HIV/Candida co-infection in Sub-Saharan African women on ART

5th FIDSSA Congress 2013: Champagne Sports Resort Drakensberg, KwaZulu Natal, South Africa - Poster Presentations.INTRODUCTION: Sub-Saharan Africa has 23.5 million cases of HIV and is home to 92% of the world’s HIV-positive pregnant women of whom 24% die of pregnancy related complications. Oral candidiasis is a common condition in HIV-AIDS patients, caused by commensal yeasts which may colonise the mucous membranes of the mouth causing morbidity due to several factors including immunosuppression, smoking, poor nutrition and the use of antibiotics. Methods: One hundred and ninety-four South African and Cameroonian HIV-positive women participated in the study. Only subjects who had white pseudomembranous plaque on the tongue or visible oral candidiasis were included. Samples were collected by scraping the patient’s oral mucosa and tongue with a sterile swab. Candida species were differentiated using selective and chromogenic media and their susceptibility to antifungal drugs was tested using the TREK Sensititre system. Results and conclusion: One hundred and ninety-six isolates, representative of six Candida species were identified. C. albicans was the predominating species, with C. glabrata and C. dubliniensis being the more frequent of the non-albicans isolates. Azole drug resistance patterns were very high for C. albicans, while C. glabrata showed high resistance patterns to echinocandins drugs. The duration of ART could be associated with the presence of different Candida species but no concrete conclusions could be drawn concerning HIV/Candida co-infection when controlling for other risk factors such as HIV stage, pregnancy, age and treatment for tuberculosis. This may be a cause for concern, particularly in the case of pregnancy, where co-infection may pose a risk for maternal morbidity and mortality.National Research Foundation of South AfricaDepartment of HE and Training approved lis

Strengths and limitations of different Chromogenic Media for the identification of Candida species

The treatment of invasive candidiasis and other Candida infections with the appropriate antifungal agent is assisted by the identification of Candida isolates to the species level. Rapid and accurate methods of differentiation are therefore imperative if treatment is to be effective, particularly in HIV-positive patients and in pregnant mothers where intervention may be necessary to reduce the risk for preterm delivery. The time used for isolation, identification and detection of mixed cultures may be reduced with the help of available chromogenic media. In this study, five commercial chromogenic media were evaluated for the differentiation of Candida species. Six type-strains of Candida species were streaked onto each of five different chromogenic media and incubated for up to 4 days at the different temperatures recommended by the manufacturers. This comparative evaluation demonstrated the strengths and weaknesses of each medium employed and found CHROMagar™ Candida and Chromogenic Candida Agar to be the most effective for distinguishing between different Candida species.National Research Foundation of South Afric

Práticas de letramentos de educadores de um assentamento no Sudoeste do Pará: representações de leitura

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão, Programa de Pós-Graduação em Linguística, Florianópolis, 2014.Este estudo pretende contribuir para a formação continuada de educadores do campo, e para isso investigamos as representações de leitura de educadores de um assentamento no sudeste do Pará, organizado pelo Movimento dos Trabalhadores Rurais Sem Terra. Dispomo-nos a identificar, através de entrevistas individuais e rodas de conversas, como se concretizam as representações de leitura desses educadores. Optamos por um aporte teórico, cujas práticas de leitura e escrita possam ou não estar associadas à escola, o que pode destoar do que a sociedade entende como sendo o processo de alfabetizar, aquele bem próximo da concepção do modelo de letramento autônomo, discutido por Street (1984); kleiman (1995), cuja referência da escrita se dá como  um produto completo em si mesmo que não estaria preso ao contexto de sua produção para ser interpretado . Contrapondo-se ao modelo ideológico de letramento considera não somente os aspectos culturais de interação, mas também  as relações de poder numa determinada sociedade . Pautamos também nossa discussão acerca de letramento em Freire, (1981;1987;2008), para quem aprender a ler, a escrever, alfabetizar-se é, antes de tudo, aprender a ler o mundo, compreender o seu contexto. Nossa metodologia ancora-se em uma perspectiva de cunho etnográfico, onde se apreende o que os sujeitos fazem com e na linguagem, em seus contextos de uso da leitura, para tal investigação, subsidiamos nossos procedimentos metodológicos em Moita Lopes (1999;2006) e Erickson (1989). Além de orientar a análise dessa pesquisa nos aportes teóricos do letramento do professor, ancorados nos estudos de Kleiman, (1995; 2001; 2006; 2008), Oliveira (2008; 2010), Tinoco, (2010) Zavala, (2004; 2010). Verificamos durante o percurso analítico dessa pesquisa, a importância de discutir concepções de ler e escrever dos cursos de formação continuada para os educadores do campo, ou propor projetos para o campo que reflitam o que os professores representam e fazem com o ato de ensinar/aprender língua materna.Abstract : This study aims to contribute to the continuing education of educators of the field, and for this we investigate the representations of reading educators from the field of a settlement in southeast Pará, organized by the Rural Landless Workers Movement. We are preparing to identify, through individual interviews and conversations wheels, as if embodying representations of reading these educators. We chose to understand the practices of reading and writing located these teachers, which may or may not be associated with the school, which may clash with what society perceives as the process of literacy , one very close to the design of autonomous literacy model by discussed Street ( 1984); Kleiman (1995 ), which references the writing occurs as " a complete product in itself that would not be tied to the context of its production to be interpreted." While the ideological model of literacy considers not only the cultural aspects of interaction, but also. "Power relations in a given society" Also we base our discussion of literacy from Freire, (1981, 1987, 2008), where "learning to read, write and become literate - is, first of all, learn to read the world, understand its context." From this, we guide our analysis in theoretical contribution of literacy teacher, anchored in studies of Kleiman (1995, 2001, 2006, 2008), Oliveira (2008, 2010), Tinoco (2010) Zavala (2004, 2010). Verified during the analytical course of this research , the importance of discussing conceptions of reading and writing of continuing education courses for educators in the field, or propose projects to the field that reflect what teachers represent and make the act of teaching native language learning

Curatela e tomada de decisão apoiada: teoria e prática

- Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à Lei de Direitos Autorais, não disponibilizamos a obra na íntegra.- Localização na estante: 347.64-056.26(81) S327

Proteomics of drug-resistant HIV-associated candidiasis

Candidiasis and HIV co-infection may cause increased patient morbidity and mortality due to oropharyngeal or systemic dissemination. Limited information exists on the prevalence, antifungal susceptibility profiles and drug resistance mechanisms of Candida species on the African continent, the highest HIV-affected region globally and home to new and emerging drug resistant Candida species. Candida species isolated from the oral mucosa of HIV-positive African patients were found to be resistant to many of the antifungals routinely used in HIV-associated candidiasis. Candida cell membrane fractions were examined using sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and high performance liquid chromatography mass spectrometry (HPLC/MS) in order to elucidate the cell membrane proteins specifically expressed by antifungal drug resistant isolates. SDS-PAGE and HPLC/MS allowed for the identification of multi-drug resistance efflux transporter CDR2 proteins and the elucidation of Candida colonization mechanisms and pH-responsive proteins, with significant associations observed between specific drug resistance and the duration of antiretroviral (ARV) therapy. This study provided useful information on the mechanisms of antifungal resistance in Candida species. It also formed the basis for further studies to address the transfer of resistance between Candida species in an oral microbial biofilm

Proteomic mechanisms of drug resistance in Candida cell membrane fractions

Poster presented at the International Association for Dental Research, 92nd General Session, Cape Town, South Africa, 25-28 June 2014.INTRODUCTION: The African continent has the highest burden of HIV infection, accounting for approximately 65% of new infections globally. Oral candidiasis is a major cause of increased morbidity in HIV-infected individuals and is usually treated with fluconazole, an antifungal drug which interferes with ergosterol synthesis in the fungal cell membrane. The increased resistance of Candida species to antifungal drugs leads to treatment failure and an increase in untreatable Candida infections. OBJECTIVES/METHODS: Drug susceptibility patterns were determined for Candida species isolated from oral swabs of 254 patients from two HIV-positive African populations. Forty cell membrane fractions isolated from the clinical isolates were analyzed using High Performance Liquid Chromatography – Mass Spectrometry (HPLC-MS) and the results compared to the UniProt protein database for the identification of Candida peptides known to be involved in colonization and drug resistance strategies within the host. RESULTS: Fluconazole-susceptible and –resistant C. albicans isolates were found to express oxidoreductases that bind mammalian estrogens with high affinity. Peptides that confer resistance to formaldehyde were found in C. albicans, C. glabrata and C. dubliniensis in both susceptible and resistant cell fractions. Multidrug resistance proteins (CDR1 and CDR2) were seen in C. albicans cell fractions. CONCLUSION: The combination of different drug resistance mechanisms and binding abilities to salivary histatins and estrogen seem to be instrumental in the colonisation and retention of Candida in these immunocompromised patients. The results also suggest the presence of differences in efflux transporter protein expression in fluconazole-susceptible and –resistant isolates within the HIV population.National Research Foundation of South Africa (NRF

Antimicrobial resistant Gram-positive cocci in pregnant mothers with aerobic vaginitis

The vaginal microbiota of a healthy asymptomatic woman consists of an extensive diversity of anaerobic and aerobic bacterial genera and species dominated by the microaerophilic genus Lactobacillus , known to inhibit the growth of potentially pathogenic non-acid tolerant microorganisms. An imbalance of species within this biofilm may result in endogenous opportunistic infections such as aerobic vaginitis (AV) caused by S. agalactiae and E. faecalis, which have been implicated in neonatal and obstetric sepsis. The prevalence and antimicrobial susceptibility of E. faecalis and S. agalactiae in pregnant women with AV in the Western Cape, South Africa was determined using standard microbiological culture methods and the Sensititre TREK system. AV was detected in 26.13% of the 199 tested pregnant women, with S. agalactiae and E. faecalis isolated from 32 and 20 mothers respectively. S. agalactiae and E. faecalis showed resistance to 12 of the 17 antibiotics tested, including those recommended for prophylaxis according to the CDC guidelines. The resistance of S. agalactiae and E. faecalis to commonly administered antimicrobials highlights the need for alternative treatment regimens for AV during pregnancy to reduce the risk of AV-associated negative pregnancy outcomes.National Research Foundation of South Afric

Reflexões sobre a conformação do instituto da curatela frente ao novo Código de Processo Civil e ao Estatuto da Pessoa com Deficiência

Reflexões sobre a conformação do instituto da curatela frente ao novo Código de Processo Civil e ao Estatuto da Pessoa com Deficiência  Reflections about the conformation of the curatorship in front of the new Civil Procedure Code and the Statute for the Person with Disability Carlos Silveira Noronha* Charlene Côrtes Santos** REFERÊNCIA NORONHA, Carlos Silveira; SANTOS, Charlene Côrtes. Reflexões sobre a conformação do instituto da curatela frente ao novo Código de Processo Civil e ao Estatuto da Pessoa com Deficiência. Revista da Faculdade de Direito da UFRGS, Porto Alegre, n. 38, p. 35-61, ago. 2018. RESUMOABSTRACTO presente artigo propõe uma análise do instituto da curatela, perscrutando a sua transformação a partir da evolução no tempo desde a Lei das XII Tábuas até as recentes alterações operadas através do Estatuto da Pessoa com Deficiência e do Novo CPC. Isto é, de um instituto com compleição eminentemente patrimonialista, converteu-se em importante ferramenta de garantia da dignidade do interditando, em uma verdadeira “virada kantiana” (kantische Wende). A partir deste exame histórico-social, buscar-se-á identificar a atual conformação do instituto, mapeando as principais alterações trazidas no ordenamento processual atinentes ao tema em apreciação. Neste particular, serão apontadas algumas inconsistências pontuais existentes em nosso sistema jurídico decorrentes do conflito existente entre as legislações alteradas. This article proposes an analysis of the curatorship, scrutinazing your transformation from the evolution in time since the Law of XII Tables to the recents changes operated through the Statute for the Person with Disability and the new Civil Procedure Code.       That is, from an institute with eminently patrimonialist constitucion, it became an important tool to guarantee the dignity of the interdicting, in a true “Kantian turn” (Kantische Wende). From this historical-social examination, we will identify the current conformation of the institute, mapping the main changes brought in the procedural order regardin the subject under consideration. In this particular, we will point out some specific inconsistencies existing in our legal system arising out the conflict between the amendeds legislations.PALAVRAS-CHAVEKEYWORDSCuratela. Estatuto da Pessoa com Deficiência. Novo Código de Processo Civil.Curatorship. Statute for the person with disability. New Civil Procedure Code.* Professor Titular de Direito Civil do Programa de Pós-Graduação em Direito da Universidade Federal do Rio Grande do Sul (UFRGS). Professor do Curso de Graduação em Direito das Faculdades Integradas São Judas Tadeu de Porto Alegre, Rio Grande do Sul. Doutor e Mestre em Direito pela Universidade de São Paulo (USP). Diretor da Revista da Faculdade de Direito da UFRGS. Diretor do Departamento de Direito Civil do Instituto dos Advogados do Rio Grande do Sul (IARGS).** Mestranda do Programa de Pós-Graduação em Direito da Universidade Federal do Rio Grande do Sul (UFRGS). Pós-graduada em Direito Público pela Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS) e pela Escola Superior Verbo Jurídico. Pesquisadora participante do grupo de pesquisa Direito das Famílias, Sucessões e Mediação (UFRGS). Advogada

The (in)ability of consumers to perceive greenwashing and its influence on purchase intent and willingness to pay

Background: Environmental concerns have led to consumers increasingly being willing to pay a premium for environmentally friendlier products. Unfortunately, this has led to the practice ‘greenwashing’, which yields handsome financial rewards. Consumers are not sufficiently aware of greenwashing, and little is known about the effects of such knowledge. Aim: This article explores how consumers who become aware of greenwashing, respond in terms of purchase intent and willingness to pay. Setting: The population was South African middle- to upper-income consumers. The findings were based on 120 responses. Methods: The study used a 2 × 2 experimental design in which greenwashing knowledge and greenwashing presence were manipulated. Results: We found that consumers reward greenwashing when it is undetected. Educating consumers about environmental issues does not develop their ability to identify greenwashing. In contrast, consumers who are educated about greenwashing and become aware of it, penalise such products through what we term a ‘greenwash penalty’. We define the greenwash penalty as the shift in consumers’ willingness to pay a premium for a product when they become aware of greenwashing. Purchase intent (PI) is also impacted by greenwashing. Conclusion: Companies often try to drive awareness of environmental problems. Our research shows that such initiatives reward all companies that make claims, even when such claims are false. Companies that sell truly green products must educate consumers about the potential harm of misleading information. Once consumers are able to spot greenwashing attempts, companies that sell real green products should then provide true and transparent information about their own products

A sensitive high performance liquid chromatography assay for the quantification of doxorubicin associated with DNA in tumor and tissues

A HPLC method was validated to quantify doxorubicin associated to DNA from tissue.Successfully applied to an in vivo mouse-based pharmacokinetic study.Important tool for future studies evaluating intracellular pharmacokinetics.Doxorubicin, a widely used anticancer agent, exhibits antitumor activity against a wide variety of malignancies. The drug exerts its cytotoxic effects by binding to and intercalating within the DNA of tumor and tissue cells. However, current assays are unable to accurately determine the concentration of the intracellular active form of doxorubicin. Thus, the development of a sample processing method and a high-performance liquid chromatography (HPLC) methodology was performed in order to quantify doxorubicin that is associated with DNA in tumors and tissues, which provided an intracellular cytotoxic measure of doxorubicin exposure after administration of small molecule and nanoparticle formulations of doxorubicin. The assay uses daunorubicin as an internal standard; liquid–liquid phase extraction to isolate drug associated with DNA; a Shimadzu HPLC with fluorescence detection equipped with a Phenomenex Luna C18 (2 μm, 2.0 × 100 mm) analytical column and a gradient mobile phase of 0.1% formic acid in water or acetonitrile for separation and quantification. The assay has a lower limit of detection (LLOQ) of 10 ng/mL and is shown to be linear up to 3000 ng/mL. The intra- and inter-day precision of the assay expressed as a coefficient of variation (CV%) ranged from 4.01 to 8.81%. Furthermore, the suitability of this assay for measuring doxorubicin associated with DNA in vivo was demonstrated by using it to quantify the doxorubicin concentration within tumor samples from SKOV3 and HEC1A mice obtained 72 h after administration of PEGylated liposomal doxorubicin (Doxil®; PLD) at 6 mg/kg IV x 1. This HPLC assay allows for sensitive intracellular quantification of doxorubicin and will be an important tool for future studies evaluating intracellular pharmacokinetics of doxorubicin and various nanoparticle formulations of doxorubicin