Comparison of the fluorescent polarization (TDx) and the enzymatic competitive (EMIT 2000) immune assays for the measurement of cyclosporin A blood concentration

Evaluation of Cyclosporin A (CyA) blood concentration is imperative in solid organ transplantation in order to achieve maximal immunosuppression with the least side effects. We compared the results of whole blood concentrations of CyA in 50 blood samples simultaneously evaluated by the fluorescent polarization immune assay (TDx) and the enzymatic competitive immune assay (EMIT 2000). There was a strong correlation between both kits for any range of CyA blood concentration (R=0.99, p<0.001). The within-run and between-days coefficient of variation were less than 4% for both assays. The cost for each CyA measurement was 50% lower for the EMIT assay when compared to the TDx assay. We concluded that the EMIT is as accurate as the TDx in measuring CyA blood concentration and has the advantage of a lower cost, as well as the possibility of widespread access to the EMIT methodology in contrast to the TDx equipment, allowing the laboratory to perform several routines within a working day.

Persistent asthma in adults: comparison of high resolution computed tomography of the lungs after one year of follow-up

OBJECTIVE: The aims of this study were to evaluate the role of high resolution computed tomography of the torax in detecting abnormalities in chronic asthmatic patients and to determine the behavior of these lesions after at least one year. METHOD: Fourteen persistent asthmatic patients with a mean forced expiratory volume in 1-second that was 63% of predicted and a mean forced expiratory volume in 1-second /forced vital capacity of 60% had two high resolution computed tomographys separated by an interval of at least one year. RESULTS: All 14 patients had abnormalities on both scans. The most common abnormality was bronchial wall thickening, which was present in all patients on both computed tomographys. Bronchiectasis was suggested on the first computed tomography in 5 of the 14 (36%) patients, but on follow-up, the bronchial dilatation had disappeared in 2 and diminished in a third. Only one patient had any emphysematous changes; a minimal persistent area of paraseptal emphysema was present on both scans. In 3 patients, a "mosaic" appearance was observed on the first scan, and this persisted on the follow-up computed tomography. Two patients had persistent areas of mucoid impaction. In a third patient, mucus plugging was detected only on the second computed tomography. CONCLUSIONS: We conclude that there are many abnormalities on the high resolution computed tomography of patients with persistent asthma. Changes suggestive of bronchiectasis, namely bronchial dilatation, frequently resolve spontaneously. Therefore, the diagnosis of bronchiectasis by high resolution computed tomography in asthmatic patients must be made with caution, since bronchial dilatation can be reversible or can represent false dilatation. Nonsmoking chronic asthmatic subjects in this study had no evidence of centrilobular or panacinar emphysema.

Vancomycin monitoring in term newborns: comparison of peak and trough serum concentrations determined by high performance liquid chromatography and fluorescence polarization immunoassay

INTRODUCTION: Peak and trough serum concentrations of vancomycin were determined in term newborn infants with confirmed or suspected Staphylococcus sp sepsis by high performance liquid chromatography and flourescence polarization immunoassay. OBJECTIVE: To statistically compare the results of the high performance liquid chromatography and flourescence polarization immunoassay techniques for measuring serum vancomycin concentrations. METHODS: Eighteen peak and 20 trough serum samples were assayed for vancomycin concentrations using high performance liquid chromatography and flourescence polarization immunoassay from October 1995 to October 1997. RESULTS: The linear correlation coefficients for high performance liquid chromatography and flourescence polarization immunoassay were 0.27 (peak, P = 0.110) and 0.26 (trough, P = 0.1045) respectively, which were not statistically significant. CONCLUSION: There was wide variation in serum vancomycin concentrations determined by high performance liquid chromatography as compared with those determined by flourescence polarization immunoassay. There was no recognizable pattern in the variability; in an apparently random fashion, the high performance liquid chromatography measurement was sometimes substantially higher than the flourescence polarization immunoassay measurement, and at other times it was substantially lower.

Histological comparison of the alar nasal cartilages in unilateral cleft lip

Patients with unilateral cleft lip display characteristic nasal changes that are independent of the degree of deformity. Defenders of the intrinsic theory consider these deformities to be due to embryogenic alterations of the alar nasal cartilages. Those that propose the extrinsic theory defend the thesis that the deformity is due to disorganization of the perioral muscles deformed by the cleft. The purpose of this study is to contribute histological evidence to help clarify the issue. PATIENTS AND METHODS: Specimens of the lateral portion of both the healthy and the cleft side of the alar cartilages were obtained from 18 patients. These uniformly cut specimens were stained by hematoxylin and eosin. Samples from 2 patients were excluded due to imperfections. The same pathologist examined all the slides. He was unaware of the origins of the specimens; he counted the number of chondrocytes and quantified the cartilage matrixes. RESULTS: All data was analyzed statistically, and no significant statistical differences were apparent, either in the number of chondrocytes or the cartilage matrix between the healthy side and the cleft side. DISCUSSION: These results apparently support the group that defend the extrinsic theory; nevertheless, the doubt about the composition of the cartilage matrix remains, not only concerning the glycosaminoglycans that compose them, but also regarding elastin and collagen and its linkages that can cause different degrees of collagen consistency.

Comparison of catheter-related infection risk in two different long-term venous devices in adult hematology-oncology patients

PURPOSE: Infection is the leading complication of long-term central venous catheters, and its incidence may vary according to catheter type. The objective of this study was to compare the frequency and probability of infection between two types of long-term intravenous devices. METHODS: Retrospective study in 96 onco-hematology patients with partially implanted catheters (n = 55) or completely implanted ones (n = 42). Demographic data and catheter care were similar in both groups. Infection incidence and infection-free survival were used for the comparison of the two devices. RESULTS: In a median follow-up time of 210 days, the catheter-related infection incidence was 0.2102/100 catheter-days for the partially implanted devices and 0.0045/100 catheter-days for the completely implanted devices; the infection incidence rate was 46.7 (CI 95% = 6.2 to 348.8). The 1-year first infection-free survival ratio was 45% versus 97%, and the 1-year removal due to infection-free survival ratio was 42% versus 97% for partially and totally implanted catheters, respectively (P <.001 for both comparisons). CONCLUSION: In the present study, the infection risk was lower in completely implanted devices than in partially implanted ones.

Impacto da crise no volume e perfil de internamento de doentes com VIH-SIDA em Portugal Continental : análise temporal 2001-2012

RESUMO - Contexto: O início da crise económica em Portugal no ano de 2009 colocou o país numa grave recessão económica aliada a diversas medidas de austeridade. Como consequência assistiu-se, ao nível nacional, uma diminuição do PIB, aumento do desemprego e assim como uma série de restrições orçamentais em várias áreas, nomeadamente a da saúde. Apesar de existir inúmeros estudos que avaliaram o impacto das recessões económicas na saúde os resultados são controversos e não existe um consenso quanto a esta associação. No que se refere às doenças infeciosas o número de estudos é bastante mais reduzido. O objetivo deste estudo foi o de analisar o impacto da crise atual no volume e perfil de internamento de doentes com VIH/SIDA, de forma a complementar a escassa evidência existente neste domínio. Metodologia: Foram analisados 53,296 episódios de internamento nos hospitais do SNS entre o ano de 2001 e 2012, cujo diagnóstico principal é a infeção pelo VIH/SIDA. Considerou-se o ano de 2009 como o ano inicial da crise. Através de regressões multivariadas avaliou-se o impacto da crise no volume de doentes internados, duração de internamento, número de co-morbilidades, risco de ser admitido via urgência e risco de mortalidade no internamento. Adicionalmente repetiu-se a análise por região NUTS II de Portugal Continental (Norte, Alentejo, LVT, Centro e Algarve). Resultados: A crise não teve impacto no volume de doentes internados. No entanto, após o ano de 2009, registou-se uma diminuição de 5.6% na duração de internamento; um aumento de 1.6% no número de co-morbilidades; um aumento de 11.1% no risco de ser admitido via urgência e um aumento de 8.6% do risco de mortalidade no internamento. As análises por região permitiram verificar que as regiões mais afetadas pela crise foram a região LVT e a região Norte. Conclusão: A crise em Portugal não teve impacto na incidência de internamentos por VIH/SIDA. Porém o aumento do número de co-morbilidades, do risco de ser admitido via urgência e do risco de mortalidade no internamento parece refletir um agravamento da severidade dos casos após o ano de 2009. Adicionalmente a diminuição da duração de internamento com o efeito da crise poderá refletir tanto aumento da eficiência dos cuidados prestados ou ao contrário, uma diminuição da sua qualidade.

Variação temporal da protoporfirina-zinco PPZ em trabalhadores expostos a chumbo

RESUMO - O doseamento da protoporfirina-zinco (PPZ) vem sendo preconizado como indicador a utilizar em primeira linha nos programas de monitorização biológica da exposição profissional a chumbo. A PPZ apresenta um elevado grau de associação com a plumbemia e representa, num dado momento, o efeito metabólico do chumbo sobre a ferro- -quelatase (enzima catalisadora da incorporação do ferro na protoporfirina IX) ao longo dos anteriores cerca de três meses. Num estudo incidindo sobre 67 trabalhadores expostos a chumbo, do sexo masculino, os autores avaliaram a variação da PPZ em relação à plumbemia determinada num determinado momento (t0) e em sucessivos doseamentos efectuados cerca de 30 (t1), 60 (t2) e 90 (t3) dias após esse momento. Da análise dos resultados obtidos conclui-se que em trabalhadores expostos a chumbo de modo considerado estável (com níveis de Pb-S entre 30 e 78 μg/dL) a PPZ não variou significativamente ao longo do período de tempo considerado. Deste modo, parece poder concluir-se que os resultados de PPZ são representativos do nível de exposição (inferida pelos níveis de dose interna) pelo menos em relação ao período de cerca de três meses anteriores, correspondendo à resposta orgânica consequente à dose em causa.

Análise comparativa da designação, definição e classificação de resíduos hospitalares em legislações da União Europeia

RESUMO - O quadro legislativo de um país, no que concerne aos resíduos hospitalares (RH), contém a sua designação, definição e classificação. É essa a matriz de referência para a separação efectuada na origem e todo o circuito que, a partir desse momento, um determinado resíduo toma até ao seu tratamento. Assim, faz-se o estudo comparativo das definições e tipos de classificação de RH em quatro países da União Europeia: Alemanha, Reino Unido, Espanha (Região Autónoma da Catalunha) e Portugal. Reconhecem-se as diferentes designações deste tipo de resíduos e discute-se o seu significado e as suas implicações na percepção de risco por parte dos profissionais e do público. Identificam-se duas estratégias subjacentes à elaboração das definições: a contaminação de materiais com microrganismos patogénicos bem definidos, as suas fontes e as actividades que os produzem. Apresentam-se as classificações de RH propostas pelos organismos internacionais de referência e analisa-se comparativamente a evolução do enquadramento legal português e da Região Autónoma da Catalunha, evidenciando-se a variabilidade temporal e justificando-se a necessidade de se efectuar o estudo da variabilidade geográfica. Utilizam-se três critérios para a análise das classificações consideradas: a concordância definição-classificação, o número e tipo de grupos das classificações e os tipos de resíduos por grupos. Identificam-se os denominadores comuns às classificações analisadas, assim como as suas principais diferenças. Conclui-se que a definição de RH adoptada por cada país condiciona o tipo de classificação de RH nesse mesmo país. Verifica-se ainda que a inexistência de critérios claros de avaliação da contaminação pode dificultar a tarefa da triagem dos RH por parte dos profissionais de saúde.

Variação espacial e temporal da irradiância solar e da razão entre vermelho e vermelho - extremo que chegam ao solo em diferentes microhabitats na região de Tucuruí - PA

RESUMOEste trabalho visa preliminarmente estudar a irradiância total entre 300 e 1100 nm, assim como a razão vermelho-vermelho extremo que chegam ao solo de um trecho de floresta primária e de uma clareira. As áreas selecionadas estão localizadas numa região próxima a cidade de Tucurui, Estado do Pará, Brasil.

A comparison analysis of the marketing strategy of Lufthansa and Emirates in Germany

The objective of this paper is to perform an analysis of the marketing strategy of Lufthansa and Emirates in Germany. Since both airlines use a similar approach to increase brand awareness an in-depth analysis is implemented in order to identify potential differences. Hereby, consumer insights about the perception and expectation travellers have in common will be analyzed and assessed with quantitative data. Both airlines are well positioned in terms of their marketing strategy, but when Emirates is strengthen its marketing campaign with that pace, the Gulf carrier will certainly make use of its economic strength and can become a frightening threat for the Lufthansa Group on long-haul destinations. Finally, recommendations for future marketing activities for both airlines will be given.

Mapping the Pasture Steppe in Bayankhongor, Mongolia: comparison of classification methods, using Landsat-8 and geophysical data

Grasslands in semi-arid regions, like Mongolian steppes, are facing desertification and degradation processes, due to climate change. Mongolia’s main economic activity consists on an extensive livestock production and, therefore, it is a concerning matter for the decision makers. Remote sensing and Geographic Information Systems provide the tools for advanced ecosystem management and have been widely used for monitoring and management of pasture resources. This study investigates which is the higher thematic detail that is possible to achieve through remote sensing, to map the steppe vegetation, using medium resolution earth observation imagery in three districts (soums) of Mongolia: Dzag, Buutsagaan and Khureemaral. After considering different thematic levels of detail for classifying the steppe vegetation, the existent pasture types within the steppe were chosen to be mapped. In order to investigate which combination of data sets yields the best results and which classification algorithm is more suitable for incorporating these data sets, a comparison between different classification methods were tested for the study area. Sixteen classifications were performed using different combinations of estimators, Landsat-8 (spectral bands and Landsat-8 NDVI-derived) and geophysical data (elevation, mean annual precipitation and mean annual temperature) using two classification algorithms, maximum likelihood and decision tree. Results showed that the best performing model was the one that incorporated Landsat-8 bands with mean annual precipitation and mean annual temperature (Model 13), using the decision tree. For maximum likelihood, the model that incorporated Landsat-8 bands with mean annual precipitation (Model 5) and the one that incorporated Landsat-8 bands with mean annual precipitation and mean annual temperature (Model 13), achieved the higher accuracies for this algorithm. The decision tree models consistently outperformed the maximum likelihood ones.

Previsão da estrutura temporal da taxa de juro na zona Euro : aproximação paramétrica e por métodos de aprendizagem automática

A estrutura temporal das taxas de juro, também conhecida por yield curve ou curva de rendimentos define a relação entre as taxas de juros e o prazo de vencimento (ou maturidades) dos investimentos feitos. Assim, o desenvolvimento de modelos que possibilitem a obtenção de previsões precisas sobre a estrutura temporal das taxas de juro e que permitam estudar a dinâmica da evolução das taxas de juro é de crucial importância em diversas áreas de financiamento. Neste estudo investigou-se a performance de diferentes métodos de previsão para obter a estrutura temporal das taxas de juro da Zona Euro, considerando o período entre 2009 e 2015. Em termos mais específicos, foi analisada a capacidade preditiva do modelo de Nelson-Siegel & Svensson assumindo que os parâmetros resultantes da estimação da especificação paramétrica podem ser modelizados através de métodos de séries temporais univariados (modelos ARIMA, Random walk) e multivariados (modelos VAR) e Redes Neuronais Artificiais (RNA) individuais e conjuntas. Os resultados deste estudo mostram que (i) as RNA com a previsão dos parâmetros em simultâneo exibem os valores de erro mais baixos para as maturidades de curto e médio prazo (3 meses a 5 anos); (ii) As RNAs individuais são melhores para prever as taxas de juro nas maturidades compreendidas entre os 7 e os 10 anos, e que (iii) para as maturidades de longo e muito longo prazo (15 e 30 anos respetivamente) deverá ser escolhido o modelo VAR(1). Estes resultados são robustos e consistentes para todos os horizontes de previsão analisados (1,2 e 3 meses). Contudo, no período analisado nenhum dos modelos testados apresenta valores de erro inferiores aos obtidos com o modelo Random Walk.

Spatial and temporal distribution of a tiger beetle guild (Coleoptera: Carabidae: Cicindelinae) along a 105m long transect in the reserva florestal A. Ducke near Manaus (Central Amazonia)

The spatial and temporal distribution of a guild of eight diurnal tiger beetle species was studied on a 105 m long transect near the field station of the Reserva Florestal A. Ducke near Manaus (AM), Brazil. The transect followed a path that included both shaded and an open areas. Five of the species, restricted to primary forest, occurrred only in shaded areas of the transect, and three species occurred in open areas. Of all eight species only two of the open habitat species showed no clear seasonality in adult activity. In six species the activity of adults was limited to the rainy season. The most pronounced annual rhythm was found in Pentacomia ventralis, an open habitat species. Activity of adults was limited to October/November. First in-star larvae appeared shortly thereafter. Larval development mainly took place from January to May. The third instar larva entered a dormancy which lasted up to 10 months, and which enabled the synchronisation of emerging adults with annual seasons.

Comprehensive comparison of a current-source and a voltage-source converter for three-phase EV fast battery chargers

This paper presents a comprehensive comparison of a current-source converter and a voltage-source converter for three-phase electric vehicle (EV) fast battery chargers. Taking into account that the current-source converter (CSC) is a natural buck-type converter, the output voltage can assume a wide range of values, which varies between zero and the maximum instantaneous value of the power grid phase-to-phase voltage. On the other hand, taking into account that the voltage-source converter (VSC) is a natural boost-type converter, the output voltage is always greater than the maximum instantaneous value of the power grid phase-to-phase voltage, and consequently, it is necessary to use a dc-dc buck-type converter for applications as EV fast battery chargers. Along the paper is described in detail the principle of operation of both the CSC and the VSC for EV fast chargers, as well as the main equations of the power theory and current control strategies. The comparison between both converters is mainly established in terms of the total harmonic distortion of the grid current and the estimated efficiency for a range of operation between 10 kW and 50 kW.

Leaf herbivory on three tree species in a monodominant and two other Terra firme forests on Maracá Island, Brazil

The aim of this study was to test the hypothesis that the monodominant non-pioneer Peltogyne gracilipes, typically does not suffer density-dependent herbivory (Janzen-Connell model). Two components of intraspecific variation in leaf herbivory were measured: 1) the variation between individuals in the population at the same time and 2) the temporal variation in rates of damage to each individual. The study was carried out on Maracá Island, Roraima, Brazil in three plots (50 m χ 50 m) in each of three forest types: Peltogyne-rich forest (PRF), Peltogyne-poor forest (PPF), and forest without Peltogyne (FWP). Two other non-pioneer species (Ecclinusa guianensis and Pradosia surinamensis) were chosen for comparison because they were fairly abundant and their seedlings could be readily identified. The values of leaf area removed by herbivores of trees and seedlings of the three study species were in the range reported for other tropical tree species (2-16%, standing damage). There were no differences within species between forests. However, there was a significant difference among species but this was not correlated with seedling density. Peltogyne seedlings showed no evidence of density-dependent herbivory as predicted by the Janzen-Connell model despite the fact that adult trees were observed to suffer a mass defoliation in April 1992. This result suggests that Peltogyne may be dominant partly due to escape from herbivory in the early stages of its life although it may suffer occasional mass defoliation as an adult.