Pulmonary tuberculosis in São Luis, State of Maranhão, Brazil: space and space-time risk clusters for death (2008-2012)

INTRODUCTION: The objective was to identify space and space-time risk clusters for the occurrence of deaths in a priority city for the control of tuberculosis (TB) in the Brazilian Northeast. METHODS: Ecological research was undertaken in the City of São Luis/Maranhão. Cases were considered that resulted in deaths in the population living in the urban region of the city with pulmonary TB as the basic cause, between 2008 and 2012. To detect space and space-time clusters of deaths due to pulmonary TB in the census sectors, the spatial analysis scan technique was used. RESULTS: In total, 221 deaths by TB occurred, 193 of which were due to pulmonary TB. Approximately 95% of the cases (n=183) were geocoded. Two significant spatial clusters were identified, the first of which showed a mortality rate of 5.8 deaths per 100,000 inhabitants per year and a high relative risk of 3.87. The second spatial cluster showed a mortality rate of 0.4 deaths per 100,000 inhabitants per year and a low relative risk of 0.10. A significant cluster was observed in the space-time analysis between 11/01/2008 and 04/30/2011, with a mortality rate of 8.10 deaths per 100,000 inhabitants per year and a high relative risk (3.0). CONCLUSIONS: The knowledge of priority sites for the occurrence of deaths can support public management to reduce inequities in the access to health services and permit an optimization of the resources and teams in the control of pulmonary TB, providing support for specific strategies focused on the most vulnerable populations.

Two decades of tuberculosis in a city in Northeastern Brazil: advances and challenges in time and space

Abstract: INTRODUCTION This study presents two decades of epidemiological data on tuberculosis (TB), in order to understanding the disease profile and its spatiotemporal dynamics. METHODS This descriptive study was performed in the City of Olinda/Pernambuco, Brazil, from 1991-2010, and it analyzed new patients with TB living in the city. We used the χ²-test with a p-value <0.05 to identify differences in trends. Incidence and cluster distribution were identified using spatial scan statistics. RESULTS In total, 6202 new cases were recorded during the two decades. The highest incidence occurred in 1995 (110 cases/100,000 inhabitants), and the lowest occurred in 2009 (65 cases/100,000 inhabitants) (β=-1.44; R²=0.43; p=0.0018). The highest mortality occurred in 1998 (16 deaths/100,000 inhabitants), and the lowest occurred in 2008 (5 deaths/100,000 inhabitants) (β=-0.19; R²=0.17; p=0.07). There was a male predominance (65%), and ages ranged from 20-49 years (65%). There was a substantial increase in the number of patients that were cured after treatment (60% to 67%; p<0.001) as well as those tested for HIV (1.9% to 58.5%; p<0.001). During the first decade, clusters with p-values <0.05 included 29% of the total notified cases, and in the second decade, that percentage was 12%. CONCLUSIONS We observed a decreasing trend in incidence, which was significant, and mortality rates, which was not significant. The increased number of laboratory tests performed reflects advances in surveillance, and a reduction in the proportion of cases in primary clusters suggests, among other things, that the disease is spreading across the region.

Vascular lesions of the lumbar epidural space: magnetic resonance imaging features of epidural cavernous hemangioma and epidural hematoma

The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scans showed hyperintense signal.

Anatomic study of the dorsal arterial system of the hand

Historically, the dorsal arterial system of the hand received less attention than the palmar system. The studies concerning dorsal arterial anatomy present some controversies regarding the origin and presence of the dorsal metacarpal artery branches. Knowledge of the anatomy of dorsal metacarpal arteries is especially applied in the surgical planning for flaps taken from the dorsum of the hand. The purpose of this study is to analyze the arterial anatomy of the dorsum of the hand, compare our observations with those of previous studies from the literature, and therefore to define parameters for surgical planning for flaps supplied by the dorsal metacarpal arteries. METHOD: Twenty-six dissections were performed at the dorsum of the right hand of 26 cadavers by making a distal-based U-shaped incision. After catheterization of the radial artery at the wrist level, a plastic dye solution with low viscosity and quick solidification was injected to allow adequate exposure of even small vessels. The radial artery and its branches, the dorsal arterial arch, the dorsal metacarpal arteries, the distal and proximal communicating branches of the palmar system, and the distal cutaneous branches were carefully dissected and identified. RESULTS: The distal cutaneous branches originating from the dorsal metacarpal arteries were observed in all cases; these were located an average of 1.2 cm proximal from the metacarpophalangeal joint. The first dorsal metacarpal artery presented in 3 different patterns regarding its course: fascial, subfascial, and mixed. The branching pattern of the radial artery at the first intermetacarpal space was its division into 3 branches. We observed the presence of the dorsal arterial arch arising from the radial artery in 100% of the cases. The distance between the dorsal arterial arch and the branching point of the radial artery was an average of 2 cm. The first and second dorsal metacarpal arteries were visualized in all cases. The third and fourth dorsal metacarpal arteries were visualized in 96.2% and 92.3% of cases, respectively. There was proximal and distal communication between the dorsal arterial arch and the palmar system through the communicating branches contributing to the dorsal metacarpal artery formation. CONCLUSION: At the dorsum of the hand there is a rich arterial net that anastomoses with the palmar arterial system. This anatomical characteristic allows the utilization of the dorsal aspect of the hand as potential donor site for cutaneous flaps.

Observations on the pollination of Rhabdodendron macrophyllum (Spruce ex Benth.) Huber.

The species Rhabdodendron macrophyllum (Spr. ex Benth.) Hub. (Rhabdondendraceae) was observed in order to determine its pollination mechanism. Although it flowers around the year, there are flowering peaks when it is visited by several species of pollen-gathering bees. The principal floral visitors are two species of trigonid bees and one Melipona. The Melipona and one other visitor used the buzz method to extract pollen from the longitudinally dehiscent anthers. The trigonid bees collected pollen without buzzing. The flowers open around 6:00 a.m. and are available to the bess until about 10:30 a.m. Pollinator exclusion experiments showed that this species sets fruit equally by self fertilization.

Observations of air composition in Brazil between the Equator and 20°s during the dry season.

Field measurement programs in Brazil during the dry season months of August and September in 1979 and 1980 have demonstrated the great importance of the continental tropics in global air chemistry. Especially in the mixed layer, the air composition over land is much different from that over the ocean and the land areas are clearly longe scale sources of many inportant trace gases. During the dry season much biomass, burning takes place especially in the cerrado regions leading to substantial emission of air pollutants, such as CO, NOx, N2O, CH4 and other hydrocarbons. Ozone concentrations are alsoenhanced due to photochemical reactions. Biogenic organic emissions from tropical forests play likewise an important role in the photochemistry of the atmosphere. Carbon monoxide was found to be present in high concentrations in the boundary layer of the tropical forest, but ozone concentrations were much lower than in the cerrado.

Observations on flower visitors to Bertholletia excelsa H.B.K. and Couratari tenuicarpa A.C. Sm. (Lecythidaceae)

Bees visiting flowers of Bertholletia excelsa. (Brazil Nut tree) and Couratari tenuicarpa were collected, their behavior described and the pollen found clinging to their dorsal thorax and stored on their legs was identified. Female bees of Xylocopa frontalis(Olivier) and males of Eulaema mocsaryi (Friese) are apparently effective pollinators of Couratari in igapó near Manaus. Female bees of Euplusia seabrai Moure in litt., Epicharis umbraculata (Fabricius), Epicharis rustica (Olivier) and Eulaema nigrita(Lepeletier), as well as male bees of Eulaema cingulata(Fabricius) and Eulaema nigrita are apparently effective pollinators of adult Brazil Nut trees in the Aleixo plantation near Manaus. Only large bees capable of uncurling the floral androecium can effectively pollinate Couratari or Bertholletia.Pollen analysis indicated that all bees captured carried pollen of the host tree in question and had been foraging on flowers of plant species common in secondary growth. Secondary growth near the Aleixo plantation supports a bee guild which appeared to effectively pollinate almost every flower on the Brazil Nut tree studied. Proximity to primary forest (and to those Euglossine bee species which occur only in primary forest) therefore does not appear to be necessary for pollination of Brazil Nut trees.In the Aleixo plantation chronic low fruit set is probably due to some factor other than pollination. Since natural occurrences of Brazil Nut trees to the north and south of Manaus are associated with a higher soil fertility, low production at the Aleixo plantation may be due to deficiencies of the soil.

Observations on dynamics of foraging hole construction of two leaf-feeding, soil-inhabiting Syntermes species (insecta: Isoptera) in an Amazonian Rainforest, Brazil

The intensity of construction of foraging access holes by two leaf-litter feeding, soil- inhabiting termite species, Syntermes molestus and Syntermes spinosus, in a Central Amazonian rain forest, was observed on consecutive nights for two weeks. Between 11 and 48 nest entrances per m2 were counted. Interaction between the two species was intense; some entrance holes were overtaken by the larger species during the observations; however, both species coexist in the area. A calculated minimum of 35 entrances/m2 is built every year by both species, emphasizing the importance of soil-burrowing termites for soil structure, aeration and water regime.

Observations on aquatic Macrophyte Dynamics In the Reservoir Of The Balbina Hydroelectric Powerplant, Amazonas State, Brazil

Between 1991 and 1995 aquatic macrophyte composition was observed in the lower part of the reservoir of the hydroelectric power plant of Balbina (Amazonas, Brazil). After closure of the dam in 1987, vegetation cover - mostly Eichhornia crassipes - was high, but was not quantified. After 1990 it declined rapidly with a characteristic succession pattern: Eichhornia ® Vincularia + Cyperaceae ® Salvinia. The Cyperaceae, and many other less dominant species, were mostly associated with drift wood, produced by the decomposing, emergent forest. Comparison of the chemical data of the Uatumã river before the construction of the dam (1983) with those of later years (1989 - 1995) suggests that the succession was the result of a relatively mild and short period of eutrophication, followed by declining nutrient levels. Annual variation of water levels, followed by aquatic and terrestrial decomposition of the marginal vegetation, may allow for the maintenance of relatively productive vegetation belts along the shore lines of islands and inundated stream valleys.

Preliminary observations on the effect of sudden changes of temperature on survival of young Matrinxã (Brycon cephalus) under laboratory conditions

Matrinxã is a very promising amazonian fish for fish culture in Brazil. This study is aimed at determining the approximate tolerated temperature range in this species. Groups of ten young matrinxã specimens (15.1±0.8 cm average length and 58.3±10.3 g average weight) were subjected to 9 different temperatures for 24 hours without previous acclimation. Fish were transferred from an initial temperature of 27ºC to those ranging from 12 to 39ºC at 3ºC intervals. Both 12ºC and 39ºC temperatures were lethal for this species with 100% mortality rate. Following 2 minutes of exposure to 39ºC fish changed behavior, showing an increase in opercular movements and erratic swimming; mortality reached 100% after 18 minutes. At 12ºC, fish lost equilibrium immediately after exposure and started swimming erratically; after only 4 minutes fish became lethargic and remained immobile on the bottom of the tank. Total mortality was only evident following 24 hours. At 15ºC matrinxã lost equilibrium after 5 to 6 minutes of exposure but mortality was only 20% after 24 hours. Fish tolerated well temperatures ranging from 18 to 36ºC with 100% survival after 24 hours. This preliminary study suggests that temperatures between 18 and 36ºC are the approximate range normally tolerated by this species, although survival at other temperatures may be increased by gradually acclimating fish to the more severe increases or decreases in temperature. In addition, it indicates that matrinxã may be cultivated over a wide geographical area.

Ecologia da ictiofauna de um córrego de cabeceira da bacia do alto rio Paraná, Brasil

Ecological studies were conducted in the ichthyofauna of Cedro, a small headwater stream located in a degraded area of State of São Paulo, Brazil, situated in the upper Paraná River basin. These are the results of two non-consecutive years observations and collections in two biotopes of that stream: a pool and a rapid. The ecological characteristics studied change in space and time. The present richness of species is high (21 species), nine of which are constant, six accessory and six accidental. The diversity is low (0.69 to 2.38), and the numeric predominance, from one to three species, occurred in both biotopes. The most frequent species are Poecilia reticulata (Peters, 1859) (28.1%), Corydoras cf. aeneus (Gill, 1858) (20.3%) and Hypostomus cf. ancistroides (Ihering, 1911) (19.8%). The density ranges from 0.7 to 19.8 specimens/m³. The similarity index indicates high similarity between the ichthyofauna (45.0% to 95.0%) inside the same or contiguous biotopes. The evenness (0.46 to 1.0) is comparable to those found in similar studies carried out in other streams.

Space-time variation of the relative abundance of Limnoperna fortunei in deep zones of São Gonçalo Channel, Rio Grande do Sul, Brazil

This work describes the spatial-temporal variation of the relative abundance and size of Limnoperna fortunei (Dunker, 1857) collected in São Gonçalo Channel through bottom trawl with a 0.5 cm mesh, at depths between 3 and 6 m. The estimative of mean relative abundance (CPUE) ranged from 2,425.3 individuals per drag (ind./drag) in the spring to 21,715.0 ind./drag in the fall, with an average of 9,515.3 ind./drag throughout the year. The estimated mean density of L. fortunei for the deep region of São Gonçalo Channel ranged from 1.2 to 10.3 ind./m², and it was recorded a maximum density of 84.9 ind./m² in the fall of 2008. The method of sampling using bottom trawl enabled the capture of L. fortunei under the soft muddy bottom of the channel, in different sizes ranging from 0.4 to 3.2 cm. This shows that the structure of the L. fortunei adult population under the bottom of the São Gonçalo Channel is composed mostly of small individuals (<1.4 cm), which represent up to 74% of the population collected.

Observations on the morphology of Australorbis nigricans

A morphological study was done on A. nigricans, based on the observation of shell, radula, renal region and genitalia of 50 specimens measuring 18 mm in diameter. The data obtained are to be compared with those recorded in our previous paper (PARAENSE & DESLANDES, 1955) on A. glabratus. The characteristics common to both species will not be mentioned here. The numerals refere to the means and their standard deviations: no special reference being done, they correspond to length measurementes. Shell - 18 mm in diameter, 6.37 ± 0.29 mm in greatest width, 6 whorls. Prevailing colur ferruginous sepia, a minority of olivaceous, ochreous, nigrescent and deeply black specimens being found. Right side variously depressed, umbilicated, 1.5 to 3.5 mm deep from the bottom of the umblicus to the highest level of the last whorl. Left side more depressed than the right one, broadly concave, 1.5 to 3.5 mm deep. Both sides show a varously distinct keel, that looks sharper at the left. Aperture deltoid, varying in outline and width. Body, extended - 60.26 ± 3.62 mm, less pigmented than in glabratus. Renal tube - 30.68 ± 1.69 mm, showing neither ridge nor pigmented line along its ventral surface, this negative character affording a sure means of separation from glabratus. Ovotestis - 14.48 ± 1.93 mm. Ovisperm duct - 13.04 ± 1.60 mm, including the non-unwound seminal vesicle. The latter was 0.97 ± 0,21 mm in greatest width. Carrefour - Resembling that of glabratus. Sperm duct - 21.36 ± 1.53 mm. Prostate - Prostate duct 7.14 ± 0.74 mm, collecting a row of long diverticula numbering 19.6 ± 3.1 and more separate than in glabratus. Last diverticulum generally bifurcate or arborescent, the remaining ones arborescent. Vas deferens - 28.68 ± 1.38. Ratio vas deferens/vergic sac = 6.8±0.8. Verge - 3.08 ± 0.28 mm long, 0.11 ± 0.02 mm wide. Vergic sac - 3.07 ± 0.28 mm long, about 0.20 mm wide. Ratio vergic sac/preputium = 0.84 ± 0.12. Preputium - 3.69 ± 0.47 mm long, 0.85 ± 0.10 mm wide. Albumen gland - Resembling taht of glabratus. Oviduct - 16.26 ± 1.41 mm, swollen at the cephalic end. Uterus - 13.24 ± 1.19 mm. Vagina - 1.70 ± 0.22 mm, swolen at the caudal portion. Spermatheca - 2.78 ± 0.40 mm long, 0.86 ± 0.16 mm wide. Spermathecal duct 1.11 ± 0.20 mm. Radula - 125 to 168 horizontal rows of teeth (mean 153.9 ± 8.4). Radula formula 28-1-28 to 36-1-36 (mean 31.8 ± 1.9). Mode formula 31-1-31. The morphological characteristics of the renal region and shell, and the great body length in the same condition of shell diameter, distinguish A. nigricans from the most related species A. glabratus, giving support to considering it a good species from a txonomic or phenotypic standpoint (morphospecies).

Some observations on the biology and morphology of the immature stages of Psychodopygus wellcomei fraiha, shaw and lainson, 1971: (Diptera: psychodidae)

Under laboratory conditions, the development from egg to adult of P. wellcomei takes an average of 42 days. The larval tages are similar to those of P. arthuri, described by barretto (1941), but can be distinguished from this species by the ratio of the first to second antennal segment, by the form of the lateral head seate and prothoracic dorsolateral setae. The pupal stage of P. wellcomei is characterized by a trifid pre-alar seta and simple spine-like thoracic and abdominal setae.