Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru.

OBJECTIVE: Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru. DESIGN AND SETTING: Images of the cervix were captured with a standard-of-care and Pocket colposcope at la Liga Contra el Cáncer in Lima, Peru. POPULATION: Two hundred Peruvian women with abnormal cytology and/or human papillomavirus positivity were enrolled. METHODS: Images were collected using acetic acid and Lugol's iodine as contrast agents. Biopsies were taken as per standard-of-care procedures. MAIN OUTCOME MEASURES: After passing quality review, images from 129 women were sent to four physicians who provided a diagnosis for each image. RESULTS: Physician interpretation of images from the two colposcopes agreed 83.1% of the time. The average sensitivity and specificity of physician interpretation compared with pathology was similar for the Pocket (sensitivity = 71.2%, specificity = 57.5%) and standard-of-care (sensitivity = 79.8%, specificity = 56.6%) colposcopes. When compared with a previous study where only acetic acid was applied to the cervix, results indicated that adding Lugol's iodine as a secondary contrast agent improved the percent agreement between colposcopes for all pathological categories by up to 8.9% and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively. CONCLUSIONS: The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru. TWEETABLE ABSTRACT: The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.

Composição do óleo essencial de quatro espécies do gênero Plectranthus / Essential oil composition of four Plectranthus species

O gênero Plectranthus é considerado um dos mais ricos em óleos essenciais dentro da família Lamiaceae, compreendendo muitas espécies com propriedades medicinais. Algumas destas são conhecidas popularmente como boldo, as quais possuem semelhanças taxonômicas e diversas sinonímias, possuindo ações anti-dispépticas, analgésicas e digestivas. O objetivo deste estudo foi avaliar quantitativa e qualitativamente os óleos essenciais presentes nas folhas das espécies P. amboinicus, P. barbatus, P. grandis e P. neochilus. A extração do óleo foi realizada por hidrodestilação, utilizando pentano como solvente extrator, repetida por três vezes para cada uma das espécies. A análise dos componentes dos óleos essenciais das quatro espécies de Plectranthus, através da CG/EM, permitiu identificar 14 componentes químicos, sendo a maioria sesquiterpenos. O trans-cariofileno se apresentou em elevada concentração nos óleos estudados. Alguns componentes químicos demonstraram ser específicos para cada espécie e outros apresentaram ocorrência comum a todas as quatro, possibilitando a diferenciação das mesmas em dois grupos, um formado por P. amboinicus e P. neochilus e o outro por P. grandis e P. barbatus. Conclui-se que as quatro espécies de boldo apresentam diferenças significativas quanto ao teor e à constituição química do óleo essencial.

Plectranthus has been considered one of the richest genera in essential oils within the Lamiaceae family, which includes several species with medicinal properties. Some of them are commonly known as boldo and present taxonomic similarities and several synonymies, with antidyspeptic, analgesic and digestive actions. The aim of this study was to evaluate quantitatively and qualitatively the essential oils from P. amboinicus, P. barbatus, P. grandis and P. neochilus leaves. The oil was extracted by hydrodistillation using pentane as extracting solvent and was repeated three times for each species. The analysis of essential oil components by GC/MS in the four Plectranthus species identified 14 chemical components, mostly sesquiterpenes. High concentration of trans-caryophyllene was found in the studied oils. Some chemical components were specific for each species and other components had common occurrence in all four species, allowing their differentiation into two groups, one composed of P. amboinicus and P. neochilus and another one by P. grandis and P. barbatus. In conclusion, the four boldo species had significant differences as to essential oil yield and chemical composition.

Diversidade genética entre acessos de espinheira-santa (Maytenus ilicifolia Mart. ex Reis.) coletados no estado do Rio Grande do Sul, Brasil / Genetic diversity of "espinheira-santa" (Maytenus ilicifolia Mart. ex Reis.) accessions collected in Rio Grande do Sul State, Brazil

Maytenus ilicifolia Mart. ex Reis., popularmente conhecida como espinheira-santa, é espécie autóctone pertencente à família Celastraceae, usada para tratamento de úlceras gástricas e gastrites. Devido à importância medicinal, houve aumento no extrativismo das populações naturais, tornando-a uma espécie prioritária para a conservação, a fim de evitar a erosão genética. Buscou-se com este trabalho analisar a diversidade genética de 20 acessos de M. ilicifolia coletados em diferentes localidades no Rio Grande do Sul. Utilizando marcadores moleculares do tipo AFLP, foram testadas oito combinações de primers, que geraram 455 bandas eletroforéticas, 100 por cento polimórficas. As combinações de primers E-ACC/M-CAA, E-ACG/M-CTA, E-ACG/M-CTC apresentaram o maior número de bandas eletroforéticas, 71 cada, totalizando 46,80 por cento do polimorfismo total. Os valores de similaridade genética calculada pelo coeficiente simple matching foram utilizados para gerar o dendrograma de similaridade pelo método UPGMA. Foi obtido alto coeficiente de correlação cofenética (r=0,94), demonstrando elevada representatividade dos dados de similaridade genética no dendrograma. Pela AMOVA verificou-se que 89,33 por cento da diversidade total ocorreram entre indivíduos dentro das populações. A caracterização molecular de acessos de Maytenus ilicifolia por meio de AFLP foi eficiente para identificar diversidade genética. Através da análise de similaridade genética o banco de germoplasma poderia ser composto com os acessos que apresentaram menor similaridade e maior número de alelos, permitindo com que estes fornecessem ampla cobertura do genoma que compõem Maytenus ilicifolia. Os acessos que ficaram agrupados em mesmo cluster e com número reduzido de alelos podem ser descartados deste banco. A diversidade genética intrapopulacional identificada por esse marcador foi muito maior do que aquela entre populações.

Maytenus ilicifolia Mart. ex Reis., popularly known as "espinheira-santa", is an autochthonous species belonging to the Celastraceae family. This species is used to treat ulcers and gastritis. Due to its medicinal importance, the exploitation of natural populations has increased, making the conservation of this species essential to prevent genetic erosion. The aim of this work was to analyze the genetic diversity of 20 M. ilicifolia accessions collected in different localities of Rio Grande do Sul State. Using AFLP-type molecular markers, eight primer combinations were tested, producing 455 electrophoretic profiles, with 100 percent polymorphism. The primer combinations E-ACC/M-CAA, E-ACG/M-CTA and E-ACG/M-CTC presented the largest number of electrophoretic profiles, 71 each, totaling 46.80 percent of the total polymorphism. The values of genetic similarity estimated by Simple Matching Coefficient were used to produce the dendrogram of similarity by the UPGMA method. A high cophenetic correlation coefficient (r = 0.94) was obtained, demonstrating high representativeness of the data of genetic similarity in the dendrogram. Using AMOVA, 89.33 percent of the total diversity were observed among individuals from the same population. The molecular characterization of Maytenus ilicifolia accessions by AFLP allowed the identification of genetic diversity. The genetic similarity analysis indicated that the germplasm bank could be composed of the accessions presenting the lowest similarity and the largest numbers of alleles, providing a comprehensive coverage of Maytenus ilicifolia genome. The accessions that were grouped into one same cluster and with a reduced number of alleles could be disposed of this bank. The genetic diversity identified by this marker within populations was much greater than that between populations.

CSF levels of diazepam-binding inhibitor correlate with REM latency in schizophrenia, a pilot study.

CSF diazepam-binding inhibitor-like immunoreactivity (DBI-LI) and polysomnography were studied in 28 drug-free male schizophrenic (DSM-III-R) patients. They underwent a three-night polysomnography evaluation and a lumbar puncture. CSF DBI-LI correlated positively with REM latency, the REM latency/2d nonREM period ratio and stage-4% sleep, and negatively with stage-1% sleep. CSF DBI-LI did not correlate significantly with duration of sleep or sleep latency. CSF DBI-LI during haloperidol treatment did not correlate significantly with sleep EEG measures. The results of this first study of the relationship between endogenous DBI and sleep in humans suggest that physiological effects of DBI other than interactions with the BZD/GABAA receptor complex may explain its positive effects on sleep. However, the absence of similar sleep data in normal subjects precludes us from establishing a specific relationship between DBI and sleep in schizophrenia.

High-dose-rate intraluminal brachytherapy in the treatment of endobronchial malignancy. Work in progress.

Remote afterloading high-dose-rate brachytherapy (RAHDRB) was used endobronchially for the management of malignant airway obstruction in 82 patients, 72 of whom had primary disease in the lung. Treatment was palliative (n = 58) or definitive (n = 24). The extent of airway compromise was determined at bronchoscopy and with symptoms of hemoptysis, dyspnea, or cough or with radiographic evidence of atelectasis. RAHDRB doses were 1,000-4,700 cGy in one to five fractions. External beam radiation was used in previously unirradiated patients. A substantial reduction ,N airway disease and an improvement in symptoms were seen in 82% of patients. Obstruction scores showed an overall 74% improvement. Complications occurred in only 10 patients (two of whom died). Median survival was short (palliative group, 5 months; definitive group, 12 months); however, symptoms remained palliated in 62 patients (76%) until death or the last follow-up examination. RAHDRB is effective and can be applied with equal success in all patients with malignant airway obstruction, even those whose disease has recurred after external beam irradiation.

CSF chromogranin A-like immunoreactivity in schizophrenia: relationships with REM latency and slow wave sleep.

Chromogranin A (CgA) is a calcium binding protein and a precursor of modulatory peptides in the brain. We measured CgA-like immunoreactivity (CgA-LI) in cerebrospinal fluid (CSF) in 15 male schizophrenic patients (diagnosed by DSM-III-R criteria) after 3 nights of polysomnography. Patients had been drug free for at least 33 days. Our earlier report that CSF CgA-LI in schizophrenic patients correlated significantly with negative symptoms and ventricle-brain ratios, which have been related to slow wave sleep, raised the possibility that CgA-LI might relate to slow wave sleep. CSF CgA-LI was significantly correlated with stage 4 sleep and rapid eye movement latency. Whether these positive relationships between CSF CgA-LI and electroencephalographic sleep measures are specific for schizophrenia awaits further study.

Effect of heparin infusates in umbilical arterial catheters on frequency of thrombotic complications.

We studied 111 infants requiring an umbilical artery catheter, 59 with heparin and 52 without. Thirty-four thrombi were detected, 16 in the heparin group and 18 in the control group. The numbers of thrombi in the two groups was not significantly different, but the number of clotted or nonfunctioning umbilical artery catheters was greater in the control group (P less than 0.05), as was the incidence of hypertension (P less than 0.05). There were no other significant differences between the two groups. We conclude that the use of low doses of heparin may not change the incidence of umbilical artery catheter-related thrombi, but it does appear to lower the incidence of their sequelae.

Non-suppressibility by room light of pineal N-acetyltransferase activity and melatonin levels in two diurnally active rodents, the Mexican ground squirrel (Spermophilus mexicanus) and the eastern chipmunk (Tamias striatus).

The rhythms in pineal N-acetyltransferase (NAT) activity and melatonin levels were studied in the diurnally active Mexican ground squirrel and Eastern chipmunk. In the ground squirrel, both NAT activity and melatonin levels exhibited a marked nocturnal rise; these increases were not prevented by the exposure of these animals to a light irradiance of 200 microW/cm2 throughout the night. In the Eastern chipmunk, darkness at night was also associated with a marked rise in both the activity of the acetylating enzyme as well as the levels of melatonin. Again, these rhythms were not suppressed by the exposure of these animals to a light irradiance of 200 microW/cm2 for either 1 night or for 7 nights; exposure of chipmunks to light for 7 consecutive days did, however, reduce the rise in melatonin normally associated with darkness. The non-suppressibility of pineal NAT and melatonin by a 200 microW/cm2 light irradiance may relate either to the activity pattern of these animals, i.e., diurnal, or to their previous lighting history.