Seroprevalence of bactericidal antibodies against serogroup B and C Meningococci in a University Hospital.

Meningococcus serogroup B (MenB), clonal complex 32 (cc 32), was the Brazilian epidemic strain of meningococcal disease (MD) in the 1990's. Currently, meningococcus serogroup C (MenC), cc 103, is responsible for most of the cases of the disease in Brazil. The aim of this study was to investigate the seroprevalence of bactericidal antibody (SBA) against representative epidemic strains of MenC, (N753/00 strain, C:23:P1.22,14-6, cc103) and MenB, (Cu385/83 strain, B:4,7:P1.15,19, cc32) in students and employees of a university hospital in the State of Rio Grande do Sul (RS, Brazil). A second MenC strain (N79/96, C:2b:P1.5-2,10, cc 8) was used as a prototype strain of Rio de Janeiro's outbreak that occurred in the 1990's. Our previous study showed a 9% rate of asymptomatic carriers in these same individuals. A second goal was to compare the SBA prevalence in meningococcal carriers and non-carriers. Fifty-nine percent of the studied population showed protective levels of SBA titers (log2≥2) against at least one of the three strains. About 40% of the individuals had protective levels of SBA against N753/00 and Cu385/83 strains. Nonetheless, only 22% of the individuals showed protective levels against N79/96 strain. Significantly higher antibody levels were seen in carriers compared to non-carriers (P≤0.009). This study showed that, similar to other States in Brazil, a MenC (23:P1.22,14-6, cc103) strain with epidemic potential is circulating in this hospital. Close control by the Epidemiological Surveillance Agency of RS of the number of cases of MD caused by MenC strains in the State is recommended to prevent a new disease outbreak.

Invasive Fungal Disease in Renal Transplant Recipients at a Brazilian Center: Local Epidemiology Matters.

INTRODUCTION: Invasive fungal disease (IFD) is an important complication after solid organ transplantation (SOT). A marked geographic variation in the epidemiology of IFD after kidney transplantation (KT) has been suggested by the results of previous studies. Nevertheless, data from Latin American centers are scarce. OBJECTIVE: This study sought to describe the epidemiology of IFD at a Brazilian KT center. METHODS: This study was a retrospective single-center cohort study that included patients who underwent KT between 1998 and 2009 and were followed up until July 2015. Cases of simultaneous kidney-pancreas transplantation were excluded. The primary study outcome was the occurrence of proven or probable IFD. RESULTS: Among 908 KT recipients, 44 cases of IFD occurred in 42 patients (4.6%). Cryptococcus spp. infection, diagnosed in 16 cases (36.3%), was the leading cause of IFD, followed by histoplasmosis in 10 cases (22.7%) and invasive candidiasis in 10 (22.7%). Sporotrichosis, mucormycosis, invasive aspergillosis, pulmonary Cladophialophora sp. infection, trichosporonosis and Saccharomyces cerevisiae fungemia occurred in 1 recipient each (2.3%). Two additional (4.5%) cases of unspecified mold infections were identified by histopathological analysis. Most cases of IFD (67%) occurred later than 6 months after transplantation. Previous use of antilymphocyte antibodies (P = .008) and corticosteroid pulse therapy (P < .001) were more frequent among cases of IFD occurring within the first 6 months after transplantation. CONCLUSIONS: The epidemiology of IFD in this Brazilian cohort was characterized by a large predominance of late infections and a high proportion of cases of cryptococcosis and histoplasmosis. These results highlight the considerable geographic variability of IFD epidemiology after KT.

Evaluation of low-contrast perceptibility in dental restorative materials under the influence of ambient light conditions.

OBJECTIVES: This study aimed to assess how details on dental restorative composites with different radio-opacities are perceived under the influence of ambient light. METHODS: Resin composite step wedges (six steps, each 1-mm thick) were custom manufactured from three materials, respectively: (M1) Filtek™ Z350 (3M/ESPE, Saint Paul, MN); (M2) Prisma AP.H™ (Dentsply International Inc., Brazil) and (M3) Glacier(®) (SDI Limited, Victoria, Australia). Each step of the manufactured wedge received three standardized drillings of different diameters and depths. An aluminium (Al) step wedge with 12 steps (1-mm thick) was used as an internal standard to calculate the radio-opacity as pixel intensity values. Standardized digital images of the set were obtained, and 11 observers independently recorded the images, noting the number of noticeable details (drillings) under 2 dissimilar conditions: in a light environment (light was turned on in the room) and in low-light conditions (light in the room was turned off). The differences between images in terms of the number of details that were observed were statistically compared using ANOVA, Cronbach's alpha coefficient and Wilcoxon and Kruskal-Wallis tests, with a significance level setting of 5% (α = 0.05). RESULTS: The M2 showed higher radio-opacity, the M1 displayed intermediate radio-opacity and the M3 showed lower radio-opacity, respectively; however, all three were without significance (p > 0.05) compared with each other. The differences in radio-opacity resulted in a significant variation (p < 0.05) in the number of noticeable details in the image, which were influenced by characteristics of details, in addition to the ambient-light level. CONCLUSIONS: The radio-opacity of materials and ambient light can affect the perception of details in digital radiographic images.

Outcome of bacteremia caused by extended-spectrum ß-lactamase-producing Enterobacteriaceae after solid organ transplantation.

INTRODUCTION: Although infection with extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-E) has been recognized as an important cause of morbidity after solid organ transplantation, there are limited data on the outcome of this complication among transplant recipients. The objective of this study was to describe the outcome and factors associated with mortality among recipients of abdominal solid organ transplants with bloodstream infection caused by ESBL-E. PATIENTS AND METHODS: This study was a retrospective analysis of a case series of patients who had bacteremia caused by ESBL-E after undergoing renal or liver transplantation between January 2000 and September 2008 at a university-affiliated hospital in Rio de Janeiro, Brazil. The primary end point of the study was death within 30 days of the diagnosis of bacteremia. RESULTS: During the study period, 997 subjects underwent kidney (759 patients) or liver (238 patients) transplantation. Fifty-four episodes of bacteremia caused by ESBL-E were diagnosed in 39 patients (4%). Mortality after the first episode of ESBL-E bacteremia was 26% (10 deaths). In multiple logistic regression analysis, the Pitt bacteremia score (P = .005) and being on mechanical ventilation at the time of infection diagnosis (P = .02) were the only variables associated with mortality. Thirteen episodes of recurrent bacteremia occurred in 8 (28%) of the 29 patients who survived the first episode. Two (25%) of these 8 patients died during the course of a recurrent episode. CONCLUSIONS: Bacteremia caused by ESBL-E was associated with high mortality and high risk of recurrence. Factors associated with clinical severity at the time of infection diagnosis were the main predictors of mortality.

Propriedade de barreira à umidade de embalagens plásticas para produtos oftálmicos / Moisture barrier properties of plastic bottles for ophthalmic eye drops

As propriedades de barreira à umidade de embalagens plásticas para produtos oftálmicos de capacidade nominal de 20 mL e terminação 15 mm nos formatos cilíndrico e oval, de diferentes composições (100% Polietileno de Baixa Densidade (PEBD), 100% Polipropileno (PP) e blendas com percentuais 10% e 40% de Polietileno de Alta Densidade (PEAD) em PEBD), foram estudadas neste trabalho. Foi verificada também a influência do batoque gotejador (de maior ou menor orifício de dosagem) e a influência do fechamento na taxa de transmissão de vapor d'água. O trabalho foi conduzido sob duas condições de estocagem a 25 ºC/40% UR e a 40 ºC/75% UR. Verificou-se que o diâmetro do orifício gotejador não interferiu significativamente na perda de peso da embalagem avaliada a 25 ºC/40% UR. Sob a condição de estocagem a 40 ºC/75% UR verificou-se um aumento da taxa de transmissão de vapor d'água das embalagens comparativamente as mesmas embalagens avaliadas a 25 ºC/40% UR. O sistema de fechamento não favoreceu um acréscimo significativo da taxa de transmissão de vapor d'água, o que indica que a permeação ocorreu principalmente através do corpo da embalagem plástica. A propriedade de barreira foi influenciada pela composição da embalagem plástica chegando a uma redução média de 47% na taxa de transmissão de vapor d'água para a embalagem de PEBD com 40% PEAD em relação à embalagem com100% PEBD de formato cilíndrico. Verificou-se ainda que o formato oval, por apresentar uma maior área superficial exposta comparativamente à embalagem de formato cilíndrico, com regiões de menor espessura de parede, pode favorecer um ligeiro aumento da taxa de transmissão de vapor d'água da embalagem...

The moisture barrier properties of plastic ophthalmic product bottles of nominal capacity 20 mL and finish diameter 15 mm, in cylindrical and oval shapes, with various compositions (100% Low Density Polyethylene(LDPE), 100% polypropylene (PP) and blends with10% and 40% High Density Polyethylene (HDPE) in LDPE), were assessed in this study. The effects of the drop hole size (higher or lower dosage diameter) and the screw cap on the Water Vapor Transmission Rate (WVTR) were also assessed. This study was conducted under two conditions of storage, at 25 °C/40% RH and 40 °C/75% RH. It was observed that the drop hole diameter did not influence significantly the weight loss of the container at 25 °C/40% RH, whereas at 40°C/75% RH, the WVTR of the container was higher than that of the same package at 25 °C/40% RH.The screw cap did not significantly affect the WVTR, indicating that the permeation occurred primarily through the plastic body. The barrier property was influenced by the composition of the plastic container; thus, compared to LDPE, there was a mean reduction of 47% in the WVTR of LDPE blended with 40% HDPE, when both bottles were cylindrical. It was found that the oval shape, because of the larger exposed surface area relative to the cylindrical shape, as well as the presence of regions of thinner wall, can favor a slight increase in the WVTR of the bottle...

Results of implementation of preventive recommendations for tuberculosis after renal transplantation in an endemic area.

This retrospective cohort study assessed the results of the implementation of preventive recommendations for tuberculosis (TB) among renal transplant recipients in an endemic area (Rio de Janeiro, Brazil). Subjects were defined as at high risk for TB if they had latent tuberculosis infection (LTBI), reported recent close contact with individuals with TB or received a graft from a donor with LTBI. A 6-month course of isoniazid preventive therapy (IPT) was targeted to high-risk subjects. The study end point was TB confirmed by culture. Altogether, 535 patients were included. Median follow-up was 59 months. The overall cumulative incidence of TB was 2.1% while among the 274 patients in whom the preventive protocol was fully implemented, the incidence was only 0.7%. The incidence of TB among 75 high-risk recipients not treated with isoniazid (7%) was significantly higher than that observed in 209 untreated low-risk patients (1%, p = 0.006) and in 65 high-risk subjects that received IPT (no case, p = 0.03). In conclusion, the implementation of preventive recommendations for TB in an endemic area allowed the appropriate discrimination between high- and low-risk renal transplant recipients and was associated with long-term reduction in the incidence of this complication among high-risk subjects.

Ação da melatonina sobre a dinâmica sanguínea de ratas prenhes e sobre a histogênese do baço e do timo da prole / The action of melatonin on the blood dynamics of pregnant rats and on the histogenesis of the spleen and thymus of offspring

Investigou-se a influência da melatonina sobre o hemograma de ratas prenhes e dos filhotes e sobre a histogênese e morfometria do baço e do timo dos filhotes. A melatonina foi administrada na dose 0,5mg/kg de peso corporal, dissolvida em 0,1mL de etanol e diluída em 0,3mL de solução salina. Para análise do hematócrito, contagem total de hemácias e contagem total e diferencial dos leucócitos, amostras de sangue foram coletadas no sétimo, 14ºe 21ºdias de prenhez e aos 10 dias de nascimento dos filhotes. Cortes histológicos do baço e do timo da prole foram utilizados para histoquímica e morfometria. A ausência da melatonina promoveu alterações no hemograma apenas no terço final da gestação, sem interferir no hemograma dos filhotes, e induziu modificações morfológicas e morfométricas no timo e no baço nos primeiros dias de vida dos filhotes. Concluiu-se que a melatonina materna é importante para a modulação do hemograma em ratas prenhes e para o desenvolvimento normal do baço e do timo dos filhotes.

We investigated the influence of melatonin on the hemogram of pregnant rats and puppies, and on the histogenesis and morphology of the spleen and thymus of puppies. Melatonin was administered at a dose 0.5mg/kgbody weight, dissolved in 0.1mL of ethanol and diluted in 0.3mL of saline. For hematocrit analysis, total erythrocyte count and total and differential leukocyte count, blood samples were collected on the 7th, 14th and 21st days of pregnancy and the offspring at 10 days of birth. Histological sections of spleen and thymus of the offspring were used for histochemistry and morphometry. The absence of melatonin promoted changes in blood count only in the final third of gestation, without interfering with the hemogram of the puppies, and induced morphological and morphometric changes in the thymus and spleen in the first days of life of the puppies. It was concluded that maternal melatonin is important for the modulation of the blood count in pregnant rats and the normal development of the spleen and thymus of the offspring.

Ação da melatonina sobre a dinâmica sanguínea de ratas prenhes e sobre a histogênese do baço e do timo da prole / The action of melatonin on the blood dynamics of pregnant rats and on the histogenesis of the spleen and thymus of offspring

Investigou-se a influência da melatonina sobre o hemograma de ratas prenhes e dos filhotes e sobre a histogênese e morfometria do baço e do timo dos filhotes. A melatonina foi administrada na dose 0,5mg/kg de peso corporal, dissolvida em 0,1mL de etanol e diluída em 0,3mL de solução salina. Para análise do hematócrito, contagem total de hemácias e contagem total e diferencial dos leucócitos, amostras de sangue foram coletadas no sétimo, 14ºe 21ºdias de prenhez e aos 10 dias de nascimento dos filhotes. Cortes histológicos do baço e do timo da prole foram utilizados para histoquímica e morfometria. A ausência da melatonina promoveu alterações no hemograma apenas no terço final da gestação, sem interferir no hemograma dos filhotes, e induziu modificações morfológicas e morfométricas no timo e no baço nos primeiros dias de vida dos filhotes. Concluiu-se que a melatonina materna é importante para a modulação do hemograma em ratas prenhes e para o desenvolvimento normal do baço e do timo dos filhotes.(AU)

We investigated the influence of melatonin on the hemogram of pregnant rats and puppies, and on the histogenesis and morphology of the spleen and thymus of puppies. Melatonin was administered at a dose 0.5mg/kgbody weight, dissolved in 0.1mL of ethanol and diluted in 0.3mL of saline. For hematocrit analysis, total erythrocyte count and total and differential leukocyte count, blood samples were collected on the 7th, 14th and 21st days of pregnancy and the offspring at 10 days of birth. Histological sections of spleen and thymus of the offspring were used for histochemistry and morphometry. The absence of melatonin promoted changes in blood count only in the final third of gestation, without interfering with the hemogram of the puppies, and induced morphological and morphometric changes in the thymus and spleen in the first days of life of the puppies. It was concluded that maternal melatonin is important for the modulation of the blood count in pregnant rats and the normal development of the spleen and thymus of the offspring.(AU)

Does aerobic exercise training promote changes in structural and biomechanical properties of the tendons in experimental animals? A systematic review.

To develop a systematic review to evaluate, through the best scientific evidence available, the effectiveness of aerobic exercise in improving the biomechanical characteristics of tendons in experimental animals. Two independent assessors conducted a systematic search in the databases Medline/PUBMED and Lilacs/BIREME, using the following descriptors of Mesh in animal models. The ultimate load of traction and the elastic modulus tendon were used as primary outcomes and transverse section area, ultimate stress and tendon strain as secondary outcomes. The assessment of risk of bias in the studies was carried out using the following methodological components: light/dark cycle, temperature, nutrition, housing, research undertaken in conjunction with an ethics committee, randomization, adaptation of the animals to the training and preparation for the mechanical test. Eight studies, comprising 384 animals, were selected; it was not possible to combine them into one meta-analysis due to the heterogeneity of the samples. There was a trend to increasing ultimate load without changes in the other outcomes studied. Only one study met more than 80% of the quality criteria. Physical training performed in a structured way with imposition of overloads seems to be able to promote changes in tendon structure of experimental models by increasing the ultimate load supported. However, the results of the influence of exercise on the elastic modulus parameters, strain, transverse section area and ultimate stress, remain controversial and inconclusive. Such a conclusion must be evaluated with reservation as there was low methodological control in the studies included in this review.

Outbreak of Neisseria meningitidis C in workers at a large food-processing plant in Brazil: challenges of controlling disease spread to the larger community.

SUMMARYAn outbreak of meningococcal disease (MD) with severe morbidity and mortality was investigated in midwestern Brazil in order to identify control measures. A MD case was defined as isolation of Neisseria meningitidis, or detection of polysaccharide antigen in a sterile site, or presence of clinical purpura fulminans, or an epidemiological link with a laboratory-confirmed case-patient, between June and August 2008. In 8 out of 16 MD cases studied, serogroup C ST103 complex was identified. Five (31%) cases had neurological findings and five (31%) died. The attack rate was 12 cases/100 000 town residents and 60 cases/100 000 employees in a large local food-processing plant. We conducted a matched case-control study of eight primary laboratory-confirmed cases (1:4). Factors associated with illness in single variable analysis were work at the processing plant [matched odds ratio (mOR) 22, 95% confidence interval (CI) 2·3-207·7, P<0·01], and residing <1 year in Rio Verde (mOR 7, 95% CI 1·11-43·9, P<0·02). Mass vaccination (>10 000 plant employees) stopped propagation in the plant, but not in the larger community.

Alterations of tendons in patients with diabetes mellitus: a systematic review.

AIMS: To perform a systematic review of observational studies which analyse tendon alterations in patients with diabetes mellitus compared with healthy individuals. METHODS: Data collection was performed, with no language restriction, using the databases of PubMed/Medline, BIREME, CINAHL, LILACS and Cochrane, as well as the references found in these studies. Three reviewers performed independent extractions of articles. Subsequently, these reviewers analysed the articles, focusing on their methodological quality, using the appropriate scale to evaluate observational studies from the Agency for Healthcare Research and Quality. RESULTS: Six articles were included in the analysis. Of these, four had used ultrasonographic diagnostics, one computed tomography and one magnetic resonance imaging. The patient pool comprised 396 individuals. All the articles evaluated tendon thickness and presented heterogeneous results. Two articles stated thickening or increased volume of the tendons in diabetic people, one article did not report any alteration, the fourth failed to determine any alterations and the fifth showed thinning of the tendons. The arrangement of collagen fibrils and the presence of calcification were analysed in only one article (n = 80), showing that 88.10% (n = 68) of individuals with diabetes presented disorientation of collagen fibril arrangement, while only 10% (n = 1) of healthy individuals presented this condition. Regarding tendon calcification, the article showed diabetic individuals with higher values than healthy individuals. CONCLUSIONS: All the articles indicated some relation between diabetes mellitus and tendon alterations in human beings, but due to methodological drawbacks, this association could not be sustained.

In vitro micronuclei tests to evaluate the genotoxicity of surface water under the influence of tanneries.

Leather manufacturing has a high potential for environmental pollution due to hides and chemicals that are not completely absorbed during the tanning process. This study aims to investigate the mutagenic potential of surface water samples from Cadeia and Feitoria rivers (RS, Brazil) in areas influenced by tanneries and leather footwear industry. Micronucleus assays using V79 cells and human lymphocytes were used. Cells were exposed to surface water collected bimonthly from three sites for a year, totaling six samples. Significant MN induction in human lymphocytes was shown by 83% of samples from sites FEI001 and CAD001 located downstream from the industrial area, followed by FEI004 (33%), upstream. Only a single sample from site FEI004 showed a positive response for MN in V79 cells. Thirteen discordant and five concordant responses were found between the two in vitro tests. Mutagenic agents were found at the sites where chemical quality was worst, corroborating studies on chronic toxicity, oxidative stress and mutagenicity performed in this area. The assay using human lymphocytes was more sensitive than V79 cells to detect the contaminants from this area, showing that it is an excellent biomarker of environmental genotoxicity.

Induction of cell migration and activation in mice by the freshwater sponge Drulia uruguayensis Bonetto & Ezcurra de Drago, 1968 (Porifera: Metaniidae)

Freshwater sponges are abundant in the Amazon region and they have been known to cause dermatitis (acute inflammation) since the beginning of the 20th century. To determine whether additional constituents, besides their body spicules, cause dermatological reactions in humans, an experimental study was developed and carried out using mice and Drulia uruguayensis prepared in three different forms: intact sponges (IS), macerated sponges (MS) or isolated spicules - megascleres (ISM). The cells most commonly involved in inflammatory reactions (mast cells, eosinophils and neutrophils), as well as intraepithelial lymphocytes and degranulated mast cells, were counted so that they could be used as parameters to determine which of the sponge preparations induced the greatest reaction. The effects of the sponge on the skin were then determined by histological analysis. The results obtained showed that IS caused the greatest inflammatory reaction (p = 0.000005), activating mainly mast cells (p = 0.0018). The histopathological analysis revealed a slight loss of continuity of the epidermis when ISM or IS were applied. These findings allow us to conclude that a structurally intact sponge can cause a greater inflammatory reaction in the first contact because of its ability to perforate the skin and allow inflammatory agents to enter. Other proteins present in dried sponge bodies could induce allergic but not toxic responses (in contact with the entire sponge, a large number of pharmacologically inert proteins may be introduced, with a potential allergen).

Induction of cell migration and activation in mice by the freshwater sponge Drulia uruguayensis Bonetto & Ezcurra de Drago, 1968 (Porifera: Metaniidae)

Freshwater sponges are abundant in the Amazon region and they have been known to cause dermatitis (acute inflammation) since the beginning of the 20th century. To determine whether additional constituents, besides their body spicules, cause dermatological reactions in humans, an experimental study was developed and carried out using mice and Drulia uruguayensis prepared in three different forms: intact sponges (IS), macerated sponges (MS) or isolated spicules - megascleres (ISM). The cells most commonly involved in inflammatory reactions (mast cells, eosinophils and neutrophils), as well as intraepithelial lymphocytes and degranulated mast cells, were counted so that they could be used as parameters to determine which of the sponge preparations induced the greatest reaction. The effects of the sponge on the skin were then determined by histological analysis. The results obtained showed that IS caused the greatest inflammatory reaction (p = 0.000005), activating mainly mast cells (p = 0.0018). The histopathological analysis revealed a slight loss of continuity of the epidermis when ISM or IS were applied. These findings allow us to conclude that a structurally intact sponge can cause a greater inflammatory reaction in the first contact because of its ability to perforate the skin and allow inflammatory agents to enter. Other proteins present in dried sponge bodies could induce allergic but not toxic responses (in contact with the entire sponge, a large number of pharmacologically inert proteins may be introduced, with a potential allergen).(AU)

Epidemiology of meningococcal disease in southern Brazil from 1995 to 2003, and molecular characterization of Neisseria meningitidis using multilocus sequence typing.

OBJECTIVE: To describe the epidemiology of meningococcal disease (MD) in southern Brazil. METHODS: Retrospective cohort study among 2215 MD cases reported from 1995 to 2003 in Rio Grande do Sul (RS) State. RESULTS: The overall incidence fell by 50%; the case-fatality rate during this period was 22%. Even so, the incidence of MD remained high after the epidemic period ended in 1999. Together, the age groups of 1-4 years and infants accounted for 54.1% of reported cases with incidences of 11.3/100 000 and 31.3/100 000, respectively; 69.8% of cases were caused by Neisseria meningitidis serogroup B, which increased significantly. There was a significant decrease in serogroup C cases in the whole period. The phenotypes B:4,7:P1.19,15, B:15:P1.7,16 and B:NT:P1.3 caused almost 50% of all serotyped cases. Fifty-six isolates obtained from RS patients during the first non-epidemic year 2000 plus 20 isolates from other southern Brazilian states (Santa Catarina and Paraná), Denmark and France were typed by multilocus sequence typing. Twenty sequence types (STs) were identified, eight of them found only in RS. ST-33 (27%) and ST-259 (18%) were the most frequent; both belong to the ST-32/ET-5 complex. ST-259 cases showed a trend towards higher risk of fatal outcome. ST-259 isolates were not detected among geographic controls or in other studies in Brazil. CONCLUSION: Our data suggest that ST-33 and ST-259 clones and the emergence of the ST-103 isolates contributed to the continued high incidence of MD in RS.

3D chitosan-gelatin-chondroitin porous scaffold improves osteogenic differentiation of mesenchymal stem cells.

A porous 3D scaffold was developed to support and enhance the differentiation process of mesenchymal stem cells (MSC) into osteoblasts in vitro. The 3D scaffold was made with chitosan, gelatin and chondroitin and it was crosslinked by EDAC. The scaffold physicochemical properties were evaluated. SEM revealed the high porosity and interconnection of pores in the scaffold; rheological measurements show that the scaffold exhibits a characteristic behavior of strong gels. The elastic modulus found in compressive tests of the crosslinked scaffold was about 50 times higher than the non-crosslinked one. After 21 days, the 3D matrix submitted to hydrolytic degradation loses above 40% of its weight. MSC were collected from rat bone marrow and seeded in chitosan-gelatin-chondroitin 3D scaffolds and in 2D culture plates as well. MSC were differentiated into osteoblasts for 21 days. Cell proliferation and alkaline phosphatase activity were followed weekly during the osteogenic process. The osteogenic differentiation of MSC was improved in 3D culture as shown by MTT assay and alkaline phosphatase activity. On the 21st day, bone markers, osteopontin and osteocalcin, were detected by the PCR analysis. This study shows that the chitosan-gelatin-chondroitin 3D structure provides a good environment for the osteogenic process and enhances cellular proliferation.

Association between serum albumin levels and in-hospital deaths due to tuberculosis.

SETTING: A tuberculosis (TB) referral hospital in the state of Bahia, north-eastern Brazil. OBJECTIVE: To evaluate the association between serum albumin at admission and in-hospital deaths due to TB. DESIGN: A prospective cohort study of 373 patients hospitalised with TB. Samples were systematically collected from all patients at hospital admission for measurement of serum albumin levels. In-hospital death was the study endpoint. Univariate analysis was used to evaluate the association between serum albumin at admission and mortality from TB, and multivariate logistic regression was used to adjust for potential confounding variables. RESULTS: The average age of the 373 patients was 41.1 years (+/-15.2); 77.2% (288/373) were male; 45 eventually died in hospital (in-hospital death rate 12.1%, 95%CI 9.0-15.7). Multivariate analysis showed that the presence of low serum albumin levels (< or =2.7 g/dl) was strongly and independently associated with in-hospital death due to TB (adjusted OR 3.38, 95%CI 1.51-7.59; P = 0.001), even after adjusting for potentially confounding variables identified in the univariate analysis (age, comorbidities, TB-human immunodeficiency virus [HIV] coinfection and history of previous default from treatment). CONCLUSION: Our results highlight the importance of measuring serum albumin levels at admission to hospital as an indicator of the prognosis for patients hospitalised with TB.

Cockroaches as carriers of fungi of medical importance.

The fungal pathogenic flora of the external surface of 103 cockroaches (Periplaneta americana) collected from the intensive care unit of a hospital were investigated. In this study, a high percentage of test cockroaches (93.2%) were found to carry fungi of medical importance. The main fungi isolated were species of Candida, Aspergillus and Penicillium. Information about the carriage of pathogenic fungi by cockroaches in hospital environment is scanty. The results suggest that cockroaches can play a role in dissemination of fungi, which they can carry on their external surface.

Masticatory performance and bite force in relation to signs and symptoms of temporomandibular disorders in children.

AIM: The aim of this study was to compare and correlate the masticatory performance (MP) and maximum bite force (BF) in children with and without signs and symptoms of temporomandibular disorders (TMD). METHODS: Thirty-six children aged 7-12 years in the mixed or beginning of permanent dentition where divided into 2 groups: with signs and symptoms of TMD (SS group, n=21) and without signs and symptoms (Control group, n=15). The signs were evaluated in the clinical exam and the symptoms through a questionnaire. The evaluated criteria were: presence of postcanine teeth in occlusion, the Angle's classification for first permanent molars, canine relationship, crossbite, midline deviation, overbite and overjet. The MP was determined by chewing a silicone tablet during 20 cycles and the particles were analyzed by an optical system. The BF was determined by a pressurized transducer placed between the upper and lower permanent first molars. The statistical tests were Student's t, Mann-Whitney, Fisher's Exact and Pearson's correlation. RESULTS: MP and BF were statistically smaller for SS group. Body variables did not show significant differences between groups. There was no correlation among the variables within each group demonstrating that MP was independent on the BF, as well as BF and MP were independent on the body variables. There was no difference in the proportion on occlusal characteristics between groups. Overbite was significantly larger for SS group. CONCLUSIONS: It is possible to infer that signs and symptoms of TMD can interfere in the proper masticatory function and muscle strength in children.

Avaliação da forca muscular respiratoria no terceiro trimestre de gestação / Respiratory muscle force assessment in the final three months of pregnancy

Durante a gravidez, o sistema respiratorio sofre adaptacoes importantes que sao responsaveis pelas alteracoes nos volumes a nas capacidades pulmonares. Acredita-se que, com o crescimento uterino, as modificacoes na posicao de repouso do diafragama e na configuracao da parede toracica interfiram na forca dos musculos respiratorios inspiratorios e expiratorios. Objetivo: este estudo visa a correlacionar os valores de volume corrente, volume minuto e a presenca de dispneia pos-esforco com a pressao inspiratoria maxima (PImax) e correlacionar a diastase dos musculos retos abdominais (DMRA) com a pressao expiratoria maxima (PEmax) durante o terceiro trimestre de gestacao. Metodo: foram estudadas 10 mulheres primiparas entre a 28ª e a 38ª semana de gestacao, com faixa etaria de 16 a 35 anos, indice de massa corporea abaixo de 40 kg/m2 e sem historico de doenca pulmonar. Conclusao: este estudo mostrou que as mudancas fisiologicas ocorridas no sistema respiratorio durante o terceiro trimestre de gestacao nao ocasionaram alteracoes nos mecanismos das forcas musculares inspiratorias e expiratoria. O estudo nao encontrou correlacoes significativas entre as variaveis estudadas