Psychiatric issues in the management of patients with multidrug-resistant tuberculosis.

Introduction: Psychiatric issues present a challenge in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs and psychosocial factors require aggressive management.

Setting: A community-based non-governmental health organization in Lima, Peru.

Characterization of the cofactor-independent phosphoglycerate mutase from Leishmania mexicana mexicana. Histidines that coordinate the two metal ions in the active site show different susceptibilities to irreversible chemical modification.

Phosphoglycerate mutase (PGAM) activity in promastigotes of the protozoan parasite Leishmania mexicana is found only in the cytosol. It corresponds to a cofactor-independent PGAM as it is not stimulated by 2,3-bisphosphoglycerate and is susceptible to EDTA and resistant to vanadate. We have cloned and sequenced the gene and developed a convenient bacterial expression system and a high-yield purification protocol.

Door-to-Balloon Delays with PCI in Acute Myocardial Infarction.

In the treatment of acute myocardial infarction (AMI), the length of time from symptom onset to revascularization is a crucial determinant of clinical outcomes such as mortality and reinfarction. Direct, or primary, percutaneous transluminal coronary angioplasty (PTCA) produces higher rates of infarct-related artery patency and improved clinical outcomes compared to thrombolytic therapy. However, primary PTCA is associated with an increased time interval from hospital arrival to revascularization, the so-called door-to-balloon time.

Adhesion and proliferation of human dermal fibroblasts on collagen matrix.

The purpose of this study was to evaluate adhesion and growth of human dermal fibroblasts on a 0.150 mm-thick matrix of reconstituted collagen isolated from horse tendon. Collagen was extracted and polymerized according to the standard procedures (Opocrin, Corlo, Modena, Italy).

Clinical and programmatic considerations in the treatment of MDR-TB in children: a series of 16 patients from Lima, Peru.

Setting: Since 2000, the directly observed treatment, short-course (DOTS) strategy has been expanded in several countries to include treatment of multidrug-resistant tuberculosis (MDR-TB). This strategy is known as DOTS-Plus. Tuberculosis is a common cause of morbidity and mortality for children throughout the developing world.

Expression, purification, crystallization and preliminary crystallographic analysis of Leishmania mexicana phosphoglycerate mutase.

Bacterially expressed 2,3-bisphosphoglycerate-independent phosphoglycerate mutase (iPGAM) from Leishmania mexicana with a six-His tag fused at its C-terminus was expressed from plasmid pET28a after IPTG induction in Escherichia coli cells and gave a yield of 20 mg of highly purified iPGAM per litre of cell culture. Crystals of the protein complexed with 3-phosphoglycerate were obtained by the hanging-drop method of vapour diffusion with PEG 4000 as the precipitating agent in the presence of cobalt chloride and diffracted synchrotron radiation to beyond 1.90 A.

[Moebius syndrome due to the use of misoprostol. Case report].

We report a patient affected with Moebius Syndrome (OMIM 157900) due to the use of misoprostol during the first trimester of the pregnancy, when abortion was intended twice using this drug, vias vaginal (600 mg) and oral (900 mg), with failure to induce abortion on both occasions. Since the use of misoprostol for abortion, without any medical indication or supervision, appears to be rather frequent in our population and since there are reports of severe malformations in children born after failed intents of abortion with this medication, it is necessary to alert the medical community and the population in general about the teratogenic risks of this drug.

Leishmania mexicana glycerol-3-phosphate dehydrogenase showed conformational changes upon binding a bi-substrate adduct.

Certain pathogenic trypanosomatids are highly dependent on glycolysis for ATP production, and hence their glycolytic enzymes, including glycerol-3-phosphate dehydrogenase (GPDH), are considered attractive drug targets. The ternary complex structure of Leishmania mexicana GPDH (LmGPDH) with dihydroxyacetone phosphate (DHAP) and NAD(+) was determined to 1.9A resolution as a further step towards understanding this enzyme's mode of action.

Safety and efficacy of tenecteplase in acute myocardial infarction.

The use of intravenous thrombolytic agents has revolutionised the treatment of acute myocardial infarction. However, the improved mortality achieved with these drugs is tempered by the risk of serious bleeding complications, especially intracranial haemorrhage (ICH). Tenecteplase (TNKase, Genetech Inc.

The role of the nurse in the community-based treatment of multidrug-resistant tuberculosis (MDR-TB).

Setting: A community-based treatment program for multidrug-resistant tuberculosis (MDR-TB) in Lima, Peru.

Objectives: To describe the activities carried out by the nurses working with the program.

Design: A qualitative study using a variety of ethnographic methods, including participant observation, focus groups, and key informant interviews over a 5-year period.

Treatment of multidrug-resistant tuberculosis during pregnancy: a report of 7 cases.

Multidrug-resistant tuberculosis (MDR-TB) is a global public health problem affecting women of childbearing age. Little is known, however, about the safety of the drugs used to treat MDR-TB during pregnancy. We describe 7 patients who were treated for MDR-TB during pregnancy.

DNA thermodynamic pressure: a potential contributor to genome evolution.

Codon usage bias is a feature of living organisms. The origin of this bias might be explained not only by external factors but also by the nature of the structure of deoxyribonucleic acid (DNA) itself. We have developed a point mutation simulation program of coding sequences, in which nucleotide replacement follows thermodynamic criteria.

Tuberculosis in Spain: epidemiological pattern and clinical practice.

Setting: Thirteen Autonomous Regions in Spain.

Objective: To study the incidence of all forms of tuberculosis (TB) and investigate clinical practice in TB.

Design: Cases of all forms of tuberculosis diagnosed in the study setting from May 1986 to April 1997 were identified though active search of different databases.

The European study of assisted reproduction families: the transition to adolescence.

Background: Findings are presented of the second phase of a European longitudinal study of families created by assisted reproduction. The present investigation reports on data obtained during the child's transition to adolescence.

Methods: A total of 102 IVF families, 94 donor insemination (DI) families, 102 adoptive families, and 102 families with a naturally conceived child were compared on standardized interview and questionnaire measures of parenting and children's psychological well-being.

Activity of cytisine and its brominated isosteres on recombinant human alpha7, alpha4beta2 and alpha4beta4 nicotinic acetylcholine receptors.

Effects of cytisine (cy), 3-bromocytisine (3-Br-cy), 5-bromocytisine (5-Br-cy) and 3,5-dibromocytisine (3,5-diBr-cy) on human (h) alpha7-, alpha4beta2- and alpha4beta4 nicotinic acetylcholine (nACh) receptors, expressed in Xenopus oocytes and cell lines, have been investigated. Cy and its bromo-isosteres fully inhibited binding of both [alpha-(125)I]bungarotoxin ([alpha-(125)I]BgTx) to halpha7- and [(3)H]cy to halpha4beta2- or halpha4beta4-nACh receptors. 3-Br-cy was the most potent inhibitor of both [alpha-(125)I]BgTx and [(3)H]cy binding.

[The hemangioma-sternum bifidum malformation syndrome. Report of a patient].

We present a male patient with a facial haemangioma extending from the lower left lid to the malar region and the upper left lip. The patient also presents a 1 cm round cutaneous notch on the upper third of the sternum. There are not other physical anomalies.

African-derived South American populations: A history of symmetrical and asymmetrical matings according to sex revealed by bi- and uni-parental genetic markers.

Estimates of African, European, and Amerindian contributions to the gene pool of 11 predominantly African-derived South American populations were obtained using five autosomal and one Y chromosome hypervariable loci, as well as mitochondrial DNA (sequences of the first hypervariable segment of the control region, plus two restriction sites and the presence or absence of the CoII/tRNA(Lys) intergenic 9-bp deletion). The three latter characteristics are reported here for the first time for 42 individuals living in three Brazilian populations. Thirty-eight sequences were identified in these persons; 17 (45%) could be classified as being of African, 4 (11%) of Amerindian, and 2 (5%) of European origin.

Morphological analysis of articular cartilage biopsies from a randomized, clinical study comparing the effects of 500-730 kDa sodium hyaluronate (Hyalgan) and methylprednisolone acetate on primary osteoarthritis of the knee.

Objective: Histomorphometric study on cartilage samples taken from osteoarthritic human knees before and 6 months after intraarticular injections of a specific fraction (500-730 kDa) of hyaluronan. The results obtained with hyaluronan were compared with the results of methylprednisolone acetate treatment.

Methods: Twenty-four subjects with primary osteoarthritis (OA) of the knee were considered.

[Trisomy 21. Report of 2 cases with unusual karyotypes].

We report two patients with trisomy 21 whose karyotypes revealed unusual translocations. In the first case there was a tandem translocation with two chromosomes 21 attached to the long arm of chromosome 10 (45,XX + tan(10:21;21). In the second case there was an inverted tandem translocation between two chromosomes 21 attached through their long arms (46,XY + dic(21q:21q).

Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis.

Objective: The study was part of a randomized open-label clinical trial designed to evaluate the effects of intra-articular injections of hyaluronan (Hyalgan) (HY) in osteoarthritis (OA) of the human knee. Data were compared with those obtained after treatment with methylprednisolone acetate (Depomedrol) (MP).

Methods: Synovial membranes from patients with OA of the knee, primary or secondary to a traumatic event and classified according to the American College of Rheumatology criteria, were examined by arthroscopy and by light and electron microscopy before and 6 months after local injection of HY (2 ml of 500-730 000 MW hyaluronan, 10 mg/ml in saline, one injection per week for 5 weeks) or MP (1 ml of methylprednisolone acetate, 40 mg/ml, one injection per week for 3 weeks).

Cell behaviour of Drosophila fat cadherin mutations in wing development.

We have studied several cell behaviour parameters of mutant alleles of fat (ft) in Drosophila imaginal wing disc development. Mutant imaginal discs continue growing in larvae delayed in pupariation and can reach sizes of several times those of wild-type. Their growth is, however, basically allometric.

[There should be freedom in nursing].

The title of this effort has reminded us of the Inconfidência Mineira, that had José Joaquim da Silva Xavier, the Tiradentes as its leader. It was a movement that longed for freedom, like nursing that, along the years, has been building its history and has been walking in search of its autonomy. This study has aims at investigating the ways nursing has gone through, while a science, it searches for its autonomy and mediates about nurse's performance while an autonomous and creative professional.

[Nursing attendants: why? How long?].

Qualification for nursing professionals is important for they deal with lives that need qualified care. This study aims at analysing health professionals opinions about nursing attendants. It was accomplished between March and July, 1997.

A comparison of colposcopy using optical and video colposcopes.

Objective: To compare the colposcopic adequacy, colposcopic impressions, histologic sampling intent, biopsy site location, procedural complications, and difficulty of colposcopic examinations using optical and video colposcopes.

Materials And Methods: Women and men presenting consecutively for colposcopy were examined independently by two colposcopists using alternately either an optical or video colposcope. Colposcopists individually recorded their exam adequacy, colposcopic impression, biopsy intent and site, procedural complications, and difficulty of examination.

The CaMV-35S promoter is sensitive to shortened photoperiod in transgenic tobacco.

 The CaMV-35S promoter is one the most widely used promoters in transgenic plant research because it exhibits a high level of transcriptional activity in a variety of plant tissues. Here, the CaMV-35S promoter fused to the GUS gene was used as a model for constitutive expression in transgenic Nicotiana tabacum (cv 'Xanthi') leaves. The transgenic plants were placed under a shortened photoperiod to determine if GUS expression changed; measurements were made using fluorometry and ribonuclease protection assays.