A randomised clinical trial of the effect of low-level laser therapy for perineal pain and healing after episiotomy: A pilot study

Objective: to evaluate the effects of low-level laser therapy for perineal pain and healing after episiotomy. Design: a double-blind, randomised, controlled clinical trial comparing perineal pain scores and episiotomy healing in women treated with low-level laser therapy (LLLT) and with the simulation of the treatment. Setting: the study was conducted in the Birth Centre and rooming-in units of Amparo Maternal, a maternity service located in the city of Sao Paulo, Brazil. Participants: fifty-two postpartum women who had had mediolateral episiotomies during their first normal delivery were randomly divided into two groups of 26: an experimental group and a control group. Intervention: in the experimental group, the women were treated with LLLT. Irradiation was applied at three points directly on the episiotomy after the suture and in three postpartum sessions: up to 2 hrs postpartum, between 20 and 24 hrs postpartum and between 40 and 48 hrs postpartum. The LLLT was performed with diode laser, with a wavelength of 660 nm (red light), spot size of 0.04 cm(2), energy density of 3.8 J/cm(2), radiant power of 15 mW and 10 s per point, which resulted in an energy of 0.15 J per point and a total energy of 0.45 J per session. The control group participants also underwent three treatment sessions, but without the emission of radiation (simulation group), to assess the possible effects of placebo treatment. Main outcomes: perineal pain scores, rated on a scale from 0 to 10, were evaluated before and immediately after the irradiation in the three sessions. The healing process was assessed using the REEDA scale (Redness, Edema, Echymosis, Discharge Aproximation) before each laser therapy session and 15 and 20 days after the women's discharge. Findings: comparing the pain scores before and after the LLLT sessions, the experimental group presented a significant within-group reduction in mean pain scores after the second and third sessions (p=0.003 and p<0.001, respectively), and the control group showed a significant reduction after the first treatment simulation (p=0.043). However, the comparison of the perineal pain scores between the experimental and control groups indicated no statistical difference at any of the evaluated time points. There was no significant difference in perineal healing scores between the groups. All postpartum women approved of the low-level laser therapy. Conclusions: this pilot study showed that LLLT did not accelerate episiotomy healing. Although there was a reduction in perineal pain mean scores in the experimental group, we cannot conclude that the laser relieved perineal pain. This study led to the suggestion of a new research proposal involving another irradiation protocol to evaluate LLLT's effect on perineal pain relief. (C) 2011 Elsevier Ltd. All rights reserved.

Influence of cardiopulmonary bypass on cefuroxime plasma concentration and pharmacokinetics in patients undergoing coronary surgery

The aims of this study were to evaluate the influence of cardiopulmonary bypass (CPB) on the plasma concentrations and pharmacokinetics of cefuroxime and to assess whether the cefuroxime dose regimen (a 1.5 g dose, followed by 750 mg every 6 h for 24 h) is adequate for cardiac surgery antibiotic prophylaxis. A prospective, controlled, observational study compared patients undergoing coronary surgery with CPB (CPB group, n = 10) or off-pump surgery (off-pump group, n = 9). After each cefuroxime dose, blood samples were sequentially collected and analysed using high-efficiency chromatography. For demographic data and pharmacokinetic parameters, the authors used Fisher's exact test for nominal variables and Student's t-test and the Mann-Whitney U-test for parametric and non-parametric variables, respectively. Plasma concentrations were compared using ANOVA, and the percentage of patients with a remaining plasma concentration of > 16 mg/l within 6 h after each bolus was quantified in tabular form. After each cefuroxime bolus was administered, both groups presented a significant decrease in plasma concentration over time (P < 0.001), without differences between the groups. The mean CPB time of 59.7 +/- 21.1 min did not change cefuroxime plasma concentrations or pharmacokinetics. The mean clearance +/- SD (ml/kg/min) and median elimination half-life (h) of the CPB group versus the off-pump group were 1.7 +/- 0.7 versus 1.6 +/- 0.6 (P = 0.67), respectively, and 2.2 versus 2.3 (P = 0.49), respectively. Up to 3 h following the first bolus of 1.5 g, but not after 6 h, all patients had plasma concentrations > 16 mg/l (CPB group = 20% and off-pump group = 44%). However, after all 750 mg boluses were administered, concentrations < 16 mg/dl were reached within 3 h. CPB does not influence cefuroxime plasma concentrations. The dosing regimen is adequate for the intraoperative period, but in the immediate postoperative period, it requires further review.

Photodynamic inactivation of biofilms formed by Candida spp., Trichosporon mucoides, and Kodamaea ohmeri by cationic nanoemulsion of zinc 2,9,16,23-tetrakis(phenylthio)-29H, 31H-phthalocyanine (ZnPc)

The biofilms formed by opportunistic yeasts serve as a persistent reservoir of infection and impair the treatment of fungal diseases. The aim of this study was to evaluate photodynamic inactivation (PDI) of biofilms formed by Candida spp. and the emerging pathogens Trichosporon mucoides and Kodamaea ohmeri by a cationic nanoemulsion of zinc 2,9,16,23-tetrakis(phenylthio)-29H,31H-phthalocyanine (ZnPc). Biofilms formed by yeasts after 48 h in the bottom of 96-well microtiter plates were treated with the photosensitizer (ZnPc) and a GaAlAs laser (26.3 J cm(-2)). The biofilm cells were scraped off the well wall, homogenized, and seeded onto Sabouraud dextrose agar plates that were then incubated at 37A degrees C for 48 h. Efficient PDI of biofilms was verified by counting colony-forming units (CFU/ml), and the data were submitted to analysis of variance and the Tukey test (p < 0.05). All biofilms studied were susceptible to PDI with statistically significant differences. The strains of Candida genus were more resistant to PDI than emerging pathogens T. mucoides and K. ohmeri. A mean reduction of 0.45 log was achieved for Candida spp. biofilms, and a reduction of 0.85 and 0.84, were achieved for biofilms formed by T. mucoides and K. ohmeri, respectively. Therefore, PDI by treatment with nanostructured formulations cationic zinc 2,9,16,23- tetrakis (phenylthio)- 29H, 31H- phthalocyanine (ZnPc) and a laser reduced the number of cells in the biofilms formed by strains of C. albicans and non-Candida albicans as well the emerging pathogens T. mucoides and K. ohmeri.

Pre-procambial cells are niches for pluripotent and totipotent stem-like cells for organogenesis and somatic embryogenesis in the peach palm: a histological study

The direct induction of adventitious buds and somatic embryos from explants is a morphogenetic process that is under the influence of exogenous plant growth regulators and its interactions with endogenous phytohormones. We performed an in vitro histological analysis in peach palm (Bactris gasipaes Kunth) shoot apexes and determined that the positioning of competent cells and their interaction with neighboring cells, under the influence of combinations of exogenously applied growth regulators (NAA/BAP and NAA/TDZ), allows the pre-procambial cells (PPCs) to act in different morphogenic pathways to establish niche competent cells. It is likely that there has been a habituation phenomenon during the regeneration and development of the microplants. This includes promoting the tillering of primary or secondary buds due to culturing in the absence of NAA/BAP or NAA/TDZ after a period in the presence of these growth regulators. Histological analyses determined that the adventitious roots were derived from the dedifferentiation of the parenchymal cells located in the basal region of the adventitious buds, with the establishment of rooting pole, due to an auxin gradient. Furthermore, histological and histochemical analyses allowed us to characterize how the PPCs provide niches for multipotent, pluripotent and totipotent stem-like cells for vascular differentiation, organogenesis and somatic embryogenesis in the peach palm. The histological and histochemical analyses also allowed us to detect the unicellular or multicellular origin of somatic embryogenesis. Therefore, our results indicate that the use of growth regulators in microplants can lead to habituation and to different morphogenic pathways leading to potential niche establishment, depending on the positioning of the competent cells and their interaction with neighboring cells. Key message Our results indicate that the use of growth regulators in microplants can lead to habituation and to different morphogenic pathways leading to potential niche establishment, depending on the positioning of the competent cells and their interaction with neighboring cells.

Bifurcation analysis of an aeroelastic system with concentrated nonlinearities

Analytical and numerical analyses of the nonlinear response of a three-degree-of-freedom nonlinear aeroelastic system are performed. Particularly, the effects of concentrated structural nonlinearities on the different motions are determined. The concentrated nonlinearities are introduced in the pitch, plunge, and flap springs by adding cubic stiffness in each of them. Quasi-steady approximation and the Duhamel formulation are used to model the aerodynamic loads. Using the quasi-steady approach, we derive the normal form of the Hopf bifurcation associated with the system's instability. Using the nonlinear form, three configurations including supercritical and subcritical aeroelastic systems are defined and analyzed numerically. The characteristics of these different configurations in terms of stability and motions are evaluated. The usefulness of the two aerodynamic formulations in the prediction of the different motions beyond the bifurcation is discussed.

Elsinoe australis; Myriangiaceae

Elsinoe australis Bitanc. & Jenkins

Indoor and outdoor atmospheric fungal spores in the So Paulo metropolitan area (Brazil): species and numeric concentrations

The aim of this study was to estimate the indoor and outdoor concentrations of fungal spores in the Metropolitan Area of Sao Paulo (MASP), collected at different sites in winter/spring and summer seasons. The techniques adopted included cultivation (samples collected with impactors) and microscopic enumeration (samples collected with impingers). The overall results showed total concentrations of fungal spores as high as 36,000 per cubic meter, with a large proportion of non culturable spores (around 91% of the total). Penicillium sp. and Aspergillus sp. were the dominant species both indoors and outdoors, in all seasons tested, occurring in more than 30% of homes at very high concentrations of culturable airborne fungi [colony forming units(CFU) m(-3)]. There was no significant difference between indoor and outdoor concentrations. The total fungal spore concentration found in winter was 19% higher than that in summer. Heat and humidity were the main factors affecting fungal growth; however, a non-linear response to these factors was found. Thus, temperatures below 16A degrees C and above 25A degrees C caused a reduction in the concentration (CFU m(-3)) of airborne fungi, which fits with MASP climatalogy. The same pattern was observed for humidity, although not as clearly as with temperature given the usual high relative humidity (above 70%) in the study area. These results are relevant for public health interventions that aim to reduce respiratory morbidity among susceptible populations.

Evaluation of thermal simulation of households in the metropolitan region of So Paulo, Brazil

This paper aims at assessing the performance of a program of thermal simulation (Arquitrop) in different households in the city of Sao Paulo, Brazil. The households were selected for the Wheezing Project which followed up children under 2 years old to monitor the occurrence of respiratory diseases. The results show that in all three study households there is a good approximation between the observed and the simulated indoor temperatures. It was also observed a fairly consistent and realistic behavior between the simulated indoor and the outdoor temperatures, describing the Arquitrop model as an efficient estimator and good representative of the thermal behavior of households in the city of Sao Paulo. The worst simulation is linked to the poorest type of construction. This may be explained by the bad quality of the construction, which the Architrop could not simulate adequately.

Downward longwave radiation estimates for clear and all-sky conditions in the Sertozinho region of So Paulo, Brazil

The accurate estimate of the surface longwave fluxes contribution is important for the calculation of the surface radiation budget, which in turn controls all the components of the surface energy budget, such as evaporation and the sensible heat fluxes. This study evaluates the performance of the various downward longwave radiation parameterizations for clear and all-sky days applied to the Sertozinho region in So Paulo, Brazil. Equations have been adjusted to the observations of longwave radiation. The adjusted equations were evaluated for every hour throughout the day and the results showed good fits for most of the day, except near dawn and sunset, followed by nighttime. The seasonal variation was studied by comparing the dry period against the rainy period in the dataset. The least square linear regressions resulted in coefficients equal to the coefficients found for the complete period, both in the dry period and in the rainy period. It is expected that the best fit equation to the observed data for this site be used to produce estimates in other regions of the State of So Paulo, where such information is not available.

Rhyacian (2.23-2.20 Ga) juvenile accretion in the southern Sao Francisco craton, Brazil: Geochemical and isotopic evidence from the Serrinha magmatic suite, Mineiro belt

The Serrinha magmatic suite (Mineiro belt) crops out in the southern edge of the Sao Francisco craton, comprising the Brito quartz-diorite, Brumado de Cima and Brumado de Baixo granodiorites, granophyres and felsic sub-volcanic and volcanic rocks, part of which intruded into the Nazareno greenstone belt. The suite rocks have petrographic features that are consistent with magma supercooling due to the low water content combined with volatile loss, leading to crystallization of quartz and alkaline feldspar at the rims of plagioclase phenocrysts (granophyric intergrowth). The investigated rocks are sub-alkaline, calc-alkaline and show low content in rare earth elements. The U-Pb zircon crystallization ages for the Brumado de Cima granodiorite [2227 +/- 22 (23) Ma] and a coeval granophyre [2211 +/- 22 (23) Ma], coupled with available single-zircon Pb evaporation ages for the Brito and Brumado de Baixo plutons, are significantly older than the ""Minas orogeny"" (ca. 2100-2050 Ga) of Quadrilatero Ferrifero area, eastward from the Serrinha suite. Our data establish an early Rhyacian event tectonically linked with the evolution of the Mineiro belt. The bulk Nd isotopic signature [low negative to positive epsilon(Nd(t)) values] of the Serrinha samples are consistent with the important role of Paleoproterozoic mantle components in the magma genesis. The integrated geologic, geochemical and isotopic information suggests that Paleoproterozoic evolution of the Mineiro belt initiated in a passive continental margin basin with deposition of the Minas Supergroup at ca. 2500 Ma. This stage was succeeded by outboard rupture of the oceanic lithosphere with development and coalescence of progressively younger magmatic arcs during Rhyacian time. One of the earliest arcs formed the Serrinha suite. The tectonic collage of the Serrinha and Ritapolis (2190-2120 Ma) arcs produced the NE-SW Lenheiro shear zone, resulting in mylonitization and recrystallization of both the granitoid intrusions and host rocks. As a matter of fact juxtaposition of distinct magmatic units in age and origin took place along the Lenheiros structure in this sector of the Mineiro belt. (C) 2009 Elsevier Ltd. All rights reserved.

Phenological aspects of flowering and fruiting at the Ecological Station of Paulo de Faria-SP-Brazil

The present work was carried out at 'Estacao Ecologica de Paulo de Faria', north of the state of Sao Paulo, southeast of Brazil (19°55'-19°58'S and 49°31'-49°32'W). The flowering and fruiting phenology of trees, shrubs, and lianas species were observed from April 1993 to December 1995. The results were compaired with those surveyed at other forests from Sao Paulo state: Santa Genebra (Campinas). Serra do Japi (Jundiai) and lianas of Mata Atlantica. The majority of species of lianas flowered from January to April and trees and shrubs between September to December. The most intense frutification period occurred during May to August. Similarly to Santa Genebra, the flowering season at 'Estacao Ecologica de Paulo de Faria' started at the beginning of the wet season while frutification during the dryest period of the year. At Serra do Japi, the flowering and frutification occurred from the end of dry and beginning of the rainy season. Considering the liana at Mata Atlantica presented two peaks of flowering, while at 'Estacao Ecologica de Paulo de Faria' occurs only one. Regarding the fruiting phenology is similar for both area, most species producing fruits during the first semestre.

Four new Neotetranychus Trägardh (Acari: Tetranychidae) from São Paulo State, Brazil

Neotetranychus peniculus Aranda n. sp. from Bauhinia holophylla (Fabaceae), N. rhaphidoseta Aranda n.sp from Tabebuia ochraceae (Bignoniaceae), N. granifer Feres and Flechtmann n. sp. from Bauhinia forficata and N. asper Feres and Flechtmann n. sp. from Alchornea glandulosa (Euphorbiaceae) from São Paulo State, Brazil, are described and figured.

Bathymetric distribution and recruitment of the spider crab Libinia spinosa H. Milne Edwards 1834 in the Ubatuba and Caraguatatuba regions, northern coast of São Paulo, Brazil (Crustacea, Brachyura, Majoidea, Pisidae)

The objective of this study was to investigate the spatial and temporal distribution of Libinia spinosa H. MILNE EDWARDS 1834 on unconsolidated sublittoral bottoms in two regions off the northern coast of the state of São Paulo, and to analyze the influence of environmental factors on the occurrence of this species and observe the recruitment pattern of its young. Crabs were collected monthly (July 2001 through June 2003) at depths of 5, 10, 15, 20, 25, 30 and 35 In, from a fishing boat equipped with two double-rig nets. Samples of water and sediment were collected for analysis of environmental factors. A total of 2112 spider crabs was obtained (701 juveniles and 1411 adults). The highest abundance was observed at depths of 20 and 25 m, in both regions. These localities were characterized by substrate composed of very fine sand and silt-clay. In regard to the temporal distribution, juveniles and adults predominated in the summer and winter months respectively. From these results, one can infer that the distribution of L. spinosa is related to environmental factors favorable for its life cycle; sediment type is the factor which most strongly determines its presence. © E. Schweizerbart'sche Verlagsbuchhandlung (Nägele u. Obermiller), 2007.

Some reflections on the future of the water quality of the corumbataí River basin, São Paulo state, Brazil

The waters of Corumbataí River in the middle and eastern part of São Paulo State, Brazil, are extensively used for human consumption; their water quality has been modified mainly due to increasing pressure caused by population growth, accompanied by a more accentuated industrial development for the whole São Paulo State in the early 1970s. The Corumbataí River basin has, over time, received significant emissions of municipal waste products and discharges of wastewater, sludge, sewage, sanitary and industrial effluents, but the first effluent treatment plant at Rio Claro city was only inaugurated at the end of the 1990s. Data on river water quality from two widely spaced locations in the Corumbataí River basin are reported in this paper; they indicate the need for continuous initiatives and efforts by decision makers in order to improve and preserve the water quality in the basin for the 21st century. Copyright © 2007 IAHS Press.

Incidence and transplacental transmission of Neospora caninum in primiparous females from Bos indicus slaughtered in Presidente Prudente, São Paulo, Brazil

To produce an epidemiological map of neosporosis in Brazil and identify the types of transmission of this disease, the present study evaluated the occurrence of Neospora caninum in Nelore cattle (Bos indicus) in Presidente Prudent, west region of Sao Paulo state; its vertical transmission; and the early stage in which fetuses are infected. To achieve this, serum samples from 518 slaughtered pregnant heifers and their fetuses were tested by ELISA technique and fetal brain tissues subjected to PCR. One hundred and three heifers (19.88%) had antibodies to N. caninum, as well as 38 (36.8%) of fetuses from 4 months of gestation. The conventional PCR failed to detect N. caninum DNA. These findings show that neosporosis occurs in the area studied and that it may be transmitted the transplacental route, althought N. caninum had not detected in brain tissue from non-aborted fetuses. The use of nested PCR it would be applied to increase the sensitivy of test.