Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison

The Global Initiative Against Asthma (GINA) was developed to meet the global challenge of asthma. GINA has been adopted in most countries and comparison of asthma management in different parts of the world may be of help when assessing the global dissemination of the guideline. The overall goals in GINA include that asthma patients should be free of symptoms, acute asthma attacks and activity limitations. The aim of the present study was to compare asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden. Information was collected from asthmatics in Sao Paulo and Uppsala with a questionnaire. The questionnaire dealt with the following issues: symptoms, smoking, self-management, hospital visits, effect on school/work and medication. The Sao Paulo patients were more likely to have uncontrolled asthma (36% vs 13%, P < 0.001), having made emergency room visits (57% vs 29%, P < 0.001) and having lost days at school or work because of their asthma (46% vs 28%, P = 0.03) than the asthmatics from Uppsala. There were no difference in the use of inhaled corticosteroids, but the Brazilian patients were more likely to be using theophylline (18% vs 1%, P = 0.001) and less likely to be using long-acting beta-2 agonists (18% vs 37%, P < 0.001). We conclude that the level of asthma control was lower among the patients from Sao Paulo than Uppsala. Few of the patients in either city reached the goals set up by GINA. Improved asthma management may therefore lead to health-economic benefits in both locations. Please cite this paper as: Skorup P, Rizzo LV, Machado-Boman L and Janson C. Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison. The Clinical Respiratory Journal 2009; 3: 22-28.

Hospital-based Surveillance to Evaluate the Impact of Rotavirus Vaccination in Sao Paulo, Brazil

Background: Brazil implemented routine immunization with the human rotavirus vaccine, Rotarix, in 2006 and vaccination coverage reached 81% in 2008 in Sao Paulo. Our aim was to assess the impact of immunization on the incidence of severe rotavirus acute gastroenteritis (AGE). Methods: We performed a 5-year (2004-2008) prospective surveillance at a sentinel hospital in Sao Paulo, with routine testing for rotavirus in all children less than 5 years of age hospitalized with AGE. Genotypes of positive samples were determined by reverse transcription polymerase chain reaction. Results: During the study, 655 children hospitalized with AGE were enrolled; of whom 169 (25.8%) were positive for rotavirus. In the post-vaccine period, a 59% reduction in the number of hospitalizations of rotavirus AGE and a 42.2% (95% confidence interval [CI], 18.6%-59.0%; P = 0.001) reduction in the proportion of rotavirus-positive results among children younger than 5 years were observed, with the greatest decline among infants (69.2%; 95% CI, 24.7%-87.4%; P = 0.004). Furthermore, the number of all-cause hospitalizations for AGE was reduced by 29% among children aged <5 years. The onset and peak incidences of rotavirus AGE occurred 3 months later in the 2007 and 2008 seasons compared with previous years. Genotype G2 accounted for 15%, 70%, and 100% of all cases identified, respectively, in 2006, 2007, and 2008. Conclusions: After vaccine implementation, a marked decline in rotavirus AGE hospitalizations was demonstrated among children younger than 5 years of age, with the greatest reduction in the age groups targeted for vaccination. The predominance of genotype G2P[4] highlights the need of continued postlicensure surveillance studies.

Shiga toxin-producing Escherichia coli and atypical enteropathogenic Escherichia coli strains isolated from healthy sheep of different populations in Sao Paulo, Brazil

Aims: Sheep are important carriers of Shiga toxin-producing Escherichia coli (STEC) in several countries. However, there are a few reports about ovine STEC in American continent. Methods and Results: About 86 E. coli strains previously isolated from 172 healthy sheep from different farms were studied. PCR was used for detection of stx(1), stx(2), eae, ehxA and saa genes and for the identification of intimin subtypes. Restriction fragment length polymorphism (RFLP)-PCR was performed to investigate the variants of stx(1) and stx(2), and the flagellar antigen (fliC) genes in nonmotile isolates. Five isolates were eae(+) and stx(-), and belonged to serotypes O128:H2/beta-intimin (2), O145:H2/gamma, O153:H7/beta and O178:H7/epsilon. Eighty-one STEC isolates were recovered, and the stx genotypes identified were stx(1c)stx(2d-O118) (46.9%), stx(1c) (27.2%), stx(2d-O118) (23.4%), and stx(1c)stx(2dOX3a) (2.5%). Pulsed-field gel electrophoresis (PFGE) revealed 27 profiles among 53 STEC and atypical enteropathogenic Escherichia coli (EPEC) isolates. Conclusions: This study demonstrated that healthy sheep in Sao Paulo, Brazil, can be carriers of potential human pathogenic STEC and atypical EPEC. Significance and Impact of the Study: As some of the STEC serotypes presently found have been involved with haemolytic uraemic syndrome (HUS) in other countries, the important role of sheep as sources of STEC infection in our settings should not be disregarded.

Diversity of Somatic Coliphages in Coastal Regions with Different Levels of Anthropogenic Activity in Sao Paulo State, Brazil

Bacteriophages are the most abundant and genetically diverse viruses on Earth, with complex ecology in both quantitative and qualitative terms. Somatic coliphages (SC) have been reported to be good indicators of fecal pollution in seawater. This study focused on determining the concentration of SC and their diversity by electron microscopy of seawater, plankton, and bivalve samples collected at three coastal regions in Sao Paulo, Brazil. The SC counts varied from < 1 to 3.4 x 103 PFU/100 ml in seawater (73 samples tested), from < 1 to 4.7 x 10(2) PFU/g in plankton (46 samples tested), and from < 1 to 2.2 x 10(1) PFU/g in bivalves (11 samples tested). In seawater samples, a relationship between the thermotolerant coliforms and Escherichia coli and SC was observed at the three regions (P = 0.0001) according to the anthropogenic activities present at each region. However, SC were found in plankton samples from three regions: Baixada Santista (17/20), Canal de Sao Sebastiao (6/14), and Ubatuba (3/12). In seawater samples collected from Baixada Santista, four morphotypes were observed: A1 (4.5%), B1 (50%), C1 (36.4%), and D1 (9.1%). One coliphage, Siphoviridae type T1, had the longest tail: between 939 and 995 nm. In plankton samples, Siphoviridae (65.8%), Podoviridae (15.8%), Microviridae (15.8%), and Myoviridae (2.6%) were found. In bivalves, only the morphotype B1 was observed. These SC were associated with enteric hosts: enterobacteria, E. coli, Proteus, Salmonella, and Yersinia. Baixada Santista is an area containing a high level of fecal pollution compared to those in the Canal de Sao Sebastiao and Ubatuba. This is the first report of coliphage diversity in seawater, plankton, and bivalve samples collected from Sao Paulo coastal regions. A better characterization of SC diversity in coastal environments will help with the management and evaluation of the microbiological risks for recreation, seafood cultivation, and consumption.

Resistance to cypermethrin, deltamethrin and chlorpyriphos in populations of Rhipicephalus (Boophilus) microplus (Acari: Ixodidae) from small farms of the State of Sao Paulo, Brazil

A field survey of resistance was conducted based on the larval packet test technique with synthetic pyrethroids (cypermethrin and deltamethrin) and organophosphates (chlorpyriphos) in Rhipicephalus (Boophilus) microplus field populations from six different regions of the State of Sao Paulo (Brazil). 82.6% of the populations showed resistance to cypermethrin, 86.36% to deltamethrin and 65.25% to chlorpyriphos, with 50% presenting resistance to both SP and OP acaricide. According to the questionnaires completed by the producers, OP + SP mixtures followed by SP-only formulations were the products most commonly used for controlling the cattle tick in the surveyed areas. The present study showed high occurrence of resistance to SP and OP in the State of Sao Paulo, Brazil and revealed the type of strategy adopted by small dairy farms in this state. This information is fundamental in order to establish the monitoring of resistance on each farm individually, contributing to the rational use of acaricides for the control of R. (B.) microplus. (C) 2011 Elsevier B.V. All rights reserved.

Evaluation of trace element levels in muscles, liver and gonad of fish species from Sao Francisco River of the Parana Brazilian state by using SR-TXRF technique

This study is focused on the analysis of an accumulation of inorganic elements in muscles, liver and gonad of seven fish species from Sao Francisco River located in the Parana state of Brazil. Concentrations of the elements were determined using the SR-TXRF technique. In the muscles of fish species, negative length dependent relationships were observed for chromium and zinc ion absorption. The obtained results showed that accumulated Cr ions values are above the limits defined in the Brazilian legislative norm on food. (C) 2010 Elsevier Ltd All rights reserved.

Tectonic fabric revealed by AARM of the proterozoic mafic dike swarm in the Salvador city (Bahia state): Sao Francisco Craton, NE Brazil

Magnetic fabric and rock magnetism studies were performed on 25 unmetamorphosed mafic dikes of the Meso-Late Proterozoic (similar to 1.02 Ga) dike swarm from Salvador (Bahia State, NE Brazil). This area lies in the north-eastern part of the Sao Francisco Craton, which was dominantly formed/reworked during the Transamazonian orogeny (2.14-1.94 Ga). The dikes crop out along the beaches and in quarries around Salvador city, and cut across both amphibolite dikes and granulites. Their widths range from a few centimeters up to 30 m with an average of similar to 4 m, and show two main trends N 140-190 and N 100-120 with vertical dips. Magnetic fabrics were determined using both anisotropy of low-field magnetic susceptibility (AMS) and anisotropy of anhysteretic remanent magnetization (AARM). The magnetic mineralogy was investigated by many experiments including remanent magnetization measurements at variable low temperatures (10-300 K), Mossbauer spectroscopy, high temperature magnetization curves (25-700 degrees C) and scanning electron microscopy (SEM). The rock magnetism study suggests pseudo-single-domain magnetite grains carrying the bulk magnetic susceptibility and AARM fabrics. The magnetite grains found in these dikes are large and we discard the presence of single-domain grains. Its composition is close to stoichiometric with low Ti substitution, and its Verwey transition occurs around 120 K. The main AMS fabric recognized in the swarm is so-called normal, in which the K(max)-K(int) plane is parallel to the dike plane and the magnetic foliation pole K(min)) is perpendicular to it. This fabric is interpreted as due to magma flow, and analysis of the K m inclination permitted to infer that approximately 80% of the dikes were fed by horizontal or sub-horizontal flows (K(max) < 30 degrees). This interpretation is supported by structural field evidence found in five dikes. In addition, based on the plunge of K(max), two mantle sources could be inferred; one of them which fed about 80% of the swarm would be located in the southern part of the region, and the other underlied the Valeria quarry. However, for all dikes the AARM tensors are not coaxial with AMS fabrics and show a magnetic lineation (AARM(max)) oriented to N30-60E, suggesting that magnetite grains were rotated clockwise from dike plane. The orientation of AARM lineation is similar to the orientation of a system of faults in which the Salvador normal fault is the most important. These faults were formed during Cretaceous rifting in the Reconcavo-Tucano-jatoba assemblage that corresponds to an aborted intra-continental rift formed during the opening of the South Atlantic. Therefore, the AARM fabric found for the Salvador dikes is probably tectonic in origin and suggests that the dike swarm was affected by the important tectonic event responsible for the break-up of the Gondwanaland. (C) 2008 Elsevier B.V. All rights reserved.

Insights into the dynamics and sources of atmospheric lead and particulate matter in Sao Paulo, Brazil, from high temporal resolution sampling

We present the first results of a study investigating the processes that control concentrations and sources of Pb and particulate matter in the atmosphere of Sao Paulo City Brazil Aerosols were collected with high temporal resolution (3 hours) during a four-day period in July 2005 The highest Pb concentrations measured coincided with large fireworks during celebration events and associated to high traffic occurrence Our high-resolution data highlights the impact that a singular transient event can have on air quality even in a megacity Under meteorological conditions non-conducive to pollutant dispersion Pb and particulate matter concentrations accumulated during the night leading to the highest concentrations in aerosols collected early in the morning of the following day The stable isotopes of Pb suggest that emissions from traffic remain an Important source of Pb in Sao Paulo City due to the large traffic fleet despite low Pb concentrations in fuels (C) 2010 Elsevier BV All rights reserved

Microgranitic Enclaves as Products of Self-mixing Events: a Study of Open-system Processes in the Maua Granite, Sao Paulo, Brazil, Based on in situ Isotopic and Trace Elements in Plagioclase

Felsic microgranular enclaves with structures indicating that they interacted in a plastic state with their chemically similar host granite are abundant in the Maua Pluton, SE Brazil. Larger plagioclase xenocrysts are in textural disequilibrium with the enclave groundmass and show complex zoning patterns with partially resorbed An-rich cores (locally with patchy textures) surrounded by more sodic rims. In situ laser ablation-(multi-collector) inductively coupled plasma mass spectrometry trace element and Sr isotopic analyses performed on the plagioclase xenocrysts indicate open-system crystallization; however, no evidence of derivation from more primitive basic melts is observed. The An-rich cores have more radiogenic initial Sr isotopic ratios that decrease towards the outermost part of the rims, which are in isotopic equilibrium with the matrix plagioclase. These profiles may have been produced by either (1) diffusional re-equilibration after rim crystallization from the enclave-forming magma, as indicated by relatively short calculated residence times, or (2) episodic contamination with a decrease of the contaminant ratio proportional to the extent to which the country rocks were isolated by the crystallization front. Profiles of trace elements with high diffusion coefficients would require unrealistically long residence times, and can be modeled in terms of fractional crystallization. A combination of trace element and Sr isotope data suggests that the felsic microgranular enclaves from the Maua Pluton are the products of interaction between end-member magmas that had similar compositions, thus recording `self-mixing` events.

Neoproterozoic glacial dynamics revealed by provenance of diamictites of the Bebedouro Formation, Sao Francisco Craton, Central Eastern Brazil

One of the main questions on Neoproterozoic geology regards the extent and dynamics of the glacial systems that are recorded in all continents. We present evidence for short transport distances and localized sediment sources for the Bebedouro Formation, which records Neoproterozoic glaciomarine sedimentation in the central-eastern Sao Francisco Craton (SFC), Brazil. New data are presented on clast composition, based on point counting in thin section and SHRIMP dating of pebbles and detrital zircon. Cluster analysis of clast compositional data revealed a pronounced spatial variability of clast composition on diamictite indicating the presence of individual glaciers or ice streams feeding the basin. Detrital zircon ages reveal distinct populations of Archean and Palaeoproterozoic age. The youngest detrital zircon dated at 874 +/- 9 Ma constrains the maximum depositional age of these diamictites. We interpret the provenance of the glacial diamictites to be restricted to sources inside the SFC, suggesting deposition in an environment similar to ice streams from modern, high latitude glaciers.

Menezesite, the first natural heteropolyniobate, from Cajati, Sao Paulo, Brazil: Description and crystal structure

Menezesite, ideally Ba2MgZr4(BaNb12O42)center dot 12H(2)O, occurs as a vug mineral in the contact zone between dolomite carbonatite and ""jacupirangite"" (=a pyroxenite) at the Jacupiranga mine, in Cajati county, Sao Paulo state, Brazil, associated with dolomite, calcite, magnetite, clinohumite, phlogopite, ancylite-(Ce), strontianite, pyrite, and tochilinite. This is also the type locality for quintinite-2H. The mineral forms rhombododecahedra up to I mm, isolated or in aggregates. Menezesite is transparent and displays a vitreous luster; it is reddish brown with a white streak. It is non-fluorescent. Mohs hardness is about 4. Calculated density derived from the empirical formula is 4.181 g/cm(3). It is isotropic, 1.93(1) (white light); n(calc) = 2.034. Menezesite exhibits weak anomalous birefringence. The empirical formula is (Ba1.47K0.53Ca0.3,Ce0.17Nd0.10Na0.06La0.02)(Sigma 2.66)(Mg0.94Mn0.23Fe0.23Al0.03)(Sigma 1.43)(Zr2.75Ti0.96Th0.29)(Sigma 4.00)[(Ba0.72Th0.26U0.02)(Sigma 1.00)(Nb9.23Ti2.29Ta0.36Si0.12)Sigma O-12.00(42)]center dot 12H(2)O. The mineral is cubic, space group 10 (204), a = 13.017(1) angstrom, V = 2206(1) angstrom(3), Z = 2. Menezesite is isostructural with the synthetic compound Mg-7[MgW12O42](OH)(4)center dot 8H(2)O. The mineral was named in honor of Luiz Alberto Dias Menezes Filho (born 1950), mining engineer, mineral collector and merchant. Both the description and the name were approved by the CNMMN-IMA (Nomenclature Proposal 2005-023). Menezesite is the first natural heteropolyniobate. Heteropolyanions have been employed in a range of applications that include virus-binding inorganic drugs (including the AIDs virus), homogeneous and heterogeneous catalysts, electro-optic and electrochromic materials, metal and protein binding, and as building blocks for nanostructuring of materials.

Rhyacian (2.23-2.20 Ga) juvenile accretion in the southern Sao Francisco craton, Brazil: Geochemical and isotopic evidence from the Serrinha magmatic suite, Mineiro belt

The Serrinha magmatic suite (Mineiro belt) crops out in the southern edge of the Sao Francisco craton, comprising the Brito quartz-diorite, Brumado de Cima and Brumado de Baixo granodiorites, granophyres and felsic sub-volcanic and volcanic rocks, part of which intruded into the Nazareno greenstone belt. The suite rocks have petrographic features that are consistent with magma supercooling due to the low water content combined with volatile loss, leading to crystallization of quartz and alkaline feldspar at the rims of plagioclase phenocrysts (granophyric intergrowth). The investigated rocks are sub-alkaline, calc-alkaline and show low content in rare earth elements. The U-Pb zircon crystallization ages for the Brumado de Cima granodiorite [2227 +/- 22 (23) Ma] and a coeval granophyre [2211 +/- 22 (23) Ma], coupled with available single-zircon Pb evaporation ages for the Brito and Brumado de Baixo plutons, are significantly older than the ""Minas orogeny"" (ca. 2100-2050 Ga) of Quadrilatero Ferrifero area, eastward from the Serrinha suite. Our data establish an early Rhyacian event tectonically linked with the evolution of the Mineiro belt. The bulk Nd isotopic signature [low negative to positive epsilon(Nd(t)) values] of the Serrinha samples are consistent with the important role of Paleoproterozoic mantle components in the magma genesis. The integrated geologic, geochemical and isotopic information suggests that Paleoproterozoic evolution of the Mineiro belt initiated in a passive continental margin basin with deposition of the Minas Supergroup at ca. 2500 Ma. This stage was succeeded by outboard rupture of the oceanic lithosphere with development and coalescence of progressively younger magmatic arcs during Rhyacian time. One of the earliest arcs formed the Serrinha suite. The tectonic collage of the Serrinha and Ritapolis (2190-2120 Ma) arcs produced the NE-SW Lenheiro shear zone, resulting in mylonitization and recrystallization of both the granitoid intrusions and host rocks. As a matter of fact juxtaposition of distinct magmatic units in age and origin took place along the Lenheiros structure in this sector of the Mineiro belt. (C) 2009 Elsevier Ltd. All rights reserved.

Geochemistry of natural chromium occurrence in a sandstone aquifer in Bauru Basin, Sao Paulo State, Brazil

Anomalous concentrations of Cr(VI) occur in groundwaters of the Adamantina Aquifer, in a large region in the western state of Sao Paulo, sometimes exceeding the potability limit (0.05 mg L(-1)). To identify the possible geochemical reactions responsible for the occurrence of Cr in groundwater in Urania, borehole rock samples were collected in order to carry out mineralogical and chemical analyses. In addition, multilevel monitoring wells were installed and groundwater samples were analyzed. Analyses of the borehole rock samples show the occurrence of a geochemical anomaly of Cr in the quartzose sandstones (average concentrations of 221 ppm). Chrome-diopside is one of the main minerals contributing to this anomaly, having an average Cr content of 1505 ppm. Sequential extraction experiments indicated weakly adsorbed Cr in the order of 0.54 ppm, and this quantity is enough to provide the Cr concentrations observed in groundwater. Groundwaters from the monitoring wells proved to be stratified, with the highest concentrations of Cr(VI) (0.13 mg L(-1)) being associated with high redox and pH values (over 10) and high concentrations of Na. Geochemical reactions that may explain the release of Cr from the solid phase to groundwater involve the release of Cr(III) from minerals (like chrome-diopside and Cr-Fe hydroxide), followed by oxidation of Cr(III) to Cr(VI), probably related to the reduction of Mn oxides present in the aquifer. Then cation exchange occurs and dissolution of carbonates which increases the pH of groundwater, resulting in the desorption and mobilization of Cr(VI) into groundwater. (C) 2011 Elsevier Ltd. All rights reserved.

Relation between sedimentary framework and hydrogeology in the Guarani Aquifer System in Sao Paulo state, Brazil

This paper presents the results of a new investigation of the Guarani Aquifer System (SAG) in Sao Paulo state. New data were acquired about sedimentary framework, flow pattern, and hydrogeochemistry. The flow direction in the north of the state is towards the southwest and not towards the west as expected previously. This is linked to the absence of SAG outcrop in the northeast of Sao Paulo state. Both the underlying Piramboia Formation and the overlying Botucatu Formation possess high porosity (18.9% and 19.5%, respectively), which was not modified significantly by diagenetic changes. Investigation of sediments confirmed a zone of chalcedony cement close to the SAG outcrop and a zone of calcite cement in the deep confined zone. The main events in the SAG post-sedimentary history were: (1) adhesion of ferrugineous coatings on grains, (2) infiltration of clays in eodiagenetic stage, (3) regeneration of coatings with formation of smectites, (4) authigenic overgrowth of quartz and K-feldspar in advanced eodiagenetic stage, (5) bitumen cementation of Piramboia Formation in mesodiagenetic stage, (6) cementation by calcite in mesodiagenetic and telodiagenetic stages in Piramboia Formation, (7) formation of secondary porosity by dissolution of unstable minerals after appearance of hydraulic gradient and penetration of the meteoric water caused by the uplift of the Serra do Mar coastal range in the Late Cretaceous, (8) authigenesis of kaolinite and amorphous silica in unconfined zone of the SAG and cation exchange coupled with the dissolution of calcite at the transition between unconfined and confined zone, and (9) authigenesis of analcime in the confined SAG zone. The last two processes are still under operation. The deep zone of the SAG comprises an alkaline pH, Na-HCO(3) groundwater type with old water and enriched delta(13)C values (<-3.9), which evolved from a neutral pH, Ca-HCO(3) groundwater type with young water and depleted delta(13)C values (>-18.8) close to the SAG outcrop. This is consistent with a conceptual geochemical model of the SAG, suggesting dissolution of calcite driven by cation exchange, which occurs at a relatively narrow front recently moving downgradient at much slower rate compared to groundwater flow. More depleted values of delta(18)O in the deep confined zone close to the Parana River compared to values of relative recent recharged water indicate recharge occur during a period of cold climate. The SAG is a ""storage-dominated"" type of aquifer which has to be managed properly to avoid its overexploitation. (C) 2011 Elsevier Ltd. All rights reserved.

Lycopodiopsis derbyi Renault from the Corumbatai Formation in the state of Sao Paulo (Guadalupian of Parana Basin, Southern Brazil): New data from compressed silicified stems

Lycopodiopsis derbyi Renault was analyzed on the basis of compressed silicified stems from four Guadalupian outcrops of the Parana Basin (Corumbatai Formation) in the State of Sao Paulo, Southern Brazil. Dichotomous stems have been recorded, and three different branch regions related to apoxogenesis are described. The most proximal region has larger, clearly rhomboidal leaf cushions, with protruding upper edges; the intermediate transitional region also has rhombic leaf cushions, but they are smaller and less elongated than the lower in the same axis; finally, the most distal region reveals only incipient cushions, with inconspicuous infrafoliar bladders; interspersed microphylls were still attached. A well preserved branch representative of this most distal region was sectioned; it has a siphonostelic cylinder similar to that previously described for L derbyi. The cortex, however, shows new traits, such as a short portion of elongated cells between the periderm and the external cortex (or leaf cushion tissue). The stems were apparently silicified prior to their final burial but were probably not transported for long distances. Their final burial may have taken place during storm events, which were common during the deposition of the Corumbatai Formation. These stems are commonly deformed due to compression, mainly because the internal cortical portions rapidly decayed prior to silicification due to their thin-walled tissue, and are therefore not preserved. The common alkalinity of a shallow marine environment such as that in which the Corumbatai Formation was deposited, should mobilize the silica and favors petrifaction. Based on the new data, an emended diagnosis is proposed and a modification of the identification key published by Thomas and Meyen in 1984 for Upper Paleozoic Lycopsida is suggested. (C) 2009 Elsevier B.V. All rights reserved.