CLINICAL AND EPIDEMIOLOGICAL PROFILE OF ELDERLY PATIENTS WITH CHAGAS DISEASE FOLLOWED BETWEEN 2005-2013 BY PHARMACEUTICAL CARE SERVICE IN CEARÁ STATE, NORTHEASTERN BRAZIL

By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%); mean age of 67 years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and family income equal to the minimum wage (51.5%). The predominant clinical forms of Chagas disease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographic changes were the right bundle branch block (41.0%), associated or not with the anterosuperior left bundle branch block (27.4%). The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%). It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.

Contaminação microbiológica e parasitológica em alfaces (Lactuca sativa) de restaurantes self-service, de Niterói, RJ

Analisou-se 30 amostras de alfaces de restaurantes self-service de Niterói quanto à presença de bactérias e parasitas. Dezesseis amostras apresentaram coliformes fecais, 16 mesófilos acima de 10(7) UFC/g e 3 cistos de Entamoeba coli. Estes dados indicam a necessidade da orientação dos manipuladores quanto a higienização no preparo de hortaliças.

Tuberculosis incidence and risk factors among patients living with HIV/AIDS in public health service institutions in Brasilia, Federal District

In order to estimate the incidence of and risk factors for developing tuberculosis, the clinical charts of a retrospective cohort of 281 HIV-positive adults, who were notified to the AIDS Program of the Health Department of Brasilia in 1998, were reviewed in 2003. All the patients were treatment-naive regarding antiretroviral therapy at the time of inclusion in the cohort. Twenty-nine patients were identified as having tuberculosis at the start of the study. Thirteen incident tuberculosis cases were identified during the 60 months of follow-up, with an incidence density rate of 1.24/100 person-years. Tuberculosis incidence was highest among patients with baseline CD4+ T-lymphocyte counts < 200 cells/µl who were not using antiretroviral therapy (incidence = 5.47; 95% CI = 2.73 to 10.94). Multivariate analysis showed that baseline CD4+ T-lymphocyte counts < 200 cells/µl (adjusted hazard ratio [AHR] = 5.09; 95% CI = 1.27 to 20.37; p = 0.02) and non-use of antiretroviral therapy (AHR = 12.17; 95% CI = 2.6 to 56.90; p = 0.001) were independently associated with increased risk of tuberculosis.

Epidemiological, clinical, and operational aspects of leprosy patients assisted at a referral service in the state of Maranhão, Brazil

INTRODUCTION: Leprosy is an infectious disease caused by Mycobacterium leprae. The aim of this study was to describe the epidemiological, clinical, and operational aspects of leprosy carriers. METHODS: A cross-sectional study leprosy patients assisted in São Luis, MA, was performed. RESULTS: Of the 85 cases analyzed, 51.7% were male participants, and 60% were brown. Concerning the age, 54.8% of women were between 35 and 49 years, and 57.6% of men were between 20 and 34 years. Lepromatous leprosy was found in 42.3% of cases, and the multibacillary form was found in 72.9%. The skin smear was positive in 42.3%. The occurrence of reaction was found in 43.5% of cases, and 83.5% had no Bacillus Calmette-Guérin scar. Leprosy in the family was reported by 44.7% of the patients. Most of the individuals (96.4%) lived in houses made of brick with more than three rooms (72.6%) and two persons per room (65.1%). Concerning the level of education, 41.4% of women and 34.1% of men had more than one to three years of education. The most evaluated age group in the beginning of the treatment was that of 35 to 49 years with a Grade 0 incapability (64.5%), and that in the end was the age group of 20 to 34 (29.9%) with Grade 0, 30.7% Grade 1, and 11.5% Grade 2. CONCLUSIONS: The frequency of multibacillary forms found in this study and the cases in family members point out delayed diagnoses. Thus, early diagnosis and appropriate treatment are important in decreasing the outcome of disabilities.

Late diagnosis and HIV infection in children attending a service of specialized care for pediatric AIDS in Brazil

Introduction: This study describes the frequency of late diagnosis and HIV among children attending a pediatric AIDS clinic. Methods: Cross-sectional study in children exposed to HIV from 2005-2008. A questionnaire was given that included questions on demographics and clinical information. Results: Two-hundred twenty-one (97.8%) children were exposed to HIV during pregnancy/childbirth. A total of 193 (87.3%) children had late enrolment in the service and late access to HIV serology. The frequency of HIV was 21.3% (95% confidence interval [CI] 15.9%-26.7%). Protective factors were earlier diagnosis [odds ratio (OR)=0.17 (0.08-0.37)] and receiving complete prophylaxis [OR=0.29 (0.09-0.97)]; being born by vaginal delivery was a risk factor [OR=4.45 (1.47-13.47)]. Conclusions: There was a high frequency of late diagnosis in this patient cohort. Earlier diagnosis is an important measure for controlling HIV among children.

Contribution to the marine propeller hydrodynamic design for small boats in the Amazon region

ABSTRACTIn the Amazon, river navigation is very important due to the length of navigable rivers and the lack of alternative road networks. Boats usually operate in unfavorable conditions, since there is no hydrodynamic relation among propellers, geometry, and the dimensions of the boat hull. Currently, there is no methodology for propeller hydrodynamic optimization with low computational cost and easy implementation in the region. The aim of this work was to develop a mathematical approach for marine propeller design applied to boats typically found on Amazon rivers. We developed an optimized formulation for the chord and pitch angle distributions, taking into account the classical model of Glauert. A theoretical analysis for the thrust and torque relationships on an annular control volume was performed. The mathematical model used was based on the Blade Element Momentum Theory (BEMT). We concluded that the new methodology proposed in this work demonstrates a good physical behavior when compared with the theory of Glauert and the experimental data of the Wageningen B3-50 propeller.

Impact of nutritional counseling in reducing serum cholesterol in public health service patients

OBJECTIVE: To assess the impact of nutritional attention on the lipid profile and nutritional status of hypercholesterolemic patients attended in health centers of Belo Horizonte. METHODS: Using nutritional attendance patient record cards from two health units, the evolution of the lipid profile and the nutritional state (BMI) was monitored of 96 hypercholesterolemic patients who received diet. The patients were appraised at the following moments: initial (1st consultation), after 3 months (2nd consultation) and last consultation (variable for each patient). RESULTS: On the first attendance, 44,4% of the patients presented not only high total cholesterol and LDL-c, but also hypertriglyceridemia and 70.3% were overweight or obese, but most patients (75.6%) presented adequate HDL-c levels. There was significant reduction in the BMI, total cholesterol, LDL-c values (p < 0.01) and also in the triglyceride levels (p < 0.05) in the first three months, without alteration in the HDL-c levels. A significant reduction (p < 0.01) was observed in the frequency of individuals with high cholesterol (from 89.6% down to 47.9%), high and very high LDL-c (from 82.6% down to 45.7%), as well as high and very high triglyceride (from 43.6% down to 16.7%). The observed reduction in frequency of the low HDL-c was statistically meaningless. CONCLUSION: This study evidences the effect of the nutritional attention on lipid profile in hypercholesterolemic patients, reinforcing the need for a multiprofessional team to attend them at the public health services.

A new recent marine Ostracoda species (Hemicytheridae) from Brazil

Ostracods were collected on Sargassum sp. from the littoral of São Sebastião, São Paulo State, southeastern Brazil. A new species, Aurila ornellasae, is illustrated and described based on a population with various instars and adult specimens. This is the first living species of this genus described from Brazil. A brief discussion on the systematics of the genus Aurila Pokorný, 1955 and its allied genera is presented.

Report of Lepocreadium Bimarium manter, 1940, Vitellibaculum Spinosa (Siddioi) & Cable, 1960) and Hirudinella Ventricosa (Pallas, 1774), parasites of marine fishes in Brazil

Lepocreadium bimarinum and Vitellibaculum spinosa are referred for the first time in Stephanolepis hispidus and in Brazil, and Hirudinella ventricosa is reported from Scomberomorus cavalla. Measurements, figures and comments are given.

Dinosoma clupeola sp. n. (Hemiuridae) and Pseudoacanthostomum floridensis Nahhas & Short, 1965 (Acanthostomidae), digenetic trematodes in Brazilian Marine fishes

Dinosoma clupeola sp. n. is described from Harengula clupeola, and resembles D. hawaiiense Yamaguti, 1970, from which it differs in the entire, elongate-saccular seminal vesicle, tegument weakly plicated, smaller size of body and internal organs, and slightly larger and narrower eggs. Pseudoacanthostomum floridensis Nahhas & Short, 1965 is referred to Netuma barba, which represents a new host record.

Schikhobalotrema solitaria sp. n. and S. acanthuri Yamaguti, 1970 (Haplosplanchnidae: Digenea) in Brazilian marine fishes

Schikhobalotrema solitaria sp. n. is described from Stephanolepis hispidus (Linnaeus, 1758), and is characterized by the relation between oral sucker and pharynx 1:1,1. This Relation in the other species ranges between 1:0.3-0.6. It is more similar to S. manteri Siddiqi & Cable, 1960 in the distribution of vitellaria, differing from it in the size of vitelline follicles, extension of uterus and in the size of the eggs. S. acanthuri Yamaguti, 1970 is referred for the first time in South America in Mugil liza Valenciennes, 1836 representing a new host record.

Some monogenoidea parasitic on peruvian marine fishes, with description of Anoplocotyloides chorrillensis new species and new records

The presence of four Monogenoidea parasitic on marine fishes from the central Peruvian coast is recorded. One of them, Anoplocotyloides chorrillensis (Monocotylidae) described from the gills of Rhinobatos planiceps (Rhinobatidae) is considered a new species. The three other species are: Caballerocotyla autralis Oliva, 1986 (Capsalidae); Callorhynchocotyle marplatensis Suriano & Incorvaia, 1982 (Hexabothriidae) and Anoplocotyloides papillatus (Doran, 1953) (Monocotylidae) parasitic on Sarda chiliensis chiliensis (Scombridae), Callorhinchus callorhinchus (Callorhinchidae) and Rhinobatos planiceps (Rhinobatidae) respectively.

Marine organisms: an alternative source of potentially valuable natural products

This paper recalls the outcoming of marine natural products research and reviews a selection of marirne bioactive metabolites in current use together with promising trends in marine pharmacology.

First report of the genera Macvicaria Gibson & Bray, 1982, Pachycreadium Manter, 1954 and Saturnius manter, 1969 (Trematoda: Digenea), in brazilian marine fishes

Macvicaria crassigula (Linton, 1910) (Opecoelidae) is referred from the intestine of Micropogonias furnieri and from Stellifer rastrifer; and from Stellifer rastrifer, and Saturnius maurepasi Overstreet, 1977 (Bunocotylidae) from the stomach of Mugil liza. This is the first report of these species in Brazil, and a new host records are presented.

New host records and localities of some Monogenea from brazilian marine fishes with scanning electron microscopy of Bicotylophora trachinoti (Mac Callum, 1921)

Bicotylophora trachinoti (Mac Callum, 1921) from Trachinotus carolinus L.; Pseudanthocotyloides heterocotyle (Van Beneden, 1871) from Cetengraulis edentulus (Cuvier), and Decapterus punctatus (Cuvier), new host records; Pseudomazocraes selene Hargis, 1957 from Selene vomer (L.) and Caranx latus Agassiz, new host record, are reported for the first time in Brazil from the coast of Rio de Janeiro State. The marine fishes Diplectrum sp. and Pomatomus saltatrix (L.) are respectively new host records for Pseudotagia cupida (Hargis, 1956) and Macrovalvitrema sinaloense Caballero & Bravo Hollis, 1955. Measurements, original figures and photos in scanning electron microscopy of B. trachinoti are presented. The egg with filaments is reffered for the first time in the genus Pseudanthocotyloides.