Multidisciplinary approach to chronic pain from myofascial pain dysfunction syndrome: A four-year experience at a Brazilian center

Chronic pain is the major complaint of myofascial pain dysfunction syndrome (MPDS) and is a complex problem which involves physical, psychological and social aspects, the etiology of MPDS is multifactorial and the multidisciplinary approach is essential for differential diagnosis and for comprehensive treatment planning, In 1993, the Dental School of Piracicaba-UNICAMP, Brazil, opened a Center for Pain Studies (CPS), staffed by health care providers including, dentists, psychologists, physicians, physiotherapists and phonoaudiologists. The major aims of the CPS are to provide clinical care and to develop basic and applied research, Sixty-two MPDS patients had been admitted to the CPS by 1997, There were 60 females and 2 males, mean age -32.5 years, the mean duration of chronic pain was 48 months. Pain intensity and unpleasantness were measured employing the Visual Analogue Scale, the tendency to develop stress-related diseases was assessed by the Social Readjustment de Scale, There was a mean reduction of chronic pain of 69.89% and 71.78% relative to intensity and unpleasantness, respectively, the experience of clinical attendance at a multidisciplinary center showed the relevance of a team consisting of health care providers from different specialties with well-established aims, completely integrated and sensitive enough to understand the painful complaints of MPDS patients.

Aquatic humus from an unpolluted Brazilian dark-brown stream: general characterization and size fractionation of bound heavy metals

The main pool of dissolved organic carbon in tropical aquatic environments, notably in dark-coloured streams, is concentrated in humic substances (HS). Aquatic HS are large organic molecules formed by micro-biotic degradation of biopolymers and polymerization of smaller organic molecules. From an environmental point of view, the study of metal-humic interactions is often aimed at predicting the effect of aquatic HS on the bioavailability of heavy metal ions in the environment. In the present work the aquatic humic substances (HS) isolated from a dark-brown stream (located in an environmental protection area near Cubatao city in São Paulo-State, Brazil) by means of the collector XAD-8 were investigated. FTIR studies showed that the carboxylic carbons are probably the most important binding sites for Hg(II) ions within humic molecules. C-13-NMR and H-1-NMR studies of aquatic HS showed the presence of constituents with a high degree of aromaticity (40% of carbons) and small substitution. A special five-stage tangential-flow ultrafiltration device (UF) was used for size fractionation of the aquatic HS under study and for their metal species in the molecular size range 1-100 kDa (six fractions). The fractionation patterns showed that metal traces remaining in aquatic HS after their XAD-8 isolation have different distributions. Generally, the major percentage of traces of Mn, Cd and Ni (determined by ICP-AES) was preferably complexed by molecules with relatively high molecular size. Cu was bound by fractions with low molecular size and Co showed no preferential binding site in the various humic fractions. Moreover, the species formed between aquatic HS and Hg(II), prepared by spiking (determined by CVAAS), appeared to be concentrated in the relatively high molecular size fraction F-1 (> 100 kDa).

Blaming the victim: Aspects of the Brazilian case

This report describes the consequences and some aspects of the origin and development of victim blaming in accident analysis, and some methods for investigating such events, with particular emphasis on the situation in Brazil. In Brazil, the spread of this practice seems to have been helped by several factors. (1) the idea that occupational accidents are simple phenomena with a limited number of causal factors linked to unsafe actions and/or conditions. In the past, the theory of accident proneness had less influence than in other countries. (2) Government regulations that stipulate the hiring of health and safety officers, production of educational material, and preventive campaigns that emphasize the role of the victim's faulty behavior in the origin of an accident. (3) Mandatory implementation of standardized models for accident investigation directed toward searching for a single cause. Usually one conclusion, expressed in terms of unsafe acts or conditions, is formulated so that whoever performs an unsafe act is responsible for the accident. (4) Lack of knowledge, as shown in Brazilian publications on occupational accidents and in the evolution of studies on the nature of accident phenomena and of strategies adopted for their prevention.

Pharmacological and toxicological studies of Drimys angustifolia Miers. (Winteraceae)

Drimys angustifolia Miers. (Winteraceae) is a Brazilian medicinal plant used as analgesic, antiulcer and anti-inflammatory without studies to assure its efficacy and safety Leaf and stem bark extracts were evaluated to determine the antiulcer, analgesic, antiinflammatory and antioxidant activities. Preliminary toxic effects and qualitative phytochemical profile were also performed. The antiulcer activity was detected in both extracts. Administration of the leaf extract at 250 mg/kg inhibited total lesion area by 76.50% (p < 0.01 in ethanol/HCl method), while carbenoxolone at 250 mg/kg reduced lesions by 69.48%. Stem bark extract (250 mg/kg) inhibited lesion by 81.42%, while carbenoxolone by 74.10%. Similar effects were observed in the ethanol-induced ulcer method, but no activity was observed in piroxican model. The effects involve nitric oxide in gastric protection, since the L-NAME treatment reversed the protection given by the extracts. Antioxidant effects suggest an involvement against oxidative stress. In the pain (writhing, tail-flick and hot-plate tests) and inflammation (carrageenan-induced paw edema) models, the extracts did not present any effect. The phytochemical studies demonstrated that both extracts contain flavonoids, saponins, glycosilated triterpenoids, fixed acids, cyanogenic glycosides, quinones, tannins, xanthone and steroidal aglycones. Toxicological studies showed that the extracts are safe at the effective antiulcer doses. (c) 2006 Elsevier B.V.. All rights reserved.

Life-cycle inventory for hydroelectric generation: a Brazilian case study

Representative Life-Cycle Inventories (LCIs) are essential for Life-Cycle Assessments (LCAs) quality and readiness. Because energy is such an important element of LCAs, appropriate LCIs on energy are crucial, and due to the prevalence of hydropower on Brazilian electricity mix, the frequently used LCIs are not representative of the Brazilian conditions. The present study developed a LCI of the Itaipu Hydropower Plant, the major hydropower plant in the world, responsible for producing 23.8% of Brazil's electricity consumption. Focused on the capital investments to construct and operate the dam, the LCI was designed to serve as a database for the LCAs of Brazilian hydroelectricity production. The life-cycle boundaries encompass the construction and operation of the dam, as well as the life-cycles of the most important material and energy consumptions (cement, steel, copper, diesel oil, lubricant oil), as well as construction site operation, emissions from reservoir flooding, material and workers transportation, and earthworks. As a result, besides the presented inventory, it was possible to determine the following processes, and respective environmental burdens as the most important life-cycle hotspots: reservoir filling (CO(2) and CH(4) emission: land use); steel life-cycle (water and energy consumption; CO, particulates, SO(x) and NO(x) emissions); cement life-cycle (water and energy consumption; CO(2) and particulate emissions); and operation of civil construction machines (diesel consumption; NO(x) emissions). Compared with another hydropower studies, the LCI showed magnitude adequacy, with better results than small hydropower, which reveals a scale economy for material and energy exchanges in the case of ltaipu Power Plant. (C) 2009 Elsevier Ltd. All rights reserved.

Abundant brachiopods on a tropical, upwelling-influenced shelf (Southeast Brazilian Bight, South Atlantic)

Rhynchonelliform brachiopods were diverse and often dominant benthos of tropical seas in the Paleozoic. In contrast, they are believed to be rare in open habitats of modern oceans, especially at low latitudes. This study documents numerous occurrences of rhynchonelliform brachiopods on a modern tropical shelf, particularly in areas influenced by upwelling. Extensive sampling of the outer shelf and coastal bays of the Southeast Brazilian Bight revealed dense populations of terebratulid brachiopods (>10(3) individuals /m(2) of seafloor) between 24 and 26 S. on the outer shelf, brachiopods are more abundant than bivalves and gastropods combined. However, brachiopod diversity is low: only four species belonging to the genera Bouchardia, Terebratulina, Argyrotheca, and Platidia were identified among over 16000 examined specimens. Brachiopods occur preferentially on carbonate bottoms and include two substrate-related associations: Bouchardia (40-70% CaCO3, weight content) and Terebratulina-Argyrotheca (70-95% CaCO3). All four species display a broad bathymetric range that contrasts with a narrow depth tolerance postulated for many Paleozoic rhynchonelliforms. The most abundant populations occur in the depth range between 100 and 200 m, and coincide with zones of shelf-break upwelling, where relatively colder and nutrient-rich water masses of the South Atlantic Central Water are brought upward by cyclonic meanders of the South Brazil Current (a western boundary current that flows poleward along the coast of Brazil). This is consistent with previous biological and paleontological studies that suggest upwelling may play a role in sustaining brachiopod-dominated benthic associations. The presence of abundant brachiopods in the open habitats of the tropical shelf of the western South Atlantic contrasts with current understanding of their latitudinal distribution and points to major gaps in our knowledge of their present-day biogeography. The ecological importance of rhynchonelliform brachiopods in modern oceans and their role as producers of biogenic sedimentary particles may be underestimated.

Utilization of epiphytes by birds in a Brazilian Atlantic Forest

Epiphytes constitute a great part of the vegetation biomass in Neotropical forests, offering a large variety of resources to birds. Despite their structural and ecological importance, few studies investigated the use of epiphytes by birds in the Neotropical region. We studied the bird species that exploit vascular epiphytes (and hemi-epiphytes) in an Atlantic forest site in southeastern Brazil. The resources exploited, seasonal variation in the use of epiphytes, the frequency of foraging and selectivity in epiphytes, and the relationship between the use of epiphytes and the participation in mixed-species bird flocks were investigated. After 360 h of observations along trails crossing the forest, 24 bird species (12 families) were recorded in a total of 74 events of epiphyte exploitation. Thamnophilidae (four species), Trochiliclae, Thraupidae and Furnariidae (three species) were the richest bird families in our sample, while Furnariidae and Dendrocolaptidae were the more frequently recorded families. Plants in the Bromeliaceae and Araceae families were the most abundant and more frequently exploited epiphytes. Nectar, water, nest material and invertebrates were the most frequently exploited resources, mainly from Bromeliaceae. None of the species for which we had enough data revealed to be a frequent user of epiphytes for foraging or selective to any epiphyte group. The White-eyed Foliage-gleaner (Automolus leucophthalmus; Furnariidae), a common participant of understory mixed-species flocks, exploited epiphytes more frequently when associated with mixed-species flocks. The utilization of epiphytes was opportunistic for most of the bird species recorded and occurred throughout the year with no seasonal variation.

Cytotoxicity of Active Ingredients Extracted from Plants of the Brazilian "Cerrado"

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

Molecular and Serologic Detection of Ehrlichia spp. in Endangered Brazilian Wild Captive Felids

Ehrlichiosis, an emergent tickborne disease that affects both humans and animals, may represent a threat to the survival and preservation of wild felids in Brazil There are few studies of ehrlichiosis in wild felids in Brazil, but Ehrlichia spp are present in domestic cats Antibodies to Ehrlichia canis have been reported in a puma (Puma concolor) In this study we assessed the presence of these hemoparasites in the blood of Brazilian wild captive felids of the 72 animals tested, 5 (7%) were seropositive for the E cams antigen, and L1 (15%) were positive for E emirs DNA sequences We also performed sequence alignment to establish the identity of the parasite species infecting these animals using 16S rRNA and omp-1 genes Sequences based on 16S rRNA were similar to those found in dogs and cats from Thailand, Brazil, China, and Taiwan and with E canis obtained from a single individual (human) in Venezuela Ehrlichia sp sequence from sampled felines based on omp-1. gene was similar to the p28 and p30 multigene family of E canis To our knowledge, this is the first study of molecular detection of Ehrlichia sp in Brazilian wild feline species

High resolution ultra high pressure liquid chromatography-time-of-flight mass spectrometry dereplication strategy for the metabolite profiling of Brazilian Lippia species

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

Foraminiferal ecological zonation along a Brazilian mangrove transect: Diversity, morphotypes and the influence of subaerial exposure time.

Two foraminiferal associations comprising only arenaceous species define two distinct environments in a 340 m-long mangrove transect at Cardoso Island, Trapande Bay (Cananeia-Iguape estuarine system, SP, Brazil). The "lower muddy flat" (LMF), from the outer mangrove fringe inwards towards land (100 m), is positioned in the lower plain between 0.04 and 0.23 m above the mean sea level (msl), and remains subaerially exposed between 48.5 and 65.6% of the time. This environment is characterized by higher foraminiferal diversity and evenness (McIntosh's D = 0.54 [plus or minus] 0.21 and Pielou's E = 0.68 [plus or minus] 0.25, respectively) and is dominated by Arenoparrella mexicana and Trochammina inflata, and to a lesser extent by Ammotium directum and Textularia earlandi. The mangrove plant of this segment is a Rhizophoretum with average height of 8.4 [plus or minus] 1.2 m. The sediment is characterized by higher concentration of organic matter (93.5 [plus or minus] 32.3 g dm-3) and metals (e.g. V = 53.4 [plus or minus] 21.8 ppm and Zn = 46.4 [plus or minus] 21.3 ppm). The "upper sandy flat" (USF), 240 m wide along the transect, is positioned in the upper plain between 0.28 and 0.89 m above the msl, and remains subaerially exposed between 69.7 and 98.5% of the time. This environment is characterized by a lower diversity and evenness (D = 0.33 [plus or minus] 0.17 and E = 0.49 [plus or minus] 0.20, respectively). The association is dominated by species T. inflata and Miliammina fusca. The Rhizophoretum exhibits a lower average height of 3.6 [plus or minus] 0.6 m. The sediment is poorer in organic matter (39.3 [plus or minus] 15.0 g dm-3) and metals (e.g. V = 13.0 [plus or minus] 6.8 ppm and Zn = 6.9 [plus or minus] 3.7 ppm). Whereas "elongate" tests (uniserial, biserial and planospiral followed by a uniserial portion) are restricted to the LMF, "spiraled" species dominate the USF. Subaerial exposure time seems to exert a primary influence on species distribution, in addition to salinity and sediment type. Species may be adapted to different exposure times, a factor dependent on their position on the intertidal zone and the tidal regime, which should be taken into account in relative sea level reconstructions based on intertidal foraminifera. These patterns have important implications for studies investigating the ecology and paleoecology of foraminifera and subtle fluctuations in relative sea level during the Quaternary.

HLA-DR in Brazilian patients with polyarteritis nodosa (PAN) and microscopic polyangiitis (MPA)

The aim of this study was to evaluate the frequency and clinical associations of HLA-DR alleles in Brazilian Caucasian patients with polyarteritis nodosa (PAN) or microscopic polyangiitis (MPA). We evaluated 29 Caucasian patients with vasculitis classified as PAN or MPA according to the American College of Rheumatology (ACR) 1990 Criteria, Chapel Hill Consensus Conference (CHCC) nomenclature for vasculitis and EULAR recommendations for conducting clinical studies in systemic vasculitis. HLA-DR alleles were typed using polymerase chain reaction-amplified DNA, hybridized with sequence-specific low resolution primers. DNA obtained from 59 Caucasian healthy blood donors were used as control. In order to evaluate if a specific HLA may have influence on the clinical profile of those diseases, we also divided the patients according to Birmingham vasculitis score (BVAS) and Five-Factors Score (FFS) at the time of diagnosis. Increased frequency of HLA-DRB1*16 (p = 0.023) and DRB4*01 (p = 0.048) was found in patients with higher disease activity at the time of diagnosis (BVAS >= 22). Patients with less severe disease (FFS = 0) had a higher frequency of HLA-DRB1*03 (p = 0.011). Patients with gastrointestinal tract involvement had significantly increased frequency of HLA-DRB1*11 or B1*12 (p = 0.046), B1*13 (p = 0.021) and B3 (p = 0.008). In contrast, patients with renal disease, had higher frequency of DRB1*15 or DRB1*16 (p = 0.035) and B5 (p = 0.035). In the subgroup of patients with MPA, increased frequency of HLA-DRB1*15 was found in patients with BVAS >= 22 (p = 0.038) and FFS >= 1 (p = 0.039) suggesting that this allele is associated with more aggressive disease. Antineutrophil cytoplasmic antibodies (ANCA) negative MPA patients had significantly increased frequency of HLA-DRB1*11 or DRB1*12 when compared to ANCA positive patients (p = 0.023). Our results suggest that HLA-DR alleles may influence PAN and MPA clinical expression and outcome and that in MPA they participate in the mechanisms involved in the development to ANCA.

Comparison of three systems of classification in predicting the outcome of diabetic foot ulcers in a Brazilian population

Objective: The aim was to compare there ulcer classification systems as predictors of the outcome of diabetic foot ulcers; the Wagner, the University of Texas (UT) and the size (area, depth), sepsis, arteriopathy, denervation system (S(AD)SAD) systems in specialist clinic in Brazil.Methods: Ulcer area, depth, appearance, infection and associated ischaemia and neuropathy were recorded in a consecutive series of 94 subjects. A novel score, the S(AD)SAD score, was derived from the sum of individual items of the S(AD)SAD system, and was evaluated. Follow-up was for at least 6 months. The primary outcome measure was the incidence of healing.Results: Mean age was 57.6 years; 57 (60.6%) were made. Forty-eight ulcers (51.1%) healed without surgery; 11 (12.2%) subjects underwent minor amputation. Significant differences in terms of healing were observed for depth (P = 0.002), infection (P = 0.006) and denervation (P = 0.002) using the S(AD)SAD system, for UT grade (P = 0.002) and stage (P = 0.032) and for Wagner grades (P = 0.002). Ulcers with an S(AD)SAD score of <= 9 (total possible 15) were 7.6 times more likely to heal than scores >= 10 (P < 0.001).Conclusions: All three systems predicted ulcer outcome. The S(AD)SAD score of ulcer severity could represent a useful addition to routine clinical practice. The association between outcome and ulcer depth confirms earlier reports. The association with infection was stronger than that reported from the centres in Europe or North America. The very strong association with neuropathy has only previously been observed in Tanzania. Studies designed to compare the outcome in different countries should adopt systems of classification, which are valid for the populations studied.

Different responses to doxorubicin-induced chromosome aberrations in Brazilian deer species

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)