Association between albuminuria, glomerular filtration rate and mortality or recurrence in stroke patients.

BACKGROUND/AIMS: In an attempt to find new predictors of stroke prognosis, we evaluated the association of albuminuria (AUr) and the estimated glomerular filtration rate (eGFR) with the recurrence of stroke and mortality. METHODS: We evaluated and followed for at least 7 months patients with first-ever stroke or transient ischemic attack admitted to a prospective cohort from March 2005 to December 2007. We analyzed traditional CV risk factors, albumin-to-creatinine ratio and eGFR (ml/min/1.73 m(2)) as predictors of mortality or recurrence. RESULTS: From a total of 185 patients included [57% (104/185) men, 64 ± 13 years], 38 patients suffered from a recurrent stroke or died, with a mean follow-up of 25.1 ± 8.7 months. AUr (≥30 mg/g) was found in 50.2% (93/185), and 38.9% (72/185) presented an eGFR <60. In univariate analysis, age >65 years, eGFR ≤50, atrial fibrillation (AF), no alcohol intake and AUr >17 mg/g were associated with the composite endpoint. In a multivariate analysis, AF and AUr >17 mg/g were independent predictors of the composite endpoints, but eGFR ≤50 was not. CONCLUSION: The presence of AUr >17 mg/g is independently associated with death or recurrence after stroke. Further studies should consider the AUr as a predictor for a worse prognosis in these patients.

Detection of bacterial DNA in acute and chronic cholecystitis.

BACKGROUND: The incidence of bacterbilia in cholelithiasis remains controversial. The positivity of cultures ranges from 0 to 73 per cent. The aim of this study was to employ the polymerase chain reaction (PCR) to detect bacterial DNA in gallbladder bile extracted during elective laparoscopic cholecystectomy, and to compare PCR findings with those of bile culture. METHODS: Bile samples from 84 laparoscopic cholecystectomies were collected for culture and PCR analysis. RESULTS: Positive results for bacterbilia were found in 42 (50 per cent) of 84 patients by PCR but in only 16 patients (19 per cent) by culture (P < 0.001). Agreement between the two methods was seen in 44 samples (52 per cent), which were negative in 35 cases. Pathological examination showed chronic cholecystitis in 69 cases (82 per cent) and acute cholecystitis in 15 (18 per cent). Thirty-three (48 per cent) of the patients with chronic cholecystitis were PCR positive but only ten (14 per cent) were culture positive (P < 0.001). Only culture results correlated with findings on pathological examination (P = 0.033). CONCLUSION: PCR is more sensitive in detecting bacterial contamination of gallbladder bile in cholecystitis than conventional culture. The clinical relevance of this high sensitivity remains unclear.

Incidence of stroke subtypes, prognosis and prevalence of risk factors in Joinville, Brazil: a 2 year community based study.

BACKGROUND: There have been few population based studies on stroke risk factors and prognosis conducted in Brazil. The objective of this study was to evaluate, over a 2 year period, the incidence of the subtypes of first ever stroke, the prevalence of cardiovascular risk factors and functional prognosis in a city located in the south of Brazil. METHODS: The period from January 2005 to December 2006 was evaluated prospectively by compiling data on first ever stroke cases, medications used prior to the morbidity and the incidence of traditional risk factors. The annual incidence was adjusted for age using the direct method. Patients were monitored for at least 6 months following the event. RESULTS: Of 1323 stroke cases, 759 were first ever stroke cases. Of these, 610 were classified as infarctions, 94 as intracerebral haemorrhage and 55 as subarachnoid haemorrhage. The crude incidence rate per 100 000 inhabitants was 61.8 for infarction (95% CI 57.0 to 66.9), 9.5 for intracerebral haemorrhage (95% CI 7.7 to 11.6) and 5.6 for subarachnoid haemorrhage (95% CI 4.2 to 7.3). The 30 day case fatality was 19.1%. The most prevalent cardiovascular risk factor was arterial hypertension. By post-stroke month 6, 25% had died (95% CI 21.4 to 29.1) whereas 61.5% had regained their independence (95% CI 56.2 to 68.3). CONCLUSIONS: Case fatality rate, prognosis and incidence adjusted for stroke subtypes were similar to those found in other population based studies. The prevalence rates of ischaemic heart disease, dyslipidaemia, arterial hypertension and diabetes suggest that Joinville presents a mixed pattern of cardiovascular risk, a pattern seen in developed and developing countries alike.

Inibição e inativação in vitro de Salmonella spp. com extratos de plantas com indicativo etnográfico medicinal ou condimentar / In vitro inhibition and inactivation activity of Salmonella spp. by plant extracts with spicy or medicinal ethnographic indicative

Determinou-se in vitro a intensidade de atividade de inibição bacteriana e a intensidade de atividade de inativação bacteriana, por meio de testes de diluição e suspensão em sistema de tubos múltiplos, de diferentes extratos, aquosos ou alcoólicos/hidroalcoólicos, de 86 plantas com indicativo etnográfico medicinal ou condimentar acessadas na região metropolitana de Porto Alegre, Rio Grande do Sul, frente a Salmonella spp., ou S. enteritidis ATCC nº 13076, ou S. cholera-suis ATCC nº10708, ou S. gallinarum CPVDF-SAA/RS/BR, em doses-desafio de <10(7)UFC.mL-1. Cinquenta plantas apresentaram alguma atividade seletiva antissalmonela, e 37 nenhuma atividade. Discute-se a validade da ferramenta etnográfica na prospecção de fatores de proteção antibacteriana em plantas, bem como a influência da inibição/inativação na preditividade do diagnóstico bacteriológico.

The in vitro intensity of bacterial inhibition activity of diverse extracts (aquous, alcoholic, or hydroalcoholic) from 86 plants with medicinal and spicy ethnographic indicative, from Porto Alegre City, Rio Grande do Sul State, Brazil, were determinated in Salmonella spp. (S. enteritidis ATCC n.13076, S. cholera-suis ATCC n. 10708, or S. gallinarum CPVDF-SAA/RS/BR) in challenge dose <10(7)CFU.mL-1. Extracts of fifty plants presented some anti-Salmonella selective activity, while the other 36 extracts presented no activity. It is discussed the validity of ethnographic search instruments in the prospection of anti-bacterial protection factors in plants, as well the influence of inhibition/inactivation results in the predictivity of bacteriological diagnostic.

Inibição e inativação in vitro de Salmonella spp. com extratos de plantas com indicativo etnográfico medicinal ou condimentar / In vitro inhibition and inactivation activity of Salmonella spp. by plant extracts with spicy or medicinal ethnographic indicative

Determinou-se in vitro a intensidade de atividade de inibição bacteriana e a intensidade de atividade de inativação bacteriana, por meio de testes de diluição e suspensão em sistema de tubos múltiplos, de diferentes extratos, aquosos ou alcoólicos/hidroalcoólicos, de 86 plantas com indicativo etnográfico medicinal ou condimentar acessadas na região metropolitana de Porto Alegre, Rio Grande do Sul, frente a Salmonella spp., ou S. enteritidis ATCC nº 13076, ou S. cholera-suis ATCC nº10708, ou S. gallinarum CPVDF-SAA/RS/BR, em doses-desafio de <10(7)UFC.mL-1. Cinquenta plantas apresentaram alguma atividade seletiva antissalmonela, e 37 nenhuma atividade. Discute-se a validade da ferramenta etnográfica na prospecção de fatores de proteção antibacteriana em plantas, bem como a influência da inibição/inativação na preditividade do diagnóstico bacteriológico.(AU)

The in vitro intensity of bacterial inhibition activity of diverse extracts (aquous, alcoholic, or hydroalcoholic) from 86 plants with medicinal and spicy ethnographic indicative, from Porto Alegre City, Rio Grande do Sul State, Brazil, were determinated in Salmonella spp. (S. enteritidis ATCC n.13076, S. cholera-suis ATCC n. 10708, or S. gallinarum CPVDF-SAA/RS/BR) in challenge dose <10(7)CFU.mL-1. Extracts of fifty plants presented some anti-Salmonella selective activity, while the other 36 extracts presented no activity. It is discussed the validity of ethnographic search instruments in the prospection of anti-bacterial protection factors in plants, as well the influence of inhibition/inactivation results in the predictivity of bacteriological diagnostic.(AU)

Trends in stroke incidence, mortality and case fatality rates in Joinville, Brazil: 1995-2006.

BACKGROUND: Studying stroke rates in a whole community is a rational way to assess the quality of patient care and primary prevention. However, there are few studies of trends in stroke rates worldwide and none in Brazil. OBJECTIVE: Established study methods were used to define the rates for first ever stroke in a defined population in Brazil compared with similar data obtained and published in 1995. METHODS: All stroke cases occurring in the city of Joinville during 2005-2006 were prospectively ascertained. Crude incidence and mortality rates were determined, and age adjusted rates and 30 day case fatality were calculated and compared with the 1995 data. RESULTS: Of the 1323 stroke cases registered, 759 were first ever strokes. The incidence rate per 100 000 was 105.4 (95% CI 98.0 to 113.2), mortality rate was 23.9 (95% CI 20.4 to 27.8) and the 30 day case fatality was 19.1%. Compared with the 1995 data, we found that the incidence had decreased by 27%, mortality decreased by 37% and the 30 day case fatality decreased by 28%. CONCLUSIONS: Using defined criteria we showed that in an industrial southern Brazilian city, stroke rates are similar to those from developed countries. A significant decrease in stroke rates over the past decade was also found, suggesting an improvement in primary prevention and inpatient care of stroke patients in Joinville.

Atividade anti-estafilócica em extratos de plantas com indicativo medicinal ou condimentar / Anti-staphylococci activity in extracts from plants presenting medicinal and spice indicative

O gênero Staphylococcus permanece em evidência no contexto das doenças transmissíveis considerando-se os portadores humanos e animais como a sua principal fonte de infecção. Por sua vez, a pesquisa de fatores de proteção antibacteriana em recursos naturais como plantas com indicativo medicinal ou condimentar vem sendo recomendado como prioridade pelas Conferências Mundiais de Saúde. A presente revisão descreve a triagem in vitro, através de testes de diluição em sistema de tubos múltiplos, de atividade anti-estafilococo de diferentes extratos de 80 plantas com indicativo etnográfico medicinal, condimentar ou aromático, acessadas na região metropolitana de Porto Alegre, RS. Demonstrou-se atividade seletiva em 39 espécies, enquanto as demais 41 não apresentaram atividade.

The genus Staphylococcus remains in evidence regarding transmissible diseases since human and animal carriers are its main infection source. Studies on antibacterial protection factors in natural resources, such as plants presenting medicinal or spice indicative, have been recommended by World Health Conferences as a priority. Dilution tests in multiple tube system were used in this review to describe the in vitro sorting of anti-staphylococci activity of different extracts from 80 plants presenting medicinal, spice or aromatic ethnographic indicatives at the metropolitan region of Porto Alegre, Rio Grande do Sul State, Brazil. Selective activity was observed for 39 species, whereas the remaining 41 species did not show activity.

Características cinemáticas, cinéticas e eletromiográficas do andar de adultos jovens com e sem suporte parcial de peso corporal / Kinematic, kinetic and electromyographic characteristics of young adults walking with and without partial body weight support

OBJETIVO: O objetivo deste estudo foi analisar as características cinemáticas, cinéticas e eletromiográficas do andar de adultos jovens em piso fixo sem colete e com suporte parcial de peso (SPP) de 0, 10, 20 e 30 por cento do peso corporal. MÉTODO: Oito jovens com idade média de 22,2 anos foram filmados andando sobre uma passarela que continha uma plataforma de força na região central para registro das componentes da força de reação do solo. Marcadores refletivos foram posicionados nos principais pontos anatômicos dos membros inferiores para registro dos dados cinemáticos, e eletrodos de superfície foram afixados nos músculos tibial anterior e gastrocnêmio medial para registro da atividade elétrica muscular. RESULTADOS: Diferenças significantes entre as cinco condições experimentais foram constatadas nas variáveis espaço-temporal, nos ângulos máximos e mínimos da coxa, joelho e tornozelo e nas amplitudes das componentes horizontal ântero-posterior e vertical da força de reação do solo. De forma geral, as maiores mudanças ocorreram na condição de SPP de 30 por cento do peso corporal. CONCLUSÃO: É importante considerar as compensações que ocorrem no padrão do andar com SPP no planejamento das intervenções terapêuticas. Ainda, para melhor definir a utilização dos sistemas de suspensão de peso na reabilitação, estudos futuros precisam ser realizados para verificar o comportamento do andar em populações com alteração de movimento em piso fixo.

OBJECTIVE: The aim of this study was to analyze the kinematic, kinetic and electromyographic characteristics of young adults walking on a fixed platform without a vest and with partial body weight support (PBWS) of 0, 10, 20 and 30 percent. METHOD: Eight young adults (mean age: 22.2 years) were videotaped walking on a walkway that contained a force plate embedded in its middle portion, to record the ground reaction force (GRF) components. Reflective markers were placed on the main anatomical points of the lower limbs in order to acquire kinematic data, and surface electrodes were attached to the tibialis anterior and gastrocnemius medialis muscles in order to record electromyographic muscle activity. RESULTS: Significant differences among the five experimental conditions were observed with regard to spatial-temporal variables, the maximum and minimum angles for the thigh, knee, and ankle, and the amplitudes of the anteroposterior horizontal and vertical GRF components. Generally, the greatest changes occurred with PBWS of 30 percent. CONCLUSION: It is important to take into consideration the compensations to walking patterns that occur with PBWS, in planning therapeutic interventions. Moreover, to better define the use of suspended weight systems in rehabilitation programs, further investigations should be conducted in order to verify the walking patterns on fixed platforms among populations with movement disorders.

Splenic haemangioma and Kasabach-Merritt Syndrome as differential diagnosis for abdominal mass in a newborn: case report

Apresentamos um caso raro de hemangioma esplênico em um recém-nascido do sexo feminino, apresentando-se como massa abdominal, coagulopatia e trombocitopenia. No ato operatório observou-se uma massa tumoral vascular do pólo inferior do baço. A paciente encontra-se em acompanhamento ambulatorial. O diagnóstico e as opções de tratamento foram revistas e discutidas. Os autores revisaram a literatura sobre hemangioma esplênico em recém-nascidos e observaram ser este o terceiro caso de associação entre hemangioma esplênico e Síndrome de Kasabach-Merritt. O hemangioma esplênico é uma doença rara no diagnóstico diferencial das massas abdominais em recém-nascidos. O hemangioma é a neoplasia benigna mais freqüente do baço. A anemia, a trombocitopenia e a coagulopatia são vistos com freqüência em hemangiomas cavernosos grandes associados à Síndrome de Kasabach-Merritt (KMS). O hemangioma cavernoso esplênico associado com esta síndrome é extremamente raro.

Hydroxymethylation and oxidation of Organosolv lignins and utilization of the products.

Organosolv lignins obtained from Eucalyptus grandis, sugarcane bagasse and Picea abies by Acetosolv, Formacell and Organocell processes were characterized, fractionated and converted to hydroxymethylated and oxidized products. The reactivity of lignins with formaldehyde did not improve significantly with the fractionation. Both eucalyptus Acetosolv (EAc) and eucalyptus Formacell (EFo) lignins retained high heterogeneity in relation to the molecular weight distribution but not in relation to structural units. The temperatures of the exothermic peaks and the apparent activation energies for the cross-linking are different for hydroxymethylated lignins and phenol, with similar cure temperatures of the resols. Chemical oxidation using cobalt(II) and manganese(II) salts furnished oxidized lignins with improved chelating properties. These chelating agents can remove up to 14% of Mn present in pulps, decreasing the peroxide consumption in the bleaching process. The products obtained can be also used as oxidized phenols and controlled-release matrices. Oxidation of Acetosolv bagasse lignin with polyphenol oxidase furnishes lignins with chelating capacity 110% higher than that of original lignin.

Mathematical modeling of controlled-release kinetics of herbicides in a dynamic-water-bath system.

Release of herbicides from lignin-based formulations follows a diffusion-controlled mechanism. For mathematical modeling of diffusive transport, the conventional approach is to assume sink conditions at both surfaces of polymeric matrix. This boundary condition proved to be inadequate to describe experimental data obtained in a water dynamic bath system. However, satisfactory descriptions for this system were obtained when a stagnant unstirred layer of herbicide solution was used as the boundary condition. The adequacy of the model incorporating this new boundary condition was statistically tested using the Fisher test at a confidence level of 95% and plotting the residual distribution.

Bleachability and characterization by Fourier transform infrared principal component analysis of Acetosolv pulps obtained from sugarcane bagasse.

Sugarcane bagasse Acetosolv pulps were bleached by xylanase and the pulps classified by using Fourier transform infrared (FTIR) spectroscopy and principal component analysis (PCA). Pulp was treated with xylanase for 4-8 hwith stirring at 30 degrees C. Some samples were further extracted with NaOH for 1 h at 65 degrees C. FTIR spectra were recorded directly from the dried pulp samples by using the diffuse reflectance technique. Reduction in kappa number of 69% was obtained after sequence xylanase (4 h)-alkaline extraction. During bleaching the viscosity decreased only 12%. FTIR-PCA showed that the first three principal components (PCs) explained more than 90% of the total variance of the pulp spectra. PC2 x PC1 plot showed that the points related to pulps from sequence xylanase (4 h)-alkaline extraction are different from the other. This group is enlarged by plotting PC3 x PC1 or PC3x PC2 containing all pulps submitted to alkaline extraction. PC2 and PC3 are the principal factor for differentiation of the pulps. These PCs suffer influence of the ester bands (1740 and 1244 cm(-1)). On the other hand, the pulps bleached only with xylanase could not be differentiated from the nonbleached pulps.

Mathematical modeling of controlled-release systems of herbicides using lignins as matrices. A review.

The herbicides applied in soils can be easily lost, owing to leaching, volatilization, and bio- and photodegradation. Controlled-release systems using polymeric matrices claim to solve these problems. The movement of the herbicides in the soil is also an important phenomenon to be studied in order to evaluate the loss processes. The development of mathematical models is a relevant requirement for simulation and optimization of such systems. This study reviews mathematical models as an initial step for modeling data obtained for controlled-release systems of herbicides (diuron, 2,4-dichlorophenoxyacetic acid, and ametryn) using sugarcane bagasse lignin as a polymeric matrix. The release kinetic studies were carried out using several acceptor systems including a water bath, soil, and soil-packed columns. Generally, these models take into account phenomena such as unsteady-state mass transfer by diffusion (Fick's law) and convection, consumption by several processes, and partitioning processes, resulting in partial differential equations with respect to time and space variables.

Artrite infecciosa por Candida albicans. Primeiro relato no Brasil. / Infectious arthritis caused by Candida albicans. First report in Brazil

Os autores relatam o primeiro caso brasileiro de artrite infecciosa por Candida albicans. E apresentado um paciente em cetoacidose diabetica que, a partir de um foco infeccioso geniturinario, evolui com disseminacao hematogenica com comprometimento articular secundario. Sao comentados a infrequencia deste agente etiologico aspectos fisiopatogenicos, clinicos, laboratoriais e terapeuticos