Factor V Leiden and Prothrombin G20210A in Portuguese Women with Recurrent Miscarriage: Is it Worthwhile to Investigate?

OBJECTIVE: To compare the prevalence of factor V Leiden (FVL) and prothrombin (PT) G20210A mutations in Portuguese women with unexplained recurrent miscarriage (RM) and a control group of parous women. MATERIALS AND METHODS: FVL and PT G20210A analysis were carried out in 100 women with three or more consecutive miscarriages and 100 controls with no history of pregnancy losses. Secondary analysis was made regarding gestational age at miscarriage (embryonic and fetal losses). RESULTS: Overall, the prevalence of FVL and PT G20210A was similar in women with RM (5 and 3%) compared with controls (5 and 1%) OR 1.36 (CI 95% 0.45-4.08). In RM embryonic subgroup, PT G20210A was observed in 1.3% of women and FVL prevalence (2.6%) was inclusively lesser than that of controls. Both polymorphisms were more prevalent in women with fetal losses than in controls, although statistical significance was not reached due to the small size of the >10 weeks' subgroup. CONCLUSION: These data indicate that neither FVL nor PT G20210A is associated with RM prior to 10 weeks of gestation. Therefore, its screening is not indicated as an initial approach in Portuguese women with embryonic RM and negative personal thromboembolic history

Multiple Polyposis of the Gallbladder. Diagnostic Difficulties About One Case

Descreve-se um caso de uma doente de 52 anos de idade, submetida a colecistectomia com o diagnóstico de litiase biliar, baseado na colecistografia oral. No decurso do acto cirúrgico, em que não se palparam cálculos, o diagnóstico inicial foi posto em dúvida. A identificação da polipose múltipla só foi possível após colecistectomia. Com base na experiência colhida neste caso, faz-se uma revisão dos critérios diagnósticos e fundamenta-se a orientação terapêutica, dado o potencial de malignidade destas lesões

An improved non-invasive method for measuring heartbeat of intertidal animals

Since its emergence two decades ago, the use of infrared technology for noninvasively measuring the heartbeat rates of invertebrates has provided valuable insight into the physiology and ecology of intertidal organisms. During that time period, the hardware needed for this method has been adapted to currently available electronic components, making the original published description obsolete. This article reviews the history of heartbeat sensing technology, and describes the design and function of a modern and simplified infrared heartbeat rate sensing system compatible with many intertidal and marine invertebrates. This technique overcomes drawbacks and obstacles encountered with previous methods of heartbeat rate measurement, and due to the sensor’s small size, versatility, and noninvasive nature, it creates new possibilities for studies across a wide range of organismal type

Reprodução na juventude: perfis sociodemográficos, comportamentais e reprodutivos na PNDS 2006

OBJETIVO: Analizar características sociodemográficas y de conductas sexual y reproductiva de mujeres jóvenes. MÉTODOS: Estudio poblacional transversal con representatividad nacional sobre el comportamiento sexual, anticonceptivo y reproductivo de 2.991 mujeres de 15 a 20 años en la Investigación Nacional de Demografía y Salud del Niño y de la Mujer (PNDS) 2006. Las jóvenes se clasificaron en tres grupos: iniciaron la vida sexual y se embarazaron antes de los 20 años (grupo A); iniciaron la vida sexual y no se embarazaron antes de los 20 (grupo B) y no iniciaron la vida sexual (grupo C). Mujeres de hasta 25 años se consideraron para el estudio de las tasas de embarazo y de sus consecuencias en la vida. Los análisis estadísticos consideraron los pesos y la planificación del muestreo complejo. La asociación entre dos variables categóricas fue evaluada por la prueba Chi-cuadrado. Para las conductuales, se utilizó el modelo linear global. RESULTADOS: Mujeres del grupo A eran principalmente negras, más pobres y con menor escolaridad. Tuvieron la primera relación sexual más precozmente, comportamiento anticonceptivo más desprotegido y menor conocimiento de la fisiología de la reproducción con relación al grupo B; las jóvenes del grupo C se caracterizaron por frecuentar más la escuela, y la preservación de la virginidad para el matrimonio fue relatada por 1/3 del grupo. En las mujeres con hasta 25 años, el embarazo antes de los 20 fue percibido con más consecuencias positivas que negativas en la vida amorosa, conyugal, social y autoestima. CONCLUSIONES: Hay asociación significativa entre embarazo antes de los 20 años con mayor pobreza y menor escolaridad. En ausencia de mejores condiciones de vida y de oportunidades, el embarazo, aunque no sea previsto, se establece como "proyecto de vida" en comparación con su inexistencia.OBJECTIVE: Analyze the sociodemographic characteristics and the sexual and reproductive behavior of young women. METHODS: A cross-sectional nationally representative study was performed about sexual, contraceptive and reproductive behavior with 2,991 women age 15 to 20 years in the National Survey on Demography and Health of Women and Children, 2006. The women were classified into three groups: sexual initiation and pregnancy before the age of 20 (group A); sexual initiation but no pregnancy before the age of 20 (group B) and no sexual initiation (group C). Women until age 25 years were included in the study about reasons for becoming pregnant and the implications for their lives. Statistical analysis considered survey weights and the complex sample design. The association between two categorical variables was assessed by chi-square test. The behavior variables were assessed using a global linear model. RESULTS: Women in group A were mainly black, poorer and with lower education level. These women had an early sexual initiation, less safe contraceptive behavior and less knowledge of reproduction physiology in comparison with group B; young women in group C were characterized by greater attendance at school and 1/3 of this group claimed to maintain their virginity until marriage. For women up to the age of 25, pregnancy before 20 years was perceived as having more positive than negative impacts upon their love life, spousal relationships, social lives and self-esteem. CONCLUSIONS: There is a significant association between pregnancy before the age of 20 and higher poverty and lower educational level. In the absence of better living conditions and opportunities, pregnancy, although unplanned, becomes "a plan for life", and is not seen as a lack of life planning.OBJETIVO: Analisar características sociodemográficas e do comportamento sexual e reprodutivo de mulheres jovens. MÉTODOS: Estudo populacional transversal com representatividade nacional sobre o comportamento sexual, contraceptivo e reprodutivo de 2.991 mulheres de 15 a 20 anos na Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher 2006. As jovens foram classificadas em três grupos: iniciaram a vida sexual e engravidaram antes dos 20 anos (grupo A); iniciaram a vida sexual e não engravidaram antes dos 20 (grupo B) e não iniciaram a vida sexual (grupo C). Mulheres de até 25 anos foram consideradas para o estudo das razões da gravidez e de suas implicações na vida. As análises estatísticas consideraram os pesos e o planejamento amostral complexo. A associação entre duas variáveis categóricas foi avaliada pelo teste tipo qui-quadrado. Quanto às comportamentais, utilizou-se modelo linear global. RESULTADOS: Mulheres do grupo A eram principalmente negras, mais pobres e com menor escolaridade. Tiveram a primeira relação sexual mais precocemente, comportamento contraceptivo mais desprotegido e menor conhecimento da fisiologia da reprodução em relação ao grupo B; as jovens do grupo C caracterizaram-se por maior frequência à escola e a preservação da virgindade para o casamento foi alegada por um 1/3 desse grupo. Para as mulheres com até 25 anos, a gravidez antes dos 20 foi percebida como tendo implicações mais positivas que negativas na vida amorosa, conjugal, social e autoestima. CONCLUSÕES: Há associação significativa entre gravidez antes dos 20 anos com maior pobreza e menor escolaridade. Na ausência de melhores condições de vida e de oportunidades, a gravidez, embora não prevista, configura-se como "projeto de vida" e não sua mera ausência

Feasibility, drug safety, and effectiveness of etiological treatment programs for Chagas disease in Honduras, Guatemala, and Bolivia: 10-year experience of Médecins Sans Frontières

BACKGROUND: Chagas disease (American trypanosomiasis) is a zoonotic or anthropozoonotic disease caused by the parasite Trypanosoma cruzi. Predominantly affecting populations in poor areas of Latin America, medical care for this neglected disease is often lacking. Médecins Sans Frontières/Doctors Without Borders (MSF) has provided diagnostic and treatment services for Chagas disease since 1999. This report describes 10 years of field experience in four MSF programs in Honduras, Guatemala, and Bolivia, focusing on feasibility protocols, safety of drug therapy, and treatment effectiveness. METHODOLOGY: From 1999 to 2008, MSF provided free diagnosis, etiological treatment, and follow-up care for patients <18 years of age seropositive for T. cruzi in Yoro, Honduras (1999-2002); Olopa, Guatemala (2003-2006); Entre Ríos, Bolivia (2002-2006); and Sucre, Bolivia (2005-2008). Essential program components guaranteeing feasibility of implementation were information, education, and communication (IEC) at the community and family level; vector control; health staff training; screening and diagnosis; treatment and compliance, including family-based strategies for early detection of adverse events; and logistics. Chagas disease diagnosis was confirmed by testing blood samples using two different diagnostic tests. T. cruzi-positive patients were treated with benznidazole as first-line treatment, with appropriate counseling, consent, and active participation from parents or guardians for daily administration of the drug, early detection of adverse events, and treatment withdrawal, when necessary. Weekly follow-up was conducted, with adverse events recorded to assess drug safety. Evaluations of serological conversion were carried out to measure treatment effectiveness. Vector control, entomological surveillance, and health education activities were carried out in all projects with close interaction with national and regional programs. RESULTS: Total numbers of children and adolescents tested for T. cruzi in Yoro, Olopa, Entre Ríos, and Sucre were 24,471, 8,927, 7,613, and 19,400, respectively. Of these, 232 (0.9%), 124 (1.4%), 1,475 (19.4%), and 1,145 (5.9%) patients, respectively, were diagnosed as seropositive. Patients were treated with benznidazole, and early findings of seroconversion varied widely between the Central and South American programs: 87.1% and 58.1% at 18 months post-treatment in Yoro and Olopa, respectively; 5.4% by up to 60 months in Entre Ríos; and 0% at an average of 18 months in Sucre. Benznidazole-related adverse events were observed in 50.2% and 50.8% of all patients treated in Yoro and Olopa, respectively, and 25.6% and 37.9% of patients in Entre Ríos and Sucre, respectively. Most adverse events were mild and manageable. No deaths occurred in the treatment population. CONCLUSIONS: These results demonstrate the feasibility of implementing Chagas disease diagnosis and treatment programs in resource-limited settings, including remote rural areas, while addressing the limitations associated with drug-related adverse events. The variability in apparent treatment effectiveness may reflect differences in patient and parasite populations, and illustrates the limitations of current treatments and measures of efficacy. New treatments with improved safety profiles, pediatric formulations of existing and new drugs, and a faster, reliable test of cure are all urgently needed

Characterization and Evaluation of Layered Bi2WO6 Nanosheets as a New Antibacterial Agent

Background: Pathogenic microorganisms are causing increasing cases of mortality and morbidity, along with alarming rates of ineffectiveness as a result of acquired antimicrobial resistance. Bi2WO6 showed good potential to be used as an antibacterial substance when exposed to visible light. This study demonstrates for the first time the dimension-dependent antibacterial activity of layered Bi2WO6 nanosheets. Materials and methods: The synthesized layered Bi2WO6 nanosheets were prepared by the hydrothermal method and characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), atomic force microscopy (AFM), and Raman and Fourier transform infrared spectroscopy (FTIR). Antibacterial and antibiotic-modulation activities were performed in triplicate by the microdilution method associated with visible light irradiation (LEDs). Results: Bi2WO6 nanosheets were effective against all types of bacteria tested, with MIC values of 256 µg/mL against Escherichia coli standard and resistant strains, and 256 µg/mL and 32 µg/mL against Staphylococcus aureus standard and resistant strains, respectively. Two-dimensional (2D) Bi2WO6 nanosheets showed antibacterial efficiency against both strains studied without the presence of light. Conclusions: Layered Bi2WO6 nanosheets revealed dimension-dependent antibacterial activity of the Bi2WO6 system.The authors thank Conselho Nacional de Desenvolvimento Científico e Tecnológico— CNPq, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES, and Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico—FUNCAP (Proc. BP4-00172-00232.01.00/20 and Proc. PR2-0101-00006.01.00/15) for the financial support. The authors would also like to thank the educational institutions UFCA, URCA, and UNILEÃO for their support during the experiments