Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

Correcció postural esportiva utilitzant un sensor Kinect

Aquest projecte s’emmarca dins de l’àmbit de la visió per computador, concretament en la utilització de dades de profunditat obtingudes a través d’un emissor i sensor de llum infraroja.El propòsit principal d’aquest projecte és mostrar com adaptar aquestes tecnologies, a l’abast de qualsevol particular, de forma que un usuari durant la pràctica d’una activitat esportiva concreta, rebi informació visual continua dels moviments i gestos incorrectes que està realitzant, en base a uns paràmetres prèviament establerts.L’objectiu d’aquest projecte consisteix en fer una lectura constant en temps real d’una persona practicant una selecció de diverses activitats esportives estàtiques utilitzant un sensor Kinect. A través de les dades obtingudes pel sensor Kinect i utilitzant les llibreries de “skeleton traking” proporcionades per Microsoft s’haurà d’interpretar les dades posturals obtingudes per cada tipus d’esport i indicar visualment i d’una manera intuïtiva els errors que està cometent en temps real, de manera que es vegi clarament a quina part del seu cos realitza un moviment incorrecte per tal de poder corregir-lo ràpidament. El entorn de desenvolupament que s’utilitza per desenvolupar aquesta aplicació es Microsoft Viusal Studio 2010.El llenguatge amb el qual es treballarà sobre Microsoft Visual Studio 2010 és C#

Oncobiguanides: Paracelsus" law and nonconventional routes for administering diabetobiguanides for cancer treatment

The dose makes the poison, the common motto of toxicology first expressed by Paracelsus more than 400 years ago, may effectively serve to guide potential applications for metformin and related biguanides in oncology. While Paracelsus' law for the dose-response effect has been commonly exploited for the use of some anti-cancer drugs at lower doses in non-neoplastic diseases (e.g., methotrexate), the opposite scenario also holds true; in other words, higher doses of non-oncology drugs, such as anti-diabetic biguanides, might exert direct anti-neoplastic effects. Here, we propose that, as for any drug, there is a dose range for biguanides that is without any effect, one corresponding to"diabetobiguanides" with a pharmacological effect (e.g., insulin sensitization in type 2 diabetes, prevention of insulin-dependent carcinogenesis, indirect inhibition of insulin and growth factor-dependent cancer growth) but with minimal toxicity and another corresponding to 'oncobiguanides' with pharmacological (i.e., direct and strong anticancer activity against cancer cells) as well as toxic effects. Considering that biguanides demonstrate a better safety profile than most oncology drugs in current use, we should contemplate the possibility of administering biguanides through non-conventional routes (e.g., inhaled for carcinomas of the lung, topical for skin cancers, intravenous as an adjunctive therapy, rectal suppositories for rectal cancer) to unambiguously investigate the therapeutic value of high-dose transient biguanide exposure in cancer. Perhaps then, the oncobiguanides, as we call them here, could be viewed as a mechanistically different type of anti-cancer drugs employed at doses notably higher than those used chronically when functioning as diabetobiguanides

Editorial del número 3 de la Revista Observar

Algunos clásicos mantenían la idea de un ojo activo que se abalanzaba sobre los objetos. En muchos casos, la diferencia en las diversas formulaciones de esta teoría estribaba en el papel desempeñado por el medio interpuesto. Y no era cosa de poca monta: de su intromisión dependía que la acción del rayo ocular se produjese con mayor o menor fortuna; que llegase a la superficie del objeto o que alcanzase sólo las masas de aire circundantes, con todas las consecuencias en materia epistemológica que un hecho como éste acarreaba. Es curioso que, cuando los antiguos reflexionaban sobre el funcionamiento del ojo, lo hiciesen pensando en el sentido humano. Y la verdad es que, una vez extraída la presunta ingenuidad de su teoría del rayo ocular, sigue vigente lo fundamental: el ojo humano no sólo ve; también mira. El mirar es antes que nada dirigir el ojo hacia un objeto; casi ponerlo el ojo allí. Bien mirado, se trata de una transacción entre lo que se toma (de la cosa) y lo que se pone (en la misma). Pero esa avenencia es desigual: se pone más; por eso, el mirar es proyectar, un lanzamiento ocular de un plan de acción que sólo cobra cuerpo en el objeto.

Editorial del número 4 de la Revista Observar

sabel Ruíz Pujadas regala al lector una imagen con trampa y cartón. A primera vista, casi podría haberse extraído de aquellas épocas en las que dibujantes intrépidos ponían su maña al servicio de la ciencia, del apoderamiento de los territorios inexplorados y de la fantasía europea. De estar en lo cierto, su regalo respira vendetta: llegó un momento en que el acta notarial de la realidad comenzó a sellarse con cristales de plata; hasta que alguien cayó en la cuenta de que la fotografía llevaba lentes y se acabó la discusión. Tal vez la imagen sea un homenaje a aquellos álbumes de plantas y bichos hechos con mucho esmero y no menos ojo. Pero, Isabel Ruíz la acompaña de un título, Mirada de gallina Leghorn, y el asunto se complica. Porque el título le da la vuelta al dibujo, desplaza su sentido y lo trae a la actualidad. Es una muestra de esas interferencias lingüísticas que apuntalan en no pocas ocasiones el efecto estético contemporáneo. Ni el rótulo ni la imagen; es su simbiosis lo que esclarece una intención hasta traerla al coto artístico.

Editorial del número 5 de la Revista Observar

Després de cinc anys de publicació ininterrompuda de la revista Observar, el Consell Editorial ha cregut que havia arribat el moment d'imprimir-li algunes modificacions. El lector que ha estat seguint la revista comprovarà en primer lloc que ha canviat lleugerament el format de pàgina. Per bé que hom ha mantingut els aspectes més importants del seu disseny i en especial la marca d"aigua amb el nom de la revista , d'una edició a dues columnes s'ha passat a una única columna i a una ampliació del seu marge dret. Amb aquest canvi s"ha pretès facilitar la lectura dels articles: hom evita així el desplaçament cap amunt al que, per tractar-se d"una revista electrònica concebuda per a ésser consultada principalment en pantalla, es veia obligat el lector en cada pàgina per tal de saltar de columna. En segon lloc, hom ha suprimit en l'editorial la lectura de la imatge de portada que precedia la presentació del sumari. Si, amb aquesta característica, s'havia volgut remarcar la provinença de la revista de l"àmbit de les arts malgrat que la major part d'allò publicat fa referència a la reflexió educativa , hom ha cregut necessari cedir aquest espai en l'editorial a aquells assumptes de més importància en la mesura que són els aspectes habitualment valorats per les entitats gestores de les bases de dades internacionals de revistes acadèmiques. En efecte, i aquesta és la tercera modificació, a partir d"aquest número hom passarà comptes d'un conjunt de dades de caràcter bibliomètric que informen de la política editorial i poden constituir indicadors de qualitat de la publicació.

Editorial del número 6 de la Revista Observar

Editorial del número 6 de OBSERVAR Revista electrónica del Observatorio sobre la Didáctica de las Artes. El sumario se abre con un artículo, de José Luis Menéndez Varela, sobre la carpeta de aprendizaje desde el momento en que entra en la educación superior. El tema del segundo artículo de Gabriela De la Cruz y Luis Felipe Abreu son las rúbricas, que según los autores no constituyen únicamente un instrumento de evaluación sino también un recurso llamado a desempeñar un papel relevante en la reorganización de los curricula. A continuación, siguen dos artículos que comparten el tema de las tutorías. Guillem Antequera aporta un artículo de revisión sobre el tutor de ABP en el que, se realiza un estudio comparado de las figuras del tutor experto y del tutor no experto. Carla Costa dedica su artículo a la tutoría entre iguales y comienza advirtiendo de una similar insuficiencia de investigaciones. El texto de Eva Gregori resulta difícil de catalogar al situarse a medio camino entre un artículo teórico clásico y un artículo de revisión. Presenta no una disertación sobre la ironía, sino una exposición de su complejidad. El número se cierra con una extensa noticia crítica de Guillem Antequera sobre las Primeras Jornadas de Innovación Docente en los Estudios de las Artes (IDEA) sobre las competencias comunicativas.

Computer-aided discovery of biological activity spectra for anti-aging and anti-cancer olive oil oleuropeins

Aging is associated with common conditions, including cancer, diabetes, cardiovascular disease, and Alzheimer"s disease. The type of multi‐targeted pharmacological approach necessary to address a complex multifaceted disease such as aging might take advantage of pleiotropic natural polyphenols affecting a wide variety of biological processes. We have recently postulated that the secoiridoids oleuropein aglycone (OA) and decarboxymethyl oleuropein aglycone (DOA), two complex polyphenols present in health‐promoting extra virgin olive oil (EVOO), might constitute a new family of plant‐produced gerosuppressant agents. This paper describes an analysis of the biological activity spectra (BAS) of OA and DOA using PASS (Prediction of Activity Spectra for Substances) software. PASS can predict thousands of biological activities, as the BAS of a compound is an intrinsic property that is largely dependent on the compound"s structure and reflects pharmacological effects, physiological and biochemical mechanisms of action, and specific toxicities. Using Pharmaexpert, a tool that analyzes the PASS‐predicted BAS of substances based on thousands of"mechanism‐ effect" and"effect‐mechanism" relationships, we illuminate hypothesis‐generating pharmacological effects, mechanisms of action, and targets that might underlie the anti‐aging/anti‐cancer activities of the gerosuppressant EVOO oleuropeins.

Multigram synthesis and in vivo efficacy studies of a novel multitarget anti-Alzheimer's compound

We describe the multigram synthesis and in vivo efficacy studies of a donepezil‒huprine hybrid that has been found to display a promising in vitro multitarget profile of interest for the treatment of Alzheimer's disease (AD). Its synthesis features as the key step a novel multigram preparative chromatographic resolution of intermediate racemic huprine Y by chiral HPLC. Administration of this compound to transgenic CL4176 and CL2006 Caenorhabditis elegans strains expressing human Aβ42, here used as simplified animal models of AD, led to a significant protection from the toxicity induced by Aβ42. However, this protective effect was not accompanied, in CL2006 worms, by a reduction of amyloid deposits. Oral administration for 3 months to transgenic APPSL mice, a well-established animal model of AD, improved short-term memory, but did not alter brain levels of Aβ peptides nor cortical and hippocampal amyloid plaque load. Despite the clear protective and cognitive effects of AVCRI104P4, the lack of Aβ lowering effect in vivo might be related to its lower in vitro potency toward Aβ aggregation and formation as compared with its higher anticholinesterase activities. Further lead optimization in this series should thus focus on improving the anti-amyloid/anticholinesterase activity ratio.

Effect of policosanol on cerebral ischemia in Mongolian gerbils

Policosanol is a mixture of higher aliphatic primary alcohols isolated from sugar cane wax, whose main component is octacosanol. An inhibitory effect of policosanol on platelet aggregation and cerebral ischemia in animal models has been reported. Thus, the objective of the present study was to evaluate the effect of policosanol on cerebral ischemia induced by unilateral carotid ligation and bilateral clamping and recirculation in Mongolian gerbils. Policosanol (200 mg/kg) administered immediately after unilateral carotid ligation and at 12- or 24-h intervals for 48 h significantly inhibited mortality and clinical symptoms when compared with controls, whereas lower doses (100 mg/kg) were not effective. Control animals showed swelling (tissue vacuolization) and necrosis of neurons in all areas of the brain studied (frontal cortex, hippocampus, striatum and olfactory tubercle), showing a similar injury profile. In the group treated with 200 mg/kg policosanol swelling and necrosis were significantly reduced when compared with the control group. In another experimental model, comparison between groups showed that the brain water content of control gerbils (N = 15) was significantly higher after 15 min of clamping and 4 h of recirculation than in sham-operated animals (N = 13), whereas policosanol (200 mg/kg) (N = 19) significantly reduced the edema compared with the control group, with a cerebral water content identical to that of the sham-operated animals. cAMP levels in the brain of control-ligated Mongolian gerbils (N = 8) were significantly lower than those of sham-operated animals (N = 10). The policosanol-treated group (N = 10) showed significantly higher cAMP levels (2.68 pmol/g of tissue) than the positive control (1.91 pmol/g of tissue) and similar to those of non-ligated gerbils (2.97 pmol/g of tissue). In conclusion, our results show an anti-ischemic effect of policosanol administered after induction of cerebral ischemia, in two different experimental models in Mongolian gerbils, suggesting a possible therapeutic effect in cerebral vascular disorders.

Inhibition of rat microsomal lipid peroxidation by the oral administration of D002

The effect of D002, a defined mixture of higher primary alcohols purified from bee wax, on in vivo and in vitro lipid peroxidation was studied. The extent of lipid peroxidation was measured on the basis of the levels of thiobarbituric acid reactive substances (TBARS). When D002 (5-100 mg/kg body weight) was administered orally to rats for two weeks, a partial inhibition of the in vitro enzymatic and non-enzymatic lipid peroxidation was observed in liver and brain microsomes. Maximal protection (46%) occurred at a dose of 25 mg/kg. D002 behaved differently depending on both the presence of NADPH and the integrity of liver microsomes, which suggests that under conditions where microsomal metabolism was favored the protective effect of D002 was increased. D002 (25 mg/kg) also completely inhibited carbon tetrachloride- and toluene-induced in vivo lipid peroxidation in liver and brain. Also, D002 significantly lowered in a dose-dependent manner the basal level of TBARS in liver (19-40%) and brain (28-44%) microsomes. We conclude that the oral administration of D002 (5, 25 and 100 mg/kg) for two weeks protected rat liver and brain microsomes against microsomal lipid peroxidation in vitro and in vivo. Thus, D002 could be useful as a dietary natural antioxidant supplement. More studies are required before these data can be extrapolated to the recommendation for the use of D002 as a dietary antioxidant supplement for humans.

Protective effect of policosanol on atherosclerotic lesions in rabbits with exogenous hypercholesterolemia

Policosanol is a mixture of higher aliphatic alcohols purified from sugar cane wax, with cholesterol-lowering effects demonstrable in experimental models and in patients with type II hypercholesterolemia. The protective effects of policosanol on atherosclerotic lesions experimentally induced by lipofundin in rabbits and rats and spontaneously developed in stumptail monkeys have been described. The present study was conducted to determine whether policosanol administered orally to rabbits with exogenous hypercholesterolemia also protects against the development of atherosclerotic lesions. Male New Zealand rabbits weighing 1.5 to 2 kg were randomly divided into three experimental groups which received 25 or 200 mg/kg policosanol (N = 7) orally for 60 days with acacia gum as vehicle or acacia gum alone (control group, N = 9). All animals received a cholesterol-rich diet (0.5%) during the entire period. Control animals developed marked hypercholesterolemia, macroscopic lesions and arterial intimal thickening. Intima thickness was significantly less (32.5 ± 7 and 25.4 ± 4 µm) in hypercholesterolemic rabbits treated with policosanol than in controls (57.6 ± 9 µm). In most policosanol-treated animals, atherosclerotic lesions were not present, and in others, thickness of fatty streaks had less foam cell layers than in controls. We conclude that policosanol has a protective effect on the atherosclerotic lesions occurring in this experimental model.

Otimização do cozimento de filé de frango empanado em forno de injeção direta de vapor

Foi estudado o efeito da temperatura do ar (205-215°C) e do tempo de cozimento (3,5 - 4,1 minutos), sobre a temperatura interna e o rendimento durante o cozimento do filé de frango empanado usando a metodologia de superfície de resposta, obtendo-se modelos estatísticos adequados. Verificou-se que as melhores condições de processo foram o emprego de temperaturas entre 206 e 209°C e tempos entre 2,5 e 3,6 minutos.

The effect of acid hydrolysis on the technological functional properties of pinhão (Araucaria brasiliensis) starch

Technological functional properties of native and acid-thinned pinhão (seeds of Araucária angustifolia, Brazilian pine) starches were evaluated and compared to those of native and acid-thinned corn starches. The starches were hydrolyzed (3.2 mol.L-1 HCl, 44 ºC, 6 hours) and evaluated before and after the hydrolysis reaction in terms of formation, melting point and thermo-reversibility of gel starches, retrogradation (in a 30-day period and measurements every three days), paste freezing and thawing stability (after six freezing and thawing cycles), swelling power, and solubility. The results of light transmittance (%) of pastes of native and acid-thinned pinhão starches was higher (lower tendency to retrogradation) than that obtained for corn starches after similar storage period. Native pinhão starch (NPS) presented lower syneresis than native corn starch (NCS) when submitted to freeze-thaw cycles. The acid hydrolysis increased the syneresis of the two native varieties under storage at 5 ºC and after freezing and thawing cycles. The solubility of NPS was lower than that of native corn starch at 25, 50, and 70 ºC. However, for the acid-thinned pinhão starch (APS), this property was significantly higher (p < 0.05) when compared to that of acid-thinned corn starch (ACS). From the results obtained, it can be said that the acid treatment was efficient in producing a potential fat substitute from pinhão starch variety, but this ability must be further investigated.