This article examines the limitations of governmental capacity to regulate private sector participation in urban water supply in developing countries through an analysis of the most dramatic failure to date of a major franchise contract for supplying water and sanitation services to a large city ± the 40-year concession awarded in September 1999 to Aguas del Tunari (AdT) in Cochabamba, Bolivia. Five months later, the population rioted against water tariff increases and the contract was cancelled. The paper analyses the background, context and factors that explain the failure of the concession and seeks to draw lessons for the regulation of future concessions.

Background: Traumatic brachial plexus injury (TBPI) typically causes sensory, motor and autonomic deficits of the affected upper limb. Recent studies have suggested that a unilateral TBPI can also affect the cortical representations associated to the uninjured limb.Objective: To investigate the kinematic features of the uninjured upper limb in participants with TBPI.Methods: Eleven participants with unilateral TBPI and twelve healthy controls matched in gender, age and anthropometric characteristics were recruited. Kinematic parameters collected from the index finger marker were measured while participants performed a free-endpoint whole-body reaching task and a cup-to-mouth task with the uninjured upper limb in a standing position.Results: For the whole-body reaching task, lower time to peak velocity (p = 0.01), lower peak of velocity (p = 0.003), greater movement duration (p = 0.04) and shorter trajectory length (p = 0.01) were observed in the TBPI group compared to the control group. For the cup-to-mouth task, only a lower time to peak velocity was found for the TBPI group compared to the control group (p = 0.02). Interestingly, no differences between groups were observed for the finger endpoint height parameter in either of the tasks. Taken together, these results suggest that TBPI leads to a higher cost for motor planning when it comes to movements of the uninjured limb as compared to healthy participants. This cost is even higher in a task with a greater postural balance challenge.Conclusion: This study expands the current knowledge on bilateral sensorimotor alterations after unilateral TBPI and should guide rehabilitation after a peripheral injury.

A construção e manipulação espacial de imagens corporais têm origem basicamente visual e somato-motora. No entanto, a contribuição relativa de cada modalidade sensorial nos processos de simulação mental pode variar. Sirigu e Duhamel (2001) propuseram que a estratégia utilizada durante a simulação mental de movimentos produziria a ativação de circuitos neurais distintos. Neste estudo, investigamos o efeito da estratégia adotada na simulação mental de uma tarefa motora que envolve ajustes posturais utilizando as técnicas de cronometria mental e de estabilometria. Os voluntários, posicionados sobre uma plataforma de força vertical com os pés unidos e os olhos fechados, foram solicitados a realizar as seguintes tarefas: a) manter a postura ereta normal durante 20 segundos; b) contar mentalmente de um a 15; c) imaginar-se realizando o movimento de flexão plantar bilateral 15 vezes e d) executar o mesmo movimento por 15 vezes. Ao final do teste, relataram qual a estratégia utilizada para a realização da simulação mental. Com base no relato verbal foram então distinguidos em dois grupos: visuais e somato-motores. A análise da cronometria mental mostrou que o tempo utilizado para simular mentalmente os movimentos de flexão plantar não foi diferente daquele gasto durante a sua execução. Diferiu, porém, da condição contar para ambos os grupos. Para a análise estabilométrica, calculou-se um índice de simulação mental (ISM). Dos valores obtidos durante o imaginar, foram subtraídos os valores da condição contar, dividindo-se então a resultante pela soma dos dois. O grupo somato-motor apresentou índices positivos e significativamente diferentes do grupo visual para a área elíptica de deslocamento e amplitude de deslocamento no eixo ântero-posterior (y). Esses dados indicam um menor bloqueio da saída motora durante o imaginar de um movimento que envolve ajustes posturais no primeiro grupo. Essa diferença sugere que circuitos corticais e sub-corticais distintos serão ativados em função da estratégia adotada para simular mentalmente o movimento.

Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding, hypertension, chronic heart failure, chronic renal failure and consumption of different drugs. We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain, nausea, melena and progressive reduction of hemoglobin index. Gastroduodenal endoscopy revealed erosions in the esophagus and stomach, with no active bleeding at the moment. In addition, the duodenal mucosa presented marked signs of melanosis; later confirmed by histopathological study. Even though PD is usually regarded as a benign condition, its pathogenesis and clinical significance is yet to be defined.

RACIONAL: As estenoses benignas de esôfago são complicações decorrentes de diversas causas. Possuem tratamentos similares, na maioria dos casos necessitando de dilatação endoscópica, no entanto a resposta terapêutica, tempo ideal de tratamento, assim como intervalo entre as sessões podem ser variáveis. OBJETIVO: Analisar, do ponto de vista endoscópico, as estenoses benignas de esôfago em 14 anos de experiência no Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, RJ, avaliando etiologia, a extensão da estenose, o número de dilatações necessário para atingir resposta terapêutica satisfatória, assim como a relação entre a extensão da estenose e a resposta terapêutica. MÉTODO: Foram analisadas 2.568 dilatações endoscópicas com uso de velas de Savary-Gilliard em 236 pacientes, durante um período de 14 anos e 10 meses, até junho de 2007. RESULTADOS: A estenose péptica foi a causa mais freqüentemente encontrada, seguida pela estenose cáustica. As estenoses longas e cáusticas necessitaram de maior número de sessões para ausência de disfagia. Estenoses pépticas e curtas responderam melhor a número menor de sessões de dilatação. CONCLUSÃO: A estenose péptica foi a causa mais comum e respondeu bem à terapia endoscópica, em concordância com a literatura. As estenoses cáusticas foram as mais refratárias, principalmente as longas. Quanto maior foi a extensão da estenose, também maior foi o número de sessões necessárias. Estenoses curtas apresentaram boa evolução na maioria dos casos. O número de dilatações necessárias dependeu diretamente da causa e da extensão da estenose.

In this chapter, we aim to discuss the neurophysiological basis of the brain reorganization (also called plasticity) that associates with a traumatic brachial plexus injury (TBPI), as well as following the brachial plexus surgical reconstruction and its physical rehabilitation. We start by reviewing core aspects of plasticity following peripheral injuries such as amputation and TBPI as well as those associated with chronic pain conditions. Then, we present recent results collected by our team centered on physiological measurements of plasticity after TBPI. Finally, we discuss that an important limitation in the field is the lack of systematic measurement of TBPI clinical features. We finish by proposing possible future venues in the domain of brain plasticity following a TBPI.

Uptake of transferrin by epimastigote forms of the protozoan Trypanosoma cruzi occurs mainly through a cytostome/ cytopharynx, via uncoated endocytic vesicles that bud off from the bottom of the cytopharynx. We have here examined whether detergent-resistant membrane (DRM) domains might be involved in this process. Purified whole cell membrane fractions were assayed for cholesterol levels and used in dot blot analyses. Detergent-resistant membrane markers (cholera B toxin and anti-flotillin-1 antibody) presented positive reaction by dot blots in cholesterolrich/ protein-poor membrane sub-fractions. The positive dot blot fraction was submitted to lipid composition analysis, showing composition similar to that of raft fractions described for other eukaryotic cells.Immunofluorescence assays allowed the localization of punctual positive signal for flotillin-1, matching the precise cytostome/ cytopharynx location. These data were confirmed by immunofluorescence assays with the co-localization of flotillin-1 and the transferrin uptake site. Our data suggest that DRM domains occur and are integrated at the cytostome/ cytopharynx of T. cruzi epimastigotes, being the main route for transferrin uptake.Key words: cytopharynx -detergent-resistant membrane -endocytosis -Trypanosoma cruzi -ultrastructure The lipid raft model proposes that cholesterol and sphingolipids of the plasma membrane outer leaflet are not randomly distributed, but rather clustered into micro-domains that float in the lipid bilayer, characterizing detergent-resistant membrane (DRM) domains in eukaryotic cells (Rietveld & Simons 1998, Handcock 2006. Transmembrane proteins (receptors, adhesion molecules, and enzymes) in the lipid bilayer would either reside in, and thus become sorted into transport vesicles, or be excluded from the rafts, depending on partitioning imparted by their physical properties (Harder et al. 1998, Simons & Vaz 2004.Lipid rafts play a role in a wide range of important biological processes, including signal transduction pathways, apoptosis, cell adhesion and migration, organization of the cytoskeleton and protein sorting during both exocytosis and endocytosis (Simons & Toomre 2000, Harris & Siu 2002.Flotillins are cholesterol-binding proteins that associate with a subset of rafts named caveolae, and are frequently used as raft markers. The flotillin protein family consists of the small (45 kDa) proteins flotillin-1 and flotillin-2/ ESA (a close homologue of the epidermal surface antigen). These proteins induce caveolae formation, bind cholesterol, and interact with signaling molecules (Anderson 1998, Kiss et al. 2004. Lipid rafts can exist independently of caveolae, but they must exist prior to formation of caveolae for proper insertion of flotillin into membranes (Graf et al. 1999, Ikonen 2001.Trypanosomatid protozoa have a particular cell body array that allows uptake of nutrients only at a specific membrane site: the flagellar pocket (Morgan et al. 2001). Trypanosoma cruzi, the causative agent of Chagas disease in Latin America, a...

RESUMO -Racional -A doença de Crohn pode acometer todo o tubo digestivo, porém o envolvimento gastroduodenal é classicamente descrito como raro (0,5% a 13%