Evaluation of the diagnostic potential of CD1a immunohistochemistry for visceral leishmaniasis

Visceral Leishmaniasis is a public health problem caused by protozoans of the genus Leishmania. K39 serological test is commonly used in the initial investigation, with high specificity, but variable sensitivity. Amastigotes can be identified by optical microscopy, however, the differential diagnosis with cellular debris or other intracellular parasites is necessary. Recent studies have raised the possibility of using immunohistochemistry in the diagnosis of visceral leishmaniasis with labeling of amastigotes by the anti-CD1a antibody. This retrospective study was based on 38 samples from patients with visceral leishmaniasis whose diagnoses were confirmed by myelogram and/or k39 testing, aside from positive (N=13) and negative biopsies (N=25), 2 samples from patients with false positive biopsies for visceral leishmaniasis and 8 samples from patients with histoplasmosis diagnosis. The histological slides were evaluated for the presence of amastigotes and their Modified Ridley Parasitic Index. The samples were submitted to immunohistochemical reactions using the anti-CD1a antibody with MTB1 and O10 clones. Immunohistochemical reactions with MTB1 and O10 clones had low sensitivity in this study. However, all bone marrow samples were previously decalcified with nitric acid which is probably a deleterious treatment for immunohistochemical reactions in this site. Excluding these samples, we obtained 58.33% sensitivity and 100% specificity with the MTB1 clone. Despite the intermediate sensitivity, the immunohistochemistry for the CD1a marker with clone MTB1 can be useful in the differential diagnosis of visceral leishmaniasis, helping to discriminate leishmania amastigotes from other pathogens with similar morphology and cellular debris in different samples, except in bone marrow biopsies previously decalcified with nitric acid

In vivo expansion of functionally integrated GABAergic interneurons by targeted increase in neural progenitors.

A central hypothesis for brain evolution is that it might occur via expansion of progenitor cells and subsequent lineage-dependent formation of neural circuits. Here, we report in vivo amplification and functional integration of lineage-specific circuitry in Drosophila Levels of the cell fate determinant Prospero were attenuated in specific brain lineages within a range that expanded not only progenitors but also neuronal progeny, without tumor formation. Resulting supernumerary neural stem cells underwent normal functional transitions, progressed through the temporal patterning cascade, and generated progeny with molecular signatures matching source lineages. Fully differentiated supernumerary gamma-amino butyric acid (GABA)-ergic interneurons formed functional connections in the central complex of the adult brain, as revealed by in vivo calcium imaging and open-field behavioral analysis. Our results show that quantitative control of a single transcription factor is sufficient to tune neuron numbers and clonal circuitry, and provide molecular insight into a likely mechanism of brain evolution

Over and Under-utilization of Cyclooxygenase-2 Selective Inhibitors by Primary Care Physicians and Specialists: The Tortoise and the Hare Revisited

To compare prescribing trends and appropriateness of use of traditional and cyclooxygenase-2 selective (COX-2) nonsteroidal anti-inflammatory drugs (NSAIDs) by primary care physicians (PCPs) and specialists. DESIGN : Retrospective cohort study. PATIENTS : One thousand five hundred and seventy-six adult patients continuously enrolled for at least 1 year with an independent practice association of a University-associated managed care plan who were started on a traditional NSAID or a COX-2 inhibitor from 1999 to 2002 and received at least 3 separate medication fills. MEASUREMENTS : Physician specialty was identified from office visits. Appropriateness of utilization was based on gastrointestinal risk characteristics. RESULTS : Primary care patients were younger and less likely to have comorbid conditions. Despite similar GI risk, COX-2 use among patients seen by PCPs was half that of patients seen by specialists (21% vs 44%, P <.001). While PCPs overused cyclooxygenase-2-specific inhibitors (COX-2s) less often than specialists (19% vs 41%, P <.001), they also tended to underuse COX-2s in patients who were at increased GI risk (46% vs 32%, P =.063). This represents a 3-fold and 8-fold difference in overuse versus underuse for PCPs and specialists, respectively. CONCLUSIONS : Using COX-2s as a model for physician adoption of new therapeutic agents, specialists were more likely to use these new medications for patients likely to benefit but were also significantly more likely to use them for patients without a clear indication. This study demonstrates the tension between appropriate adoption of innovative therapies for those individuals who would benefit from their use and those individuals who would receive no added clinical benefit but would incur added cost and be placed at increased risk.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75173/1/j.1525-1497.2006.00463.x.pd

Intelligent control for energy-positive street lighting

The paper investigates the application of solar energy in public lighting for realizing a street lighting sub-grid with positive yearly energy balance. The focus is given to the central controller, which ensures the adaptive behavior of the overall system and provides smart city services to the end users via its web-based user interface. A functionality of the controller of special interest is the optimization of the energy management of the system, i.e., determining when to sell and buy electricity to/from the grid, in order to minimize the cost of electricity (or to maximize the profit) subject to a given, time-of-use variable energy tariff. This requires precise forecasts of the energy produced and consumed, as well as appropriate robust optimization techniques that guarantee that the system bridges potential power outages of moderate duration in island mode

Seismic structure across the rift valley of the Mid-Atlantic Ridge at 23°20′ (MARK area): Implications for crustal accretion processes at slow spreading ridges

International audienc

Duration of temporary catheter use for hemodialysis: an observational, prospective evaluation of renal units in Brazil

<p>Abstract</p> <p>Background</p> <p>For chronic hemodialysis, the ideal permanent vascular access is the arteriovenous fistula (AVF). Temporary catheters should be reserved for acute dialysis needs. The AVF is associated with lower infection rates, better clinical results, and a higher quality of life and survival when compared to temporary catheters. In Brazil, the proportion of patients with temporary catheters for more than 3 months from the beginning of therapy is used as an evaluation of the quality of renal units. The aim of this study is to evaluate factors associated with the time between the beginning of hemodialysis with temporary catheters and the placement of the first arteriovenous fistula in Brazil.</p> <p>Methods</p> <p>This is an observational, prospective non-concurrent study using national administrative registries of all patients financed by the public health system who began renal replacement therapy (RRT) between 2000 and 2004 in Brazil. Incident patients were eligible who had hemodialysis for the first time. Patients were excluded who: had hemodialysis reportedly started after the date of death (inconsistent database); were younger than 18 years old; had HIV; had no record of the first dialysis unit; and were dialyzed in units with less than twenty patients. To evaluate individual and renal unit factors associated with the event of interest, the frailty model was used (N = 55,589).</p> <p>Results</p> <p>Among the 23,824 patients (42.9%) who underwent fistula placement in the period of the study, 18.2% maintained the temporary catheter for more than three months until the fistula creation. The analysis identified five statistically significant factors associated with longer time until first fistula: higher age (Hazard-risk - HR 0.99, 95% CI 0.99-1.00); having hypertension and cardiovascular diseases (HR 0.94, 95% CI 0.9-0.98) as the cause of chronic renal disease; residing in capitals cities (HR 0.92, 95% CI 0.9-0.95) and certain regions in Brazil - South (HR 0.83, 95% CI 0.8-0.87), Midwest (HR 0.88, 95% CI 0.83-0.94), Northeast (HR 0.91, 95% CI 0.88-0.94), or North (HR 0.88, 95% CI 0.83-0.94) and the type of renal unit (public or private).</p> <p>Conclusion</p> <p>Monitoring the provision of arteriovenous fistulas in renal units could improve the care given to patients with end stage renal disease.</p

Spreading continents kick-started plate tectonics

International audienceStresses acting on cold, thick and negatively buoyant oceanic litho- sphere are thought to be crucial to the initiation of subduction and the operation of plate tectonics, which characterizes the present- day geodynamics of the Earth. Because the Earth’s interior was hotter in the Archaean eon, the oceanic crust may have been thicker, thereby making the oceanic lithosphere more buoyant than at present, and whether subduction and plate tectonics occurred during this time is ambiguous, both in the geological record and in geodynamic models. Here we show that because the oceanic crust was thick and buoyant5, early continents may have produced intra-lithospheric gravitational stresses large enough to drive their gravitational spreading, to initiate subduction at their margins and to trigger episodes of subduction. Our model predicts the co-occurrence of deep to progressively shallower mafic volcanics and arc magmatism within continents in a self-consistent geodynamic framework, explaining the enigmatic multimodal volcanism and tectonic record of Archaean cratons. Moreover, our model predicts a petrological stratification and tectonic structure of the sub-continental lithospheric mantle, two predictions that are consistent with xenolith and seismic studies, respectively, and consistent with the existence of a mid-lithospheric seismic discontinuity. The slow gravitational collapse of early continents could have kick-started transient episodes of plate tectonics until, as the Earth’s interior cooled and oceanic lithosphere became heavier, plate tectonics became self-sustaining