Immunogenicity of a Whole-Cell Pertussis Vaccine with Low Lipopolysaccharide Content in Infants

The lack of a clear correlation between the levels of antibody to pertussis antigens and protection against disease lends credence to the possibility that cell-mediated immunity provides primary protection against disease. This phase I comparative trial had the aim of comparing the in vitro cellular immune response and anti-pertussis toxin (anti-PT) immunoglobulin G (IgG) titers induced by a cellular pertussis vaccine with low lipopolysaccharide (LPS) content (wP(low) vaccine) with those induced by the conventional whole-cell pertussis (wP) vaccine. A total of 234 infants were vaccinated at 2, 4, and 6 months with the conventional wP vaccine or the wP(low) vaccine. Proliferation of CD3(+) T cells was evaluated by flow cytometry after 6 days of peripheral blood mononuclear cell culture with stimulation with heat-killed Bordetella pertussis or phytohemagglutinin (PHA). CD3(+), CD4(+), CD8(+), and T-cell receptor gamma delta-positive (gamma delta(+)) cells were identified in the gate of blast lymphocytes. Gamma interferon, tumor necrosis factor alpha, interleukin-4 (IL-4), and IL-10 levels in super-natants and serum anti-PT IgG levels were determined using enzyme-linked immunosorbent assay (ELISA). The net percentage of CD3(+) blasts in cultures with B. pertussis in the group vaccinated with wP was higher than that in the group vaccinated with the wP(low) vaccine (medians of 6.2% for the wP vaccine and 3.9% for the wP(low) vaccine; P = 0.029). The frequencies of proliferating CD4(+), CD8(+), and gamma delta(+) cells, cytokine concentrations in supernatants, and the geometric mean titers of anti-PT IgG were similar for the two vaccination groups. There was a significant difference between the T-cell subpopulations for B. pertussis and PHA cultures, with a higher percentage of gamma delta(+) cells in the B. pertussis cultures (P < 0.001). The overall data did suggest that wP vaccination resulted in modestly better specific CD3(+) cell proliferation, and gamma delta(+) cell expansions were similar with the two vaccines.

Decline in homicide rates in Sao Paulo, Brasil: a descriptive analysis

Objective. To describe homicide mortality in the municipality of Sao Paulo according to type of weapon, sex, race or skin color, age, and areas of socioeconomic inequalities, between 1996 and 2008. Method. For this ecological time-series study, data about deaths in the municipality of Sao Paulo were collected from the municipal program for improvement of mortality information, using International Classification of Diseases, 10th revision (ICD-10) codes. Homicide mortality rates (HMR) were calculated for the overall population and specifically for each sex, race or skin color, age range, type of weapon, and occurrence in social deprivation/affluence areas. HMR were adjusted for age using the direct method. The percentage age of variation in HMR was calculated for the study period. For areas of socioeconomic inequalities, the relative risk of death from homicide was calculated. Results. HMR fell 73.7% between 2001 and 2008. A reduction in HMR was observed in all groups, especially males (-74.5%), young men between 15 and 24 years of age (-78.0%), and residents in areas of extreme socioeconomic deprivation (-79.3%). The reduction occurred mostly in firearm homicide rates (-74.1%). The relative risk of death from homicide in areas of extreme socioeconomic deprivation, as compared to areas with some degree of socioeconomic deprivation, was 2.77 in 1996, 3.9 in 2001, and 2.13 in 2008. In areas of high socioeconomic deprivation, the relative risk was 2.07 in 1996 and 1.96 in 2008. Conclusions. To understand the reduction in homicide rates in the municipality of Sao Paulo, it is important to take into consideration macrodeterminants that affect the entire municipality and all population subgroups, as well as micro/local determinants that have special impact on homicides committed with firearms and on subgroups such as the young, males, and residents of areas of high socioeconomic deprivation.

A pilot double-blind sham-controlled trial of repetitive transcranial magnetic stimulation for patients with refractory schizophrenia treated with clozapine

Schizophrenia is a complex and heterogeneous psychiatric disorder. Auditory verbal hallucinations occur in 50-70% of patients with schizophrenia and are associated with significant distress, decreased quality of life and impaired social functioning. This study aimed to investigate the effects of active compared with sham 1-Hz repetitive transcranial magnetic stimulation (rTMS) applied to the left temporal-parietal cortex in patients with schizophrenia treated with clozapine. Symptom dimensions that were evaluated included general psychopathology, severity of auditory hallucinations, quality of life and functionality. Seventeen right-handed patients with refractory schizophrenia experiencing auditory verbal hallucinations and treated with clozapine were randomly allocated to receive either active rTMS or sham stimulation. A total of 384 min of rTMS was administered over 20 days using a double-masked, sham-controlled, parallel design. There was a significant reduction in Brief Psychiatric Rating Scale (BPRS) scores in the active group compared with the sham group. There was no significant difference between active and sham rTMS on Quality of Life Scale (QLS), Auditory Hallucinations Rating Scale (AHRS), Clinical Global Impressions (CGI) and functional assessment staging ( FAST) scores. Compared with sham stimulation, active rTMS of the left temporoparietal cortex in clozapine-treated patients showed a positive effect on general psychopathology. However, there was no effect on refractory auditory hallucinations. Further studies with larger sample sizes are needed to confirm these findings. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Cardiopulmonary Manifestations of Hepatosplenic Schistosomiasis

Background -Schistosomiasis is a highly prevalent disease with >200 million infected people. Pulmonary hypertension is one of the pulmonary manifestations in this disease, particularly in its hepatosplenic presentation. The aim of this study was to determine the prevalence of pulmonary hypertension in schistosomiasis patients with the hepatosplenic form of the disease. Methods and Results -All patients with hepatosplenic schistosomiasis followed up at the gastroenterology department of our university hospital underwent echocardiographic evaluation to search for pulmonary hypertension. Patients presenting with systolic pulmonary artery pressure >40 mm Hg were further evaluated through right heart catheterization. Our study showed an 18.5% prevalence of patients with elevated systolic pulmonary artery pressure at echocardiography. Invasive hemodynamics confirmed the presence of pulmonary hypertension in 7.7% (95% confidence interval, 3.3 to 16.7) of patients, with a prevalence of precapillary (arterial) pulmonary hypertension of 4.6% (95% confidence interval, 1.5 to 12.7). Conclusions -Our study reinforces the role of echocardiography as a screening tool in the investigation of pulmonary hypertension, together with the need for invasive monitoring for a proper diagnosis. We conclude that hepatosplenic schistosomiasis may account for one of the most prevalent forms of pulmonary hypertension worldwide, justifying the development of further studies to evaluate the effect of specific pulmonary hypertension treatment in this particular form of the disease. (Circulation. 2009; 119: 1518-1523.)

Nutritional Course of Patients Submitted to Bariatric Surgery

Background Surgical treatment has proved to be effective for weight loss, improving the quality of life of obese individuals. However, metabolic and nutritional deficiencies may occur during the late postoperative period. The objective of the present study was to assess the metabolic and nutritional profile of grade III obese individuals for 12 months after Roux-en-Y gastric bypass (RYGBP). Methods Forty-eight patients with mean body mass index (BMI) of 51.9 +/- 7.8 kg/m(2) were submitted to RYGBP. Anthropometric, food intake, and biochemical data were obtained before and for 12 months after surgery. Results There was an average weight and body fat reduction of 35% and 46%, respectively. Calorie intake was reduced, ranging from 773 +/- 206 to 1035 +/- 345 kcal during the study. Protein intake remained below recommended values throughout follow-up, corresponding to 0.5 +/- 0.3 g/kg/current body weight/day during the 12th month. Iron and fiber intake was significantly reduced, remaining below recommended levels throughout the study. Serum cholesterol, low-density lipoprotein cholesterol, and glycemia were reduced. Albumin deficiency was present in 15.6% of subjects at the beginning of the study vs 8.9% at the end, calcium deficiency was present in 3.4% vs 16.7%, and iron deficiency was present in 12.2% vs 14.6%. Conclusions RYGBP was effective for weight loss and for the reduction of obesity rates and risk factors for comorbidities. The diet of these patients, who frequently present inadequate intake of macronutrients and micronutrients, should receive special attention. Patient follow-up and assessment at short intervals are necessary for an early correction of nutritional deficiencies.

Low-intensity Treadmill Exercise-related Changes in the Rat Stellate Ganglion Neurons

Stellate ganglion (SG) represents the main sympathetic input to the heart. This study aimed at investigating physical exercise-related changes in the quantitative aspects of SG neurons in treadmill-exercised Wistar rats. By applying state-of-the-art design-based stereology, the SG volume, total number of SG neurons, mean perikaryal volume of SG neurons, and the total volume of neurons in the whole SG have been examined. Arterial pressure and heart rate were also measured at the end of the exercise period. The present study showed that a low-intensity exercise training program caused a 12% decrease in the heart rate of trained rats. In contrast, there were no effects on systolic pressure, diastolic pressure, or mean arterial pressure. As to quantitative changes related to physical exercise, the main findings were a 21% increase in the fractional volume occupied by neurons in the SG, and an 83% increase in the mean perikaryal volume of SG neurons in treadmill-trained rats, which shows a remarkable neuron hypertrophy. It seems reasonable to infer that neuron hypertrophy may have been the result of a functional overload imposed on the SG neurons by initial posttraining sympathetic activation. From the novel stereological data we provide, further investigations are needed to shed light on the mechanistic aspect of neuron hypertrophy: what role does neuron hypertrophy play? Could neuron hypertrophy be assigned to the functional overload induced by physical exercise? (C) 2008 Wiley-Liss, Inc.

PRECLINICAL INVESTIGATION OF THE RETINAL BIOCOMPATIBILITY OF SIX NOVEL VITAL DYES FOR CHROMOVITRECTOMY

Purpose: To investigate the retinal biocompatibility of six novel vital dyes for chromovitrectomy. Methods: An amount of 0.05 mL of 0.5% and 0.05% light green (LG), fast green (FG), Evans blue (EB), brilliant blue (BriB), bromophenol blue (BroB), or indigo carmine (IC) was injected intravitreally in the right eye, whereas in the left eye balanced salt solution was applied for control in rabbits` eyes. Clinical examination, fluorescein angiography, histology with light microscopy, and transmission electron microscopy were performed after 1 and 7 days. Retinal cell layers were evaluated for morphologic alterations and number of cells. The electroretinographic changes were assessed at baseline, 24 hours and 7 days. Results: Fluorescein angiography disclosed hypofluorescent spots only in the 0.5% EB group. Light microscopy and transmission electron microscopy disclosed slight focal morphologic changes in eyes exposed to 0.05% IC, FG, BriB, similar to the control at 1 and 7 days. In the lower dose groups, EB, LG, and BroB caused substantial retinal alterations by light microscopy. At the higher dose, BroB and EB produced diffuse cellular edema and vacuolization within the ganglion cells, bipolar cells, and photoreceptors. FG and IC at 0.5% caused slight retinal alterations similar to balanced salt solution injection. LG at 0.5% caused diffuse vacuolization of bipolar cells after 1 and 7 days. Injection of 0.5% EB caused a significant decrease in neuroretinal cell counts in comparison to control eyes in the 7-day examination (P < 0.05). Electroretinography revealed intermittent prolonged latency and decreased amplitude in eyes injected with 0.5% EB, LG, BriB, and BroB, while at the lower dose, only LG and EB induced few functional changes. Conclusion: The progressive order of retinal biocompatibility, from safest to most toxic, was IC, FG, BriB, BroB, LG, EB.

Gest??o por compet??ncias em organiza????es de governo

Ao longo dos ??ltimos anos vem se ampliando os espa??os e o interesse, no meio acad??mico e empresarial, pelas discuss??es sobre uso da abordagem da compet??ncia como marco importante para as atividades de gest??o de recursos humanos. A difus??o dessa abordagem entre as organiza????es p??blicas brasileiras ??, entretanto, bem mais recente, e conta, ainda hoje, com um n??mero insuficiente de estudos e publica????es. ?? esta a raz??o da import??ncia e pertin??ncia da publica????o do livro " Gest??o por compet??ncias em organiza????es de governo"

Altera����es microclim��ticas causadas pelo uso de tela pl��stica

Com o objetivo de caracterizar as altera����es microclim��ticas provocadas pelo uso de tela pl��stica na agricultura, foi desenvolvido um experimento com alface, em ��rea de cultivo agr��cola, em Alegre - ES (latitude 20��45 S, longitude 41��28 W e altitude 150 m), no per��odo de setembro a dezembro de 1996. Foram utilizados sombreamentos de 0; 30; 50, e 70%, segundo especifica����o comercial. Os resultados mostraram que a tela com especifica����o comercial de 50% de sombreamento provocou uma atenua����o m��dia de 41% na radia����o solar global, ocorrendo, no entanto, uma flutua����o significativa ao longo do dia em fun����o do movimento aparente do sol. A cobertura com a tela pl��stica n��o provocou altera����es significativas da temperatura e umidade relativa do ar. Em rela����o �� temperatura do solo, foi poss��vel verificar uma atenua����o com o aumento do sombreamento.

Distribui����o espacial de atributos de solo e de plantas na cultura do mamoeiro no norte capixaba

No Brasil, as lavouras de mamoeiro das plan��cies dos tabuleiros costeiros s��o as que melhor desenvolvem e aplicam tecnologias para a produ����o de mam��o no mundo. O objetivo foi aplicar a estat��stica cl��ssica e a geoestat��stica no mapeamento e na correla����o da variabilidade espacial de atributos qu��micos e f��sicos de solo e de plantas de mamoeiro (Carica papaya L.) de uma lavoura comercial do norte capixaba cultivada em um Argissolo t��pico dos tabuleiros costeiros. O solo de textura arenosa de car��ter coeso foi preparado convencionalmente e cultivado com mamoeiro variedade Golden THB. Ap��s a sexagem, procederam-se as amostragens de solo, amostrado na proje����o da copa (0-0,20 e 0,20-0,40 m) para a determina����o dos atributos qu��micos e f��sicos, e de atributos biom��tricos das plantas em uma ��rea de 1,2 ha (114 x 110 m) totalizando 129 pontos amostrais georreferenciados. Ao nono m��s ap��s o transplantio, registrou-se a altura da colheita dos primeiros frutos, o n��mero e a massa dos frutos colhidos para estimativa da produtividade, amostrando tr��s plantas por ponto amostral durante tr��s meses. Os dados foram submetidos �� an��lise estat��stica descritiva e �� correla����o de Pearson. A depend��ncia espacial das vari��veis foi analisada atrav��s da ferramenta geoestat��stica, com obten����o de semivariograma e os mapas de distribui����o das vari��veis. A maior parte dos atributos de solo e de plantas de mamoeiro apresenta depend��ncia espacial e �� mapeada adequadamente. H�� correla����o de depend��ncia vertical para densidade do solo, argila, silte, resist��ncia do solo �� penetra����o na linha de plantio e na rua e volume total de poros. Dos atributos qu��micos n��o ocorre este comportamento apenas para K, Al e Sat K. As fra����es areia e argila foram os principais atributos a constitu��rem correla����o com os demais. H�� poucas correla����es dos atributos do solo com os atributos biom��tricos e a produtividade do mamoeiro. Ocorre correla����o positiva entre a produtividade inicial do mamoeiro com caracter��sticas biom��tricas ideias para as plantas de mamoeiro. A fertilidade e o preparo do solo s��o expressivos para o desenvolvimento do mamoeiro e para a variabilidade espacial dos atributos avaliados.

Variabilidade espacial do estado nutricional do cafeeiro conilon utilizando ��ndice DRIS

A combina����o da agricultura de precis��o e do Sistema Integrado de Recomenda����o Foliar (DRIS) possibilita monitorar espacialmente o balan��o nutricional dos cafezais para fornecer recomenda����es de aduba����o mais equilibradas e mais ajustadas economicamente. O objetivo deste trabalho foi avaliar a variabilidade espacial do estado nutricional do cafeeiro conilon, utilizando o ��ndice de Balan��o Nutricional (IBN) e sua rela����o com a produtividade. A produtividade das plantas em cada ponto amostral foi determinada e construiu-se o seu mapa considerando a variabilidade espacial; determinou-se o ��ndice de Equil��brio Nutricional (IBN) das plantas em cada ponto amostral e construiu-se o seu mapa; e utilizou-se a an��lise de componentes principais (ACP) para estimar o IBN do cafeeiro por cokrigagem. Os dados do cafeeiro conilon foram coletados em fazenda experimental, no munic��pio de Cachoeiro de Itapemirim-ES. O IBN do cafeeiro e a sua produtividade foram analisados por meio de geoestat��stica, com base nos modelos e par��metros dos semivariogramas, utilizando o m��todo de interpola����o krigagem ordin��ria para estimar valores para locais n��o amostrados. O ��ndice de Balan��o Nutricional da lavoura do cafeeiro conilon apresentou depend��ncia espacial, por��m n��o apresentou correla����o linear e nem espacial com a produtividade. A lavoura em estudo se encontra em desequil��brio nutricional, sendo que entre os macronutrientes, o Pot��ssio foi o que apresentou maior desequil��brio na ��rea, entre os micronutrientes, o Zinco e o Ferro foram os que apresentaram menores concentra����es nas folhas. A confec����o dos mapas possibilitou a distin����o de regi��es com maior e menor desequil��brio nutricional e produtividade, o que possibilita adotar o manejo de forma diferenciada e localizada. A an��lise multivariada baseada em componentes principais fornece componentes com alta correla����o com as vari��veis originais P, Ca, Zn , Cu, K e B. A cokrigagem utilizando as componentes principais permite estimar o IBN e a produtividade da ��rea.

Utiliza����o da l��gica fuzzy na gera����o de zonas de manejo

Este trabalho teve como objetivo utilizar a l��gica fuzzy para gera����o de zonas de manejo, na ��rea agr��ria e ambiental. Uma das aplica����es consistiu da utiliza����o do m��todo fuzzy C-means, para gera����o de zonas de manejo para a cultura do mamoeiro, em um plantio comercial localizado em S��o Mateus-ES, com base em determina����es realizadas atrav��s de amostragens e an��lises qu��micas do solo, considerando os atributos: P, K, Ca, Mg, e Satura����o por bases (V%). Aplicou-se tamb��m a l��gica fuzzy para desenvolver e executar um procedimento para dar suporte ao processo de tomada de decis��es, envolvendo an��lise multicrit��rio, gerando mapas de adequabilidade ao uso p��blico e a conserva����o no Parque Estadual da Cachoeira da Fuma��a, no munic��pio de Alegre-ES, considerando como fatores a localiza����o da cachoeira, o uso do solo, os recursos h��dricos, as trilhas, os locais de acessos, a infraestrutura, a declividade da ��rea, e utilizando a abordagem de Sistema de Informa����es Geogr��ficas para an��lise e combina����o da base de dados. A partir das zonas de manejo geradas, foi poss��vel explicar a variabilidade espacial dos atributos do solo na ��rea de estudo da cultura do mamoeiro, e observa-se que as similaridades entre as zonas geradas, a partir de diferentes atributos, mostrou varia����o, mas observa-se uma influ��ncia nos dados, principalmente pelos atributos P e V. A partir do zoneamento da Unidade de Conserva����o foi poss��vel selecionar ��reas mais aptas ao ecoturismo, sendo encontradas pr��ximas da cachoeira, trilhas em zonas de reflorestamento e de Mata Atl��ntica. Quanto ��s ��reas propensas a medidas de conserva����o localizam-se pr��ximas �� cachoeira e ��s estruturas do parque, devido �� maior press��o antr��pica exercida nesses locais. Outras ��reas que se destacaram, foram as ��reas de pastagem, por estarem em est��gio de regenera����o natural. Os resultados indicam ��reas de mesmo potencial de produ����o do mamoeiro, ou quando aplicado �� ��rea ambiental, ��reas que devem receber maior cuidado para utiliza����o por ecoturismo e para preserva����o e servem de base para a tomada de decis��es, visando melhor aproveitamento da ��rea.

From Tegucigalpa to Teheran: Brazil's diplomacy as an emerging Western country

This paper reviews Brazil's pursuit for international insertion by: discussing its search for new partners; presenting an overview of the historical, cultural, and political features that render it the most Western of the emerging nations; and analyzing its participation in the management of two major international crises, the Honduran constitutional crisis and the Iranian nuclear crisis.

Estudo da fertilidade de um Latossolo Vermelho-Amarelo h��mico sob cultivo de caf�� ar��bica por meio de geoestat��stica

Este trabalho teve por objetivo avaliar a fertlidade de um Latossolo Vermelho-Amarelo h��mico, sob cultivo de caf�� ar��bica, por meio de t��cnicas de geoestat��stica uni e multivariada. O estudo foi realizado em uma ��rea cultivada com Coffea arabica L. variedade catua��, em uma malha, totalizando 50 pontos. A amostragem de solo foi realizada na profundidade de 0 - 0,2 m, para determinar os atributos P, K, Ca, Mg, argila, areia e silte. Os valores encontrados foram analisados por meio da estat��stica descritiva e explorat��ria, seguida de an��lise geoestat��stica. Os atributos foram interpolados por krigagem ordin��ria e cokrigagem. O solo apresentou, de modo geral, baixa fertilidade. A utiliza����o da areia na estimativa dos valores de K acarretou a superestimativa dos valores deste nutriente, na regi��o mais alta da ��rea, e subestimativa, nas regi��es mais baixas. A estimativa de Mg em fun����o do silte possibilitou obter um mapa representativo da sua distribui����o com menor erro.

Spatial variability in nutritional status of arabic coffee based on dris index

The combined use of precision agriculture and the Diagnosis and Recommendation Integrated System (DRIS) allows the spatial monitoring of coffee nutrient balance to provide more balanced and cost-effective fertilizer recommendations. The objective of this work was to evaluate the spatial variability in the nutritional status of two coffee varieties using the Mean Nutritional Balance Index (NBIm) and its relationship with their respective yields. The experiment was conducted in eastern Minas Gerais in two areas, one planted with variety Catuca�� and another with variety Catua��. The NBIm of the two varieties and their yields were analyzed through geostatistics and, based on the models and parameters of the variograms, were interpolated to obtain their spatial distribution in the studied areas. Variety Catucai, with grater spatial variability, was more nutritional unbalanced than variety Catuai, and consequently produced lower yields. Excess of Fe and Mn makes these elements limiting yield factors.