The performance of mobile screening units in a breast cancer screening program in Brazil.

PURPOSE: In Brazil, access to breast cancer screening outside of urban centers is limited. This study aims to describe the coverage and performance of a breast cancer screening program implemented with Mobile Screening Units (MSU) in northern São Paulo state. METHODS: This is a retrospective cohort study of a population-based mammography program targeting women ages 40-69 in 108 municipalities from 12/2010 to 07/2015. Screening coverage rates were estimated using the Brazil 2010 census data. We calculated performance measures for the number of exams, recalls, and detected cases of cancer. Screen-detected cases were compared to clinically detected cases using hospital cancer registry data and a propensity-score matching method. The down-staging of screen-detected cases relative to clinically detected cases was assessed using logistic regression to calculate risk ratios (RRs) with 95% confidence intervals. RESULTS: 122,634 women were screened through the MSU program, representing a cumulative coverage rate of 54.8% in the target population. For initial and subsequent rounds, recall rates were 12.25 and 6.10% and cancer detection rates were 3.63 (95% CI 3.23-4.10) and 1.94 (95% CI 1.59-2.41), respectively. 92.51% of referrals were successful. Screen-detected cases had more favorable prognoses than clinically detected cases, including smaller tumor size and a decreased risk of late-stage detection (RR 0.14 95% CI 0.074-0.25). CONCLUSIONS: MSUs are a feasible method for the delivery of mammography services in this setting. Patients who had breast cancer detected on an MSU had favorable prognostic factors when compared with clinically detected cases arising from the same target population.

Collaborative Brazilian Pediatric Renal Transplant Registry (CoBrazPed-RTx): A Report From 2004 to 2013.

BACKGROUND: The Collaborative Brazilian Pediatric Renal Transplant Registry started in 2004 as a multicenter initiative aiming to analyze, report, and share the results of pediatric kidney transplantation in Brazil. Data from all pediatric kidney transplants performed between January 2004 and December 2013 were recorded electronically and periodically updated. All patients under 18 years old from the participating centers were enrolled. Demographic data, etiology of chronic kidney disease, and patient and graft survival were analyzed. From a total of 2443 pediatric kidney transplants performed in Brazil during the study period, we report data from 1751 pediatric renal transplants performed in 13 centers enrolled in the collaborative study. Median age at transplantation was 12.4 years, and most of recipients were male (56%). The most common underlying renal etiologies were obstructive uropathy (31%) and glomerulopathy (26%). METHODS: According to donor source, 1155 (66%) of transplants were performed with deceased donors (DD). Initial immunosuppression consisted mainly of tacrolimus, mycophenolate, steroids, and induction therapy with anti-IL-2R antibodies. RESULTS: One-year graft survival (death-censored) was 93% and 90% (log rank test, P < .01), respectively, for living donor (LD) and DD. Graft losses (15%) were most frequently caused by vascular thrombosis, chronic allograft nephropathy, death with functioning kidney, acute rejection, and recurrent renal disease. Recipients of DD had 2.02 (95% confidence interval: 1.14-3.59) times the hazard of graft loss compared with those of LD (P = .015). Patient survival rates at 1 and 5 years were 98% and 97% for LD and 97% and 93% for DD, respectively. The mortality rate was 3.8%, mainly as the result of infection and cardiovascular disease. CONCLUSIONS: The results of this collaborative pediatric transplant study are comparable to international registries. Our effort has been able to maintain an exchange of information, both among the participating centers and with other international registries.

DETECÇÃO DE INFECÇÕES POR Cryptosporidium spp. EM FILHOTES CANINOS POR MÉTODOS MOLECULARES / DETECTION OF Cryptosporidium spp. INFECTIONS IN PUPPIES BY MOLECULAR METHODS

 O protozoário Cryptosporidium spp. é considerado um importante patógeno em termos de saúde pública (CIELOSZYK et al., 2012), sendo principalmente associado a baixo poder socioeconômico e precárias condições de saneamento básico (ASSIS et al., 2013). Cães eliminam oocistos fecais, com ou sem diarreia, sendo considerados potenciais fontes de infecção humana (WANG et al., 2012), apesar de isto não ter sido confirmado experimentalmente (BOWMAN & LUCIO-FORSTER, 2010; UEHLINGER et al., 2013). Detectar infecções por Cryptosporidium spp. em amostras fecais de filhotes caninos por meio da reação em Cadeia da Polimerase-Nested (Nested-PCR), foi o objetivo deste estudo. As amostras, previamente identificadas e congeladas, foram destinadas à inquérito molecular. A extração de DNA foi realizada por meio do kit comercial QIAamp DNA Stool (Qiagen) e a técnica de nested-PCR foi empregada para a amplificação de fragmentos do gene da subunidade 18S do RNA ribossômico. Um total de 200 cães foram examinados, sendo 100 machos e 100 fêmeas, 111 de padrão racial determinad

DETECÇÃO DE INFECÇÕES POR Cryptosporidium spp. EM FILHOTES CANINOS POR MÉTODOS MOLECULARES / DETECTION OF Cryptosporidium spp. INFECTIONS IN PUPPIES BY MOLECULAR METHODS

 O protozoário Cryptosporidium spp. é considerado um importante patógeno em termos de saúde pública (CIELOSZYK et al., 2012), sendo principalmente associado a baixo poder socioeconômico e precárias condições de saneamento básico (ASSIS et al., 2013). Cães eliminam oocistos fecais, com ou sem diarreia, sendo considerados potenciais fontes de infecção humana (WANG et al., 2012), apesar de isto não ter sido confirmado experimentalmente (BOWMAN & LUCIO-FORSTER, 2010; UEHLINGER et al., 2013). Detectar infecções por Cryptosporidium spp. em amostras fecais de filhotes caninos por meio da reação em Cadeia da Polimerase-Nested (Nested-PCR), foi o objetivo deste estudo. As amostras, previamente identificadas e congeladas, foram destinadas à inquérito molecular. A extração de DNA foi realizada por meio do kit comercial QIAamp DNA Stool (Qiagen) e a técnica de nested-PCR foi empregada para a amplificação de fragmentos do gene da subunidade 18S do RNA ribossômico. Um total de 200 cães foram examinados, sendo 100 machos e 100 fêmeas, 111 de padrão racial determinad

Rhinovirus detection using different PCR-based strategies

Human rhinoviruses (HRVs) are the major cause of the common cold. HRVs were recently reclassified into the Enterovirus genus (HEV) in the Picornaviridae family. HRVs and other members of the HEV genus share many common features, including sense RNA genomes and partial nucleotide sequence identity. The aim of this study was to evaluate different HRV detection strategies. Samples from adults with acute respiratory infection (n = 291) who were treated in Sao Paulo Hospital (2001-2003) were tested using three assays. The first assay detected picornaviruses by RT-PCR and hybridization, the second detected rhinoviruses using RT-PCR/sequencing, and the third differentiated HRV from HEV using duplex semi-nested-RT-PCR. Analysis of the results obtained from the first two strategies revealed 83% concordance. Discordant samples were then evaluated by the third protocol, and 82% were negative. The picornavirus detection protocol was more sensitive but less specific than the rhinovirus detection protocols. The semi-nested protocol utilized in the present study was less sensitive and was not useful in differentiating HRV from HEV. Sequencing assays examining different genes would address the best strategy of confirming rhinovirus and enterovirus infections.

Rhinovirus detection using different PCR-based strategies.

Human rhinoviruses (HRVs) are the major cause of the common cold. HRVs were recently reclassified into the Enterovirus genus (HEV) in the Picornaviridae family. HRVs and other members of the HEV genus share many common features, including sense RNA genomes and partial nucleotide sequence identity. The aim of this study was to evaluate different HRV detection strategies. Samples from adults with acute respiratory infection (n = 291) who were treated in Sao Paulo Hospital (2001-2003) were tested using three assays. The first assay detected picornaviruses by RT-PCR and hybridization, the second detected rhinoviruses using RT-PCR/sequencing, and the third differentiated HRV from HEV using duplex semi-nested-RT-PCR. Analysis of the results obtained from the first two strategies revealed 83% concordance. Discordant samples were then evaluated by the third protocol, and 82% were negative. The picornavirus detection protocol was more sensitive but less specific than the rhinovirus detection protocols. The semi-nested protocol utilized in the present study was less sensitive and was not useful in differentiating HRV from HEV. Sequencing assays examining different genes would address the best strategy of confirming rhinovirus and enterovirus infections.

Rhinovirus detection using different PCR-based strategies

Human rhinoviruses (HRVs) are the major cause of the common cold. HRVs were recently reclassified into the Enterovirus genus (HEV) in the Picornaviridae family. HRVs and other members of the HEV genus share many common features, including sense RNA genomes and partial nucleotide sequence identity. The aim of this study was to evaluate different HRV detection strategies. Samples from adults with acute respiratory infection (n = 291) who were treated in Sao Paulo Hospital (2001-2003) were tested using three assays. The first assay detected picornaviruses by RT-PCR and hybridization, the second detected rhinoviruses using RT-PCR/sequencing, and the third differentiated HRV from HEV using duplex semi-nested-RT-PCR. Analysis of the results obtained from the first two strategies revealed 83% concordance. Discordant samples were then evaluated by the third protocol, and 82% were negative. The picornavirus detection protocol was more sensitive but less specific than the rhinovirus detection protocols. The semi-nested protocol utilized in the present study was less sensitive and was not useful in differentiating HRV from HEV. Sequencing assays examining different genes would address the best strategy of confirming rhinovirus and enterovirus infections.

Real-time monitoring and kinetic parameter estimation of the affinity interaction of jArtinM and rArtinM with peroxidase glycoprotein by the electrogravimetric technique.

ArtinM is a D-mannose binding lectin that has been arousing increasing interest because of its biomedical properties, especially those involving the stimulation of Th1 immune response, which confers protection against intracellular pathogens. The potential pharmaceutical applications of ArtinM have motivated the production of its recombinant form (rArtinM) so that it is important to compare the sugar-binding properties of jArtinM and rArtinM in order to take better advantage of the potential applications of the recombinant lectin. In this work, a biosensor framework based on a Quartz Crystal Microbalance was established with the purpose of making a comparative study of the activity of native and recombinant ArtinM protein. The QCM transducer was strategically functionalized to use a simple model of protein binding kinetics. This approach allowed for the determination of the binding/dissociation kinetics rate and affinity equilibrium constant of both forms of ArtinM with horseradish peroxidase glycoprotein (HRP), a N-glycosylated protein that contains the trimannoside Manα1-3[Manα1-6]Man, which is a known ligand for jArtinM (Jeyaprakash et al., 2004). Monitoring of the real-time binding of rArtinM shows that it was able to bind HRP, leading to an analytical curve similar to that of jArtinM, with statistically equivalent kinetic rates and affinity equilibrium constants for both forms of ArtinM. The lower reactivity of rArtinM with HRP than jArtinM was considered to be due to a difference in the number of Carbohydrate Recognition Domains (CRDs) per molecule of each lectin form rather than to a difference in the energy of binding per CRD of each lectin form.

Qualitative parameters of the piapara semen (Leporinus elongatus Valenciennes, 1850).

Qualitative parameters of piapara semen (Leporinus elongatus) were evaluated before and after hormonal induction with carp pituitary extract at 2.5 mg.kg(-1) of live weight. The progressive motility, the spermatic vigor and the lifetime of the spermatozoa were higher before the hormonal induction (P > 0.05). The percentage of normal spermatozoa and spermatozoa with secondary pathologies did not differ (P > 0.05) between treatments: before induction (44.0 and 44.4%, respectively) and after-induction (44.3 and 46.7%, respectively). However, the percentage of primary pathologies was higher (P < 0.05) for the semen collected before induction than for the semen collected after induction; the estimates were 12.2 and 8.0%, respectively. The most frequent pathologies were the taillessness with the frequencies of 27.4 and 36.3% followed by the headlessness for which the estimates were 10.1 and 3.9%, before and after induction respectively. The semen collected before the hormonal induction presented better qualitative parameters.

Qualitative parameters of the piapara semen (Leporinus elongatus Valenciennes, 1850) / Parâmetros qualitativos do sêmen de piapara (Leporinus elongatus Valenciennes, 1850)

Qualitative parameters of piapara semen (Leporinus elongatus) were evaluated before and after hormonal induction with carp pituitary extract at 2.5 mg.kg-1 of live weight. The progressive motility, the spermatic vigor and the lifetime of the spermatozoa were higher before the hormonal induction (P > 0.05). The percentage of normal spermatozoa and spermatozoa with secondary pathologies did not differ (P > 0.05) between treatments: before induction (44.0 and 44.4 percent, respectively) and after-induction (44.3 and 46.7 percent, respectively). However, the percentage of primary pathologies was higher (P < 0.05) for the semen collected before induction than for the semen collected after induction; the estimates were 12.2 and 8.0 percent, respectively. The most frequent pathologies were the taillessness with the frequencies of 27.4 and 36.3 percent followed by the headlessness for which the estimates were 10.1 and 3.9 percent, before and after induction respectively. The semen collected before the hormonal induction presented better qualitative parameters.

Os parâmetros qualitativos do sêmen de piaparas (Leporinus elongatus) foram avaliados antes e após a indução hormonal com o extrato de hipófise de carpa na dosagem 2,5 mg.kg-1 de peso vivo. A motilidade progressiva, o vigor espermático e o tempo de vida dos espermatozóides apresentaram valores superiores (P < 0,05) no sêmen coletado antes da indução hormonal. Já a estimativa da porcentagem de espermatozóides normais ou com patologias leves, na pré-indução (44,0 e 44,4 por cento, respectivamente) e na pós-indução hormonal (44,3 e 46,7 por cento, respectivamente) não diferiram (P > 0,05) entre os tratamentos. Porém a estimativa de patologias graves foi maior (P < 0,05) no sêmen de pré-indução do que no pós-induzido com 12,2 e 8 por cento, respectivamente. A patologia mais freqüente foi cabeça solta com 27,4 e 36,3 por cento seguida por cauda solta com 10,1 e 3,9 por cento, antes e após a indução hormonal respectivamente. De acordo com os resultados, o sêmen de piapara coletado na pré-indução hormonal apresentou os melhores parâmetros qualitativos.

Bacterial translocation, microcirculation injury and sepsis.

Sepsis is the result from a complex bacterial-host interaction, which is an often-fatal response when host protective molecular mechanisms designed to fight invading bacteria surpass the beneficial intensity to the point of causing injury to the host. Increasing evidences have implicated the bacterial translocation (BT) as the main source for the induction of sepsis, although the beneficial effect of BT process has been related to the development of the intestinal immune response by physiological interaction between bacteria and host. In this article, we examined evolving concepts concerning to BT and discussed about its potential role in the promotion of microcirculation injury, moreover, its possible participation in the sepsis induction. According to our data obtained from in-vivo BT animal-model, both bacterial overgrowth and bacterial pathogenic determinants seem to be major predisposing factors for the induction of BT. Besides, translocation of luminal bacteria through the lymphatic via elicits the activation of the GALT inflammatory response contributing to microcirculation injuries, and the haematological via of BT was responsible to the systemic bacterial spread. On other hand, the combination of BT process to the pre-existing host systemic infection played a crucial role in the worsening of the clinical outcome. In our understanding, studies concerning to intestinal immune response and the pathophysiology of bacterial-host interaction, under normal and disease conditions, seems to be the key elements to the development of therapeutic approaches towards sepsis.

Rhnull syndrome: identification of a novel mutation in RHce.

BACKGROUND: The deficiency of Rh proteins on red blood cells (RBCs) from individuals of the Rh(null) amorph type are the result of homozygosity for a silent RHCE in cis with a deleted RHD. A novel mutation in RHce was identified in two Caucasian Brazilian girls with the amorph type of Rh(null) who were born to parents who were first cousins. STUDY DESIGN AND METHODS: RBCs from the Rh(null) sisters and from family members were analyzed by serology and flow cytometry with specific antibodies. Genomic DNA and transcripts were tested by polymerase chain reaction and sequence analysis. RESULTS: Rh(null) RBCs were nonreactive with anti-Rh and anti-LW. Molecular analyses showed a deletion of RHD and of one nucleotide (960/963; GGGG-->GGG) in exon 7 of the RHce. This deletion introduced a frameshift after Gly321, a new C-terminal sequence, and a premature stop codon, resulting in a shorter predicted protein with 357 amino acids. CONCLUSION: The detection of a unique RHce transcript indicated that the two sisters were homozygous, whereas the other family members were heterozygous for the mutation. A novel mutation resulting in the amorph Rh(null) with loss of Rh antigen expression is described.

Measurements of LET distribution and dose equivalent onboard the Space Shuttle IML-2 (STS-65) and S/MM#4 (STS-79).

Space radiation dosimetry measurements have been made onboard the Space Shuttle STS-65 in the Second International Microgravity Laboratory (IML-2: 28.5 degrees x 300 km: 14.68 days) and the STS-79 in the 4th Shuttle MIR mission (S/MM#4: 51.6 degrees x 300-400km: 10.2 days). In these measurements, three kinds of detectors were used; one is a newly developed active detector telescope called "Real-time Radiation Monitoring Device (RRMD-I for IML-2 and RRMD-II with improved triggering system for S/MM#4)" utilizing silicon semi-conductor detectors and the other detectors are conventional passive detectors of thermoluminescence dosimeters (TLDs) and CR-39 plastic track detectors. The main contribution to dose equivalent for particles with LET > 5.0 keV/micrometer (IML-2) and LET > 3.5 keV/micrometer (S/MM#4) is seen to be due to galactic cosmic rays (GCRs) and the contribution of the South Atlantic Anomaly (SAA) is less than 5% (IML-2: 28.5 degrees x 300 km) and 15% (S/MM#4: 51.6 degrees x 400 km) in the above RRMD LET detection conditions. For the whole LET range (> 0.2 kev/micrometer) obtained by TLDs and CR-39 in these two typical orbits (a small inclination x low altitude and a large inclination x high altitude), absorbed dose rates range from 94 to 114 microGy/day, dose equivalent rates from 186 to 207 microSv/day and average quality factors from 1.82 to 2.00 depending on the locations and directions of detectors inside the Spacelab at the highly protected IML-2 orbit (28.5 degrees x 300 km), and also, absorbed dose rates range from 290 to 367 microGy/day, dose equivalent rates from 582 to 651 microSv/day and average quality factors from 1.78 to 2.01 depending on the dosimeter packages around the RRMD-II "Detector Unit" at the S/MM#4 orbit (5l.6 degrees x 400km). In general, it is seen that absorbed doses depend on the orbit altitude (SAA trapped particles contribution dominant) and dose equivalents on the orbit inclination (GCR contribution dominant). The LET distributions obtained by two different types of active and passive detectors, RRMDs and CR-39, are in good agreement for LET of 15 - 200 kev/micrometer and difference of these distributions in the regions of LET < 15 kev/micrometer and LET > 200 kev/micrometer can be explained by considering characteristics of CR-39 etched track formation especially for the low LET tracks and chemical etching conditions.