Por que os portadores de cardiomiopatia chagásica têm pior evolução que os não-chagásicos?

FUNDAMENTO: A insuficiência cardíaca é uma doença de alta prevalência, com prognóstico dependente de diferentes fatores preditores. OBJETIVO: A doença de Chagas é um preditor de mau prognóstico em pacientes com insuficiência cardíaca (IC) crônica. O objetivo deste estudo é analisar se ela também prediz pior evolução para pacientes agudamente descompensados. MÉTODOS: Estudamos 417 pacientes hospitalizados por IC descompensada. A idade média foi de 51,8 anos, sendo 291 (69,8%) homens. Os pacientes foram divididos em dois grupos: 133 (31,9%) chagásicos (CH) e 284 com outras etiologias. Num subgrupo de 63 pacientes (15,1% com doença de Chagas), dosaram-se citocinas e noradrenalina. RESULTADOS: Na internação, 24,6% necessitaram de inotrópicos, e em um ano a mortalidade foi de 54,7%. Os CH apresentaram maior mortalidade (69,2% vs. 47,9%, p < 0,001). Na comparação de dados, os CH eram mais jovens (47,6 vs. 53,8 anos, p < 0,001) e apresentavam, em média, PA sistólica (96,7 vs. 111,2 mmHg, p < 0,001), fração de ejeção (32,7 vs. 36,4%, p < 0,001), Na sérico (134,6 vs. 136,0, p = 0,026) mais baixos e TNF-alfa mais elevado (33,3 vs. 14,8, p = 0,001). A presença de hipotensão necessitando de inotrópicos, o diâmetro diastólico do ventrículo esquerdo (VE), os dados de função renal, os níveis de interleucina-6 e os de noradrenalina não diferiram nos dois grupos. CONCLUSÃO: Os pacientes chagásicos hospitalizados com IC descompensada tiveram pior prognóstico quando comparados com aqueles de outras etiologias. Esse fato pode dever-se ao maior comprometimento cardíaco (fração de ejeção mais baixa), maior instabilidade hemodinâmica (pressão sistólica e freqüência cardíaca mais baixas) e maior ativação do sistema renina angiotensina (sódio mais baixo) e das citocinas (TNF-alfa).

Controle da pressão arterial em pacientes sob tratamento anti-hipertensivo no Brasil: Controlar Brasil

FUNDAMENTO: O controle da pressão arterial (PA) é fundamental na hipertensão arterial (HA). OBJETIVO: Conhecer o porcentual de pacientes exigindo metas específicas de controle da PA, atendidos em consultórios no Brasil. MÉTODOS: Cada pesquisador, em número de 291, deveria avaliar, por medida convencional da PA, em cinco dias consecutivos, os dois primeiros pacientes atendidos. Determinou-se o número de hipertensos tratados por, pelo menos, quatro semanas, e com controle da pressão arterial, de acordo com as metas desejadas para o grupo de risco a que pertenciam. RESULTADOS: Foram avaliados 2.810 pacientes, em 291 centros. Os indivíduos obedeceram à seguinte distribuição, por grupo: A (HA estágios 1 e 2, risco adicional baixo e médio) = 1.054 (37,51%); B (HA e PA limítrofe, risco adicional alto) = 689 (24,52%); C (HA e PA limítrofe risco adicional muito alto, incluindo diabéticos) = 758 (26,98%) e D (HA com nefropatia e proteinúria > 1 g/l) = 309 (11%). As médias de PA na população foram: 138,9 ± 17,1 e 83,1 ± 10,7 mmHg. Fatores relacionados ao menor controle da PA: idade, circunferência abdominal, diabete, tabagismo e doença coronariana. Os porcentuais de controle da PA em cada um dos grupos foram, respectivamente: 61,7; 42,5; 41,8 e 32,4. CONCLUSÃO: O baixo controle da PA segundo as metas predefinidas, como explicitado nos resultados, reforça a necessidade de medidas que promovam melhores taxas de controle.

O espessamento da íntima-média associa-se independentemente ao Acidente Vascular Cerebral Isquêmico

FUNDAMENTO: O Acidente Vascular Cerebral (AVC) constitui uma das primeiras causas de morte a nível mundial. A importância do espessamento da íntima-média na estratificação de risco cardiovascular tem sido recorrentemente estudada; contudo, essa relação gera ainda alguma controvérsia. OBJETIVOS: Determinar se o espessamento da íntima-média na Artéria Carótida Comum (ACC) pode ser utilizado como um marcador independente de alto risco para a ocorrência do AVC. MÉTODOS: A amostra compreende um grupo de 948 doentes consecutivamente estudados por Triplex Scan Cervical no período compreendido entre janeiro de 2004 e junho de 2009. Esses doentes foram agrupados em razão da presença ou ausência de AVC recente, do que resultou um grupo de doentes com AVC Isquémico (AVC I) (n = 452, 48%), outro com AVC Hemorrágico (AVC H) (n = 22, 2%) e um grupo de doentes Sem Eventos (n = 474, 50%). RESULTADOS: Na análise de regressão logística ajustada para fatores de risco cardiovascular clássicos, o espessamento da íntima-média na ACC associou-se significativamente e de forma aproximadamente linear com o AVC I (Odds Ratio = 1.808, Intervalo de Confiança: 1.291-2.534, p = 0,01), mas não com o AVC H (p = ns). Uma interação significativa com a idade foi também encontrada, demonstrando-se uma capacidade discriminativa do risco de AVC I maior em indivíduos com idade inferior a 50 anos. CONCLUSÕES: O espessamento da íntima-média na ACC revelou-se um preditor de risco independente para o AVC I, mas não para AVC H reforçando assim a utilidade da sua avaliação na prática clínica. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0)

Correlação entre a cistatina C sérica e marcadores de aterosclerose subclínica em pacientes hipertensos

FUNDAMENTO: A cistatina C sérica (s-CC), um marcador endógeno da função renal, tem sido proposta também como um marcador de risco cardiovascular. No entanto, ainda não está estabelecido se se trata de um marcador direto de aterosclerose, independentemente da função renal. OBJETIVO: O objetivo deste estudo foi correlacionar a s-CC com dois marcadores substitutos de aterosclerose subclínica. MÉTODOS: Trata-se de um estudo transversal envolvendo 103 pacientes hipertensos ambulatoriais, de meia idade (57,49 ± 11,7 anos), sendo 60 do sexo feminino (58,25%) e a maioria com função renal preservada. A s-CC foi correlacionada com a espessura mediointimal carotídea (EMIc) e a dilatação mediada por fluxo de artéria braquial (DMF), ambas avaliadas por ultrassonografia, bem como com o clearance de creatinina medido e fatores de risco cardiovascular estabelecidos. RESULTADOS: A s-CC não se correlacionou significativamente nem com a EMIc (r = -0,024, p = 0,84) nem com a DMF (r = -0,050 e p = 0,687), e não foi observada também associação significativa com fatores de risco convencionais nem marcadores inflamatórios. Na análise univariada, a s-CC se correlacionou com o clearance de creatinina medido (r = - 0,498, p < 0,001), idade (r = 0,408, p < 0,001), microalbuminúria (r = 0,291, p = 0,014), ácido úrico (r = 0,391, p < 0,001), relação E/e' (r = 0,242, p = 0,049) e escore de Framingham (r = 0,359, p = 0,001). No entanto, após análise de regressão múltipla, apenas a associação com o clearance de creatinina medido permaneceu significativa (r = -0,491, p <0,001). CONCLUSÃO: Em pacientes hipertensos ambulatoriais de meia idade, a s-CC se correlacionou com o clearance de creatinina medido,como esperado, mas não foi observada associação com marcadores de aterosclerose nem com fatores de risco cardiovascular estabelecidos.

Validação prospectiva do escore de risco dante pazzanese em síndrome coronariana aguda sem supradesnivelamento do segmento ST

FUNDAMENTO: Em Síndrome Coronariana Aguda (SCA) sem Supradesnivelamento do segmento ST (SST) é importante estimar a probabilidade de eventos adversos. Para esse fim, as diretrizes recomendam modelos de estratificação de risco. O escore de risco Dante Pazzanese (escore DANTE) é um modelo simples de estratificação de risco, composto das variáveis: aumento da idade (0 a 9 pontos); antecedente de diabete melito (2 pontos) ou acidente vascular encefálico (4 pontos); não uso de inibidor da enzima conversora da angiotensina (1 ponto); elevação da creatinina (0 a 10 pontos); combinação de elevação da troponina e depressão do segmento ST (0 a 4 pontos). OBJETIVO: Validar o escore DANTE em pacientes com SCA sem SST. MÉTODOS: Estudo prospectivo, observacional, com inclusão de 457 pacientes, de setembro de 2009 a outubro de 2010. Os pacientes foram agrupados em: muito baixo, baixo, intermediário e alto risco de acordo com a pontuação do modelo original. A habilidade preditiva do escore foi avaliada pela estatística-C. RESULTADOS: Foram 291 (63,7%) homens e a média da idade 62,1 anos (11,04). Dezessete pacientes (3,7%) apresentaram o evento de morte ou (re)infarto em 30 dias. Ocorreu aumento progressivo na proporção do evento, com aumento da pontuação: muito baixo risco = 0,0%; baixo risco = 3,9%; risco intermediário = 10,9%; alto risco = 60,0%; p < 0,0001. A estatística-C foi de 0,87 (IC 95% 0,81-0,94; p < 0,0001). CONCLUSÃO: O escore DANTE apresentou excelente habilidade preditiva para ocorrência dos eventos específicos e pode ser incorporado na avaliação prognóstica de pacientes com SCA sem SST.

Excesso de Peso, Variáveis Antropométricas e Pressão Arterial em Escolares de 10 a 18 Anos

Fundamento: Estima-se que a prevalência de hipertensão em crianças e adolescentes varie entre 1-13%. O excesso de peso e a obesidade central estão relacionados aos níveis pressóricos em adultos e podem ser importantes na patogênese precoce da HAS quando presentes na infância. Objetivos: Identificar a associação entre variáveis antropométricas e níveis pressóricos em escolares de 5.ª a 8.ª séries e avaliar qual medida obteve maior correlação com a medida dos níveis pressóricos. Métodos: Estudo transversal contemporâneo com amostra de base populacional probabilística por conglomerados em escolas públicas do ensino fundamental de Porto Alegre, de alunos matriculados entre a 5.ª e a 8.ª série. Foram coletados dados sobre fatores de risco familiares e antropometria. A análise estatística incluiu correlações e ajuste dos intervalos de confiança para conglomerados. Resultados: A média de idade dos participantes foi de 12,57 (± 1,64) anos, dos quais 55,2% eram do sexo feminino. Encontraram-se 11,3% da amostra com níveis pressóricos alterados e 16,2% com valores limítrofes. Das variáveis antropométricas analisadas, a que demonstrou maior correlação com valores pressóricos aumentados foi o diâmetro do quadril (r = 0,462, p < 0,001) seguido de circunferência abdominal menor (r = 0,404, p < 0,001) e prega cutânea abdominal (r = 0,291, p < 0,001). Conclusão: Foi observada associação entre as circunferências da cintura e dobras cutâneas e níveis pressóricos aumentados nos escolares da amostra. Portanto, é de fundamental importância que a aferição da pressão arterial e as medidas de cintura e quadril sejam rotina nos serviços de saúde de forma precoce a fim de prevenir essa condição patológica.

Bases para o estudo da genética de populações dos Hymenoptera em geral e dos Apinae sociais em particular

This paper deals with problems on population genetics in Hymenoptera and particularly in social Apidae. 1) The studies on populations of Hymenoptera were made according to the two basic types of reproduction: endogamy and panmixia. The populations of social Apinae have a mixed method of reproduction with higher percentage of panmixia and a lower of endogamy. This is shown by the following a) males can enter any hive in swarming time; b) males of Meliponini are expelled from hives which does not need them, and thus, are forced to look for some other place; c) Meliponini males were seen powdering themselves with pollen, thus becoming more acceptable in any other hive. The panmixia is not complete owing to the fact that the density of the breeding population as very low, even in the more frequent species as low as about 2 females and 160 males per reproductive area. We adopted as selection values (or survival indices) the expressions according to Brieger (1948,1950) which may be summarised as follows; a population: p2AA + ²pq Aa + q2aa became after selection: x p2AA + 2pq Aa + z q²aa. For alge-braics facilities Brieger divided the three selective values by y giving thus: x/y p2 AA + y/y 2 pq Aa + z/y q²aa. He called x/y of RA and z/y of Ra, that are survival or selective index, calculated in relation to the heterozygote. In our case all index were calculated in relation to the heterozygote, including the ones for haploid males; thus we have: RA surveval index of genotype AA Ra surveval index of genotype aa R'A surveval index of genotype A R'a surveval index of genotype a 1 surveval index of genotype Aa The index R'A ande R'a were equalized to RA and Ra, respectively, for facilities in the conclusions. 2) Panmitic populations of Hymenoptera, barring mutations, migrations and selection, should follow the Hardy-Weinberg law, thus all gens will be present in the population in the inicial frequency (see Graphifc 1). 3) Heterotic genes: If mutation for heterotic gene ( 1 > RA > Ra) occurs, an equilibrium will be reached in a population when: P = R A + Ra - 2R²a _____________ (9) 2(R A + Ra - R²A - R²a q = R A + Ra - 2R²A _____________ (10) 2(R A + Ra - R²A - R²a A heterotic gene in an hymenopteran population may be maintained without the aid of new mutation only if the survival index of the most viable mutant (RA) does not exced the limiting value given by the formula: R A = 1 + √1+Ra _________ 4 If RA has a value higher thah the one permitted by the formula, then only the more viable gene will remain present in the population (see Graphic 10). The only direct proof for heterotic genes in Hymenoptera was given by Mackensen and Roberts, who obtained offspring from Apis mellefera L. queens fertilized by their own sons. Such inbreeding resulted in a rapid loss of vigor the colony; inbred lines intercrossed gave a high hybrid vigor. Other fats correlated with the "heterosis" problem are; a) In a colony M. quadrifasciata Lep., which suffered severely from heat, the percentage of deths omong males was greater .than among females; b) Casteel and Phillips had shown that in their samples (Apis melifera L). the males had 7 times more abnormalities tian the workers (see Quadros IV to VIII); c) just after emerging the males have great variation, but the older ones show a variation equal to that of workers; d) The tongue lenght of males of Apis mellifera L., of Bombus rubicundus Smith (Quadro X), of Melipona marginata Lep. (Quadro XI), and of Melipona quadrifasciata Lep. Quadro IX, show greater variationthan that of workers of the respective species. If such variation were only caused by subviables genes a rapid increasse of homozigoty for the most viable alleles should be expected; then, these .wild populations, supposed to be in equilibrium, could .not show such variability among males. Thus we conclude that heterotic genes have a grat importance in these cases. 4) By means of mathematical models, we came to the conclusion tht isolating genes (Ra ^ Ra > 1), even in the case of mutations with more adaptability, have only the opor-tunity of survival when the population number is very low (thus the frequency of the gene in the breeding population will be large just after its appearence). A pair of such alleles can only remain present in a population when in border regions of two races or subspecies. For more details see Graphics 5 to 8. 5) Sex-limited genes affecting only females, are of great importance toHymenoptera, being subject to the same limits and formulas as diploid panmitic populations (see formulas 12 and 13). The following examples of these genes were given: a) caste-determining genes in the genus Melipona; b) genes permiting an easy response of females to differences in feeding in almost all social Hymenoptera; c) two genes, found in wild populations, one in Trigona (Plebéia) mosquito F. SMITH (quadro XII) and other in Melipona marginata marginata LEP. (Quadro XIII, colonies 76 and 56) showing sex-limited effects. Sex-limited genes affecting only males do not contribute to the plasticity or genie reserve in hymenopteran populations (see formula 14). 6) The factor time (life span) in Hymenoptera has a particular importance for heterotic genes. Supposing one year to be the time unit and a pair of heterotic genes with respective survival indice equal to RA = 0, 90 and Ra = 0,70 to be present; then if the life time of a population is either one or two years, only the more viable gene will remain present (see formula 11). If the species has a life time of three years, then both alleles will be maintained. Thus we conclude that in specis with long lif-time, the heterotic genes have more importance, and should be found more easily. 7) The colonies of social Hymenoptera behave as units in competition, thus in the studies of populations one must determine the survival index, of these units which may be subdivided in indice for egg-laying, for adaptive value of the queen, for working capacity of workers, etc. 8) A study of endogamic hymenopteran populations, reproduced by sister x brother mating (fig. 2), lead us to the following conclusions: a) without selection, a population, heterozygous for one pair of alleles, will consist after some generations (theoretically after an infinite number of generation) of females AA fecundated with males A and females aa fecundated with males a (see Quadro I). b) Even in endogamic population there is the theoretical possibility of the presence of heterotic genes, at equilibrium without the aid of new mutations (see Graphics 11 and 12), but the following! conditions must be satisfied: I - surveval index of both homozygotes (RA e Ra) should be below 0,75 (see Graphic 13); II - The most viable allele must riot exced the less viable one by more than is permited by the following formula (Pimentel Gomes 1950) (see Gra-fic 14) : 4 R5A + 8 Ra R4A - 4 Ra R³A (Ra - 1) R²A - - R²a (4 R²a + 4 Ra - 1) R A + 2 R³a < o Considering these two conditions, the existance of heterotic genes in endogamic populations of Hymenoptera \>ecames very improbable though not - impossible. 9) Genie mutation offects more hymenopteran than diploid populations. Thus we have for lethal genes in diploid populations: u = q2, and in Hymenoptera: u = s, being u the mutation ratio and s the frequency of the mutant in the male population. 10) Three factors, important to competition among species of Meliponini were analysed: flying capacity of workers, food gathering capacity of workers, egg-laying of the queen. In this connection we refer to the variability of the tongue lenght observed in colonies from several localites, to the method of transporting the pollen in the stomach, from some pots (Melliponi-ni storage alveolus) to others (e. g. in cases of pillage), and to the observation that the species with the most populous hives are almost always the most frequent ones also. 11) Several defensive ways used for Meliponini to avoid predation are cited, but special references are made upon the camouflage of both hive (fig. 5) and hive entrance (fig. 4) and on the mimetism (see list in page ). Also under the same heading we described the method of Lestrimelitta for pillage. 12) As mechanisms important for promoting genetic plasticity of hymenopteran species we cited: a) cytological variations and b) genie reserve. As to the former, duplications and numerical variations of chromosomes were studied. Diprion simile ATC was cited as example for polyploidy. Apis mellife-ra L. (n •= 16) also sugests polyploid origen since: a) The genus Melipona, which belongs to a" related tribe, presents in all species so far studied n = 9 chromosomes and b) there occurs formation of dyads in the firt spermatocyte division. It is su-gested that the origin of the sex-chromosome of Apis mellifera It. may be related to the possible origin of diplo-tetraploidy in this species. With regards to the genie reserve, several possible types of mutants were discussed. They were classified according to their survival indices; the heterotic and neutral mutants must be considered as more important for the genie reserve. 13) The mean radius from a mother to a daghter colony was estimated as 100 meters. Since the Meliponini hives swarm only once a year we may take 100 meters a year as the average dispersion of female Meliponini in ocordance to data obtained from Trigona (tetragonisca) jaty F. SMITH and Melipona marginata LEP., while other species may give different values. For males the flying distance was roughly estimated to be 10 times that for females. A review of the bibliography on Meliponini swarm was made (pg. 43 to 47) and new facts added. The population desity (breeding population) corresponds in may species of Meliponini to one male and one female per 10.000 square meters. Apparently the males are more frequent than the females, because there are sometimes many thousands, of males in a swarm; but for the genie frequency the individuals which have descendants are the ones computed. In the case of Apini and Meliponini, only one queen per hive and the males represented by. the spermatozoos in its spermateca are computed. In Meliponini only one male mate with the queen, while queens of Apis mellijera L. are fecundated by an average of about 1, 5 males. (Roberts, 1944). From the date cited, one clearly sees that, on the whole, populations of wild social bees (Meliponini) are so small that the Sewall Wright effect may become of great importance. In fact applying the Wright's formula: f = ( 1/aN♂ + 1/aN♀) (1 - 1/aN♂ + 1/aN♀) which measures the fixation and loss of genes per generation, we see that the fixation or loss of genes is of about 7% in the more frequent species, and rarer species about 11%. The variation in size, tergite color, background color, etc, of Melipona marginata Lep. is atributed to this genetic drift. A detail, important to the survival of Meliponini species, is the Constance of their breeding population. This Constance is due to the social organization, i. e., to the care given to the reproductive individuals (the queen with its sperm pack), to the way of swarming, to the food storage intended to control variations of feeding supply, etc. 14) Some species of the Meliponini are adapted to various ecological conditions and inhabit large geographical areas (e. g. T. (Tetragonisca jaty F. SMITH), and Trigona (Nanno-trigona testaceicornis LEP.) while others are limited to narrow regions with special ecological conditions (e. g. M. fuscata me-lanoventer SCHWARZ). Other species still, within the same geographical region, profit different ecological conditions, as do M. marginata LEP. and M. quadrifasciata LEP. The geographical distribution of Melipona quadrifasciata LEP. is different according to the subspecies: a) subsp anthidio-des LEP. (represented in Fig. 7 by black squares) inhabits a region fron the North of the S. Paulo State to Northeastern Brazil, ,b) subspecies quadrifasciata LEP., (marked in Fig. 7 with black triangles) accurs from the South of S. Paulo State to the middle of the State of Rio Grande do Sul (South Brazil). In the margined region between these two areas of distribution, hi-brid colonies were found (Fig. 7, white circles); they are shown with more details in fig. 8, while the zone of hybridization is roughly indicated in fig. 9 (gray zone). The subspecies quadrifasciata LEP., has 4 complete yellow bands on the abdominal tergites while anthidioides LEP. has interrupted ones. This character is determined by one or two genes and gives different adaptative properties to the subspecies. Figs. 10 shows certains meteorological isoclines which have aproximately the same configuration as the limits of the hybrid zone, suggesting different climatic adaptabilities for both genotypes. The exis-tance of a border zone between the areas of both subspecies, where were found a high frequency of hybrids, is explained as follows: being each subspecies adapted to a special climatic zone, we may suppose a poor adaptation of either one in the border region, which is also a region of intermediate climatic conditions. Thus, the hybrids, having a combination of the parent qualities, will be best adapted to the transition zone. Thus, the hybrids will become heterotic and an equilibrium will be reached with all genotypes present in the population in the border region.

Review of the breeding status of birds in Rio Grande do Sul, Brazil

Information on the breeding biology of birds is essential for improving avian life-history theory and implementing sound management and conservation actions for these organisms. Comprehensive reviews of this kind of information are lacking for most Neotropical regions, including Rio Grande do Sul, the southernmost Brazilian state. Aiming to update the knowledge on the reproductive status of birds in Rio Grande do Sul, we reviewed breeding records of all potential breeding species recorded in the state using a set of predefined, restrictive criteria for accepting breeding evidences as effective. Data satisfying our criteria were available for 165 species in the literature. We also collected novel breeding information obtained in the state for an additional 126 species, including observations for several species whose reproductive biology is poorly known. Among these are birds previously unknown to breed in Brazil. This new data and the critical review of the previous information resulted in a total of 291 species for which breeding evidences are accepted as effective. This corresponds to 54.7% of the 532 species considered either confirmed or potential breeders in the state. In addition to providing information on nesting dates, clutch size, nest architecture and breeding behavior of south Brazilian birds, our review serves as a benchmark for the adequate assessment of avian breeding records elsewhere. We hope to stimulate observers to rigorously document breeding events, especially for taxa for which basic information is lacking.

Colicinogeny in Salmonella serovars isolated in Brazil

A study of colicinogeny was made in 748 strains of Salmonella (97 serovars) isolated from different sources; human (291), animal (119), environmental (141), food (102) and animal feed (95). Colicin production was detected in 64 strains (8.6%), particularly isolated from foods (30.4%). Col. E1 (53) and Ia (44) were the most frequently observed, especially in S. agona for environment and food sources. Col V production was identified in 5 strains of S. typhimurium within 8 producer cultures isolated from humans. Its relationship with the sources and serovars of Salmonella are discussed.

Expression of mosquito active toxin genes by a Colombian native strain of the gram-negative bacterium Asticcacaulis excentricus

Mosquito control with biological insecticides, such as Bacillus sp. toxins, has been used widely in many countries. However, rapid sedimentation away from the mosquito larvae feeding zone causes a low residual effect. In order to overcome this problem, it has been proposed to clone the Bacillus toxin genes in aquatic bacteria which are able to live in the upper part of the water column. Two strains of Asticcacaulis excentricus were chosen to introduce the B. sphaericus binary toxin gene and B. thuringiensis subsp. medellin cry11Bb gene cloned in suitable vectors. In feeding experiments with these aquatic bacteria, it was shown that Culex quinquefasciatus, Aedes aegypti, and Anopheles albimanus larvae were able to survive on a diet based on this wild bacterium. A. excentricus recombinant strains were able to express both genes, but the recombinant strain expressing the B. sphaericus binary toxin was toxic to mosquito larvae. Crude protease A. excentricus extracts did not degrade the Cry11Bb toxin. The flotability studies indicated that the recombinant A. excentricus strains remained in the upper part of the water column longer than the wild type Bacillus strains.

Prevalence of infection with hantavirus in rodent populations of central Argentina

We studied hantavirus seroprevalence and virus variability in rodent populations in Diego Gaynor, northwest of Buenos Aires province, Argentina. Rodent samplings were conducted in railroads and cropfield borders in March and July 1999, September and December 2000, and March 2001. Antibody detection was performed by an enzyme link immunosorbent assay (ELISA), using the recombinant nucleoprotein of Andes (AND) virus as antigen. Tissue samples were taken from positive antibody individuals in order to confirm the presence of hantavirus genomic material and to identify virus genotypes. Akodon azarae was the most abundant species, followed by Oligoryzomys flavescens, while Calomys laucha and C. musculinus were rarely caught. We found a rate of seroprevalence of 9.3% for a total sample of 291 A. azarae and 13.5% for 37 O. flavescens. After molecular analyses of hantavirus, we confirmed the presence of hantavirus genomic material in 16 individuals with ELISA (+) results and two individuals with ELISA (-). Four amplimers for each species were sequenced and compared to the corresponding sequences of representative hantaviruses. We identified the AND Cent Lec from three O. flavescens, and the Pergamino virus from four A. azarae and from one O. flavescens. A. azarae males had higher seroprevalence than females, and heavier individuals showed higher seroprevalence than lighter ones. We did not find seroprevalence differences according to sex in O. flavescens, although this result may have been produced by the low sample size. The lowest seroprevalence was found in a period of high rodent density, when juveniles prevailed in the population. We found higher seroprevalences than those detected in previous studies for other localities of central Argentina where cases of hantavirus pulmonary syndrome (HPS) have been reported. The presence of AND Cent Lec virus in rodent populations of the study area, which is responsible of HPS cases in central Argentina, suggests that human populations are at risk of HPS disease, although there were not reported cases of this disease until today.

Mycobacterium tuberculosis complex differentiation using gyrB-restriction fragment length polymorphism analysis

Mycobacterium tuberculosis complex (MTBC) members are causative agents of human and animal tuberculosis. Differentiation of MTBC members is required for appropriate treatment of individual patients and for epidemiological purposes. Strains from six MTBC species - M. tuberculosis, M. bovis subsp. bovis, M. bovis BCG, M. africanum, M. pinnipedii, and "M. canetti" - were studied using gyrB-restriction fragment length polymorphism (gyrB-RFLP) analysis. A table was elaborated, based on observed restriction patterns and published gyrB sequences. To evaluate applicability of gyrB-RFLP at Instituto Adolfo Lutz, São Paulo, Mycobacterial Reference Laboratory, 311 MTBC clinical isolates, previously identified using traditional methods as M. tuberculosis (306), M. bovis (3), and M. bovis BCG (2), were analyzed by gyrB-RFLP. All isolates were correctly identified by the molecular method, but no distinction between M. bovis and M. bovis BCG was obtained. Differentiation of M. tuberculosis and M. bovis is of utmost importance, because they require different treatment schedules. In conclusion, gyrB-RFLP is accurate and easy-to-perform, with potential to reduce time needed for conventional differentiation methods. However, application for epidemiological studies remains limited, because it cannot differentiate M. tuberculosis from M. africanum subtype II, and "M. canetti", M. africanum subtype I from M. pinnipedii, and. M. bovis from M. bovis BCG.

Application of PCR ribotyping and tDNA-PCR for Klebsiella pneumoniae identification

PCR analysis of 16S-23S internal transcribed spacer (PCR ribotyping) and tRNA intergenic spacer (tDNA-PCR) were evaluated for their effectiveness in identification of clinical strains of Klebsiella pneumoniae and differentiation with related species. For this purpose both methods were applied to forty-three clinical isolates biochemically identified as K. pneumoniae subsp. pneumoniae isolated from patients clinical specimens attended at five hospitals in three Brazilian cities. References strains of K. pneumoniae subsp. pneumoniae, K. pneumoniae subsp. ozaenae, K. oxytoca, K. planticola and Enterobacter aerogenes were also analyzed. Both PCR methods showed specific patterns for each species. A conserved PCR ribotype pattern was observed for all clinical K. pneumoniae isolates, while differing from other related analyzed species. tDNA-PCR revealed five distinct patterns among the K. pneumoniae clinical isolates studied, demonstrating a predominant group with 90,6% of isolates presenting the same pattern of K. pneumoniae type strain. Both PCR-based methods were not able to differentiate K. pneumoniae subspecies. On the basis of the results obtained, both methods were efficient to differentiate the Klebsiella species analyzed, as well as E. aerogenes. Meanwhile tDNA-PCR revealed different tRNA arrangements in K. pneumoniae, suggesting intra-species heterogeneity of their genome organization, the polymorphism of the intergenic spacers between 16S and 23S rRNA genes appears to be highly conserved whithin K. pneumoniae clinical isolates, showing that PCR ribotyping can be an useful tool for identification of K. pneumoniae isolates.

Fatores associados à infecção pelo uso do cateter central de inserção periférica em Unidade de Terapia Intensiva Neonatal

Estudo epidemiológico, longitudinal e analítico, desenvolvido em um hospital de Minas Gerais, com o objetivo de analisar os fatores associados à infecção pelo uso do cateter central de inserção periférica em recém-nascidos internados em unidade de terapia intensiva. A coleta dos dados foi realizada por meio de uma ficha estruturada, preenchida pelos profissionais e verificada pelos pesquisadores. Foram estudados 291 cateteres inseridos em 233 recém-nascidos. Os fatores associados à retirada por suspeita de infecção foram: prematuridade, peso ao nascer até 1.500 gramas, cateter de poliuretano, localização não centralizada do cateter e tempo de uso superior a 30 dias. Após ajuste multivariado, permaneceram independentemente associados: peso inferior a 2.500 gramas na inserção, reparo e tempo de uso do cateter. Conclui-se que fatores relacionados à prática dos profissionais contribuíram para a retirada dos cateteres, sinalizando para a necessidade de intervenções que melhorem a segurança e a eficácia em seu uso.

Soil organic matter and fertility of anthropogenic dark earths (Terra Preta de Índio) in the Brazilian Amazon basin

Fertility properties, total C (Ctot), and chemical soil organic matter fractions (fulvic acid fraction - FA, humic acid fraction - HA, humin fraction - H) of anthropogenic dark earths (Terra Preta de Índio) of the Amazon basin were compared with those of Ferralsols with no anthropogenic A horizon. Terra Preta soils had a higher fertility (pH: 5.1-5.4; Sum of bases, SB: 8.93-10.33 cmol c kg-1 , CEC: 17.2-17.5 cmol c kg-1 , V: 51-59 %, P: 116-291 mg kg-1) and Ctot (44.6-44.7 g kg-1) than adjacent Ferralsols (pH: 4.4; SB: 2.04 cmol c kg-1, CEC: 9.5 cmol c kg-1, V: 21 %, P 5 mg kg-1, C: 37.9 g kg-1). The C distribution among humic substance fractions (FA, HA, H) in Terra Preta soils was also different, as shown by the ratios HA:FA and EA/H (EA=HA+FA) (2.1-3.0 and 1.06-1.08 for Terra Preta and 1.2 and 0.72 for Ferralsols, respectively). While the cation exchange capacity (CEC), of Ferralsols correlated with FA (r = 0.97), the CEC of Terra Preta correlated with H (r = 0.82). The correlation of the fertility of Terra Preta with the highly stable soil organic matter fraction (H) is highly significant for the development of sustainable soil fertility management models in tropical ecosystems.