Respiratory functional characteristics of human leptospirosis

Introdução: O comprometimento respiratório da leptospirose humana pode ser sua principal manifestação clínica e comumente está associado a maior morbimortalidade. Métodos: Objetivando descrever aspectos funcionais respiratórios nessa doença, foram analisados 21 pacientes com oximetrias de pulso e espirometrias em dois momentos: em avaliação inicial e após cerca de 28 dias. Resultados: Dois (9,5%) doentes tinham saturação periférica de oxigênio menor que 95%. Padrões espirométricos normais foram observados em 8 (38,1%) casos; distúrbios ventilatórios restritivos foram inferidos em 7 (33,3%), obstrutivos com capacidade vital forçada reduzida em 4 (19%), e inespecíficos em 2 (9,5%). Espirometrias anormais se associaram a pior escore APACHE II (p=0,02) e anormalidades na radiografia de tórax (p=0,05). Após resolução clínica, verificou-se ganho funcional significativo (p<0,05) no grupo de pacientes com espirometria alterada. Conclusões: Alterações espirométricas foram detectadas no curso da enfermidade e estiveram associadas a pior gravidade clínica e maior freqüência de anormalidades radiológicas torácicas. _________________________________________________________________________________________ ABSTRACT: Introduction: Respiratory impairment may be the main clinical manifestation of human leptospirosis. Methods: With the aim of describing the respiratory functional characteristics of this disease, 21 patients were evaluated using pulse oximetry and spirometry at two times: an initial evaluation and after around 28 days. Results: Two (9.5%) patients presented peripheral oxygen saturation of less than 95%. Normal spirometric patterns were observed in eight (38.1%); cases restrictive ventilatory disorders were inferred in seven (33.3%), obstructive disorders with reduced forced vital capacity in four (19%), and nonspecific disorders in two (9.5%). Abnormal spirometry findings were associated with worse APACHE II scores (p = 0.02) and abnormalities on chest x-ray (p = 0.05). After clinical resolution, significant functional gain was observed (p < 0.05) in the group of patients with abnormal spirometry findings. Conclusions: It was concluded that respiratory functional abnormalities were detected during the course of the disease and were associated with greater clinical severity and higher frequency of chest radiographic abnormalities

Valid and reliable instruments for arm-hand assessment at ICF activity level in persons with hemiplegia: a systematic review

Contains fulltext : 110141.pdf (publisher's version ) (Open Access)BACKGROUND: Loss of arm-hand performance due to a hemiparesis as a result of stroke or cerebral palsy (CP), leads to large problems in daily life of these patients. Assessment of arm-hand performance is important in both clinical practice and research. To gain more insight in e.g. effectiveness of common therapies for different patient populations with similar clinical characteristics, consensus regarding the choice and use of outcome measures is paramount. To guide this choice, an overview of available instruments is necessary. The aim of this systematic review is to identify, evaluate and categorize instruments, reported to be valid and reliable, assessing arm-hand performance at the ICF activity level in patients with stroke or cerebral palsy. METHODS: A systematic literature search was performed to identify articles containing instruments assessing arm-hand skilled performance in patients with stroke or cerebral palsy. Instruments were identified and divided into the categories capacity, perceived performance and actual performance. A second search was performed to obtain information on their content and psychometrics. RESULTS: Regarding capacity, perceived performance and actual performance, 18, 9 and 3 instruments were included respectively. Only 3 of all included instruments were used and tested in both patient populations. The content of the instruments differed widely regarding the ICF levels measured, assessment of the amount of use versus the quality of use, the inclusion of unimanual and/or bimanual tasks and the inclusion of basic and/or extended tasks. CONCLUSIONS: Although many instruments assess capacity and perceived performance, a dearth exists of instruments assessing actual performance. In addition, instruments appropriate for more than one patient population are sparse. For actual performance, new instruments have to be developed, with specific focus on the usability in different patient populations and the assessment of quality of use as well as amount of use. Also, consensus about the choice and use of instruments within and across populations is needed

Kinetic characterization of the group II helicoverpa armigera nucleopolyhedrovirus propagated in suspension cell cultures: Implications for development of a biopesticides production process

Large-scale commercialization of baculovirus biopesticides for the control of insect pests requires a cell culture production process, and knowledge of the infection kinetics is a vital prerequisite for process optimization. Well-characterized kinetic parameters have so far only been reported for the commercially established recombinant Autographa californica nucleopolyhedrovirus (AcMNPV), a Group I NPV. In this work, key infection kinetic parameters of the Group II NPV Helicoverpa armigera nucleopolyhedrovirus (HaSNPV), and its Few Polyhedra (FP) mutant, were well characterized for the first time, in suspension HzAM1 insect cell cultures, to facilitate the scale-up of an HaSNPV-based biopesticide. The FP mutant had a selective advantage over wild-type HaSNPV in cell cultures, and the kinetic analysis showed that this was due to a superior budding rate, rather than a faster binding rate (BR) or longer budding duration. Another finding was that wild-type HaSNPV had very poor infection kinetics when compared with AcMNPV, exhibiting an 18-fold lower BR, a more than 50-fold lower budding rate, and a 60-fold lower extracellular/total progeny virus ratio. Such poor infection kinetics have serious implications during scale-up of an HaSNPV biopesticide production process, including the requirement for large volumes of virus inocula and the difficulty of achieving synchronous infections. Groups I and II NPVs may have very different infection kinetics because of their different envelope fusion proteins. This study is the first to compare the two groups of NPVs in terms of well-characterized cell-specific infection kinetics, and the findings may indicate a phylogenetic basis for kinetic differences

Tabagismo e etilismo em funcionários da Universidade Estadual do Ceará Smoking and alcohol drinking practices among employees of Universidade Estadual do Ceará

O presente estudo pretendeu identificar os hábitos de tabagismo e etilismo de funcionários da Universidade Estadual do Ceará, em Fortaleza. O estudo abrangeu 317 funcionários. Aplicou-se um questionário contendo dados de identificação, socioeconômicos e referentes ao tabagismo e etilismo, que foram tabulados e analisados pelo Epi-Info 6.0. O grupo entrevistado foi constituído de 157 homens e 160 mulheres, com faixa etária predominante de 30-49 anos e alta escolaridade. A renda familiar para 146 funcionários situou-se na faixa igual ou superior a 10 salários mínimos mensais. Declararam-se fumantes 83 funcionários, observando-se maior prevalência no sexo masculino (56). Em média, o consumo de cigarros foi de 12,3/dia e tal atividade era exercida havia 23,2 anos. Quanto ao etilismo, 183 indivíduos ingeriam bebida alcóolica, também encontrando-se maior prevalência nos homens. A freqüência do consumo foi principalmente em fins de semana ou raramente. A bebida mais citada foi a cerveja - 96, seguida pela aguardente de cana - 20 pessoas. O consumo médio diário de etanol foi de 29,9g. Os consumidores simultâneos de tabaco e álcool foram eminentemente do sexo masculino. A escolaridade e a renda foram maiores nas mulheres exclusivamente fumantes e a renda foi maior entre as exclusivamente etilistas. Apesar de as prevalências de tabagismo e etilismo encontradas não terem sido elevadas, ainda configuram um risco para doenças crônico-degenerativas, principalmente quanto à quantidade de etanol ingerida pelos homens, devendo haver aprofundamento do estudo em relação à associação com outras diferentes variáveis ambientais.<br>The aim of the present study was to identify smoking and alcohol drinking practices among Universidade Estadual do Ceará employees in the city of Fortaleza. The study used 317 employees as subjects. An interview questionnaire containing personal, socioeconomic, tobacco and alcohol consumption data was applied. The tabulation and analysis were made by Epi-Info 6.0. 157 of the interviewed subjects were male and 160 were female, the most prevalent age bracket being 30-49 years of age, and high level of instruction. 146 workers showed a family income starting from 10 minimal living wages per month. 83 workers were considered smokers, and a higher prevalence was detected among males (56). Mean tobacco consumption was 12.3 cigarettes a day, a practice that took place in the last 23.2 years. Alcohol was ingested by 183 employees and the prevalence was also higher among males. The consumption occurred mainly on weekends or rarely. The most ingested drink was beer - 96, followed by Brazilian white rum - 20 employees. The mean daily consumption of ethanol was 29.9 g. The ones who were both smokers and drinkers were mainly males. The instruction and income level were higher among smoking females and the income level was higher among drinking females. Although the prevalence of tobacco and alcohol consumption was low, it is a risk of chronic-degenerative diseases, specially in relation to the ethanol ingested by males. It is necessary to continue this study to provide a deeper association among the different environmental variables