Comparative Study of a Real-Time PCR Assay Targeting senX3-regX3 versus Other Molecular Strategies Commonly Used in the Diagnosis of Tuberculosis.

BACKGROUND Nucleic acid amplification tests are increasingly used for the rapid diagnosis of tuberculosis. We undertook a comparative study of the efficiency and diagnostic yield of a real-time PCR senX3-regX3 based assay versus the classical IS6110 target and the new commercial methods. METHODS This single-blind prospective comparative study included 145 consecutive samples: 76 from patients with culture-confirmed tuberculosis (86.8% pulmonary and 13.2% extrapulmonary tuberculosis: 48.7% smear-positive and 51.3% smear-negative) and 69 control samples (24 from patients diagnosed with non-tuberculous mycobacteria infections and 45 from patients with suspected tuberculosis which was eventually ruled out). All samples were tested by two CE-marked assays (Xpert®MTB/RIF and AnyplexTM plus MTB/NTM) and two in-house assays targeting senX3-regX3 and the IS6110 gene. RESULTS The detection limit ranged from 1.00E+01 fg for Anyplex, senX3-regX3 and IS6110 to 1.00E+04 fg for Xpert. All three Xpert, senX3-regX3 and IS6110 assays detected all 37 smear-positive cases. Conversely, Anyplex was positive in 34 (91.9%) smear-positive cases. In patients with smear-negative tuberculosis, differences were observed between the assays; Xpert detected 22 (56.41%) of the 39 smear-negative samples, Anyplex 24 (61.53%), senX3-regX3 28 (71.79%) and IS6110 35 (89.74%). Xpert and senX3-regX3 were negative in all control samples; however, the false positive rate was 8.7% and 13% for Anyplex and IS6110, respectively. The overall sensitivity was 77.6%, 85.7%, 77.3% and 94.7% and the specificity was 100%, 100%, 90.8% and 87.0% for the Xpert, senX3-regX3, Anyplex and IS6110 assays, respectively. CONCLUSION Real-time PCR assays targeting IS6110 lack the desired specificity. The Xpert MTB/RIF and in-house senX3-regX3 assays are both sensitive and specific for the detection of MTBC in both pulmonary and extrapulmonary samples. Therefore, the real time PCR senX3-regX3 based assay could be a useful and complementary tool in the diagnosis of tuberculosis.

Thyroid metastasis as initial presentation of clear cell renal carcinoma.

INTRODUCTION Metastatic tumors account for 1.4-2.5% of thyroid malignancies. About 25-30% of patients with clear cell renal carcinoma (CCRC) have distant metastasis at the time of diagnosis, being the thyroid gland a rare localization [5%]. PRESENTATION OF THE CASE A 62-year woman who underwent a cervical ultrasonography and a PAAF biopsy reporting atypical follicular proliferation with a few intranuclear vacuoles "suggestive" of thyroid papillary cancer in the context of a multinodular goiter was reported. A total thyroidectomy was performed and the histology of a clear cell renal carcinoma (CCRC) was described in four nodules of the thyroid gland. A CT scan was performed and a renal giant right tumor was found. The patient underwent an eventful radical right nephrectomy and the diagnosis of CCRC was confirmed. DISCUSSION Thyroid metastasis (TM) from CCRC are usually apparent in a metachronic context during the follow-up of a treated primary (even many years after) but may sometimes be present at the same time than the primary renal tumor. Our case is exceptional because the TM was the first evidence of the CCRC, which was subsequently diagnosed and treated. CONCLUSION The possibility of finding of an incidental metastatic tumor in the thyroid gland from a previous unknown and non-diganosed primary (as CCRC in our case was) is rare and account only for less than 1% of malignancies. Nonetheless, the thyroid gland is a frequent site of metastasis and the presence of "de novo" thyroid nodules in oncologic patients must be always considered and studied.

Sorteio de domicílios em favelas em inquéritos por amostragem

OBJETIVO: Identificar vantagens e desvantagens do uso de segmentos em relação ao sorteio feito a partir da lista completa de endereços, para o sorteio de domicílios em amostragem por conglomerados em múltiplos estágios em favelas. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo realizado em quatro favelas sorteadas no Inquérito de Saúde do Município de São Paulo, SP, 2008, nas quais foram aplicadas as duas técnicas. Foram realizados grupos focais com pesquisadores de campo - arroladores e entrevistadores do inquérito. Os conteúdos das conversações foram analisados, agrupados em categorias e organizados em núcleos temáticos. ANÁLISE DOS RESULTADOS: A utilização de segmentos de domicílios foi associada a numerosas vantagens e poucas desvantagens. Entre as vantagens, constaram a rapidez e facilidade na elaboração do cadastro de endereços e na localização e identificação de domicílios na etapa de realização das entrevistas, maior segurança dos entrevistadores e da população, maior acesso aos entrevistados, maior estabilidade e maior cobertura do cadastro produzido, e menor ocorrência de erros na identificação dos domicílios sorteados. CONCLUSÕES: A construção de cadastro de domicílios por meio da criação de segmentos é vantajosa em relação à listagem completa de endereços, quando feita em favelas. Por ter se mostrado uma opção econômica e fácil de ser aplicada, constitui alternativa para a simplificação do processo de amostragem em áreas com as suas características de desorganização e adensamento de domicílios.

The ACB technique: a biomagentic tool for monitoring gastrointestinal contraction directly from smooth muscle in dogs

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Validation of ACB in vitro and in vivo as a biomagnetic method for measuring stomach contraction

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O advérbio então já se gramaticalizou como conjunção?

Este estudo limita-se ao exame do conector então no português falado culto do Brasil. O objetivo é fornecer uma descrição detalhada do comportamento sintático-semântico desse juntor e verificar se já se gramaticalizou como conjunção. O universo de pesquisa é uma amostragem do corpus mínimo do Projeto de Gramática do Português Falado (PGPF). O texto se organiza em quatro partes. Na primeira colocam-se os objetivos em face das hipóteses de trabalho; na segunda apresentam-se os procedimentos metodológicos e técnicas de investigação; a terceira parte constitui uma descrição do uso desse conector no português falado e, nas considerações finais, resumem-se as principais conseqüências para um equacionamento mais preciso da relação de conclusão obtida por meio do conector então.

Qualitative methodogy: revealing a new path for research in dentistry

Currently, it is easy to find health professionals who not only attach importance to qualitative methods, but also recognize their help to better understand their patients' lives. However, its use in dentistry is still incipient, either due to ignorance or because of technical / operational difficulties in identifying possibilities for their use in research. Thus, the purpose of this study was to review the literature on the characteristics and peculiarities of the qualitative methodology, demonstrating their techniques of collecting, recording and analyzing data. For this, we performed a descriptive literature, from a survey in the "LILACS", "BBO" and "PUBMED" databases, by keywords related to the theme, selecting only the papers that mentioned the "importance" of qualitative research, the "characteristics and fundamentals," and the "techniques of collecting, recording and data analysis" involving this methodology. It was found that all studies have highlighted the importance of qualitative research to the construction of new knowledge that cannot be achieved by quantitative data. We found many different techniques to gather, record and analyze qualitative data applied to the dentistry field. It was concluded that qualitative research represents a new path to be followed by dentistry, so that we are able to plan actions in ethical and humane public health dentistry, bringing better results to the population, because of the depth of knowledge that your date can.

Paediatrics in Berlin

The aim of this report is to describe the highlights of the European Respiratory Society annual congress in Berlin, Germany. The best abstracts in asthma and allergy, cystic fibrosis, respiratory infection, paediatric and neonatal intensive care, paediatric investigative techniques (in particular respiratory physiology and bronchoscopy) and respiratory epidemiology are presented and set in the context of the current literature.

A COMUNICAÇÃO POPULAR NA CONSTRUÇÃO E PRESERVAÇÃO DA MEMÓRIA DAS LUTAS POPULARES NO BRASIL (décadas de 1970 e 1980)

Nas décadas de 1970 e 1980 houve a eclosão de experiências comunicacionais populares, em todo Brasil, com vasta produção de materiais, especialmente arquivados pelos centros de documentação. Em sua maioria, criados e financiados por setores progressistas da Igreja Católica e Protestante. Entre eles, o Centro de Pastoral Vergueiro (CPV) e o Centro de Comunicação e Educação Popular de São Miguel Paulista (CEMI) que também tiveram importante papel na construção e preservação da memória das lutas populares no período de reorganização social, no contexto de distensão da ditadura militar. No entanto, tais acervos estão em iminente risco, por falta de investimento e vontade política. O que seria um prejuízo histórico e científico para movimentos sociais atuais e à pesquisa acadêmica. O objetivo do estudo é identificar a que se deve este desinteresse. A abordagem se dá pelo método da história oral e como técnicas de investigação adotamos a pesquisa bibliográfica, documental e a pesquisa de campo, por meio da entrevista em profundidade. A falta de uma política pública que garanta a preservação dos documentos é sinal de que no Brasil predomina uma cultura que não privilegia a memória, sobretudo das camadas empobrecidas da população. Além do que, a memória pode ser subversiva. Afinal tais documentos expressam a força da participação popular no processo de transformação social e podem despertar novas ações, o que não interessa aos grupos que estão no poder.

Can you tell your clunis from your cubitus? A benchmark for functional imaging

Advances in functional brain imaging have allowed the development of new investigative techniques with clinical application—ranging from presurgical mapping of eloquent cortex to identifying cortical regions involved in religious experiences. Similarly a variety of methods are available to referring physicians, ranging from metabolic measures such as functional magnetic resonance imaging and positron emission tomography to measurements based on electrical activity such as electroencephalography and magnetoencephalography. However, there are no universal benchmarks by which to judge between these methods. In this study we attempt to develop a standard for functional localisation, based on the known functional organisation of somatosensory cortex. Studies have shown spatially distinct sites of brain activity in response to stimulation of various body parts. Generally these studies have focused on areas with large cortical representations, such as the index finger and face. We tested the limits of magnetoencephalography source localisation by stimulation of body parts, namely the clunis and the cubitus, that map to proximal and relatively poorly represented regions of somatosensory cortex.

Ocular response to silicone-hydrogel contact lenses

The thesis investigates the ocular response to silicone-hydrogel (SiH) contact lens wear, a relatively new contact lens material that has a higher modulus of rigidity and different surface coating than used in conventional hydrogel materials. The properties of SiH materials differ significantly from conventional hydrogels and, using subjective and objective means of assessment, the thesis examines how these properties affect reflection and biometry, ocular physiology, tear film characteristics, symptomatology, adverse events and complications. A range of standard and newly designed investigative techniques were employed, and latter involving novel imaging techniques, for the objective assessment of physiological changes which occur with contact lens wear. The study is the first to combine these techniques with biochemical analyses of the tear film composition. Forty-seven subjects were fitted with SiH lenses and randomly allocated to one of the two materials currently on the market (Lotrafilcon A or Balafilcon A) on an either daily or continuous wear basis. An additional control group of 14 age-matched non-contact lens wearers were monitored over the same period. Measurements were taken before and 1, 3, 6, 12 and 18 months after initial fitting. The findings reported in this thesis will enable contact lens practitioners and manufacturers to understand further the optical, physiological and biochemical nature of the ocular response to SiH contact lenses and hence facilitate the development of this important generation of contact lens material.

The effect of intraocular scattered light on the contrast sensitivity function

Intraocular light scatter is high in certain subject groups eg the elderly, due to increased optical media turbidity, which scatters and attenuates light travelling towards the retina. This causes reduced retinal contrast especially in the presence of glare light. Such subjects have depressed Contrast Sensitivity Functions (CSF). Currently available clinical tests do not effectively reflect this visual disability. Intraocular light scatter may be quantified by measuring the CSF with and without glare light and calculating Light Scatter Factors (LSF). To record the CSF on clinically available equipment (Nicolet CS2000), several psychophysical measurement techniques were investigated, and the 60 sec Method of Increasing Contrast was selected as the most appropriate. It was hypothesised that intraocular light scatter due to particles of different dimensions could be identified by glare sources at wide (30°) and narrow (3.5°) angles. CSFs andLSFs were determined for: (i) Subjects in young, intermediate and old age groups. (ii) Subjects during recovery from large amounts of induced corneal oedema. (iii) A clinical sample of contact lens (CL) wearers with a group of matched controls. The CSF was attenuated at all measured spatial frequencies with the intermediate and old group compared to the young group. High LSF values were found only in the old group (over 60 years). It was concluded that CSF attenuation in the intermediate group was due to reduced pupil size, media absorption and/or neural factors. In the old group, the additional factor was high intraocular light scatter levels of lenticular origin. The rate of reduction of the LSF for the 3.5° glare angle was steeper than that for the 30° angle, following induced corneal oedema. This supported the hypothesis, as it was anticipated that epithelial oedema would recover more rapidly than stromal oedema. CSFs and LSFs were markedly abnormal in the CL wearers. The analytical details and the value of these investigative techniques in contact lens research are discussed.

Ophthalmic factors in dyslexia

Although the role of ophthalmic factors in dyslexia remains the subject of controversy, recent research has indicated that the correlates of dyslexia may include binocular dysfunction, unstable motor ocular dominance, a deficit of the transient visual subsystem, and an anomaly that can be treated with tinted lenses. These features, typically, have been studied in isolation and their inter-relationship has received little attention. The aim of the present research was to investigate ophthalmic factors in dyslexia, with a particular emphasis on the interaction between optometric variables. Further aims were to establish the most appropriate investigative techniques for optometric practice and to explore the relationship between optometric and psychometric variables. A pilot study was used to refine the experimental design for a subsequent detailed study of 39 children with a specific reading disability and 43 good readers, who were selected from 240 children. The groups were matched for age, sex, and performance IQ. The following factors emerged as correlates of dyslexia: slight impaired visual acuity; reduced vergence amplitudes; increased vergence instability; decreased accommodative amplitude; poor peformance at tests that were designed to assess the function of the transient visual system; and slightly slower performance at a non-verbal simulated reading visual search task. The `transient system deficit', as measured by reduced flicker sensitivity, was significantly associated with decreased accommodative and vergence amplitudes. This links the motor and sensory visual correlates of dyslexia. Although the binocular dysfunction was correlated with increased symptoms, the difference in the groups' simulated reading visual search task performance was largely attributable to psychometric variables. The results suggest tht optometric problems may be a contributory factor in dyslexia, but are unlikely to play a key causative role. Several optometric variables were confounded by psychometric parameters, and this interaction should be a priority for future investigation.

Cognitive neuroscience: the evolution of a discipline

Preface. The evolution of cognitive neuroscience has been spurred by the development of increasingly sophisticated investigative techniques to study human cognition. In Methods in Mind, experts examine the wide variety of tools available to cognitive neuroscientists, paying particular attention to the ways in which different methods can be integrated to strengthen empirical findings and how innovative uses for established techniques can be developed. The book will be a uniquely valuable resource for the researcher seeking to expand his or her repertoire of investigative techniques. Each chapter explores a different approach. These include transcranial magnetic stimulation, cognitive neuropsychiatry, lesion studies in nonhuman primates, computational modeling, psychophysiology, single neurons and primate behavior, grid computing, eye movements, fMRI, electroencephalography, imaging genetics, magnetoencephalography, neuropharmacology, and neuroendocrinology. As mandated, authors focus on convergence and innovation in their fields; chapters highlight such cross-method innovations as the use of the fMRI signal to constrain magnetoencephalography, the use of electroencephalography (EEG) to guide rapid transcranial magnetic stimulation at a specific frequency, and the successful integration of neuroimaging and genetic analysis. Computational approaches depend on increased computing power, and one chapter describes the use of distributed or grid computing to analyze massive datasets in cyberspace. Each chapter author is a leading authority in the technique discussed.

Methods in mind

The evolution of cognitive neuroscience has been spurred by the development of increasingly sophisticated investigative techniques to study human cognition. In Methods in Mind, experts examine the wide variety of tools available to cognitive neuroscientists, paying particular attention to the ways in which different methods can be integrated to strengthen empirical findings and how innovative uses for established techniques can be developed. The book will be a uniquely valuable resource for the researcher seeking to expand his or her repertoire of investigative techniques. Each chapter explores a different approach. These include transcranial magnetic stimulation, cognitive neuropsychiatry, lesion studies in nonhuman primates, computational modeling, psychophysiology, single neurons and primate behavior, grid computing, eye movements, fMRI, electroencephalography, imaging genetics, magnetoencephalography, neuropharmacology, and neuroendocrinology. As mandated, authors focus on convergence and innovation in their fields; chapters highlight such cross-method innovations as the use of the fMRI signal to constrain magnetoencephalography, the use of electroencephalography (EEG) to guide rapid transcranial magnetic stimulation at a specific frequency, and the successful integration of neuroimaging and genetic analysis. Computational approaches depend on increased computing power, and one chapter describes the use of distributed or grid computing to analyze massive datasets in cyberspace. Each chapter author is a leading authority in the technique discussed.