Healthcare-Associated Infective Endocarditis: a Case Series in a Referral Hospital from 2006 to 2011

Background: Healthcare-associated infective endocarditis (HCA-IE), a severe complication of medical care, shows a growing incidence in literature. Objective: To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods: Observational prospective case series study (2006-2011) in a public hospital in Rio de Janeiro. Results: Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE) were included. There were 26 (49%) males (mean age of 47 ± 18.7 years), 27 (51%) females (mean age of 42 ± 20.1 years). IE was acute in 37 (70%) cases and subacute in 16 (30%) cases. The mitral valve was affected in 19 (36%) patients and the aortic valve in 12 (36%); prosthetic valves were affected in 23 (43%) patients and native valves in 30 (57%). Deep intravenous access was used in 43 (81%) cases. Negative blood cultures were observed in 11 (21%) patients, Enterococcus faecalis in 10 (19%), Staphylococcus aureus in 9 (17%), and Candida sp. in 7 (13%). Fever was present in 49 (92%) patients, splenomegaly in 12 (23%), new regurgitation murmur in 31 (58%), and elevated C-reactive protein in 44/53 (83%). Echocardiograms showed major criteria in 46 (87%) patients, and 34 (64%) patients were submitted to cardiac surgery. Overall mortality was 17/53 (32%). Conclusion: In Brazil HCA-IE affected young subjects. Patients with prosthetic and native valves were affected in a similar proportion, and non-cardiac surgery was an infrequent predisposing factor, whereas intravenous access was a common one. S. aureus was significantly frequent in native valve HCA-IE, and overall mortality was high.

Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010)

Background: Sudden cardiac death (SCD) is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents) according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR) was attempted were collected. Results: We identified 899 cases of SCD (20%); the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD) (64%) and occurred in men (67%), between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3%) and CPR was attempted in almost half of victims (49.7%). The most prevalent comorbidity was systemic hypertension (57.3%). Chagas’ disease was present in 49 cases (5.5%). Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

Taxonomic studies of the subgenus Helcocyrtomya: I. Series Oswaldoi (Diptera, Psychodidae, Phlebotominae)

Attempting to review the species of sandflies in the series oswaldoi of the subgenus Helcocyrtomyia, we examined 7650 specimens collected in different Brazilian regions during 35 years and deposited in the collection of the Centro de Pesquisas René Rachou, FIOCRUZ, Belo Horizonte, MG. As main results of this study new species of Helcocyrtomyia were described (Lutzomya pusilla and Lutzomya capixaba), in addition to the females of Lutzomyia ferreirana and Lutzomyia peresi; which had been described only by the males. The geographic distribution of the material examined is also presented.

Taxonomic studies of the subgenus Helcocyrtomyia: II. series Vexator (Diptera, Psychodidae, Phlebotominae)

Continuing to review the subgenus Helcocyrtomyia (Diptera, Psychodidae, Phlebotomiane) some specimens of sandflies from the vexator series were examined. Taxonomic remarks, geographic distribution and drawings of those species are presented.

Descriptions of Lutzomyia (Evandromyia) georgii n. sp. and a Synopsis of the Series infraspinosa (Diptera: Psychodidae)

Lutzomyia georgii n. sp. and the female of L. tarapacaensis in the Series infraspinosa of the subgenus Evandromyia are described, from specimens collected in rainforest in the north of the State of Pará, Brazil. The new species was taken together with five other Evandromyia species including L. infraspinosa (sensu strictu) in the same locality. L. georgii has previously been confused with both L. begonae and L. infraspinosa, whereas L. tarapacaensis would run to L. infraspinosa in recent taxonomic keys. The fact that both L. georgii and L. tarapacaensis are locally sympatric with L. infraspinosa helps to clarify the taxonomic limits of the latter species. New keys to the subgenus Evandromyia are provided.

Taxonomic revision of phlebotomine sand fly species in the series davisi and panamensis of the subgenus Psychodopygus Mangabeira, 1941 (Diptera: Psychodidae: Phlebotominae)

Several species of the subgenus Psychodopygus Mangabeira, 1941 are known to be leishmaniosis vectors in Brazil. Some of them are morphologically similar, which makes their identification quite difficult concerning epidemiological studies. The aim of the current work is to study the morphology of adult specimens of the subgenus Psychodopygus, in accordance with the morphological similarity and still taking into account the epidemiological importance of some species. Thus 11 species have been studied, including four subspecies of adult specimens deposited in the phlebotomine collection of Centro de Pesquisas René Rachou-Fiocruz. Morphological characters found in the literature and new features observed in this study were recorded in a taxonomic discussion format. These characters make it easy to separate such species. Four taxa, previously considered as subspecies, were raised to the category of species.

Caries prevalence in skeletal series: is it possible to compare?

Because of the relationship with subsistence, dental caries is a central issue in paleopathological research. Usually, comparisons between caries prevalence exhibited in different skeletal series are made. Dietary variation is the most common explanation for cavities prevalence. The aim of this paper is to verify if it is possible to compare caries prevalence reported on papers for archaeological skeletal series. Another goal is to determine if other factors besides diet are implicated in dental cavity prevalence explanation. Twenty six papers about dental health with caries prevalences published from 1999 to 2004 were analyzed for completeness. This assessment includes carious lesion diagnosis and characteristics, age, sex and size characteristics of samples, and prevalence calculation method. The majority of the analyzed papers do not provide adequate information in the topics listed above. Only very few implicated factors other than diet as a contributor to caries lesions development.

Assessment of growth and yield performance of rubber tree clones of the IAC 500 series

The objective of this work was to evaluate the performance of 15 clones of the IAC 500 series of Hevea brasiliensis, developed at Instituto Agronômico (IAC), over a 12-year period, in the northwest region of São Paulo State, Brazil. The 15 new clones evaluated are primary clones obtained from selected ortets within half-sib progenies. The clone RRIM 600, of Malaysian origin, was used as the control. Dry rubber yield performance over a four-year period, mean girth at the tenth year, girth increment before and during tapping, thermal properties of the natural rubber produced and other characters of the laticiferous system were evaluated. Forty percent of the clones were superior in comparison to the control for yield. Clone IAC 500 recorded the highest yield (66.81 g per tree per tapping) over four years of tapping, followed by IAC 502 (62.37 g per tree per tapping), whereas the control recorded 48.71 g per tree per tapping. All selected clones were vigorous in growth. The natural rubber from this IAC clones showed thermal stability up to 300ºC. No differences were observed in the thermal behavior of rubber among the IAC series and the RRIM 600 clones. The clones IAC 500, IAC 501, IAC 502, IAC 503 and IAC 506 are the more promising for small-scale plantations, due to growth and yield potential.

Cropland area estimates using Modis NDVI time series in the state of Mato Grosso, Brazil

The objective of this work was to evaluate a simple, semi‑automated methodology for mapping cropland areas in the state of Mato Grosso, Brazil. A Fourier transform was applied over a time series of vegetation index products from the moderate resolution imaging spectroradiometer (Modis) sensor. This procedure allows for the evaluation of the amplitude of the periodic changes in vegetation response through time and the identification of areas with strong seasonal variation related to crop production. Annual cropland masks from 2006 to 2009 were generated and municipal cropland areas were estimated through remote sensing. We observed good agreement with official statistics on planted area, especially for municipalities with more than 10% of cropland cover (R² = 0.89), but poor agreement in municipalities with less than 5% crop cover (R² = 0.41). The assessed methodology can be used for annual cropland mapping over large production areas in Brazil.

Predicting soil erosion using Rusle and NDVI time series from TM Landsat 5

The objective of this work was to evaluate the seasonal variation of soil cover and rainfall erosivity, and their influences on the revised universal soil loss equation (Rusle), in order to estimate watershed soil losses in a temporal scale. Twenty-two TM Landsat 5 images from 1986 to 2009 were used to estimate soil use and management factor (C factor). A corresponding rainfall erosivity factor (R factor) was considered for each image, and the other factors were obtained using the standard Rusle method. Estimated soil losses were grouped into classes and ranged from 0.13 Mg ha-1 on May 24, 2009 (dry season) to 62.0 Mg ha-1 on March 11, 2007 (rainy season). In these dates, maximum losses in the watershed were 2.2 and 781.5 Mg ha-1 , respectively. Mean annual soil loss in the watershed was 109.5 Mg ha-1 , but the central area, with a loss of nearly 300.0 Mg ha-1 , was characterized as a site of high water-erosion risk. The use of C factor obtained from remote sensing data, associated to corresponding R factor, was fundamental to evaluate the soil erosion estimated by the Rusle in different seasons, unlike of other studies which keep these factors constant throughout time.

Multidetector-row computed tomography in the preoperative diagnosis of intestinal complications caused by clinically unsuspected ingested dietary foreign bodies: a case series emphasizing the use of volume rendering techniques

Objective The present study was aimed at describing a case series where a preoperative diagnosis of intestinal complications secondary to accidentally ingested dietary foreign bodies was made by multidetector-row computed tomography (MDCT), with emphasis on complementary findings yielded by volume rendering techniques (VRT) and curved multiplanar reconstructions (MPR). Materials and Methods The authors retrospectively assessed five patients with surgically confirmed intestinal complications (perforation and /or obstruction) secondary to unsuspected ingested dietary foreign bodies, consecutively assisted in their institution between 2010 and 2012. Demographic, clinical, laboratory and radiological data were analyzed. VRT and curved MPR were subsequently performed. Results Preoperative diagnosis of intestinal complications was originally performed in all cases. In one case the presence of a foreign body was not initially identified as the causal factor, and the use of complementary techniques facilitated its retrospective identification. In all cases these tools allowed a better depiction of the entire foreign bodies on a single image section, contributing to the assessment of their morphology. Conclusion Although the use of complementary techniques has not had a direct impact on diagnostic performance in most cases of this series, they may provide a better depiction of foreign bodies' morphology on a single image section.

Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series

Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

Time-series forecasting of pollutant concentration levels using particle swarm optimization and artificial neural networks

This study evaluates the application of an intelligent hybrid system for time-series forecasting of atmospheric pollutant concentration levels. The proposed method consists of an artificial neural network combined with a particle swarm optimization algorithm. The method not only searches relevant time lags for the correct characterization of the time series, but also determines the best neural network architecture. An experimental analysis is performed using four real time series and the results are shown in terms of six performance measures. The experimental results demonstrate that the proposed methodology achieves a fair prediction of the presented pollutant time series by using compact networks.

SYNTHESIS AND BIOLOGICAL ACTIVITY OF NEW SERIES OF ORGANOTIN(IV) ESTERS WITH N,N-DIACETYLGLYCINE

A bioactive N,N-diacetylglycine (NNDAG) and new organotin(IV) complexes (OTCs) (1-7) were synthesized. Spectroscopic techniques were employed to characterize NNDAG and OTCs. FTIR was employed to verify N,N protection of glycine by acetyl groups. The disappearance of υ(OH) at 3000-2600 cm-1 showed de-protonation of free ligand. The Δυ 150<200 cm-1 of OTCs 4-7 verified bidentate coordination with tetrahedral geometry. The Δυ of OTCs1 and 3 was <200 cm-1 exhibitingtrans -octahedral geometry while OTC 2 dimer was assigned a unique sinusoidal view. The 1H NMR spectra of OTCs verified their synthesis by de-protonation of NNDAG and no chemical shift was found downfield for carboxylic acid proton. The 13C, 119Sn NMR and Mass spectrometric data also supported FTIR and 1H NMR descriptions. The OTCs 4, 5, 6 and7 (500 ppm) proved twice as active against Escherichia coli as the standard antibiotic enoxacin (1000 ppm). The promising property of the OTCs (4, 5, 6 and7) is clearly due to their tetrahedral. The OTCs 4and 5 exhibited excellent activity against M. minimum and good activity against T. castaneum.LD50 of all the compounds were determined and OTCs4, 5 and 7 were found to be active.

Thermal decomposition and stability in a series of heterobimetallic carbonyl compounds of the type [Fe(CO)4(HgX)2] (X=Cl, Br, I)

Heterobimetallic carbonyl compounds of the type [Fe(CO)4(HgX)2] (X= Cl, Br, I), which have metal-metal bonds, have been prepared in order to study their thermal stabilities as a function of the halogen coordinated to mercury atoms. The characterization of the above complexes was carried out by elemental analysis, IR and NMR spectroscopies. Their thermal behaviour has been investigated and the final product was identified by IR spectroscopy and by X-ray powder diffractogram.