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This article discusses the problem of estimation with step stress partially accelerated life tests using Type-II progressively censored samples. The lifetime of items under use condition follows the two-parameters inverted Kumaraswamy distribution. The maximum likelihood estimates for the unknown parameters are computed numerically. Using the property of asymptotic distributions for maximum likelihood estimation, we constructed asymptotic interval estimates. The Bayes procedure is used to calculate estimates of the unknown parameters from symmetrical and asymmetric loss functions. The Bayes estimates cannot be obtained explicitly, therefor the Lindley's approximation and the Markov chain Monte Carlo technique are used to obtaining the Bayes estimates. Furthermore, the highest posterior density credible intervals for the unknown parameters are calculated. An example is presented to illustrate the methods of inference. Finally, a numerical example of March precipitation (in inches) in Minneapolis failure times in the real world is provided to illustrate how the approaches will perform in practice.

The quadratic rank transmutation map is used in this article to suggest a novel extension of the power inverted Topp–Leone distribution. The newly generated distribution is known as the transmuted power inverted Topp–Leone (TPITL) distribution. The power inverted Topp–Leone and the inverted Topp–Leone are included in the recommended distribution as specific models. Aspects of the offered model, including the quantile function, moments and incomplete moments, stochastic ordering, and various uncertainty measures, are all discussed. Plans for acceptance sampling are created for the TPITL model with the assumption that the life test will end at a specific time. The median lifetime of the TPITL distribution with the chosen variables is the truncation time. The smallest sample size is required to obtain the stated life test under a certain consumer's risk. Five conventional estimation techniques, including maximum likelihood, least squares, weighted least squares, maximum product of spacing, and Cramer-von Mises, are used to assess the characteristics of TPITL distribution. A rigorous Monte Carlo simulation study is used to evaluate the effectiveness of these estimators. To determine how well the most recent model handled data modeling, we tested it on a range of datasets. The simulation results demonstrated that, in most cases, the maximum likelihood estimates had the smallest mean squared errors among all other estimates. In some cases, the Cramer-von Mises estimates performed better than others. Finally, we observed that precision measures decrease for all estimation techniques when the sample size increases, indicating that all estimation approaches are consistent. Through two real data analyses, the suggested model's validity and adaptability are contrasted with those of other models, including the power inverted Topp–Leone, log-normal, Weibull, generalized exponential, generalized inverse exponential, inverse Weibull, inverse gamma, and extended inverse exponential distributions.

In this study, an extended exponentiated Pareto distribution is proposed. Some statistical properties are derived. We consider maximum likelihood, least squares, weighted least squares and Bayesian estimators. A simulation study is implemented for investigating the accuracy of different estimators. An application of the proposed distribution to a real data is presented.

Purpose to- Report the largest outbreak of infectious endophthalmitis after intravitreal injection (IVI) of bevacizumab (BCZ) from a single-use vial to 14 Libyan patients. Design- A retrospective non-comparative case series. Methods- Medical records and microbiology results of 13 out of 14 endophthalmitis patients who were injected with BCZ on two consecutive days September 3 and September 4, 2019, were reviewed. Results – Fourteen patients were injected by four physicians on 2 consecutive days with BCZ, prepared by a well-trained operation theatre (OT) nurse at the major operation theatre in Alkeish polyclinic under aseptic technique. All of them presented the next day with signs and symptoms of endophthalmitis, (13 out of 14 patients) were treated by intravitreal antibiotic injections as an emergency measure and they underwent PPV within 5-7 days. Microbiology results revealed that Acinetobacter baumannii was the organism responsible for the infection. After one month of the incident; One patient (7.5%) recovered vision of 6/24, four patients (31%) had a vision of 6/60, but eight patients (61.5%) did not recover their vision and had a vision of count-fingers and less. Conclusion- The unavailability of a single-use ampule of BCZ and its compounding from a larger volume vial is a risk that mandates following the standard guidelines for IVI for the prevention of complications.

In real-life experiments, collecting complete data is time-, finance-, and resources-consuming as stated by statisticians and analysts. Their goal was to compromise between the total time of testing, the number of units under scrutiny, and the expenditures paid through a censoring scheme. Comparing failure-censored schemes (Type-Ⅱ and Progressive Type-Ⅱ) to Time-censored schemes (Type-Ⅰ), it's worth noting that the former is time-consuming and is no more suitable to be applied in real-life situations. This is the reason why the Type-Ⅰ adaptive progressive hybrid censoring scheme has exceeded other failure-censored types; Time-censored types enable analysts to accomplish their trials and experiments in a shorter time and with higher efficiency. In this paper, the parameters of the inverse Weibull distribution are estimated under the Type-Ⅰ adaptive progressive hybrid censoring scheme (Type-Ⅰ APHCS) based on competing risks data. The model parameters are estimated using maximum likelihood estimation and Bayesian estimation methods. Further, we examine the asymptotic confidence intervals and bootstrap confidence intervals for the unknown model parameters. Monte Carlo simulations are carried out to compare the performance of the suggested estimation methods under Type-Ⅰ APHCS. Moreover, Markov Chain Monte Carlo by applying Metropolis-Hasting algorithm under the square error of loss function is used to compute Bayes estimates and related to the highest posterior density. Finally, two data sets are studied to illustrate the introduced methods of inference. Based on our results, we can conclude that the Bayesian estimation outperforms the maximum likelihood estimation for estimating the inverse Weibull parameters under Type-Ⅰ APHCS.

The objective was to evaluate the efficacy of a dentifrice containing Brazilian Red Propolis (BRP) against salivary Lactobacillus spp. and plaque formation.This was a randomized, double-blind clinical trial. Forty-two participants were randomized into two groups according to the dentifrice employed: G1 (fluoridated BRP dentifrice) and G2 (fluoridated common dentifrice). Saliva was collected and the visible plaque index (VPI) was recorded at the baseline (D0) and 4 weeks after day 0 (D28). Microbiological analysis was performed using two dilutions. Lactobacillus spp. isolates were identified and their abundance was expressed as log (CFU/mL).For the first dilution, the counts of Lactobacillus spp. in G1 was 1.15 ± 0.41 at D0 and 0.68 ± 0.15 at D28 (P0.05) and in G2 it was 1.33 ± 0.52 at D0 and 1.84 ± 0.39 at D28 (P0.05). For the second dilution, the corresponding values in G1 and G2 were 0.87 ± 0.34 and 0.64 ± 0.37, respectively (P = 0.1547), and 1.54 ± 0.47 and 1.62 ± 0.37, respectively (P = 0.9999). The corresponding VPI values for G1 and G2 were 38.10 ± 17.95 and 20.60 ± 16.44, respectively (P0.05), and 38.38 ± 19.65 and 27.40 ± 14.63, respectively (P = 0.03).The dentifrice containing BRP showed antimicrobial activity against Lactobacillus spp. and decreased the VPI for up to 4 weeks.

Introduction Several minimally invasive spine approaches and techniques have been developed in recent years. While the disease processes affecting the spinal motion segment have remained largely the same, the emerging technologies have changed treatment options radically and not necessarily in an organized fashion. The current diagnostic techniques, also evolving, have helped us appreciate the disease's pathoanatomy in minute details. A comprehensive classification method accounting for all anatomical variations in the disc disease, tailored to treatment options, is necessary. Such a classification will allow the surgeon to choose an appropriate surgical option in a consistent fashion. We feel that our classification system will help the spine surgeon make that important decision consistently, with minimal risk of leaving behind a significant lesion or disrupting an otherwise normal structure of the spinal motion segment. Furthermore, we feel such a comprehensive classification will help surgeons and other caregivers to standardize treatment approaches to the various presentations of disc disease, and apply the evolving technology in an organized fashion. Purpose To develop a comprehensive, treatment-orientated classification of the lumbar disc disease. Materials and Methods The literature was reviewed for the classification of disc disease. The morphology of the disc disease, the topography of the disc lesion, and the symptom-complex produced by the disc lesion are identified and graded. The features so identified and graded are placed in a matrix. The combinations of the anatomical features and symptoms are then computed as shown in the matrix. The MRI database held in the office was studied to determine the most frequent combinations of the disc disease and symptom complex. Results A total of 494 combinations were identified, but most have no clinical relevance. The retrospective study of the clinical data and MRI studies of 93 patients (50 male and 43 female) revealed the most affected motion-segment was L5-S1 (male = 19.3%, and female = 23.8%). The most common patho-anatomy is a globally bulging disc (T3L1), representing 37.6% of the total. The second most common combination is a degenerated disc with central, intra-annular tear T4L1), representing 20.4% of the total. At 11.8%, globally bulging with severe axial pain and moderate radicular pain represented the most common patho-anatomic/clinical classification (T3L1B4R2). The most frequent top 10 patho-anatomic/clinical classifications represented 15.5% of the total. Conclusion In light of the multiple surgical options for excision of the herniated lumbar disc, including the conventional and minimally invasive, and the fact that the imaging technology allows spine surgeons to see in great detail, the disease status of each of the components of the spinal motion segment, it is imperative to develop comprehensive classification systems which take account of the unique characteristics of the disease entity and guide treatment strategies. The classification system presented here is fairly complex, but the software technology will be utilized for the classification system along with the most appropriate treatment approach.

This article deals with the constant–stress partially accelerated life test using type I and type II censored data in the presence of competing failure causes. Suppose that the occurrence time of the failure cause follows Weibull distribution. Maximum likelihood technique is employed to estimate the population parameters of the distribution. The performance of the theoretical estimators of the parameters are evaluated and investigated by using a simulation algorithm.

Constant stress partially accelerated life tests are studied according to exponentiated Weibull distribution. Grounded on multiple censoring, the maximum likelihood estimators are determined in connection with unknown distribution parameters and accelerated factor. The confidence intervals of the unknown parameters and acceleration factor are constructed for large sample size. However, it is not possible to obtain the Bayes estimates in plain form, so we apply a Markov chain Monte Carlo method to deal with this issue, which permits us to create a credible interval of the associated parameters. Finally, based on constant stress partially accelerated life tests scheme with exponentiated Weibull distribution under multiple censoring, the illustrative example and the simulation results are used to investigate the maximum likelihood, and Bayesian estimates of the unknown parameters.

Multi-functional nanocomposites were prepared based on magnetite nanoparticles, chitosan nanoparticles and polythiophene for efficient and selective mercury (II) removal from its aqueous solution. The prepared materials combine several functionalities; hydroxyl, amino, sulphur and phosphate groups in addition to the magnetite property of magnetite nanoparticles. The produced nanocomposites not only show a complete removal of mercury (II) ions but also a higher selectivity was recorded in presence of other metal ions over a wider pH range. Keywords: Chitosan, Magnetite nanoparticles, Polythiophene, Coating, Nanocomposites, Heavy metals uptake, Mercury uptake, Kinetics, Isotherms

In this paper, we introduce a new family of probability distributions generated from a power Lindley random variable called the power Lindley-generated family. The new family extends several classical distributions as well as generalizes the odd Lindley family which is performed by Silva et al. (Austrian J Stat 46:65–87, 2017). Some of the mathematical properties are obtained involving moments, incomplete moments, quantile function and order statistics. New four distributions are provided as special models from the family. The model parameters of the family are estimated by the maximum likelihood technique. An application to real data set and simulation study are provided to demonstrate the flexibility and interest of one special model of the suggested family.

In this paper, we investigate the maximum likelihood estimation of the unknown parameters of the Burr Type-XII distribution and the acceleration factor based on two different progressively hybrid censoring schemes, namely, Type-I progressive hybrid censoring scheme (T-I PHCS) proposed by Kundu and Joarder (Comput Stat Data Anal 50:2509–2528, 2006) and adaptive Type-II progressive hybrid censoring scheme (AT-II PHCS) introduced by Ng et al. (Nav Res Logist 56:687–698, 2009) under step-stress partially accelerated life test model. The observed Fisher information matrix is obtained to construct an approximate confidence interval for the unknown parameters. The performances of the estimators of the model parameters using the above mentioned progressively hybrid censoring schemes are evaluated and compared in terms of the mean squared errors and relative errors through a Monte Carlo simulation study.

The present paper deals with very important practical problems of wide range of applications. The main target of the present paper is to track all moving boundaries that appear throughout the whole process when dealing with multi-moving boundary problems continuously with time up to the end of the process with high accuracy and minimum number of iterations. A new numerical iterative scheme based the boundary integral equation method is developed to track the moving boundaries as well as compute all unknowns in the problem. Three practical applications, one for vaporization and two for ablation were solved and their results were compared with finite element, heat balance integral and the source and sink results and a good agreement were obtained.

OBJETIVO: Realizar uma comparação crítica entre a Relação Nacional de Medicamentos Essenciais (Rename, 2012) e a Lista de Medicamentos Essenciais para Crianças (LMEC, 2011) da Organização Mundial de Saúde (OMS), com relação às diferenças entre os medicamentos e as formulações listadas para crianças. MÉTODOS: Os medicamentos da LMEC foram classificados em quatro grupos: 1) não constam na Rename; 2) constam na Rename, porém sem qualquer formulação adequada para crianças; 3) listados na Rename apenas com algumas formulações; 4) constam na Rename em todas as formulações. As formulações que faltam foram analisadas por grupos terapêuticos. As alternativas presentes na Rename foram pesquisadas. RESULTADOS: Dos 261 medicamentos de interesse listados na LMEC, 30,3% não estão presentes na Rename, 11,1% estão na Rename, mas sem qualquer formulação pediátrica, e 32,3% estão presentes em algumas, mas não todas as formulações listadas na LMEC. Considerando todos os itens de formulações listados na LMEC (n = 577), 349 não constam na Rename, desses, 19,6% devido à intensidade de dosagem, e 18,5% devido à forma farmacêutica. Faltam formulações úteis específicas para cuidado neonatal, trato respiratório e sistema nervoso central, anti-infecciosos, entre outros grupos. CONCLUSÃO: A ausência de formulações adequadas à idade de medicamentos essenciais para crianças no Brasil inclui importantes grupos terapêuticos e medicamentos indispensáveis para quadros clínicos graves. Alguns desses produtos são encontrados no mercado farmacêutico brasileiro, porém não existem em unidades públicas; outros poderiam ser produzidos por laboratórios nacionais com interesse comercial ou estimulados por uma política governamental específica, como é feito em outros países.OBJECTIVE: To perform a critical comparison between the Brazilian national essential medicines list (Rename, 2012) with the list of essential medicines for children (LEMC, 2011) of the World Health Organization (WHO), regarding the differences among drugs and formulations listed for children. METHODS: The LEMC drugs were classified into four categories: 1) absent in Rename; 2) included in Rename but without any formulation suitable for children; 3) listed in Rename only in some formulations; 4) present in Rename in all formulations. The missing formulations were analyzed by therapeutic group. Alternatives present in Rename were searched. RESULTS: From the 261 drugs of interest on the LEMC, 30.3% are absent from Rename, 11.1% are in Rename but without any pediatric formulation, and 32.2% are present in some but not all formulations listed in LEMC. Considering all formulations items listed in the LEMC (n = 577), 349 are missing from Rename, of these 19.6% due to their strength, and 18.5% due to the the dosage form. Useful formulations specific for neonatal care, respiratory tract, central nervous system, and anti-infectives, among other groups, are missing. CONCLUSIONS: The lack of age-appropriate formulations of essential medicines for children in Brazil includes important therapeutic groups and indispensable drugs for severe clinical conditions. Some of these products exist in the Brazilian pharmaceutical market, but not in public facilities; others could be produced by national laboratories with commercial interest or stimulated by a specific governmental policy, as in other countries.

Background The standard approach to the thoracic disc is through thoracotomy. The video-assisted thoracoscopic approach has been used as an alternative to the open approach for nearly 20 years, and more recently, extracavitary, posterolateral approaches have been introduced. Both the transthoracic procedures involve deflating the lung for access to the spine, and postoperative thoracic drainage is necessary; postoperative morbidity can be significant. The retropleural procedures are in their infancy, but the published results are promising. The purpose of this study is to introduce the posterolateral arthroscopic thoracic decompression and fusion procedure, which is extrapleural, less disruptive to normal anatomy, and cost-effective. Methods Fifteen consecutive patients who underwent arthroscopic decompression and interbody fusion of the thoracic spine were prospectively studied according to the hospital's institutional review board protocol. The Short Form 36 and visual analog scale questionnaires were completed preoperatively and postoperatively. Paired t tests were used for statistical analysis. The patient was placed in the prone position on a radiolucent table, and instrumentation was performed under fluoroscopic control. Two portals were developed ipsilaterally (one for the arthroscope and the other for instruments) on the side of disc herniation, and a single portal was used on the contralateral side. Various instruments were used for disc excision and exploration of the spinal canal. Fusion was accomplished with bilateral corticocancellous dowels obtained from the iliac crests. Infiltration of the access channel and facet injections of the contiguous joints were performed with bupivacaine, for immediate postoperative pain control. Results Fifteen patients with a mean age of 54 years were followed up for 28 months postoperatively. The overall back pain score decreased from 7.2 (SD, 1.5) to 3 (SD, 2) after the procedure (P < .005). Eleven patients were satisfied with their current lifestyle postoperatively as opposed to one preoperatively. Two patients had reoccurrences. Hospital stay averaged 18.5 hours. The operating room cost and the cost of hospital stay was 51.9% of the cost of anterior open discectomy. Conclusions The extrapleural, biportal, ipsilateral arthroscopic approach for the decompression and interbody fusion of the thoracic spine is feasible, cost-effective, less traumatic, and associated with minimal complications. The best results were obtained in patients with single-level thoracic disc herniation. The technique is applicable for most thoracic disc herniations.

In this paper, step-stress partially accelerated life tests are considered when the lifetime of a product follows a Burr type XII distribution. Based on type I censoring, the maximum likelihood estimates (MLEs) are obtained for the distribution parameters and acceleration factor. In addition, asymptotic variance and covariance matrix of the estimators are given. An iterative procedure is used to obtain the estimators numerically using Mathcad (2001). Furthermore, confidence intervals of the estimators are presented. Simulation results are carried out to study the precision of the MLEs for the parameters involved.

p. 81-87 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2014-03-12T14:05:54Z No. of bitstreams: 1 0100-879X2007000100011.pdf: 471976 bytes, checksum: 8730c69bee7be44e04c80e2c01cbaddf (MD5) Approved for entry into archive by Rodrigo Meirelles (rodrigomei@ufba.br) on 2014-09-09T14:50:03Z (GMT) No. of bitstreams: 1 0100-879X2007000100011.pdf: 471976 bytes, checksum: 8730c69bee7be44e04c80e2c01cbaddf (MD5) Made available in DSpace on 2014-09-09T14:50:03Z (GMT). No. of bitstreams: 1 0100-879X2007000100011.pdf: 471976 bytes, checksum: 8730c69bee7be44e04c80e2c01cbaddf (MD5) Previous issue date: 2007 The long-term effects of low-level lead intoxication are not known. The sympathetic skin response (SSR) was evaluated in a group of 60 former workers of a primary lead smelter, located in Santo Amaro, BA, Brazil. The individuals participating in the study were submitted to a clinical-epidemiological evaluation including questions related to potential risk factors for intoxication, complaints related to peripheral nervous system (PNS) involvement, neurological clinical examination, and also to electromyography and nerve conduction studies and SSR evaluation. The sample consisted of 57 men and 3 women aged 34 to 69 years (mean ± SD: 46.8 ± 6.9). The neurophysiologic evaluation showed the presence of lumbosacral radiculopathy in one of the individuals (1.7%), axonal sensorimotor polyneuropathy in 2 (3.3%), and carpal tunnel syndrome in 6 (10%). SSR was abnormal or absent in 12 cases, representing 20% of the sample. More than half of the subjects (53.3%) reported a history of acute abdominal pain requiring hospitalization during the period of work at the plant. A history of acute palsy of radial and peroneal nerves was reported by about 16.7 and 8.3% of the individuals, respectively. Mean SSR amplitude did not differ significantly between patients presenting or not the various characteristics in the current neurological situation, except for diaphoresis. The results suggest that chronic lead intoxication induces PNS damage, particularly affecting unmyelinated small fibers. Further systematic study is needed to more precisely define the role of lead in inducing PNS injury.

In this paper, the problem of estimating the shear force affecting the tip of the cantilever in a Transverse Dynamic Force Microscope (TDFM) using a real-time implementable sliding mode observer is addressed. The behaviour of a vertically oriented oscillated cantilever, in close proximity to a specimen surface, facilitates the imaging of the specimen at nano-metre scale. Distance changes between the cantilever tip and the specimen can be inferred from the oscillation amplitudes, but also from the shear force acting at the tip. Thus, the problem of accurately estimating the shear force is of significance when specimen images and mechanical properties need to be obtained at submolecular precision. A low order dynamic model of the cantilever is derived using the method of lines, for the purpose of estimating the shear force. Based on this model, an estimator using sliding mode techniques is presented to reconstruct the unknown shear force, from only tip position measurements and knowledge of the excitation signal applied to the top of the cantilever. Comparisons to methods assuming a quasi-static harmonic balance are made.

Background On the basis of the experiences gained from conventional open spinal procedures, a long list of desirable objectives have emerged with the evolution of the lesser invasive spinal procedures. At the top of that list is the desire to minimize the trauma of surgery. The rest of the objectives, which include reductions of operating time, surgical blood loss, hospital stay, postoperative narcotic medication, convalescence, complication rates, and escalating health care costs, as well as the desire of elderly patients to continue rigorous physical activities, largely depend on the ability to minimize the trauma of surgery. The purpose of this study was to investigate the feasibility of the least invasive lumbar decompression, interbody fusion and percutaneous pedicle screw implantation, to minimize surgical trauma without compromising the quality of the treatment outcome, as well as to minimize risk of complications. Methods In this case series, 60 patients with diagnoses of degenerative disc disease, degenerative motion segments with stenosis, and spondylolisthesis, in whom nonoperative treatments failed, were treated with endoscopic transforaminal decompression and interbody fusion by 1 surgeon in 2 centers. The outcome measures were as follows: operating time, intraoperative blood loss, hospital stay, Visual Analogue Scale (VAS) scores for back and leg pain, scores on the Roland-Morris Disability Questionnaire, and postoperative imaging studies. A consecutive series of patients who met the treatment criteria completed VAS forms and Roland-Morris questionnaires preoperatively. Surgical procedures included arthroscopic decompression of the foramina and the discs; endplate preparation and implantation of allograft bone chips and bone morphogenetic protein 2 on absorbable collagen sponge into the disc space; and percutaneous implantation of pedicle screws. Postoperatively, the patients again completed the VAS forms and Roland-Morris questionnaires. Their charts were reviewed for office notes, operative notes, hospital stay, medications, and imaging studies. The latest X-ray and computed tomography scan films were reviewed and analyzed. Patients were followed up for a minimum of 6 months. The literature was reviewed for comparison of outcomes. Results Sixty patients met the inclusion criteria. The mean age was 52.8 years. The duration of illness averaged 5 years. Follow-up ranged from 6 to 25 months, with a mean of 12 months. Preoperative diagnoses included degenerative disc disease, degenerative motion segments with stenosis, and spondylolisthesis. The mean time in the operating room was 2 hours 54 minutes. Estimated blood loss averaged 57.6 mL. The duration of the hospital stay averaged 2.6 days. Preoperative back pain and leg pain were significantly reduced (P < .005). Forty-seven imaging studies obtained at the last visit, including X-ray and computed tomography scans, showed solid fusion in 28 patients (59.6%), stable fixation in 17 (36.2%), and osteolysis around the pedicle screws in 2 (4.2%). All patients had improvement of motor function, whereas 2 patients complained of residual numbness. In addition, 8 patients (13%) complained of residual discomfort on extension of the lumbar spine. Two patients had pedicle screw–related complications requiring surgery. A review of the literature showed that endoscopic transforaminal decompression and interbody fusion performed better than open transforaminal lumbar interbody fusion/posterior lumbar interbody fusion, minimally invasive transforaminal lumbar interbody fusion, and extreme lateral lumbar interbody fusion, with regard to most parameters studied. Conclusions The endoscopic transforaminal lumbar decompression, interbody fusion, and percutaneous pedicle screw instrumentation consistently produced satisfactory results in all demographics. It performed better than the alternative procedures for most parameters studied.

Compliance control is highly relevant to human safety in human robot interaction (HRI). This paper presents a review of various compliance control techniques. The paper is aimed to provide a good background knowledge for new researchers and highlight the current hot issues in compliance control research. Active compliance, passive compliance, adaptive and reinforcement learning based compliance control techniques are discussed. This paper provides a comprehensive literature survey of compliance control keeping inview physical human robot interaction, e.g. passing an object, such as a cup, between a human and a robot. Compliance control may eventually provide an immediate and effective layer of safety by avoiding pushing, pulling or clamping in physical human robot interaction. Emerging areas such as soft robotics, which exploit the deformability of biomaterial as well as hybrid approaches which combine active and passive compliance are also highlighted.

OBJETIVO: Realizar uma comparação crítica entre a Relação Nacional de Medicamentos Essenciais (Rename, 2012) e a Lista de Medicamentos Essenciais para Crianças (LMEC, 2011) da Organização Mundial de Saúde (OMS), com relação às diferenças entre os medicamentos e as formulações listadas para crianças. MÉTODOS: Os medicamentos da LMEC foram classificados em quatro grupos: 1) não constam na Rename; 2) constam na Rename, porém sem qualquer formulação adequada para crianças; 3) listados na Rename apenas com algumas formulações; 4) constam na Rename em todas as formulações. As formulações que faltam foram analisadas por grupos terapêuticos. As alternativas presentes na Rename foram pesquisadas. RESULTADOS: Dos 261 medicamentos de interesse listados na LMEC, 30,3% não estão presentes na Rename, 11,1% estão na Rename, mas sem qualquer formulação pediátrica, e 32,3% estão presentes em algumas, mas não todas as formulações listadas na LMEC. Considerando todos os itens de formulações listados na LMEC (n = 577), 349 não constam na Rename, desses, 19,6% devido à intensidade de dosagem, e 18,5% devido à forma farmacêutica. Faltam formulações úteis específicas para cuidado neonatal, trato respiratório e sistema nervoso central, anti-infecciosos, entre outros grupos. CONCLUSÃO: A ausência de formulações adequadas à idade de medicamentos essenciais para crianças no Brasil inclui importantes grupos terapêuticos e medicamentos indispensáveis para quadros clínicos graves. Alguns desses produtos são encontrados no mercado farmacêutico brasileiro, porém não existem em unidades públicas; outros poderiam ser produzidos por laboratórios nacionais com interesse comercial ou estimulados por uma política governamental específica, como é feito em outros países. OBJECTIVE: To perform a critical comparison between the Brazilian national essential medicines list (Rename, 2012) with the list of essential medicines for children (LEMC, 2011) of the World Health Organization (WHO), regarding the differences among drugs and formulations listed for children. METHODS: The LEMC drugs were classified into four categories: 1) absent in Rename; 2) included in Rename but without any formulation suitable for children; 3) listed in Rename only in some formulations; 4) present in Rename in all formulations. The missing formulations were analyzed by therapeutic group. Alternatives present in Rename were searched. RESULTS: From the 261 drugs of interest on the LEMC, 30.3% are absent from Rename, 11.1% are in Rename but without any pediatric formulation, and 32.2% are present in some but not all formulations listed in LEMC. Considering all formulations items listed in the LEMC (n = 577), 349 are missing from Rename, of these 19.6% due to their strength, and 18.5% due to the the dosage form. Useful formulations specific for neonatal care, respiratory tract, central nervous system, and anti-infectives, among other groups, are missing. CONCLUSIONS: The lack of age-appropriate formulations of essential medicines for children in Brazil includes important therapeutic groups and indispensable drugs for severe clinical conditions. Some of these products exist in the Brazilian pharmaceutical market, but not in public facilities; others could be produced by national laboratories with commercial interest or stimulated by a specific governmental policy, as in other countries.

Bixa orellana L., urucum, or urucu, a native tropical tree of Central and South American rain forests is used to treat various diseases in popular medicine. In Ceará, Northeast of Brazil, the seeds of urucum have been used for the treatment of high lipid blood levels. The present study investigated the effects of the aqueous extract from Bixa orellana seeds (AEBO) in mice with hyperlipidemia induced by tyloxapol, fructose and ethanol. In hyperlipidemia induced by TritonWR1339, 400 and 800mg/kg AEBO reduced triglycerides (TG) serum levels at 24 h and 48 h. In the study of hypertriglyceridemia induced by fructose, AEBO in doses of 400mg/kg and 800mg/kg reduced TG levels by 48.2%and 48.7%, respectively. Finally, the ethanol experimental model with 400mg/kg AEBO promoted a reduction of 33.6% of TG levels, while the 800mg/kg concentration reduced hypertriglyceridemia in 62.2%. In conclusion, the aqueous extract of the seeds of Bixa orellana was capable of reversing the hypertriglyceridemia induced by Triton, fructose and ethanol, demonstrating a hypolipidemic effect. However, further studies are necessary to discover the precise mechanism of action. Copyright © 2012 John Wiley & Sons, Ltd.

Lapachol is a naphthoquinone found in several species of the Bignoniaceae family possessing mainly anticancer activity. The present work consists of the development and validation of analytical methodology for lapachol and its preparations. The results here obtained show that lapachol has a low quantification limit, that the analytical methodology is accurate, reproducible, robust and linear over the concentration range 0.5-100 µg/mL of lapachol.

International audience

Bixa orellana L., urucum, or urucu, a native tropical tree of Central and South American rain forests is used to treat various diseases in popular medicine. In Ceará, Northeast of Brazil, the seeds of urucum have been used for the treatment of high lipid blood levels. The present study investigated the effects of the aqueous extract from Bixa orellana seeds (AEBO) in mice with hyperlipidemia induced by tyloxapol, fructose and ethanol. In hyperlipidemia induced by Triton WR1339, 400 and 800 mg/kg AEBO reduced triglycerides (TG) serum levels at 24 h and 48 h. In the study of hypertriglyceridemia induced by fructose, AEBO in doses of 400 mg/kg and 800 mg/kg reduced TG levels by 48.2% and 48.7%, respectively. Finally, the ethanol experimental model with 400 mg/kg AEBO promoted a reduction of 33.6% of TG levels, while the 800 mg/kg concentration reduced hypertriglyceridemia in 62.2%. In conclusion, the aqueous extract of the seeds of Bixa orellana was capable of reversing the hypertriglyceridemia induced by Triton, fructose and ethanol, demonstrating a hypolipidemic effect. However, further studies are necessary to discover the precise mechanism of action.

In this research paper, the estimation of the unknown parameters for the exponentiated Weibull Poisson distribution using the concept of generalized order statistics is investigated from Bayesian approach. The squared error, LINEX and general entropy loss functions are considered for Bayesian computation. Bayes estimates based on Progressively type II censored and the joint density function of ordinary order statistics are considered as special cases of generalized order statistics. Finally simulation study is conducted for illustrative purposes.

BACKGROUND: Phenotype-genotype correlations, generally based on predominant associated signs, are being increasingly used to distinguish different types of autosomal recessive cerebellar ataxias (ARCA). CASE REPORTS: Two brothers developed signs of cerebellar ataxia with peripheral axonal motor and sensory neuropathy, distal muscular atrophy, pes cavus and steppage gait as seen in Charcot-Marie-Tooth neuropathy. The examination also showed oculomotor apraxia. Sural nerve biopsy revealed conspicuous reduction in the density of myelinated fibres but preservation of unmyelinated nerve fibres. Blood tests revealed low serum albumin and elevated cholesterol. A homozygous W279X truncating mutation was identified in exon 6 of the APTX gene, confirming the diagnosis of cerebellar ataxia with oculomotor apraxia type 1 (AOA1). CONCLUSIONS: These cases illustrate the presentation of AOA1 type of ARCA and discuss the role of peripheral neuropathy in the differential diagnostic of the ARCAs variants.

International audience

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Lapachol is a naphthoquinone found in several species of the Bignoniaceae family possessing mainly anticancer activity. The present work consists of the development and validation of analytical methodology for lapachol and its preparations. The results here obtained show that lapachol has a low quantification limit, that the analytical methodology is accurate, reproducible, robust and linear over the concentration range 0.5-100 µg/mL of lapachol.

Background The lumbosacral junction is a difficult area for spine surgery because of the complex anatomy. In the era of minimally invasive spine surgery, the presence of the iliac wing has, at the level of lumbosacral junction, created a major obstacle in the paths of two of the major approaches, namely, the direct lateral and percutaneous posterolateral endoscopic approaches. A trans-iliac cadaver study published by the senior author and co-workers in 1997, suggested the possibility of an alternative approach to the lumbosacral junction. Purpose To determine the feasibility of percutaneous, endoscopic trans-iliac approach to the L5-S1 disc and foramen Study Design Prospective case series study. Materials and Methods 15 consecutive patients undergoing the transiliac approach to L5-S1 disc and foramen were included in the study. Pre- and postoperative visual analogue scale (VAS); Oswestry Disability Index (ODI); and intra-operative blood loss and operative time, were obtained for the study. Preoperative MRI or CT scan was used to determine the need for trans-iliac access. The procedure was performed with the patient in prone position and under monitored sedation for decompression. Endotracheal anesthesia was used for fusion cases. The transiliac access was established with a cannulated drill or core drill through the iliac wing. Once the trans-iliac window had been created, the rest of the procedure proceeded as for percutaneous endoscopic transforaminal decompression and fusion. Results 15 patients (9 male and 6 female) participated in the study. The VAS for back and leg pain significantly improved in all patients. The ODI dropped by more than 50%. There was minimal blood loss, and transient post-operative dysesthesia in 2 cases which resolved after 3 weeks. Conclusion Endoscopic trans-iliac approach to the L5-S1 disc and foramen is feasible and safe. Decompression can be performed safely via trans-iliac access with minimal blood loss, and in a short operative time.

A 20-year-old man developed over three weeks a sensory and painful neuropathy associated with diffuse alopecia. There was motor weakness, and superficial and deep hypoesthesia of the inferior limbs. Deep tendon reflexes were normal. Electrophysiological study mainly showed axonal motor neuropathy. This patient was admitted six weeks after the first symptoms. The clinical picture suggested thallium poisoning, which was confirmed by thallium concentrations in plasma, urine, hair and nails. After search, thallium was identified in a rat poison.

We conducted a retrospective study of 45 Egyptian patients with coronary artery ectasia who underwent coronary bypass grafting at our institution between 1980 and 1995. We examined the anatomic distribution and type of coronary ectasia and its association with coronary risk factors in these patients, and evaluated the severity of their coronary artery disease. We compared these findings with those from a group of 230 Egyptian patients who did not have coronary ectasia. These patients also underwent coronary artery bypass grafting between 1980 and 1995 at our institution. Obesity was present in 60% of the patients who had coronary artery ectasia, compared with 42% of patients who did not have ectasia (P < 0.01). Coronary artery ectasia was not related to any coronary risk factors other than obesity. However, patients who had ectasia did have a higher rate of triple-vessel coronary artery disease than did patients without ectasia (82% vs 67%, P < 0.05). Of the coronary vessels affected by ectasia, 43% were left anterior descending arteries. Diffuse disease was noted in 84% of all ectatic segments. We conclude that in this patient population, 2 conditions had a positive correlation with coronary ectasia: obesity and the severity of coronary artery disease.