A Cost-Benefit Evaluation of the Air Quality and Health Impacts in Sao Paulo,Brazil

The objective was to assess the impact on health due to the exposure to air pollution derived from the renewal of the urban bus fleet in S?o Paulo. The study analyzed the substitution of the bus fleet through the variation of the concentration of atmospheric pollutants such as PM10 in the municipality of S?o Paulo and its associated health’s benefits values compared to the investments performed in the bus fleet renewal. PM10 average annual reduction due to the bus improvement system resulted on 22.3%. A cost-benefit evaluation considered the renewal investments’ costs compared to the obtained valued health benefits and it resulted in 4.31. Although the result may suggest a not viable investment, it must be observed that air pollution reduction favors health impacts and that this relation could be improved if additional investments on sustainable transportation increase.

Bone marrow-derived mesenchymal stem cells versus adipose-derived mesenchymal stem cells for peripheral nerve regeneration

Studies have confirmed that bone marrow-derived mesenchymal stem cells （MSCs） can be used for treatment of several nervous system diseases. However, isolation of bone marrow-derived MSCs （BMSCs） is an invasive and painful process and the yield is very low. Therefore, there is a need to search for other alterative stem cell sources. Adipose-derived MSCs （ADSCs） have phenotypic and gene expression profiles similar to those of BMSCs. The production of ADSCs is greater than that of BMSCs, and ADSCs proliferate faster than BMSCs. To compare the effects of venous grafts containing BMSCs or ADSCs on sciatic nerve injury, in this study, rats were randomly divided into four groups： sham （only sciatic nerve exposed）, Matrigel （MG; sciatic nerve injury ＋ intravenous transplantation of MG vehicle）, ADSCs （sciatic nerve injury ＋ intravenous MG containing ADSCs）, and BMSCs （sciatic nerve injury ＋ intravenous MG containing BMSCs） groups. Sciatic functional index was calculated to evaluate the function of injured sciatic nerve. Morphologic characteristics of nerves distal to the lesion were observed by toluidine blue staining. Spinal motor neurons labeled with Fluoro-Gold were quantitatively assessed. Compared with sham-operated rats, sciatic functional index was lower, the density of small-diameter fibers was significantly increased, and the number of motor neurons significantly decreased in rats with sciatic nerve injury. Neither ADSCs nor BMSCs significantly improved the sciatic nerve function of rats with sciatic nerve injury,increased fiber density, fiber diameters, axonal diameters, myelin sheath thickness, and G ratios （axonal diameter/fiber diameter ratios） in the sciatic nerve distal to the lesion site. There was no significant difference in the number of spinal motor neurons among ADSCs, BMSCs and MG groups. These results suggest that neither BMSCs nor ADSCs provide satisfactory results for peripheral nerve repair when using MG as the conductor for engraftment.

Characterization and functions of beta defensins in the epididymis

The epididymal β-defensins have evolved by repeated gene duplication and divergence to encode a family of proteins that provide direct protection against pathogens and also support the male reproductive tract in its primary function. Male tract defensins also facilitate recovery from pathogen attack. The β-defensins possess ancient conserved sequence and structural features widespread in multi-cellular organisms, suggesting fundamental roles in species survival. Primate SPAG11, the functional fusion of two ancestrally independent β-defensin genes, produces a large family of alternatively spliced transcripts that are expressed according to tissue-specific and species-specific constraints. The complexity of SPAG11 varies in different branches of mammalian evolution. Interactions of human SPAG11D with host proteins indicate involvement in multiple signaling pathways. （Asian J Andro12007 July; 9： 453- 462）

Defining metabolic activity of nephrolithiasis--Appropriate evaluation and follow-up of stone formers

Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between single and recurrent stone formers,and develop a schema for metabolic and radiologic follow-up.A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis.Both single and recurrent stone formers share many similarities in metabolic profiles.The study group determined that based on an assessment of risk for stone recurrence and metabolic activity,single and recurrent stone formers should be evaluated comprehensively,including two 24 h urine studies on a random diet.Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence.Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient,the risk of chronic kidney disease and the risk of osteoporosis/osteopenia.A standard scheme includes a baseline metabolic profile,a repeat study 3e6 months after initiation of treatment,and then yearly when stable,with abdominal imaging obtained every 1-2 years.

Effects on Cell Viability and on Apoptosis in Tumoral(MCF-7)and in Normal(MCF10A)Epithelial Breast Cells after Human Chorionic Gonadotropin and Derivated-Angiotensin Peptides Treatments

Angiotensin-(1 - 7) [Ang-(1 - 7)] is an endogenous heptapeptide hormone of the renin-angiotensin system that has antiproliferative properties. The aim of this work was to evaluate the anti-proliferative and pro-apoptotic properties of Ang-(1 - 7) and of Ang-(1 - 7)-substituents 9-fluorenylmethyloxycarbonyl (Fmoc) e Ang II-derivatives containing the TOAC (2,2,6,6-tetramethylpiperidine-N-oxyl-4-amino-4-carboxylic acid) in normal (MCF10A) and in tumoral (MCF7) epithelial mammary cell lines. Both cell lines received an hCG and angiotensin peptides 24-hour treatment, in combination or alone followed by cell viability, apoptosis and cell cycle assays performed by flow cytometer (GUAVA). After hCG, Ang-(1 - 7), hCG + Ang-(1 - 7) and hCG + Ang-(1 - 7)-Fmoc treatments, MCF7 displayed cell viability decrease and mid-apoptosis increase. We also observed cell viability decrease in MCF10A after Ang-(1 - 7), Ang-(1 - 7) Fmoc and hCG + AngII Toac treatments. These cells had an increase in late apoptosis and necrosis after AngII Toac, hCG + Ang-(1 - 7) and hCG + Ang-(1 - 7)-Fmoc treatments. Regarding the cell cycle analysis, we did not observed any changes in cell cycle phases. In summary, cell viability was decreased and apoptosis (initial, mid and late) was increased after hCG and/or Ang-(1 - 7) peptides treatments. These results point out hCG and Ang-(1 - 7) as effective compounds to inhibit cell proliferation, since they decrease cell viability and increase apoptosis in both normal and in tumoral breast cells, being the effect more pronounced in the tumoral cell line. Our results support the idea of investigating more closely the putative use of these compounds as novel therapeutic agents for breast cancer.

Identification of IL11RA and MELK amplification in gastric cancer by comprehensive genomic profiling of gastric cancer cell lines

AIM To identify common copy number alterations on gastric cancer cell lines.METHODS Four gastric cancer cell lines(ACP02, ACP03, AGP01 and PG100) underwent chromosomal comparative genome hybridization and array comparative genome hybridization. We also confirmed the results by fluorescence in situ hybridization analysis using the bacterial artificial chromosome clone and quantitative real time PCR analysis.RESULTS The amplification of 9p13.3 was detected in all cell lines by both methodologies. An increase in the copy number of 9p13.3 was also confirmed by fluorescence in situ hybridization analysis. Moreover, the interleukin 11 receptor alpha(IL11RA) and maternal embryonic leucine zipper kinase(MELK) genes, which are present in the 9p13.3 amplicon, revealed gains of the MELK gene in all the cell lines studied. Additionally, a gain in the copy number of IL11 RA and MELK was observed in 19.1%(13/68) and 55.9%(38/68) of primary gastric adenocarcinoma samples, respectively. CONCLUSION The characterization of a small gain region at 9p13.3 in gastric cancer cell lines and primary gastric adenocarcinoma samples has revealed MELK as a candidate target gene that is possibly related to the development of gastric cancer.

Irbesartan desmotropes:Solid-state characterization,thermodynamic study and dissolution properties

Irbesartan (IBS) is a tetrazole derivative and antihypertensive drug that has two interconvertible structures, 1H- and 2H-tautomers. The difference between them lies in the protonation of the tetrazole ring. In the solid-state, both tautomers can be isolated as crystal forms A (1H-tautomer) and B (2H-tautomer). Studies have reported that IBS is a polymorphic system and its forms A and B are related monotropically. These reports indicate form B as the most stable and less soluble form. Therefore, the goal of this contribution is to demonstrate through a complete solid-state characterization, thermodynamic study and dissolution properties that the IBS forms are desmotropes that are not related monotropically. However, the intention is also to call attention to the importance of conducting strict chemical and in solid-state quality controls on the IBS raw materials. Hence, powder X-ray diffraction (PXRD) and Raman spectroscopy (RS) at ambient and non-ambient conditions, differential scanning calorimetry (DSC), hot stage microscopy (HSM), Fourier transform infrared (FT-IR) and scanning electron microscopy (SEM) techniques were applied. Furthermore, intrinsic dissolution rate (IDR) and structural stability studies at 98% relative humidity (RH), 25℃ and 40 ℃ were conducted as well. The results show that in fact, form A is approximately four-fold more soluble than form B. In addition, both IBS forms are stable at ambient conditions. Nevertheless, structural and/or chemical instability was observed in form B at 40℃ and 98% RH. IBS has been confirmed as a desmotropic system rather than a polymorphic one. Consequently, forms A and B are not related monotropically.

MALDI-TOF MS Assessment to Identify Environmental Mycobacteria

Over the past few decades, there has been a significant increase in the number of mycobacterial species described. Currently, the genus?Mycobacterium?consists of 170 species. Most species are called nontuberculous mycobacteria (NTM) and are potentially or rarely pathogenic and ubiquitous. One of the main challenges in mycobacteriology is the rapid and precise identification of these microorganisms. In this work, we compared two protein extraction protocols for the identification of 38 reference strains and clinical isolates, representing 27 species, by mass spectrometry (MALDI-TOF MS) to subsequently use the best method for identifying environmental mycobacteria. The results obtained with reference strains and clinical isolates showed that protocol A was effective in identifying 92.1% of mycobacterial specimens at the species level and protocol B, 50%. Therefore, protocol A was evaluated for the rapid identification of 27 environmental mycobacterial isolates. These isolates were subjected to PCR-restriction enzyme analysis (PRA-hsp65). Two isolates were misidentified by PRA-hsp65, whereas MALDI-TOF MS was able to identify them correctly. The results were confirmed by?hsp65 and 16S rRNA gene sequencing. Mass spectrometry has the advantage of being a simpler and faster technique than PRA-hsp65, and our results showed that MALDI-TOF MS is a valuable tool for the identification of environmental mycobacterial isolates.

Are Family Table Foods Appropriate for Infants? Comparing the Nutritional Quality of Homemade Meals Adapted from the Family’s Table Foods and Those Specially Prepared for Infants

The Brazilian Ministry of Health recommends that by 8 months of age, children should eat the same types of foods consumed by the other members of the family. Thus, this study sought to evaluate whether the nutritional composition of meals specially prepared (SM) for children aged 7 to 18 months in low-income families was superior to that of meals adapted (AM) from the family’s table foods. Protein, fat, carbohydrate, energy, dietary fiber, iron, sodium and sodium chloride values, were determined by chemical analyses and compared to dietetic guidelines. The infants’ hemoglobin levels were also investigated. In total, sixty samples of the infants’ lunch meal (51 AM and 9 SM) were taken for during a home visit. The values of protein, fat, carbohydrate, dietary fiber and energy of the AM were significantly lower, while the sodium and sodium chloride values were significantly higher, compared to those of the SM. The AM also contained significantly more water. No differences were seen with regard to iron values. Sodium chloride amounted for most of the sodium content. Neither the SM nor AM was adequate in terms of iron and sodium. All SM were adequate for protein and fat, whereas AM showed significantly more samples with inadequate energy levels. SM fell within the Acceptable Macronutrient Distribution Range, while AM fell below the lower value for fat and slightly above the upper value for carbohydrate. The prevalence of anemia was 60% in the study population (36/60). In conclusion, meals adapted from the family’s table foods showed a lower nutrient density and a less balanced macronutrient range when compared to meals specially prepared for infants. The main nutritional shortcomings, for both AM and SM, were the extremely low content of iron and the high content of sodium.

A proposed model for understanding human-bacterial interactions:Space-time approach on community Escherichia coli occurrence and resistance phenomenon

Due to ecological effect, it is expected that population exposures to antimicrobial drugs may lead to microorganisms’ modifications, occasionally leading to resistance emergence. The present review was based on previous empirical data and on related literature search for quantitative empirical models exploring the human-bacterial interactions. Our previous studies have shown the emergence of ciprofloxacin resistant (CIP-R) Escherichia coli significantly related to previous specific levels of ciprofloxacin consumption and to urban clusters of CIP-R E. coli. The evidence of significant spatial clustering of antimicrobial resistance (ciprofloxacin resistance E. coli) reinforces the ecological effect hypothesis as a major drive in resistance emergence. In other words, human populations submitted to a certain ciprofloxacin or quinolone usage level may affect neighbours within certain geographical areas, not necessarily due to individual antimicrobial intake, but as a driving pressure over a modified circulating E. coli population. Apparently quantitative spatial-temporal analytical frameworks may be better for understanding human-bacterial interactions based on any of their epiphenomena (antimicrobial consumption, antimicrobial resistance, geno/phenotypic characteristics).

Association between Premenstrual Dysphoric Disorder and Systemic Lupus Erythematosus: Exacerbation of Major Depression Symptoms?

Introduction: Systemic Lupus Erythematosus (SLE) usually presents neuropsychiatric manifestations, such as psychosis, convulsion, mood disorder and chronic headache, with mood disorder being the most prevalent. It is also known that other psychiatric disorders and menstrual cycle disorders are frequent in SLE. The aim of this study was to describe for the first time the frequency of premenstrual dysphoric disorder in patients with SLE diagnosis, and its association with depression and anxiety. Material and Methods: An evaluation was made of 62 (sixty-two) patients with diagnosis of SLE, based on the American College of Rheumatology criteria, who received follow-up care at an ambulatory reference center. The patients were submitted to a sociodemographic evaluation questionnaire, upon which the Mini International Neuropsychiatric Interview (MINI PLUS), Brazilian Version 5.0.0, was used to evaluate the diagnosis. Results: Twenty (32%) patients were found to have premenstrual dysphoric disorder, and there was a statistically significant association with major depression (p = 0.010), but no statistical significance was found with dysthymia (p = 0.063) or anxiety (p = 0.223). Conclusions: The frequency of premenstrual dysphoric disorder (PMDD) in patients with SLE was high, as well as the frequency of major depression in this group. There was an association between these two disorders.

Management of liver transplantation biliary stricture: Results from a tertiary hospital

AIM: To review results of endoscopic treatment for anastomotic biliary strictures after orthotopic liver transplantation(OLT) during an 8-year period. METHODS: This is a retrospective review of all endoscopic retrograde cholangiopancreatographys(ERCPs) performed between May 2006 and June 2014 in deceased OLT recipients with anastomotic stricture at a tertiary care hospital. Patients were divided into 2 groups, according to the type of stent used(multiple plastic or covered self-expandable metal stents), which was chose on a case-by-case basis and their characteristics. The primary outcome was anastomotic stricture resolution rate determined if there was no more than a minimum waist at cholangiography and a 10 mm balloon could easily pass through the anastomosis with no need for further intervention after final stent removal. Secondary outcomes were technical successrate, number or ERCPs required per patient, number of stents placed, stent indwelling, stricture recurrence rate and therapy for recurrent anastomotic biliary stricture(AS). Stricture recurrence was defined as clinical laboratorial and/or imaging evidence of obstruction at the anastomosis level, after it was considered completely treated, requiring subsequent interventional procedure.RESULTS: A total of 195 post-OLT patients were assessed for eligibility. One hundred and sixty-four(164) patients were diagnosed with anastomotic biliary stricture. ERCP was successfully performed in 157/164(95.7%) patients with AS, that were treated with either multiple plastic(n = 109) or metallic billiary stents(n = 48). Mean treatment duration, number of procedures and stents required were lower in the metal stent group. Acute pancreatitis was the most common procedure related complication, occurring in 17.1% in the covered self-expandable metal stents(c SEMS) and 4.1% in the multiple plastic stent(MPS) group. Migration was the most frequent stent related complication, observed in 4.3% and 5.5%(c SEMS and MPS respectively). Stricture resolution was achieved in 86.8% in the c SEMS group and in 91% in MPS group. Stricture recurrence after a median follow up of 20 mo was observed in 10(30.3%) patients in the c SEMS and 7(7.7%) in the plastic stent group, a statistically significant difference(P = 0.0017). Successful stricture resolution after secondary treatment was achieved in 66.6% and 62.5% of patients respectively in the c SEMS and plastic stents groups. CONCLUSION: Multiple plastic stents are currently the first treatment option for AS in patients with duct-toduct anastomosis. c SEMS was associated with increased pancreatitis risk and higher recurrence rate.

Role of mi RNAs and their potential to be useful as diagnostic and prognostic biomarkers in gastric cancer

Alterations in epigenetic control of gene expression play an important role in many diseases, including gastric cancer. Many studies have identified a large number of upregulated oncogenic mi RNAs and downregulated tumour-suppressor mi RNAs in this type of cancer. In this review, we provide an overview of the role of mi RNAs, pointing to their potential to be useful as diagnostic and/or prognostic biomarkers in gastric cancer. Moreover, we discuss the influence of polymorphisms and epigenetic modifications on mi RNA activity.

In situ Colonization of Marine Biofilms on UNS S32760 Duplex Stainless Steel Coupons in Areas with Different Water Qualities： Implications for Corrosion Potential Behavior

面对 biofilms，不锈钢(SS ) 展览腐蚀潜力的增加，叫的崇高。在现在的学习，腐蚀潜力(E < 潜水艇 class= “ a-plus-plus ” > 双 SS UNS S32760 的 corr ) 行为同时被记录与在里面在 Arraial 的区域做 Cabo 的在二的 situ 水兵 biofilm 形成，东南的巴西。在 Forno 港口(一个人为地扰乱的区域) 的 biofilm 被更高相对的许多细菌在白天 2 点描绘，在白天 10 上由硅藻(特别 Navicula sp ) 列在后面并且白天 18 上的 dinoflagellates，而没有清楚的趋势在 Cabo Frio 岛(一个没受到干扰的区域) 被记录。E 的崇高 < 潜水艇 class= “ a-plus-plus ” > corr 价值是地点依赖者。在互补实验室试金， biofilms 被移开并且 E < 潜水艇 class= “ a-plus-plus ” > corr 价值处于无菌的条件登记了为随后 10 天并且在 situ 结果支持了。理解 biofilms 和 SS 相互作用象帮助在这知识填重要差距一样为材料科学和工程决定有重要含意。

Bifid pancreatic tail as cause of acute pancreatitis

To the Editor:Wepresentacaseofa22-year-oldwomanwithrecurrent episodes of acute pancreatitis. The patient had no known risk factors such as history of alcoholism, smoking, pre-existing medical conditions, family members with pancreatitis, autoimmune disease orregularuseofmedications.Duringthelastepisode,anamylase peak (1175 U/L) and increased inflammatory markers were de-

Anti-inflammatory properties of the glial scar

Glial cells comprise -90% of the human brain and are divided into two subtypes： microglia and astrocytes. Astrocytes play a vital role in maintaining central nervous system （CNS） homeostasis, regulating ion concentrations and providing metabolic support for neighboring neurons, stabilizing synapses, supporting the neurovascular system including maintenance of the blood-brain barrier （BBB） and also producing the extracellular matrix （ECM）.

护理诊断——失眠的相关因素及高危人群的文献分析

目的总结有关成人失眠预测因素的文献证据,并确定其与北美护理诊断学会国际组织(NorthAmerica Nursing Diagnosis Association International,NANDA-I)护理诊断——失眠的诊断指标的一致性。方法检索Pubmed,虚拟健康图书馆和CINAHI数据库,纳入2011—2018年以英语、葡萄牙语或西班牙语发表的48篇文章。分析失眠的预测因素、NANDA-I相关因素之间的一致性。结果本研究发现的预测因素与NANDA-I相关因素具有一致性,但悲伤和白天频繁打盹除外。吸烟、咖啡因摄入,睡眠信念功能失调、肥胖和照顾者角色障碍可能是新的相关因素;慢性病可能也是新的相关因素,婚姻状况变化,经济困难、女性、年龄增长和夜班工作者可能是新的高危人群。结论与NANDA-I诊断要素相一致的失眠预测因素可为护理诊断提供证据基础。本研究发现的与失眠护理诊断相关因素没有对应关系的预测因素可考虑纳入NANDA-I分类,从而为护士和学生的临床应用提供支持。

The Evaluation of Bioremediation Potential of a Yeast Collection Isolated from Composting

The influence of xenobiotic compounds on environment and on living organisms has been reported as an imminent public health problem. Among them we can list the contamination by Alkanes present in petroleum, hydrocarbons and organic contaminant substances from industrial effluents. Also, heavy metals are of particular interest because of their persistence in the environment contaminating the food webs. Among the innovative solutions for treatment of contaminated water and soil is the use of biological materials like living or dead microorganisms. Yeasts exhibit the ability to adapt to extreme condition such as temperature, pH and levels of organic and inorganic contaminants that make them a potential material to be used to remediate contaminated environment application. The goal of this work was to search for yeast isolates capable to use n-hexadecane (alkane hydrocarbon) as a primary carbon source and for those able to tolerate high concentration of lead (Pb) within a collection of 90 isolates obtained from the Sao Paulo Zoo composting system. The isolated yeast strains were identified by mass spectrometry (MALDI-TOF-MS) and by sequencing of the ribosomal DNA (18S and D1/D2) conserved regions. We found that the collection bares 23 isolates capable of utilizing n-hexadecane and one which is able to tolerate high concentration of lead (Pb) with a high biosorption index compared to the reference yeast strains (BY4742, PE-2, CAT-1 and BG-1). These results confirm the initial hypothesis that the Sao Paulo Zoo composting is the source for diverse yeasts species with biotechnological application potential.

Stress urinary incontinence in women and cell therapy: What can we expect from the future?

Stress urinary incontinence(SUI)is a common disorder that affects a large number of women and their quality of life.The aim of SUI therapy is to restore the existing urethral function via physical therapy,biofeedback,pelvic floor rehabilitation,pharmacological therapy,bulking agents and surgical approaches.Currently,the gold standard for the management of SUI is the tensionfree vaginal sling,which provides structural support to the female urethra.However,even minimally invasive surgical procedure such as"slings"carries risks for the patients,lost efficacy over the time and has long-term complications.For this reason,new therapeutic modalities are needed.Cell therapy has been emerged as an alternative to be used on the treatment of different diseases.The use of stem cells as a therapeutic option for SUI is an attractive alternative because,theoretically,injected cells could restore functional muscle cells and aid in sphincter closure in women with sphincterassociated incontinence.This study aims to review the current literature regarding evidences for using stem cell therapy on stress urinary incontinence in women.

Impact of Radical Prostatectomy on Urinary Incontinence, Erectile Dysfunction and General Quality of Life

The aims of this study were to evaluate the impact of radical retropubic prostatectomy on patient’s quality of life. Patients undergoing radical retropubic prostatectomy were followed for six months after surgery. We used quality of life questionnaires to study specific urinary symptoms and general health. WHOQOL-Bref (World Health Organization for Quality of Life) questionnaire was used to evaluate general health aspects, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form), OABq (Overactive Bladder) and IPSS (International Prostatic Symptom Score) to evaluate incontinence and overactive bladder symptoms and Male Sexual Quotient to assess postoperative sexual dysfunctions. The questionnaires were scheduled before surgery, one, three and six months after surgery. Regarding the OAB-q scores, I-PSS and WHOQOL-Bref (physical, psychological, environmental, general, Question 1 and Question 2), symptoms worsened after one month if compared to preoperative symptoms. After six months, the WHOQOL’s social domain, the ICIQ-SF and QS-M scores remained worse if compared to preoperative evaluation. The incidence of sexual dysfunctions after six months was 0.83. In conclusion, urinary incontinence affects patient’s quality of life with gradual recovery after six months postoperatively. The social domain was the most common aspect affected by urinary incontinence. Our sexual dysfunction incidence was higher than other studies and this fact could be explained by many surgeries having been done by residents.