Showing papers by "Federal University of São Paulo published in 1996"
TL;DR: The trial showed that a 60-day course of benznidazole treatment of early chronic T cruzi infection was safe and 55.8% effective in producing negative seroconversion of specific antibodies.
472 citations
TL;DR: The early diagnosis of the ocular abnormalities in patients with Down's syndrome, by using Teller acuity cards in assessing visual acuity facilitates the treatment of refractive errors, strabismus, and amblyopia and may minimize handicaps.
234 citations
TL;DR: The acute and chronic behavioral, electrographic and histologic effects of sustained seizures induced by pilocarpine in mice are characterized.
Abstract: Summary: Purpose: To characterize the acute and chronic behavioral, electrographic and histologic effects of sustained seizures induced by pilocarpine in mice.
Methods: After status epilepticus, the surviving animals were continuously monitored for 24 h/day for 120 days. The brains were processed by using neo-Timm and Nissl stains.
Results: The first spontaneous seizures occurred between 4 and 42 days after status epilepticus. The mean “seizure-silent period” lasted for 14.4 ± 11.9 days. During the chronic phase, recurrent spontaneous seizures were observed 1–5 times per animal per week and were associated with sprouting in the supragranular layer of the dentate gyrus.
Conclusions: Structural brain damage promoted by pilocar-pine-induced status epilepticus may underlie or be associated with recurrent spontaneous seizures in mice.
190 citations
TL;DR: Patients with a late diagnosis of chronic renal failure have a higher mortality risk during the first 6 months of maintenance dialysis, related to comorbid conditions, some of which could be prevented by predialysis care.
Abstract: Background. Recent observations in our country have shown that late diagnosis of chronic renal failure (CRF) is an important cause of late referral and late commencement of maintenance dialysis. We prospectively investigated the influence of late diagnosis of CRF on patient mortality during dialysis therapy. Methods. Among 184 consecutive patients with nondiabetic end-stage renal disease starting chronic dialysis at the Federal University Hospital in the city of Sao Paulo, 106 had a late diagnosis of CRF (less than 1 month before starting dialysis) and 78 had an early diagnosis. During the first 6 months of dialysis treatment, patient survival was compared in the two groups, using the Kaplan-Meier method and the Cox proportional hazards model. Results. Six-month patient survival rate was lower in the late than in the early diagnosis group (69% versus 87%, / > <0.01). In the late diagnosis group, the hazard ratio of mortality was 2.77 (95% CI, 1.36-5.66) times that of the early diagnosis group. In a multivariate analysis, after adjusting for age, comorbid illness, and serum biochemical measurements, time of diagnosis did not remain significantly associated with mortality risk. In this analysis, age, pulmonary infection, and low serum albumin were significant predictors of mortality. Conclusions. Patients with a late diagnosis have a higher mortality risk during the first 6 months of maintenance dialysis. This increased risk is related to comorbid conditions, some of which could be prevented by predialysis care. Interventions to promote early diagnosis of CRF and adequate predialysis follow-up need to be evaluated if the survival of patients with chronic renal failure is to improve.
186 citations
TL;DR: In this article, o grupo focal, metodo qualitativo de coleta de dados de ampla aplicacao na Saude Publica, is discussed.
Abstract: Descreve-se e discute-se o grupo focal, metodo qualitativo de coleta de dados de ampla aplicacao na Saude Publica. Especial enfase e conferida as potencialidades do uso do grupo focal em investigacoes, na area de abuso de drogas.
163 citations
TL;DR: The results indicate that chronic seizures following pilocarpine-induced status epilepticus can be induced in rats if the status is induced after the 18th day of life and provide for an apparent distinction between the mechanisms of epileptogenesis in the mature and developing nervous system.
157 citations
TL;DR: Internal and COOH-terminal gene fragments of the gp43 were expressed as recombinant fusion proteins, which reacted with antibodies elicited against the native antigen and showed similarities with exo-1,3-β-D-glucanases from Saccharomyces cerevisiae and Candida albicans.
142 citations
TL;DR: Testing the hypothesis that audiogenic kindling recruits the forebrain, which may be behaviorally evaluated and associated with morphological changes as well, showed the evolution of the kindling installation by the presence of limbic seizure clusters, competing in time with the original tonic-clonic clusters.
130 citations
TL;DR: The results indicate that physical activity improves the sleep patterns of spinal cord injured volunteers and noticed that PLM and RLS after physical activity were inhibited during sleep.
Abstract: The purpose of the present study was to evaluate sleep patterns and complaints, and Periodic Limb Movement (PLM) and the Restless Legs Syndrome (RLS) in subjects with complete spinal cord injury. Volunteers were submitted to two polysomnograms (Oxford Medilog SAC system--EEG, EMG, EOC): (1) basal night, when the volunteer arrived at the Sleep Center, and (2) after a maximal physical test (Cybex Met 300/increase of 12.5 watts/2 min until exhaustion). Eleven volunteers with complete spinal cord injury between T7-T12 were evaluated. Data were analyzed by the paired Student's test (total sleeping time) and by the Wilcoxon matched paired test (change of sleep states, number of awakenings during sleep, latency to REM sleep and leg movements--PLM + RLS). Comparison of sleep recordings from the night before with that from the night after (12 h) practice of physical activity, showed a significant reduction in all of the sleep parameters. The results indicate that physical activity improves the sleep patterns of spinal cord injured volunteers. In particular, we noticed that PLM and RLS after physical activity were inhibited during sleep.
118 citations
TL;DR: CDP at a 250 mg/day dose was able to prevent disease exacerbation, reduce the required prednisone dose, and help inducing a better control of patients with non life- threatening SLE, suggesting that antimalarials might have a broader indication in the treatment of SLE other than solely the management of skin and articular manifesta tions.
Abstract: Introduction: Antimalarials have been recognized as effective drugs for the treatment of articular and cutaneous manifestations of systemic lupus erythematosus (SLE), but its potential in the management of systemic features of the disease has not yet been thoroughly evaluated.Objectives: This study intended to evaluate the efficacy of chloroquine diphosphate (CDP) in preventing flares and in reducing the maintenance corticosteroid dose in patients with SLE without life-threatening manifestations.Materials and methods: Twenty-four SLE patients with no life-threatening manifestation were enrolled in a 12-month double blind placebo-controlled trial with CDP (250 mg/day). Patients were subjected each month to clinical examination by a rheumatologist and to SLE-relevant laboratory tests. At each visit, prednisone dose could be adjusted according to the clinical status. Ophthalmologic examination was performed every six months. Outcome measures included SLEDAI score and the required prednisone dose. SLE flare w...
115 citations
TL;DR: ECTI inhibits trypsin and chymotrypsin in the stoichiometric ratio of 1:1 and also Factor XIIa, plasma kallikrein and plasmin, but not thrombin and Factor Xa.
TL;DR: This preliminary study shows that implantation of an intrastromal corneal ring of this dimension (0.3-mm thick) can reduce approximately 1.50 to 3.00 D of myopia and maintain spectacle-corrected visual acuity.
Abstract: Background To evaluate the efficacy, predictability, and stability of the refractive effect produced by the Intrastromal Corneal Ring (ICR), the authors completed a 12-month study on 10 myopic eyes. Methods Ten patients with preoperative refractive errors ranging from -2.63 diopters (D) to -4.25 D (mean, -3.30 D) participated in the study. The attempted correction was -2.50 D for a 7.0-mm diameter, 0.3-mm thick ICR. One eye of each patient received an ICR. Results The average change in spherical equivalent at 12 months was -2.25 D (SD 0.54 D; range, -1.62 to -3.25 D). All patients maintained a spectacle-corrected visual acuity of 20/20 or better during the 12-month study period, with the exception of patient no. 6 who saw 20/30 at the 6-month examination. Her spectacle-corrected visual acuity returned to 20/20 a few days after the ICR was explanted and remained stable throughout the study. Uncorrected visual acuity had improved to 20/40 or better in all patients on postoperative day 1 and remained in this range for the 9 eyes (90%) during the 12 months of follow up. At postoperative month 12, 9 of 9 eyes (100%) had an uncorrected visual acuity of 20/40 or better with 3 of 9 eyes (33%) seeing 20/20 or better. The remaining patient, no. 6, experienced a tear in Descemet's membrane during the procedure and required explantation of the ring after 6 months due to induced astigmatism and deterioration of uncorrected visual acuity. Two patients developed infiltrates that resolved with the use of antibiotics. The most common postoperative ocular findings were peripheral corneal haze in all eyes that diminished over time, minute lamellar channel deposits (7 of 10 eyes, 70%), deep stromal neovascularization (5 of 10 eyes, 50%), and pannus (5 of 10 eyes, 50%). Conclusion This preliminary study shows that implantation of an intrastromal corneal ring of this dimension (0.3-mm thick) can reduce approximately 1.50 to 3.00 D of myopia and maintain spectacle-corrected visual acuity.
TL;DR: The results suggest that the 6-O-sulfotransferases, in the absence of their natural substrates (keratan sulfate) may catalyze the sulfation of chondroitin 4-solfate as alternative substrate, and apparently, the K for galactosyltransferases involved in the synthesis of linkage regions of heparan sulfate and chond Detroitin sulfate are significantly lower than those participating in thehesis of keratan sulfates polymer.
TL;DR: The results indicate that the CAR haplotype may be associated with more severe disease, as in other studies.
Abstract: To compare the features of sickle-cell anemia in Brazil with those in other locales, we studied the effects of the β-globin-like gene cluster haplotype and α-thalassemia upon the clinical and hematological features in 85 patients. The distribution of haplotypes differed from that in the United States and Jamaica. The Central African Republic (CAR) haplotype predominated; 34% of patients were CAR haplotype homozygotes, 45% CAR/Benin homozygotes, and 11% Benin homozygotes. No Senegal haplotype chromosomes were observed. α-thalassemia was present in 17.5% of patients. HbF levels were higher in Benin homozygotes, compared with the other two groups (P < 0.05). Nearly half the patients with a CAR haplotype had leg ulcers, compared to 12.5% of the Benin homozygote group; stroke did not occur in α-thalassemia carriers, but neither result was statistically significant. As in other studies, our results indicate that the CAR haplotype may be associated with more severe disease. © 1996 Wiley-Liss, Inc.
TL;DR: The observed RBC alloimmunization rate in SCD patients in Brazil is lower than that reported by studies from North America, suggesting that the requirement for extended antigen‐matched RBC transfusion for SCd patients in the setting of a RBC phenotype concordant donor‐recipient population may not be cost‐effective in some countries.
Abstract: Red blood cell (RBC) transfusions are widely used in the management of patients with sickle cell disease (SCD). However, repeated RBC transfusions are often complicated by RBC alloimmunization. To investigate whether the frequency of RBC alloimmunization could be accounted for by racial and RBC phenotype differences between donors and recipients in Brazil, in this study we compared the RBC phenotype of 100 SCD patients with that observed in 120 randomly selected blood donors. A comparison of the RBC phenotype between the two groups revealed a statistically significant increase in the frequency of the C antigen in the donor population (P < 0.01), but no significant difference was observed for the A,B,D,c,E,e,K,k,Fya,M,N,S,s, and Jka antigens. Using standard techniques (indirect antiglobulin test, enzyme treatment, and low-ionic-strength solution) we observed an RBC alloimmunization rate of 12.9% (11/85) in the SCD patients. Fifteen alloantibodies were detected in 11 patients, and most (80%) involved antigens in the Rhesus and Kell systems. This observed RBC alloimmunization rate in SCD patients in Brazil is lower than that reported by studies from North America, suggesting that the requirement for extended antigen-matched RBC transfusion for SCD patients in the setting of a RBC phenotype concordant donor-recipient population may not be cost-effective in some countries.
TL;DR: Data suggest that subtype F is related to injecting drug use in Brazil, and envelope sequence subtypes determined by heteroduplex mobility analysis using prototypic subtypes as references are suggested.
Abstract: Objective: To determine the distribution of HIV-1 subtypes in Sao Paulo, Brazil. Methods: Samples were obtained from 80 consecutive HIV-1-infected individuals attending the Immunodeficiency Clinic at the University of Sao Paulo in 1993. Peripheral blood mononuclear cells (PBMC) were separated by Ficoll-Hypaque gradient and a portion was used for routine CD4 counts; the remainder were frozen. PBMC were proteinase-K-digested and DNA-purified by organic extraction. Samples were amplified for the env region of HIV, and envelope sequence subtypes determined by heteroduplex mobility analysis using prototypic subtypes as references. A subset of these were also sequenced through the C2-V3 region of env. Results: A total 69 of 80 samples yielded env polymerase chain reaction product enabling subtype determination; samples that did not amplify were those with low DNA yields. Among 12 injecting drug users (IDU) or sexual partners of IDU, four were typed as clade F and eight as clade B. Forty-three homosexual men or female sexual partners of bisexual men were typed as clade B. The 14 additional cases without known risk factors were typed as clade B. Conclusion: These data suggest that subtype F is related to injecting drug use in Brazil.
TL;DR: When the thickness of the endometrial echo is less than 3 mm there is no need for anatomopathologic investigation, and when the limit was 4 mm or more, active endometria were detected, requiring further histopathological investigation by hysteroscopy and directed biopsies.
TL;DR: The results showed a highly significant association of HLA‐Cw6 with both psoriasis, and benign migratory glossitis, with this antigen being present in 59.1% of the patients with Psoriasis and in 43.8% ofThe finding reinforces the concept of a pathogenetic relationship between benign migratories glossitis and psOriasis.
Abstract: This study was undertaken to investigate human leucocyte antigen (HLA) associations with benign migratory glossitis and psoriasis in Brazilian patients and particularly to determine whether benign migratory glossitis is also associated with HLA-Cw6, the classical association observed in psoriasis. The results showed a highly significant association of Cw6 with both psoriasis and benign migratory glossitis, with this antigen being present in 59.1% of the patients with psoriasis, in 43.8% of the patients with benign migratory glossitis, and in only 12.6% of the controls. Other significant positive associations, although at a lower significance level, were with B13, both in psoriasis and in benign migratory glossitis, and with B17, only in psoriasis. To our knowledge, this is the first report on the association of Cw6 with benign migratory glossitis. We believe that this finding reinforces the concept of a pathogenetic relationship between benign migratory glossitis and psoriasis.
TL;DR: Production and characterization of 12 monoclonal antibodies against the gp43 that recognize peptide sequences in the molecule detecting at least three different epitopes as well as different isoforms of this antigen suggest that P. brasiliensis propagules may start infection in man by strongly adhering to human lung cells.
Abstract: The surface glycoprotein gp43, a highly immunogenic component of Paracoccidioides brasiliensis, is used in the serodiagnosis of paracoccidioidomycosis (PCM) and has recently been shown to specifically bind the extracellular matrix protein laminin. Binding to laminin induces the increased adhesion of the fungus to epithelial cells; a hamster testicle infection model has shown that the gp43-dependent binding of fungal cells to laminin enhances their pathogenicity in vivo. We report on the production and characterization of 12 monoclonal antibodies against the gp43 that recognize peptide sequences in the molecule detecting at least three different epitopes as well as different isoforms of this antigen. MAbs interfered in the fungal pathogenicity in vivo either by inhibiting or enhancing granuloma formation and tissue destruction. Results suggest that P. brasiliensis propagules may start infection in man by strongly adhering to human lung cells. Thus, laminin-mediated fungal adhesion to human lung carcinoma (A549) cells was much more intense than to Madin-Darby canine kidney cells (MDCK), indicating differences in binding affinity. Subsequent growth of fungi bound to the lung cells could induce the granulomatous inflammatory reaction characteristic of PCM. Both steps are greatly stimulated by laminin binding in infective cells expressing gp43.
TL;DR: The high sensitivity of the (AN+DN) term to detect differentiated solvation behaviors of peptide-resins seems to be in agreement with the previously proposed two-parameter model, where the sum of the Lewis acidity and Lewis basicity characters of solvent are proposed for scaling solvent effect.
Abstract: The solvation properties of model resin and peptide-resins measured in ca. 30 solvent systems correlated better with the sum of solvent electron acceptor (AN) and electron donor (DN) numbers, in 1:1 proportion, than with other solvent polarity parameters. The high sensitivity of the (AN+DN) term to detect differentiated solvation behaviors of peptide-resins, taken as model of heterogeneous and complex solutes, seems to be in agreement with the previously proposed two-parameter model, where the sum of the Lewis acidity and Lewis basicity characters of solvent are proposed for scaling solvent effect. Besides these physicochemical aspects regarding solute−solvent interactions, important implications of this study for the solid phase peptide synthesis were also observed. Each class of peptide-resin displayed a specific solvation profile that was dependent on the amount and the nature of the resin-bound peptide sequence. Plots of resin swelling versus solvent (AN+DN) values allowed the visualization of a maxim...
TL;DR: The results favor the idea that epilepsy is a progressive disorder where one seizure begets the next, and suggest that even single generalized spontaneous tonic-clonic seizures can induce long-lasting morphological changes.
TL;DR: Findings provide further evidence for a nonrandom association between POF and the FRAXA premutation.
Abstract: A family is described in which six females in three generations experienced premature ovarian failure (POF). In three of them a FRAXA premutation was documented and the carrier status of a fourth female could be inferred, because her son had the fragile X syndrome. These findings provide further evidence for a nonrandom association between POF and the FRAXA premutation.
TL;DR: In this paper, the prevalence of self-reported NIDDM and IGT in Japanese-Brazilians living in the city of Bauru, Sao Paulo, Brazil was investigated and the impact of western environment on the frequency of obesity, dyslipidemia and hypertension was investigated.
TL;DR: The use of gp43 as paracoccidioidin in humans showed that this molecule can be used to evaluate the DTH response in patients with PCM, and a perivascular inflammatory response constituted predominantly by T lymphocytes, macrophages and polymorphonuclear leukocytes was shown.
Abstract: A purified glycoprotein of 43,000 daltons from Paracoccidioides brasiliensis (gp43) was tested as paracoccidioidin in delayed-type hypersensitivity (DTH) tests in both experimental animals (guinea pig and mice) and patients with paracoccidioidomycosis (PCM). The gp43 paracoccidioidin was compared with the traditional Fava Netto antigen (AgFN). In guinea pigs, the intradermal injection of 2 micrograms of gp43 showed a similar response to those obtained with AgFN, showing in histological sections a population of lymphoid cells that participate in DTH. In mice, gp43 at a dose of 3.75 micrograms showed positive DTH response. The use of gp43 as paracoccidioidin in humans showed that this molecule can be used to evaluate the DTH response in patients with PCM. Of 25 PCM patients studied, 48% were positive to gp43 while only 28% were positive to AgFN; 12 PCM patients were completely anergic to both antigens. Considering only those 13 PCM patients who were responsive to gp43 and/or to AgFN, 92.3% reacted against gp43 and 53.8% reacted against AgFN (P < 0.05). Gp43 skin test responses (13.67 +/- 9.56 mm) were significantly larger than those obtained with AgFN (8.43 +/- 3.69 mm). Immunohistochemical study of the human skin showed a perivascular inflammatory response constituted predominantly by T lymphocytes, macrophages and polymorphonuclear leukocytes.
TL;DR: The results show that AN in IDDM patients is associated with a reduced nocturnal fall in BP and suggest a pathogenic role of autonomic dysfunction in the development of diabetic nephropathy, possibly favoring both BP elevation during the night and increases in intraglomerular pressure.
Abstract: To evaluate the relationship between autonomic neuropathy (AN) and nephropathy we measured 24-h blood pressure (BP) and overnight urinary albumin excretion (UAE) in 38 patients with insulin dependent diabetes mellitus (IDDM). Autonomic function was evaluated by the heart rate response to deep breathing. Valsalva maneuver, heart rate at rest and BP variation with posture. Sympathetic cutaneous reflex was also tested in both inferior and superior limbs. Patients with mean day diastolic BP (DDBP) 90 mmHg, only three were free of AN and only two of the eight with AN where free of diabetic nephropathy. The percentage day/night changes in systolic BP were lower in patients with AN (13 vs 7.9%; p < 0.05) and were inversely related to autonomic score, used as an index of the degree of autonomic dysfunction (r = -0.48; p < 0.01) and to UAE (r = -0.39; p < 0.05). Furthermore, UAE correlated with autonomic score (r = 0.69; p < 0.0001) and with NDBP (r = 0.44; p < 0.01). Our results show that AN in IDDM patients is associated with a reduced nocturnal fall in BP and suggest a pathogenic role of autonomic dysfunction in the development of diabetic nephropathy, possibly favoring both BP elevation during the night and increases in intraglomerular pressure.
TL;DR: A prevalencia de carie in creches of criancas of 3-4 and 5-6 anos was found to be higher in Bauru and Sao Paulo.
Abstract: Foi avaliada a prevalencia de carie na denticao decidua de criancas entre 0 e 6 anos, matriculadas em creches dos Municipios de Bauru e Sao Paulo, SP (Brasil). O primeiro grupo (Bauru) nao recebia cuidados sistematizados de saude na instituicao e o segundo (Sao Paulo) apresentava uma rotina de cuidados como norma institucional. Foram analisadas as variaveis relativas aos modos de viver desses grupos populacionais e sua associacao com a ocorrencia de carie, efetuando um estudo de caso para caracterizacao de fatores coletivos de risco a carie. Atraves de analise de regressao multipla, verificou-se a influencia da idade e frequencia de consultas odontologicas sobre a prevalencia de carie na amostra estudada (p<0,05). Na faixa etaria de 5-6 anos, 23,3% das criancas de Bauru e 9,3% de Sao Paulo estavam isentas de carie, contra a expectativa de 50% prevista na Meta n.o 1 da Organizacao Mundial da Saude para o ano 2000. A prevalencia de carie foi mais elevada em Bauru nas criancas de 3-4 e 5-6 anos, apresentando significância estatistica apenas para o grupo 3-4 anos (p<0,05). Nao foram observadas diferencas estatisticamente significantes entre os sexos quanto a ocorrencia de carie.
TL;DR: The prevalence of diabetes in Japanese Brazilians (12.8 and 16.2% for first and second generations) are higher than the rates reported for Japan at comparable age-groups and obesity was more prevalent in the second generation among men.
TL;DR: The major diagnostic antigen of Paracoccidioides brasiliensis is the exocellularly secreted 43,000 Da glycoprotein (gp43) which contains a single N-linked oligosaccharide chain which is responsible for the cross-reactivity of the gp43 with sera from patients with histoplasmosis, and may have a role in fungal virulence.
Abstract: The major diagnostic antigen of Paracoccidioides brasiliensis is the exocellularly secreted 43,000 Da glycoprotein (gp43) which contains a single N-linked oligosaccharide chain. This oligosaccharide, although poorly immunogenic in man, is responsible for the cross-reactivity of the gp43 with sera from patients with histoplasmosis, and may have a role in fungal virulence. It contains a neutral high-mannose core (Man7GlcNAc2) to which a (1-->6)-linked alpha-D-Manp chain of variable length, substituted at the 2-O positions by single alpha-D-Manp residues, is attached. A terminal unit of beta-D-galactofuranose is (1-->6)-linked to one of the (1-->2)-linked mannosyl residues, either in the C or in the A arm of the oligosaccharide. The heterogeneity of the oligosaccharide is determined by the different sizes of the A arm and the sites of insertion of the beta-galactofuranosyl unit. The complete structure was determined by methylation analysis, 1H-NMR, mass spectrometry, acetolysis and mannosidase degradation. Electrospray mass spectrometry showed that the oligosaccharide comprises several subtypes ranging from Hex18GlcNAc2 to Hex10GlcNAc2 which accounts for the diffuse migration of the gp43 in polyacrylamide gels. The average size of the most frequent subtype is Hex13.6GlcNAc2. Dilute acid treatment to remove beta-D-Galf reduced the molecular masses of the majority of the subtypes by a single sugar unit.
TL;DR: Characteristics of self-reported diabetes mellitus in the city of Sao Paulo, Brazil, obtained from the Brazilian Multicenter Study on Prevalence of Diabetes Mellitus in 1986-88 are analyzed.
Abstract: This report analyzes characteristics of self-reported diabetes mellitus in the city of Sao Paulo, Brazil. The data were obtained from the Brazilian Multicenter Study on Prevalence of Diabetes Mellitus, a household survey performed in 1986-88. The Sao Paulo sample consisted of 2,007 individuals aged 30-69 years, of both sexes, selected from three areas with distinct socio-economic levels. The estimated prevalence using a 75g glucose load and measurement of two-hour capillary glycemia was 9.7%. Prevalence of self-reported diabetes was 4.7% and increased with age and presence of family history of diabetes. There was a significant difference between sexes (3.5% in men and 5.7% in women), with higher rates of self-reported diabetes at higher economic levels among men and higher rates at lower socio-economic levels among women.