SAFIIRA: A heavy-ion multi-purpose irradiation facility in Brazil.

This work describes the new facility for applied nuclear physics at the University of Sao Paulo, mainly for irradiation of electronic devices. It is a setup composed of a quadrupole doublet for beam focusing/defocusing plus multiple scattering through gold foils to produce low intensity, large-area, and high-uniformity heavy-ion beams from 1H to 107Ag. Beam intensities can be easily adjusted from 102 particles cm2/s to hundreds of nA for an area as large as 2.0 cm2 and uniformity better than 90%. Its irradiation chamber has a high-precision motorized stage, and the system is controlled by a LabViewTM environment, allowing measurement automation. Design considerations and examples of use are presented.

Best practice in primary care pathology: review 14.

This 14th best practice review is the second of a pair that examines tumour marker requesting primary care situations. This review considers carbohydrate antigen 125, α-fetoprotein and human chorionic gonadotropin. It is presented in question-answer format, referenced for each question. The recommendations represent a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by MEDLINE EMBASE searches to identify relevant primary research documents. They will be updated periodically to take into account new information.

Best practice in primary care pathology: review 13.

This 13th best practice review examines tumour marker requesting primary care situations. The review is presented in question--answer format, referenced for each question. This review considers carcinoembryonic antigen carbohydrate antigen 15-3 (Ca15-3) and carbohydrate antigen 19-9 (Ca19-9). The recommendations represent a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by MEDLINE EMBASE searches to identify relevant primary research documents. They will be updated periodically to take account of new information.

Performance of blood tests in diagnosis of inflammatory bowel disease in a specialist clinic.

AIMS: To determine the reliability of a panel of blood tests in screening for ulcerative colitis and Crohn's disease. METHODS: The subjects were 153 children referred to a paediatric gastroenterology department with possible inflammatory bowel disease (IBD). Of these, 103 were found to have IBD (Crohn's disease 60, ulcerative colitis 37, indeterminate colitis 6). The 50 without IBD formed the controls. Blood tests evaluated included haemoglobin, platelet count, ESR, CRP, and albumin. Receiver operating characteristic curves were used where possible to determine optimal threshold values. Binary logistic regression analysis was used to investigate the five screening tests in combination, and a stepwise method was used to find the best test combination. RESULTS: The optimal screening strategy used a combination of haemoglobin and platelet count and "1 of 2 abnormal" as the criterion for positivity. This was associated with a sensitivity of 90.8% (95% CI 83.3 to 95.7%), a specificity of 80.0% (95% CI 65.7 to 89.8%), and positive and negative predictive values of 94.4% and 75.9% respectively. CONCLUSIONS: Haemoglobin and platelet count provide a useful screening test combination for patients with suspected IBD. These tests are not completely reliable however. If clinical suspicion is high further investigations are required.

Development and evaluation of the neutralizing capacity of horse antivenom against the Brazilian spider Loxosceles intermedia.

Spider bites due to Loxosceles intermedia are currently a major public health problem in South Brazil. About 3000 cases are reported annually. Specific treatment for spider bites is provided by the polyvalent anti-arachnidic antiserum produced by Butantan Institute, São Paulo, Brazil by immunizing horses with mixtures of venoms from Tityus serrulatus and T. bahiensis scorpions, as well as Phoneutria nigriventer and L. gaucho spiders. Due to the large amounts of the anti-arachnidic antivenom required and since L. intermedia venom has some biochemical and pharmacological variations, we have produced a specific anti-L. intermedia antivenom. This study shows that horses immunized with crude L. intermedia venom produced IgG antibodies that neutralized the dermonecrotic and lethal activities of the venom. The neutralizing potency of the anti-loxoscelic antivenom was compared with that of the anti-arachnidic antivenom. Our results indicate that both antivenoms were effective in terms of neutralization. However, the anti-loxoscelic antivenom was more efficient than the anti-arachnidic.

Phenylketonuria: treatment in adolescence and adult life.

In our clinic the decision on whether to continue with dietary treatment of phenylketonuria or not is left to each adolescent and adult patient after the advantages and disadvantages, as discussed in this paper, of continuing diet have been presented to them. As a result 61 of 132 patients have stopped diet or declined to restart and only 4 of them have phenylalanine values below 1000 mumol/l. Seventy-one patients have remained on diet or started again with phenylalanine values below 1000 mumol/l in 58 of them. This series of 132 excludes women who returned to diet to conceive.

Association of viral hepatitis A with HLA-A9.

HLA-A and B phenotyping was carried out, during a viral hepatitis A (VHA) epidemic in Brazil, on 47 unrelated patients with VHA and 53 unrelated healthy subjects of the same age, sex, social status, and ethnic origin. An increased frequency of HLA-A9 (44.7% vs. 15.1%) and a decrease of that of HLA-A3 (2.1% vs. 22.6%) were observed when compared with controls. After correction for the number of antigens tested, only the positive association with HLA-A9 was observed. It was found that the relative risk for an HLA-A9 carrier to develop VHA was 4.5.