Avaliação hemodinâmica e metabólica da cetamina e cetamina S(+) após a reposição volêmica com hidroxietilamido 130/0,4 e solução salina hipertônica 7,5%

O objetivo deste estudo foi avaliar os efeitos hemodinâmicos e metabólicos, após a administração de solução salina hipertônica (NaCL) 7,5% ou em associação ao hidroxietilamido (HES), em cães com hipovolemia induzida e tratados com cetamina. Após a indução da hipovolemia, administrou-se NaCl 7,5% (4,0ml kg-1) no grupo hipertônica levógira (GHL) e grupo hipertônica racêmica (GHR) ou HES 130/0,4 na mesma proporção de sangue retirado, associado a NaCl 7,5% (4ml kg-1) no grupo hipertônica colóide levógira (GHCL) e no grupo hipertônica colóide racêmica (GHCR). Após 30 minutos, administrou-se, por via IV, cetamina levógira (CL) (5mg kg-1) no GHL e GHCL ou cetamina racêmica (CR) (10mg kg-1) no GHR e GHCR. Empregou-se a análise de variância de uma única via com repetições múltiplas (ANOVA) e o teste de Student Newman Keuls (P£0,05). A frequência cardíaca e a pressão arterial sistólica foram menores após a hipovolemia e após a CR. As pressões arteriais média e diastólica foram menores após a hipovolemia e cetamina. A pressão venosa central foi maior após a administração do colóide. Os índices cardíaco e sistólico foram menores após a hipovolemia em todos os grupos e, após a fase de expansão no GHL e GHR. A pressão média da artéria pulmonar foi menor após a hipovolemia em todos os grupos. A pressão de oclusão da artéria pulmonar foi maior após o colóide. O índice do trabalho ventricular esquerdo foi menor após a hipovolemia no GHCL e GHCR. O índice da resistência periférica total foi maior após a hipovolemia e menor após a CL. Observou-se acidose metabólica após a hipovolemia e após a cetamina. Ocorreu acidose respiratória após a cetamina no GHL e GHR. Conclui-se que a administração de NaCl 7,5% associado ao HES 130/0,4 promove o restabelecimento imediato dos parâmetros hemodinâmicos e metabólicos no paciente hipovolêmico; a administração isolada de NaCl 7,5% não é capaz de restaurar a PAM no período imediato, mas melhora os demais parâmetros hemodinâmicos e metabólicos; a administração de CR ou CL produz efeitos hemodinâmicos e metabólicos similares no paciente hipovolêmico.

A fuzzy reed-frost model for epidemic spreading

In this paper, we present a fuzzy approach to the Reed-Frost model for epidemic spreading taking into account uncertainties in the diagnostic of the infection. The heterogeneities in the infected group is based on the clinical signals of the individuals (symptoms, laboratorial exams, medical findings, etc.), which are incorporated into the dynamic of the epidemic. The infectivity level is time-varying and the classification of the individuals is performed through fuzzy relations. Simulations considering a real problem with data of the viral epidemic in a children daycare are performed and the results are compared with a stochastic Reed-Frost generalization

Treinamento de escolares de 7 a 10 anos para o preenchimento de um Diário Alimentar

INTRODUÇÃO: É reconhecida a efetividade de um treinamento para melhorar a qualidade no relato do consumo alimentar em adultos, porém poucos estudos avaliam esta efetividade em crianças. OBJETIVO: Investigar o efeito da realização de um treinamento para o desenvolvimento de habilidades para um correto preenchimento de um Diário Alimentar, por escolares de 7 a 10 anos. METODOLOGIA: O estudo foi conduzido em uma escola pública da cidade de São Paulo e envolveu a realização de 3 sessões de treinamento de 30 minutos cada, direcionadas a 40 escolares de ambos os sexos. Para verificação do efeito do treinamento, 3 examinadores avaliaram o preenchimento dos dados antes e após o mesmo. Foram atribuídos escores de 0 a 5 para aspectos relativos à identificação, detalhamento e quantificação do alimento consumido, e calculado o escore médio a partir dos escores de cada examinador para cada aspecto. Utilizou-se o teste de Wilcoxon para comparação de amostras dependentes. RESULTADOS: Foi constatada evidência estatística de diferença entre os escores antes e após o treinamento para os três aspectos: identificação (p < 0,001), detalhamento (p = 0,003) e quantificação do alimento (p < 0,001), sendo grande parte dos valores após o treinamento maiores que os iniciais. CONCLUSÃO: É possível aumentar a habilidade de escolares de 7 a 10 anos no preenchimento de um Diário Alimentar a partir da realização de um treinamento nos moldes apresentados neste artigo

Harmonização e classificação de periculosidade de agrotóxicos: impactos na classificação toxicológica, Brasil, 1992

Em 1992 o Brasil modificou seus critérios de classificação toxicológica de agrotóxicos adequando-os à recomendação de classificação de periculosidade da Organização Mundial da Saúde (OMS). Em 2002, o Sistema Globalmente Harmonizado de Classificação e Rotulagem de Produtos Químicos (GHS) foi adotado pela Organização das Nações Unidas. Em decorrência, a OMS está adequando ao GHS sua recomendação de classificação de agrotóxicos, o que também deverá ser feito pelo Brasil. Considerou-se oportuno estimar o impacto da alteração de critérios, ocorrida em 1992, na reclassificação toxicológica dos produtos comerciais que se encontravam registrados na ocasião. Encontrou-se que 58,6% do total dos agrotóxicos então registrados (74,9% das formulações líquidas e 31,0% das sólidas) podem ter sofrido reclassificação para Classes Toxicológicas consideradas de menor periculosidade, sofrendo mudanças na comunicação de riscos expressa na rotulagem. Isto pode ter ocasionado conseqüências negativas devido à confusões de interpretação pelos agricultores. Nos países que já dispõem de sistemas de classificação de periculosidade de agrotóxicos, como o Brasil, recomenda-se estimar, antes da implantação, os impactos das mudanças que poderão decorrer da adoção do GHS

Emergence of Klebsiella pneumoniae carrying the novel extended-spectrum 'beta'-lactamase gene variants 'bla IND. SHV-40', 'bla IND. TEM-116' and the class I integron-associated 'bla IND. GES-7' in Brazil

A clinical Klebsiella pneumoniae isolate carrying the extended-spectrum beta-lactamase gene variants bla(SHV-40), bla(TEM-116) and bla(GES-7) was recovered. Cefoxitin and ceftazidime activity was most affected by the presence of these genes and an additional resistance to trimethoprim-sulphamethoxazole was observed. The bla(GES-7) gene was found to be inserted into a class 1 integron. These results show the emergence of novel bla(TEM) and bla(SHV) genes in Brazil. Moreover, the presence of class 1 integrons suggests a great potential for dissemination of bla(GES) genes into diverse nosocomial pathogens. Indeed, the bla(GES-7) gene was originally discovered in Enterobacter cloacae in Greece and, to our knowledge, has not been reported elsewhere

Dendritic Cells Transfected with scFv from Mab 7.B12 Mimicking Original Antigen gp43 Induces Protection against Experimental Paracoccidioidomycosis

Paracoccidioidomycosis (PCM), endemic in Latin America, is a progressive systemic mycosis caused by Paracoccidioides brasiliensis (P. brasiliensis), which primarily attacks lung tissue. Dendritic cells (DCs) are able to initiate a response in naive T cells, and they also participate in Th-cell education. Furthermore, these cells have been used for therapy in several disease models. Here we transfected DCs with a plasmid (pMAC/PS-scFv) encoding a single chain variable fragment (scFv) of an anti-Id antibody that is capable of mimicking gp43, the main antigenic component of P. brasiliensis. First, Balb/c mice were immunized subcutaneously with pMAC/PS-scFv and, after seven days, scFv protein was presented to the regional lymph nodes cells. Moreover, we showed that the DCs transfected with scFv were capable of efficiently activating proliferation of total lymph node cells and inducing a decrease in lung infection. Therefore, our results suggested that the use of scFv-transfected DCs may be a promising therapy in the paracoccidioidomycosis (PCM) model.

Synthesis and total H-1- and C-13-NMR assignment of cephem derivatives for use in ADEPT approaches

We report the synthesis and total NMR characterization of 5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid-3-[[[(4''-nitrophenoxy)carbonyl]oxy]-methyl]-8-oxo-7[(2-thienyloxoacetyl)amino]-diphenylmethyl ester-5-dioxide (5), a new cephalosporin derivative. This compound can be used as the carrier of a wide range of drugs containing an amino group. The preparation of the intermediate product, 5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid-3-[methyl-4-(6-methoxyquinolin-8-ylamino) pentylcarbamate]-8-oxo-7-[(2-thienyloxoacetyl)amino]-diphenylmethyl ester-5-dioxide (6), as well as the synthesis of the antimalarial primaquine prodrug 5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid-3-[methyl-4-(6-methoxyquinolin-8-ylamino) pentylcarbamate]-8-oxo-7-[(2-thienyloxoacetyl)amino]-5-dioxide (7) are also described, together with their total H-1- and C-13-NMR assignments.

Selenium and Mercury in the Brazilian Amazon: Opposing Influences on Age-Related Cataracts

BACKGROUND: Age-related cataracts (ARCs) are an important cause of blindness in developing countries. Although antioxidants may be part of the body's defense to prevent ARC, environmental contaminants may contribute to cataractogenesis. In fish-eating populations of the lower Tapajos region, elevated exposure to mercury (Hg) has been reported, and blood levels of selenium (Se) range from normal to very high (> 1,000 mu g/L). OBJECTIVES: We examined ARCs in relation to these elements among adults (>= 40 years of age) from 12 riverside communities. METHODS: Participants (n = 211) provided blood samples and underwent an extensive ocular examination. Inductively coupled plasma mass spectrometry was used to assess Hg and Se in blood and plasma. RESULTS: One-third (n = 69; 32.7%) of the participants had ARC. Lower plasma Se (P-Se; < 25th percentile, 110 mu g/L) and higher blood Hg (B-Hg; >= 25th percentile, 25 mu g/L) were associated with a higher prevalence odds ratio (POR) of ARC [adjusted POR (95% confidence interval), 2.69 (1.11-6.56) and 4.45 (1.43-13.83), respectively]. Among participants with high P-Se, we observed a positive but nonsignificant association with high B-Hg exposure, whereas among those with low B-Hg, we observed no association for P-Se. However, compared with the optimum situation (high P-Se, low B-Hg), the POR for those with low P-Se and high B-Hg was 16.4 (3.0-87.9). This finding suggests a synergistic effect. CONCLUSION: Our results suggest that persons in this population with elevated Hg, the cataractogenic effects of Hg may be offset by Se. Because of the relatively small sample size and possible confounding by other dietary nutrients, additional studies with sufficient power to assess multiple nutrient and toxic interactions are required to confirm these findings.

Efficacy of a 7-day course of furazolidone, levofloxacin, and lansoprazole after failed Helicobacter pylori eradication

Background: Increasing resistance to clarithromycin and nitroimidazole is the main cause of failure in the Helicobacter pylori eradication. The ideal retreatment regimen remains unclear, especially in developing countries, where the infection presents high prevalence and resistance to antibiotics. The study aimed at determining the efficacy, compliance and adverse effects of a regimen that included furazolidone, levofloxacin and lansoprazole in patients with persistent Helicobacter pylori infection, who had failed to respond to at least one prior eradication treatment regimen. Methods: This study included 48 patients with peptic ulcer disease. Helicobacter pylori infection was confirmed by a rapid urease test and histological examination of samples obtained from the antrum and corpus during endoscopy. The eradication therapy consisted of a 7-day twice daily oral administration of lansoprazole 30 mg, furazolidone 200 mg and levofloxacin 250 mg. Therapeutic success was confirmed by a negative rapid urease test, histological examination and 14C- urea breath test, performed 12 weeks after treatment completion. The Chi-square method was used for comparisons among eradication rates, previous treatments and previous furazolidone use. Results: Only one of the 48 patients failed to take all medications, which was due to adverse effects (vomiting). Per-protocol and intention-to-treat eradication rates were 89% (95% CI-89%-99%) and 88% (88-92%), respectively. Mild and moderate adverse effects were reported by 41 patients (85%). For patients with one previous treatment failure, the eradication rate was 100%. Compared to furazolidone-nave patients, eradication rates were lower in those who had failed prior furazolidone-containing regimen(s) (74% vs. 100%, p = 0.002). Conclusion: An empiric salvage-regimen including levofloxacin, furazolidone and lansoprazole is very effective in the eradication of Helicobacter pylori, particularly in patients that have failed one prior eradication therapy.

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992-2003

Background: The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods: The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992-1994, 1995-1997, 1998-2000, and 2001-2003). Results: Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion: This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.

On the mass determination of super-Earths orbiting active stars: the CoRoT-7 system

Context. Star activity makes the mass determination of CoRoT-7b and CoRoT 7c uncertain. Investigators of the CoRoT team proposed several solutions, but all but one of them are larger than the initial determinations of 4.8 +/- 0.8 M(Earth) for CoRoT-7b and 8.4 +/- 0.9 M(Earth) for CoRoT 7c. Aims. This investigation uses the excellent HARPS radial velocity measurements of CoRoT-7 to redetermine the planet masses and to explore techniques for determining mass and orbital elements of planets discovered around active stars when the relative variation in the radial velocity due to the star activity cannot be considered as just noise and can exceed the variation due to the planets. Methods. The main technique used here is a self-consistent version of the high-pass filter used by Queloz et al. (2009, A&A, 506, 303) in the first mass determination of CoRoT-7b and CoRoT-7c. The results are compared to those given by two alternative techniques: (1) the approach proposed by Hatzes et al. (2010, A&A, 520, A93) using only those nights in which two or three observations were done; (2) a pure Fourier analysis. In all cases, the eccentricities are taken equal to zero as indicated by the study of the tidal evolution of the system. The periods are also kept fixed at the values given by Queloz et al. Only the observations done in the time interval BJD 2 454 847-873 are used because they include many nights with multiple observations; otherwise, it is not possible to separate the effects of the rotation fourth harmonic (5.91 d = P(rot)/4) from the alias of the orbital period of CoRoT-7b (0.853585 d). Results. The results of the various approaches are combined to give planet mass values 8.0 +/- 1.2 M(Earth) for CoRoT-7b and 13.6 +/- 1.4 M(Earth) for CoRoT 7c. An estimation of the variation of the radial velocity of the star due to its activity is also given. Conclusions. The results obtained with three different approaches agree to give higher masses than those in previous determinations. From the existing internal structure models they indicate that CoRoT-7b is a much denser super-Earth. The bulk density is 11 +/- 3.5 g cm(-3), so CoRoT-7b may be rocky with a large iron core.

The CoRoT-7 planetary system: two orbiting super-Earths

We report on an intensive observational campaign carried out with HARPS at the 3.6 m telescope at La Silla on the star CoRoT-7. Additional simultaneous photometric measurements carried out with the Euler Swiss telescope have demonstrated that the observed radial velocity variations are dominated by rotational modulation from cool spots on the stellar surface. Several approaches were used to extract the radial velocity signal of the planet(s) from the stellar activity signal. First, a simple pre-whitening procedure was employed to find and subsequently remove periodic signals from the complex frequency structure of the radial velocity data. The dominant frequency in the power spectrum was found at 23 days, which corresponds to the rotation period of CoRoT-7. The 0.8535 day period of CoRoT-7b planetary candidate was detected with an amplitude of 3.3 m s(-1). Most other frequencies, some with amplitudes larger than the CoRoT-7b signal, are most likely associated with activity. A second approach used harmonic decomposition of the rotational period and up to the first three harmonics to filter out the activity signal from radial velocity variations caused by orbiting planets. After correcting the radial velocity data for activity, two periodic signals are detected: the CoRoT-7b transit period and a second one with a period of 3.69 days and an amplitude of 4 m s(-1). This second signal was also found in the pre-whitening analysis. We attribute the second signal to a second, more remote planet CoRoT-7c. The orbital solution of both planets is compatible with circular orbits. The mass of CoRoT-7b is 4.8 +/- 0.8 (M(circle plus)) and that of CoRoT-7c is 8.4 +/- 0.9 (M(circle plus)), assuming both planets are on coplanar orbits. We also investigated the false positive scenario of a blend by a faint stellar binary, and this may be rejected by the stability of the bisector on a nightly scale. According to their masses both planets belong to the super-Earth planet category. The average density of CoRoT-7b is rho = 5.6 +/- 1.3 g cm(-3), similar to the Earth. The CoRoT-7 planetary system provides us with the first insight into the physical nature of short period super-Earth planets recently detected by radial velocity surveys. These planets may be denser than Neptune and therefore likely made of rocks like the Earth, or a mix of water ice and rocks.

The isolated neutron star candidate 2XMM J104608.7-594306

Over the last decade, X-ray observations have revealed the existence of several classes of isolated neutron stars (INSs) which are radio-quiet or exhibit radio emission with properties much at variance with those of ordinary radio pulsars. The identification of new sources is crucial in order to understand the relations among the different classes and to compare observational constraints with theoretical expectations. A recent analysis of the 2XMMp catalogue provided fewer than 30 new thermally emitting INS candidates. Among these, the source 2XMM J104608.7-594306 appears particularly interesting because of the softness of its X-ray spectrum, kT = 117 +/- 14 eV and N(H) = (3.5 +/- 1.1) x 10(21) cm(-2) (3 sigma), and of the present upper limits in the optical, m(B) greater than or similar to 26, m(V) greater than or similar to 25.5 and m(R) greater than or similar to 25 (98.76% confidence level), which imply a logarithmic X-ray-to-optical flux ratio log(F(X)/F(V)) greater than or similar to 3.1, corrected for absorption. We present the X-ray and optical properties of 2XMM J104608.7-594306 and discuss its nature in the light of two possible scenarios invoked to explain the X-ray thermal emission from INSs: the release of residual heat in a cooling neutron star, as in the seven radio-quiet ROSAT-discovered INSs, and accretion from the interstellar medium. We find that the present observational picture of 2XMM J104608.7-594306 is consistent with a distant cooling INS with properties in agreement with the most up-to-date expectations of population synthesis models: it is fainter, hotter and more absorbed than the seven ROSAT sources and possibly located in the Carina Nebula, a region likely to harbour unidentified cooling neutron stars. The accretion scenario, although not entirely ruled out by observations, would require a very slow (similar to 10 km s(-1)) INS accreting at the Bondi-Hoyle rate.

The close circumstellar environment of Betelgeuse II. Diffraction-limited spectro-imaging from 7.76 to 19.50 mu m with VLT/VISIR

Context. Mass-loss occurring in red supergiants (RSGs) is a major contributor to the enrichment of the interstellar medium in dust and molecules. The physical mechanism of this mass loss is however relatively poorly known. Betelgeuse is the nearest RSG, and as such a prime object for high angular resolution observations of its surface (by interferometry) and close circumstellar environment. Aims. The goal of our program is to understand how the material expelled from Betelgeuse is transported from its surface to the interstellar medium, and how it evolves chemically in this process. Methods. We obtained diffraction-limited images of Betelgeuse and a calibrator (Aldebaran) in six filters in the N band (7.76 to 12.81 mu m) and two filters in the Q band (17.65 and 19.50 mu m), using the VLT/VISIR instrument. Results. Our images show a bright, extended and complex circumstellar envelope at all wavelengths. It is particularly prominent longwards of approximate to 9-10 mu m, pointing at the presence of O-rich dust, such as silicates or alumina. A partial circular shell is observed between 0.5 and 1.0 '' from the star, and could correspond to the inner radius of the dust envelope. Several knots and filamentary structures are identified in the nebula. One of the knots, located at a distance of 0.9 '' west of the star, is particularly bright and compact. Conclusions. The circumstellar envelope around Betelgeuse extends at least up to several tens of stellar radii. Its relatively high degree of clumpiness indicates an inhomogeneous spatial distribution of the material lost by the star. Its extension corresponds to an important intermediate scale, where most of the dust is probably formed, between the hot and compact gaseous envelope observed previously in the near infrared and the interstellar medium.

The merging cluster Abell 1758 revisited: multi-wavelength observations and numerical simulations

Context. Cluster properties can be more distinctly studied in pairs of clusters, where we expect the effects of interactions to be strong. Aims. We here discuss the properties of the double cluster Abell 1758 at a redshift z similar to 0.279. These clusters show strong evidence for merging. Methods. We analyse the optical properties of the North and South cluster of Abell 1758 based on deep imaging obtained with the Canada-France-Hawaii Telescope (CFHT) archive Megaprime/Megacam camera in the g' and r' bands, covering a total region of about 1.05 x 1.16 deg(2), or 16.1 x 17.6 Mpc(2). Our X-ray analysis is based on archive XMM-Newton images. Numerical simulations were performed using an N-body algorithm to treat the dark-matter component, a semi-analytical galaxy-formation model for the evolution of the galaxies and a grid-based hydrodynamic code with a parts per million (PPM) scheme for the dynamics of the intra-cluster medium. We computed galaxy luminosity functions (GLFs) and 2D temperature and metallicity maps of the X-ray gas, which we then compared to the results of our numerical simulations. Results. The GLFs of Abell 1758 North are well fit by Schechter functions in the g' and r' bands, but with a small excess of bright galaxies, particularly in the r' band; their faint-end slopes are similar in both bands. In contrast, the GLFs of Abell 1758 South are not well fit by Schechter functions: excesses of bright galaxies are seen in both bands; the faint-end of the GLF is not very well defined in g'. The GLF computed from our numerical simulations assuming a halo mass-luminosity relation agrees with those derived from the observations. From the X-ray analysis, the most striking features are structures in the metal distribution. We found two elongated regions of high metallicity in Abell 1758 North with two peaks towards the centre. In contrast, Abell 1758 South shows a deficit of metals in its central regions. Comparing observational results to those derived from numerical simulations, we could mimic the most prominent features present in the metallicity map and propose an explanation for the dynamical history of the cluster. We found in particular that in the metal-rich elongated regions of the North cluster, winds had been more efficient than ram-pressure stripping in transporting metal-enriched gas to the outskirts. Conclusions. We confirm the merging structure of the North and South clusters, both at optical and X-ray wavelengths.