Identification of human T-cell lymphotropic virus infection in a semi-isolated Afro-Brazilian quilombo located in the Marajó Island (Pará, Brazil)

Antibodies to human T-cell lymphotropic virus-1 and 2 (HTLV-1 and 2) were tested in 259 inhabitants (98 males and 161 females) of four villages of the Marajó Island (Pará, Brazil) using enzyme immunoassays (ELISA and Western blot). Types and subtypes of HTLV were determined by nested polymerase chain reaction (PCR) targeting the pX, env and 5´LTR regions. HTLV-1 infection was detected in Santana do Arari (2.06%) and Ponta de Pedras (1%). HTLV-2 was detected only in Santana do Arari (1.06%). Sequencing of the 5´LTR region of HTLV-1 and the phylogenetic analysis identified the virus as a member of the Cosmopolitan Group, subgroup Transcontinental. Santana do Arari is an Afro-Brazilian community and the current results represent the first report of HTLV-1 infection in a mocambo located in the Brazilian Amazon region.

Clinical spectrum of uncomplicated malaria in semi-immune Amazonians: beyond the " symptomatic " vs " asymptomatic " dichotomy

We analyzed prospectively 326 laboratory-confirmed, uncomplicated malarial infections (46.3% due to Plasmodium vivax, 35.3% due to P. falciparum, and 18.4% mixed-species infections) diagnosed in 162 rural Amazonians aged 5-73 years. Thirteen symptoms (fever, chills, sweating, headache, myalgia, arthralgia, abdominal pain, nausea, vomiting, dizziness, cough, dyspnea, and diarrhea) were scored using a structured questionnaire. Headache (59.8%), fever (57.1%), and myalgia (48.4%) were the most frequent symptoms. Ninety-six (29.4%) episodes, all of them diagnosed during cross-sectional surveys of the whole study population (96.9% by molecular technique only), were asymptomatic. Of 93 symptom-less infections left untreated, only 10 became symptomatic over the next two months following diagnosis. Fever was perceived as " intense " in 52.6% of 230 symptomatic malaria episodes, with no fever reported in 19.1% episodes although other symptoms were present. We found significant differences in the prevalence and perceived intensity of fever and other clinical symptoms in relation to parasite load at the time of diagnosis and patient's age, cumulative exposure to malaria, recent malaria morbidity, and species of malaria parasite. These factors are all likely to affect the effectiveness of malaria control strategies based on active or passive detection of febrile subjects in semi-immune populations.

Biological activity of neosergeolide and isobrucein B (and two semi-synthetic derivatives) isolated from the Amazonian medicinal plant Picrolemma sprucei (Simaroubaceae)

In the present study, in vitro techniques were used to investigate a range of biological activities of known natural quassinoids isobrucein B (1) and neosergeolide (2), known semi-synthetic derivative 1,12-diacetylisobrucein B (3), and a new semi-synthetic derivative, 12-acetylneosergeolide (4). These compounds were evaluated for general toxicity toward the brine shrimp species Artemia franciscana, cytotoxicity toward human tumour cells, larvicidal activity toward the dengue fever mosquito vector Aedes aegypti, haemolytic activity in mouse erythrocytes and antimalarial activity against the human malaria parasite Plasmodium falciparum. Compounds 1 and 2 exhibited the greatest cytotoxicity against all the tumor cells tested (IC50 = 5-27 µg/L) and against multidrug-resistant P. falciparum K1 strain (IC50 = 1.0-4.0 g/L) and 3 was only cytotoxic toward the leukaemia HL-60 strain (IC50 = 11.8 µg/L). Quassinoids 1 and 2 (LC50 = 3.2-4.4 mg/L) displayed greater lethality than derivative 4 (LC50 = 75.0 mg/L) toward A. aegypti larvae, while derivative 3 was inactive. These results suggest a novel application for these natural quassinoids as larvicides. The toxicity toward A. franciscana could be correlated with the activity in several biological models, a finding that is in agreement with the literature. Importantly, none of the studied compounds exhibited in vitro haemolytic activity, suggesting specificity of the observed cytotoxic effects. This study reveals the biological potential of quassinoids 1 and 2 and to a lesser extent their semi-synthetic derivatives for their in vitro antimalarial and cytotoxic activities.

Oocyst wall formation and composition in coccidian parasites

The oocyst wall of coccidian parasites is a robust structure that is resistant to a variety of environmental and chemical insults. This resilience allows oocysts to survive for long periods, facilitating transmission from host to host. The wall is bilayered and is formed by the sequential release of the contents of two specialized organelles - wall forming body 1 and wall forming body 2 - found in the macrogametocyte stage of Coccidia. The oocyst wall is over 90% protein but few of these proteins have been studied. One group is cysteine-rich and may be presumed to crosslink via disulphide bridges, though this is yet to be investigated. Another group of wall proteins is rich in tyrosine. These proteins, which range in size from 8-31 kDa, are derived from larger precursors of 56 and 82 kDa found in the wall forming bodies. Proteases may catalyze processing of the precursors into tyrosine-rich peptides, which are then oxidatively crosslinked in a reaction catalyzed by peroxidases. In support of this hypothesis, the oocyst wall has high levels of dityrosine bonds. These dityrosine crosslinked proteins may provide a structural matrix for assembly of the oocyst wall and contribute to its resilience.

Granulocyte macrophage colony-stimulating factor enhances the modulatory effect of cytokines on monocyte-derived multinucleated giant cell formation and fungicidal activity against Paracoccidioides brasiliensis

Multinucleated giant cells (MGC) are cells present in characteristic granulomatous inflammation induced by intracellular infectious agents or foreign materials. The present study evaluated the modulatory effect of granulocyte macrophage colony-stimulating factor (GM-CSF) in association with other cytokines such as interferon-gamma (IFN-γ), tumour necrosis factor-alpha, interleukin (IL)-10 or transforming growth factor beta (TGF-β1) on the formation of MGC from human peripheral blood monocytes stimulated with Paracoccidioides brasiliensis antigen (PbAg). The generation of MGC was determined by fusion index (FI) and the fungicidal activity of these cells was evaluated after 4 h of MGC co-cultured with viable yeast cells of P. brasiliensis strain 18 (Pb18). The results showed that monocytes incubated with PbAg and GM-CSF plus IFN-γ had a significantly higher FI than in all the other cultures, while the addition of IL-10 or TGF-β1 had a suppressive effect on MGC generation. Monocytes incubated with both pro and anti-inflammatory cytokines had a higher induction of foreign body-type MGC rather than Langhans-type MGC. MGC stimulated with PbAg and GM-CSF in association with the other cytokines had increased fungicidal activity and the presence of GM-CSF also partially inhibited the suppressive effects of IL-10 and TGF-β1. Together, these results suggest that GM-CSF is a positive modulator of PbAg-stimulated MGC generation and on the fungicidal activity against Pb18.

The antimicrobial susceptibility, biofilm formation and genotypic profiles of Staphylococcus haemolyticus from bloodstream infections

We analysed the antimicrobial susceptibility, biofilm formation and genotypic profiles of 27 isolates of Staphylococcus haemolyticus obtained from the blood of 19 patients admitted to a hospital in Rio de Janeiro, Brazil. Our analysis revealed a clinical significance of 36.8% and a multi-resistance rate of 92.6% among these isolates. All but one isolate carried the mecA gene. The staphylococcal cassette chromosome mec type I was the most prevalent mec element detected (67%). Nevertheless, the isolates showed clonal diversity based on pulsed-field gel electrophoresis analysis. The ability to form biofilms was detected in 66% of the isolates studied. Surprisingly, no icaAD genes were found among the biofilm-producing isolates.

Reduced susceptibility to vancomycin and biofilm formation in methicillin-resistant Staphylococcus epidermidis isolated from blood cultures

This study aimed to correlate the presence of ica genes, biofilm formation and antimicrobial resistance in 107 strains of Staphylococcus epidermidis isolated from blood cultures. The isolates were analysed to determine their methicillin resistance, staphylococcal cassette chromosome mec (SCCmec) type, ica genes and biofilm formation and the vancomycin minimum inhibitory concentration (MIC) was measured for isolates and subpopulations growing on vancomycin screen agar. The mecA gene was detected in 81.3% of the S. epidermidis isolated and 48.2% carried SCCmec type III. The complete icaADBC operon was observed in 38.3% of the isolates; of these, 58.5% produced a biofilm. Furthermore, 47.7% of the isolates grew on vancomycin screen agar, with an increase in the MIC in 75.9% of the isolates. Determination of the MIC of subpopulations revealed that 64.7% had an MIC ≥ 4 μg mL-1, including 15.7% with an MIC of 8 μg mL-1 and 2% with an MIC of 16 μg mL-1. The presence of the icaADBC operon, biofilm production and reduced susceptibility to vancomycin were associated with methicillin resistance. This study reveals a high level of methicillin resistance, biofilm formation and reduced susceptibility to vancomycin in subpopulations of S. epidermidis. These findings may explain the selection of multidrug-resistant isolates in hospital settings and the consequent failure of antimicrobial treatment.

Ocorrência e significado do toque entre profissionais de enfermagem e pacientes de uma UTI e Unidade Semi-intensiva cirúrgica

Este trabalho tem como objetivos identificar a utilização, pelos profissionais de Enfermagem, do toque instrumental e/ou afetivo e suas características, na comunicação não-verbal com os pacientes da UTI e unidade semi-intensiva cirúrgica do HU-USP; e os sentimentos e percepções dos profissionais de Enfermagem e dos pacientes em relação aos toques experimentados. O estudo foi desenvolvido com 19 profissionais e 19 pacientes, no período de outubro a novembro de 2000, através de observação direta das interações e entrevista individual. Os sentimentos e percepções relatados foram categorizados e percebemos que a maioria dos toques é instrumental-afetivo.

Conseqüências dos erros de medicação em unidades de terapia intensiva e semi-intensiva

O estudo objetivou caracterizar erros de medicação e avaliar conseqüências na gravidade dos pacientes e carga de trabalho de enfermagem em duas Unidades de Terapia Intensiva (UTI) e duas Semi-Intensiva (USI) de duas instituições hospitalares do município de São Paulo. A amostra foi constituída por 50 pacientes e os dados obtidos por meio do registro de ocorrências e prontuários, retrospectivamente. A gravidade e carga de trabalho de enfermagem foram avaliadas antes e após o erro. Do total de 52 erros, 12 (23,08%) ocorreram por omissão de dose, 11 (21,15%) e 9 (17,31%) por medicamento e dose erradas, respectivamente. Não houve mudança na gravidade dos pacientes (p=0,316), porém houve aumento na carga de trabalho de enfermagem (p=0,009). Quanto ao grupo de medicamentos envolvidos, potencialmente perigosos e não potencialmente perigosos, não houve diferenças estatisticamente significantes na gravidade (p=0,456) e na carga de trabalho de enfermagem (p=0,264), após o erro de medicação.

Ressuscitação cardiopulmonar com a utilização do desfibrilador externo semi-automático: avaliação do processo ensino-aprendizagem

Estudos demonstram que a sobrevida após uma parada cardíaca diminui 10% para cada minuto de atraso na desfibrilação, e que a taxa de sobrevivência é de 98% quando ela é conseguida em 30 segundos. No atendimento de uma parada cardíaca, é primordial que seja incluído no treinamento a utilização dos desfibriladores externos semi-automáticos (DEA). O objetivo deste estudo foi comparar a Habilidade Psicomotora e o Conhecimento Teórico de leigos na técnica da ressuscitação cardiopulmonar (RCP) utilizando o DEA, antes e após treinamento. A amostra constituiu-se de 40 funcionários administrativos de uma instituição pública que receberam treinamento da técnica da RCP, utilizando o DEA, em laboratório. O aumento significativo de acertos nos itens do instrumento de avaliação da Habilidade Psicomotora e do Conhecimento Teórico, após o treinamento, indica que houve melhora no desempenho dos participantes.

Nursing workload in specialized Semi-intensive Therapy unit: workforce size criteria

Abstract OBJECTIVE To assess the nursing workload (NW) in Semi-intensive Therapy Unit, specialized in the care of children with Craniofacial anomalies and associated syndromes; to compare the amount of workforce required according to the Nursing Activities Score (NAS) and the COFEN Resolution 293/04. METHOD Cross-sectional study, whose sample was composed of 72 patients. Nursing workload was assessed through retrospective application of the NAS. RESULTS the NAS mean was 49.5%. Nursing workload for the last day of hospitalization was lower in patients being discharged to home (p<0.001) and higher on the first compared to last day of hospitalization (p< 0.001). The number of professionals required according to NAS was superior to the COFEN Resolution 293/04, being 17 and 14, respectively. CONCLUSION the nursing workload corresponded to approximately 50% of the working time of nursing professional and was influenced by day and outcome of hospitalization. The amount of professionals was greater than that determined by the existing legislation.

A new species of Calloconophora Dietrich (Hemiptera, Membracidae) from the semi-arid region of northeastern Brazil

A new species of treehopper, Calloconophora gaudencia sp. nov., from Araruna, Paraíba State, is described and illustrated.

Duas novas espécies de Enchenopa Amyot & Serville (Hemiptera, Membracidae) do semi-árido do Estado da Paraíba, Brasil

Enchenopa eunicea sp. nov. e Enchenopa minuta sp. nov. (ambas de São José dos Cordeiros, Paraíba, Brasil ) são descritas e ilustradas.

Seasonality of insects in the semi-arid Caatinga of northeastern Brazil

Insects are essential to tropical ecosystems functioning. In semi-arid regions, the increase in abundance and/or activity (e.g. reproduction and foraging behavior) of insects is usually associated with climatic variables. The present study investigates which climatic variables are best predictors of insect abundance in an area of Caatinga in northeastern Brazil. Individuals were sampled for 24 months using Malaise and pitfall traps, and beating trays. A total of 58925 individuals belonging to 20 insect orders were collected. The most abundant orders were Hymenoptera, Diptera, Collembola and Coleoptera. Most orders studied showed a clear maximum abundance in the rainy season. Rainfall and humidity were the best predictors of insect abundance in the Caatinga. However, no climatic variable could explain Psocoptera and Blattodea variance in abundance/activity. Our results suggest that climatic changes associated with rainfall patterns in the Caatinga may affect ecosystem processes and services that depend direct or indirectly on insect abundance/activity.

Seasonal activity of Dinoponera quadriceps Santschi (Formicidae, Ponerinae) in the semi-arid Caatinga of northeastern Brazil

Seasonal activity of Dinoponera quadriceps Santschi (Formicidae, Ponerinae) in the semi-arid Caatinga of northeastern Brazil. We studied seasonal foraging patterns of the queenless ant D. quadriceps (Formicidae, Ponerinae) for 24 months in a Caatinga area of northeastern Brazil, an ecosystem characterized by strong climatic changes throughout the year, in order to determine if regulation of worker activity is based on environmental conditions (air temperature, relative humidity, precipitation) and/or food resources (potential prey: Coleoptera, Diptera, Hemiptera, Hymenoptera, Lepidoptera, Orthoptera, Araneae, Chilopoda and Diplopoda). Foraging activity of D. quadriceps varied over the course of both years, with the highest frequency occurring from May to August, corresponding to the late rainy season and early dry season. This foraging activity was negatively correlated with temperature and positively correlated with the availability of potential prey, but not with total abundance of soil arthropods or with rainfall and relative humidity. Diet composition, in relation to the main taxonomic prey groups, seems to be common to the species, regardless of habitat. Our results suggest that D. quadriceps workers adjust foraging activity to the most suitable period of the year, to avoid thermal stress and increase efficiency. Thus, they present an appropriate behavioral response to seasonal fluctuations in the Caatinga.