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Objective The objective of this study was to evaluate the direct and indirect costs of tuberculosis (TB) (active and latent TB [LTB]) and HIV co-infection from the patient perspective. Study design Costing study conducted alongside a pragmatic clinical trial. Methods The study was conducted in Brazil in a referral service for HIV/AIDS. We applied a standardised questionnaire to collect data about out-of-pocket expenses and indirect cost. The questionnaire was applied at every patient's appointment in the referral service after TB or LTB diagnosis. We followed all patients' pathways during the prediagnosis period and treatment period. For patients on sickness benefit due to TB/HIV, income loss was calculated as the difference between an employee's wages forgone and the sickness benefit received. The monetary value of the time loss was calculated based on the Brazilian minimum wage/2015. Results Among 239 people living with HIV recruited in the first year of the trial, 31 patients were included into the costing study, 26 patients who were diagnosed and treated for TB/HIV and five patients who were diagnosed and treated for LTB/HIV. TB/HIV patients incurred higher total costs than LTB/HIV (US$ 1,429 vs US$ 166). The main cost component for TB/HIV was indirect costs, especially income loss (US$ 749). Conclusions Public health policies may address ways to prevent high patients' costs through the introduction of more accurate algorithms for TB diagnosis to prevent delays in the diagnosis and treatment. [ABSTRACT FROM AUTHOR]

As part of a monitoring program initiated in 1998 and conducted by IDAD – Institute for Environment and Development and supported by regional municipal solid waste (MSW) management authorities, an extensive database of dioxins’ and furans’ (PCDD/PCDF) concentrations in ambient air was collected in Porto, in two sites classified as suburban. The present paper summarizes the analytical results of PCDD/PCDF in ambient air obtained from 2001 to 2014 through this intensive monitoring work. The toxic equivalent (WHO-TEQ 1998) concentrations of the PCDD/PCDF in the air ranged from 8.2 to 904.4 fg TEQ m −3 , with an average and median values of 104.5 fg TEQ m −3 and 49.8 fg TEQ m −3 , respectively. The PCDD/PCDF concentration trend in Porto’s ambient air shows a clear drop of the annual average values occurred during the study period. The presence of seasonal variations is very clear in the present study. Winter levels (average: 154.3 fg TEQ m −3 ) are significantly higher than summer levels (average: 42.9 fg TEQ m −3 ). The PCDD/PCDF profiles’ details show that several differences occurred over time. The homologue profiles presented changes and the PCDD congeners have decreased in terms of mass. The analysis of concentrations in combination with specific homologue and congener patterns of PCDD/PCDF allowed identification of potential emission sources. [ABSTRACT FROM AUTHOR]

Copper and silicon substrates were coated by chemical vapor deposition using hexamethyldisiloxane (HMDSO) as the precursor gas. Substrates were placed both at the anode and cathode of a glow discharge reactor, and films were deposited using different self-bias voltages. This study focuses on comparing the differences between the hydrophilicity, polymeric character, chemical structure and nanomechanical properties of HMDSO films produced at the cathode and anode of the reactor at different self-bias voltages. Fourier transform infrared spectroscopy and Raman confocal spectroscopy indicated a significant increase in the content of organic groups when films were deposited at the anode. Analyzing the nanomechanical properties of the cathode and anode films indicated that the penetration depth was higher for samples prepared at the cathode (lower hardness) compared with the samples produced at the anode. The measured contact angles indicated that all samples became hydrophobic with water contact angles close to 100°; however, a different lyophobic character was observed when diiodomethane was used. Films produced at the anode with diiodomethane exhibited higher contact angles than did films produced at the cathode. [ABSTRACT FROM AUTHOR]

Duchenne muscular dystrophy (DMD) is a genetic muscle disease caused by DMD gene mutations. Symptoms begin in early childhood with progressive muscle weakness and loss of walking, progressing to cardiac and respiratory failure. The muscle ultrasound (US) technique has been used to detect degrees of muscle involvement and disease progression in neuromuscular diseases. To correlate lung function with respiratory and non-respiratory muscles using muscle US in patients with DMD at different stages of the disease. This prospective observational study included DMD male patients between 5 and 18 years of age. Clinical data were collected, and muscle US was performed to evaluate 12 muscle types (respiratory, appendicular, and axial) and transformed into quantitative analysis using histograms. Pulmonary lung function evaluation comprised FVC (forced vital capacity) and peak cough flow (PCF). Motor function was assessed by applying the MFM-32 (Motor Function Measure). 42 DMD patients were included. All underwent muscle US, and 24 underwent pulmonary function testing and application of the MFM scale. The average age was 11 years. The average age at diagnosis was 6.3 years, and 35.7% had lost walking ability. The average FVC was 87.7%, and the PCF was 231.9 l/min. There was a statistically significant correlation between age and FVC with the US histograms of the 1st interosseous, biceps brachii, medial gastrocnemius, and digastric muscles. There was no statistical correlation between diaphragm thickness and FVC or age. On the motor scale, the variables D1, D2, and total D (MFM-32) were correlated with FVC, and D1 with age. Conclusion: Muscle US can be an important tool for evaluating respiratory muscles involvement and disease progression in patients with DMD and identifying indirect markers of pulmonary involvement. [ABSTRACT FROM AUTHOR]

Abnormal dystrophin proteins (Dps) in Duchenne muscular dystrophy (DMD) are known to alter retinal electrophysiology, but their repercussion on visual functions have not been investigated in detail. In the present study we investigated whether different Dps influence vision by measuring psychophysical dark-adapted visual thresholds driven by cone and rod photoreceptors in DMD patients with different genetic backgrounds. Control group comprised 28 healthy volunteers (mean age=17.9±6.5 years). DMD groups were 29 patients (mean age=14.9±4.4 years) divided in three genetic groups depending on presumable affected Dps: group 1 (only Dp427 affected), group 2 (Dp427+Dp260+Dp140 affected) and group 3 (all Dps affected). Visual detection thresholds to 625-nm (red, cone-driven) and 527-nm (green, rod-dominated) flashes of 2° were measured during dark adaptation after 1-minute exposure to a bleaching light (3000 cd/m2). Initially, 8 minutes of interleaved 625-nm and 527-nm thresholds were measured. After an additional 5 minutes of dark-adaptation, a second set of threshold measurements to 527-nm stimuli was performed during the subsequent 6 minutes. Control thresholds were -1.7 ± 0.4 (cone) and -4.2 ± 0.2 (rod) log cd/m². Affected Dp427 alone (group 1) was not sufficient to alter visual thresholds (p = 0.28 cone and p = 0.48 rod) while affected Dp427+Dp260+Dp140 (group 2) caused elevated rod thresholds (-3.4 ± 0.9 log cd/m², p < 0.01). Interestingly, patients with presumable alteration of all retinal Dps (Dp427+Dp260+Dp140+Dp71, group 3) showed visual thresholds similar to controls (cone: -2.4 ± 1.4 and rod: -3.9 ± 0.4 log cd/m², p = 0.99). Affected retinal dystrophins are associated with alterations of the visual detection thresholds in DMD patients besides their well-known associations with retinal electrophysiology. It is worthy to highlight that the visual thresholds of the patients with all Dps affected (presumably) were similar to control thresholds despite the alteration of Dp260+Dp140. We speculate that compensatory mechanisms may be operating in the retina of DMD patients presumably lacking all Dps. [ABSTRACT FROM AUTHOR]

Bien que le blé soit la céréale la plus cultivée et la plus consommée de par le monde, sa fraction protéique est associée à différentes pathologies représentées par la maladie cœliaque, l'allergie au blé ou encore récemment la sensibilité non cœliaque au blé. De nos jours, la stratégie nutritionnelle la plus efficace pour prendre en charge les patients allergiques alimentaires est d'éliminer l'allergène en cause de l'alimentation du patient allergique. Les procédés alimentaires industriels peuvent représenter une alternative pour diminuer l'allergénicité des aliments. Parmi ces procédés, la fermentation constitue une approche prometteuse. En effet, les bactéries lactiques dotées d'un système protéolytique jouent un rôle essentiel dans le processus de fermentation alimentaire et impactent les propriétés de l'aliment (goût, texture, disponibilité des nutriments). Ce travail vise à explorer l'activité protéolytique d'une collection de bactéries lactiques isolées à partir de différents aliments fermentés et d'évaluer leur effet sur l'antigénicité et l'allergénicité des protéines de gluten. Cent soixante-douze souches de bactéries lactiques précédemment isolées à partir de différents aliments et boissons fermentés ont été criblées pour leur capacité à hydrolyser du gluten par électrophorèse sur gel de polyacrylamide (SDS-PAGE) et chromatographie (RP-HPLC). Les gliadines ont été extraites et leur antigénicité évaluée par Western blot à l'aide d'anticorps polyclonaux IgG spécifiques des gliadines. L'allergénicité résiduelle du gluten fermenté a été explorée par un test de dégranulation en utilisant une lignée cellulaire de basophiles de rat sensibilisées aux sérums de patients allergiques au blé. Le criblage de l'activité protéolytique et l'identification moléculaire 16s ARNr a permis l'identification et la sélection de neuf souches protéolytiques appartenant à deux espèces : Lactococcus lactis LLGKC18 et Enterococcus feacalis EFGKC18. L'analyse RP-HPLC des gliadines après fermentation par Lactococcus lactis LLGKC18 a révélé que cette souche hydrolysait plus de 90 % des gliadines. Quel que soit l'anticorps utilisé, une diminution significative de l'antigénicité a été observée dans le gluten fermenté, suggérant que les protéases ont hydrolysé efficacement les séquences renfermant les épitopes des gliadines. Le test de dégranulation avec les basophiles RBL-SX38 a montré que cette souche réduit d'un tiers la capacité du gluten à dégranuler après 24 h de fermentation. La fermentation par Lactococcus lactis LLGKC18 permet de réduire l'antigénicité du gluten ainsi que son allergénicité in vitro mesurée par des tests fonctionnels. Ce résultat montre que cette souche de bactérie lactique est capable de couper un certain nombre d'épitopes des gliadines responsables de l'allergie au blé par son action protéolytique. [ABSTRACT FROM AUTHOR]