the Thrasher Foundation. Sandra Maria Conceição Pinheiro is a National Council on Technological Development Scholarship Awardee (CNPq), #302228/81-0.

Risk factors for infection with Giardia duodenalis in pre-school children in the city of Salvador, Brazil.

A cross-sectional study of 694 children aged 2 to 45 months selected from 30 clusters throughout the city of Salvador, Bahia (pop. 2.3 million) was carried out as part of a longitudinal study of diarrhoea in order to identify risk factors for infection with Giardia duodenalis. Variables studied included three social and demographic factors (such as mother's education and marital status), five relating to the peri-domestic environment (rubbish disposal, open sewers, paving of the street), seven relating to the home itself (house construction, susceptibility to flooding, water supply and sanitation) as well as a score for hygiene behaviour based on structured observation. After multivariate analysis using a hierarchical model, only four significant risk factors were found: (a) number of children in the household under five years (b) rubbish not collected from the house (c) presence of visible sewage nearby, and (d) absence of a toilet. All four were significant at the 1% level.

Childhood diarrhea and observed hygiene behavior in Salvador, Brazil.

Brief biweekly home visits, made as part of a cohort study of diarrhea in young children under age 5 years that was carried out in Salvador, Brazil, in 1998-1999, were used as a low-cost way to collect structured observation data on domestic hygiene behavior. Field-workers were trained to check a list of 23 forms of hygienic or unhygienic behavior by the child or the child's caretaker, if any behaviors were seen during the visit. Children were grouped according to whether mainly unhygienic behavior or mainly hygienic behavior had been recorded. This permitted study of the determinants of hygiene behavior and of its role in the transmission or prevention of diarrheal disease. Observations were recorded on roughly one visit in 20. Households with adequate excreta disposal were significantly more likely to be in the "mainly hygienic" group. The prevalence of diarrhea among children for whom mainly unhygienic behavior was recorded was 2.2 times that among children in the "mainly hygienic" group. The relative risk for prevalence was 2.2 (95% confidence interval: 1.7, 2.8). The relative risk fell to 1.9 (95% confidence interval: 1.5, 2.5) after data were controlled for confounding, but the difference was still highly significant.

[Tolerance to administration of massive doses of vitamin A associated to mass immunization of children in Northeast Brazil]. / Tolerância à aplicação de megadoses de vitamina A associada à vacinação em crianças no Nordeste do Brasil.

A follow-up study was carried out in two localities in the semi-arid region of the State of Bahia, Northeast Brazil, with the aim of identifying the occurrence and nature of possible acute side effects subsequent to vitamin A megadose supplement given together with mass immunization in children 6-59 months old. The sample consisted of 852 children, 416 from the county of Teofilandia who received vitamin A together with vaccines and 436 from Santa Barbara, who received only vaccine. In the 24 hours before immunization, children from both groups had similar incidences of diarrhea, fever, and vomiting. Anorexia was more prevalent in Teofilandia and remained so throughout the study period. The results suggest that acute side effects like diarrhea, vomiting, fever, or anorexia were not associated with the vitamin A dosage given with mass OPV, DPT, and measles immunization.

Determination of methotrimeprazine in pharmaceutical preparations by visible spectrophotometry.

A spectrophotometric method is described for determination of methotrimeprazine (levomepromazine). The aim of this work was to develop a simple, rapid, precise, and accurate visible spectrophotometric method for determination of methotrimeprazine in tablet, oral solution, and injection. The method is based on methotrimeprazine reaction with bromophenol blue, resulting in a stable, light yellow-green ion-pair complex that, after extraction with chloroform, presented maximum absorption at 409 nm. Beer's law was obeyed in the concentration range from 5.0 to 25.0 micrograms/ml. The proposed standardized method was applied to commercially available and simulated samples. The accuracy of the method was confirmed by recovery tests.

Method validation for diclofenac sodium in pharmaceuticals by capillary electrophoresis.

A capillary electrophoresis method for the determination of diclofenac sodium in a commercial and simulated tablet formation has been described. The aim of this research was to develop a rapid, simple, efficient, and economical method to determine diclofenac sodium in pharmaceutials. The analysis was carried out in a bare silica capillary (75 pm i.d.) with a total length of 50 cm (28 cm to the detector) with a buffer solution containing 20 mM sodium tetraborate, pH 9.23. The applied voltage was 20 kV. Detection was achieved by ultraviolet absorption at 276 nm. Acetaminophen was used as an internal standard. The calibration curve was linear to the concentration range from 40.0 to 120.0 microg/mL with a correlation coefficient of 0.9992. The percentage recovery was found to be 103.12 +/- 0.91. The results showed that the method allows the determination of diclofenac sodium in commercially available pharmaceutical preparations.

Schistosoma mansoni infection and nutritional status in schoolchildren: a randomized, double-blind trial in northeastern Brazil.

Brazilian schoolchildren with mild- to moderate-intensity schistosome infections (<400 Schistosoma mansoni eggs/g stool) were randomly allocated to a treatment (oxamniquine) or placebo group in a double-blind fashion. Anthropometric measurements were made at baseline, 6 mo, and 1 y for 353 students. At baseline, the groups were not significantly different with respect to nutritional status or selected socioeconomic and biological characteristics, including anthropometric measures. One year later, significant differences were noted only in the nutritional status of boys treated for schistosome infection. Treated boys had greater measurements for weight, triceps skinfold thickness, midarm circumference, arm muscle area, and body mass index than untreated boys. They also showed significant increases over the year in weight, height, midarm circumference, and body mass index. The rates of improvement in weight and height were more accelerated in the first 6 mo after therapy than the last. These results indicate that, at least in boys, chronic S. mansoni infection at any intensity is detrimental to short-term growth and development.

Gender differences in growth of school-aged children with schistosomiasis and geohelminth infection.

Light or moderate intensity infection with Schistosoma mansoni may contribute to growth deficits. We report on the effects of treatment for S. mansoni on growth and development in Brazilian schoolchildren. Anthropometric measurements were taken from 539 S. mansoni-infected children and their age- and sex-matched egg-negative controls between the ages of 7 and 15 years. The children as a whole exhibited chronic malnutrition, with growth retardation in height evident in 21% of the population. Infected children, however, were significantly smaller in height, weight, mid upper arm circumference (UAC), tricep skinfold (TSF), and subscapular skinfold (SSF) measurements than control children (P < 0.05). These differences were due primarily to a greater disparity between infected and egg-negative girls in height (P < 0.01), weight (P = 0.01), UAC (P = 0.O2), and TSF (P < 0.01). Nevertheless, girls demonstrated a better level of development and nutrition compared with boys. While infected boys were shorter and weighed less than controls, these differences were not significant. Growth and development in girls was negatively correlated with intensity of infection. Coinfection with S. mansoni and Trichuris appeared to act synergistically in the development of malnutrition.