406 research outputs found

    Are Rapid Population Estimates Accurate? A Field Trial of Two Different Assessment Methods.

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    Emergencies resulting in large-scale displacement often lead to populations resettling in areas where basic health services and sanitation are unavailable. To plan relief-related activities quickly, rapid population size estimates are needed. The currently recommended Quadrat method estimates total population by extrapolating the average population size living in square blocks of known area to the total site surface. An alternative approach, the T-Square, provides a population estimate based on analysis of the spatial distribution of housing units taken throughout a site. We field tested both methods and validated the results against a census in Esturro Bairro, Beira, Mozambique. Compared to the census (population: 9,479), the T-Square yielded a better population estimate (9,523) than the Quadrat method (7,681; 95% confidence interval: 6,160-9,201), but was more difficult for field survey teams to implement. Although applicable only to similar sites, several general conclusions can be drawn for emergency planning

    Preoperative left ventricular ejection fraction and left atrium reverse remodeling after mitral regurgitation surgery

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    Background: Left atrium enlargement has been associated with cardiac events in patients with mitral regurgitation (MR). Left atrium reverse remodeling (LARR) occur after surgical correction of MR, but the preoperative predictors of this phenomenon are not well known. It is therefore important to identify preoperative predictors for postoperative LARR.Methods: We enrolled 62 patients with chronic severe MR (prolapse or flail leaflet) who underwent successful mitral valve surgery (repair or replacement); all with pre-and postoperative echocardiography. LARR was defined as a reduction in left atrium volume index (LAVI) of >= 25%. Stepwise multiple regression analysis was used to identify independent predictors of LARR.Results: LARR occurred in 46 patients (74.2%), with the mean LAVI decreasing from 85.5 mL/m(2) to 49.7 mL/m(2) (p = 25% with a sensitivity of 71.7% and a specificity of 56.3%.Conclusions: LARR occurs frequently after mitral valve surgery and is associated with preoperative LVEF higher than 63.5%.Inst Dante Pazzanese Cardiol, SĂŁo Paulo, BrazilUniversidade Federal de SĂŁo Paulo, Escola Paulista Med, SĂŁo Paulo, BrazilDisciplina Cardiol, BR-04024002 SĂŁo Paulo, BrazilUniversidade Federal de SĂŁo Paulo, Escola Paulista Med, SĂŁo Paulo, BrazilWeb of Scienc

    Human mucocutaneous leishmaniasis in TrĂȘs Braços, Bahia - Brazil : an area of Leishmania braziliensis braziliensis transmission. II. Cutaneous disease. Presentation and evolution

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    Foram analisados os dados clĂ­nicos de 182 pacientes com leishmaniose cutĂąnea, provavelmente causada por Leishmania braziliensis braziliensis. Sessenta e oito por cento apresentavam uma Ășnica lesĂŁo, usualmente uma Ășlcera, na terça parte inferior anterior da tĂ­bia. Todos os grupos etĂĄrios estavam representados e muitos apresentaram histĂłrico de um a dois meses. Treze por cento apresentavam lesĂ”es fechadas de natureza verrucosa ou em placa. ApĂłs tratamento, a evolução destas lesĂ”es foi relacionada Ă  regularidade da terapia por antimĂŽnio. Embora a cura usualmente ocorresse em trĂȘs meses, o tempo de cicatrização, apĂłs o inĂ­cio de tratamento, foi variĂĄvel e relativo ao tamanho da lesĂŁo (p < 0.01). Em geral a lesĂŁo fechava quando era dado suficiente antimĂŽnio como tratamento. Sete entre dez pacientes que apresentavam teste cutĂąneo negativo para leishmania tomavam positivos apĂłs o tratamento. Observou-se por fluorescĂȘncia indireta, um declĂ­nio significante nos tĂ­tulos de anticorpos em pacientes acompanhados durante e apĂłs a terapia. _________________________________________________________________________________ ABSTRACTThe clinical records of 182 patients with cutaneous leishmaniasis probably due to Leishmania braziliensis braziliensis are analysed. 68% had a single lesion which was usually an ulceron the lower anterior tibial third. Many had short histories of one to two months and all age groups were represented 13% had closed lesions of a verrucose or plaque like nature. Evolution of these skin lesions after treatment was related to the regularity of antimony therapy. Although healing usually occurred in three months, the time to scarring after commencing treatment was variable and related to the size ofthe lesion (p < 0.01). Usually if sufficient antimony treatment was given the lesion closed. Seven of the ten patients with initially negative leishmanin skin tests converted to positive after treatment. A significant decline of indirect fluorescent antibody titres occurred in patients followed, during and after therapy

    Anålise nutricional e complementação alimentar de cesta båsica derivada do consumo

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    INTRODUCTION: The Dieese & Procon Basket (DPB) is a list of basic foodstuffs, drawn up on the basis of a Standard of Living and Work Research project in S. Paulo city, Brazil. Seeing that it has been used as a standard for price variations, it is desirable that such an economic instrument as this, should also represent a truly healthy standard of nutrition. Thus, this study seeks to verify the adequacy of the food products in the DPB in relation to the nutritional needs of a typical reference family in S. Paulo city. It also proposes some techniques for dietary complementation. METHODOLOGY: A demographic census, undertaken in 1991 has been used to establish the reference family, as well as 2/3rds of RDA as corresponding to its nutritional needs, and the food composition tables of McCance & Widdowson to analyse the nutrient content of the DPB. Dietary complementation were undertaken by three different methods: Ad Hoc (direct suggestions), Linear Programming (computer software was utilized to minimize costs), and Hybrid (a combination of the first two). RESULTS: Food items in the DPB showed insufficient values for vitamins A, C, B2 and B6, and for minerals Ca, Mg, Fe, Zn, I and Se; besides, a relatively high fat content was found. The Hybrid Method of food complementation seems to present the best results, associating low cost and local dietary habits. DISCUSSION: A relation between the dietary deficiencies of the DPB and the nutritional transition in the developing countries may be infered. The epidemiological risks associated with these changes in eating patterns should not be incorporated into a reliable economic instrument.INTRODUÇÃO: A "cesta bĂĄsica Dieese e Procon", originada de uma Pesquisa de PadrĂŁo de Vida e Emprego no MunicĂ­pio de SĂŁo Paulo, tem sido empregada como parĂąmetro para o acompanhamento de preços. Seria desejĂĄvel que um instrumento econĂŽmico, utilizado com esta finalidade, correspondesse tambĂ©m a uma nutrição efetivamente saudĂĄvel. Assim, foram analisados os nĂ­veis de adequação dos itens alimentares da cesta bĂĄsica em relação Ă s necessidades nutricionais de uma famĂ­lia-referĂȘncia paulistana, e propostas tĂ©cnicas de complementação dietĂ©tica para sanar possĂ­veis deficiĂȘncias ou desbalanceamento. METODOLOGIA: Utilizou-se o Censo DemogrĂĄfico do IBGE, de 1991, para se determinar a famĂ­lia-referĂȘncia; adotaram-se dois terços das "Recommended Dietary Allowances" como parĂąmetro de necessidades nutricionais; e utilizou-se das tabelas de composição centesimal para verificação do aporte de nutrientes da cesta bĂĄsica. Efetuou-se a complementação alimentar por meio de trĂȘs diferentes mĂ©todos: Ad Hoc (proposta direta e fixa), Programação Linear (proposta via computador e sazonal, com ĂȘnfase na minimização de custos), HĂ­brido (uma combinação dos dois anteriores). RESULTADOS: Foram encontrados valores insuficientes para as vitaminas A, C, B2 e B6 e para os minerais Ca, Mg, Fe, Zn, I e Se; o percentual de lipĂ­dios no total calĂłrico mostrou-se elevado. Entre as tĂ©cnicas de complementação, o mĂ©todo HĂ­brido pareceu assimilar, mais eficientemente, os baixos custos e os hĂĄbitos dietĂ©ticos. DISCUSSÃO: Inferiu-se uma eventual correspondĂȘncia entre os problemas nutricionais detectados na relação de itens da cesta bĂĄsica e a chamada transição alimentar que se processa nos paĂ­ses em desenvolvimento. NĂŁo parece aconselhĂĄvel que os riscos epidemiolĂłgicos associados a essa alteração nos padrĂ”es dietĂ©ticos sejam incorporados num instrumento econĂŽmico que tenha por finalidade mensurar os preços de uma alimentação equilibrada

    CaracterĂ­sticas epidemiolĂłgicas da leishmaniose tegumentar americana em uma regiĂŁo endĂȘmica do Estado da Bahia : II leishmaniose canina

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    Um inquĂ©rito em cĂŁes realizado na regiĂŁo de TrĂȘs Braços, Bahia, mostrou que 3,0% de 98 animais tinham amastigotas em lesĂ”es de pele. Parasitos nĂŁo foram encontrados em pele normal da orelha. De uma amostra selecionada de 13 cĂŁes, portadores de lesĂŁo cutĂąnea ativa, nove (69,2%) deles estavam comprovadamente infectados. Sete amostras de lesĂŁo produziram infecção em hamsters. O estudo biolĂłgico (crescimento em meio de cultura, evolução da lesĂŁo em hamster e desenvolvimento no tubo digestivo de Lutzomyia longipalpis) identificou o parasito como pertencente ao complexo L. braziliensis. A caracterização bioquĂ­mica (mobilidade eletroforĂ©tica de enzimas em placas de acetato de celulose) e o estudo imunotaxonĂŽmico (anticorpos monoclonais) definiram as amostras como L. braziliensis braziliensis. O papel do cĂŁo como um possĂ­vel reservatĂłrio de L. b. braziliensis na regiĂŁo de TrĂȘs Braços Ă© discutido. _______________________________________________________________________________ ABSTRACTDuring a survey of domestic and hunting dogs conducted in the TrĂȘs Braços region, State of Bahia, 3,0% of 98 dogs had amastigotes in skin lesions. Parasites were not found in normal ear skin. In a nonrandomly selected sample of 13 dogs with active cutaneous lesions, infection was confirmed in nine (69,2%). Tissue biopsies from seven dog lesions produced infection in hamsters. The biological behaviour of the parasite (rate of growth in culture media, evolution of lesions in hamsters and development in the gut of Lutzomyia longipalpis,) identified it to the Leishmania braziliensis complex. Characterization by biochemical means (eletrophoretic mobility of enzymes in cellulose acetate plates) and immunotaxonomic studies (monoclonal antibodies) defined the strains as L. braziliensis braziliensis. The role of dogs as a possible reservoir host of L. b. braziliensis in TrĂȘs Braços region is discussed

    Human mucocutaneous leishmaniasis in TrĂȘs Braços, Bahia - Brazil : an area of Leishmania braziliensis braziliensis transmission. I. laboratory diagnosis

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    Foram analisados os dados clĂ­nicos de 182 pacientes com leishmaniose cutĂąnea, provavelmente causada por Leishmania braziliensis braziliensis. Sessenta e oito por cento apresentavam uma Ășnica lesĂŁo, usualmente uma Ășlcera, na terça parte inferior anterior da tĂ­bia. Todos os grupos etĂĄrios estavam representados e muitos apresentaram histĂłrico de um a dois meses. Treze por cento apresentavam lesĂ”es fechadas de natureza verrucosa ou em placa. ApĂłs tratamento, a evolução destas lesĂ”es foi relacionada Ă  regularidade da terapia por antimĂŽnio. Embora a cura usualmente ocorresse em trĂȘs meses, o tempo de cicatrização, apĂłs o inĂ­cio de tratamento, foi variĂĄvel e relativo ao tamanho da lesĂŁo (p < 0.01). Em geral a lesĂŁo fechava quando era dado suficiente antimĂŽnio como tratamento. Sete entre dez pacientes que apresentavam teste cutĂąneo negativo para leishmania tomavam positivos apĂłs o tratamento. Observou-se por fluorescĂȘncia indireta, um declĂ­nio significante nos tĂ­tulos de anticorpos em pacientes acompanhados durante e apĂłs a terapia. _______________________________________________________________________________ ABSTRACTThe clinical records of 182 patients with cutaneous leishmaniasis probably due to Leishmania braziliensis braziliensis are analysed. 68% had a single lesion which was usually an ulceron the lower anterior tibial third. Many had short histories of one to two months and all age groups were represented 13% had closed lesions of a verrucose or plaque like nature. Evolution of these skin lesions after treatment was related to the regularity of antimony therapy. Although healing usually occurred in three months, the time to scarring after commencing treatment was variable and related to the size ofthe lesion (p < 0.01). Usually if sufficient antimony treatment was given the lesion closed. Seven of the ten patients with initially negative leishmanin skin tests converted to positive after treatment. A significant decline of indirect fluorescent antibody titres occurred in patients followed, during and after therapy

    The pregnane X receptor drives sexually dimorphic hepatic changes in lipid and xenobiotic metabolism in response to gut microbiota in mice.

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    The gut microbiota-intestine-liver relationship is emerging as an important factor in multiple hepatic pathologies, but the hepatic sensors and effectors of microbial signals are not well defined. By comparing publicly available liver transcriptomics data from conventional vs. germ-free mice, we identified pregnane X receptor (PXR, NR1I2) transcriptional activity as strongly affected by the absence of gut microbes. Microbiota depletion using antibiotics in Pxr &lt;sup&gt;+/+&lt;/sup&gt; vs Pxr &lt;sup&gt;-/-&lt;/sup&gt; C57BL/6J littermate mice followed by hepatic transcriptomics revealed that most microbiota-sensitive genes were PXR-dependent in the liver in males, but not in females. Pathway enrichment analysis suggested that microbiota-PXR interaction controlled fatty acid and xenobiotic metabolism. We confirmed that antibiotic treatment reduced liver triglyceride content and hampered xenobiotic metabolism in the liver from Pxr &lt;sup&gt;+/+&lt;/sup&gt; but not Pxr &lt;sup&gt;-/-&lt;/sup&gt; male mice. These findings identify PXR as a hepatic effector of microbiota-derived signals that regulate the host's sexually dimorphic lipid and xenobiotic metabolisms in the liver. Thus, our results reveal a potential new mechanism for unexpected drug-drug or food-drug interactions. Video abstract
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