Recurrent chronic suppurative osteomyelitis in the maxilla of a patient with diabetes mellitus and glucose-6-phosphate dehydrogenase deficiency.

AIMS: To report the case of chronic osteomyelitis of a maxilla in a woman with uncontrolled diabetes mellitus (DM), glucose-6-phosphate dehydrogenase (G6PD) deficiency and mental illness, in an attempt to clarify its pathogenesis and treatment. METHODS AND RESULTS: A case of a woman with moderate G6PD deficiency (Class III) who developed bilateral and asynchronous chronic suppurative osteomyelitis (CSO) of her maxilla with extensive bone sequestra, fistulae and whose management was performed by local surgery for bony sequestra and fistulae removal; closure communication under 4 weeks antibiotic cover. CONCLUSIONS: CSO of the jaw may be a complication of the G6PD deficiency and DM and its severity depends on patient's medical status.

Precauções para linfedema em mulheres acometidas por câncer de mama pós esvaziamento axilar: revisão de escopo / Precautions against lymphedema in women with breast cancer after axillary dissection: scoping review / Precauciones para el linfedema em mujeres com câncer de mama después del vaciamento axilar: revision de alcance

Objetivo: identificar e mapear estratégias preconizadas para prevenção de linfedema em pacientes submetidas a esvaziamento axilar em tratamento do câncer de mama. Método: revisão de escopo realizada em agosto de 2019 considerando oito bases de dados e oito bases da literatura cinzenta. A amostra final foi composta por 13 artigos, selecionados de acordo com critérios de elegibilidade. Resultados: os estudos foram predominantemente randomizados, com nível de evidência 1a, e realizados na América do Norte. Medidas preventivas tradicionalmente utilizadas, como limitar exercícios com carga ou evitar punção venosa e aferição de pressão arterial, não se demonstraram efetivas em nenhum dos estudos encontrados. Foi evidenciado como medida preventiva o controle dos fatores de risco modificáveis associados ao linfedema: IMC elevado (> 25 kg/m2 ) e quimioterapia administrada no braço ipsilateral. Conclusões: não foram apresentadas evidências significativas para medidas cotidianamente preconizadas na prevenção do linfedema, e fatores de risco modificáveis se destacaram entre os riscos para seu desenvolvimento.

Objective: to identify and map strategies recommended for prevention of lymphedema in patients after axillary dissection during breast cancer treatment. Method: this scoping review was conducted in August 2019 across eight databases and eight gray literature data sources. The final sample comprised 13 journal articles that met eligibility criteria. Results: the studies, most of which were randomized, conducted in North America, and offered Level 1a evidence. None of the studies reviewed found traditionally employed preventive measures, such as limiting weight training or avoiding venipuncture and blood pressure measurements, to be effective. Evidence indicated that controlling modifiable lymphedema-related risk factors ­ namely high BMI (> 25 kg/m²) and chemotherapy administration in the ipsilateral arm ­ was a preventive measure. Conclusion: no significant evidence was reported for traditionally recommended preventive measures against lymphedema, and modifiable factors figured prominently among risk factors for lymphedema.

Objetivo: identificar y mapear las estrategias recomendadas para la prevención del linfedema en pacientes después de una disección axilar durante el tratamiento del cáncer de mama. Método: esta revisión de alcance se realizó en agosto de 2019 en ocho bases de datos y ocho fuentes de datos de literatura gris. La muestra final comprendió 13 artículos de revistas que cumplieron con los criterios de elegibilidad. Resultados: los estudios, la mayoría de los cuales fueron aleatorios, se realizaron en Norteamérica y ofrecieron evidencia de Nivel 1a. Ninguno de los estudios revisados encontró que las medidas preventivas empleadas tradicionalmente, como limitar el entrenamiento con pesas o evitar la punción venosa y las mediciones de la presión arterial, sean efectivas. La evidencia indicó que el control de los factores de riesgo relacionados con el linfedema modificables, a saber, un IMC alto (> 25 kg / m²) y la administración de quimioterapia en el brazo ipsilateral, era una medida preventiva. Conclusión: no se informó evidencia significativa de las medidas preventivas recomendadas tradicionalmente contra el linfedema, y los factores modificables figuraron de manera prominente entre los factores de riesgo para el linfedema.

Evaluation of access to mammographies in Brazil and socioeconomic indicators: a space study. / Avaliação do acesso em mamografias no Brasil e indicadores socioeconômicos: um estudo espacial.

OBJECTIVE: To evaluate the correlation between mammography screening coverage in women from 50 to 69 years old and the socioeconomic indicators Human Development Index (HDI) and Gini Index. METHODS: Epidemiological, retrospective and ecological study carried out in Brazil with secondary data. The sample is made up of 5565 municipalities in Brazil. As a dependent variable: the ratio of screening mammography examinations performed in women aged 50 to 69 years, from 2008 to 2015, and as independent variables: The Human Development Index (HDI) and the Gini Index. Descriptive analysis, univariate and bivariate spatial analysis were performed. RESULTS: North, Northeast and Center-West are regions that are more propitious for breast cancer, due to the low access for mammograms. CONCLUSION: The HDI and the Gini index, determinants of inequalities, directly influence the mammography numbers in Brazil, highlighting the importance of evaluating public policies.

Avaliação do acesso em mamografias no Brasil e indicadores socioeconômicos: um estudo espacial / Evaluación del acceso en mamografías en Brasil e indicadores socioeconómicos: un estudio espacial / Evaluation of access to mammographies in Brazil and socioeconomic indicators: a space study

Resumo OBJETIVO Avaliar a correlação entre a cobertura do exame mamografia em mulheres de 50 a 69 anos e os indicadores socioeconômicos Índice de Desenvolvimento Humano (IDH) e Índice de Gini. MÉTODOS Estudo epidemiológico, retrospectivo e ecológico realizado no Brasil com dados secundários. A amostra é composta por 5565 municípios do Brasil. Como variável dependente: a Razão de exames de mamografia de rastreamento realizados em mulheres de 50 a 69 anos, de 2008 a 2015, e como variáveis independentes: o Índice de desenvolvimento humano (IDH) e Índice de Gini. Foi realizada a análise descritiva, análise espacial univariada e bivariada. RESULTADOS Norte, Nordeste e Centro-Oeste são regiões que se mostram mais propícias para o câncer de mama, devido ao baixo acesso para mamografias. CONCLUSÃO O IDH e o índice de Gini, determinantes de desigualdades, influenciam diretamente na cobertura de exames de mamografia no Brasil, destacando a importância de avaliação das políticas públicas.

Resumen OBJETIVO Evaluar la correlación entre la cobertura del examen mamografía en mujeres de 50 a 69 años y los indicadores socioeconómicos Índice de Desarrollo Humano (IDH) e Índice de Gini. MÉTODOS Estudio epidemiológico, retrospectivo y ecológico realizado en Brasil con datos secundarios. Muestra compuesta por 5565 municipios de Brasil. Como variable dependiente: Razón de exámenes de mamografía de rastreo realizados en mujeres de 50 a 69 años, de 2008 a 2015, y como variables independientes: el Índice de desarrollo humano (IDH) y el Índice de Gini. Se realizó análisis descriptivo y análisis espacial univariado y bivariado. RESULTADOS Norte, Nordeste y Centro-Oeste son regiones que se muestran más propicias para el cáncer de mama, debido al bajo acceso para mamografías. CONCLUSIÓN El IDH y el índice de Gini, determinantes de desigualdades, influencian directamente en cobertura de exámenes de mamografía en Brasil, destacando la importancia de evaluación de políticas públicas.

Abstract OBJECTIVE To evaluate the correlation between mammography screening coverage in women from 50 to 69 years old and the socioeconomic indicators Human Development Index (HDI) and Gini Index. METHODS Epidemiological, retrospective and ecological study carried out in Brazil with secondary data. The sample is made up of 5565 municipalities in Brazil. As a dependent variable: the ratio of screening mammography examinations performed in women aged 50 to 69 years, from 2008 to 2015, and as independent variables: The Human Development Index (HDI) and the Gini Index. Descriptive analysis, univariate and bivariate spatial analysis were performed. RESULTS North, Northeast and Center-West are regions that are more propitious for breast cancer, due to the low access for mammograms. CONCLUSION The HDI and the Gini index, determinants of inequalities, directly influence the mammography numbers in Brazil, highlighting the importance of evaluating public policies.

A Gas Chromatography-Mass Spectrometry Method for the Detection and Quantitation of Monofluoroacetate in Plants Toxic to Livestock.

Monofluoroacetate (MFA) is a potent toxin that occurs in over 50 plant species in Africa, Australia, and South America and is responsible for significant livestock deaths in these regions. A gas chromatography-mass spectrometry (GC-MS) method for the analysis of MFA in plants based on the derivatization of MFA with n-propanol in the presence of sulfuric acid to form propyl fluoroacetate was developed. This method compared favorably to a currently employed high-performance liquid chromatography-mass spectrometry (HPLC-MS) method for the analysis of MFA in plants. The GC-MS method was applied to the analysis of MFA in herbarium specimens of Fridericia elegans, Niedenzuella stannea, N. multiglandulosa, N. acutifolia, and Aenigmatanthera lasiandra. This is the first report of MFA being detected in F. elegans, N. multiglandulosa, N. acutifolia, and A. lasiandra, some of which have been reported to cause sudden death or that are toxic to livestock.

Studies in regard to the classification and putative toxicity of Fridericia japurensis (Arrabidaea japurensis) in Brazil.

Numerous plant species worldwide including Palicourea marcgravii (Rubiaceae) and Tanaecium bilabiatum (Bignoniaceae) in Brazil cause acute cardiac failure (sudden death) and are known to contain monofluoroacetate (MFA). Other Bignoniaceae species including Fridericia japurensis (Arrabidaea japurensis) are reported to cause sudden death in livestock in the Brazilian state of Roraima and are suspected to contain MFA due to the similarity of clinical signs. In this study herbarium specimens of Fridericia japurensis and field collections suspected to be F. japurensis were analyzed for MFA, and plant material from the field collections was dosed to rabbits. No MFA was detected in the herbarium specimens authoritatively identified as F. japurensis; however, MFA was detected in the field collections, which were identified as T. bilabiatum. Rabbits dosed orally with T. bilabiatum died acutely. Voucher toxic specimens initially described as F. japurensis were incorrectly identified, and the correct botanical name for this plant is T. bilabiatum (Arrabidaea bilabiata). Based on this study we conclude that there are no data to support the toxicity of F. japurensis and that the plant previously reported under this name as causing acute cardiac failure in cattle in Roraima is T. bilabiatum. This research highlights the importance of voucher specimens as part of any toxic plant investigation and corrects the literature regarding these toxic plants.

Alkylphospholipids - a promising class of chemotherapeutic agents with a broad pharmacological spectrum.

PURPOSE: Since when alkylphospholipds (ALPs) were discovered and, even further after miltefosine's approval for the treatment of cutaneous metastasis of breast cancer and leishmaniasis, their activity against many other diseases have been extensively studied. This review aims to provide a summary of the alkylphospholipids' applications investigated so far. RESULTS: The mechanism of action of ALPs is not fully understood, however it is believed that they interfere with lipid homeostasis leading to cell apoptosis. Due to ALPs cytotoxic activity, this class of molecules has shown to be effective against many diseases and conditions. Besides the approval of miltefosine for application in cutaneous metastasis of breast cancer and visceral and cutaneous leishmaniasis, several other analogs have proved efficacy and are promising as less toxic alternatives. ALPs have also shown in vitro and in vivo activity against Trypanosoma spp., amoebae, Tricomonas vaginalis, Schistosoma mansoni, HIV, and some fungi and bacteria species. The use of ALPs for intraocular lens coating is also under investigation. In addition, a clinical trial comparing miltefosine with usual treatments to spontaneous urticaria is also being conducted. CONCLUSIONS: Alkylphospholipids present such a broad pharmacological spectrum that justifies the need for further investigations of the drug class mechanisms of action, as well as the search for new analogs with improved activity and toxicological profiles.

Polycyclic aromatic hydrocarbons from wood pyrolyis in charcoal production furnaces.

Polycyclic aromatic hydrocarbons (PAH) were measured in smoke samples from wood carbonization during charcoal production, in both particulate matter (PM) and gaseous phases. Samples were acquired using a medium-volume air sampler at 1.5 m distance from the furnace. Particle-bound PAH were collected on Fluoropore polytetrafluoroethylene filters and gas-phase PAH were collected into sorbent tubes with XAD-2 resin. PAH were extracted with dichloromethane-methanol and analyzed using gas chromatography-mass spectrometry. The results showed total emission from the furnace of 26 microg/m3 for the 16 PAH and 2.8 microg/m3 for the 10 genotoxic PAH (from fluoranthene to benzo[g,h,i]perylene). High emission of 16 PAH in the first 8 h of wood carbonization was detected (64 microg/m3; 56% of the total emission). Associated with PM, 11% of the total emission of 16 PAH (in both phases) and 60% of 10 genotoxic PAH were found. Relative ratios (for example, [Phe]/[Phe]+[Ant]) for the PAH of the same molecular weight were obtained and compared with the published data. The concentrations of benzo[a]pyrene equivalent (BaP(eq)) were estimated using the list of toxic equivalent factors suggested by . The values of 0.30 and 0.06 mg/m3 were obtained for the total concentrations of BaP(eq) in PM and gaseous phase, respectively.