Estudos sobre a resistência ao jejum e aspectos nutricionais de Triatoma lecticularia (Stal, 1859) (Hemiptera, Reduviidae, Triatominae)

Foi feito um estudo sobre a resistência ao jejum em todas as fases evolutivas e pesagens em diferentes situações nutricionais de Triatoma lecticularia (alimentado; não alimentado; na morte após o jejum) com temperatura e umidade registradas. Observou-se que os períodos de resistência das fases ninfais apresentaram médias (dias) crescentes: 1º: 45,84; 2º: 61; 3º: 88,74; 4º: 123,47; 5º 162,30. Na fase adulta as médias foram aproximadas à do 3º estádio (para os machos 88,94 e para as fêmeas 83,66). O procedimento de pesagens permitiu registrar a quantidade de sangue ingerido, a perda de peso durante o jejum e o respectivo percentual em relação ao peso inicial. Esta espécie tem assinalada sua distribuição geográfica na região Neártica, onde tem sido encontrda infectada com Trypanosoma cruzi associada a Neotoma micropus Baird e Spermophilus variagatus (Erxeleben).

Onchocerciasis in Ecuador: the situation in 1989

Details are given of the prevalence rates of onchocerciasis from the most recent surveys (1989) conducted in northern Ecuador. The disease has intensified and dispersed considerably due to migration of infected individuals and the presence of a highly efficient vector. Comparison of these data with those from two previous surveys carried out in 1982/83 and 1986 and correlated with entomological findings highly the danger of the formation of new foci of onchocerciasis in areas currently free of the disease. Recommendations are made for further entomological studies in areas either recently or likely to be affected by the disease where potential vectors are unknown or different to those registred in the Santiago focus. Invermectin treatment with local vector control in specific areas is advocated to reduce the disease to a low level of public health importance.

Exploitation of parasite derived antigen in therapeutic success of human cutaneous leishmaniasis in Brazil

In a complete study in 25 patients with American cutaneous leishmaniasis, caused by Leishmania braziliensis complex, immunotherapeutic efficacy of parasite derived antigen (94-67 KD) has been compared to antimonial therapy. Additionally, to delineate the mechanism of therapeutic success, microscopical features of immune response in active lesions and healed or non-healed lesions following therapy were analyzed. The results showed that cure rates in immunotherapy and chemoterapy were equal (>83 por cento). The immunohistochemical changes in two therapeutic groups were also largely similar. The analysis of humoral and cellular immune response suggest that appropriate stimulation of T helper cells in the lesion site, in association with one or more cytokines, play a key role in the healing process.

Schistosomal myeloradiculopathy due to Schistosoma mansoni: report on 23 cases

Schistosoma mansoni infection is likely to be responsible for a significant proportion of cases of myelopathy occurring in areas where schistosomiasis is endemic. The aim of this study is to describe the clinical, laboratory and therapeutic data of 23 patients with schistosomal myeloradiculopathy. The medical records of 23 patients with schistosomal myelopathy admitted to two general hospitals of Belo Horizonte (MG), in Brazil, from 1995 to 1999, were reviewed retrospectively. Seventeen patients were male (74%). The mean age for the whole group was 27 years. Lower limb weakness and associated lumbar and/or lower limb pain were reported by 20 patients (87%), and 16 (70%) were unable to walk. All individuals presented urinary retention and 19 (83%) complained of intestinal dysfunction. The treatment was based on the association of antischistosomal drugs and corticosteroids. Five patients (22%) presented a full response to treatment, 13 (57%) partial response without functional limitations and 4 (17%) partial improvement with limitations or no response. Three out of the 4 patients who stopped steroids before 45 days of treatment developed recurrence of the symptoms and signs of myelopathy. Our cases demonstrate the severe presentation of the disease and the data disclosed here suggest that treatment with steroids should be kept for months after clinical improvement.

Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition

A combined clinical and sonographic classification of hepatosplenic schistosomiasis mansoni to be used in field-based studies is proposed herein. Seven hundred forty one individuals out of 892 (83%), living in an area endemic for schistosomiasis in Brazil, have been ubmitted to clinical and ultrasound examinations. Based on two stool examinations the overall prevalence for schistosomiasis in this area was 73%. Abdominal palpation was performed with patients in dorsal decubit, during deep breath, by two experienced physicians and a portable ultrasound was used for the evaluation of liver fibrosis, portal collaterals and spleen size. Four groups of individuals were identified using data obtained by abdominal palpation and ultrasound examination: (1) palpable spleen and intense periportal thickening in 9 individuals (1.2%); (2) spleen not palpable and intense periportal thickening in 15 (2%); (3) palpable spleen with light to moderate periportal thickening in 32 (4.3%), and (4) palpable spleen with a normal liver on ultrasound in 30 (4%). The definition of hepatosplenic schistosomiasis in field-based studies as the finding of Schistosoma mansoni eggs in the stools in an individual with splenomegaly is not acceptable anymore. Abdominal ultrasound should be combined with clinical examination to accurately identify hepatosplenics in endemic areas for schistosomiasis.

Infection by Schistosoma mansoni sambon 1907 in the first four months of life of Biomphalaria straminea (Dunker, 1848) in Brazil

Compatibility between Schistosoma mansoni and Biomphalaria straminea when exposed to the parasite on the first four months of age was assessed for five parasitological aspects: indices of infection and mortality, duration of precercarial and cercarial periods, and rate of cercarial emission. Infections were made on molluscs from laboratory colonies, at the following ages: 8, 13, 18, 21, 53, 83 and 114 days. Two B. straminea colonies were used (Camorim, PE and Picos, PI), and one B. glabrata colony (Ressaca, MG) was used as control. The main results are as follows: (I) infection was significantly associated with mollusc age, being proportionally higher in sexually immature than in mature molluscs for the three colonies; (II) for B. straminea from Camorim, mortality did not differ significantly between infected and non-infected snails; for B. straminea from Picos significantly more deaths occurred among infected than among non-infected snails, while the opposite was observed for B. glabrata from Ressaca; (III) for the three colonies, the precercarial period was significantly shorter for immature molluscs than for mature ones; (IV) the duration of the cercarial period was extremely variable for the three colonies; (V) sexual maturity did not influence cercarial emission for the three colonies.

Patterns of infection with the nematodes Syphacia obvelata and Aspiculuris tetraptera in conventionally maintained laboratory mice

Data on the frequency, distribution and mean intensity of the helminth fauna recovered from outbred and inbred mice conventionally maintained in Brazilian animal houses, are reported. The oxyurid nematodes Syphacia obvelata and Aspiculuris tetraptera presented overall frequencies of 91.5% and 8.5%, respectively. The frequency of S. obvelata in animals of three groups out of the four investigated ranged from 9% to 74% and A. tetraptera from 17% to 83%, since animals of one of the groups were negative for helminths. Infections due to a single species were observed in 62% of the animals, compared to 16% related to associations. The frequency of single infections in each group varied from 58.6% to 100% whereas associations varied from 24.1% to 41.4%. The analysis of specific mean intensities showed that S. obvelata was represented by 13.35 to 66.58 specimens/host and A. tetraptera by 5.85 to 16.75 specimens/host.

A randomised double-blind clinical trial of two yellow fever vaccines prepared with substrains 17DD and 17D-213/77 in children nine-23 months old

This randomised, double-blind, multicentre study with children nine-23 months old evaluated the immunogenicity of yellow fever (YF) vaccines prepared with substrains 17DD and 17D-213/77. YF antibodies were tittered before and 30 or more days after vaccination. Seropositivity and seroconversion were analysed according to the maternal serological status and the collaborating centre. A total of 1,966 children were randomised in the municipalities of the states of Mato Grosso do Sul, Minas Gerais and São Paulo and blood samples were collected from 1,714 mothers. Seropositivity was observed in 78.6% of mothers and 8.9% of children before vaccination. After vaccination, seropositivity rates of 81.9% and 83.2%, seroconversion rates of 84.8% and 85.8% and rates of a four-fold increase over the pre-vaccination titre of 77.6% and 81.8% were observed in the 17D-213/77 and 17DD subgroups, respectively. There was no association with maternal immunity. Among children aged 12 months or older, the seroconversion rates of 69% were associated with concomitant vaccination against measles, mumps and rubella. The data were not conclusive regarding the interference of maternal immunity in the immune response to the YF vaccine, but they suggest interference from other vaccines. The failures in seroconversion after vaccination support the recommendation of a booster dose in children within 10 years of the first dose.

Instrumento para avaliação de detergentes enzimáticos

Estudo de desenvolvimento metodológico que teve por objetivo construir um instrumento de avaliação de detergentes enzimáticos e analisar a ação dos produtos sobre os instrumentais. O instrumento foi submetido à análise de três juízes. O pré-teste foi realizado com 25 instrumentos. A amostra para a análise de campo foi constituída por mais 25 instrumentais cirúrgicos. Os resultados obtidos permitiram a construção de um instrumento com 19 itens e a análise de campo constatou que houve diferenças nos escores das soluções avaliadas. O produto P5 obteve a melhor média 78,7 (DP 6,68) e mediana 80,2 e o produto P4 obteve o pior desempenho, média 56,2 (DP 7,09) e mediana 56,7, em um intervalo possível de 19 a 95. O instrumento de medida mostrou-se confiável ao estudo, apresentando valor do Alpha de Cronbach de 0,83.

Escala optométrica para pré-escolares: método para determinação de figuras regionais

As crianças muitas vezes apresentam dificuldade na identificação dos optótipos da escala de figuras. Com o objetivo de identificar figuras conhecidas das crianças e construir optótipos adequados a uma realidade local, elaborou-se um estudo quantitativo experimental, com uma amostra aleatória de 384 crianças de seis escolas. Percebeu-se, com a confecção de desenhos pelas crianças, o quanto as figuras estavam atreladas ao seu cotidiano. Como desenhos mais significativos mencionam-se: sol, boneco, casa, nuvem, árvore, carro, bola, estrela e coração. As figuras de maior freqüência foram sintetizadas na tentativa de aproximá-las de optótipos, sendo validadas com base em intervalo de confiança de 95% para o número de acertos: carro (100%), casa (98%), coração (98%), estrela (95%), bola (89%), flor (85%), sol (83%) e boneco (78%). Conclui-se que estas figuras têm aderência à cultura local.

Situação de trabalho dos profissionais da Estratégia Saúde da Família em Ceará-Mirim

O objetivo deste estudo foi analisar as situações de trabalho vivenciadas pelos profissionais da Estratégia Saúde da Família (ESF). Estudo descritivo realizado em Ceará-Mirim, Rio Grande do Norte, em 2007. A população constituiu-se de 190 profissionais da ESF, na qual foi aplicada um questionário com questões fechadas. Os resultados apontaram que o conhecimento da área geográfica adstrita pelos profissionais da ESF foi considerado como um aspecto positivo para a realização das atividades executadas por 83,2% dos profissionais, e o número de famílias acompanhadas por equipe foi considerado como uma dificuldade por 40,5%. Em relação às condições de trabalho, 93,2% referiram a presença de profissionais com perfil em saúde pública, e 86,8%, indisponibilidade de equipamentos e instrumentos. Dos profissionais que trabalham exclusivamente na ESF, 74% são agentes comunitários de saúde. O compromisso e a responsabilidade para substituir as práticas tradicionais de assistência devem ser de todos, havendo a necessidade de interação de fatores históricos, políticos, sociais, econômicos e culturais.

Clinical treatment adherence of health care workers and students exposed to potentially infectious biological material

OBJECTIVE To assess adherence to clinical appointments by health care workers (HCW) and students who suffered accidents with potentially infectious biological material. METHOD A retrospective cross-sectional study that assessed clinical records of accidents involving biological material between 2005 and 2010 in a specialized unit. RESULTS A total of 461 individuals exposed to biological material were treated, of which 389 (84.4%) were HCWs and 72 (15.6%) students. Of the 461 exposed individuals, 307 (66.6%) attended a follow-up appointment. Individuals who had suffered an accident with a known source patient were 29 times more likely to show up to their scheduled follow-up appointments (OR: 29.98; CI95%: 16.09-55.83). CONCLUSION The predictor in both univariate and multivariate analyses for adherence to clinical follow-up appointment was having a known source patient with nonreactive serology for the human immunodeficiency virus and/or hepatitis B and C.