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.

Nasce um Estado: a construção do Timor Leste

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Spatial Assessment of Indices for Characterizing the Erosive Force of Rainfall in El Salvador Republic

Soil erosion data in El Salvador Republic are scarce and there is no rainfall erosivity map for this region. Considering that rainfall erosivity is an important guide for planning soil erosion control practices, a spatial assessment of indices for characterizing the erosive force of rainfall in El Salvador Republic was carried out. Using pluviometric records from 25 weather stations, we applied two methods: erosivity index equation and the Fournier index. In all study area, the rainiest period is from May to November. Annual values of erosivity index ranged from 7,196 to 17,856 MJ mm ha(-1) h(-1) year(-1) and the Fournier index ranged from 52.9 to 110.0 mm. The erosivity map showed that the study area can be broadly divided into three major erosion risk zones, and the Fournier index map was divided into four zones. Both methods revealed that the erosive force is severe in all study area and presented significant spatial correlation with each other. The erosive force in the country is concentrated mainly from May to November.

Layer by layer TiO2 thin films and photodegradation of Congo red

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A prelude of a 'little army'? São Paulo police force in the early years of the Republic (1890-1895)

This article analyzes the creation and development of the São Paulo police force during the early years of the republican regime. In a period of political change and turbulence, institutional upheaval (uprising of the Navy and federalist revolution), and social pressure, São Paulo's police force played an important role. As the state sought to organize the public sphere, the police force became a tool in the new government's hands. A more martial set of demands mobilized a large portion of the troops on behalf of the federal government against the Custodio de Mello uprising, and sought to defend São Paulo's borders. Despite official discourse that fomented a militarized response, São Paulo's police force found itself unable to dismiss old personnel and practices and dislodge entrenched interests.

Militarism, conflicts and indiscipline in police practices in the State of São Paulo during the First Brazilian Republic

This article examines the challenges involved in the process of police militarization and implementation of police discipline in the State of São Paulo during the First Brazilian Republic (1889 to 1930). The implementation of a militarized police model, initiated by the 1906 French Military Mission, was not fully able to deal with indiscipline issues among policemen. Beyond creating problems of its own, such as fostering a corporatist culture and strengthening rigid hierarchies, military discipline prevented police forces to address new issues that would affect its practices. Documents in the São Paulo State Public Archive provides a window to the daily violence, the personal compromises, the institutional conflicts and the political meddling that was part of police life in the State of São Paulo at the turn of the century.

Yield and mineral nutrition of soybean, maize, and congo signal grass as affected by limestone and slag

The objective of this work was to evaluate the efficiency of superficial applicationof limestone and slag, and their effects on soil chemical attributes and on yield and mineral nutrition of soybean, maize, and Congo signal grass (Urochloa ruziziensis). The experiment was carried out in a Rhodic Hapludox under no tillage system. The treatments consisted of the use of limestone or slag (silicates of calcium and magnesium) to correct soilacidity, and of a control treatment without the use of soil correctives. Rates were calculated in order to raise soil base saturation up to 70%. Soybean was sown in November 2006and maize in December 2007. Congo signal grass was sown right after the harvests of soybean and maize, and it was cropped during the offseasons. Soil chemical attributes were evaluated at 6, 12, and 18 months after the application of the corrective materials. Slag isan efficient source for soil acidity correction, being able to raise the exchangeable base levels in the soil profile faster than lime. Both limestone and slag increase dry matter yield of Congo signal grass, and grain yield of soybean and maize. Slag is more effective in improving maize grain yield.

A responsabilidade do Estado por dano causado à imagem

Pós-graduação em Direito - FCHS

“Brasil mostra a tua cara”: rock nacional, mídia e a redemocratização política (1982-1989)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Formação da Rede Vida de Televisão: entre a política brasileira de concessões televisivas e as diretrizes católicas de comunicação social, 1989-1995

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

Para além da nagocracia: a (re)africanização do camdomblé nação angola-congo em São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Informação e segurança pública: modelo de banco de dados para a gestão de informações em Moçambique

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A escola da escolha pública e o logrolling: um teste para o Senado Federal brasileiro, entre os anos de 2003 e 2006

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A campanha civilista nas ruas: uma análise de sua construção retórico-política

Pós-graduação em História - FCLAS

Congo grass grown in rotation with soybean affects phosphorus bound to soil carbon

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