Avaliação imediata e após 6 meses da resistência de união a dentina de restaurações de resina composta classe I in vivo e in vitro

Pós-graduação em Odontologia Restauradora - ICT

Anomalous diffusion evidenced by particle tracking at high frame rates.

Diffusion is a common phenomenon in nature and generally is associated with a system trying to reach a local or a global equilibrium state, as a result of highly irregular individual particle motion. Therefore it is of fundamental importance in physics, chemistry and biology. Particle tracking in complex fluids can reveal important characteristics of its properties. In living cells, we coat the microbead with a peptide (RGD) that binds to integrin receptors at the plasma membrane, which connects to the CSK. This procedure is based on the hypothesis that the microsphere can move only if the structure where it is attached move as well. Then, the observed trajectory of microbeads is a probe of the cytoskeleton (CSK), which is governed by several factors, including thermal diffusion, pressure gradients, and molecular motors. The possibility of separating the trajectories into passive and active diffusion may give information about the viscoelasticity of the cell structure and molecular motors activity. And also we could analyze the motion via generalized Stokes-Einstein relation, avoiding the use of any active techniques. Usually a 12 to 16 Frames Per Second (FPS) system is used to track the microbeads in cell for about 5 minutes. Several factors make this FPS limitation: camera computer communication, light, computer speed for online analysis among others. Here we used a high quality camera and our own software, developed in C++ and Linux, to reach high FPS. Measurements were conducted with samples for 10£ and 20£ objectives. We performed sequentially images with different intervals, all with 2 ¹s exposure. The sequences of intervals are in milliseconds: 4 5 ms (maximum speed) 14, 25, 50 and 100 FPS. Our preliminary results highlight the difference between passive and active diffusion, since the passive diffusion is represented by a Gaussian in the distribution of displacements of the center of mass of individual beads between consecutive frames. However, the active process, or anomalous diffusion, shows as long tails in the distribution of displacements.

Mercury-induced autoimmunity : Genetics and immunoregulation

The existence of immune self-tolerance allows the immune system to mount responses against infectious agents, but not against self-molecular constitutes. Although self-tolerance is a robust phenomenon, in some individuals as well as in experimental models, the self-tolerance breaks down and as a result, a self-destructive autoimmune disease emerges. The underlying mechanisms for the development of autoimmune diseases are not known, but genetic, environmental and immunological factors are suggested to be involved. In this thesis, we used murine mercury-induced autoimmunity to test this suggestion. In susceptible mice mercuric chloride induces a systemic autoimmune disease characterized by increased serum levels of IgG1 and IgE, production of anti-nucleolar autoantibodies (ANolA) and formation of renal IgG deposits. In contrast, in resistant DBA/2 (H-2d) mice, none of these characteristics develop after exposure to mercury. By crossing and backcrossing mercury-resistant DBA/2 mice to mercury susceptible strains, we found that the resistance was inherited as a dominant trait in F1 hybrids and that one gene or a cluster of genes located in the H-2 loci determined the resistance to ANolA production, whereas resistance to the other characteristics was found to be controlled by two or three non-H-2 genes. We further put forward the “cryptic peptide hypothesis” to investigate whether mercury and another xenobiotic metal use similar pathway(s) to induce the H-2 linked production of ANolA. We found that while mercury stimulated ANolA synthesis in all H-2 susceptible (H-2s, H-2q and H-2f) mouse strains, silver induced only ANolA responses in H-2s and H-2q mice, but not in H-2f mice. Further studies showed that the resistance to silver-induced ANolA production in H-2f mice was inherited as a dominant trait. We next tested the proposition that mercury induces more adverse immunological effects in mouse strains, which are genetically prone to develop autoimmune diseases, using tight-skin 1 mice, an animal model for human Scleroderma. It was found that in this strain, mercury induced a strong immune activation with autoimmune characteristics, but did not accelerate the development of dermal fibrosis, a characteristic in Tsk/1 mice. Finally we addressed the Th1/Th2 cross-regulation paradigm by examining if a Th1-type of response could interact with a Th2-type of response if simultaneous induced in susceptible mice. Our findings demonstrated that mercury-induced autoimmunity (Th2-type) and collagen-induced arthritis (CIA) (Th1-type) can interact in a synergistic, antagonistic or additive fashion, depending on at which stage of CIA mercury is administered.

Messung des Wirkungsquerschnitts der Reaktion d(e,e'p)n für fehlende Impulse bis 950 MeV/c und Trennung der longitudinalen und transversalen Reaktionsanteile für fehlende Impulse bis 350 MeV/c

Die Dreispektrometeranlage der A1-Kollaboration am MainzerElektronenbeschleuniger MAMI wurde im Rahmen dieser Arbeitverwendet, um die Elektrodisintegration des Deuteronsmit Hilfe der Reaktion d(e,e'p)n zu untersuchen. Im ersten Teil der Untersuchungen wurde die longitudinaleund transversale Strukturfunktion aus denWirkungsquerschnitten extrahiert. Die Zentralwerte derkinematischen Parameter waren dabei wie folgt eingestellt:1) Der Impulsübertrag wurde für alle Messungen auf 450 MeV/c festgelegt.2) Das Proton wurde in Richtung des Impulsübertrags nachgewiesen (parallele Kinematik).3) Vier Einstellungen des Energieübertrags, und damit korrespondierend des fehlenden Impulses, wurden gemessen: Energieübertrag / MeV : 128, 226, 289, 360. Fehlender Impuls / (MeV/c): 50, 200, 275, 350.4) Für jede dieser vier Kinematiken wurden mindestens drei verschiedene Einschußenergien bzw. Elektronenstreuwinkel eingestellt, um die Strukturfunktionen mit Hilfe der Rosenbluth-Separation zu bestimmen. Im zweiten Teil der Untersuchungen wurde derWirkungsquerschnitt für hohe fehlende Impulse bestimmt.Dessen Zentralwerte wurden von 30 MeV/c bis 906 MeV/cvariiert, wobei für die hohen fehlenden Impulse das Protonweit außerhalb der Richtung des Impulsübertragesnachzuweisen war. Der Energieübertrag lag dabei zwischen180 MeV und 600 MeV und der Impulsübertrag zwischen608 MeV/c und 698 MeV/c.

Hypersurfaces with many singularities

1. Teil: Bekannte Konstruktionen. Die vorliegende Arbeit gibt zunächst einen ausführlichen Überblick über die bisherigen Entwicklungen auf dem klassischen Gebiet der Hyperflächen mit vielen Singularitäten. Die maximale Anzahl mu^n(d) von Singularitäten auf einer Hyperfläche vom Grad d im P^n(C) ist nur in sehr wenigen Fällen bekannt, im P^3(C) beispielsweise nur für d<=6. Abgesehen von solchen Ausnahmen existieren nur obere und untere Schranken. 2. Teil: Neue Konstruktionen. Für kleine Grade d ist es oft möglich, bessere Resultate zu erhalten als jene, die durch allgemeine Schranken gegeben sind. In dieser Arbeit beschreiben wir einige algorithmische Ansätze hierfür, von denen einer Computer Algebra in Charakteristik 0 benutzt. Unsere anderen algorithmischen Methoden basieren auf einer Suche über endlichen Körpern. Das Liften der so experimentell gefundenen Hyperflächen durch Ausnutzung ihrer Geometrie oder Arithmetik liefert beispielsweise eine Fläche vom Grad 7 mit $99$ reellen gewöhnlichen Doppelpunkten und eine Fläche vom Grad 9 mit 226 gewöhnlichen Doppelpunkten. Diese Konstruktionen liefern die ersten unteren Schranken für mu^3(d) für ungeraden Grad d>5, die die allgemeine Schranke übertreffen. Unser Algorithmus hat außerdem das Potential, auf viele weitere Probleme der algebraischen Geometrie angewendet zu werden. Neben diesen algorithmischen Methoden beschreiben wir eine Konstruktion von Hyperflächen vom Grad d im P^n mit vielen A_j-Singularitäten, j>=2. Diese Beispiele, deren Existenz wir mit Hilfe der Theorie der Dessins d'Enfants beweisen, übertreffen die bekannten unteren Schranken in den meisten Fällen und ergeben insbesondere neue asymptotische untere Schranken für j>=2, n>=3. 3. Teil: Visualisierung. Wir beschließen unsere Arbeit mit einer Anwendung unserer neuen Visualisierungs-Software surfex, die die Stärken mehrerer existierender Programme bündelt, auf die Konstruktion affiner Gleichungen aller 45 topologischen Typen reeller kubischer Flächen.

Die Rolle von gamma2-Adaptin im endo-lysosomalen Proteintransport von Säuger-Zellen

Ziel der Arbeit war es, die physiologische Funktion von 2-Adaptin zu charakterisieren. 2 Adaptin wurde 1998 erstmals von Takatsu et al. und Lewin et al. als mögliches Mitglied der Clathrin-Adapter-Proteinfamilie beschrieben. Seine genaue physiologische Funktion ist aber bis heute noch unklar. Bisherige Ergebnisse deuten darauf hin, das 2-Adaptin unabhängig von den AP-Komplexen wirkt. rnIn der HBV-Morphogenese ist eine spezielle Funktion von 2-Adaptin bekannt, da es dort nach seiner Ubiquitinierung durch Nedd4 als Adapter zwischen dem HBV L- und Core-Protein fungiert und Änderungen in der 2 Konzentration die HBV-Freisetzung blockieren.rn2-Adaptin besitzt neben den für die Clathrin-Adapter Proteine typischen Clathrin-bindenden Eigenschaften auch die Fähigkeit, Ubiquitin über sein UIM zu binden. Darüberhinaus wird 2-Adaptin durch seine Interaktion mit der Ubiquitin-Ligase Nedd4 selbst ubiquitiniert. Damit besitzt 2-Adaptin typische Eigenschaften eines Ubiquitin-Adapters. 2-Adaptin ist an MVBs lokalisiert und Abweichungen in der 2 Konzentration verändern die MVB-Morphologie. Zudem führt die Überexpression von 2-Adaptin zur Blockade der Freisetzung retroviraler VLPs und die 2 Depletion blockiert den lysosomalen Abbau von EGF, einem Substrat des endo-lysosomalen Proteintransports. Dies alles deutet auf eine mögliche Funktion von 2-Adaptin in diesem Transportsystem hin, welche in dieser Arbeit näher untersucht wurde.rnEs konnte gezeigt werden, dass die Depletion von 2-Adaptin den Abbau von endogenen (z.B. EGF, ubiquitinierte Proteine) und exogenen (z.B. das retrovirale MLV.gag-Polyprotein) Substraten des endo-lysosomalen Weges inhibiert, während sie bei 2 Überexpression verstärkt abgebaut werden. Alle bisher identifizierten „Substrate“ von 2 Adaptin, also Proteine, die durch überschüssiges 2-Adaptin abgebaut werden, besitzen eine Verbindung zum endo-lysosomalen System und / oder zur Ubiquitin-Maschinerie der Zelle. Weitere Hinweise auf eine Rolle von 2 Adaptin im MVB-Weg lieferte die Identifikation von Vps28 und Chmp2A als spezifische Interaktionspartner von 2-Adaptin. Über Vps28 erhält -Adaptin direkten Zugang zum ESCRT-I- und über Chmp2A zum ESCRT-III-Komplex. rnZudem konnte neben dem UIM eine PH-Domäne in 2-Adaptin als wichtige funktionelle Domäne identifiziert werden. Sie stellt das Modul für die Interaktion mit Rab7 dar, welche erstmals gezeigt werden konnte. Auch die Interaktion mit Rab7 deutet auf eine Rolle von 2 Adaptin im endo-lysosomalen Transportsystem hin, da Rab7 an späten Endosomen lokalisiert ist und u.a. die Fusion der MVBs mit den Lysosomen vermittelt. Da die Auswirkungen der Rab7-Überexpression und Depletion auf MLV.gag denen der 2 Überexpression bzw. Depletion entsprechen, liegt die Vermutung nahe, dass 2-Adaptin an einem ähnlich späten Schritt im endo-lysosomalen Transportsystem wirkt wie Rab7. Jedoch blockiert überschüssiges 2 Adaptin die ESCRT-abhängige VLP-Ausschleusung an der Plasmamembran und fungiert daher möglicherweise als negativer Regulator der ESCRT-Kaskade. Da die Überexpression von -Adaptin aber gleichzeitig zum vermehrten lysosomalen Abbau führt, ist eine Funktion von 2-Adaptin bei der MVB-Lysosomen-Fusion wenig wahrscheinlich. Einer solchen Funktion widerspricht auch, dass die intrazelluläre Konzentration von Rab7 und Vps28 durch überschüssiges 2-Adaptin reduziert werden. rnAls dritte funktionell wichtige Domäne in 2-Adaptin konnte ein LIR-Motiv identifiziert werden, über welches -Adaptin mit dem Autophagie-Markerprotein LC3 interagieren kann. Die Interaktion mit LC3, und damit die Verbindung zur Autophagie-Machinerie, liefert eine mögliche Erklärung für den vermehrten Abbau bei 2-Überexpression und den Abbau von Proteinen auf der MVB-Oberfläche. Dabei induziert 2-Adaptin nicht die Autophagie per se, sondern scheint als Autophagie-Adapter zu wirken, der seine Substrate, z.B. MVBs, selektiv dem Abbau durch Autophagie zuführt. rnrnEine mögliche Rolle von 2-Adaptin im zum Lysosom hin gerichteten zellulären Transport konnte bestätigt werden, wobei 2-Adaptin dabei verschiedene Funktionen übernimmt: rn als Ubiquitin-Adapter im endo-lysosomalen System, rn als negativer Regulator der ESCRT-Kaskadern und / oder als Autophagie-Adapter.rn

A 13-year analysis from Switzerland of non-fatal sledging (sledding or tobogganing) injuries

INTRODUCTION: Winter sports have evolved from an upper class activity to a mass industry. Especially sledging regained popularity at the start of this century, with more and more winter sports resorts offering sledge runs. This study investigated the rates of sledging injuries over the last 13 years and analysed injury patterns specific for certain age groups, enabling us to make suggestions for preventive measures. METHODS: We present a retrospective analysis of prospectively collected data. From 1996/1997 to 2008/2009, all patients involved in sledging injuries were recorded upon admission to a Level III trauma centre. Injuries were classified into body regions according to the Abbreviated Injury Scale (AIS). The Injury Severity Score (ISS) was calculated. Patients were stratified into 7 age groups. Associations between age and injured body region were tested using the chi-squared test. The slope of the linear regression with 95% confidence intervals was calculated for the proportion of patients with different injured body regions and winter season. RESULTS: 4956 winter sports patients were recorded. 263 patients (5%) sustained sledging injuries. Sledging injury patients had a median age of 22 years (interquartile range [IQR] 14-38 years) and a median ISS of 4 (IQR 1-4). 136 (51.7%) were male. Injuries (AIS≥2) were most frequent to the lower extremities (n=91, 51.7% of all AIS≥2 injuries), followed by the upper extremities (n=48, 27.3%), the head (n=17, 9.7%), the spine (n=7, 4.0%). AIS≥2 injuries to different body regions varied from season to season, with no significant trends (p>0.19). However, the number of patients admitted with AIS≥2 injuries increased significantly over the seasons analysed (p=0.031), as did the number of patients with any kind of sledging injury (p=0.004). Mild head injuries were most frequent in the youngest age group (1-10 years old). Injuries to the lower extremities were more often seen in the age groups from 21 to 60 years (p<0.001). CONCLUSION: Mild head trauma was mainly found in very young sledgers, and injuries to the lower extremities were more frequent in adults. In accordance with the current literature, we suggest that sledging should be performed in designated, obstacle-free areas that are specially prepared, and that children should always be supervised by adults. The effect of routine use of helmets and other protective devices needs further evaluation, but it seems evident that these should be obligatory on official runs.

Carbon dioxide insufflation in colonoscopy is safe: a prospective trial of 347 patients

Available evidence suggests that the use of CO(2) insufflation in endoscopy is more comfortable for the patient. The safety of CO(2) use in colonoscopy remains contentious, particularly in sedated patients. The objective of the present prospective trial was to assess the safety of CO(2) colonoscopies. Methods. 109 patients from our previous randomized CO(2) colonoscopy study and an additional 238 subsequent consecutive unselected patients who had a routine colonoscopy performed in a private practice were enrolled from April 2008 through September 2008. All but 2 patients were sedated. All patients were routinely monitored with transcutaneous CO(2) measurement. Volumes of CO(2) administered were correlated with capnographic measurements from transcutaneous monitoring. Results. Of the 347 patients examined, 57% were women; mean (SD) age of participants was of 60.2 years (12.8). Mean propofol dosage was 136 mg (64 mg). Mean CO(2) values were 34.7 mm Hg (5.3) at baseline, 38.9 mm Hg (5.5) upon reaching the ileum, and 36.9 mm Hg (5.0) at examination's end. Mean maximum increase of CO(2) was 4.5 mm Hg (3.6). No correlation was observed between volume of CO(2) administered and increase in level of CO(2) (correlation coefficient: 0.01; P value: 0.84). No complications were observed. Conclusions. The present prospective study, which was based on one of the largest sedated patient sample reported to date in this setting, provides compelling evidence that CO(2) insufflation in colonoscopy is safe and unassociated with relevant increases in transcutaneously measured levels of CO(2).

Use of straight and curved 3-dimensional titanium miniplates for fracture fixation at the mandibular angle

PURPOSE: The aim of this follow-up study was to evaluate the clinical usefulness of a new type of 3-dimensional (3D) miniplate for open reduction and monocortical fixation of mandibular angle fractures. PATIENTS AND METHODS: In 20 consecutive patients, noncomminuted mandibular angle fractures were treated with open reduction and fixation using a 2 mm 3D miniplate system in a transoral approach. All patients were systematically monitored until 6 months postoperatively. Among the outcome parameters recorded were infection, hardware failure, wound dehiscence, and sensory disturbance of the inferior alveolar nerve. RESULTS: The mean operation time from incision to wound closure was 65 minutes. Two patients had a mucosal wound dehiscence with no consequences. None developed an infection requiring a plate removal. All but 2 patients had normal sensory function 3 months after surgery. Plate fracture occurred in one patient in whom a preceding surgical removal of the third molar had been the reason for the mandibular fracture. In the absence of clinical symptoms, the patient declined plate removal. On final follow-up, fracture healing was considered clinically complete in all patients. CONCLUSIONS: The 3D plating system described here is suitable for fixation of simple mandibular angle fractures and is an easy-to-use alternative to conventional miniplates. The system may be contraindicated in patients in whom insufficient interfragmentary bone contact causes minor stability of the fracture.

Soft tissue profile changes following mandibular advancement and setback surgery an average of 12 years postoperatively

PURPOSE: The aim of this study was to assess long-term changes in position of soft tissue landmarks following mandibular advancement and setback surgery. MATERIALS AND METHODS: Twenty-seven patients (14 women, 13 men; mean age, 36 years) who had undergone either mandibular advancement (15 patients) or setback surgery (12 patients), were available for a long-term follow-up an average of 12 years postoperatively. In all of these cases, lateral cephalometric radiographs taken immediately before operation, at 1 week, 14 months, and 12 years postoperatively, were studied. RESULTS: During the 14 months postoperatively, soft tissue chin and mentolabial fold followed its underlying hard tissue in all patients. A continuous skeletal relapse was observable 12 years after mandibular advancement, but soft tissue chin moved more in an anterior direction. After mandibular setback, soft and hard tissue landmarks remained almost unchanged. Over the entire observation period, a thickening of soft tissue at pogonion was generally seen, and particularly a thickening of the whole chin in the setback group. All patients showed a significant lengthening and thinning of the upper lip. In all except 2 males, the patient's body weight increased markedly. CONCLUSION: In contrast to the immediate postoperative stage, soft tissue changes observed an average of 12 years after the primary operation do not directly follow the movements of the underlying skeletal structure. The soft tissue profile changes observed over such a long term seem to be influenced not only by the underlying skeletal structure but also by other factors such as weight gain and aging process.

Long-term outcome of ablative therapy of postoperative supraventricular tachycardias in patients with univentricular heart: a European multicenter study

BACKGROUND: Catheter ablation has evolved as a possible curative treatment modality for supraventricular tachycardias (SVT) in patients with univentricular heart. However, the long-term outcome of ablation procedures is unknown. We evaluated the procedural and long-term outcome of ablative therapy of late postoperative SVT in patients with univentricular heart. METHODS AND RESULTS: Patients with univentricular heart (n=19, 11 male; age, 29+/-9 years) referred for ablation of SVT were studied. Ablation was guided by 3D electroanatomic mapping in all but 2 procedures. A total of 41 SVT were diagnosed as intra-atrial reentrant tachycardia (n=30; cycle length, 310+/-68 ms), typical atrial flutter (n=4; cycle length, 288+/-42 ms), focal atrial tachycardia (n=6; cycle length, 400+/-60 ms), and atrial fibrillation (n=1). Ablation was successful in 73% of intra-atrial reentrant tachycardia, 75% of atrial flutter, and all focal atrial tachycardia and focal atrial fibrillation. During the follow-up period of 53+/-34 months, 2 patients were lost to follow-up, 3 died of heart failure, 2 underwent heart transplantation, and 1 underwent conduit replacement. Of the remaining group, 8 had sinus rhythm and 3 had SVT. CONCLUSIONS: Focal and reentrant mechanisms underlie postoperative SVT in patients with univentricular heart. Successive SVT developing over time may be caused by different mechanisms. Ablative therapy is potentially curative, with a procedural success rate of 78%. In patients who had multiple ablation procedures, the SVT originated from different atrial sites, suggesting that these new SVT were caused by progressive atrial disease. Despite recurrent SVT, sinus rhythm at the end of the follow-up period was achieved in 72%.

Neonatal procedural pain exposure and pain management in ventilated preterm infants during the first 14 days of life

OBJECTIVES: Ventilated preterm infants are at high risk for procedural pain exposure. In Switzerland there is a lack of knowledge about the pain management in this highly vulnerable patient population. The aims of this study were to describe the type and frequency of procedures and to determine the amount of analgesia given to this patient group in two Swiss neonatal intensive care units. METHOD: A retrospective cohort study was performed examining procedural exposure and pain management of a convenience sample of 120 ventilated preterm infants (mean age = 29.7 weeks of gestation) during the first 14 days of life after delivery and born between May 1st 2004 and March 31st 2006. RESULTS: The total number of procedures all the infants underwent was 38,626 indicating a mean of 22.9 general procedures performed per child and day. Overall, 75.6% of these procedures are considered to be painful. The most frequently performed procedure is manipulation on the CPAP prongs. Pain measurements were performed four to seven times per day. In all, 99.2% of the infants received either non-pharmacological and/or pharmacological agents and 70.8% received orally administered glucose as pre-emptive analgesia. Morphine was the most commonly used pharmacological agent. DISCUSSION: The number of procedures ventilated preterm infants are exposed to is disconcerting. Iatrogenic pain is a serious problem, particularly in preterm infants of low gestational age. The fact that nurses assessed pain on average four to seven times daily per infant indicates a commitment to exploring a painful state in a highly vulnerable patient population. In general, pharmacological pain management and the administration of oral glucose as a non-pharmacological pain relieving intervention appear to be adequate, but there may be deficiencies, particularly for extremely low birth weight infants born <28 weeks of gestation.

How Comprehensible, Interesting and Relevant is Current Research in Traditional Chinese Medicine for Practitioners?

Purpose: In traditional Chinese medicine (TCM) as in other fields of complementary medicine, research does not necessarily follow the sequence from in vitro studies via phase I to phase IV clinical trials, but all steps are being investigated simultaneously. Here, we aimed to investigate which kinds of studies were interesting and relevant for practitioners. Methods: Thirty abstracts from articles on TCM published between April and June 2012 were randomly chosen, including 5 abstracts each of in vitro studies, animal studies, case reports or series, studies with healthy volunteers, trials with patients, or reviews and meta-analyses. Six TCM practitioners (2 female, 5 non-medical, average age 46 years, average practical TCM experience 9 years) rated 10 abstracts each on a 5 point Likert scale (1=very poor to 5=very good) regarding comprehensibility, interest, relevance to practice, information for patients, and promoting reputation of TCM. Average ratings for each group of abstracts were calculated. Results: Comprehensibility of the abstracts was generally rated as good. Case reports/series, studies in healthy volunteers and trials with patients were rated interesting by the practitioners (average rating = 3.7, 3.8 and 3.7, respectively). Relevance to practice was mediocre for all types (2.5 to 3.5). In vitro studies and reviews/meta-analyses were not rated useful as information for patients (2.0). Reviews/Meta-analyses were considered negative for the reputation of TCM (2.2). Conclusions: Practitioners of TCM find abstracts of study results generally comprehensible and interesting. Case reports/series were rated in a similar way as trials with patients. Although TCM is commonly taught by means of case reports, practitioners seemed to value clinical trials. Abstracts of reviews/meta-analyses were rated rather uninformative, which was possibly due to several inconclusive results and the lack of detailed information in these abstracts.

Acute muscular sarcocystosis: an international investigation among ill travelers returning from tioman island, malaysia, 2011-2012.

BACKGROUND Through 2 international traveler-focused surveillance networks (GeoSentinel and TropNet), we identified and investigated a large outbreak of acute muscular sarcocystosis (AMS), a rarely reported zoonosis caused by a protozoan parasite of the genus Sarcocystis, associated with travel to Tioman Island, Malaysia, during 2011-2012. METHODS Clinicians reporting patients with suspected AMS to GeoSentinel submitted demographic, clinical, itinerary, and exposure data. We defined a probable case as travel to Tioman Island after 1 March 2011, eosinophilia (>5%), clinical or laboratory-supported myositis, and negative trichinellosis serology. Case confirmation required histologic observation of sarcocysts or isolation of Sarcocystis species DNA from muscle biopsy. RESULTS Sixty-eight patients met the case definition (62 probable and 6 confirmed). All but 2 resided in Europe; all were tourists and traveled mostly during the summer months. The most frequent symptoms reported were myalgia (100%), fatigue (91%), fever (82%), headache (59%), and arthralgia (29%); onset clustered during 2 distinct periods: "early" during the second and "late" during the sixth week after departure from the island. Blood eosinophilia and elevated serum creatinine phosphokinase (CPK) levels were observed beginning during the fifth week after departure. Sarcocystis nesbitti DNA was recovered from 1 muscle biopsy. CONCLUSIONS Clinicians evaluating travelers returning ill from Malaysia with myalgia, with or without fever, should consider AMS, noting the apparent biphasic aspect of the disease, the later onset of elevated CPK and eosinophilia, and the possibility for relapses. The exact source of infection among travelers to Tioman Island remains unclear but needs to be determined to prevent future illnesses.

Relative Predicativity and dependent recursion in second-order set theory and higher-orders theories

This article reports that some robustness of the notions of predicativity and of autonomous progression is broken down if as the given infinite total entity we choose some mathematical entities other than the traditional ω. Namely, the equivalence between normal transfinite recursion scheme and new dependent transfinite recursion scheme, which does hold in the context of subsystems of second order number theory, does not hold in the context of subsystems of second order set theory where the universe V of sets is treated as the given totality (nor in the contexts of those of n+3-th order number or set theories, where the class of all n+2-th order objects is treated as the given totality).