bluuebunny/crossref_metadata_2025 huggingface dataset:
Intratidal variability and transport of petroleum aromatic hydrocarbons in an anthropized tropical estuarine system: the Suape estuary (8.4S 35W)
Authors: Zanardi-Lamardo Eliete , Schettini Carlos Augusto França , Vieira-Campos Amanda Alves , Cabral Carolina Barbosa , Silva Marília S.
Published: May 2018

Abstract The Suape Estuary encompasses the Suape Industrial Port Complex (SIPC), a major industrial development in Brazil's Northeast region, which, in order to be implanted, caused drastic environmental changes in this system. This study presents the first physical characterization of the Suape estuarine system, focusing on the local hydrodynamics, material transport and its influence on some specific properties. Physical properties were also associated to dissolved dispersed petroleum hydrocarbons (DDPHs). A study was undertaken during a complete semi-diurnal tidal cycle (13 hr), during which water level, water flow, current velocity and direction, water properties (salinity, temperature, suspended particulate matter - SPM -, chlorophyll and dissolved oxygen) were recorded using ADCP and CTD systems. The DDPHs were investigated in surface and bottom waters, by spectrofluorescence, using Carmópolis oil and chrysene as analytical standards. Results showed a well-mixed vertical structure, a semi-diurnal tide regime and a diurnal thermal pattern. There was no statistical difference between DDPH concentrations at surface and bottom, due to the tide acting as an important homogenizer. DDPHs were low and the main contribution seems to be that from SIPC, as the residual transport of DDPHs, chlorophyll and dissolved oxygen, was towards the Massangana estuary. An opposite pattern was observed for salinity and SPM, whose residual transport was towards the lagoon. The results pointed local hydrodynamics as an essential tool for understanding material transport and exchanges among the estuarine segments. A longer time series should be studied in order to obtain more robust conclusions.
The legacy of man-made organic compounds in surface sediments of Pina Sound and Suape Estuary, northeastern Brazil
Authors: Yogui Gilvan Takeshi , Taniguchi Satie , Silva Josilene da , Miranda Daniele de Almeida , Montone Rosalinda Carmela
Published: May 2018

Abstract Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) are man-made organic chemicals that have adverse effects on aquatic organisms, sometimes altering ecosystem functioning with potential consequences for the coastal carbon cycle. This study assessed PCBs and OCPs in surface sediments of two estuaries with distinct historical land use on the coast of Pernambuco, northeastern Brazil. OCPs such as HCB, aldrin, dieldrin, isodrin, mirex, methoxychlor, endosulfans (α- and β-isomers), HCHs (α-, β-, γ- and δ-isomers) and chlordane-related compounds were below their respective limits of detection in all samples. Mean levels of PCBs in Pina Sound and Suape Estuary were 4.37 and 0.94 ng g-1 dry weight (dw), respectively. Average concentrations of DDTs in those same estuaries were 5.24 and 0.42 ng g-1 dw, respectively. No significant correlations were found between mud and contaminants (either PCBs or DDTs) at Pina Sound. In contrast, PCBs were significantly associated with mud at Suape Estuary. The greater contamination found at Pina Sound is consistent with land use of the urban, densely populated city of Recife. Residues of DDTs found in sediments of both estuaries reflect past local usage. Occasional adverse biological effects may be expected due to the levels of DDTs at several sites in Pina Sound. Lower levels of chemicals such as PCBs in the newly industrialized Suape Estuary suggest that a similarly low impact of legacy pollutants may be expected for future industrial enterprises around the world.
Influence of fluvial discharge on the dynamics of Chlorophyll-α in the continental shelf adjacent to the Recife Port Basin (Pernambuco-Brazil)
Authors: Otsuka Amanda Yumi , Feitosa Fernando Antônio do Nascimento , Montes Manuel de Jesus Flores , Silva Alex Costa da
Published: May 2018

Abstract This study was undertaken in the coastal zone of the state of Pernambuco adjacent to the Recife port area, which corresponds to the inner shelf. This research aimed to analyze the dynamics of chlorophyll-a and several other environmental variables. Sampling was undertaken bimonthly on the surface from September 11th to May 10th, thus including the rainy and dry periods, and during low tide in spring tide. The parameters analyzed were chlorophyll-a, salinity, temperature, transparency, dissolved oxygen, oxygen saturation rate, pH, suspended solids, dissolved inorganic nutrients. Phytoplankton biomass ranged from 13.48 to 145.09 mg m-3 in the estuarine area and on the inner shelf, the variation being from 0.24 to 19.29 mg m-3 in the dry season and from 0.78 to 5.20 mg m-3 in the rainy season. PCA showed a direct relationship of chlorophyll-a with ammonia, phosphate and transparency and an inverse relationship with suspended particulate matter and nitrate. Biomass did not vary significantly different as a result of seasonal or spatial dynamics. The estuary of the Capibaribe River is considered highly impacted, and as it forms the Recife port basin, it joins with two more strongly eutrophic water bodies, the Beberibe River and the Pina Basin, leading to an amplification of its influence on the adjacent shelf. In terms of the river plume's dispersion in the Port of Recife, the presence of a dike causes some disturbance in the direction of the current, limiting the plume to the area close to the coast and influences the oceanographic variables on the inner continental shelf.
Different silicon forms sinalize an input of urbanized river and indicate the presence of phytoplankton with silicon structures in the tropical coastal area of Recife (PE-Brazil)
Authors: Bastos Ana Teresa Cordeiro Cid , Braga Elisabete de Santis
Published: May 2018

Abstract The urbanized areas mark its presence in the hydrological systems with some biogeochemical signs including silicon inputs. Natural influence of leaching and erosion is done by silicate contribution and sometimes, the agriculturally soil contains microphytoliths and contributes with biogenic silica. Once in the hydrological system, the silicon can integrate the biogeochemical cycles showing a balance or not between inorganic and biological forms that reveals a tendency of processes that occur in each sector of the estuarine-marine interface. This study aims to evaluate the impact of a heavily polluted/urbanized river, whose input can be evidenced by the contribution of different forms of silicon that can evidence the terrestrial contribution, erosion process, the presence of phytoplankton species with siliceous structures, mainly associated to diatoms and also, to study the river plume spreading on the coastal area by undertaking silicon profiles in the region adjacent to the river mouth. The coastal region of Recife is under influence of fluvial inputs from Capibaribe and Beberibe rivers verified by observed low salinity (min. 33.93). The distribution of silicon forms showed sectorial variation, and the maximum values were dissimilar. Dissolved silicate reached 14.40 µmol L-1, lithogenic silicon (LSi) maximum of 25.76 µmol L-1 and biogenic silica (BSi) reaching 7.39 µmol L-1 near the river mouth toward the sea, evidencing the river influence coming from the west, achieving the port barrier at the end and propagating in the sea toward northeast. Due to higher nutrient availability in the stations nearest to the coast, primary production was encouraged with evidencing by high values of chlorophyll-a associated to silicate (r=0.71) and to BSi (r=0.44). In the stations more distant to the coast, the forms of silicon showed very low concentrations and BSi/Chlorophyll-a showed negative correlation associated with chlorophyll-a concentrations evidencing the participation of non-silicon actors in the primary production in medium depth in oligotrophic tropical waters.
Alkalinity, inorganic carbon and CO2 flux variability during extreme rainfall years (2010-2011) in two polluted tropical estuaries NE Brazil
Authors: Gaspar Felipe Lima , Pinheiro Barbara Ramos , Noriega Carlos Esteban Delgado , Araujo Moacyr , Lefèvre Nathalie , Montes Manuel de Jesus Flores
Published: May 2018

Abstract The susceptibility of coastal environments to shifts in the biogeochemical cycles of carbon and nutrients driven by anthropogenic pressure and climate change is a real challenge for the scientific community. This paper evaluated the effects of an extreme rainfall event over the nutrients and carbonate parameters in two polluted tropical estuaries. Surface water samples were taken seasonally along a salinity gradient in the Capibaribe and Barra de Jangadas estuaries in order to investigate the spatial and seasonal variability of dissolved nutrients, chlorophyll-a, dissolved oxygen, total alkalinity, inorganic carbon, partial pressure of CO2 (pCO2) and CO2 fluxes. The increased riverine influence caused by the fluvial flooding during the extremely rainy season augmented the nitrogen concentrations in the plumes, which also presented reduced salinity, alkalinity and dissolved oxygen values. In the Capibaribe plume it has also shifted the mean CO2 flux value of - 4.01 mmolC m-2 d-1 during the dry season, to a positive mean flux of + 5.7 mmolC m-2 d-1 during the rainy season. Within the estuaries the BOD5,20 and dissolved phosphorus values were higher during the dry season (p<0.0001), they showed positive correlation with the phytoplanktonic blooms that reached a chl-a value of 85 mg m-3 in the Capibaribe. The high alkalinity found in both estuaries, with mean values between dry and wet seasons respectively from 1808 to 1373 µmol kg-1 in the Capibaribe estuary and 1616 to 1058 µmol kg-1 in Barra de Jangadas estuary, may act as a buffer to the process of coastal acidification due to eutrophication. The increased rivers discharge lead to a greater transport of organic matter and nutrients to the coast, decreasing the oxygen availability and shifting the metabolic status of the estuarine plume to heterotrophic, whereas increased the water quality within the estuaries due the flushing promoted by the extreme rainfall event.
Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant tuberculosis
Authors: Vasconcelos Karla Anacleto de , Frota Silvana Maria Monte Coelho , Ruffino-Netto Antonio , Kritski Afrânio Lineu
Published: May 2018

ABSTRACT Objective: To investigate early detection of amikacin-induced ototoxicity in a population treated for multidrug-resistant tuberculosis (MDR-TB), by means of three different tests: pure-tone audiometry (PTA); high-frequency audiometry (HFA); and distortion-product otoacoustic emission (DPOAE) testing. Methods: This was a longitudinal prospective cohort study involving patients aged 18-69 years with a diagnosis of MDR-TB who had to receive amikacin for six months as part of their antituberculosis drug regimen for the first time. Hearing was assessed before treatment initiation and at two and six months after treatment initiation. Sequential statistics were used to analyze the results. Results: We included 61 patients, but the final population consisted of 10 patients (7 men and 3 women) because of sequential analysis. Comparison of the test results obtained at two and six months after treatment initiation with those obtained at baseline revealed that HFA at two months and PTA at six months detected hearing threshold shifts consistent with ototoxicity. However, DPOAE testing did not detect such shifts. Conclusions: The statistical method used in this study makes it possible to conclude that, over the six-month period, amikacin-associated hearing threshold shifts were detected by HFA and PTA, and that DPOAE testing was not efficient in detecting such shifts.
Clinical aspects in patients with pulmonary infection caused by mycobacteria of the Mycobacterium abscessus complex, in the Brazilian Amazon
Authors: Monteiro José Tadeu Colares , Lima Karla Valéria Batista , Barretto Adriana Rodrigues , Furlaneto Ismari Perini , Gonçalves Glenda Moraes , Costa Ana Roberta Fusco da , Lopes Maria Luiza , Dalcolmo Margareth Pretti
Published: May 2018

ABSTRACT Objective: To describe the clinical manifestations of patients with pulmonary infection caused by mycobacteria of the Mycobacterium abscessus complex (MABSC), and to compare these manifestations with those of patients infected with other nontuberculous mycobacteria (NTM). Methods: This was a retrospective cohort study involving 43 patients divided into two groups: the MABSC group, consisting of patients with pulmonary infection caused by MABSC (n = 17); and the NTM group, consisting of patients with pulmonary infection caused by NTM other than MABSC (n = 26). Patients were previously treated with a regimen of rifampin, isoniazid, pyrazinamide, and ethambutol before the diagnosis of NTM was confirmed by two culture-positive sputum samples. The nucleotide sequences of the hsp65, 16S rRNA, and/or rpoB genes were analyzed to identify the mycobacteria. Data were collected on demographic, clinical, and radiological characteristics, as well as on treatment responses and outcomes. Results: Loss of appetite was the only clinical manifestation that was significantly more common in the MABSC group than in the NTM group (p = 0.0306). The chance of having to use a second treatment regimen was almost 12 times higher in the MABSC group than in the NTM group. Treatment success was significantly higher in the NTM group than in the MABSC group (83.2% vs. 17.6%; p < 0.0001). The chance of recurrence was approximately 37 times higher in the MABSC group than in the NTM group. Conclusions: In the study sample, treatment response of pulmonary disease caused by MABSC was less favorable than that of pulmonary disease caused by other NTM.
Impact of smoking on sputum culture conversion and pulmonary tuberculosis treatment outcomes in Brazil: a retrospective cohort study
Authors: Cailleaux-Cezar Michelle , Loredo Carla , Silva José Roberto Lapa e , Conde Marcus Barreto
Published: May 2018

ABSTRACT Objective: To evaluate the impact of smoking on pulmonary tuberculosis (PTB) treatment outcomes and the two-month conversion rates for Mycobacterium tuberculosis sputum cultures among patients with culture-confirmed PTB in an area with a moderate incidence of tuberculosis in Brazil. Methods: This was a retrospective cohort study of PTB patients diagnosed and treated at the Thoracic Diseases Institute of the Federal University of Rio de Janeiro between 2004 and 2012. Results: Of the 298 patients diagnosed with PTB during the study period, 174 were included in the outcome analysis: 97 (55.7%) were never-smokers, 31 (17.8%) were former smokers, and 46 (26.5%) were current smokers. Smoking was associated with a delay in sputum culture conversion at the end of the second month of TB treatment (relative risk = 3.58 &091;95% CI: 1.3-9.86&093;; p = 0.01), as well as with poor treatment outcomes (relative risk = 6.29 &091;95% CI: 1.57-25.21&093;; p = 0.009). The association between smoking and a positive culture in the second month of treatment was statistically significant among the current smokers (p = 0.027). Conclusions: In our sample, the probability of a delay in sputum culture conversion was higher in current smokers than in never-smokers, as was the probability of a poor treatment outcome.
Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital
Authors: Casela Marilda , Cerqueira Silvânia Maria Andrade , Casela Thais de Oliveira , Pereira Mariana Araújo , Santos Samanta Queiroz dos , Pozo Franco Andres Del , Freire Songeli Menezes , Matos Eliana Dias
Published: May 2018

ABSTRACT Objective: To evaluate the impact of the use of the molecular test for Mycobacterium tuberculosis and its resistance to rifampin (Xpert MTB/RIF), under routine conditions, at a referral hospital in the Brazilian state of Bahia. Methods: This was a descriptive study using the database of the Mycobacteriology Laboratory of the Octávio Mangabeira Specialized Hospital, in the city of Salvador, and georeferencing software. We evaluated 3,877 sputum samples collected from symptomatic respiratory patients, under routine conditions, between June of 2014 and March of 2015. All of the samples were submitted to sputum smear microscopy and the Xpert MTB/RIF test. Patients were stratified by gender, age, and geolocation. Results: Among the 3,877 sputum samples evaluated, the Xpert MTB/RIF test detected M. tuberculosis in 678 (17.5%), of which 60 (8.8%) showed resistance to rifampin. The Xpert MTB/RIF test detected M. tuberculosis in 254 patients who tested negative for sputum smear microscopy, thus increasing the diagnostic power by 59.9%. Conclusions: The use of the Xpert MTB/RIF test, under routine conditions, significantly increased the detection of cases of tuberculosis among sputum smear-negative patients.
Nontuberculous mycobacterial lung disease in a high tuberculosis incidence setting in Brazil
Authors: Carneiro Maiara dos Santos , Nunes Luciana de Souza , David Simone Maria Martini De , Dias Claudia Fontoura , Barth Afonso Luís , Unis Gisela
Published: May 2018

ABSTRACT Objective: The incidence of lung disease caused by nontuberculous mycobacteria (NTM) has been increasing worldwide. In Brazil, there are few studies about nontuberculous mycobacterial lung disease (NTMLD), and its prevalence is yet to be known. Our objective was to determine the specific etiology of the disease in the state of Rio Grande do Sul, Brazil, as well as the frequency and diversity of NTM species in our sample of patients. Methods: This is a retrospective analysis of the medical records of patients diagnosed with NTMLD treated in a referral center located in the city of Porto Alegre, Brazil, between 2003 and 2013. Results: Our sample comprised 100 patients. The most prevalent NTM species were Mycobacterium avium complex (MAC), in 35% of the cases; M. kansasii, in 17%; and M. abscessus, in 12%. A total of 85 patients had received previous treatment for tuberculosis. Associated conditions included structural abnormalities in the lungs, such as bronchiectasis, in 23% of the cases; COPD, in 17%; and immunosuppressive conditions, such as AIDS, in 24%. Conclusions: MAC and M. kansasii were the most prevalent species involved in NTMLD in the state, similarly to what occurs in other regions of Brazil. Data on regional epidemiology of NTMLD, its specific etiology, and associated conditions are essential to establish appropriate treatment, since each species requires specific regimens. Most patients with NTMLD had received previous tuberculosis treatment, which might lead to development of resistance and late diagnosis.
Who are the patients with tuberculosis who are diagnosed in emergency facilities? An analysis of treatment outcomes in the state of São Paulo, Brazil
Authors: Ranzani Otavio Tavares , Rodrigues Laura Cunha , Waldman Eliseu Alves , Prina Elena , Carvalho Carlos Roberto Ribeiro
Published: May 2018

ABSTRACT Objective: Early tuberculosis diagnosis and treatment are determinants of better outcomes and effective disease control. Although tuberculosis should ideally be managed in a primary care setting, a proportion of patients are diagnosed in emergency facilities (EFs). We sought to describe patient characteristics by place of tuberculosis diagnosis and determine whether the place of diagnosis is associated with treatment outcomes. A secondary objective was to determine whether municipal indicators are associated with the probability of tuberculosis diagnosis in EFs. Methods: We analyzed data from the São Paulo State Tuberculosis Control Program database for the period between January of 2010 and December of 2013. Newly diagnosed patients over 15 years of age with pulmonary, extrapulmonary, or disseminated tuberculosis were included in the study. Multiple logistic regression models adjusted for potential confounders were used in order to evaluate the association between place of diagnosis and treatment outcomes. Results: Of a total of 50,295 patients, 12,696 (25%) were found to have been diagnosed in EFs. In comparison with the patients who had been diagnosed in an outpatient setting, those who had been diagnosed in EFs were younger and more socially vulnerable. Patients diagnosed in EFs were more likely to have unsuccessful treatment outcomes (adjusted OR: 1.54; 95% CI: 1.42-1.66), including loss to follow-up and death. At the municipal level, the probability of tuberculosis diagnosis in EFs was associated with low primary care coverage, inequality, and social vulnerability. In some municipalities, more than 50% of the tuberculosis cases were diagnosed in EFs. Conclusions: In the state of São Paulo, one in every four tuberculosis patients is diagnosed in EFs, a diagnosis of tuberculosis in EFs being associated with poor treatment outcomes. At the municipal level, an EF diagnosis of tuberculosis is associated with structural and socioeconomic indicators, indicating areas for improvement.
New and repurposed drugs to treat multidrug- and extensively drug-resistant tuberculosis
Authors: Silva Denise Rossato , Dalcolmo Margareth , Tiberi Simon , Arbex Marcos Abdo , Munoz-Torrico Marcela , Duarte Raquel , D’Ambrosio Lia , Visca Dina , Rendon Adrian , Gaga Mina , Zumla Alimuddin , Migliori Giovanni Battista
Published: May 2018

ABSTRACT Multidrug-resistant and extensively drug-resistant tuberculosis (MDR-TB and XDR-TB, respectively) continue to represent a challenge for clinicians and public health authorities. Unfortunately, although there have been encouraging reports of higher success rates, the overall rate of favorable outcomes of M/XDR-TB treatment is only 54%, or much lower when the spectrum of drug resistance is beyond that of XDR-TB. Treating M/XDR-TB continues to be a difficult task, because of the high incidence of adverse events, the long duration of treatment, the high cost of the regimens used, and the drain on health care resources. Various trials and studies have recently been undertaken (some already published and others ongoing), all aimed at improving outcomes of M/XDR-TB treatment by changing the overall approach, shortening treatment duration, and developing a universal regimen. The objective of this review was to summarize what has been achieved to date, as far as new and repurposed drugs are concerned, with a special focus on delamanid, bedaquiline, pretomanid, clofazimine, carbapenems, and linezolid. After more than 40 years of neglect, greater attention has recently been paid to the need for new drugs to fight the “white plague”, and promising results are being reported.
Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs
Authors: Silva Denise Rossato , Muñoz-Torrico Marcela , Duarte Raquel , Galvão Tatiana , Bonini Eduardo Henrique , Arbex Flávio Ferlin , Arbex Marcos Abdo , Augusto Valéria Maria , Rabahi Marcelo Fouad , Mello Fernanda Carvalho de Queiroz
Published: May 2018

ABSTRACT Tuberculosis continues to be a major public health problem. Although efforts to control the epidemic have reduced mortality and incidence, there are several predisposing factors that should be modified in order to reduce the burden of the disease. This review article will address some of the risk factors associated with tuberculosis infection and active tuberculosis, including diabetes, smoking, alcohol use, and the use of other drugs, all of which can also contribute to poor tuberculosis treatment results. Tuberculosis can also lead to complications in the course and management of other diseases, such as diabetes. It is therefore important to identify these comorbidities in tuberculosis patients in order to ensure adequate management of both conditions.
Chest X-ray and chest CT findings in patients diagnosed with pulmonary tuberculosis following solid organ transplantation: a systematic review
Authors: Giacomelli Irai Luis , Schuhmacher Neto Roberto , Marchiori Edson , Pereira Marisa , Hochhegger Bruno
Published: May 2018

ABSTRACT The objective of this systematic review was to select articles including chest X-ray or chest CT findings in patients who developed pulmonary tuberculosis following solid organ transplantation (lung, kidney, or liver). The following search terms were used: “tuberculosis”; “transplants”; “transplantation”; “mycobacterium”; and “lung”. The databases used in this review were PubMed and the Brazilian Biblioteca Virtual em Saúde (Virtual Health Library). We selected articles in English, Portuguese, or Spanish, regardless of the year of publication, that met the selection criteria in their title, abstract, or body of text. Articles with no data on chest CT or chest X-ray findings were excluded, as were those not related to solid organ transplantation or pulmonary tuberculosis. We selected 29 articles involving a collective total of 219 patients. The largest samples were in studies conducted in Brazil and South Korea (78 and 35 patients, respectively). The imaging findings were subdivided into five common patterns. The imaging findings varied depending on the transplanted organ in these patients. In liver and lung transplant recipients, the most common pattern was the classic one for pulmonary tuberculosis (cavitation and “tree-in-bud” nodules), which is similar to the findings for pulmonary tuberculosis in the general population. The proportion of cases showing a miliary pattern and lymph node enlargement, which is most similar to the pattern seen in patients coinfected with tuberculosis and HIV, was highest among the kidney transplant recipients. Further studies evaluating clinical data, such as immunosuppression regimens, are needed in order to improve understanding of the distribution of these imaging patterns in this population.
Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy
Authors: Carvalho Anna Cristina Calçada , Cardoso Claudete Aparecida Araújo , Martire Terezinha Miceli , Migliori Giovanni Battista , Sant’Anna Clemax Couto
Published: May 2018

ABSTRACT Tuberculosis continues to be a public health priority in many countries. In 2015, tuberculosis killed 1.4 million people, including 210,000 children. Despite the recent progress made in the control of tuberculosis in Brazil, it is still one of the countries with the highest tuberculosis burdens. In 2015, there were 69,000 reported cases of tuberculosis in Brazil and tuberculosis was the cause of 4,500 deaths in the country. In 2014, the World Health Organization approved the End TB Strategy, which set a target date of 2035 for meeting its goals of reducing the tuberculosis incidence by 90% and reducing the number of tuberculosis deaths by 95%. However, to achieve those goals in Brazil, there is a need for collaboration among the various sectors involved in tuberculosis control and for the prioritization of activities, including control measures targeting the most vulnerable populations. Children are highly vulnerable to tuberculosis, and there are particularities specific to pediatric patients regarding tuberculosis development (rapid progression from infection to active disease), prevention (low effectiveness of vaccination against the pulmonary forms and limited availability of preventive treatment of latent tuberculosis infection), diagnosis (a low rate of bacteriologically confirmed diagnosis), and treatment (poor availability of child-friendly anti-tuberculosis drugs). In this review, we discuss the epidemiology, clinical manifestations, and prevention of tuberculosis in childhood and adolescence, highlighting the peculiarities of active and latent tuberculosis in those age groups, in order to prompt reflection on new approaches to the management of pediatric tuberculosis within the framework of the End TB Strategy.
11th Biennial International Congress of the South African Sports Medicine Association
Authors: Lambert M
Published: May 2018

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Cricket injuries - a longitudinal study of the nature of injuries to South African cricketers
Authors: Stretch R
Published: May 2018

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A comparison of the nature and severity of injuries in younger and older professional soccer players
Authors: Nematswerani H
Published: May 2018

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Assessment of endocrine stress status in athletes - new twists to the tale
Authors: Smith C
Published: May 2018

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The prediction of endurance performance from work rates at fixed blood lactate concentrations is a mathematical not a physiological phenomenon - a novel hypothesis
Authors: Cook I
Published: May 2018

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Rectal prolapse in a young adult male patient and its unique aetiology
Authors: Kulkarni D
Published: May 2018

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A practical guide to the use of nutritional supplements in South Africa
Authors: Kohler R
Published: May 2018

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HBV genotyping by multiplex nested PCR v1
Authors: E Ahmad Abdurrahman , Bakari Girei Adamu , O. P. Musa Bolanle , K. Mustapha Shettima , Abdullahi Nasir Idris , Ibrahim Tahir Mohammed , Yusuf Jamoh Bello , O. Olatunji Abdulqadri , Hamza Maishanu Sumayya , Ahmed Suleiman Babangida , Hawkins Claudia , T. Olayinka Adebola.
Published: May 2018

Hepatitis B virus is hyperendemic in Nigeria with a national seroprevalence of 12.2%. Worldwide, 10 genotypes have been identified on the basis of ≤8% difference in genome sequences, each with a distinctive geographical distribution. Available literature reveal genotype E as being predominant in West Africa. This study aimed at identifying the current pattern and prevalent genotypes of HBV in Zaria, a prominent and ancient region of northern Nigeria. Four milliliter of blood was collected in EDTA-container from each of 165 HBsAg-positive participants recruited consecutively. Plasma was separated and frozen at -20oC till analysis. Multiplex- nested PCR using type-specific primers was used to identify the various HBV genotypes.
Shallow Inclusion (or Integration) and Deep Exclusion: En-Dis-Abling Identities through Government Webpages in Hong Kong
Authors: Cockain Alex
Published: May 2018

This article is primarily concerned with how government webpages in Hong Kong claiming to embrace social inclusion and provide services and support for persons with disabilities construct issues relating to disability. These texts are not read in isolation. Instead, they are considered in conjunction with discourse produced in several United Nations documents, especially the Convention on the Rights of Persons with Disabilities, to which Hong Kong is a signatory. These documents appear to both proffer and retract social inclusion in ways that complicate, if not undermine entirely, their purportedly inclusionary intentions. This article also reflects upon commentary produced by university students at a public university in Hong Kong responding to government discourse. Such focus upon ‘non-disabled’ readers reveals how texts do more than merely mediate pre-existing messages. Instead, they constitute a “social location and organizer for the accomplishment of meaning”, thereby counting as “a form of social action” (Titchkosky, 2007, p. 27). Through the texts they conspire to make about disability, authors and readers become complicit in the production, maintenance, and reinforcement of non-disabled (or abled)/disabled identities and dis/ableist ideology in ways that implicate the entire population in exclusionary processes.
Being a Disabled Patient: Negotiating the Social Practices of Hospitals in England
Authors: Read Stuart , Williams Val , Heslop Pauline , Mason-Angelow Victoria , Miles Caroline
Published: May 2018

Accessing hospital care and being a patient is a highly individualised process, but it is also dependent on the culture and practices of the hospital and the staff who run it. Each hospital usually has a standard way of ‘doing things’, and a lack of flexibility in this may mean that there are challenges in effectively responding to the needs of disabled people who require ‘reasonably adjusted’ care. Based on qualitative stories told by disabled people accessing hospital services in England, this article describes how hospital practices have the potential to shape a person’s health care experiences. This article uses insights from social practice theories to argue that in order to address the potential problems of ‘misfitting’ that disabled people can experience, we first need to understand and challenge the embedded hospital practices that can continue to disadvantage disabled people.
Theorising Disability Care (Non-)Personalisation in European Countries: Comparing Personal Assistance Schemes in Switzerland, Germany, Sweden, and the United Kingdom
Authors: Tschanz Christoph
Published: May 2018

This article examines four European countries (Switzerland, Germany, Sweden, and the United Kingdom) with respect to their degree of disability care personalisation. The approach is embedded in a broader theoretical analysis, which in turn is inspired by the notion of bivalent social justice as presented by Nancy Fraser (2003). The theoretical argument is that claims for personal assistance are part of a broader movement toward emancipation. However, it is argued that the specific settings of welfare regimes provide structures that empower or mitigate the possible implementation of personal assistance schemes. The author argues that conservative-corporatist welfare regimes provide less-supportive opportunity structures for policy change pertaining to personal assistance than other welfare regimes. This heuristic argument is developed further by looking more closely at key figures of Sweden, Germany, and the United Kingdom as being ideal-typical welfare regime cases. Furthermore, the case of Switzerland is outlined in an in-depth manner as it seems to have conservative-corporatist characteristics regarding the organisation of disability care while simultaneously being difficult to theorise. It is the aim of this article to serve as a first heuristic undertaking for analysing the low level of disability care personalisation in certain continental European cases.
Workplace Adaptations Promoting the Inclusion of Persons with Disabilities in Mainstream Employment: A Case-Study on Employers’ Responses in Norway
Authors: Kuznetsova Yuliya , Bento João Paulo Cerdeira
Published: May 2018

This case-study conducted in Norway investigates employers’ responses to policy measures implemented throughout 2006–2015 and aimed at promoting the inclusion of persons with disabilities (PwDs) into mainstream employment by providing workplace adaptations. For this purpose, we apply a multi-method approach by combining in-depth qualitative interviews conducted with the managers at two large private companies in Norway and quantitative shift-share analysis performed on the Norwegian Disabled People LFS data. While the shift-share analysis has demonstrated positive effects in the employment of PwDs at the national level and in providing adaptations at work during 2011–2015 for ‘changes of working time’, ‘need for one or more adaptations’ and ‘changes of work tasks’, ‘physical adaptations’ remain negative. The qualitative interviews report that ‘flexibility’ or ‘changes of working time’ is the main workplace adaptation the managers at both companies provide to own employees who return to work after acquiring a disability or having a long-term illness. Both companies demonstrate high conformity to accessibility standards, however, the provision of workplace adaptations to PwDs without prior work experience remains limited or absent despite the disability policy measures in Norway in that period and the companies’ commitment to inclusion.
‘Evidence’ of Neglect as a Form of Structural Violence: Parents with Intellectual Disabilities and Custody Deprivation
Authors: Sigurjónsdóttir Hanna Björg , Rice James G.
Published: May 2018

This contribution draws upon the findings from a multi-year project in Iceland entitled Family Life and Disability. One goal of the project was to analyse whether or not parents with intellectual disabilities (ID) experienced differential treatment in custody deprivation proceedings. The dataset consisted of the analysis of publicly available court documents concerning custody deprivation cases from 2012 to 2017. The project later expanded its dataset to include supplementary information provided by parents. The initial findings mirrored that of the international literature, that parents with ID faced disproportionate levels of permanent custody deprivation and prejudicial attitudes from the child protection system. This contribution critically explores the evidence of parenting neglect that forms of basis for custody deprivation in our dataset. Both authors noted a preponderance of evidence in our dataset that appeared strange and at times absurd, and generally did not appear in cases were ID was not a factor. We contend that this evidence played a prejudicial role in the outcome of these cases. In conclusion we argue that the patterned reliance upon this kind of ‘evidence’ is a form of structural violence which serves to unjustly exclude marginalised groups from the parenting role.
Deaf Learners’ Experiences in Malaysian Schools: Access, Equality and Communication
Authors: Khairuddin Khairul Farhah , Miles Susie , McCracken Wendy
Published: May 2018

The Government of Malaysia has embraced international policy guidelines relating to disability equality, including the United Nations Convention on the Rights of Persons with Disabilities. Its aim is to ensure that 75% of children with disabilities are included in mainstream classrooms by 2025 as part of a wider agenda to eliminate discrimination against people with disabilities. Including deaf children on an equal basis in the linguistically diverse, exam-oriented Malaysian school system is an ambitious and complex task given the difficulties they face in developing effective language and communication skills. The data presented here are taken from a larger study which explored teachers’, head teachers’, parents’, and children’s experiences of inclusion through in-depth interviews in three Malaysian schools. The study design was informed by a framework developed in the UK to guide best practice of educating deaf children in mainstream schools and focused specifically on the learning environment. This article presents contrasting educational experiences of two deaf adults, and then considers the experiences of four deaf children in their government-funded primary schools. A series of inter-related dimensions of inclusion were identified—these include curricular, organisational, social, acoustic and linguistic dimensions, which impact upon children’s ability to communicate and learn on an equal basis. Poor maintenance of assistive technology, insufficient teacher training and awareness, inflexibility of the education system, and limited home-school communication are some of the factors constraining efforts to promote equal participation in learning. There are promising signs, however, of teacher collaboration and the creation of more equitable and child-centred educational opportunities for deaf children.
A Refamilialized System? An Analysis of Recent Developments of Personal Assistance in Sweden
Authors: Rauch Dietmar , Olin Elisabeth , Dunér Anna
Published: May 2018

The Swedish system of disability support is often praised for its comparably well-developed Personal Assistance (PA) scheme. PA is formally prescribed as a social right for disabled people with comprehensive support needs in the Act Concerning Support and Services to Persons with Certain Functional Impairments (LSS). In the decade following the introduction of LSS in 1994, the PA-scheme expanded steadily to accommodate the support needs of more and more disabled people. It is commonly believed that the expansion of PA has substantially boosted the agency of both disabled people and their relatives. This article critically discusses in what direction the Swedish system of disability support has moved in the past decade. Is the common image of a system moving towards an ever increasing defamilialization of disability support still accurate? Or are there signs of stagnation, or even reversal towards refamilialization? What are the possible consequences of the more recent developments for disabled people and their relatives in terms of agency and equality? These questions will be discussed with the help of an analysis of the regulatory framework of disability support, statistical data and findings from public reports.
Domestic violence and anxiety levels in infertile women
Authors: ŞAHİN Sevil , İLÇİOĞLU Kevser , ÜNSAL Alaettin
Published: May 2018

Purpose: The aim of the study is to determine the frequency of domestic violence in infertile women, to review some associated variables and to evaluate anxiety level.Materials and Methods: The study group consisted of a total of 774 women (88.1%) admitted to the infertility outpatient clinic of the hospital and agreed to take part in the study. The questionnaire forms prepared by using the literature in line with the study objective were completed by the investigators with face-to-face interview method. The women who suffered from minimum one type of domestic violence at least once within last 1 year were regarded to have a “history of domestic violence”. The Beck Anxiety Inventory was used to assess anxiety level. Results: 116 (15.0%) infertile women in our study reported to suffer from domestic violence. The most frequently reported domestic violence type was emotional (56.1%) and sexual (21.9%). In our study, exposure to domestic violence was determined to be higher in women aged 25 years and above, with an education level of high school and above, with no job, with addiction of smoking and alcohol, with obesity, who got married more than once, whose first marriage age is 19 years and below, who are married for 4 years or below, with primary infertility, who are infertile for 2 years and below and with a family history of infertility. Anxiety levels of infertile women with a history of domestic violence were determined to be significantly higher.Conclusion: Domestic violence against infertile women is an important issue with regard to women health and in social terms. Treatment of infertile women enabling them to have children will affect their mental health positively.
Association between leptin and weight gain in patients receiving iron treatment
Authors: SOLMAZ Soner , ACIBUCU Fettah , SANCAKDAR Enver , GEREKLİOĞLU Çiğdem , KORUR Aslı , OĞUZ ACIBUCU Duygu
Published: May 2018

Purpose: The aim of this study was to evaluate the relationship between leptin and weight gain in patients receiving iron treatment.Materials and Methods: A total of 42 female patients who were diagnosed with IDA were included in the study. Whole blood count, serum iron, serum unsaturated iron binding capacity (UIBC), serum ferritin level were measured at the time of diagnosis and on month one after treatment; serum hepcidin level and serum leptin level were measured at the time of diagnosis and 96 hours after commencement of parenteral therapy; body weight and appetite alterations were recorded at the time of diagnosis and on month one.Results: A statistically significant difference was not found between hepcidin and leptin values at the time of diagnosis and after treatment. Increased appetite was detected in 22 (52.4%) patients on month one after treatment. While mean weight of all patients was 69.6±17.9 kg at the time of diagnosis, it was 70.7±17.5 kg on month one after treatment and there was a statistically significant difference between two values. Conclusion: Our study revealed that appetite and body weight increased following iron therapy, consistently with our observations and hypothesis. However no  significant relationship was found with leptin levels and weight increase.
Dikkat ve öğrenme bozukluklarında WISC-R alt testleri ile psikiyatrik semptom grupları arasındaki ilişki
Authors: Baykal Saliha , Ceylan Gülsüm , Karabekiroğlu Koray , Tekin Atilla
Published: May 2018

Amaç: Bu çalışmada dikkat eksikliği hiperaktivite bozukluğu (DEHB) ve/ özgül öğrenme bozukluğu (ÖÖB) tanılı çocuklarda, Wechsler Çocuklar İçin Zekâ Ölçeği-Geliştirilmiş Formu (WISC-R) ve Özgül Öğrenme Bozukluğu bataryası kullanılarak bilişsel ve akademik farkların araştırılması amaçlanmıştır.Gereç ve Yöntem: Çalışmaya DEHB ve/veya ÖÖB tanılı 72-131 ay aralığında olan 81 çocuk (%77.8 erkek) dahil edildi. Teste alınan çocukların bir kısmında aktif semptomlar remisyondaydı (Klinik Global İzlenim Ölçeği: 3’den daha az). Değerlendirme süreci sırasında olgular (n=81) dört gruba ayrılmıştır: (1) DEHB tanılı çocuklar (n=11), (2) ÖÖB tanılı çocuklar (n=33), (3) DEHB+ÖÖB tanılı çocuklar (n=15) ve (4) tedavi sürecinde aktif olarak ÖÖB ve DEHB tanısı almayacak düzeyde olan (Klinik Global İzlenim Ölçeği: 3’den daha az) çocuklar (n=22). Ölçüm aracı olarak WISC-R ve ÖÖB bataryası kullanıldı.Bulgular: ÖÖB tanılı çocuklar ÖÖB bataryası okuma süresi dışındaki tüm testlerde ve WISC-R benzerlikler alt testi dışındaki tüm alt testlerde ÖÖB tanısı olmayanlara göre daha düşük puan aldı. DEHB tanılı çocuklar DEHB tanısı olmayanlar ile karşılaştırıldığında sadece ÖÖB bataryası “saat çizme testi” ve WISC-R “şifre” alt testinden daha düşük puan aldılar. Sonuç: WISC-R ve ÖÖB bataryası, birbiri ile ilişkili bozukluklarda (ÖÖB, DEHB ve ÖÖB+DEHB) farkların ayırt edilmesinde geçerli ve güvenilir araçlardır.
Assessment of pedicle screw malposition rates in thoracolumbosacral spine: results of postoperative computed tomography in 100 patients
Authors: Aslanbaş Özcan , Oktay Kadir , Özsoy Kerem Mazhar , Çetinalp Nuri Eralp , Tuna Metin
Published: May 2018

Purpose: The purpose of this retrospective study was to evaluate the screw malpositions of patients who underwent transpedicular screw application in various elective and emergency conditions.Material and Methods: 100 patients who underwent transpedicular screw application with various spinal pathologies between January 2012 and September 2016 were included in this retrospective study. Anteroposterior and lateral X-rays and thin section spinal computed tomography scans were performed within 72 hours after the operation. The data including age, gender, operation levels, number of screws placed, preoperative and postoperative neurological conditions, complications, number of screw malpositions and revision surgeries of the patients were gathered.Results: A total of 692 transpedicular screws were applied to 100 cases. 610 (88.15%) of the 692 transpedicular screws placed were evaluated as normal. 82 screws (11.85%) were evaluated as malpositions and 5 of them were revised. According to Gertzbein classification; 20 screws were grade 1, 44 screws were grade 2 and 18 screws were grade 3. 4 patients had anterior perforation, 39 patients had medial perforation, 38 patients had lateral perforation and 1 patient had inferior perforation. There was a dominancy of thoracal levels in screw malpositions.Conclusion: Thin section CT scans taken postoperatively was found to be the gold standard for detecting screw malpositions. We identified that malpositions were most frequently seen as medial pedicle wall perforations in the thoracal region due to anatomical structure of the pedicles.
Çocukluk çağı kanserlerinde vitamin B12 ve folik asit düzeyleri
Authors: KÜPELİ Serhan , ÖZKAN Ayşe , EKER Tuna , SEZGİN Gülay , BAYRAM İbrahim
Published: May 2018

Amaç: Vitamin B12 ve folik asit DNA sentezi, tamiri ve ekspresyonunda önemli görevler alırlar. Bu çalışmada çocukluk çağı kanserleri ile vitamin B12 ve folik asit düzeyleri arasındaki ilişki araştırıldı.Gereç ve Yöntem: Kasım 2013 ve Aralık 2015 arasında yeni tanı alan solid tümörlü 125, lenfoproliferatif/miyeloproliferatif malign hastalığı olan 113 hasta ve 63 kontrol çalışmaya dahil edildi. Vitamin B12 ve folik asit düzeyleri tanısal çalışmaların bir parçası olarak tanı anında ölçüldü.Bulgular: Vitamin B12 ve folik asit düzeyleri malign hastalığı olan çocuklarda kontrol grubuna oranla anlamlı olarak düşük bulundu. Homosistein düzeyleri ise kontrol grubuna göre istatistiksel olarak daha yüksekti. Folik asit düzeyleri lenfoproliferatif/miyeloproliferatif malign hastalığı olanlarda solid tümör grubuna oranla daha düşüktü.Sonuç: Düşük vitamin B12 ve folik asit düzeyleri kanser tanısında destekleyici belirteçler olarak kullanılabilir. Bu ilişkinin gelecekte daha geniş serilerle ortaya konması gerekmektedir.