Do anti-retroviral treatments encourage individuals to get tested for HIV/AIDS in Sub-Saharan Africa?

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics

Venomous and poisonous arthropods: identification, clinical manifestations of envenomation, and treatments used in human injuries

Abstract This review presents the main species of venomous and poisonous arthropods, with commentary on the clinical manifestations provoked by the toxins and therapeutic measures used to treat human envenomations. The groups of arthopods discussed include the class Arachnida (spiders and scorpions, which are responsible for many injuries reported worldwide, including Brazil); the subphylum Myriapoda, with the classes Chilopoda and Diplopoda (centipedes and millipedes); and the subphylum Hexapoda, with the class Insecta and the orders Coleoptera (beetles), Hemiptera (stink bugs, giant water bugs, and cicadas), Hymenoptera (ants, wasps, and bees), and Lepidoptera (butterflies and moths).

Effect of chemical and plasma DBD treatments on pseudostem plantain fiber properties

Las fibras del seudotallo de plátano (FSP) fueron modificadas mediante epiclorhidrina (EP), anhídrido acético (AA), y su combinación (AA_EP), y con plasma a tres descargas de barrera dieléctrica (DBD) 1, 3 y 6 kW min m-2. Las FSP tratadas y sin tratar fueron caracterizadas mediante espectroscopia infrarroja por la transformada de Fourier (FT-IR), termogravimetría (TGA), microscopía electrónica de barrido (SEM) y pruebas mecánicas de tensión y de humectabilidad. Los espectros FT-IR, las micrografías SEM, y el análisis TGA indicaron pérdidas de lignina, hemicelulosa, impurezas y ceras. Estos efectos en conjunto con las reacciones de grupos OH y -C-C-, con los tratamientos químicos y de plasma respectivamente, incrementaron la hidrofobicidad de las FSP tratadas. Los tratamientos químicos produjeron reacciones de esterificación, eterificación y entrecruzamiento de los grupos OH libres en las FSP, lo que hizo que mostraran mayor rigidez que las expuestas al plasma. Las micrografías SEM mostraron que las FSP expuestas al plasma quedaron con superficie más irregular y rugosa que la de las FSP tratadas químicamente. La humectabilidad de las fibras, medida mediante pruebas de ángulo de contacto, se redujo como consecuencia de ambos tratamientos, característica importante para un relleno en los materiales compuestos.

The mediator role of psychological morbidity in patients with chronic low back pain in differentiated treatments

This study analyzed the mediating role of psychological morbidity and the variables that discriminated low versus high disability, in patients receiving physiotherapy and acupuncture. A total of 203 patients answered measures of illness and medication representations, coping, depression, anxiety, quality of life, and functional disability. Morbidity was a mediator between functional disability and quality of life. Treatment consequences and quality of life, in the acupuncture group, and emotional representations, quality of life, depression, anxiety, and active strategies for pain relief, in the physiotherapy group, discriminated patients with low versus high disability. These results have important implications for identifying high-risk patients.

Enzymatic treatments to improve mechanical properties and surface hydrophobicity of jute fiber membranes

Fiber membranes prepared from jute fragments can be valuable, low cost, and renewable. They have broad application prospects in packing bags, geotextiles, filters, and composite reinforcements. Traditionally, chemical adhesives have been used to improve the properties of jute fiber membranes. A series of new laccase, laccase/mediator systems, and multi-enzyme synergisms were attempted. After the laccase treatment of jute fragments, the mechanical properties and surface hydrophobicity of the produced fiber membranes increased because of the cross-coupling of lignins with ether bonds mediated by laccase. The optimum conditions were a buffer pH of 4.5 and an incubation temperature of 60 °C with 0.92 U/mL laccase for 3 h. Laccase/guaiacol and laccase/alkali lignin treatments resulted in remarkable increases in the mechanical properties; in contrast, the laccase/2,2-azino-bis-(3-ethylthiazoline-6-sulfonate) (ABTS) and laccase/2,6-dimethoxyphenol treatments led to a decrease. The laccase/ guaiacol system was favorable to the surface hydrophobicity of jute fiber membranes. However, the laccase/alkali lignin system had the opposite effect. Xylanase/laccase and cellulase/laccase combined treatments were able to enhance both the mechanical properties and the surface hydrophobicity of jute fiber membranes. Among these, cellulase/laccase treatment performed better; compared to mechanical properties, the surface hydrophobicity of the jute fiber membranes showed only a slight increase after the enzymatic multi-step processes.

Analytical evaluation of fining treatments for white wines contaminated by Ochratoxin A

Mycotoxins are toxic secondary metabolites produced by certain molds. Ochratoxin A (OTA) is one of the most relevant. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L--phenylalanine via an amide bond. OTA in wine is a risk to consumer health [1]. According to the Regulation No. 123/2005 of the European Commission, the maximum limit for OTA in wine is 2 µg/kg [2]. Then, it is important to control its occurrence. So, the aim of this work was to know the effect of different fining agents on OTA removal from white wine.

Impacto de las prácticas agrícolas en los recursos hídricos de la provincia de Córdoba: aislamiento y caracterización de bacterias degradadoras de pesticidas para su utilización en procesos de biorremediación. Impact of agricultural activities on aquatic environments of Córdoba: isolation and characterization of bacteria with pesticide removal capacities for bioremediation treatments.

Los sistemas de agua dulce constituyen fuentes vitales para el desarrollo de la vida. Entre otras causas, el excesivo y poco controlado uso de pesticidas por las prácticas agrícolas modernas ha contribuido con la degradación de estos ecosistemas en la provincia de Córdoba (Secretaría de Ambiente, 2008). Los pesticidas son compuestos tóxicos y químicamente estables en el ambiente. Diversas especies microbianas presentan la capacidad para mineralizar dichos compuestos, siendo uno de los mecanismos de descomposición más importante. En el presente trabajo se pretende (1) Detectar y cuantificar principios activos de pesticidas en diferentes aguas ambientales de la región centro-sur de la provincia de Córdoba; (2) Aislar y caracterizar especies bacterianas a partir de muestras de aguas superficiales y subterráneas de la región que demuestren ser eficientes en la biodegradación de diferentes pesticidas. Para ello, se estudiará la presencia de 10 pesticidas organoclorados y organofosforados (lindano, 2,4D, DDT, p,p-DDE, �-endosulfán, �-endosulfán, clorpirifós, dimetoato) y herbicidas (atrazina) en muestras de agua superficiales y subterráneas (8 - 12m de profundidad) de la región agrícola centro-sur de Córdoba. Se establecerán diferentes puntos de muestreo en las principales cuencas hidrográficas: Río Tercero y Embalse de Río Tercero, Canal Desviador de Bell Ville, Laguna La Salada, Río Saladillo, Río Carcarañá y Río Cuarto. La determinación de pesticidas se realizará mediante Cromatografía de Gases (GC). Conjuntamente, se realizará el aislamiento de microorganismos a partir de las muestras de agua suplementadas con diferentes concentraciones de pesticidas (López et al., 2005) y se procederá a la caracterización morfológica y bioquímica (Lechevalier, 1989). Se realizarán curvas de crecimiento (DO600) y se determinará la viabilidad celular mediante el método de recuento en placa. El potencial catabólico de cada aislamiento se determinará analizando la concentración residual de pesticidas en el sobrenadante de los cultivos (Benimeli et al, 2003) y mediante ensayos de resting-cell (Hernández et al, 2008). Finalmente se realizará la caracterización genética (Weisburg, 1991) de los aislamientos que demuestren una mayor eficiencia en la biodegradación de pesticidas. El presente estudio pretende abordar una temática prioritaria como es la contaminación ambiental de ecosistemas acuáticos de la provincia de Córdoba. la detección de principios activos de pesticidas sería, por lo tanto, un indicador de contaminación de origen antropológica y brindaría información respecto al deterioro de la calidad del agua. Por otra parte, el aislamiento de bacterias adaptadas a las condiciones ecológicas de la región y capaces de metabolizar eficientemente diferentes pesticidas como fuentes de carbono y energía sería beneficioso para su utilización en futuros ensayos de biorremediación.

Impact of disease and treatments on growth and puberty of pediatric patients with inflammatory bowel disease.

Growth retardation, associated with delayed puberty, is a frequent feature in pediatric patients with inflammatory bowel disease (IBD), especially with Crohn's disease. It is mainly induced by malnutrition and the effects of the inflammatory process on the growth hormone/insulin-like growth factor-1 axis or on the growth plate. Therefore, control of disease activity and mucosal healing are paramount to promote growth and adequate pubertal onset. Current therapeutic strategies for maintenance in IBD include anti-inflammatory drugs, immunosuppressives, and, more recently, biologic agents. Although these treatments are efficient in minimizing inflammation and inducing prolonged remission, their long-term effects on growth and final height remain controversial. Furthermore, glucocorticoid therapy, even though very efficient in inducing remission, clearly shows deleterious effects on growth, which is not the case for exclusive enteral nutrition showing comparable results regarding induction of remission. Thus regular assessment of weight, height and pubertal stage is essential in children and adolescents with chronic disease, namely IBD.

Demyelination as a complication of new immunomodulatory treatments.

Purpose of review: This review discusses demyelinating events of the nervous system that have been associated with new immunomodulatory treatments, in particular monoclonal antibodies (mAbs). Recent findings: Natalizumab, a mAb targeting the alpha-4 integrins, which is efficient in relapsing-remitting multiple sclerosis, has been associated with progressive multifocal leukoencephalopathy (PML). We will review the putative mechanisms linking natalizumab with JC virus, the agent of PML. Efalizumab, a mAb targeting a member of the integrin family, CD11a, was approved for the treatment of psoriasis, but had to be withdrawn in 2009 because of the occurrence of three cases of PML. Rituximab, an anti-CD20 mAb, is used in different neoplastic and autoimmune diseases and may soon enter the pharmacopeia of multiple sclerosis. It has been suggested that rituximab is a risk factor for PML; however, evidence of such a link is unclear. Antitumor necrosis factor-alpha agents are used in several autoimmune diseases. Several cases of demyelinating events of the nervous system have been reported, prompting a heightened surveillance of treated patients. Recent data are reassuring, suggesting that the incidence of such events is relatively low. Summary: Neurologists must become familiar with neurological complications of new immunomodulatory treatments, a field situated at the interface of neurology, immunology and infection.

The effectiveness and safety of rescue treatments in 108 patients with steroid-refractory ulcerative colitis with sequential rescue therapies in a subgroup of patients.

BACKGROUND: Among patients with steroid-refractory ulcerative colitis (UC) in whom a first rescue therapy has failed, a second line salvage treatment can be considered to avoid colectomy. AIM: To evaluate the efficacy and safety of second or third line rescue therapy over a one-year period. METHODS: Response to single or sequential rescue treatments with infliximab (5mg/kg intravenously (iv) at week 0, 2, 6 and then every 8weeks), ciclosporin (iv 2mg/kg/daily and then oral 5mg/kg/daily) or tacrolimus (0.05mg/kg divided in 2 doses) in steroid-refractory moderate to severe UC patients from 7 Swiss and 1 Serbian tertiary IBD centers was retrospectively studied. The primary endpoint was the one year colectomy rate. RESULTS: 60% of patients responded to the first rescue therapy, 10% went to colectomy and 30% non-responders were switched to a 2(nd) line rescue treatment. 66% of patients responded to the 2(nd) line treatment whereas 34% failed, of which 15% went to colectomy and 19% received a 3(rd) line rescue treatment. Among those, 50% patients went to colectomy. Overall colectomy rate of the whole cohort was 18%. Steroid-free remission rate was 39%. The adverse event rates were 33%, 37.5% and 30% for the first, second and third line treatment respectively. CONCLUSION: Our data show that medical intervention even with 2(nd) and 3(rd) rescue treatments decreased colectomy frequency within one year of follow up. A longer follow-up will be necessary to investigate whether sequential therapy will only postpone colectomy and what percentage of patients will remain in long-term remission.

Schistosomiasis mansoni in three localities of western lowland of the state of Maranhão before and after mass treatments

A cross-sectional study for schistosomiasis was carried out in the localities of Aliança, Alegre and Coroatá (districts of Cururupu, São Bento and São João Batista, respectively) in the lowland of the state of Maranhão, after respectively 13, 11 and 4 mass treatments with oxamniquine in the period of ten years (1977-1987). The study included clinical and quantitative fecal examination, skin test for Shistosoma mansoni infection, evaluation of man-water contact of the total population (829 persons) in the three localities and other epidemiological investigations such as infection rate and dynamics of the snail population. After 13 mass treatments in Aliança, the prevalence of S. mansoni infection was reduced from 57.9% to 7.4%. In Coroatá with 11 mass treatments the prevalence fell from 69.2% to 12.8% and in Alegre, with only 4 mass treatments there was pratically no reduction in prevalence: 22.9% to 21%. After mass treatments the type II hepatointestinal clinical form was 10.8% in Aliança, 17.9% in Alegre and 18% in Coroatá. The hepatosplenic (type III) form was not seen in Aliança and Coroatá but unexplanably it was 7.6% in Alegre. There was no correlation between the egg load elimination and the clinical forms.

Control of schistosomiasis mansoni in ravena (Sabará, State of Minas Gerais, Brazil) through Water supply and quadrennial treatments

In this study, the results obtained in a control programme of schistosomiasis in Ravena (Sabará, Minas Gerais) between 1980 and 1992 are evaluated. Control measures used in this programme were: specific treatment of the people infected with Schistosoma mansoni at four year-intervals (1980/84/88) and the supply of tap water to 90% of the residences in 1980. A significant reduction of the prevalence (36.7% to 11.5%, p < 0.05) and of the intensity of the infection (228.9 eggs per gram of feces (epg), s = 3.7 to 60.3 epg, s = 3.5, p < 0.05) was observed. No cases of the severe form of the disease were diagnosed in the area. Factors independently associated with the infection were in 1980 daily sand extraction and the lack of tap water in residences and in 1992 daily sand extraction and fishing and weekly swimming. Concluding, the supply of tap water together with quadrennial treatments significantly diminished both the prevalence and intensity of the S. mansoni infection, with the additional gain of persistent low indices even after four-year intervals between the treatments.