Comparison of two laboratory-developed PCR methods for the diagnosis of Pulmonary Tuberculosis in Brazilian patients with and without HIV infection

Abstract Background Direct smear examination with Ziehl-Neelsen (ZN) staining for the diagnosis of pulmonary tuberculosis (PTB) is cheap and easy to use, but its low sensitivity is a major drawback, particularly in HIV seropositive patients. As such, new tools for laboratory diagnosis are urgently needed to improve the case detection rate, especially in regions with a high prevalence of TB and HIV. Objective To evaluate the performance of two in house PCR (Polymerase Chain Reaction): PCR dot-blot methodology (PCR dot-blot) and PCR agarose gel electrophoresis (PCR-AG) for the diagnosis of Pulmonary Tuberculosis (PTB) in HIV seropositive and HIV seronegative patients. Methods A prospective study was conducted (from May 2003 to May 2004) in a TB/HIV reference hospital. Sputum specimens from 277 PTB suspects were tested by Acid Fast Bacilli (AFB) smear, Culture and in house PCR assays (PCR dot-blot and PCR-AG) and their performances evaluated. Positive cultures combined with the definition of clinical pulmonary TB were employed as the gold standard. Results The overall prevalence of PTB was 46% (128/277); in HIV+, prevalence was 54.0% (40/74). The sensitivity and specificity of PCR dot-blot were 74% (CI 95%; 66.1%-81.2%) and 85% (CI 95%; 78.8%-90.3%); and of PCR-AG were 43% (CI 95%; 34.5%-51.6%) and 76% (CI 95%; 69.2%-82.8%), respectively. For HIV seropositive and HIV seronegative samples, sensitivities of PCR dot-blot (72% vs 75%; p = 0.46) and PCR-AG (42% vs 43%; p = 0.54) were similar. Among HIV seronegative patients and PTB suspects, ROC analysis presented the following values for the AFB smear (0.837), Culture (0.926), PCR dot-blot (0.801) and PCR-AG (0.599). In HIV seropositive patients, these area values were (0.713), (0.900), (0.789) and (0.595), respectively. Conclusion Results of this study demonstrate that the in house PCR dot blot may be an improvement for ruling out PTB diagnosis in PTB suspects assisted at hospitals with a high prevalence of TB/HIV.

Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report

This report describes a rare case of coexistence of benign phyllodes tumor, which measured 9 cm in the right breast, and invasive ductal carcinoma of 6 cm in the left breast, synchronous and independent, in a 66-year-old patient. The patient underwent a bilateral mastectomy due to the size of both lesions. Such situations are rare and usually refer to the occurrence of ductal or lobular carcinoma in situ when associated with malignant phyllodes tumors, and more often in ipsilateral breast or intra-lesional.

Contribution to the stratigraphy of the onshore Paraíba Basin, Brazil

Several publications have contributed to improve the stratigraphy of the Paraíba Basin in northeastern Brazil. However, the characterization and distribution of sedimentary units in onshore areas of this basin are still incomplete, despite their significance for reconstructing the tectono-sedimentary evolution of the South American passive margin. This work provides new information to differentiate among lithologically similar strata, otherwise entirely unrelated in time. This approach included morphological, sedimentological and stratigraphic descriptions based on surface and sub-surface data integrated with remote sensing, optically stimulated luminescence dating, U+Th/He dating of weathered goethite, and heavy mineral analysis. Based on this study, it was possible to show that Cretaceous units are constrained to the eastern part of the onshore Paraíba Basin. Except for a few outcrops of carbonatic rocks nearby the modern coastline, deposits of this age are not exposed to the surface in the study area. Instead, the sedimentary cover throughout the basin is constituted by mineralogically and chronologically distinctive deposits, inserted in the Barreiras Formation and mostly in the Post-Barreiras Sediments, of early/middle Miocene and Late Pleistocene-Holocene ages, respectively. The data presented in this work support tectonic deformation as a factor of great relevance to the distribution of the sedimentary units of the Paraíba Basin.

Processos interativos de bebês em creche

O artigo trata de estudo sobre interações de bebês com pares, que buscou apreender aspectos qualitativos desses processos relacionais, considerando particularidades dos bebês. No estudo, utilizaram-se videogravações e entrevistas, do projeto "Processos de Adaptação de Bebês a Creche", que acompanhou 21 bebês (4-13 meses) em creche. Os dados foram coletados e analisados pela perspectiva da Rede de Significações. Selecionaram-se, então, cinco episódios, a partir de três sujeitos-focais e seus pares. Análise indica ocorrência de interação, em que se destacam o papel do olhar, relações triádicas (mesmo em bebês menores de nove meses), a abreviação de recursos comunicativos e a empatia. Ainda, apesar da ausência de linguagem verbal, verificou-se ocorrência de significação. Algumas implicações teórico-práticas são apontadas.

Acolhimento de crianças e adolescentes em situações de abandono, violência e rupturas

A proteção integral à infância encontra-se em reordenamento. Baseadas nas experiências do GIAAA-CINDEDI (Grupo de Investigação sobre Abrigamento, Acolhimento Familiar e Adoção - Centro de Investigações sobre Desenvolvimento Humano e Educação Infantil), buscamos compreender a rede de significações que permeia as práticas de acolhimento familiar, institucional e adoção. Investigamos vários contextos e protagonistas: sistema judiciário, abrigos, mães e famílias de origem, de acolhimento e adotivas. Diversos procedimentos foram utilizados: investigações sócio-demográficas, estudos de caso, entrevistas, pesquisa documental nos abrigos e no Fórum, grupos de discussão. Ressaltamos achados comuns: "invisibilidade" da família de origem; freqüente (re)violação da criança; falhas na Rede de Proteção; significações sobre "família saudável" e papel das concepções sobre apego que permeiam o campo. Implicações para políticas públicas e práticas sociais na área são discutidas.

Nursing care time in the Intensive Care Unit: evaluation of the parameters proposed in COFEN Resolution Nº 293/04

This study aimed to evaluate the parameters established in COFEN Resolution 293/04 concerning nursing staff dimensioning in adult intensive care units (AICU). The research was conducted in six hospitals in São Paulo City. The daily quantitative average of professionals needed for patient care was calculated according to the parameters established by COFEN. The obtained results were compared with the existing number of daily staff members in these units. It was observed that the proportions recommended by COFEN for the nurse category are superior to those used in the hospitals studied, which represents a challenge for Brazilian nursing. Mean care time values were found appropriate and represent important standards for dimensioning the minimum number of professionals in AICU. This study contributed to the validation of the parameters indicated in Resolution 293/04 for nursing staff dimensioning in the AICU.

Endo-PDI is required for TNFα-induced angiogenesis

Protein disulfide isomerase (PDI) and its homologs are oxidoreductases facilitating protein folding in the ER. Endo-PDI (also termed ERp46) is highly expressed in endothelial cells. It belongs to the PDI family but its physiological function is largely unknown. We studied the role of Endo-PDI in endothelial angiogenic responses. Stimulation of human umbilical vein endothelial cells (with TNFα (10ng/ml) increased ERK1/2 phosphorylation. This effect was largely attenuated by Endo-PDI siRNA, whereas JNK and p38 MAP kinase phosphorylation was Endo-PDI independent. Similarly, TNFα-stimulated NF-κB signaling determined by IκBα degradation as well as TNFα-induced ICAM expression was unaffected by Endo-PDI siRNA. The action of Endo-PDI was not mediated by extracellular thiol exchange or cell surface PDI as demonstrated by nonpermeative inhibitors and PDI-neutralizing antibody. Moreover, exogenously added PDI failed to restore ERK1/2 activation after Endo-PDI knockdown. This suggests that Endo-PDI acts intracellularly potentially by maintaining the Ras/Raf/MEK/ERK pathway. Indeed, knockdown of Endo-PDI attenuated Ras activation measured by G-LISA and Raf phosphorylation. ERK activation influences gene expression by the transcriptional factor AP-1, which controls MMP-9 and cathepsin B, two proteases required for angiogenesis. TNFα-stimulated MMP-9 and cathepsin B induction was reduced by silencing of Endo-PDI. Accordingly, inhibition of cathepsin B or Endo-PDI siRNA blocked the TNFα-stimulated angiogenic response in the spheroid outgrowth assays. Moreover ex vivo tube formation and in vivo Matrigel angiogenesis in response to TNFα were attenuated by Endo-PDI siRNA. In conclusion, our study establishes Endo-PDI as a novel, important mediator of AP-1-driven gene expression and endothelial angiogenic function

The role of Nox2-derived ROS in the development of cognitive impairment after sepsis

BACKGROUND: Sepsis- associated encephalopathy (SAE) is an early and common feature of severe infections. Oxidative stress is one of the mechanisms associated with the pathophysiology of SAE. The goal of this study was to investigate the involvement of NADPH oxidase in neuroinflammation and in the long-term cognitive impairment of sepsis survivors. METHODS: Sepsis was induced in WT and gp91phox knockout mice (gp91phox-/-) by cecal ligation and puncture (CLP) to induce fecal peritonitis. We measured oxidative stress, Nox2 and Nox4 gene expression and neuroinflammation in the hippocampus at six hours, twenty-four hours and five days post-sepsis. Mice were also treated with apocynin, a NADPH oxidase inhibitor. Behavioral outcomes were evaluated 15 days after sepsis with the inhibitory avoidance test and the Morris water maze in control and apocynin-treated WT mice. RESULTS: Acute oxidative damage to the hippocampus was identified by increased 4-HNE expression in parallel with an increase in Nox2 gene expression after sepsis. Pharmacological inhibition of Nox2 with apocynin completely inhibited hippocampal oxidative stress in septic animals. Pharmacologic inhibition or the absence of Nox2 in gp91phox-/- mice prevented glial cell activation, one of the central mechanisms associated with SAE. Finally, treatment with apocynin and inhibition of hippocampal oxidative stress in the acute phase of sepsis prevented the development of long-term cognitive impairment. CONCLUSIONS: Our results demonstrate that Nox2 is the main source of reactive oxygen species (ROS) involved in the oxidative damage to the hippocampus in SAE and that Nox2-derived ROS are determining factors for cognitive impairments after sepsis. These findings highlight the importance of Nox2-derived ROS as a central mechanism in the development of neuroinflammation associated with SAE.

Design and development of new pressure sensors for aerodynamic applications

This artwork reports on two different projects that were carried out during the three years of Doctor of the Philosophy course. In the first years a project regarding Capacitive Pressure Sensors Array for Aerodynamic Applications was developed in the Applied Aerodynamic research team of the Second Faculty of Engineering, University of Bologna, Forlì, Italy, and in collaboration with the ARCES laboratories of the same university. Capacitive pressure sensors were designed and fabricated, investigating theoretically and experimentally the sensor’s mechanical and electrical behaviours by means of finite elements method simulations and by means of wind tunnel tests. During the design phase, the sensor figures of merit are considered and evaluated for specific aerodynamic applications. The aim of this work is the production of low cost MEMS-alternative devices suitable for a sensor network to be implemented in air data system. The last two year was dedicated to a project regarding Wireless Pressure Sensor Network for Nautical Applications. Aim of the developed sensor network is to sense the weak pressure field acting on the sail plan of a full batten sail by means of instrumented battens, providing a real time differential pressure map over the entire sail surface. The wireless sensor network and the sensing unit were designed, fabricated and tested in the faculty laboratories. A static non-linear coupled mechanical-electrostatic simulation, has been developed to predict the pressure versus capacitance static characteristic suitable for the transduction process and to tune the geometry of the transducer to reach the required resolution, sensitivity and time response in the appropriate full scale pressure input A time dependent viscoelastic error model has been inferred and developed by means of experimental data in order to model, predict and reduce the inaccuracy bound due to the viscolelastic phenomena affecting the Mylar® polyester film used for the sensor diaphragm. The development of the two above mentioned subjects are strictly related but presently separately in this artwork.

Studio del comportamento meccanico di smalti porcellanati per substrati metallici

Composite porcelain enamels are inorganic coatings for metallic components based on a special ceramic-vitreous matrix in which specific additives are randomly dispersed. The ceramic-vitreous matrix is made by a mixture of various raw materials and elements and in particular it is based on boron-silicate glass added with metal oxides(1) of titanium, zinc, tin, zirconia, alumina, ecc. These additions are often used to improve and enhance some important performances such as corrosion(2) and wear resistance, mechanical strength, fracture toughness and also aesthetic functions. The coating process, called enamelling, depends on the nature of the surface, but also on the kind of the used porcelain enamel. For metal sheets coatings two industrial processes are actually used: one based on a wet porcelain enamel and another based on a dry-silicone porcelain enamel. During the firing process, that is performed at about 870°C in the case of a steel substrate, the enamel raw material melts and interacts with the metal substrate so enabling the formation of a continuous varying structure. The interface domain between the substrate and the external layer is made of a complex material system where the ceramic vitreous and the metal constituents are mixed. In particular four main regions can be identified, (i) the pure metal region, (ii) the region where the metal constituents are dominant compared with the ceramic vitreous components, (iii) the region where the ceramic vitreous constituents are dominant compared with the metal ones, and the fourth region (iv) composed by the pure ceramic vitreous material. It has also to be noticed the presence of metallic dendrites that hinder the substrate and the external layer passing through the interphase region. Each region of the final composite structure plays a specific role: the metal substrate has mainly the structural function, the interphase region and the embedded dendrites guarantee the adhesion of the external vitreous layer to the substrate and the external vitreous layer is characterized by an high tribological, corrosion and thermal shock resistance. Such material, due to its internal composition, functionalization and architecture can be considered as a functionally graded composite material. The knowledge of the mechanical, tribological and chemical behavior of such composites is not well established and the research is still in progress. In particular the mechanical performances data about the composite coating are not jet established. In the present work the Residual Stresses, the Young modulus and the First Crack Failure of the composite porcelain enamel coating are studied. Due to the differences of the porcelain composite enamel and steel thermal properties the enamelled steel sheets have residual stresses: compressive residual stress acts on the coating and tensile residual stress acts on the steel sheet. The residual stresses estimation has been performed by measuring the curvature of rectangular one-side coated specimens. The Young modulus and the First Crack Failure (FCF) of the coating have been estimated by four point bending tests (3-7) monitored by means of the Acoustic Emission (AE) technique(5,6). In particular the AE information has been used to identify, during the bending tests, the displacement domain over which no coating failure occurs (Free Failure Zone, FFZ). In the FFZ domain, the Young modulus has been estimated according to ASTM D6272-02. The FCF has been calculated as the ratio between the displacement at the first crack of the coating and the coating thickness on the cracked side. The mechanical performances of the tested coated specimens have also been related and discussed to respective microstructure and surface characteristics by double entry charts.

Il museo e la città

La città di Ferrara può essere considerata un unicum che emerge rispetto ad altre realtà urbane, pur dotate di loro peculiarità storiche e morfologiche. La base per la formazione di questa unicità, fu gettata dagli Este, e da Biagio Rossetti, che, con l'addizione erculea, raddoppiarono la superficie della città medioevale. L'addizione, fu realizzata per una previsione di aumento della popolazione,che mai si concretizzò, se non, in parte, nel corso dell'ultimo secolo. Ciò, si tradusse in una notevole stabilità del rapporto pieni/vuoti, all'interno della città: vuoti che divennero spazi verdi urbani, e pieni che, nonostante le ristrutturazioni divenute necessarie nel corso dei secoli, mantennero prevalentemente le volumetrie e i sedimi storici. Infatti, il verde degli orti e dei giardini del tessuto storico, costituisce un sistema inscindibile con il costruito, e ne caratterizza la forma urbana dall'interno. Nel corso del Novecento, il centro storico, subì notevoli cambiamenti, anche se gli interventi riguardarono prevalentemente i vuoti urbani, mantenendo quasi intatto l'esistente. L'immobilismo dei secoli passati, ha mantenuto Ferrara una città a misura d'uomo, non tormentata dal caotico traffico automobilistico delle città attuali;per le sue peculiarità, storiche e morfologiche, Ferrara fu dichiarata "Patrimonio dell'Umanità" dall'Unesco, ponendo fine ad eventuali modifiche del centro storico, che avrebbero potuto intaccarne i caratteri. L'area della quale ci occupiamo, nonostante si trovi all'interno del tessuto medioevale consolidato, ha subito delle importanti trasformazioni nel secolo scorso; il duecentesco Convento agostiniano di San Vito, che occupava gran parte dell'isolato, assieme ai giardini di Palazzo Schifanoia, fu demolito per far posto ad una nuova caserma; probabilmente perché il convento stesso, dopo le conquiste napoleoniche e con vicende alterne, era già adibito a tale funzione. La nuova caserma mal si inserisce nel tessuto urbano, poiché rappresenta un "fuori scala", un evidente distacco dal rapporto verde/costruito della città medioevale circostante. Fin dalle analisi dei primi piani regolatori del secondo dopoguerra, la caserma fu considerata un elemento incongruo con il tessuto esistente, prevedendone quindi la possibilità di demolizione; dagli anni '90, inoltre, l'area militare è inutilizzata, e oggigiorno, versa in una condizione di avanzato degrado superficiale. L'area di progetto, ha una grande importanza storica, poiché rappresentava il terzo polo estense di amministrazione del potere, dopo il Castello Estense, e l'area del Palazzo dei Diamanti. I palazzi estensi che caratterizzavano l'area in epoca rinascimentale, Palazzo Schifanoia, Palazzo Bonacossi e Palazzina Marfisa d'Este, sono sopravissuti, anche se profondamente cambiati in particolar modo negli spazi verdi. Il progetto che ci proponiamo di realizzare, vuole stabilire, un nuovo rapporto tra pieni e vuoti, basandoci sulla lettura della città storica, delle sue tipologie e peculiarità. Impostando il progetto sulla realizzazione concreta del Polo dei Musei Civici di Arte Antica di Ferrara, oggi esistente solo a livello burocratico e amministrativo, ridefiniamo una parte di città, attribuendole quella centralità nel tessuto storico, che già la caratterizzava in passato.

Il museo e la città

La città di Ferrara può essere considerata un unicum che emerge rispetto ad altre realtà urbane, pur dotate di loro peculiarità storiche e morfologiche. La base per la formazione di questa unicità, fu gettata dagli Este, e da Biagio Rossetti, che, con l'addizione erculea, raddoppiarono la superficie della città medioevale. L'addizione, fu realizzata per una previsione di aumento della popolazione,che mai si concretizzò, se non, in parte, nel corso dell'ultimo secolo. Ciò, si tradusse in una notevole stabilità del rapporto pieni/vuoti, all'interno della città: vuoti che divennero spazi verdi urbani, e pieni che, nonostante le ristrutturazioni divenute necessarie nel corso dei secoli, mantennero prevalentemente le volumetrie e i sedimi storici. Infatti, il verde degli orti e dei giardini del tessuto storico, costituisce un sistema inscindibile con il costruito, e ne caratterizza la forma urbana dall'interno. Nel corso del Novecento, il centro storico, subì notevoli cambiamenti, anche se gli interventi riguardarono prevalentemente i vuoti urbani, mantenendo quasi intatto l'esistente. L'immobilismo dei secoli passati, ha mantenuto Ferrara una città a misura d'uomo, non tormentata dal caotico traffico automobilistico delle città attuali; per le sue peculiarità, storiche e morfologiche, Ferrara fu dichiarata "Patrimonio dell'Umanità" dall'Unesco, ponendo fine ad eventuali modifiche del centro storico, che avrebbero potuto intaccarne i caratteri. L'area della quale ci occupiamo, nonostante si trovi all'interno del tessuto medioevale consolidato, ha subito delle importanti trasformazioni nel secolo scorso; il duecentesco Convento agostiniano di San Vito, che occupava gran parte dell'isolato, assieme ai giardini di Palazzo Schifanoia, fu demolito per far posto ad una nuova caserma; probabilmente perché il convento stesso, dopo le conquiste napoleoniche e con vicende alterne, era già adibito a tale funzione. La nuova caserma mal si inserisce nel tessuto urbano, poiché rappresenta un "fuori scala", un evidente distacco dal rapporto verde/costruito della città medioevale circostante. Fin dalle analisi dei primi piani regolatori del secondo dopoguerra, la caserma fu considerata un elemento incongruo con il tessuto esistente, prevedendone quindi la possibilità di demolizione; dagli anni '90, inoltre, l'area militare è inutilizzata, e oggigiorno, versa in una condizione di avanzato degrado superficiale. L'area di progetto, ha una grande importanza storica, poiché rappresentava il terzo polo estense di amministrazione del potere, dopo il Castello Estense, e l'area del Palazzo dei Diamanti. I palazzi estensi che caratterizzavano l'area in epoca rinascimentale, Palazzo Schifanoia, Palazzo Bonacossi e Palazzina Marfisa d'Este, sono sopravissuti, anche se profondamente cambiati in particolar modo negli spazi verdi. Il progetto che ci proponiamo di realizzare, vuole stabilire, un nuovo rapporto tra pieni e vuoti, basandoci sulla lettura della città storica, delle sue tipologie e peculiarità. Impostando il progetto sulla realizzazione concreta del Polo dei Musei Civici di Arte Antica di Ferrara, oggi esistente solo a livello burocratico e amministrativo, ridefiniamo una parte di città, attribuendole quella centralità nel tessuto storico, che già la caratterizzava in passato.

The language of action. How language translates the dynamics of our actions.

The general aim of the thesis was to investigate how and to what extent the characteristics of action organization are reflected in language, and how they influence language processing and understanding. Even though a huge amount of research has been devoted to the study of the motor effects of language, this issue is very debated in literature. Namely, the majority of the studies have focused on low-level motor effects such as effector-relatedness of action, whereas only a few studies have started to systematically investigate how specific aspects of action organization are encoded and reflected in language. After a review of previous studies on the relationship between language comprehension and action (chapter 1) and a critical discussion of some of them (chapter 2), the thesis is composed by three experimental chapters, each devoted to a specific aspect of action organization. Chapter 3 presents a study designed with the aim to disentangle the effective time course of the involvement of the motor system during language processing. Three kinematics experiments were designed in order to determine whether and, at which stage of motor planning and execution effector-related action verbs influence actions executed with either the same or a different effector. Results demonstrate that the goal of an action can be linguistically re-activated, producing a modulation of the motor response. In chapter 4, a second study investigates the interplay between the role of motor perspective (agent) and the organization of action in motor chains. More specifically, this kinematics study aims at deepening how goal can be translated in language, using as stimuli simple sentences composed by a pronoun (I, You, He/She) and a verb. Results showed that the perspective activated by the pronoun You reflects the motor pattern of the “agent” combined with the chain structure of the verb. These data confirm an early involvement of the motor system in language processing, suggesting that it is specifically modulated by the activation of the agent’s perspective. In chapter 5, the issue of perspective is specifically investigated, focusing on its role in language comprehension. In particular, this study aimed at determining how a specific perspective (induced for example by a personal pronoun) modulates motor behaviour during and after language processing. A classical compatibility effect (the Action-sentence compatibility effect) has been used to this aim. In three behavioural experiments the authors investigated how the ACE is modulated by taking first or third person perspective. Results from these experiments showed that the ACE effect occurs only when a first-person perspective is activated by the sentences used as stimuli. Overall, the data from this thesis contributed to disentangle several aspects of how action organization is translated in language, and then reactivated during language processing. This constitutes a new contribution to the field, adding lacking information on how specific aspects such as goal and perspective are linguistically described. In addition, these studies offer a new point of view to understand the functional implications of the involvement of the motor system during language comprehension, specifically from the point of view of our social interactions.