Avaliação dos resultados neonatais do método canguru no Brasil

Objective: To evaluate the results of the kangaroo mother method in Brazil. Methods: A prospective cohort study comparing 16 units that have or do not have the second phase of the kangaroo mother method: eight were national centers of excellence for the kangaroo mother method (study group) and eight were part of the Brazilian Neonatal Research Network (control group). A total of 985 newborn infants with birth weights of 500 to 1,749 g were enrolled. Multivariate analyses employedmultiple linear regression and Poisson regression with robust adjustment. Results: The adjusted analysis (controlled for birth weight, gestational age, Score for Neonatal Acute Physiology Perinatal Extension II, Neonatal Therapeutic Intervention Scoring System, and maternal age and educational level) demonstrated that mean length of hospital stay (p = 0.14) and intercurrent clinical conditions in the intermediate or kangaroo unit were equal for both groups. Weight (p = 0.012), length (p = 0.039) and head circumference (p = 0.006) at 36 weeks' corrected gestational age were all lower at the kangaroo units. The kangaroo units exhibited superior performance in relation to exclusive breastfeeding at discharge (69.2 vs. 23.8%, p=0.022). Conclusions: The evidence suggests that the humanization strategy adopted by the Brazilian Ministry of Health is a safe alternative to conventional treatment and a good strategy for promoting breastfeeding. Copyright © 2008 by Sociedade Brasileira de Pediatria.

The perception of brazilian researchers concerning the factors that influence the citation of their articles: A study in the field of sustainability

With growing institutional pressure from the Brazilian government to increase the impact of research that it funds, Brazilian researchers are increasingly interested in discovering factors that affect the citation of their articles. The aim of the present article was to assess the perceptions of Brazilian sustainability researchers to identify factors that influence the impacts of their research. A survey was conducted with researchers in the field of sustainability and 89 questionnaires were completed. All of those researchers have articles or research projects in the field of sustainability (mixing environmental, social and/or economical) recorded in the Scielo or Lattes Curriculum Brazilian databases. Results suggest four factors that may explain the impact of article citations: (1) prestige of the author and the research network; (2) prestige of the means of publication and indexing; (3) accessibility and quality characteristics of the article; and (4) international nature of communication and scope of the study. Surprisingly, such factors were not statistically significant in explaining the citations of the participating researchers. These results show the need to consider other factors that can explain the impact of research, discovering the missing links. © 2013 Elsevier Inc.

Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Clinical assessment of nifedipine-induced gingival overgrowth in a group of brazilian patients

Although it has been established that nifedipine is associated with gingival overgrowth (GO), there is little information on the prevalence and severity of this condition in the Brazilian population. The aim of this study was to assess the occurrence of nifedipine-induced GO in Brazilian patients and the risk factors associated using a Clinical Index for Drug Induced Gingival Overgrowth (Clinical Index DIGO). The study was carried out on 35 patients under treatment with nifedipine (test group) and 35 patients without treatment (control group). Variables such as demographic (age, gender), pharmacological (dose, time of use), periodontal (plaque index, gingival index, probing depth, clinical insertion level, and bleeding on probing), and GO were assessed. Statistical analysis showed no association between GO and demographic or pharmacological variables. However, there was an association between GO and periodontal variables, except for plaque index. According to our study, the Clinical Index DIGO can be used as a parameter to evaluate GO. Therefore, we conclude that the presence of gingival inflammation was the main risk factor for the occurrence of nifedipine-induced GO.

Practices related to late-onset sepsis in very low-birth weight preterm infants

Objective: To understand the practices related to late-onset sepsis (LOS) in the centers of the Brazilian Neonatal Research Network, and to propose strategies to reduce the incidence of LOS.Methods: This was a cross-sectional descriptive multicenter study approved by the Ethics Committee. Three questionnaires regarding hand hygiene, vascular catheters, and diagnosis/treatment of LOS were sent to the coordinator of each center. The center with the lowest incidence of LOS was compared with the others.Results: All 16 centers answered the questionnaires. Regarding hand hygiene, 87% use chlorhexidine or 70% alcohol; alcohol gel is used in 100%; 80% use bedside dispensers (50% had one dispenser for every two beds); practical training occurs in 100% and theoretical training in 70% of the centers, and 37% train once a year. Catheters: 94% have a protocol, and 75% have a line insertion team. Diagnosis/treatment: complete blood count and blood culture are used in 100%, PCR in 87%, hematological scores in 75%; oxacillin and aminoglycosides is the empirical therapy in 50% of centers. Characteristics of the center with lowest incidence of LOS: stricter hand hygiene; catheter insertion and maintenance groups; use of blood culture, PCR, and hematological score for diagnosis; empirical therapy with oxacillin and aminoglycoside.Conclusion: The knowledge of the practices of each center allowed for the identification of aspects to be improved as a strategy to reduce LOS, including: alcohol gel use, hand hygiene training, implementation of catheter teams, and wise use of antibiotic therapy. (C) 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Radiopacity evaluation of contemporary luting cements by digitization of images

The aim of this study was to evaluate the radiopacity of two conventional cements (Zinc Cement and Ketac Cem Easymix), one resin-modified glass ionomer cement (RelyX Luting 2) and six resin cements (Multilink, Bistite II DC, RelyX ARC, Fill Magic Dual Cement, Enforce and Panavia F) by digitization of images. Methods. Five disc-shaped specimens (10×1.0 mm) were made for each material, according to ISO 4049. After setting of the cements, radiographs were made using occlusal films and a graduated aluminum stepwedge varying from 1.0 to 16 mm in thickness. The radiographs were digitized, and the radiopacity of the cements was compared with the aluminum stepwedge using the software VIXWIN-2000. Data (mmAl) were submitted to one-way ANOVA and Tukey's test (=0.05). Results. The Zinc Cement was the most radiopaque material tested (<0.05). The resin cements presented higher radiopacity (<0.05) than the conventional (Ketac Cem Easymix) or resin-modified glass ionomer (RelyX Luting 2) cements, except for the Fill Magic Dual Cement and Enforce. The Multilink presented the highest radiopacity (<0.05) among the resin cements. Conclusion. The glass ionomer-based cements (Ketac Cem Easymix and RelyX Luting 2) and the resin cements (Fill Magic Dual Cement and Enforce) showed lower radiopacity values than the minimum recommended by the ISO standard.

Coastal and shelf circulation in the vicinity of Camamu Bay (14 degrees S), Eastern Brazilian Shelf

The Camamu Bay (CMB) is located on the narrowest shelf along the South American coastline and close to the formation of two major Western Boundary Currents (WBC), the Brazil/North Brazil Current (BC/NBC). These WBC flow close to the shelf break/slope region and are expected to interact with the shelf currents due to the narrowness of the shelf. The shelf circulation is investigated in terms of current variability based on an original data set covering the 2002-2003 austral summer and the 2003 austral autumn. The Results show that the currents at the shelf are mainly wind driven, experiencing a complete reversal between seasons due to a similar change in the wind field. Currents at the inner-shelf have a polarized nature, with the alongshore velocity mostly driven by forcings at the sub-inertial frequency band and the cross-shore velocity mainly supra-inertially forced, with the tidal currents playing an important role at this direction. The contribution of the forcing mechanisms at the mid-shelf changes between seasons. During the summer, forcings in the two frequency bands are important to drive the currents with a similar contribution of the tidal currents. On the other hand, during the autumn season, the alongshore velocity is mostly driven by sub-inertial forcings and tidally driven currents still remain important in both directions. Moreover, during the autumn when the stratification is weaker, the response of the shelf currents to the wind forcing presents a barotropic signature. The meso-scale processes related to the WBC flowing at the shelf/slope region also affect the circulation within the shelf, which contribute to cause significant current reversals during the autumn season. Currents at the shelf-estuary connection are clearly supra-inertially forced with the tidal currents playing a key role in the generation of the along-channel velocities. The sub-inertial forcings at this location act mainly to drive the weak ebb currents which were highly correlated with both local and remote wind forcing during the summer season. (C) 2010 Elsevier Ltd. All rights reserved.

Bladder expression of CD cell surface antigens and cell-type-specific transcriptomes

Many cell types have no known functional attributes. In the bladder and prostate, basal epithelial and stromal cells appear similar in cytomorphology and share several cell surface markers. Their total gene expression (transcriptome) should provide a clear measure of the extent to which they are alike functionally. Since urologic stromal cells are known to mediate organ-specific tissue formation, these cells in cancers might exhibit aberrant gene expression affecting their function. For transcriptomes, cluster designation (CD) antigens have been identified for cell sorting. The sorted cell populations can be analyzed by DNA microarrays. Various bladder cell types have unique complements of CD molecules. CD9(+) urothelial, CD104(+) basal and CD13(+) stromal cells of the lamina propria were therefore analyzed, as were CD9(+) cancer and CD13(+) cancer-associated stromal cells. The transcriptome datasets were compared by principal components analysis for relatedness between cell types; those with similarity in gene expression indicated similar function. Although bladder and prostate basal cells shared CD markers such as CD104, CD44 and CD49f, they differed in overall gene expression. Basal cells also lacked stem cell gene expression. The bladder luminal and stromal transcriptomes were distinct from their prostate counterparts. In bladder cancer, not only the urothelial but also the stromal cells showed gene expression alteration. The cancer process in both might thus involve defective stromal signaling. These cell-type transcriptomes provide a means to monitor in vitro models in which various CD-isolated cell types can be combined to study bladder differentiation and bladder tumor development based on cell-cell interaction.

DNA vaccine containing the mycobacterial hsp65 gene prevented insulitis in MLD-STZ diabetes

Abstract Background Our group previously demonstrated that a DNA plasmid encoding the mycobacterial 65-kDa heat shock protein (DNA-HSP65) displayed prophylactic and therapeutic effect in a mice model for tuberculosis. This protection was attributed to induction of a strong cellular immunity against HSP65. As specific immunity to HSP60 family has been detected in arthritis, multiple sclerosis and diabetes, the vaccination procedure with DNA-HSP65 could induce a cross-reactive immune response that could trigger or worsen these autoimmune diseases. Methods In this investigation was evaluated the effect of a previous vaccination with DNA-HSP65 on diabetes development induced by Streptozotocin (STZ). C57BL/6 mice received three vaccine doses or the corresponding empty vector and were then injected with multiple low doses of STZ. Results DNA-HSP65 vaccination protected mice from STZ induced insulitis and this was associated with higher production of IL-10 in spleen and also in the islets. This protective effect was also concomitant with the appearance of a regulatory cell population in the spleen and a decreased infiltration of the islets by T CD8+ lymphocytes. The vector (DNAv) also determined immunomodulation but its protective effect against insulitis was very discrete. Conclusion The data presented in this study encourages a further investigation in the regulatory potential of the DNA-HSP65 construct. Our findings have important implications for the development of new immune therapy strategies to combat autoimmune diseases.

Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

Abstract Background Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. Methods This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. Results The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001). Conclusions The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in future studies, aiming to estimate risk and identify possible causal relations.

A resource management scenario for traditional and scientific management of pink shrimp (Farfantepenaeus paulensis) in the Patos Lagoon estuary (RS), Brazil

Abstract Background This article aims to discuss the incorporation of traditional time in the construction of a management scenario for pink shrimp in the Patos Lagoon estuary (RS), Brazil. To meet this objective, two procedures have been adopted; one at a conceptual level and another at a methodological level. At the conceptual level, the concept of traditional time as a form of traditional ecological knowledge (TEK) was adopted. Method At the methodological level, we conduct a wide literature review of the scientific knowledge (SK) that guides recommendations for pink shrimp management by restricting the fishing season in the Patos Lagoon estuary; in addition, we review the ethno-scientific literature which describes traditional calendars as a management base for artisanal fishers in the Patos Lagoon estuary. Results Results demonstrate that TEK and SK describe similar estuarine biological processes, but are incommensurable at a resource management level. On the other hand, the construction of a “management scenario” for pink shrimp is possible through the development of “criteria for hierarchies of validity” which arise from a productive dialog between SK and TEK. Conclusions The commensurable and the incommensurable levels reveal different basis of time-space perceptions between traditional ecological knowledge and scientific knowledge. Despite incommensurability at the management level, it is possible to establish guidelines for the construction of “management scenarios” and to support a co-management process.

Effects of Aedes aegypti salivary components on dendritic cell and lymphocyte biology

Abstract Background Saliva is a key element of interaction between hematophagous mosquitoes and their vertebrate hosts. In addition to allowing a successful blood meal by neutralizing or delaying hemostatic responses, the salivary cocktail is also able to modulate the effector mechanisms of host immune responses facilitating, in turn, the transmission of several types of microorganisms. Understanding how the mosquito uses its salivary components to circumvent host immunity might help to clarify the mechanisms of transmission of such pathogens and disease establishment. Methods Flow cytometry was used to evaluate if increasing concentrations of A. aegypti salivary gland extract (SGE) affects bone marrow-derived DC differentiation and maturation. Lymphocyte proliferation in the presence of SGE was estimated by a colorimetric assay. Western blot and Annexin V staining assays were used to assess apoptosis in these cells. Naïve and memory cells from mosquito-bite exposed mice or OVA-immunized mice and their respective controls were analyzed by flow cytometry. Results Concentration-response curves were employed to evaluate A. aegypti SGE effects on DC and lymphocyte biology. DCs differentiation from bone marrow precursors, their maturation and function were not directly affected by A. aegypti SGE (concentrations ranging from 2.5 to 40 μg/mL). On the other hand, lymphocytes were very sensitive to the salivary components and died in the presence of A. aegypti SGE, even at concentrations as low as 0.1 μg/mL. In addition, A. aegypti SGE was shown to induce apoptosis in all lymphocyte populations evaluated (CD4+ and CD8+ T cells, and B cells) through a mechanism involving caspase-3 and caspase-8, but not Bim. By using different approaches to generate memory cells, we were able to verify that these cells are resistant to SGE effects. Conclusion Our results show that lymphocytes, and not DCs, are the primary target of A. aegypti salivary components. In the presence of A. aegypti SGE, naïve lymphocyte populations die by apoptosis in a caspase-3- and caspase-8-dependent pathway, while memory cells are selectively more resistant to its effects. The present work contributes to elucidate the activities of A. aegypti salivary molecules on the antigen presenting cell-lymphocyte axis and in the biology of these cells.

Resonanzionisation zum Nachweis und zur Erzeugung radioaktiver Ionenstrahlen

Die resonante Laserionisation hat sich als ein universales Verfahren für eine Vielzahl von Anwendungen etabliert, die eine selektive Ionisation bei hoher Effizienz erfordern. Hierzu wurden zwei Lasersysteme mit unterschiedlichen Zielsetzungen und Schwerpunkten entwickelt und in dieser Arbeit angewendet. Im ersten Teil der Arbeit wird die Entwicklung der hochauflösenden Resonanzionisations-Massenspektrometrie zum Ultraspurennachweis von 41Ca vorgestellt. Hierzu wurden drei kontinuierliche Diodenlaser mit einem Quadrupolmassenspektrometer kombiniert. Bei einer Nachweiseffizienz von 1 × 10^−5 konnte eine Nachweisgrenze von 2 × 10^-13 41Ca/totCa erreicht werden. Das in den Routinebetrieb überführte Meßverfahren ermöglichte die Teilnahme an einem interdisziplinären Netzwerk zur Osteoporose-Forschung. In Vergleichsmessungen der Resonanzionisations-Massenspektrometrie mit allen derzeit existierenden Meßverfahren zum 41Ca-Ultraspurennachweis konnte eine sehr gute Übereinstimmung erzielt werden. Der zweite Teil der Arbeit beinhaltet die Adaption eines durchstimmbaren, hochrepetierenden Titan:Saphir-Lasersystem für den Einsatz an Laserionenquellen zur selektiven Erzeugung radioaktiver Ionenstrahlen. Das entwickelte Lasersystem ermöglicht eine effiziente, resonante Anregung des Großteils der Elemente im Periodensystem. Hierzu wurde eine kombinierte Frequenzverdopplungs- und Frequenzverdreifachungseinheit zur Erzeugung höherer Harmonischer aufgebaut. Die Anwendbarkeit eines solchen reinen Festkörper-Lasersystems wurde in zahlreichen off-line Testmessungen sowohl in Mainz als auch an den ISOL Einrichtungen am TRIUMF und ORNL gezeigt und führte zum ersten on-line Einsatz am TRIUMF.

Toward cell therapy using placenta-derived cells: disease mechanisms, cell biology, preclinical studies, and regulatory aspects at the round table

Among the many cell types that may prove useful to regenerative medicine, mounting evidence suggests that human term placenta-derived cells will join the list of significant contributors. In making new cell therapy-based strategies a clinical reality, it is fundamental that no a priori claims are made regarding which cell source is preferable for a particular therapeutic application. Rather, ongoing comparisons of the potentiality and characteristics of cells from different sources should be made to promote constant improvement in cell therapies, and such comparisons will likely show that individually tailored cells can address disease-specific clinical needs. The principle underlying such an approach is resistance to the notion that comprehensive characterization of any cell type has been achieved, neither in terms of phenotype nor risks-to-benefits ratio. Tailoring cell therapy approaches to specific conditions also requires an understanding of basic disease mechanisms and close collaboration between translational researchers and clinicians, to identify current needs and shortcomings in existing treatments. To this end, the international workshop entitled "Placenta-derived stem cells for treatment of inflammatory diseases: moving toward clinical application" was held in Brescia, Italy, in March 2009, and aimed to harness an understanding of basic inflammatory mechanisms inherent in human diseases with updated findings regarding biological and therapeutic properties of human placenta-derived cells, with particular emphasis on their potential for treating inflammatory diseases. Finally, steps required to allow their future clinical application according to regulatory aspects including good manufacturing practice (GMP) were also considered. In September 2009, the International Placenta Stem Cell Society (IPLASS) was founded to help strengthen the research network in this field.