Epidemiological profile of hepatitis C in blood donors at the Uberaba Regional Blood Center

The aim of the present study was to outline the serological profile of hepatitis C among blood donors seen at the Uberaba Regional Blood Center, Hemominas Foundation, over the last 14 years. The frequency of hepatitis C was compared between first-time and repeat donors and the epidemiological characteristics of those with positive and indeterminate ELISA anti-HCV (third and fourth generation) were analyzed based on the donor histories kept in the archives of the Uberaba Regional Blood Center. The serological ineligibility rate was 0.3%, with higher prevalence in the group of first-time donors. We did not find any significant differences regarding age, skin color, marital status or place of residence between eligible and ineligible donors; however, the frequency of positive serology was higher among men. The lower (0.3%) rate of ineligibility due to hepatitis C that was observed at the Uberaba Regional Blood Center, in relation to most Brazilian blood centers, is probably due to the large number of repeat donors (83.3%). This reinforces the importance of achieving donor commitment for increasing transfusion safety.

Caracterização molecular de Pseudomonas aeruginosa resistentes a carbapenêmicos e produtoras de metalo-β-lactamase isoladas em hemoculturas de crianças e adolescentes com câncer

INTRODUCÃO: O objetivo do estudo foi avaliar a prevalência e a disseminação de amostras de Pseudomonas aeruginosa resistente aos carbapenêmicos e produtoras de metalo-β-lactamases isoladas de hemoculturas (2000-2005) de pacientes do Instituto de Oncologia Pediátrica da UNIFESP (IOP-GRAACC). MÉTODOS E RESULTADOS: Cinquenta e seis amostras de Pseudomonas aeruginosa foram isoladas de 49 pacientes. Trinta e duas dessas amostras foram classificadas como resistentes aos carbapenêmicos pela técnica de disco difusão e submetidas a reação de PCR para detecção de genes de MBL. Dezoitos dessas 32 amostras evidenciaram o gene blaSPM-1. Oito amostras selecionadas em diferentes anos no período de estudo apresentaram o mesmo perfil genético por pulsed-field gel electrophoresis. A terapêutica antimicrobiana foi considerada adequada em apenas 23,5% dos pacientes com bacteremia por P. aeruginosa carreando blaSPM-1 e letalidade de 70,6% no período de até 30 dias após a bacteremia e uma inadequação inicial dos esquemas antibióticos utilizados CONCLUSÕES: Evidenciamos a presença de um clone de P. aeruginosa resistente aos carbapenêmicos carreando blaSPM-1 que persistiu em amostras de hemocultura pelo período de 6 anos na instituição, com alta letalidade, justificando uma vigilância epidemiológica rigorosa e uma readequação dos esquemas de terapia antimicrobianos na instituição.

Declínio da prevalência do HTLV-1/2 em doadores de sangue do Hemocentro Regional da Cidade de Uberaba, Estado de Minas Gerais, 1995 a 2008

INTRODUCÃO: Estudo retrospectivo com o objetivo de avaliar a prevalência e fatores associados à soropositividade para o HTLV-1/2, no período de 1995 a 2008, no Hemocentro Regional de Uberaba e descrever os doadores soropositivos quanto ao gênero, idade, estado civil, cor de pele e procedência. MÉTODOS: Foram realizados análise estatística descritiva, testes qui-quadrado e odds ratio para comparação de proporções e gráfico de dispersão com coeficiente de correlação linear. RESULTADOS: Dentre x doadores testados, foi encontrada a prevalência de sorologia positiva para o HTLV de 0,02% e indeterminada de 0,09%. Houve uma redução significativa da sorologia positiva para HTLV, no período de 2002 a 2008, em comparação ao período de 1995 a 2001. Dentre os soropositivos, observou predomínio significante no gênero feminino. CONCLUSÕES: Imputamos a queda gradativa de soropositividade no período à exclusão permanente dos doadores de repetição soropositivos e ao aprimoramento dos métodos de triagem clínica e dos testes sorológicos ao longo dos anos com reflexos positivos na segurança transfusional.

Prevalence of Chagas disease in blood donors at the Uberaba Regional Blood Center, Brazil, from 1995 to 2009

INTRODUCTION: A retrospective study was conducted to assess the occurrence of blood donations that were ineligible due to Chagas disease infection from 1995 to 2009 at the Uberaba Regional Blood Center (HRU), Brazil, verify the tendency of this ineligibility, and describe the epidemiologic profile of the donors. METHODS: Retrospective studies of serological ineligibility due to Chagas disease, statistical analysis by means of the chi-square test and odds ratio, study of the tendencies using a dispersion graph and the linear correlation coefficient (r) were performed. RESULTS: In the period under study, a 0.2% serum prevalence of ineligibility due to Chagas disease was found, with a significant drop in ineligible donations from 2001 to 2009. Among the serum positive-donors, there was a significant predominance among those aged 30 years or above and non-single individuals. CONCLUSIONS: The results show a rate of occurrence that is lower than that described in literature, as well as a progressive drop during the 15 years under assessment. Such results are a consequence of systematic combat of the vector since the 70s and the progressive and consistent increase of returning donors, resulting in a drop of the contamination risk factor by means of blood transfusion and in the improvement of the quality of hemotherapy practices in the HRU.

Epidemiology of the viral hepatitis B and C in female prisoners of Metropolitan Regional Prison Complex in the State of Goiás, Central Brazil

INTRODUCTION: Little information regarding hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian female prisoners exists. This study investigated the prevalence and risk factors associated with HBV and HCV infections and identified viral genotypes among female prisoners in Goiás, Central Brazil. METHODS: Women incarcerated in the largest prison in the State of Goiás were invited to participate in the study. All female prisoners were interviewed and tested for the detection of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), against hepatitis B core antigen (anti-HBc), and antibody against HCV (anti-HCV) by ELISA. HBsAg and anti-HCV positive samples were tested for HBV DNA and HCV RNA and genotyped, respectively. RESULTS: Participants (n=148; 98.6%) completed the study with an overall HBV prevalence of 18.9%. Age >30 years, a low education level, sex with a sexually transmitted diseases carrier, and a male sexual partner serving in the same penitentiary were associated with HBV infections. Only 24% of the women were anti-HBs positive suggesting previous HBV vaccination. Nine female prisoners (6.1%) were anti-HCV positive. Age >40 years, injecting drug use and length of incarceration were statistically associated with anti-HCV antibodies. Five samples were HCV RNA positive and classified as genotypes 1 (subtypes 1a; n=3 and 1b; n=1) and 3 (subtype 3a; n=1). The HBsAg-reactive sample was HBV DNA positive and genotype A. CONCLUSIONS: These findings highlight the necessity of public policies to control hepatitis B and C infections and emphasize the importance of hepatitis B vaccination in prison environments.

Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS) has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR) and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

COMPOSIÇÃO QUÍMICA E PERCENTUAL DE ADEQUAÇÃO DA DIETA REGIONAL DE MANAUS - AM.

A dieta regional de Manaus foi avaliada nutricionalmente por meio da análise química e percentual de adequação, tomando-se como referencial os padrões da National Academy of Science (19Ô9). A dieta foi elaborada utilizando-se os dados de Shrimpton & Giugliano (1979), para famílias com rendimentos de até dois salários mínimos mensais e preparadae de acordo com as técnicas culinárias habitualmente utilizadas pela população. Doe resultados obtidos, observou-se um déficit calorico de 54,3% para o homem adulto e 13,4% para a mulher adulta. Pas 1906 Kcal totale, os glicídios contribuíram com 60%, lipídios 20% e proteínas 20%. Quantitativamente, as proteínas estavam em níveis adequados, embora parte delas pudessem estar eendo utilizadas com finalidade energética. Dos minerais, o cálcio estava mais deficiente com um percentual de adequação da ordem de 50%. 0 ferro mostrou-se deficiente para a mulher adulta quando comparado com as necessidades recomendadae. Em relação ao teor de retino! proveniente do B-caroteno da dieta, o percentual foi de 12,6% e 15,0% respectivamente para homem e mulher. De acordo com os dados obtidos, concluiu-se que a dieta não atende às recomendações preconizadas para a maioria dos nutrientes estudados.

BIODISPONIBILIDADE DE ZINCO EM DIETA REGIONAL DE MANAUS, AM. ESTUDO EM RATOS

Foi estudada a biodisponibilidade de zinco em ratos recebendo uma dieta regional de Manaus, AM. A dieta foi elaborada segundo os dados de SHRIMPTON & GIUGLIANO, (1979) para famílias com rendimentos inferiores a 2 salários mínimos. O ensaio biológico com ratos da linhagem Wistar se baseou inicialmente, na depleção de zinco e vitamina A na lactação, adaptação dos filhotes com a dieta regional por 7 dias e período de repleção onde se realizou a suplementação com zinco de acordo com as recomendações do "COMMITTEE ON LABORATORY ANIMAL DIETS" (1979). Os resultados nos permitiram concluir que a quantidade de zinco presente na dieta, avaliada pelos parâmetros de medida de biodisponibilidade de zinco como crescimento, concentração nos órgãos e de enzima zinco dependente, foi utilizada adequadamente pelos animais, provavelmente pelos fatores promotores da dieta.

The drought of the century in the Amazon Basin: an analysis of the regional variation of rainfall in South America in 1926

The most severe drought in tropical South America during the 20th century occurred in 1926. This extreme El Nino year is further documented anecdotally, in an update of the river stage observations at Manaus, and in annual rainfall records. The annual rainfall anomaly is an east-west dipole over tropical South America, with drought to the west over the Amazon basin whose discharge is documented at Manaus, and with a surplus to the east and including the Nordeste region of Brazil. Speculations about a role for aerosol in aggravating the drought are discussed.

Sintomas depressivos no câncer de mama: Inventário de Depressão de Beck - Short Form

OBJETIVOS: Verificar a prevalência de sintomas depressivos em mulheres com câncer de mama e identificar os fatores de risco associados à sua ocorrência. MÉTODOS: Foi realizado um estudo transversal, em que foram entrevistadas 71 mulheres com câncer de mama. Foram empregados dois instrumentos: um questionário para verificar os dados sociodemográficos e clínicos e o Inventário de Depressão de Beck - Short Form (BDI-SF), para avaliação dos sintomas depressivos. Para análise dos dados, utilizaram-se medidas descritivas e o teste de qui-quadrado, que avaliou a associação entre variáveis sociodemográficas e clínicas e os sintomas depressivos. O nível de significância considerado foi de 5%. RESULTADOS: A prevalência de sintomas depressivos foi de 29,6%. Os fatores associados à presença desses sintomas foram o tratamento quimioterápico (p = 0,021), presença de dor (p = 0,018) e limitação do movimento do membro superior (p = 0,010) e pior percepção da saúde (p = 0,018). CONCLUSÃO: Sintomas depressivos são frequentes no câncer de mama, assim a saúde mental das mulheres com esse tipo de câncer deve ser investigada e tratada quando necessário, reduzindo o impacto desses sintomas na vida da mulher.

Myocardial Revascularization Surgery with Regional Anesthesia Without an Endotracheal Tube in Conscious Patients

OBJECTIVE: To report initial experience with myocardial revascularization surgery (MRS) performed on patients who were totally awake and without an endotracheal tube.METHODS: Between January 1994 and May 2001, 272 patients underwent MRS without extracorporeal circulation. In 24, the operations were performed without the use of an endotracheal tube and with the patients totally awake and breathing normally. The age ranged from 51-75 years with the predominant male sex. Epidural thoracic administratios of the anesthesia was performed. Surgery was performed through a habitual anterolateral thoracotomy. During the entire procedure, the left lung remained partially collapsed.RESULTS: The 24 patients progressed well through the surgery. Pneumothorax time ranged from 70-190 minutes. No electrocardiographic, echocardiographic, or enzymatic alterations occurred that characterized pre- and postoperative infarcts. Twenty-three patients were stable enough to be released after 24 hours.CONCLUSION: This technique could be performed on an large number of selected patients. However, more experience is necessary.

Regional myocardial function in healthy adults: assessment through tissue Doppler echocardiography

OBJECTIVE: To characterize left ventricular regional myocardial function through tissue Doppler echocardiography in healthy adults and to assess the influence of aging in this function. METHODS: In 45 healthy volunteers divided in two groups (< 45 and > 45 years old) we assessed longitudinal and radial regional function (velocities, times intervals and velocity-time integrals). Data were compared in each group and between groups. RESULTS: Systolic function: a) longitudinal: higher velocities and integrals in lateral and inferior walls and in basal segments, with a trend to reduction of these parameters with aging; b) radial: higher basal velocities, no significant change with aging. Diastolic function: a) longitudinal: higher velocities in lateral and inferior walls and in basal segments. With aging e and e/a velocities and integrals decreased, a increased and older individuals showed lower percentage of segments with e/a >1; b) radial: aging was associated with lower e and higher a velocities. CONCLUSION: 1) Tissue Doppler echocardiography detects physiological differences between regional myocardial function of different ventricular segments, in velocities, times intervals and integrals, with physiological heterogeneity and asynchrony; 2) Many of these data are age dependent; 3) Our data contribute to define normal values, and may become useful when compared with data from populations with heart diseases.