A list of mosquito species of the Brazilian State of Pernambuco, including the first report of Haemagogus janthinomys (Diptera: Culicidae), yellow fever vector and 14 other species (Diptera: Culicidae)

INTRODUCTION: Besides mosquito species adapted to urban environments (Culex quinquefasciatus, Aedes aegypti and Aedes albopictus), only 15 species of Anopheles had been recorded in the State of Pernambuco. METHODS: Human-landing mosquitoes were collected in Dois Irmãos Park, in Recife. RESULTS: The first report for the state of Haemagogus janthinomys, an important vector of yellow fever virus, and 14 other species, including Trichoprosopon lampropus, a first reported for Brazil. CONCLUSIONS: The mosquito fauna in the area is diversified and has potential medical and veterinary importance.

Soropositividade para doença de Chagas entre doadores de sangue em Araraquara, Estado de São Paulo, no período de 2004 a 2008

INTRODUÇÃO: A transfusão sanguínea é uma fonte potencial importante para transmissão da doença de Chagas. MÉTODOS: Foi verificado, nos arquivos do Hemonúcleo Regional de Araraquara, o resultado dos exames para doença de Chagas entre janeiro de 2004 e dezembro de 2008. RESULTADOS: Foram diagnosticadas com sorologia positiva 0,04% das 49541 doações de sangue realizadas. A idade dos soropositivos situou-se entre 51 e 60 anos. CONCLUSÕES: O baixo índice de doadores soropositivos pode reduzir o risco de transmissão via transfusional da doença de Chagas. A alta ocorrência de resultados inconclusivos indicam que os métodos diagnósticos devem ser melhorados.

Biologia comparativa e comportamento alimentar de Rhodnius neglectus e Rhodnius robustus (Triatominae) sob condições de laboratório

INTRODUÇÃO: A competência vetorial de triatomíneos é determinada a partir de estudos sobre biologia e comportamento alimentar em condições de campo e/ou laboratório. Fatores como número de picadas, quantidade de sangue ingerido e tempo de defecação têm implicações na transmissão de tripanosomatídeos. Parâmetros biológicos e comportamentais de Rhodnius neglectus e R. robustus foram comparados experimentalmente para estimar diferenças no potencial de transmissão de tripanosomatídeos. MÉTODOS: Os triatomíneos foram observados diariamente para determinar o período de desenvolvimento ninfal, mortalidade, detecção da fonte alimentar, número de picadas, tempo do repasto sanguíneo, quantidade de sangue ingerido, tempo entre o final do repasto e a primeira defecação e frequência de defecação. RESULTADOS: Apesar do período ninfal de R. neglectus (156,4 ± 25,05d) ter sido menor que o de R. robustus (204,7 ± 13,22d), a mortalidade foi similar entre as espécies (63,8 e 65%, respectivamente). R. robustus e R. neglectus detectaram rapidamente a fonte alimentar, especialmente no primeiro estádio (2,5 e 1,6min, respectivamente). Apesar do tempo de repasto sanguíneo ter sido similar entre as espécies, R. robustus ingeriu em média uma maior quantidade de sangue em todos os estádios, com maiores valores para as ninfas V. As ninfas de R. neglectus picaram mais vezes as fontes alimentares, defecaram mais rápido e mais frequentemente que as de R. robustus. CONCLUSÕES: Sob as condições de laboratório usadas, R. neglectus possui um maior potencial para transmissão de Trypanosoma cruzi e T. rangeli que R. robustus, atributo que deve ser avaliado em infecções experimentais.

Molecular characterization of Trypanosoma cruzi Mexican strains and their behavior in the mouse experimental model

INTRODUCTION: For a long time, the importance of Chagas disease in Mexico, where many regarded it as an exotic malady, was questioned. Considering the great genetic diversity among isolates of Trypanosoma cruzi, the importance of this biological characterization, and the paucity of information on the clinical and biological aspects of Chagas disease in Mexico, this study aimed to identify the molecular and biological characterization of Trypanosoma cruzi isolates from different endemic areas of this country, especially of the State of Jalisco. METHODS: Eight Mexican Trypanosoma cruzi strains were biologically and genetically characterized (PCR specific for Trypanosoma cruzi, multiplex-PCR, amplification of space no transcript of the genes of the mini-exon, amplification of polymorphic regions of the mini-exon, classification by amplification of intergenic regions of the spliced leader genes, RAPD - (random amplified polymorphic DNA). RESULTS: Two profiles of parasitaemia were observed, patent (peak parasitaemia of 4.6×10(6) to 10(7) parasites/mL) and subpatent. In addition, all isolates were able to infect 100% of the animals. The isolates mainly displayed tropism for striated (cardiac and skeletal) muscle. PCR amplification of the mini-exon gene classified the eight strains as TcI. The RAPD technique revealed intraspecies variation among isolates, distinguishing strains isolated from humans and triatomines and according to geographic origin. CONCLUSIONS: The Mexican T. cruzi strains are myotrophic and belong to group TcI.

Effects of an exercise program on the functional capacity of patients with chronic Chagas' heart disease, evaluated by cardiopulmonary testing

INTRODUCTION: Despite all efforts to restrict its transmission, Chagas' disease remains a severe public health problem in Latin America, affecting 8-12 million individuals. Chronic Chagas' heart disease, the chief factor in the high mortality rate associated with the illness, affects more than half a million Brazilians. Its evolution may result in severe heart failure associated with loss of functional capacity and quality of life, with important social and medical/labor consequences. Many studies have shown the beneficial effect of regular exercise on cardiac patients, but few of them have focused on chronic Chagas' heart disease. METHODS: This study evaluated the effects of an exercise program on the functional capacity of patients with chronic Chagas' disease who were treated in outpatient clinics at the Evandro Chagas Institute of Clinical Research and the National Institute of Cardiology, Rio de Janeiro, Brazil. The exercises were performed 3 times a week for 1 h (30 min of aerobic activity and 30 min of resistance exercises and extension) over 6 months in 2010. Functional capacity was evaluated by comparing the direct measurement of the O2 uptake volume (VO2) obtained by a cardiopulmonary exercise test before and after the program (p < 0.05). RESULTS: Eighteen patients (13 females) were followed, with minimum and maximum ages of 30 and 72 years, respectively. We observed an average increase of VO2peak > 10% (p = 0.01949). CONCLUSIONS: The results suggest a statistically significant improvement in functional capacity with regular exercise of the right intensity.

Carbohydrate-rich high-molecular-mass antigens are strongly recognized during experimental Histoplasma capsulatum infection

INTRODUCTION: During histoplasmosis, Histoplasma capsulatum soluble antigens (CFAg) can be naturally released by yeast cells. Because CFAg can be specifically targeted during infection, in the present study we investigated CFAg release in experimental murine histoplasmosis, and evaluated the host humoral immune response against high-molecular-mass antigens (hMMAg. >150 kDa), the more immunogenic CFAg fraction. METHODS: Mice were infected with 2.2x10(4) H. capsulatum IMT/HC128 yeast cells. The soluble CFAg, IgG anti-CFAg, IgG anti-hMMAg, and IgG-hMMAg circulating immune complexes (CIC) levels were determined by enzymelinked immunosorbent assay, at days 0, 7, 14, and 28 post-infection. RESULTS: We observed a progressive increase in circulating levels of CFAg, IgG anti-CFAg, IgG anti-hMMAg, and IgG-hMMAg CIC after H. capsulatum infection. The hMMAg showed a high percentage of carbohydrates and at least two main immunogenic components. CONCLUSIONS: We verified for the first time that hMMAg from H. capsulatum IMT/HC128 strain induce humoral immune response and lead to CIC formation during experimental histoplasmosis.

Impact of an intervention in the use of sequential antibiotic therapy in a Brazilian university hospital

INTRODUCTION: Sequential antibiotic therapy (SAT) is safe and economical. However, the unnecessary use of intravenous (IV) administration usually occurs. The objective of this work was to get to know the effectiveness of an intervention to implement the SAT in a teaching hospital in Brazil. METHODS: This was a prospective and interventional study, historically controlled, and was conducted in the Hospital de Clínicas, Universidade Federal de Uberlândia, State of Minas Gerais, Brazil, a high complexity teaching hospital having 503 beds. In each of the periods, from 04/04/05 to 07/20/05 (pre-intervention) and from 09/24/07 to 12/20/07 (intervention), 117 patients were evaluated. After the pre-intervention period, guidelines were developed which were implemented during the intervention period along with educational measures and a reminder system added to the patients' prescription. RESULTS: In the pre-intervention and intervention periods, the IV antibiotics were used as treatment for a average time of 14.8 and 11.8 days, respectively. Ceftriaxone was the antibiotic most prescribed in both periods (23.4% and 21.6% respectively). Starting from the first prescription of antibiotics, the average length of hospitalization time was 21.8 and 17.5 days, respectively. The SAT occurred only in 4 and 5 courses of treatment, respectively, and 12.8% and 18.8% of the patients died in the respective periods. CONCLUSIONS: Under the presented conditions, the evaluated intervention strategy is ineffective in promoting the exchange of the antibiotic administration from IV to oral treatment (SAT).

Infection of the central nervous system with dengue virus 3 genotype I causing neurological manifestations in Brazil

Abstract: A case of dengue virus 3 (DENV-3) genotype I infection with neurological manifestations occurred in Belo Horizonte, Minas Gerais in October 2012. The serotype was detected by PCR, and the genotype was assessed by sequencing and phylogenetic analysis of the C-prM region. The virus causing neurological manifestations clustered with other sequences of DENV-3 genotype I. Because neurological manifestations of DENV are possibly misdiagnosed in Brazil, this study serves as an alert of the importance of DENV diagnoses in CNS infections.

Isokinetic assessment of knee flexor/extensor muscular strength in elderly women

OBJECTIVE: To assess knee flexor-extensor muscular strength in elderly women with no previous history of musculoskeletal disorders on the lower limbs using an isokinetic dynamometer, in order to obtain data that could be used as a comparative parameter in the evaluation of elderly women with knee disorders, thus facilitating a better rehabilitation of these patients. METHODS: Twenty-six volunteers aged 75 to 83 years were studied using a Cybex® 6000 isokinetic dynamometer. The chosen angular velocity was 60 º/s, and concentric exercise was used for either flexion or extension. The studied parameters were: peak torque, angle of peak torque, and flexor-extensor torque rate. RESULTS: There were no differences between dominant (D) and nondominant (ND) knee peak torque values. This was true for both flexor (D = 42.46 ± 9.09 Nm / ND = 40.65 ± 9.38 Nm) and extensor (D = 76.92 ± 13.97 Nm / ND = 77.65 ± 15.21 Nm) movements. The descriptive statistical analysis of the values obtained for the flexor-extensor peak torque rate and for the angle of occurrence of peak torque was the same for the dominant and nondominant sides. CONCLUSIONS: The values of peak torque for the contralateral side can be used as a reference during rehabilitation of elderly women with acute disease of the knee, and the angular velocity of 60 º/s is proper and safe for isokinetic assessment of elderly people.

Critical analysis of the allocation policy for liver transplantation in Brazil

Liver transplantation is now the standard treatment for end-stage liver disease. Given the shortage of liver donors and the progressively higher number of patients waiting for transplantation, improvements in patient selection and optimization of timing for transplantation are needed. Several solutions have been suggested, including increasing the donor pool; a fair policy for allocation, not permitting variables such as age, gender, and race, or third-party payer status to play any role; and knowledge of the natural history of each liver disease for which transplantation is offered. To observe ethical rules and distributive justice (guarantee to every citizen the same opportunity to get an organ), the "sickest first" policy must be used. Studies have demonstrated that death has no relationship with waiting time, but rather with the severity of liver disease at the time of inclusion. Thus, waiting time is no longer part of the United Network for Organ Sharing distribution criteria. Waiting time only differentiates between equally severely diseased patients. The authors have analyzed the waiting list mortality and 1-year survival for patients of the State of São Paulo, from July 1997 through January 2001. Only the chronological criterion was used. According to "Secretaria de Estado da Saúde de São Paulo" data, among all waiting list deaths, 82.2% occurred within the first year, and 37.6% within the first 3 months following inclusion. The allocation of livers based on waiting time is neither fair nor ethical, impairs distributive justice and human rights, and does not occur in any other part of the world.

Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review

Gastrointestinal mesenchymal tumors comprise a rare group of gastrointestinal tract wall tumors that have long been a source of confusion and controversy, especially in terms of pathological classification, preoperative diagnosis, management strategies, and prognosis. This report describes the clinical manifestations and management of 2 rectal leiomyomas and reviews the pertinent literature. Case 1: A 44-year-old woman was admitted reporting a nodule in the right para-anal region for the previous 2 years. At proctological examination, a 4-cm diameter fibrous mass situated in the para-anal region that produced an arch under the smooth muscle on the right rectal wall just above the anorectal ring was noted. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed the lesion and detected no other abnormalities. Surgical treatment consisted of wide local resection of the tumor through a para-anal incision, with no attempts to perform lymphadenectomy. Case 2: A 40-year-old male patient was admitted reporting constant anal pain for 4 months. He presented a 3-cm submucosal nodule at the anterior rectal wall just above the dentate line. After 2 inconclusive preoperative biopsies, transanal resection of the tumor was performed. Histological analysis of the specimen showed a benign leiomyoma. A review of the literature is presented, emphasizing some clinical and therapeutic aspects of this unusual rectal tumor.

Observações preliminares sobre a periodicidade e taxa de crescimento em árvores tropicais

Resultados preliminares sobre a periodicidade e taxa de crescimento de Cardeiro (Scleronema micranthum Ducke, Bombacaceae) são apresentados. Observou-se ama periodicidade de crescimento. As taxas de incremento são correlacionadas aos resultados referidos da Guiana Francesa.

Estudos farmacológicos preliminares dos extratos da Casearia sylvestris Swartz

O "chá de bugre", Casearia sylvestris Sawartz tem sido popularmente usado com várias finalidades. Mais recentemente lhe tem sido atribuído características abortivas. Esta possibilidade levou-nos a avaliar a toxicidade dos extratos brutos de suas folhas e os efeitos no útero sobre a motilidade espontânea e as contrações induzidas pela ocitocina. A dose letal média do extrato aquoso a quente é de 1,792g de resíduo por quilo de peso, para camundongos albinos. Com a solução aquosa do extrato etanólico observamos, "in vitro", na motilidade espontânea uterina de ratos aumento da freqüência de contração e do tonus basal e diminuição da amplitude de contração; na curva dose-resposta à ocitocina, diminuição da resposta máxima e aumento da dose efetiva média. O extrato aquaso a frio produziu, na motilidade espontânea uterina, aumento de todos os parâmetros observados; na curva-dose-resposta à ocitocina, também aumentou a resposta máxima, diminuindo, entretanto, sua dose efetiva média. Os resultados sugerem que os extratos de folhas de C.sylvestrissão capazes de modificar a atividade uterina "in vitro". Estes dados poderiam explicar o uso abortivo.

COMPORTAMENTO FENOLÓGICO DA SUCUPIRA-PRETA (Diplotropis purpurea (Rich.) Amsh. var. coriacea Amsh.), NA RESERVA FLORESTAL DUCKE

Este trabalho analisa dados de 6 anos (1980-1985) de observações da fenologia de cinco indivíduos arbóreos da espécie Diplotropis purpures (Rich.) Amsh. var. coriacea Amsh., da família Leguminosae, subfamília Papilionoideae, localizados na Reserva Florestal Ducke. Determinou-se a época, duração e freqüência das fases reprodutivas, bem como o tipo de mudança foliar. A espécie apresentou a fase de floração na estação seca. A fase de frutificação foi observada no meio da estação seca e início da estação chuvosa. A duração média da fase de floração foi de 6 meses e a fase de frutificação 7 meses. Ao nível de espécie, o padrão de ocorrência da fase de floração e frutificação foi anual à irregular. Porém, ao nível de indivíduo, o padrão de comportamento foi irregular. Quanto ao tipo de mudança foliar, a espécie apresentou características de ser semi-caducifólia durante a floração, na época seca.