Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil

BACKGROUND: Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. METHODS: We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. RESULTS: There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. CONCLUSION: Low socioeconomic status areas have higher tuberculosis rates, and low socioeconomic individuals have higher risk of treatment abandonment, in Fortaleza. Treatment abandonment rates are growing despite the advent of universal DOT recommendations in Brazil. Proactive social policies, and active contact tracing to find missed cases, may help reduce the tuberculosis burden in this setting

Miniprobe endoscopic ultrasonography for the diagnosis of colon hemangiolymphangioma

Hemangiolymphangioma is a very rare benign vascular tumor that affects the gastrointestinal tract in less than 1% of cases. We present the case of an asymptomatic 52-year-old female referred for endoscopic colorectal cancer screening. A sub-epithelial pediculated polypoid lesion in the splenic angle of the colon was identified. An endoscopic ultrasonography with a miniprobe was performed, which identified an anechoic lesion in the submucosal layer. Surgery was performed and the histologic findings were compatible with two hemangiolymphangioma lesions. This is one of the few cases reported in the literature of hemangiolymphangioma diagnosed by miniprobe endoscopic ultrasonography and the first to describe two lesions in the same patient.info:eu-repo/semantics/publishedVersio

Human cachexia induces changes in mitochondria, autophagy and apoptosis in the skeletal muscle

Cachexia is a wasting syndrome characterized by the continuous loss of skeletal muscle mass due to imbalance between protein synthesis and degradation, which is related with poor prognosis and compromised quality of life. Dysfunctional mitochondria are associated with lower muscle strength and muscle atrophy in cancer patients, yet poorly described in human cachexia. We herein investigated mitochondrial morphology, autophagy and apoptosis in the skeletal muscle of patients with gastrointestinal cancer-associated cachexia (CC), as compared with a weight-stable cancer group (WSC). CC showed prominent weight loss and increased circulating levels of serum C-reactive protein, lower body mass index and decreased circulating hemoglobin, when compared to WSC. Electron microscopy analysis revealed an increase in intermyofibrillar mitochondrial area in CC, as compared to WSC. Relative gene expression of Fission 1, a protein related to mitochondrial fission, was increased in CC, as compared to WSC. LC3 II, autophagy-related (ATG) 5 and 7 essential proteins for autophagosome formation, presented higher content in the cachectic group. Protein levels of phosphorylated p53 (Ser46), activated caspase 8 (Asp384) and 9 (Asp315) were also increased in the skeletal muscle of CC. Overall, our results demonstrate that human cancer-associated cachexia leads to exacerbated muscle-stress response that may culminate in muscle loss, which is in part due to disruption of mitochondrial morphology, dysfunctional autophagy and increased apoptosis. To the best of our knowledge, this is the first report showing quantitative morphological alterations in skeletal muscle mitochondria in cachectic patients

Desempenho de genótipos de arroz sob deficiência hídrica e irrigação adequada.

O objetivo do trabalho foi avaliar o desempenho produtivo de genótipos de arroz de terras altas, em ambientes de irrigação adequada e de deficiência hídrica.bitstream/item/34968/1/comt-194.pd

First report of Papaya ringspot virus-type W infecting fevillea species (cucurbitaceae) in South America.

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Study of Gaseous Emissions Derived from the Combustion of Diesel/Beef Tallow Biodiesel Blends

Air pollution is one of the main environmental problems of modern society. The road and transportation segment is a key source of polluting gases worldwide. In its research for transportation’s emission reduction alternatives, the Brazilian government instituted a wide-spread biodiesel, adding 7% (B7) of biodiesel to the diesel used in the country. Therefore, studies such as this must be carried out to guarantee the environmental sustainability of the new matrix of renewable energies, with the useof biofuels, as well as evaluate the gases emitted to for the environment by the combustion of the same ones. This work was detected CO, CO2 and NO gas emissions released into the atmosphere from the combustion of blends diesel/beef tallow biodiesel in a bench-scale engine. Using electrochemical sensors, the of these gases concentration were successfully registered for two modes of operation of the engine diesel, low rotation, 3500 rpm, and high rotation, 7000 rpm. The CO levels in this experiment in low rotation varied between values minimum and maximum range of 866.7 to 1333.3 ppm, and in high rotation, ranging of 666 and 1000 ppm respectively. For the CO2 concentration in low rotation varied between values minimum and maximum range of 2.1 to 2.4%, and high rotation, ranging of 2.2 to 2.5%, and for NO concentrations of the samples for the mode low rotation had a variation of 83 to 109.5 ppm, and for high rotation were 81.7 to 98.7 ppm respectively

Ajuste de modelo heteroscedástico em estudo toxicológico usando o SAS.

A principal motivação desse trabalho é apresentar uma aplicação, em estudo toxicológico, de modelo de análise de variância com dois fatores com variâncias residuais heterogêneas, usando os procedimentos MIXED e PLM do SAS. O experimento foi conduzido no laboratório de ecotoxicologia e biossegurança da Embrapa Meio Ambiente e teve como um de seus objetivos avaliar os efeitos de sexo e dose na quantidade de nanopartículas encontradas nos tecidos dos íleos de ratos Wistar que receberam diariamente ao longo de 28 dias, via oral, doses repetidas de um nanocomposto. O modelo heteroscedástico foi ajustado usando o procedimento MIXED. Os desdobramentos da interação significativa, entre os níveis dos fatores sexo e dose, foram feitos usando o procedimento PLM que possibilitou um maior detalhamento dos mesmos. A tendência crescente das concentrações médias de nanopartículas nos íleos dos machos em relação às doses do nanocomposto, foi descrita por um modelo de regressão linear ponderada. Nesse caso, ainda que o procedimento MIXED pudesse ser usado, o procedimento REG, por ser mais específico para esse tipo de análise, disponibilizou gráficos mais completos

Evolução da maturação e determinação do ponto de colheita de banana nas condições de cultivo da região do Submédio do Vale do São Francisco.

O elevado índice de perdas desde a produção até a comercialização de banana no Brasil faz com que apenas uma parcela, entre 50 a 60% da produção, chegue à mesa do consumidor. A determinação do ponto de colheita mais adequado tem como finalidade permitir o máximo aproveitamento da fruta. O objetivo deste trabalho foi o acompanhamento da maturação dos frutos desde a emissão da inflorescência até a maturação completa do cacho na planta e, assim, verificar a época ideal de colheita, por meio de análises físicas e químicas, quanto a tamanho, peso, textura, pH, acidez total titulável e açucares solúveis totais, nas condições de cultivo do Vale do São Francisco. Verificou-se que o diâmetro, comprimento e desaparecimento da angulosidade dos frutos, não foram adequados para determinação do ponto de colheita de bananas de cultivar Pacovan, visto que os frutos mantiveram-se irregular em tamanho e forma até a completa maturação e que a acidez total titulável e textura foram os melhores indicativos para o ponto de colheita

Efeito do óleo essencial de citronela sobre a mortalidade e oviposição do caruncho do feijão-caupi.

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