Ecological competition and the incidence of Acinetobacter baumannii bloodstream infections in a teaching hospital in Southeastern Brazil

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

Clonal monosomy of chromosome 21 in a case of myelodysplastic syndrome

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Collaboration of ultrasonography in the diagnosis of thyroid gland carcinoma in a dog - case report

The sonographic evaluation of thyroid glands in veterinary medicine presents challenges due to the complexity of the anatomical region, professional experience and type of ultrasonography equipment. The technique is considered a versatile diagnostic method that is noninvasive and has a low cost indicated in different clinical situations. Thyroid carcinoma is a malignant tumor that is often invasive and frequently metastatic to regional lymph nodes and lungs. The prognostic indicators for survival after surgery include tumor size, histological type, mobility and presence or absence of metastasis. The objective of the present report is to demonstrate the importance of ultrasound as a complementary method in the evaluation of thyroid carcinoma in dogs. At the Dr. Halim Atique Veterinary Hospital, an eight-year-old male Pit Bull was examined due to a history of firm painless swelling, approximately six inches in diameter, in the ventral cervical region, for about two months. The sonogram showed a nodular area, with defined and regular margins, and heterogeneous hypoechoic parenchyma, with areas of cavitation and swelling of the thyroid. Histopathology of the nodule was consistent with carcinoma. After thyreoidectomy and hormone replacemet, the patient is in good clinical condition.

Una lapide in via Mazzini: os sofrimentos em Auschwitz e os desafios da tradução

Giorgio Bassani in his book Una lapide in via Mazzin seeks to show to the readers all the sufferings passed by Italians during the Second World War and emphasized those persists until today. Aiming to make an unprecedented translation of this tale, it is expected that the text provides us great experiences in the language and we could see the actual difficulties and differences with the Portuguese language, despite being considered these languages closed ones. The objective of this work is to produce a translation that allows us to transmit all anxieties and reflections suffered by the main character of the tale. After the war, the survivor of the concentration camp can go back to your city. He appears exactly at the moment is being placed a headstone on the synagogue wall in homage to Jews deported and killed in the camps. Given the gaunt figure of the man with his striped pajamas, the population is driven to rethink their own indifference and , in a way, its share of blame. Thus, the return should be celebrated is rejected and the figure of the survivor becomes a nuisance. The function of the headstone is actually and literally put a stone on the story. To achieve the proposed objective for this work, we analyzed all the chapters of the story Una lapide in via Mazzini and tried to find equivalents in Portuguese. However, we not ignored the traces of meaning that Giorgio Bassani invested in his work. Therefore, it was necessary to use both printed and virtual dictionaries. With the advancement of the translation work, we realized the difficulty of finding appropriate solutions to achieve the desired effect . The fidelity proposed by the author became increasingly difficult as our work progressed. In the course of all the discussions, it was concluded that , in fact , when it comes to translation, maintaining fidelity to the original text in a foreign language is a difficult and laborious process

O jogo como mediador na entrevista: um novo lugar no processo psicoterápico com adolescentes

It is a fact that between the child and the adult there is an adolescent being that experiments his experiences in a different way than those others. Therefore, in clinical care, the use of toys and play do not have the same value as for the children, and, on the other hand, the majority of adolescents are not ready, as the adult is, for the exclusive use of speech in the psychotherapy context. There is the need to introduce some specific strategy in order to give the adolescent conditions to express himself openly in the psychotherapy process. The mediator's resource introduces this variable to enable the expression of emotions for those who cannot find the available channels for that. This paper seeks to answer this question by presenting the Time Tunnel Game in the psychotherapy with young people, based, during several years, on its clinical use with patients during this period of their lives. Explaining, when it is a question of a demand for a game, that the youngster tries to respect the rules, therefore, expressing his experiences more at ease. By using the mentioned game, it is not the psychotherapist that questions or addresses the youngster, but it is through this playing that the questions arise, providing the youngster a facilitating context for his experiences, even for the more difficult ones. At the direct request of the psychotherapist, it is possible that the adolescent may have the imposing idea that he is being evaluated, which is inadequate when attending any youngster. It is understood that this facilitation also occurs because in a game the atmosphere of lucidity is less threatening to the patient to reveal himself as playing. It is the game that "interviews" and, therefore, the youngster has less to be afraid of when expressing his experiences.

Activation of monocytes and cytokine production in patients with peripheral atherosclerosis obliterans

Background: Arterial peripheral disease is a condition caused by the blocked blood flow resulting from arterial cholesterol deposits within the arms, legs and aorta. Studies have shown that macrophages in atherosclerotic plaque are highly activated, which makes these cells important antigen-presenting cells that develop a specific immune response, in which LDLox is the inducing antigen. As functional changes of cells which participate in the atherogenesis process may occur in the peripheral blood, the objectives of the present study were to evaluate plasma levels of anti-inflammatory and inflammatory cytokines including TNF-alpha, IFN-gamma, interleukin-6 (IL-6), IL-10 and TGF-beta in patients with peripheral arteriosclerosis obliterans, to assess the monocyte activation level in peripheral blood through the ability of these cells to release hydrogen peroxide (H(2)O(2)) and to develop fungicidal activity against Candida albicans (C. albicans) in vitro.Methods: TNF-alpha, IFN-gamma, IL-6, IL-10 and TGF-beta from plasma of patients were detected by ELISA. Monocyte cultures activated in vitro with TNF-alpha and IFN-gamma were evaluated by fungicidal activity against C. albicans by culture plating and Colony Forming Unit (CFU) recovery, and by H(2)O(2) production.Results: Plasma levels of all cytokines were significantly higher in patients compared to those detected in control subjects. Control group monocytes did not release substantial levels of H(2)O(2) in vitro, but these levels were significantly increased after activation with IFN-gamma and TNF-alpha. Monocytes of patients, before and after activation, responded less than those of control subjects. Similar results were found when fungicidal activity was evaluated. The results seen in patients were always significantly smaller than among control subjects. Conclusions: The results revealed an unresponsiveness of patient monocytes in vitro probably due to the high activation process occurring in vivo as corroborated by high plasma cytokine levels.

Anesthesia-related and perioperative cardiac arrest in low- and high-income countries: a systematic review with meta-regression and proportional meta-analysis

The anesthesia-related cardiac arrest (CA) rate is a quality indicator to improve patient safety in the perioperative period. A systematic review with meta-analysis of the worldwide literature related to anesthesia-related CA rate has not yet been performed.This study aimed to analyze global data on anesthesia-related and perioperative CA rates according to country's Human Development Index (HDI) and by time. In addition, we compared the anesthesia-related and perioperative CA rates in low- and high-income countries in 2 time periods.A systematic review was performed using electronic databases to identify studies in which patients underwent anesthesia with anesthesia-related and/or perioperative CA rates. Meta-regression and proportional meta-analysis were performed with 95% confidence intervals (CIs) to evaluate global data on anesthesia-related and perioperative CA rates according to country's HDI and by time, and to compare the anesthesia-related and perioperative CA rates by country's HDI status (low HDI vs high HDI) and by time period (pre-1990s vs 1990s-2010s), respectively.Fifty-three studies from 21 countries assessing 11.9 million anesthetic administrations were included. Meta-regression showed that anesthesia-related (slope: -3.5729; 95% CI: -6.6306 to -0.5152; P = 0.024) and perioperative (slope: -2.4071; 95% CI: -4.0482 to -0.7659; P = 0.005) CA rates decreased with increasing HDI, but not with time. Meta-analysis showed per 10,000 anesthetics that anesthesia-related and perioperative CA rates declined in high HDI (2.3 [95% CI: 1.2-3.7] before the 1990s to 0.7 [95% CI: 0.5-1.0] in the 1990s-2010s, P < 0.001; and 8.1 [95% CI: 5.1-11.9] before the 1990s to 6.2 [95% CI: 5.1-7.4] in the 1990s-2010s, P < 0.001, respectively). In low-HDI countries, anesthesia-related CA rates did not alter significantly (9.2 [95% CI: 2.0-21.7] before the 1990s to 4.5 [95% CI: 2.4-7.2] in the 1990s-2010s, P = 0.14), whereas perioperative CA rates increased significantly (16.4 [95% CI: 1.5-47.1] before the 1990s to 19.9 [95% CI: 10.9-31.7] in the 1990s-2010s, P = 0.03).Both anesthesia-related and perioperative CA rates decrease with increasing HDI but not with time. There is a clear and consistent reduction in anesthesia-related and perioperative CA rates in high-HDI countries, but an increase in perioperative CA rates without significant alteration in the anesthesia-related CA rates in low-HDI countries comparing the 2 time periods.

Bamboo as sustainable material used in design and civil construction: species, management, characterization and applications

The use of bamboo as construction and raw material for producing products can be considered a feasible alternative to the abusive use of steel, concrete and oil byproducts. Its use can also reduce the pressure on the use of wood from native and planted forests. Although there are thousands of bamboo species spread about the world and Brazil itself has hundreds of native species, the use and basic knowledge of its characteristics and applications are still little known and little disseminated. This paper's main objective is to introduce the species, the management phases, the physical and mechanical characteristics and the experiences in using bamboo in design and civil construction as per the Bamboo Project implemented at UNESP, Bauru campus since 1994. The results are divided into: a) Field activities - description of the technological species of interest, production chain flows, types of preservative treatments and clump management practices for the development, adaptation and production of different species of culms; b) Lab experiments - physical and mechanical characterization of culms processed as laminated strips and as composite material (glue laminated bamboo – glubam); c) Uses in projects - experiences with natural bamboo and glubam in design, architecture and civil construction projects. In the final remarks, the study aims to demonstrate, through practical and laboratory results, the material's multi-functionality and the feasibility in using bamboo as a sustainable material.

The Flower Workshop: a social self-organizing practice in mental health nursing

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

African American and Teaching in Higher Education IS a Course on Race and Culture

Using theoretical applications, the authors present an overview of theories that highlight approaches for teaching culturally sensitive content, personal experiences as educator and colleague in a predominantly white college campus and strategies for addressing culturally insensitive experiences in and outside the classroom. Presenters focus on the recruitment and retention of people of color and stress the need for today's predominantly white institutions to become more knowledgeable, tolerant and sensitive about their environments in an effort to make them more accepting.

Immunohistochemistry Analysis of Proteins Related with Apoptosis as Prognostic Factor in Epidermoid Carcinoma of Penis

The aim was to analyze the protein expression of apoptotic genes caspase-3, caspase-8 and bcl-2 with the immunohistochemistry technique, correlating with tumor grade (I, II and III) and with the patient survival in order to understand the basic mechanism of tumoral transformation. The immunohistochemistry reactions on 50 samples of squamous cell carcinoma were carried out with the avidin-biotin immunoperoxidase method and antigen recovery. The analyses were made using the graduation method "in crosses" (0 to 4 crosses - no stain to more than 75% of positives cells) and in categories (low, intermediate, high) of the cytoplasm immunoreactivity of the epidermoid penile carcinoma cells. It was observed a statistically significant difference when the expression of caspase-3 were compared with the grades land II of the tumor (p=0.0010) and when comparing the patient survival with the grades I and II of the tumor (p=0.0212). The protein bcl-2 was more expressed than caspase-3 and caspase-8 proteins, suggesting that the apoptotic rate in this carcinoma is low. The higher expression of the anti-apoptotic protein bcl-2 suggests a higher preservation of the tumoral cells.

Incidental mild hyperglycemia in children: two MODY 2 families identified in Brazilian subjects

Maturity-onset diabetes of the young (MODY) is characterized by an autosomal dominant mode of inheritance, early onset of hyperglycemia, and defects of insulin secretion. MODY subtypes described present genetic, metabolic, and clinical differences. MODY 2 is characterized by mild asymptomatic fasting hyperglycemia, and rarely requires pharmacological treatment. Hence, precise diagnosis of MODY is important for determining management and prognosis. We report two heterozygous GCK mutations identified during the investigation of short stature. Case 1: a prepubertal 14-year-old boy was evaluated for constitutional delay of growth and puberty. During follow-up, he showed abnormal fasting glucose (113 mg/dL), increased level of HbA1c (6.6%), and negative beta-cell antibodies. His father and two siblings also had slightly elevated blood glucose levels. The mother had normal glycemia. A GCK heterozygous missense mutation, p.Arg191Trp, was identified in the proband. Eighteen family members were screened for this mutation, and 11 had the mutation in heterozygous state. Case 2: a 4-year-old boy investigated for short stature revealed no other laboratorial alterations than elevated glycemia (118 mg/dL); beta-cell antibodies were negative. His father, a paternal aunt, and the paternal grandmother also had slightly elevated glycemia, whereas his mother had normal glycemia. A GCK heterozygous missense mutation, p.Glu221Lys, was identified in the index patient and in four family members. All affected patients had mild elevated glycemia. Individuals with normal glycemia did not harbor mutations. GCK mutation screening should be considered in patients with chronic mild early-onset hyperglycemia, family history of impaired glycemia, and negative beta-cell antibodies. Arq Bras Endocrinol Metab. 2012;56(8):519-24

HIV-1 tropism and CD4 T lymphocyte recovery in a prospective cohort of patients initiating HAART in Ribeirao Preto, Brazil

While human immunodeficiency virus (HIV)-1 chemokine co-receptors 5 tropism and the GWGR motif in the envelope third variable region (V3 loop) have been associated with a slower disease progression, their influence on antiretroviral response remains unclear. The impact of baseline V3 characteristics on treatment response was evaluated in a randomised, double blind, prospective cohort study with patients initiating highly active antiretroviral therapy with lopinavir or efavirenz plus azithothymidine/3TC (1:1) over 48 weeks. Similar virological and immunological responses were observed for both treatment regimens. The 43 individuals had a mean baseline CD4 T cell count of 119 cells/mm(3) [standard deviation (SD) = 99] and a mean viral load of 5.09 log(10) copies/mL (SD = 0.49). The GWGR motif was not associated with a CD4 T cell response, but predicted R5 tropism by the geno2pheno([clinical20%]) algorithm correlated with higher CD4 T cell levels at all monitoring points (p < 0.05). Moreover, higher false-positive rates (FPR) values from this analysis revealed a strong correlation with CD4 T cell recovery (p < 0.0001). Transmitted drug resistance mutations, documented in 3/41 (7.3%) cases, were unrelated to the assigned antiretroviral regimen and had no impact on patient outcomes. In conclusion, naive HIV-1 R5 infected patients exhibited higher CD4 T cell counts at baseline; this difference was sustained throughout therapy. The geno2pheno[clinical] option FPR positively correlated with CD4 T cell gain and may be useful in predicting CD4 T cell recovery.

Microbiota benefits after inulin and partially hydrolized guar gum supplementation - a randomized clinical trial in constipated women

Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation. Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids. Methods: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d I-PHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively. Results: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile. Conclusions: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut rnicrobiota by decreasing the amount of pathological bacteria of the Clostridium genera.

Circulating matrix metalloproteinases and their endogenous inhibitors in patients with erectile dysfunction

Erectile dysfunction (ED) may reflect vascular alterations associated with imbalanced matrix metalloproteinases (MMPs) activities. However, no previous study has compared MMPs levels in ED patients with those found in healthy subjects. We measured the circulating MMP-2, MMP-9, TIMP-1 and TIMP-2 levels in ED patients, with or without diabetes mellitus (DM), and in healthy controls. We studied 28 healthy men (control group), 35 men with ED (ED group), and 33 men with ED and DM (ED/DM group). MMP-2, MMP-9, TIMP-1 and TIMP-2 plasma levels were measured by enzyme-linked immunosorbent assay and zymography. We found no differences in MMP-9 levels (P>0.05) among groups. However, while patients in the ED group had similar TIMP-1 levels compared with those found in the control group, we found higher TIMP-1 levels and lower MMP-9/TIMP-1 ratios in the ED/DM group compared with controls (P<0.05). While both groups of patients (ED and ED/DM) had slightly lower MMP-2 levels compared with controls (P<0.05), we found no differences in TIMP-2 levels among the study groups (P>0.05), and no differences in MMP-2/TIMP-2 ratios (P>0.05). We found evidence indicating lack of significant alterations in circulating net MMP-9 and MMP-2 activities in patients with ED, and lower net MMP-9 activity in diabetic patients with ED. International Journal of Impotence Research (2012) 24, 38-43; doi:10.1038/ijir.2011.44; published online 15 September 2011