ABSTRACT OBJECTIVE To evaluate the accuracy of yellow fever (YF) suspected case definitions from the Brazilian Ministry of Health (BMH) and World Health Organization (WHO), as well as propose and evaluate new definitions of suspected cases, considering confirmed and discarded cases. METHODS The retrospective study was conducted at the Instituto de Infectologia Emílio Ribas (IIER), using the Epidemiologic Surveillance Form of YF cases. From the confirmed and discarded cases of YF, a logistic regression model was developed. The independent variables were used in a proposed definition of a suspected case of YF and its accuracy was evaluated. RESULTS In total, 113 YF suspect cases were reported, with 78 confirmed (69.0%). The definitions by BMH and WHO presented low sensitivity, 59% and 53.8%, and reduced accuracy, 53.1% and 47.8%, respectively. Predictive factors for YF were thrombocytopenia, leukopenia, and elevation of transaminases greater than twice normal. The definition including individual with acute onset of fever, followed by elevation of ALT or AST greater than twice the reference value AND leukopenia OR thrombocytopenia presented high sensitivity (88.3%), specificity (62.9%), and the best accuracy (80.4%), as proposed in the model. CONCLUSION The YF suspected case definitions of the BMH and the WHO have low sensitivity. The inclusion of nonspecific laboratory tests increases the accuracy of YF definition.

ABSTRACT OBJECTIVE To evaluate the accuracy of yellow fever (YF) suspected case definitions from the Brazilian Ministry of Health (BMH) and World Health Organization (WHO), as well as propose and evaluate new definitions of suspected cases, considering confirmed and discarded cases. METHODS The retrospective study was conducted at the Instituto de Infectologia Emílio Ribas (IIER), using the Epidemiologic Surveillance Form of YF cases. From the confirmed and discarded cases of YF, a logistic regression model was developed. The independent variables were used in a proposed definition of a suspected case of YF and its accuracy was evaluated. RESULTS In total, 113 YF suspect cases were reported, with 78 confirmed (69.0%). The definitions by BMH and WHO presented low sensitivity, 59% and 53.8%, and reduced accuracy, 53.1% and 47.8%, respectively. Predictive factors for YF were thrombocytopenia, leukopenia, and elevation of transaminases greater than twice normal. The definition including individual with acute onset of fever, followed by elevation of ALT or AST greater than twice the reference value AND leukopenia OR thrombocytopenia presented high sensitivity (88.3%), specificity (62.9%), and the best accuracy (80.4%), as proposed in the model. CONCLUSION The YF suspected case definitions of the BMH and the WHO have low sensitivity. The inclusion of nonspecific laboratory tests increases the accuracy of YF definition.

Alumina films were deposited from a new plasma method using aluminum acetylacetonate (AAA) powder as precursor. The AAA was sputtered in argon and oxygen plasma mixtures. It was investigated the effect of the oxygen proportion (O2%) on the properties of the coatings. Deposition rate was derived from the layer height measured by profilometry. The elemental composition and molecular structure of the films were determined by Rutherford backscattering and infrared spectroscopies, respectively. Grazing incidence X-ray diffraction was used to investigate the microstructure of the films while hardness was determined by nanoindentation technique. Inspections on the surface morphology and on the film composition were conducted associating scanning electron microscopy and energy dispersive spectroscopy. Incorporation of oxygen affects the plasma kinetics and consequently the properties of the coatings. As moderated concentrations of oxygen (< 25%) are added, the structure is predominantly organic containing stoichiometric amorphous alumina. On the other hand, as high O2% (> 25%) are incorporated, the structure become rich in metallic aluminum with carbon rising at low proportions. The deposited layer is not homogeneous in thickness once the chemical composition of the precursor is changed by the action of the reactive oxygen plasma. Oxygen ablation on the film surface also contributes to the lack of homogeneity of the structure, especially as high oxygen proportions are imposed. Hardness data (0.5-2.0 GPa) corroborated the idea of an amorphous structure. Based on the results presented here it was possible to identify the oxygen concentration in the plasma atmosphere which mostly removed organics while preserving the stoichiometric alumina precipitation, subject of great relevance as one considers the reduction in the energy necessary for the creation of fully oxide coatings.

Enxertos aorto-coronários anastomosados inapropriadamente no sistema venoso representam complicação infrequente, porém potencialmente grave, das cirurgias de revascularização miocárdica. Técnicas cirúrgicas e dispositivos percutâneos diversos têm sido descritos para a correção definitiva dessas fístulas. Relatamos aqui dois casos de fístulas aorto-coronárias iatrogênicas submetidas à oclusão percutânea com sucesso, utilizando-se dispositivo autoexpansível de nitinol (plug vascular).

Inadequate anastomosis of aorto-coronary grafts to the coronary venous system represent an infrequent but potentially serious complication of coronary artery bypass surgery. Different surgical techniques and percutaneous devices have been described for the permanent correction of these fistulas. We report two cases of iatrogenic aorto-coronary fistulas successfully treated with percutaneous occlusion using the self-expandable nitinol device (vascular plug).

A reação entre (eta5-C5H5)2NbCl2, eta5-C5H5 = Cp, e (Ph)3Sn(SPh), em THF, originou os complexos (eta5-C5H5)2Nb(Cl)( mi-S)Sn(Ph)3(Cl), 1, e (eta5-C5H5)2Nb(S)Cl, 2. Os complexos 1 e 2 foram caracterizados por espectroscopias no IV, de RMN ¹H, RMN 13C, RMN 119Sn, Mössbauer, análise elementar e absorção atômica. Hidrólise de 1 originou a espécie mi-oxo (eta5-C5H5)2Nb(Cl)(mi-O)Sn(Ph)3Cl, 3, que foi caracterizada por espectroscopias no IV, RMN ¹H, RMN 13C, Mössbauer, análise elementar, absorção atômica bem como por cristalografia de raios-X. O complexo 3 cristaliza no grupo de espaço Pca2(1) com a = 17.282(3), b = 18.122(4), c = 17.3269(2), V = 5426.2(16) ų e Z = 8. Estudos adicionais indicaram que os complexos foram formados como resultado da substituição nucleofílica do cloro da ligação nióbio-cloro pelo ligante tiolato seguido da quebra da ligação C-S. A quebra ocorre com um excesso do composto tiolato igual ou maior que 2:1.

Upon reacting (eta5-C5H5)2NbCl2, eta5-C5H5 = Cp, and (Ph)3Sn(SPh), in THF, (eta5-C5H5)2Nb(Cl)(mu-S)Sn(Ph)3(Cl), 1, and (eta5-C5H5)2Nb(S)Cl, 2, were obtained. Complexes 1 and 2 were characterized by IR, ¹H-NMR, 13C-NMR, Mössbauer spectroscopies, elemental analysis as well as by atomic absorption. Hydrolysis of 1 yielded the mu-oxo species, (eta5-C5H5)2Nb(Cl)(mu-O)Sn(Ph)3Cl, 3, which was characterized by IR, ¹H-NMR, 13C-NMR and Mössbauer spectroscopies, elemental analysis, atomic absorption as well as by X-ray crystallography. It crystallizes in the space group Pca2(1) with a = 17.282(3), b = 18.122(4), c = 17.3269(2), V = 5426.2(16) ų, and Z = 8. Additional studies indicated that the complexes were formed as a result of the nucleophilic displacement of the niobium-chloride bond by the thiolate ligand followed by a C-S bond cleavage. The cleavage occurs with an excess of the thiolate compound equal to or greater than 2:1.