Diabetes mellitus associated with the mitochondrial mutation A3243G: frequency and clinical presentation

Maternal inherited diabetes and deafness (MIDD) has been related to an A to G transition in the mitochondrial RNA Leu (UUR) at base pair 3243. The prevalence of MIDD in the diabetes population ranges between 0.5-3.0% depending on the ethnic background. AIM: To examine the frequency and clinical features of diabetes associated with this mutation in Brazilian patients with glucose intolerance. METHODS: The study population comprised: 78 type 1 diabetic subjects (group I), 148 patients with type 2 diabetes (group II), 15 patients with either type 1 or type 2 diabetes and hearing loss (group III) and 492 Japanese Brazilians with varying degrees of glucose intolerance. DNA was extracted from peripheral blood leucocytes and the A3243G mutation was determined by PCR amplification and Apa 1 digestion. In some individuals DNA was also extracted from buccal mucosa and hair follicles. The 3243 bp mutation was found in three individuals, all from group III, resulting in a prevalence of 0.4%. These subjects had an early age of diagnosis of diabetes, low or normal body mass index and requirement of insulin therapy. In conclusion MIDD is rare in our population and should be investigate in patients with diabetes and deafness.Diabetes mitocondrial é freqüentemente associado à mutação mitocondrial A3243G. A prevalência desse subtipo de diabetes na população diabética varia de 0,5 a 3%, dependendo do grupo populacional estudado. OBJETIVO: Examinar a freqüência e o quadro clínico do diabetes associado com a mutação mitocondrial A3243G em pacientes brasileiros com tolerância a glicose alterada. MÉTODOS: A população estudada foi composta por 78 indivíduos portadores de diabetes mellitus tipo 1 (grupo I), 148 diabéticos tipo 2 (grupo II), 15 diabéticos tipo 1 ou tipo 2 portadores de disacusia (grupo III) e 492 indivíduos da comunidade nipo-brasileira com vários graus de intolerância a glicose. O DNA foi extraído de leucócitos do sangue periférico e a mutação A3243G foi determinada através da amplificação por PCR e digestão por Apa 1. Em alguns pacientes, o DNA também foi extraído da mucosa oral e folículo capilar. A mutação A3243G foi identificada em três indivíduos, todos do grupo III, resultando em uma prevalência de 0,4%. Os carreadores da mutação apresentavam diagnóstico do diabetes em idade jovem, índice de massa corpórea normal ou baixo e requerimento de insulina. CONCLUSÃO: Diabetes mitocondrial é um subtipo raro de diabetes em nossa população e deve ser investigado naqueles indivíduos portadores de diabetes e surdez.Universidade Federal de São Paulo (UNIFESP) Departamento de MedicinaUniversidade Federal de São Paulo (UNIFESP) Departamento de Medicina PreventivaUNIFESP, Depto. de MedicinaUNIFESP, Depto. de Medicina PreventivaSciEL

Perbandingan Hasil Belajar Menggunakan Model Everyone Is A Teacher Here dan Make A Match

This study aimed to compare the learning outcomes of students on the subjects of geography XI in high schools 10 Bandar Lampung. The purpose of this research is that is to knowing the difference learning outcomes of students, between students who use the model of learning everyone is a teacher here with students who use the learning model make a match that was given the assignment and project portfolio. Research method used is experiment with specious approach. Engineering data collection is done through poll and tests. To test instrument use the validity, test reliability, the trouble, and the different.Analysis techniques data using analysis variant two roads and the hypothesi. The research results show that the difference study results students, between students who use learning model everyone is a teacher here with students who use learning model make a match given the assignment portfolio and project.Penelitian ini dilatarbelakangi masalah rendahnya hasil belajar siswa pada mata pelajaran Geografi XI semester ganjil di SMA Negeri 10 Bandar Lampung. Tujuan penelitian ini adalah yaitu untuk mengetahui perbedaan hasil belajar siswa, antara siswa yang menggunakan model pembelajaran Everyone Is A Teacher Here dengan siswa yang menggunakan model pembelajaran Make A Match yang diberi Penugasan Portofolio dan Proyek. Metode penelitian yang digunakan adalah dengan pendekatan eksperimen semu. Teknik pengumpulan data dilakukan melalui angket dan tes. Untuk uji instrument menggunakan uji validitas, reliabilitas tes, tingkat kesukaran, dan daya beda. Teknik analisis data menggunakan analisis varian dua jalan dan uji t. Hasil Penelitian menunjukkan bahwa ada perbedaan hasil belajar siswa, antara siswa yang menggunakan model pembelajaran Everyone Is A Teacher Here dengan siswa yang menggunakan model pembelajaran Make A Match yang diberi Penugasan Portofolio dan Proyek

Profundidade de semeadura e tipo de palhada influenciam a produtividade da soja

Implementing a crop such as a soybean requires favorable sowing conditions so that uniform and healthy seedlings emerge. This study aimed to evaluate the yield of soybeans crop concerning the type of soil cover and sowing depth. The experiment was conducted at the State University of Mato Grosso do Sul - University Unit of Cassilândia. A Completely randomized design with four replications in a 3x5 factorial scheme was used. Three cropping systems (without soil cover, millet straw, and brachiaria straw) and five sowing depths (2, 4, 6, 8, and 10 cm) were evaluated. The emergence speed index, plant height, stem diameter, first pod insertion height, number of branches, number of pods per plant, number of grains per pod, and grain yield per plant were assessed. The highest yield per plant was obtained with millet straw and a sowing depth of 6 cm. It can be concluded that the sowing depth and type of straw influence the soybean grain yield.A implantação de uma cultura como a soja exige que na semeadura ocorram condições propícias, para que se obtenha uma emergência de plântulas uniformes e sadias. O objetivo do trabalho foi avaliar a produtividade da cultura de soja em relação ao tipo de cobertura vegetal e profundidade de semeadura. O experimento foi realizado na Universidade Estadual de Mato Grosso do Sul – Unidade Universitária de Cassilândia. O delineamento utilizado foi inteiramente casualizado, com 4 repetições em esquema fatorial 3x5, sendo três sistemas de cultivo (convencional, com palhada de milheto e palhada de braquiária) e cinco profundidades de semeadura (2, 4, 6, 8 e 10 cm). Avaliou-se o índice de velocidade de emergência, altura de planta, diâmetro, altura de inserção primeira vagem, número de ramificações, vagens por planta, grãos por vagem e produtividade por planta. Obteve-se maior produtividade por planta no tratamento associado a palhada de milheto e profundidade de semeadura de 6 cm. Conclui-se que a profundidade de semeadura e o tipo de palhada influenciam na produtividade da cultura de soja

TRATAMENTO DE FRATURA COMPLEXA DO RAMO MANDIBULAR. RELATO DE CASO

O tratamento das fraturas mandibulares complexas, ou seja, aquelas em que ocorre mais de um traço de fratura concomitantemente, representam um desafio para o cirurgião buco-maxilo-facial devido às altas taxas de complicações pós-operatórias. Este trabalho tem como objetivo apresentar através do relato de um caso clínico os princípios do tratamento de fraturas complexas da mandíbula. Um paciente de 17 anos, branco, gênero masculino, apresentou-se no Hospital XV após ter sofrido acidente ciclístico com traumatismo facial. Ao exame clínico o paciente apresentava edema na região de ângulo e ramo mandibular do lado esquerdo, parestesia do nervo alveolar inferior, alteração oclusal, limitação dos movimentos mandibulares e creptação óssea à manipulação. Aos exames de imagem foi confirmada a presença de fratura complexa do ramo mandibular do lado esquerdo. Instituiu-se tratamento cirúrgico através de acesso submandibular para redução e fixação dos segmentos ósseos fraturados, com controle da oclusão. Utilizou-se fixação interna rígida com 1 placa do sistema 2.3mm com parafusos bicorticais e 1 placa do sistema 2.0mm com parafusos monocorticais. O paciente encontra-se em acompanhamento ambulatorial, apresentando resultado final satisfatório tanto estético quanto funcional. A filosofia de tratamento bem como os resultados obtidos neste caso serão confrontados àqueles disponíveis na literatura.

Analysis of Three-Dimensional Scar Architecture and Conducting Channels by High-Resolution Contrast-Enhanced Cardiac Magnetic Resonance Imaging in Chagas Heart Disease

We aimed to describe the morphology of the border zone of viable myocardium surrounded by scarring in patients with Chagas heart disease and study their association with clinical events.Adult patients with Chagas heart disease (n=22; 55% females; 65.5 years, SD 10.1) were included. Patients underwent high-resolution contrast-enhanced cardiac magnetic resonance using myocardial delayed enhancement with postprocessing analysis to identify the core scar area and border zone channels number, mass, and length. The association between border zone channel parameters and the combined end-point (cardiovascular mortality or internal cardiac defibrillator implantation) was tested by multivariable Cox proportional hazard regression analyses. The significance level was set at 0.05. Data are presented as the mean (standard deviation [SD]) or median (interquartile range).A total of 44 border zone channels (1[1-3] per patient) were identified. The border zone channel mass per patient was 1.25 (0.48-4.39) g, and the extension in layers of the border zone channels per patient was 2.4 (1.0-4.25). Most border zone channels were identified in the midwall location. Six patients presented the studied end-point during a mean follow-up of 4.9 years (SD 1.6). Border zone channel extension in layers was associated with the studied end-point independent from left ventricular ejection fraction or fibrosis mass (HR=2.03; 95% CI 1.15-3.60).High-resolution contrast-enhanced cardiac magnetic resonance can identify border zone channels in patients with Chagas heart disease. Moreover, border zone channel extension was independently associated with clinical events

Emotional factors relating to weight gain during the COVID-19 pandemic at post-bariatric women from São Paulo: a cross-sectional study

Objective: Evaluate the impact of the covid-19 pandemic on weight regain in post bariatric women and correlate it with symptoms of anxiety, depression, binge eating and fear of covid-19.  Methods: It was collected anthropometric and mental health information with application of psychometric scales at the patients mentioned above, between May/2021 and January/2022. Frequencies (descriptive statistics), test t for independent samples and Spearman were used to obtain correlation between weight gain and the psychometric scales. Results: The sample comprised 25 women. The average age was 53.0 years and average body mass index was 35.2kg/m2 before the pandemic. We observed an average increase at the body mass index of 1.4 points during the pandemic. However, 40% maintained or lost weight during the same period. The weight gain group had higher scores for depression, anxiety and binge eating symptoms. Fear of covid-19 scores did not differ between the groups. Conclusion: Anxiety, depression and binge eating symptoms have influenced weight regain in a small sample of post-bariatric women during the covid-19 pandemic

Proteins selected in Leishmania (Viannia) braziliensis by an immunoproteomic approach with potential serodiagnosis applications for tegumentary leishmaniasis

The serodiagnosis of human tegumentary leishmaniasis (TL) presents some problems, such as the low level of antileishmanial antibodies found in most of the patients, as well as the cross-reactivity in subjects infected by other trypanosomatids. In the present study, an immunoproteomic approach was performed aimed at identification of antigens in total extracts of stationaryphase promastigote and amastigote-like forms of Leishmania (Viannia) braziliensis using sera from TL patients. With the purpose of reducing the cross-reactivity of the identified proteins, spots recognized by sera from TL patients, as well as those recognized by antibodies present in sera from noninfected patients living in areas where TL is endemic and sera from Chagas disease patients, were discarded. Two Leishmania hypothetical proteins and 18 proteins with known functions were identified as antigenic. The study was extended with some of them to validate the results of the immunoscreening. The coding regions of five of the characterized antigens (enolase, tryparedoxin peroxidase, eukaryotic initiation factor 5a, β-tubulin, and one of the hypothetical proteins) were cloned in a prokaryotic expression vector, and the corresponding recombinant proteins were purified and evaluated for the serodiagnosis of TL. The antigens presented sensitivity and specificity values ranging from 95.4 to 100% and 82.5 to 100%, respectively. As a comparative antigen, a preparation of Leishmania extract showed sensitivity and specificity values of 65.1 and 57.5%, respectively. The present study has enabled the identification of proteins able to be employed for the serodiagnosis of TLThis work was supported by grants from Instituto Nacional de Ciência e Tecnologia em Nano-biofarmacêutica (INCT-Nanobiofar), FAPEMIG (CBB-APQ-00496-11 and CBB-APQ-00819-12), and CNPq (APQ- 472090/2011-9, APQ-482976/2012-8, and APQ-488237/2013-0). In addition, this study was partially funded in Madrid by a Spanish grant from Ministerio de Economía y Competitividad-FEDER (FISPI14/00366 from the Instituto de Salud Carlos III). M.A.C.F. is a grant recipient of FAPEMIG/CAPES. E.A.F.C., A.P.F., and M.O.C.R. are recipients of grants from CNP

VEGF gene therapy for angiogenesis in refractory angina: phase I/II clinical trial

OBJECTIVE: Safety, feasibility and early myocardial angiogenic effects evaluation of transthoracic intramyocardial phVEGF165 administration for refractory angina in no option patients. METHODS: Cohort study, in which 13 patients with refractory angina under optimized clinical treatment where included, after cineangiograms had been evaluated and found unfeasible by surgeon and interventional cardiologist. Intramyocardial injections of 5mL solution containing plasmidial VEGF165 where done over the ischemic area of myocardium identified by previous SPECT/Sestamibi scan. Evaluations included a SPECT scan, stress test, Minnesotta QOL questionnaire and NYHA functional class and CCS angina class determinations. RESULTS: There were no deaths or new interventions during the study period. There were no significant variations in SPECT scans, QOL scores and stress tests results during medical treatment in the included patients. After the 3rd post operative month, there was improvement in SPECT segmental scores, SSS (18.38±7.51 vs. 15.31±7.29, P=0.003) and SRS (11.92±7.49 vs. 8.53±6.68, P=0.002). The ischemic area extension, however, had non-significant variation (23.38±13.12% vs. 20.08±13.88%, P=0.1). Stress tests METs varied from 7.66±4.47 pre to 10.29±4.36 METs post-op (P=0.08). QOL score improved from 48.23±18.35 pre to 30.15±20.13 post-op points (P=0.02). NYHA class was 3.15±0.38 pre vs. 1.77±0.83 post-op (P=0.001) and angina CCS class, 3.08±0.64 vs. 1.77±0.83 (P=0.001). CONCLUSIONS: Intramyocardial VEGF165 therapy for refractory angina, in this small trial of no option patients, resulted feasible and safe. Early clinical and scintilographic data showed improvements in symptoms and myocardial perfusion, with regression of ischemia severity in treated areas.OBJETIVO: Avaliar a segurança, viabilidade e efeitos iniciais, clínicos e sobre a perfusão miocárdica, da administração intramiocárdica, transtorácica, de VEGF 165 plasmidial em pacientes com doença arterial coronariana avançada e angina refratária, não passíveis de revascularização percutânea e cirúrgica. MÉTODOS: Ensaio clínico fase I/II. Treze pacientes cardiopatas isquêmicos com angina refratária apesar de tratamento medicamentoso máximo por no mínimo seis meses, não passíveis de revascularização cirúrgica ou por cateter foram submetidos a injeções intramiocárdicas de 2000µg VEGF 165 plasmidial. Os pacientes foram avaliados por cintilografia miocárdica, teste ergométrico, questionário de qualidade de vida (Minnesota) e determinação das classes de insuficiência cardíaca (NYHA) e angina (CCS). RESULTADOS: Não houve óbitos ou reintervenções. Durante o período de tratamento medicamentoso máximo, não se observou diferenças em cintilografias miocárdicas, testes ergométricos e questionários de qualidade de vida, ainda, houve tendência a piora das classes NYHA (P=0,05) e CCS (P=0,05). Três meses após intervenção, observou-se melhora dos escores cintilográficos SSS (18,38±7,51 vs. 15,31±7,29, P=0,003) e SRS (11,92±7,49 vs. 8,53±6,68, P=0,002), porém não na proporção da extensão da área de miocárdio isquêmico (23,38±13,12% vs. 20,08±13,88%, P=0,1). Houve tendência a melhora dos METs nas ergometrias (7,66±4,47 vs. 10,29±4,36, P=0,08), melhora do escore de qualidade de vida (48,23±18,35 vs. 30,15±20,13; P=0,02) e das classes NYHA (3,15±0,38 vs. 1,77±0,83, P=0,001) e CCS (3,08±0,64 vs. 1,77±0,83, P=0,001), no mesmo período. CONCLUSÕES: A terapia demonstrou-se segura e viável nesta série de pacientes. Os resultados iniciais tendem a demonstrar melhora na gravidade da angina e redução da intensidade da isquemia miocárdica.Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de CardiologiaUFCSPAUniversidade Federal de São Paulo (UNIFESP) Centro Interdisciplinar de Terapia GênicaInstituto de Cardiologia do RS/Fundação Universitária de Cardiologia Laboratório de Cardiologia Molecular e CelularUNIFESP, Centro Interdisciplinar de Terapia GênicaSciEL