Domestic Violence Against Women on Yap,Federated States of Micronesia

Anecdotally there are high rates of domestic violence in the small Micronesian State of Yap, Federated States of Micronesia (FSM), but there have been no studies to quantify the prevalence or characteristics of domestic violence in Yap or in any other state of the FSM. A survey was administered to women at the Yap hospital and community health centers from February through June 2011. Survey data were on domestic violence, which was supplemented by a focus group to explore the issues involved in greater detail. A high prevalence of domestic violence was documented by the survey; perceptions about this were explored in the focus group. On the questionnaire, 148 of 194 (76%) women reported at least one form of abuse. Given the small number of adult women in Yap, these findings suggest that domestic violence is a serious, pervasive problem that Yap needs urgently to address. The issue clearly needs to be investigated throughout the other states of the FSM and addressed at the national policy level as well as at the state level.     

Amphiphilic Antimony(V) Complexes for Oral Treatment of Visceral Leishmaniasis

The need for daily parenteral administration is an important limitation in the clinical use of pentavalent antimonial drugs against leishmaniasis. In this study, amphiphilic antimony(V) complexes were prepared from alkylmethylglucamides (L8 and L10, with carbon chain lengths of 8 and 10, respectively), and their potential for the oral treatment of visceral leishmaniasis (VL) was evaluated. Complexes of Sb and ligand at 1:3 (SbL8 and SbL10) were obtained from the reaction of antimony(V) with L8 and L10, as evidenced by elemental and electrospray ionization-tandem mass spectrometry (ESI-MS) analyses. Fluorescence probing of hydrophobic environment and negative-staining transmission electron microscopy showed that SbL8 forms kinetically stabilized nanoassemblies in water. Pharmacokinetic studies with mice in which the compound was administered by the oral route at 200 mg of Sb/kg of body weight indicated that the SbL8 complex promoted greater and more sustained Sb levels in serum and liver than the levels obtained for the conventional antimonial drug meglumine antimoniate (Glucantime [Glu]). The efficacy of SbL8 and SbL10 administered by the oral route was evaluated in BALB/c mice infected with Leishmania infantum after a daily dose of 200 mg of Sb/kg for 20 days. Both complexes promoted significant reduction in the liver and spleen parasite burdens in relation to those in the saline-treated control group. The extent of parasite suppression (>99.96%) was similar to that achieved after Glu given intraperitoneally at 80 mg of Sb/kg/day. As expected, there was no significant reduction in the parasitic load in the group treated orally with Glu at 200 mg of Sb/(kg day). In conclusion, amphiphilic antimony(V) complexes emerge as an innovative and promising strategy for the oral treatment of VL.     

Induction of cancer cell death by apoptosis and slow release of 5-fluoracil from metal-organic frameworks Cu-BTC

This study aimed to evaluate the mechanism associated with cytotoxic activity displayed by the drug 5-fluorouracil incorporated in Cu-BTC MOF and its slow delivery from the Cu-BTC MOF. Structural characterization encompasses elemental analysis (CHNS), differential scanning calorimetry (DSC), thermogravimetric analysis (TG/DTG), Fournier transform infrared (FIT-IR) and X-ray diffraction (XRD) was performed to verify the process of association between the drug 5-FU and Cu-BTC MOF. Flow cytometry was done to indicate that apoptosis is the mechanism responsible for the cell death. The release profile of the drug 5-FU from Cu-BTC MOF for 48 hours was obeisant. Also, the anti-inflammatory activity was evaluated by the peritonitis testing and the production of nitric oxide and pro-inflammatory cytokines were measured. The chemical characterization of the material indicated the presence of drug associated with the coordination network in a proportion of 0.82 g 5-FU per 1.0 g of Cu-BTC MOF. The cytotoxic tests were carried out against four cell lines: NCI-H292, MCF-7, HT29 and HL60. The Cu-BTC MOF associated drug was extremely cytotoxic against the human breast cancer adenocarcinoma (MCF-7) cell line and against human acute promyelocytic leukemia cells (HL60), cancer cells were killed by apoptosis mechanisms. The drug demonstrated a slow release profile where 82% of the drug was released in 48 hours. The results indicated that the drug incorporated in Cu-BTC MOF decreased significantly the number of leukocytes in the peritoneal cavity of rodents as well as reduced levels of cytokines and nitric oxide production.     

A study of the post-burned restored skin.

The color of restored skin (RS) resulting from healing of partial skin thickness burns was analyzed. Comparisons within symmetric skin areas were performed between RS and healthy undamaged skin (HS), using spectrophotometry, in 118 subjects, 64 males, 54 females with an age range of 1-70 years. A total of 379 samples were analyzed. The CIE-1976 color system was adopted where L*, a* and b*, characterizes the sample color. L*, a* and b* values from restored and healthy skin were obtained and differences between them calculated. Age, sex, sun exposure and time span after burn were taken into account and the data was submitted to statistical analysis: Wilcoxon test for age and chi 2 for other variables. RS became darker: one year after the original burn; in subjects with sun exposure and in older subjects. Sex did not show any influence on brightness index. RS became more red in subjects with sun exposure; in older subjects; within the first six months after the burn. Sex did not show any influence on a* chromaticity axis. RS became more blue: in male subjects and within one year after the burn. Age and sun exposure did not yield any influence on b* chromaticity axis.     

Self-expanding endovascular stent-graft implant for treatment of descending aortic diseases

A bstract Background: Aneurysms and dissections involving the descending thoracic aorta and the distal portion of the aortic arch are difficult to resolve surgically. The introduction of endovascular self-expanding stent-grafts has simplified the operation. Given the complications associated with their peripheral placement, we explored the feasibility of surgical insertion. Methods: Thirteen patients underwent surgical insertion of a stent-graft into the aortic arch via longitudinal aortotomy. Six patients had aneurysms (ruptured in two, and seven dissections (acute in two, ruptured in one). Five patients also underwent associated procedures including aortic valve replacement (one), ascending aorta replacement (two), arch replacement (one), and coronary artery bypass (one). Results: There was one intraoperative death due to ascending aortic dissection, and two hospital deaths due to multiple complications. Of ten patients discharged, one died 3 months postoperatively. The remaining survivors are well, and imaging studies confirmed adequate correction of the aortic disease. Conclusions: The use of this technique simplifies the operation and treatment of particular cases of aortic disease. The observed morbidity and mortality are due to factors independent of the technique.     

Prevalence of apical periodontitis detected in cone beam CT images of a Brazilian subpopulation

Objectives

The aim of this study was to determine the prevalence of apical periodontitis (AP) detected in cone beam CT (CBCT) images from a database.

Methods

CBCT images of 300 Brazilian patients were assessed. AP images were measured in three dimensions. Age, gender, number and location of total teeth in each patient were considered. AP location was considered according to tooth groups. The extent of AP was determined by the largest diameter in any of the three dimensions. Percentages and the χ² test were used for statistical analysis.

Results

AP was found in 51.4% of the patients and in 3.4% of the teeth. Higher prevalence of AP was found in 60- to 69-year-olds (73.1%) and in mandibular molars (5.9%) (p < 0.05). Inadequate endodontic treatment presented higher prevalence of AP (78.1%).

Conclusions

AP can be frequently found in CBCT examinations. The presence of AP has a significant association with patients'' age, and tooth type and condition. CBCT databases are useful for cross-sectional studies about AP prevalence in a population.     

Limb lengthening and correction of deformity in the lower limbs of children with osteogenesis imperfecta

We performed limb lengthening and correction of deformity of nine long bones of the lower limb in six children (mean age, 14.7 years) with osteogenesis imperfecta (OI). All had femoral lengthening and three also had ipsilateral tibial lengthening. Angular deformities were corrected simultaneously. Five limb segments were treated using a monolateral external fixator and four with the Ilizarov frame. In three children, lengthening was done over previously inserted femoral intramedullary rods. The mean lengthening achieved was 6.26 cm (mean healing index, 33.25 days/cm). Significant complications included one deep infection, one fracture of the femur and one anterior angulation deformity of the tibia. The abnormal bone of OI tolerated the external fixators throughout the period of lengthening without any episodes of migration of wires or pins through the soft bone. The regenerate bone formed within the time which is normally expected in limb-lengthening procedures performed for other conditions. We conclude that despite the abnormal bone characteristics, distraction osteogenesis to correct limb-length discrepancy and angular deformity can be performed safely in children with OI.     

Clinical and Histopathologic Comparative Analysis Between Kidney Transplant Recipients From Expanded-Criteria Donors and Standard-Criteria Donors

Owing to the disparity between the supply of kidney donors and demand, the use of organs from older deceased donors was initiated in recent years. The potentially poor outcome of these grafts is a major concern. This retrospective study compares graft and patient 1-year survivals between recipients from expanded-criteria donors (ECD; n = 30) and standard-criteria donors (SCD; n = 104). Rates of delayed graft function (DGF), acute rejection (AR), and chronic injury in the pre-implantation biopsy were also assessed. Increasing donor age was associated with increased rates of DGF, and DGF correlated with AR. Cold ischemia time >30 hours was associated with worse graft outcomes. Induction with Simulect correlated with better patient survival compared with Timoglobulina. Chronic injury pre-implantation biopsy correlated with worse renal function, but graft survival was similar. Death-censored graft survival at 1 year was 90% and patient survival 82%, and these were similar in ECD and SCD recipients. Selection of transplant candidates for ECD kidneys must be performed with caution. One-year graft survival was similar to that of SCD kidneys, but kidney function was worse during the same period. This may result in poorer graft survival over longer follow-up.