Behavioural/emotional problems in Brazilian children: findings from parents' reports on the Child Behavior Checklist.

Background. To compare Child Behavior Checklist (CBCL) findings for a large Brazilian general population sample with those for US children considering: (a) mean problem item ratings; (b) fit of the US-derived CBCL 8-syndrome model; (c) scale internal consistency measured by Cronbach's alphas; (d) effects of society, age, gender on CBCL problem scores; and (e) ability to discriminate referred from non-referred children. Methods. Parents of 1228 non-referred 6-to-11-year-olds from three different regions of Brazil and 247 referred 6-to-11-year-olds from one clinic rated their children's behavioural and emotional problems using the CBCL/6-18. Results. Results for mean item ratings and scale internal consistencies were very similar to those found in the US and in Uruguay. Confirmatory factor analysis indicated that Brazilian data showed the best fit to the US 8-syndrome model of all countries studied to date. Gender patterns were comparable to those reported in other societies, but mean problem scores for non-referred Brazilian children were higher than those for US children. Therefore, the CBCL discriminated less well between non-referred and referred children in Brazil than in the US. Conclusions. Overall, our findings replicated those reported in international comparisons of CBCL scores for 31 societies, thereby providing support for the multicultural robustness of the CBCL in Brazil.

Effect of selected antimicrobial compounds on the radiosensitization of Salmonella Typhi in ground beef.

AIMS: In this study, we extended our previous work to determine the efficiency of antimicrobial compounds in increase of relative radiosensitivity of Salmonella Typhi in medium fat ground beef (23% fat) by testing 41 different essential oils (EOs), oleoresins and food sauces. METHODS AND RESULTS: Ground beef samples inoculated with Salmonella Typhi (10(6) CFU g(-1)) were treated with each antimicrobial compound at a concentration of 0.5% (w/w). Then, the samples (25 g each) were packaged under air and irradiated in a (60)Co irradiator at doses from 0 to 1.75 kGy. Radiosensitivity was evaluated by calculating relative radiation sensitivity, defined as the ratio of radiation D(10) value in the absence/presence of antimicrobial compound. CONCLUSIONS: Depending on the compound tested, the addition of antimicrobial compound decreased the D(10) value of Salmonella Typhi, resulting in an increase of the radiation sensitivity up to more than four times. Among these antimicrobial compounds, Chinese cinnamon EO, clove EO and trans-cinnamaldehyde were most effective to increase the radiosensitivity of Salmonella Typhi in ground beef. SIGNIFICANCE AND IMPACT OF THE STUDY: These observations demonstrate that some active compounds can function as radiosensitizers of Salmonella Typhi.

Combined effect of natural essential oils, modified atmosphere packaging, and gamma radiation on the microbial growth on ground beef.

Selected Chinese cinnamon, Spanish oregano, and mustard essential oils (EOs) were used in combination with irradiation to evaluate their ability to eliminate pathogenic bacteria and extend the shelf life of medium-fat-content ground beef (23% fat). Shelf life was defined as the time when the total bacterial count reached 10(7) CFU/g. The shelf life of ground beef was determined for 28 days at 4 degrees C after treatment with EOs. The concentrations of EOs were predetermined such that sensory properties of cooked meat were maintained: 0.025% Spanish oregano, 0.025% Chinese cinnamon, and 0.075% mustard. Ground beef samples containing EOs were then packaged under air or a modified atmosphere and irradiated at 1.5 kGy. Ground beef samples (10 g) were taken during the storage period for enumeration of total mesophilic aerobic bacteria, Escherichia coli, Salmonella, total coliforms, lactic acid bacteria, and Pseudomonas. Mustard EO was the most efficient for reducing the total mesophilic aerobic bacteria and eliminating pathogenic bacteria. Irradiation alone completely inhibited the growth of total mesophilic aerobic and pathogenic bacteria. The combination of irradiation and EOs was better for reducing lactic acid bacteria (mustard and cinnamon EOs) and Pseudomonas (oregano and mustard EOs). The best combined treatment for extending the shelf life of ground beef for up to 28 days was EO plus irradiation (1.5 kGy) and modified atmosphere packaging.

Effect of selected plant essential oils or their constituents and modified atmosphere packaging on the radiosensitivity of Escherichia coli O157:H7 and Salmonella typhi in ground beef.

Twenty-six different essential oils were tested for their efficiency to increase the relative radiosensitivity of Escherichia coli and Salmonella Typhi in medium-fat ground beef (23% fat). Ground beef was inoculated with E. coli O157:H7 or Salmonella (10(6) CFU/g), and each essential oil or one of their main constituents was added separately at a concentration of 0.5% (wt/wt). Meat samples (10 g) were packed under air or under modified atmosphere and irradiated at doses from 0 to 1 kGy for the determination of the D10-value of E. coli O157:H7, and from 0 to 1.75 kGy for the determination of the D10-value of Salmonella Typhi. Depending on the compound tested, the relative radiation sensitivity increased from 1 to 3.57 for E. coli O157:H7 and from 1 to 3.26 for Salmonella Typhi. Addition of essential oils or their constituents before irradiation also reduced the irradiation dose needed to eliminate both pathogens. In the presence of Chinese cinnamon or Spanish oregano essential oils, the minimum doses required to eliminate the bacteria were reduced from 1.2 to 0.35 and from 1.4 to 0.5 for E. coli O157:H7 and Salmonella Typhi, respectively. Cinnamon, oregano, and mustard essential oils were the most effective radiosensitizers.

Combined effect of carvacrol and packaging conditions on radiosensitivity of Escherichia coli and Salmonella Typhi in ground beef.

This study was undertaken to evaluate the effect of 1.0% carvacrol and 0.1% tetrasodium pyrophosphate on the radiation D10 of Escherichia coli and Salmonella Typhi added to ground beef at a concentration of 10(5) CFU/g. The ground beef was then packaged under four different atmosphere conditions: air (78.1% N2, 20.9% O2, 0.036% CO2), 100% CO2, modified atmosphere (60% O2, 30% CO2, 10% N2) and vacuum. Samples were irradiated at doses of 0.1 to 0.6 kGy for E. coli and 0.5 to 2.0 kGy for Salmonella Typhi. Radiation D10-values of 0.126 and 0.526 kGy were observed for E. coli and Salmonella Typhi, respectively, when meat was packed under air. When meat was packed under modified atmosphere conditions, the radiation D10-values for E. coli and Salmonella Typhi were 0.086 and 0.221 kGy, respectively. The addition of carvacrol and tetrasodium pyrophosphate and the use of modified atmosphere packaging reduced the radiation D10-value from 0.126 to 0.046 kGy for E. coli and from 0.526 to 0.053 kGy for Salmonella Typhi. Under vacuum and 100% CO2 conditions, the radiation D10 reduction was not as great as that for the modified atmosphere regardless of the presence or absence of carvacrol and tetrasodium pyrophosphate.

Radiosensitization of Escherichia coli and Salmonella Typhi in ground beef.

The radiosensitization of two pathogenic bacteria, Escherichia coli and Salmonella Typhi, was evaluated in the presence of thyme and its principal essential oil constituents (carvacrol and thymol) in ground beef. Ground beef was inoculated with E. coli or Salmonella Typhi (10(5) CFU/g), and each compound was added separately at various concentrations (0 to 3.5%, wt/wt). The antimicrobial potential of carvacrol, thymol, and thyme was evaluated in unirradiated meat by determining the MIC in percentage (wt/wt) after 24 h of storage at 4 +/- 1 degree C. Results showed a MIC of 0.88 +/- 0.12%, 1.14 +/- 0.05%, and 2.33 +/- 0.32% for E. coli in the presence of carvacrol, thymol, and thyme, respectively. MICs of 1.15 +/- 0.02%, 1.60 +/- 0.01%, and 2.75 +/- 0.17% were observed for Salmonella Typhi in the presence of the same compounds, respectively. The best antimicrobial compound (i.e., carvacrol) was selected and added to the sterilized ground beef along with ascorbic acid (0.5%, wt/wt) and tetrasodium pyrophosphate (0.1%, wt/wt). Meat samples (10 g) were packed in air and then irradiated in a 60Co irradiator at doses of 0 to 0.7 kGy for the determination of E. coli radiation D10 and 0 to 2.25 kGy for the determination of Salmonella Typhi radiation D10. Addition of carvacrol increased the relative sensitivity of both bacteria 2.2 times. The radiation D10 was reduced from 0.126 +/- 0.0039 to 0.057 +/- 0.0015 kGy for E. coli and from 0.519 +/- 0.0308 to 0.235 +/- 0.0158 kGy for Salmonella Typhi. The addition of tetrasodium pyrophosphate did not affect significantly (P > 0.05) the radiosensitization of either bacterium. However, the presence of ascorbic acid in the media reduced significantly (P < or = 0.05) the radiosensitivity of both bacteria. An additive effect of carvacrol addition and packaging under modified atmosphere conditions (60% O2-30% CO2-10% N2) was also observed on bacterial radiosensitization at 4 degrees C. Compared with the control packed under air, modified atmosphere packaging conditions in the presence of carvacrol and tetrasodium pyrophosphate improved the relative sensitivity of E. coli by 2.7 times and Salmonella Typhi by 9.9 times.

Kinetic transport of pesticide from contaminated fabric through a model skin.

Most protective clothing research for workers exposed to pesticides has focused on the primary dermal exposure that results from direct contact with the pesticide and on the penetration, versus repellency, of protective materials. The role of absorption and retention in the function of traditional clothing materials to limit pesticide exposure has received less attention. This project investigates the transfer of pesticides from contaminated work clothing in the dry state to human skin with the goal of furthering our understanding of the role of absorption and retention in the function of traditional clothing materials. Our objective was to study the use of synthetic membrane to evaluate the kinetic transport of pesticide from contaminated clothing through human skin. Transport of pesticide through the test system with and without the presence of fabric was characterized by a three-parameter single exponential rise to maximum equation. The synthetic membrane system was an appropriate model for human skin in this situation. Starching applied to the fabric gave additional absorption and retention, reducing pesticide transport from the fabric to the skin, and heavier weight fabric, such as denim, provided protection through absorption and retention of the pesticide.

Anatomical considerations in the surgical management of blunt thoracic aortic injury.

PURPOSE: Blunt aortic injury (BAI) involving the thoracic aorta is usually described as occurring at the isthmus. We hypothesized that injuries 1 cm or less from the inferior border of the left subclavian artery (LSCA) are associated with an increased mortality rate compared with injuries that are more distal. METHODS: A retrospective review of patients admitted with the diagnosis of BAI was performed. Injuries were divided into two groups: group I, injuries that were 1 cm or less from the junction of the LSCA and the thoracic aorta; group II, injuries that were more than 1 cm from the LSCA. Primary outcome measures included cross-clamp time, rupture, and death. RESULTS: In a 14-year period, 122 patients were admitted with BAI. The anatomy relative to the LSCA could be determined in 91 patients who underwent operative repair. Forty-two injuries (46%) were classified as group I, and 49 injuries were classified as group II. Group I injuries were characterized by an increased mortality rate (18/42 or 43% in group I vs 11/49 or 22% in group II, P = .04), intraoperative rupture rate (7/42 or 17% in group I vs 1/49 or 2% in group II, P = .003), and cross-clamp time (39.5 +/- 21.9 minutes in group I vs 28.4 +/- 13 minutes in group II, P = .04). Three ruptures occurred while proximal control was being obtained. CONCLUSION: Increased technical difficulty and risk of rupture characterize injuries that occur proximally in the descending thoracic aorta, 1 cm from the LSCA. These injuries may be better managed by instituting bypass before attempting to obtain proximal control and by routinely clamping proximal to the LSCA.

Peripherally inserted central catheters with distal versus proximal valves: prospective randomized trial.

PURPOSE: To evaluate whether peripherally inserted central catheters (PICCs) with a proximal valve have any advantage compared to those with a distal valve in regard to the incidence of occlusion, infection, or malfunction. MATERIALS AND METHODS: One hundred patients (mean age, 46 y) were randomized to receive either a distal-valved Bard Groshong catheter (n = 48) or a proximal-valved Catheter Innovations Pressure Activated Safety Valve catheter (n = 52). All catheters were 4-F, single-lumen PICCs. Catheters were placed under fluoroscopic (n = 82) or sonographic (n = 18) guidance. Most (91%) were placed for the administration of antibiotics. The placement procedure, maintenance, and weekly follow-up were the same for both catheters. RESULTS: Percutaneous placement with the catheter tip in the central veins was successful in all patients. Mean dwell time was 36 days. There were 12 (25%) occlusive or infectious complications in the distal valve catheter group and six (11.5%) in the proximal valve group (P = .08). There were 25 fractures in 17 distal valve catheters (35.4%) and three (5.8%) proximal valve catheter fractures (P < .01). CONCLUSION: There was a marked difference in durability between the valved catheters, in favor of the catheter with a proximal valve. There was also a trend for fewer occlusive and infectious complications with the proximal valve catheter.

Type III heart block with peripheral use of the Angiojet thrombectomy system.

The authors describe the occurrence of type III heart block in a patient undergoing a transjugular intrahepatic portosystemic shunt recanalization with use of the AngioJet thrombectomy system.

Stent placement in the treatment of pulmonary artery stenosis secondary to fibrosing mediastinitis.

This article describes an initial experience with stent placement in three patients with severe pulmonary artery stenosis secondary to fibrosing mediastinitis. All three patients were severely symptomatic on admission and all three were asymptomatic after treatment and remained symptom-free approximately 1 year after treatment.

CT-guided transfemoral portocaval shunt creation.

A patient with superior vena cava (SVC) occlusion presented with severe ascites and urgent transjugular intrahepatic portosystemic shunt (TIPS) was requested. The patient had a chronically occluded SVC. An alternative to classic TIPS was employed using CT guidance to traverse the left portal vein to the inferior vena cava with a small gauge needle. Fluoroscopic guidance was then used to snare a wire placed through the needle and then work from the femoral vein to create a portocaval shunt that passed through the caudate lobe. This procedure was a technical success and improved the patient's ascites.

Evaluation of local abciximab delivery from the surface of a polymer-coated covered stent: in vivo canine studies.

PURPOSE: To determine the in vitro feasibility of abciximab absorption and elution from a polymer-coated, silicone-covered stent, and to determine the in vivo effect of local delivery of abciximab concerning endothelialization of a polymer-coated, silicone-covered stent in a canine model. MATERIALS AND METHODS: Six polymer-coated, silicone-lined Wallstents were soaked in 2 mg/mL of concentrated solution of I131-labeled abciximab for a period as long as 48 hours. Quantification of abciximab absorption was determined by photon emission. Six maximally drug-loaded devices were then washed continuously with normal saline with use of a pustule pump apparatus. The quantity of residual abciximab was determined by photon emission for a period as long as 16 days. Eight similar devices (as described previously) were then implanted within the iliac arteries of four adult canines. Devices were identical except that four of eight were maximally loaded with abciximab. For each animal, one control implant was placed in the right iliac artery and one experimental implant (drug loaded) was placed in the left iliac artery, via right carotid cutdown. Animals were allowed to recover and no chronic medications were given. After an interval of 6 weeks, the animals were killed. Implants were isolated and perfused with 10% buffered formalin at a pressure of approximately 100 mm Hg for a period of 1 hour. Each implant was encased in methacrylate, sectioned into six equal segments, ground and polished, and stained with hematoxylin and eosin. Each slide was projected on a screen and the thickness of the neointima quantified. The mean neointima was determined for control and experimental groups, and compared for a potential significant difference with a Student t test. RESULTS: Mean absorption of abciximab was 21.53 microg +/- 2.99 per device. Devices were fully saturated at 24 hours. Forty percent was absorbed at 1 hour, and 60% and 80% were absorbed at 4 hours and 12 hours, respectively. Regarding elution, 30% of abciximab was washed out after 1 hour. There was a gradual elution of the drug to 16 days, with approximately 40% remaining at the end of the term. Mean neointimal thickness was 995 microm +/- 597 for the experimental group and 1,738 microm +/- 1,042 for the control group. The difference was significant (P <.05). CONCLUSIONS: Absorption and elution of abciximab from the surface of a covered stent is feasible. Local delivery of abciximab from the surface of this covered stent reduced the thickness of endothelial lining in the canine iliac artery compared to control.

Ehlers-Danlos syndrome mimicking mesenteric vasculitis: therapy, then diagnosis.

The etiology of acute intraabdominal bleeding is often unclear at the time emergent arteriography is performed. During localization and embolization, the arteriogram may suggest the diagnosis of vasculitis. However, controlling the bleeding remains the priority. Connective tissue diseases such as Ehlers-Danlos syndrome (EDS) may also cause bleeding and mimic vasculitis and must be included in the differential diagnosis. We present such a case in which the initial findings were misleading.

Seat belt aorta: endovascular management with a stent-graft.

PURPOSE: To report the endovascular treatment of a relatively uncommon type of deceleration injury to the abdominal aorta. CASE REPORT: A 21-year-old backseat passenger was wearing a single lap belt without shoulder harness when the car was involved in a collision. He sustained a transverse (Chance) fracture of the third lumbar vertebra and a circumferential dissection of the infrarenal abdominal aorta with pseudoaneurysm. As an interim measure while a stent-graft was obtained, a Wallstent was deployed to tack down the dissection and prevent distal embolization. Thirty-six hours later, an AneuRx endograft was successfully implanted inside the Wallstent to seal the pseudoaneurysm. The patient's recovery was uneventful, and the endograft remains secure and the pseudoaneurysm excluded at 10 months after the accident. CONCLUSIONS: Endovascular repair of "seat belt aorta" is a minimally invasive, straightforward method of management for this type of aortic injury. The potential for infection in a contaminated peritoneal cavity and the long-term outcome of this treatment have not been determined.