Helicobacter pylori genotyping from positive clotests in patients with duodenal ulcer

Even though the seroprevalence of H. pylori may be high in the normal population, a minority develops peptic ulcer. Colonization of the gastric mucosa by more pathogenic vacA strains of H. pylori seems to be associated with enhanced gastric inflammation and duodenal ulcer. H. pylori genotyping from positive CLOtests was developed to determine the vacA genotypes and cagA status in 40 duodenal ulcer patients and for routine use. The pathogenic s1b/ m1/ cagA genotype was the most frequently occurring strain (17/42.5%); only two (5%) patients presented the s2/ m2 genotype, the less virulent strain. Multiple strains were also detected in 17 (42.5%) patients. Multiple strains of H. pylori colonizing the human stomach have been underestimated, because genotyping has been performed from cultures of H. pylori. We concluded that genotyping of H. pylori from a positive CLOtest had the advantages of reducing the number of biopsies taken during endoscopy, eliminating the step of culturing H. pylori, and assuring the presence of H. pylori in the specimen being processed.

Associations, causation and model in psychiatry

This paper discusses models, associations and causation in psychiatry. The different types of association (linear, positive, negative, exponential, partial, U shaped relationship, hidden and spurious) between variables involved in mental disorders are presented as well as the use of multiple regression analysis to disentangle interrelatedness amongst multiple variables. A useful model should have internal consistency, external validity and predictive power; be dynamic in order to accommodate new sound knowledge; and should fit facts rather than they other way around. It is argued that whilst models are theoretical constructs they also convey a style of reasoning and can change clinical practice. Cause and effect are complex phenomena in that the same cause can yield different effects. Conversely, the same effect can have a different range of causes. In mental disorders and human behaviour there is always a chain of events initiated by the indirect and remote cause; followed by intermediate causes; and finally the direct and more immediate cause. Causes of mental disorders are grouped as those: (i) which are necessary and sufficient; (ii) which are necessary but not sufficient; and (iii) which are neither necessary nor sufficient, but when present increase the risk for mental disorders.

Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

Adaptação transcultural da escala Locus of Control of Behaviour para o português: versão para idosos

Objetivo Apresentar a adaptação transcultural da escala Locus of Control of Behavior (LCB) para a língua portuguesa falada no Brasil. Métodos O processo de adaptação foi realizado em cinco etapas: tradução, retradução, avaliação da equivalência entre a retradução e a escala original, elaboração de uma versão pré-teste e aplicação na população-alvo composta por 16 idosos (56 a 80 anos), com quatro anos mínimos de escolaridade. Resultados A versão adaptada não gerou problemas de compreensão, aceitabilidade ou impacto emocional negativo. Conclusão Este trabalho torna disponível a primeira versão em Português da LCB, uma escala que tem sido particularmente utilizada para avaliar o tipo de locus de controle (LoC) no que concerne ao prognóstico de tratamentos em saúde mental.

Doppler echocardiographic evaluation of HIV-positive patients in different stages of the disease

OBJETIVE: To evaluate by Doppler echocardiography (DE) early abnormalities of ventricular function in HIV-positive patients, as well as other cardiac abnormalities that can be detected by this method, with special emphasis on mitral valve flow. METHODS: 84 HIV- positive patients, 59 with CD4 cell count >500/mm³ (Group A) and 25 with CD4 cell count <500/mm³ (Group B), were analyzed. CD4 cells were counted and matched with structural data and systolic and diastolic function of the left ventricle (LV), as analyzed by DE. The results were compared with those obtained in 47 healthy individuals (Group C). RESULTS: 8% of patients in Group B had mild pericardial effusion; 31.5% showed decreased systolic function of the LV, and 12% had moderate mitral regurgitation. A wave velocity from the mitral inflow was different among the 3 groups, being higher in Group B, where the deceleration time of the E wave of the mitral inflow and the E/A ratio were significantly lower with a normal value of the isovolumic relaxation time (IVRT). CONCLUSION: HIV-positive patients with a CD4 cell count >500/mm³ had no abnormalities by DE. Patients with a more advanced infection (those with a CD4 cell count <500/mm³), had a significantly abnormal LV systolic function and a higher incidence of pericardial effusion and mitral regurgitation. Mitral valve inflow by Doppler did not indicate diastolic dysfunction.

Oxygen therapy, continuous positive airway pressure, or noninvasive bilevel positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema

OBJECTIVE: To compare the effects of 3 types of noninvasive respiratory support systems in the treatment of acute pulmonary edema: oxygen therapy (O2), continuous positive airway pressure, and bilevel positive pressure ventilation. METHODS: We studied prospectively 26 patients with acute pulmonary edema, who were randomized into 1 of 3 types of respiratory support groups. Age was 69±7 years. Ten patients were treated with oxygen, 9 with continuous positive airway pressure, and 7 with noninvasive bilevel positive pressure ventilation. All patients received medicamentous therapy according to the Advanced Cardiac Life Support protocol. Our primary aim was to assess the need for orotracheal intubation. We also assessed the following: heart and respiration rates, blood pressure, PaO2, PaCO2, and pH at begining, and at 10 and 60 minutes after starting the protocol. RESULTS: At 10 minutes, the patients in the bilevel positive pressure ventilation group had the highest PaO2 and the lowest respiration rates; the patients in the O2 group had the highest PaCO2 and the lowest pH (p<0.05). Four patients in the O2 group, 3 patients in the continuous positive pressure group, and none in the bilevel positive pressure ventilation group were intubated (p<0.05). CONCLUSION: Noninvasive bilevel positive pressure ventilation was effective in the treatment of acute cardiogenic pulmonary edema, accelerated the recovery of vital signs and blood gas data, and avoided intubation.

Oviposition behaviour of Gryon gallardoi (Hymenoptera, Scelionidae) on eggs of different ages of Spartocera dentiventris (Hemiptera, Coreidae)

The oviposition behaviour of Gryon gallardoi (Brèthes, 1914) on eggs of Spartocera dentiventris Mendonça Jr. (Berg, 1884) of different ages (2, 3, 4, 5, 6, 7, 8 and 12 days) was investigated. Groups of 12 eggs of each age were exposed to single females of G. gallardoi, and the oviposition behaviour was recorded under a stereomicroscope for two hours. Ten replicates were used for each age. In order to identify the moment the parasitoid egg was released inside the host, 1-day old eggs of S. dentiventris were exposed to G. gallardoi females, and the oviposition was interrupted at intervals of 20, 40, 60, 80, 100, 120, 140 and 160s after ovipositor insertion had initiated. Five behavioural steps were recorded: drumming, ovipositor insertion, marking, walking and resting. The average drumming and ovipositor insertion times increased with the host age (P<0.01). Ovipositor insertion usually occurred next to the longitudinal extremities of the host eggs. Marking took on average 19.5 ± 0.7s, and as walking and resting, was not affected by host age. Self-parasitism behaviour was observed in only 13.8 ± 2.3% of the eggs, being more evident with increasing patch depletion (reduction in non-parasitized eggs in the egg group, P<0.01), again with no variation due to changes in host egg age. For all ages tested, self-parasitized host eggs were less frequently contacted and accepted than non-parasitized ones (P<0.01). The parasitoid egg was released 137.0 ± 3.7s after ovipositor insertion. Spartocera dentiventris egg condition can lead to parasitoid behavioural changes, especially during the process of host choice and discrimination.

Feeding ecology of Ozotoceros bezoarticus: conservation implicationsin Uruguay

The pampas deer (Ozotoceros bezoarticus Linnaeus, 1758) was in the recent past one of the most characteristic species in the Uruguayan grasslands. However, today the species is very rare, with small relict populations inhabiting in few ranches. To improve our understanding of pampas deer habitat use in modified ecosystems and propose management guidelines we analyzed the pampas deer feeding ecology at Los Ajos ranch. We performed an annual vegetation survey with the purpose to identify the main components of pampas's deer diet and the spatial overlap with livestock. Vegetation offer was characterized by predominance of monocotyledon plants; in three of the four sample periods. The preference values for the crops were positive for ryegrass in winter (0.24) and spring (0.54), the moments of greatest productivity of this pasture; while the rice crops values were negative all year round. The spatial overlap indexes with sheep show a complete exclusion, whereas with cattle the indexes gave values of 0.95 in spring to 0.14 in summer. The niche amplitude was significantly correlated with the spatial overlap levels with cattle. Pampas deer foraging behaviour is opportunistic, typical of mixed feeders. Conservation efforts should focus on implementation of management guidelines of agriculture and cattle breeding activities.

The study of insect blood-feeding behaviour: 1. Feeding equipment, physical and endogenous factors, dose effect analysis, and diet destination

Experimental techniques that we have found useful during our studies of insect blood-feeding behaviour are reviewed. Some of the principal findings resulting from these techniques are discussed. Where directly applicable, the work of others is included, but no complete review of the subject has been attempted.

The study of insect blood-feeding behaviour: 2. Recording techniques and the use of flow charts

This paper continues a discussion of approaches and methodologies we have used in our studies of feeding in haematophagous insects. Described are techniques for directly monitoring behaviour: electrical recording of feeding behaviour via resistance changes in the food canal, optical methods for monitoring mouthpart activity, and a computer technique for behavioural event recording. Also described is the use of "flow charts" or "decision diagrams" to model interrelated sequences of behaviours.

Influence of several plant extracts on the oviposition behaviour of Aedes fluviatilis (Lutz) (Diptera: Culicidae) in the laboratory

Whole, ethanolic, hexanic, lyophilized extracts of several plants and anacardic acid tested in respect of their influence on the oviposition behavior of Aedes fluviatilis (Lutz) at 100, 10 and 1 ppm concentrations. Extracts of Allium stivum, Jatropha curcas, Mikania schenkii, Poinciana regia and Spatodea campanulata had a repulsive effect (α=0.05) on females at 100 ppm, those of Anacardium occidentale, Bidens segetum and Caesalpinia peltophoroides were also repelent at 10 ppm. Extracts of Coriandrum sativum (100, 10 and 1 ppm), Chara Zeylanica (10 ppm), Cupressus sempervirens (10 ppm), Foeniculum vulgare (10 ppm) and Spatodea campanulata (1 ppm) were attractive to the females; 13 (52.0%) of the extracts tested, did not influence the oviposition behavior.

Experimental infection with Leishmania (Viannia) braziliensis, and Leishmania (Leishmania) amazonensis in the marmoset, Callithrix penicillata (Primates: Callithricidae)

Foureen marmosets (Callithrix penicillata) were inoculated intradermally with promastigotes and/or amastigotes of Leishmania (Viannia) brazilensis (L. (V) b.) strains MHOM/BR/83/LTB-300MHOM/BR/85/LTB-12 MHOM/BR/81/LTB-179 and MHOM/BR/82/LTB-250. The evolution of subsequent lesions was studied for 15 to 75 weeks post-inoculation (PI). All but of the L. (V) b. injected marmosets developed a cutaneous lesion at the point of inoculation after 3 to 9 weeks, characterized by the appearance of subcutaneous nodules containing parasites. parasites were isolated by culture (Difco Blood Agar) from all 11 positive animals. The maximum size of the lesions was variable and ranged between 37 mm² to 107 mm². Ulceration of primary nodules became evident after 3 to 12 weeks in all infected marmosets, but was faster and larger in 5 of the 11 animals. The active lesions persisted in 9 out of 11 Callithrix until the en of the observation period, which varied from 15-75 weeks. In 3 animals spontaneous healing of their lesions (13 to 25 weeks, PI) was observed buth with cryptic parasitism. In another 2 infected animals there was regression followed by reactivation of the cutaneous lesions. The appearance of smaller satellite lesions adjacent to primary ones, as well as metastatic lesions to the ear lobes, were documented in 2 animals. Promastigotes of L. (Leishmania) amazonensis (L.(L)a.) MHOM/BR/77/LTB-16 were inoculated in 1 marmoset. This animal remained chronically infected for 6 months and the lesions developed in a similar manner to L.(V)b. infected marmosets. No significant differences in clinical and parasitological behaviour were observed between promastigote or amastigote derived infections of the 2 species. Both produced chronic, long lasting lesions which eventually healed. The same was true for parameters of size and ulceration. Skin tests converted to parasite in 11 of 15 inected masmosets and in 10 of 12 parasite positive animnals. Moderate levels of circulating antibodies were also observed by IFAT /IgG assays. In spite of the failure to reproduce the mucosal form of the disease, an important aspect of the Callithrix model in experimental cutaneous leishmaniasis lies in the reproduction of 2 clinical events that are common in humans, namely, the chronic ulceration and spontaneous healing of the lesions.