bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalência de Mycobacterium tuberculosis resistente em pacientes sob tratamento parcialmente intermitente ou sob tratamento diário
Authors: Alvarez Tomás Aiza , Rodrigues Marcelo Palmeira , Viegas Carlos Alberto de Assis
Published: July 2009

OBJETIVO: Comparar as taxas de prevalência de Mycobacterium tuberculosis resistentes entre pacientes sob tratamento parcialmente intermitente e daqueles sob tratamento diário. MÉTODOS: Foram utilizados dados da Organização Mundial de Saúde de 5.138 pacientes com TB pulmonar bacilífera no Brasil, que foram separados em dois grupos: um grupo de pacientes do Distrito Federal submetidos a um regime intermitente de três tomadas semanais após o primeiro mês de regime diário, e um grupo de pacientes dos estados brasileiras, submetidos somente a um regime diário. O padrão de resistência foi categorizado em resistência primária ou adquirida, conforme a existência de tratamento anterior. Além disso, multirresistência foi definida como a resistência simultânea à isoniazida e à rifampicina, enquanto monorresistência como a resistência a uma única droga. RESULTADOS: A prevalência da resistência primária como um todo no Distrito Federal e no restante do Brasil foi de 9,2% e 9,3% (p = 0,94), respectivamente. A prevalência de monorresistência foi de 6,6% e 6,9% (p = 0,89), respectivamente, e a de multirresistência, 1,0% e 1,2% (p = 0,85), respectivamente. A prevalência de resistência adquirida como um todo no Distrito Federal e no restante do Brasil foi de 15,8% e 26,8% (p = 0,39), respectivamente. A prevalência de monorresistência adquirida foi de 5,3% e 13,7% (p = 0,33), respectivamente, e a de multirresistência, 0,0% e 10,2% (p = 0,16), respectivamente. CONCLUSÕES: Não houve diferença significativa entre os índices de resistência observados na comunidade usuária do esquema parcialmente intermitente e do diário.
Eosinofilia pulmonar
Authors: Campos Luiz Eduardo Mendes , Pereira Luiz Fernando Ferreira
Published: July 2009

As formas de eosinofilia pulmonar constituem um grupo heterogêneo definido pela presença de um ou dois critérios: infiltrado pulmonar com eosinofilia sanguínea e/ou eosinofilia tissular caracterizada por eosinófilos demonstrados na biópsia pulmonar ou no lavado broncoalveolar. Embora o infiltrado inflamatório seja composto de macrófagos, linfócitos, neutrófilos e eosinófilos, a presença de eosinofilia é um marcador importante para o diagnóstico e tratamento. A apresentação clínica e radiológica pode revelar eosinofilia pulmonar simples, pneumonia eosinofílica crônica, pneumonia eosinofílica aguda, aspergilose broncopulmonar alérgica e eosinofilia pulmonar associada à doença sistêmica, como na síndrome de Churg-Strauss e na síndrome hipereosinofílica. A asma está frequentemente associada, podendo ser um pré-requisito, como na aspergilose broncopulmonar alérgica e na síndrome de Churg-Strauss. Nas doenças com acometimento sistêmico, a pele, o coração e o sistema nervoso são os órgãos mais comprometidos. A apresentação radiológica pode ser considerada como típica, ou pelo menos sugestiva, para três formas de eosinofilia pulmonar: pneumonia eosinofílica crônica, aspergilose broncopulmonar alérgica e pneumonia eosinofílica aguda. A etiologia da eosinofilia pulmonar pode ser de causa primária (idiopática) ou secundária, compreendendo causas conhecidas, como drogas, parasitas, infecções por fungos e micobactérias, irradiação e toxinas. A eosinofilia pulmonar pode também estar associada a doenças pulmonares difusas, doenças do tecido conectivo e neoplasias.
Nódulo sincrônico pulmonar e hepático em paciente com antecedente de carcinoma broncogênico: a importância da confirmação histopatológica
Authors: Camargo José de Jesus Peixoto , Machuca Tiago Noguchi , Camargo Spencer Marcantonio , Schio Sadi Marcelo , Bello Rodrigo Moreira
Published: July 2009

A apresentação de lesão sincrônica pulmonar e hepática em um paciente com antecedente de carcinoma broncogênico operado gera a suspeita de recidiva tumoral e indica a necessidade de re-estadiamento. Apresentamos o caso de um paciente de 71 anos submetido à lobectomia pulmonar com ressecção de pericárdio e linfadenectomia mediastinal (T3N0M0). Cinco anos após a cirurgia, detectou-se a presença de uma nova lesão pulmonar. No re-estadiamento, foi diagnosticada uma lesão sincrônica no fígado. Apesar da forte suspeita de recidiva tumoral, prosseguiu-se a investigação e uma punção hepática revelou carcinoma hepatocelular. Para esclarecer a etiologia da lesão pulmonar (hipóteses de recidiva de carcinoma brônquico ou de metástase de carcinoma hepatocelular), foi realizada uma biópsia a céu aberto, compatível com reação inflamatória crônica com focos de antracose e de calcificação distrófica. O paciente foi então submetido à ressecção hepática não-regrada com intuito curativo. Teve boa evolução, com alta no 10º dia de pós-operatório. O presente relato destaca a importância do diagnóstico histopatológico em pacientes com antecedente de carcinoma broncogênico e suspeita de recidiva. Hipóteses diagnósticas e condutas terapêuticas são discutidas.
Derrame pleural incomum: metástase pleuropulmonar de tumor neuroectodérmico primitivo
Authors: Antonangelo Leila , Rosa Adriana Gonçalves , Corá Aline Pivetta , Acencio Milena Marques Pagliarelli , Moreira Luís César , Suso Francisco Vargas
Published: July 2009

O tumor neuroectodérmico primitivo é uma neoplasia com diferenciação neural de comportamento invasivo que origina metástases para diversos órgãos. Relatamos um caso de tumor neuroectodérmico primitivo primário em axila com metástases para pulmão, pleura, osso, músculo ilíaco e medula óssea. Enfatizamos o achado incomum da análise citológica do líquido pleural.
Questionário para avaliação de desempenho de serviços de atenção básica no controle da TB no Brasil
Authors: Villa Tereza Cristina Scatena , Ruffino-Netto Antônio
Published: July 2009

O objetivo do estudo foi divulgar e disponibilizar um questionário utilizado como instrumento de avaliação dos elementos organizacionais e de desempenho dos serviços de atenção básica no controle da TB no Brasil, comparando as dimensões organizacionais selecionadas por unidade de saúde, por município e pelos diferentes atores (doentes, profissionais de saúde e gestores). Os resultados mostraram que os municípios com maior cobertura de tratamento supervisionado apresentaram indicadores mais favoráveis para o acesso ao tratamento da TB. A forma de organização da atenção a TB-programas de saúde da família ou unidades de referência com programas de controle da TB (PCT)-não foi um fator que ampliou o acesso ao diagnóstico. Os PCT que atendiam um menor número de doentes apresentaram desempenho mais favorável no que se refere ao vínculo entre o doente e o profissional de saúde. A maioria dos doentes enfrentava dificuldades de ordem econômica e social, e grande parte dos gerentes desconheciam os recursos aplicados nas ações de TB. O instrumento apresentou viabilidade de aplicação e potencial de avaliação dos serviços de saúde nos centros urbanos do estudo.
Methylnaltrexone
Authors: Hendrikx Jeroen J.M.A. , Beijnen Jos H. , Schellens Jan H.M.
Published: July 2009

This article provides a brief summary of the use of methylnaltrexone for opioid-induced constipation in patients with advanced illness receiving palliative care when the response to laxatives is insufficient.
Nodular Lymphocyte Predominant Hodgkin Lymphoma
Authors: Lee Alfred Ian , LaCasce Ann S.
Published: July 2009

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare subtype of HL with unique clinicopathologic features. The hallmark histologic feature is the presence of malignant LP cells, unusual CD20+CD15−CD30− variants of Reed-Sternberg cells, embedded within a nodular pattern of infiltrating lymphocytes. Compared with classical HL, NLPHL shows a slightly older median age at presentation (30–40 years), greater male predominance (3:1), less mediastinal involvement (<15%), and lower occurrence of classical HL risk factors. The differential diagnosis includes progressive transformation of germinal centers, lymphocyte-rich classical HL, and T-cell/histiocyte-rich large B-cell lymphoma, the latter of which may share a common biologic relationship. The vast majority of patients present with limited stage disease (70%–80%), the standard treatment for which is involved field radiotherapy at 30–36 Gy. Response rates to primary therapy exceed 90%, although relapses are common and may occur years after the initial diagnosis. Secondary malignancies, particularly non-Hodgkin lymphoma, may also occur at a frequency similar to that of relapsed NLPHL. Patients with advanced stage disease may have lower response rates and overall survival times than those with limited stage disease. For relapsed disease, treatment options include the salvage therapies used in classical HL, and rituximab.
Bioaccumulation of Polychlorinated Dibenzodioxins and Dibenzofurans in Catfish and Crabs Along an Estuarine Salinity and Contamination Gradient
Authors: Dean Kirk E. , Suarez Monica P. , Rifai Hanadi S. , Palachek Randy M. , Koenig Larry
Published: July 2009

Elevated but variable levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDD/Fs) were observed in hardhead sea catfish (HH) and blue crabs (BCs), as well as in water and sediment, of the Houston Ship Channel system, Texas, USA. It is hypothesized that the variation was caused by the spatial variability of PCDD/F contamination, together with the natural mobility of organisms in satisfying prey, temperature, salinity, and reproductive requirements. Structural equation modeling was applied to explore the congener-specific relationships between PCDD/F levels in HH and BC tissues and independent predictors such as PCDD/F contamination levels, environmental factors such as salinity and temperature, temporal-spatial factors such as site depth and season, and biological factors such as length, weight, and lipid content. Contamination levels in both sediment and water were statistically significant predictors of the levels of less chlorinated congeners in both HH and BCs, with the standardized regression weight for sediment concentration roughly twice that for the water concentration. This implies that sediments are the dominant route for PCDD/F exposure and remediation efforts should focus on legacy sediment contamination. Tissue lipid content was a significant predictor of tissue concentrations in HH but only to a lesser extent in BCs, perhaps due to their low lipid content. Site depth and seasonal factors also were significant predictors of tissue concentrations. For the highly chlorinated congeners, only a small fraction of the variance in tissue concentrations was explained by the independent predictors, possibly indicating that uptake and elimination kinetics, biotransformation processes, or both may be more important factors controlling the bioaccumulation of those congeners.
Multiple stressor effects of methoprene, permethrin, and salinity on limb regeneration and molting in the mud fiddler crab (UCA pugnax)
Authors: Stueckle Todd A. , Shock Barbara , Foran Christy M.
Published: July 2009

Exposure to multiple stressors from natural and anthropogenic sources poses risk to sensitive crustacean growth and developmental processes. Applications of synthetic pyrethroids and insect growth regulators near shallow coastal waters may result in harmful mixture effects depending on the salinity regime. The potential for nonadditive effects of a permethrin (0.01–2 μg/L), methoprene (0.03–10 μg/L), and salinity (10–40 ppt) exposure on male and female Uca pugnax limb regeneration and molting processes was evaluated by employing a central composite rotatable design with multifactorial regression. Crabs underwent single-limb autotomy followed by a molting challenge under 1 of 16 different mixture treatments. During the exposure (21–66 d), individual limb growth, major molt stage duration, abnormal limb regeneration, and respiration were monitored. At 6 d postmolt, changes in body mass, carapace width, and body condition factor were evaluated. Dorsal carapace tissue was collected, and protein and chitin were extracted to determine the composition of newly synthesized exoskeleton. The present results suggest chronic, low-dose exposures to multiple pesticide stressors cause less-than-additive effects on U. pugnax growth processes. Under increasing concentrations of methoprene and permethrin, males had more protein in their exoskeletons and less gain in body mass, carapace width, and body condition compared to females. Females exhibited less gain in carapace width than controls in response to methoprene and permethrin. Females also displayed elevated respiration rates at all stages of molt, suggesting a high metabolic rate. Divergent growth and fitness between the sexes over the long term could influence crustacean population resilience.
A model predicting waterborne cadmium bioaccumulation in Gammarus pulex: The effects of dissolved organic ligands, calcium, and temperature
Authors: Pellet Bastien , Geffard Olivier , Lacour Céline , Kermoal Thomas , Gourlay-Francé Catherine , Tusseau-Vuillemin Marie-Hélène
Published: July 2009

Metal bioavailability depends on the presence of organic ligands in the water and on the concentrations of competitive cations. The present study aims at testing whether the diffusive gradient in thin films technique (DGT) could be used to take into account Cd speciation and its consequences on bioavailability in a bioaccumulation model and whether the influences of the Ca concentration and temperature also should be considered. Four kinetic experiments were conducted on Gammarus pulex: a calibration of Cd turnover rates and of the DGT lability in mineral water, a study of the influence of ethylenediaminetetraacetic acid (EDTA) and humic acids (HA) on uptake rates, and two experiments testing the influence of the Ca concentrations and temperature on Cd uptake clearance rates (ku). In mineral water, where Cd was considered fully labile, the ku was 0.46 L g−1 d−1, and the depuration rate was 0.032 d−1. The initial Cd influxes were lowered significantly by additions of 10 μg L−1 of EDTA or 10 mg L−1 of HA in the water but not at 5 mg L−1 HA, even if DGT measurements proved that Cd formed Cd–HA complexes in that treatment. Increasing Ca concentrations lowered ku values, and a competitive inhibition model between Ca and Cd fitted the data. A 30% enhancement of ku values was observed when the temperature was increased by 8°C, which appeared comparatively as a weak effect. Thus, taking into account the metal speciation and the influence of the Ca concentration should improve Cd bioaccumulation modeling in amphipods. In freshwater, where metal bioavailability is reduced by the presence of dissolved organic matter, forecasting Cd waterborne uptake using the labile concentrations should allow robust comparisons between laboratory and field studies.
Small but Different Effect of Fouling on the Uptake Rates of Semipermeable Membrane Devices and Polar Organic Chemical Integrative Samplers
Authors: Harman Christopher , Bøyum Olav , Thomas Kevin V. , Grung Merete
Published: July 2009

Semipermeable membrane devices (SPMD) and polar organic chemical integrative samplers (POCIS) were exposed to a cocktail of organic chemicals using a flow-through system. Samplers were removed and analyzed every 7 d over a four-week period in order to determine sampling rates (Rs) for individual compounds. Prior to laboratory exposure, half of the samplers were allowed to foul naturally for six weeks, in order to examine differences in uptake due to fouling. The amount of fouling ranged from 0.2 to 2.8 g dry weight/dm2 for POCIS and 0.1 to 1.4 g dry weight/dm2 for SPMDs, and the pattern of accumulation was also different between them. The Rs values were determined by fitting curves to time course uptake data and also by using performance reference compounds (PRCs) for SPMDs. Sampling rates ranged from 2.7 to 14.2 L/d for SPMDs and 0.01 to 0.27 L/d for POCIS. Fouled SPMDs showed a reduction in Rs (<20%) for all but one compound, and there was a similar reduction in the release of PRCs. However, PRC-predicted Rs values were overall somewhat higher than those from fitted curves. Uptake of alkylated phenols in POCIS was generally higher (up to 55%) in fouled samplers. The reason for this is not known, but is possibly due to some reduction in interactions with the membrane in fouled samplers. There was no overall pattern in the relationship of sampling rate differences with log KOW or over time for either sampler. Release of compounds from POCIS after a drop in exposure water concentrations provides some encouragement for the application of a PRC approach to polar passive samplers.
Metal Accumulation in Marine Bivalves Under Various Tributyltin Burdens
Authors: Tang Chuan-Ho , Lin Chan-Shing , Wang Wei-Hsien
Published: July 2009

In the present study, a field survey was conducted to measure the accumulation of butyltin, Cu, Zn, and Cd in green mussels (Perna viridis) and Pacific oysters (Crassostrea gigas) at the regions along a tributyltin pollution gradient. A negative correlation was found between the tributyltin/total butyltin ratio (0.87–0.31) and tributyltin content (114–5,817 ng/g as tin dry wt) in oysters, while the Cu content (44.2–381 mg/kg dry wt) was positively correlated with the logarithm of tributyltin content during the summer and winter. This suggests that as the tributyltin burden increases, the rates of tributyltin metabolism may be elevated, leading to enhanced Cu accumulation. A similar accumulation pattern for Zn was also found in oysters. In mussels, however, the tributyltin/total butyltin ratio and the Cu and Zn contents remained relatively constant (∼0.7, 12, and 100 mg/kg dry wt, respectively) regardless of the tributyltin burden. Clearly, the butyltin and Cu/Zn accumulation processes in oysters differ from those in mussels under tributyltin pollution. These observations provide valuable information for those who evaluate or compare tributyltin and/or Cu/Zn pollution using oysters and mussels as bioindicators.
Women's Preferences for Place of Delivery in Rural Tanzania: A Population-Based Discrete Choice Experiment
Authors: Kruk Margaret E. , Paczkowski Magdalena , Mbaruku Godfrey , de Pinho Helen , Galea Sandro
Published: July 2009

Objectives. We fielded a population-based discrete choice experiment (DCE) in rural western Tanzania, where only one third of women deliver children in a health facility, to evaluate health-system factors that influence women's delivery decisions.

Methods. Women were shown choice cards that described 2 hypothetical health centers by means of 6 attributes (distance, cost, type of provider, attitude of provider, drugs and equipment, free transport). The women were then asked to indicate which of the 2 facilities they would prefer to use for a future delivery. We used a hierarchical Bayes procedure to estimate individual and mean utility parameters.

Results. A total of 1203 women completed the DCE. The model showed good predictive validity for actual facility choice. The most important facility attributes were a respectful provider attitude and availability of drugs and medical equipment. Policy simulations suggested that if these attributes were improved at existing facilities, the proportion of women preferring facility delivery would rise from 43% to 88%.

Conclusions. In regions in which attended delivery rates are low despite availability of primary care facilities, policy experiments should test the effect of targeted quality improvements on facility use.
Estimate of Equation of State Uncertainty for Manometric Sorption Experiments: Case Study With Helium and Carbon Dioxide
Authors: van Hemert P.. , Rudolph E.S.J.. S.J. , Bruining J.. , Wolf K-H.A.A.. A.A.
Published: July 2009

The sorption of gases on coal is of great importance for the use of gas injection to enhance coalbed methane production. Furthermore, when injecting carbon dioxide (CO2), the project is eligible for carbon credits as the CO2 is sequestrated.

Accurate measurements of sorption at in-situ conditions have proven to be a complicated matter. Especially, the sorption of CO2, pure or in a mixture, are particularly sensitive to experimental errors, because common in-situ conditions of deep coalbeds are near the critical point of CO2. One source of uncertainty in sorption measurements is the accuracy with which gas densities have been determined. Accurate determinations of gas densities at in-situ conditions are complex and require the inclusion of specialized equipment. Therefore, gas densities are usually calculated from pressure and temperature measurements using an Equation of State (EoS). The accuracy of this EoS then influences the uncertainty in the sorption measurement. Therefore, it is essential that an EoS is used that is most accurate at the experimental conditions. However, there is generally little information available on the accuracy of an EoS for the conditions of interest. This is particularly true for the calculation of densities of mixtures with an EoS.

This paper describes an experimental method to estimate the accuracy of an EoS using a manometric sorption apparatus. This is demonstrated by using He and CO2 at 318.11 K and pressures between 0.1 and 17 MPa, which covers the range of interest for deep coalbeds.

The accuracies of the following EoSs have been estimated: Peng-Robinson with Stryjek-Vera modification for CO2; Peng-Robinson with an alpha parameter proposed by Twu in 1995 for He; multiparameter crossover equation of state by Sun, Kiselev, and Ely for CO2; modified Benedict-Webb-Rubin EoS by McCarty and Arp for He; and the reference EoS for CO2 by Span and Wagner.

The experimental method provides a lower limit estimate of the accuracy for an EoS. This estimate can be used as a first approximation of the EoS accuracy in the a priori error analysis of manometric sorption experiments.
Wellbore-Stability Performance of Water-Based Mud Additives
Authors: Ewy Russell T. , Morton E. Keith
Published: July 2009

A critical property for many water-based muds is the ability to prevent near-wellbore pore pressure increase in shales. By slowing or preventing this pressure increase, a true overbalance pressure is maintained, which promotes wellbore stability. Using a device that simulates downhole rock stress and overbalance fluid pressure conditions and using preserved shale samples, we tested four different muds containing different additives. Direct measurements of shale pore pressure vs. time were obtained, representing the pore pressure inside the wall of the wellbore. All muds slowed the loss of overbalance pressure compared to a base-case brine fluid, but two muds were very effective at slowing and/or preventing the loss of overbalance. One active mechanism appears to be an increase in the osmotic membrane efficiency, but permeability measurements conducted during these same tests show that physical plugging of the pore space is also an important mechanism for these two fluids. Measurements of fluid-induced swelling were also conducted in this same set of tests, and all four muds resulted in less swelling than the base-case brine. The most effective fluid was repeat tested using completely different shales; it again was found to be very effective at preventing near-wellbore pore pressure increase for one of the shales, but not for all shales.
Pseudoangiomatous Stromal Hyperplasia of the Breast in Pediatric Patients: An Underrecognized Entity
Authors: Shehata Bahig M. , Fishman Inessa , Collings Margaret H. , Wang Jenny , Poulik Janet M. , Ricketts Richard R. , Parker Paul M. , Heiss Kurt , Bhatia Amina M. , Worcester Heath D. , Gow Kenneth W.
Published: July 2009

Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion consisting of mammary stromal proliferation with anastomosing slits mimicking vascular spaces. Grossly, it most often resembles fibroadenoma, but may commonly be confused with angiosarcoma and other types of benign vascular proliferations. While PASH has been described in female and male adults since the mid-1980s, there have been only a few accounts in the pediatric population. We present a series of 12 pediatric patients with PASH, including a 3-year-old male, who we believe to be the youngest patient to present with this entity. In our study, PASH was found in 12% of tumors diagnosed preoperatively as fibroadenomas and in 12% of cases diagnosed preoperatively as gynecomastia. Our series documents that PASH is not uncommon in pediatric breast pathology and delineates important differences between adult and pediatric presentations of this entity.
Are we Practicing Evidenced Based Medicine for Common Paediatric Problems?
Authors: Sharma Pushpa Raj
Published: July 2009

doi: 10.3126/jnps.v29i2.2039J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.57-58
Maternal Risk Factors and Morbidity Pattern of Very Low Birth Weight Infants: A NICU Based Study at Eastern Nepal
Authors: Poudel Prakash , Budhathoki Sunil , Shrivastava Manoj Kumar
Published: July 2009

Background: Preterm deliveries of babies weighing less than 1500 grams (VLBW, very low birth weight) are of major concern because of maximum perinatal morbidity and mortality found in this group. VLBW babies overload the neonatal intensive care unit (NICU) and their mortality contributes significantly to neonatal and infant mortality. Objectives: To study the common maternal risk factors associated with VLBW births. To study the morbidity and mortality patterns of VLBW babies. Methods: This was a hospital based retrospective study done in NICU of BP Koirala Institute of Health Sciences. Data were collected from medical records of VLBW babies admitted in NICU over a period of three years (13 April 2005 to 12 April 2008). Data were analyzed with SPSS 10.0 software. Results: Data of 140 VLBW babies were analyzed. Mean birth weight was 1188.9 (±212.78), 10.7% were home deliveries, 24.3% were twins, 31.4% required active resuscitation at birth and 46.4% were exposed to antenatal steroid. Common maternal risk factors associated with premature deliveries were inadequate antenatal check up (ANC) visits (95.7%), twin pregnancy (24.3%), antepartum hemorrhage (APH, 28.6%), premature rupture of membrane (23.6%), pregnancy induced hypertension (12.9%), bad obstetric history (12.9%) and maternal age less than 20 years (8.6%). Common morbidities among VLBW babies were clinical sepsis (77.1%), non physiological hyperbilirubinemia (73.6%), apnea (48.6%), shock (42.9%), hypoglycemia(39.3%), anemia (29.3%), hyaline membrane disease (HMD, 21.4%), patent ductus arteriosus (15.0%), severe hypothermia (12.1%), culture proven sepsis (15.7%), retinopathy of prematurity (5.7%), and bronchopulmonary dysplasia (3.6%). Overall survival was 54.3% and major causes of death were HMD (51.0%) and sepsis (34.7%). Median durations of hospital stay were 17.5 days for survivors and five days for expired cases.Conclusion: Increasing the coverage of ANC visits, early diagnosis and treatment of APH and pregnancy induced hypertension, discouraging the childbirth at too young age, early diagnosis and treatment of acute infections and chronic medical diseases in mothers are important measures to decrease the burden of VLBW births. Common morbidities in VLBW babies are sepsis, HMD, apnea, hyperbilirubinemia, patent ductus arteriosus, shock, anemia, hypoglycemia, hypothermia and hypocalcemia. Common causes death of VLBW babies are HMD and sepsis. Overall survival of VLBW babies in our settings is less. More numbers of well equipped NICUs and services like surfactant therapy are needed to improve survival of VLBW infants in our set up. Key words: Maternal risk factors, Morbidity, Mortality, Very low birth weight.   doi: 10.3126/jnps.v29i2.2040 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.59-66
Study of Visceral Leishmaniasis (Kala-azar) in Children of Nepal
Authors: Joshi Durga Datt
Published: July 2009

Introduction: Visceral leishmaniasis (VL) or Kala-azar is a potentially fatal vector-borne (sand fly phlebotomies spp) zoonotic disease caused by a protozoan parasite, Leishmania donovani. In Nepal, the disease is restricted to the Eastern Terai region which lies adjacent to the Bihar state of India. Although leishmaniasis is regarded as a significant health problem in Nepal by the Ministry of Health, there is no active case detection programme in the country. Objective: Objectives of this study were to determine the up-to-date morbidity and mortality trend for VL in children of Nepal. Method: The epidemiological surveillance team from the NZFHRC visited to eight zonal hospitals in Terai region during the month from September to December of each year 2003 to 2007. The morbidity and mortality data up to the year 2007 were collected every year. The team has also collected 66 blood serum samples of which 18 samples from children were collected for the diagnosis. Results: A total 25890 cases with 599 deaths were reported during the year 1980-2006. The case fatality rate (CFR) varied from 0.23% to 13.2%. Districtwise analysis showed that, during 2003, highest incidence was in Mahottari district (184/100,000), followed by Sarlahi (100/100,000) and Sunsari (96/100,000). The highest CFR was in Dhanusha (2.9%) followed by Bara (2.4%) and Saptari (2.0%). Majority (70.9%) of persons affected by VL were aged 15 years and above, followed by 10-14 years (13.9%), 5-9 years (11.9%) and 1-4 years (3.3%). VL cases recorded from different district of Nepal for the year 2004, 2005, 2006 and 2007 are recorded. CFR for the year 2004, 2005, 2006 and 2007 were 3.2%, 3.7%, 16.67% and 11.42% respectively. Conclusions: There should be regular surveillance research work to be carried out in endemic area. Mass public health education, to make the people aware about preventive aspects of the disease is important. The possibility of the existence of animal reservoirs as zoonotic disease should also be considered. This disease is very much serious in children below 15 years of age both in male and female, therefore it is essential to have paediatrician post at least in all VL six endemic districts. Key words: Epidemiology, Leishmaniasis, Kala-azar, Sandfly   doi: 10.3126/jnps.v29i2.2041 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.67-73
Child Health Status of Nepal: Social Exclusion Perspective
Authors: Gurung Gagan
Published: July 2009

Introduction: Nepal has achieved a spectacular success in child health over the last decades but the achievement is not uniform across different social groups. Therefore, there is urgent need to identify the groups who are excluded from access of child health services which would give us population at risk to prioritize and utilize the scarce resources available in health sector more effectively and efficiently. Methods: The study was descriptive type and was based on review of secondary data of different studies done in past. The study used World Bank framework of dimension of exclusion to analyze social exclusion in child health in Nepal. The health differentials in child health across different social groups were analyzed using simple descriptive analysis like percentage and ratios. The trends of the child health disparities over the ten years were done comparing the data of NFHS1996 and NDHS 2006. Results: The study showed there were disparities in child health status by ethnicity, location, wealth status. In most of the cases, the trends of disparities are increasing for mortality indicators and malnutrition status. Interestingly, the gaps in accessibility indicators of child health services are becoming narrowed down. Conclusion: This study showed the discrepancies in child health status in different social groups. The inequality in childhood mortality and malnutrition are increasing over the period for different groups where as it is decreasing for accessibility indicators of childhood health services. Key words: Child health status, inequality, social exclusion, social groups.   doi: 10.3126/jnps.v29i2.2044 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.79-84
Japanese Encephalitis Vaccination in Children Population of Nepal During the year 2005, 2006 and 2008
Authors: Joshi Durga Datt
Published: July 2009

Japanese Encephalitis (JE) is caused by a Flavivirus that, in a proportion of human cases, causes severe encephalitis leading to death or sometimes permanent disablement. It is a zoonotic disease, transferred from animals (commonly pigs or wild birds) by a mosquito vector to humans. In Southeast Asia it is thought to cause up to 50000 clinical cases and 10000 deaths per year. JE vaccination programme was carried out in high risk districts of Nepal. Japanese encephalitis vaccination was carried out during the years 2005, 2006, 2008 and 2009. The data collected from primary and secondary sources from the District Health Offices and other concerned central offices of the Department of Health Services, was tabulated and analysed. Thirty-five lakh of JE vaccine doses was procured by the Ministry of Health during the year 2006/2007. This vaccine was used in children under 15 years of age of 12 districts of JE risk and high-risk areas of Nepal. It was found that during the year 2005; 85% children in Banke and 81% in Kailali were vaccinated against JE. In Kailali and Banke districts it was found to be about 103% coverage in children population targeted, in Dang district it was 100% coverage, and in Bardiya district it was 73% coverege but in Rupandehi and Kanchanpur districts it was only about 40% and 41% respectively. JE vaccine coverage was very low in two Rupandehi and Kanchanpur districts during 2005 and 2006 and very high coverage during the year 2008. JE vaccination coverage results for the year 2009 have not been made available yet due to unavailability of data. This type of mass vaccination campaign needs regularlity, mass awareness and health education programme should be carried out before JE vaccination campaign in the children in the future. Key words: Japanese Encephalitis, flavivirus, zoonotic, vector borne, lyophilized vaccine.   doi: 10.3126/jnps.v29i2.2045 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.85-91
Disappearing Bone Disease with Disappearing Spleen!
Authors: John BM , Singh Daljit
Published: July 2009

A 6-year-old girl who reported for pain abdomen was incidentally detected to have multiple osteolytic lesions on X-ray. She was diagnosed as a case of Gorham's disease following confirmation with histopathology and kept on close follow-up. She was admitted again after 2 years for fever and investigations revealed an absent spleen apart from multicentric osteolytic lesions. This is the first case reported of a child with Gorham's disease who has had an auto-splenectomy on follow-up. Key words: Gorham's disease (disappearing bone disease), osteolytic lesions, spleen.   doi: 10.3126/jnps.v29i2.2047 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.94-97
Parietal Epidural Dermoid Mimicking a Scalp Abscess in an Infant: Case Report
Authors: Roka Yam B , Bajracharya A , Shrestha K , Khaniya S
Published: July 2009

Scalp masses that involve the scalp or the cranium especially over the parietal bone are uncommon presentation in infants. We report a case of an 8-week old female child who presented with a left parietal scalp mass which had been progressively increasing since birth. CT scan revealed the mass extending into the cranium with underlying bone defect over the parietal area, with medial extension till the sagittal suture. Intraoperatively there was presence of thick white infected flaky material with small tufts of hair which was removed completely till the bone edges and from the epidural space. There was no recurrence postoperatively and the baby was discharged after a week of antibiotics. This case provides an example that simple looking scalp masses in infants and children should be managed with caution to prevent further morbidity. Key words: Dermoid, Scalp abscess   doi: 10.3126/jnps.v29i2.2048 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.98-100
Epistasis between IL1A, IL1B, TNF, HTR2A, 5-HTTLPR and TPH2 Variations Does Not Impact Alcohol Dependence Disorder Features
Authors: Drago Antonio , Liappas Ioannis , Petio Carmine , Albani Diego , Forloni Gianluigi , Malitas Petros , Piperi Christina , Politis Antonis , Tzavellas Elias O. , Zisaki Katerina K. , Prato Francesca , Batelli Sara , Polito Letizia , De Ronchi Diana , Paparrigopoulos Thomas , Kalofoutis Anastasios , Serretti Alessandro
Published: July 2009

We assessed a set of biological (HDL, LDL, SGOT,SGPT, GGT, HTc, Hb and T levels) and psychometric variables (investigated through HAM-D, HAM-A, GAS, Liebowitz Social Anxiety Scale, Mark & Mathews Scale, Leyton scale, and Pilowski scale) in a sample of 64 alcohol dependent patients, at baseline and after a detoxification treatment. Moreover, we recruited 47 non-consanguineous relatives who did not suffer alcohol related disorders and underwent the same tests. In both groups we genotyped 11 genetic variations (rs1800587; rs3087258; rs1799724; 5-HTTLPR; rs1386493; rs1386494; rs1487275; rs1843809; rs4570625; rs2129575; rs6313) located in genes whose impact on alcohol related behaviors and disorders has been hypothesized (IL1A, IL1B, TNF, 5-HTTLPR, TPH2 and HTR2A). We analyzed the epistasis of these genetic variations upon the biological and psychological dimensions in the cases and their relatives. Further on, we analyzed the effects of the combined genetic variations on the short – term detoxification treatment efficacy. Finally, being the only not yet investigated variation within this sample, we analyzed the impact of the rs6313 alone on baseline assessment and treatment efficacy. We detected the following results: the couple rs6313 + rs2129575 affected the Leyton -Trait at admission (p = 0.01) (obsessive-compulsive trait), whilst rs1800587 + 5-HTTLPR impacted the Pilowski test at admission (p = 0.01) (hypochondriac symptoms). These results did not survive Bonferroni correction (p ≤ 0.004). This lack of association may depend on the incomplete gene coverage or on the small sample size which limited the power of the study. On the other hand, it may reflect a substantial absence of relevance of the genotype variants toward the alcohol related investigated dimensions. Nonetheless, the marginal significance we detected could witness an informative correlation worth investigating in larger samples.
Prevalence of Alcohol Consumption and Hazardous Drinking, Tobacco and Drug Use in Urban Tanzania, and Their Associated Risk Factors
Authors: Mbatia Joseph , Jenkins Rachel , Singleton Nicola , White Bethany
Published: July 2009

Evidence suggests substance abuse in Tanzania is a growing public health problem. A random sample of 899 adults aged 15-59 in two urban sites of differing levels of poverty surveyed alcohol, tobacco and illicit substance use. Rates of substance use were 17.2%. 8.7% and 0.8% for alcohol, tobacco and cannabis, respectively. Living in the less affluent area was associated with higher lifetime rates of tobacco and alcohol use. Substance use is less prevalent in Tanzania than in richer countries, but lifetime consumption is higher in poorer areas. The association of substance use with a range of socio-economic factors warrants further research.
The Evaluation of the Possibilities of Using PLGA Co-Polymer and Its Composites with Carbon Fibers or Hydroxyapatite in the Bone Tissue Regeneration Process – in Vitro and in Vivo Examinations
Authors: Cieślik Magdalena , Mertas Anna , Morawska-Chochół Anna , Sabat Daniel , Orlicki Rajmund , Owczarek Aleksander , Król Wojciech , Cieślik Tadeusz
Published: July 2009

Synthetic polymers belonging to the aliphatic polyester group have become highly promising biomaterials for reconstructive medicine. The purpose of the present work is a biological evaluation of lactide-glycolide co-polymer (PLGA) and its composites with carbon fibers (PLGA+CF) or hydroxyapatite (PLGA+HA). The cytotoxicity of the evaluated materials towards hFOB 1.19 human osteoblast-like cells was assessed. Moreover, during the one-year contact of the assessed materials with living osseous tissue, the progress of bone formation was analyzed and the accompanying process of the materials’ degradation was evaluated. The materials under evaluation proved to be biocompatible.
Fuels for Thought!
Authors: Louime Clifford
Published: July 2009

When it comes to the marketing of the bioenergy brand, one of the catchiest slogans out these days is “25 by ‘25”. Adopted and supported by industries, academia and government agencies alike, this organization simply aims to supply 25 percent of our energy from renewable resources by the year 2025. By focusing its future efforts on wind, solar and biomass resources, the “25 by 25” initiative is expected to create new jobs, develop novel technologies, help mitigate the effects of global warming and reduce our dependence on fossil fuels. [...]
4,4’-[(2-Chlorophenyl)methylene]bis[1-phenyl-3-(trifluoromethyl)-1H-pyrazol-5-ol]
Authors: Guo Changbin , Holzer Wolfgang
Published: July 2009

The reaction of 1-phenyl-3-trifluoromethyl-2-pyrazolin-5-one and 2-chlorobenzaldehyde leads to the title compound, which results from addition of a second pyrazolone unit to the primarily formed 1:1 condensation product. Detailed spectroscopic data (1H NMR, 13C NMR, 19F NMR, IR, MS) are presented.
Extraction of Oil from Wheat Germ by Supercritical CO2
Authors: Piras Alessandra , Rosa Antonella , Falconieri Danilo , Porcedda Silvia , Dessì Maria. A. , Marongiu Bruno
Published: July 2009

This study examined the supercritical fluid extraction of wheat germ oil. The effects of pressure (200-300 bar at 40 °C) and extraction time on the oil quality/quantity were studied. A comparison was also made between the relative qualities of material obtained by SFE and by organic solvent extraction. The extracts were analyzed for α-tocopherol and polyunsaturated fatty acid content. The maximum wheat germ oil yield at about 9% was obtained with supercritical carbon dioxide extraction at 300 bar, while fatty acid and α-tocopherol composition of the extracts was not remarkable affected by either pressure or the extraction method.
Synthesis, Crystal Structure, and Kinetics of the Thermal Decomposition of the Nickel(II) Complex of the Schiff Base 2-[(4 Methylphenylimino)methyl]-6-methoxyphenol
Authors: Wang Yan-Fang , Liu Jian-Feng , Xian Hui-Duo , Zhao Guo-Liang
Published: July 2009

A new dinuclear complex, [Ni2(H2O)L4]·5H2O, consisting of chelating bidentate and bridging tridentate coordinated 2-[(4-methylphenylimino)methyl]-6-methoxyphenol (HL) Schiff base ligands and water molecules has been synthesized using a traditional method. The structure of this complex was characterized by FTIR and UV/Vis spectroscopy and thermogravimetric analyses (TG-DTG) and further confirmed by single-crystal X-ray diffraction. Its crystal structure is of monoclinic system, space group P21/c with a = 13.2837(5) Å, b = 27.3886(10) Å, c = 17.5415(6) Å, α = 90 º, β = 108.429(2) º, γ = 90 º, V = 6054.7(4) Å3, Z = 4. The crystal structure reveals that there is a Ni·Ni core, with a separation of 3.183 Å. Its thermal decomposition kinetics were also studied.
Calixpyrrole Derivatives: “Multi Hydrogen Bond” Catalysts for γ-Butenolide Synthesis
Authors: Cafeo Grazia , De Rosa Margherita , Kohnke Franz  H. , Soriente Annunziata , Talotta Carmen , Valenti Luca
Published: July 2009

Calix[4]pyrrole (1), calix[2]m-benzo[4]pyrrole (2), 10α,20β- and 10α,20α- bis(4-nitrophenyl)-calix[4]pyrroles 3 and 4, respectively, were found to exhibit various organocatalytic activities in the diastereoselective vinylogous addition reaction of 2-trimethylsilyloxyfuran (TMSOF, 7) to aldehydes. The γ-hydroxybutenolide products are obtained in fairly good yields and with moderate diastereoselectivity. The structures of the catalysts, as well as the reaction conditions, strongly influence the efficiency of the reaction.
Synthesis and Biological Activity of Some New 1,3,4-Thiadiazole and 1,2,4-Triazole Compounds Containing a Phenylalanine Moiety
Authors: Moise Mihaela , Sunel Valeriu , Profire Lenuta , Popa Marcel , Desbrieres Jacques , Peptu Cristian
Published: July 2009

New 1,3,4-thiadiazole, 6, 7 and 1,2,4-triazole derivatives, 8, 9 containing a phenylalanine moiety have been synthesized by intramolecular cyclization of 1,4-disubstituted thiosemicarbazides, 4, 5, in acid and alkaline media, respectively; the thiosemicarbazides were obtained by reaction of hydrazide 3 with appropriate aromatic isothiocyanates. The toxicity of the synthesized compounds was evaluated and the anti-inflammatory study of the triazole compound 9 established an appreciable anti-inflammatory activity that is comparable with that of other nonsteroidal anti-inflammatory agents.
A Highly Accurate Classification of TM Data through Correction of Atmospheric Effects
Authors: Elmahboub Widad , Scarpace Frank , Smith Bill
Published: July 2009

Atmospheric correction impacts on the accuracy of satellite image-based land cover classification are a growing concern among scientists. In this study, the principle objective was to enhance classification accuracy by minimizing contamination effects from aerosol scattering in Landsat TM images due to the variation in solar zenith angle corresponding to cloud-free earth targets. We have derived a mathematical model for aerosols to compute and subtract the aerosol scattering noise per pixel of different vegetation classes from TM images of Nicolet in north-eastern Wisconsin. An algorithm in C++ has been developed with iterations to simulate, model, and correct for the solar zenith angle influences on scattering. Results from a supervised classification with corrected TM images showed increased class accuracy for land cover types over uncorrected images. The overall accuracy of the supervised classification was improved substantially (between 13% and 18%). The z-score shows significant difference between the corrected data and the raw data (between 4.0 and 12.0). Therefore, the atmospheric correction was essential for enhancing the image classification.
Quantitative Analysis of Nucleic Acid Hybridization on Magnetic Particles and Quantum Dot-Based Probes
Authors: Lim Sun Hee , Bestvater Felix , Buchy Philippe , Mardy Sek , Yu Alexey Dan Chin
Published: July 2009

In the present study we describe sandwich design hybridization probes consisting of magnetic particles (MP) and quantum dots (QD) with target DNA, and their application in the detection of avian influenza virus (H5N1) sequences. Hybridization of 25-, 40-, and 100-mer target DNA with both probes was analyzed and quantified by flow cytometry and fluorescence microscopy on the scale of single particles. The following steps were used in the assay: (i) target selection by MP probes and (ii) target detection by QD probes. Hybridization efficiency between MP conjugated probes and target DNA hybrids was controlled by a fluorescent dye specific for nucleic acids. Fluorescence was detected by flow cytometry to distinguish differences in oligo sequences as short as 25-mer capturing in target DNA and by gel-electrophoresis in the case of QD probes. This report shows that effective manipulation and control of micro- and nanoparticles in hybridization assays is possible.