Two decades of tuberculosis in a city in Northeastern Brazil: advances and challenges in time and space

Abstract: INTRODUCTION This study presents two decades of epidemiological data on tuberculosis (TB), in order to understanding the disease profile and its spatiotemporal dynamics. METHODS This descriptive study was performed in the City of Olinda/Pernambuco, Brazil, from 1991-2010, and it analyzed new patients with TB living in the city. We used the χ²-test with a p-value <0.05 to identify differences in trends. Incidence and cluster distribution were identified using spatial scan statistics. RESULTS In total, 6202 new cases were recorded during the two decades. The highest incidence occurred in 1995 (110 cases/100,000 inhabitants), and the lowest occurred in 2009 (65 cases/100,000 inhabitants) (β=-1.44; R²=0.43; p=0.0018). The highest mortality occurred in 1998 (16 deaths/100,000 inhabitants), and the lowest occurred in 2008 (5 deaths/100,000 inhabitants) (β=-0.19; R²=0.17; p=0.07). There was a male predominance (65%), and ages ranged from 20-49 years (65%). There was a substantial increase in the number of patients that were cured after treatment (60% to 67%; p<0.001) as well as those tested for HIV (1.9% to 58.5%; p<0.001). During the first decade, clusters with p-values <0.05 included 29% of the total notified cases, and in the second decade, that percentage was 12%. CONCLUSIONS We observed a decreasing trend in incidence, which was significant, and mortality rates, which was not significant. The increased number of laboratory tests performed reflects advances in surveillance, and a reduction in the proportion of cases in primary clusters suggests, among other things, that the disease is spreading across the region.

Knowledge and practices related to dengue and its vector: a community-based study from Southeast Brazil

Abstract INTRODUCTION: This study investigated the knowledge of users of primary healthcare services living in Ribeirão Preto, Brazil, about dengue and its vector. METHODS: A cross-sectional survey of 605 people was conducted following a major dengue outbreak in 2013. RESULTS: Participants with higher levels of education were more likely to identify correctly the vector of the disease. CONCLUSIONS: The results emphasize the relevance of health education programs, the continuous promotion of educational campaigns in the media, the role of the television as a source of information, and the importance of motivating the population to control the vector.

Vascular lesions of the lumbar epidural space: magnetic resonance imaging features of epidural cavernous hemangioma and epidural hematoma

The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scans showed hyperintense signal.

Heart hypoplasia in an animal model of congenital diaphragmatic hernia

PURPOSE: In previous papers, we described a new experimental model of congenital diaphragmatic hernia in rabbits, and we also reported noninvasive therapeutic strategies for prevention of the functional and structural immaturity of the lungs associated with this defect. In addition to lung hypoplasia, pulmonary hypertension, biochemical, and structural immaturity of the lungs, the hemodynamics of infants and animals with congenital diaphragmatic hernia are markedly altered. Hence, cardiac hypoplasia has been implicated as a possible cause of death in patients with congenital diaphragmatic hernia, and it is hypothesized to be a probable consequence of fetal mediastinal compression by the herniated viscera. Cardiac hypoplasia has also been reported in lamb and rat models of congenital diaphragmatic hernia. The purpose of the present experiment was to verify the occurrence of heart hypoplasia in our new model of surgically produced congenital diaphragmatic hernia in fetal rabbits. METHODS: Twelve pregnant New Zealand rabbits underwent surgery on gestational day 24 or 25 (normal full gestational time - 31 to 32 days) to create left-sided diaphragmatic hernias in 1 or 2 fetuses per each doe. On gestational day 30, all does again underwent surgery, and the delivered fetuses were weighed and divided into 2 groups: control (non-surgically treated fetuses) (n = 12) and congenital diaphragmatic hernia (n = 9). The hearts were collected, weighed, and submitted for histologic and histomorphometric studies. RESULTS: During necropsy, it was noted that in all congenital diaphragmatic hernia fetuses, the left lobe of the liver herniated throughout the surgically created defect and occupied the left side of the thorax, with the deviation of the heart to the right side, compressing the left lung; consequently, this lung was smaller than the right one. The body weights of the animals were not altered by congenital diaphragmatic hernia, but heart weights were decreased in comparison to control fetuses. The histomorphometric analysis demonstrated that congenital diaphragmatic hernia promoted a significant decrease in the ventricular wall thickness and an increase in the interventricular septum thickness. CONCLUSION: Heart hypoplasia occurs in a rabbit experimental model of congenital diaphragmatic hernia. This model may be utilized for investigations in therapeutic strategies that aim towards the prevention or the treatment of heart hypoplasia caused by congenital diaphragmatic hernia.

An experimental model for the transplantation of fetal central nervous system cells to the injured spinal cord in rats

INTRODUCTION: Traumatic spinal cord injury is one of the most disabling conditions occurring in man and thus stimulates a strong interest in its histopathological, biochemical, and functional changes, primarily as we search for preventive and therapeutic methods. PURPOSE: To develop an experimental model for transplantation of cells from the fetal rat central nervous system to the site of an injured spinal cord of an adult rat in which the transplanted cells survive and become integrated. This experimental model will facilitate investigations of factors that promote regeneration and functional recovery after spinal cord trauma. MATERIAL AND METHODS: Fifteen adult Wistar rats underwent laminectomy, and an spinal cord lesion was made with microdissection. Fetal spinal cord tissue was then transplanted to the site of the injury. The rats were monitored over a 48-hour period, and then their vertebral column was completely removed for histological analysis. RESULTS: In 60% of transplanted rats, the fetal tissue at the injured site remained viable in the site of the lesion.

Cholestasis in a murine experimental model: lesions include hepatocyte ischemic necrosis

OBJECTIVE: To establish a murine experimental model of bile duct obstruction that would enable controlled observations of the acute and subacute phases of cholestasis. METHODOLOGY: Adult male isogenic BALB/c mice underwent a bile duct ligation (22 animals) or a sham operation (10 animals). Fifteen days after surgery, or immediately after the animal's death, macroscopic findings were noted and histological study of the liver, biliary tree, and pancreas was performed (hematoxylin-eosin and Masson trichromic staining). RESULTS: Beginning 24 hours after surgery, all animals from the bile duct ligation group presented progressive generalized malaise. All animals presented jaundice in the parietal and visceral peritoneum, turgid and enlarged liver, and accentuated dilatation of gallbladder and common bile duct. Microscopic findings included marked dilatation and proliferation of bile ducts with accentuated collagen deposits, frequent areas of ischemic necrosis, hepatic microabscesses, and purulent cholangitis. Animals from the sham operation group presented no alterations. CONCLUSION: We established a murine experimental model of induced cholestasis, which made it possible to study acute and subacute tissue lesions. Our data suggests that in cholestasis, hepatic functional ischemia plays an important role in inducing hepatic lesions, and it also suggests that the infectious process is an important factor in morbidity and mortality.

Low coronary perfusion pressure is associated with endocardial fibrosis in a rat model of volume overload cardiac hypertrophy

Left ventricular hypertrophy following volume overload is regarded as an example of cardiac remodeling without increased fibrosis accumulation. However, infarction is associated with increased fibrosis within the noninfarcted, hypertrophied myocardium, particularly in the subendocardial regions. It is conceivable to suppose that, as also occurs postinfarction, low coronary driving pressure may also interfere with accumulation of myocardial fibrosis following aortocaval fistula. PURPOSE: To investigate the role of acute hemodynamic changes in subsequent deposition of cardiac fibrosis in response to aortocaval fistula. METHOD: Aortocaval fistula were created in 4 groups of Wistar rats that were followed over 4 and 8 weeks: aortocaval fistula 4 and aortocaval fistula 8 (10 rats each) and their respective controls (sham-operated controls - Sh), Sh4 and Sh8 (8 rats each). Hemodynamic measurements were performed 1 week after surgery. Hypertrophy and fibrosis were quantified by myocyte diameter and collagen volume fraction at the end of follow up. RESULT: Compared with Sh4 and Sh8, pulse pressure, left ventricular end-diastolic pressure, and +dP/dt were higher in aortocaval fistula 4 and aortocaval fistula 8, but -dP/dt was similar. Coronary driving pressure (mm Hg), used as an estimate of perfusion pressure, was lower in aortocaval fistula 8 (52.6 ± 4.1) than in Sh8 (100.8 ± 1.3), but comparable between aortocaval fistula 4 (50.0 ± 8.9) and Sh4 (84.8 ± 2.3). Myocyte diameter was greater in aortocaval fistula 8, whereas interstitial and subendocardial fibrosis were greater in aortocaval fistula 4 and aortocaval fistula 8. Coronary driving pressure correlated inversely and independently with subendocardial fibrosis (r² = .86, P <.001), whereas left ventricular systolic pressure (r² = 0.73, P = .004) and end-diastolic pressure (r² = 0.55, P = 012) correlated positively and independently with interstitial fibrosis. CONCLUSION: Coronary driving pressure falls and ventricular pressures increase early after aortocaval fistula and are associated with subsequent myocardial fibrosis deposition.

TRANSFERTS DE QUANTITE DE MOUVEMENT AU-DESSUS ET A L'INTERIEUR DE LA VEGETATION

The aborptlon of momentum by the vegetation Is studied In this work through an analytical approach which also provides the appropriate formulations to describe wind velocity and drffusivities profiles above and Inside the space occupied by the foliage elements. A first comparison between the observed and calculated profiles of wind volocity for Amazonian forest (Réserva Pucke, Manaus - AM) is presented to test the realism of the model.

PALEOENVIRONMENTAL MODEL FOR THE LATE CENOZOIC OF SOUTHWESTERN AMAZONIA: PALEONTOLOGY AND GEOLOGY

Our study provides paleontological and geological data substantiating a paleoenvironmental model for the upper Miocene-Pliocene of Southwestern Amazonia. The extensive Late Tertiary sediments of The Solimões Formation, outcropping in Southwestern Amazonia, were deposited by a complex megafan system, originating in the high Peruvian Andes. The megafan system was the sedimentological response to the Andean Quechua tectonic phase of Tertiary age, producing sediments that fdled the foreland basin of Southwestern Amazonia. Occurrences of varied vertebrate fossil assemblages of the Huayquerian-Montehermosan Mammal age collected in these sediments support this interpretation. The fauna includes several genera and species of fishes, reptiles, birds, mammals and appears to be one that could have lived in or near a riverine habitat. In the Late Pliocene, the megafan system became inactive as a result of the influence of the Diaguita Tectonical Phase.

Field oriented control of an axial flux permanent magnet synchronous motor for traction solutions

Electric Vehicles (EVs) are increasingly used nowadays, and different powertrain solutions can be adopted. This paper describes the control system of an axial flux Permanent Magnet Synchronous Motor (PMSM) for EVs powertrain. It is described the implemented Field Oriented Control (FOC) algorithm and the Space Vector Modulation (SVM) technique. Also, the mathematical model of the PMSM is presented. Both, simulation and experimental, results with different types of mechanical load are presented. The experimental results were obtained using a laboratory test bench. The obtained results are discussed.

An agent-based model to assess the attractiveness of industrial estates

This article describes the main approaches adopted in a study focused on planning industrial estates on a sub-regional scale. The study was supported by an agent-based model, using firms as agents to assess the attractiveness of industrial estates. The simulation was made by the NetLogo toolkit and the environment represents a geographical space. Three scenarios and four hypotheses were used in the simulation to test the impact of different policies on the attractiveness of industrial estates. Policies were distinguished by the level of municipal coordination at which they were implemented and by the type of intervention. In the model, the attractiveness of industrial estates was based on the level of facilities, amenities, accessibility and on the price of land in each industrial estate. Firms are able to move and relocate whenever they find an attractive estate. The relocating firms were selected by their size, location and distance to an industrial estate. Results show that a coordinated policy among municipalities is the most efficient policy to promote advanced-qualified estates. In these scenarios, it was observed that more industrial estates became attractive, more firms were relocated and more vacant lots were occupied. Furthermore, the results also indicate that the promotion of widespread industrial estates with poor-quality infrastructures and amenities is an inefficient policy to attract firms.

An integrated system for human action recognition from video using hidden Markov model

In this paper, we present an integrated system for real-time automatic detection of human actions from video. The proposed approach uses the boundary of humans as the main feature for recognizing actions. Background subtraction is performed using Gaussian mixture model. Then, features are extracted from silhouettes and Vector Quantization is used to map features into symbols (bag of words approach). Finally, actions are detected using the Hidden Markov Model. The proposed system was validated using a newly collected real- world dataset. The obtained results show that the system is capable of achieving robust human detection, in both indoor and outdoor environments. Moreover, promising classification results were achieved when detecting two basic human actions: walking and sitting.

Child abuse monitor system model: a health care critical knowledge monitor system

The Childhood protection is a subject with high value for the society, but, the Child Abuse cases are difficult to identify. The process from suspicious to accusation is very difficult to achieve. It must configure very strong evidences. Typically, Health Care services deal with these cases from the beginning where there are evidences based on the diagnosis, but they aren’t enough to promote the accusation. Besides that, this subject it’s highly sensitive because there are legal aspects to deal with such as: the patient privacy, paternity issues, medical confidentiality, among others. We propose a Child Abuses critical knowledge monitor system model that addresses this problem. This decision support system is implemented with a multiple scientific domains: to capture of tokens from clinical documents from multiple sources; a topic model approach to identify the topics of the documents; knowledge management through the use of ontologies to support the critical knowledge sensibility concepts and relations such as: symptoms, behaviors, among other evidences in order to match with the topics inferred from the clinical documents and then alert and log when clinical evidences are present. Based on these alerts clinical personnel could analyze the situation and take the appropriate procedures.

Calibração do "simplified simple biosphere model - SSiB" para áreas de pastagem e floresta na Amazônia com dados do LBA

Os parâmetros do "Simplified Simple Biosphere Model"-SSiB foram validados e posteriormente calibrados para os sítios de pastagem da Fazenda Nossa Senhora Aparecida (62º22'W; 10º45'S) e de floresta da Reserva Biológica do Jaru (62º22'W; 10º45'S), ambos situados no estado de Rondônia. Foram utilizadas medidas micrometeorológicas e hidrológicas obtidas durante o período seco de 2001, como parte do Experimento de Grande Escala da Biosfera-Atmosfera na Amazônia - LBA. Os resultados indicam que o modelo simulou bem o saldo de radiação, tanto na pastagem quanto na floresta. O fluxo de calor latente foi superestimado nos dois sítios nos períodos de simulação, o que deve estar relacionado aos parâmetros utilizados no cálculo dessa variável. O modelo subestimou o fluxo de calor sensível na pastagem e na floresta, principalmente no período noturno; porém, para a floresta, os valores foram mais próximos daqueles observados. Com os parâmetros ajustados, melhores estimativas dos fluxos de calor latente e de calor sensível foram geradas e, conseqüentemente, representou melhor as partições de energia na floresta e na pastagem.

A new species of Cerqueirellum Py-Daniel, 1983 (Diptera: Simuliidae) and proven new vector of mansonelliasis from the Ituxi River, Amazon basin, Brazil

A new species of the genus Cerqueirellum Py-Daniel, 1983 (Diptera: Simuliidae) is described. The adults are similar to the species C. oyapockense (Floch & Abonnenc, 1946) and C. roraimense (Nunes de Mello, 1974), of which the females are similar, and the males present discrete differences. The main differences of this new species to others of the genus Cerqueirellum are the integument of the larva recovered from stout spines and long cephalic trichomes in the pupa. Some females were infected with Mansonella ozzardii (Manson, 1897) (Nematoda, Onchocercidae) and probably transmit mansonelliasis in the Ituxi river, state of Amazonas, Brazil.