Association of vitamin D and vitamin B12 with cognitive impairment in elderly aged 80 years or older: a cross-sectional study.

BACKGROUND: The present study aimed to assess the association of vitamin D and vitamin B12 with cognitive impairment in elderly people. METHODS: The data were obtained from a cross-sectional study that included individuals aged 80 years or older living in the urban and rural areas of the cities of Siderópolis and Treviso in the state of Santa Catarina, Brazil. In total, 165 elderly people were included in the analysis. The outcome of cognitive decline was assessed by the Mini-Mental State Examination. Vitamin D and vitamin B12 levels were measured from blood samples. The socio-demographic, anthropometric and health variables used in the analysis were collected from a questionnaire. Crude and adjusted analyses of the relationship between vitamins D and B12 and cognitive decline were performed using a Poisson regression model. RESULTS: The prevalence of cognitive decline was 35.2%. In the adjusted model, individuals who had vitamin D levels >19 ng mL-1 showed a lower prevalence of cognitive decline (prevalence ratio = 0.59; 95% confidence interval = 0.39-0.87). Those participants who had vitamin B12 levels of ≥496 pg mL-1 had a higher prevalence of cognitive decline (prevalence ratio = 1.90; 95% confidence interval = 1.08-3.36). CONCLUSIONS: The present study showed that individuals aged ≥80 years who had vitamin D levels of ≤18 ng mL-1 had a higher prevalence of cognitive decline even after adjustment for potential confounders. In addition, the study demonstrated that vitamin B12 levels of ≥496 pg mL-1 in this population were also a risk factor for cognitive decline. A cross-sectional analysis does not enable the inference of a cause-effect relationship and additional studies are needed to understand these relationships.

Shrinkage evaluation of heavyweight and lightweight polypropylene meshes in inguinal hernia repair: a randomized controlled trial.

BACKGROUND: One of the current complications in inguinal repair is shrinkage following the use of mesh. The selected mesh material, heavyweight (HWM) mesh or lightweight (LWM) mesh, is associated with the frequency of shrinkage. The aim of this study was to investigate shrinkage of these two types of mesh in a controlled trial of male inguinal hernia repair. METHODS: Thirty-two healthy men with primary unilateral inguinal hernias (Nyhus classification), who presented at São José Hospital of Criciúma, Brazil, underwent the Lichtenstein procedure. In total, 16 polypropylene HWM (105 g/m(2)) and 16 partially absorbable LWM (28 g/m(2)) were implanted into randomly selected patients. On post-operative days 1, 30, 60 and 90, the area of the mesh was evaluated by digital radiography. RESULTS: The study randomized 32 patients and analyzed 30 patients--15 for each type of mesh. At baseline, there were no differences between groups. There were significant differences between the two meshes when comparing the total area initially and on postoperative day 90 (P = 0.001). The HWM had significantly less area initial area, as compared with 90 days postoperatively (P = 0.04). CONCLUSION: Shrinkage was significantly higher for HWM, although the difference was not large.

Accuracy of telomerase in cervical lesions: a systematic review.

The detection of telomerase activity in cervix may provide information on cervical carcinogenesis and may be a marker to monitor cervical intraepithelial neoplasia transition. A quantitative systematic review was performed to estimate the accuracy of telomerase assay in cervical lesions. Studies that evaluated the telomerase test (telomerase repeated amplification protocol) for the diagnosis of cervix lesions and compared it to paraffin-embedded sections as the diagnostic standard were included. Ten studies were analyzed, which included 1069 women. The diagnostic odds ratio (DOR) for a positive telomerase test for low-grade squamous intraepithelial lesions (Lo-SIL) vs normal or benign lesions was 3.2 (95% CI, 1.9-5.6). The DOR for a positive telomerase test for high-grade squamous intraepithelial lesions (Hi-SIL) vs Lo-SIL, normal or benign lesions was 5.8 (95% CI, 3.1-10). For cervix cancer vs Hi-SIL, the DOR for a positive telomerase test was 8.1 (95% CI, 3.2-20.3) and for cervix cancer vs Lo-SIL, normal or benign lesions, it was 40.9 (95% CI, 18.2-91). Our data support the current hypothesis that telomerase may activate an early event in cervical carcinogenesis that could be associated with the initiation and progression of cervical lesions.

Acquired immunity in schistosomiasis with purified Fasciola hepatica cross-reactive antigens.

We have previously demonstrated that a Fasciola hepatica-derived adult worm antigen, which is cross-reactive with Schistosoma mansoni and designated FhSmIII(M), induces resistance to challenge infection with S. mansoni in mice. The current review concerns the methods developed to isolate and partially characterize a major component of FhSmIII(M), a 12-kDa polypeptide, as well as immunity studies involving this antigen. Utilizing conventional gel filtration, followed by diethylaminoethyl (DEAE) Sephadex A-120 and monitoring the fractions by polyacrylamide gel electrophoresis (PAGE) and enzyme-linked immunoelectrotransfer blot techniques (EITB), we were able to isolate the 12-kDa antigenic polypeptide to homogeneity. Conventional gel filtration chromatography was followed by high-pressure, liquid anion, exchange chromatography, when highly purified material was needed, although the effective yields diminished drastically with the latter. Mice, rabbits and calves with a primary infection of F. hepatica developed antibodies (detectable in enzyme linked immunosorbent assay (ELISA) to the F. hepatica 12-kDa polypeptide within 2 weeks of infection. Mice with a primary infection of S. mansoni developed significant, but low, levels of anti-12-kDa antibodies by 7 weeks post-infection. Immunization of mice with microgram amounts of this 12-kDa polypeptide in Freunds' adjuvant resulted in the development of up to 77% less S. mansoni worms than the controls. Treatment with either endoglycosidase H, neuraminidase or dithiothreitol had no effect on the protein's mobility on sodium dodecyl sulfate (SDS)-PAGE or in its recognition by antibodies, suggesting the absence of carbohydrate moieties or disulphide bonds in relation to its antigenic determinants. Degradation by proteinase K further confirmed its polypeptide nature and points to recombinant DNA technology for the large-scale manufacture of this potential vaccine. Further use of this antigen in immunity studies should greatly contribute to the clarification of the mechanisms involved in cross-resistance against schistosomiasis.

Successful vaccination against murine Schistosoma mansoni infection with a purified 12 Kd Fasciola hepatica cross-reactive antigen.

A 12 Kd antigen was isolated from Fasciola hepatica adult worm extracts by gel filtration in Sephadex G-50 and ion exchange chromatography using DEAE Sephadex A-120. Mice immunized with this Fasciola-derived 12 Kd antigen developed antibodies to Schistosoma mansoni adult worm extracts, demonstrating its cross-reactivity with schistosomes. Vaccination of mice with microgram amounts of the antigen in Freund's adjuvant induced up to 77% reduction in worm burdens after challenge with S. mansoni cercariae. F. hepatica 12 Kd degraded by proteinase K to lower molecular weight polypeptides which still retain their antigenicity as determined by the enzyme-linked immunoelectrotransfer blot technique. Treatment with either Endoglycosidase H, neuraminidase, or dithiothreitol had no effect on its mobility in sodium dodecyl sulfate polyacrylamide gels, or in its recognition by antibody, suggesting the absence of carbohydrate moieties or disulphide bonds in relation to its antigenic determinants and also suggesting that the antigen is a pure polypeptide. These studies establish that a molecularly defined cross-reactive component of one parasitic trematode (F. hepatica) induces resistance to challenge infection with another parasitic trematode (S. mansoni). Its polypeptide nature makes recombinant DNA technology an alternative for the manufacture of a vaccine.