Acute and sustained effects of early administration of inhaled nitric oxide to children with acute respiratory distress syndrome

OBJECTIVE: To determine the acute and sustained effects of early inhaled nitric oxide on some oxygenation indexes and ventilator settings and to compare inhaled nitric oxide administration and conventional therapy on mortality rate, length of stay in intensive care, and duration of mechanical ventilation in children with acute respiratory distress syndrome. DESIGN: Observational study. SETTING: Pediatric intensive care unit at a university-affiliated hospital. PATIENTS: Children with acute respiratory distress syndrome, aged between 1 month and 12 yrs. INTERVENTIONS: Two groups were studied: an inhaled nitric oxide group (iNOG, n = 18) composed of patients prospectively enrolled from November 2000 to November 2002, and a conventional therapy group (CTG, n = 21) consisting of historical control patients admitted from August 1998 to August 2000. MEASUREMENTS AND MAIN RESULTS: Therapy with inhaled nitric oxide was introduced as early as 1.5 hrs after acute respiratory distress syndrome diagnosis with acute improvements in Pao(2)/Fio(2) ratio (83.7%) and oxygenation index (46.7%). Study groups were of similar ages, gender, primary diagnoses, pediatric risk of mortality score, and mean airway pressure. Pao(2)/Fio(2) ratio was lower (CTG, 116.9 +/- 34.5; iNOG, 62.5 +/- 12.8, p <.0001) and oxygenation index higher (CTG, 15.2 [range, 7.2-32.2]; iNOG, 24.3 [range, 16.3-70.4], p <.0001) in the iNOG. Prolonged treatment was associated with improved oxygenation, so that Fio(2) and peak inspiratory pressure could be quickly and significantly reduced. Mortality rate for inhaled nitric oxide-patients was lower (CTG, ten of 21, 47.6%; iNOG, three of 18, 16.6%, p <.001). There was no difference in intensive care stay (CTG, 10 days [range, 2-49]; iNOG, 12 [range, 6-26], p >.05) or duration of mechanical ventilation (TCG, 9 days [range, 2-47]; iNOG, 10 [range, 4-25], p >.05). CONCLUSIONS: Early treatment with inhaled nitric oxide causes acute and sustained improvement in oxygenation, with earlier reduction of ventilator settings, which might contribute to reduce the mortality rate in children with acute respiratory distress syndrome. Length of stay in intensive care and duration of mechanical ventilation are not changed. Prospective trials of inhaled nitric oxide early in the setting of acute lung injury in children are needed.

Exercise programs improve mobility and balance in people with Parkinson's disease

Compromised balance and loss of mobility are among the major consequences of Parkinson's disease (PD). The literature documents numerous effective interventions for improving balance and mobility. The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD. Thirty-four participants, with idiopathic PD that ranged from Stage I to Stage III on the Hoehn & Yahr (H&Y) scale, were assigned to two groups. Group 1 (n = 21; 67±9 years old) was engaged in an intensive exercise program (aerobic capacity, flexibility, strength, motor coordination and balance) for 6 months: 72 sessions, 3 times a week, 60 minutes per session; while Group 2 (n = 13; 69±8 years old) participated in an adaptive program (flexibility, strength, motor coordination and balance) for 6 months: 24 sessions, once a week, 60 minutes per session. Balance and basic functional mobility were assessed in pre- and post-tests by means of the Berg Balance Scale and the Timed Up and Go Test. Before and after the interventions, groups were similar in clinical conditions (H&Y, UPDRS, and Mini-Mental). A MANOVA 2 (programs) by 2 (moments) revealed that both groups were affected by the exercise intervention. Univariate analyses showed that participants improved their mobility and balance from pre- to post-test. There were no differences between groups in either mobility or balance results. Both the intensive and adaptive exercise programs improved balance and mobility in patients with PD. © 2009 Elsevier Ltd. All rights reserved.

Creative industries in the Caribbean: a new road for diversification and export growth

Includes bibliography

Study of a series of cobalt(II) sulfonamide complexes: Synthesis, spectroscopic characterization, and microbiological evaluation against M. tuberculosis. Crystal structure of [Co(sulfamethoxazole)2(H 2O)2]·H2O

Nowadays, the research for new and better antimicrobial compounds is an important field due to the increase of immunocompromised patients, the use of invasive medical procedures and extensive surgeries, among others, that can affect the incidence of infections. Another big problem associated is the occurrence of drug-resistant microbial strains that impels a ceaseless search for new antimicrobial agents. In this context, a series of heterocyclic- sulfonamide complexes with Co(II) was synthesized and characterized with the aim of obtaining new antimicrobial compounds. The structural characterization was performed using different spectroscopic methods (UV-Vis, IR, and EPR). In spite of the fact that the general stoichiometry for all the complexes was Co(sulfonamide)2·nH2O, the coordination atoms were different depending on the coordinated sulfonamide. The crystal structure of [Co(sulfamethoxazole)2(H2O)2]·H 2O was obtained by X-ray diffraction showing that Co(II) is in a slightly tetragonal distorted octahedron where sulfamethoxazole molecules act as a head-to-tail bridges between two cobalt atoms, forming polymeric chains. Besides, the activity against Mycobacterium tuberculosis, one of the responsible for tuberculosis, and the cytotoxicity on J774A.1 macrophage cells were evaluated. © 2012 Elsevier B.V. All rights reserved.

Development and validation of a D-loop mtDNA SNP assay for the screening of specimens in forensic casework

Mitochondrial DNA (mtDNA) analysis is usually a last resort in routine forensic DNA casework. However, it has become a powerful tool for the analysis of highly degraded samples or samples containing too little or no nuclear DNA, such as old bones and hair shafts. The gold standard methodology still constitutes the direct sequencing of polymerase chain reaction (PCR) products or cloned amplicons from the HVS-1 and HVS-2 (hypervariable segment) control region segments. Identifications using mtDNA are time consuming, expensive and can be very complex, depending on the amount and nature of the material being tested. The main goal of this work is to develop a less labour-intensive and less expensive screening method for mtDNA analysis, in order to aid in the exclusion of non-matching samples and as a presumptive test prior to final confirmatory DNA sequencing. We have selected 14 highly discriminatory single nucleotide polymorphisms (SNPs) based on simulations performed by Salas and Amigo (2010) [1] to be typed using SNaPShotTM (Applied Biosystems, Foster City, CA, USA). The assay was validated by typing more than 100 HVS-1/HVS-2 sequenced samples. No differences were observed between the SNP typing and DNA sequencing when results were compared, with the exception of allelic dropouts observed in a few haplotypes. Haplotype diversity simulations were performed using 172 mtDNA sequences representative of the Brazilian population and a score of 0.9794 was obtained when the 14 SNPs were used, showing that the theoretical prediction approach for the selection of highly discriminatory SNPs suggested by Salas and Amigo (2010) [1] was confirmed in the population studied. As the main goal of the work is to develop a screening assay to skip the sequencing of all samples in a particular case, a pair-wise comparison of the sequences was done using the selected SNPs. When both HVS-1/HVS-2 SNPs were used for simulations, at least two differences were observed in 93.2% of the comparisons performed. The assay was validated with casework samples. Results show that the method is straightforward and can be used for exclusionary purposes, saving time and laboratory resources. The assay confirms the theoretic prediction suggested by Salas and Amigo (2010) [1]. All forensic advantages, such as high sensitivity and power of discrimination, as also the disadvantages, such as the occurrence of allele dropouts, are discussed throughout the article. © 2013 Elsevier B.V.

Recreational anglers and fishing guides from an estuarine protected area in southeastern Brazil: Socioeconomic characteristics and views on fisheries management

The Iguape and Cananéia Lagoon-Estuarine Complex is a biodiversity hotspot in southeastern Brazil. In recent decades, the region has become an important destination for recreational fishing. The objective of this study was to analyze the socioeconomic characteristics of visiting anglers and fishing guides working in the Cananéia-Iguape-Peruíbe Environmental Protected Area and their views on fisheries management. Data were collected through semi-structured interviews conducted between January 2009 and January 2010. We interviewed 278 anglers, who were predominantly male (93%) with a mean age of 47 years and from the state of São Paulo. The targeted species were snooks (Centropomus undecimales and Centropomus parallelus) and weakfishes (Cynoscion leiarchus and Cynoscion acoupa). Only half the anglers had the mandatory fishing license, and many of them lacked knowledge about catch quotas and minimum size requirements for specific species. The fishing guides (n = 80) were all male, with a mean age of 39 years and extensive experience. Most of the guides believe that the study area is somewhat degraded due to the removal of riparian vegetation, siltation, pollution, and especially the depletion of fish stocks. The opinions of the stakeholders (anglers and guides) converge on the high priority needs of the fishery and possible management actions regarding recreational fishing, such as improved fisheries enforcement (first in order of importance), proper training of fishing guides, zoning of fishing areas, and the definition of a maximum size limit. © 2013 Elsevier Ltd.

Prevalência de Salmonella spp. em bovinos provenientes de sistemas de engorda extensiva e confinamento

Pós-graduação em Medicina Veterinária - FMVZ

Distúrbios comportamentais em ruminantes não associados a doenças: origem, significado e importância

O estudo científico do comportamento animal frente às distintas modificações do ambiente (inanimado ou não) onde os mesmos estão sendo criados constitui o principal objetivo da etologia. Por outro lado, muitas doenças que acometem os ruminantes também cursam produzindo diversas alterações no comportamento desses animais; portanto, os profissionais que trabalham com ruminantes precisam reconhecer o que vem a ser um comportamento anormal, decorrente do empobrecimento ambiental associado ou não a erros alimentares e que resulta em prejuízos ao bem-estar dos animais (p.ex. confinamentos com superlotação, falta de sombra nas pastagens, volumosos finamente moídos) daqueles oriundos de doenças ou estados carenciais, como por exemplo, a depravação do apetite causada pelas deficiências de sódio, cobalto e de fibra fisicamente efetiva. O propósito dessa revisão é discutir sobre os principais desvios comportamentais verificados nos ruminantes domésticos criados em sistemas intensivos ou não no Brasil.

Prediction of Oncogenic Interactions and Cancer-Related Signaling Networks Based on Network Topology

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

Interplay of Late Cenozoic Siliciclastic Supply and Carbonate Response on the Southeast Florida Platform

High-resolution seismic-reflection data collected along the length of the Caloosahatchee River in southwestern Florida have been correlated to nannofossil biostratigraphy and strontium-isotope chemostratigraphy at six continuously cored boreholes. These data are interpreted to show a major Late Miocene(?) to Early Pliocene fluvial– deltaic depositional system that prograded southward across the carbonate Florida Platform, interrupting nearly continuous carbonate deposition since early in the Cretaceous. Connection of the platform top to a continental source of siliciclastics and significant paleotopography combined to focus accumulation of an immense supply of siliciclastics on the southeastern part of the Florida Platform. The remarkably thick (> 100 m), sand-rich depositional system, which is characterized by clinoformal progradation, filled in deep accommodation, while antecedent paleotopography directed deltaic progradation southward within the middle of the present-day Florida Peninsula. The deltaic depositional system may have prograded about 200 km southward to the middle and upper Florida Keys, where Late Miocene to Pliocene siliciclastics form the foundation of the Quaternary carbonate shelf and shelf margin of the Florida Keys. These far-traveled siliciclastic deposits filled accommodation on the southeastern part of the Florida Platform so that paleobathymetry was sufficiently shallow to allow Quaternary recovery of carbonate sedimentation in the area of southern peninsular Florida and the Florida Keys.

Extensive Rhodolith Beds Cover the Summits of Southwestern Atlantic Ocean Seamounts

Calcium carbonate production by marine organisms is an essential process in the global budget of CO32-, and coralline reefs are the most important benthic carbonate producers. Crustose coralline algae (CCA) are well recognized as the most important carbonate builders in the tropical Brazilian continental shelf, forming structural reefs and extensive rhodolith beds. However, the distribution of CCA beds, as well as their role in CO32- mineralization in mesophotic communities and isolated carbonate banks, is still poorly known. To characterize the bottom features of several seamount summits in the Southwestern Atlantic (SWA), side-scan sonar records, remotely operated vehicle imagery, and benthic samples with mixed-gas scuba diving were acquired during two recent research cruises (March 2009 and February 2011). The tops of several seamounts within this region are relatively shallow (similar to 60 m), flat, and dominated by rhodolith beds (Vitoria, Almirante Saldanha, Davis, and Jaseur seamounts, as well as the Trindade Island shelf). On the basis of abundance, dimensions, vitality, and growth rates of CCA nodules, a mean CaCO3 production was estimated, ranging from 0.4 to 1.8 kg m(-2) y(-1) with a total production reaching 1.5 x 10(-3) Gt y(-1). Our results indicate that these SWA seamount summits provide extensive areas of shallow reef area and represent 0.3% of the world's carbonate banks. The importance of this habitat has been highly neglected, and immediate management needs must be fulfilled in the short term to ensure long-term persistence of the ecosystem services provided by these offshore carbonate realms.

Morphological and Biometric Study of the Infraorbital Foramen (E2-Sibai Point) in Adult Skulls

The objective of this work was to study the morphology and biometry of the infraorbital foramen (FIO), variations in its shape, size and number as well as to obtain measurements of its location. 60 dry skulls were analyzed. The test of Qui-quadrant and the T Test were used in measurements with a 5% significance. On the right side, the FIO was measured at a distance of 6.49(+/- 1.68) mm from the lower, 39.65(+/- 3) mm from the upper, 17.7(+/- 2.97) mm from the medial and 20.46(+/- 2.9) mm from the lateral margin of the orbit; its pear-shaped opening distance was 13.67(+/- 2.17) mm. On the left side, the distance of the FIO to the lower margin of the orbit was 6.52(+/- 1.82) mm; to the upper margin was 39.9(+/- 2.62) mm and to the lateral and medial margin were 17.93(+/- 2.58) mm and 21.12(+/- 3) mm, respectively; its distance to the pear-shaped opening was 14.26(+/- 1.83) mm. It was found predominately in an oval shape, in 39 (65%) of the skulls, on both sides. Accessory foramens were present in 11 samples on the right and in 15 samples on the left side. The FIO was most frequently found on the side of, or laterally to the sagittal plane that passes through the middle of the supraorbital foramen/incisures, in 38 skulls (63.3%) on the right side and in 45 skulls (75%) on the left and middle to the zigomatic-maxillary suture, in 41 skulls (68.3%) on right and in 42 skulls (70%) on the left side, besides being most frequently found in a region between the first and second premolars, in 22 skulls (36.7%) on the right side and in 17 skulls (28.3%) on the left.

Psychosocial and clinical predictors of retention in outpatient alcoholism treatment

Objective: One of the factors associated with low rates of compliance in the treatment for alcoholism seems to be the intensity of craving for alcohol. This study aimed to evaluate the associations between alcohol craving and biopsychosocial addiction model-related variables and to verify whether these variables could predict treatment retention. Methods: The sample consisted of 257 male alcoholics who were enrolled in two different pharmacological trials conducted at the Universidade de Sao Paulo in Brazil. Based on four factors measured at baseline - biological (age, race, and family alcoholism), psychiatric (depression symptoms), social (financial and marital status), and addiction (craving intensity, severity of alcohol dependence, smoking status, drinking history, preferential beverage, daily intake of alcohol before treatment) - direct logistic regression was performed to analyze these factors' influence on treatment retention after controlling for medication groups and AA attendance. Results: Increasing age, participation in Alcoholics Anonymous groups, and beer preference among drinkers were independently associated with higher treatment retention. Conversely, higher scores for depression increased dropout rates. Conclusion: Health services should identify the treatment practices and therapists that improve retention. Information about patients' characteristics linked to dropouts should be studied to render treatment programs more responsive and attractive, combining pharmacological agents with more intensive and diversified psychosocial interventions.

Evaluation of frozen-section analysis of surgical margins in the treatment of breast cancer

Objective: To evaluate surgical margins in cases of ductal carcinoma through a histopathological exam using frozen sections. Materials and Methods: Retrospective study encompassing 242 conservative surgeries, 179 of which included intraoperative frozensection histopathology and 63 intraoperative nonfreezing techniques (macroscopy/gross examination and cytology). The results of such analyses were compared with those of the histology processing following paraffin embedment and hematoxylin and eosin (H & E) staining. A margin was deemed free when the distance between the tumor and the surgical border was equal to or greater than two millimeters. The factors given consideration for possibly affecting the results were: age, surgical aspects (skin removal and widening of surgical margins), histopathological findings (size, affected lymph nodes, and angiolymphatic invasion), and extensive intraductal and immunohistochemical components (estrogen, progesterone, Ki-67, and HER-2 receptors). In the statistical analyses, the chi-square test was used and negative predictive values were calculated. Results: The negative predictive values were 87.1% and 79.3% for frozen and nonfrozen sections, respectively. There was no significant difference between the two groups (p = 0.14). The factors under consideration had no influence on the results of the intraoperative exam of the margins. Conclusion: The present study allowed to conclude that the intraoperative exam of the surgical margins by frozen section is not superior to a macroscopy and / or cytology exam.

New species of Pseudanos Winterbottom, 1980 (Characiformes: Anostomidae), with notes on the taxonomy of P. gracilis and P. trimaculatus

A new species of Pseudanos (Characiformes, Anostomidae) is described from the Rio Negro in Brazil, and the Rio Casiquiare and Rio Atabapo, in Venezuela. Specimens of the new species were previously mistakenly identified as Pseudanos gracilis. The new species is diagnosed by having three branchiostegal rays (vs. four in P. gracilis and most specimens of P. winterbottomi), dark transversal bars on dorsum absent (vs. present in P. trimaculatus), dark spots present on the center of each body scale, forming conspicuous, straight dark lines (vs. dark spots absent in P. gracilis and in some specimens of P. trimaculatus), four midlateral dark blotches on body (vs. usually two, sometimes three or four in P. trimaculatus, or body lacking midlateral blotches and presenting instead a broad midlateral stripe in P. winterbottomi), angle of dorsal and ventralmost radii of body scales between 40 degrees and 90 degrees (vs. angle between 110 degrees and 180 degrees in P. gracilis and P. trimaculatus), and cranial fontanel opened along its entire length (vs. cranial fontanel partially closed in P. trimaculatus). Type specimens and extensive additional material of Pseudanos gracilis and P. trimaculatus were examined and comments on the taxonomy of both species are provided. Pseudanos irinae is herein considered a junior synonym of P. trimaculatus. In addition, an updated key to identification of valid species of Pseudanos is presented.