Response to Treatment in a Prospective Cohort of Patients with Large Ulcerated Lesions Suspected to Be Buruli Ulcer (Mycobacterium ulcerans Disease)

Background: The World Health Organization (WHO) advises treatment of Mycobacterium ulcerans disease, also called Buruli ulcer'' (BU), with a combination of the antibiotics rifampicin and streptomycin (R+S), whether followed by surgery or not. In endemic areas, a clinical case definition is recommended. We evaluated the effectiveness of this strategy in a series of patients with large ulcers of >= 10 cm in longest diameter in a rural health zone of the Democratic Republic of Congo (DRC).Methods: A cohort of 92 patients with large ulcerated lesions suspected to be BU was enrolled between October 2006 and September 2007 and treated according to WHO recommendations. The following microbiologic data were obtained: Ziehl-Neelsen (ZN) stained smear, culture and PCR. Histopathology was performed on a sub-sample. Directly observed treatment with R+S was administered daily for 12 weeks and surgery was performed after 4 weeks. Patients were followed up for two years after treatment.Findings: Out of 92 treated patients, 61 tested positive for M. ulcerans by PCR. PCR negative patients had better clinical improvement than PCR positive patients after 4 weeks of antibiotics (54.8% versus 14.8%). For PCR positive patients, the outcome after 4 weeks of antibiotic treatment was related to the ZN positivity at the start. Deterioration of the ulcers was observed in 87.8% (36/41) of the ZN positive and in 12.2% (5/41) of the ZN negative patients. Deterioration due to paradoxical reaction seemed unlikely. After surgery and an additional 8 weeks of antibiotics, 98.4% of PCR positive patients and 83.3% of PCR negative patients were considered cured. The overall recurrence rate was very low (1.1%).Interpretation: Positive predictive value of the WHO clinical case definition was low. Low relapse rate confirms the efficacy of antibiotics. However, the need for and the best time for surgery for large Buruli ulcers requires clarification. We recommend confirmation by ZN stain at the rural health centers, since surgical intervention without delay may be necessary on the ZN positive cases to avoid progression of the disease. PCR negative patients were most likely not BU cases. Correct diagnosis and specific management of these non-BU ulcers cases are urgently needed.

Maximal lactate steady state in rats submitted to swimming exercise

The higher concentration during exercise at which lactate entry in blood equals its removal is known as 'maximal lactate steady state' (MLSS) and is considered an important indicator of endurance exercise capacity. The aim of the present study was to determine MLSS in rats during swimming exercise. Adult male Wistar rats, which were adapted to water for 3 weeks, were used. After this, the animals were separated at random into groups and submitted once a week to swimming sessions of 20 min, supporting loads of 5, 6, 7, 8, 9 or 10% of body wt. for 6 consecutive weeks. Blood lactate was determined every 5 min to find the MLSS. Sedentary animals presented MLSS with overloads of 5 and 6% at 5.5 mmol/l blood lactate. There was a significant (P < 0.05) increase in blood lactate with the other loads. In another set of experiments, rats of the same strain, sex and age were submitted daily to 60 min of swimming with an 8% body wt. overload, 5 days/week, for 9 weeks. The rats were then submitted to a swimming session of 20 min with an 8% body wt. overload and blood lactate was determined before the beginning of the session and after 10 and 20 min of exercise. Sedentary rats submitted to the same acute exercise protocol were used as a control. Physical training did not alter the MLSS value (P < 0.05) but shifted it to a higher exercise intensity (8% body wt. overload). Taken together these results indicate that MLSS measured in rats in the conditions of the present study was reproducible and seemed to be independent of the physical condition of the animals. © 2001 Elsevier B.V. All rights reserved.

Ant fauna (Hymenoptera: Formicidae) in Magnoliophyta native to the Atlantic forest

The aim of the study was to analyze the preferences of ant species visiting the trunks of eight species of Magnoliophyta, belonging to the families Fabaceae, Arecaceae, Myrtaceae, Melastomataceae and Euphorbiaceae, located in a fragment of the Atlantic Forest in southeastern Brazil. A total of 101 ant species, belonging to eight subfamilies and 32 genera, were sampled during the 12-month collection period. Close to 30% of the ant species can be considered arboreal, and the others are species that nest in the ground and use trees only for foraging, which can be occasional, as in the case of the Ecitoninae sampled in Arecaceae and Euphorbiaceae. Pachycondyla mesonotalis was the only species collected on all the Magnoliophyta, whereas Camponotus rufipes, Acromyrmex niger and Crematogaster spp., were found on 87.5% of the trees analyzed. No strong similarities were found, using the Jaccard Index, among plant species in the same family of Magnoliophyta based on the visiting ants, except for the Euphorbiaceae species. This result is probably related to the presence of extra-floral nectar, which is very attractive to ants and characteristic of this family.

Visual evaluation of color stability after accelerated aging of pigmented and nonpigmented silicones to be used in facial prostheses

Objectives: The objective of this study was to evaluate by a visual method of comparison the color stability of nonpigmented and pigmented facial silicones after accelerated aging. Materials and Methods: Two kinds of silicones were used in this study; one specifically formulated for facial prostheses and the other an acetic silicone for industrial use. Twenty-four trial bodies were made for each silicone. These were divided into colorless and intrinsically pigmented groups: ceramic, make-up, and iron oxide. The groups were submitted to accelerated aging for nonmetallic materials. An initial reading and subsequent readings were made at 163, 351, 692, and 1000 hours using a visual method of comparison. The values were annotated in a spreadsheet by two observers, according to scores elaborated for this study. Results: All groups presented color stability in the visual method. According to the results obtained and analyzed in this study, we can conclude that both silicones, Silastic 732 RTV and Silastic MDX 4-4210, behaved similarly, they can therefore be indicated for use in maxillofacial prosthesis. The time factor of aging influenced negatively, independently of the pigmentation, or lack of it, and of silicones and no group had visually noticeable alterations in any of the accelerated aging time, independently of the addition or not of pigments.

The infuence of production systems in postponement make-to-stock compagny in the graphic industry

The supply chain management, postponement and demand management operations are of strategic importance to the economic success of organizations because they directly influence the production process. The aim of this paper is to analyze the influence of the postponement in an enterprise production system with make-to-stock and with seasonal demand. The research method used was a case study, the instruments of data collection were semi-structured interviews, document analysis and site visits. The research is based on the following issues: Demand Management which can be understood as a practice that allows you to manage and coordinate the supply chain in reverse, in which consumers trigger actions for the delivery of products. The Supply Chain Management is able to allow the addition of value, exceeding the expectations of consumers, developing a relationship with suppliers and customer's win-win. The Postponement strategy must fit the characteristics of markets that require variety of customized products and services, lower cost and higher quality, aiming to support decision making. The production system make-to-stock shows enough interest to organizations that are operating in markets with high demand variability. © 2011 IEEE.

Adjuvant therapy with GnRH agonists/tamoxifen in breast cancer should be a good council for patients with hormone receptor-positive tumours and wish to preserve fertility

Infertility represents one of the main long-term consequences of combination chemotherapy used for the treatment of breast cancer. Approximately 60%-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ tumors with respect to recurrence-free survival and overall survival, Presentation of the hypothesis: It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. Testing the hypothesis: Assessment of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen. The recurrence-free survival and overall survival should be analysed. Implications of the hypothesis: The major implication will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

An iterated sample construction with path relinking method: Application to switch allocation in electrical distribution networks

We present a metaheuristic approach which combines constructive heuristics and local searches based on sampling with path relinking. Its effectiveness is demonstrated by an application to the problem of allocating switches in electrical distribution networks to improve their reliability. Our approach also treats the service restoration problem, which has to be solved as a subproblem, to evaluate the reliability benefit of a given switch allocation proposal. Comparisons with other metaheuristics and with a branch-and-bound procedure evaluate its performance. © 2012 Published by Elsevier Ltd.

Slimmer or Fertile? Pharmacological Mechanisms Involved in Reduced Sperm Quality and Fertility in Rats Exposed to the Anorexigen Sibutramine

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Anaerobic digestion of stillage to produce bioenergy in the sugarcane-to-ethanol industry

Stillage is the main wastewater from ethanol production, containing a high chemical oxygen demand in addition to acidic and corrosive characteristics. Though stillage may be used as a soil fertilizer, its land application may be considered problematic due its high polluting potential. Anaerobic digestion represents an effective alternative treatment to reduce the pollution load of stillage. In addition, the methane gas produced within the process may be converted to energy, which can be directly applied to the treatment plant. The objective of this paper was to investigate the energetic potential of anaerobic digestion applied to stillage in the sugarcane ethanol industry. An overall analysis of the results indicates energy recovery capacity (ERC) values for methane ranging from 3.5% to 10%, respectively, for sugarcane juice and molasses. The processes employed to obtain the fermentable broth, as well as the distillation step, represent the main limiting factors to the energetic potential feasibility. Considering financial aspects the annual savings could reach up to US$ 30 million due to anaerobic digestion of stillage in relatively large-scale distilleries (365,000 m3 of ethanol per year). The best scenarios were verified for the association between anaerobic digestion of stillage and combustion of bagasse. In this case, the fossil fuels consumption in distilleries could be fully ceased, such the ERC of methane could reach values ranging from 140% to 890%. © 2013 Taylor & Francis.

Deposition of Al2O3 by resistive evaporation and thermal oxidation of Al to be applied as a transparent FET insulating layer

Alumina thin films have been obtained by resistive evaporation of Al layer, followed by thermal oxidation by means of annealing in appropriate atmosphere (air or O2-rich), with variation of annealing time and temperature. Optical and structural properties of the investigated films reveal that the temperature of 550 °C is responsible for reasonable oxidation, which is accelerated up to 8 times for O2-rich atmosphere. Results of surface electrical resistivity and Raman spectroscopy are in good agreement with these findings. Surprisingly, X-ray and Raman data suggest also the crystallization of Si nuclei at glass substrate-alumina interface, which would come from the soda-lime glass used as substrate. © 2013 Elsevier Ltd and Techna Group S.r.l.

O sentido da autoridade nas destituições do poder familiar em Marília a partir dos relatos dos operadores do direito na perspectiva do gênero

Pós-graduação em Ciências Sociais - FFC

The invisible blackness of Harryette Mullen's poetry: writing, miscegenation and what remais to be seen

Este ensaio aborda a poética de Harryette Mullen, poetisa afro-americana cuja obra questiona os limites que moldam as expectativas pela inteligibilidade acessível na literatura afro-americana. Os poemas de Mullen exploram as bordas da inteligibilidade, avançando para além das expectativas por uma forma visível/ Rev. Let., São Paulo, v.52, n.1, p.101-120, jan./jun. 2012. 119 inteligível de linguagem que abarcaria a experiência da negritude. Argumenta-se que a escrita na poesia de Mullen funciona como um processo de miscigenação ao jogar com a ilegibilidade da negritude, para além de uma linha visível de distinção entre o que é ou que deveria ser considerado como parte apropriada da negritude, o que possibilita novas formas de reflexão sobre a poesia como um instrumento politicamente significativo para se repensar o papel da poetisa e do poeta negros no espaço da diáspora negra.

Digit Ratio (2D:4D), Aggression, and Testosterone in Men Exposed to an Aggressive Video Stimulus

The relative lengths of the 2nd and 4th digits (2D:4D) is a negative biomarker for prenatal testosterone, and low 2D:4D may be associated with aggression. However, the evidence for a 2D:4D-aggression association is mixed. Here we test the hypothesis that 2D:4D is robustly linked to aggression in challenge situations in which testosterone is increased. Participants were exposed to an aggressive video and a control video. Aggression was measured after each video and salivary free testosterone levels before and after each video. Compared to the control video, the aggressive video was associated with raised aggression responses and a marginally significant increase in testosterone. Left 2D:4D was negatively correlated with aggression after the aggressive video and the strength of the correlation was higher in those participants who showed the greatest increases in testosterone. Left 2D:4D was also negatively correlated to the difference between aggression scores in the aggressive and control conditions. The control video did not influence testosterone concentrations and there were no associations between 2D:4D and aggression. We conclude that 2D:4D moderates the impact of an aggressive stimulus on aggression, such that an increase in testosterone resulting from a challenge is associated with a negative correlation between 2D:4D and aggression.

Dental anomalies in children submitted to antineoplastic therapy

Cancer is the third most frequent cause of death in children in Brazil. Early diagnosis and medical advances have significantly improved treatment outcomes, which has resulted in higher survival rates and the management of late side effects has become increasingly important in caring for these patients. Dental abnormalities are commonly observed as late effects of antineoplastic therapy in the oral cavity. The incidence and severity of the dental abnormalities depend on the child's age at diagnosis and the type of chemotherapeutic agent used, as well as the irradiation dose and area. The treatment duration and aggressivity should also be considered. Disturbances in dental development are characterized by changes in shape, number and root development. Enamel anomalies, such as discoloration, opacities and hypoplasia are also observed in these patients. When severe, these abnormalities can cause functional and esthetic sequelae that have an impact on the children's and adolescents' quality of life. General dentists and pediatric dentists should understand these dental abnormalities and how to identify them aiming for early diagnosis and appropriate treatment.

Validation of analytical methodology for quantification of cefazolin sodium pharmaceutical dosage form by high performance liquid chromatography to be applied for quality control in pharmaceutical industry

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)