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A simple and efficient method was developed for the determination of cocaine in post-mortem samples of human liver via solid-liquid extraction with low temperature partitioning (SLE-LTP) and analysis by gas chromatography coupled to mass spectrometry (GC-MS). The extraction procedure was optimized by evaluating the influence of the following variables: pH of the extract, volume and composition of the extractor solvent, addition of a sorbent material (PSA: primary-secondary amine) and NaCl to clean up and increase the ionic strength of the extract. A bovine liver sample that was free of cocaine was used as a blank for the optimization of the SLE-LTP extraction procedure. The highest recovery was obtained when crushed bovine liver (2g) was treated with 2mL of ultrapure water plus 8mL of acetonitrile at physiological pH (7.4). The results also indicated no need for using PSA and NaCl. The complete analytical procedure was validated for the following figures of merit: selectivity, lower limit of quantification (LLOQ), calibration curve, recovery, precision and accuracy (for within-run and between-run experiments), matrix effect, dilution integrity and stability. The within-run and between-run precision (at four levels) varied from 2.1% to 9.4% and from 4.0% to 17.0%, respectively. A maximum deviation of 11.62% for the within-run and between-run accuracies in relation to the nominal concentrations was observed. Moreover, the LLOQ value for cocaine was 50.0ngg(-1) whereas no significant effects were noticed in the assays of dilution integrity and stability. To assess its overall performance, the optimized method was applied to the analysis of eight human liver samples collected from individuals who died due to the abusive consumption of cocaine. Due to the existence of a significant matrix effect, a blank human liver was used to construct a matrix-matched analytical curve. The concentrations of cocaine found in these samples ranged from 333.5 to 5969ngg(-1)., (Copyright © 2013 Elsevier B.V. All rights reserved.)

A new compound of formula (Bu4N)2[Mn2{Cu(opba)}2ox] (1) [Bu4N(+) = tetra-n-butylammonium cation, H4opba = 1,2-phenylenebis(oxamic acid), and H2ox = oxalic acid] has been synthesized and magneto-structurally investigated. The reaction of manganese(II) acetate, [Cu(opba)](2-), and ox(2-) in dimethyl sulfoxide yielded single crystals of 1. The structure of 1 consists of heterobimetallic oxamato-bridged Cu(II)Mn(II) chains which are connected through bis-bidentate oxalate coordinated to the manganese(II) ions to afford anionic heterobimetallic layers of 6(3)-hcb net topology. The layers are interleaved by n-Bu4N(+) counterions. Each copper(II) ion in 1 is four-coordinate in a square planar environment defined by two amidate-nitrogen and two carboxylate-oxygen atoms from the two oxamate groups of the obpa ligand. The manganese(II) ion is six-coordinate in a somewhat distorted octahedral surrounding that is built by two oxalate-oxygen and four carbonyl-oxygen atoms from two [Cu(opba)](2-) units. The magnetic properties of 1 in the temperature range 1.9-300 K correspond to those expected for the coexistence of intralayer antiferromagnetic interactions of the type copper(II)-manganese(II) across oxamato and manganese(II)-manganese(II) through oxalato bridges plus a weak spin canting in the very low temperature domain. Simulation of the magnetic data through quantum Monte Carlo methodology reveals the magnitude of the intralayer magnetic interactions [J(CuMn) = -32.5(3) cm(-1), and J(MnMn) = -2.7(3) cm(-1)], their values being within the range of those previously observed in lower nuclearity systems.

The enthalpy of hydrogenation of uracil was derived from the experimental enthalpies of formation, in the gaseous phase, of uracil and 5,6-dihydrouracil, in order to analyze its aromaticity. The enthalpy of formation of 5,6-dihydrouracil was obtained from combustion calorimetry, Knudsen effusion technique and Calvet microcalorimetry results. High-level computational methods were tested for the enthalpy of hydrogenation of uracil, but only with G3 was possible to obtain results in agreement with the experimental ones. It was found that uracil possesses 30.0% of aromatic character in the gaseous phase. Using both implicit, explicit, and hybrid solvation methods, it was possible to obtain a reference value for the enthalpy of hydrogenation of uracil in the aqueous solution and the effect of polarity and hydrogen bonds on the aromaticity of uracil was analyzed. The value of the hydrogenation enthalpy of uracil in aqueous solution was compared with the experimental value in the crystal phase, also dominated by polarity and hydrogen bonds, derived from combustion calorimetry results. The supramolecular effects on the crystal lattice were explored by the computational simulation of π-π staking dimers and hydrogen bonded dimers.

Aim: To analyze reliability among endoscopists in diagnosing portal hypertensive gastropathy (PHG) and to determine which criteria from the most utilized classifications are the most suitable., Methods: From January to July 2009, in an academic quaternary referral center at Santa Casa of São Paulo Endoscopy Service, Brazil, we performed this single-center prospective study. In this period, we included 100 patients, including 50 sequential patients who had portal hypertension of various etiologies; who were previously diagnosed based on clinical, laboratory and imaging exams; and who presented with esophageal varices. In addition, our study included 50 sequential patients who had dyspeptic symptoms and were referred for upper digestive endoscopy without portal hypertension. All subjects underwent upper digestive endoscopy, and the images of the exam were digitally recorded. Five endoscopists with more than 15 years of experience answered an electronic questionnaire, which included endoscopic criteria from the 3 most commonly used Portal Hypertensive Gastropathy classifications (McCormack, NIEC and Baveno) and the presence of elevated or flat antral erosive gastritis. All five endoscopists were blinded to the patients' clinical information, and all images of varices were deliberately excluded for the analysis., Results: The three most common etiologies of portal hypertension were schistosomiasis (36%), alcoholic cirrhosis (20%) and viral cirrhosis (14%). Of the 50 patients with portal hypertension, 84% were Child A, 12% were Child B, 4% were Child C, 64% exhibited previous variceal bleeding and 66% were previously endoscopic treated. The endoscopic parameters, presence or absence of mosaic-like pattern, red point lesions and cherry-red spots were associated with high inter-observer reliability and high specificity for diagnosing Portal Hypertensive Gastropathy. Sensitivity, specificity and reliability for the diagnosis of PHG (%) were as follows: mosaic-like pattern (100; 92.21; High); fine pink speckling (56; 76.62; Unsatisfactory); superficial reddening (69.57; 66.23; Unsatisfactory); red-point lesions (47.83; 90.91; High); cherry-red spots (39.13; 96.10; High); isolated red marks (43.48; 88.31; High); and confluent red marks (21.74; 100; Unsatisfactory). Antral elevated erosive gastritis exhibited high reliability and high specificity with respect to the presence of portal hypertension (92%) and the diagnosis of portal hypertensive gastropathy (88.31%)., Conclusion: The most suitable endoscopic criteria for the diagnosis of PHG were mosaic-like pattern, red-point lesions and cherry-red spots with no subdivisions, which were associated with a high rate of inter-observer reliability.

Background: A clear relationship between asthma and obesity has been reported, but the mechanisms remain unclear. The aim of this study was to evaluate the influence of obesity on eosinophil activity (chemotaxis and adhesion) in asthmatic children and adolescents compared with cells from healthy volunteers., Methods: Asthmatic obese (AO), asthmatic non-obese (ANO), non-asthmatic obese (NAO) and non-asthmatic non-obese (NANO) individuals were included in the present study. The chemotaxis of eosinophils after stimulation with eotaxin (300 ng/ml), platelet-activating factor (10 μM; PAF) and RANTES (100 ng/ml) was performed using a microchemotaxis chamber. The eosinophil peroxidase activity was measured to determine the adhesion activity of eosinophils cultivated on fibronectin-coated plates. The serum leptin, adiponectin, TNF-α and IgE levels were quantified using ELISA assays., Results: The serum IgE levels and eosinophil counts were significantly higher in asthmatic (obese and non-obese) individuals compared with non-asthmatic individuals (obese and non-obese). Spontaneous eosinophil chemotaxis was greater in the AO group compared with either the ANO or NANO groups. The activation of eosinophils using eotaxin and PAF increased eosinophil chemotaxis in the AO group. RANTES treatment increased eosinophil chemotaxis in the NAO group compared with the NANO or ANO groups. The activation of eosinophils using eotaxin significantly increased eosinophil adhesion in the AO group compared with other groups. The serum leptin and TNF-α levels were higher in obese subjects (asthmatic and non-asthmatic), whereas the levels of adiponectin did not significantly differ among these groups., Conclusion: This study is the first to show increased eosinophilic activity (chemotaxis and adhesion) associated with high serum leptin and TNF-α levels in atopic asthmatic obese children and adolescents compared with non-obese healthy volunteers.

Background: Measurements of CFTR function in rectal biopsies ex vivo have been used for diagnosis and prognosis of Cystic Fibrosis (CF) disease. Here, we aimed to evaluate this procedure regarding: i) viability of the rectal specimens obtained by biopsy forceps for ex vivo bioelectrical and biochemical laboratory analyses; and ii) overall assessment (comfort, invasiveness, pain, sedation requirement, etc.) of the rectal forceps biopsy procedure from the patients perspective to assess its feasibility as an outcome measure in clinical trials., Methods: We compared three bowel preparation solutions (NaCl 0.9%, glycerol 12%, mannitol), and two biopsy forceps (standard and jumbo) in 580 rectal specimens from 132 individuals (CF and non-CF). Assessment of the overall rectal biopsy procedure (obtained by biopsy forceps) by patients was carried out by telephone surveys to 75 individuals who underwent the sigmoidoscopy procedure., Results: Integrity and friability of the tissue specimens correlate with their transepithelial resistance (r = -0.438 and -0.305, respectively) and are influenced by the bowel preparation solution and biopsy forceps used, being NaCl and jumbo forceps the most compatible methods with the electrophysiological analysis. The great majority of the individuals (76%) did not report major discomfort due to the short procedure time (max 15 min) and considered it relatively painless (79%). Importantly, most (88%) accept repeating it at least for one more time and 53% for more than 4 times., Conclusions: Obtaining rectal biopsies with a flexible endoscope and jumbo forceps after bowel preparation with NaCl solution is a safe procedure that can be adopted for both adults and children of any age, yielding viable specimens for CFTR bioelectrical/biochemical analyses. The procedure is well tolerated by patients, demonstrating its feasibility as an outcome measure in clinical trials.

We herein present the synthesis and X-ray structures of five copper(II) complexes of formulae [Cu(bpca)(CF3SO3)(H2O)]·H2O (1), [Cu(bpca)(Phpr)(H2O)]·3/2H2O (2), {[Cu(bpca)]2[Cu(opba)(H2O)]}·H2O (3), {[Cu(bpca)]2(H2opba)}2·6H2O (4) and [Cu(bpca)(EtH2opba)]n (5), where bpca = bis(2-pyridylcarbonyl)amidate, Phpr = 3-phenylpropionate, CF3SO3(−) = triflate (anion of the trifluoromethanesulphonic acid), H4opba = N,N′-1,2-phenylenebis(oxamic acid), and EtH3opba = monoethyl ester derivative of the H4opba. 1 and 2 are mononuclear copper(II) complexes where the copper atom is five-coordinate in distorted square pyramidal surroundings with a tridentate bpca and a water molecule (1)/carboxylate oxygen (2) building the basal plane and a triflate oxygen (1)/water molecule (2) filling the apical position. 3 is a neutral tricopper(II) complex where the [Cu(opba)(H2O)]2− unit acts as a bis-bidentate ligand toward two peripheral [Cu(bpca)]+ fragments. The three crystallographically independent copper(II) ions in 3 are five-coordinate with two nitrogen and two oxygen atoms (inner copper atom)/three bpca-nitrogen and an oxamate oxygen (outer copper atom) building the basal plane plus a water molecule (inner copper)/an oxamate oxygen (outer copper) in the apical position (inner copper atom) of somewhat distorted square pyramidal surroundings. 4 is a centrosymmetric tetracopper(II) compound where four [Cu(bpca)]+ fragments are assembled by two H2opba2− groups adopting an unusual bidentate/bis-monodentate bridging mode. The two crystallographically independent copper(II) ions in 4 are also five-coordinate having the three bpca-nitrogens in basal positions, the other two sites of the distorted square pyramid being filled by two oxygens of either a bidentate oxamate (at one copper centre) or two bis-monodentate oxamates (at the other copper atom). 5 is a zigzag chain of [Cu(bpca)(H2O)]+ units which are connected through the EtH2opba− ligand adopting a bidentate/monodentate bridging mode across the monodeprotonated oxamate group. Each copper(II) ion in 5 is six-coordinate in an elongated octahedral CuN3O3 chromophore. The magnetic properties of 3–5 were investigated in the temperature range 1.9–300 K. 3 exhibits an intermediate intramolecular antiferromagnetic interaction [J = -65.8(2) cm(-1) with the Hamiltonian H = -J(S(Cu1)·S(Cu2) + S(Cu2)·S(Cu3))] which leads to a low-lying spin doublet at low temperatures. A weak antiferromagnetic coupling between the inner copper(II) ions occurs in 4 [J = -2.36(2) cm(-1), H = -JS1·S2)] and a very small intrachain antiferromagnetic interaction is observed in 5 [J = -0.17(1) cm(-1) with H = -J∑(i)S(i)·S(i+1)]. These values are analyzed by means of simple orbital symmetry considerations and compared with those previously reported for parent systems.

Bi-stable molecular systems presenting valence tautomerism are associated with the development of new functional materials, which can be used for applications in organic electric conductors, optoelectronic and molecular magnetic devices. The properties of these materials can be adjusted with slight chemical changes and can be induced by external stimuli. Typical examples of valence tautomer compounds are coordination complexes of Co and o-dioxolene ligands, notably quinone like ones. In the search for a new class of cobalt complexes presenting valence tautomerism we report herein the synthesis and characterization of five new coordination compounds of cobalt and 2-hydroxy-1,4-naphthoquinone (lawsone or shortly Law). Complexes [Co(Law)2(im)2]·C6H5CH3 (1), [Co(Law)2(py)2]·CH3OH (2), [Co(Law)2(phen)]·(C4H8O)2 (3), [Co(Law)2(2,2-bpy)]·C6H5CH3 (4) and [Co(Law)2(2,2-bpy)] (5) were synthesized and fully characterized by X-ray diffraction and EPR techniques in a wide range of temperatures and under illumination. Despite presenting similar molecular and geometry packing of the valence tautomer complexes of cobalt and o-dioxolenes, neither structural nor electronic evidence of valence tautomerism could be found in the Co and lawsone complexes.

Reflux laryngitis is a common clinic complication of nasogastric intubation (NSGI). Since there is no report concerning the effects of low level laser therapy (LLLT) on reflux laryngitis, this study aimed to analyze the protective effect of single and combined therapies with low level laser at the doses of 2.1J and 2.1+1.2 J with a total irradiation time of 30s and 30+30 s, respectively, on a model of neurogenic reflux laryngitis. NSGI was performed in Wistar rats, assigned into groups: NGI (no treatment), NLT17.5 (single therapy), and NLT17.5/10.0 (combined therapy, applied sequentially). Additional non-intubated and non-irradiated rats were use as controls (CTR). Myeloperoxidase (MPO) activity was assessed by colorimetric method after the intubation period (on days 1, 3, 5, and 7), whereas paraffin-embedded laryngeal specimens were used to carry out histopathological analysis of the inflammatory response, granulation tissue, and collagen deposition 7 days after NSGI. Significant reduction in MPO activity (p<0.05) and in the severity of the inflammatory response (p<0.05), and improvement in the granulation tissue (p<0.05) was observed in NLT17.5/10.0 group. Mast cells count was significantly decreased in NGI and NLT17.5 groups (p<0.001), whereas no difference was observed between NLT17.5/10.0 and CTR groups (p>0.05). NLT17.5/10.0 group also showed better collagenization pattern, in comparison to NGI and NLT17.5 groups. This study suggests that the combined therapy successfully modulated the inflammatory response and collagenization in experimental model of NSGI-induced neurogenic laryngitis., (Copyright © 2013 Elsevier B.V. All rights reserved.)

For the new organic salt 1H-imidazol-3-ium 1,4-dioxo-1,4-dihydronaphthalen-2-olate, C3H5N2(+)·C10H5O3(-), ab initio calculations of the gas-phase structures of the lawsonate and imidazolium ions were performed to help in the interpretation of the structural features observed. Three different types of hydrogen bond are responsible for the three-dimensional packing of the salt.

Unlabelled: In recent decades, many studies on mouth breathing (MB) have been published; however, little is known about many aspects of this syndrome, including severity, impact on physical and academic performances., Objective: Compare the physical performance in a six minutes walk test (6MWT) and the academic performance of MB and nasal-breathing (NB) children and adolescents., Method: This is a descriptive, cross-sectional, and prospective study with MB and NB children submitted to the 6MWT and scholar performance assessment., Results: We included 156 children, 87 girls (60 NB and 27 MB) and 69 boys (44 NB and 25 MB). Variables were analyzed during the 6MWT: heart rate (HR), respiratory rate, oxygen saturation, distance walked in six minutes and modified Borg scale. All the variables studied were statistically different between groups NB and MB, with the exception of school performance and HR in 6MWT., Conclusion: MB affects physical performance and not the academic performance, we noticed a changed pattern in the 6MWT in the MB group. Since the MBs in our study were classified as non-severe, other studies comparing the academic performance variables and 6MWT are needed to better understand the process of physical and academic performances in MB children.

The damage control surgery is a widely accepted concept today among abdominal trauma specialists when it comes to the severely traumatized. In these patients, the death is due, in most cases, to the installation of the lethal triad (hypothermia, coagulopathy and acidosis) and not the inability to repair the serious initial damage. In this review, the authors address the lethal triad in its three phases and emphasize the measures taken to prevent them, as well as discussing the indication and employment of damage control surgery in its various stages. Restoring the physiological status of the patient in the ICU, so that he/she can be submitted to final operation and closure of the abdominal cavity, another challenge in severe trauma patients, is also discussed.

Background: HTLV-1 proviral load is a risk marker for HAM/TSP, but it is insufficient to determine the disease outcome. HTLV-1 Tax and HBZ proteins have been implicated in HAM/TSP pathogenesis in inducing cell proliferation and cytotoxic T lymphocytes response., Objectives: To quantify the expression of tax and HBZ mRNA in asymptomatic carriers (AC) and HAM patients, and to investigate their association with HAM/TSP., Study Design: We quantified the expression of HTLV-1 tax and HBZ mRNA in 37 AC and 26 HAM patients classified according to proviral load as low (AC(L) and HAM(L): <1% infected cells) or high (AC(H) and HAM(H): >1%)., Results: The AC(L) subgroup showed the lowest frequency of individuals expressing tax mRNA in comparison with AC(H), HAM(L) and HAM(H), and tax mRNA load normalized by proviral load was significantly lower in the AC(L). In turn, normalized HBZ mRNA expression was similar in all subgroups. Both tax and HBZ mRNA expression were moderately correlated with proviral load in AC (r=0.6, p<0.001) and were weaker in HAM (r=0.4, p<0.05). In contrast, the correlation between tax and HBZ mRNA load was moderate in AC (r=0.5, p=0.001) and was much stronger in HAM (r=0.8, p<0.001). In addition, HBZ mRNA load, but not tax, was significantly associated with motor disability in HAM patients (p=0.036)., Conclusions: The expression of tax mRNA seems to be best to estimate the risk of HAM/TSP, whereas HBZ mRNA appears to be a surrogate marker to disease progression, indicating that they have important but distinct roles in HAM/TSP pathogenesis., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Chagas' disease is one of the most serious parasitic diseases of Latin America, with a social and economic impact far outweighing the combined effects of other parasitic diseases such as malaria, leishmaniasis and schistosomiasis. In the chronic phase of this disease, the destruction of enteric nervous system (ENS) components leads to megacolon development. Previous data presented that the regeneration tax in the ENS neurons is augmented in chagasic patients. Although, there are several neuronal types with different functions in the intestine a detailed study about the regeneration of every neuronal type was never performed before. Therefore, the aim of this study was to evaluate the regeneration tax of every neuronal cell type in the ENS from chagasic patients with megacolon and non-infected individuals. A neuronal regeneration marker (GAP-43) was used in combination with a pan-neuronal marker (Peripherin) and several neuropeptides markers (cChat, Substance P, NPY, VIP and NOS), and it was considered as positive just with the combination of these markers. Our results demonstrated that the regeneration levels of cChat, Substance P, and NPY were similar in chagasic patients and non-infected individuals. However, levels of VIP and NOS neuropeptides were increased in chagasic patients when compared with non-infected individuals. We believe that the augment in the regeneration occur due to an increased destruction of selective neuronal types. These results corroborates with previous studies that pointed out to selective destruction of VIP and NOS neurons in chagasic patients., (Copyright © 2012 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.)

Objective: This study reviewed the scientific evidence available on the effects of manipulative techniques on children with respiratory diseases., Method: Three databases (SciELO, PEDro, and MEDLINE) were searched for clinical trials on the effects of manual therapy techniques on children and adolescents with respiratory diseases. The relevant studies were chosen by 2 independent researchers who assessed their abstracts and selected the studies that met the criteria for a complete and structured review., Results: Of the 1147 relevant titles, 103 titles were selected for abstract assessment, and of these, 24 were selected for a full-text review. After critical analysis, 8 studies were included in the review and 16 were excluded for the following reasons: 1 covered only conventional therapy, 7 were not about the studied theme, and 8 included adults. Of the 8 studies included in the present review, 5 consisted of asthmatic children and the others of children with the following conditions: cystic fibrosis, bronchiolitis, recurrent respiratory infections, among others. Only 2 studies did not identify positive results with the use of manual therapy. The other 6 studies found some benefit, specifically in spirometric parameters, immunologic tests, anxiety questionnaire, or level of salivary cortisol., Conclusion: The use of manual techniques on children with respiratory diseases seems to be beneficial. Chiropractic, osteopathic medicine, and massage are the most common interventions. The lack of standardized procedures and limited variety of methods used evidenced the need for more studies on the subject., (Copyright © 2013 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.)

Background: The aim of this study was to assess the relationship between the preoperative volume of the right liver lobe (as determined by computed tomography) and the intraoperative graft weight with or without the middle hepatic vein., Methods: Sixty-three patients who underwent liver transplantation were included in this study. The preoperative volumes of both the left and the right liver lobe were measured in all patients using computed tomography. The intraoperative weight of the right liver lobe was also measured with (group 1, n = 29) and without (group 2, n = 34) the middle hepatic vein. The results were compared with respect to gender, age, body weight, height, body mass index (BMI), weights of the left and right liver lobes as measured by computed tomography, and intraoperative weight of the right liver lobe., Results: A 21.64 % difference was observed between the weight of the right liver lobe as measured by computed tomography and the weight of the right lobe without the hepatic vein as measured intraoperatively (group 2). Moreover, a 12.38 % difference was observed between the weight of the right liver lobe as measured by computed tomography and the weight of the right lobe plus the middle hepatic vein as measured intraoperatively (group 1)., Conclusions: The weight of the right liver lobe graft in a living-donor transplantation is less than that calculated by preoperative computed tomography, and the inclusion of the middle hepatic vein in the right liver lobe graft resulted in a statistically significant decrease in this difference.

The filling material remaining after post space preparation may not be enough to prevent the contamination of periapical tissues when the root canal is exposed to saliva. Thus, the purpose of this study was to evaluate leakage through three different materials used as barriers over the remaining filling. Thirty-two human premolars were selected for this study. Following the endodontic treatment, post spaces were prepared, leaving 4 mm of filling material. A barrier 1 mm high was placed over the filling material using Cotosol, VitoFil or MTA (n = 8). Absence of barrier was used as control. The specimens were immersed in 2% methylene blue dye for 12 hours, after which they were sectioned immediately below the barriers and the apical portions were ground into powder in a mill for hard tissues. The powder was immersed in absolute alcohol to dilute the dye and then the dye concentration was analyzed using an absorbance spectrophotometer. Dye concentration was classified according to scores from 0 to 4, and the scores were submitted to Kruskal-Wallis and Tukey's post-hoc tests (alpha = 0.05). Only Cotosol and MTA reduced the leakage when compared to control. Vitrofil showed leakage values similar to both MTA and control, but higher than Cotosol. In conclusion, the material used as a barrier can have an effect on leakage through the remaining filling material.

Background: Human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) causes serious diseases and is endemic in many parts of the world. It is transmitted from mother to child in 15-25% of the cases, primarily through breastfeeding. Proviral load and duration of breastfeeding are thought to play a role in transmission. This study aimed to detect HTLV-seropositive mothers through testing of neonates, to evaluate maternal HTLV proviral load and to measure the rates of transmission blocking when interruption of breastfeeding was implemented., Methods: Neonates were screened for HTLV-1/2 IgG by enzyme immunoassay using the neonatal screening program of Minas Gerais State, Brazil. Breastfeeding interruption was recommended to those whose mothers were confirmed HTLV-positive. Children were tested by polymerase chain reaction at birth and at 12 months of age., Results: Of 55,293 neonates tested, 42 (0.076%) were positive for HTLV-1 or HTLV-2 IgG. All 42 were polymerase chain reaction-negative at birth and 1 of 37 (2.7%) became antibody-positive after 12 months. His mother had delivered him vaginally and was informed of the positive HTLV-1 polymerase chain reaction after 7 days of breastfeeding. The mother's proviral load was 271 copies/10,000 cells, whereas the average is 109.2 copies/10,000 cells (95% confidence interval: 70.56-147.83)., Conclusions: Maternal HTLV-1 proviral load and the route of delivery may have played a role in the transmission observed. Avoidance of breastfeeding was an effective measure to reduce HTLV transmission. In endemic countries, routine prenatal or neonatal screening combined with formula feeding for mothers confirmed HTLV-positive may be an important strategy to prevent future development of illnesses related to HTLV.

Unlabelled: Temporomandibular disorders (TMD) are characterized by the presence of temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected., Objective: To systematically review studies that investigated the effect of low level laser therapy (LLLT) on the pain levels in individuals with TMD., Material and Methods: The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events., Results: After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm², while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo., Conclusion: Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the best application protocol for pain relief in patients with TMD.

Background: Manual hyperinflation (MH) is used to improve mucociliary clearance and alveolar expansion in mechanically ventilated patients. Despite the popularity of MH, studies with adults have shown considerable variability in the results from its use. This study assessed if professional training on the application of MH influences its performance., Methods: An experimental study was conducted with physiotherapists, including 11 with previous professional experience (experienced) and 11 without previous experience (inexperienced). They applied MH in a test lung model using self-inflating bags in 2 sizes (infant and pediatric) from 3 manufacturers (Hudson, Laerdal, and JG Moriya). The test lung simulated the lung mechanics of a newborn and a pediatric patient in 2 different clinical situations: at normal and reduced compliance. The professionals were instructed to perform MH as described in the literature. Measurements of inspiratory volume, peak inspiratory pressure, peak inspiratory flow, and peak expiratory flow were recorded using a pneumotachograph in each condition., Results: The delivered peak inspiratory flow was higher in the experienced group (P = .03) than in the inexperienced group. This result was observed in both neonatal and pediatric self-inflating bags. There was no difference in the parameters delivered between the experienced and inexperienced groups., Conclusions: The experienced and inexperienced groups were similar in their overall MH performance; the only difference was the observation of the highest PIF in the results from the experienced group.

Samples of sewage from a university hospital and a chemistry technical school were analysed for the percentage of bacterial tolerance to chromium (Cr), silver (Ag) and mercury (Hg). Additionally, we investigated the effect of these metals on pigmentation and on some enzymatic activities of the metal tolerant strains isolated, as well as antimicrobial resistance in some metal tolerant Enterobacteriaceae strains. Tolerance to Cr was observed mainly in Gram positive bacteria while in the case of Ag and Hg the tolerant bacteria were predominately Gram negative. Hg was the metal for which the percentage of tolerance was significantly higher, especially in samples from the hospital sewage (4.1%). Mercury also had the most discernible effect on color of the colonies. Considering the effect of metals on the respiratory enzymes, one strain of Ag-tolerant Bacillus sp. and one of Hg-tolerant P. aeruginosa were unable to produce oxidase in the presence of Ag and Hg, respectively, while the expression of gelatinase was largely inhibited in various Gram negative strains (66% by Cr). Drug resistance in Hg-tolerant Enterobacteriaceae strains isolated from the university hospital sewage was greater than 80%, with prevalence of multiple resistance, while the Ag-tolerant strains from the same source showed about 34% of resistance, with the predominance of mono-resistance. Our results showed that, despite the ability of metal tolerant strains to survive and grow in the presence of these elements, the interactions with these metals may result in metabolic or phisiological changes in this group of bacteria.

Objective: to validate the operational definitions of the defining characteristics and risk factors of the three NANDA International (NANDA-I) nursing diagnoses and to revise these diagnoses' definitions., Method: content validation of nursing diagnosis. 146 defining characteristics and risk factors were identified in the literature in Brazilian and international databases. This was followed by content validation of the definitions of these diagnoses (presented by NANDA-I) and of the operational definitions (developed by the researchers) of the defining characteristics and risk factors, carried out by six expert nurses, regarding relevance, clarity and comprehensiveness., Result: of the 146 defining characteristics and risk factors, 22 were considered redundant and were excluded. The experts proposed changing the definitions of the diagnoses of Impaired Tissue Integrity and Risk for Impaired Skin Integrity. It was possible to identify various defining characteristics and risk factors which are not present in the NANDA-I taxonomy but which are indicated in the literature., Conclusion: the process attained its objective of producing valid operational definitions for defining characteristics and risk factors, which will permit the undertaking of validation studies for these diagnoses. The study's contribution to advancing scientific knowledge consists in its presenting clearer operational definitions for these diagnoses and a higher number of defining characteristics and risk factors, which will assist the nurses in the identification and use of the same with greater accuracy in clinical practice.

Purpose: To present a review about a comparative study of bile duct ligation versus carbon tetrachloride Injection for inducing experimental liver cirrhosis., Methods: This research was made through Medline/PubMed and SciELO web sites looking for papers on the content "induction of liver cirrhosis in rats". We have found 107 articles but only 30 were selected from 2004 to 2011., Results: The most common methods used for inducing liver cirrhosis in the rat were administration of carbon tetrachloride (CCl4) and bile duct ligation (BDL). CCl4 has induced cirrhosis from 36 hours to 18 weeks after injection and BDL from seven days to four weeks after surgery., Conclusion: For a safer inducing cirrhosis method BDL is better than CCl4 because of the absence of toxicity for researches and shorter time for achieving it.

Botulinum toxin (BTX) is the best therapeutic option inpatients with cervical dystonia (CD), but physical therapy (PT) can be added to the treatment to achieve better results. Forty of our 70 patients with CD were en-rolled in a controlled open study. Subjects were divided into two groups: G1 (intervention group comprising patients receiving BTX and PT) and G2 (control group comprising patients receiving BTX only). Both groups were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the 36-Item Short-Form Health Survey (SF-36). On the TWSTRS, significant improvements in disease severity were seen in G1 and G2 but significant improvements on the pain and disability subscales were seen only in G1 patients.There was a significant difference only on the pain sub-scale between G2 and G1 following treatment. An analysis of the physical aspects of SF-36 showed significant improvement in G1 on three subscales. An intergroup difference was also seen on two subscales.Regarding emotional aspects, G1 showed a significant improvement on three subscales. A significant difference on two subscales was also seen between G2 and G1 following treatment. BTX plus PT treatment achieved symptom relief in patients with CD and improved their quality of life.

Objectives: To assess the impact of increased thoracic kyphosis on pulmonary function and functional capacity in children and adolescents with cystic fibrosis (CF) and to verify the influence of disease severity, age and nutritional status on this deformity., Method: This was a cross-sectional, analytical study conducted at a university hospital. It included CF patients with confirmed diagnosis and without pulmonary exacerbation. The sample was submitted to postural assessment, spirometry (FEV1, FVC and FEV1/FVC) and 6-minute walk test distance (6-MWT distance). Data were analyzed using the Mann Whitney test, Spearman correlation and logistic regression., Results: Forty-two patients were enrolled, 61.9% presented increase of thoracic kyphosis. There was no difference in values of FEV1, FVC, FEV1/FVC and 6-MWT distance between the groups with or without thoracic kyphosis (p = 0.407; p = 0.756; p = 0.415; p = 0.294). In the group without alteration, patients with more disease severity had a mean FEV1 of 74.1±21.9% and FVC of 79.8±18.7% while in those of lesser severity higher values were found (95.6±12.2% and 97.6±13.2%, respectively) (p = 0.027 and p = 0.027). The presence of kyphosis was correlated with age (p = 0.048) but not with severity (p = 0.151) and body mass index (p = 0.088)., Conclusions: There was a high prevalence of increased thoracic kyphosis in children and adolescents with CF. The deformity did not affect pulmonary function and functional capacity and there was no relationship with disease severity. Regardless of posture, worsening of disease severity determined worsening of pulmonary function.

Background: In a previous study, we showed that a saponin mixture isolated from the roots of Ampelozizyphus amazonicus Ducke (SAPAaD) reduces urine excretion in rats that were given an oral loading of 0.9 % NaCl (4 ml/100 g body weight). In the present study, we investigated whether atrial natriuretic peptides (ANP) and renal ATPases play a role in the SAPAaD- induced antidiuresis in rats., Methods: To evaluate the effect of SAPAaD on furosemide-induced diuresis, Wistar rats (250-300 g) were given an oral loading of physiological solution (0.9 % NaCl, 4 ml/100 g body weight) to impose a uniform water and salt state. The solution containing furosemide (Furo, 13 mg/kg) was given 30 min after rats were orally treated with 50 mg/kg SAPAaD (SAPAaD + Furo) or 0.5 ml of 0.9 % NaCl (NaCl + Furo). In the SAPAaD + NaCl group, rats were pretreated with SAPAaD and 30 min later they received the oral loading of physiological solution. Animals were individually housed in metabolic cages, and urine volume was measured every 30 min throughout the experiment (3 h). To investigate the role of ANP and renal Na(+) pumps on antidiuretic effects promoted by SAPAaD, rats were given the physiological solution (as above) containing SAPAaD (50 mg/kg). After 90 min, samples of urine and blood from the last 30 min were collected. Kidneys and atria were also removed after previous anesthesia. ANP was measured by radioimmunoassay (RIA) and renal cortical activities of Na(+)- and (Na(+),K(+))-ATPases were calculated from the difference between the [32P] Pi released in the absence and presence of 1 mM furosemide/2 mM ouabain and in the absence and presence of 1 mM ouabain, respectively., Results: It was observed that SAPAaD inhibited furosemide-induced diuresis (at 90 min: from 10.0 ± 1.0 mL, NaCl + Furo group, n = 5, to 5.9 ± 1.0 mL, SAPAaD + Furo group n = 5, p < 0.05), increased both Na(+)-ATPase (from 25.0 ± 5.9 nmol Pi.mg(-1).min(-1), control, to 52.7 ± 8.9 nmol Pi.mg(-1).min(-1), p < 0.05) and (Na(+),K(+))-ATPase (from 47.8 ± 13.3 nmol Pi.mg(-1).min(-1), control, to 79.8 ± 6.9 nmol Pi .mg(-1).min(-1), p < 0.05) activities in the renal cortex. SAPAaD also lowered urine ANP (from 792 ± 132 pg/mL, control, to 299 ± 88 pg/mL, p < 0.01) and had no effect on plasma or atrial ANP., Conclusion: We concluded that the SAPAaD antidiuretic effect may be due to an increase in the renal activities of Na(+)- and (Na(+),K(+))-ATPases and/or a decrease in the renal ANP.

Heme-copper oxygen reductases (HCO) reduce O(2) to water being the last enzymatic complexes of most aerobic respiratory chains. These enzymes promote energy conservation coupling the catalytic reaction to charge separation and charge translocation across the prokaryotic cytoplasmatic or mitochondrial membrane. In this way they contribute to the establishment and maintenance of the transmembrane difference of electrochemical potential, which is vital for solute/nutrient cell import, synthesis of ATP and motility. The HCO enzymes most probably share with the nitric oxide reductases, NORs, a common ancestor. We have proposed the classification of HCOs into three different types, A, B and C; based on the constituents of their proton channels (Pereira, Santana and Teixeira (2001) Biochim Biophys Acta, 1505, 185-208). This classification was recently challenged by the suggestion of other different types of HCOs. Using an enlarged sampling we performed an exhaustive bioinformatic reanalysis of HCOs family. Our results strengthened our previously proposed classification and showed no need for the existence of more divisions. Now, we analyze the taxonomic distribution of HCOs and NORs and the congruence of their sequence trees with the 16S rRNA tree. We observed that HCOs are widely distributed in the two prokaryotic domains and that the different types of enzymes are not confined to a specific taxonomic group or environmental niche., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Human T-lymphotropic virus 1 (HTLV-1) infection is associated with HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), which affects approximately 5% of carriers. High proviral load is a risk marker for HAM/TSP, although there is an overlap of proviral load levels in peripheral blood between asymptomatic carriers and HAM/TSP patients. In this study, receiver operating characteristic curve analysis was used to define a set point of HTLV-1 proviral load that better indicates an increased risk for HAM/TSP. Proviral load was quantified in 75 asymptomatic carriers and 78 HAM/TSP patients in a Brazilian cohort. The cut-off of proviral load was defined as 114 copies/10(4)  cells, with 78.2% sensitivity to identify true HAM/TSP patients. The mean proviral load levels were not significantly different between males and females with the same clinical status, and there was no significant correlation between proviral load and age at blood sampling, age at the onset of illness, or duration of disease. In HAM/TSP patients, proviral load was significantly higher in wheelchair-bound patients than in individuals able to walk without support and in those with the worst spinal cord injuries. Follow-up of HTLV-1-infected individuals showed that proviral load was more stable in asymptomatic carriers than in HAM/TSP patients. In a cohort study, periodically quantifying proviral load in asymptomatic carriers is necessary to identify those at risk for developing neurological disease, and it is necessary for HAM/TSP patients to monitor spinal injury and progression to walking disability. The measure of proviral load in clinical practice implicates the definition of the cut-off of proviral load and its validation during follow-up., (Copyright © 2012 Wiley Periodicals, Inc.)

Liver metastases of colorectal cancer are a challenge in current oncology. Less than 5% of untreated patients are alive after 5 years of diagnosis. The only curative treatment is surgical resection, but there are other options for palliative or neoadjuvant treatment such as transarterial chemoembolization. Serious complications after liver chemoembolization are very rare, and one of the possible complications is a liver abscess. We report a case of hepatogastric fistula caused by a liver abscess ten days after the chemoembolization of a liver metastasis. It was treated surgically with left hepatectomy and parcial gastrectomy, with good outcome. There are only a few reported cases of hepatogastric fistula after liver transarterial chemoembolization.

Background: Cystic Fibrosis (CF) is caused by ∼1,900 mutations in the CF transmembrane conductance regulator (CFTR) gene encoding for a cAMP-regulated chloride (Cl(-)) channel expressed in several epithelia. Clinical features are dominated by respiratory symptoms, but there is variable organ involvement thus causing diagnostic dilemmas, especially for non-classic cases., Methodology/principal Findings: To further establish measurement of CFTR function as a sensitive and robust biomarker for diagnosis and prognosis of CF, we herein assessed cholinergic and cAMP-CFTR-mediated Cl(-) secretion in 524 freshly excised rectal biopsies from 118 individuals, including patients with confirmed CF clinical diagnosis (n=51), individuals with clinical CF suspicion (n=49) and age-matched non-CF controls (n=18). Conclusive measurements were obtained for 96% of cases. Patients with "Classic CF", presenting earlier onset of symptoms, pancreatic insufficiency, severe lung disease and low Shwachman-Kulczycki scores were found to lack CFTR-mediated Cl(-) secretion (<5%). Individuals with milder CF disease presented residual CFTR-mediated Cl(-) secretion (10-57%) and non-CF controls show CFTR-mediated Cl(-) secretion ≥ 30-35% and data evidenced good correlations with various clinical parameters. Finally, comparison of these values with those in "CF suspicion" individuals allowed to confirm CF in 16/49 individuals (33%) and exclude it in 28/49 (57%). Statistical discriminant analyses showed that colonic measurements of CFTR-mediated Cl(-) secretion are the best discriminator among Classic/Non-Classic CF and non-CF groups., Conclusions/significance: Determination of CFTR-mediated Cl(-) secretion in rectal biopsies is demonstrated here to be a sensitive, reproducible and robust predictive biomarker for the diagnosis and prognosis of CF. The method also has very high potential for (pre-)clinical trials of CFTR-modulator therapies.

The Brazilian Water Resources Policy (Law 9433/1997) establishes participatory and decentralized management, involving civil society, water users and governmental bodies, with the basin committees as the basis of this process. Fifteen years after its implementation, it is possible to perceive accomplishments, but, at the same time, there are some difficulties in regards to the operation of the basin committees in the country. Considering the North Paraíba River Basin - which is completely included in the State of Paraíba, Northeastern Brazil, and presents great social and economic importance for the state - this article analyzes the process of formation, installation and functioning of its Basin Committee (CBH-PB), focusing on its composition, the reasons for the mobilization and demobilization of its members, the intra-relations between segments, and the inter-relations between the CBH-PB and other entities of the State Water Management System (the Water Executive Agency and the State Water Resources Council). The level of decentralization and the quality of participatory management (as it is being performed at the CBH-PB) are discussed and guidelines are suggested in order to allow greater effectiveness to the committee.

Background/aims: Leaves of Echinodorus macrophyllus (EM), from the Alismataceae family, have been used in Brazilian folk medicine for their anti-inflammatory and diuretic properties. In this work, the diuretic and nephroprotective activities of crude extracts of EM were evaluated., Methods: Normal Wistar rats were given 0.9% NaCl containing either EM (10-300 mg/kg), furosemide (13 mg/kg) or arginine vasopressin (0.2 mg/kg). Thereafter, the rats were individually housed in metabolic cages, and urine volume was measured every 30 min for a total of 3 h. Acute kidney injury was induced by gentamicin (GM, 80 mg·kg(-1)·day(-1), b.i.d., 5 days). Along with GM, 0.9% NaCl (control) or EM (30 mg/kg) was given to the rats by gavage., Results: EM produced a dose-dependent reduction in urine elimination. EM was effective in reversing all GM-induced alterations such as polyuria and glomerular filtration rate reduction. The GM-induced morphological alterations were not observed when EM was given concomitantly with GM., Conclusion: This study provides evidence that EM possesses nephroprotective effect which indicates that EM may have therapeutic applications in GM-induced acute kidney injury.

The methanol crude extract of the leaves of Ficus radicans Roxb. 'Variegata' (Moraceae) and the n-hexane, ethyl acetate and aqueous methanol fractions resulting from its fractionation were evaluated for their anti-inflammatory, molluscicidal and free-radical scavenging activities. The crude extract and fractions exhibited significant inhibition of inflammation in both croton oil (CO)-induced ear oedema in mice (p<0.001) and carrageenan-induced rat paw oedema models (p<0.01). The molluscicidal assay against Biomphalaria glabrata showed a weak activity for the n-hexane fraction (DL(50)= 400 µg mL(-1)). A moderated 1,1-diphenyl-1-picrylhydrazyl (DPPH) free-radical scavenging activity was observed for the ethyl acetate fraction (IC(50)= 66.2 µg mL(-1)). Fractionation of the extracts through chromatographic methods afforded the coumarins 7-methoxycoumarin, 7-hydroxy-6-methoxycoumarin and methoxy-3,4-dihydrocoumarin, the steroids β-sitosterol and β-sitosterol 3-O-β-glucopyranoside, as well as a cinnamic acid derivative and a flavonoid identified as trans-4-methoxy-2-β-D-glucopyranosyloxy cinnamic acid and quercetin 3-O-β-D-xylopyranosyl-(1 → 2)-α-L-rhamnopyranoside, respectively. The compounds were identified on the basis of their NMR spectral data and comparison with those previously reported in the literature.

The present paper reports an experimental calorimetric study of 2-pyrrolecarboxaldehyde and 1-methyl-2-pyrrolecarboxaldehyde, which aims to determine their standard (p° = 0.1 MPa) molar enthalpies of formation, in the gaseous phase, at T = 298.15 K. These values were derived from the standard (p° = 0.1 MPa) molar enthalpies of formation, in the condensed phase, Δ(f)H(m)°(cr,l), at T = 298.15 K, obtained from the standard molar enthalpies of combustion, ΔcHm°, measured by static bomb combustion calorimetry, and from the standard molar enthalpies of phase transition, Δ(cr,l)(g) H(m)° at T = 298.15 K, obtained by high temperature Calvet microcalorimetry. Additionally, the standard enthalpies of formation of these two compounds were estimated by computations based on standard ab initio molecular calculations at the G3(MP2)//B3LYP level. The estimated values are in very good agreement with experimental data, giving us support to estimate the gas-phase enthalpies of formation of the 3-pyrrolecarboxaldehyde and 1-methyl-3-pyrrolecarboxaldehyde that were not studied experimentally. N-H bond dissociation enthalpies, gas-phase acidities and basicities, proton and electron affinities, and adiabatic ionization enthalpies were also calculated. Furthermore, the molecular structure of the four molecules was established and the structural parameters were determined at the B3LYP/6-31G(d) level of theory.

This paper aimed to evaluate the improvement of burn wounds healing by sodium alginate/chitosan-based films and laser therapy. Natural polymers with different biological activities are widely used as film dressings to improve wound healing. Lasers arrays accelerate the healing repair of soft tissue injuries. Burn procedures were performed on the backs of 60 male rats assigned into six groups: untreated (CTR), dressed with cellulose films (CL), dressed with sodium alginate/chitosan-based films (SC), laser-irradiated undressed wounds (LT), laser-irradiated wounds with cellulose (CLLT) and sodium alginate/chitosan-based films (SCLT). Laser therapy was applied for 7 days. Animals of each group were euthanised 8 and 14 days after the burn procedures. The inflammatory reaction was significantly more intense in the CTR group than in the irradiated groups after 8 and 14 days. Laser therapy stimulated myofibroblastic differentiation in 8 days, with or without dressing films. Combined laser therapy and both dressings improved epithelisation, blood vessels formation and collagenization, promoted rapid replacement of type III for type I collagen and favored the better arrangement of the newly formed collagen fibres. The combination of laser therapy and sodium alginate/chitosan-based dressing improves burn healing, apparently by modulating the epithelisation, blood vessels formation and collagenization processes., (Copyright © 2011 Elsevier B.V. All rights reserved.)

In networks of plant-animal mutualisms, different animal groups interact preferentially with different plants, thus forming distinct modules responsible for different parts of the service. However, what we currently know about seed dispersal networks is based only on birds. Therefore, we wished to fill this gap by studying bat-fruit networks and testing how they differ from bird-fruit networks. As dietary overlap of Neotropical bats and birds is low, they should form distinct mutualistic modules within local networks. Furthermore, since frugivory evolved only once among Neotropical bats, but several times independently among Neotropical birds, greater dietary overlap is expected among bats, and thus connectance and nestedness should be higher in bat-fruit networks. If bat-fruit networks have higher nestedness and connectance, they should be more robust to extinctions. We analyzed 1 mixed network of both bats and birds and 20 networks that consisted exclusively of either bats (11) or birds (9). As expected, the structure of the mixed network was both modular (M = 0.45) and nested (NODF = 0.31); one module contained only birds and two only bats. In 20 datasets with only one disperser group, bat-fruit networks (NODF = 0.53 ± 0.09, C = 0.30 ± 0.11) were more nested and had a higher connectance than bird-fruit networks (NODF = 0.42 ± 0.07, C = 0.22 ± 0.09). Unexpectedly, robustness to extinction of animal species was higher in bird-fruit networks (R = 0.60 ± 0.13) than in bat-fruit networks (R = 0.54 ± 0.09), and differences were explained mainly by species richness. These findings suggest that a modular structure also occurs in seed dispersal networks, similar to pollination networks. The higher nestedness and connectance observed in bat-fruit networks compared with bird-fruit networks may be explained by the monophyletic evolution of frugivory in Neotropical bats, among which the diets of specialists seem to have evolved from the pool of fruits consumed by generalists.

Calorimetric measurements are expected to provide useful data regarding the relative stability of α- versus β-amino acid isomers, which, in turn, may help us to understand why nature chose α- instead of β-amino acids for the formation of the biomolecules that are essential constituents of life on earth. The present study is a combination of the experimental determination of the enthalpy of formation of N-benzyl-β-alanine, and high-level ab initio calculations of its molecular structure. The experimentally determined standard molar enthalpy of formation of N-benzyl-β-alanine in gaseous phase at T = 298.15 K is -(298.8 ± 4.8) kJ·mol(-1), whereas its G3(MP2)//B3LYP-calculated enthalpy of formation is -303.7 kJ·mol(-1). This value is in very good agreement with the experimental one. Although the combustion experiments of N-benzyl-α-alanine were unsuccessful, its calculated enthalpy of formation is -310.7 kJ·mol(-1); thus, comparison with the corresponding experimental enthalpy of formation of N-benzyl-β-alanine, -(298.8 ± 4.8) kJ/mol, is in line with the concept that the more branched amino acid (α-alanine) is intrinsically more stable than the linear β-amino acid, β-alanine.

Objective: To investigate associations between mouth breathing (MBr), nose breathing (NBr) and body posture classification and clinical variables in children and adolescents, by comparing patients with mouth breathing syndrome with a control group of similar age., Methods: This was an observational, analytical, controlled, cross-sectional study conducted at a university hospital. Children aged 5 years or more were recruited to one of two groups: healthy controls (NBr) or an MBr group. The MBr group comprised patients with a diagnosis of mouth breathing syndrome confirmed by clinical examination by a physician plus nasal endoscopy. The control group comprised healthy volunteers of the same age, with NBr confirmed by medical examination. All participants underwent postural assessment. Data were analyzed using the Mann-Whitney nonparametric test, the chi-square test and Fisher's exact test, to a significance level of 0.05%., Results: A total of 306 MBr and 124 NBr were enrolled. Mouth breathers were more likely to be male (p = 0.0002), have more frequent and more severe nasal obstruction and larger tonsils (p = 0.0001) than NBr. Mouth breathers also exhibited higher incidence rates of allergic rhinitis (p = 0.0001), of thoracic respiratory pattern (p = 0.0001), high-arched palate (p = 0.0001) and unfavorable postural classifications (p = 0.0001) with relation to the control group. Postural classification scores were directly proportional to nasal obstruction (p = 0.0001) and male sex (p = 0.0008)., Conclusions: Postural problems were significantly more common among children in the group with mouth breathing syndrome, highlighting the need for early interdisciplinary treatment of this syndrome.

Bedridden patients are in risk to developing pressure ulcers and represent a priority group to be studied to identify this condition. To reach this goal, specific instruments are used to assess this problem. The objective of this study was to analyze the risk factors to developing pressure ulcers in adult patients hospitalized in ICUs. This is a sectional analytical study, in which evaluations were performed on 140 patients, hospitalized in 22 ICUs, using the Braden scale. Results showed that patients hospitalized from 15 days or more showed some level of risk. The highest frequencies of pressure ulcers were found in patients in the following categories: sensorial perception (completely limited), moistness (constantly moist), mobility (completely immobilized), activity (bedridden), nutrition (adequate) and friction and shear (problem). In conclusion, the use of this scale is an important strategy when providing care to patients in intensive treatment.

Objectives: To study changes in the variables of volumetric capnography in children and adolescents with asthma compared with a control group and to investigate their changes with the use of bronchodilators and bronchial provocation test with methacholine., Methods: One hundred and three patients with controlled persistent asthma and 40 healthy volunteers participated in the study. All of them underwent volumetric capnography and spirometry. All asthmatics repeated the tests after bronchodilator use. Among 103 asthma patients, 33 underwent methacholine challenge test, and measures were recorded on three occasions: before and after methacholine and after bronchodilator use., Results: Compared with the control group, asthmatics had an increase in the slope of phase III normalized by tidal volume and decreases in tidal volume, forced expiratory volume in one second, forced vital capacity, rate of obstruction and forced expiratory flow between 25 to 75% of forced vital capacity. After bronchodilator use, there was an increase in spirometric variables, volume of anatomic dead space, and decrease in the slope of phase II normalized by tidal volume, but the slope of phase III normalized by tidal volume did not change. After methacholine, there was an increase in this variable, which decreased after bronchodilator use., Conclusions: The increase in the slope of phase III normalized by tidal volume in asthma patients suggests that these patients have ventilation inhomogeneity in the distal air spaces, which may reflect chronic structural disorders or reversible acute changes seen on the bronchial provocation test.

Mutualistic networks are crucial to the maintenance of ecosystem services. Unfortunately, what we know about seed dispersal networks is based only on bird-fruit interactions. Therefore, we aimed at filling part of this gap by investigating bat-fruit networks. It is known from population studies that: (i) some bat species depend more on fruits than others, and (ii) that some specialized frugivorous bats prefer particular plant genera. We tested whether those preferences affected the structure and robustness of the whole network and the functional roles of species. Nine bat-fruit datasets from the literature were analyzed and all networks showed lower complementary specialization (H(2)' = 0.37±0.10, mean ± SD) and similar nestedness (NODF = 0.56±0.12) than pollination networks. All networks were modular (M = 0.32±0.07), and had on average four cohesive subgroups (modules) of tightly connected bats and plants. The composition of those modules followed the genus-genus associations observed at population level (Artibeus-Ficus, Carollia-Piper, and Sturnira-Solanum), although a few of those plant genera were dispersed also by other bats. Bat-fruit networks showed high robustness to simulated cumulative removals of both bats (R = 0.55±0.10) and plants (R = 0.68±0.09). Primary frugivores interacted with a larger proportion of the plants available and also occupied more central positions; furthermore, their extinction caused larger changes in network structure. We conclude that bat-fruit networks are highly cohesive and robust mutualistic systems, in which redundancy is high within modules, although modules are complementary to each other. Dietary specialization seems to be an important structuring factor that affects the topology, the guild structure and functional roles in bat-fruit networks.

Background: For living-related liver transplantation, harvesting a right hepatic graft that includes the middle hepatic vein (MHV) has been recommended to improve venous drainage of the graft. However, it may result in congestion of the donor's remaining segment IV, increasing the potential risk to the donor. This study aimed to compare safety levels for liver donors during procedures with or without removal of the MHV., Methods: A total of 68 living donor liver transplantations were performed from March 2001 to May 2007. In 39 procedures, the MHV was not included in the graft (group A), and in 29 the MHV was included in the graft (group B). The analyzed data included surgical time, use of blood derivatives, length of hospital stay, laboratory analyses, weight of the graft, and clinical complications., Results: No differences were observed regarding the need for blood derivatives or laboratory parameters. The frequency of postoperative complications was similar in the two groups, with 10 cases (25.6%) in group A and 7 cases (24.1%) in group B (P=0.887). No deaths were seen. The rate of observed complications was 25% among living donors, most of them being managed without surgical intervention., Conclusions: The inclusion of the MHV does not add morbidity in living donors in selected cases.

Objective: To compare blood pressure measurements in newborn infants using the flush method, pulse oximetry and oscillometry according to Doppler findings., Methods: Noninvasive blood pressure measurements were made using three techniques (flush method, pulse oximetry and oscillometry) in three groups of newborns: 15 normal term infants, 16 stable preterm infants, and 14 critically ill infants. All measurements were video recorded, edited separately, coded and analyzed independently by three neonatologists., Results: Fifty-seven measurements were made using each method. The flush method and pulse oximetry had a better correlation with Doppler findings than oscillometry (correlation coefficients: 0.89, 0.85, 0.71; p < 0.01). The difference between measurement means, their standard deviations and the 95% confidence intervals when compared with Doppler findings were: -5.2 ± 7.9 (-21.1:10.7) mmHg for the flush method; 0.4 ± 8.9 (-17.5:18.2) mmHg for pulse oximetry; and 6.4 ± 16.1 (-25.8:8.6) mmHg for oscillometry. The flush method had a better agreement with Doppler findings for the diagnosis of hypotension than oximetry and oscillometry., Conclusions: The flush method and pulse oximetry seem to be useful techniques to measure systolic blood pressure in newborn infants; oscillometry had the poorest agreement with Doppler findings to detect hypotension.

Hepatic hemangiomas are congenital vascular malformations, considered the most common benign mesenchymal hepatic tumors, composed of masses of blood vessels that are atypical or irregular in arrangement and size. Hepatic hemangiomas can be divided into two major groups: capillary hemangiomas and cavernous hemangiomas These tumors most frequently affect females (80%) and adults in their fourth and fifth decades of life. Most cases are asymptomatic although a few patients may present with a wide variety of clinical symptoms, with spontaneous or traumatic rupture being the most severe complication. In cases of spontaneous rupture, clinical manifestations consist of sudden abdominal pain, and anemia secondary to a haemoperitoneum. Disseminated intravascular coagulopathy can also occur. Haemodynamic instability and signs of hypovolemic shock appear in about one third of cases. As the size of the hemangioma increases, so does the chance of rupture. Imaging studies used in the diagnosis of hepatic hemangiomas include ultrasonography, dynamic contrast-enchanced computed tomography scanning, magnetic resonance imaging, hepatic arteriography, digital subtraction angiography, and nuclear medicine studies. In most cases hepatic hemangiomas are asymptomatic and should be followed up by means of periodic radiological examination. Surgery should be restricted to specific situations. Absolute indications for surgery are spontaneous or traumatic rupture with hemoperitoneum, intratumoral bleeding and consumptive coagulopathy (Kassabach-Merrit syndrome). In a patient presenting with acute abdominal pain due to unknown abdominal disease, spontaneous rupture of a hepatic tumor such as a hemangioma should be considered as a rare differential diagnosis.

Thermochemical and thermodynamic properties of 2,5-dimethyl-1-phenylpyrrole and 2,5-dimethyl-1-(4-nitrophenyl)pyrrole have been determined by using a combination of calorimetric and effusion techniques as well as high-level ab initio molecular orbital calculations. The standard (p° = 0.1 MPa) molar enthalpies of formation, in the crystalline state, Δ(f)H(m)°(cr), at T = 298.15 K, were derived from the standard molar enthalpies of combustion, Δ(c)H(m)°, which were obtained from static bomb combustion calorimetry. The Knudsen mass-loss effusion technique was used to determine the standard molar enthalpies of sublimation, Δ(cr)(g)H(m)°, at T = 298.15 K. From the experimental results, the standard molar enthalpies of formation, in the gaseous phase, at T = 298.15 K, were derived. The results were analyzed and interpreted in terms of enthalpic increments and molecular structure. For comparison purposes, standard ab initio molecular calculations at the G3(MP2)//B3LYP level were performed, using a set of working reactions and the gas-phase enthalpies of formation of both compounds were estimated; the results are in excellent agreement with experimental data. The computational study was also extended to the determination of proton and electron affinities, basicities and adiabatic ionization enthalpies.

This paper reports an experimental and theoretical study of the gas phase standard (p° = 0.1 MPa) molar enthalpies of formation, at T = 298.15 K, of α-alanine (DL) and β-alanine. The standard (p° = 0.1 MPa) molar enthalpies of formation of crystalline α-alanine (DL) and β-alanine were calculated from the standard molar energies of combustion, in oxygen, to yield CO2(g), N2(g), and H2O(l), measured by static-bomb combustion calorimetry at T = 298.15 K. The vapor pressures of both amino acids were measured as function of temperature by the Knudsen effusion mass-loss technique. The standard molar enthalpies of sublimation at T = 298.15 K was derived from the Clausius−Clapeyron equation. The experimental values were used to calculate the standard (p° = 0.1 MPa) enthalpy of formation of α-alanine (DL) and β-alanine in the gaseous phase, Δ(f)H(m)°(g), as −426.3 ± 2.9 and −421.2 ± 1.9 kJ·mol(−1), respectively. Standard ab initio molecular orbital calculations at the G3 level were performed. Enthalpies of formation, using atomization reactions, were calculated and compared with experimental data. Detailed inspections of the molecular and electronic structures of the compounds studied were carried out.

The objective of this a cross-sectional analytical study was to estimate the occurrence of pressure ulcers and their associated factors in adult ICUs in the city of Belo Horizonte, Brazil. The sample consisted of 142 patients aged 18 or older, admitted before midnight of the day prior to data collection, from a total of 316 beds distributed in 22 ICUs. Presence of at least one pressure ulcer per patient was 35.2% (CI 95% = 27.4-47.7). Of the 99 ulcers identified, the ones in the sacral region were most frequent (36.0%), followed by those in the calcaneus (22.0%). We observed that the presence of sepsis (OR = 6.04, CI 95% = 1.09-33.53), period of stay > or = 10 days (OR = 7.61, CI 95% = 2.92-19.82) and being high risk and very high-risk in the Braden scale (OR = 4.96, CI 95% = 1.50-16.50) were independent factors significantly associated with the presence of pressure ulcers. Results suggest that sepsis, length of stay, and having high and very high risk" in the Braden scale are factors potentially associated to the development of ulcers in bedridden patients.

Production of meals in Food and Nutrition Units (FNU) requires human labor performance in order to attend demand. Stress is one of the factors responsible for alterations in the health of these professionals. Reduced attention is one of the negative effects caused by stress., Objective: The objective of this study was to evaluate attention in Food Handlers (FH)., Methods: 67 professionals were evaluated, subdivided into FH with less than 5 years in the profession, who were included as the control group (Control, n=29), and FH with more than 5 years in the profession (FH>5, n=38). Lipp's Inventory of Stress Symptoms for adults (LISS), the digit symbol, d2, forward digit span, backward digit span and paced auditory serial addition tests were applied. The data found on the LISS were analysed by Fisher's Exact and Chi-Square tests and individual attention tests were analyzed by the Mann-Whitney test, with data expressed as Median (Minimum and Maximum) with p<0.05. A total of 73.68% of FH>5 presented stress versus 13.79% of Control. Also, 57.89% of FH>5 with stress presented physical symptoms and 15.79% psychological symptoms. In the Control, 9.68% presented physical symptoms., Results: 73.68% of FH>5 with stress and 17.24% of the Control were in the resistance phase. Regarding attention, the FH>5 presented reduced focused attention (32.5±2.9), auditory attention (7.25±0.4) and resistance to interference (4.67±1.1), compared to their respective controls (43.88±1.39), (8.63±0.38), (9.25±1.16), p<0.05., Discussion and Conclusions: The activity of food handling can cause stress and attention level reduction after 5 years., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objective: To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma (MPAA)., Methods: A randomized, prospective study of children and adolescents (age 7-18 years) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil. After a 1-month run-in period, 61 patients (34 female) were randomized into two groups, a swimming group (n = 30) and a control group (n = 31), and followed for 3 months. Both patient groups received inhaled fluticasone (dry powder, 250 mcg twice a day) and salbutamol as needed. The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions. Both groups underwent spirometric assessment and methacholine challenge test--provocative concentration of methacholine causing a 20% fall in FEV1 (PC₂₀)--before and after the study period. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured only in the swimming group., Results: Significant increases in PC₂₀ (pre-training, 0.31±0.25; post-training, 0.63±0.78; p = 0.008), MIP (pre-training, 67.08±17.13 cm H₂O; post-training 79.46±18.66; p < 0.001), and MEP (pre-training, 71.69±20.01 cm H₂O; post-training, 78.92±21.45 cm H₂O; p < 0.001) were found in the swimming group., Conclusion: Children and adolescents with MPAA subjected to a swim training program experienced a significant decrease in bronchial hyperresponsiveness, as determined by increased PC₂₀ values, when compared with asthmatic controls who did not undergo swim training. Participants in the swimming group also showed improvement in elastic recoil of the chest wall.