Performance of polymyxin B agar-based tests among carbapenem-resistant Enterobacterales.

Therapeutic options for infections caused by Carbapenem-resistant Enterobacterales (CRE) are restricted and include polymyxins-centred schemes. Evaluation of in vitro susceptibility is difficult and time consuming. Agar-based methodologies are an alternative to broth microdilution (BMD) and we aimed to evaluate the accuracy of those methods among Enterobacterales. A total of 137 non-duplicated CRE were subjected to polymyxin B BMD, agar screening test (Mueller Hinton plates containing 3 µg ml-1 of polymyxin B) and agar dilution (antibiotic serially diluted 0·25-64 µg ml-1 ). CRE of 42·3% were resistant to polymyxin B (MICs range: 0·25->64 µg ml-1 ) and 16·8% presented borderline MICs. Sensitivity, specificity, PPV and NPV were 86·2, 98·7, 98 and 90·7% for screening test and 86·2, 97·5, 96·1 and 90·6% for agar dilution. ME was 0·73 and 1·5% for screening and agar dilution respectively; VME was 5·8% for both techniques. In general, agar-based methods had a good performance. As far as we know, this is the first study to propose an agar screening test using polymyxin B instead of colistin.

Cryolipolysis with Plate for Treatment of Localized Adiposity.

BACKGROUND: Cryolipolysis is a non-invasive method capable of reducing the thickness of the fat layer. OBJECTIVE: To evaluate the effects of cryolipolysis with the use of plate applicators in the treatment of abdominal fat in women. MATERIALS AND METHODS: The sample was composed of 15 participants, who were evaluated before and at the end of the intervention. Three applications of cryolipolysis were performed in the infraumbilical portion of the abdominal region. The volunteers were divided into three groups G-1 (temperature of -2°C), G-2 (temperature of -3°C) and G3 (temperature of -4°C). RESULTS: There was a reduction in plicometry measurements in groups G2 and G3, in the comparison between the initial and final moments (p <0.05), and a reduction in perimetry and ultrasound (p < 0.05) in all groups. It was found that the G3 group was subject to higher risk of first degree burns and redness when compared to the other groups. CONCLUSION: It is suggested that plate cryolipolysis is a possibly effective resource for reducing adiposity, as shown in the evaluation of perimetry, plicometry, and ultrasound results, and in the photographic analysis.

Effects of cryolipolysis with adiposity plates located with the Crioplace concept in women.

BACKGROUND: Cryolipolysis with plates is a method of applying cooling without a vacuum system, which can be used in regions with less chance of forming a "crease." OBJECTIVE: To investigate the effects of cryolipolysis using a plate-shaped applicator (Crioplac) in the treatment of fat. MATERIALS AND METHODS: This is an experimental study in which women aged 25 to 45 years with adiposity located in the abdomen participated. Two applications of 75 min were made, using 04 plates in the abdomen regions, with -4 degree C being programmed as a temperature parameter. Anthropometric and ultrasound assessments were performed, and a satisfaction questionnaire on the validated treatment was conducted. The reassessments were performed 30 and 60 days after the first intervention. RESULTS: A reduction in adiposity was observed in the measurements of perimetry, plicometry and abdominal ultrasound (p<0.05). It was found that about 62.5% of the volunteers reported an improvement in water retention, about 62.5% reported the presence of loose clothing, and 31.3% reported satisfaction with the results obtained. It was observed that 18.5% of the volunteers reported that the treatment was excellent. CONCLUSION: The Crioplace method proved to be effective in reducing adiposity, with a high clinical satisfaction with the reduction in body measurements.

Effects of Cryolipolysis with Plates in Localized Adiposity with the CrioPlace Concept.

BACKGROUND: Plate cryolipolysis is a method of applying cooling without a vacuum system, which can be used in regions with less possibility of skin suction or fibrosis. OBJECTIVE: To investigate the effects of cryolipolysis with the use of plate-shaped applicators (CrioPlaceTM) for localized fat treatment. METHODS: The sample consisted of men aged 20 to 45 years with complaints of localized adiposity in the abdominal region and flanks. Two plates were positioned in the flank and abdomen regions, respectively. They received two 60-min applications in the temperature of -2°C. The anthropometric, thermographic and ultrasound assessments were performed, and a satisfaction questionnaire was applied after treatment. The re-evaluations occurred 30 and 60 days after the first intervention. RESULT: A reduction in adiposity was observed in flank region plicometry (p<0.05) and abdominal and flank ultrasound (p < 0.05). About 66.7% of the volunteers reported less water retention, about 41.7% reported that their clothes were looser, and 100% reported overall satisfaction. Fifty percent rated the treatment as excellent and 58.3% felt improvement in overall aesthetics. CONCLUSION: The CrioPlaceTM method was effective in reducing localized adiposity, with clinical satisfaction of measurement reduction, both in plicometry and ultrasound analyses, with highlights to the flank region results.

Effects of cryolipolysis on abdominal adiposity of women.

　　BACKGROUND: The cryolipolysis is on the spotlight as a non-invasive method which reduces fat layer thickness with no damage to surrounding tissues. OBJECTIVE: This study aims to verify the effectiveness of cryolipolysis in the reduction of localized adiposity in women. MATERIALS AND METHODS: This is an experimental study, without a control group, with pre- and post- treatment evaluation through a single application on the lower abdominal area. SETTING: Research conducted in the period from July to December 2015 at the University Potiguar. PARTICIPANTS: A group of 15 women, age between 25-50 years. The cryolipolysis was used in the following parameters: temperature (-7 degree C); suction power (30 kPa), and application time (60 min). MEASUREMENTS: After the cryolipolysis was performed, a follow-up of 2 months was conducted to verify the changes related to weight, body circumference, fat layer thickness, which were evaluated by ultrasonography and photogrammetry. RESULTS: From data analysis, the reductions observed on perimeter (p=0.03) and ultrasonography (p=0.03) showed significant results, considering p <0.05. As of body weight results (p=0.57), the average value varied during the study; however, at the end of the research, no significant weight increase or decrease was reported, as it is known that this method does not interfere with this variable. Additionally, quantitative data were satisfactory. The photogrammetry analysis showed that cryolipolysis positively affected subjects' results. CONCLUSION: A change in body contouring, especially in individuals with lower body mass, reinforces the idea that the parameters must be suitable for individual needs.

Conjunctival flora, Schirmer's tear test, intraocular pressure, and conjunctival cytology in neotropical primates from Salvador, Brazil.

BACKGROUND: This study aimed to establish reference values for selected ophthalmic diagnostic tests in healthy neotropical primates from Salvador, Brazil. METHODS: A total of 73 intact adults, including Callithrix jacchus (n = 31), Callithrix penicillata (n = 8), Cebus sp. (n = 22), and Cebus xanthosternos (n = 9) were used to evaluate the normal conjunctival bacterial flora. Cebus xanthosternos (n = 12) were used to evaluate tear production with Schirmer's tear test (STT), intraocular pressure (IOP), and conjunctival cytology. RESULTS: For all animals evaluated, Gram-positive bacteria were predominant. Results of the diagnostic tests in Cebus xanthosternos were as follows: STT: 14.92 ± 5.46 mm/minutes, IOP: 19.62 ± 4.57 mmHg, and conjunctival cytology revealed intermediate squamous epithelial cells in great quantities. CONCLUSIONS: These ophthalmic reference values will be particularly useful to diagnose discrete or unusual pathological changes in the neotropical primates eye.

Evaluation of a histocompatibility antigen related to hepatitis B virus in patients with hepatocellular carcinoma in the western Brazilian Amazon.

Hepatocellular carcinoma is an infection of variable incidence that can be caused by hepatitis B virus (HBV), which is endemic in the Amazon region. The diagnosis of HBV can be performed through the use of serum markers such as the hepatitis B surface antigen. The chronic HBV can cause mutagenesis and carcinogenesis, being the susceptibility of infection due to allele human leukocyte antigen (HLA). Thus, we evaluated the clinical, molecular and laboratory profile (histocompatibility complex) of HBV in 22 patients with hepatocellular carcinoma in Amazonia, including 18 males and 4 females, using a blood sample for generic HLA class II. The results showed increased frequency of disease evolution in adults between 25 and 64 years old, who comprised 19 of the 22 patients studied. Most patients (16/22) presented high levels of alpha-fetoprotein and transaminases (14/22). The most common HLA alleles were DRB1 04 (8/44), DRB1 08 (9/44), DRB 03 (16/44), and DQB1 04 (9/44). When we compared specific phenotype frequencies of HLA-DRB1 between patients and controls, we found that patients had a significantly higher frequency of allele DRB1 08 and a significantly lower frequency of DRB1 07 and DRB1 12 compared to previous studies on Asian and Amazonian populations suggesting ethnic differences. We suggest that alleles HLA-DRB 08, HLA-DRB 03 and HLA-DQB1 04 may be risk factors for hepatocellular carcinoma in Amazon.

Controlling soft vortex matter: edge effects on vortex configurations and partial vortices in a superconducting type-II/type-I bilayer.

We demonstrate that the presence of edges in a superconducting film made of a type-I/type-II bilayer stabilizes type-II/type-I hybrid (inter-type) flux patterns, as vortex clusters, chains, and gel phase. These patterns are very sensitive to primary parameters such as applied magnetic field, layer coupling, and temperature. Thus, the magnetization versus temperature curves, M(T), for many values of coupling were used to estimate the strength of the layer couplings, and also as a guide for obtaining sequentially the flux patterns. We also show that the effect of the borders on the unrestricted states is to shift them to states of higher density, since they introduce extra compression on the vortex matter. For a low layer coupling regime, we observe an unusual magnetic response where few partial vortices (partial in a sense they miss the contribution of the type I part), repelling each other and bounded to the surfaces, populate one layer leaving the other empty. We expect that the predicted flux configurations can stimulate experimentalists in trying to observe them by direct imaging techniques.

Spontaneous pattern formation in superconducting films.

Superconducting films are usually regarded as type II superconductors even when they are made of a type I material. The reason is the presence of stray magnetic fields that stabilize the vortex matter by inducing long-range repulsive interactions between vortices. While very thin films indeed reach this limit, there is a large interval of thicknesses where magnetic properties of superconducting films cannot be classified as either of the two conventional superconductivity types. Recent calculations revealed that in this interval the system exhibits spontaneous formation of magnetic flux-condensate patterns and superstructures appearing due to the interplay between the long-range stray field effects and proximity to the Bogomolnyi self-duality point. These calculations were based on the periodic in-plane boundary conditions which, as is well known from classical electrodynamics, for systems with long-range interactions can lead to field distortions and considerable discrepancies between results of different calculation methods. Here we demonstrate that similar spontaneous patterns are obtained for superconducting films with open in-plane boundary conditions (vanishing in-plane currents perpendicular to the edges of the finite film) and thus the phenomenon is not an artefact of chosen boundary conditions.

Decay of the distance autocorrelation and Lyapunov exponents.

This work presents numerical evidence that for discrete dynamical systems with one positive Lyapunov exponent the decay of the distance autocorrelation is always related to the Lyapunov exponent. Distinct decay laws for the distance autocorrelation are observed for different systems, namely, exponential decays for the quadratic map, logarithmic for the Hénon map, and power-law for the conservative standard map. In all these cases the decay exponent is close to the positive Lyapunov exponent. For hyperchaotic conservative systems the power-law decay of the distance autocorrelation is not directly related to any Lyapunov exponent.

Drug resistance mutation profile and accumulation kinetics in human immunodeficiency virus-positive individuals infected with subtypes B and F failing highly active antiretroviral therapy are influenced by different viral codon usage patterns.

The major human immunodeficiency virus type 1 subtype circulating in Brazil is B, followed by F and C. We have genotyped 882 samples from Brazilian patients for whom highly active antiretroviral therapy failed, and we found subtype B and the unique recombinant B/F1 forms circulating. Due to codon usage variation, there is a significantly lower incidence of the substitutions L210W, Q151M, and F116Y in subtype F1 isolates than in the subtype B counterparts.

Evaluation of leucocytes from sputum samples of pulmonary tuberculosis patients using flow cytometry.

SETTING: Information about the sputum cells of pulmonary tuberculosis (PTB) patients is scarce. The analysis of sputum cells using optical microscopy (OM) is a well-established method, but it has some serious limitations. OBJECTIVE: To establish a new flow cytometry (FC) protocol for the leucocyte evaluation of sputum samples from PTB patients. DESIGN: A new FC protocol using 0.1% dithiothreitol and 0.5% paraformaldehyde was developed to fluidise sputum samples and kill Mycobacterium tuberculosis, respectively, to allow the analysis of sputum samples collected from TB patients. The protocol was validated by comparing it with OM, and the cellularity of 30 sputum samples from patients with PTB was evaluated. RESULTS: The comparison between leucocyte subsets analysed using OM and FC showed agreement. Immunophenotyping of leucocytes from sputum samples showed that neutrophils (95.7%) comprised the largest proportion of sputum cells, followed by monocytes/macrophages (2.6%) and lymphocytes (1.6%). Among the total T-lymphocytes (100%), 12.3% were T-helper cells, 24.1% were cytotoxic T-cells and 62.9% were gamma/delta T; none of the T lymphocytes had the CD4+/CD8+ phenotype. CONCLUSION: FC is a useful method for evaluating the different subtypes of leucocytes present in the sputum samples of PTB patients.

Characterizing weak chaos using time series of Lyapunov exponents.

We investigate chaos in mixed-phase-space Hamiltonian systems using time series of the finite-time Lyapunov exponents. The methodology we propose uses the number of Lyapunov exponents close to zero to define regimes of ordered (stickiness), semiordered (or semichaotic), and strongly chaotic motion. The dynamics is then investigated looking at the consecutive time spent in each regime, the transition between different regimes, and the regions in the phase space associated to them. Applying our methodology to a chain of coupled standard maps we obtain (i) that it allows for an improved numerical characterization of stickiness in high-dimensional Hamiltonian systems, when compared to the previous analyses based on the distribution of recurrence times; (ii) that the transition probabilities between different regimes are determined by the phase-space volume associated to the corresponding regions; and (iii) the dependence of the Lyapunov exponents with the coupling strength.

Giant paramagnetic Meissner effect in multiband superconductors.

Superconductors, ideally diamagnetic when in the Meissner state, can also exhibit paramagnetic behavior due to trapped magnetic flux. In the absence of pinning such paramagnetic response is weak, and ceases with increasing sample thickness. Here we show that in multiband superconductors paramagnetic response can be observed even in slab geometries, and can be far larger than any previous estimate - even multiply larger than the diamagnetic Meissner response for the same applied magnetic field. We link the appearance of this giant paramagnetic response to the broad crossover between conventional Type-I and Type-II superconductors, where Abrikosov vortices interact non-monotonically and multibody effects become important, causing unique flux configurations and their locking in the presence of surfaces.

Schistosomiasis mansoni: immunoblot analysis to diagnose and differentiate recent and chronic infection.

One hundred seven patients classified into three different groups (11 with acute schistosomiasis, 58 with chronic schistosomiasis, and 38 children with high IgM-specific antibody titers against schistosome gut-associated antigens living in an endemic schistosomiasis area) were studied by immunoblotting for the presence of IgG, IgM, and IgA antibodies against Schistosoma mansoni soluble adult worm antigen preparation. We used sera from 15 individuals infected with various intestinal parasites, as well as sera from 19 uninfected individuals, as controls. An immunogenic fraction with a molecular weight of 31-32 kD (Sm31/32) was the most frequently recognized by the different antibody isotypes. In the group with acute disease, this fraction was recognized by IgG and IgM antibodies of all patients, and by 10 (90.9%) of 11 samples for IgA antibodies. Approximately 98% of the patients with chronic infections had IgG antibodies against Sm31/32, but only about 10% had IgM and IgA antibodies against this fraction. The IgG immunoblot profiles of the children from the endemic area were similar to those obtained for the group with acute schistosomiasis. This observation suggests recent infection of these children. Our data show that the Sm31/32 protein fraction is highly immunogenic and may be a useful serologic marker for diagnosing and differentiating between acute and chronic schistosomiasis infection.

Efficacy of an enzyme-linked immunosorbent assay in the diagnosis of and serologic distinction between acute and chronic Schistosoma mansoni infection.

To determine the efficacy of an ELISA to diagnose and differentiate the clinical phases of schistosomiasis, serum from patients with acute (11) and chronic schistosomiasis (58), from individuals infected with other parasites (53), and from uninfected individuals (40) was analyzed for the presence of anti-schistosomal of IgG, IgM, and IgA antibodies. Immunofluorescence for IgM and IgA antibodies was also performed on serum from all patients and controls. The IgG antibodies against worm antigen (ELISA-w) were detected in all schistosomiasis patients, with only one false-positive result. The IgA antibodies were detected by ELISA-w in 81.8% of patients with acute disease and in only 5.9% of patients with chronic disease. In addition, the mean optical density values for IgM and IgA antibodies was statistically higher in the patients with acute disease than in those with chronic disease. The results of this study show that the use of a crude adult worm extract as an ELISA antigen can provide a serologic method with high sensitivity and specificity for 1) the diagnosis of acute and chronic schistosomiasis and (2) the serologic distinction between the two forms of the disease.

[Occurrence of Taenia sp. in the population seen at the Central Laboratory of the Adolfo Lutz Institute, São Paulo, SP, Brazil (1960/1989)]. / Ocorrência de Taenia sp. na população atendida no Laboratório Central do Instituto Adolfo Lutz, São Paulo, SP, Brasil (1960/1989).

Monthly and yearly reports of the Seção de Enteroparasitoses of the Instituto Adolfo Lutz (São Paulo, SP, Brazil) from 1960 to 1989 with 1,519,730 parasitological stool examinations were studied. There were also 355 identifications of Taenia sp. proglottids. Using Hoffman, Pons & Janer's method, 7,663 (0.5%) cases of taeniasis were diagnosed, and 311 (87.60%) of the 355 proglottids were on easy terms to be specified, 273 (87.80%) of them were from Taenia saginata.

A comparative epidemiologic study of specific antibodies (IgM and IgA) and parasitological findings in an endemic area of low transmission of schistosoma mansoni.

The diagnostic potential of circulating IgM and IgA antibodies against Schistosoma mansoni gut-associated antigens detected by the immunofluorescence test (IFT) on adult worm paraffin sections was evaluated comparatively to the fecal parasitological method, for epidemiological purposes in low endemic areas for schistosomiasis. Blood samples were collected on filter paper from two groups of schoolchildren living in two different localities of the municipality of Itariri (São Paulo, Brazil) with different histories and prevalences of schistosomiasis. The parasitological and serological data were compared to those obtained for another group of schoolchildren from a non-endemic area for schistosomiasis. The results showed poor sensitivity of the parasitological method in detecting individuals with low worm burden and indicate the potential of the serological method as an important tool to be incorporated into schistosomiasis control and vigilance programs for determining the real situation of schistosomiasis in low endemic areas.

Detection of IgM antibodies to Schistosoma mansoni gut-associated antigens for the study of the dynamics of schistosomiasis transmission in an endemic area with low worm burden.

For a period of 2 years, five follow-up measures of prevalence and incidence rates were estimated in a prospective study of S. mansoni infection in a group of schoolchildren who were living in a rural area of the Municipality of Itariri (São Paulo, Brazil), where schistosomiasis is transmitted by Biomphalaria tenagophila. Infection was determined by the examination of three Kato-Katz stool slides, and the parasitological findings were analyzed in comparison to serological data. In the five surveys, carried out at 6-month intervals (March-April and September-October), the prevalences were, respectively, 8.6, 6.8, 9.9, 5.8 and 17.2% by the Kato-Katz, and 56.5, 52.6, 60.8, 53.5 and 70.1% by the immunofluorescence test (IFT). Geometric mean egg counts were low: 57.8, 33.0, 35.6, 47.3 and 40.9 eggs per gram of feces, respectively. Of the total of 299 schoolchildren, who submitted five blood samples at 6-month intervals, one for each survey, 40% were IFT-positive throughout the study, and 22% were IFT-negative in all five surveys. Seroconversion from IFT negative to positive, indicating newly acquired S. mansoni infection, was observed more frequently in surveys carried out during March-April (after Summer holidays), than during September-October. Seasonal trends were not statistically significant for detection of S. mansoni eggs in stool. The results indicate that the use of IgM-IFT is superior to parasitological methods for detection of incidence of S. mansoni infection in areas with low worm burden.

[Occurrence of Strongyloides stercoralis in patients with acquired immunodeficiency syndrome (AIDS)]. / Ocorrência de Strongyloides stercoralis em pacientes portadores da síndrome de imunodeficiência adquirida (AIDS).

A comparative study on the occurrence of Strongyloides stercoralis larvae in 554 patients with AIDS and in 142 patients suffering from infectious diseases other than AIDS was conducted during the period from January 1987 to December 1988. The two groups was constituted by male individuals in-patients at Emílio Ribas Hospital--São Paulo. Faeces samples from 696 patients were submitted to spontaneous sedimentation method and Rugai method. The data obtained from the present investigation demonstrated a similar prevalence of Strongyloides stercoralis in both groups (p > 0.05) indicating no significant statistical differences.