Socioepidemiological screening of serologically ineligible blood donors due to Chagas disease for the definition of inconclusive cases

Epidemiological screening combined with serological tests has become an important tool at blood banks for the characterization of donors with or without Trypanosoma cruzi infection. Thus, the objective of the present study was to describe the sociodemographic and epidemiological characteristics of blood donors with non-negative serology for T. cruzito determine possible risk factors associated with serological ineligibility. Sociodemographic and epidemiological data were collected by analysis of patient histories and interviews. The data were analyzed descriptively using absolute and relative frequencies and odds ratio (OR) evaluation. The frequency of serological ineligibility was 0.28%, with a predominance of inconclusive reactions (52%) and seropositivity among first-time donors (OR = 607), donors older than 30 years (OR = 3.7), females (OR = 1.9), donors from risk areas (OR = 4) and subjects living in rural areas (OR = 1.7). The risk of seropositivity was higher among donors who had contact with the triatomine vector (OR = 11.7) and those with a family history of Chagas disease (OR = 4.8). The results demonstrate the value of detailed clinical-epidemiological screening as an auxiliary tool for serological definition that, together with more specific and more sensitive laboratory methods, will guarantee a higher efficacy in the selection of donors at blood centres.

Evaluation of rapid techniques for the detection of mycobacteria in sputum with scanty bacilli or clinically evident, smear negative cases of pulmonary and extra-pulmonary tuberculosis

The objective of the current study was to compare two rapid methods, the BBL Mycobacteria Growth Indicator Tube (MGIT TM) and Biotec FASTPlaque TB TM (FPTB) assays, with the conventional Löwenstein-Jensen (LJ) media assay to diagnose mycobacterial infections from paucibacillary clinical specimens. For evaluation of the clinical utility of the BBL MGIT TM and FPTB assays, respiratory tract specimens (n = 208), with scanty bacilli or clinically evident, smear negative cases and non-respiratory tract specimens (n = 119) were analyzed and the performance of each assay was compared with LJ media. MGIT and FPTB demonstrated a greater sensitivity (95.92% and 87.68%), specificity (94.59% and 98.78%), positive predictive value (94.91% and 99.16%) and negative predictive value (96.56% and 90.92%), respectively, compared to LJ culture for both respiratory tract and non-respiratory tract specimens. However, the FPTB assay was unable to detect nontuberculous mycobacteria and few Mycobacterium tuberculosis complex cases from paucibacillary clinical specimens. It is likely that the analytical sensitivity of FPTB is moderately low and may not be useful for the direct detection of tuberculosis in paucibacillary specimens. The current study concluded that MGIT was a dependable, highly efficient system for recovery of M. tuberculosis complexes and nontuberculous mycobacteria from both respiratory and non-respiratory tract specimens in combination with LJ media.

Prevalence of human papillomavirus and Epstein-Barr virus DNA in penile cancer cases from Brazil

Penile cancer is a potentially mutilating disease. Although its occurrence is relatively rare worldwide, penile cancer rates can be high in developing countries. A few studies have been conducted on the involvement of human papillomavirus (HPV) in penile carcinoma, which have found HPV present in 30-70% of penile malignant lesions, with a higher prevalence of HPV 16 and 18. It has been assumed that cofactors, such as Epstein-Barr virus (EBV) infections, may play a role in the progression of penile neoplasia. The aim of this study was to determine HPV and EBV prevalence in 135 penile malignant lesions from Brazilian men through the use of MY09/11 polymerase chain reaction (PCR), type-specific PCR and restriction fragment length polymorphism analysis. HPV prevalence among the men tested was 60.7%. Of the men who tested positive, 27 presented with HPV 16 (29.7%), five with HPV 18 (5.5%), 21 with HPV 45 (23.1%) and nine with HPV 6 (9.9%). Seven mixed infections were detected (9.2%), while 11 cases remained untyped (13.4%). Regarding EBV positivity, 46.7% of the samples contained EBV DNA with EBV-1 as the most prevalent type (74.6%). More than 23% of the men were co-infected with both HPV and EBV, while 35% presented exclusively with HPV DNA and 20% presented only with EBV DNA. Penile carcinoma aetiology has not been fully elucidated and the role of HPV and EBV infections individually or synergistically is still controversial. Hence, more studies are needed to determine their possible role in carcinogenesis.

Phaeohyphomycosis: a clinical-epidemiological and diagnostic study of eighteen cases in Rio Grande do Sul, Brazil

The goal of this study was to review 18 cases of phaeohyphomycosis in Rio Grande do Sul. The records of all of the patients with a diagnosis of phaeohyphomycosis between 1995-2010 were reviewed. Twelve of the 18 patients (66.6%) were male. The average age of the patients was 50 years old (range: 16-74 years). Eleven patients (61%) presented with subcutaneous lesions. Seven patients (38.8%) had received a solid organ transplant. In all of the cases, the presence of melanin in the fungal cells was determined by Fontana-Masson staining of tissue sections and documented. Among the 18 patients, a total of 11 different fungal species were isolated. The causative organisms included Exophiala jeanselmei, Alternaria, Curvularia, Cladophialophora and Colletotrichum gloeosporioides. To our knowledge, this review reports the first case of subcutaneous phaeohyphomycosis caused by C. gloeosporioides in a lung transplant patient. The number of reported cases of phaeohyphomycosis has increased in the last decade. In a number of cases, this increased incidence may be primarily attributed to iatrogenic immunodeficiency.

Characteristics of leprosy diagnosed through the surveillance of contacts: a comparison with index cases in Rio de Janeiro, 1987-2010

Contact surveillance is an important strategy to ensure effective early diagnosis and control of leprosy; passive detection may not be as efficient because it is directly tied to the ready availability of heath care services and health education campaigns. The aim of this study was to reinforce that contact surveillance is the most effective strategy for the control of leprosy. The analysed data were obtained from a cohort of contacts and cases diagnosed through a national referral service for leprosy. We analysed data from patients diagnosed between 1987-2010 at the Souza Araújo Ambulatory in Rio de Janeiro. Epidemiological characteristics of leprosy cases diagnosed through contact surveillance and characteristics of passively detected index cases were compared using a conditional logistic regression model. Cases diagnosed by contact surveillance were found earlier in the progression of the disease, resulting in less severe clinical presentations, lower levels of initial and final disability grades, lower initial and final bacterial indices and a lower prevalence of disease reaction. In this respect, contact surveillance proved to be an effective tertiary prevention strategy, indicating that active surveillance is especially important in areas of high endemicity, such as Brazil.

Molecular identification of Rickettsia parkeri infecting Amblyomma triste ticks in an area of Argentina where cases of rickettsiosis were diagnosed

Specimens of the hard tick Amblyomma triste were found infected with Rickettsia parkeri in an area of Argentina (General Lavalle, Buenos Aires Province) where cases of human illness attributed to this microorganism have been reported. Molecular detection of R. parkeri was based on polymerase chain reactions that amplify a ca. 400-bp fragment of the 23S-5S intergenic spacer and a ca. 500-bp fragment of the gene encoding a 190-kDa outer membrane protein. Three (6.97%) of 43 A. triste ticks were determined to be positive for R. parkeri. These results provide strong evidence that A. triste is the vector of R. parkeri in the study area. The findings of this work have epidemiological relevance because human parasitism by A. triste ticks has been frequently recorded in some riparian areas of Argentina and Uruguay and new cases of R. parkeri rickettsiosis might arise in the South American localities where humans are exposed to the bites of this tick species.

Quantification of C4d deposition and hepatitis C virus RNA in tissue in cases of graft rejection and hepatitis C recurrence after liver transplantation

Histology is the gold standard for diagnosing acute rejection and hepatitis C recurrence after liver transplantation. However, differential diagnosis between the two can be difficult. We evaluated the role of C4d staining and quantification of hepatitis C virus (HCV) RNA levels in liver tissue. This was a retrospective study of 98 liver biopsy samples divided into four groups by histological diagnosis: acute rejection in patients undergoing liver transplant for hepatitis C (RejHCV+), HCV recurrence in patients undergoing liver transplant for hepatitis C (HCVTx+), acute rejection in patients undergoing liver transplant for reasons other than hepatitis C and chronic hepatitis C not transplanted (HCVTx-). All samples were submitted for immunohistochemical staining for C4d and HCV RNA quantification. Immunoexpression of C4d was observed in the portal vessels and was highest in the HCVTx- group. There was no difference in C4d expression between the RejHCV+ and HCVTx+ groups. However, tissue HCV RNA levels were higher in the HCVTx+ group samples than in the RejHCV+ group samples. Additionally, there was a significant correlation between tissue and serum levels of HCV RNA. The quantification of HCV RNA in liver tissue might prove to be an efficient diagnostic test for the recurrence of HCV infection.

A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of São Paulo, Brazil

We propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of São Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of São Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions.

Map of homicides by firearms: profile of the victims and the assaults

AbstractOBJECTIVEDescribing the profile of victims and assaults by gunshot, where the outcome was death.METHODAn ecological study conducted in the city of Maceió/AL, in 2012. Data were collected from the death statements. The variables studied were: the death circumstances, gender, age, marital status, place, date, time, month and proportion according to the occurring neighborhood.RESULTSThe homicide mortality rate was 65.2 per 100,000 inhabitants, with 130.6 per 100,000 men and 7.8 per 100,000 women. Of the total number of homicides, 93.6% of the victims were men. The age group between 15 and 29 years of age was the most affected, with 68.8%. In 97.6% of cases the death occurred at the site of aggression, 74.1% in the streets. In relation to the date, 54.2% of cases occurred between Friday and Sunday. 59.7% of the homicides were concentrated in seven neighborhoods.CONCLUSIONThe map of violence presented shows heterogeneous areas for the occurrence of assaults with firearms, characterizing the existing urban inequality in violence distribution.

Triplectides larvae in empty cases of Nectopsyche (Trichoptera, Leptoceridae) at Parque Estadual Intervales, São Paulo State, Brazil

The frequent occurrence of Triplectides sp. larvae in cases of Nectopsyche Müller in Ribeirão Bocaina, Parque Estadual Intervales, São Paulo, Brazil is recorded. Leaf packs were collected from November 1999 to June 2000 in riffles and pools. Triplectides sp. larvae in cases of Nectopsyche were found mostly in pools.

A educação infantil e a questão da escola: o caso da França

Nos últimos trinta anos, a prioridade dada a uma lógica escolar para justificar a pré-escola coincide com uma dupla mudança na instituição. A primeira diz respeito às relações que a escola maternal mantém com a escolarização obrigatória e com as estruturas de cuidados para as crianças pequenas. A outra refere-se às reformas do currículo escolar e ao desenvolvimento dos processos de avaliação. A escola maternal, local de acolhimento, de cuidados e de preparação para a escola, tornou-se institucionalmente uma verdadeira escola. A difusão das comparações internacionais contribuiu para essas mudanças.

Trabalho social e intervenção social na França: o estado do conhecimento

As escolas de trabalho social na França estão, finalmente, desenvolvendo investigação científica nos centros de pesquisa e de estudo para formação e ação social - Prefas - ou em parceria com as universidades. O caráter científico do trabalho social é questionado e contestado de acordo com as interações entre os atores sociais e as referências que estes mobilizam enquanto competem. Essas questões metodológicas cristalizam-se em torno da luta entre os campos das ciências sociais e do trabalho social, bem como dentro do próprio trabalho social como parte de uma reativação da dicotomia entre conhecimentos teórico prático situado e universal. Assim, o desenvolvimento de um paradigma científico de profissões como o trabalho social e também a questão dos modelos institucionais com epistemologias híbridas podem não se encaixar totalmente na lógica existente em razão da recusa histórica da academia em articular ciência e eficiência.

Produção e certificação de mudas de videira na França 1: situação Atual da Produção

A França é o principal país produtor de mudas de videira, enxertando anualmente 270 milhões de mudas. Neste país, o programa de certificação de mudas alcança mais de 90% do material produzido, e, para tanto, a área utilizada de matrizes de porta-enxertos e produtoras atinge 3.454 ha. As principais cultivares multiplicadas, em ordem decrescente, são Merlot Noir, Cabernet Sauvignon, Syrah, Chardonnay, e os principais porta-enxertos o SO4, 110 Richter, 3309 Couderc, 41 B e 140 Ruggieri. Os percentuais atuais de pegamento da enxertia situam-se em torno de 58% (ano de 1999), oscilando de 45,2% para a variedade Pinot Noir até 58% para o Cabernet Sauvignon. Do total das mudas enxertadas, 90% são produzidas diretamente em canteiros para comercialização sob a forma de raiz nua, e os 10% restantes em vasos biodegradáveis. A quantidade de mudas enxertadas atingiu 270,4 milhões no ano de 2000, ultrapassando todos os valores produzidos na década de 90, e é considerada como limite para absorção do mercado. As exportações de mudas pela França atingiram o montante de 19,2 milhões de mudas, sendo Itália, Espanha, Portugal, Alemanha e Argentina os principais importadores.

Produção e certificação de mudas de videira na França 2: técnica de produção de mudas pela enxertia de mesa

A técnica de produção de mudas pela enxertia de mesa é o principal meio de propagação da videira na França. A produção de estacas e borbulhas de qualidade em matrizeiros certificados, aliada ao controle das condições ambientais de estratificação, o tratamento com fitorreguladores e as condições de plantio em viveiro têm permitido a melhoria constante dos índices de pegamento e a produção de mudas com alto padrão de qualidade. As técnicas empregadas nas diferentes etapas da confecção de mudas são apresentadas neste artigo, ao mesmo tempo em que são discutidas as possibilidades de adaptação da tecnologia às condições brasileiras.

Comparação da disponibilidade de radiação solar global e fotoperíodo entre as regiões vinícolas de Campo Belo do Sul-SC, Brasil e Pech Rouge, França

Realizaram-se a caracterização e a comparação da disponibilidade de radiação solar global e do fotoperíodo para o Planalto de Santa Catarina, representado por Campo Belo do Sul (latitude -28º00'00'', longitude -51º00'00'' e altitude de 950 metros), e para a região Mediterrânea do Sul da França, representada por Pech Rouge (latitude 43º08'35'', longitude 03º07'59'' altitude de 1,5 metro). Este estudo foi realizado para a fase de maturação das variedades de videira Chardonnay, Portan, Syrah, Viognier, Carignan, Grenache, Marselan, Mourvèdre e Cabernet Sauvignon. Foram também avaliadas as durações do fotoperíodo anual, do período noturno, da radiação solar global, da radiação solar e da insolação máxima no período de maturação, para ambas as localidades. As diferenças de comportamento fenológico e das posições geográficas dos dois locais promoveram diferenças quanto à disponibilidade e intensidade da radiação solar global, assim como do fotoperíodo. Apesar da uma maior transmissividade da atmosfera para Pech Rouge, o Planalto Catarinense apresentou maior disponibilidade e intensidade de radiação solar durante a fase de maturação da videira. Também, o acúmulo de horas de fotoperíodo foi superior no Planalto Catarinense do que em Pech Rouge. Estas diferenças de disponibilidade de radiação solar e fotoperíodo foram provenientes da menor duração da fase de maturação para Pech Rouge, da declinação solar em relação aos dois locais por ocasião da ocorrência desta fase e da diferença da camada atmosférica resultante da diferença de altitude.