Spontaneous reporting of adverse events following pandemic influenza A (H1N1) immunization in a reference center in the State of Sao Paulo, Brazil

Introduction This paper describes adverse events (AEs) temporally associated to the pandemic influenza A (H1N1) vaccine observed in a reference center in São Paulo, Brazil, during a 2010 mass vaccination campaign. Methods A retrospective study involving persons who sought medical care for AEs following influenza vaccination. Data were retrieved from medical records, vaccine AE notification forms, and a computerized system for immunobiological registration. Results Sixty-six vaccinees sought medical care for AEs after immunization. The most frequent AEs were fever, headache, myalgia, and pain at the injection site. No serious AEs were reported. Conclusions Few vaccinees spontaneously reported AEs to influenza A (H1N1) vaccine at this center.

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases

AbstractINTRODUCTION:We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database.METHODS:A descriptive and retrospective epidemiological study was conducted from 2007 to 2013.RESULTS:A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases).CONCLUSIONS:Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.

Description of continuous data using bar graphs: a misleading approach

INTRODUCTION:With the ease provided by current computational programs, medical and scientific journals use bar graphs to describe continuous data.METHODS:This manuscript discusses the inadequacy of bars graphs to present continuous data.RESULTS:Simulated data show that box plots and dot plots are more-feasible tools to describe continuous data.CONCLUSIONS:These plots are preferred to represent continuous variables since they effectively describe the range, shape, and variability of observations and clearly identify outliers. By contrast, bar graphs address only measures of central tendency. Bar graphs should be used only to describe qualitative data.

Malaria epidemiology in the State of Piauí, Northeastern Brazil: a retrospective study with secondary data

Abstract: INTRODUCTION Malaria is not considered endemic in State of Piauí. METHODS Malaria epidemiology was examined using surveillance data. RESULTS: During 2002-2013, of the 484 cases of malaria, 217 were classified as probably acquired in Piauí, most frequently in the Campo Largo, Buriti dos Lopes, and Luzilândia municipalities, and 267 were considered probably imported, from the States of Pará, Maranhão, Amazonas, Roraima, and Rondônia. Probably-imported cases occurred throughout the year, while 80.2% of the probably-acquired cases occurred in April-August, peaking at the end of the rainy season. CONCLUSIONS Malaria surveillance should be intensified. Further ecoepidemiological and entomological studies are needed.

Pressure sores among malnourished necropsied adults - preliminary data

Pressure sores are common among bedridden, elderly, or malnourished patients, and may occur in terminal ill patients because of impaired mobility, fecal or urinary incontinence, and decreased healing capacity. The aim of this study was to compare frequency of pressure sores between malnourished and non-malnourished necropsied adults. METHOD: All (n = 201) adults (age ³ 18 years) autopsied between 1986 and 1996 at the Teaching Hospital of Triangulo Mineiro Medical School (Uberaba) were eligible for the study. Gender, race, weight, height and main diagnoses were recorded. Ninety-six cases were excluded because of probable body water retention (congestive heart failure, hepatic insufficiency, nephrotic syndrome) or pressure sores secondary to peripheral vascular ischemia. Body mass index (BMI) was used to define malnourished (BMI < 18.5 kg/m²) and non-malnourished (BMI > 18.5kg/m²) groups. RESULTS: Except for weight (42.5kg; range: 28-57 vs. 60; 36-134.5kg) and BMI (16.9; range: 12.4-18.5 vs. 22.7; range: 18.5-54.6kg/m²), respectively, there were no statistical differences among 43 malnourished and 62 non-malnourished cases in relation to age (54.9 ± 20.4 vs. 52.9 ± 17.9 years), percentage of white persons (74.4 vs. 64.5%), male gender (76.7 vs. 69.3%) and main diagnoses. Five malnourished (11.6%) and 7 (11.5%) non-malnourished cases had pressure sores (p=0.89). CONCLUSION: Pressure sores were equally common findings in necropsied persons with protein-energy malnutrition, as assessed by body mass index.

Pelvic lymphoscintigraphy: contribution to the preoperative staging of rectal cancer

PURPOSE: Preservation of the anal sphincter in surgery for cancer of the distal rectum in an attempt to avoid colostomy has been a main concern of colorectal surgeons. Various proposed procedures contradict oncological principles, especially with respect to pelvic lymphadenectomy. Therefore, prior knowledge of pelvic lymph node involvement is an important factor in choosing the operative technique, i.e., radical or conservative resection. Introduction of ultrasound, computerized tomography, and magnetic resonance have made preoperative study of the area possible. Nevertheless, these resources offer information of an anatomical nature only. Lymphoscintigraphy enables the morphological and functional evaluation of the pelvic area and contributes toward complementing the data obtained with the other imaging techniques. The objective of this prospective study is twofold: to standardize the lymphoscintigraphy technique and to use it to differentiate patients with rectal cancer from those with other coloproctologic diseases. CASUISTIC AND METHODS: Sixty patients with various coloproctologic diseases were studied prospectively. Ages ranged from 21 to 96 years (average, 51 and median, 55 years). Twenty-six patients were male and 34 were female. Thirty patients had carcinoma of the distal rectum as diagnosed by proctologic and anatomic-pathologic examinations, 20 patients had hemorrhoids, 5 had chagasic megacolon, 2 had diverticular disease, 2 had neoplasm of the right colon, and 1 had ulcerative colitis as diagnosed by proctologic exam and/or enema. The lymphoscintigraphy method consisted of injecting 0.25 mL of a dextran solution marked with radioactive technetium-99m into the right and left sides of the perianal region and obtaining images with a gamma camera. The results were analyzed statistically with a confidence level of 95% (P < .05) using the following statistical techniques: arithmetic and medium average, Fisher exact test, chi-square test corrected for continuity according to Yates, and distribution tables for the number of patients. RESULTS: In rectal cancer, the tracer progresses unilaterally or is absent; in other patients, the progress of the tracer is bilateral and symmetrical, although its progress may be slow. Statistical tests showed with high significance that the agreement index between the clinical diagnosis and the result of the lymphoscintigraphic exam was 93%. CONCLUSIONS: Lymphoscintigraphy is a standardized, painless, and harmless test that can be performed in all cases; it differentiates patients with rectal cancer from those with other coloproctological diseases.

Bionomics data for Anopheles (Anopheles) forattinii Wilkerson & Sallum, 1999

Immature and adult stages of Anopheles (Anopheles) forattinii were collected in the Parque Nacional do Jaú, Novo Airão, Amazonas, Brazil. Larvae and pupae were taken from fresh water among floating plant debris inside flooded "igapó" forest. This species may make use of plant debris for passive dispersal throughout its distribution range.

Modelling Amazonian forest eddy covariance data: a comparison of big leaf versus sun/shade models for the C-14 tower at Manaus I. Canopy photosynthesis

In this study, we concentrate on modelling gross primary productivity using two simple approaches to simulate canopy photosynthesis: "big leaf" and "sun/shade" models. Two approaches for calibration are used: scaling up of canopy photosynthetic parameters from the leaf to the canopy level and fitting canopy biochemistry to eddy covariance fluxes. Validation of the models is achieved by using eddy covariance data from the LBA site C14. Comparing the performance of both models we conclude that numerically (in terms of goodness of fit) and qualitatively, (in terms of residual response to different environmental variables) sun/shade does a better job. Compared to the sun/shade model, the big leaf model shows a lower goodness of fit and fails to respond to variations in the diffuse fraction, also having skewed responses to temperature and VPD. The separate treatment of sun and shade leaves in combination with the separation of the incoming light into direct beam and diffuse make sun/shade a strong modelling tool that catches more of the observed variability in canopy fluxes as measured by eddy covariance. In conclusion, the sun/shade approach is a relatively simple and effective tool for modelling photosynthetic carbon uptake that could be easily included in many terrestrial carbon models.

Evaluation of geostatistical techniques to estimate the spatial distribution of aboveground biomass in the Amazon rainforest using high-resolution remote sensing data

ABSTRACT The spatial distribution of forest biomass in the Amazon is heterogeneous with a temporal and spatial variation, especially in relation to the different vegetation types of this biome. Biomass estimated in this region varies significantly depending on the applied approach and the data set used for modeling it. In this context, this study aimed to evaluate three different geostatistical techniques to estimate the spatial distribution of aboveground biomass (AGB). The selected techniques were: 1) ordinary least-squares regression (OLS), 2) geographically weighted regression (GWR) and, 3) geographically weighted regression - kriging (GWR-K). These techniques were applied to the same field dataset, using the same environmental variables derived from cartographic information and high-resolution remote sensing data (RapidEye). This study was developed in the Amazon rainforest from Sucumbíos - Ecuador. The results of this study showed that the GWR-K, a hybrid technique, provided statistically satisfactory estimates with the lowest prediction error compared to the other two techniques. Furthermore, we observed that 75% of the AGB was explained by the combination of remote sensing data and environmental variables, where the forest types are the most important variable for estimating AGB. It should be noted that while the use of high-resolution images significantly improves the estimation of the spatial distribution of AGB, the processing of this information requires high computational demand.

Prognostic value of technetium-99m-labeled single-photon emission computerized tomography in the follow-up of patients after their first myocardial revascularization surgery

OBJECTIVE: To assess the prognostic value of Technetium-99m-labeled single-photon emission computerized tomography (SPECT) in the follow-up of patients who had undergone their first myocardial revascularization. METHODS: We carried out a retrospective study of 280 revascularized patients undergoing myocardial scintigraphy under stress (exercise or pharmacological stress with dipyridamole) and at rest according to a 2-day protocol. A set of clinical, stress electrocardiographic and scintigraphic variables was assessed. Cardiac events were classified as "major" (death, infarction, unstable angina) and "any" (major event or coronary angioplasty or new myocardial revascularization surgery). RESULTS: Thirty-six major events occurred as follows: 3 deaths, 11 infarctions, and 22 unstable anginas. In regard to any event, 22 angioplasties and 7 new surgeries occurred in addition to major events, resulting a total of 65 events. The sensitivity of scintigraphy in prognosticating a major event or any event was, respectively, 55% and 58%, showing a negative predictive value of 90% and 83%, respectively. Diabetes mellitus, inconclusive stress electrocardiography, and a scintigraphic visualization of left ventricular enlargement were significant variables for the occurrence of a major event. On multivariate analysis, abnormal myocardial scintigraphy was a predictor of any event. CONCLUSION: Myocardial perfusion tomography with Technetium-99m may be used to identify high-risk patients after their first myocardial revascularization surgery.

A new species of Phrixotrichus (Araneae, Theraphosidae) from southwestern Argentina and new distributional data for P. vulpinus

ABSTRACT A new species of Phrixotrichus Simon, 1889, P. pucara sp. nov., is described and illustrated based on a male from Pucará river, Neuquén province, Argentina. Male can be distinguished from all other species of the genus by the presence of a long strong spine on inner face of prolateral branch of tibial apophysis; also, it differs from P. scrofa (Molina, 1788) and P. vulpinus (Karsch, 1880) by a serrated prolateral keel of the male palpal bulb. Male resembles P. jara Perafán & Pérez-Miles, 2014 but can be distinguished by the uniform color on dorsal cephalothorax and by the palpal organ morphology being wider on the bulb base and embolus shorter and thicker, with the tip of embolus not so directed retrolaterally and prolateral keel bearing a serrated edge with three teeth. Additionally, P. vulpinus is reported for the first time for Argentina along with new distributional data.

New morphological data on Opecoeloides pedicathedrae Travassos, Freitas & Buhrnheim, 1966 (Digenea: Opecoelidae)

New morphological data on the ventral sucker of Opecoeloides pedicathedrae with ten papilliform processes, original figures and measurementes, are reported.

Effects of precocene and azadirachtin in Rhodnius prolixus: some data on development and reproduction

The results presented in this paper clearly indicate that precocene and azadirachtin are effective inhibitors of moulting and reproduction in the hemipteran Rhodnius prolixus. The time of application is important and only applications of these substances early in the intermoulting period cause their effects in nymphs. The inhibition of moulting is fully reversed by ecdysone therapy. Precocene and azadirachtin also affected drastically the oogenesis and egg deposition in this insect. Precocene-induced sterilization is reversed by application of juvenile hormone III. However, this hormone is unable to reverse the effect of azadirachtin on reproduction. Ecdysteroid titers in nymphs and adult females are decreased by these treatments. In vitro analysis suggest that precocene and azadirachtin may act directly on the prothoracic glands and ovaries producing ecdysteroids. Based on these and other findings the possible mode of action of these compounds on the development and reproduction of Rhodnius prolixus is discussed.

Effects of azadirachtin in Rhodnius prolixus: data and hypotheses

The effects of azadirachtin A, a tetranortriterpenoid from the neem tree Azadirachta indica J., on both development and interaction between Trypanosoma cruzi, the causative agent of Chagas' disease, and its vector Rhodnius prolixus were studied. Given through a blood meal, a dose-rsponse relationship of azadirachtin was established using antifeedant effect and ecdysis inhibition as effective parameters. A singlo dose of azadirachtin A was able to block the onset of mitosis in the epidermis and ecdysteroid titers in the hemnolymph, determined by radioimmuneassay, were too low for an induction of ecadysis. The survival of T. cruzi was also studied in R. prolixus treated with the drug. If the trypomastigotes were fed in presence of azadirachtin A the number of parasites drastically decreased. If the drug was applied after infection of the bug with T. cruzi, the parasite was still abolished from the gut. If the insect was pretreated with azadirachtin A before infection the same observation was obtained. A single dose of azadirachtin A was enough for a permanent resistance of the insect host against its reinfection with T. cruzi and for blocking the ecdysis for a long time. The effects of azadirachtin A on the hormonal balance of the host and growth inhibition of the parasite will be discussed on the basis of the present results.

Effects of proallatotoxins (precocenes) on the development and reproduction of Rhodnius prolixus: some data

Proallatotoxins, and particularly preconcenes, are exceptionally promising models for studying Rhodnius prolixus physiology and for comparison with other natural compounds with anti-hormonal activities. Effects of preconcenes on feeding, development and reproduction of R. prolixus are being detailed. The precocenes reveal significant effects on feeding, moulting cycle (inducing precocious metamorphosis and ecdysial stasis), and reproduction of these insect. The mechanism of action of proallatotoxins was discussed based on the corpus allatum cytotoxic effect and on the ecdysteroid biosynthesis in prothoracic glands and ovaries. Further studies of these compounds on R. prolixus are need and will hopefully reveal other unesplored points regarding the action of the proallatotoxins on insects.