Controle da leishmaniose visceral no município de Porteirinha, estado de Minas Gerais, no período de 1998 a 2003

INTRODUÇÃO: No município de Porteirinha, Estado de Minas Gerais, foram registrados 23 casos humanos de leishmaniose visceral (LV) nos anos de 1998 e 1999. MÉTODOS: Foi realizado um estudo envolvendo a tríade de ações preconizadas no controle da LV. Pacientes com leishmaniose humana foram tratados e cães sorologicamente positivos foram eutanasiados, trimestralmente. O inseticida piretróide α-cipermetrina foi aplicado nos bairros onde casos humanos foram registrados. RESULTADOS: Houve uma redução da soroprevalência canina e de flebotomíneos capturados, após a implementação das medidas de controle, refletindo na diminuição de casos humanos de leishmaniose visceral. CONCLUSÕES: Os resultados mostraram a eficiência destas medidas quando empregadas em conjunto.

The changing distribution of malaria in the Brazilian Amazon, 2003-2004 and 2008-2009

Introduction More than half of the malaria cases reported in the Americas are from the Brazilian Amazon region. While malaria is considered endemic in this region, its geographical distribution is extremely heterogeneous. Therefore, it is important to investigate the distribution of malaria and to determine regions whereby action might be necessary. Methods Changes in malaria indicators in all municipalities of the Brazilian Amazon between 2003-2004 and 2008-2009 were studied. The malaria indicators included the absolute number of malaria cases and deaths, the bi-annual parasite incidence (BPI), BPI ratios and differences, a Lorenz curve and Gini coefficients. Results During the study period, mortality from malaria remained low (0.02% deaths/case), the percent of municipalities that became malaria-free increased from 15.6% to 31.7%, and the Gini coefficient increased from 82% to 87%. In 2003, 10% of the municipalities with the highest BPI accumulated 67% of all malaria cases, compared with 2009, when 10% of the municipalities (with the highest BPI) had 80% of the malaria cases. Conclusions This study described an overall decrease in malaria transmission in the Brazilian Amazon region. As expected, an increased heterogeneity of malaria indicators was found, which reinforces the notion that a single strategy may not bring about uniformly good outcomes. The geographic clustering of municipalities identified as problem areas might help to define better intervention methods.

Spatial analysis of visceral leishmaniasis in the municipality of Rondonópolis, in the Brazilian State of Mato Grosso, from 2003 to 2012: human, canine and vector distribution in areas of disease transmission

INTRODUCTION: Visceral leishmaniasis (VL) is a zoonosis of great importance to public health and is considered a neglected disease by the World Health Organization. The disease has expanded and become more prevalent in urban areas in Brazil. METHODS: Geospatial analyses were performed and thematic maps of the triad of the disease were produced for the study period (2003-2012) in the urban area of the municipality of Rondonópolis in the midwestern State of Mato Grosso (MT), Brazil, TerraView 4.2.2 software was used for the analyses. RESULTS: A total of 87.9% of the 186 confirmed human cases of VL were cured. Children between the ages of 1 and 4 were the most affected. Registered deaths were predominant among adults aged 60 years or older. The urban area of the municipality consists of eight strata and 12 census districts include 237 neighborhoods. All sectors had confirmed cases of VL. During the study period, human cases of the disease were recorded in 90 neighborhoods. The 23 deaths from the disease were distributed in 21 neighborhoods. Sandflies carrying the parasite were captured in 192 out of 200 neighborhoods evaluated for the presence of the VL vector. The presence of dogs carrying the parasite was confirmed in, 140 out of 154 surveyed neighborhoods. CONCLUSIONS: The data demonstrated the endemic nature of VL, with a high percentage of infected children, a high distribution of canine infection, and a wide adaptation and dispersal of the vectors in the urban environment. These results, illustrate the process of urbanization of VL in the municipality of Rondonópolis, MT, Brazil.

Updated checklist of aquatic macrophytes from Northern Brazil

Field collection and herbaria data did not allow to quantify the diversity of aquatic plants from Northern Brazil, so we could not detect biogeographic patterns. Therefore, our objectives were to identify and quantify the aquatic macrophytes of North Brazilian states, analyzing herbaria data plataforms (SpeciesLink and Flora do Brasil). The checklist was produced by bibliographic search (articles published between 1980 and 2000), herbaria collections of the platforms SpeciesLink and Flora do Brasil and field expeditions, where we utilized asystematic sampling. We also analyzed the floristic similarity of aquatic macrophytes among Northern Brazil, wetlands of distinct Brazilian regions and the Neotropics. We recorded 539 species, of which 48 are endemic to Brazil. The states with highest number of species were Amazonas and Pará, independently on platform. The most represented families were Poaceae (89 species), Podostemaceae (55), Cyperaceae (50) and Fabaceae (47). We highlight the unprecedent richness of Podostemaceae, due to our own field collection efforts on favorable habitats, 25 species being endemic. Emergent and/or amphibious plants (515) were dominant in total species richness and were best represented in lotic habitats. We found significant differences in richness and floristics among states, obtained from the platforms. There is floristic similarity among Northern states and other Brazilian wetlands. In conclusion, we observed a rich aquatic flora in Northern Brazil, in spite of scarcity of records for Acre, Rondonia and Tocantins; we highlight the unprecedent number of endemic species of Podostemaceae (25) and contrasting richness between SpeciesLink and Flora do Brasil.

Updated List and identification key of 219 tree species of white sand forests of the Allpahuayo Mishana National Reserve, Loreto, Peru

White sand forests, although low in nutrients, are characterized not only by several endemic species of plants but also by several monodominant species. In general, plants in this forest have noticeably thin stems. The aim of this work was to elaborate a parallel dichotomous key for the identification of Angiosperm tree species occurring on white sand forests at the Allpahuayo Mishana National Reserve, Loreto, Peru. We compiled a list of species from several publications in order to have the most comprehensive list of species that occur on white sand forest. We found 219 species of Angiosperm, the more abundant species were Pachira brevipes (26.27%), Caraipa utilis (17.90%), Dicymbe uaiparuensis (13.27%), Dendropanax umbellatus (3.28%), Sloanea spathulata (2.52%), Ternstroemia klugiana (2.30%), Haploclathra cordata (2.28%), Parkia igneiflora (1.20%), Emmotum floribundum (1.06%), Ravenia biramosa (1.04%) among others. Most species of white sand forests can be distinguished using characteristics of stems, branches and leaves. This key is very useful for the development of floristic inventories and related projects on white sand forests from Allpahuayo Mishana National Reserve.

Concepts and objects of awareness in Alzheimer’s disease: an updated systematic review

ABSTRACT Objectives To compare and discuss the objects of awareness in Alzheimer’s disease (AD): awareness of cognitive deficits, of functional activities, of social-emotional functioning and behavioral impairment. Methods A search in the PsycINFo, Pilots, PubMed/Medline and ISI electronic databases according to Prisma methodology was performed. We included studies about awareness in people with AD published between 2010 and 2015, with the combination of keywords: “Alzheimer AND awareness of deficits”, “Alzheimer AND anosognosia”, “Alzheimer AND insight”, “dementia AND awareness of deficits”, “dementia AND anosognosia”, “dementia AND insight”. The articles were categorized according to the specific object of awareness. Results Seven hundred and ten records were identified and, after application of the exclusion criteria, 191 studies were retrieved for potential use. After excluding the duplicates, 46 studies were included. Most studies assessed the cognitive domain of awareness, followed by the functional, social-emotional, and behavioral impairment domains. Memory deficits were not sufficient to explain impaired awareness in AD. Longitudinal studies did not find discrepancies between patients and caregivers’ reports, indicating that awareness is not related to cognition. Conflicting findings were observed, including the relation between awareness, mood, severity of disease, and personal characteristics. Conclusions The studies show lack of conceptual consensus and significant methodological differences. The inclusion of samples without differentiation of dementia etiology is associated to symptomatic differences, which affect awareness domains. Awareness in AD is a complex and multidimensional construct. Different objects elicit different levels of awareness.

Caso 4/2003 - Paciente de 61 anos, portadora de cardiopatia da doença de Chagas, com disfunção ventricular, taquicardia ventricular recorrente e marcapasso cardíaco, que apresentou morte em assistolia após ressecção cirúrgica de aneurisma de ponta

A 61 year-old Chagasic woman, with previous left ventricular systolic disfunction, ventricular tachychardia and cardiac pacemaker, presented cardiac arrest in asystolia after surgical ressection of apical aneurysm.