Green Synthesis of Er-Doped ZnO Nanoparticles: An Investigation on the Methylene Blue, Eosin, and Ibuprofen Removal by Photodegradation

We present a study on the green synthesis of undoped and Er-doped ZnO compounds using Mangifera indica gum (MI). A set of tests were conducted to assess the structure of the material. The tests included X-ray diffraction, Raman, and Fourier-transform infrared spectroscopy. Optical properties were studied using diffuse reflectance and photoluminescence. Morphological and textural investigations were done using SEM images and N2 adsorption/desorption. Furthermore, photocatalytic tests were performed with methylene blue (MB), yellow eosin (EY), and the pharmaceutical drug ibuprofen (IBU) under UV irradiation. The study demonstrated that replacing the stabilizing agent with Mangifera indica gum is an effective method for obtaining ZnO nanoparticles. Additionally, the energy gap of the nanoparticles exhibits a slight reduction in value. Photoluminescence studies showed the presence of zinc vacancies and other defects in both samples. In the photocatalytic test, the sample containing Er3+ exhibited a degradation of 99.7% for methylene blue, 81.2% for yellow eosin, and 52.3% for ibuprofen over 120 min. In the presence of methyl alcohol, the degradation of MB and EY dyes is 16.7% and 55.7%, respectively. This suggests that hydroxyl radicals are responsible for the direct degradation of both dyes. In addition, after the second reuse, the degradation rate for MB was 94.08%, and for EY, it was 82.35%. For the third reuse, the degradation rate for MB was 97.15%, and for EY, it was 17%. These results indicate the significant potential of the new semiconductor in environmental remediation applications from an ecological synthesis.

Facile Synthesis of Ni-Doped ZnO Nanoparticles Using Cashew Gum: Investigation of the Structural, Optical, and Photocatalytic Properties

This work adopted a green synthesis route using cashew tree gum as a mediating agent to obtain Ni-doped ZnO nanoparticles through the sol-gel method. Structural analysis confirmed the formation of the hexagonal wurtzite phase and distortions in the crystal lattice due to the inclusion of Ni cations, which increased the average crystallite size from 61.9 nm to 81.6 nm. These distortions resulted in the growth of point defects in the structure, which influenced the samples' optical properties, causing slight reductions in the band gaps and significant increases in the Urbach energy. The fitting of the photoluminescence spectra confirmed an increase in the concentration of zinc vacancy defects (VZn) and monovacancies (Vo) as Zn cations were replaced by Ni cations in the ZnO structure. The percentage of VZn defects for the pure compound was 11%, increasing to 40% and 47% for the samples doped with 1% and 3% of Ni cations, respectively. In contrast, the highest percentage of VO defects is recorded for the material with the lowest Ni ions concentration, comprising about 60%. The influence of dopant concentration was also reflected in the photocatalytic performance. Among the samples tested, the Zn0.99Ni0.01O compound presented the best result in MB degradation, reaching an efficiency of 98.4%. Thus, the recovered material underwent reuse tests, revealing an efficiency of 98.2% in dye degradation, confirming the stability of the photocatalyst. Furthermore, the use of different inhibitors indicated that •OH radicals are the main ones involved in removing the pollutant. This work is valuable because it presents an ecological synthesis using cashew gum, a natural polysaccharide that has been little explored in the literature.

External causes in women assisted by the Mobile Emergency Service - SAMU, in Espírito Santo, Brazil

Background

External causes are events that lead to traumas, injuries and any health problems, whether deliberate or not, with sudden onset and with immediate consequence, which may or may not lead to death or incapacitating injuries. Studies show that the main causes of death of women in fertile period are external causes, and they associate this fact with the change in habits and lifestyle adopted by this group in modern times that make them more vulnerable to the risks of becoming ill or dying from such causes. The objective of this study is precisely to analyze the prevalence of the main external causes in women assisted by SAMU 192 in Espírito Santo, Brazil, and in this way, assist in the development of accident and violence prevention strategies and also contribute to the scientific society through the description of the profile epidemiological profile of these events.

Methods

This is a cross-sectional study of primary care provided by SAMU 192, in the state of Espírito Santo, in 2015, in which only women victims of traffic accidents, aggression or falls were selected.

Results

Among the women assisted by SAMU 192, 23.5% were victims of accidents and violence. Of this total, 48.6% received assistance for falls, 46.6% for traffic accidents and 4.9% for aggression. Adulthood was the most frequent, with an average age of 44.9 ± 22.7 years.

Conclusions

External causes involving women represent a major problem in Brazil and worldwide. In Espírito Santo, falling was the most common type of external cause and mainly affected the elderly woman, while the traffic accident mainly affected the adult woman. As for the aggressions, these occurred mainly at night with association with the use of alcoholic beverages. Thus, it is immensely necessary to develop actions to promote and prevent external causes of harm to women's health in the state of Espírito Santo.

Key messages

Knowing what affects the most women's health in an emerging country like Brazil, is essential for public policy actions aimed at reducing the femininity, sexism and the death of women in general. Violence against women is an underreported event because of several factors, leading to the concealment of violence, emphasizing once again the importance of public policies for this purpose.

Prevalence of fasciolosis in slaughtered dairy cattle from São Miguel Island, Azores, Portugal

Fasciolosis, caused by the trematode Fasciola hepatica, is considered one of the most important parasitosis in dairy cattle due to significant economic losses. The main objectives of this study were to determine the prevalence of fasciolosis in dairy cattle slaughtered at São Miguel Island (SMI) slaughterhouse and to ascertain areas (parishes and dairy herds), within the island, with highest risk for fasciolosis. The association among cattle age and weight with the occurrence of fasciolosis was also determined. From a sample of 24,389 cattle slaughtered in two years (2015-2016), a total of 1134 dairy cattle livers were inspected and, during this period, 531 were positive to fasciolosis and 603 presented no typical fasciolosis lesions. This study showed that fasciolosis has a broad geographical distribution on SMI and that is also found in cattle from other islands of the Azores archipelago, namely Flores Island. Although there were no significant differences in weight between healthy animals and parasitized ones, we observed that the older animals present a greater level of liver lesions and a higher level of parasitization, reflecting their longer period of exposure to the risk factor (ingestion of metacercariae in pastures infested by Galba truncatula).

Effects of Lippia sidoides essential oil, thymol, p-cymene, myrcene and caryophyllene on rat sciatic nerve excitability

Lippia sidoides Cham is a typical herb species of Northeast Brazil with widespread use in folk medicine. The major constituents of the essential oil of L. sidoides (EOLs) are thymol, p-cymene, myrcene, and caryophyllene. Several studies have shown that the EOLs and its constituents have pharmacological effects, including antibacterial, anti-inflammatory, antioxidant and neuroprotective activity. Therefore, this work aimed to investigate the effects of the EOLs and their main constituents on rat sciatic nerve excitability. The sciatic nerves of adult Wistar rats were dissected and mounted in a moist chamber. Nerves were stimulated by square wave pulses, with an amplitude of 40 V, duration of 100 μs to 0.2 Hz. Both EOLs and thymol inhibited compound action potential (CAP) in a concentration-dependent manner. Half maximal inhibitory concentration for CAP peak-to-peak amplitude blockade were 67.85 and 40 µg/mL for EOLs and thymol, respectively. CAP peak-to-peak amplitude was significantly reduced by concentrations ≥60 µg/mL for EOLs and ≥30 µg/mL for thymol. EOLs and thymol in the concentration of 60 µg/mL significantly increased chronaxie and rheobase. The conduction velocities of 1st and 2nd CAP components were also concentration-dependently reduced by EOLs and thymol in the range of 30-100 µg/mL. Differently from EOLs and thymol, p-cymene, myrcene and caryophyllene did not reduce CAP in the higher concentrations of 10 mM. These data demonstrated that EOLs and thymol inhibited neuronal excitability and were promising agents for the development of new drugs for therapeutic use.

In-Lab Upfront Use of Tirofiban May Reduce the Occurrence of No-Reflow During Primary Percutaneous Coronary Intervention. A Pilot Randomized Study

Background

Despite successful opening of culprit coronary artery, myocardial reperfusion does not always follows primary percutaneous coronary intervention (PPCI). Glycoprotein IIb/IIIa inhibitors are used in the treatment of no-reflow (NR), but their role to prevent it is unproven.

Objective

To evaluate the effect of in-lab administration of tirofiban on the incidence of NR in ST-elevation myocardial infarction (STEMI) treated with PPCI.

Methods

STEMI patients treated with PPCI were randomized (24 tirofiban and 34 placebo) in this double-blinded study to assess the impact of intravenous tirofiban on the incidence of NR after PPCI according to angiographic and electrocardiographic methods. End-points of the study were: TIMI-epicardial flow grade; myocardial blush grade (MBG); resolution of ST-elevation < 70% (RST < 70%) at 90min and 24h after PPCI.

Results

Baseline anthropometric, clinical and angiographic characteristics were balanced between the groups. The occurrence of TIMI flow < 3 was not significantly different between the tirofiban (25%) and placebo (35.3%) groups. MBG ≤ 2 did not occur in the tirofiban group, and was seen in 11.7% of patients in the placebo group (p=0.13). RST < 70% occurred in 41.6% x 55.8% (p=0.42) at 90min and in 29% x 55.9% (p=0.06) at 24h in tirofiban and placebo groups, respectively. Severe NR (RST ≤ 30%) was detected in 0% x 26.5% (p=0.01) at 90 min, and in 4.2% x 23.5% (p=0.06) at 24h in tirofiban and placebo groups, respectively.

Conclusion

This pilot study showed a trend toward reduction of NR associated with in-lab upfront use of tirofiban in STEMI patients treated with PPCI and paves the way for a full-scale study testing this hypothesis.

About the in vivo quantitation of skin anisotropy

BACKGROUND/PURPOSE

Human skin anisotropy is difficult to quantify. The Cutiscan^® , is allegedly, the first biometrical system to provide information on the elastic and viscoelastic properties, as well as on anisotropy and directionality of the human skin in vivo. Thus, this study aims to contribute to characterize this new device and its applicability, and to compare its behavior with two other well-known devices-the Cutometer^® and the Reviscometer^® .

METHODS

Measurements were conducted with each device in three different anatomical sites (forehead, forearm and leg) of 20 female volunteers engaged after informed consent. The participants in the study were aged 19-73 years (mean age 37 ± 18.7 years old), and were divided in two groups (n = 10), based on their age - Group I, mean age 22 ± 1.3 years; Group II, mean age 52 ± 13.7 years.

RESULTS

All devices were useful tools to explore the anatomical and the age dependant changes in biomechanical terms, showing different discriminative capacities. Interesting correlations were established between the variables provided by the equipment.

CONCLUSION

The Cutiscan^® descriptors delivered excellent relationships with those from Cutometer^® and Reviscometer^® , while providing more detailed information about skin anisotropy through a full 360° analysis.

Essential oil of Lippia alba and its main constituent citral block the excitability of rat sciatic nerves

Lippia alba is empirically used for infusions, teas, macerates, and hydroalcoholic extracts because of its antispasmodic, analgesic, sedative, and anxiolytic effects. Citral is a mixture of trans-geranial and cis-neral and is the main constituent of L. alba essential oil and possesses analgesic, anxiolytic, anticonvulsant, and sedative effects. The present study evaluated the effects of the essential oil of L. alba (EOLa) and citral on compound action potentials (CAPs) in Wistar rat sciatic nerves. Both drugs inhibited CAP in a concentration-dependent manner. The calculated half-maximal inhibitory concentrations (IC₅₀) of peak-to-peak amplitude were 53.2 µg/mL and 35.00 µg/mL (or 230 µM) for EOLa and citral, respectively. Peak-to-peak amplitude of the CAP was significantly reduced by 30 µg/mL EOLa and 10 µg/mL citral. EOLa and citral (at 60 and 30 µg/mL, values close to their respective IC₅₀ for CAP blockade) significantly increased chronaxy and rheobase. The conduction velocity of the first and second CAP components was statistically reduced to ∼86% of control with 10 µg/mL EOLa and ∼90% of control with 3 µg/mL citral. This study showed that EOLa inhibited nerve excitability and this effect can be explained by the presence of citral in its composition. Both EOLa and citral showed inhibitory actions at lower concentrations compared with other essential oils and constituents with local anesthetic activity. In conclusion, these data demonstrate that EOLa and citral are promising agents in the development of new drugs with local anesthetic activity.

Limb immobilization alters functional electrophysiological parameters of sciatic nerve

Immobilization, used in clinical practice to treat traumatologic problems, causes changes in muscle, but it is not known whether changes also occur in nerves. We investigated the effects of immobilization on excitability and compound action potential (CAP) and the ultrastructure of the rat sciatic nerve. Fourteen days after immobilization of the right leg of adult male Wistar rats (n=34), animals were killed and the right sciatic nerve was dissected and mounted in a moist chamber. Nerves were stimulated at a baseline frequency of 0.2 Hz and tested for 2 min at 20, 50, and 100 Hz. Immobilization altered nerve excitability. Rheobase and chronaxy changed from 3.13±0.05 V and 52.31±1.95 µs (control group, n=13) to 2.84±0.06 V and 59.71±2.79 µs (immobilized group, n=15), respectively. Immobilization altered the amplitude of CAP waves and decreased the conduction velocity of the first CAP wave (from 93.63±7.49 to 79.14±5.59 m/s) but not of the second wave. Transmission electron microscopy showed fragmentation of the myelin sheath of the sciatic nerve of immobilized limbs and degeneration of the axon. In conclusion, we demonstrated that long-lasting leg immobilization can induce alterations in nerve function.

Removal of phosphorus from wastewaters by biomass ashes

Removal batch assays of phosphates from a synthetic wastewater (SWW) and a pulp and paper mill wastewater (PPWW) with two forestry biomass ashes were performed. The supernatants were not only chemically characterized but also the ecotoxicity was determined using two organisms: Vibrio fischeri and Artemia franciscana. The addition of fly ash and bottom ash to the SWW in solid/liquid (S/L) ratios of 3.35 and 9.05 g L(-1), respectively, achieved removal percentages of phosphates >97% for both ashes. The addition of fly ash and bottom ash to the PPWW in S/L ratios of 34.45 and 46.59 g L(-1), respectively, yield removal percentages of phosphates >90% for both ashes. According to the results of the Langmuir and Freundlich isotherms, the removal of phosphates from the SWW was mainly explained by surface removal mechanisms, while the removal from the PPWW was partially explained by multi-layer mechanisms. The supernatants resulting from the treatment of SWW and PPWW with both biomass ashes did not present acute ecotoxicity.

Characterization of chars produced in the co-pyrolysis of different wastes: decontamination study

The present work is devoted to the study of the decontamination of chars obtained in the co-pyrolysis of plastics, biomass and tyre wastes. The chars were extracted with several organic solvents of different polarities either individually or in sequence. The ability of each selected extractant to remove toxic pollutants was evaluated by comparing the extraction yields and by characterizing the crude extracts with a combination of chemical analysis and toxicity bioassays. Also, the mineral composition of the treated and non-treated chars was assessed. The results obtained in this study indicate that hexane is the more efficient extraction solvent to be used in the organic decontamination of chars obtained in the co-pyrolysis of plastics, tyres and biomass. A sequential extraction with solvents of increasing polarity can provide a better decontamination of the raw pyrolysis char than any individual extraction. The compounds removed from the char during the decontamination process are mainly aliphatic hydrocarbons and aromatic hydrocarbons, therefore a material that may be upgraded to be used as a fuel and/or as raw material for the organic chemical industry.

Toxicity of char residues produced in the co-pyrolysis of different wastes

Char residues produced in the co-pyrolysis of different wastes (plastics, pine biomass and used tyres) were characterized using chemical and toxicity assays. One part of the solid chars was submitted to extraction with dichloromethane (DCM) in order to reduce the toxicity of the char residues by removing organic contaminants. The different volatility fractions present in the extracted char (Char A) and in the raw char (Char B) were determined by progressive weight loss combustion. A selected group of heavy metals (Cd, Pb, Zn, Cu, Hg and As) was determined in both chars. The chars were subjected to the leaching test ISO/TS 21268 - 2, 2007 and the resulting eluates were further characterized by determining a group of inorganic parameters (pH, conductivity, Cd, Pb, Zn, Cu, Hg and As contents) and the concentrations of several organic contaminants (volatile aromatic hydrocarbons and alkyl phenols). An ecotoxicological characterization was also performed by using the bio-indicator Vibrio fischeri. The chemical and ecotoxicological results were analyzed according to the Council Decision 2003/33/CE and the criteria on the evaluation methods of waste ecotoxicity (CEMWE). The results obtained in this work indicated that the extraction with DCM is an effective method for the removal of organic contaminants of high to medium volatility from pyrolysis solid residues, thus decreasing their toxicity potential. Zn can be leached from the chars even after the DCM extraction treatment and can contribute to the ecotoxicity of the eluates obtained from chars. Both chars (treated and non treated with DCM) were classified as hazardous and ecotoxic wastes.

Chemical and ecotoxicological characterization of solid residues produced during the co-pyrolysis of plastics and pine biomass

A mixture of 70% (w/w) pine biomass and 30% (w/w) plastics (mixture of polypropylene, polyethylene, and polystyrene) was subjected to pyrolysis at 400 degrees C, for 15 min, with an initial pressure of 40 MPa. Part of the solid residue produced was subjected to extraction with dichloromethane (DCM). The extracted residue (residue A) and raw residue (residue B) were analyzed by weight loss combustion and submitted to the leaching test ISO/TS 21268-2 using two different leachants: DCM (0.2%, v/v) and calcium chloride (0.001 mol/L). The concentrations of the heavy metals Cd, Cr, Ni, Zn, Pb and Cu were determined in the eluates and in the two residues. The eluates were further characterized by determining their pH and the concentrations of benzene, toluene, ethylbenzene and xylenes (BTEX). The presence of other organic contaminants in the eluates was qualitatively evaluated by gas chromatography, coupled with mass spectrometry. An ecotoxicological characterization was also performed by using the bio-indicator Vibrio fischeri. The chemical and ecotoxicological results were analyzed according to the French proposal of Criteria on the Evaluation Methods of Waste Ecotoxicity (CEMWE). Residue A was not considered to be ecotoxic by the ecotoxicological criterion (EC(50) (30 min) >or=10%), but it was considered to be ecotoxic by the chemical criterion (Ni>or=0.5mg/L). Residue B was considered to be ecotoxic by the ecotoxicological criterion: EC(50) (30 min)<or=10%. Besides that, residue B was considered to be hazardous according the European legislation (BTEX concentrations higher than 100 ppb). The results indicate that volatile organic contaminants can be present in sufficient amounts in these residues and their eluates to induce ecotoxicity levels. The extraction of the pyrolysis residue with DCM was an efficient method for removing lighter organic contaminants.

Determination of aromatic compounds in eluates of pyrolysis solid residues using HS-GC-MS and DLLME-GC-MS

A method for the determination of 15 aromatic hydrocarbons in eluates from solid residues produced during the co-pyrolysis of plastics and pine biomass was developed. In a first step, several sampling techniques (headspace solid phase microextraction (HS-SPME), static headspace sampling (HS), and dispersive liquid-liquid microextraction (DLLME) were compared in order to evaluate their sensitivity towards these analytes. HS-SPME and HS sampling had the better performance, but DLLME was itself as a technique able to extract volatiles with a significant enrichment factor. HS sampling coupled with GC-MS was chosen for method validation for the analytes tested. Calibration curves were constructed for each analyte with correlation coefficients higher than 0.999. The limits of detection were in the range of 0.66-37.85 ng/L. The precision of the HS method was evaluated and good repeatability was achieved with relative standard deviations of 4.8-13.2%. The recoveries of the analytes were evaluated by analysing fortified real eluate samples and were in the range of 60.6-113.9%. The validated method was applied in real eluate samples. Benzene, toluene, ethylbenzene and xylenes (BTEX) were the compounds in higher concentrations. The DLLME technique coupled with GC-MS was used to investigate the presence of less volatile contaminants in eluate samples. This analysis revealed the presence of significant amounts of alkyl phenols and other aromatic compounds with appreciable water solubility.

Manual asymmetry in a complex coincidence-anticipation task: handedness and gender effects

This study investigated the effects of handedness and gender on manual asymmetry in the performance of a complex coincidence-anticipation task. Left-handed (N=63) and right-handed (N=93) undergraduate students (78 males, 78 females) were required to press six buttons sequentially in conjunction with visual stimulation provided by a coincidence-anticipation apparatus. Participants were further separated into subgroups based on the degree of hand preference. Timing accuracy (AE, CE, VE) and timing response (IT, MT, AT) were analysed. Results showed that, concerning accuracy, (i) strong left-handers were more accurate than the other groups; (ii) performance with the preferred hand was superior to that of the non-preferred hand; and (iii) males outperformed females. Concerning timing response, (i) the preferred hand was faster than the non-preferred hand for movement time and (ii) males were faster in initiating the movement than females. These findings indicate that coincidence-anticipation competence appears to be influenced by hand preference, performing hand, and gender. In addition, findings are discussed in the framework of the hemispheric functional lateralisation for the planning and organisation of movement execution.

Influence of clay incorporation on the physical properties of polyethylene/Brazilian clay nanocomposites

High density polyethylene/Brazilian clay nanocomposites were prepared by the melt intercalation technique. A montmorillonite sample from Boa Vista/PB, Northeast of Brazil, was organically modified with esthearildimethylammonium chloride (Praepagen WB) quaternary ammonium salt. The unmodified and modified clays with the quaternary ammonium salt were introduced in 1, 2, 3 and 5 wt% in a PE polymer matrix. The dispersion analysis and the interlayer distance of the clay particles were obtained by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The mechanical properties of tensile and the flammability of the nanocomposites were studied. In general, the mechanical properties of the systems presented superior values compared to the matrix. The systems showed a reduction on the burning rate, indicating that the flammability resistance of nanocomposites was improved.

Chemical and ecotoxicological characterization of ashes obtained from sewage sludge combustion in a fluidised-bed reactor

In 1999, the DEECA/INETI and the UBiA/FCT/UNL started a researching project on the partition of heavy metals during the combustion of stabilised sewage sludge (Biogran), in a fluidised-bed reactor, and on the quality of the bottom ashes and fly ashes produced. This project was entitled Bimetal and was funded by the Portuguese Foundation for Science and Technology. In this paper only the results on the combustion of Biogran are reported. The combustion process was performed in two different trials, in which different amounts of sewage sludge and time of combustion were applied. Several ash samples were collected from the bed (bottom ashes) and from two cyclones (first cyclone and second cyclone ashes). Sewage sludge, bed material (sand) and ash samples were submitted to the leaching process defined in the European leaching standard EN 12457-2. The eluates were characterized for a set of inorganic chemical species. The ecotoxicological levels of the eluates were determined for two biological indicators (Vibrio fischeri and Daphnia magna). The results were compared with the limit values of the CEMWE French Regulation. The samples were also ranked according to an index based on the chemical characterization of the eluates. It was observed an increase of the concentration of metals along the combustion system. The ashes trapped in the second cyclone, for both combustion trials, showed the highest concentration of metals in the eluates. Chemically, the ashes of the second cyclone were the most different ones. In the ecotoxicological point of view, the ecotoxicity levels of the eluates of the ashes, for both combustion cycles, did not follow the same pattern as observed for the chemical characterization. The ashes of the first cyclone showed the highest ecotoxicity levels for V. fischeri and D. magna. This difference on chemical and ecotoxicological results proves the need for performing both chemical and ecotoxicological characterizations of the sub-products of such type of thermal processes.

Bleeding patterns of women using extended regimens of the contraceptive vaginal ring

INTRODUCTION

This prospective observational study evaluated the bleeding patterns of women using a vaginal ring releasing 120 microg of etonogestrel and 15 microg of ethinyl estradiol daily, over a continuous period of 84 days followed by 7 ring-free days.

METHODS

The study enrolled 75 volunteers aged 18 to 37 years. Sixty-two (82.8%) recorded their menstrual cycles during 1 year.

RESULTS

At the end of the study, 85.5% had adequate menstrual patterns (two to four bleeding episodes, none lasting 10 days or more, with a range of bleeding-free intervals not exceeding 17 days), 9.7% had infrequent bleeding, 1.6% reported prolonged bleeding episodes, 1.6% had frequent bleeding and 1.6% had irregular bleeding.

CONCLUSION

Only 5 of the initial 75 patients discontinued the method due to bleeding. Among these 75 women, dissatisfaction with bleeding patterns was not a frequent reason given for discontinuation of the contraceptive vaginal ring.

Correction of long term joint contractures of the hand by distraction. A case report

Joint contractures are a common complication of hand trauma. The conventional treatment consists of arthrolysis, tenolysis and occasionally arthrodesis. Frequently, this does not achieve a good result, particularly when there has been a long delay in presentation. Progressive lengthening of a joint by distraction (joint distraction) allows the release of joint contractures even in cases of failure of traditional methods. We present a case of a delayed (20 years) work related traumatic flexion deformity of the PIP joint of the left index and middle fingers. This was the result of a complete division of both flexor tendons of both fingers. The range of movements, both active and passive, was limited to 90/100 degrees in the index finger and 95/100 degrees in the middle finger. Following joint distraction using our lengthening device (Antãotrade mark, Portugal) the patient was able to achieve an active and passive range of movements of 10/100 degrees for the PIP joint of the index finger and 40/100 degrees of the middle. This clinical case shows the simplicity and application of our technique for the correction of joint contractures.

A pilot study to evaluate the safety and feasibility of the administration of AZT/3TC fixed dose combination to HIV infected pregnant women and their infants in Rio de Janeiro, Brazil

OBJECTIVES

To evaluate the safety and feasibility of zidovudine and lamivudine (AZT/3TC) given to HIV infected pregnant women and their infants in Rio de Janeiro, Brazil.

METHODS

This open label phase II study enrolled 40 HIV infected antiretroviral naive women >or=20 weeks gestation, CD4 <500 cells x10(6)/l, from two public hospitals.

TREATMENT

fixed dose AZT 300 mg/3TC 150 mg by mouth every 12 hours until labour; AZT 300 mg by mouth every 3 hours until delivery; infants: AZT 4 mg/kg every 12 hours plus 3TC 2 mg/kg every 12 hours for 6 weeks. Blood haematology and chemistry were monitored; adherence evaluated by pills count; efficacy measured by changes in lymphocyte (CD4) and viral load, and by HIV RNA-PCR tests performed at birth, 6 and 12 weeks, to diagnose infant infection. No women breast fed.

RESULTS

PATIENT CHARACTERISTICS

mean age 24.48 (SD 3.5) years; gestational age 24.5 (4.5) weeks; AZT/3TC duration 14.4 (4.4) weeks; vaginal delivery: 11/39; caesarean section: 28/39. Entry and pre-labour CD4: 310/486 cells x10(6)/l (p<0.001); entry and pre-labour viral load: 53 818/2616 copies/ml (p<0.001). Thirty nine women tolerated treatment with >80% adherence; one was lost to follow up. Five newborns were excluded from 3TC receipt. All 39 babies were uninfected. Haematological toxicity in newborns was common: anaemia in 27; neutropenia in five (two severe); platelets counts <100000 in two. All values recovered on study completion.

CONCLUSIONS

Fixed dose AZT/3TC is well accepted, gives improvements in CD4 and viral load; no infants were HIV infected. Haematological toxicity in infants needs careful monitoring.

Ecotoxicological assessment of leachates from MSWI bottom ashes

In this paper, chemical and ecotoxicological data of leachates from bottom ashes collected in different Municipal Solid Waste Incinerators (MSWI) are shown. The bottom ashes were collected in Belgium (three incinerators--samples B1 to B3), France, Germany, Italy and United Kingdom (one incinerator in each country--samples F1, D1, I1 and UK1, respectively). Both chemical and ecotoxicological characterizations of leachates were done on the framework of the European Directive 91/689/EEC and the European Council Decision 94/904/EC. This work was carried out under the European project called Valomat, which was supported by the European Commission through Brite-Euram III program. Twenty-one inorganic parameters were analyzed. The ecotoxicological assays were done under standard laboratory conditions, using the bacterium Photobacterium phosphoreum, the freshwater alga Pseudokirchneriella subcapitata, the crustacean Daphnia magna and the vegetable Lactuca sativa. Chemical data varied from sample to sample. Similar results were obtained in biological assays. The samples can be classified as ecotoxic/hazardous according to the French proposal for a Criterion and Evaluation Methods of Waste Ecotoxicity (CEMWE) and the German regulation on Hazardous Waste Classification (HWC). However, samples B1, B2, B3 and D1 comply the maximum limits for direct valorization category defined in the French Classification of Bottom Ashes based on their Polluting Potential (CBAPP). Sample B1 presented the lowest level of ecotoxicity, being considered as the most interesting to be used in the development of new materials for civil engineering works.

Assessment of a rapid HIV test strategy during labor: a pilot study from Rio de Janeiro, Brazil

OBJECTIVES

To use two rapid human immunodeficiency virus (HIV) tests at labor, measure test acceptance and performance, and measure HIV prevalence in these women.

METHODS

Between February and October 2000, two rapid tests (Determine; Abbott, Chicago, IL, U.S.A. and Double Check; Orgenics, Yavne, Israel) were used in three public maternities in Rio de Janeiro, Brazil. Enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) analysis confirmed positive and discordant results.

RESULTS

Of the 858 patients who were enrolled, the mean gestational age was 36 weeks (median = 39, mode = 40) and 17 (2%) refused testing. Of the 841 patients tested, 13 were positive by both tests, which represents a 1.5% prevalence (95% confidence interval: 0.7%-2.3%); all were confirmed by ELISA and WB analysis. Seven samples gave discordant results by the rapid tests; of these, six were ELISA-negative/WB-negative and one was ELISA-negative/WB-indeterminate. The positive predictive value for samples that were positive by both rapid tests simultaneously was 100%.

CONCLUSIONS

Two rapid HIV tests used at labor were well accepted (98%). When the combined results of the two rapid tests (but not a single rapid test) were analyzed, this strategy was as efficient as the standard ELISA and WB HIV strategy for correctly classifying individuals.

Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure

BACKGROUND

The cardiopulmonary effects of the combination of abdominal and thoracic pressures in humans have not been well delineated.

OBJECTIVE

To study the cardiopulmonary effects of 15 mm Hg of intra-abdominal pressure in the presence and absence of 10 cm H20 of positive end-expiratory pressure (PEEP).

DESIGN

Prospective.

SETTING

University hospital.

METHODS

Nine patients undergoing laparoscopic cholecystectomy had pulmonary compliance, cardiac output, exhaled carbon dioxide, and preload (left ventricular end-diastolic volume) determined at 4 points while undergoing ventilation with (1) no PEEP before pneumoperitoneum; (2) 10 cm H20 of PEEP and no pneumoperitoneum; (3) no PEEP and 15 mm Hg of pneumoperitoneum; and (4) 10 cm H20 of PEEP and 15 mm Hg of pneumoperitoneum. Preload and cardiac output were determined by means of transesophageal echocardiography. Pulmonary compliance and exhaled carbon dioxide were determined by an attachment to the end of the endotracheal tube.

MAIN OUTCOME MEASURES

Preload, cardiac output, exhaled carbon dioxide, and pulmonary compliance.

RESULTS

There was no significant change from baseline in preload, cardiac output, or pulmonary compliance when either PEEP or pneumoperitoneum was applied separately. However, there was a significant decrease in preload (P<.01), cardiac output (P = .01), and exhaled carbon dioxide (P =.04) when PEEP and pneumoperitoneum were applied together. Pulmonary compliance was not significantly affected at any of these points.

CONCLUSIONS

There was a significant reduction in preload and cardiac output when there was intra-abdominal pressure of 15 mm Hg in the presence of 10 cm H20 of PEEP. This combination of pressures may pose a contraindication to laparoscopic surgery.

Eradication of brucellosis from a cattle herd in the Amazonian region (short communication)

The authors intend to elaborate a brucellosis eradication program which could be used in the Amazonian region, an area characterised by extremely extensive animal husbandry practices. Under such conditions, eradication by selection is the only feasible approach. Brucellosis has been successfully eradicated from a herd with 22.1% prevalence of infection by two serological surveys using an indirect ELISA and the complement fixation test.

[Contraceptive choices and experience of sexuality: a comparison between sterilized and non-sterilized women in a metropolitan area of southeastern Brazil]

A cross sectional study involving 357 women, 174 of them sterilized and 183 non-sterilized, with a view to comparing their sexual and reproductive behaviour, was undertaken. The questionnaire was based on previous focus group discussions with both women and men, to find out the best way to approach related questions. The results show that sterilized women-who are older and more often have steady partnerships than non-sterilized women-fulfil traditional gender roles more closely than the others. Furthermore, no sterilized woman had used the condom in the month prior to the interview. It is suggested that public messages for the prevention of the spread of the HIV, sexually-transmissible disease and cervical cancer should target women who have been sterilized for the purpose of increasing the use of the condom in accordance with specific strategies.