Country differences and determinants of yield in programmatic migrant TB screening in four European countries.

INTRODUCTION The WHO End TB Strategy emphasises early diagnosis and screening of TB in high-risk groups, including migrants. We analysed TB yield data from four large migrant TB screening programmes to inform TB policy.METHODS We pooled routinely collected individual TB screening episode data from Italy, the Netherlands, Sweden and the United Kingdom under the European Union Commission E-DETECT.TB grant, described characteristics of the screened population, and analysed TB case yield.RESULTS We collected data on 2,302,260 screening episodes among 2,107,016 migrants, mostly young adults aged 18-44 years (77.8%) from Asia (78%) and Africa (18%). There were 1,658 TB cases detected through screening, with substantial yield variation (per 100,000): 201.1 for Sweden (95% confidence intervals CI 111.4-362.7), 68.9 (95% CI 65.4-72.7) for the United Kingdom, 83.2 (95% CI 73.3-94.4) for the Netherlands and 653.6 (95% CI 445.4-958.2) in Italy. Most TB cases were notified among migrants from Asia (n = 1,206, 75/100,000) or Africa (n = 370, 76.4/100,000), and among asylum seekers (n = 174, 131.5/100,000), migrants to the Netherlands (n = 101, 61.9/100,000) and settlement visa migrants to the United Kingdom (n = 590, 120.3/100,000).CONCLUSIONS We found considerable variations in yield across programmes, types of migrants and country of origin. These variations may be partly explained by differences in migration patterns and programmatic characteristics.

Using Raman spectroscopy and an exponential equation approach to detect adulteration of olive oil with rapeseed and corn oil.

This study presents a method to determine adulteration of olive oil (obtained from Olea europea, i.e. olives) with rapeseed oil (obtained from Brassica napus) or with corn oil (also named maize oil, obtained from Zea mays, i.e. maize) using Raman spectroscopy and a mathematical method based on exponential equation fit. The samples were prepared by mixing olive oil with volume fractions (0-100%) of rapeseed or corn oil. The oils were differentiated spectroscopically using intensity ratio for specific Raman peaks; Raman spectroscopy is able to detect changes within a liquid molecular environment without the need for sample treatment. It was possible to determine rapeseed or corn oil volume fractions added into the olive oil using the method proposed. Thus, the potential of Raman spectroscopy as a technique for determining adulteration of olive oil was corroborated clearly, opening the potential to investigate adulteration of other liquid foods, without any need for sample preparation.

Avaliação clínica de ovinos após a ingestão de elevada quantidade de manga / Clinical evaluation of sheep after high ingestion of mango fruit

Objetivou-se avaliar clinicamente os efeitos da administração intrarruminal de duas quantidades distintas de manga em ovinos. Foram utilizados sete ovinos machos, hígidos, que não receberam carboidratos não fibrosos por, pelo menos, seis meses previamente ao período experimental, quando se avaliou pH ruminal, total de protozoários no suco de rúmen, pH urinário, pH sanguíneo estimado e parâmetros vitais nos tempos zero, 12, 16, 20 e 24 após a administração da manga. Os sete ovinos foram distribuídos aleatoriamente em dois grupos e receberam 0,625% ou 1,875% da MS de manga/kg/PV (M1 e M2, respectivamente), distribuídos em delineamento cross-over, com uma parcela perdida, e 30 dias de washout. Os ovinos M2 apresentaram valores médios para pH ruminal significativamente inferiores a M1 a partir do tempo T12 (5,1 e 6,9, respectivamente), o que indica ocorrência de acidose ruminal. Os animais tratados com M1 não apresentaram alterações sistêmicas, ao passo que os ovinos tratados com M2 apresentaram acidose metabólica leve, detectada por meio do pH urinário ácido (4,8). A ingestão apenas de manga in natura na quantidade de 1,875% da MS de manga/kg/PV mostrou-se capaz de provocar acidose ruminal em ovinos, levando-os a: ligeira depressão, aumento da frequência cardíaca, diminuição dos movimentos ruminais e diarreia em alguns casos.(AU)

The aim of this study is to clinically evaluate the effects of intra ruminal administration of two different amounts of mango in sheep. The sample was of seven male healthy sheep, which did not receive non-fibrous carbohydrates for at least six months prior to the trial. Rumen fluid pH, total of protozoa in the rumen fluid, urine pH, estimated blood pH, and vital parameters were evaluated at the following times: zero, 12, 16, 20 and 24 hours after administration of the mango. The seven sheep were randomly divided into two groups and received either 0.625% or 1.875% of the dry matter of the pulp and mango peel per kg body weight (M1 and M2, respectively), distributed in cross-over design with a lost portion and 30 days washout. Sheep treated with M2 showed significantly lower average values for ruminal pH than the M1 since T12 (5.1 and 6.9, respectively), indicating the occurrence of ruminal acidosis. The animals treated with M1 showed no systemic changes, while the sheep treated with M2 had mild metabolic acidosis, detected through the lower urinary pH (4.8). The in natura mango ingestion in the amount of 1.875% of the dry matter of mango per kg of body weight proved to provoke rumen acidosis in sheep, leading these animals to: slight depression, rise in heart rate, diminished rumen movement, and diarrhea in some cases.(AU)

Morfologia e dinâmica testicular em cutias (Dasyprocta prymnolopha) adultas / Testicular morphology and dynamic in adult agoutis (Dasyprocta prymnolopha)

Este trabalho objetivou apresentar a caracterização da morfologia do testículo de cutia (Dasyproctaprymnolopha) macho, com o intuito de colaborar com o conhecimento da morfofisiologia reprodutiva da espécie. Foram utilizados testículos de 47 animais, com idade entre um e dois anos, pesos homogêneos (2,08 ± 0,23kg), oriundos do Núcleo de Estudos e Preservação de Animais Silvestres do Centro de Ciências Agrárias da Universidade Federal do Piauí. As estruturas foram dissecadas, descritas, e fragmentos foram processados para a microscopia de luz, sendo, posteriormente avaliada a atividade gonadal. Observou-se que os testículos são órgãos elipsoides alongados, podendo ser encontrados na região inguinal ou na cavidade abdominal, não apresentando um escroto bem delimitado. Verificou-se também parênquima com característica histológica padrão para o órgão em mamíferos, com a identificação de oito tipos de associações celulares, caracterizando os estádios do ciclo do epitélio seminífero, com menor e maior frequência dos estádios 3 e 5, respectivamente.(AU)

This study meant to characterize the morphology of the testicle from (Dasyprocta prymnolopha) agouti males, in order to collaborate with the knowledge of reproductive morphophysiology of the specie. Testicles were used from 47 animals aged between 1 and 2 years, homogeneous weight (2.08±0.23kg), coming from the Centre for the Study and Conservation of Wild Animals of Agricultural Sciences Center of the Federal University of Piauí. The structures were dissected, described and fragments were processed for light microscopy, and, subsequently, gonadal activity was evaluated. Testes were observed to be elongated ellipsoidal bodies that can be found in the groin or in the abdominal cavity, not having a clearly defined scrotum. We also could see parenchymal with standard histological characteristic for the mammalian body, with the identification of eight types of cell associations, characterized epithelium Seminiferous stages of the cycle, with lower and higher frequency of stages 3 and 5, respectively.(AU)

Role of new Immunophenotypic Markers on Prognostic and Overall Survival of Acute Myeloid Leukemia: a Systematic Review and Meta-Analysis.

Despite technological advances, the prognosis and survival of acute myeloid leukemia (AML) adult patients remain low, compared with other hematologic malignancies. Some antigens detected by immunophenotyping may soon play a significant role in the pathophysiologic, prognostic, and overall survival (OS) rate of AML patients. Therefore, we conducted a systematic review and meta-analysis of PubMed, Scopus, Science Direct, Web of Science, and the Cochrane Library (using PRISMA guidelines). We analyzed 11 studies and 13 antigens, detected through the immunophenotyping of 639 patients. From them, twelve exhibited a negative impact with AML prognosis. The meta-analysis demonstrated a high expression of AML markers, which have been associated with a decrease in survival over 10 months (RR 2.55; IC 95%; 1.49-4.37) and over 20 months (RR 2.46; IC 95%; 1.75-3.45). Knowing that the expression of immunophenotypic markers, which are not used on a routine basis, might be able to influence disease behavior, looks promising. However, they have been associated with a poor prognosis as well as a decrease in survival. This may allow for different chemotherapeutical protocols, including future studies for new therapeutic targets.

Cinética ruminal de dietas contendo farelo de mamona destoxificado / Ruminal kinetics of diets containing detoxicated castor bean meal

The kinetics of gas production and in vitro ruminal degradation of diets contained replacement of soybean meal (SBM) by detoxicated castorbean meal (DCBM) (0, 15, 30 and 45% of substitution) were evaluated in this study. Values of gas production of non-fibrous carbohydrates (Vf1), fibrous carbohydrates (Vf2) and total carbohydrates (V) showed quadratic behavior, and by observation of equations can be obtained inclusions of 25% the V and Vf1 obtained maximum values of 174.7 and 237.8 ml gas / g DM, respectively. The potential degradability (PD) and effective degradability (ED) of dry matter showed quadratic behavior and by observation of equations can be perceive that up to 18.0% there was an increase in the values of PD and ED that obtained maximum values of 93.7% and 55.7%, respectively. The replacement of SBM by DCBM from 15 to 30% increased the kinetics of gas production and rumen degradation.(AU)

In vitro rumen fermentation kinetics of diets containing oldman saltbush hay and forage cactus, using a cattle inoculum / Cinética de fermentação ruminal in vitro de dietas contendo feno de erva-sal e palma forrageira, utilizando inóculo bovino

The aim of this experiment was to evaluate, by means of the semi-automated in vitro gas production technique, fermentation kinetics of carbohydrates and degradability of dry matter (DM) and organic matter (OM) of diets containing oldman saltbush hay levels (8.4; 18.8; 31.2 and 48.3%) associated to forage cactus in natura. Pressure readings of the gases were done with a pressure transducer at 2, 4, 6, 8, 10, 12, 17, 20, 24, 28, 34, 48, 72 and 96h post-inoculation. The rumen kinetics was described by the following parameters: maximum potential of gas production, lag time and production rates of gas (k), fibrous carbohydrates (FC) and non-fibrous carbohydrates (NFC). It could be observed that the addition of oldman saltbush hay to the diets promoted a quadratic effect in the production of gases originated from NFC. However, there was no significant effect on the production of gases originated from FC and on production rates of gases from NFC and FC. The degradability of DM and OM did not differ due to the addition of oldman saltbush hay. The use of 8.4% hay and 74.9% forage cactus promoted the maximum potential of production of gases from the fibrous fraction of diets containing cactus and oldman saltbush hay.

O objetivo deste experimento foi avaliar, por meio da técnica in vitro semiautomática de produção de gases, a cinética de fermentação dos carboidratos e a degradabilidade da matéria seca (MS) e da orgânica (MO) de dietas contendo níveis de feno de erva-sal (8,4; 18,8; 31,2 e 48,3%) associado à palma forrageira in natura. As leituras de pressão dos gases foram feitas com transdutor de pressão às 2, 4, 6, 8, 10, 12, 14, 17, 20, 24, 28, 34, 48, 72, 96 horas pós-inoculação. A cinética ruminal foi descrita pelos parâmetros: potencial máximo de produção de gases, "lag time" e taxa de produção de gases (k) dos carboidratos fibrosos (CF) e não fibrosos (CNF). Verificou-se que a adição de feno de erva-sal às dietas promoveu efeito quadrático na produção de gases provenientes dos CNF, em que o menor valor observado (136,48mL) foi encontrado com a adição de 38,25% de feno, e o maior valor, com a adição de 8,4% de feno e 74,9% de palma forrageira. O tempo de latência teve comportamento quadrático em função da adição de feno. No entanto não houve efeito significativo na produção de gases provenientes dos CF (média de 111,6mL) e nas taxas de produção de gases dos CNF e CF que apresentaram média de 0,090h-1 e 0,028h-1, respectivamente. A degradabilidade da MS e MO não diferiram em função da adição de feno de erva-sal e apresentaram médias de 85,8 e 90,9%, respectivamente. O uso de 8,4% de feno e 74,9 de palma forrageira propiciou o máximo potencial de produção de gases da fração fibrosa de dietas contendo palma e feno de erva-sal.

Fracionamento de carboidratos e proteínas de gramíneas tropicais cortadas em três idades / Carbohydrates and proteins fractions of tropical grasses cut at three ages

Avaliou-se o fracionamento dos carboidratos e das proteínas das gramíneas tropicais tifton 85 (Cynodon dactylon cv Tiffon 85), braquiária (Brachiaria brizantha cv Marandu) e tanzânia (Panicum maximum Jacq. cv Tanzânia), cortadas aos 28, 35 e 54 dias de idade. Determinaram-se os teores de matéria seca (MS), matéria orgânica (MO), proteína bruta (PB), extrato etéreo (EE), fibra em detergente neutro corrigida para cinzas e proteína (FDN CP), fibra em detergente ácido (FDA), lignina (LIG), nitrogênio insolúvel em detergente neutro (NIDN) e nitrogênio insolúvel em detergente ácido (NIDA). Para PB determinaram-se as frações A, B1+B2, B3 e C, e para os carboidratos as frações A+B1, B2 e C. Foi utilizado o delineamento inteiramente ao acaso, em arranjo em parcelas (gramíneas) subdivididas (idades de corte). Houve efeito significativo (P<0,05) da idade de corte sobre os teores de MS, FDN CP, NIDN e NIDA. Os teores de PB apresentaram declínio com o avanço da idade. O capim-marandu apresentou teores elevados para as frações A+B1 e B2 dos carboidratos (25,5 e 34,8 por cento dos carboidratos totais, respectivamente) e para as frações A e B1+B2 das proteínas (28,1 por cento aos 35 dias e 53,8 por cento da PB aos 28 dias, respectivamente).

The carbohydrates and proteins fractions of tropical grasses Tifton 85 (Cynodon dactylon cv Tifton 85), brachiaria (Brachiaria brizantha cv Marandu), and Tanzania (Panicum maximum Jacq. cv Tanzania) were evaluated at cut ages of 28, 35, and 54 days. Contents of dry matter (DM), organic matter (OM), crude protein (CP), ether extract (EE), fiber in neutral detergent corrected for ashes and protein (NDF CP), fiber in acid detergent (ADF), lignin (LIG), neutral detergent insoluble nitrogen (NDIN), and acid detergent insoluble nitrogen (ADIN) were determined. For CP, the A, B1+B2, B3, and C fractions were determined. For carbohydrates, the fractions A+B1, B2, and C were measured. A completely randomized split-plot design was used. Effect of cut age on DM, NDF CP, NDIN and ADIN was observed. The CP contents decreased with the progress of the age for the three grasses. The Marandu grass presented high percentage of the fractions A+B1 and B2 for the total carbohydrate (25.5 and 34.8 percent, respectively) and of the fractions A and B1+B2 for the proteins (28.1 percent CP at 35 days and 53.8 percent CP at 28 days, respectively).

Sistematização da assistência de enfermagem às mulheres mastectomizadas / Nursing care systematization for mastectomized women / Sistematización de la atención de enfermería a las mujeres mastectomizadas

A sistematização da assistência de enfermagem permite ao enfermeiro coordenar a assistência prestada, identificando as necessidades individuais do paciente. Foi objetivo utilizar a sistematização da assistência de enfermagem às mulheres mastectomizadas. Trata-se de estudo descritivo, realizado em uma instituição especializada em oncologia. Participaram dez mulheres cadastradas no grupo de apoio à mulher mastectomizada da instituição, com idade igual ou superior a 18 anos, em tratamento no período da pesquisa; e consciente ou apta a responder aos questionamentos. Para coleta dos dados foram utilizados entrevista e exame físico. Foram detectados cinco diagnósticos de enfermagem real, cinco de promoção da saúde, quatro de risco e três de bem-estar. A análise demonstrou que, após a mastectomia, as mulheres apresentam algumas limitações, mas enfrentam de maneira satisfatória a mudança corporal.

Nursing care systematization allows nurses to coordinate the delivery of care, by the identification of the individual patient needs. The aim of this study was to use the systematization of nursing care for women with mastectomies. This is a descriptive study developed at an institution specialized in oncology. A total of ten women enrolled in a support group for women with mastectomies of the institution, aged over 18 years, on treatment during the study; and conscious or able to respond to questions joined the study. It was used the interview and physical examination for data collection. Five real nursing diagnoses, five of health promotion, four of risk and three of well-being were detected. The analysis showed that after mastectomy women have some limitations, but they face body changes in a satisfactory way.

La sistematización de la asistencia de enfermería permite al enfermero coordinar la atención prestada, identificando las necesidades individuales del paciente. Fue objetivo utilizar la sistematización de la asistencia de enfermería a las mujeres mastectomizadas. Se trata de estudio descriptivo, realizado en una institución especializada en oncología. Participaron diez mujeres registradas en el grupo de apoyo a la mujer mastectomizada de la institución, con edad igual o superior a 18 años, en tratamiento en el periodo de la investigación; y consciente o apta a responder a los cuestionamientos. Para colecta de los datos fueron utilizados la entrevista y examen físico. Fueron detectados cinco diagnósticos de enfermería real, cinco de promoción de la salud, cuatro de riesgo y tres de bien estar. El análisis demostró que, después de la mastectomía, las mujeres presentan algunas limitaciones, pero enfrentan de manera satisfactoria la mudanza corporal.

Níveis de ureia em dietas contendo co-produto de vitivinícolas e palma forrageira para ovinos Santa Inês / Urea levels in diets containing dried grape byproduct and forage cactus for Santa Inês sheep

Avaliou-se o efeito da inclusão de níveis crescentes de ureia sobre o consumo e a digestibilidade aparente dos nutrientes de dietas contendo coproduto de vitivinícolas desidratado (CVD) e palma forrageira in natura. Foram utilizados 16 ovinos da raça Santa Inês machos, não castrados, com peso médio de 37kg e média de idade de 11 meses. As dietas continham 60 por cento de CVD e 40 por cento de palma forrageira, e níveis crescentes de ureia, 0, 1, 2 e 3 por cento, na matéria seca (MS). O delineamento experimental foi o inteiramente ao acaso, e o experimento foi desenvolvido em dois períodos, com 15 dias de adaptação e cinco dias de coleta cada. Os consumos da MS, fibra em detergente neutro (FDN), carboidratos não fibrosos (CNF) e nutrientes digestíveis totais (NDT) apresentaram comportamento quadrático com valores máximos de 2,04; 0,66; 0,74; 1,50kg/dia, respectivamente. No consumo de proteína bruta (PB), a cada acréscimo de uma unidade percentual de ureia ocorreu aumento de 20 gramas no consumo de PB. Os coeficientes de digestibilidade da MS, PB, FDN e CNF apresentaram comportamento quadrático com valores máximos de 62,5; 85,0; 81,0; e 97,8 por cento, respectivamente. A inclusão de ureia até 2 por cento nas dietas contendo coproduto de vitivinícolas desidratado e palma forrageira in natura possibilitou incrementos no consumo e no coeficiente de digestibilidade dos nutrientes.

The effect of urea levels on intake and apparent digestibility of nutrients in diets containing dried wine grape byproduct and fresh forage cactus was evaluated. Sixteen male, non-castrated, Santa Inês sheep, averaging 37kg and 11-month-old were used. The diets had 60 percent of dried grape byproduct (DGB) and 40 percent of forage cactus, and increasing levels of urea - 0, 1, 2, and 3 percent in dry matter. Completely randomized designs with two periods with 15 adjust days and five days for samples collection was carried out. Dry matter (DM), neuter detergent fiber (NDF), non-fibrous carbohydrates (NFC), and total digestive nutrients (TDN) intakes presented quadratic behavior with maximum values of 2.04; 0.66; 0.74; and 1.50kg/day, respectively. For each increase of an unit percentage of urea an increase of 20 grams in the CP intake occurred. The digestibility coefficients of DM, CP, NDF, and NFC presented quadratic behavior with maximum values of 62.5, 85.0, 81.0, and 97.8 percent, respectively. The inclusion of urea up to 2 percent in the diets containing dried grape byproduct and fresh forage cactus made possible increases in nutrient intake and coefficient of digestibility of nutrients.

Hospital strain colonization by Staphylococcus epidermidis.

The skin and mucous membranes of healthy subjects are colonized by strains of Staphylococcus epidermidis showing a high diversity of genomic DNA polymorphisms. Prolonged hospitalization and the use of invasive procedures promote changes in the microbiota with subsequent colonization by hospital strains. We report here a patient with prolonged hospitalization due to chronic pancreatitis who was treated with multiple antibiotics, invasive procedures and abdominal surgery. We studied the dynamics of skin colonization by S. epidermidis leading to the development of catheter-related infections and compared the genotypic profile of clinical and microbiota strains by pulsed field gel electrophoresis. During hospitalization, the normal S. epidermidis skin microbiota exhibiting a polymorphic genomic DNA profile was replaced with a hospital-acquired biofilm-producer S. epidermidis strain that subsequently caused repetitive catheter-related infections.

Hospital strain colonization by Staphylococcus epidermidis

The skin and mucous membranes of healthy subjects are colonized by strains of Staphylococcus epidermidis showing a high diversity of genomic DNA polymorphisms. Prolonged hospitalization and the use of invasive procedures promote changes in the microbiota with subsequent colonization by hospital strains. We report here a patient with prolonged hospitalization due to chronic pancreatitis who was treated with multiple antibiotics, invasive procedures and abdominal surgery. We studied the dynamics of skin colonization by S. epidermidis leading to the development of catheter-related infections and compared the genotypic profile of clinical and microbiota strains by pulsed field gel electrophoresis. During hospitalization, the normal S. epidermidis skin microbiota exhibiting a polymorphic genomic DNA profile was replaced with a hospital-acquired biofilm-producer S. epidermidis strain that subsequently caused repetitive catheter-related infections.

Antivenom action on renal effects induced by Thalassophryne nattereri venom

Thalassophryne nattereri (niquim) is a venomous fish responsible for numerous accidents involving fishermen in northern and northeastern Brazil. The aim of the present investigation was to evaluate the action of antivenom on renal effects caused by Thalassophryne nattereri venom. Isolated kidneys of Wistar rats were perfused with a previously dialyzed Krebs-Henseleit solution containing 6 g% bovine serum albumin. The antivenom action was studied through perfusion pressure (PP), renal vascular resistance (RVR), urinary flow (UF) and glomerular filtration rate (GFR). The niquim venom (1 miug/mL), the antivenom alone (1 miug/mL) or the venom incubated with antivenom were added to the system 30 minutes after the beginning of each perfusion. Previous works have shown venom induced-alterations of renal function parameters. In the isolated rat Kidney, T. nattereri venom (1 miug/mL) increased the perfusion pressure and renal vascular resistance at 60, 90 and 120 minutes. UF and GFR also increased at 60, 90 and 120 minutes when compared with the control group; however, no effects were observed on the percent of sodium (% TNa more control equal 81.1 more or less 0.86; % TNa more 60 equal 78.04 more or less 1.18; % TNa more 90 equal -5.16 more or less 3.34; %TNa more 120 equal 79.49 more or less 0.87) and potassium (%TKcontrol equal 72.29 more or less 1.12; %TK more 60 equal 75.41 more or less 0.65; % TK more 90 equal 71.23 more or less 2.55; % TK more 120 equal 76.62 more or less 1.04) tubular transporto. The administration of the antivenom (1 miug/mL) incubated with venom (1 miug/mL) reduced the changes in PP, RVR, UF and GFR provoked by Thalassophryne nattereri venom. The group perfused with venom alone showed a moderate deposit of a proteinaceous material in the tubules and urinary space.(...)

Avaliação toxicológica do extrato acetato de etila de Spigelia anthelmia Linn, em ratos e camundongos / Toxicological evaluation of an ethyl acetate extract of Spigelia anthelmia Linn in rats and mice

O extrato acetato de etila de Spigelia anthelmia (EASa) mostrou formalmente ser altamente eficaz contra o desenvolvimento larvar e a eclosão de ovos de Haemonchus contorlus, um importante parasito de ruminantes, in vitro. A OL, e a OL,o de EASa foram administradas subcrônica e cronicamente pela via oral em ratos wistar e o perfil bioquímico foi comparado antes e após cada tratamento e com veículo. Vários órgãos foram coletados e processados para análise histopatológica. Os parâmetros hematológicos foram avaliados antes e depois da administração de EASa durante 30 dias. E os efeitos do EASa administrado pela via oral durante o período embriogênico ou organogênico a camundongas gestantes foram estudados. Os efeitos diretos de EASa, in vivo, foram calculados na pressão sangüínea arterial média e no eletrocardiograma (ECG), e in vitro no coração isolado e no átrio isolado de ratos. A administração de EASa não afetou qualquer parâmetro bioquímico, hematológico ou reprodutivo estudado. EASa induziu um efeito hipotensivo de curto prazo em ratos normotensivos sem qualquer alteração concomitante nos parâmetros do ECG. As maiores doses de EASa induziram uma significante diminuição da amplitude de contração do coração e átrio direito. EASa é desprovido de toxicidade significante e tem leves efeitos no sistema cardiovascular(

[Treatment results and complications after PFN osteosynthesis]. / Behandlungsergebnisse und Komplikationen nach PFN-Osteosynthese.

UNLABELLED: Intramedullary implants, such as the proximal femur nails (PFN), are inserted for the treatment of per-, inter- and subtrochanteric fractures. The initial experiences with these PFN, carried out by AO/ASIF in 1996, have been published. PATIENTS AND METHODS: This study makes a systematic examination of the complications and clinical treatment results from 133 patients treated at our clinic from December 1997-2001 with 139 PFN in per-, inter- and subtrochanteric femur fractures. The mean age at the time of surgery was 78.4 years. All fractures were classified according to the AO system. The most frequent injuries were 31 A2.3 fractures (61.2%). All intraoperative image-converter images and all radiographs from the total period of treatment were evaluated retrospectively in accordance with 28 criteria. The degree of osteoporosis was estimated using the Singh classification. RESULTS: A total of 44 (31.7%) complications arose in 31 (23.3%) patients. On 11 occasions, hip screw cut-out was observed. Of these, two cases involved a Z-effect and one an inverted Z-effect. Two patients suffered a femoral neck fracture following removal of the hip screws. There were 38 (27.3%) reoperations required with 13 changes in procedure. In autumn 2002, clinical follow-up examinations were carried out on 65 (48.9%) patients who were assessed according to the Merle d'Aubigné score. A total of 51 (38.3%) patients had died at the time of follow-up. Normal ambulation was achieved by 33.8% of patients, while 64.6% were free of pain. CONCLUSIONS: The PFN is an appropriate implant in cases of per-, inter- and subtrochanteric femur fractures. Anatomical resetting and correct implant positioning are the keys to successful osteosynthesis. The risk of implant failure is highest in the case of multi-fragmentary per- and intertrochanteric fractures in which medial strengthening has been degraded in patients aged over 80 years. The clinical results in elderly patients are unsatisfactory.

Avaliação toxicológica do extrato acetato de etila de Spigelia anthelmia Linn, em ratos e camundongos

O extrato acetato de etila de Spigelia anthelmia (EASa) mostrou formalmente ser altamente eficaz contra o desenvolvimentolarvar e a eclosão de ovos de Haemonchus contortus, um importante parasito de ruminantes, in vitro. A DL1 e a DL10 de EASaforam administradas subcrônica e cronicamente pela via oral em ratos wistar e o perfil bioquímico foi comparado antes e apóscada tratamento e com veículo. Vários órgãos foram coletados e processados para análise histopatológica. Os parâmetroshematológicos foram avaliados antes e depois da administração de EASa durante 30 dias. E os efeitos do EASa administradopela via oral durante o período embriogênico ou organogênico a camundongas gestantes foram estudados. Os efeitos diretosde EASa, in vivo, foram calculados na pressão sangüínea arterial média e no eletrocardiograma (ECG), e in vitro no coraçãoisolado e no átrio isolado de ratos. A administração de EASa não afetou qualquer parâmetro bioquímico, hematológico oureprodutivo estudado. EASa induziu um efeito hipotensivo de curto prazo em ratos normotensivos sem qualquer alteraçãoconcomitante nos parâmetros do ECG. As maiores doses de EASa induziram uma significante diminuição da amplitude decontração do coração e átrio direito. EASa é desprovido de toxicidade significante e tem leves efeitos no sistema cardiovascular.

Clonal dissemination of VanA-type glycopeptide-resistant Enterococcus faecalis between hospitals of two cities located 100 km apart

Nosocomial dissemination of glycopeptide-resistant enterococci represents a major problem in hospitals worldwide. In Brazil, the dissemination among hospitals in the city of São Paulo of polyclonal DNA profiles was previously described for vancomycin-resistant Enterococcus faecium. We describe here the dissemination of VanA phenotype E. faecalis between two hospitals located in different cities in the State of São Paulo. The index outbreak occurred in a tertiary care university hospital (HCUSP) in the city of São Paulo and three years later a cluster caused by the same strain was recognized in two patients hospitalized in a private tertiary care hospital (CMC) located 100 km away in the interior of the state. From May to July 1999, 10 strains of vancomycin-resistant E. faecalis were isolated from 10 patients hospitalized in the HCUSP. The DNA genotyping using pulsed-field gel electrophoresis (PFGE) showed that all isolates were originated from the same clone, suggesting nosocomial dissemination. From May to July 2002, three strains of vancomycin-resistant E. faecalis were isolated from two patients hospitalized in CMC and both patients were colonized by the vancomycin-resistant Enterococcus in skin lesions. All isolates from CMC and HCUSP were highly resistant to vancomycin and teicoplanin. The three strains from CMC had minimum inhibitory concentration >256 æg/ml for vancomycin, and 64 (CMC 1 and CMC 2) and 96 æg/ml (CMC 3) for teicoplanin, characterizing a profile of VanA resistance to glycopeptides. All strains had the presence of the transposon Tn1546 detected by PCR and were closely related when typed by PFGE. The dissemination of the E. faecalis VanA phenotype among hospitals located in different cities is of great concern because E. faecalis commonly colonizes the gastrointestinal tract of patients and healthy persons for periods varying from weeks to years, which, together with the persistence of vancomycin-resistant Enterococcus in hospital rooms after standard cleaning procedures, increases the risk of the dissemination and reservoir of the bacteria.

Avaliação toxicológica do extrato acetato de etila de Spigelia anthelmia Linn, em ratos e camundongos

O extrato acetato de etila de Spigelia anthelmia (EASa) mostrou formalmente ser altamente eficaz contra o desenvolvimentolarvar e a eclosão de ovos de Haemonchus contortus, um importante parasito de ruminantes, in vitro. A DL1 e a DL10 de EASaforam administradas subcrônica e cronicamente pela via oral em ratos wistar e o perfil bioquímico foi comparado antes e apóscada tratamento e com veículo. Vários órgãos foram coletados e processados para análise histopatológica. Os parâmetroshematológicos foram avaliados antes e depois da administração de EASa durante 30 dias. E os efeitos do EASa administradopela via oral durante o período embriogênico ou organogênico a camundongas gestantes foram estudados. Os efeitos diretosde EASa, in vivo, foram calculados na pressão sangüínea arterial média e no eletrocardiograma (ECG), e in vitro no coraçãoisolado e no átrio isolado de ratos. A administração de EASa não afetou qualquer parâmetro bioquímico, hematológico oureprodutivo estudado. EASa induziu um efeito hipotensivo de curto prazo em ratos normotensivos sem qualquer alteraçãoconcomitante nos parâmetros do ECG. As maiores doses de EASa induziram uma significante diminuição da amplitude decontração do coração e átrio direito. EASa é desprovido de toxicidade significante e tem leves efeitos no sistema cardiovascular.

A phase I dose-finding study of combined treatment with an antisense Bcl-2 oligonucleotide (Genasense) and mitoxantrone in patients with metastatic hormone-refractory prostate cancer.

PURPOSE: Bcl-2 is a negative prognostic indicator in prostate cancer, implicated in the development of androgen independence and treatment resistance, and is overexpressed in hormone-refractory prostate cancer (HRPC). Genasense is a phosphorothioate antisense oligonucleotide complementary to the bcl-2 mRNA open reading frame that in preclinical studies has shown significant activity in inhibiting expression of Bcl-2, delaying androgen independence, and improving chemosensitivity in prostate and other cancer models. In this dose escalation study, we evaluated the combination of Genasense and mitoxantrone, a standard chemotherapy for patients with HRPC. DESIGN: Twenty-six patients with HRPC were treated at seven dose levels receiving Genasense at a dose ranging from 0.6 to 5.0 mg/kg/day and mitoxantrone from 4 mg/m(2) to 12 mg/m(2). Genasense was administered as a 14-day i.v. continuous infusion every 28 days with mitoxantrone given as an i.v. bolus on day 8. RESULTS: No dose-limiting toxicities were observed. Hematological toxicities were transient and included neutropenia, thrombocytopenia, and lymphopenia. Nonhematological toxicities included fatigue, fever, nausea, arthralgias, myalgias, and transient elevations in serum creatinine, none of which were severe. Two patients had >50% reductions in prostate-specific antigen. One patient, who received six cycles of Genasense at 1.2 mg/kg/day and a low dose (4 mg/m(2)) of mitoxantrone, also had symptomatic improvement in bone pain. Peripheral blood lymphocyte Bcl-2 protein expression decreased in five of five patients given Genasense at 5mg/kg/day (mean change from baseline, -12.8%; SD, 16.4%) as assessed by flow cytometry. Serum concentrations of Genasense given at doses of 3 mg/kg/day and greater, exceeded 1 microg/ml. CONCLUSIONS: Genasense and mitoxantrone are well tolerated in combination, and mitoxantrone can be delivered at a standard dose with biologically active doses of Genasense without significant additional toxicity. This observation allays concerns about trials that combine Genasense with full doses of other cytotoxic agents seeking greater evidence of activity.