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BACKGROUND: Voluntary post-mortem donation to science (PDS) is the most appropriate source for body dissection in medical education and training, and highly useful for biomedical research. In Mexico, unclaimed bodies are no longer a legal source, but PDS is legally possible, although scarcely facilitated, and mostly ignored by the general population. Therefore, we aimed to evaluate the attitude and willingness for PDS and to identify a sociodemographic profile of people with willingness toward PDS. METHODS: A validated on-line survey was distributed by the convenience method via the social networks of a Catholicism-inspired, private university in northern Mexico. Frequency analyses of all variables and coded free comments were complemented with association studies. RESULTS: Although the responder cohort (n = 143) was too small and biased to be representative of the university community (n = 13,500), willingness to post-mortem organ donation was 90.7% and to PDS 70.7%. In this cohort, PDS willingness had the strongest association with mature age (> 40 years old; P, 0.0008). Among young adults, willingness to PDS was the lowest among volunteers from technical and business schools and the highest among those from the social sciences (P, 0.009). Respondents from the social sciences were also the most consistent between attitude and behavior with respect to organ donation. A free comment option revealed respondents were interested in the unusual taboo topic. CONCLUSIONS: A small, but sufficiently large proportion expressed willingness toward PDS. In our university cohort, which was biased in higher education and altruism, mature age and social interest were associated with PDS willingness.

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The effect of annual at-home bleaching on the color, translucency, and whiteness properties of computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials requires investigation. The aim of the present in vitro study was to evaluate the effect of simulated annual at-home bleaching (consisting of daily applications for 10 hours a day for 14 days), for up to 3 years, on susceptibility to staining (ΔE00), translucency (ΔTP00), and whiteness (ΔWID) variations and on topography of CAD-CAM monolithic materials. Disks from the Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), and IPS e.max CAD (EMAX) were allocated as follows: 1) nonbleached or 2) bleached with 10% carbamide peroxide. After reading the CIE L*a*b* coordinates at baseline (R0), specimens were bleached or not and subsequently immersed for a 1-year simulated period in coffee before the next reading (R1). This process was repeated two more times, resulting in R2 and R3. The ΔE00, ΔTP00, and ΔWID between R1, R2, and R3 in relation to R0 were calculated. The surface topography was analyzed by scanning electron microscopy. In general, bleaching increased the staining susceptibility of all materials when compared to the nonbleached groups and that of the LU, VE, and EMAX over the years. Bleaching decreased the translucency of the VE in all years and over the years. When compared to the nonbleached groups, bleaching decreased the whiteness of the LU and EMAX and increased the whiteness of the EMP, while the VE was not affected. In the LU, the whiteness decreased over the years in both treatments, whereas the other materials were not affected with time. All materials showed progressive topographic changes over the years. The simulated annual at-home bleaching with 10% carbamide peroxide adversely affected the topography and the optical and/or colorimetric properties of the evaluated materials.

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The goal of this study was to analyse the spatial pattern of tuberculosis (TB) mortality using different approaches, namely: mortality rates (MR), spatial relative risks (RR) and Bayesian rates (Global and Local) and their association with human development index (HDI), Global and its three dimensions: education, longevity and income. An ecological study was developed in Curitiba, Brazil based on data from Mortality Information System (2008-2014). Spatial scan statistics were used to compute RR and identify high-risk clusters. Bivariate Local Indicator of Spatial Associations was used to assess associations. MR ranged between 0 and 25.24/100.000 with a mean (standard deviation) of 1.07 (2.66). Corresponding values for spatial RR were 0-27.46, 1.2 (2.99) and for Bayesian rates (Global and Local) were 0.49-1.66, 0.90 (0.19) and 0-6.59, 0.98 (0.80). High-risk clusters were identified for all variables, except for HDI-income and Global Bayesian rate. Significant negative spatial relations were found between MR and income; between RR and HDI global, longevity and income; and Bayesian rates with all variables. Some areas presented different patterns: low social development/low risk and high risk/high development. These results demonstrate that social development variables should be considered, in mortality due TB.

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Acinetobacter baumannii has often been associated with colonization and/or infection in neonatal intensive care units (NICU). This study describes a clonal spread of carbapenem-resistant A. baumannii (CRAB) isolates in an NICU. In total, 21 CRAB isolates were collected from premature newborns. Only polymyxin B was active against such isolates. Nineteen CRAB isolates were clonally related (Cluster C, which belonged to worldwide-disseminated ST1). All newborns had peripheral access and had received ß-lactam therapy previously. The implementation of strict infection control measures was of fundamental importance to eradicate the clonal type in the study hospital.

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AIM: To compare the diagnostic accuracy of digital enhancement filters in the diagnosis of vertical root fractures. METHODOLOGY: The sample consisted of 40 single-rooted teeth randomly divided into two groups: experimental and control. Vertical root fractures were induced in the experimental group using a universal testing machine. All teeth were individually radiographed with three different horizontal angles using the Digora Optime(®) digital system. Three observers separately examined the original and filtered images (3D Emboss, Negative, Sharpen and Shadow). The area under Receiver Operating Characteristic curve values (Az) for each protocol were compared by one-way anova with post hoc Bonferroni test. The significance level was set at 5%. RESULTS: The highest Az value was obtained using the Sharpen filter, with significant differences from the original and other filtered images (P < 0.05). The 3D Emboss filter had the lowest Az value, which was significantly different from the other filtered images (P < 0.05). CONCLUSION: When using the Digora Optime(®) system, the 'Sharpen' filter is recommended to improve the radiographic detection of vertical root fractures.

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The Brazilian rosewood (Dalbergia nigra) is an endangered tree endemic to the central Brazilian Atlantic Forest, one of the world's most threatened biomes. The population diversity, phylogeographic structure and demographic history of this species were investigated using the variation in the chloroplast DNA (cpDNA) sequences of 185 individuals from 19 populations along the geographical range of the species. Fifteen haplotypes were detected in the analysis of 1297 bp from two non-coding sequences, trnV-trnM and trnL. We identified a strong genetic structure (F(ST)=0.62, P<0.0001), with a latitudinal separation into three phylogeographic groups. The two northernmost groups showed evidence of having maintained historically larger populations than the southernmost group. Estimates of divergence times between these groups pointed to vicariance events in the Middle Pleistocene (ca. 350,000-780,000 years ago). The recurrence of past climatic changes in the central part of the Atlantic forest, with cycles of forest expansion and contraction, may have led to repeated vicariance events, resulting in the genetic differentiation of these groups. Based on comparisons among the populations of large reserves and small, disturbed fragments of the same phylogeographic group, we also found evidence of recent anthropogenic effects on genetic diversity. The results were also analysed with the aim of contributing to the conservation of D. nigra. We suggest that the three phylogeographic groups could be considered as three distinct management units. Based on the genetic diversity and uniqueness of the populations, we also indicate priority areas for conservation.

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Hymenaea courbaril is a tropical timber species, intensely exploited and found in the Amazon, Atlantic Forest and Brazilian Cerrado biome. Nine highly polymorphic microsatellite loci were developed from a genomic library enriched for AG/TC repeats. In a total of 41 individuals, from two natural populations, seven to 13 alleles per locus were detected and expected heterozygosity ranged from 0.75 to 0.90. Seven loci were effectively transferred to Hymenaea stigonocarpa. High levels of polymorphism make the present primers useful for population genetic studies and are a powerful tool to investigate mating system, gene flow and spatial genetic structure.

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Mycosis fungoides is the most common disease of the primary cutaneous T-cell lymphoma group. This is a retrospective study to evaluate the outcome of 30 patients with mycosis fungoides who were followed up for at least 3 years, 18 of them followed for 5 years and 9 of them followed for 7 years. A total of 10 patients achieved a sustained remission, 2 patients achieved a remission but then relapsed and three patients died from lymphoma-related death. It is concluded that the majority of the patients with T1 or T2 stage MF usually have a good prognosis. As a rule, those who do progress further in the disease have advanced stages at the moment of the diagnosis; the disease progression occurring during the first 3-5 years after diagnosis.

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ABSTRACT Tetranychus urticae is considered one of the most important mite species, attacking several agricultural crops. The aim of this work was to verify, in the greenhouse, the acaricide activity of some plant extracts on a population of T. urticae, infesting bean plants. Each plot consisted of 5 bean plants with 7 to 10 leaves previously infested with 5 T. urticae females each. The plant species used were Allamanda cathartica, Dieffenbachia brasiliensis, Pennisetum purpureum, Annona squamosa, Ruta graveolens, Sonchus oleraceus, Spondias purpurea, Codiaeum variegatum, Impatiens walleriana, Stryphnodendron barbatiman, Solanum melongena, Agave angustifolia and Allium cepa. The vegetable material collected was dried in an oven at 40º C and after that triturated, and the resulting dust was submitted to extraction with distilled water for 14 hours and then filtered. The filtered residues were utilized for tests after a period of 30 to 45 days of infestation, when they were applied on infested plants in doses of 100 mL of extract/L of water utilizing a knapsack sprayer of 5 L. Previously and 7 days after treatment an evaluation was made of the number of live mites (active stages) on 1cm2 of 10 leaves in each plot. The aqueous extracts of D. brasiliensis, R. graveolens, A. cepa, A. angustifolia and A. squamosa promoted a significant reduction of the T. urticae population, showing 86.87%, 83.95%, 80.97%, 76.30 and 75.40% efficiency, respectively.

RESUMO O ácaro rajado Tetranychus urticae é considerado um dos ácaros de maior importância por atacar várias culturas. O objetivo desse trabalho foi verificar, em casa de vegetação, a ação acaricida de alguns extratos vegetais sobre população de T. urticae, infestando plantas de feijão. Cada parcela constou de 5 plantas de feijão com 07-10 folhas previamente infestadas com 5 fêmeas de T. urticae cada. As espécies vegetais utilizadas foram Allamanda cathartica, Dieffenbachia brasiliensis, Pennisetum purpureum, Annona squamosa, Ruta graveolens, Sonchus oleraceus, Spondias purpurea, Codiaeum variegatum, Impatiens walleriana, Stryphnodendron barbatiman, Solanum melongena, Agave angustifolia e Allium cepa. O material vegetal coletado foi seco em estufa a 40º C e posteriormente moído e o pó resultante submetido à extração com água destilada por 14h e em seguida, filtrado. Os resíduos filtrados foram utilizados nos testes após um período de 30-45 dias da infestação, sendo aplicados sobre as plantas infestadas, na dose de 100 mL de extrato/L de água, empregando-se um pulverizador costal de 5 L. Previamente e após 7 dias do tratamento, foi avaliado o número de ácaros vivos (formas móveis), em uma área de 1 cm2 em 10 folhas de cada parcela. Os extratos aquosos de D. brasiliensis, R. graveolens, A. cepa, A. angustifolia e A. squamosa promoveram redução significativa da população de T. urticae, apresentando 86,87%, 83,95%, 80,97%, 76,30 e 75,40% de eficiência, respectivamente.

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In the present study, we investigated in rats the effect of third ventricle injections of 1-(3-chlorophenyl)piperazine (mCPP), a 5-HT(2) receptor agonist, on water intake induced by three different physiological stimuli: fluid deprivation, acute salt load and hypovolemia. Injections of mCPP in the doses of 80 and 160 nmol/rat were able to decrease water intake in all three conditions studied. Third ventricle injections of mCPP (160 nmol/rat) were no longer able to diminish water intake in the groups of rats pretreated with central injections of an equimolar amount of (+)-cis-4,5,7a,8,9,10,11,11a-octahydro-7H-10-methylindolo[1,7-bc][2,6]-naphthyridine (SDZ SER 082), a selective 5-HT(2B/2C) antagonist. The central administration of mCPP (160 nmol/rat) was not able to modify the intake of a 0.1% saccharin solution. It is suggested that the central activation of a 5-HT(2B/2C) component is able to impair the drive for water intake induced by the physiological stimuli represented by fluid deprivation, acute salt load and hypovolemia. This effect seems not to be consequent on a general nonspecific central nervous system depression or on a locomotor deficit, because saccharin intake is not affected by third ventricle injections of mCPP.

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A rare case of a 32-year-old male with situs inversus totalis viscerum admitted to hospital for hematemesis owing to portal hypertension of Laennec cirrhosis was treated for the first time by videolaparoscopic surgery. Situs inversus diagnosis was confirmed by thoracic radiography, electrocardiogram, echocardiogram, abdominal echography and computed tomography. Upper gastrointestinal endoscopy showed esophageal varices and large varices in the fundus of the stomach. A successful operation (azygo-portal disconnection, splenic artery ligation without splenectomy; transesophageal suturing of esophageal varices without opening the esophagus and cholecystectomy), was performed by videolaparoscopy. The uneventful postoperative evolution (4-day hospitalization) reinforces the viability of the videolaparoscopic approach and the possibility of the application of this procedure even to situs inversus totalis organorum.

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We analyzed HIV-1 genetic variability, phylogenetic relationships, and association with transmission modes among 58 HIV-1-infected patients from Buenos Aires City, Argentina. The 58 strains were classified as env(gp41) HIV-1 group M subtype B (n = 34) and subgroup F1 of subtype F (n = 24). Potential recombinants combining parts of viral regions from different subtypes, B(prot)/F(env) and F(prot)/B(env), were found in two patients, and a dual infection with HIV-1 prot subtypes B and F was identified in one individual. Epidemiologic analysis of behavioral risks revealed that the frequency of infection with subtype F viruses was significantly higher (p < 0.0001) among heterosexual patients (71%) compared with homosexual patients (11%). The spread of non-B subtypes into heterosexual populations may be more common than previously thought. Our findings provide important information for monitoring the transmission of HIV-1 strains among different risk groups in Argentina as well as for vaccine development.

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During the period between August 1991 and November 1995, seven patients under age 17 were submitted to videolaparoscopic cholecystectomy (LC). Two were males and five females with ages ranging from 12 to 16 years (mean 13.8 years). The diagnosis of chronic cholecystitis with gallstones was made by the clinical history and physical and ultrasonographic examinations. There was no evidence of an association with hemolytic diseases, familial hyperlipidemia or Glucose-6-phosphate dehydrogenase (G6PD) deficiency. The surgery was performed under general anesthesia and the abdomen approached by four ports: a 10 mm umbilical incision, a 5 mm cystic, a 5 mm one at the xiphoid appendix and a 10 mm one at the left lateral margin of the left rectus abdominal muscle between the umbilical scar and the xiphoid appendix. Operative time averaged 120 minutes (105-150 min). One case required conversion to laparotomic approach because of Mirizzi's Syndrome, which was diagnosed by intraoperative cholangiography performed in all cases. There were no deaths or major postoperative complications. Hospital stays ranged from 1-3 days in the six patients submitted to LC. Thus LC in children can be considered a good method, requiring only more care regarding the use of proper equipment, complete and careful dissection of the biliary hilus, and intraoperative cholangiography. The latter is indispensable, as these children can present a higher rate of anatomic anomalies. The advantages of this techniques include a less painful postoperative period with a faster recovery, and it is especially recommended in children, who are less tolerant to physical restriction and pain than adults.

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Laparoscopic surgery, mainly laparoscopic cholecystectomy, is a recently developed surgical procedure that has rapidly gained acceptance. Its complications remain to be critically analyzed. In this initial series of 69 patients, the rate of complications was 4.3%, and the conversion to open rate was 8.7%. A late complication occurring 4 months after surgery is presented. Upper gastrointestinal bleeding from hemobilia resulted from a cystic artery aneurysm communication with the cystic duct. This study stresses the importance of careful management of biliary structures to avoid the possibility of late and severe complications that can result from using this new surgical procedure.

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We studied the effect of carnitine supplementation in patients with diphtheria. Six hundred and twenty five children of diphtheria received either DL-carnitine (100 mg/kg/day in two divided doses orally for four days), or no carnitine, in addition to the routine treatment for diphtheria. The patients receiving carnitine (n = 327) and controls (n = 298) were matched for age, sex, duration of symptoms, grade of toxemia and immunization status. Patients receiving carnitine showed a significant reduction in incidence of myocarditis as compared to controls (p = 0.001). Cases with myocarditis receiving carnitine therapy showed a significant reduction in mortality as compared to controls (p < 0.001). In view of a significant decline in incidence and mortality of myocarditis in cases of diphtheria, we recommended that all cases with diphtheria should receive carnitine supplementation.

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Foi medida a atividade da isoenzima MB da creatinafosfoquinase (CPK-MB) em 124 pacientes com diagnostico de difteria, e estudada a correlacao de suas alteracoes com a evolucao clinica, eletrocardiografica e radiologica, bem como com os indices de letalidade e ocorrencia de sequelas cardiacas na alta. A incidencia total de miocardite foi de 75,8%.A elevacao isolada da CPK-MB ocorreu em 20 pacientes, possibilitando, assim, o diagnostico de formas subclinicas em 15,2% do total de casos de miocardite. Niveis normais de atividade da CPK-MB mostraram-se associados a baixos indices de complicacoes, enquanto que atividades superiores a 20 U/l estiveram associados a altos indices de letalidade e presenca de sequelas cardiacas na alta. A medida da atividade da CPK-MB pode ser usada como ensaio enzimatico para deteccao de dano miocardico na difteria, aumentando a sensibilidade diagnostica e conferindo valor prognostico

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