One stage procedure for developmental dysplasia of the hip in patients aged eight years or older. Systematic review and meta-analysis.

The objective of the present study is to perform a systematic review with meta-analysis of the literature on treatment of developmental dysplasia of the hip (DDH) in patients over eight years of age to provide better understanding of therapeutic strategies and results. Authors carried out a systematic review and metanalysis of the literature on DDH treated in patients aged eight years of age or older. A literature search was carefully performed from June 2019 to June 2020. The articles had to report one stage reconstructive surgical treatment of DDH for patients eight years or older, presenting clinical and radiographic evaluation according to the Tonnis and Severin, and McKay systems. Meta-analysis was carried out using the software metanalyst to perform the pooled effect size Nine studies met the inclusion criteria. They assessed a total of 234 patients and 266 hips. Female patients accounted for 75.7% (eight unknown) and the follow-up ranged from 1 to 17.4 years. The majority of the procedures included an acetabular surgery (93.9%) while femoral shortening was performed in 78%. Acceptable outcomes were found in between 67% (Mckay system) and 91% (Severin system) of the cases. Femoral varus and derrotation shortening associated with redirectional osteotomy of the acetabulum (for those with closed triradiate cartilage) or acetabular redirection/reshaping were the most prevalent combined procedures; this strategy can lead to 60% of acceptable clinical results and 90% of radiographically acceptable results. Therefore, our findings give credence to the recommendation for the treatment of DDH in patients over eight years old.

Prevalence of hepatitis B virus infection among tuberculosis patients with or without HIV in Goiânia City, Brazil.

BACKGROUND: Hepatitis B virus (HBV) and tuberculosis (TB) represent major public health problems. There is currently little data on HBV infection among TB patients with and without human immunodeficiency virus (HIV). OBJECTIVES: To assess HBV prevalence among TB patients with and without HIV. STUDY DESIGN: From April 2008 to March 2010, a cross-sectional study was conduct among TB patients attended at a reference hospital in Goiânia City, Brazil. The participants were tested for serological markers of HBV infection and HIV antibodies. HBV DNA was detected in HBsAg-positive samples, and also in HBsAg-negative/anti-HBc-positive samples to look for HBV occult infection. RESULTS: Of 425 patients, 402 (94.6%) agreed to participate in the study. The overall prevalence of HBV (HBsAg and/or anti-HBc positive) and HIV infections were 25.6% (103/402) and 27.6% (111/402), respectively. A higher HBV infection rate was found among HIV-infected patients (36.9%; 41/111) compared to patients infected with TB only (20.0%; 57/285). A multivariate analysis of risk factors showed that age ≥ 50 years (p=0.03), non-injecting (p<0.01) and injecting (p<0.01) drugs use were associated with HBV infection. Among the HBsAg-positive samples (n=13), HBV DNA was detected in 10 (76.9%) samples. Of the 90 anti-HBc-positive samples, 13 were HBV DNA positive (with very low levels) resulting in an occult HBV infection rate of 14.4%. PCR-RFLP was successfully performed in 20 HBV DNA-positive samples: 15 were genotype A and 5 were genotype D. CONCLUSIONS: HBV infection was common, particularly among this with HIV infection.

Effect of surface modification on protein retention and cell proliferation under strain.

When culturing cells on flexible surfaces, it is important to consider extracellular matrix treatments that will remain on the surface under mechanical strain. Here we investigate differences in laminin deposited on oxidized polydimethylsiloxane (PDMS) with plasma treatment (plasma-only) vs. plasma and aminopropyltrimethoxysilane treatment (silane-linked). We use specular X-ray reflectivity (SXR), transmission electron microscopy (TEM), and immunofluorescence to probe the quantity and uniformity of laminin. The surface coverage of laminin is approximately 45% for the plasma-only and 50% for the silane-linked treatment as determined by SXR. TEM and immunofluorescence reveal additional islands of laminin aggregates on the plasma-only PDMS compared with the relatively smooth and uniform silane-linked laminin surface. We also examine laminin retention under strain and vascular smooth muscle cell viability and proliferation under static and strain conditions. Equibiaxial stretching of the PDMS surfaces shows greatly improved retention of the silane-linked laminin over plasma-only. There are significantly more cells on the silane-linked surface after 4 days of equibiaxial strain.

Hepatitis C virus infection in patients with tuberculosis in Central Brazil.

SETTING: Goiânia City, Goiás State, Brazil. OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) infection, risk factors, HCV genotype/ subtype, HCV viral load and human immunodeficiency virus (HIV) status in patients with tuberculosis (TB) in Central Brazil. DESIGN: A cross-sectional study was carried out with 402 patients who were under tuberculosis (TB) treatment in the reference hospital for infectious diseases in Goiânia, Goiás, Central Brazil. RESULTS: The prevalence rates of HCV and HIV were respectively 7.5% and 27.6%. Two thirds of the HCV-infected patients (20/30) were HIV-positive. Age, injecting drug use (IDU) and HIV status were factors independently associated with HCV infection. HCV RNA was detected in 23 serum samples; HCV RNA levels were measured in 22/23 samples. HCV RNA level was slightly higher in HCV-HIV co-infected patients than in HCV monoinfected patients. Genotypes 1 (n = 17) and 3 (n = 6) were determined by LiPA. Using phylogenetic tree analysis of the NS5B region, subtypes 1a (n = 12), 1b (n = 2) and 3a (n = 6) were identified. CONCLUSION: These data indicate that patients with TB may benefit from integrated HIV and HCV screening, which may have an important impact upon TB management and treatment.

Epidemiology of hepatitis B virus infection in truck drivers in Brazil, South America.

OBJECTIVE: To investigate the epidemiology of hepatitis B virus (HBV) infection and viral genotypes in long distance truck drivers in Brazil. METHODS: We interviewed 641 long distance truck drivers to gather data on sociodemographics and risk factors and collected blood samples to test for HBV markers (HBsAg, anti-HBs and anti-HBc) by ELISA. HBsAg-positive samples were submitted to HBV DNA detection and genotyped. RESULTS: We found a global HBV prevalence of 18.9% (95% CI 15.9 to 22.2). Thirty truck drivers (4.7%) had only anti-HBs, suggesting that they had a previous HBV vaccination. More than 20 years in the profession, more than 15 days away from home and a history of sexual transmitted infections were independently and positivity associated with HBV markers. HBV DNA was detected in nine samples in which genotypes A (n = 5), D (n = 2) and F (n = 2) were found. CONCLUSIONS: These findings confirm that truck drivers are at high risk for hepatitis B infection and highlight the importance of having a public health policy that addresses this population and is based on the characteristics of HBV acquisition and dissemination.

Separate collection of the biodegradable fraction of MSW: an economic assessment.

There is little experience in Portugal with the separate collection of the biodegradable fraction of municipal solid waste (MSW). Therefore, it is relevant to evaluate how this process could economically affect the actual practices of MSW collection in small municipalities. This article simulates the costs of collection by means of a fixed container system and a transfer station, using values from a municipality with a population of 28,000 inhabitants. The main goal of this exercise is to compare the economic effects of three alternative scenarios: (i) the traditional, unsorted collection; (ii) the separate collection of whole biowaste; and (iii) the separate collection of biowaste generated in the major urban communities, while setting aside the other biowaste for home composting. The input data are from 2001, and include waste quantities, travel times, work crew composition, crew time shifts, vehicles, and containers. Calculations of the proposed mathematical method were carried out using the Microsoft Excel software. This study concludes that the global cost for separate collection of biowaste (alternative ii) need not necessarily be higher than the corresponding cost of the traditional, unsorted method of collection (alternative i). Furthermore, the global cost for collection with separated biowaste and home composting (alternative iii) could also be lower than the corresponding cost of the traditional, unsorted method of collection.

Effect of ifosfamide on bone healing.

The effect of ifosfamide on bone healing was tested in a controlled experiment of fibular osteotomy in immature rabbits. Standardized shaft osteotomy was implemented in 10 experimental subjects (group 2) and 10 controls (group 1). Experimental animals received a 50 mg/kg ifosfamide dose by intraperitoneal injection on the fourth post-operative day, and for five days thereafter, while controls received injections of distilled water. After five weeks, all animals were submitted to pharmacological euthanasia and the resulting bone callus samples were studied with histomorphometry, using hematoxylin-eosin stain. Group 2 presented smaller bone volume (69.03% versus 84.98%), larger fibrosis volume (30.96% versus 15.02%), and larger resorption surface (22.02% versus 16.17%) than group 1 (all p< or = 0.05). We conclude that ifosfamide is able to alter the physiological bone healing process by producing a less mature callus (characterized by a smaller quantity of bone tissue), a larger quantity of fibrous tissue, and a smaller resorption surface.

Blood glucose discrimination training: the role of internal and external cues.

The effects of observing internal and external events on blood glucose (BG) discrimination were assessed in eight patients with type 1 diabetes using an intrasubject design. During baseline condition, participants estimated their BG, then measured and recorded it (feedback-only procedure) three times a day. Participants were then divided randomly into two groups. Both were submitted to internal cue (IC) and external cue (EC) training conditions in a balanced order, and then both cues were presented together in combined cues (CC) training conditions. Under IC, participants observed and recorded their symptoms before estimating BG. Under EC, they observed and recorded environmental events prior to BG estimation. In CC conditions, participants paid attention to both internal and external cues before the estimate-feedback routine. BG estimation accuracy improved after either IC or EC conditions. When the two types of cues were combined, only two participants improved their BG estimation accuracy. The remainder did not, probably because they had already attained high accuracy levels (ceiling effect).

Thermochemical and Theoretical Study of tert-Butyl and Di-tert-butylphenol Isomers.

The standard (p(o) = 0.1MPa) molar enthalpies of formation for 2-, 3-, and 4-tert-butylphenol and 2,4- and 2,6-di-tert-butylphenol in the gaseous phase were derived from the standard molar enthalpies of combustion, in oxygen, at 298.15 K, measured by static bomb combustion calorimetry and the standard molar enthalpies of evaporation at 298.15 K, measured by Calvet microcalorimetry: 2-tert-butylphenol, -184.7 +/- 2.6 kJ mol(-)(1); 3-tert-butylphenol, -198.0 +/- 2.1 kJ mol(-)(1); 4-tert-butylphenol, -187.3 +/- 3.3 kJ mol(-)(1); 2,4-di-tert-butylphenol -283.3 +/- 3.8 kJ mol(-)(1); 2,6-di-tert-butylphenol -272.0 +/- 4.0 kJ mol(-)(1). The most stable geometries of all mono- and disubstituted phenols as well as those of the corresponding radicals were obtained, respectively, by ab initio restricted Hartree-Fock (RHF) and restricted Hartree-Fock open shell (ROHF) methods with the 6-31G basis set. The resulting geometries were then used to obtain estimates of the effect of the tert-butyl substituent on the O-H bond dissociation energy and on the formation enthalpies of all substituted phenols.

Genetic and physiological relationships in N, P and K mobilisation in some sorghum mutants and parents.

The mutation breeding program of alteration in plant type in two local Sorghum varieties resulted in several productive mutants of which 16 are far superior to the parents CRP, CBA and recommended hybrids. An earlier analysis of leaf area and photosynthetic efficiency revealed a diversity of mechanisms between mutants of the same yield group. Differences in the transfer of nutrients from leaf to the panicle were also indicated. Further analysis of the partition of nutrients in the panicle, flag leaf and rachis for N, P and K revealed that most of the mutants are at least equal to the parent in grain N but are superior in N content of flag leaf and rachis. Similarly, three mutants had a higher P content in grain than CRP and all other mutants were equal to CRP. Two mutants had more P in the flag leaf but this was not reflected in the grain. However, no differences were observed for the K content in the flag leaf, grain and rachis. The interrelations of the nutrients in different plant parts suggest that each mutant has a different pattern of nutrient accumulation and transfer. It could be concluded that selection for flag leaf N and P can improve grain N and P. There was no negative association between N and P accumulation in different plant parts. No adverse association was observed for other combinations. A study on the grain digestability of the mutants confirmed that the quality of the protein was not adversely affected in this material. This study indicated that simultaneous improvement of grain yield and grain N, P and K can be obtained even among the few mutants generated in this breeding program contrary to the belief of some cereal breeders that grain yield and its N content have a major negative association limiting the improvement of yield and protein content simultaneously.