Bronchoscopy for the diagnosis of pulmonary tuberculosis in patients with negative sputum smear microscopy results

Objective: To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. Methods: A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to bronchoscopy-BAL and transbronchial biopsy (TBB). The BAL specimens were submitted to direct testing and culture for AFB and fungi, whereas the TBB specimens were submitted to histopathological examination. Results: Of the 286 patients studied, 225 (79%) were diagnosed on the basis of bronchoscopic findings, as follows: pulmonary tuberculosis, in 127 (44%); nonspecific chronic inflammation, in 51 (18%); pneumocystis, fungal infections, or nocardiosis, in 20 (7%); bronchiolitis obliterans organizing pneumonia, alveolites, or pneumoconiosis, in 14 (5%); lung or metastatic neoplasms, in 7 (2%); and nontuberculous mycobacterium infections, in 6 (2%). For the diagnosis of tuberculosis, BAL showed a sensitivity and a specificity of 60% and 100%, respectively. Adding the TBB findings significantly increased this sensitivity (to 84%), as did adding the post-bronchoscopy sputum smear microscopy results (total sensitivity, 94%). Minor post-procedure complications occurred in 5.6% of the cases. Conclusions: Bronchoscopy is a reliable method for the diagnosis of pulmonary tuberculosis, with low complication rates. The combination of TBB and BAL increases the sensitivity of the method and facilitates the differential diagnosis with other diseases.

A generalized finite element method with global-local enrichment functions for confined plasticity problems

The main feature of partition of unity methods such as the generalized or extended finite element method is their ability of utilizing a priori knowledge about the solution of a problem in the form of enrichment functions. However, analytical derivation of enrichment functions with good approximation properties is mostly limited to two-dimensional linear problems. This paper presents a procedure to numerically generate proper enrichment functions for three-dimensional problems with confined plasticity where plastic evolution is gradual. This procedure involves the solution of boundary value problems around local regions exhibiting nonlinear behavior and the enrichment of the global solution space with the local solutions through the partition of unity method framework. This approach can produce accurate nonlinear solutions with a reduced computational cost compared to standard finite element methods since computationally intensive nonlinear iterations can be performed on coarse global meshes after the creation of enrichment functions properly describing localized nonlinear behavior. Several three-dimensional nonlinear problems based on the rate-independent J (2) plasticity theory with isotropic hardening are solved using the proposed procedure to demonstrate its robustness, accuracy and computational efficiency.

Alternative Tasks for the Teaching and the Learning of functions: analysis of an intervention in the High School

In this paper we focus on the application of two mathematical alternative tasks to the teaching and learning of functions with high school students. The tasks were elaborated according to the following methodological approach: (i) Problem Solving and/or mathematics investigation and (ii) a pedagogical proposal, which defends that mathematical knowledge is developed by means of a balance between logic and intuition. We employed a qualitative research approach (characterized as a case study) aimed at analyzing the didactic pedagogical potential of this type of methodology in high school. We found that tasks such as those presented and discussed in this paper provide a more significant learning for the students, allowing a better conceptual understanding, becoming still more powerful when one considers the social-cultural context of the students.

Automated analysis of lidocaine and its metabolite in plasma by in-tube solid-phase microextraction coupled with LC-UV for pharmacokinetic study

A sensitive, selective, and reproducible in-tube solid-phase microextraction and liquid chromatographic (in-tube SPME/LC-UV) method for determination of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in human plasma has been developed, validated, and further applied to pharmacokinetic study in pregnant women with gestational diabetes mellitus (GDM) subjected to epidural anesthesia. Important factors in the optimization of in-tube SPME performance are discussed, including the draw/eject sample volume, draw/eject cycle number, draw/eject flow rate, sample pH, and influence of plasma proteins. The limits of quantification of the in-tube SPME/LC method were 50 ng/mL for both metabolite and lidocaine. The interday and intraday precision had coefficients of variation lower than 8%, and accuracy ranged from 95 to 117%. The response of the in-tube SPME/LC method for analytes was linear over a dynamic range from 50 to 5000 ng/mL, with correlation coefficients higher than 0.9976. The developed in-tube SPME/LC method was successfully used to analyze lidocaine and its metabolite in plasma samples from pregnant women with GDM subjected to epidural anesthesia for pharmacokinetic study.

Interpolation estimate for a finite-element space with embedded discontinuities

We consider a recently proposed finite-element space that consists of piecewise affine functions with discontinuities across a smooth given interface Γ (a curve in two dimensions, a surface in three dimensions). Contrary to existing extended finite element methodologies, the space is a variant of the standard conforming Formula space that can be implemented element by element. Further, it neither introduces new unknowns nor deteriorates the sparsity structure. It is proved that, for u arbitrary in Formula, the interpolant Formula defined by this new space satisfies Graphic where h is the mesh size, Formula is the domain, Formula, Formula, Formula and standard notation has been adopted for the function spaces. This result proves the good approximation properties of the finite-element space as compared to any space consisting of functions that are continuous across Γ, which would yield an error in the Formula-norm of order Graphic. These properties make this space especially attractive for approximating the pressure in problems with surface tension or other immersed interfaces that lead to discontinuities in the pressure field. Furthermore, the result still holds for interfaces that end within the domain, as happens for example in cracked domains.

Meningoencephalitis associated with Mycoplasma pneumoniae

We report a case of a child with meningoencephalitis of atypical etiology. The patient developed the disease after an infection in the upper airways with unfavorable evolution. The clinical recovery was only possible after the administration of adequate antibiotic therapy for the etiological agent. This case report describes a child with meningoencephalitis of atypical etiology. The patient developed the disease after an infection in the superior airways with negative evolution. The clinical recovery was possible only after the introduction of adequate antibiotic therapy for the etiological agent.

Contribution to assessing the stiffness reduction of structural elements in the global stability analysis of precast concrete multi-storey buildings

This study deals with the reduction of the stiffness in precast concrete structural elements of multi-storey buildings to analyze global stability. Having reviewed the technical literature, this paper present indications of stiffness reduction in different codes, standards, and recommendations and compare these to the values found in the present study. The structural model analyzed in this study was constructed with finite elements using ANSYS® software. Physical Non-Linearity (PNL) was considered in relation to the diagrams M x N x 1/r, and Geometric Non-Linearity (GNL) was calculated following the Newton-Raphson method. Using a typical precast concrete structure with multiple floors and a semi-rigid beam-to-column connection, expressions for a stiffness reduction coefficient are presented. The main conclusions of the study are as follows: the reduction coefficients obtained from the diagram M x N x 1/r differ from standards that use a simplified consideration of PNL; the stiffness reduction coefficient for columns in the arrangements analyzed were approximately 0.5 to 0.6; and the variation of values found for stiffness reduction coefficient in concrete beams, which were subjected to the effects of creep with linear coefficients from 0 to 3, ranged from 0.45 to 0.2 for positive bending moments and 0.3 to 0.2 for negative bending moments.

Epidemiological aspects of tuberculosis in children and adolescents in Rio de Janeiro

Objective: To describe the epidemiological aspects of childhood tuberculosis (TB) in a Brazilian reference hospital. Methods: This was a retrospective study (1999-2008) of 473 subjects (0-14 year olds) with confirmed TB, or with clinical improvement by the fourth month of treatment under the unit's care, including the review of medical records, monitoring reports and notifications by the TB unit. Results: Among 473 TB cases included in the study, positive tuberculin skin test was observed in 52%, history of contact with a patient with pulmonary tuberculosis in 66%, mostly intra-household, and with the father/stepfather most commonly involved; and disseminated TB in 22%. The result of HIV testing was obtained in 265 (56%) cases, being positive in 45 (17%). The diagnosis of TB was confirmed in 31% of cases, most frequently in children older than 5 years, with negative tuberculin skin test, and in disseminated forms. Of the 65 cultures positive for TB performed in the study, drug sensitivity testing to anti-TB drugs was done in 30 (46%) clinical samples, among which 10 (33%) were resistant to one or more anti-TB drugs, and 2 (0.8%) were multi-drug-resistant. Among patients with confirmed pulmonary TB, 31% did not meet the criteria for starting anti-TB treatment according to the scores of the Ministry of Health (<= 25 points). Conclusion: The high proportion of drug-resistant TB and co-infection with HIV identified in this study highlight the necessity to carry out additional studies in order to evaluate the impact of TB control activities on childhood TB.

Characterization and properties of blended cement matrices containing activated bamboo leaf wastes

The worldwide production of bamboo generates large volumes of leaf wastes, which are deposited in landfills or burned in an uncontrolled manner, with negative effects in the environment. The ash obtained by calcining of the bamboo leaf waste, shows good qualities as supplementary cementing material for the production of blended cements. The current paper shows a detailed scientific study of a Brazilian bamboo leaf ash (BLA) calcined at 600 degrees C in small scale condition, by using different techniques (XRF, XRD, SEM/EDX, FT-IR, TG/DTG) and technical study in order. to analyse the behaviour of this ash in blended cements elaborated with 10% and 20% by mass of BLA. The results stated that this ash shows a very high pozzolanic activity, with a reaction rate constant K of the order of 10(-1)/h and type I CSH gel was the main hydrated phase obtained from pozzolanic reaction. The BLA blended cements (10% and 20%) complied with the physical and mechanical requirements of the existing European standards. (c) 2012 Elsevier Ltd. All rights reserved.

The Effects of Processing Non-Timber Forest Products and Trade Partnerships on People's Well-Being and Forest Conservation in Amazonian Societies

This study evaluated whether processing non-timber forest products (NTFPs) and establishing trade partnerships between forest communities and companies enhance the outcomes of NTFP commercialization. In particular, we evaluated whether product processing, partnerships, or their combination was associated with a number of outcomes related to the well-being of forest inhabitants and forest conservation. We based our analyses on ethnographic and quantitative data (i.e., survey and systematic observations) gathered at seven communities from five societies of the Brazilian and Bolivian Amazon. Our results indicated that product processing and partnerships do not represent a silver bullet able to improve the results of NTFP commercialization in terms of well-being and conservation indicators. Compared with cases without interventions, households adopting partnerships but not product processing were most often associated with improved economic proxies of well-being (total income, NTFP income, food consumption and gender equality in income). In comparison, the combination of product processing and partnerships was associated with similar outcomes. Unexpectedly, product processing alone was associated with negative outcomes in the economic indicators of well-being. All of the investigated strategies were associated with less time spent in social and cultural activities. With respect to forest conservation, the strategies that included a partnership with or without processing produced similar results: while household deforestation tended to decrease, the hunting impact increased. Processing alone was also associated with higher levels of hunting, though it did not reduce deforestation. Our results indicate that establishing partnerships may enhance the outcomes of NTFP trade in terms of the financial outcomes of local communities, but practitioners need to use caution when adopting the processing strategy and they need to evaluate potential negative results for indicators of social and cultural activities. With respect to conservation, the three strategies are promising for reducing deforestation, but more pervasive impacts, such as hunting, might increase.

Ordovician A-type granitoid magmatism on the Ceara Central Domain, Borborema Province, NE-Brazil

We present field relationships, major and trace element geochemistry and U-Pb SHRIMP and ID-TIMS geochronology of the A-type Ordovician Quintas pluton located in the Ceara Central Domain of the Borborema Province, in northeastern Brazil. This pluton presents a concentric geometry and is composed mainly of syenogranite, monzogranite, quartz syenite to quartz monzodiorite, monzogabbro and diorite. Its geochemical characteristics [SiO2 (52-70%), Na2O/K2O (1.55-0.65), Fe2O3/MgO (2.2-7.3), metaluminous to sligthly alkaline affinity, post-collisional type in (Y + Nb) x Rb diagram, and A-type affinity (Ga > 22 ppm, Nb > 20 ppm, Zn > 60 ppm), REE fractioned pattern with negative Eu anomaly] are coherent with post-collisional A(2)-type granitoids. However, the emplacement of this pluton is to some extent temporally associated with the deposition of the first strata of the Parnaiba intracratonic basin, attesting also to a purely anorogenic character (A(1)-type granitoid). The emplacement of this pluton is preceded by one of the largest known orogenesis of the planet (Neoproterozoic Pan-African/Brasiliano) and, if it is classified as an A(2)-type granitoid, it provides interesting constraints about how long can last A(2)-type magmatic activity after a major collisional episode, arguably triggered by disturbance of the underlying mantle, a topic extensively debated in the geoscience community. (C) 2011 Elsevier Ltd. All rights reserved.

Burnout syndrome and Brazilian civil aviation: a short essay on the focus on prevention

Introduction: At the same time that there are increased demands we have become more sedentary, increasing risk factors for new diseases. All this reflects on our quality of life with special emphasis upon a particular syndrome called Burnout. Aviation is no exception and packed into its processes each day more expeditious, promotes a perfect environment for the development and spread of the syndrome. Aim: To evaluate the quality of life, organizational climate, and the level of physical activity among employees of a Brazilian airline. Methods: A cross-sectional design was conducted with 8 subjects. Results: Total score on the WHOQOL quality of life questionnaire was 64.7 (SD 10.8), and the environmental field showed the lowest score. Nevertheless, the sedentary risk factor was performed in 25% of the sample. About the organizational climate, it can be seen that 6.12% of the sample was framed in "Professional Exhaustive", 29.60% in the condition of "Warning", and 64.37% in the condition of "Professional Efficiency". Conclusion: the study found a low quality of life, especially in the environmental category, sedentary people and a large proportion of employees in this Brazilian airline with negative scores on the Organizational Climate.

Electromagnetic energy within coated spheres containing dispersive metamaterials

An exact expression is derived for the time-averaged electromagnetic energy within a magneto-dielectric coated sphere, which is irradiated by a plane and time-harmonic electromagnetic wave. Both the spherical shell and core are considered to be dispersive and lossy, with a realistic dispersion relation of an isotropic split-ring resonator metamaterial. We obtain analytical expressions for the stored electromagnetic energies inside the core and the shell separately and calculate their contributions to the total average energy density. The stored electromagnetic energy is calculated for two situations involving a metamaterial coated sphere: a dielectric shell and dispersive metamaterial core, and vice versa. An explicit relation between the stored energy and the optical absorption efficiency is also obtained. We show that the stored electromagnetic energy is an observable sensitive to field interferences responsible for the Fano effect. This result, together with the fact that the Fano effect is more likely to occur in metamaterials with negative refraction, suggest that our findings may be explored in applications.

New characterizations for hyperbolic cylinders in anti-de Sitter spaces

In this paper we study complete maximal spacelike hypersurfaces in anti-de Sitter space H-1(n+1) with either constant scalar curvature or constant non-zero Gauss-Kronecker curvature. We characterize the hyperbolic cylinders H-m(c(1)) x Hn-m(c(2)), 1 <= m <= n - 1, as the only such hypersurfaces with (n - 1) principal curvatures with the same sign everywhere. In particular we prove that a complete maximal spacelike hypersurface in H-1(5) with negative constant Gauss-Kronecker curvature is isometric to H-1(c(1)) x H-3(c(2)). (C) 2012 Elsevier Inc. All rights reserved.

DETERMINATION OF DICLOFENAC SODIUM IN RABBIT PLASMA BY HPLC/UV: EVALUATION AND CHARACTERIZATION OF ITS CRYSTALLINE FORMS, ANHYDROUS AND HYDRATE, ON THE ANTIPYRETIC EFFECT

Diclofenac sodium (DS) is a non-steroidal anti-inflammatory drug that is widely prescribed for the treatment of rheumatoid arthritis and post-surgery analgesia. The active pharmaceutical ingredient is the anhydrous form; however, it can also exist in hydrate form. In this context, knowing the properties of the solid state is important and relevant in the pharmaceutical area because they have a significant impact on the solubility, bioavailability, and chemical stability of the drugs. In the present study, data from XRPD, FTIR spectroscopy, and thermal analysis were used for the identification and characterization of DS forms (anhydrous and hydrate). An HPLC method was optimized to evaluate the plasma concentration of DS in rabbits. The optimized method exhibited good linearity over the range 0.1-60 mu g/mL with correlation coefficients of >0.9991. The mean recovery was 100%. Precision and accuracy were determined within acceptable limits. Finally, to compare the pharmacological properties of anhydrous and hydrate DS forms, we investigated their effects in the febrile response induced by lipopolysaccharide from E. coli in rabbits. The results show that the antipyretic effect of anhydrous and hydrate DS forms are similar.