Qualidade de vida e desempenho ocupacional de pacientes submetidos à cirurgia de epilepsia

OBJETIVO: este estudo teve como objetivo comparar a qualidade de vida e as áreas do desempenho ocupacional de pacientes epilépticos antes e doze meses após tratamento cirúrgico. METODOLOGIA: a amostra foi composta por 30 pacientes epilépticos que frequentavam o Centro de Cirurgia de Epilepsia da Faculdade de Medicina de São José do Rio Preto - FAMERP. Todos os participantes responderam a uma entrevista semiestruturada para coleta de dados sociodemográficos, ao Questionário de Qualidade de Vida em Epilepsia - 31 (QOLIE-31) e à Medida Canadense de Desempenho Ocupacional - MCDO. RESULTADOS: dezenove pacientes(63,3%) eram do sexo feminino e onze (36,7%) do sexo masculino, com idade entre 22 e 65 anos (42,1±11,9). Os resultados obtidos com o QOLIE-31 apontaram diferenças significativas em seis dos sete domínios que compõe o questionário quando comparados o período pré e pós-cirúrgico. A comparação dos resultados da COPM mostrou aumento significativo tanto na performance quanto na satisfação dos pacientes com suas atividades de vida diária, instrumentais de vida diária e de lazer. CONCLUSÃO: o tratamento cirúrgico se mostrou eficaz na melhora da qualidade de vida e no desempenho ocupacional o que pode traduzir-se a médio e longo prazo em integração social mais adequada para os pacientes epilépticos.

Vírus respiratório sincicial humano em crianças hospitalizadas por infecções agudas das vias aéreas inferiores

OBJETIVO: Avaliar a prevalência e a sazonalidade do vírus respiratório sincicial humano (VRSH) em crianças de 0 a 6 anos hospitalizadas por infecção aguda das vias aéreas inferiores (IVAI) em São José do Rio Preto (SP) e a associação entre faixa etária, diagnóstico e VRSH. MÉTODOS: Entre maio de 2004 e setembro de 2005, foram estudados 290 episódios consecutivos de IVAI adquiridos na comunidade em crianças de 0 a 6 anos internadas no Hospital de Base de São José do Rio Preto. Para identificação do VRSH, foram coletadas amostras de secreção de nasofaringe e realizou-se análise molecular por meio da técnica de RT-PCR. RESULTADOS: A prevalência de VRSH foi de 29,3% nos episódios de IVAI hospitalizados. A IVAI foi frequente em lactentes (mediana de idade = 13,5 meses). O VRSH foi mais frequente nos casos de bronquiolite (64%) e no primeiro ano de vida (35%). Os episódios de infecção por VRSH ocorreram entre o outono e a primavera, com frequência maior em 2004 do que em 2005. Os critérios clínicos e radiológicos não foram suficientes para o diagnóstico de infecção pelo VRSH. Em 78,8% dos episódios de VRSH, houve tratamento com antibiótico. CONCLUSÕES: A prevalência do VRSH em crianças de 0 a 6 anos hospitalizadas por IVAI foi elevada, com predomínio nas mais jovens ou com bronquiolite. A circulação do vírus variou nos dois anos estudados. Os resultados sugerem necessidade de diagnóstico laboratorial do VRSR na prática clínica.

Presença de culicídeos em município de porte médio do Estado de São Paulo e risco de ocorrência de febre do Nilo Ocidental e outras arboviroses

INTRODUÇÃO: O objetivo deste estudo foi mensurar a diversidade de espécies de culicídeos, descrever sua abundância e variação sazonal em áreas urbanas e matas de São José do Rio Preto, SP, e discutir o risco de ocorrência de arboviroses. MÉTODOS: Coletas de larvas e de mosquitos adultos foram realizadas mensalmente, em 2006 e 2007, em área urbana e em quatro fragmentos de mata. No perímetro urbano, coletaram-se larvas nos sítios mais prováveis de oviposição para mosquitos do gênero Culex e nas matas foi realizada a coleta de mosquitos adultos, sendo que em duas utilizaram-se armadilhas CDC à noite e, em duas, aspirador de Nasci de dia. RESULTADOS: Na área urbana identificaram-se 34 espécies de culicídeos em um total de 8.683 exemplares; destes, 80,7% corresponderam ao Culex quinquefasciatus, 9,6% ao Culex grupo Coronator, 3,2% ao Aedes albopictus (3,2%) e 1,1% ao Ochlerotatus fluviatilis. A abundância de larvas de Cx. quinquefasciatus correlacionou-se negativamente com a chuva. Nas quatro matas, foram coletados 2.268 mosquitos distribuídos entre 10 gêneros, 46 espécies ou grupos. As mais abundantes foram Aedeomyia squamipennis, Culex. coronator, Culex (Mel.) seção Melanoconion, Culex declarator, Ochlerotatus scapularis, Anopheles triannulatus, Culex bidens/interfor e Culex habilitator/pseudojhantinosoma. CONCLUSÕES: A abundância de Cx. quinquefasciatus na área urbana e a presença de outros culicídeos nas áreas urbanas e de matas apontam para a possibilidade de transmissão do vírus do Nilo Ocidental e de outras arboviroses em São José do Rio Preto e outras cidades do Brasil, sendo fundamental o estabelecimento de medidas visando à vigilância destas arboviroses.

Evaluation of oviposition traps as an entomological surveillance method for Aedes aegypti (Diptera, Culicidae)

This study aimed to describe the behavior of oviposition traps for Aedes aegypti over time, to compare it with the larval survey and to investigate the association with climatic variables. It was conducted in São José do Rio Preto city, São Paulo. Daily climatic data and fortnightly measurements for oviposition traps and larval infestation were collected from October 2003 to September 2004. Three different periods were identified in the behavior of oviposition traps' positivity and mean number of eggs: increase, plateau and decrease in values. These measurements followed the variation of climatic data from the first and third periods. High correlation was obtained between the positivity and the mean number of eggs. The oviposition traps showed higher capacity to detect the vector than did larval survey. It was observed that the first (October to December) and third (May to September) periods were considered to be the most suitable to use oviposition traps than larval surveys.

VARIATION IN STOMATAL NUMBERS OF GLOSSOPTERIS LEAVES FROM THE LOWER PERMIAN OF PARANA BASIN, BRAZIL

The stomatal density and index in compressed leaves of Glossopteris communis from two different roof shales from the Lower Permian in Parana Basin, Brazil (Western Gondwana) have been investigated to test the possible relationship with modeled global changes in atmospheric CO(2) during the Phanerozoic. The obtained parameters show that the genus Glossopteris from the Cool Temperate biome can be used as CO(2) -proxy, despite the impossibility of being compared with living relatives or equivalents. When confronted with already published data for the Tropical Summer Wet biome, the present results confirm the detection of low levels of atmospheric CO(2) during the Early Permian, as predicted by the modeled curve. Nevertheless, the lower stomatal numbers detected at the climax of the coal interval (Faxinal Coalfield, Sakmarian) when compared to the higher ones obtained in leaves from a younger interval (Figueira Coalfield, Artinskian) could be attributed to temporarily high levels of atmospheric CO(2). Therefore, the occurrence of an extensive peat generating event at the southern part of the basin and subsequent greenhouse gases emissions from this environment may have been enough to reverse regionally and temporarily the reduction trend in atmospheric CO(2). Additionally, the Faxinal flora is preserved in a tonstein layer, which is a record of volcanic activity that could also cause a rise in atmospheric CO(2). During the Artinskian, the scarce generation of peat mires, as revealed by the occurrence of thin and discontinuous coal layers, and the lack of volcanism evidence would be insufficient to affect the general low CO(2) trend.

Morphology and biology of a new Pseudopolydora (Annelida: Spionidae) species from Brazil

Adults of Pseudopolydora rosebelae sp. nov. inhabit silty tubes on muddy bottoms in shallow water in southern Brazil, states of Sao Paulo and Rio de Janeiro. They are rare and extremely delicate, attaining 20 mm long for 55 chaetigers. The worms are distinctive by their colourful yellow and black pigmentation on the anterior part of body and palps, prominent transverse hood on the dorsal anterior edge of chaetiger 3, and lack of coloured respiratory pigment in blood. Of 12 examined individuals, all were females. Oogenesis is intraovarian; oocytes develop from chaetigers 14-15 to chaetigers 24-36. Recently laid oocytes were about 150 mu m in diameter, with embryos and developing larvae found in capsules inside female tubes in March-June. Broods comprised up to 23 capsules with 400 propagules. Capsules were joined to each other in a string and each attached by a single thin stalk to the inner wall of the tube. Larvae hatched at the 4-chaetiger stage and fed on plankton. Pelagic larvae are unique among Pseudopolydora in having large ramified mid-dorsal melanophores from chaetiger 3 onwards. Competent larvae are able to settle and metamorphose at the 15-chaetiger stage, but can remain planktonic up to 18 chaetigers. They have one pair of unpigmented ocelli and three pairs of black eyes in the prostomium, unpaired ramified mid-dorsal melanophores on chaetiger 1 and on the pygidium, ramified lateral melanophores on chaetigers 5-10, prominent yellow chromatophores in the prostomium, peristomium, on dorsal and ventral sides of chaetigers and in the pygidium. Branchiae are present on chaetigers 7-10, and gastrotrochs are arranged on chaetigers 3, 5, 7 and 12. Provisional serrated bristles are present in all notopodia, and hooks are present in neuropodia from chaetiger 8 onwards. Two pairs of provisional protonephridia are present in chaetigers 1 and 2, and adult metanephridia are present from chaetiger 4.

Molecular evidence of phytoplasma associated with witches` broom on passion fruit in five Brazilian States

Phytoplasmas are cell wall-less prokaryotes and phloem-inhabitants associated with diseases that affect several crops. Passion fruit is a tropical plant species cultivated in various Brazilian regions. Diseases are among the factors that may cause damage to this crop, and witches` broom is a very important one. This disease, associated with a phytoplasma, has been reported only in Brazil, where it was described in Rio de Janeiro and Pernambuco States at the beginning of the 1980`s. In 2005-2006, symptomatic plants Suspected of phytoplasma infection were sampled in areas located in Sao Paulo, Parana, Rio de Janeiro, Sergipe and Bahia. Amplification of DNA fragments of 1.2kb from nested PCR primed by the pairs 16mF2/mR1 and 16F2n/R2 revealed the presence of phytoplasma in the tissue of plants from all sampled regions. Molecular detection of the agent allowed confirmation of the diagnosis based on the symptomatology; demonstrated the strong association between diseased plants and a phytoplasma, confirming previous investigations based on electron microscopy;, and revealed the present occurrence of the agent in the States of Bahia, Parana, Rio de Janeiro, Sergipe, and Sao Paulo.

Biochemical and functional properties of a thrombin-like enzyme isolated from Bothrops pauloensis snake venom

In the present study, a thrombin-like enzyme named BpSP-I was isolated from Bothrops pauloensis snake venom and its biochemical, enzymatic and pharmacological characteristics were determined. BpSP-I is a glycoprotein that contains both N-linked carbohydrates and sialic acid in its structure, with M(r) = 34,000 under reducing conditions and pI similar to 6.4. The N-terminal sequence of the enzyme (VIGGDECDINEHPFL) showed high similarity with other thrombin-like enzymes from snake venoms. BpSP-I showed high clotting activity upon bovine and human plasma and was inhibited by PMSF, benzamidine and leupeptin. Moreover, this enzyme showed stability when examined at different temperatures (-70 to 37 degrees C), pH values (3-9) or in the presence of divalent metal ions (Ca(2+), Mg(2+), Zn(2+) and Mn(2+)). BpSP-I showed high catalytic activity upon substrates, such as fibrinogen, TAME, S-2238 and S-2288. It also showed kallikrein-like activity, but was unable to act upon factor Xa and plasmin substrates. Indeed, the enzyme did not induce hemorrhage, myotoxicity or edema. Taken together, our data showed that BpSP-I is in fact a thrombin-like enzyme isoform isolated from Bothrops pauloensis snake venom. (C) 2009 Elsevier Ltd. All rights reserved.

Therapeutic Leukapheresis in Patients with Leukostasis Secondary to Acute Myelogenous Leukemia

Leukostasis is a relatively uncommon but potentially catastrophic complication of acute myelogenous leukemia (AML). Prompt leukoreduction is considered imperative to reduce the high mortality rate in this condition. Leukapheresis, usually associated with chemotherapy, is an established approach to diminish blast cell counts. We report a single center experience in managing leukostasis with leukapheresis. Fifteen patients with leukostasis of 187 patients with AML (8.02%) followed at our institution were treated with leukapheresis associated with chemotherapy. The procedures were scheduled to be performed on a daily basis until clinical improvement was achieved and WBC counts were significantly reduced. Overall and early mortalities, defined as that occurred in the first 7 days from diagnosis, were reported. A high proportion of our patients with leukostasis (46.66%) had a monocytic subtype AML (M4/M5, according to French-American-British classification). The median overall survival was 10 days, despite a significant WBC reduction after the first apheresis procedure (from 200.7 X 10(9)/L to 150.3 X 10(9)/L). Almost half of patients (7/15) had an early death. Therapeutic leukapheresis, associated or not to chemotherapy, is an effective approach to reduce WBC counts in patients with AML and leukostasis; however, this therapeutic procedure does not appear to change significantly the sombre prognosis observed in the majority of patients with this complication. Other forms of treatment must be found to reduce the high mortality rate related to leukostasis. J. Clin. Apheresis 26:181-185, 2011. (C) 2011 Wiley-Liss, Inc.

Human leukocyte antigen (HLA) and single nucleotide polymorphisms (SNPs) tumor necrosis factor (TNF)-alpha-238 and-308 as genetic markers of susceptibility to psoriasis and severity of the disease in a long-term follow-up Brazilian study

Background The strongest genetic marker for psoriasis is Cw*06. Polymorphisms in the tumor necrosis factor (TNF)-alpha promoter region, especially replacement of guanine with adenine in positions -238 and -308 are related to higher TNF-alpha production and higher risk for psoriasis in Caucasoid populations, not found in Asians. We performed a case-control study of 69 patients with psoriasis type I and 70 controls, characterized clinical progression along 10-years of follow-up in mild or severe disease and determined HLA class I, II, and TNF single nucleotide polymorphisms (SNPs) -238 and -308 polymorphisms to demonstrate whether these polymorphisms may be genetic risk for susceptibility to psoriasis or severity of the disease in Brazilians. Methods Polymorphisms were identified using PCR/SSP. Alleles, genotypes, and haplotypes frequencies were compared using Fisher`s test. Results More severe disease was found in male patients. It may be suggested that alleles B*37, Cw*06, Cw*12, and DRB1*07 were associated with severe disease course, while B*57 with mild disease. No statistical difference was found between the patients and controls regarding polymorphisms frequencies in TNF SNPs. This study pointed to a higher TNF-238 G/G genotype frequency (OR: 3.21; CI: 1.06-9.71; P = 0.04) in the group with severe disease. Conclusions Polymorphisms in the TNF-alpha SNPs do not seem to be a more important genetic risk factor for psoriasis than the already known Cw*06 in Brazilian patients, but these markers may be related to clinical manifestations.

Genetic diversity among Toxoplasma gondii isolates of small ruminants from Brazil: Novel genotypes revealed

Recent studies indicated that Toxoplasma gondii isolates of many domestic animal hosts from Brazil are genetically and biologically different from those in USA and Europe. Despite of high pathogenicity of this parasite to small ruminants, the epidemiology and genetic diversity of T. gondii in these animals are not well understood in Brazil. In this study, a total of 28 T. gondii samples (16 isolates from sheep in Sao Paulo state, and 12 isolates from goats in the states of Sao Paulo and Rio Grande do Norte) were genotyped using genetic markers SAG1, SAG2, SAG3, BTUB, CRAG, c22-8, c29-2, L358, PK1, Apico and CS3. Eleven genotypes were identified from these T. gondii isolates. Eight isolates (4 from sheep and 4 from goats) were grouped into the common clonal type Brl lineage. One sheep isolate was grouped to the type BrIII lineage. Five isolates grouped to three previously identified genotypes in Brazil, and 13 isolates grouped to six novel genotypes. Mixed genotype was found in one isolate from goat in Sao Paulo. No classical clonal Type I. II or III isolates were found, confirming previous reports that these clonal lineages are rare in Brazil. The allele types at the CS3 locus are strongly linked to mouse virulence of the parasite. The results of this study indicate that even though a large number of T. gondii genotypes have been identified from a variety of animal hosts in Brazil, high percentage of new genotypes are continuously identified from different animal species, suggesting extremely high diversity of T. gondii in the population. (C) 2010 Elsevier B.V. All rights reserved.

Ultrasonic Chemical Vapor Deposition-coated Tip versus High- and Low-speed Carbide Burs for Apicoectomy: Time Required for Resection and Scanning Electron Microscopy Analysis of the Root-end Surfaces

This study compared ultrasonic chemical vapor deposition (CVD)-coated tip (CVDentus #8.1117-1; Clorovale Diamantes Ind. e Com. Ltda Epp, Sao Jose dos Campos, SP, Brazil) versus high-speed (#FG700L) and low-speed (#699) carbide burs for apicoectomy, evaluating the time required for resection and analyzing the root-end surfaces by scanning electron microscopy. Thirty extracted human premolars had the canals instrumented and obturated and were randomly assigned to 3 groups (n = 10), according to the instrument used for root-end resection. The time required for resection of the apical 2 mm of each root was recorded. The resected apical segments were dried, sputter coated with gold, and examined with a scanning electron microscope at X 350 magnification. A four-point (0-3) scoring system was used to evaluate the apical surface smoothness. The results were analyzed statistically by the Kruskal-Wallis test and two-by-two comparisons analyses were performed using the Miller test. The significance level was set at 5%. Root-end resection with the high-speed bur was significantly faster (p < 0.05) compared with the low-speed bur and CVD tip. The carbide burs produced significantly smoother root-end surfaces than the CVD tip (p < 0.05). The low-speed bur produced the smoothest root-end surfaces, whereas the roughest and most irregular root ends (p < 0.05) were obtained with the CVD tip. However, no statistically significant difference (p > 0.05) was found between the high- and low-speed burs regarding the surface roughness of the resected root ends (p > 0.05). In conclusion, under the tested conditions, ultrasonic root-end resection took a longer time and resulted in rougher surfaces compared with the use of carbide burs at both high and low speed. (J Endod 2009;35:265-268)

Capillariaisis (Trichurida, Trichinellidae, Capillaria hepatica) in the Brazilian Amazon: low pathogenicity, low infectivity and a novel mode of transmission

Background: Human capillariasis caused by Capillaria hepatica (syn. Calodium hepaticum) is a rare disease with no more than 40 cases registered around the world. Classically, the disease has severe symptoms that mimic acute hepatitis. Natural reservoirs of C. hepatica are urban rodents (Mus musculus and Rattus novergicus) that harbor their eggs in the liver. After examining the feces of 6 riverine inhabitants (Rio Preto area, 8 degrees 03`S and 62 degrees 53`W to 8 degrees 14`S and 62 degrees 52`W) of the State of Rondonia, Brazil, and identifying C. hepatica eggs in their feces, the authors decided to investigate the real dimension of these findings by looking for two positive signals. Methods: Between June 1(st) and 15(th), 2008, 246 out of 304 individuals were clinically examined. Blood samples were collected, kept under -20 degrees C, and test by the indirect immunofluorescence technique. Results: The first positive signal was the presence of specific antibodies at 1: 150 dilution, which indicates that the person is likely to have been exposed to eggs, most likely non-infective eggs, passing through the food chain or via contaminated food (total prevalence of 34.1%). A second more specific signal was the presence of antibodies at higher titers, thus indicating true infection. Conclusions: The authors concluded that only two subjects were really infected (prevalence of 0.81%); the rest was false-positives that were sensitized after consuming non-embryonated eggs. The present study is the first one carried out in a native Amazonian population and indicates the presence of antibodies against C. hepatica in this population. The results further suggest that the transmission of the parasite occurs by the ingestion of embryonated eggs from human feces and/or carcasses of wild animals. The authors propose a novel mode of transmission, describing the disease as a low pathogenic one, and showing low infectivity.

The isolation and characterization of virulence factors of Cryptococcus spp. from saprophytic sources in the city of Ribeirao Preto, Sao Paulo, Brazil

Yeasts of the Cryptococcus genus are distributed in nature associated to animal and vegetal organic residues. Occasionally, species other than C. neoformans may be responsible for infectious diseases in human and animals. This study aims to determine the occurrence of Cryptococcus species in the atmosphere and bird droppings in the city of Ribeirao Preto, Sao Paulo, Brazil, and to evaluate three virulence factors: capsule formation, growth at 37 degrees C and melanin production. We analyzed 86 environmental samples (54 droppings and 32 air). Of the 41 strains isolated, 15 were C. neoformans var. neoformans (12 droppings and 3 air), 15 C. albidus (12 droppings and 3 air), 9 C. laurentii (7 droppings and 2 air) and 2 C. uniguttulatus (from droppings). Capsules were produced by 93.3% of C. neoformans var. neoformans, 66.7% of C. albidus, 88.9% of C. laurentii and 50% (1/2) of C. uniguttulatus. All, strains of C. neoformans, 20% of C. albidus and 44.4% of C. laurentii were able to grow at 37 degrees C. The melanin production on DOPA agar was verified in C. neoformans (93.3%), C. albidus (26.7%) and C. laurentii (66.7%). We concluded that different Cryptococcus species coexist in the same ecological niche and they are able to produce virulence factors. (C) 2007 Elsevier GmbH. All rights reserved.

Chondrichthyans from the base of the Irati Formation (Early Permian, Parana Basin), Sao Paulo, Brazil

Three species of chondrichthyans are reported from conglomeratic sandstone at the base of the Lower Permian (Artinskian) Irati Formation (Parana Basin) near Rio Claro, Sao Paulo State, Brazil. The fossils include: 1) dispersed teeth of the petalodont ltapyrodus punctatus Silva Santos 1990, first described from the Permian (Artinskian) Pedra do Fogo Formation, Parnaiba Basin, Northeast Brazil; 2) a new species of tooth of the Order Orodontiformes; and 3) a new species of finspine of the Order Ctenacanthiformes. These fossils occur in an allochthonous assemblage of vertebrate remains including other Chondrichthyes, Xenacanthiformes and cladodonts, paleonisciform bony fish, and tetrapods. This discovery is a significant contribution to the sparse record of South American Chondrichthyes from the Early Permian and raises questions regarding the paleoenvironmental adaptations among these fish within Paleozoic basins of Brazil at this time. (C) 2010 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.