On an acute case of Chagas disease in a region under vector control in the state of São Paulo, Brazil

Desde a década de 1970 não se notificavam casos autóctones de doença de Chagas aguda em São Paulo. em março de 2006 a Vigilância Epidemiológica registrou óbito por doença de Chagas aguda, em Itaporanga, de paciente de seis anos de idade. Exame histopatológico post mortem realizado no Hospital das Clínicas da Faculdade de Medicina de Botucatu confirmou o diagnóstico. Consultamos prontuários de hospitais e entrevistamos profissionais de saúde envolvidos além de familiares do paciente. Descrevemos medidas adotadas in loco para identificar a via de transmissão, reservatórios e vetores. Discutimos as possíveis fontes de infecção. Na região não foram identificados outros casos humanos, vetores ou reservatórios vertebrados infectados por Trypanosoma cruzi. Salientamos a importância de manter a vigilância, mesmo em áreas onde a transmissão de doença de Chagas está interrompida e naquelas ainda infestadas por triatomíneos. Deve-se admitir a hipótese diagnóstica de doença de Chagas quando observados: edema palpebral (uni ou bilateral), insuficiência cardíaca, miocardite, pericardite, anasarca, quadros similares aos de síndrome nefrótica ou glomerulonefrite sem causas outras aparentes, em pacientes com dados epidemiológicos positivos. Encontro, mesmo em raras ocasiões, de triatomíneos na região ou ainda contato com alimento contaminável com formas infectantes de T. cruzi.

Auditory processing in children and adolescents in situations of risk and vulnerability

CONTEXTO E OBJETIVO: Crianças e adolescentes que vivem em situação de vulnerabilidade social apresentam uma série de problemas de saúde. Apesar disso, ainda é controversa a afirmação sobre a existência de alterações cognitivas e/ou sensoriais. O objetivo deste estudo foi investigar aspectos relacionados ao processamento auditivo, através da aplicação de testes de potencial evocado auditivo de tronco encefálico (PEATE) e avaliação comportamental do processamento auditivo em crianças em situação de rua, comparando a um grupo controle. TIPO DE ESTUDO E LOCAL: Estudo transversal no Laboratório de Processamento Auditivo, Faculdade de Medicina da Universidade de São Paulo. MÉTODOS: Os testes de processamento auditivo foram aplicados em um grupo de 27 indivíduos, subdivididos em grupos de 11 crianças (7 a 10 anos) e 16 adolescentes (11 a 16 anos) de ambos os sexos, em situação de vulnerabilidade social, e comparado a um grupo controle, formado por 21 crianças, subdivididas em grupos de 10 crianças e 11 adolescentes, pareados por idade, sem queixas. Também se aplicou os PEATE para investigação da integridade da via auditiva. RESULTADOS: Para ambas as faixas etárias, foram encontradas diferenças significantes entre grupos estudo e controle para a maioria dos testes aplicados, sendo que o grupo estudo apresentou desempenho estatisticamente pior do que o controle para todos os testes, exceto para o teste pediatric speech intelligibility. Apenas uma criança apresentou resultado alterado para os PEATE. CONCLUSÕES: Os resultados demonstraram pior desempenho do grupo estudo (crianças e adolescentes) para os testes comportamentais de processamento auditivo, apesar de estes apresentarem integridade da via auditiva em nível de tronco encefálico, demonstrada pela normalidade nos resultados do PEATE.

Experimental model for transanal endorectal pull-through surgery. Technique of de la Torre and Ortega

Background: We describe an experimental model for transanal endorectal pull-through surgery using the method of de]a Torre and Ortega that can be used for training purposes in experimental laboratories.Methods: Ten rabbits were submitted to the transanal endorectal pull-through technique of de la Torre and Ortega. Animals were randomly selected in the Botucatu School of Medicine experimental laboratory. Animals weighted between 2800 and 4400 g. Colons were not prepared, and antibiotic therapy was not used; dipyrone(1) was administered postoperatively for analgesic purposes. We standardized resected segment size, recorded surgical time, and observed Survival and possible complications for 1 month.Results: All animals survived the initial follow-up period without infection. Bowel movements returned quickly, and all animals were evacuating regularly within the first 24 hours. Mean surgical time was 48.6 minutes.Conclusions: the experimental model proposed in this study is very useful for training and improving surgical techniques using the method of de la Torre and Ortega. The rabbit is an excellent animal for this surgery because of its size and postoperative resistance. (c) 2005 Elsevier B.V. All rights reserved.

Antimicrobial activity of the essential oils of some spice herbs

Essential oils were obtained from fennel seeds, dill, cumin and coriander. Their antimicrobial activity was tested on isolated clinical specimens of patients treated at the University Hospital of the School of Medicine of Botucatu, SP, UNESP. Microorganisms were grown in BHI (Brain Heart Infusion/Oxoid) at 37oC/18 hours and resuspended in 0,5 Mac Farland's Standard (1,5 x 108 CFU/mL). The diffusion method was performed, putting 10 μl of the essential oils on paper disks (6mm of diameter) (Blank Disks/CECON) at 37oC/24 hours. After this period, the disks were put on plates containing Mueller Hinton Agar (Oxoid) and inoculated with the microorganisms. After 48 hours at 37oC, inhibitory zones were measured (mm) for the respective oils and strains. The essential oil from Anethum graveolens showed antimicrobial activity against Staphylococcus aureus (inhibitory zone=18 mm), Salmonella sp. (=11 mm) and E. coli (10 mm). The Cuminum cyminum essential oil was effective against E. coli, P. aeruginosa and Salmonella sp. and their inhibitory zones were 18, 10 and 23 mm, respectively. Coriandrum sativum oil was active only against Salmonella sp. (18 mm) and Foeniculum vulgare inhibited only E. coli (9 mm).

Clinical and nutritional profile of individuals with Chagas disease

Chagas disease (CD), caused by the protozoan Trypanossoma cruzi, affects approximately 18 million individuals in the Americas, 5 million of which five in Brazil. Most chronic sufferers have either the indeterminate form of the disease, without organic compromise, or the cardiac or digestive forms. Despite the importance of this disease, there is no information on the effect of nutrition on CD evolution. We evaluated the clinical-nutritional profile of individuals with CD treated at the Tropical Diseases Nutrition Out-Patient Clinic of the Botucatu School of Medicine, UNESP.A retrospective cohort study was performed between 2002 and 2006, on 66 patients with serum and parasitological diagnosis of CD. Epidemiological, clinical, nutritional, and biochemical data were collected, including gender, age, skin color, smoking, alcoholism, physical activity, weight, stature, body mass index, abdominal circumference, glycemia, and lipid profile. Fifty-three percent were mate and 47% female; 96% were white skinned. Mean age was 49.6±6.36 years. The predominant form was indeterminate in 71 %; smoking and drinking were recorded in 23% and 17%, respectively. Sedentariness predominated in 83%, and 55% presented increased abdominal circumference. Most, 94%, were overweight or obese. The biochemical exam revealed hyperglycemia in 12% and dyslipidemia in 74%. These findings suggest that the Chagas population presents co-morbidities and risk factors for developing chronic non-transmissible diseases, including cardiovascular diseases, making CD evolution even worse. © 2007 by The Brazilian Journal of Infectious Diseases and Contexto Publishing. All rights reserved.

Health status profile of climacteric women

Study design: Retrospective analysis of medical records. Purpose: This study aimed to determine the prevalence of obesity, diabetes mellitus, hypertension and dyslipidemia in a group of climacteric women. Methods: Study of the first patients treated at the Menopause Clinic (ACLI), Department of Obstetrics and Gynecology, School of Medicine of Ribeirão Preto (USP), from 1983 to 2007. Data on weight, height, BMI, biological group, diagnosis of hypertension, diabetes and dyslipidemia was collected from February/2008 until April/2008. Results: From 1983 until 2007, 400 patients were followed up, and 272 had their records registered. Of these 272 patients, 628 were selected queries, and therefore, on average, each woman had three returns. Women over the age of 29 and maximum of 80 years and median BMI above 25kg/m2. The prevalence of diabetes, hypertension and dyslipidemia was respectively 32%, 68% and 54%. The prevalence of NCDs and BMI was higher for the later groups. Conclusion: Climacteric women treated at a hospital level care center showed a worsening of the BMI and the prevalence of noncommunicable chronic diseases over time, which is urging a closer look at health professionals in this population group.

Impact of Epstein-Barr virus load, virus genotype, and frequency of the 30bp deletion in the viral BNLF-1 gene in patients harboring the human immunodeficiency virus

Patients infected with the human immunodeficiency virus (HIV) are at higher risk of developing Epstein-Barr Virus (EBV)-associated lymphomas. The usefulness of monitoring EBV in peripheral blood mononuclear cells (PBMCs) of patients infected with HIV has not been established. The aim of this study was to evaluate the EBV viral load in PBMCs, the frequency of viral genotypes, and the presence of the 30-bp deletion in the BNLF-1 gene. DNA samples from 156 patients attending the HIV/AIDS Day Clinic at Botucatu School of Medicine, Sao Paulo State University were evaluated. The EBV viral load was detectable by real time PCR in 123/156 (78.8%) cases and was higher in patients not receiving antiretroviral treatment or under therapeutic failure than in patients under successful highly active antiretroviral therapy (HAART) (P=0.0076). Overall, the profile of patients with high EBV viral load included elevated HIV viremia (P=0.0005), longer time of HIV diagnosis (P=0.0026), and increased levels of T CD8 + lymphocytes (P=0.0159). The successful amplification of the EBNA-2 gene by nested-PCR was achieved in 95 of 123 (77.2%) cases, of which 75.8% were EBV-1, 9.5% EBV-2, and 14.7% were co-infected with both EBV-1 and -2. The analysis of the BNLF-1 gene was possible in 99 of 123 (80.5%) cases, of which 50.5% had the 30-bp deletion. EBV-1 was more common than EBV-2, which may reflect the fact that the cohort was predominantly Caucasian and heterosexual. J. Med. Virol. 85:2110-2118, 2013. © 2013 Wiley Periodicals, Inc.

Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Cross-sectional Study

OBJECTIVE: This study aimed at evaluating the flora and bacterial load of chronic leg ulcers (CLUs) according to the clinical judgment of colonization or infection.DESIGN: This was an analytical and cross-sectional study.SETTING: This study was conducted in an outpatient wound care unit in the Dermatology Department of the Botucatu School of Medicine-UNESP, Brazil.PARTICIPANTS: The participants were patients with CLUs who did not use systemic antibiotics.METHODS: The ulcers were clinically divided into 3 groups: ulcers with good granulation tissue (GGT), critical colonization (CC), and infection. Secretion was collected from a 1-cm(2) area using a swab and seeded by the semiquantitative method.OUTCOME MEASURES: The main outcome measures were genus and species of the bacteria found in the cultures and result of the semiquantitative culture correlating with the clinical diagnosis of GGT, CC, and infection.MAIN RESULTS: Seventy-seven ulcers were evaluated: 27 with GGT, 29 with CC, and 21 with infection. Gram-negative bacteria were most often found in all groups (81%): Pseudomonas aeruginosa, in granulation and colonized ulcers, and Proteus mirabilis, in infected ulcers. Ulcers from the infected group showed higher bacterial load.CONCLUSIONS: The flora of CLUs was predominantly constituted by gram-negative bacteria, and P aeruginosa was the most prevalent. The bacterial load of infected ulcers was higher as compared with the others, although some ulcers with GGT also presented a high load. The interpretation of microbiologic tests based on the swab techniques and even on semiquantitative analysis requires close clinical correlation.

Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from a Brazilian university hospital

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Particle Physics in the teaching practice of the participants of the School of Physics CERN

A atualização dos currículos escolares e, em especial, a inserção de assuntos de física moderna e contemporânea já foram defendidos com justificativas satisfatórias, tanto por professores em atividade escolar como por pesquisadores da área de ensino de física. Entre os assuntos que deveriam ser discutidos encontramos a Física das Partículas Elementares. O ensino deste tópico é justificado pelo fato dele permitir a discussão: a) de uma nova visão de mundo; b) de uma visão mais adequada da ciência; c) da reinterpretação da Física Clássica; d) da dinâmica da Ciência e seu desenvolvimento; e) da contribuição dos diversos cientistas; f) do papel da experimentação; g) do investimento financeiro e cooperativo de diversos países e pesquisadores. No entanto, para que a inserção de assuntos de física moderna e contemporânea ocorra de maneira eficiente é necessária a atualização dos professores que já estão em docência escolar, bem como uma formação adequada daqueles que estão em processo de formação inicial. Neste sentido, desde 2010 a Sociedade Brasileira de Física realiza anualmente a Escola de Física do CERN, na qual participam professores brasileiros de física de escolas públicas do Ensino Médio. Nesta escola são desenvolvidas aulas sobre física de partículas, sessões experimentais e visitas aos laboratórios do CERN. Perante isso, investigamos como os professores participantes da Escola de Física do CERN abordam a física de partículas em suas aulas após participarem dela.

Detection of oxacillin resistance in Staphylococcus aureus isolated from the neonatal and pediatric units of a brazilian teaching hospital

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)