Visual and automatic classification of the cyclic alternating pattern in electroencephalography during sleep

Cyclic alternating pattern (CAP) is a neurophysiological pattern that can be visually scored by international criteria. The aim of this study was to verify the feasibility of visual CAP scoring using only one channel of sleep electroencephalogram (EEG) to evaluate the inter-scorer agreement in a variety of recordings, and to compare agreement between visual scoring and automatic scoring systems. Sixteen hours of single-channel European data format recordings from four different sleep laboratories with either C4-A1 or C3-A2 channels and with different sampling frequencies were used in this study. Seven independent scorers applied visual scoring according to international criteria. Two automatic blind scorings were also evaluated. Event-based inter-scorer agreement analysis was performed. The pairwise inter-scorer agreement (PWISA) was between 55.5 and 84.3%. The average PWISA was above 60% for all scorers and the global average was 69.9%. Automatic scoring systems showed similar results to those of visual scoring. The study showed that CAP could be scored using only one EEG channel. Therefore, CAP scoring might also be integrated in sleep scoring features and automatic scoring systems having similar performances to visual sleep scoring systems.

A Bayesian approach to estimate the accuracy of "in-house" ELISA assay to measure rabies antibodies from compulsory vaccinated dogs and cattle

Rabies is a vaccine-preventable disease that causes acute encephalitis in mammals, and it is still a significant public health problem in numerous countries. lnfected dogs represent the main vectors involved in human rabies. Additionally, cattle rearing close to geographic areas where vampire bats are found presents an important connection with rural epidemiology. We applied two "in-house" enzyme-linked immunosorbent assay (ELISA) methodologies, considered alternatives to measure antibodies from vaccinated dogs and cattle, without employing the gold standard approach. The ELISA assays were performed on individual serum samples taken from domestic adult dogs and cows compulsory vaccinated against rabies (147 urban dogs and 64 cows; n equal 211). The sandwich and liquid-phase competitive ELISA (scELlSA and ipcELlSA). considered "in-house" assays. were performed according to previous works. The only statistical methodology that allows this study is the Bayesian approach, developed to replace the conventional Hui-Walter paradigm. For conditional independent Bayesian model (one population, two tests and no gold standard) the prior information for sensitivity and specificity of each test, mode, prevalence and transformed (alpha, beta) were submitted to Bayesian inference. The "in-house" IpcELISA revealed 16 - out of 261 serum samples - negative results, whereas in scELISA all results were positive. The Bayesian approach showed that prior information was specified for all parameters; posterior medians were SescELISA 89%, SpscELISA 88%, SPipcELISA 95% SeipcELISA 98%, and prevalence (pi) of 99%, without the use of gold standard analysis to measure specific anti-rabies antibodies

Potential pathogenic role of aggregative-adhering Corynebacterium diphtheriae of different clonal groups in endocarditis

Invasive diseases caused by Corynebacterium diphtheriae have been described increasingly. Several reports indicate the destructive feature of endocarditis attributable to nontoxigenic strains. However, few reports have dealt with the pathogenicity of invasive strains. The present investigation demonstrates a phenotypic trait that may be used to identify potentially invasive strains. The study also draws attention to clinical and microbiological aspects observed in 5 cases of endocarditis due to C. diphtheriae that occurred outside Europe. Four cases occurred in female school-age children (7-14 years) treated at different hospitals in Rio de Janeiro, Brazil. All patients developed other complications including septicemia, renal failure and/or arthritis. Surgical treatment was performed on 2 patients for valve replacement. Lethality was observed in 40 percent of the cases. Microorganisms isolated from 5 blood samples and identified as C. diphtheriae subsp mitis (N = 4) and C. diphtheriae subsp gravis (N = 1) displayed an aggregative adherence pattern to HEp-2 cells and identical one-dimensional SDS-PAGE protein profiles. Aggregative-adhering invasive strains of C. diphtheriae showed 5 distinct RAPD profiles. Despite the clonal diversity, all 5 C. diphtheriae invasive isolates seemed to display special bacterial adhesive properties that may favor blood-barrier disruption and systemic dissemination of bacteria. In conclusion, blood isolates from patients with endocarditis exhibited a unique adhering pattern, suggesting a pathogenic role of aggregative-adhering C. diphtheriae of different clones in endocarditis. Accordingly, the aggregative-adherence pattern may be used as an indication of some invasive potential of C. diphtheriae strains.

Effects of handling and storage on sterile dental instruments

The microbial contamination post-sterilization of dental instruments has been the object of permanent study. The aim of the present study was to evaluate factors affecting long-term sterility of dental instruments sterilized in the dry-oven or autoclave at the Central Sterilizing Service of the School of Dentistry, University of Buenos Aires stored under room temperature and humidity conditions. Half of the 192 samples were placed in standard closed metal containers and sterilized in a dry-oven (D.O), and the remaining half were placed in perforated metal containers and sterilized in an autoclave (A). All the samples were placed in sterilizing paper bags for medical use. Post sterilization, each group (DO and A) was divided into: Group I: minimal handling (control); Group II: wrapping torn mechanically (1 cm); Group III: wrapping torn manually (1 cm). All the samples were stored a closed cabinet. Contamination was evaluated at 30 and 180 days, by seeding under aerobic and anaerobic conditions. Temperature was monitored throughout the experiment, and ranged between 20 degrees C and 31 degrees C (x: 24 degrees C +/- 3.9). Humidity was measured with a digital hygrometer, and ranged between 40

+/- 10). Group I evidenced no microbial contamination, unlike Groups II and III. Our results evidence that 1) dry oven or autoclave sterilized material that is handled properly during storage remains sterile regardless of variations in temperature and humidity; 2) improper handling affects sterility, and contamination is time-dependent.

Caracteristicas epidemiologicas da leishmaniose tegumentar americana em uma regiao endemica do Estado da Bahia. II Leishmaniose canina. / Epidemiological characteristics of American tegumentary leishmaniasis in an endemic region of the State of Bahia. II Canine leishmaniasis

Um inquerito em caes realizado na regiao de Tres Bracos, Bahia, mostrou que 3,0% de 98 animais tinham amastigotas em lesoes de pele. Parasitos nao foram encontrados em pele normal da orelha. De uma amostra selecionada de 13 caes, portadores de lesao cutanea ativa, nove (69,2%) deles estavam comprovadamente infectados. Sete amostras de lesao produziram infeccao em hamsters.O estudo biologico (crescimento em meio de cultura, evolucao da lesao em hamster e desenvolvimento no tubo digestivo de Lutzomyia longipalpis) identificou o parasito como pertencente ao complexo L. braziliensis. A caracterizacao bioquimica (mobilidade eletroforetica de enzimas em placas de acetato de celulose) e o estudo imunotaxonomico (anticorpos monoclonais) definiram as amostras como L. braziliensis braziliensis. O papel do cao como um possivel reservatorio de L.b. braziliensis na regiao de Tres Bracos e discutido