Leishmaniasis in cat shelters: A serological,molecular and entomological study

An epidemiological Leishmania spp. and entomological Phlebotomine sandflies survey was performed in cat shelters at leishmaniasis endemic area of Brazil. Blood and conjunctival swab (CS) samples were collected from 94 cats in two animal protection shelters. These samples were subjected to serological tests using the indirect immunofluorescence antibody test (IFAT) and indirect enzyme‐linked immunosorbent assay (ELISA) and to molecular test by polymerase chain reaction (PCR). In addition, a Phlebotomine sandflies survey was performed in the same shelters. The analyses revealed a positivity of 31.91% (30/94) through ELISA and 29.79% (28/94) through IFAT. The two serological tests showed a positive association with perfect agreement (k = 0.925). None of the cats were positive by Leishmania spp. DNA. One Lutzomyia (Lutzomyia) longipalpis male was found in one of the cat shelters. The results and the implications of our findings are discussed below.     

Nebulization associated with bi-level noninvasive ventilation: analysis of pulmonary radioaerosol deposition

Nebulization associated with noninvasive ventilation is used in emergency services and intensive care units. PURPOSES: To compare pulmonary radioaerosol deposition during jet nebulization associated to noninvasive ventilation versus spontaneous breathing nebulization; to measure the rate of lung depuration and the correlation between lung deposition, inspiratory flow and tidal volume (V(t)) using scintigraphy. SUBJECTS: Thirteen healthy volunteers (with normal spirometry), mean age (23.3+/-1.49) years, body mass index 21.2+/-2.3 kg/m(2). METHODS: Nebulization was performed in spontaneous breathing and associated with bi-level noninvasive ventilation (inspiratory pressure=12 cm H(2)O, expiratory pressure=5 cm H(2)O). The radioaerosol used in the nebulization was technetium (Tc99m) with diethylene triamine penta acetic acid, generated over a period of 9 min in a jet nebulizer. Analysis was performed through scintigraphy. Statistical analysis was performed by analysis of variance (for repeated measures), Bonferroni method, Student's t-test and Person's correlation. RESULTS: There was a decrease in radioaerosol lung deposition with nebulization associated to noninvasive ventilation (mean counts in spontaneous breathing 200,510+11,012 and mean counts in noninvasive ventilation 106,093+2811 (P<0.001). During spontaneous breathing nebulization there was a significant correlation between V(t) and radioaerosol deposition (r=0.565, P<0.05), also between inspiratory flow and radioaerosol deposition in the lungs (r=0.141, P<0.05). However, there was no correlation between V(t) and pulmonary deposition of radioaerosol in bi-level noninvasive ventilation nebulization (r=0.082). CONCLUSION: During nebulization with noninvasive ventilation in healthy volunteers, there was an increase in V(t) associated to a higher inspiratory flow rate, without resulting in a significant increase in pulmonary radioaerosol deposition.     

Synergistic antiallodynic interaction between gabapentin or carbamazepine and either benfotiamine or cyanocobalamin in neuropathic rats

Anticonvulsants, including gabapentin and carbamazepine, have shown activity against several types of neuropathic pain; however, they have limiting side effects that may minimize their use. In this study the possible synergistic interaction between anticonvulsants and benfotiamine or cyanocobalamin on spinal nerve ligation-induced tactile allodynia was assessed. Oral administration of gabapentin (15-300 mg/kg), carbamazepine (10-300 mg/kg), benfotiamine (30-600 mg/kg) or cyanocobalamin (0.3-6.0 mg/kg) significantly reduced tactile allodynia in rats. Maximal antiallodynic effects were reached with gabapentin 300 mg/kg (approximately 70%), carbamazepine 300 mg/kg (approximately 66%), benfotiamine 600 mg/kg (approximately 51%) and cyanocobalamin 6 mg/kg (approximately 59%). At the highest tested doses, gabapentin, but not carbamazepine, benfotiamine or cyanocobalamin, significantly reduced motor coordination. Coadministration of gabapentin or carbamazepine with benfotiamine or cyanocobalamin in a fixed ratio markedly reduced spinal nerve ligation-induced tactile allodynia, showing a synergistic interaction between anticonvulsants and B vitamins. Data indicate that combinations of anticonvulsants with benfotiamine or cyanocobalamin are able to reduce tactile allodynia without affecting motor coordination in rats, and suggest the possible clinical use of these combinations in the treatment of neuropathic pain in humans.     

Dental students' perceptions of community-based education: a retrospective study at a dental school in Brazil

Community-based educational activities have been introduced into health education programs across the world. However, research on students' perceptions of their experiences in these settings has been limited. The objectives of this study were to assess a group of Brazilian dental students' views of their experiences in a service-learning program focusing on pediatric dental care and to explore changes in their perceptions over the course of the program. Data were collected from fifty-five fourth-year dental students, who submitted a total of 185 reports at four points in time. The students spent sixteen of the 128 hours of their pediatric dentistry course in community-based education developing activities linked to pediatric dental care. Two professors rated each report as a positive or negative experience (Kappa 0.7) and recorded whether the students' reports reflected one or more of five types of response. The response types concerned dental treatment practice, multidisciplinary activities, observation of infant/toddler consultations, commitment of the outreach health team, and change of plans due to technical problems. The data showed that the students had a positive first impression after a short stay in a community-service program, but there was a decrease in the students' positive experiences over time (p<0.001). The students' perceptions of the outreach health team as "being not committed" (OR 6.82, 95 percent CI 2.12-21.90) and experiences of a "no change of plans due to technical problems" (OR 0.09, 95 percent CI 0.04-0.20) associated with negative student experiences.