Molecular fingerprinting methods for the discrimination between C-albicans and C-dubliniensis

Opportunistic fungal pathogens are becoming increasingly important causes of both community-acquired and nosocomial infections. The most important fungal pathogens are yeast species belonging to the genus Candida. These species show differences in levels of resistance to antifungal agents and mortality. Consequently, it is important to correctly identify the causative organism to the species level. Identification of Candida dubliniensis in particular remains problematic because of the high degree of phenotypic similarity between this species and Candida albicans. However, as the differences between both are most pronounced at the genetic level, several studies have been conducted in order to provide a specific and rapid identification fingerprinting molecular test. In most candidal infectious, no single DNA fingerprinting technique has evolved as a dominant method, and each method has its advantages, disadvantages and limitations. Moreover, the current challenge of these techniques is to compile standardized patterns in a database for interlaboratory use and future reference. This review provides an overview of most common molecular fingerprinting techniques currently available for discrimination of C. albicans and C. dubliniensis.

Phenotypic methods and commercial systems for the discrimination between C-albicans and C-dubliniensis

Candida dubliniensis is a recently described Candida species associated with oral candidosis that exhibits a high degree of phenotypic similarity to Candida albicans. However, these species show differences in levels of resistance to antimycotic agents and ability to cause infections. Therefore, accurate clinical identification of C. dubliniensis and C. albicans species is important in order to treat oral candidal infections. Phenotypic identification methods are easy-to-use procedures for routine discrimination of oral isolates in the clinical microbiology laboratory. However, C. dubliniensis may be so far underreported in clinical samples because most currently used identification methods fail to recognize this yeast. Phenotypic methods depend on growth temperature, carbon source assimilation, chlamydospore and hyphal growth production, positive or negative growth on special media and intracellular enzyme production, among others. In this review, some phenotypic methods are presented with a special emphasis on the discrimination of C. dubliniensis and C. albicans.

CD147 overexpression allows an accurate discrimination of bladder cancer patients' prognosis

Background: Urothelial bladder carcinoma (UBC) is a chemo-sensitive tumour, but the response to treatment is heterogeneous. CD 147 has been associated with chemotherapy resistance. We aimed to define tumours with an aggressive phenotype by the combined analysis of clinicopathological and biological parameters.Methods: 77 patients with T1G3 or muscle-invasive UBC treated by radical cystectomy were studied. Immunohistochemistry was performed to detect CD147, heparanase, CD31 (blood vessels identification) and D2-40 (lymphatic vessels identification) expressions. The immunohistochemical reactions were correlated with the clinicopathological and the outcome parameters. 5-year disease-free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. Multivariate analysis was performed by Cox proportional hazards analysis.Results: The 5-year DFS and OS rates were significantly influenced by the classical clinicopathological parameters, and by the occurrence of lymphovascular invasion. CD 147 and heparanase immunoexpression did not affect patients' outcome. However, patients with pT3/pT4 tumours had a median OS time of 14.7 months (95% CI 7.1-22.3, p = 0.003), which was reduced to 9.2 months (95% CI 1.5-17.0, p = 0.008) if the tumours were CD147 positive. We developed a model of tumour aggressiveness using parameters as stage, grade, lymphovascular invasion and CD147 immunoexpression, which separated a low aggressiveness from a high aggressiveness group, remaining as an independent prognostic factor of DFS (HR 3.746; 95% CI 1.244-11.285; p = 0.019) and OS (HR 3.247; 95% CI 1.015-10.388, p = 0.047).Conclusion: CD 147 overexpression, included in a model of UBC aggressiveness, may help surgeons to identify patients who could benefit from a personalized therapeutic regimen. Additional validation is needed. (C) 2011 Elsevier Ltd. All rights reserved.

Surveillance Programme for Healthcare Associated Infections in the State of São Paulo, Brazil. Implementation and the first three years' results

Governmental programmes should be developed to collect and analyse data on healthcare associated infections (HAIs). This study describes the healthcare setting and both the implementation and preliminary results of the Programme for Surveillance of Healthcare Associated Infections in the State of São Paulo (PSHAISP), Brazil, from 2004 to 2006. Characterisation of the healthcare settings was carried out using a national database. The PSHAISP was implemented using components for acute care hospitals (ACH) or long term care facilities (LTCF). The components for surveillance in ACHs were surgical unit, intensive care unit and high risk nursery. The infections included in the surveillance were surgical site infection in clean surgery, pneumonia, urinary tract infection and device-associated bloodstream infections. Regarding the LTCF component, pneumonia, scabies and gastroenteritis in all inpatients were reported. In the first year of the programme there were 457 participating healthcare settings, representing 51.1% of the hospitals registered in the national database. Data obtained in this study are the initial results and have already been used for education in both surveillance and the prevention of HAI. The results of the PSHAISP show that it is feasible to collect data from a large number of hospitals. This will assist the State of São Paulo in assessing the impact of interventions and in resource allocation. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Inequalities in access to education and healthcare

The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce.

Morphological prediction of worker size discrimination and relative abundance of sympartic species of Pseudacteon (Dipt., Phoridae) parasitoids of the fire ant, Solenopsis saevissima (Hym., Formicidae) in Brazil

Patterns of attack for collected species of phorids are predicted using multivariate morphometrics of female Pseudacteon species and worker size distributions of parasitized fire ants, Solenopsis saevissima. The model assumes that there is a direct correlation between phorid size and the size range of the worker ant attacked, and presumes that worker sizes are a resource that is divided by sympatric phorid species to minimize joint parasitism. These results suggest that the community of sympatric Pseudacteon species on only one host species coexists by restricting the size of workers attacked, and secondarily by differing diel patterns of ovipositional activity. When we compared relative abundance of species of Pseudacteon with the size distribution of foragers of S. saevissima, our observed distribution did not differ significantly from our predicted relative abundance of females of Pseudacteon. The activity of Pseudacteon may be a factor determining forager size distributions.

Indicators for monitoring the implementation of the Convention on the Elimination of all Forms of Discrimination against Woman

Includes bibliography

Hacia la igualdad de la mujer: avances legales desde la aprobación de la Convención sobre la Eliminación de Todas las Formas de Discriminación Contra la Mujer = Towards equality for women: progress in legislation since the adoption of the Convention on the Elimination of All Forms of Discrimination Against Women

Incluye Bibliografía

The impact of gender discrimination on poverty in Brazil

Includes bibliography

Advancing gender equality in the Caribbean: legislative approaches to sex discrimination

Includes bibliography

Is price dispersion always an indication of price discrimination?

It has been established for a long time that there is significant dispersion in prices charged for seemingly homogeneous goods. This may happen in competitive markets because the world is not frictionless, and certainly in other markets where price discrimination is carried out by firms with oligopolistic power. This paper is the first survey of the economic literature on price dispersion that addresses the following three key issues: i) its characteristics as a result of optimizing search behavior; ii) its relevance as a reflection of price discrimination and its consequences for social welfare and policy intervention; and iii) the empirical evidence of price dispersion. By contributing to a better understanding of price dispersion, this survey may help in the design and implementation of competition and anti-trust policies

eHealth handbook for managers of healthcare services and systems

Prefacio de Alicia Bárcena y Luciano Sáez

Discrimination of complex visual stimuli in Cebus apella: identity matching with pictures

Do capuchin monkeys respond to photos as icons? Do they discriminate photos of capuchin monkeys' faces? Looking for answers to these questions we trained three capuchin monkeys in simple and conditional discrimination tasks and tested the discriminations when comparison stimuli were partially covered. Three capuchin monkeys experienced in simultaneous simple discrimination and IDMTS were trained with repeated shifts of simple discriminations (RSSD), with four simultaneous choices, and IDMTS (1 s delay, 4 choices) with pictures of known capuchins monkeys' faces. All monkeys did discriminate the pictures in both procedures. Performances in probes with partial masks with one fourth of the stimulus hidden were consistent with baseline level. Errors occurred when a picture similar to the correct one was available among the comparison stimuli, when the covered part was the most distinct, or when pictures displayed the same monkey. Capuchin monkeys do match pictures of capuchin monkeys' faces to the sample. The monkeys treated different pictures of the same monkey as equivalent, suggesting that they respond to the pictures as icons, although this was not true to pictures of other monkeys. Subsequent studies may bring more evidence that capuchin monkeys treat pictures as depictions of real scenes.