Current status of herpesvirus identification in the oral cavity of HIV-infected children

INTRODUCTION: Some viruses of the Herpesviridae family are frequently the etiologic agents of oral lesions associated with HIV. The aim of this study was to identify the presence of herpes simplex virus types 1 and 2 (HSV-1, HSV-2), Varicella Zoster virus (VZV), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus type 6, type 7 and type 8 (HHV-6, HHV-7 and HHV-8) in the oral cavity of HIV-infected children/adolescents and verify the association between viral subtypes and clinical factors. METHODS: The cells of oral mucosa were collected from 50 HIV infected children/adolescents, 3-13 years old (mean age 8.66). The majority (66%) of selected were girls, and they were all outpatients at the pediatric AIDS clinic of a public hospital in Rio de Janeiro. Nested-PCR was used to identify the viral types. RESULTS: Absence of immunosuppression was observed in 66% of the children. Highly active antiretroviral therapy (HAART) was used by 72.1% of selected and moderate viral load was observed in 56% of the children/adolescents. Viral types were found in 86% of the children and the subtypes were: HSV-1 (4%), HSV-2 (2%), VZV (4%), EBV (0%), HCMV (24%), HHV6 (18%), HHV-7 (68%), HHV8 (0%). CONCLUSIONS: The use of HAART has helped to reduce oral lesions, especially with herpes virus infections. The health professionals who work with these patients should be aware of such lesions because of their predictive value and the herpes virus can be found circulating in the oral cavity without causing lesions.

Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy

Introduction Even with current highly active antiretroviral therapy, individuals with AIDS continue to exhibit important nutritional deficits and reduced levels of albumin and hemoglobin, which may be directly related to their cluster of differentiation 4 (CD4) cell counts. The aim of this study was to characterize the nutritional status of individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and relate the findings to the albumin level, hemoglobin level and CD4 cell count. Methods Patients over 20 years of age with AIDS who were hospitalized in a university hospital and were receiving antiretroviral therapy were studied with regard to clinical, anthropometric, biochemical and sociodemographic characteristics. Body mass index, percentage of weight loss, arm circumference, triceps skinfold and arm muscle circumference were analyzed. Data on albumin, hemoglobin, hematocrit and CD4 cell count were obtained from patient charts. Statistical analysis was performed using Fisher's exact test, Student's t-test for independent variables and the Mann-Whitney U-test. The level of significance was set to 0.05 (α = 5%). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 17.0 software for Windows. Results Of the 50 patients evaluated, 70% were male. The prevalence of malnutrition was higher when the definition was based on arm circumference and triceps skinfold measurement. The concentrations of all biochemical variables were significantly lower among patients with a body mass index of less than 18.5kg/m2. The CD4 cell count, albumin, hemoglobin and hematocrit anthropometric measures were directly related to each other. Conclusions These findings underscore the importance of nutritional follow-up for underweight patients with AIDS, as nutritional status proved to be related to important biochemical alterations.

Vitamin A, vitamin E, iron and zinc status in a cohort of HIV-infected mothers and their uninfected infants

Introduction We hypothesized that nutritional deficiency would be common in a cohort of postpartum, human immunodeficiency virus (HIV)-infected women and their infants. Methods Weight and height, as well as blood concentrations of retinol, α-tocopherol, ferritin, hemoglobin, and zinc, were measured in mothers after delivery and in their infants at birth and at 6-12 weeks and six months of age. Retinol and α-tocopherol levels were quantified by high performance liquid chromatography, and zinc levels were measured by atomic absorption spectrophotometry. The maternal body mass index during pregnancy was adjusted for gestational age (adjBMI). Results Among the 97 women 19.6% were underweight. Laboratory abnormalities were most frequently observed for the hemoglobin (46.4%), zinc (41.1%), retinol (12.5%) and ferritin (6.5%) levels. Five percent of the women had mean corpuscular hemoglobin concentrations < 31g/dL. The most common deficiency in the infants was α-tocopherol (81%) at birth; however, only 18.5% of infants had deficient levels at six months of age. Large percentages of infants had zinc (36.8%) and retinol (29.5%) deficiencies at birth; however, these percentages decreased to 17.5% and 18.5%, respectively, by six months of age. No associations between infant micronutrient deficiencies and either the maternal adjBMI category or maternal micronutrient deficiencies were found. Conclusions Micronutrient deficiencies were common in HIV-infected women and their infants. Micronutrient deficiencies were less prevalent in the infants at six months of age. Neither underweight women nor their infants at birth were at increased risk for micronutrient deficiencies.

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

The systematic and biogeographical status of Fredius reflexifrons (Ortmann, 1897) and Fredius fittkaui (Bott, 1967) (Crustacea: Brachyura: Pseudothelphusidae) from the Amazon and Atlantic Guianas River basins

There is considerable confusion in the literature regarding the systematic position and distribution of two pseudothelphusid crabs originally described as Potamocarcinus reflexifrons Ortmann, 1897 and Potamocarcinus reflexifrons fittkaui Bott, 1967, and now included in the genus Fredius Pretzman, 1965, as F. reflexifrons and F. fittkaui. Study of numerous specimens from recent collections, together with a critical analysis of the data published in the literature, shows that both taxa could be easily separated by gonopodal characters. The two species occupy discrete areas of distribution along the main axis of the Amazon River and in the upper Rio Negro Basin, respectively, with an overlap in the Atlantic Guianas. It is postulated that they originated from a common ancestor, through a process of vicariance, in the two areas observed at present. Permeability of barriers allowed their further occupancy of the Atlantic Guianas after the marine regressions in this area.

Nutritional status and specific leaf area of mahogany and tonka bean under two light environments

Studies on nutritional status and leaf traits were carried out in two tropical tree species Swietenia macrophylla King (mahogany) and Dipetryx odorata Aubl. Willd. (tonka bean) planted under contrasting light environments in Presidente Figueiredo-AM, Brazil. Leaves of S. macrophylla and D. odorata were collected in three year-old trees grown under full sunlight (about 2000 µmol m-2 s-1) and natural shade under a closed canopy of Balsa-wood plantation (Ochroma pyramidale Cav. Ex. Lam.Urb) about 260 µmol m-2 s-1. The parameters analysed were leaf area (LA), leaf dry mass (LDM), specific leaf area (SLA) and leaf nutrient contents. It was observed that, S. macrophylla leaves grown under full sunlight showed LA 35% lower than those grown under shade. In D. odorata leaves these differences in LA were not observed. In addition, it was observed that S. macrophylla shade leaves, for LDM, were 50% smaller than sun leaves, while in D. odorata, there differences were not observed. SLA in S. macrophylla presented that sun leaves were three times smaller than those grown under shade. In D. odorata, no differences were observed. Nutrient contents in S. macrophylla, regardless of their light environments, showed higher contents for P and Ca than those found in D. odorata. The N, K, Fe and Mn contents in S. macrophylla leaves decreased under shade. Finally, we suggest that the decreasing in leaf nutrient contents may have a negative influence on leaf growth. The results demonstrated that the tested hypothesis is true for leaf traits, which D. odorata, late-successional species, showed lower plasticity for leaf traits than Swietenia macrophylla, mid-successional species.

Influência do rio Negro sobre o status nutricional de juvenis de curimatã Prochilodus nigricans (Characiformes; Prochilodontidae) no médio rio Solimões-Amazonas, Brasil

As diferenças limnológicas entre as águas pretas do rio Negro e as águas brancas do rio Solimões-Amazonas podem ter influência sobre o status nutricional de peixes detritívoros pela diferença nas fontes dos recursos alimentares entre estes sistemas. Para verificar a influência do rio Negro sobre o status nutricional de juvenis de curimatã Prochilodus nigricans foi medida a condutividade em pontos de amostragem e estimado o fator de condição (K, a partir da relação peso/comprimento) dos juvenis em três áreas de inundação do médio rio Solimões-Amazonas: (1) com influência do rio Negro, próxima a Manaus; (2) sem influência do rio Negro, próxima a Manaus e (3) sem influência do rio Negro, em um trecho do Solimões-Amazonas 500 km a montante de Manaus. A condutividade nos pontos de amostragem com influência do rio Negro foi significativamente menor do que as outras áreas e o K dos juvenis de águas com influência do rio Negro foi significativamente maior. A alta seletividade do curimatã pode dificultar a assimilação de itens alimentares quando estes estão em alta abundância. Em adição, as águas pretas possuem detritos com alto potencial de assimilação devido à sua qualidade protéica, o que demonstra a grande importância das florestas inundadas por água pretas para os detritívoros amazônicos.

The influence of the conservation status and changes in the rainfall regime on forest-savanna mosaic dynamics in Northern Brazilian Amazonia

Coupled carbon/climate models are predicting changes in Amazon carbon and water cycles for the near future, with conversion of forest into savanna-like vegetation. However, empirical data to support these models are still scarce for Amazon. Facing this scenario, we investigated whether conservation status and changes in rainfall regime have influenced the forest-savanna mosaic over 20 years, from 1986 to 2006, in a transitional area in Northern Amazonia. By applying a spectral linear mixture model to a Landsat-5-TM time series, we identified protected savanna enclaves within a strictly protected nature reserve (Maracá Ecological Station - MES) and non-protected forest islands at its outskirts and compared their areas among 1986/1994/2006. The protected savanna enclaves decreased 26% in the 20-years period at an average rate of 0.131 ha year-1, with a greater reduction rate observed during times of higher precipitation, whereas the non-protected forest islands remained stable throughout the period of study, balancing the encroachment of forests into the savanna during humid periods and savannization during reduced rainfall periods. Thus, keeping favorable climate conditions, the MES conservation status would continue to favor the forest encroachment upon savanna, while the non-protected outskirt areas would remain resilient to disturbance regimes. However, if the increases in the frequency of dry periods predicted by climate models for this region are confirmed, future changes in extension and directions of forest limits will be affected, disrupting ecological services as carbon storage and the maintenance of local biodiversity.

Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

Status de fragilidade entre idosos com indicativo de depressão segundo o sexo

Objetivos : Descrever as variáveis socioeconômicas de idosos com indicativo de depressão segundo o sexo, verificar a associação entre o status de fragilidade e o sexo, e descrever o componente do fenótipo de fragilidade mais impactado entre os idosos com indicativo de depressão pré-frágeis e frágeis. Métodos Estudo observacional, transversal e analítico, conduzido com 418 idosos com indicativo de depressão residentes no município de Uberaba, MG. Utilizaram-se a Escala de Depressão Geriátrica Abreviada e o Fenótipo de Fragilidade de Fried. Foram utilizados análise descritiva e o teste Qui-quadrado (p < 0,05). Resultados Verificou-se que, entre os idosos com indicativo de depressão, 27,8% eram frágeis e 51,7%, pré-frágeis. O status de fragilidade não esteve associado ao sexo (p = 0,910). Dentre os pré-frágeis, os componentes do fenótipo mais impactados foram o autorrelato de exaustão/fadiga para as mulheres e diminuição da força muscular para os homens. Nos frágeis, prevaleceu a diminuição da força muscular para ambos os sexos. Conclusão Mediante os achados deste estudo, conclui-se que, embora não tenha ocorrido associação entre a síndrome de fragilidade e o sexo, a identificação dos componentes do fenótipo de fragilidade mais impactados pode favorecer o atendimento multiprofissional, considerando as especificidades dos grupos. O diagnóstico precoce contribui para o estabelecimento de condutas e prevenção de agravos.

Cognitive-behavioral therapy for anxiety disorders in children and adolescents: a systematic review of follow-up studies

Objective To conduct a systematic review about the long-term response to cognitive-behavioral therapy (CBT) for anxiety disorders (ADs) in children and adolescents. Methods The PubMed and ISI Web of Science databases were consulted. Search in the databases was performed in November 2012 and included cohort studies after CBT for ADs in children and adolescents with a follow-up period over 12 months. Results A total of 10 papers met the inclusion criteria. The follow-up period ranged from 12 months to 13 years and the results generally showed maintenance of the short-term benefits with CBT. However, the studies presented limitations, especially regarding methods, such as lack of a control group and losses to follow-up. Conclusion The long-term benefits of CBT were identified, however it would be interesting to conduct other studies with more frequent assessment periods, in order to minimize losses to follow-up, in addition to evaluating children and adolescents in the various stages of their development.

Cognitive processes affect the gait of subjects with Parkinson’s and Alzheimer’s disease in dual tasks

Objective To investigate the relation between gait parameters and cognitive impairments in subjects with Parkinson’s disease (PD) and Alzheimer’s disease (AD) during the performance of dual tasks. Methods This was a cross-sectional study involving 126 subjects divided into three groups: Parkinson group (n = 43), Alzheimer group (n = 38), and control group (n = 45). The subjects were evaluated using the Timed Up and Go test administered with motor and cognitive distracters. Gait analyses consisted of cadence and speed measurements, with cognitive functions being assessed by the Brief Cognitive Screening Battery and the Clock Drawing Test. Statistical procedures included mixed-design analyses of variance to observe the gait patterns between groups and tasks and the linear regression model to investigate the influence of cognitive functions in this process. A 5% significant level was adopted. Results Regarding the subjects’ speed, the data show a significant difference between group vs task interaction (p = 0.009), with worse performance of subjects with PD in motor dual task and of subjects with AD in cognitive dual task. With respect to cadence, no statistical differences was seen between group vs task interaction (p = 0.105), showing low interference of the clinical conditions on such parameter. The linear regression model showed that up to 45.79%, of the variance in gait can be explained by the interference of cognitive processes. Conclusion Dual task activities affect gait pattern in subjects with PD and AD. Differences between groups reflect peculiarities of each disease and show a direct interference of cognitive processes on complex tasks.

Duke Activity Status Index em Doenças Cardiovasculares: Validação de Tradução em Português

Fundamentos: O Duke Activity Status Index (DASI) avalia a capacidade funcional de pacientes com doença cardiovascular (DCV), mas não há versão validada em português para doenças cardiovasculares. Objetivos: Traduzir e adaptar culturalmente o DASI para o idioma português do Brasil, e verificar suas propriedades psicométricas na avaliação da capacidade funcional de pacientes com doenças cardiovasculares. Métodos: O DASI foi traduzido para o português, verificado pela retrotradução para o inglês e avaliado por um comitê de especialistas. A versão pré-teste foi avaliada pela primeira vez em 30 indivíduos. As propriedades psicométricas e a correlação com o teste de esforço foram verificadas em um segundo grupo de 67 indivíduos. Uma análise fatorial exploratória foi realizada em todos os 97 pacientes para verificar a validade de construto do DASI. Resultados: O coeficiente de correlação intraclasse para a confiabilidade teste-reteste foi de 0,87 e para a confiabilidade entre avaliadores foi de 0,84. O alfa de Cronbach para consistência interna foi de 0,93. A validade concorrente foi verificada por correlações positivas significativas de pontuações do DASI com o VO2 max (r = 0,51, p < 0,001). A análise fatorial mostrou dois fatores que explicaram 54% da variância total, com o fator 1 responsável por 40 % da variância. A aplicação do DASI requer entre um e três minutos e meio por paciente. Conclusão: A versão brasileira do DASI parece ser um instrumento válido, confiável, rápido e fácil de administrar para avaliar a capacidade funcional em pacientes com doenças cardiovasculares.