Effectiveness of local anaesthetics with and without vasoconstrictors for perineal repair during spontaneous delivery: Double-blind randomised controlled trial

Objective: to investigate the use of local anaesthetics, in the presence or absence of vasoconstrictors, for perineal repair during spontaneous delivery. Design: double-blind, randomised-controlled trial. Setting: a birth centre, in the city of Sao Paulo, Brazil. Participants: from June to December 2004, a total of 96 women were allocated into three groups (first-degree perineal lacerations, second-degree perineal lacerations or episiotomy), and treated with local anaesthesia (1% lidocaine or 1% lidocaine with epinephrine) (n = 16 per treatment per group). Interventions: an initial local infiltration of the anaesthetic solution was given so that episiotomy could be carried out (5 ml) and to suture spontaneous lacerations (1 ml), followed by repeated doses (1 ml) until pain was completely inhibited. Measurements and findings: the main outcome measurement was the volume of anaesthetic used during episiotomy and perineal suture. Our data suggest that the concomitant use of the vasoconstrictor resulted in a significantly lower average volume used in the treatment of first-degree (1 ml, 95% confidence interval (0) 0.4-1.6) and second-degree (3.7 ml, 95% CI 1.6-5.8) lacerations (p = 0.002 and 0.001, respectively). A 0.3 ml (95% CI 1.5-2.1) average decrease in anaesthetic volume was observed with episiotomy (p = 0.724). The maximum volume of anaesthetic used with and without vasoconstrictor was 1-2 ml in 95% and 3-4 ml in 50% of first-degree lacerations, respectively, and 1-6 ml in 88% and 7-15 ml in 81% of second-degree lacerations, respectively. For episiotomy, the maximum dose was 15 ml, regardless of anaesthetic solution used. Key conclusions: our data confirm the hypothesis that the use of anaesthetics in conjunction with vasoconstrictors is more effective than anaesthetics alone in the repair of perineal lacerations, but not for episiotomy. (C) 2007 Elsevier Ltd. All rights reserved.

Influence of EVA and acrylate polymers on some mechanical properties of cementitious repair mortars

In repair works of reinforced concrete, patch repairs tend to crack in the interfacial zone between the mortar and the old concrete. This occurs basically due to the high degree of restriction that acts on a patch repair. For this reason, the technology of patch repair needs to be the subject of a discussion involving professionals who work with projects, construction maintenance and mix proportioning of repair mortars. In the present work, a study is presented on the benefits that the ethylene vinyl acetate copolymer (EVA) and acrylate polymers can provide in the mix proportioning of a repair mortar with respect to compressive, tensile and direct-shear bond strength. The results indicated that the increase in bond strength and the reduction in the influence of the deficiency in Curing conditioning are the main contributions offered by the polymers studied here. (C) 2009 Elsevier, Ltd. All rights reserved.

Localization of Pantoea ananatis inside lesions of maize White Spot Disease using transmission electron microscopy and molecular techniques

The etiological agent of maize white spot (MWS) disease has been a subject of controversy and discussion. Initially the disease was described as Phaeosphaeria leaf spot caused by Phaeosphaeria maydis. Other authors have Suggested the existence of different fungal species causing similar symptoms. Recently, a bacterium, Pantoea ananatis, was described as the causal agent of this disease. The purpose of this Study was to offer additional information on the correct etiology of this disease by providing visual evidence of the presence of the bacterium in the interior of the MWS lesions by using transmission electron microscopy (TEM) and molecular techniques. The TEM allowed Visualization of a large amount of bacteria in the intercellular spaces of lesions collected from both artificially and naturally infected plants. Fungal structures were not visualized in young lesions. Bacterial primers for the 16S rRNA and rpoB genes were used in PCR reactions to amplify DNA extracted from water-soaked (young) and necrotic lesions. The universal fungal oligonucleotide ITS4 was also included to identity the possible presence of fungal structures inside lesions. Positive PCR products from water-soaked lesions, both from naturally and artificially inoculated plants, were produced with bacterial primers, whereas no amplification was observed when ITS4 oligonucleotide was used. On the other hand, DNA amplification with ITS4 primer was observed when DNA was isolated from necrotic (old) lesions. These results reinforced previous report of P. ananatis as the primary pathogen and the hypothesis that fungal species may colonize lesions pre-established by P. ananatis.

Strongyloides venezuelensis: The antigenic identity of eight strains for the immunodiagnosis of human strongyloidiasis

The antigens of eight strains of Strongyloides venezuelensis were identified by means of the indirect immunofluorescence antibody (IFAT), enzyme-linked immunosorbent assay (ELISA) and immunoblot (IB) tests. Infective larvae (L3) from these strains were obtained from Rattus norvegicus feces cultures. For IFAT, sections of U were used while the ELISA and IB, tests were conducted with alkaline extract. Ninety serum samples were tested: 30 from patients with S. stercoralis, 30 from patients with other parasitic diseases, and 30 from healthy subjects (free of parasites). Average sensitivity and specificity among all eight strains, both for IFAT and ELISA, were, respectively, 93% and 100%. In the IB, anti-S. stercoralis IgG recognized a single antigenic fraction with 45 kDa. Serum samples from patients with S. stercoralis revealed antigens from different strains of S. venezuelensis, indicating antigenic identity for possible use in the synthesis of recombinant antigen that could be useful in immunodiagnosis and vaccine against this parasite. (C) 2008 Elsevier Inc. All rights reserved.

On the threshold of forgetting: Amnesiac identities and the Brazilian capital

Centuries after Locke asserted the importance of memory to identity, Freudian psychology argued that what was forgotten was of equal importance as to what was remembered. The closing decades of the nineteenth century saw a rising interest in the nature of forgetting, resulting in a reassessment and newfound distrust of the long revered faculty of memory. The relationship between memory and identity was inverted, seeing forgetting also become a means for forging identity. This newfound distrust of memory manifested in the writings of Nietzsche who in 1874 called for society to learn to feel unhistorically and distance itself from the past - in what was essentially tantamount to a cultural forgetting. Following the Nietzschean call, the architecture of Modernism was also compelled by the need to 'overcome' the limits imposed by history. This paper examines notions of identity through the shifting boundaries of remembering and forgetting, with particular reference to the construction of Brazilian identity through the ‘repression’ of history and memory in the design of the Brazilian capital. Designed as a forward-looking modernist utopia, transcending the limits imposed by the country's colonial heritage, the design for Brasilia exploited the anti-historicist agenda of modernism to emancipate the country from cultural and political associations with the Portuguese Empire. This paper examines the relationship between place, memory and forgetting through a discussion of the design for Brasilia.

(FAB12_2_019) National identity at Arakawa & Gins’ Site of Reversible Destiny—Yoro, Japan

This paper examines the manipulation of forms of the traditional Japanese stroll garden at Site of Reversible Destiny, a tourist park designed by the New Yorkbased collaborators Shusaku Arakawa and Madeline Gins. Landscape and its representations are central to the construction of national identity in Japan since the cultural distinctiveness of the Japanese people has been argued to rest on their unique relationship to nature and the country’s idiosyncratic geography. The stroll garden of the larger estates and palaces of the Edo period (1615–1867) developed out of earlier temple gardens and most public parks in contemporary Japan are in the grounds of these historic sites or reproduce their forms.

Perceptions of a media campaign: The role of social identity and the changing intergroup context

This study examined the effects of political identity and the changing intergroup context on communication perceptions during an election campaign. Perceptions of media bias and of campaign impact on self and others were assessed before and after the election. The responses of politically aligned voters reflected their membership in a dominant or subordinate group preelection and in a losing or winning group postelection. Dominant group members were initially less biased in their views of the campaign and its impact but sought to blame their party's loss on media bias and on the gullibility of political out-group members and voters in general. Subordinate group members initially showed strong in-group-serving biases but were less critical of the media and the electorate after their party had won. Results highlight the dynamic, intergroup, nature of media perceptions.

Microsatellite instability and loss of heterozygosity at DNA mismatch repair gene loci occurs during hepatic carcinogenesis

DNA mismatch repair is an important mechanism involved in maintaining the fidelity of genomic DNA. Defective DNA mismatch repair is implicated in a variety of gastrointestinal and other turners; however, its role in hepatocellular carcinoma (HCC) has not been assessed. Formalin-fixed, paraffin-embedded archival pathology tissues from 46 primary liver tumors were studied by microdissection and microsatellite analysis of extracted DNA to assess the degree of microsatellite instability, a marker of defective mismatch repair, and to determine the extent and timing of allelic loss of two DNA mismatch repair genes, human Mut S homologue-2 (hMSH2) and human Mut L homologue-1 (hMLH1), and the tumor suppressor genes adenomatous polyposis coli gene (APC), p53, and DPC4. Microsatellite instability was detected in 16 of the tumors (34.8%). Loss of heterozygosity at microsatellites linked to the DNA mismatch repair genes, hMSH2 and/or hMLH1, was found in 9 cases (19.6%), usually in association with microsatellite instability. Importantly, the pattern of allelic loss was uniform in 8 of these 9 tumors, suggesting that clonal loss had occurred. Moreover, loss at these loci also occurred in nonmalignant tissue adjacent to 4 of these tumors, where it was associated with marked allelic heterogeneity. There was relatively infrequent loss of APC, p53, or DPC4 loci that appeared unrelated to loss of hMSH2 or hMLH1 gene loci. Loss of heterozygosity at hMSH2 and/or hMLH1 gene loci, and the associated microsatellite instability in premalignant hepatic tissues suggests a possible causal role in hepatic carcinogenesis in a subset of hepatomas.

Refining the risk-benefit equation for thrombolysis: How to identity the low risk patient before administering thrombolytic therapy

In view of the relative risk of intracranial haemorrhage and major bleeding with thrombolytic therapy, it is important ro identify as early as possible the low risk patient who may not have a net clinical benefit from thrombolysis in the setting of acute myocardial infarction. An analysis of 5434 hospital-treated patients with myocardial infarction in the Perth MONICA study showed that age below 60 and absence of previous infarction or diabetes, shock, pulmonary oedema, cardiac arrest and Q-wave or left bundle branch block on the initial ECG identified a large group of patients with a 28 day mortality of only 1%, and one year mortality of only 2%. Identification of baseline risk in this way helps refine the risk-benefit equation for thrombolytic therapy, and may help avoid unnecessary use of thrombolysis in those unlikely to benefit.

Social identity and perceptions of media persuasion: Are we always less influenced than others?

People typically perceive negative media content (e.g., violence) to have more impact on others than on themselves (a third-person effect). To examine the perceived effects of positive content (e.g., public-service advertisements) and the moderating role of social identities, we examined students' perceptions of the impact of AIDS advertisements on self, students (in- group), nonstudents (out-group), and people in general. Perceived self-other differences varied with the salience of student identity. Low identifiers displayed the typical third-person effect, whereas high identifiers were more willing to acknowledge impact on themselves and the student in-group. Further, when influence was normatively accept able within the in-group, high identifiers perceived self and students (us) as more influenced than nonstudents (them). The theoretical and practical implications of this reversal in third-person perceptions are discussed.