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Biomedical subjects

A A Silva

Publications and source records attributed to A A Silva.

At least 19 recordsLinked to original sources

Lycopene and beta-carotene protect in vivo iron-induced oxidative stress damage in rat prostate.

It has been suggested that iron overload may be carcinogenic. In the present study, we evaluated the effect of plasma and prostate carotenoid concentration on oxidative DNA damage in 12-week-old Wistar rats treated with intraperitoneal (ip) ferric nitrilotriacetate (Fe-NTA) (10 mg Fe/kg). Plasma beta-carotene and lycopene concentrations were measured as a function of time after ip injection of carotenoids (10 mg kg(-1) day(-1) beta-carotene or lycopene) in rats. The highest total plasma concentration was reached 3 and 6 h after ip injection of lycopene or beta-carotene, respectively. After 5 days of carotenoid treatment, lycopene and beta-carotene were present in the 0.10-0.51 nmol/g wet tissue range in the prostate. Using a sensitive method to detected 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) by HPLC/EC, the level of 8-oxodGuo in rat prostate DNA was significantly higher (6.3 +/- 0.6 residues/10(6) dGuo) 3 h after Fe-NTA injection compared with control rats (1.7 +/- 0.3 residues/10(6) dGuo). Rats supplemented with lycopene or beta-carotene for 5 days prior to Fe-NTA treatment showed a reduction of about 70% in 8-oxodGuo levels to almost control levels. Compared with control rats, the prostate of Fe-NTA-treated animals showed a 78% increase in malondialdehyde accumulation. Lycopene or beta-carotene pre-treatment almost completely prevented lipid damage. Epidemiological studies have suggested a lower risk of prostate cancer in men reporting a higher consumption of tomato products. However, before associating this effect with tomato sauce constituents, more information is required. The results described here may contribute to the understanding of the protective effects of carotenoids against iron-induced oxidative stress.

8-Hydroxy-2'-Deoxyguanosine↗

CC-chemokine receptors: a potential therapeutic target for Trypanosoma cruzi-elicited myocarditis.

The comprehension of the pathogenesis of Trypanosoma cruzi-elicited myocarditis is crucial to delineate new therapeutic strategies aiming to ameliorate the inflammation that leads to heart dysfunction, without hampering parasite control. The augmented expression of CCL5/RANTES and CCL3/MIP-1alpha, and their receptor CCR5, in the heart of T. cruzi-infected mice suggests a role for CC-chemokines and their receptors in the pathogenesis of T. cruzi-elicited myocarditis. Herein, we discuss our recent results using a CC-chemokine receptor inhibitor (Met-RANTES), showing the participation of CC-chemokines in T. cruzi infection and unraveling CC-chemokine receptors as an attractive therapeutic target for further evaluation in Chagas disease.

Animals↗

Assessment of pulmonary function in patients before and after laparoscopic and open esophagogastric surgery.

BACKGROUND: Laparoscopy is a technique used in various surgical procedures. Few studies in the literature compare stress between laparoscopic and open surgery used for esophagogastric surgical procedures. Pulmonary function is known to be significantly affected in open surgeries, increasing postoperative morbidity and mortality. The current study aimed to assess pulmonary function in patients before and after open and laparoscopic esophagogastric surgery. METHODS: For this study, 75 patients were divided into two groups: 50 patients undergoing laparoscopy and 25 patients undergoing open surgery. The following parameters were determined by spirometry before and after surgery: forced expiratory volume in the first second (FEV(1)), forced vital capacity (FVC), and forced expiratory flow in the midexpiratory phase (FEF(25-75%)). RESULTS: A decrease in FEV(1,) FVC, and FEF((25-75%)) was observed in the two groups on postoperative days 2, 3, and 4, as compared with the preoperative period. Likewise, FEV(1) and FVC showed a significant reduction on postoperative days 2, 3, and 4 in the patients who underwent to open surgery, but only on the day 2 in those who underwent to laparoscopic surgery. A significant decrease in FEF((25-75%)) was observed only on postoperative day 2 in the group that underwent open surgery. Significant differences in FEV(1) between the groups were observed on postoperative days 2, 3, and 4. No significant difference in FVC was noted between the groups, and a difference in FEF((25-75%)) was observed only on postoperative day 4. CONCLUSIONS: Postoperative pulmonary dysfunction was more important for the patients undergoing open surgery than for those undergoing laparoscopic surgery.

Digestive System Surgical Procedures↗

Aging and life quality: an otorhinolaryngological review.

The increase in the number of people over the age of 65 and the current rise in the proportion of old people represents an important change in the demographic patterns in the world. Since some structural and physiological changes generally occur in elderly patients, maintaining function is surely an important goal. The most devastating disabilities affecting elderly patients are those that diminish the capacity to function independently and those that have a serious impact on the quality of life. Otolaryngologists play a major role within the braod field of geriatrics. Our involvement in caring for the elderly requires us to know how to improve their quality of life. This article provides an overview of many problems that arise within our specialties.

Aged↗

Trypanosoma cruzi infection: a continuous invader-host cell cross talk with participation of extracellular matrix and adhesion and chemoattractant molecules.

Several lines of evidence have shown that Trypanosoma cruzi interacts with host extracellular matrix (ECM) components producing breakdown products that play an important role in parasite mobilization and infectivity. Parasite-released antigens also modulate ECM expression that could participate in cell-cell and/or cell-parasite interactions. Increased expression of ECM components has been described in the cardiac tissue of chronic chagasic patients and diverse target tissues including heart, thymus, central nervous system and skeletal muscle of experimentally T. cruzi-infected mice. ECM components may adsorb parasite antigens and cytokines that could contribute to the establishment and perpetuation of inflammation. Furthermore, T. cruzi-infected mammalian cells produce cytokines and chemokines that not only participate in the control of parasitism but also contribute to the establishment of chronic inflammatory lesions in several target tissues and most frequently lead to severe myocarditis. T. cruzi-driven cytokines and chemokines may also modulate VCAM-1 and ICAM-1 adhesion molecules on endothelial cells of target tissues and play a key role in cell recruitment, especially of activated VLA-4+LFA-1+CD8+ T lymphocytes, resulting in a predominance of this cell population in the inflamed heart, central nervous system and skeletal muscle. The VLA-4+-invading cells are surrounded by a fine network of fibronectin that could contribute to cell anchorage, activation and effector functions. Since persistent "danger signals" triggered by the parasite and its antigens are required for the establishment of inflammation and ECM alterations, therapeutic interventions that control parasitism and selectively modulate cell migration improve ECM abnormalities, paving the way for the development of new therapeutic strategies improving the prognosis of T. cruzi-infected individuals.

Animals↗

The rise of the plasma lipid concentration elicited by dietary sodium chloride restriction in Wistar rats is due to an impairment of the plasma triacylglycerol removal rate.

Studies in humans have indicated that dietary salt restriction raises plasma levels of total cholesterol (TC) and triacylglycerols (TAG). In order to explain the mechanisms involved, a rat experimental model was developed consisting of chronic feeding ad libitum isocaloric diets with variable sodium chloride contents. Rates of synthesis of plasma TAG were measured either as the increase of plasma TAG after blocking its removal from plasma by the intra-arterial pulse infusion of Triton-WR 1339, or as the plasma rate of incorporation of [(14)C]-oleic acid [(14)C]-TAG. Plasma TAG removal rate was determined by the intra-arterial pulse infusion of a lipid emulsion. Severe salt restriction increased the plasma concentrations of TAG (71%) and of TC (10%). This result was not due to modification of the rate of synthesis of plasma TAG but was attributed to a 55% slower rate of removal of the TAG-containing lipoproteins. An increased plasma non-esterified fatty acid concentration, probably due to a salt restriction-related insulin resistance, may have impaired the activity of the enzyme lipoprotein lipase.

Animals↗

Prevalence of CD8(+)alpha beta T cells in Trypanosoma cruzi-elicited myocarditis is associated with acquisition of CD62L(Low)LFA-1(High)VLA-4(High) activation phenotype and expression of IFN-gamma-inducible adhesion and chemoattractant molecules.

The determinants of the prevalence of CD8(+) T cells in the inflamed myocardium of Trypanosoma cruzi-infected patients and experimental animals are undefined. Using C3H/He mice infected with the Colombiana strain of T. cruzi, we found that the distribution of CD4(+)/CD8(-) and CD4(-)/CD8(+) T cells in the myocardium mirrors the frequency of cells expressing the CD62L(Low)LFA-1(High)VLA-4(High) activation phenotype among CD4(+)/CD8(-) and CD4(-)/CD8(+ )peripheral blood T cells. Consistently, vascular cell adhesion molecule-1-positive endothelial cells and a fine fibronectin network surrounding VLA-4(+) mononuclear cells were found in the inflamed myocardium. Further, interferon gamma (IFN-gamma) and IFN-gamma-induced chemokines (RANTES, MIG and CRG-2/IP-10), as well as JE/MCP-1 and MIP1-alpha, were found to be the dominant cytokines expressed in situ during acute and chronic myocarditis elicited by T. cruzi. In contrast, interleukin 4 mRNA was only detected during the chronic phase. Altogether, the results indicate that the distribution of T-cell subsets in the myocardium of T. cruzi-infected mice reflects the particular profile of adhesion molecules acquired by most peripheral CD8(+) T lymphocytes and point to the possibility that multiple IFN-gamma-inducible molecules present in the inflamed tissue contribute to the establishment and maintenance of T. cruzi-induced myocarditis.

Animals↗

Risk factors for low birthweight in north-east Brazil: the role of caesarean section.

Caesarean section (CS) delivery is associated with low birthweight (LBW) in south-east Brazil. A hospital-based study was conducted on singleton infants from mothers residing in São Luís, to assess if an association between CS and LBW was found in the northern part of the country, where the CS rate is lower than in the south-east. A standardised questionnaire was administered to a sample of 2541 mothers in 10 hospitals, representing 94% of all deliveries, from March 1997 to February 1998. In a logistic model, type of delivery was the independent variable, the other variables were treated as confounders, and interaction terms were added between type of delivery and all other factors. LBW was associated with low maternal height, maternal smoking, primiparity, previous LBW, public insurance, preterm birth and CS. The CS rate was 33.7%. The risk of CS was higher for primiparous and married mothers, those with high level of schooling and attended by the same physician during prenatal and delivery care, deliveries held in private hospitals, daylight hours or evenings, and for those mothers who had adequate prenatal care. Because it appears unlikely that only medical reasons are operative, it is a possibility that CS could cause LBW, reflecting abusive indications for elective CS.

Adult↗

Cardiovascular risk factors after Kawasaki disease: a case-control study.

OBJECTIVES: To determine cardiovascular risk profiles of patients with Kawasaki disease and to relate them to a noninvasive measure of endothelial function. STUDY DESIGN: Case-control study. Cardiovascular risk assessment including brachial artery reactivity was performed in 24 patients 11.3 +/- 1.8 (mean +/- SD) years after Kawasaki disease and in 11 subjects in a normal control group. RESULTS: The case versus control groups were similar regarding age, sex, race, body mass index, and percentage of ideal body weight, although cases had a higher mean z score of body mass index than normal (+1.00 +/- 1.18; P <.001). Cases had normal fasting total cholesterol levels but a higher mean z score of triglyceride levels (+1.35 +/- 2.04; P <.004). The case group had significantly higher mean systolic and diastolic resting blood pressure z scores (+0.76 +/- 1.06; P <.01 and +0.96 +/- 1.19; P <.01, respectively) than the control group and population norms. Endothelial function as indicated by brachial artery reactivity was not significantly different between the case versus control groups. In the case group higher blood pressure, increasing adiposity, and higher fasting triglyceride levels were significantly interrelated but did not relate to brachial artery reactivity or coronary artery abnormalities. CONCLUSIONS: Patients after Kawasaki disease tend to have a more adverse cardiovascular risk profile potentially indicative of an increased predisposition to premature atherosclerotic changes.

Adolescent↗

[Evaluation of data quality from the information system on live births in 1997-1998].

OBJECTIVE: To verify the concordance between data routinely collected by the Sinasc (Information System on Live Births) and data obtained by a cross-sectional survey (gold standard). METHODS: The survey was performed in a sample of 2,831 hospital deliveries in ten maternity hospitals of the municipality of São Luís, Brazil. The sample frame represented about 98% of hospital births. Sinasc's data was compared with the survey data using a computerized linkage program. Sinasc's hospital births coverage, percentage of missing or unrecorded data and consistency between Sinasc 's and the survey's data were analyzed. Concordance was measured using the kappa indicator for qualitative variables and the intraclass correlation coefficient for quantitative variables. RESULTS: The estimated Sinasc coverage was 75.8% (95% CI: 73.3%-78.2%). Five Sinasc's data fields showed good reliability: birth weight, newborn sex, hospital of birth, type of delivery and maternal age. Low birth weight rates estimated by the two data sources were similar and the concordance was high (kappa=0.94). However, preterm birth rates were higher in the survey (11.2%) than according to Sinasc 's data (1.7%) and the concordance was low (kappa=0.09). CONCLUSIONS: Estimated Sinasc coverage was low. Low birth weight rates from Sinasc's data seem to be valid and reliable. Preterm birth rates from Sinasc's data are underestimated.

Birth Rate↗

Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil.

OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.

Adult↗

[Gastrointestinal bleeding]

OBJECTIVE: To present an analysis of the occurrence of gastrointestinal bleeding in children and emphasize: i) diagnostic methods; ii) the organized use of different therapeutic approaches in upper gastrointestinal bleeding; iii) the review of concepts, classifications and techniques used in endoscopy, which are important to the practice of clinical pediatrics. METHODS: Literary review of chapters selected from textbooks, pertinent articles obtained through the Medline system and active search, as well as personal archives belonging to the authors. RESULTS: The differential diagnosis of gastrointestinal bleeding in children varies according to the age. The causes of upper gastrointestinal bleeding are subdivided into variceal and nonvariceal. Nonselective beta-blockers are recommended to prevent variceal bleeding. Vasoactive drugs, such as somatostatin, octreotide, and glypressin may be used, showing good results in both variceal and nonvariceal acute bleeding. Both sclerotherapy and variceal ligation can be used in children to achieve variceal eradication. Cyanoacrylate is effective and presents the lowest complication rate related to gastric variceal bleeding. The presence of hemorrhage stigmata, such as active bleeding and visible vessel in ulcers is indicative of a higher risk for recurrent bleeding, suggesting the need for endoscopic hemostasis. Proton pump inhibitors are more efficacious than H2-receptor antagonists to promote the peptic ulcer healing. CONCLUSION: The correct etiologic diagnosis of gastrointestinal bleeding in children is fundamentally important to adopt the adequate therapeutic approach, whose main advances concern the pharmacological and the endoscopic treatment.

Journal Article↗

Chagas' disease encephalitis: intense CD8+ lymphocytic infiltrate is restricted to the acute phase, but is not related to the presence of Trypanosoma cruzi antigens.

Central nervous system (CNS) damage can occur during Chagas' disease, especially in children and immunosuppressed patients. During the acute phase, amastigotes are rarely found, but inflammatory infiltrates are scattered throughout the CNS. Moreover, peripheral lymphocytes and antibodies recognizing neural components were described, suggesting the participation of the immune system in the genesis of neural lesions. Herein, we performed a histopathological study of Colombian-infected C3H/He mice, comparing the distribution of CNS-inflammatory infiltrates versus Trypanosoma cruzi antigens. Inflammatory infiltrates were observed during the acute phase, but did not correlate with the presence of detectable T. cruzi antigens. Infiltrates consisted mainly of CD8+ lymphocytes, although macrophages and a few CD4+ cells were observed. In the chronic stage of infection, although neuropathies were a common finding, only mild inflammatory infiltrates could be detected. Our results suggest that the presence of CNS inflammatory infiltrates is not directly related to the presence of parasite antigens and indicate that, different from chronic myocarditis, encephalitis resolves during the acute phase of Chagas' disease.

Acute Disease↗

Synthesis and herbicidal activity of 2alpha, 4alpha-dimethyl-8-oxabicyclo[3.2.1]oct-6-en-3-one derivatives.

The catalytic oxidation of 2alpha,4alpha-dimethyl-8-oxabicyclo[3.2. 1]oct-6-en-3-one with osmium tetraoxide and excess hydrogen peroxide resulted in the formation of 2alpha,4alpha-dimethyl-6, 7-exo-isopropylidenedioxy-8-oxabicyclo[3.2.1]octan-3-one (2), with 91% yield. Addition of aryllithium reagents to this compound resulted in the formation of the aromatic alcohols (6a-h) with 48-76% yield. These alcohols were treated with thionyl chloride in pyridine, and the corresponding alkenes (7a-h) were obtained with 46-80% yield. The effect of compounds 6a-h and 7a-h on the root growth of Sorghum bicolor was evaluated at a concentration of 6.6 microg g(-)(1). The alcohols 6a-h caused an inhibitory effect (8-100%) on the S. bicolor radicle growth. The three most active compounds were 6e (aryl = p-methylphenyl), 6g (aryl = p-chlorophenyl), and 6h (aryl = p-fluorophenyl) and caused 100% inhibition. The effect of alkenes 7a-h was less pronounced and varied from 15% to 46% inhibition. Another experiment was carried out in a greenhouse to evaluate the effect of alcohols 6e, 6g, and 6h, at a 6.6 microg g(-)(1) dose, against Cucumis sativus, S. bicolor and the weeds Bidens pilosa, Desmodiumtortuosum, and Pennisetum setosum. All three compounds showed an inhibitory effect on the development of the aerial parts (26-73%) and roots (13-79%) of the weeds and crops.

Bridged Bicyclo Compounds, Heterocyclic↗

Risk factors for the increasing caesarean section rate in Southeast Brazil: a comparison of two birth cohorts, 1978-1979 and 1994.

BACKGROUND: Brazil has the highest caesarean section (CS) rate in the world (36.4% in 1996). METHODS: Risk factors for increasing CS rate were studied in two population-based cohorts of singleton live births in families residing in the municipality of Ribeirao Preto, State of Saõ Paulo, Southeast Brazil. The first comprised births from June 1978 to May 1979 (6750 births-one-year survey) and the second births from May to August 1994 (2846 births-4-month survey). Multiple unconditional logistic regression modelling was used to control for confounding. RESULTS: The CS rate rose from 30.3% in 1978-1979 to 50.8% in 1994. In 1978-1979, socioeconomic, reproductive and demographic variables, and health service factors were associated with CS rate. In 1994, only reproductive, demographic and health service factors remained associated, e.g. hour of delivery (from 7 a.m. to 12 p.m.), attendance by the same physician for prenatal care and delivery, > or =4 prenatal visits, maternal age > or =30 years, 1-3 previous live births and birthweight 3500-3999 g. CONCLUSION: Caesarean section in Brazil is widely performed for non-medical reasons in which physician convenience plays an important role. There is an urgent need for public health interventions to reduce the CS rate in Brazil, mainly directed towards cultural beliefs and physician behaviour.

Adult↗

Expression of extracellular matrix components and their receptors in the central nervous system during experimental Toxoplasma gondii and Trypanosoma cruzi infection.

Alterations in extracellular matrix (ECM) expression in the central nervous system (CNS) usually associated with inflammatory lesions have been described in several pathological situations including neuroblastoma and demyelinating diseases. The participation of fibronectin (FN) and its receptor, the VLA-4 molecule, in the migration of inflammatory cells into the CNS has been proposed. In Trypanosoma cruzi infection encephalitis occurs during the acute phase, whereas in Toxoplasma infection encephalitis is a chronic persisting process. In immunocompromised individuals such as AIDS patients. T. cruzi or T. gondii infection can lead to severe CNS damage. At the moment, there are no data available regarding the molecules involved in the entrance of inflammatory cells into the CNS during parasitic encephalitis. Herein, we characterized the expression of the ECM components FN and laminin (LN) and their receptors in the CNS of T. gondii- and T. cruzi-infected mice. An increased expression of FN and LN was detected in the meninges, leptomeninges, choroid plexus and basal lamina of blood vessels. A fine FN network was observed involving T. gondii-free and T. gondii-containing inflammatory infiltrates. Moreover, perivascular spaces presenting a FN-containing filamentous network filled with alpha 4+ and alpha 5+ cells were observed. Although an increased expression of LN was detected in the basal lamina of blood vessels, the CNS inflammatory cells were alpha 6-negative. Taken together, our results suggest that FN and its receptors VLA-4 and VLA-5 might be involved in the entrance, migration and retention of inflammatory cells into the CNS during parasitic infections.

Animals↗

Trends in low birth weight: a comparison of two birth cohorts separated by a 15-year interval in Ribeirão Preto, Brazil.

The incidence and some determinants of low birth weight (LBW) were studied in two population-based cohorts of singletons born live to families in Ribeirão Preto, São Paulo State, Brazil. The first cohort comprised infants born between June 1978 and May 1979 (6750 births--population survey) and the second, infants born between May and August 1994 (2990 births--sample survey). The incidence of LBW was 7.2% in 1978-79 and 10.6% in 1994. After adjustment for confounding factors, the following determinants remained significant in 1978-79: female sex, maternal age > or = 35 years, preterm delivery, < four antenatal health visits, maternal smoking, lower level of maternal education, and manual work/unemployment. In 1994, the significant determinants were preterm delivery, maternal smoking and caesarean section. The adjusted percentage population attributable risk (PAR%) fell for the majority of risk factors but increased for caesarean section, preterm birth, multiparity (> or = 5), primiparity and non-cohabitation. The increase in the rate of LBW from 1978-79 to 1994 was higher for families with more qualified occupations, and occurred only for infants delivered at 36-40 weeks' gestational age and weighing 1500-2499 g, i.e. those most likely to be born by elective caesarean section. The caesarean section rate rose from 30.3% in 1978-79 to 51.1% in 1994. The increase in LBW was probably due to iatrogenic practices associated with elective caesarean section.

Adult↗

Optimisation of the experimental conditions of a new method, based on a quartz crystal microbalance, for the determination of cyanide.

A new method based on a quartz crystal microbalance was developed for the determination of cyanide. As the sensitivity depends on pH, temperature and nitrogen flow rate, a modified simplex was used to optimise these experimental parameters. Two different versions of the proposed method were optimised. For the first version a sensitivity increase of 1.5 was observed after 27 runs, whereas for the second version a sensitivity increase of 1.7 was observed after 12 runs.

Cyanides↗