Re-evaluation of the basic procedures involved in the storage of measles vaccine in public health units of the municipality of Niterói, state of Rio de Janeiro, Brazil

Four years after the first visit seventeen public health units were visited again and evaluated as to standards of storage recommended by the Brazilian Immunization Programme. In 100% of the units, refrigerators and proper inside location of vaccines in the refrigerator were adequatety or regularfy maintained and checked, respectively. However, when control of temperature was checked, onfy 64.7% presented adequate storage conditions. In 94.1 % of the units, health workers complained of lack of immediate technical support in emergency situations. In 55.2 % the titers vaccine samples of were under the minimal recommended potency. It is necessary that the factors concerning the cold chain be continualfy evaluated so that the quality of the vaccines that will be used is not affected.

Chemotherapeutic effects on larval stages of Schistosoma mansoni during infection and re-infection of mice

The sensitivity of the larval stages of Schistosoma mansoni to chemotherapy with praziquantel and oxamniquine was tested in mice during primary and secondary infections and after different intervals from cercarial exposure. Worm recovery by perfusion of the porto-mesenteric system, followed by counting and a morphometric study of the parasite, allowed the conclusion that the relative resistance of the larval stages of S. mansoni to schistosomicide drugs, demonstrated in primary infections, also persists when the host is already infected. This indicates that a therapeutic failure may result when an infected host is treated some time after being re-infected, because of the presence of migrating, drug-resistant, immature forms of the parasite.

Quantification of HIV-1 viral RNA in the blood in needles used for venous puncture in HIV-infected individuals

INTRODUCTION: Occupational HIV infection among healthcare workers is an important issue in exposures involving blood and body fluids. There are few data in the literature regarding the potential and the duration of infectivity of HIV type 1 (HIV-1) in contaminated material under adverse conditions. METHODS: We quantified HIV-1 viral RNA in 25×8mm calibre hollow-bore needles, after punctures, in 25 HIV-1-infected patients selected during the sample collection. All of the patients selected were between the ages of 18 and 55. Five samples were collected from 16 patients: one sample for the immediate quantification of HIV-1 RNA in the plasma and blood samples from the interior of 4 needles to be analyzed at 0h, 6h, 24h, and 72h after collection. In nine patients, another test was carried out in the blood from one additional needle, in which HIV-1 RNA was assessed 168h after blood collection. The method used to assess HIV-1 RNA was nucleic acid sequence-based amplification. RESULTS: Up to 7 days after collection, HIV-1 RNA was detected in all of the needles. The viral RNA remained stable up to 168h, and there were no statistically significant differences among the needle samples. CONCLUSIONS: Although the infectivity of the viral material in the needles is unknown, the data indicate the need to re-evaluate the practices in cases of occupational accidents in which the source is not identified.

Impact of the introduction of an automated microbiologic system on the clinical outcomes of bloodstream infections caused by Enterobacteriaceae strains

INTRODUCTION: Enterobacteriaceae strains are a leading cause of bloodstream infections (BSI). The aim of this study is to assess differences in clinical outcomes of patients with BSI caused by Enterobacteriaceae strains before and after introduction of an automated microbiologic system by the microbiology laboratory. METHODS: We conducted a retrospective cohort study aimed to evaluate the impact of the introduction of an automated microbiologic system (Phoenix(tm) automated microbiology system, Becton, Dickinson and Company (BD) - Diagnostic Systems, Sparks, MD, USA) on the outcomes of BSIs caused by Enterobacteriaceae strains. The study was undertaken at Hospital São Paulo, a 750-bed teaching hospital in São Paulo, Brazil. Patients with BSI caused by Enterobacteriaceae strains before the introduction of the automated system were compared with patients with BSI caused by the same pathogens after the introduction of the automated system with regard to treatment adequacy, clinical cure/improvement and 14- and 28-day mortality rates. RESULTS: We evaluated 90 and 106 patients in the non-automated and automated testing periods, respectively. The most prevalent species in both periods were Klebsiella spp. and Proteus spp. Clinical cure/improvement occurred in 70% and 67.9% in non-automated and automated period, respectively (p=0.75). 14-day mortality rates were 22.2% and 30% (p=0.94) and 28-day mortality rates were 24.5% and 40.5% (p= 0.12). There were no significant differences between the two testing periods with regard to treatment adequacy, clinical cure/improvement and 14- and 28-day mortality rates. CONCLUSIONS: Introduction of the BD Phoenix(tm) automated microbiology system did not impact the clinical outcomes of BSIs caused by Enterobacteriaceae strains in our setting.

Larval control of Anopheles (Nyssorhinchus) darlingiusing granular formulation of Bacillus sphaericus in abandoned gold-miners excavation pools in the Brazilian Amazon Rainforest

INTRODUCTION: Use of a Bacillus sphaericus based mosquito larvicide was evaluated as an intervention for malaria vector control at a mining site in Amapá, Brazil. Impacts on larval and adult densities of the primary vector Anopheles darlingi were measured over the course of a 52 week study period.METHODS: In Calçoene, State of Amapá, gold mining activity occurs in 19 mining sites in gold-miners of Lourenço. Large pools are formed in mining sites and naturally colonized by Anopheles darlingi. During one year, the impact of applications of VectoLex(r) CG to these larval sources was evaluated. Applications of 20kg/ha were made as needed, based on 10 immature (3rd, 4th instars and pupae) surveillance of health and established thresholds. RESULTS: One hundred percent initial control was observed 48h after each treatment. The pools received from 2-10 (5.3±1.6) treatments during the year. The average re-treatment interval in productive pools was 9.4±4.3 weeks. During weeks 3-52 of the study, mean density of late stage larvae was 78% and pupae were 93% lower in the treated pools than in untreated pools (p< 0.0001, n=51) while reduction of adult mosquitoes was 53% in comparison to the untreated area during the last five months of the study, which were the rainy season (p<0.001).CONCLUSIONS:VectoLex(r) CG reduced immature Anopheles darlingi infestation levels during the entire study period, and reduced adult mosquito populations during the rainy season.

Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis

Introduction This study evaluated the efficacy of retreatment of pulmonary tuberculosis (TB) with regard to treatment outcomes and antimicrobial susceptibility testing (ST) profiles. Methods This retrospective cohort study analyzed 144 patients treated at a referral hospital in Brazil. All of them had undergone prior treatment, were smear-positive for TB and received a standardized retreatment regimen. Fisher's 2-tailed exact test and the χ2 test were used; RRs and 95% CIs were calculated using univariate and multivariate binary logistic regression. Results The patients were cured in 84 (58.3%) cases. Failure was associated with relapsed treatment and abandonment (n=34). Culture tests were obtained for 103 (71.5%) cases; 70 (48.6%) had positive results. ST results were available for 67 (46.5%) cases; the prevalence of acquired resistance was 53.7%. There were no significant differences between those who achieved or not therapeutic success (p=0.988), despite being sensitive or resistant to 1 or more drugs. Rifampicin resistance was independently associated with therapeutic failure (OR: 4.4, 95% CI:1.12-17.37, p=0.034). For those cases in which cultures were unavailable, a 2nd model without this information was built. In this, return after abandonment was significantly associated with retreatment failure (OR: 3.59, 95% CI:1.17-11.06, p=0.026). Conclusions In this cohort, the general resistance profile appeared to have no influence on treatment outcome, except in cases of rifampicin resistance. The form of reentry was another independent predictor of failure. The use of bacterial culture identification and ST in TB management must be re-evaluated. The recommendations for different susceptibility profiles must also be improved.

Incidence of canine leptospirosis in the metropolitan area of Curitiba, State of Parana, Southern Brazil

Introduction The incidence of canine leptospirosis in Brazil needs to be assessed Methods The same dogs in southern Brazil were sampled over two years to determine the prevalence, incidence and association of canine leptospirosis with various risk factors. Results In 2009, the prevalence was 33 (14.4%) of 228 dogs, with a predominance of serovar Canicola (33.4%). In 2010, 90 dogs were re-evaluated (the remaining dogs were lost to deaths, address changes and donations), and the prevalence was found to be 35 (38.9%) of 90, with the predominant serovar being Icterohaemorrhagiae (51.4%). Moreover, the incidence was 26 of 90 (28.9%), and the disease was statistically associated with age (2009) and street access (2010). Conclusions Our findings revealed instability in the dog population and age to be relevant risk factors for canine leptospirosis.

Leptospirosis in animals and human contacts in Egypt: broad range surveillance

INTRODUCTION: Leptospirosis is a re-emerging zoonotic disease of humans and animals worldwide. The disease is caused by pathogenic species of the genus Leptospira. These organisms are maintained in nature via chronic renal infection of carrier animals, which excrete the organisms in their urine. Humans become infected through direct or indirect exposure to infected animals and their urine or through contact with contaminated water and soil. This study was conducted to investigate Leptospira infections as a re-emerging zoonosis that has been neglected in Egypt. METHODS: Samples from 1,250 animals (270 rats, 168 dogs, 625 cows, 26 buffaloes, 99 sheep, 14 horses, 26 donkeys and 22 camels), 175 human contacts and 45 water sources were collected from different governorates in Egypt. The samples were collected from different body sites and prepared for culture, PCR and the microscopic agglutination test (MAT). RESULTS: The isolation rates of Leptospira serovars were 6.9%, 11.3% and 1.1% for rats, dogs and cows, respectively, whereas the PCR results revealed respective detection rates of 24%, 11.3% and 1.1% for rats, dogs and cows. Neither the other examined animal species nor humans yielded positive results via these two techniques. Only six Leptospira serovars (Icterohaemorrhagiae, Pomona, Canicola, Grippotyphosa, Celledoni and Pyrogenes) could be isolated from rats, dogs and cows. Moreover, the seroprevalence of leptospiral antibodies among the examined humans determined using MAT was 49.7%. CONCLUSIONS: The obtained results revealed that rats, dogs and cows were the most important animal reservoirs for leptospirosis in Egypt, and the high seroprevalence among human contacts highlights the public health implications of this neglected zoonosis.

Molecular characterization of group A rotavirus before and after the introduction of vaccines in Brazil

ABSTRACTINTRODUCTION:In this study, the molecular characteristics of group A rotavirus (RVA) were compared in samples obtained before and after RVA vaccine-introduction in Brazil.METHODS:Eighty samples were screened for the presence of RVA. Positive samples were molecularly analyzed.RESULTS:RVA positivity was 16.9%, with a predominance of G2P[4]. Periods: pre-vaccination: predominance of IId (G1), IId (G2) lineages, and I1 and E1 genotypes; post-vaccination: predominance of Ib (G1), IIa, and IIc (G2) lineages and I2 and E2 genotypes.CONCLUSIONS:Although changes in RVA-circulation pattern were observed in the post-vaccination period, it could not be attributed to vaccination process.

Monoterpene isolated from the essential oil of Trachyspermum ammi is cytotoxic to multidrug-resistant Pseudomonas aeruginosa and Staphylococcus aureus strains

Abstract INTRODUCTION: The aim of this study was to determine whether an herbal extract containing monoterpene exhibited activity against multidrug-resistant Staphylococcus aureus and Pseudomonas aeruginosa isolated from clinical infection samples. METHODS: The essential oil of Trachyspermum ammi (L.) Sprague ex Turrill (Apiaceae) fruit was extracted by hydrodistillation. Fruit residues were treated with hydrochloric acid and re-hydrodistilled to obtain volatile compounds. Compounds in the distilled oil were identified using gas-chromatography (GC) and GC-mass spectrometry (MS). The antibiotic susceptibility of all bacterial isolates was analyzed using both the disc diffusion method and determination of the minimum inhibitory concentration (MIC). The sensitivity of antibiotic-resistant isolates to essential oil was also determined by using the disc diffusion method and MIC determination. RESULTS: Of 26 clinical isolates, 92% were multidrug-resistant (MDR). Aromatic monoterpenes (thymol, paracymene, and gamma-terpinene) were the major (90%) components of the oil. Growth of S. aureus strains was successfully inhibited by the oil, with an inhibitory zone diameter (IZD) between 30-60mm and MIC <0.02μL/mL. The oil had no antimicrobial activity against clinical isolates of P. aeruginosa; rather, it prevented pigment production in these isolates. CONCLUSIONS: This study revealed that the essential oil of Trachyspermum ammi, which contains monoterpene, has good antibacterial potency. Monoterpenes could thus be incorporated into antimicrobial ointment formulas in order to treat highly drug-resistant S. aureus infections. Our findings also underscore the utility of research on natural products in order to combat bacterial multidrug resistance.

Neuroptera of the Amazon basin. Part 11a. Introduction and chrysopint.

33 species of Chrisopini are described and illustrated, of wich 30 are recorded from the Amazon Basin. Ten new species are described in Chrisopodes(duckei, spínella, nebulosa, lineafrons, polygonica, indetata, conisetosa, breviata, mediocris, and tetifera(, and nine in Ceraesochrysa(squalidens, acutipuppis, rafaeli, reddyi, nigripes, teneuícornis, ariasi, falceifera, and michaelmuris). Neosuarus (type species collaris (Schneider), a new subgenus of Chrysopodes, also contains divisa (Walker), escomeli (Navás) porterina (Navás), and flavescens (Blanchard). Orlandsia Navás and Ancylochrysa Navás are synonymized with Chrysopodes limbata (Navás), Chrysoperla asoralis (Banks) and Suarius nesotala (Banks). A neotype is designate for Ceraeochrysa cubana (Hagen). Ceraeochrysa caligata(Banks) and scapularis (Navás) are valid species. C. gloriae Alayo is synonymized with Ceraeochrysa everes (Banks).

Re-hospitalizações e morte por insuficiência cardíaca: índices ainda alarmantes

FUNDAMENTO: Os pacientes com insuficiência cardíaca (IC) que necessitam ser hospitalizados para compensação constituem grupo de maior gravidade, que evoluem com alta mortalidade e alta taxa de re-hospitalizações. OBJETIVO: Procuramos avaliar a atual história natural da IC por meio da taxa de mortalidade e de re-hospitalizações, nessa nova era do bloqueio neuro-hormonal. MÉTODOS: Acompanhamos a evolução de 263 pacientes com FE média de 27,1%, internados para compensação, entre janeiro de 2005 e outubro de 2006. Foram hospitalizados somente os pacientes que após avaliação e medicação no PS não estavam em condições de ter alta. Os pacientes encontravam-se em CF III/IV, a idade média foi de 59,9±15,2 anos, a maioria homens e 63,1% necessitaram de inotrópicos para compensação na fase aguda. RESULTADOS: O tempo médio de internação foi de 25,1±16,7 dias. Durante a internação 23 (8,8%) morreram. Após a alta, no período médio de seguimento de 370 dias, dos 240 que tiveram alta, 123 (51,2%) procuraram o PS de 1 a 12 vezes (total de passagens: 350), sendo 76 re-internados, sendo a média de dias da re-hospitalização de 23,5±18,0. No primeiro ano de seguimento 62 (25,8%) pacientes morreram. CONCLUSÃO: A IC continua evoluindo com alta mortalidade e alta taxa de re-hospitalização. Ao final do primeiro ano 44,5% desses pacientes não necessitaram passar no PS ou morreram, números que indicam que devemos continuar dando grande atenção aos portadores de IC, na tentativa de mudar a história natural dos portadores dessa síndrome, cada vez mais freqüente.

Hereditariedade da homeose

A preliminary account on the normal development of the imaginai discs in holometabolic Insects is made to serve as an introduction to the study of the hereditary homoeosis. Several facts and experimental data furnished specially by the students of Drosophila are brought here in searching for a more adequate explanation of this highly interesting phenomenon. The results obtained from the investigations of different homoeotic mutants are analysed in order to test Goldschmidt's theory of homoeosis. Critical examination of the basis on which this theory was elaborated are equally made. As a result from an extensive theoretical consideration of the matter and a long discussion of the most recent papers on this subject the present writer concludes that the Goldschmidt explanation of the homoeotic phenomena based on the action of diffusing substances produced by the genes, the "evocators", and on the alteration of the normal speed of maturation of the imaginai discs equally due to the activity of the genes, could not be proved and therefore should be abandoned. In the same situation is any other explanation like that of Waddington or Villee considered as fundamentally identical to that of Goldschmidt. In order to clear the problem of homoeosis in terms which seem to put the phenomenon in complete agreement with the known facts the present writer elaborated a theory first published a few years ago (1941) based entirely on the assumption that the imaginai discs are specifically determined by some kind of substances, probably of chemical nature, contained in the cytoplam of the cells entering in the consti- tution of each individual disc. These substances already present in the blastem of the egg in which they are distributed in a definite order, pass to different cells at the time the blastem is transformed into blastoderm. These substances according to their organogenic potentiality may be called antenal-substance, legsubstance, wing-substance, eye-substance, etc. The hipoderm of the embryo resulting from the multiplication of the blastoderm cells would be constituted by a series of cellular areas differing from each other in their particular organoformative capacity. Thus the hypoderm giving rise to the imaginai discs, it follows that each disc must have the same organogenic power of the hypodermal area it came from. Therefore the discs i*re determinated since their origin by substances enclosed in the cytoplasm of their cells and consequently can no longer alter their potentiality. When an antennal disc develops into a leg one can conclude that this disc in spite of its position in the body of the larva is not, properly speaking, an antennal disc but a true leg disc whose cells instead of having in their cytoplasm the antennal substance derived from the egg blastem have in its place the leg-substance. Now, if a disc produces a tarsus or an antenna or even a compound appendage partly tarsus-like, partly antenna-like, it follows tha,t both tarsal and antennal substances are present in it. The ultimate aspect of the compound structure depends upon the reaction of each kind of substance to the different causes influencing development. For instance, temperature may orient the direction of development either lowards arista or tarsus, stimulating, or opposing to the one or the other of these substances. Confering to the genes the faculty of altering the constitution of the substances containing in the cytoplasm forming the egg blastem or causing transposition of these substances from one area to another or promoting the substitution of a given substance by a different one, the hereditary homoeocis may be easily explained. However, in the opinion of the present writer cytoplasm takes the initiative in all developmental process, provoking the chromosomes to react specifically and proportionally. Accordingly, the mutations causing homoeotic phenomena may arise independently at different rime in the cytoplasm and in the chromosomes. To the part taken by the chromosomes in the manifestation of the homoeotic characters is due the mendalian ratio observed in homoeotic X normal crosses. Expression, in itself, is mainly due to the proportion of the different substances in the cells of the affected discs. Homoeotic phenomena not presenting mendelian ratio may appear as consequence of cytoplasmic mutation not accompanied by chromosomal mutation. The great variability in the morphology of the homoeotic characteres, some individual being changed towards an extreme expression of the mutant phenotype while others in spite of their homozigous constitution cannot be distinguished from the normal ones, strongly supports the interpretation based on the relative proportion of the determining substances in the discs. To the same interpretation point also asymetry and other particularities observed in the exteriorization of the phenomenon. In conformity with this new conception homoeosis should not prove homology of Insect appendages (Villee 1942) since a more replacement of substances may cause legs to develop in substitution of the wings, as it was already observed (requiring confirmation in the opinion of Bateson 1894, p. 184) and no one would conclude for the homology of these organs in the usual meaning of the term.

Some new species of Caryospora (Apicomplexa: Eimeriidae) from brazilian snakes, and a re-description of C. jararacae Carini, 1939

The mature ooxysts of six new species of Caryospora are described from the faeces of Brazilian snakes. They are differentiated from other species previously recorded from reptiles, largely on the size and shape of the oocyst and sporocyst, structure of the oocyst wall, and presence or absence of a polar body. C. paraensis n. sp., and C. carajasensis n. sp., are from the "false coral", Oxyrhopus petola digitalis; C. pseustesi n. sp., from the "egg-eater", Pseustes sulphureus sulphureus; C. epicratesi n. sp., from the "red boa", Epicrates cenchria cenchria; and C. micruri n. sp., and C. constancieae n. sp., from the "coral snake", Micrurus spixii spixii. A re-description is given of C. jararacae Carini, 1939, from the "jararaca" Bothrops atrox, embodying some additional morphological features.

Introduction and spreading of Biomphalaria straminea (Dunker, 1848) (Mollusca: Pulmonata: Planorbidae) in Guadeloupe, French West Indies

The finding in 1985 of a well-established population of Biomphalaria straminea in a pond in Grande Terre of Guadeloupe constitutes a new species record for the freshwater molluscan fauna of that island. The following years a rapid extension of the species was documented on Grande Terre and Marie Galante. However, it was never found in the neighboring island of Basse Terre. The invasion of the whole hydrographic system of this island by Melanoides tuberculata during the last decade and the current presence of well-established and dense populations of this snail may explain the failure of the colonization by B. straminea.