16(th) IHIW: population global distribution of killer immunoglobulin-like receptor (KIR) and ligands.

In the last fifteen years, published reports have described KIR gene-content frequency distributions in more than 120 populations worldwide. However, there have been limited studies examining these data in aggregate to detect overall patterns of variation at regional and global levels. Here, we present a summary of the collection of KIR gene-content data for 105 worldwide populations collected as part of the 15th and 16th International Histocompatibility and Immunogenetics Workshops, and preliminary results for data analysis

Breastfeeding training for health professionals and resultant changes in breastfeeding duration

CONTEXT: Promotion of breastfeeding in Brazilian maternity hospitals. OBJECTIVE: To quantify changes in the breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC course, comparing them with changes among mothers attended by institutions not exposed to this course. DESIGN: Randomized Institutional Trial. SETTING: The effects of training on breastfeeding duration was assessed in eight Brazilian hospitals assigned at random to either an exposed group (staff attending the Wellstart-SLC course) or a control group. SAMPLE: For each of the eight study hospitals, two cohorts of about 50 children were visited at home at one and six months after birth. The first cohort (n = 494) was composed of babies born in the month prior to exposure to the Wellstart-SLC course, and the second cohort (n = 476) was composed of babies born six months subsequent to this exposure. MAIN MEASUREMENTS: Kaplan-Meier curves were plotted to describe the weaning process and log-rank tests were used to assess statistical differences among survival curves. Hazard ratio (HR) estimates were calculated by fitting Cox proportional hazard regression models to the data. RESULTS: The increases in estimated, adjusted rates for children born in hospitals with trained personnel were 29% (HR = 0.71) and 20% (HR = 0.80) for exclusive and full breastfeeding, respectively. No changes were identified for total breastfeeding. CONCLUSION: This randomized trial supports a growing body of evidence that training hospital health professionals in breastfeeding promotion and protection results in an increase in breastfeeding duration.CONTEXTO: Promoção do aleitamento materno em maternidades brasileiras. OBJETIVO: Quantificar mudanças na duração do aleitamento materno de mães assistidas em maternidades expostas ao curso Wellstart-SLC, comparando-as com mudanças em mães assistidas por maternidades não expostas. TIPO DE ESTUDO: Ensaio institucional randomizado. LOCAL: Os efeitos do treinamento na duração do aleitamento materno foi avaliado em oito maternidades randomicamente alocadas ao grupo exposto (equipe freqüenta o curso Wellstart-SLC) ou controle. AMOSTRA: Em cada uma das oito maternidades, duas coortes de cerca de 50 crianças foram visitadas em suas casas ao completarem um e seis meses de vida. As primeiras coortes (n = 494) foram compostas de bebês nascidos no mês anterior ao treinamento, enquanto que as segundas coortes (n = 476) foram compostas por bebês nascidos seis meses após a exposição ao curso Weelstart-SLC. VARIÁVEIS ESTUDADAS: Para descrever o processo de desmame foram traçadas curvas de Kaplan-Meier. Para avaliar as diferenças estatísticas entre as curvas de sobrevivência foi utilizado o teste log-rank. Foram calculadas estimativas das razões de risco(HR) ajustando modelos de regressão de riscos proporcionais de Cox aos dados. RESULTADOS: O aumento estimado, a partir das razões ajustadas para crianças nascidas em hospitais com pessoal treinado, foi 29% (HR = 0,71) e 20% (HR = 0,80) para aleitamento exclusivo e pleno respectivamente. Não foram identificadas mudanças para o tempo de aleitamento total. CONCLUSÕES: Esse ensaio randomizado confirma evidências crescentes de que treinar profissionais de saúde em hospitais, na promoção e proteção do aleitamento materno, resulta em aumento do tempo de aleitamento materno.Universidade Federal de São Paulo (UNIFESP) Department of PediatricsUniversidade de Santo Amaro Maternal and Child Health Graduate ProgramUniversidade Federal de São Paulo (UNIFESP) School of Public HealthState of São Paulo State Health Secretariat Health InstituteUNIFESP, Department of PediatricsUNIFESP, School of Public HealthSciEL

Reliability of race assessment based on the race of the ascendants: a cross-sectional study

BACKGROUND: Race is commonly described in epidemiological surveys based on phenotypic characteristics. Training of interviewers to identify race is time-consuming and self identification of race might be difficult to interpret. The aim of this study was to determine the agreement between race definition based on the number of ascendants with black skin colour, with the self-assessment and observer's assessment of the skin colour. METHODS: In a cross-sectional study of 50 women aged 14 years or older, from an outpatient clinic of an University affiliated hospital, race was assessed through observation and the self-assignment of the colour of skin and by the number of black ascendants including parents and grandparents. Reliability was measured through Kappa coefficient. RESULTS: Agreement beyond chance between self-assigned and observed skin colour was excellent for white (0.75 95% CI 0.72–0.78) and black women (0.89 95% CI 0.71–0.79), but only good for participants with mixed colour (0.61 95% CI 0.58–0.64), resulting in a global kappa of 0.75 (95% CI 0.71–0.79). However, only a good agreement for mixed women was obtained. The presence of 3 or more black ascendants was highly associated with observed and self-assessed black skin colour. Most women self-assigned or observed as white had no black ascendants. CONCLUSIONS: The assessment of race based on the race of ascendants showed reasonable agreement with the ascertainment done by trained interviewers and with the self-report of race. This method may be considered for evaluation of race in epidemiological surveys, since it is less time-consuming than the evaluation by interviewers

Activating KIR and HLA Bw4 Ligands Are Associated to Decreased Susceptibility to Pemphigus Foliaceus, an Autoimmune Blistering Skin Disease

The KIR genes and their HLA class I ligands have thus far not been investigated in pemphigus foliaceus (PF) and related autoimmune diseases, such as pemphigus vulgaris. We genotyped 233 patients and 204 controls for KIR by PCR-SSP. HLA typing was performed by LABType SSO reagent kits. We estimated the odds ratio, 95% confidence interval and performed logistic regression analyses to test the hypothesis that KIR genes and their known ligands influence susceptibility to PF. We found significant negative association between activating genes and PF. The activating KIR genes may have an overlapping effect in the PF susceptibility and the presence of more than three activating genes was protective (OR = 0.49, p = 0.003). A strong protective association was found for higher ratios activating/inhibitory KIR (OR = 0.44, p = 0.001). KIR3DS1 and HLA-Bw4 were negatively associated to PF either isolated or combined, but higher significance was found for the presence of both together (OR = 0.34, p<10−3) suggesting that the activating function is the major factor to interfere in the PF pathogenesis. HLA-Bw4 (80I and 80T) was decreased in patients. There is evidence that HLA-Bw4(80T) may also be important as KIR3DS1 ligand, being the association of this pair (OR = 0.07, p = 0.001) stronger than KIR3DS1-Bw4(80I) (OR = 0.31, p = 0.002). Higher levels of activating KIR signals appeared protective to PF. The activating KIR genes have been commonly reported to increase the risk for autoimmunity, but particularities of endemic PF, like the well documented influence the environmental exposure in the pathogenesis of this disease, may be the reason why activated NK cells probably protect against pemphigus foliaceus

PHYSICAL ACTIVITY LEVEL DOES NOT INFLUENCE THE NEUROMUSCULAR FATIGUE IN ADULTS

Introduction: Fatigue during voluntary muscle contractions is a complex and multifactorial phenomenon associated with central changes and adaptations of the neuromuscular system. Objective: The purpose of this study was to evaluate the fatigue induced by intermittent successive extension of the knee between active and inactive university students. Method: Twenty healthy men (≥18 years), voluntarily participated in this study. To determine the maximum voluntary isometric contraction (MVIC) of the knee extensors muscle group, three sets of isometric contractions of knee extension were performed for five seconds with five minutes of rest between sets. The fatigue protocol consisted of 10 sets of 10 maximal concentric contractions of the extensor on the right knee, performed at 75% of MVIC with an interval of 45". Results: Significant reductions were observed (p<0.01), both in isometric strength (-34±4%) and the dynamic strength (-40 ± 3%). In addition, the slope of relationship strength x repetition was -0.79±0.07 Nm/repetitions and the magnitude of the effect reached -8.90. Conclusion: The protocol was useful to induce peripheral fatigue, although muscle strength is greater in the active group. In both isometric and dynamic action, muscle fatigue did not differ between groups

HOXA1 is overexpressed in oral squamous cell carcinomas and its expression is correlated with poor prognosis

<p>Abstract</p> <p>Background</p> <p>HOX genes encode homeodomain-containing transcription factors involved in the regulation of cellular proliferation and differentiation during embryogenesis. However, members of this family demonstrated oncogenic properties in some malignancies. The present study investigated whether genes of the HOXA cluster play a role in oral cancer.</p> <p>Methods</p> <p>In order to identify differentially expressed HOXA genes, duplex RT-PCR in oral samples from healthy mucosa and squamous cell carcinoma was used. The effects of HOXA1 on proliferation, apoptosis, adhesion, invasion, epithelial-mesenchymal transition (EMT) and anchorage-independent growth were assessed in cells with up- and down-regulation of HOXA1. Immunohistochemical analysis using a tissue microarray (TMA) containing 127 oral squamous cell carcinomas (OSCC) was performed to determine the prognostic role of HOXA1 expression.</p> <p>Results</p> <p>We showed that transcripts of HOXA genes are more abundant in OSCC than in healthy oral mucosa. In particular, HOXA1, which has been described as one of the HOX members that plays an important role in tumorigenesis, was significantly more expressed in OSCCs compared to healthy oral mucosas. Further analysis demonstrated that overexpression of HOXA1 in HaCAT human epithelial cells promotes proliferation, whereas downregulation of HOXA1 in human OSCC cells (SCC9 cells) decreases it. Enforced HOXA1 expression in HaCAT cells was not capable of modulating other events related to tumorigenesis, including apoptosis, adhesion, invasion, EMT and anchorage-independent growth. A high number of HOXA1-positive cells was significantly associated with T stage, N stage, tumor differentiation and proliferative potential of the tumors, and was predictive of poor survival. In multivariate analysis, HOXA1 was an independent prognostic factor for OSCC patients (HR: 2.68; 95% CI: 1.59-2.97; p = 0.026).</p> <p>Conclusion</p> <p>Our findings indicate that HOXA1 may contribute to oral carcinogenesis by increasing tumor cell proliferation, and suggest that HOXA1 expression might be helpful as a prognostic marker for patients with OSCC.</p