Controle de vetores utilizando mosquitos geneticamente modificados

Formas químicas de controle de mosquitos vetores são ineficazes, levando ao desenvolvimento de novas estratégias. Assim, foi realizada revisão das estratégias de controle genético de populações de mosquitos vetores baseada na técnica do inseto estéril. Uma delas consiste na liberação de machos esterilizados por radiação, a outra, na integração de um gene letal dominante associado a um promotor específico de fêmeas imaturas. Entre as vantagens sobre outras técnicas biológicas e químicas de controle de vetores estão: alta especificidade, não prejudicial ao meio ambiente, baixo custo de produção e alta eficácia. O uso desta técnica de modificação genética pode vir a ser uma importante ferramenta do manejo integrado de vetores.

Escala de Depressão Pós-natal de Edimburgo para triagem no sistema público de saúde

OBJETIVO: Avaliar a utilização da Escala de Depressão Pós-natal de Edimburgo como instrumento de triagem no sistema público de saúde. MÉTODOS: A Escala foi administrada entre o 40º e 90º dia do pós-parto, a 245 mulheres que tiveram parto em uma maternidade privada no município de Belo Horizonte (MG), entre 2005 e 2006. As participantes foram submetidas a uma entrevista psiquiátrica estruturada (Mini-Plus 5.0) utilizada como padrão-ouro para diagnóstico de depressão. Foram calculadas sensibilidade e especificidade da escala e utilizou-se a curva ROC para achar o melhor ponto de corte. Foi utilizado o teste t de Student para comparação das variáveis numéricas e o qui-quadrado para as variáveis categóricas. A confiabilidade foi aferida pelo coeficiente de consistência interna á de Cronbach. RESULTADOS: Foram diagnosticadas 66 mulheres com o quadro depressivo pós-parto (26,9% da amostra). Não houve diferença entre as mulheres com e sem depressão pós-parto em relação à idade, escolaridade, número de partos anteriores e estado civil. Utilizando-se o ponto de corte de 10, a sensibilidade da escala foi 86,4, a especificidade 91,1 e o valor preditivo positivo 0,78. CONCLUSÕES: As propriedades psicométricas da Escala a caracterizam como um bom instrumento de triagem da depressão pós-parto e seu uso disseminado no Sistema Único de Saúde poderia repercutir positivamente com aumento significativo na taxa de reconhecimento, diagnóstico, e tratamento da depressão pós parto.

Reducao do uso de acucar em escolas publicas: ensaio randomizado por conglomerados

OBJETIVO Analisar a eficácia de ações de educação nutricional com merendeiras na redução da adição de açúcar na alimentação escolar e no próprio consumo. MÉTODOS Ensaio randomizado por conglomerado, controlado, conduzido em 20 escolas municipais na cidade metropolitana de Niterói, RJ, de março a dezembro de 2007. Programa de educação nutricional foi implementado nas escolas de intervenção, junto a merendeiras, usando mensagens, atividades e material educativo que encorajassem a redução da adição de açúcar na alimentação escolar e no consumo. A redução da disponibilidade de açúcar pelas escolas foi analisada por planilhas com dados da utilização dos itens do estoque. O consumo individual das merendeiras foi avaliado pelo uso de questionário de frequência de consumo alimentar. As medidas antropométricas foram realizadas de acordo com técnicas padronizadas e a variação na mudança do peso foi medida ao longo do estudo. RESULTADOS A redução da disponibilidade de açúcar ocorreu mais acentuadamente nas escolas de intervenção quando comparadas às escolas controle (-6,0 kg versus 3,4 kg), sem diferença estatisticamente significante (p = 0,21), embora o poder do estudo tenha sido baixo. Houve redução do consumo de doces e bebidas açucaradas nos dois grupos, mas o consumo de açúcar não apresentou diferenças estatisticamente significativas entre eles. Houve redução do peso e do consumo de energia total nos dois grupos, mas sem diferença estatisticamente significante entre eles e sem modificação dos percentuais de adequação dos macronutrientes em relação ao consumo de energia. CONCLUSÕES Não foi possível provar que a estratégia de redução da disponibilidade e do consumo de açúcar por merendeiras de escolas públicas se mostrou eficaz.

Hospitalizations for ambulatory care-sensitive conditions, Minas Gerais, Southeastern Brazil, 2000 and 2010

OBJECTIVE To analyze hospitalization rates and the proportion of deaths due to ambulatory care-sensitive hospitalizations and to characterize them according to coverage by the Family Health Strategy, a primary health care guidance program. METHODS An ecological study comprising 853 municipalities in the state of Minas Gerais, under the purview of 28 regional health care units, was conducted. We used data from the Hospital Information System of the Brazilian Unified Health System. Ambulatory care-sensitive hospitalizations in 2000 and 2010 were compared. Population data were obtained from the demographic censuses. RESULTS The number of ambulatory care-sensitive hospitalizations declined from 20.75/1,000 inhabitants [standard deviation (SD) = 10.42) in 2000 to 14.92/thousand inhabitants (SD = 10.04) in 2010 Heart failure was the most frequent cause in both years. Hospitalizations rates for hypertension, asthma, and diabetes mellitus, decreased, whereas those for angina pectoris, prenatal and birth disorders, kidney and urinary tract infections, and other acute infections increased. Hospitalization durations and the proportion of deaths due to ambulatory care-sensitive hospitalizations increased significantly. CONCLUSIONS Mean hospitalization rates for sensitive conditions were significantly lower in 2010 than in 2000, but no correlation was found with regard to the expansion of the population coverage of the Family Health Strategy. Hospitalization rates and proportion of deaths were different between the various health care regions in the years evaluated, indicating a need to prioritize the primary health care with high efficiency and quality.

Methylphenidate use in children with attention deficit hyperactivity disorder

A Brazilian Health Technology Assessment Bulletin (BRATS) article regarding scientific evidence of the efficacy and safety of methylphenidate for treating attention deficit hyperactivity disorder (ADHD) has caused much controversy about its methods. Considering the relevance of BRATS for public health in Brazil, we critically reviewed this article by remaking the BRATS search and discussing its methods and results. Two questions were answered: did BRATS include all references available in the literature? Do the conclusions reflect the reviewed articles? The results indicate that BRATS did not include all the references from the literature on this subject and also that the proposed conclusions are different from the results of the articles chosen by the BRATS authors themselves. The articles selected by the BRATS authors showed that using methylphenidate is safe and effective. However, the BRATS final conclusion does not reflect the aforementioned and should not be used to support decisions on the use of methylphenidate.

Pre-harvest cane burning and health: the association between school absences and burning sugarcane fields

The objective of this study was to investigate an association between pre-harvest sugarcane burning and respiratory diseases in children under five years of age. The following data were collected in five schools in the city of Araraquara, SP, Southeastern Brazil, between March and June 2009: daily records of absences and the reasons stated for these absences, total concentration of suspended particulate matter (µg/m3), and air humidity. The relationship between the percentage of school absences due to respiratory problems and the concentration of particulate matter in March and from April to June presented a distinct behavior: absences increased alongside the increase in particulate matter concentration. The use of school absences as indicators of this relationship is an innovative approach.

Demarcação da atividade anti-helmíntica do albendazol. Estudo referente à estrongiloidíase humana

Os Autores utilizaram novo anti-helmíntico, o albendazol, no tratamento de 32 pessoas com estrongiloidíase. A casuística foi composta por adultos, de ambos os sexos, que receberam, pela via oral, dose cotidiana única de 400 mg, repetida em três oportunidades intervaladas por períodos de 24 horas. O controle da terapêutica sucedeu através de exames das fezes realizados sete, 14 e 21 dias após o término da administração, tendo sido empregado o método de Rugai, Mattos e Brisola. A porcentagem de curas verificada correspondeu a 28,1% e, ao lado da boa tolerância observada, essa constatação demonstrou baixa eficácia do medicamento em apreço no combate à infecção causada pelo Strongyloldes stercoralis, a despeito de méritos comprovados em investigações anteriores e concernentes a outras parasitoses intestinais.

Severe scorpion envenomation in Brazil: clinical, laboratory and anatomopathological aspects

Scorpion stings in Brazil are important not only because of their incidence but also for their potential ability to induce severe, and often fatal, clinical situations, especially among children. In this report we present the clinical and laboratory data of 4 patients victims of scorpion stings by T. serrulatus, who developed heart failure and pulmonary edema, with 3 of them dying within 24 hours of the sting. Anatomopathologic study of these patients revealed diffuse areas of myocardiocytolysis in addition to pulmonary edema. The surviving child presented enzymatic, electrocardiographic and echocardiographic changes compatible with severe cardiac involvement, which were reversed within 5 days. These findings reinforce the need for continuous monitoring of patients with severe scorpion envenoming during the hours immediately following the sting.

Murine virus contaminant of Trypanosoma cruzi experimental infection

The possibility that some virus contaminants could be altering host response to Trypanosoma cruzi experimental infection was investigated. Data obtained showed that CBA/J mice infected with stocks of parasite maintained in mice (Y1UEC) presented higher level of parasitemia and shorter survival times than those infected with a stock (Y1TC) which was also maintained in mice but had been previously passaged in cell culture. Mouse antibody production tests, performed with the filtered plasma of mice infected with Y1UEC, indicated the presence of mouse hepatitis virus (MHV) while no virus was detected when testing the plasma of Y1TC infected mice. Filtered plasma of Y1EUC infected mice was shown to contain a factor able to enhance the level of parasitemia and to reduce the mean survival time of mice challenged with 10(5) Y1TC. This factor, that could be serially passaged to naïve mice was shown to be a coronavirus by neutralization tests.

Erythema nodosum: prospective study of 32 cases

The results of 32 cases studied lead us to the conclusion that erythema nodosum's investigation routine is very important, once in our retrospective study, the percentage of cases of unknown etiology was 69.4%, and in this prospective study it is 21.8%. In 10 cases (31.2%), more than one causing agent was suspected. Infections (bacterial, helminthic, fungal, by protozoa) were diagnosed in 26 cases, streptococcal infection having predominated (12 cases). Drugs-dipirone, aspirin, anovulatory - were suspected as causing agents in 13 cases. The association of erythema nodosum and histoplasmosis capsulata is described for the first time in Brazil. We consider erythema nodosum to be a complex syndrome which should be regarded as a manifestation of underlying diseases. The fact that all 32 subjects were women, 26 of them during menacme, suggests that particular hormonal media may favor the action of various processes (infections and drugs), precipitating erythema nodosum's clinical picture.

Bancroftian filariasis in two urban areas of Recife, Brasil: the role of individual risk factors

Bancroftian filariasis is spreading in towns of endemic areas as in Recife, northeastern Brazil, where it is a major public health problem. This paper deals with the prevalence of microfilaraemia and filarial disease in two urban areas of Recife, studying their association with individual characteristics and variables related to the exposure to the vectors. The parasitologic survey was performed through a "door-to-door" census and microfilaraemia was examined by the thick-drop technique using 45µl of peripheral blood collected between 20:00 and 24:00 o' clock. 2,863 individuals aged between 5 and 65 years were interviewed and submitted to clinical examination. Males aged between 15 and 44 years old presented the greatest risk of being microfilaraemic. Microfilaraemia was also significantly associated with no use of bednet to sleep. The risk of being microfilaraemic was greater among those who had lived in the studied areas for more than 5 years. The overall disease prevalence was 6.3%. Males presented the greatest risk of developing acute disease. The risk of developing chronic manifestations was also greater among males and increased with age. We found no association between time of residence, bednet use, microfilaraemia and acute and chronic disease. We may conclude that in endemic areas there are subgroups of individuals who has a higher risk of being microfilariae carriers due to different behaviours in relation to vector contact.

Peptic disease and Helicobacter pylori are highly prevalent in patients with the indeterminate form of chagas’ disease: report of 21 cases

Given that chagasic patients in the indeterminate form of this disease, can have abnormal motility of the digestive tract and immunologic abnormalities, we decided to assess the frequency of peptic disease and Helicobacter pylori (Hp) infection in these individuals. Twenty-one individuals, 13 males and 8 females, mean age 37.6 ± 11.1 years, were examined. Biopsies of the duodenum, antrum, lesser and greater gastric curvature and esophagus were performed. The endoscopic findings were of chronic gastritis in 20 (95.2%) patients, duodenal ulcer in 3 (14.3%), gastric and duodenal ulcer in 3 (14.3%), gastric ulcer alone in 1 (4.8%), esophagitis in 5 (23.8%), and duodenitis in 5 (23.8%). The diagnosis of infection by the Hp was done by the urease test and histologic examination. Hp infection was found in 20 (95.2%) individuals: in 20 out of them in the antrum, in 17 in the lesser curvature, and in 17 in the greater curvature. Hp was not found in the esophagus and duodenum. The only individual with no evidence of infection by Hp was also the only one with normal endoscopic and histologic examinations. The histologic examinations confirmed the diagnoses of gastric ulcer as peptic, chronic gastritis in 20 patients, duodenitis in 14, and esophagitis in 9. In this series the patients had a high frequency of peptic disease, which was closely associated with Hp infection

Hantavirus Pulmonary Syndrome: Report of the first three cases in São Paulo, Brazil

The hantavirus pulmonary syndrome was first recognized in cases that occurred in the U.S. in 1993, which served as an alert not only for American physicians but also for physicians in other countries for the identification of the disease. In the city of São Paulo, Brazil, 3 cases of the syndrome were recorded in 1993. The patients were young brothers residing in the Mata Atlântica (Atlantic Forest) region submitted to recent deforestation. Two of the patients died of acute respiratory insufficiency and the third recovered without sequelae. In the surviving patient the diagnosis was established by a laboratory criterion based on the detection of specific IgM and IgG class antibodies by indirect immunofluorescence. In the two patients who died, the diagnosis was confirmed by laboratory tests using immunoperoxidase technique for hantavirus in tissue, in histological lung and heart sections in one case, and by clinical and epidemiological data in the other