Clinical correlates of social adjustment in patients with obsessive-compulsive disorder

Background: Patients with obsessive-compulsive disorder (OCD) frequently show poor social adjustment, which has been associated with OCD severity. Little is known about the effects that age at symptom onset, specific OCD symptoms, and psychiatric comorbidities have on social adjustment. The objective of this study was to investigate the clinical correlates of social functioning in OCD patients. Methods: Cross-sectional study involving 815 adults with a primary DSM-IV diagnosis of OCD participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were assessed with the Social Adjustment Scale, the Medical Outcomes Study 36-item Short-Form Health Survey, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Clinical correlates of social adjustment were assessed with generalized linear models with gamma distribution. Results: Poor overall social functioning was associated with greater OCD severity (p = 0.02); hoarding symptoms (p = 0.004); sexual/religious obsessions (p = 0.005); current major depressive disorder (p = 0.004); current post-traumatic stress disorder (p = 0.002); and current eating disorders (p = 0.02). Poor social adjustment was also associated with impaired quality of life. Conclusions: Patients with OCD have poor social functioning in domains related to personal relationships and professional performance. Hoarding symptoms and sexual/religious obsessions seem to have the strongest negative effects on social functioning. Early age at OCD symptom onset seems to be associated with professional and academic underachievement and impairment within the family unit, whereas current psychiatric comorbidity worsen overall social functioning. In comparison with quality of life, social adjustment measures seem to provide a more comprehensive overview of the OCD-related burden. (C) 2012 Elsevier Ltd. All rights reserved.

Genome analysis of DNA repair genes in the alpha proteobacterium Caulobacter crescentus

Abstract Background The integrity of DNA molecules is fundamental for maintaining life. The DNA repair proteins protect organisms against genetic damage, by removal of DNA lesions or helping to tolerate them. DNA repair genes are best known from the gamma-proteobacterium Escherichia coli, which is the most understood bacterial model. However, genome sequencing raises questions regarding uniformity and ubiquity of these DNA repair genes and pathways, reinforcing the need for identifying genes and proteins, which may respond to DNA damage in other bacteria. Results In this study, we employed a bioinformatic approach, to analyse and describe the open reading frames potentially related to DNA repair from the genome of the alpha-proteobacterium Caulobacter crescentus. This was performed by comparison with known DNA repair related genes found in public databases. As expected, although C. crescentus and E. coli bacteria belong to separate phylogenetic groups, many of their DNA repair genes are very similar. However, some important DNA repair genes are absent in the C. crescentus genome and other interesting functionally related gene duplications are present, which do not occur in E. coli. These include DNA ligases, exonuclease III (xthA), endonuclease III (nth), O6-methylguanine-DNA methyltransferase (ada gene), photolyase-like genes, and uracil-DNA-glycosylases. On the other hand, the genes imuA and imuB, which are involved in DNA damage induced mutagenesis, have recently been described in C. crescentus, but are absent in E. coli. Particularly interesting are the potential atypical phylogeny of one of the photolyase genes in alpha-proteobacteria, indicating an origin by horizontal transfer, and the duplication of the Ada orthologs, which have diverse structural configurations, including one that is still unique for C. crescentus. Conclusion The absence and the presence of certain genes are discussed and predictions are made considering the particular aspects of the C. crescentus among other known DNA repair pathways. The observed differences enlarge what is known for DNA repair in the Bacterial world, and provide a useful framework for further experimental studies in this organism.

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

Renal function evaluation in patients with American Cutaneous Leishmaniasis after specific treatment with pentavalent antimonial

Background Renal evaluation studies are rare in American Cutaneous Leishmaniasis (ACL). The aim of this study is to investigate whether specific treatment reverts ACL-associated renal dysfunction. Methods A prospective study was conducted with 37 patients with ACL. Urinary concentrating and acidification ability was assessed before and after treatment with pentavalent antimonial. Results The patients mean age was 35.6 ± 12 years and 19 were male. Before treatment, urinary concentrating defect (U/Posm <2.8) was identified in 27 patients (77%) and urinary acidification defect in 17 patients (46%). No significant glomerular dysfunction was observed before and after specific ACL treatment. There was no reversion of urinary concentrating defects, being observed in 77% of the patients before and in 88% after treatment (p = 0.344). Urinary acidification defect was corrected in 9 patients after treatment, reducing its prevalence from 40% before to only 16% after treament, (p = 0.012). Microalbuminuria higher than 30 mg/g was found in 35% of patients before treatment and in only 8% after treatment. Regarding fractional excretion of sodium, potassium, calcium, phosphorus and magnesium, there was no significant difference between pre and post-treatment period. Conclusion As previously described, urinary concentrating and acidification defects were found in an important number of patients with ACL. Present results demonstrate that only some patients recover urinary acidification capacity, while no one returned to normal urinary concentration capacity.

Management of diabetes mellitus and associated cardiovascular risk factors in Brazil – the Brazilian study on the practice of diabetes care

Abstract Background The Brazilian Study on the Practice of Diabetes Care main objective was to provide an epidemiological profile of individuals with type 1 and 2 diabetes mellitus (DM) in Brazil, concerning therapy and adherence to international guidelines in the medical practice. Methods This observational, cross-sectional, multicenter study collected and analyzed data from individuals with type 1 and 2 DM attending public or private clinics in Brazil. Each investigator included the first 10 patients with type 2 DM who visited his/her office, and the first 5 patients with type 1 DM. Results A total of 1,358 patients were analyzed; 375 (27.6%) had type 1 and 983 (72.4%) had type 2 DM. Most individuals were women, Caucasian, and private health care users. High prevalence rates of hypertension, dyslipidemia and central obesity were observed, particularly in type 2 DM. Only 7.3% and 5.1% of the individuals with types 1 and 2 DM, respectively, had optimal control of blood pressure, plasma glucose and lipids. The absence of hypertension and female sex were associated with better control of type 1 DM and other cardiovascular risk factors. In type 2 DM, older age was also associated with better control. Conclusions Female sex, older age, and absence of hypertension were associated with better metabolic control. An optimal control of plasma glucose and other cardiovascular risk factors are obtained only in a minority of individuals with diabetes. Local numbers, compared to those from other countries are worse.

Lexical-semantic processing in the semantic priming paradigm in aphasic patients

There is evidence that the explicit lexical-semantic processing deficits which characterize aphasia may be observed in the absence of implicit semantic impairment. The aim of this article was to critically review the international literature on lexical-semantic processing in aphasia, as tested through the semantic priming paradigm. Specifically, this review focused on aphasia and lexical-semantic processing, the methodological strengths and weaknesses of the semantic paradigms used, and recent evidence from neuroimaging studies on lexical-semantic processing. Furthermore, evidence on dissociations between implicit and explicit lexical-semantic processing reported in the literature will be discussed and interpreted by referring to functional neuroimaging evidence from healthy populations. There is evidence that semantic priming effects can be found both in fluent and in non-fluent aphasias, and that these effects are related to an extensive network which includes the temporal lobe, the pre-frontal cortex, the left frontal gyrus, the left temporal gyrus and the cingulated cortex.

A study of multidrug-resistant tuberculosis in risk groups in the city of Santos, São Paulo, Brazil

Monitoring the extent of and trends in multidrug-resistant tuberculosis (MDR-TB) is a priority of the Brazilian National Tuberculosis Control Programme. The current study aimed to estimate the incidence of MDR-TB, describe the profile of TB drug resistance in risk groups and examine whether screening for MDR-TB adhered to the recommended guidelines. A descriptive study that examined diagnosed cases of pulmonary TB was conducted in the city of Santos, Brazil, between 2000-2004. Of the 2,176 pulmonary TB cases studied, 671 (30.8%) met the criteria for drug sensitivity testing and, of these cases, 31.7% (213/671) were tested. Among the tested cases, 9.4% were resistant to one anti-TB drug and 15% were MDR. MDR was observed in 11.6% of 86 new TB cases and 17.3% of 127 previously treated cases. The average annual incidence of MDR-TB was 1.9 per 100,000 inhabitants-years. The extent of known MDR-TB in the city of Santos is high, though likely to be underestimated. Our study therefore indicates an inadequate adherence to the guidelines for MDR-TB screening and suggests the necessity of alternative strategies of MDR-TB surveillance.

Effects of in vitro selenium supplementation on blood and milk neutrophils from dairy cows

The study was designed to assess the effects of in vitro selenium addition on intracellular hydrogen peroxide production by neutrophils from the milk and blood of dairy cows. Blood from 10 dairy cows and 20 milk samples from five dairy cows were incubated with 0 mg (control) or 10μM of sodium selenite. Then, milk and blood neutrophils were submitted for evaluation of intracellular hydrogen peroxide production by flow cytometry using 2',7'-dichlorofluorescein diacetate as a probe. The selenium status of the animals was evaluated by determination of the blood glutathione peroxidase activity. The results of the present work showed that in vitro selenium supplementation leads to an enhancement in intracellular hydrogen peroxide production, which indicates an improvement in the bactericidal effects of blood and milk neutrophils even in cows with a selenium-adequate status. Thus, the present study showed that in vitro Se supplementation leads to an enhancement in intracellular hydrogen peroxide production, indicating an improvement in the bactericidal effects of blood and milk neutrophils in cows with Se-adequate status.

Reduced occurrence of programmed cell death and gliosis in the retinas of juvenile rabbits after shortterm treatment with intravitreous bevacizumab

OBJECTIVE: Bevacizumab has been widely used as a vascular endothelial growth factor antagonist in the treatment of retinal vasoproliferative disorders in adults and, more recently, in infants with retinopathy of prematurity. Recently, it has been proposed that vascular endothelial growth factor acts as a protective factor for neurons and glial cells, particularly in developing nervous tissue. The purpose of this study was to investigate the effects of bevacizumab on the developing retinas of juvenile rabbits. METHODS: Juvenile rabbits received bevacizumab intravitreously in one eye; the other eye acted as an untreated control. Slit-lamp and fundoscopic examinations were performed both prior to and seven days after treatment. At the same time, retina samples were analyzed using immunohistochemistry to detect autophagy and apoptosis as well as proliferation and glial reactivity. Morphometric analyses were performed, and the data were analyzed using the Mann-Whitney U test. RESULTS: No clinical abnormalities were observed in either treated or untreated eyes. However, immunohistochemical analyses revealed a reduction in the occurrence of programmed cell death and increases in both proliferation and reactivity in the bevacizumab-treated group compared with the untreated group. CONCLUSIONS: Bevacizumab appears to alter programmed cell death patterns and promote gliosis in the developing retinas of rabbits; therefore, it should be used with caution in developing eyes

An experimental and theoretical approach to correct for the scattered radiation in an X-ray computer tomography system for industrial applications

The main problem connected to cone beam computed tomography (CT) systems for industrial applications employing 450 kV X-ray tubes is the high amount of scattered radiation which is added to the primary radiation (signal). This stray radiation leads to a significant degradation of the image quality. A better understanding of the scattering and methods to reduce its effects are therefore necessary to improve the image quality. Several studies have been carried out in the medical field at lower energies, whereas studies in industrial CT, especially for energies up to 450 kV, are lacking. Moreover, the studies reported in literature do not consider the scattered radiation generated by the CT system structure and the walls of the X-ray room (environmental scatter). In order to investigate the scattering on CT projections a GEANT4-based Monte Carlo (MC) model was developed. The model, which has been validated against experimental data, has enabled the calculation of the scattering including the environmental scatter, the optimization of an anti-scatter grid suitable for the CT system, and the optimization of the hardware components of the CT system. The investigation of multiple scattering in the CT projections showed that its contribution is 2.3 times the one of primary radiation for certain objects. The results of the environmental scatter showed that it is the major component of the scattering for aluminum box objects of front size 70 x 70 mm2 and that it strongly depends on the thickness of the object and therefore on the projection. For that reason, its correction is one of the key factors for achieving high quality images. The anti-scatter grid optimized by means of the developed MC model was found to reduce the scatter-toprimary ratio in the reconstructed images by 20 %. The object and environmental scatter calculated by means of the simulation were used to improve the scatter correction algorithm which could be patented by Empa. The results showed that the cupping effect in the corrected image is strongly reduced. The developed CT simulation is a powerful tool to optimize the design of the CT system and to evaluate the contribution of the scattered radiation to the image. Besides, it has offered a basis for a new scatter correction approach by which it has been possible to achieve images with the same spatial resolution as state-of-the-art well collimated fan-beam CT with a gain in the reconstruction time of a factor 10. This result has a high economic impact in non-destructive testing and evaluation, and reverse engineering.

The Time-Of-Flight detector of ALICE at LHC: construction, test and commissioning with cosmic rays

The Time-Of-Flight (TOF) detector of ALICE is designed to identify charged particles produced in Pb--Pb collisions at the LHC to address the physics of strongly-interacting matter and the Quark-Gluon Plasma (QGP). The detector is based on the Multigap Resistive Plate Chamber (MRPC) technology which guarantees the excellent performance required for a large time-of-flight array. The construction and installation of the apparatus in the experimental site have been completed and the detector is presently fully operative. All the steps which led to the construction of the TOF detector were strictly followed by a set of quality assurance procedures to enable high and uniform performance and eventually the detector has been commissioned with cosmic rays. This work aims at giving a detailed overview of the ALICE TOF detector, also focusing on the tests performed during the construction phase. The first data-taking experience and the first results obtained with cosmic rays during the commissioning phase are presented as well and allow to confirm the readiness state of the TOF detector for LHC collisions.

Dispersioni di inquinanti in acque costiere dal porto canale di Cesenatico. Modellazione e misure.

La presente dissertazione si apre con l’analisi della costa dell’Emilia Romagna, in particolare quella antistante la città di Cesenatico. Nel primo capitolo si è voluto fare un breve inquadramento delle problematiche che affliggono le acque costiere a debole ricambio. Il Mare Adriatico e in particolare le acque costiere, ormai da più di trent’anni, sono afflitti da una serie di problemi ambientali correlati all’inquinamento. Sulla costa romagnola, già verso la metà degli anni settanta, le prime estese morie di organismi viventi acquatici avevano posto sotto gli occhi dell’opinione pubblica l’insorgenza di situazioni drammatiche per l’ambiente, per la salute pubblica e per due importanti settori dell’economia regionale e nazionale quali il turismo e la pesca. Fino ad allora aveva dominato la diffusa convinzione che la diluizione nell’enorme quantità di acqua disponibile avrebbe consentito di immettere nel mare quantità crescenti di sostanze inquinanti senza intaccare in misura apprezzabile la qualità delle acque. Questa teoria si rivelò però clamorosamente errata per i mari interni con scarso ricambio di acqua (quali per esempio il Mare Adriatico), perché in essi le sostanze che entrano in mare dalla terraferma si mescolano per lungo tempo solo con un volume limitato di acqua antistante la costa. Solo se l’immissione di sostanze organiche è limitata, queste possono essere demolite agevolmente attraverso processi di autodepurazione per opera di microrganismi naturalmente presenti in mare. Una zona molto critica per questo processo è quella costiera, perché in essa si ha la transizione tra acque dolci e acque salate, che provoca la morte sia del plancton d’acqua dolce che di quello marino. Le sostanze estranee scaricate in mare giungono ad esso attraverso tre vie principali: • dalla terraferma: scarichi diretti in mare e scarichi indiretti attraverso corsi d’acqua che sfociano in mare; • da attività svolte sul mare: navigazione marittima e aerea, estrazione di materie prime dai fondali e scarico di rifiuti al largo; • dall’atmosfera: tramite venti e piogge che trasportano inquinanti provenienti da impianti e attività situati sulla terraferma. E’ evidente che gli scarichi provenienti dalla terraferma sono quelli più pericolosi per la salvaguardia delle acque costiere, in particolare vanno considerati: gli scarichi civili (enormemente accresciuti nel periodo estivo a causa del turismo), gli scarichi agricoli e gli scarichi industriali. Le sostanze estranee scaricate in mare contengono una grande abbondanza di sali nutrienti per i vegetali (in particolare nitrati e fosfati) che provengono dai concimi chimici, dai residui del trattamento biologico negli impianti di depurazione e dall’autodepurazione dei fiumi. Queste sostanze una volta giunte in mare subiscono un nuovo processo di autodepurazione che genera ulteriori quantità di nutrienti; i sali di fosforo e azoto così formati si concentrano soprattutto nelle acque basse e ferme della costa e vengono assimilati dalle alghe che possono svilupparsi in modo massivo: tale fenomeno prende il nome di eutrofizzazione. La produzione eccessiva di biomasse vegetali pone seri problemi per la balneazione in quanto può portare a colorazioni rossastre, brune, gialle o verdi delle acque; inoltre la decomposizione delle alghe impoverisce di ossigeno l’acqua, soprattutto sul fondo, provocando morie della fauna ittica. Nello specifico, in questo lavoro di tesi, si prende in considerazione il Porto Canale di Cesenatico, e come le acque da esso convogliate vadano ad influenzare il recettore finale, ovvero il Mar Adriatico. Attraverso l’uso di un particolare software, messo a mia disposizione dal D.I.C.A.M. è stata portata avanti un’analisi dettagliata, comprendente svariati parametri, quali la velocità dell’acqua, la salinità, la concentrazione dell’inquinante e la temperatura, considerando due possibili situazioni. A monte di ciò vi è stata una lunga fase preparatoria, in cui dapprima sono state recepite, attraverso una campagna di misure progettata ad hoc, ed elaborate le informazione necessarie per la compilazione del file di input; in seguito è stato necessario calibrare e tarare il programma, in quanto sono state apportate numerose variazioni di recepimento tutt’altro che immediato; dopodiché è stata introdotta la geometria rappresentante l’area presa in esame, geometria molto complessa in quanto trattasi di una zona molto ampia e non uniforme, infatti vi è la presenza di più barriere frangiflutti, sommerse ed emerse, che alterano in svariati punti la profondità del fondale. Non è stato semplice, a tal proposito, ricostruire l’area e ci si è avvalsi di una carta nautica riportante la batimetria del litorale antistante Cesenatico. Come è stato già detto, questa fase iniziale ha occupato molto tempo e si è dimostrata molto impegnativa. Non sono state comunque da meno le fasi successive. Inoltre, tale simulazione è stata effettuata su due scenari differenti, per poter valutare le differenti conclusioni alle quali essi hanno indotto. Dopo molti “tentativi”, l’eseguibile ha girato ed è arrivato al termine ricoprendo un lasso di tempo pari a ventiquattro ore. I risultati ottenuti in output, sono stati tradotti e vagliati in modo da essere graficati e resi più interpretabili. Segue infine la fase di analisi che ha portato alle deduzioni conclusive. Nei prossimi capitoli, si riporta nel dettaglio quello che in questo paragrafo è stato sinteticamente citato.

Hardware and software development of a multichannel readout board named CARLOSrx for the ALICE experiment

ALICE, that is an experiment held at CERN using the LHC, is specialized in analyzing lead-ion collisions. ALICE will study the properties of quarkgluon plasma, a state of matter where quarks and gluons, under conditions of very high temperatures and densities, are no longer confined inside hadrons. Such a state of matter probably existed just after the Big Bang, before particles such as protons and neutrons were formed. The SDD detector, one of the ALICE subdetectors, is part of the ITS that is composed by 6 cylindrical layers with the innermost one attached to the beam pipe. The ITS tracks and identifies particles near the interaction point, it also aligns the tracks of the articles detected by more external detectors. The two ITS middle layers contain the whole 260 SDD detectors. A multichannel readout board, called CARLOSrx, receives at the same time the data coming from 12 SDD detectors. In total there are 24 CARLOSrx boards needed to read data coming from all the SDD modules (detector plus front end electronics). CARLOSrx packs data coming from the front end electronics through optical link connections, it stores them in a large data FIFO and then it sends them to the DAQ system. Each CARLOSrx is composed by two boards. One is called CARLOSrx data, that reads data coming from the SDD detectors and configures the FEE; the other one is called CARLOSrx clock, that sends the clock signal to all the FEE. This thesis contains a description of the hardware design and firmware features of both CARLOSrx data and CARLOSrx clock boards, which deal with all the SDD readout chain. A description of the software tools necessary to test and configure the front end electronics will be presented at the end of the thesis.