Large congenital myopericytoma of the lower eyelid.

Congenital fibrous soft tissue tumors in the eyelids are exceptionally rare, with only seven cases of neonatal myofibromas reported. Myopericytoma, a variant with pericytic differentiation, has not previously been described in neonatal eyelid tumors. This report details a case of a massive congenital myopericytoma in a newborn's lower eyelid. The lesion had a broad area of adhesion to the anterior lamella of the lid. After resection, when the child was 11 days old, the resulting defect was successfully reconstructed with a V-Y type perforator-based flap.

The Relation of the Anterior Ethmoidal Foramen to the Cranial Base.

PURPOSE: To perform a radiological analysis of the relation of the anterior ethmoidal foramen (AEF) to the cranial base and olfactory fossa (OF). METHODS: Retrospective analysis of computed tomography coronal scans of 35 orbits of 35 patients with Graves orbitopathy. Following a standard multiplanar reconstruction of the orbit, the authors measured the vertical and the horizontal distances of the AEF to the cranial base and to the lateral border of the OF, respectively. The height of the OF was measured at the level of the AEF and at the position of Keros classification. The presence of supraorbital ethmoid cells (SOEC) was also recorded. RESULTS: The vertical distance of the AEF to the cranial base ranged from 0.1 to 7.3 mm with a mean = 2.5 mm (SD = 2.17). In 47.5% of the orbits the foramen was adjacent (<1 mm) to the cranial base. The horizontal distance of the AEF to the lateral border of the OF ranged from 2.3 to 9.5 mm (mean = 5.4 mm, SD = 1.98). The presence of an SOEC (n = 12) increased significantly both the distance from the AEF to the cranial base and to the lateral border of the OF. The height of the OF at the level of AEF is not correlated with the depth of the OF at the level of Keros classification. CONCLUSIONS: In the absence of supraorbital pneumatization, the AEF location is a dangerous landmark for the upper limit of the transconjunctival medial wall decompression.

Evaluation of a short training course of chest X-ray interpretation for the diagnosis of paediatric TB.

BACKGROUND: Chest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries. METHODS: Within the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features. We performed a pre-post training assessment on a pre-defined set of 20 CXR readings. We compared the proportion of correctly interpreted CXRs and the median reading score before and after the training using the McNemar test and a linear mixed model. RESULTS: Of 191 HCWs, 43 (23%) were physicians, 103 (54%) nurses, 18 (9.4%) radiology technicians and 12 (6.3%) other professionals. Of 2,840 CXRs with both assessment, respectively 1,843 (64.9%) and 2,277 (80.2%) were correctly interpreted during pre-training and post-training (P < 0.001). The median reading score improved significantly from 13/20 to 16/20 after the training, after adjusting by country, facility and profession (adjusted ß = 3.31, 95% CI 2.44-4.47). CONCLUSION: Despite some limitations of the course assessment that did not include abnormal non-TB suggestive CXR, study findings suggest that a short CXR training course could improve HCWs' interpretation skills in diagnosing paediatric TB.

CONTEXTE: L'interprétation de la radiographie thoracique (CXR) est un défi pour le diagnostic de la TB pédiatrique. Nous avons évalué la performance d'un module de formation de trois demi-journées sur la CXR destiné aux agents de santé (HCWs) dans six pays où l'incidence de la TB est élevée et où les ressources en services de santé sont limitées. MÉTHODES: Dans le cadre de l'étude de décentralisation TB-Speed, nous avons mis au point un cours de formation de trois demi-journées pour identifier une CXR normale, une CXR de bonne qualité et six caractéristiques suggestives de la TB. Nous avons effectué une évaluation avant et après la formation sur un ensemble prédéfini de 20 clichés radiologiques. Nous avons comparé la proportion de CXR correctement interprétées et le score médian de lecture avant et après la formation à l'aide du test de McNemar et d'un modèle linéaire mixte. RÉSULTATS: Sur les 191 HCWs, 43 (23%) étaient des médecins, 103 (54%) des infirmières, 18 (9,4%) des techniciens en radiologie et 12 (6,3%) d'autres professionnels. Sur 2 840 CXR avec les deux évaluations, respectivement 1 843 (64,9%) et 2 277 (80,2%) ont été correctement interprétées avant et après la formation (P < 0,001). Le score médian de lecture s'est amélioré de manière significative, passant de 13/20 à 16/20 après la formation, après ajustement par pays, établissement et profession (ß ajusté = 3,31; IC 95% 2,44­4,47). CONCLUSION: Malgré certaines limites de l'évaluation du cours qui n'incluait pas de CXR anormale non évocatrice de TB, les résultats de l'étude suggèrent qu'une formation courte sur la CXR pourrait améliorer les compétences d'interprétation des HCWs dans le diagnostic de la TB pédiatrique.

Models of experimental hypertension in mice.

Experimental models of hypertension in various animals are useful in the research of vasoactive mechanisms. Recombinant DNA technology has produced genetically engineered animals, mostly mice, useful in hypertension research. However, the development of hypertensive models in mice is fraught with technical difficulties. We describe here the successful development in mice of two common types of experimental hypertension: the renovascular two-kidney, one clip and mineralocorticoid deoxycorticosterone-salt models. By adapting technology previously used in rats, we succeeded in developing hypertension (defined as systolic pressures higher than 140 mm Hg) in more than 50% of mice so treated. We also adapted the methodology for indirect tail-cuff blood pressure measurements as well as for direct intra-arterial monitoring of blood pressure in conscious, freely moving mice. Application of these techniques in transgenic or gene knockout mice with altered vasoactive hormones or receptors should allow elucidation of the role of the target gene products in various types of hypertension.

Structure of arboreal and herbaceous strata in a neotropical seasonally flooded monodominant savanna of Tabebuia aurea.

Large areas in the Pantanal wetland are covered by monodominant formations, e.g. typical landscapes with local names such as "paratudal", dominated by T. aurea. Studies on structure of these formations generally include only woody strata, consequently the species richness registered is usually low due to the absence of the 'ground layer' of herbaceous and others low species. We recorded 13 species, 12 genera and 11 families for the arboreal stratum. Considering arboreal flora without the dominant (T. aurea) individuals showed great establishment in relation to the flood level between 35 - 45 cm while the individuals of the dominant species of 30 - 45 cm. The diameter distribution revealed that the population of T. aurea did not show the reverse J curve, the usual pattern for species in constant regeneration, also evidenced in inconstant Licourt quotient, indicating an episodic recruitment that could lead to future changes in structure. In the herbaceous strata we recorded 78 species, included in 62 genera and 27 families. Using plots method we sampled 46 species, 40 genera and 22 families, while in line interception we found 65 species distributed in 57 genera and 26 families. The floristic similarity of Sørensen between both methods was 59.4%, with 33 species in common, and the method of line interception was more efficient in detecting richness, with 35% more species found in the same time. According to the methods of plots and line interception applied on the woody stratum, our results gave similar detailed information on the structure of this type of savanna, and in spite of being monodominant it shows high species richness when the herbaceous stratum is taken into account. Plots and line interception methods showed similar results for the woody stratum and high species richness of the herbaceous stratum.

Methods to assess the viability of cryopreserved Jatropha curcas L. seed germplasm / Métodos para avaliar a viabilidade de germoplasma semente criopreservado de Jatropha curcas L

ABSTRACT Jatropha curcas L. is a plant species with many potential applications, especially medicinal uses (hypoglycemic, anti-inflammatory, haemostatic, healing, anti-tumor). The objective of this study was to test germination in moist paper rolls for whole seeds and in vitro for excised embryonic axes, in an attempt to identify the best method to assess the quality of J. curcas seed germplasm, cryopreserved with different water contents. The experimental sample with a 6.2% moisture content (MC) was divided in subsamples which were hydrated and dehydrated for 0 (control), 4, 8, 11 and 24h. The initial germination percentages were 63% for whole seeds and 81% for excised embryonic axes. After exposure to liquid nitrogen (LN), germination percentages were 48% (whole seeds) and 57% (excised embryonic axes). There was no significant difference between germination percentages in embryonic excised from seeds subjected or not subjected to freezing, with different MC. In contrast, there was a reduction of the whole seed germination percentage when exposed to LN (contrast = 0.17, standard error = 0.04, t = 4.09, p = 0.001) and not for the hydration and dehydration treatments. The methodology based on in vitro cultures of the embryonic axis isolated from seeds stored in LN with distinct MC values was more efficient than the standard germination test to evaluate the viability of J. curcas seeds before and after LN storage.

RESUMO Jatropha curcas L., é uma espécie com várias aplicações potenciais, principalmente para usos medicinais (hipoglicemina, anti-inflamatório, homeostático, cicatrizante, antitumoral). O objetivo deste estudo foi testar a germinação em rolo de papel para sementes inteiras e in vitro para eixos embrionários excisados visando identificar o melhor método para avaliar a qualidade de germoplasma semente de J. curcas, criopreservado com diferentes teores de água. A amostra experimental com 6,2% de teor de água foi dividida em subamostras que foram hidratadas e desidratadas por 0 (controle), 4, 8, 11 e 24 h. Os percentuais de germinação inicial foram de 63% para sementes inteiras e de 81% para eixos embrionários excisados. Após exposição ao nitrogênio líquido (NL) os percentuais de germinação foram de 48% (sementes inteiras) e 57% (eixos embrionários). Não houve diferença significativa entre os percentuais de germinação de eixos embrionários excisados de sementes com diferentes umidades e submetidas ou não ao congelamento. Em contraste, houve redução de percentuais de germinação das sementes inteiras expostas ao NL (contraste = 0.17, erro padrão = 0.04, t = 4.09, p = 0.001), mas não aos tratamentos de hidratação e desidratação. A metodologia baseada em cultura de eixos embrionários in vitro isolados de sementes armazenadas em NL, com distintos teores de água foi mais eficiente que a germinação padrão para avaliar a viabilidade de sementes J. curcas antes e após a armazenamento em NL.

Cost effectiveness of chemotherapy for pulmonary tuberculosis in three sub-Saharan African countries.

The value of programmes to control pulmonary tuberculosis in developing countries remains the subject of debate. We have examined the cost-effectiveness of chemotherapy programmes for the control of pulmonary sputum-smear-positive tuberculosis in Malawi, Mozambique, and Tanzania. Effective cure rates of 86-90% were achieved with short-course chemotherapy and of 60-66% with standard chemotherapy. The average incremental costs per year of life saved were US $1.7-2.1 for short-course chemotherapy with hospital admission, $2.4-3.4 for standard chemotherapy with hospital admission, $0.9-1.1 for ambulatory short-course chemotherapy, and $0.9-1.3 for ambulatory standard chemotherapy. Chemotherapy for smear-positive tuberculosis is thus cheaper than other cost-effective health interventions such as immunisation against measles and oral rehydration therapy. Because the greatest benefit of chemotherapy is reduced transmission of the bacillus, treating HIV-seropositive, tuberculosis smear-positive patients would be only slightly less cost-effective than treating HIV-seronegative, tuberculosis-smear-positive patients.

Cost-effectiveness of chemotherapy for sputum smear-positive pulmonary tuberculosis in Malawi, Mozambique and Tanzania.

The cost-effectiveness of chemotherapy for pulmonary sputum smear-positive tuberculosis was examined in the national tuberculosis control programmes of Malawi, Mozambique and Tanzania. In these three programmes, routine cure rates have exceeded 80 per cent. Average, average incremental and marginal unit costs for standard, short-course and retreatment regimens with and without hospitalization have been measured. The average incremental cost per year of life saved through chemotherapy ranged from US $0.90-3.10. In all conditions, short-course chemotherapy is preferable to standard 12-month chemotherapy. When hospitalization during the intensive phase of chemotherapy increases the cure rate by 10-15 percentage points, it can be relatively cost-effective. Analysing the cost-effectiveness of short-course and standard chemotherapy, where the depth of the margin of benefit is different, illustrates some of the dangers of simplistic use of cost-effectiveness ratios.

Benefits of intraluminal injection of glutamine for intestinal mucosa during ischemia-reperfusion.

BACKGROUND: We investigated the effect of intraluminal glutamine on the intestinal mucosa in the presence of ischemia-reperfusion injury (IRI). METHODS: Six blind sacs were created in the small bowel (3 at the jejunum and 3 at the ileum) in 10 Wistar rats. The lateral sacs of both bowel regions were submitted to IRI (30/30 min), while the medial sacs were left free to receive blood supply. In the lateral sacs, a solution containing either saline plus 4% glutamine or pure saline was injected at the bowel lumen. No fluid was injected in the medial sacs. RESULTS: Both at the jejunum and at the ileum, the score of the mucosal injury was higher in saline-injected sacs than in either glutamine-injected or control sacs. There was a significantly greater number of neutrophils in the sacs treated with saline than in the other two groups of sacs. CONCLUSION: Glutamine protects the mucosa and diminishes the accumulation of neutrophils at the lamina propria of the small bowel in IRI.