Comparison of the performance of polymerase chain reaction and pp65 antigenemia for the detection of human cytomegalovirus in immunosuppressed patients

INTRODUCTION: Human cytomegalovirus (HCMV) is often reactive in latently infected immunosuppressed patients. Accordingly, HCMV remains one of the most common infections following solid organ and hemopoietic stem cell transplantations, resulting in significant morbidity, graft loss and occasional mortality. The early diagnosis of HCMV disease is important in immunosuppressed patients, since in these individuals, preemptive treatment is useful. The objective of this study was to compare the performance of the in-house qualitative polymerase chain reaction (PCR) and pp65 antigenemia to HCMV infection in immunosuppressed patients in the Hospital de Clínicas of Porto Alegre (HCPA). METHODS: A total of 216 blood samples collected between August 2006 and January 2007 were investigated. RESULTS: Among the samples analyzed, 81 (37.5%) were HCMV-positive by PCR, while 48 (22.2%) were positive for antigenemia. Considering antigenemia as the gold standard, sensitivity, specificity, positive predictive values and negative predictive values for PCR were 87.5%, 76.8%, 51.8% and 95.5% respectively. CONCLUSIONS: These results demonstrated that qualitative PCR has high sensitivity and negative predictive value (NPV). Consequently PCR is especially indicated for the initial diagnosis of HCMV infection. In the case of preemptive treatment strategy, identification of patients at high-risk for HCMV disease is fundamental and PCR can be useful tool.

Notification of the first isolation of Cacipacore virus in a human in the State of Rondônia, Brazil

Flavivirus is a genus of arthropod-transmitted viruses of the family Flaviviridae, and in Brazil, up to eleven different Flavivirus have been isolated. We collected blood from farmers in the municipality of Theobroma, which is located 320km from the City of Porto Velho, the former capital of the Brazilian State of Rondônia. For viral isolation, we used newborn mouse brain, followed by RT-PCR with specific universal Flavivirus primers. We obtained fragments 958bp and 800bp in length. Based on BLAST, these sequences were 91% similar to a sequence of Cacipacore virus.

Normal values of echocardiographic measurements. A population-based study

OBJECTIVE: To describe echocardiographic measurements and left ventricular mass in a population sample of healthy adults inhabitants of the urban region of Porto Alegre. METHODS: An analytical, observational, population-based, cross-sectional study was done. Through a multi-stage probability sample, 114 individuals were selected to be submitted to a M-mode and two-dimensional echocardiogram with color Doppler. The analyses were restricted to healthy participants. Echocardiographic measurements were described by mean, standard deviation, 95 percentile and 95% confidence limits. RESULTS: A total of 100 healthy participants, with several characteristics similar to those from the original population, had a complete and reliable echocardiographic examination. The measurements of aorta, left atrium, interventricular septum, left ventricle in systole and diastole, left posterior wall and left ventricular mass, adjusted or not for body surface area or height, were significantly higher in males. The right ventricle size was similar among the genders. Several echocardiographic measurements were within standard normal limits. Interventricular septum, left posterior wall and left ventricular mass, adjusted or not for anthropometric measurements, and aortic dimensions had lower mean and range than the reference limits. CONCLUSION: The means and estimates of distribution for the measurements of interventricular septum, left posterior wall and left ventricular mass found in this survey were lower than those indicated by the international literature and accepted as normal limits.

Establishing the prevalence of hypertension. Influence of sampling criteria

OBJECTIVE: To compare the prevalence of systemic hypertension in two different populations: a representative sample of the adult urban population of Porto Alegre, and individuals who sought blood pressure measurement in a hypertension prevention and control campaign. METHODS: A cross-sectional study was carried out involving a representative sample of the adult urban population of Porto Alegre and a population sample obtained from a hypertension prevention and control campaign, which included all the individuals who sought the blood pressure assessment unit at the Hospital das Clínicas in Porto Alegre. The following parameters were investigated: history of hypertension, use of antihypertensive drugs, age, and sex. Adjustments for age and sex in the prevalence rates were performed to make them comparable. RESULTS: Hypertension prevalence, defined as values > or = 160/95mmHg or treatment with antihypertensive drugs, was higher in the campaign sample (42%) as compared with the population sample (24%). Among those who were aware of their hypertensive condition and were under medication, 54% of the campaign sample and 62% of the representative population sample maintained their pressure levels <160/90mmHg. CONCLUSION: Prevalence rates of hypertension differed a lot in the campaign sample and in the representative population sample, showing that the sampling criterion may influence assessment of risk factors and bias the association between risk factors and health aggravations.

Trends of the Risk of Death due to Circulatory, Cerebrovascular, and Ischemic Heart Diseases in 11 Brazilian Capitals from 1980 to 1998

OBJECTIVE: To assess the trends of the risk of death due to circulatory (CD), cerebrovascular (CVD), and ischemic heart diseases (IHD) in 11 Brazilian capitals from 1980 to 1998. METHODS: Data on mortality due to CD, CVD and IHD were obtained from the Brazilian Health Ministry, and the population estimates were calculated by interpolation with the Lagrange method based on census data from 1980 and 1991 and the population count of 1996. The trends were analyzed with the multiple linear regression method. RESULTS: CD showed a trend towards a decrease in most capitals, except for Brasília, where a mild increase was observed. The cities of Porto Alegre, Curitiba, Rio de Janeiro, Cuiabá, Goiânia, Belém, and Manaus showed a decrease in the risk of death due to CVD and IHD, while the city of Brasília showed an increase in CVD and IHD. The city of São Paulo showed a mild increase in IHD for individuals of both sexes aged 30 to 39 years and for females aged 40 to 59 years. In the cities of Recife and Salvador, a reduction in CD was observed for all ages and both sexes. In the city of Recife, however, an increase in IHD was observed at younger ages (30 to 49 years), and this trend decreased until a mild reduction (-4%) was observed in males ³ 70 years. CONCLUSION: In general, a reduction in the risk of death due to CD and an increase in IHD were observed, mainly in the cities of Recife and Brasília.

Temperature, urbanization and body color polymorphism in South Brazilian populations of Drosophila kikkawai (Diptera, Drosophilidae)

Body color polymorphism of urban populations of cosmopolite fly Drosophila kikkawai Burla, 1954 was investigated in relation to its possible association with environmental temperature. Samples of D. kikkawai were collected in spring, summer, autumn and winter between 1987 to 1988, in zones with different levels of urbanization in the southern Brazilian city of Porto Alegre, Rio Grande do Sul. A clear association was observed between darker flies and both seasons with low temperatures and areas of low urbanization (where temperature is generally lower than in urbanized areas). Results of preliminary laboratory experiments involving six generations of flies grown in chambers at temperatures of 17º and 25ºC confirmed this tendency to a relationship between body color and temperature, with allele frequency of the main gene involved in body pigmentation changing over time.

Population ecology of the multivoltine Neotropical gall midge Eugeniamyia dispar (Diptera, Cecidomyiidae)

Our understanding of the population ecology of insect gallers is largely built on examples from temperate zones, but tropical and subtropical gallers may present distinct patterns of abundance and distribution across time. Eugeniamyia dispar Maia, Mendonça & Romanowski, 1996 is a multivoltine Neotropical cecidomyiid that induces spongy leaf galls on Eugenia uniflora (Myrtaceae). Galls were censused in the urban area of Porto Alegre, southern Brazil on six plants at two sites, for two years, at roughly weekly intervals. Overall 9,694 eggs, galling attempts and galls were counted. New galls continuously appear on developing leaves, but galls with live inducers are absent from June to at least early August. Galls on a same shoot develop synchronically, thus the shoot is probably the unit for oviposition. Given the also synchronic appearance of galls on different plants on a site, it seems midges can disperse and attack close-by plants. Gall cohorts varied in abundance by two orders of magnitude; there were more galls during summer than for spring and autumn, in a wave-like pattern. Host plant leaf production was seasonal, with low production during winter and cyclic production during the rest of the year. Perhaps because of this very variable pattern, gall abundance did not follow leaf production: this galler is not synchronised with its host at least during most of the year. This multivoltine gall inducer with "labile" galls, short development time, partially overlapping generations and low host synchronisation differs from the commonly studied species of the temperate regions providing a subject for ecological comparisons.

Prevalence and levels of IgG and IgM antibodies against Plasmodium falciparum and P. vivax in blood donors from Rondônia, Brazilian Amazon

Antibodies of IgG and IgM isotopes reacting with Plasmodium falciparum and P. vivax thick-smear antigens were searched for by the indirect fluorescent antibody test (IFAT) in a random sample of 230 blood donors at the transfusion centre of Porto Velho (HEMERON), Rondônia State, western Brazilian Amazon. A high prevalence of IgG seropositivity (32% against P. falciparum, 24% against P. vivax and 37% against either P. falciparum or P. vivax antigens) was detected among them, despite the fact that candidates reporting recent (<12 months) malaria attacks were not elegible. Only a small proportion of them had also detectable IgM antibodies to these antigens. These data suggest an intense, relatively recent exposure to malaria in such an urban population sample. However, parasitaemia (as detected by microscopical examination of Giemsa-stained thick smears) was patent in only one prospective donor. The antibody profile of blood donors was compared with that of healthy subjects of all age groups, living in a close endemic area (Candeias village, 21 km east of Porto Velho). The villagers were classified into two groups according to their history of a recent (<12 months) or a remote (>12 months) past malaria attack due to either P. falciparum or P. vivax. Extensive overlapping was observed when the distribution of antibody titres of healthy subjects from Candeias village with a recent and remote malaria history was compared. In conclusion, subjects with a recent or a remote malaria history could not be distinguished by sorological criteria alone.

Neotropical Monogenoidea. 24. Rhinoxenus bulbovaginatus n. sp. (Dactylogyridae, Ancyrocephalinae) from the nasal cavity of Salminus maxillosus (Osteichthyes, Characidae) from the Rio Paraná, Paraná, Brazil

Rhinoxenus bulbovaginatus n. sp. is described from the nose of Salminus maxillosus (Characidae) collected in the basin of the rio Paraná, near the city of Porto Rico, state of Paraná, Brazil. The new species can be differentiated from the other three species in the genus by the morphology of the copulatory complex, vagina, and ventral anchor. The sister group relationship of the known species of Rhinoxenus was determined using techniques of Phylogenetic Systematics (Cladism). The resulting cladogram (C.I.=100%) indicates that the new species is most closely related to R. piranhus Kritsky, Boeger and Thatcher, 1988. The other two species of the genus, R. arietinus Kritsky, Boeger and Thatcher, 1988 and R. nyttus Kritsky, Boeger and Thatcher, 1988, both parasites of Anostomidae fishes, have a paraphyletic position in the cladogram, suggesting that the origin of at least one of them can not be associated to cospeciation.

Urban malaria in the Brazilian Western Amazon Region I: high prevalence of asymptomatic carriers in an urban riverside district is associated with a high level of clinical malaria

Cross sectional studies on malaria prevalence was performed in 2001, 2002, and 2004 in Vila Candelária, an urban riverside area of Porto Velho, Rondônia, in the Brazilian Western Amazon, followed by longitudinal surveys on malaria incidence. Vila Candelária is a working class district, provided with electricity, water supply, and basic sanitation. Previous preliminary surveys indicated high malaria incidence in this community. At the end of year 2000 regular diagnostic and treatment measures for malaria were introduced, with active search of febrile cases among residents. Despite of both rapid treatment of cases and relative good sanitary and housing conditions, the malaria incidence persisted at high levels during the following years with an annual parasite index of 150 to 300/1000 inhabitants. Parasite surveys in 2001, 2002, and 2004 achieved through microscopy and polymerase chain reaction to diagnose malaria showed a constant high prevalence of asymptomatic carriers for both Plasmodium falciparum and P. vivax parasites. It was concluded that asymptomatic carriers represent an important reservoirs of parasites and that the carriers might contribute to maintaining the high level of transmission. Comparing our findings to similar geo-demographic situations found in other important urban communities of the Brazilian Amazon, we propose that asymptomatic carriers could explain malaria's outbreaks like the one recently observed in Manaus.

The Construction Of Ethical Competence In The Perception Of Primary Care Nurses


The study intended to understand the perception of nurses of Primary Care Services about the construction of ethical competence on their formation and practices. This is a qualitative study, with an interpretative phenomenological approach and interviews with ten nurses of the community health services of Porto Alegre, RS. The results showed that the interviewed professionals had already experienced situations with ethical conflicts and knew what ethical competence means. The central themes point out three fundamental issues in the construction of the ethical competence: personal values, education and practice. Taking into account that ethical competence is in permanent construction, the study shows the importance to promote organizational and educational activities in a transversal manner, as a tool to cope the moral stress and contribute in improving the quality of care in the primary health attention.


Description of the male of Evandromyia gaucha Andrade Filho, Souza, Falcão (Psychodidae, Phlebotominae)

Here, we present the description of male of the sand fly species Evandromyia gaucha. Six male specimens of E. gaucha, together with conspecific females, were collected in native forest areas of the municipalities of Porto Alegre, Caçapava do Sul (type locality of E. gaucha) and Santa Cruz do Sul, in Rio Grande do Sul state, Brazil. The specimens are distinguished from other species of the rupicola series of the genus Evandromyia by the presence of dilatation in the apical quarter of the genital filaments followed by tapering of the final portion.

Estudo das emissões de fontes móveis na região metropolitana de Porto Alegre, Rio Grande do Sul

The present study aims at assessing the influence of pollution from mobile sources on air quality in the Metropolitan Area of Porto Alegre by means of an inventory based on methods applied specifically to vehicular emissions. The study uses the method described by CETESB, based on inventories on vehicular emissions, according to USEPA methodology. Following fuel types were taken into account: gasoline (24% ethanol), alcohol, diesel oil, and CNG (compressed natural gas). Results have shown that gasoline-powered vehicles are still responsible for emitting the highest CO and HC concentrations, while diesel-powered vehicles are the source of highest NOx, MP and SOx concentrations.

Composição química da precipitação úmida da região metropolitana de Porto Alegre, Brasil, 2005- 2007

This work aims to quantify the wet precipitation the Metropolitan Area of Porto Alegre (MAPA), in southern Brazil, through the analysis of major ions (by ion chromatography) and metallic elements (ICP/AES). By principal components analysis and cluster analysis was possible to identify the influence of natural and anthropic sources in wet precipitation. The results indicated of the higher contribution to the ions NH4+, SO4(2-) and Ca2+. Thus it was possible to identify the contribution of anthropogenic sources in wet precipitation in the study area, such as power plants, oil refineries, steel and vehicle emissions.

Critical analysis of thoracotomies performed in the emergency room in 10 years

OBJECTIVE: To conduct a critical analysis of thoracotomies performed in the emergency rooms.METHODS: We analyzed mortality rates and survival as outcome variables, mechanism of injury, site of injury and anatomic injury as clinical variables, and gender and age as demographic variables of patients undergoing thoracotomy in the emergency room after traumatic injury.RESULTS: Of the 105 patients, 89.5% were male. The average age was 29.2 years. Penetrating trauma accounted for 81% of cases. The most common mechanism of trauma was wound by a firearm projectile (gunshot), in 64.7% of cases. Patients with stab wounds (SW) accounted for 16.2% of cases. Overall survival was 4.7%. Survival by gunshot was 1.4%, and by SW, 23.5%. The ERT following blunt trauma showed a 100%mortality.CONCLUSION: The results obtained in the Emergency Hospital of Porto Alegre POA-HPS are similar to those reported in the world literature.