DOTS in primary care units in the city of Rio de Janeiro, Southeastern Brazil

OBJECTIVE: To describe the implantation and the effects of directly-observed treatment short course (DOTS) in primary health care units. METHODS: Interviews were held with the staff of nine municipal health care units (MHU) that provided DOTS in Rio de Janeiro City, Southeastern Brazil, in 2004-2005. A dataset with records of all tuberculosis treatments beginning in 2004 in all municipal health care units was collected. Bivariate analyses and a multinomial model were applied to identify associations between treatment outcomes and demographic and treatment process variables, including being in DOTS or self-administered therapy (SAT). RESULTS: From 4,598 tuberculosis cases treated in public health units administrated by the municipality, 1,118 (24.3%) were with DOTS and 3,480 (75.7%) with SAT. The odds of DOTS were higher among patients with age under 50 years, tuberculosis relapse and prior history of default or treatment failure. The odds of death were 52.0% higher among patients on DOTS as compared to SAT. DOTS modality including community health workers (CHWs) showed the highest treatment success rate. A reduction of 21.0% was observed in the odds of default (vs. cure) among patients on DOTS as compared to patients on SAT, and a reduction of 64.0% among patients on DOTS with CHWs as compared to those without CHWs. CONCLUSIONS: Patients with a "low compliance profile" were more likely to be included in DOTS. This strategy improves the quality of care provided to tuberculosis patients, although the proposed goals were not achieved.

Studying nanotoxic effects of CdTe quantum dots in Trypanosoma cruzi

Semiconductor nanoparticles, such as quantum dots (QDs), were used to carry out experiments in vivo and ex vivo with Trypanosoma cruzi. However, questions have been raised regarding the nanotoxicity of QDs in living cells, microorganisms, tissues and whole animals. The objective of this paper was to conduct a QD nanotoxicity study on living T. cruzi protozoa using analytical methods. This was accomplished using in vitro experiments to test the interference of the QDs on parasite development, morphology and viability. Our results show that after 72 h, a 200 μM cadmium telluride (CdTe) QD solution induced important morphological alterations in T. cruzi, such as DNA damage, plasma membrane blebbing and mitochondrial swelling. Flow cytometry assays showed no damage to the plasma membrane when incubated with 200 μM CdTe QDs for up to 72 h (propidium iodide cells), giving no evidence of classical necrosis. Parasites incubated with 2 μM CdTe QDs still proliferated after seven days. In summary, a low concentration of CdTe QDs (2 μM) is optimal for bioimaging, whereas a high concentration (200 μM CdTe) could be toxic to cells. Taken together, our data indicate that 2 μM QD can be used for the successful long-term study of the parasite-vector interaction in real time.

Cobertura do tratamento diretamente observado (DOTS) da Tuberculose no Estado de São Paulo (1998 a 2004)

Objetivando descrever a cobertura do DOTS, analisou-se o Tratamento Supervisionado (TS) nos 36 municípios prioritários para o controle da TB do Estado de São Paulo entre 1998 e 2004. Estudo exploratório fundamentado no Banco de Dados EPI-TB da Secretaria de Estado da Saúde de São Paulo. Foi elaborado um instrumento de coleta de dados e calculada a cobertura do TS. Os dados foram dispostos no programa Excel. Nos municípios que implantaram o TS em 1998, a cobertura foi inferior a 20%. Em 1999, metade dos municípios alcançou cobertura entre 11 e 49%. Em 2000, houve 100% de implantação do TS, porém, o valor máximo de cobertura alcançado foi 61 %. Entre 2001 e 2002, a cobertura aumentou em 69,44 % dos municípios. Em 2003, em 22 municípios a cobertura estava abaixo de 50%. Em 2004 houve tendência de aumento de cobertura em 63,89% destes municípios.

Plasmódio de primata do Brasil

A second species of monkey Plasmodium of the New World is described from the howler monkey Alouatta`fusca GEOFFROY, 1812, captured in Itapecirica, São Paulo, Brazil. The new species differs from Plasmodium brasilianum GONDER et VON BERENBERG-GOSSLER, 1909 by following characters: 1st. Almost constant presence in the blood cells of granulations of the same type as SCHÜFFNER dots. 2nd. Considerable hypertrophy of the parasitised cells. 3rd. Greater number of merozoites after schizogony with an habitual minimum of 16 elements in contrast with the maximum of 16 in Plasmodium brasilianum. 4th. Extreme rarity of band forms. This morphology strongly suggests an infection of the benignan tertian type. To this new species the name of Plasmodium simium, sp.n. is proposed.

Physa Marmorata Guilding, 1828 (Pulmonata: Physidae)

A description of Physa marmorata Guilding, 1828, based on material collected at its type-locality, the Caribbean island of Saint Vincent, is presented. The shell is thin, horn-colored, surface very glossy, diaphanous. Spire acute, elevated; protoconch distinct, rounded-conical, reddish-brown; five not shouldered, broadly convex whorls with subobsolete spiral lines and thin growth lines. Aperture elongated, 1.4-2.0 times as long as the remaining shell length, narrow obovate-lunate; upper half acute-angled,lower half oval,narrowly rounded at the base, outer lip sharp, inner lip completely closing the umbilical region; a very distinct callus on the parietal wall; columellar lip with a low ridge gradually merging into the callus. ratios: shell width/shell length = 0.44 - 0.52 (mean 0.47); spire length /shell lenght = 0.33-0.41 (mean 0.39); aperture length/shell lenght = 0.59-0.67 (mean 0.62). Oral lappets laterally mucronate, foot spatulate with deeply pigmented acuminate tail. Mantle reflection with 6-10 short triangular dentations covering nearly half the right surface of the body whorl, and 4-6 covering a part of the ventral wall. Body surface with tiny dots of greenish-yellow pigment besides melanin. Renal tube tightly folded in toa zigzag course. Ovotestis diverticula acinous, laterally pressed against each other around a collecting canal. Ovispermiduct with well-developed seminal vesicle. oviduct highly convoluted, merging into a less convoluted nidamental gland which narrows to a funnel-shaped uterus and a short vagina. Spermathecal body oblong, more or less constricted in the middle and somewhat curved; spermathecal duct uniformly narrow, a little longer than be body. About 20 prostatic diverticula, simple, bifurcate or divided into a few short branches, distalmost ones assembled into a cluster. Penis long, nearly uniformly narrow; penial canal with lateral opening about the junction of its middle and lower thirds. Penial sheath with a bulbous terminal expasion the tip of which isinserted into the caudal end of the prepuce. Prepuce shouldered, much wider than the narrow portion of the penial sheath. Penial sheath/prepuce ratio about 2.08 (1.45-2.75). The main extrinsic muscles of the penial complex are a retractor, with a branch attached to the bulb, and another to the caudal end of the penial sheath; and a protractor, with a branch attached to the shoulder of the prepuce and adjoining area of the penial sheath, and another to the caudal end of the penial sheath. Egg capsule C-shaped, with 10-30 elliptical eggs (snails 10mm long) measuring about 1.10 mm (0.90-1.32) through the long axis and surrounded by an inner and an outer lamellate membranes. Jaw a simple obtusely V-shaped plate. radula will be described separately.

O sistema de informação e o controle da tuberculose nos municípios prioritários da Paraíba - Brasil

Objetivou-se conhecer a percepção dos coordenadores do Programa de Controle da Tuberculose quanto à utilização do Sistema de Informação de Agravos de Notificação (SINAN) como instrumento da estratégia DOTS (Directly Observed Treatment). Estudo de natureza qualitativa utilizou a entrevista semi-estruturada com oito coordenadores do Programa de Controle da Tuberculose de seis municípios paraibanos. Os resultados evidenciaram que os municípios utilizam o SINAN para avaliação das ações de controle da tuberculose, apontando como dificuldades, deficiência do preenchimento das fichas de notificação de tuberculose; precária infra-estrutura de informática; qualificação insuficiente de recursos humanos; falta de integração entre profissionais de diferentes setores; deficiência do fluxo da informação entre unidades de saúde/municípios. Considerando que a qualidade da informação pode comprometer o monitoramento dos resultados de tratamento dos pacientes e conseqüentemente a eficácia da estratégia DOTS, conclui-se que é fundamental o compromisso político da gestão para superar as fragilidades identificadas.

Tuberculose: tratamento supervisionado nas Coordenadorias de Saúde Norte, Oeste e Leste do Município de São Paulo

O estudo objetivou analisar potencialidades e limites da estratégia do Tratamento Diretamente Supervisionado (DOTS), sob o ponto de vista de pacientes e trabalhadores de Unidades Básicas de Saúde das Coordenadorias Norte, Oeste e Leste, do Município de São Paulo. Os depoimentos foram coletados, após consentimento livre e esclarecido, e decodificados por meio de técnica de análise de discurso. Tomando-se como referencial teórico a Teoria da Determinação Social do Processo Saúde-Doença, de modo geral, identificou-se que o DOTS possibilita a criação de vínculo e que a adesão ao tratamento se associa à necessidade de volta ao trabalho. Os limites identificados foram: o não envolvimento dos profissionais no tratamento e a irregular distribuição de incentivos. Os achados revelam que a adesão ao tratamento transcende o âmbito biológico e individual, apontando-se como fundamental que os trabalhadores de saúde reconheçam os pacientes como portadores de necessidades, que não se restringem ao tratamento da tuberculose.

O estado da arte da síntese de semicondutores nanocristalinos coloidais

Colloidal semiconductor nanocrystals, also known as quantum dots, have attracted great attention since they have interesting size-dependent properties due to the quantum confinement effect. These nanoparticles are highly luminescent and have potential applications in different technological areas, including biological labeling, light-emitting diodes and photovoltaic devices. The synthetic methods of semiconductor nanocrystals have progressed in the last 30 years, and several protocols were developed to synthesize monodisperse nanocrystals with good optical properties, different compositions and morphologies. This review describes the main methods used to synthesize nanocrystals in the II-VI and III-V systems, and the recent approaches in this field of research.

Precipitação seletiva de tamanhos em nanopartículas semicondutoras coloidais de CdTe e CdSe: um estudo por espectroscopia UV-VIS

The post-preparative size-selective precipitation technique was applied in CdTe and CdSe semiconductor nanocrystals prepared via colloidal route in water. The synthesis of CdTe and CdSe nanoparticles and the effect of the post-preparative size-selective precipitation have been characterized mainly by mean of ultraviolet and visible absorption spectroscopy (UV-Vis). It was demonstrated that the size-selective precipitation are able to isolate particles of different sizes and purify the nanoparticles as well.

EFEITO DA ESTRUTURA MOLECULAR DE LIGANTES DE SUPERFÍCIE EM PONTOS QUÂNTICOS DE CdTe DISPERSOS EM ÁGUA

Water-soluble CdTe quantum dots are synthesized to investigate how short-chain surface ligands bearing -SH, -COOH, and -NH2 groups interact with CdTe during nucleation/growth processes. Their optical properties and colloidal stability after the ligand exchange are also investigated. We then characterize the resulting CdTe by fluorescence, UV–Vis absorption, and infrared spectroscopies. The stability of the colloidal dispersions was determined by their Zeta potentials. The results show that in the synthesis of water-soluble CdTe, surface ligands with at least two functional groups are required and the hard/soft character of them is an important factor in the stability of CdTe.

PREPARAÇÃO DE PONTOS DE CARBONO E SUA CARACTERIZAÇÃO ÓPTICA: UM EXPERIMENTO PARA INTRODUZIR NANOCIÊNCIA NA GRADUAÇÃO

Carbon dots (CDs) constitute a new class of carbon-based nanomaterials that measure less than 10 nm and display attractive physical and chemical features such as fluorescence. CDs have been considered the new “power” carbon nanomaterials since their accidental discovery in 2004. This study reports a simple, easy, and accessible experiment for undergraduate courses. The experiment involves the preparation of CDs by pyrolysis using commercial gelatin as a low cost precursor as well as CD purification and optical characterization. The optical properties of CDs such as absorption and emission properties make them a promising material for teaching the basic concepts and techniques used for characterization of nanomaterials. Also, the reactants and final product are suitable for undergraduate courses since they are non-toxic materials. The prepared CDs can be used in such applications as bioimaging, solar cells, and photocatalysis.

Experimental validation of a 3-D vision-based measurement system applied to robot calibration

One of the problems that slows the development of off-line programming is the low static and dynamic positioning accuracy of robots. Robot calibration improves the positioning accuracy and can also be used as a diagnostic tool in robot production and maintenance. A large number of robot measurement systems are now available commercially. Yet, there is a dearth of systems that are portable, accurate and low cost. In this work a measurement system that can fill this gap in local calibration is presented. The measurement system consists of a single CCD camera mounted on the robot tool flange with a wide angle lens, and uses space resection models to measure the end-effector pose relative to a world coordinate system, considering radial distortions. Scale factors and image center are obtained with innovative techniques, making use of a multiview approach. The target plate consists of a grid of white dots impressed on a black photographic paper, and mounted on the sides of a 90-degree angle plate. Results show that the achieved average accuracy varies from 0.2mm to 0.4mm, at distances from the target from 600mm to 1000mm respectively, with different camera orientations.

The attentional modulation of the flash-lag effect

If a dot is flashed in perfect alignment with a pair of dots rotating around the visual fixation point, most observers perceive the rotating dots as being ahead of the flashing dot (flash-lag effect). This perceptual effect has been interpreted to result from the perceptual extrapolation of the moving dots, the differential visual latencies between flashing and moving stimuli, as well as the modulation of attentional mechanisms. Here we attempted to uncouple the attentional effects brought about by the spatial predictability of the flashing dot from the sensory effects dependent on its visual eccentricity. The stimulus was a pair of dots rotating clockwise around the fixation point. Another dot was flashed at either the upper right or the lower left of the visual field according to three separate blocked situations: fixed, alternate and random positions. Twenty-four participants had to judge, in all three situations, the location of the rotating dots in relation to the imaginary line connecting the flashing dot and the fixation point at the moment the dot was flashed. The flash-lag effect was observed in all three situations, and a clear influence of the spatial predictability of the flashing dot on the magnitude of the perceptual phenomenon was revealed, independently of sensory effects related to the eccentricity of the stimulus in the visual field. These findings are consistent with our proposal that, in addition to sensory factors, the attentional set modulates the magnitude of the differential latencies that give rise to the flash-lag phenomenon.

An immunohistochemical, clinical and electroneuromyographic correlative study of the neural markers in the neuritic form of leprosy

The nerve biopsies of 11 patients with pure neuritic leprosy were submitted to routine diagnostic procedures and immunoperoxidase staining with antibodies against axonal (neurofilament, nerve growth factor receptor (NGFr), and protein gene product (PGP) 9.5) and Schwann cell (myelin basic protein, S-100 protein, and NGFr) markers. Two pairs of non-adjacent histological cross-sections of the peripheral nerve were removed for quantification. All the fascicles of the nerve were examined with a 10X-ocular and 40X-objective lens. The immunohistochemistry results were compared to the results of semithin section analysis and clinical and electroneuromyographic data. Neurofilament staining was reduced in 100% of the neuritic biopsies. NGFr positivity was also reduced in 81.8%, PGP staining in 100% of the affected nerves, S100 positivity in 90.9%, and myelin basic protein immunoreactivity in 90.9%. Hypoesthesia was associated with decreased NGFr (81.8%) and PGP staining (90.9%). Reduced potential amplitudes (electroneuromyographic data) were found to be associated with reduced PGP 9.5 (63.6%) and nerve fiber neurofilament staining (45.4%) by immunohistochemistry and with loss of myelinated fibers (100%) by semithin section analysis. On the other hand, the small fibers (immunoreactive dots) seen amid inflammatory cells continued to be present even after 40% of the larger myelinated fibers had disappeared. The present study shows an in-depth view of the destructive effects of leprosy upon the expression of neural markers and the integrity of nerve fiber. The association of these structural changes with the clinical and electroneuromyographic manifestations of leprosy peripheral neuropathy was also discussed.