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Background: Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to bladder cancer., Objective: To evaluate the role of PAHs in bladder cancer, PAHs serum levels were measured in patients and controls from a case-control study., Methods: A total of 140 bladder cancer patients and 206 healthy controls were included in the study. Sixteen PAHs were analyzed from the serum of subjects by gas chromatography-mass spectrometry., Results: Serum PAHs did not appear to be related to bladder cancer risk, although the profile of contamination by PAHs was different between patients and controls: pyrene (Pyr) was solely detected in controls and chrysene (Chry) was exclusively detected in the cases. Phenanthrene (Phe) serum levels were inversely associated with bladder cancer (OR = 0·79, 95%CI = 0·64-0·99, P = 0·030), although this effect disappeared when the allelic distribution of glutathione-S-transferase polymorphisms of the population was introduced into the model (multinomial logistic regression test, P = 0·933). Smoking (OR = 3·62, 95%CI = 1·93-6·79, P<0·0001) and coffee consumption (OR = 1·73, 95%CI = 1·04-2·86, P = 0·033) were relevant risk factors for bladder cancer., Conclusions: Specific PAH mixtures may play a relevant role in bladder cancer, although such effect seems to be highly modulated by polymorphisms in genes encoding xenobiotic-metabolizing enzymes.

We have evaluated the successes and failures of the Hubbard-corrected density functional theory approach to study Mg doping of LiCoO2. We computed the effect of the U parameter on the energetic, geometric, and electronic properties of two possible doping mechanisms: (1) substitution of Mg onto a Co (or Li) site with an associated impurity state and (2) formation of impurity-state-free complexes of substitutional Mg and point defects in LiCoO2. We find that formation of impurity states results in changes on the valency of Co in LiCoO2. Variation of the Co U shifts the energy of the impurity state, resulting in energetic, geometric, and electronic properties that depend significantly on the specific value of U. In contrast, the properties of the impurity-state-free complexes are insensitive to U. These results identify reasons for the strong dependence on the doping properties on the chosen value of U and for the overall difficulty of achieving agreement with the experimentally known energetic and electronic properties of doped transition metal oxides such as LiCoO2.

Context: Adult-onset GH deficiency (GHD) increases visceral adiposity and the activity of the enzyme 11β-hydroxysteroid dehydrogenase, which converts cortisone (E) to cortisol (F), both linked to insulin resistance and increased cardiovascular risk. Conversely, we reported that adults with congenital isolated GHD (IGHD) have increased insulin sensitivity., Objective: To assess the type of fat distribution and the amount of visceral and sc fat and to correlate them to the F/E ratio in adults with untreated IGHD due to a mutation in the GHRH receptor gene., Methods: Body composition was assessed by dual-energy x-ray absorptiometry, thickness of sc and visceral fat was measured by sonography, and serum F and E were measured in 23 IGHD subjects and 21 age-matched controls., Results: Waist/hip ratio (WHR), trunk fat, and trunk/extremity fat (TR/EXT) ratio were higher in IGHD subjects. Visceral fat index (VFI) (but not sc fat index [SFI]) was higher in IGHD. F and F/E ratio were also higher in IGHD. In all 44 individuals, WHR correlated with TR/EXT ratio, thickness of visceral fat, VFI/SFI ratio, F, and F/E ratio. TR/EXT ratio correlated with visceral fat thickness, VFI/SFI ratio, and F. Age had a significant effect on VFI and on F/E ratio. Body mass index SD score and WHR have a similar significant effect on TR/EXT ratio and on F/E ratio., Conclusions: Lifetime congenital untreated IGHD causes increased visceral adiposity with a high F/E ratio. However, the increased insulin sensitivity suggests that visceral adiposity needs a minimal GH secretion to translate into increased insulin resistance.

The GH/IGF-I axis has essential roles in regulating bone and vascular status. The age-related decrease in GH secretion ("somatopause") may contribute to osteoporosis and atherosclerosis, commonly observed in the elderly. Adult-onset GH deficiency (GHD) has been reported to be associated with reduced bone mineral density (BMD), increased risk of fractures, and premature atherosclerosis. We have shown the young adult individuals with isolated GHD (IGHD) due to a homozygous for the c.57+1G>A GHRH receptor gene mutation have normal volumetric BMD (vBMD), and not develop premature atherosclerosis, despite adverse risk factor profile. However, the bone and vascular impact of lifetime GHD on the aging process remains unknown. We studied a group of ten older IGHD subjects (≥60 years) homozygous for the mutation, comparing them with 20 age- and gender-matched controls (CO). Areal BMD was measured, and vBMD was calculated at the lumbar spine and total hip. Vertebral fractures and abdominal aortic calcifications (expressed as calcium score) were also assessed. Areal BMD was lower in IGHD, but vBMD was similar in the two groups. The percent of fractured individuals was similar, but the mean number of fractures per individual was lower in IGHD than CO. Calcium score was similar in the two groups. A positive correlation was found between calcium score and number of fractures. Untreated lifetime IGHD has beneficial consequences on bone status and does not have a deleterious effect on abdominal aorta calcification.

Nonalcoholic fatty liver disease (NAFLD) is known to be associated with insulin resistance, atherosclerosis, and low serum IGF1 levels. We have described a large cohort of patients with isolated GH deficiency (IGHD) due to the c.57+1G→A mutation in the GHRH receptor gene. These subjects have increased insulin sensitivity (IS), delayed atherosclerosis, and normal longevity. We hypothesized that, despite visceral obesity, NAFLD would be absent or mild due to the increased IS. To assess the prevalence and severity of NAFLD in adult subjects with lifetime, congenital, untreated IGHD, we studied 22 IGHD adults and 25 controls (COs) matched for age and sex. NAFLD was assessed by a comprehensive liver function panel, and ultrasonographic pattern (hyperechogenic pattern, HP) coded as follows: 0, absent; 1, mild; 2, moderate; and 3, severe. Compared with COs, IGHD individual had lower serum IGF1 (P<0.0001), higher total cholesterol (P=0.027), lower prothrombin time (P=0.017), and similar activated partial thromboplastin time and fibrinogen values. Alanine transaminase (ALT) values were similar in the two groups, but aspartate transaminase was higher in IGHD (P=0.013). However, more IGHD subjects (7/22) than COs (3/23) had ALT above the upper limit of normal (P=0.044). The prevalence of NAFLD was higher in IGHD than COs (61 vs 29%, P=0.032), and the HP score was higher in IGHD than COs (P=0.041), but severe NAFLD was not observed in any IGHD (or CO) individual. Liver HP score is increased in lifetime, untreated, congenital IGHD, but the increase in transaminases is mild, suggesting a lack of advanced forms of NAFLD., (© 2014 The authors.)

Background: Brucellosis caused by Brucella abortus is one of the most important zoonoses in the world. Multiple-locus variable-number tandem repeat analysis (MLVA16) has been shown be a useful tool to epidemiological traceback studies in B. abortus infection. Thus, the present study aimed (i) to evaluate the genetic diversity of B. abortus isolates from a brucellosis outbreak, and (ii) to investigate the in vivo stability of the MLVA16 markers., Results: Three-hundred and seventy-five clinical samples, including 275 vaginal swabs and 100 milk samples, were cultured from a brucellosis outbreak in a cattle herd, which adopted RB51 vaccination and test-and-slaughter policies. Thirty-seven B. abortus isolates were obtained, eight from milk and twenty-nine from post-partum/abortion vaginal swabs, which were submitted to biotyping and genotyping by MLVA16. Twelve B. abortus isolates obtained from vaginal swabs were identified as RB51. Twenty four isolates, seven obtained from milk samples and seventeen from vaginal swabs, were identified as B. abortus biovar 3, while one isolate from vaginal swabs was identified as B. abortus biovar 1. Three distinct genotypes were observed during the brucellosis outbreak: RB observed in all isolates identified as RB51; W observed in all B. abortus biovar 3 isolates; and Z observed in the single B. abortus biovar 1 isolate. Epidemiological and molecular data show that the B. abortus biovar 1 genotype Z strain is not related to the B. abortus biovar 3 genotype W isolates, and represents a new introduction B. abortus during the outbreak., Conclusions: The results of the present study on typing of multiple clinical B. abortus isolates from the same outbreak over a sixteen month period indicate the in vivo stability of MLVA16 markers, a low genetic diversity among B. abortus isolates and the usefulness of MLVA16 for epidemiological studies of bovine brucellosis.

The aim of this study was to evaluate the Enterobacterial Repetitive Intergenic Consensus (ERIC-PCR) as a tool for molecular typing of C. pseudotuberculosis isolates from eight different hosts in twelve countries. Ninety-nine C. pseudotuberculosis field strains, one type strain (ATCC 19410T) and one vaccine strain (1002) were fingerprinted using the ERIC-1R and ERIC-2 primers, and the ERIC-1R+ERIC-2 primer pair. Twenty-nine different genotypes were generated by ERIC 1-PCR, 28 by ERIC 2-PCR and 35 by ERIC 1+2-PCR. The discriminatory index calculated for ERIC 1, ERIC 2, and ERIC 1+2-PCR was 0.89, 0.86, and 0.92, respectively. Epidemiological concordance was established for all ERIC-PCR assays. ERIC 1+2-PCR was defined as the best method based on suitability of the amplification patterns and discriminatory index. Minimal spanning tree for ERIC 1+2-PCR revealed three major clonal complexes and clustering around nitrate-positive (biovar Equi) and nitrate-negative (biovar Ovis) strains. Therefore, ERIC 1+2-PCR proved to be the best technique evaluated in this study for genotyping C. pseudotuberculosis strains, due to its usefulness for molecular epidemiology investigations.

We demonstrate that Fe2TeO6 is a magnetoelectric antiferromagnet with voltage-controllable boundary magnetization. This provides experimental evidence of the theoretical prediction that boundary magnetization is a universal property of magnetoelectric antiferromagnets including boundary magnetization at a surface orthogonal to the polar direction. Highly (110) textured Fe2TeO6 thin films were grown by pulsed laser deposition, terminating in Te-O at the (110) surface due to a surface reconstruction. Magnetic dc susceptibility measurements of both Fe2TeO6 powder and thin film samples confirm antiferromagnetic long-range order. Finally, measurements of x-ray magnetic circular dichroism combined with photoemission electron microscopy (XMCD-PEEM) provide a lower bound to the spin and angular magnetic moment of the surface Fe ions.

Context: The GH/IGF-I axis is important for bone growth, but its effects on joint function are not completely understood. Adult-onset GH-deficient individuals have often reduced bone mineral density (BMD). However, there are limited data on BMD in adult patients with untreated congenital isolated GH-deficient (IGHD). We have shown that adult IGHD individuals from the Itabaianinha, homozygous for the c.57+1G>A GHRHR mutation, have reduced bone stiffness, but BMD and joint status in this cohort are unknown., Objective: The goal is to study BMD, joint function, and osteoarthritis score in previously untreated IGHD adults harboring the c.57+1G>A GHRHR mutation., Design: This is a cross-sectional study., Methods: Areal BMD by dual-energy X-ray absorptiometry was measured in 25 IGHD and 23 controls (CO). Volumetric BMD (vBMD) was calculated at the lumbar spine and total hip. Joint function was assessed by goniometry of elbow, hips, and knees. X-rays were used to measure the anatomic axis of knee and the severity of osteoarthritis, using a classification for osteophytes (OP) and joint space narrowing (JSN)., Results: Genu valgum was more prevalent in IGHD than CO. The osteoarthritis knees OP score was similar in both groups, and knees JSN score showed a trend to be higher in IGHD. The hips OP score and JSN score were higher in IGHD. Areal BMD was lower in IGHD than CO, but vBMD was similar in the two groups. Range of motion was similar in elbow, knee, and hip in IGHD and CO., Conclusions: Untreated congenital IGHD due to a GHRHR mutation causes hip joint problems and genu valgum, without apparent clinical significance, reduces bone size, but does not reduce vBMD of the lumbar spine and hip.

The aims of the present study were (i) to assess the in vitro genetic stability of S19 and RB51 Brucella abortus vaccines strains and (ii) to evaluate the ability of multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA) as a tool to be used in the quality control of live vaccines against brucellosis. Sixty-three batches of commercial S19 (n=53) and RB51 (n=10) vaccines, produced between 2006 and 2009, were used in this study. S19 and RB51 vaccines were obtained from, respectively, seven and two different manufacturers. Ten in vitro serial passages were performed on reference strains and on selected batches of commercial vaccines. All batches, reference strains and strains of serial passages were typed by the MLVA16. The results demonstrated that B. abortus S19 and RB51 vaccine strains are genetically stable and very homogeneous in their respective groups. Anyway, batches of S19 from one manufacturer and batches of RB51 from another presented genotypes distincts from the reference vaccine strains. In both cases, differences were found on locus Bruce07, which had addition of one repeat unit in the case of S19 batches and the deletion of one repeat unit in the case of RB51 batches. In summary, MLVA16 proved to be a molecular tool capable of discriminating small genomic variations and should be included in in vitro official tests., (Copyright © 2013. Published by Elsevier Ltd.)

The modification of MCM-41 was performed with 3-aminopropropyltrimethoxysilane. The structural order and textural properties of the synthesized materials were studied by X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetry/differential thermogravimetry, nitrogen adsorption, and desorption analysis. The adsorption capacity of NH2-MCM-41 was studied with Remazol Red dye. The following parameters were studied in the adsorption process: pH, temperature, adsorbent dosage, and initial concentration. The desorption process was studied in different concentrations of NaOH solutions. The Freundlich isotherm model was found to be fit with the equilibrium isotherm data. Kinetics of adsorption follows the modified Avrami rate equation. The maximum adsorption capacity was estimated to be 45.9 mg g(-1), with removal of the dye of 99.1%. The NH2-MCM-41 material exhibited high desorption capacity with 98.1%.

Purpose: To compare pain related to intravitreal injection and panretinal photocoagulation in the management of patients with high-risk proliferative diabetic retinopathy., Methods: Prospective study including patients with high-risk proliferative diabetic retinopathy and no prior laser treatment randomly assigned to receive panretinal photocoagulation (PRP group) or panretinal photocoagulation plus intravitreal ranibizumab (PRPplus group). In all patients, panretinal photocoagulation was administered in two sessions (weeks 0 and 2), and intravitreal ranibizumab was administered at the end of the first laser session in the PRPplus group. Retreatment was performed at weeks 16 and 32 if active new vessels were detected at fluorescein angiography. Patients in the PRPplus group received intravitreal ranibizumab and patients in the PRP group received 500-µm additional spots per quadrant of active new vessels. After the end of retreatment, a 100-degree Visual Analog Scale was used for pain score estimation. The patient was asked about the intensity of pain during the whole procedure (retinal photocoagulation session or intravitreal ranibizumab injection). Statistics for pain score comparison were performed using a non-parametric test (Wilcoxon rank sums)., Results: Seventeen patients from PRPplus and 14 from PRP group were evaluated for pain scores. There were no significant differences between both groups regarding gender, glycosylated hemoglobin and disease duration. Mean intravitreal injection pain (±SEM) was 4.7 ± 2.1 and was significantly lower (p<0.0001) than mean panretinal photocoagulation pain (60.8 ± 7.8). Twelve out of 17 patients from the PRPplus group referred intensity pain score of zero, while the minimal score found in PRP group was found in one patient with 10.5., Conclusion: In patients with high-risk proliferative diabetic retinopathy who needed retreatment for persistent new vessels, there was more comfort for the patient when retreatment was performed with an intravitreal injection in comparison with retinal photocoagulation. Further larger studies are necessary to confirm our preliminary findings.

Motivated by the use of electrodes modified at the nanoscale by supported metal species, we studied computationally how the reactivity changes in such a composite system compared to the reactivity of the individual systems, metal clusters and metal surfaces. Specifically, we examined hydrogen adsorption on and hydrogen spillover from Au- and Cu-supported Pt(3) and Pd(3) clusters, using a method based on Density Functional Theory. Two distinctive types of sites were found for the adsorption of atomic hydrogen: (i) on the supported clusters and (ii) at the cluster-substrate interfaces. The adsorption energy of hydrogen on the supported clusters is ∼20 kJ mol(-1) smaller when the cluster is supported by Cu instead of Au. In contrast, the substrate has no effect on hydrogen adsorbed at the cluster-substrate interfaces. Adsorbed Pt(3) and Pd(3) clusters locally modify the reactivity of the substrates as quantified by the reduced adsorption energy of hydrogen compared to the corresponding clean substrate. Hydrogen dissociative adsorption followed by spillover is thermodynamically and kinetically favored for clusters supported on a Cu surface, but not on Au. Moreover, spillover of hydrogen is more likely from metal-supported Pd than Pt clusters as revealed by barriers that are calculated 40-50 kJ mol(-1) lower in energy.

The aim of this randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia with a combination of tramadol+dexamethasone or tramadol+diclofenac sodium. The study included 30 patients (age range: 16-30 years), who were randomly assigned to 2 groups by the split-mouth method. Postoperative pain was assessed with a visual analogue scale at 4, 6, 12, 24, and 48 h postoperatively (p.o.h.). Swelling was measured at 48 p.o.h. Maximal interincisor distance was measured at 48 p.o.h. and 7 postoperative days (p.o.d.). Significant differences in postoperative pain intensity were detected between the drug combinations at 4, 6, and 12p.o.h., suggesting the importance of preemptive analgesia. Patients treated with tramadol+dexamethasone showed lower pain scores compared to the tramadol+diclofenac sodium combination, larger postoperative mouth opening, and less swelling. The tramadol+dexamethasone combination also was more effective than tramadol+diclofenac sodium at reducing inflammation., (Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

The local metallicities of Hf(0.97)Gd(0.03)O(2), Ga(0.97)Gd(0.03)N, Eu(0.97)Gd(0.04)O and EuO films were studied through a comparison of the findings from constant initial state spectroscopy using synchrotron light. Resonant enhancements, corresponding to the 4d → 4f transitions of Eu and Gd, were observed in some of the valence band photoemission features. The resonant photoemission intensity enhancements for the Gd 4f photoemission features are far stronger for the more insulating host systems than for the metallic system Eu(0.96)Gd(0.04)O. The evidence seems to suggest a correlation between the effective screening in the films and the resonant photoemission process.

Corynebacterium pseudotuberculosis, the infectious agent of caseous lymphadenitis (CLA), is responsible for substantial economic losses in goat and sheep production. Molecular characterization of C. pseudotuberculosis isolates by enterobacterial repetitive intergenic consensus (ERIC)-PCR has shown promising results in genotyping strains isolated from sheep with CLA. We evaluated the genetic diversity of C. pseudotuberculosis isolates collected from the Sertão region of the Pernambuco (PE) State, Brazil, and investigated the potential of ERIC-PCR as a tool for the molecular typing of strains of C. pseudotuberculosis isolated from goats. Thirty-two C. pseudotuberculosis strains isolated from goats in the municipalities of Floresta and Ibimirim, PE, C. pseudotuberculosis type strain ATCC 19410, the 1002 vaccine strain, and a field isolate of Rhodococcus equi were fingerprinted using the primers ERIC-1R and ERIC-2 and the primer pair ERIC- 1R+ERIC-2. Using 100% similarity as the cutoff, 8, 10, and 7 genotypes were obtained with ERIC-1-PCR, ERIC-2-PCR, and ERIC-1+2-PCR, respectively. The Hunter-Gaston discriminatory index calculated for the ERIC-1-PCR was 0.75. The index for the ERIC-2-PCR was 0.88, and the index for the ERIC-1+2-PCR was 0.79. Among goat isolates of C. pseudotuberculosis, three, two and four genotypes (found by ERIC-1-PCR, ERIC-2-PCR, and ERIC-1+2-PCR, respectively) had been previously described among sheep isolates from Minas Gerais State, Brazil. These results showed that ERIC-PCR has good discriminatory power and typeability, making it a useful tool for discrimination among C. pseudotuberculosis isolates from goats.

Background and Objectives: Mechanical ventilation (MV) strategies have been modified over the last decades with a tendency for increasingly lower tidal volumes (VT). However, in patients without acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) the use of high VTs is still very common. Retrospective studies suggest that this practice can be related to mechanical ventilation-associated ALI. The objective of this review is to search for evidence to guide protective MV in patients with healthy lungs and to suggest strategies to properly ventilate lungs with ALI/ARDS., Contents: A review based on the main articles that focus on the use of strategies of mechanical ventilation was performed., Conclusions: Consistent studies to determine which would be the best way to ventilate a patient with healthy lungs are lacking. Expert recommendations and current evidence presented in this article indicate that the use of a VT lower than 10 mL.kg(-1), associated with positive end-expiratory pressure (PEEP) ≥ 5 cmH(2)O without exceeding a pressure plateau of 15 to 20 cmH(2)O could minimize alveolar stretching at the end of inspiration and avoid possible inflammation or alveolar collapse., (Copyright © 2011 Elsevier Editora Ltda. All rights reserved.)

Advanced diabetic retinopathy with tractional retinal detachment or persistent vitreous hemorrhage often requires surgical treatment with pars plana vitrectomy. Despite advances in vitrectomy, surgery for complications of diabetic retinopathy can be a challenge and may be impaired by intense fibrovascular proliferation. Antiangiogenic drugs have been used for the treatment of diabetic retinopathy because of their inhibitory action on vascular endothelial growth factor. In this review, we discuss aspects related to the adjuvant use of these drugs in vitrectomy for complications of diabetic retinopathy. Bevacizumab shows beneficial effects regarding the surgical technique facilitation, but its long-term benefit still needs to be studied.

A density-functional theory study of the electrochemical adsorption of sulfuric acid anions was conducted at the Pt(111)/electrolyte interface over a wide range of electrode potential, including the anomalous region of the hydrogen voltammogram of this electrode. We focus on the precise nature of the binding species and their bonding to the surface, identifying the adsorbed species as a function of electrode potential. In particular, the origin of anomalous or so-called "butterfly" feature in this voltammogram between +0.30 and +0.50 V vs. the reference hydrogen electrode and the nature of the adsorbed species on the Pt(111) surface in this potential range were explicated.

The experimental and theoretical surface band structures of Mo(112) are compared. This surface band structure mapping is presented with corrections included for the lattice relaxation of the Mo(112) surface. Quantitative low energy electron diffraction (LEED) has been used to determine the details of the Mo(112) surface structure. The first layer contraction is 14.9% by LEED intensity versus voltage analysis and is in general agreement with the 17.6% contraction found from total surface energy optimization. The electronic band structure is mapped out along [Formula: see text]-[Formula: see text] and [Formula: see text]-[Formula: see text] of the surface Brillouin zone (SBZ). There is strong evidence of electron-phonon coupling particularly in the region of the Fermi level band crossing at 0.54 Å(-1).

This study is a retrospective case series aiming to evaluate the relation between toxoplasmic retinochoroiditis scars and the occurrence of retinal tears. Ten patients with retinal tear and toxoplasmic retinochoroiditis examined at the School of Medicine of Ribeirão Preto Clinics Hospital, between January 2007 and April 2008, were included. Fisher test and qui-square test with significance level of p<0.05 were used. Eight cases (80%) had retinal detachment. Twelve tears were found and localized mostly in the temporal superior periphery (6 cases, 50%). No statistically significant association between retinal tear and chorioretinal scar localization was observed considering five retinal quadrants (p=0.0828) or three zones (p=0.2507). The occurrence of retinal tears in patients with uveitis may be related to early posterior vitreous detachment caused by the intraocular inflammatory process. No correlation was observed between the localization of retinal tears and chorioretinal scars in this study, which suggests a causative factor not directly related to the presence of a scar.

Purpose: To describe an intravitreal injection technique using a commercially available 29-gauge insulin needle syringe (29GN syringe) and a 21-gauge (G) needle, comparing compound waste associated with this technique application and the one described in ranibizumab (Lucentis) kit instructions., Methods: Ten 0.3 ml doses of distilled water were aspirated using the 29GN syringe and 21G needle (PT technique), and another ten equal doses were aspirated employing the sterilized Lucentis kit (LK technique), which contains a 1ml tuberculin syringe, a 18G needle for compound aspiration and a 30G needle for intravitreal injection. For aspiration using the PT technique, a 21G needle is attached over a 29GN syringe. After compound aspiration, the 21G needle is removed and intravitreal injection is performed using the 29G needle. Using a precision balance, the aspiration needles (21G for PT; 18G for LK) were weighed before and after water aspiration and the syringe-needle complexes for injection (29GN for PT; 30G for LK) were weighed before aspiration and after emptying them. The volumes left in the aspiration needles and needle-syringe complexes were estimated by the difference in weight in grams, which were converted to millilitres., Results: The mean (+/-SD) residual volume (ml) of aspiration needles (21G for PT; 18G for LK) was significantly lower with PT technique (0.0034 +/- 0.0016) when compared to LK tech nique (0.0579 +/- 0.0011) (p<0.01). The mean (+/-SD) residual volume (ml) of syringe-needle complexes was significantly lower with PT technique (0.0056 +/- 0.0011) than with LK (0.0906 +/- 0.003 ml) (p<0.01)., Conclusion: The proposed technique is a reasonable alternative for minimizing medication loss during intravitreal injection procedures.

Proliferative sickle cell retinopathy is an uncommon complication in individuals with sickle cell trait (AS). However, the risk for proliferative retinopathy development is increased in patients with AS hemoglobinopathy associated with systemic conditions or ocular trauma. A case of a patient with AS hemoglobinopathy who developed proliferative sickle cell retinopathy after the occurrence of gestational diabetes and pregnancy-induced hypertension is reported. Hemoglobin electrophoresis revealed presence of A2 5.0%, S 35.0% and A 53.2%. The present case emphasizes the importance of evaluating systemic comorbidities in patients with sickle cell trait during pregnancy since sickle cell retinopathy can progress rapidly, as well as the importance of regular eye fundus examination in these patients.

If the ocular media are clear, indirect binocular ophthalmoscopy allows retinal detachment and retinal tear identification and treatment under direct visualization. However, if opacities are present preventing direct fundus examination, ultrasonography becomes the most important tool for evaluating the posterior segment. In addition, ultrasonography can be useful in retinal tear treatment by guiding cryotherapy. In this article we describe a rhegmatogenous retinal detachment treatment technique applied to a patient with corneal opacity. Cryopexy and circumferential and radial buckle positioning were guided by ultrasonography, resulting in retinal attachment during the 6-month follow-up period.

Traumatic optic nerve avulsion is a rare event. A case of complete unilateral optic nerve avulsion after blunt ocular trauma without major damage to other ocular structures is reported. B-scan ultrasonography with 10 and 20 MHz probes proved to be helpful in diagnosing the optic nerve lesion, whereas orbital computed tomography was inconclusive. The prognosis is ominous and it is dependent on the initial visual acuity, which was no light perception in this case. There is no efficient treatment for complete optic nerve avulsion, and no specific treatment was performed in this case.

Purpose: To evaluate eye manifestations in mansonelliasis patients from Coari, AM, rural area on the middle Amazonas River., Methods: Cross-sectional study consisted of evaluation of 543 subjects from Coari rural area on Solimões River right margin. All subjects were submitted to blood test for microfilaria and the subjects who had a positive test also were submitted to skin biopsies and ophthalmologic examination. Histopathology and PCR research for microfilaria were done on eye biopsies of suspect lesions., Results: Mansonella ozzardi was found in peripheral blood of 103 (18.9%) subjects. Ninety-five mansonelliasis patients were examined. Punctate keratitis was observed in 12 of them, nummular keratitis in one subject and sclerosing keratitis in another one. Skin biopsies were negative in all subjects. Conjunctival and limbal biopsies were done in five mansonelliasis patients and corneal biopsy in another three patients. Conjunctival and limbal biopsies of two patients and corneal biopsy of one patient showed no microfilaria or alterations due to its presence on histopathology. PCR showed no evidence of microfilaria in the other biopsies., Conclusion: Association between Mansonella ozzardi infection and corneal lesions with no evident etiology was observed in this study, but the lack of conclusive findings on histopathology and PCR make us doubt the corneal involvement in mansonelliasis. Large studies of high mansonelliasis prevalence populations and extensive employment of microfilaria identification tests in ocular tissue are needed to evaluate the microfilaria corneal pathogenicity.

In Manaus, Amazonas State, Brazil, the degree of individual exposure to leishmaniasis is related to disorganized land occupation. In order to evaluate predisposing factors for an outbreak, confirm the parasitological diagnosis, treat patients, and assess etiological agents, reservoirs, and vectors, a 12-month study was conducted in Manaus in a community located along the BR-174 federal highway. Some 451 individuals were studied, among whom 17 cases of American tegumentary leishmaniasis (ATL) were diagnosed (six women and 11 men). Age varied from one to 64 years. Eleven patients had from one to three lesions. As for reservoirs, three opossums were captured. No hemoflagellates were found in the blood tests. Lutzomyia umbratilis was the predominant vector species captured. Many ATL patients were engaged in activities that exposed them to Leishmania vectors. Some patients may have been infected in the household and peridomiciliary environments. The epidemiological profile of ATL in this community is similar that of other foci in the region. This case series characterizes ATL as an endemic local public health problem.

Background: Vestibular rehabilitation in vestibular disorders., Aim: To study the benefits of Vestibular Rehabilitation through the Brazilian Dizziness Handicap Inventory-DHI., Method: Application of the Vestibular Rehabilitation proposed by Zee (1985) and analysis using the Sign; T-Student and Kendall's T tests., Results: A change in the diagnosis of vestibular peripheral disorder to normal vestibular patterns was obtained in 75% of the cases., Conclusion: Our results indicated a change of the diagnosis and in the quality of life of the tested individuals. The use of the DHI demonstrated to be an excellent tool for qualitative studies.

Five cases of pregnancy complicated by pancreatitis are discussed. In three of the five cases there was, at the time of the pregnancy, some pathology which might have been responsable for the acute pancreatitis. Three patients were operated on. The phisiopathology and the ethiopathology of this condition are commented, as well as the principal clinical and laboratorial findings. The complications are discussed. The medical treatment represents the best management in these cases. Surgery, ideally, should only be undertaken when the pregnancy is over.

It is important not to confuse the 46,X,i(Xq) syndrome with the 45,X classical Turner's syndrome. There are profound cytogenetic and clinical differences between the two syndromes, which must be borne in mind in the differential diagnosis of amenorrhea and of infertility.