HPV load and anal cytological abnormalities.

OBJECTIVES: The objective of this study was to evaluate the association between estimated human papillomavirus (HPV) viral load and abnormal cytology on anal samples. METHODS: Anal cytological samples of 42 HIV-positive patients were analysed by conventional cytology and Hybrid Capture II. RESULTS: On cytology, 30.95% (13 of 42) anal samples were positive for cytological abnormalities, 47.61% (20 of 42) were negative and 21.42% (nine of 42) were unsatisfactory. High-risk HPV infection was more frequent in anal samples with cytological abnormalities than in negative samples (P = 0.0002, Fisher's exact test), it was detected in all samples with cytological abnormalities and in 35% (seven of 20) of the negative samples. On samples with cytological abnormalities, the median of the relative light unit/cutoff (RLU/CO) value (viral load estimate) was 10.39 (1.02-572.6) and in negative samples it was 0.51 (0.26-51.70). The median of the RLU/CO value was higher in samples with cytological abnormalities when compared with the median in negative samples (P = 0.0001, Mann-Whitney U-test) and only samples with cytological abnormalities showed RLU/CO values > 100. CONCLUSIONS: The estimated high-risk HPV viral load is significantly higher in samples with cytological abnormalities than in negative anal samples and may be useful as an adjunct to anal cytology for triage of patients to high-resolution anoscopy and biopsy.

Bursts in discontinuous Aeolian saltation.

Close to the onset of Aeolian particle transport through saltation we find in wind tunnel experiments a regime of discontinuous flux characterized by bursts of activity. Scaling laws are observed in the time delay between each burst and in the measurements of the wind fluctuations at the fluid threshold Shields number θc. The time delay between each burst decreases on average with the increase of the Shields number until sand flux becomes continuous. A numerical model for saltation including the wind-entrainment from the turbulent fluctuations can reproduce these observations and gives insight about their origin. We present here also for the first time measurements showing that with feeding it becomes possible to sustain discontinuous flux even below the fluid threshold.

Midair collisions enhance saltation.

Here we address the old question in aeolian particle transport about the role of midair collisions. We find that, surprisingly, these collisions do enhance the overall flux substantially. The effect depends strongly on restitution coefficient and wind speed. We can explain this observation as a consequence of a soft bed of grains which floats above the ground and reflects the highest flying particles. We make the unexpected observation that the flux is maximized at an intermediate restitution coefficient of about 0.7, which is comparable to values experimentally measured for collisions between sand grains.

Drug-induced acute esophageal lesions and use of ciprofloxacin.

We report the case of a 95-year-old woman who had acute esophageal lesions while being treated with oral ciprofloxacin for an acute cystitis. On day 2 of treatment, she reported retroesternal pain with a globus sensation, and presented hematemesis and melena. There was no history of gastric or esophageal disturbances. An upper digestive endoscopy showed bleeding lesions on the middle third of the esophagus. Ciprofloxacin was discontinued and a proton pump inhibitor was administered. One week later, the endoscopic aspect of the esophagus was normal. Only two cases of ciprofloxacin-induced esophageal lesions have been reported previously. A short review of this kind of esophageal injuries is presented, focusing on the main risk factors and preventive measures.

Candidemia in a brazilian tertiary hospital: microbiological and clinical features over a six-year period

Yeasts are becoming a common cause of nosocomial fungal infections in immunocompromised patients. Such infections often develop into sepsis with high mortality rates. The aim of this study was to evaluate some of the numerous factors associated with the development of candidemia. Medical records were retrospectively analyzed of 98 Candida spp. patients. Results showed that the most prevalent risk factors for developing candidemia were: antibiotics and antifungal agents (93.9% and 79.6%, respectively); the use of central venous catheter (93.9%); mechanical ventilation (73.5%); and parenteral nutrition (60.2%). The main species of Candida found were: C. parapsilosis (37.76%), C. albicans (33.67%); and others (28.57%). C. glabrata showed the highest mortality rate (75%), followed by C. tropicalis (57.1%) and C. albicans (54.5%). The elevated mortality rate found in this study indicates that preventive measures against candidemia must be emphasized in hospitals.(AU)

Candida spp: manual identification (reference method) and automated identification (Vitek system platform)

Yeasts are becoming a common cause of nosocomial fungal infections that affect immunocompromised patients. Such infections can evolve into sepsis, whose mortality rate is high. This study aimed to evaluate the viability of Candida species identification by the automated system Vitek-Biomerieux (Durham, USA). Ninety-eight medical charts referencing the Candida spp. samples available for the study were retrospectively analyzed. The system Vitek-Biomerieux with Candida identification card is recommended for laboratory routine use and presents 80.6% agreement with the reference method. By separate analysis of species, 13.5% of C. parapsilosis samples differed from the reference method, while the Vitek system wrongly identified them as C. tropicalis, C. lusitaneae or as Candida albicans. C. glabrata presented a discrepancy of only one sample (25%), and was identified by Vitek as C. parapsilosis. C. guilliermondii also differed in only one sample (33.3%), being identified as Candida spp. All C. albicans, C. tropicalis and C. lusitaneae samples were identified correctly.

Jump at the onset of saltation.

We reveal that the transition in the saturated flux for aeolian saltation is generically discontinuous by explicitly simulating particle motion in turbulent flow. This is the first time that a jump in the saturated flux has been observed. The discontinuity is followed by a coexistence interval with two metastable solutions. The modification of the wind profile due to momentum exchange exhibits a maximum at high shear strength.

Spontaneous emergence of spatial patterns in a predator-prey model.

We present studies for an individual based model of three interacting populations whose individuals are mobile in a two-dimensional lattice. We focus on the pattern formation in the spatial distributions of the populations. Also relevant is the relationship between pattern formation and features of the populations' time series. Our model displays both traveling wave solutions, clustering and uniform distributions, both related to the parameter values. We also observed that the regeneration rate, the parameter associated to the primary level of trophic chain, the plant, regulated the presence of predators, as well as the type of spatial configuration. This result corroborates the theory that the enrichment of prey can stabilize the predator-prey dynamic in more realistic models.

Soluble transferrin receptor in sickle cell diseases: correlation with spleen function.

OBJECTIVE: To correlate spleen function with soluble transferrin receptor (sTfR) levels and red cell ferritin (RCF) values in patients with sickle cell diseases. DESIGN: Prospective study. LOCATION: University Hospital, School of Medical Sciences, State University of Campinas; a tertiary hospital. PARTICIPANTS: 60 patients with sickle cell diseases, in a steady state, who had not received blood transfusions for 3 months; 28 normal individuals with no clinical or laboratory signs of anemia. MEASUREMENTS: Determination of serum iron, transferrin iron-binding capacity, serum ferritin, RCF and sTfR. Evaluation of spleen function: erythrocytes with pits were quantified. RESULTS: Patients with sickle cell anemia had sTfR levels significantly higher than in normal individuals or those with HbSC (p=0.0001) and there was an inverse correlation between sTfR and fetal Hb (p=0.0016). RCF values were significantly higher in sickle cell anemia patients than in normal individuals or those with HbSC (p=0.0001), and there was a correlation between RCF and pitted erythrocytes (p=0.0512). CONCLUSION: The association between sTfR and fetal Hb confirms the contribution of fetal Hb to improving the hemolytic state by minimizing the consequent reactive erythrocyte expansion. High sTfR levels are not related to the degree of spleen function deficiency seen in sickle cell disease patients. The deficiency in the exocytosis process of the spleen occurring in sickle cell anemia patients may contribute to their accumulation of RCF.

Intraaortic balloon pump support during coronary angioplasty. Initial experience.

OBJECTIVE: To evaluate the use of the intraaortic balloon (IAoB) in association with coronary angioplasty in high-risk patients. METHODS: Fourteen high-risk patients unresponsive to clinical therapy and with formal contraindication to surgical revascularization were treated by coronary angioplasty, most of which was followed by stenting. All procedures were performed with circulatory support with the IAoB. This study reports the early results and the late findings after 12 months of follow-up. Six patients had multivessel coronary disease; of these, four had left main equivalent lesions and two had unprotected left main coronary artery disease, one of whom had severe "end-vessel" stenosis and the other was a patient with Chagas' disease with single-vessel lesion. Eleven patients had a left ventricular ejection fraction < 30%. RESULTS: In 100% of the patients, the procedures were initially successful. Two patients had severe bleeding during the withdrawal of the left femoral sheath. At the end of twelve months, 4 patients were asymptomatic and the others were clinically controlled. There were two late deaths in the 7th and 11th months. CONCLUSION: The combined use of the intraaortic balloon pump and percutaneous coronary angioplasty in high-risk patients with acute ischemic syndromes provides the necessary hemodynamic stability to successfully perform the procedures.