Compatibilidad entre nueve cepas de Biomphalaria glabrata de áreas endémicas y no endémicas y una cepa de Schistosoma mansoni venezolanas

Se infectaron experimentalmente 9 lotes de 32 caracoles B. glabrata (de 5 a 7mm de diámetro) con miracidios de la cepa C5 de Schistosoma mansoni a razón de 5 miracidios por caracol, pertenecientes a las siguientes cepas: En el área endémica de transmisión de Esquistosomiasis mansoni a) Sector Puerta Negra, Lago Valencia, b) Cagua c) Ingenio Bolívar (Estado Aragua) d) Mariara e) Caserío El 25 f) Güigüe (Estado Carabobo). Fuera del área endémica de transmisión g) Anzoátegui (Estado Lara), h) Chabasquén (Estado Portuguesa), i) Sector La Elvira, Caripe (Estado Monagas). El período prepatente intramolusco, osciló entre 23 y 25 días, para las 9 cepas evaluadas. La duración total de la infección fue muy variable desde 20 días para la cepa Chabasquén, hasta 93 días para la de Güigüe.La producción total promedio de cercarias al tercer día de iniciada la emisión varió desde X = 74,4 para la cepa de Mariara, hasta X = 591,7 para la cepa de Chabasquén. Se evidenció la existencia de diferencias estadísticamente significativas (H = 97,4, P < 0,05) en la producción total de cercarias al tercer día de iniciada la emisión, detectándose diferencias estadísticamente significativas para casi todas las 36 combinaciones, excepto para las cuatro siguientes: Mariara/Ingenio Bolívar, Cagua/Caserío El 25, Lago de Valencia/Güigüe y Güigüe/Caripe.En lo que respecta al porcentaje de caracoles que presentaron cura espontánea, los valores mas elevados se obtuvieron en las cepas del Lago de Valencia (88,8%), Cagua (85,2%), Chabasquén (82,6%), Caripe (82,6%) y Anzoátegui (80%). Mientras que el porcentaje mas bajo se obtuvo para la cepa de Güigüe (21,4%).

Resposta de fase aguda, subnutrição e estado nutricional do ferro em adultos com AIDS

Foram comparados o estado nutricional e parâmetros do metabolismo do ferro de adultos HIV-positivos, com ou sem resposta de fase aguda (RFA). Adultos HIV-positivos (n = 29) submeteram-se a antropometria, recordatório alimentar e determinação sérica de albumina, proteína C reativa (PCR), ferritina e capacidade total de ligação do ferro (CTLF), além de creatinina urinária. Infecção mais PCR > 7mg/dl foram critérios de positividade da RFA. Índice de massa corporal (IMC < 18,5kg/m2) e índice creatinina-altura (ICA < 70%) definiram subnutrição. Subnutrição (77,8 vs 40%) e tuberculose pulmonar (44,4 vs 9,5%) foram mais freqüentes nos pacientes RFA-positivos, que também apresentaram menores níveis de albumina (3,7 ± 0,9 vs 4,3 ± 0,9g/dl), CTLF (165,8 ± 110,7 vs 265,9 ± 74,6mg/dl) e hemoglobina (10,5± 1,8 vs 12,6 ± 2,3g/dl). A ingestão de ferro foi adequada e similar entre RFA-positivos e RFA-negativos, o mesmo ocorrendo, respectivamente, quanto à ferritina sérica (mediana; variação, 568; 45,3-1814 vs 246; 18,4-1577ng/ml). Pacientes HIV-positivos com resposta de fase aguda são nutricionalmente mais comprometidos e têm anemia que parece não depender da ingestão recente de ferro.

Seasonal profile and level of CD4+ lymphocytes in the occurrence of cryptosporidiosis and cystoisosporidiosis in HIV/AIDS patients in the Triângulo Mineiro region, Brazil

Patients with AIDS are particularly susceptible to infection with intestinal coccidia. In this study the prevalence of infections with Cryptosporidium sp and Cystoisospora belli were evaluated among HIV/AIDS patients in the Triângulo Mineiro region, Brazil. Between July 1993 and June 2003 faecal samples from 359 patients were collected and stained by a modified Ziehl-Neelsen method, resulting in 19.7% of positivity for coccidian (8.6% with Cryptosporidium sp, 10.3% with Cystoisospora belli and 0.8% with both coccidian). Patients with diarrhoea and T CD4+ lymphocyte levels < 200 cells/mm3 presented higher frequency of these protozoans, demonstrating the opportunistic profile of these infections and its relationship with the immunological status of the individual. It was not possible to determine the influence of HAART, since only 8.5% of the patients positive for coccidian received this therapy regularly. Parasitism by Cryptosporidium sp was more frequent between December and February and thus was characterised by a seasonal pattern of infection, which was not observed with Cystoisospora belli.

Clinical and radiographic features of HIV-related pulmonary tuberculosis according to the level of immunosuppression

Medical charts and radiographs from 38 HIV-infected patients with positive cultures for Mycobacterium tuberculosis from sputum or bronchoalveolar lavage were reviewed in order to compare the clinical, radiographic, and sputum bacilloscopy characteristics of HIV-infected patients with pulmonary tuberculosis according to CD4+ lymphocyte count (CD4). The mean age of the patients was 32 years and 76% were male. The median CD4 was 106 cells/mm³ and 71% had CD4 < 200 cells/mm³. Sputum bacilloscopy was positive in 45% of the patients. Patients with CD4 < 200 cells/mm³ showed significantly less post-primary pattern (7% vs. 63%; p = 0.02) and more frequently reported weight loss (p = 0.04). Although not statistically significant, patients with lower CD4 showed lower positivity of sputum bacilloscopy (37% vs. 64%; p = 0.18). HIV-infected patients with culture-confirmed pulmonary tuberculosis had a high proportion of non-post-primary pattern in thoracic radiographs. Patients with CD4 lower than 200 cells/mm³ showed post-primary patterns less frequently and reported weight loss more frequently.

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

OBJETIVE: to evaluate the efficacy of urine culture by bag specimen for the detection of neonatal urinary tract infection in full-term newborn infants. Retrospective study (1997) including full-term newborn infants having a positive urine culture (>100,000 CFU/ml) by bag specimen collection. The urinary tract infection diagnosis was confirmed by positive urine culture (suprapubic bladder aspiration method). The select cases were divided into three groups, according to newborn infant age at the bag specimen collection: GI (< 48 h, n = 17), GII (48 h to 7 d, n = 35) and GIII (> 7 d, n = 9). Sixty one full-term newborn infants were studied (5.1 % of total infants). The diagnosis was confirmed on 19/61 (31.1 %) of full-term infants born alive. Distribution among the groups was: GI = 2/17 (11.8 %), GII = 10//35 (28.6 %), and GIII = 7/9 (77.7 %). The most relevant clinical symptoms were: fever (GI - 100 %, GII - 91.4 %) and weight loss (GI - 35.3 %, GII - 45.7 %). Urine culture results for specimens collected by suprapubic aspiration were: E. coli GI (100 %), GII (40 %) and GIII (28.6 %), E. faecalis GI (30%), Staphylococcus coagulase-negative GII (20 %) and GIII (42.8 %), and Staphylococcus aureus GII (10 %). Correlation between positive urine culture collection (bag specimen method) and urinary tract infection diagnosis, using relative risk analysis, produced the following results: GI=0.30 (CI95% 0.08-1.15), GII=0.51 (CI 95% 0.25-1.06) and GIII=3.31 (CI95% 1.8-6.06) The most frequent urinary tract infection clinical signs in the first week were fever and weight loss, while non-specific symptomatology occurred later. E. coli was most frequent infectious agent, although from the 7th day of life, staphylococcus was noted. The urine culture (bag specimen method) was effective in detecting urinary tract infection only after the 7th day of life.

Relationship between plasma creatinine concentration and glomerular filtration in preterm newborn infants

Fluid management and dosage regimens of drugs in preterm infants should be based on the glomerular filtration rate. The current methods to determine glomerular flitration rate are invasive, time-consuming, and expensive. In contrast, creatinine clearance can be easy obtained and quickly determined. The purpose of this study was to compare plasma creatinine on the third and seventh day of life in preterm newborn infants, to evaluate the influence of maternal creatinine, and to demonstrate creatinine clearance can be used as a reliable indicator of glomerular filtration rate. We developed a prospective study (1994) including 40 preterm newborns (gestational age < 37 weeks), average = 34 weeks; birth weight (average) = 1840 g, in the first week of life. Inclusion criteria consisted of: absence of renal and urinary tract anomalies; O2 saturation 3 92%; adequate urine output (>1ml/kg/hr); normal blood pressure; absence of infections and no sympathomimetic amines in use. A blood sample was collected to determine plasma creatinine (enzymatic method) on the third and seventh day of life and creatinine clearance (CrCl) was obtained using the following equation: , k = 0.33 in preterm infant All plasma creatinine determinations showed normal values [third day: 0.78 mg/dl ± 0.24 (mean ± SD)and seventh day: 0.67 mg/dl ± 0.31 - (p>0.05)]. Also all creatinine clearance at third and seventh day of life were normal [third day: 19.5 ml/min ± 5.2 (mean ± SD) and seventh day: 23.8 ml/min ± 7.3 - (p>0,05)]. All preterm infants developed adequate renal function for their respective gestational age. In summary, our results indicate that, for clinical practice, the creatinine clearance, using newborn length, can be used to estimate glomerular filtration rate in preterm newborn infants.

Intraventricular hemorrhage in very low birth weight infants: associated risk factors and outcome in the neonatal period

Intraventricular hemorrhage (IVH) is a severe complication in very low birth weight (VLBW) newborns (NB). With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification) performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101) and the incidence of IVH was 29.8% (20/67) : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB <1,000 g was 53.8% (p = 0.035) and for gestational age <30 weeks was 47.3% (p = 0.04), both considered risk factors for IVH. The length of hospitalization (p = 0.00015) and mechanical ventilation (p = 0.038) were longer in IHV NB. The IVH NB had a relative risk of 2.3 of developing apnea (p = 0.02), 3.7 of hydrocephalus (p = 0.0007), and 7.7 of periventricular leukomalacia (p < 0.00001). The authors emphasize the importance of knowing the risk factors related to IVH so as to introduce prevention schemes to reduce IVH and to improve outcomes of affected newborns.

ESTIMACION DE EDAD Y CRECIMIENTO EN LA "PACORA" (PLAGIOSCION SURINAMENSIS BLEECKER, 1873) POR MEDIO DE LA COMPARACION DE LOS METODOS DE ANALISIS DE DISTRIBUCION DE FRECUENCIAS Y LAS MARCAS EN ESCAMAS Y OTOLITOS

En la presente investigación se estima la edad y creecimiento de la pacora (Plagiosclon surinamensis), por medio de la comparación de los métodoe de distribución de frecuencias, marcas en las escamas y marcae en los otolitos; de esta comparación se concluye que la pacora forma tres anillos en las escamas por año y con base en este método, estableciendo los grupos de edad anuales, se calcula la ecuación de crecimiento de Von Bertalanffy, la cual se expressa de la siguiente manera:Lt (ram) = 775.1 * {1 - e -0.362 * (t - 0.0978)}. La relación talla-peso se calculó ordenando las tallas en intervalos de 10 ram y corresponde a la ecuación:Peso (gr) = 1.1 * 10-5 * L. E.(3.08), no encontrándose diferencias significativas entre el crecimiento de hembras y el de machos. Se complementa la investigación con información sobre tallas mínimas y medias de madurez sexual y espectro trófico de la especie en la parte baja de la cuenca del Río Magdalena y su plano inundable.

Complexação de íons de metais por matéria orgânica dissolvida: modelagem e aplicação em sistemas reais

Os íons de metais pesados são conhecidos tanto pela sua importância fisiológica e industrial, bem como pelo risco ambiental e à saúde humana. Para elucidar o comportamento dessas espécies nos corpos hídricos, os quais recebem grande parte da descarga de metais, seja de origem antrópica ou por fontes naturais, é necessário entender as interações que elas apresentam com o meio, principalmente a especiação química. Um dos mais importantes processos pelos quais passam as espécies metálicas em corpos aquáticos naturais é a interação com a matéria orgânica dissolvida (MOD), que pode ser por adsorção, reações de troca iônica ou por complexação. Neste trabalho foram realizados vários experimentos com o objetivo de descrever o comportamento da complexação de três importantes cátions Cu(II), Cd(II) e Pb(II) com a matéria orgânica (ácido húmico comercial), sob condições diversas de força iônica em meio tamponado. Os resultados foram avaliados de acordo com o modelo de van den Berg e Kramer para a complexação de metais. O modelo foi aplicado na determinação da capacidade de complexação dos íons em amostras reais, oriundas de três rios maranhenses que integram a Amazônia legal: Itapecuru, Bacanga e Pericumã. Nas águas dos rios utilizou-se o parâmetro carbono orgânico dissolvido (COD) para expressar a MOD. Os resultados confirmaram forte interação entre a MOD e íons de metais pesados e que o modelo de van den Berg e Kramer é satisfatório para se estimar a constante de complexação (K) e a concentração de sítios de complexação (Lt). Nas amostras simuladas em laboratório a ordem de complexação dos metais foi Cu(II) > Cd(II) > Pb(II) e a capacidade de complexação mostrou ser linear em função da concentração de ácido húmico comercial. Acredita-se que por ter menor raio iônico, o íon Cu(II) possui maior afinidade com os sítios de complexação. Nas amostras retiradas dos corpos aquáticos, observou-se que o rio com maior concentração de COD (rio Bacanga) apresentou maior capacidade de complexação; entretanto, a ordem foi Pb(II) > Cu(II) > Cd(II) provavelmente devido à presença de íons Cu(II) em maior quantidade nas águas dos rios.

Prevalência de fatores de risco coronarianos e alterações da perfusão miocárdica à cintilografia em pacientes diabéticos assintomáticos ambulatoriais

OBJETIVO: Determinar a prevalência de fatores de risco (FR) para doença arterial coronariana (DAC) e isquemia miocárdica em uma amostra de diabéticos assintomáticos atendidos ambulatorialmente. MÉTODOS: De 80 diabéticos tipo 2 inicialmente recrutados no ambulatório de endocrinologia do nosso Hospital Universitário, sem sintomas e/ou diagnóstico de DAC, apenas 61 completaram o protocolo da pesquisa, sendo 52,5% do sexo feminino, com uma média de idade de 56,3±10,9anos. Os pacientes foram submetidos a entrevista procurando-se identificar os FR e à realização de eletrocardiograma, ecocardiograma e cintilografia miocárdica perfusional (CMP), em repouso e sob estresse. De acordo com o resultado da CMP, foram distribuídos em dois grupos: um isquêmico e outro normal. RESULTADOS: Os FR identificados foram: sexo masculino (48%), idade > 55 anos (51%), história familiar de doença aterosclerótica precoce (16%), passado de tabagismo (46%), hipertensão arterial (44%), sedentarismo (62%), sobrepeso / obesidade (67%), HDL-colesterol &lt; 45 mg/dl (69%), LDL-colesterol > 100 mg/dl (85%) e triglicérides > 150 mg/dl (54%). A CMP foi positiva para isquemia em 15% dos pacientes. As variáveis associadas a esse diagnóstico foram sexo masculino (p=0,007), HDL baixo (p=0,046), história de tabagismo (p=0,038), hipertrofia ventricular esquerda (HVE) (p=0,043) e fração de ejeção do ventrículo esquerdo (FEVE) < 60% (p=0,01). CONCLUSÃO: Observou-se uma alta prevalência de FR associados, bem como uma expressiva prevalência, de 15%, de isquemia miocárdica. Sexo masculino, HDL-colesterol baixo, passado de tabagismo, HVE e FEVE < 60% foram as variáveis identificadas como preditoras do diagnóstico de isquemia miocárdica.

Eficácia da atorvastatina sem administração diária

FUNDAMENTO: As estatinas têm larga utilização por reduzirem eventos cardíacos. Indicadas para uso diário, no entanto alguns a utilizam em dias alternados, principalmente visando diminuição de custos. OBJETIVO: Avaliar a eficácia da atorvastatina sem administração diária sobre os níveis de LDL-colesterol (LDL-C) e a redução dos custos. MÉTODOS: Foram avaliados 100 pacientes (P) hipercolesterolêmicos em prevenção primária (PP) e secundária (PS). Após período de dieta de 12 semanas iniciou-se atorvastatina 10 mg por dia. Após seis semanas foi dosado o LDL-C, e se níveis &lt;80 ou &lt;104 mg/dl conforme PS e PP, respectivamente, foi feita subtração de duas tomadas de atorvastatina da semana. Caso LDL-C continuasse &lt;80 ou &lt;104 mg/dl permitiria novo ajuste para três vezes na semana, sendo feita última dosagem após seis semanas. A variação porcentual de custos foi a forma de apreciar a economia. RESULTADOS: Em 47 P, dos 52 desse grupo, observou-se redução de LDL-C de 32%, permanecendo com atorvastatina diária. Quarenta e um ficaram até o final do estudo e tiveram redução da posologia semanal. Em 25 P, a medicação foi administrada três vezes por semana e, em 16, cinco vezes por semana, exibindo redução de LDL-C de 42,4% e 46,1%, respectivamente. Sobre custos, um dos grupos teve despesa mensal de R$ 106,65 reduzido para R$ 74,65, e outro grupo, o gasto de R$ 106,65 foi reduzido a R$ 53,33. CONCLUSÃO: Os resultados sugerem que é possível administrar a atorvastatina de forma não-diária e observou-se redução dos custos entre 30% e 50%.

Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Patients with Heart Failure

Background:Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown.Objective:We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF.Methods:Total testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients.Results:Length of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58–4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67–8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23–8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001).Conclusion:These results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT.

Crescimento de Chasmagnathus granulatus (Crustacea, Decapoda, Varunidae) na Lagoa do Peixe, Rio Grande do Sul, Brasil

O estudo do crescimento em largura da carapaça de Chasmagnathus granulatus Dana, 1851 foi baseado em dados de 1940 exemplares coletados na Lagoa do Peixe, Estado do Rio Grande do Sul, Brasil. As coletas foram realizadas de julho/1994 a junho/1995. Os caranguejos foram coletados manualmente nas margens da lagoa e em laboratório foram separados por sexo e a largura da carapaça mensurada. O modelo de von Bertalanffy foi utilizado para a descrição do crescimento. As curvas de crescimento em largura (mm), para dados obtidos através da progressão modal, são descritas pelas equações: Lt= 44,69 [1- e -0.0066(t+20,45)] e Lt= 37,63 [1- e -0.0072(t+21,92)], resultando em idades máximas estimadas de 2 anos para ambos os sexos.

Reproductive traits of Gymnogeophagus labiatus (Teleostei, Cichlidae), in an upper stretch of Sinos river, Caraá, Brazil

This work describes the reproduction of Gymnogeophagus labiatus (Hensel, 1870) from an upper stretch of Sinos river, southern Brazil, based on the analysis of 174 males and 132 females captured in monthly samples taken from January to December 2007. Results showed that reproductive activity occur in spring and summer although ripe males were found along the year. The standard length of the smallest ripe male was 104.74 mm (Lt) and the smallest ripe female was 55.00 mm (Lt). There was a significant difference in total sex ratio, with 1.32 males to each female (χ2 = 5.76). Males were much more abundant in March (1.75 males: 1 female) and December (5 males: 1 female). Females were more abundant in the 62├77 mm interval (1 male: 2.36 female) while males were more abundant in the 77├92 mm size interval (2.57 males: 1 female). The largest length intervals were composed of only males. Mean absolute fecundity was 113.4 (± 31.24 sd) and mean relative fecundity was 0.0125 (± 0.0026 sd) oocytes/mg. In ripe ovaries, small-diameter oocytes were observed at high frequencies while larger ones occurred at lower frequencies. This pattern is common in fishes with asynchronous oocyte development. Characteristics of G. labiatus, such as low fecundity, asynchrony in oocyte development, multiple spawning, and its well-known parental care behavior, are consistent with an equilibrium strategy, as proposed for other cichlids.

Tuberculin Skin Test and CD4+/CD8+ T Cell Counts in Adults Infected with the Human Immunodeficiency Virus in Medellín, Colombia

To evaluate the effect of BCG vaccination and T lymphocyte subpopulations on the reactivity to the tuberculin skin test, 113 asymtomatic HIV+ individuals were tuberculin tested by intradermal injection of 5TU of purified protein derivative and the levels of circulating lymphocyte (CD3, CD4 and CD8) subpopulations determined by indirect immunofluorescence. Ninety-two percent of the subjects included in the study were males. The mean age of the group was 32.1±7.4 years. Sixty-two percent presented a BCG scar. However, only 22% exhibited positive tuberculin reactions (³5mm) irrespective of the presence of the BCG scar. Tuberculin positive individuals exhibited higher CD4+ cell counts (p=0.004) and CD4+/CD8+ ratios (p=0.006) than tuberculin negative (&lt;5mm) HIV+ individuals. The number of individuals with positive tuberculin reactions was significantly higher in subjects with more than 500 CD4+ lymphocytes/ml (p=0.02) or CD4+/CD8+ ratios ³1.12 (p=0.002). These results suggest that a prior BCG vaccination does not influence the reactivity to the tuberculin skin test in HIV+ asymptomatic individuals and that the number of CD4+ lymphocytes and the CD4+/CD8+ ratio positively correlate with the tuberculin reactivity