Dermoscopy of naevi in patients with oculocutaneous albinism.

Oculocutaneous albinism (OCA) increases predisposition to skin malignancies. Nevertheless, the differential diagnosis between melanoma and naevi in patients with OCA is still challenging, because pigmentary lesions have rarely been described in this population. We aimed to describe the dermoscopic patterns of naevi in patients with OCA. We prospectively evaluated 83 naevi from 37 patients with OCA in a single centre in Brazil. Lesions were analysed by eye and by dermoscopy and were grouped by dermoscopic pattern. Eight main patterns were identified: homogeneous structureless pattern (n = 28; 33.7%), globular pattern (n = 27; 32.5%), reticular pattern (n = 8; 9.6%), peripheral reticular pattern with central hypopigmentation (n = 8; 9.6%), peripheral globules (n = 8; 9.6%), irregular brown globules with pink background (n = 2; 2.4%), reticular globular disorganized pattern (n = 1; 1.2%) and peripheral reticular globular with central hypopigmentation (n = 1; 1.2%). We found previously undescribed dermoscopic patterns in patients with OCA, in addition to confirming previously described patterns. These descriptions may help the understanding of pigmented naevi in patients with OCA.

Shooter-Experienced Blast Overpressure in .50-Caliber Rifles.

BACKGROUND: Increasingly, military and law enforcement are using .50-caliber rifles for conflict resolution involving barricades, armor, vehicles, and situations that require increased kinetic energy. Consequences to the shooter resulting from the blast produced while firing these rifles remain unknown. We measured blast overpressure (OP) and impulse across various positions, environments, and weapon configurations to evaluate blast exposures to shooters. METHODS: Two separate, multiday, .50-caliber rifle training courses were evaluated to understand the blast exposure profile received from various tactical training scenarios, such as different firing positions (e.g., standing, prone, seated, kneeling) and locations (e.g., inside and atop vehicles, inside buildings, on hard/soft surfaces) across a variety of .50-caliber rifles with various barrel lengths, muzzle devices, and ammunition. Blackbox Biometrics, Generation 6, gauges were placed on operators to measure incident blast exposure. A total of 444 rounds fired from various .50-caliber rifles were evaluated to determine what OP was received by 32 different shooters. RESULTS: Our findings indicate OPs >4 psi are common and that muzzle devices are critical to blast exposure. Shooting positions closer to the ground experienced higher OP and impulse than did other positions. Suppressors mitigated blast effects well. CONCLUSION: When resources and operational parameters allow, suppressors are recommended, as are positions that move the shooter farther from reflective surfaces (standing preferred) to effectively reduce blast exposure. These shooter positions may require the use of supplemental rifle rests/tripods to provide sufficiently stable firing platforms from the standing position.

Effect of Lactobacillus plantarum and Pseudomonas aeruginosa culture supernatants on polymorphonuclear damage and inflammatory response.

In a previous study we determined that by-products of Lactobacillus plantarum inhibited pathogenicity of Pseudomonas aeruginosa and is effective in the treatment of infected wounds. This study assesses the cytotoxic activity of acetic acid (AA), supernatants of L. plantarum and P. aeruginosa, with and without signal acyl-homoserine-lactones (AHL), and mixtures of both bacterial supernatants on human neutrophils. Cytotoxicity was determined through viability using trypan blue, apoptosis by Annexin V, necrosis by propidium iodide and intracellular pH by SNARF-1. We found that supernatants of L. plantarum caused less cytotoxicity than AA at the same extracellular pH (p<0.05). P. aeruginosa induced a remarkable drop in intracellular pH, which was independent of extracellular pH. This intracellular acidity was correlated with a significant decrease in viability and was higher than supernatants of AHL producing P. aeruginosa (p<0.05). When supernatants were mixed, the quantity of AHL diminished (p<0.001) and the cytotoxic effect induced by P.aeruginosa was ameliorated by L. plantarum supernatant (p<0.001 vs p<0.01). These results are in agreement with the inflammatory in vivo assays determined by intradermal inoculations in Balb/c mice. Our findings will be useful for the formulation of effective and inexpensive products to resolve infected chronic wounds in our hospitals.

Differences between Pseudomonas aeruginosa in a clinical sample and in a colony isolated from it: comparison of virulence capacity and susceptibility of biofilm to inhibitors.

We study the differences between Pseudomonas aeruginosa from an infected wound (clinical strain) and a colony isolated from it. We assessed the in vitro inhibition of these P. aeruginosa biofilms by DNase and filtrate of Lactobacillus plantarum cultures (acid=AF and neutralize=NF) with crystal violet technique. Inhibition by AF was greatest than DNase for clinical and isolated strain (p<0.001) and greatest than NF for clinical (p<0.05) and isolated strain (p<0.001). Using a burn model in mice, we compared the infection producing by clinical and isolated strains in planktonic and biofilm form. Deaths were quantified and the infection was assessed by determining CFU/g of tissue in the lesion, spleen and liver. The infections with planktonic bacteria tended to become systemic and more deadly than biofilm infections. All infected wounds required the same healing period (30 days). These findings were independent of the origin of the bacteria (clinical or colony isolated strain).

[The various meanings of Brazil's certification as free of Chagas disease]. / Os diferentes significados da certificação conferida ao Brasil como estando livre da doença de Chagas.

The article discusses Brazil's recent certification as free of Chagas disease transmission by Triatoma infestans, analyzing the various meanings ascribed to this position. Resulting mainly from measures by both the Chagas Disease Control Program (PCDCh) established in Brazil in 1975 and the Southern Cone Initiative launched in 1991, this certification has been interpreted in ways that lead to confusion between the elimination of Chagas disease transmission by T. infestans and eradication of the disease. The present status of vector transmission control in Brazil is discussed, with emphasis on the Northeast, in most States of which T. infestans is not the main species involved in transmission. The article highlights the need to broaden the discussion of the readings and consequences involved in the present control achievements in light of possible harm from misinterpretations that might jeopardize further efforts to control the disease.