Polyvinylidene fluoride - Hydroxyapatite 0-3 biocomposite filaments processed by twin-screw extrusion.

Polyvinylidene fluoride - hydroxyapatite composite filaments were processed by twin-screw extrusion at different processing angular velocities and characterized by scanning electron and atomic force microscopies, differential scanning calorimetry and tensile tests. Polymer-ceramic composites with a 0-3 connectivity were successfully obtained. Regardless of the used processing parameters, all composite filaments present very similar melting (∼152°C) and solidification (∼139°C) points and elastic moduli (∼1.0 GPa) for hydroxyapatite as dispersed phase in the composite with concentrations up to 25 wt%, indicating that they are adequate for twin-screw extrusion and 3D printing. However, the yield strength (∼29 MPa), ultimate tensile strength (∼36 MPa) and tensile point (∼29 MPa) parameters are similar only for hydroxyapatite concentrations up to 15 wt%, once higher concentrations of hydroxyapatite as dispersed phase result in fragile samples (∼50% lower for each studied property).

Is the wearing of elastic stockings for half a day as effective as wearing them for the entire day?

Background There is good evidence for the use of compression for some clinical indications but little is known about dosimetry in compression. Objective The aim of this work was to evaluate whether or not the use of compression stockings during part of the day would help in the reduction of evening oedema in patients with clinical, epidemiological, anatomical and physiopathological (CEAP) classifications C0 and C1. Methods The effects of elastic compression stockings on volumetric variations during the working day were evaluated for the legs of two men and 18 women (40 legs). The inclusion criterion was classification as C0 (10 legs) or C1 (30 legs) according to the CEAP criteria. Participants used three-quarter-length elastic compression stockings (20-30 mmHg) on three consecutive days for the entire day or only for the morning or they did not use the stockings at all. Volumetry using the water displacement technique was performed in the morning and in the evening. When the patients wore the stockings only during the morning, volumetry was also performed at 13:00 h. Results Significant increases in volume were observed for both legs when stockings were not used compared with the use of stockings in the morning only. After removing the stockings, both legs had significant increases in volume in the afternoon. However, use for half the day was better than not using the stockings at all. Conclusions The use of elastic compression stockings can reduce volumetric variations during working hours, with the use of stockings for the entire day being better than for just half the day.

Rate of occupational leg swelling is greater in the morning than in the afternoon.

The aim of this study was to investigate the rate of occupational leg swelling depending on the time period of the working day. Volumetric variations of the legs of 70 hospital employees, enrolled in three groups, were evaluated. Group I: 35 morning shift workers; Group II: 35 afternoon shift workers; and Group III: 15 individuals randomly selected from Groups I and II, who were evaluated on the day they worked 12 hours consecutively. Volumetry was performed before and after each shift for both legs of the participants in Groups I and II. For Group III volumetry was performed early in the morning, at noon and in the evening. For statistical analysis, the Student's t-test and Mann-Whitney test were used with an alpha error of 5% being considered acceptable (P value<0.05). Significant increases in volume were recorded for the limbs in all three groups (P value<0.001). On comparing Groups I and II, the accumulation of fluids was significantly higher in the morning than in the afternoon (P value<0.003). Asymptomatic workers may present with oedema of the legs during their work with the rate of oedema being different for morning and afternoon shifts. The possibility of wearing compression stockings should be considered for this type of work.

Colleters in Bathysa nicholsonii K. Schum. (Rubiaceae): ultrastructure, secretion protein composition, and antifungal activity.

Colleters are secretory structures well distributed in many organs of Angiosperms. Ultrastructurally, the colleters secretory cell presents an enhanced endoplasmic reticulum, Golgi apparatus, and mitochondria. Secretion synthesis, transportation, and passage through outer cell wall is poorly characterized. This study characterized the anatomy and ultrastructure of BATHYSA NICHOLSONII (Rubiaceae) colleters and evaluated the presence of protein in the secretion and its antifungal property. Samples were collected and prepared according to usual techniques in light and electron microscopy, electrophoresis, and fungal growth inhibition assay. Colleters are of a standard type, cylindrical and elongated, formed by one secretory epidermal palisade layer, and a central axis formed by parenchymatic cells and a vascular trace. Epidermal cells have dense cytoplasm with abundant ribosome, a nucleus, enhanced endoplasmic reticulum and Golgi apparatus. The outer cell wall presented morphologically distinct layers. The presence of secretory cavities was noted in all outer cell wall extents. Secretion preparations analyzed by SDS-PAGE showed that B. NICHOLSONII secretion is a mixture of proteins with molecular masses covering a range of approximately 66 to 24 kDa. This preparation presented an inhibitory effect on the fungi spore growth.

Association between atopy and recurrent vaginal candidiasis.

To determine whether there is an association between atopy and recurrent vaginal candidiasis (RVC) and to evaluate the type-2 immune response in patients with RVC. Evaluation of immediate hypersensitivity skin tests to aeroallergens, measurement of total IgE and Candida albicans specific IgE and levels of IL-5 in 44 women with RVC and 26 with sporadic vaginal candidiasis (SVC). Statistical analyses were performed by Mann-Whitney test and chi(2) test with Yates correction. History of atopy (68%) and positive skin test (42%) were higher (P < 0.05) in RVC than in patients with SVC. No significant difference was found in total IgE, C. albicans specific IgE and IL-5 levels. There was a strong association between atopy and RVC, but type-2 immune response to C. albicans antigen was absent or similar in the two groups of patients.

Further morphological studies on the behavior of Trypanosoma rangeli in the hemocytes of Rhodnius prolixus.

The hemocytes of Rhodnius prolixus were analyzed during the course of infection with the protozoan Trypanosoma rangeli. The following cell types were identified: prohemocyte, plasmatocyte, adipocyte, granular cell and oenocytoid. The number of these cells changes during the infection course thus indicating a cell response to infection of R. prolixus by T. rangeli. Transmission electron microscopy showed that plasmatocytes were able to ingest epimastigote forms of the parasite, which were then found within a parasitophorous vacuole. Amorphous material was seen within the vacuole suggesting that fusion of host cell lysosomes with the vacuole took place. Intravacuolar parasites in process of digestion were observed. In addition, reaction product indicative of the presence of acid phosphatase was observed in parasite-containing vacuoles. No dividing parasites were seen within the vacuole in contrast to what was observed outside the host cells.

[Human leptospirosis in Belo Horizonte City, Minas Gerais, Brazil: a geographic approach]. / Leptospirose humana no município de Belo Horizonte, Minas Gerais, Brasil: uma abordagem geográfica.

A retrospective study on human leptospirosis, was done in Belo Horizonte in 1995, using geographic processing resources. Thirty suspected and 19 confirmed cases of leptospirosis were mapped in the area. The majority of confirmed cases (68.4 +/- 13%) were located in North, Northeast and West of the city. The main foci of disease were found in slums and other poor areas: 73.7 +/- 12% of the confirmed cases and 26.7 +/- 12% of suspected cases. Ninety-five percent +/- 6% of the confirmed cases were found in the outskirts of the city where there was a population increase and inadequate infrastructure. It was observed that 50 +/- 14% of the suspected cases and 42 +/- 14% of the confirmed cases were found in areas of high concentration of water resources. Suspected (83.3 +/- 10%) and confirmed cases (79 +/- 11%) occurred in lower altitude areas of the city (750 to 1,000m) and 78 +/- 12% of the individuals had been in contact with contaminated water and/or animals.

Factorial design of electrolyte systems for the separation of fatty acids by capillary electrophoresis.

In this work, a capillary zone electrophoretic methodology using UV indirect detection (224 nm) for the analysis of fatty acids (FAs) in saponified oils is proposed. The electrolyte consisted of a 5 mmol l(-1) phosphate buffer, pH 7. containing 4 mmol l(-1) sodium dodecylbenzenesulfonate (SDBS) as chromophore, 4 mmol l(-1) dimethyl-beta-cyclodextrin and 45% acetonitrile (ACN). The composition of the electrolyte was optimized by a 2(3) factorial design with triplicate at the central point. The design established practical concentration boundaries for SDBS and ACN. In a defined concentration range of 2-4 l(-1), SDBS can certainly be used as a chromophore for indirect detection without imparting excessive baseline noise. For ACN, a suitable interval of 45-55% was found to enhance FAs solubilization without overflowing the system with bubble formation and current interruption. Additionally, the design revealed the importance of dimethyl-beta-cyclodextrin in the resolution of difficult pairs and its function as a solubilizing agent for long chain FAs. At the optimized conditions, nine FAs from C10 to C20, including mono- di- and tri-unsaturated C18 fatty acids were baseline separated in less than 10 min. The proposed method was applied to the separation of FAs in edible oils and polyunsaturated fatty acid enriched margarine. Additionally, spectral monitoring at 206 nm was used to confirm peak identity in the samples.

Interaction of Trypanosoma rangeli Tejera, 1920 with different cell lines in vitro.

Intracellular multiplication of Trypanosoma rangeli was evaluated in vitro using experimental infection of Vero cells, murine macrophages, and promonocytes with T. rangeli Choachi, Macias, and SC-58 clone B1 strains. Our results revealed a low infectivity of all T. rangeli strains to these cell lines. Macrophages showed the highest infection rate; however, intracellular forms were no longer observed 48 h post infection Despite the observation of intracellular parasites up to 144 h post infection, the infection rates of Vero cells and J774G.8 promonocytes with these parasite strains were always below 5%. Pre-incubation of parasites with normal mouse serum increased the initial infectivity but not the time course of the infection. Under our experimental conditions, we did not observe any evidence of intracellular multiplication of T. rangeli within these cell lines.

An electron microscopic study of penetration by Trypanosoma rangeli into midgut cells of Rhodnius prolixus.

The process of interaction of the Choachi strain of Trypanosoma rangeli with intestinal epithelial cells of Rhodnius prolixus was analyzed in experiments carried out in vitro and in vivo. For the in vitro experiments small fragments of the anterior region of the posterior midgut were incubated in the presence of the parasites, fixed, and processed for observation with the scanning electron microscope. Parasites attached to the surface of some epithelial cells, especially to the extracellular membrane layers (perimicrovillar membranes), were observed. For the in vivo experiments insects were infected with cultures of T. rangeli, sacrificed at different time intervals, and then processed for scanning and transmission electron microscopy. An intimate contact between the parasites and the membrane layers was observed. The parasites penetrated into cells that showed an electronlucent cytoplasm and a damaged surface, moved within the cytoplasm of the epithelial cell, reached the basal region, crossed the basal lamina, and entered the hemocoel.

[Possibilities and limits of epidemiologic surveillance at the local level towards health surveillance]. / Possibilidades e limites do trabalho de vigilância epidemiológica no nível local em direção à vigilância à saúde.

The aim of this study is to describe and analyze Epidemiological Surveillance activities (ES) developed in a Health Care Unit and to identify their adherence to recommended Health Surveillance (HS) strategies. A checklist with the activities recommended by the Ministry of Health was used to conduct interviews with health professionals involved in ES activities. The data obtained from these interviews showed that Epidemiological Surveillance activities are limited to the notification and control of infectious diseases, and the nurses' labor is characterized by bureaucratic tasks. This shows that further discussion about Health Surveillance strategies is necessary to find ways to better implement them in health services.

Evaluation of an educational programme for socially deprived asthma patients.

The aim of this study was to evaluate the effectiveness of an asthma education programme in moderate and severe asthma patients in a longitudinal, prospective and randomized study with a control group. Fifty-three asthmatic patients were studied, 26 of whom were assigned to the educational group and 27 to the control group. The educational group attended the programme regularly for a period of 6 months. The programme included information about asthma, instruction on the appropriate use of medication and training in the metered dose inhaler (MDI) technique, and information about the identification and control of asthma attacks and the recognition of early signs of exacerbation. The control group was submitted to the routine care provided at the Asthma Clinic, with no formal instruction regarding asthma control. The groups were identical with regard to severity parameters, skills, lung function and quality of life at the beginning of the trial. At the end of the study, the education group showed significant differences when compared with the control group (education/control (mean values)) with respect to: visits to the asthma emergency room over the previous 6 months, 0.7/2 (p=0.03); nocturnal symptoms, 0.3/0.7 (p=0.04); score of symptoms, 1.3/2 (p=0.04). Improvements were also observed in skills and quality of life, knowledge of how to deal with attacks and how to control the environmental triggering factors, 73/35 (<0.05); correct use of the MDI, 8/4 (0.001); understanding of the difference between relief and anti-inflammatory medication, 86/20 (<0.05); and in the global limitation quality of life score, 28/50 (0.02). It is concluded that the educational programme led to a significant improvement in asthma morbidity and that the implantation of educational programmes is possible for special populations when these programmes are adapted to the socioeconomic profile of the patients, with a significant gain in terms of the reduction of symptoms and improved pulmonary function and quality of life of asthmatics.

[Efficacy of and tolerance to salmeterol compared to salbutamol in patients with bronchial asthma]. / Estudo da eficácia e tolerabilidade do salmeterol comparativamente ao salbutamol em pacientes com asma brônquica.

UNLABELLED: Beta 2-agonists are considered one of the cornerstones of the asthma therapy, but their short action requires frequent administration and an association with other broncodilators. The development of long-acting beta 2-agonists may represent an important improvement in asthma treatment. PURPOSE: The present study was designed to assess the efficacy and safety of inhaled salmeterol compared to salbutamol in patients with mild-to-moderate asthma. METHODS: After the two run-in weeks, the patients received either salmeterol 50 mg twice a day or salbutamol 200 mg four times a day, over a four week period, following a double blind, parallel group study. Sixty patients had the following inclusion criteria: FEV1 > 50% or PEFR over the past seven days > 50% of predicted normal; reversibility of FEV1 > 15%; symptoms scores > 2 (score 0 and 5) in 4 of the last seven days or PEFR variation > 15%. RESULTS: Seven patients discontinued the protocol (see methods). Of the 53 analyzable patients, 25 were of the salmeterol group and 28 of the salbutamol group. Our results showed that in the run-in period there were not differences among the groups comparing the values of FEV1 in % predicted, morning PEFR and asthma symptoms scores. The improvement rate of morning FEV1 and PEFR in patients who received salmeterol was significantly higher (p < 0.05) compared to the patients who received salbutamol, for two and four weeks of treatment. Also, the salmeterol group have shown reduction of the symptoms in the nocturnal period(significantly in the first fortnight of treatment) demonstrated by the significative increase in the symptoms improvement rate when compared salmeterol and to salbutamol groups. The number of rescue medication inhaled, side effects, heart rate, blood pressure, serum potassium dosage and electrocardiograms, did no show significative differences between the groups. CONCLUSION: This study showed that in mild to moderate asthmatic patients, salmeterol in the dosage of 100 mg/day raised the FEV1 and the morning PEF and led to pronounced decrease in the nocturnal symptoms as compared to salbutamol. The side effects were similar.

[Listeria monocytogenes meningitis. Case reports in patients from the Federal District]. / Meningite por Listeria monocytogenes. Relato de casos em pacientes do Distrito Federal.

It has been shown the role of Listeria monocytogenes as a etiological agent identified by bacteriological analysis among cases of human meningitis in Distrito Federal, Brazil. Laboratorial characteristics and some clinical and epidemiological aspects are reported.

Vitamin D receptor alleles and bone mineral density in a normal premenopausal Brazilian female population.

Studies on the association between vitamin D receptor (VDR) polymorphism and bone mineral density (BMD) in different populations have produced conflicting results probably due to ethnic differences in the populations studied. The Brazilian population is characterized by a very broad genetic background and a high degree of miscegenation. Of an initial group of 164, we studied 127 women from the city of São Paulo, aged 20 to 47 years (median, 31 years), with normal menses, a normal diet and no history of diseases or use of any medication that could alter BMD. VDR genotype was assessed by PCR amplification followed by BsmI digestion of DNA isolated from peripheral leukocytes. BMD was measured using dual energy X-ray absorptiometry (Lunar DPX) at the lumbar site (L2-L4) and femoral neck. Most of the women (77.6%) were considered to be of predominantly European ancestry (20.6% of them reported also native American ancestry), 12.8% were of African-Brazilian ancestry and 9.6% of Asian ancestry, 41.0% (52) were classified as bb, 48.8% (62) as Bb and 10.2% (13) as BB. The BB, Bb and bb groups did not differ in age, height, weight, body mass index or age at menarche. Lumbar spine BMD was significantly higher in the bb group (1.22 +/- 0.16 g/cm2) than in the BB group (1.08 +/- 0.14; P < 0.05), and the Bb group presented an intermediate value (1.17 +/- 0.15). Femoral neck BMD was higher in the bb group (0.99 +/- 0.11 g/cm2) compared to Bb (0.93 +/- 0.12) and BB (0.90 +/- 0.09) (P < 0.05). These data indicate that there is a significant correlation between the VDR BsmI genotype and BMD in healthy Brazilian premenopausal females.

Transhiatal esophagectomy for esophageal cancer.

The two main approaches currently used for surgical treatment of esophageal cancer are transhiatal esophagectomy (THE) and esophagectomy through a right thoracotomy. Among technical variations of THE, wide opening of the diaphragm with ample mediastinal exposure allows resection under direct view with acceptable postoperative morbidity and mortality rates. Transthoracic esophagectomy, associated with extensive mediastinal lymphadenectomy, still offers the best chance of definitive cure in intermediate stages (stages II and III), but does not influence survival in advanced cases (stage IV). In early stages, the lymph node invasion rate is negligible and may be treated by other techniques (THE or endoscopic mucosectomy). THE restores oral ingestion and avoids respiratory complications of thoracotomy, and consequently can be reserved for early cases (mucosal or submucosal lesions) or for patients with poor clinical status. To improve results of surgical treatment, protocols of associated radiochemotherapy are currently under research.

Evaluation of an educational program for asthma control in adults.

We have developed a 6-month educational plan associated with outpatient follow-up and special clinical care for asthmatic patients in a deprived population, with serious socioeconomic problems and a very low level of education. The objective was to determine the effects of the program on clinical asthma outcomes, lung function, and quality of life. Forty patients were enrolled in the program with a regular schedule of outpatient visits, and 31 finished the 6-month intervention, which included information about asthma, instruction in appropriate use of medication, training in metered-dose inhaler technique, how to identify and control asthma triggers, how to use symptom diary cards, and how to recognize early signs of deterioration. Patients included 8 males and 23 females, 47.8 +/- 16.5 years old, with 77.4% elementary school education and 22.6% illiterate, and an average monthly income of around $450. After the 6-month program there was a significant change in asthma control with a reduction in asthma emergency visits and hospitalization, reduction of score symptoms, and improvement in quality of life. Based on the results, educational programs are recommended and should be adapted to the socioeconomic and cultural characteristics of the target population.

[Persistent trigeminal artery associated with aneurysm of the middle cerebral artery. Case report and review of the literature]. / Persistência da artéria trigeminal primitiva associada com eneurisma da artéria cerebral média. Relato de caso e revisão da literatura.

The authors report a case of persistent primitive trigeminal artery angiographically demonstrated as an incidental finding. The persistent primitive trigeminal artery was associated with an aneurysm arising from the circle of Willis in the middle cerebral artery territory. The literature is reviewed and the embryology involved is related.

Inhibition of epidural morphine-induced pruritus by intravenous droperidol. The effect of increasing the doses of morphine and of droperidol.

BACKGROUND AND OBJECTIVES: Because the mechanism of inhibition of epidural morphine-induced pruritus by droperidol is not clear, this study was undertaken to determine the effects of larger doses of droperidol or morphine, or both. METHODS: A double-blind study was performed in 210 ASA I or II patients undergoing cesarean delivery, who were randomly assigned to six groups. All patients received epidural anesthesia with 0.5% bupivacaine containing 1:200,000 epinephrine, to which 2 mg (groups 1, 2, and 3) or 4 mg (groups 4, 5, and 6) morphine sulfate was added. Just after delivery, 2.5 mg droperidol was given intravenously to groups 2 and 5, and 5 mg was given to groups 3 and 6. During the postoperative period, the patients were assessed for the occurrence and severity of pruritus (classified as absent, mild, moderate, or severe) or other untoward symptoms. The groups were compared for the incidence of pruritus by the Mann-Whitney nonparametric test. RESULTS: The incidence of pruritus was significantly reduced only when the control group. (no droperidol) was compared with the group that received 2.5 mg droperidol, both when 2 mg and when 4 mg morphine was used. A 5-mg dose of droperidol had no inhibitory effect. There was no difference in the incidence of pruritus between use of 2 mg and 4 mg morphine. Other untoward effects of morphine either could not be observed or occurred with an incidence unaffected by either dose of droperidol. CONCLUSION: Pruritus caused by epidural use of 2 or 4 mg of morphine is inhibited by the intravenous use of 2.5 mg droperidol but not by a larger dose.