Clinical outcome after a reactive hypothermic EEG following cardiac arrest.

BACKGROUND: Reactive electroencephalography (EEG) background during therapeutic hypothermia (TH) is related to favorable prognosis after cardiac arrest (CA), but its predictive value is not 100 %. The aim of this study was to investigate outcome predictors after a first reactive EEG recorded during TH after CA. METHODS: We studied a cohort of consecutive comatose adults admitted between February 2008 and November 2012, after successful resuscitation from CA, selecting patients with reactive EEG during TH. Outcome was assessed at three months, and categorized as survivors and non-survivors (no patient was in vegetative state). Demographics, clinical variables, EEG features, serum neuron-specific enolase (NSE) and procalcitonin, were compared using uni- and multivariable analyses. RESULTS: A total of 290 patients were treated with TH after cardiac arrest; 146 had an EEG during TH, which proved reactive in 90 of them; 77 (86 %) survived and 13 (14 %) died (without recovery from coma). The group of non-survivors had a higher occurrence of discontinuous EEG (p = 0.006; multivariate analysis p = 0.026), and a higher serum NSE peak (p = 0.021; multivariate analysis p = 0.014); conversely, demographics, and other clinical variables including serum procalcitonin did not differ. CONCLUSIONS: A discontinuous EEG and high serum NSE are associated with mortality after CA in patients with poor outcome despite a reactive hypothermic EEG. This suggests more severe cerebral damage, but not to higher extent of systemic disease.

Resposta diferencial de cultivares de algodão ao manganês em solução nutritiva

Enquanto a toxidez de Mn pode ser um problema para a cultura do algodoeiro nos estados de São Paulo e Paraná, a deficiência pode causar problemas nas áreas de solos sob cerrado. No presente trabalho, objetivou-se o estudo da resposta comparativa de cultivares de algodão ao Mn, em solução nutritiva. Plantas de algodão dos cultivares Coodetec 401, CNPA-ITM 90 e IAC 22 foram cultivadas em vasos, com solução nutritiva que continha 0,0, 36,4, 72,8, 145,5 e 290,9 ∝mol L-1 de Mn, por 70 dias. Foi observado sintoma de deficiência de Mn apenas no tratamento sem Mn, para os três cultivares. A deficiência de Mn na solução nutritiva provocou a diminuição da altura das plantas, produção de matéria seca, absorção de Mn e retenção de estruturas reprodutivas. Não foram notados sintomas visuais de toxidez de Mn em qualquer dos três cultivares, mesmo com teores muito altos do nutriente nas folhas. Embora os três cultivares não apresentem diferenças quanto à absorção total de Mn, IAC 22 é mais sensível à toxidez, enquanto Coodetec 401 e CNPA-ITM 90 são mais sensíveis à deficiência do nutriente. Pode haver prejuízo na fixação de estruturas reprodutivas, tanto com deficiência como com toxidez de Mn, sem sintomas aparentes.

Application of real-time PCR for total airborne bacterial assessment : comparison with epifluorescence microscopy and culture-dependent methods

Traditional culture-dependent methods to quantify and identify airborne microorganisms are limited by factors such as short-duration sampling times and inability to count nonculturableor non-viable bacteria. Consequently, the quantitative assessment of bioaerosols is often underestimated. Use of the real-time quantitative polymerase chain reaction (Q-PCR) to quantify bacteria in environmental samples presents an alternative method, which should overcome this problem. The aim of this study was to evaluate the performance of a real-time Q-PCR assay as a simple and reliable way to quantify the airborne bacterial load within poultry houses and sewage treatment plants, in comparison with epifluorescencemicroscopy and culture-dependent methods. The estimates of bacterial load that we obtained from real-time PCR and epifluorescence methods, are comparable, however, our analysis of sewage treatment plants indicate these methods give values 270-290 fold greater than those obtained by the ''impaction on nutrient agar'' method. The culture-dependent method of air impaction on nutrient agar was also inadequate in poultry houses, as was the impinger-culture method, which gave a bacterial load estimate 32-fold lower than obtained by Q-PCR. Real-time quantitative PCR thus proves to be a reliable, discerning, and simple method that could be used to estimate airborne bacterial load in a broad variety of other environments expected to carry high numbers of airborne bacteria. [Authors]

Pierre-Joseph Proudhon. Papiers. VI Cahiers de notes et extraits.

Fauré-Fremiet, Mme. Manuscrit(s) provenant d'elle

Registre des dépêches adressées à la Cour, principalement à Henri-Auguste de Loménie de Brienne, à Mazarin et à Hugues de Lionne, par Antoine DE LUMBRES, seigneur d'Herbinghem, ambassadeur en Allemagne et en Pologne. Minutes. (1652 et 1655-1666.). III 19 janvier 1662-27 mars 1666.

A la fin du volume (f. 285 et suiv.), pièces annexes.

ROBETH: un logiciel pour les procédés statistiques robustes [ROBETH: a library for robust statistical procedures].

In the past 20 years the theory of robust estimation has become an important topic of mathematical statistics. We discuss here some basic concepts of this theory with the help of simple examples. Furthermore we describe a subroutine library for the application of robust statistical procedures, which was developed with the support of the Swiss National Science Foundation.

Solos do topo da Serra São José (Minas Gerais) e suas relações com o paleoclima no Sudeste do Brasil

A diversidade de ecossistemas do sudeste do Brasil nem sempre pode ser relacionada com fatores edáficos, geomorfológicos ou hidrológicos. Topos de elevações, onde os solos são caracterizados pela unicidade de material de origem, podem constituir ambiente especial para estudos de gênese de solos e datações de eventos cíclicos relacionados com a dinâmica do clima regional. Depois de um levantamento detalhado de solos no topo da Serra São José (Prados - Minas Gerais), dois perfis de solo (P1 e P2), originados de metarenitos da Formação Tiradentes e caracterizados por deposições sucessivas de camadas arenosas alternadas com camadas arenosas enriquecidas com matéria orgânica, foram estudados, com intuito de encontrar testemunhos de paleoambientes. O pequeno platô localiza-se a 1.350 m acima do nível de mar e 350 m acima do nível topográfico regional dominante. No P1, foram identificadas trinta e três camadas enriquecidas com matéria orgânica, alternadas com camadas de areia. Três camadas no P1 (20-30, 70-80 e 100-110 cm), com conteúdo de C orgânico respectivamente de 0.5, 7 e 1 dag kg-1, apresentam idades radiocarbônicas < 40, 180 ± 60 e 350 ± 80 anos AP, respectivamente, e taxas de deposição de 0,177 cm ano-1 entre 110 e 70 cm e de 0,357 cm ano-1 entre 70 e 20 cm de profundidade. No P2, as camadas enriquecidas com matéria orgânica são mais espessas (entre 10 e 130 mm) e apresentam descontinuidades abruptas. Situam-se entre 20-30, 80-90, 110-120 e 170-180 cm de profundidade, têm um conteúdo de C orgânico de 3, 2.5, 21 e 1.5 dag kg-1 e idade radiocarbônica de 3580 ± 80, 3750 ± 80, 21210 ± 180 e 24060 ± 130 anos AP, respectivamente. Suas taxas de deposição são de 0,352 cm ano-1, entre 20 e 80 cm; de 0,002 cm ano-1, entre 80 e 110 cm, e de 0,021 cm ano-1, entre 110 e 170 cm de profundidade. Nos dois perfis, a relação C/N aumenta com a profundidade e com a idade das camadas. Os teores de Ti e Zr, elementos de baixa mobilidade, são mais elevados nas camadas mais antigas dos perfis, enquanto o Cu e o Pb concentram-se nas camadas mais ricas em matéria orgânica. Um fragmento de planta de 5 cm de diâmetro e 62 cm de comprimento, situado na base de P2, foi datado de 32220 ± 290 anos AP e relacionado com o início da gênese deste perfil. Os solos do topo da Serra São José são formados a partir de metarenitos da Formação Tiradentes, sem aporte de materiais de outra litologia. A água pluvial é o principal fator que adiciona energia a este ambiente, relacionando os atributos dos solos com o clima. P1 é um solo holocênico (Neossolo Flúvico Psamítico típico), formado a partir de deposições episódicas de areia, alternadas com material enriquecido com matéria orgânica. A formação de P2 (Paleossolo) iniciou-se no Pleistoceno, prolongou-se até o Holoceno e a morfologia de suas camadas enterradas de turfa relaciona-se com a oscilação do espelho d'água de uma lagoa, decorrente de fases mais secas e mais úmidas do clima. As idades radiocarbônicas encontradas estão relacionadas com alternâncias climáticas pleistocênicas e holocênicas em P2 e holocênicas em P1. O perfil P2 está situado em um local propício para realização de estudos palinológicos, com intuito de identificar ecótipos que ocuparam a área a partir do Pleistoceno tardio, relacionando-os com os paleoclimas.

Influence of segmental chromosome abnormalities on survival in children over the age of 12 months with unresectable localised peripheral neuroblastic tumours without MYCN amplification.

BACKGROUND: The prognostic impact of segmental chromosome alterations (SCAs) in children older than 1 year, diagnosed with localised unresectable neuroblastoma (NB) without MYCN amplification enrolled in the European Unresectable Neuroblastoma (EUNB) protocol is still to be clarified, while, for other group of patients, the presence of SCAs is associated with poor prognosis. METHODS: To understand the role of SCAs we performed multilocus/pangenomic analysis of 98 tumour samples from patients enrolled in the EUNB protocol. RESULTS: Age at diagnosis was categorised into two groups using 18 months as the age cutoff. Significant difference in the presence of SCAs was seen in tumours of patients between 12 and 18 months and over 18 months of age at diagnosis, respectively (P=0.04). A significant correlation (P=0.03) was observed between number of SCAs per tumour and age. Event-free (EFS) and overall survival (OS) were calculated in both age groups, according to both the presence and number of SCAs. In older patients, a poorer survival was associated with the presence of SCAs (EFS=46% vs 75%, P=0.023; OS=66.8% vs 100%, P=0.003). Moreover, OS of older patients inversely correlated with number of SCAs (P=0.002). Finally, SCAs provided additional prognostic information beyond histoprognosis, as their presence was associated with poorer OS in patients over 18 months with unfavourable International Neuroblastoma Pathology Classification (INPC) histopathology (P=0.018). CONCLUSIONS: The presence of SCAs is a negative prognostic marker that impairs outcome of patients over the age of 18 months with localised unresectable NB without MYCN amplification, especially when more than one SCA is present. Moreover, in older patients with unfavourable INPC tumour histoprognosis, the presence of SCAs significantly affects OS.

A Novel Acute Retroviral Syndrome Severity Score Predicts the Key Surrogate Markers for HIV-1 Disease Progression.

OBJECTIVE: Best long-term practice in primary HIV-1 infection (PHI) remains unknown for the individual. A risk-based scoring system associated with surrogate markers of HIV-1 disease progression could be helpful to stratify patients with PHI at highest risk for HIV-1 disease progression. METHODS: We prospectively enrolled 290 individuals with well-documented PHI in the Zurich Primary HIV-1 Infection Study, an open-label, non-randomized, observational, single-center study. Patients could choose to undergo early antiretroviral treatment (eART) and stop it after one year of undetectable viremia, to go on with treatment indefinitely, or to defer treatment. For each patient we calculated an a priori defined "Acute Retroviral Syndrome Severity Score" (ARSSS), consisting of clinical and basic laboratory variables, ranging from zero to ten points. We used linear regression models to assess the association between ARSSS and log baseline viral load (VL), baseline CD4+ cell count, and log viral setpoint (sVL) (i.e. VL measured ≥90 days after infection or treatment interruption). RESULTS: Mean ARSSS was 2.89. CD4+ cell count at baseline was negatively correlated with ARSSS (p = 0.03, n = 289), whereas HIV-RNA levels at baseline showed a strong positive correlation with ARSSS (p<0.001, n = 290). In the regression models, a 1-point increase in the score corresponded to a 0.10 log increase in baseline VL and a CD4+cell count decline of 12/µl, respectively. In patients with PHI and not undergoing eART, higher ARSSS were significantly associated with higher sVL (p = 0.029, n = 64). In contrast, in patients undergoing eART with subsequent structured treatment interruption, no correlation was found between sVL and ARSSS (p = 0.28, n = 40). CONCLUSION: The ARSSS is a simple clinical score that correlates with the best-validated surrogate markers of HIV-1 disease progression. In regions where ART is not universally available and eART is not standard this score may help identifying patients who will profit the most from early antiretroviral therapy.

Contaminação do solo com antraceno e creosoto e o crescimento vegetal e a colonização micorrízica pelo Glomus etunicatum

A contaminação do solo por compostos orgânicos, especialmente os hidrocarbonetos aromáticos policíclicos (HAPs) de petróleo, é um problema crescente e que traz graves conseqüências ambientais. Para avaliar os impactos causados por esses compostos, torna-se necessário conhecer seus efeitos sobre as plantas e a microbiota rizosférica associada. No presente estudo avaliaram-se os efeitos de antraceno e creosoto no crescimento e na colonização micorrízica de Brachiaria brizantha e Pueraria phaseoloides. Antraceno e creosoto foram aplicados a um solo infestado com o fungo micorrízico Glomus etunicatum, sendo: antraceno nas concentrações de 0; 0,25; 0,5; 0,75 e 1 g kg-1 solo; e creosoto nas concentrações de 0; 0,5; 1; 2 e 3 g kg-1 solo. O solo com os tratamentos foi colocado em tubetes (290 cm³) e semeado com as plantas-teste, as quais foram cultivadas por seis semanas. Verificou-se que o antraceno não afetou o crescimento da puerária e teve pequeno estímulo no crescimento da braquiária na dose mais baixa, enquanto o creosoto reduziu o crescimento da braquiária e não teve efeito na puerária. Entretanto, ambos os contaminantes inibiram a colonização micorrízica da puerária, atingindo redução de cerca de 90 % em relação ao controle. Em concentrações bem inferiores às encontradas em solos contaminados, a colonização micorrízica foi inibida em 50 %, ficando evidente o potencial de impacto desses poluentes na relação planta-fungo micorrízico. Na braquiária não foi encontrada colonização micorrízica. Fica evidenciada a resposta diferenciada das duas espécies estudadas aos contaminantes e o acentuado efeito negativo destes sobre a colonização micorrízica. A puerária, por ter se mostrado insensível aos HAPs, nas concentrações estudadas, apresenta potencial para aplicação na fitorremediação de áreas impactadas por esses contaminantes.

Patterns and trends in esophageal cancer mortality and incidence in Europe (1980-2011) and predictions to 2015

BACKGROUND: Over the last few decades, esophageal cancer incidence and mortality trends varied substantially across Europe, with important differences between sexes and the two main histological subtypes, squamous cell carcinoma (ESCC) and adenocarcinoma (EAC). PATIENTS AND METHODS: To monitor recent esophageal cancer mortality trends and to compute short-term predictions in the European Union (EU) and selected European countries, we analyzed data provided by the World Health Organization (WHO) for 1980-2011. We also analyzed incidence trends and relative weights of ESCC and EAC across Europe using data from Cancer Incidence in Five Continents. RESULTS: Long-term decreasing trends were observed for male esophageal cancer mortality in several southern and western European countries, whereas in central Europe mortality increased until the mid-1990s and started to stabilize or decline over the last years. In some eastern and northern countries, the rates were still increasing. Mortality among European women remained comparatively low and showed stable or decreasing trends in most countries. Between 2000-2004 and 2005-2009, esophageal cancer mortality declined by 7% (from 5.34 to 4.99/100 000) in EU men, and by 3% (from 1.12 to 1.09/100 000) in EU women. Predictions to 2015 show persistent declines in mortality rates for men in the EU overall, and stable rates for EU women, with rates for 2015 of 4.5/100 000 men (about 22 300 deaths) and 1.1/100 000 women (about 7400 deaths). In northern Europe, EAC is now the predominant histological type among men, while for European women ESCC is more common and corresponding rates are still increasing in several countries. CONCLUSION(S): The observed trends reflect the variations in alcohol drinking, tobacco smoking and overweight across European countries.