Patients with AIDS-defining cancers are not universally screened for HIV: a 10-year retrospective analysis of HIV-testing practices in a Swiss university hospital.

OBJECTIVES: Kaposi's sarcoma (KS), invasive cervical carcinoma (ICC) and non-Hodgkin lymphoma (NHL) have been listed as AIDS-defining cancers (ADCs) by the Centers for Disease Control and Prevention since 1993. Despite this, HIV screening is not universally mentioned in ADC treatment guidelines. We examined screening practices at a tertiary centre serving a population where HIV seroprevalence is 0.4%. METHODS: Patients with KS, ICC, NHL and Hodgkin lymphoma (HL), treated at Lausanne University Hospital between January 2002 and July 2012, were studied retrospectively. HIV testing was considered part of the oncology work-up if performed between 90 days before and 90 days after the cancer diagnosis date. RESULTS: A total of 880 patients were examined: 10 with KS, 58 with ICC, 672 with NHL and 140 with HL. HIV testing rates were 100, 11, 60 and 59%, and HIV seroprevalence was 60, 1.7, 3.4 and 5%, respectively. Thirty-seven patients (4.2%) were HIV-positive, of whom eight (22%) were diagnosed at oncology work-up. All newly diagnosed patients had CD4 counts < 200 cells/μL and six (75%) had presented to a physician 12-236 weeks previously with conditions warranting HIV testing. CONCLUSIONS: In our institution, only patients with KS were universally screened. Screening rates for other cancers ranged from 11 to 60%. HIV seroprevalence was at least fourfold higher than the population average. As HIV-positive status impacts on cancer patient medical management, HIV screening should be included in oncology guidelines. Further, we recommend that opt-out screening should be adopted in all patients with ADCs and HL.

Combination of MRI and dynamic FET PET for initial glioma grading.

AIM: MRI and PET with 18F-fluoro-ethyl-tyrosine (FET) have been increasingly used to evaluate patients with gliomas. Our purpose was to assess the additive value of MR spectroscopy (MRS), diffusion imaging and dynamic FET-PET for glioma grading. PATIENTS, METHODS: 38 patients (42 ± 15 aged, F/M: 0.46) with untreated histologically proven brain gliomas were included. All underwent conventional MRI, MRS, diffusion sequences, and FET-PET within 3±4 weeks. Performances of tumour FET time-activity-curve, early-to-middle SUVmax ratio, choline / creatine ratio and ADC histogram distribution pattern for gliomas grading were assessed, as compared to histology. Combination of these parameters and respective odds were also evaluated. RESULTS: Tumour time-activity-curve reached the best accuracy (67%) when taken alone to distinguish between low and high-grade gliomas, followed by ADC histogram analysis (65%). Combination of time-activity-curve and ADC histogram analysis improved the sensitivity from 67% to 86% and the specificity from 63-67% to 100% (p < 0.008). On multivariate logistic regression analysis, negative slope of the tumour FET time-activity-curve however remains the best predictor of high-grade glioma (odds 7.6, SE 6.8, p = 0.022). CONCLUSION: Combination of dynamic FET-PET and diffusion MRI reached good performance for gliomas grading. The use of FET-PET/MR may be highly relevant in the initial assessment of primary brain tumours.

Extratores químicos empregados na determinação de P como indicadores ambientais em solos tratados com lodo de esgoto

A aplicação de lodo de esgoto pode contribuir para elevar os teores de alguns nutrientes no solo de forma inadequada, como, por exemplo, o P. Na prática, as doses de lodo de esgoto são calculadas com base na necessidade de N das culturas, não levando em conta a necessidade de P ou o destino do P aplicado com o resíduo. O P é um nutriente frequentemente associado com a aceleração da eutrofização nos corpos hídricos, em virtude do seu transporte por meio da enxurrada. O presente trabalho teve por objetivo avaliar se três extratores químicos empregados na determinação de P em solos para fins de fertilidade (CaCl2 0,01 mol L-1; Mehlich-1 e RTA) e um índice ambiental (GSP) poderiam ser utilizados na avaliação de impactos ambientais negativos, promovidos pelo deslocamento de P adicionado ao solo por lodo de esgoto em direção a corpos de água. A resposta desses extratores na determinação de P dos solos tratados com lodo de esgoto foi avaliada nas condições convencionais de uso e variando o tempo de extração do método original em busca da maior extração de P. Além disso, os extratores também foram avaliados após a alteração do pH das amostras de solo originais para modificar a disponibilidade de P. Os resultados obtidos com os extratores químicos foram comparados com os do fracionamento do P nas amostras. O fracionamento de P mostrou que a aplicação de lodo aumentou não apenas as concentrações totais de P no solo, mas também sua disponibilidade. Esse efeito foi mais pronunciado no solo de Jaguariúna (argiloso) do que no de Itatinga (arenoso). Houve aumento nas frações de P orgânico e inorgânico lábil e de P ligado a Al e Fe, em decorrência da aplicação do resíduo. Contudo, as frações de P solúvel e P ligado a Ca não foram encontradas em teores significativos nas amostras estudadas. Considerando que a alteração da disponibilidade de P induzida pela alteração do pH original das amostras não alterou as classes de teores do nutriente no solo empregadas usualmente nas recomendações de adubação, os extratores químicos e o indicador ambiental estudados são muito razoáveis para prever também riscos ambientais

Diffusion tensor imaging shows structural remodeling of stroke mirror region: results from a pilot study.

Background: The role of the non-injured hemisphere in stroke recovery is poorly understood. In this pilot study, we sought to explore the presence of structural changes detectable by diffusion tensor imaging (DTI) in the contralesional hemispheres of patients who recovered well from ischemic stroke. Methods: We analyzed serial DTI data from 16 stroke patients who had moderate initial neurological deficits (NIHSS scores 3-12) and good functional outcome at 3-6 months (NIHSS score 0 or modified Rankin Score ≤1). We segmented the brain tissue in gray and white matter (GM and WM) and measured the apparent diffusion coefficient (ADC) and fractional anisotropy in the infarct, in the contralesional infarct mirror region as well as in concentrically expanding regions around them. Results: We found that GM and WM ADC significantly increased in the infarct region (p < 0.01) from acute to chronic time points, whereas in the infarct mirror region, GM and WM ADC increased (p < 0.01) and WM fractional anisotropy decreased (p < 0.05). No significant changes were detected in other regions. Conclusion: DTI-based metrics are sensitive to regional structural changes in the contralesional hemisphere during stroke recovery. Prospective studies in larger cohorts with varying levels of recovery are needed to confirm our findings.

Peatlands of Wallony (S-Belgium)

Tiivistelmä: Wallonian suot (Etelä-Belgia)

RNA interference against aquaporin-4 decreases the apparent diffusion coefficient in the normal brain

Aim: Diffusion weighted magnetic resonance imaging (MRI) is now widely used in human brain diagnosis.1 To date molecular mechanisms underlying changes in Apparent Diffusion Coefficient (ADC) signals remain poorly understood. AQP4, localized to astrocytes, is one of the most highly expressed cerebral AQPs.2 AQP4 is involved in water movement within the cell membrane of cultured astrocytes.3 We hypothesize that AQP4 contributes to water diffusion and underlying ADC values in normal brain. Methods: We used an RNA interference (RNAi) protocol in vivo, to acutely knockdown expression of AQP4 in rat brain and to determine whether this was associated with changes in brain ADC values using MRI protocols as previously described.4 RNAi was performed using specific small interference RNA (siRNA) against AQP4 (siAQP4) and a non-targeted-siRNA (siGLO) as a control. The specificity and efficiency of the siAQP4 were first tested in vitro in astrocyte and hippocampal slice cultures. In vivo, siRNAs were injected into the rat cortex 3d prior to MRI acquisition and AQP4 was assessed by western blot (n=4) and immunohistochemistry (n=6). Histology was performed on adjacent slices. Results: siAQP4 application on primary astrocyte cultures induced a 76% decrease in AQP4 expression after 4 days. In hippocampal slice cultures; we also found a significant decrease in AQP4 expression in astrocytes after siAQP4. In vivo, injection of non-targeted siRNA (siGLO) tagged with CY3 allowed us to show that GFAP positive cells (astrocytes) were positively stained with CY3-siGLO, showing efficient transfection. Western blot and immunohistochemical analysis showed that siAQP4 induced a ~30% decrease in AQP4 expression without modification of tissue properties or cell death. After siAQP4 treatment, a significant decrease in ADC values (~50%) were observed without altered of T2 values. Conclusions: Together these results suggest that AQP4 reduces water diffusion through the astrocytic plasma membrane and decreases ADC values. Our findings demonstrate for the first time that astrocytic AQP4 contributes significantly to brain water diffusion and ADC values in normal brain. These results open new avenues to interpretation of ADC values under normal physiological conditions and in acute and chronic brain injuries.

Combination of MRI and dynamic FET PET for initial glioma grading.

AIM: MRI and PET with 18F-fluoro-ethyl-tyrosine (FET) have been increasingly used to evaluate patients with gliomas. Our purpose was to assess the additive value of MR spectroscopy (MRS), diffusion imaging and dynamic FET-PET for glioma grading. PATIENTS, METHODS: 38 patients (42 ± 15 aged, F/M: 0.46) with untreated histologically proven brain gliomas were included. All underwent conventional MRI, MRS, diffusion sequences, and FET-PET within 3±4 weeks. Performances of tumour FET time-activity-curve, early-to-middle SUVmax ratio, choline / creatine ratio and ADC histogram distribution pattern for gliomas grading were assessed, as compared to histology. Combination of these parameters and respective odds were also evaluated. RESULTS: Tumour time-activity-curve reached the best accuracy (67%) when taken alone to distinguish between low and high-grade gliomas, followed by ADC histogram analysis (65%). Combination of time-activity-curve and ADC histogram analysis improved the sensitivity from 67% to 86% and the specificity from 63-67% to 100% (p < 0.008). On multivariate logistic regression analysis, negative slope of the tumour FET time-activity-curve however remains the best predictor of high-grade glioma (odds 7.6, SE 6.8, p = 0.022). CONCLUSION: Combination of dynamic FET-PET and diffusion MRI reached good performance for gliomas grading. The use of FET-PET/MR may be highly relevant in the initial assessment of primary brain tumours.

Doses de gesso em cafeeiro: influência nos teores de cálcio, magnésio, potássio e ph na solução de um latossolo vermelho distrófico

O desbalanço entre Ca2+, Mg2+ e K+ no solo como consequência das aplicações elevadas de gesso deve-se às relações de tamanho (raio iônico) e densidades de cargas (relação carga/raio) de cada espécie iônica. Quanto maior a densidade de carga, mais intensa será a ligação iônica do cátion com íons de cargas opostas como OH- e SO4-2. Dessa maneira, o uso excessivo de gesso agrícola, sem considerar o balanço de cargas das partículas do solo; o equilíbrio iônico; e a CTC podem resultar em expressiva lixiviação ao longo do perfil do solo. O objetivo deste estudo foi avaliar o efeito de elevadas doses de gesso (0, 7 e 56 t ha-1) nos teores de Ca2+, Mg2+, K+ e pH na solução de um Latossolo Vermelho distrófico cultivado com cafeeiro, obtida pelo método adaptado do extrato aquoso. O solo foi amostrado nas profundidades de 0,15-0,25; 0,35-0,45; 0,75-0,85; 1,15-1,25 e 2,35-2,45 m na linha de plantio, em quatro tratamentos: G-0 - gesso no preparo (aplicação ocorreu em setembro de 2008, distribuído a lanço, na quantidade de 2 t ha-1) e sem gesso na linha de plantio; G-7 - gesso adicionado durante a preparação do solo (2 t ha-1), na mesma condição do G-0 e 7,0 t ha-1 de gesso na linha de plantio; G-56 - gesso adicionado durante a preparação do solo (2 t ha-1), na mesma condição do G-0 e 56 t ha-1 de gesso na linha de plantio (nessas parcelas experimentais as entrelinhas de plantio foram cobertas com braquiária); e CV-7: ausência de braquiária na entrelinha, com gesso no preparo e 7 t ha-1 de gesso na linha, com três repetições distribuídas em blocos ao acaso, totalizando 60 amostras. Após 16 meses da adição de gesso, observou-se redução do pH na solução do solo nas profundidades de 0,15-0,25; 0,35-0,45 e 0,75-0,85 m. A aplicação de gesso agrícola foi eficiente na melhoria do ambiente radicular no subsolo, aumentou a concentração de Mg2+ e Ca2+ na solução do solo, mas reduziu o K+ em profundidade, a partir de 0,85 m. Os teores de Ca2+ e Mg2+ trocáveis na solução do solo estiveram acima do nível crítico; entretanto, os teores de K+ trocável se mantiveram na faixa do valor crítico, indicado para o desenvolvimento da cultura.

A multi-center study: intra-scan and inter-scan variability of diffusion spectrum imaging.

The objective of this study was to investigate whether it is possible to pool together diffusion spectrum imaging data from four different scanners, located at three different sites. Two of the scanners had identical configuration whereas two did not. To measure the variability, we extracted three scalar maps (ADC, FA and GFA) from the DSI and utilized a region and a tract-based analysis. Additionally, a phantom study was performed to rule out some potential factors arising from the scanner performance in case some systematic bias occurred in the subject study. This work was split into three experiments: intra-scanner reproducibility, reproducibility with twin-scanner settings and reproducibility with other configurations. Overall for the intra-scanner and twin-scanner experiments, the region-based analysis coefficient of variation (CV) was in a range of 1%-4.2% and below 3% for almost every bundle for the tract-based analysis. The uncinate fasciculus showed the worst reproducibility, especially for FA and GFA values (CV 3.7-6%). For the GFA and FA maps, an ICC value of 0.7 and above is observed in almost all the regions/tracts. Looking at the last experiment, it was found that there is a very high similarity of the outcomes from the two scanners with identical setting. However, this was not the case for the two other imagers. Given the fact that the overall variation in our study is low for the imagers with identical settings, our findings support the feasibility of cross-site pooling of DSI data from identical scanners.

Solução do Solo e Análise de Componentes Principais para Monitoramento da Aplicação de Lodo de Esgoto

O uso agrícola do lodo é uma alternativa viável para a reciclagem de nutrientes, embora haja certa preocupação com o aumento de espécies químicas solúveis originadas da mineralização da fração orgânica. Assim, para conhecer a disponibilidade de nutrientes e o risco de contaminação do solo e da água, o estudo da solução do solo é uma ferramenta valiosa. Nesses estudos, o número de variáveis utilizadas ultrapassa facilmente uma dezena, e ferramentas de análise exploratória, como a análise de componentes principais (ACP), revelam a existência ou não de amostras anômalas, de relações entre as variáveis medidas e sua contribuição relativa e de relações ou agrupamentos entre amostras. O objetivo deste trabalho foi identificar variáveis relacionadas com a solução do solo e alteradas, em razão do uso do lodo de esgoto e da adubação mineral, de forma a complementar os procedimentos para monitoramento/avaliação de áreas que recebem esse tipo de resíduo. A composição da solução do solo de uma área que recebeu lodo de esgoto por sete anos consecutivos foi estudada dos 22 aos 46 meses após a sua última aplicação. Com a solução do solo foi possível, por meio da ACP, distinguir as áreas em função da adubação aplicada. Após quatro anos da interrupção das aplicações sucessivas de lodo de esgoto, não verificou-se concentração apreciável de metais na solução do solo, embora ainda seja possível identificar traços da mineralização do resíduo. As variáveis pH, Mn2+, COD, SO4(2-), NO3- e NH4+ na solução do solo podem ser utilizadas no monitoramento de áreas tratadas com lodo de esgoto.

Design, data management, and population baseline characteristics of the PERFORM magnetic resonance imaging project.

Quantitative information from magnetic resonance imaging (MRI) may substantiate clinical findings and provide additional insight into the mechanism of clinical interventions in therapeutic stroke trials. The PERFORM study is exploring the efficacy of terutroban versus aspirin for secondary prevention in patients with a history of ischemic stroke. We report on the design of an exploratory longitudinal MRI follow-up study that was performed in a subgroup of the PERFORM trial. An international multi-centre longitudinal follow-up MRI study was designed for different MR systems employing safety and efficacy readouts: new T2 lesions, new DWI lesions, whole brain volume change, hippocampal volume change, changes in tissue microstructure as depicted by mean diffusivity and fractional anisotropy, vessel patency on MR angiography, and the presence of and development of new microbleeds. A total of 1,056 patients (men and women ≥ 55 years) were included. The data analysis included 3D reformation, image registration of different contrasts, tissue segmentation, and automated lesion detection. This large international multi-centre study demonstrates how new MRI readouts can be used to provide key information on the evolution of cerebral tissue lesions and within the macrovasculature after atherothrombotic stroke in a large sample of patients.

Bolsa Família e políticas pública universalizantes: o caso de um município paulista

O artigo apresenta resultados de pesquisa realizada junto ao Cadastro Único do Governo Federal, que reúne informações socioeconômicas das famílias atendidas pelo programa Bolsa Família em Campinas (SP). As informações contidas no cadastro permitiram detectar os arranjos familiares que se encontram em situação de maior vulnerabilidade em termos econômicos. O estudo mostrou também a importância da conjugação do Bolsa Família com outras políticas públicas de caráter universalizante como forma de contribuir para que famílias mais pobres saiam da situação de vulnerabilidade em que muitas delas se encontram.

Hepatic hemangiomas: Factors associated with T2 shine-through effect on diffusion-weighted MR sequences.

PURPOSE: To determine the frequency and factors associated with the presence of T2 shine-through effect in hepatic hemangiomas on diffusion-weighted (DW) magnetic resonance (MR) sequences. MATERIALS AND METHODS: This retrospective study was approved by institutional review board with waiver of informed consent. One hundred forty-nine consecutive patients with 388 hepatic hemangiomas who underwent a liver MR between January 2010 and November 2011 were included. MR analysis evaluated the lesion characteristics (signal intensities and enhancement patterns (classical, rapidly filling, delayed filling)), the presence of T2 shine-through effect on DW sequences (b values of 0, 150, and 600s/mm(2)), and apparent diffusion coefficient (ADC) values. Multivariate analysis was performed to study the factors associated with the T2 shine-through effect. RESULTS: T2 shine-through effect was observed in 204/388 (52.6%) of hepatic hemangiomas and in 100 (67.1%) patients. Mean ADC value of hemangiomas with T2 shine-through effect was significantly lower than hemangiomas without (2.0±0.48 vs 2.38±0.45, P<.0001). On multivariate analysis, high signal intensity on fat-suppressed T2-weighted fast spin-echo images, hemangiomas with classical or delayed enhancement, and the ADC of the liver were the only significant factors associated with T2 shine-through effect. CONCLUSION: T2 shine-through effect is commonly observed in hepatic hemangiomas and is related to hemangiomas characteristics. Radiologists should be aware of this phenomenon which could lead to misdiagnosis. Its presence should not question the diagnosis of hemangiomas when typical MR findings are found.

A.A.V.V.: Montbarbat (1978-1986), Lloret de Mar, 1996

Debe reconocerse que en estos años próximos al fin del milenio la publicación de estudios sobre el mundo ibérico goza de excelente salud, cuando menos en volumen. Artículos, ponencias y comunicaciones amenazan con abrumar al lector más impenitente. Por ello resulta aleccionador acudir al meritorio trabajo de Fernando Quesada: "La cultura ibérica: una aproximación bibliográfica (1992-1993)", RE/b, 1, 1994, 335-377, que reúne la producción en revistas y series no excesivamente locales -imposibles de controlar, por otro lado-, y comprobar un balance de unos doscientos títulos anuales. Ahora bien, si consideramos el número de monografías, nos situaremos en un plano selectivo, que rondará la docena al año. Diversos factores -y entre ellos la desidia de diferentes niveles administrativos y académicos- parecen confabularse para que no se disponga de un conjunto de memorias impresas proporcional al volumen de excavaciones realizadas en las dos últimas décadas.

O IMPACTO DO MERCOSUL SOBRE A EDITORAÇÃO NO BRASIL

O Mercosul, o mercado comum que reúne Argentina, Brasil, Paraguai e Uruguai, está se consolidando rapidamente em nível comercial. O possível impacto do Mercosul sobre a indústria da editoração é discutido e fatores de relevância para bibliotecas e sistemas informacionais são examinados. Materiais que promovem a expressão cultural devem circular livremente entre os quatro países, desde que os direitos de propriedade intelectual forem respeitados. O Brasil precisa promover sua própria produção literária, musical e cinematográfica e, ao mesmo tempo, dar maior atenção à cultura dos seus parceiros no novo bloco econômico.