Quimiotipagem do Cryptococcus neoformans. Revis��o da literatura. Novos dados epidemiológicos sobre a criptococose. Nossa experi��ncia com o emprego do meio de C.G.B. no estudo daquela levedura

O presente trabalho, al��m da revis��o da literatura sobre quimiotipagem do C. neoformans, com novos dados sobre a epidemiologia da criptococose, teve por finalidade principal a caracterizaç��o das duas variedades desta levedura em pacientes com neurocriptococose, HIV + e HIV -. As variedades neoformans e gattii est��o hoje bem definidas bioquimicamente, com o emprego do meio C.G.B., proposto por KWON-CHUNG et al. (1982) 24. O isolamento do C. neoformans var. gattii das flores e folhas do Eucalyptus camaldulensis e do Eucalyptus tereticornis, na Austrália, através dos trabalhos de ELLIS & PFEIFFER (1990)16 e PFEIFFER & ELLIS (1992)41, possibilitou investigações epidemiol��gicas das mais interessantes sobre este microrganismo, levedura capsulada a qual SANFELICE50, 51, na It��lia, em 1894 e 1895 despertou a atenção do meio médico. BUSSE8, em 1894, descrevia o primeiro caso de criptococose humana sob a forma de les��o óssea, simulando sarcoma. As pesquisas nacionais sobre o assunto em foco foram destacadas, seguindo-se a experi��ncia dos Autores com o meio de C.G.B. (L - canavanina, glicina e azul de bromotimol). Foi possível, através deste meio o estudo de 50 amostras de l��quor, sendo 39 procedentes de aidéticos (78%) e 11 de não aidéticos (22%). De pacientes HIV+, 37 (74%) foram identificados como C. neoformans var. neoformans e 2 (4%) como C. neoformans var. gattii. Dos HIV- 8 ( 16%) foram classificados como C. neoformans var. neoformans e 3 (6%) como C. neoformans var. gattii. Através deste trabalho, evidencia-se a import��ncia da neurocriptococose, principalmente entre os aidéticos, demonstrando-se mais uma vez o interesse do meio CGB na quimiotipagem do C. neoformans em suas duas variedades, ganhando em import��ncia a demonstra��ão de que duas esp��cies de eucalipto podem funcionar como "��rvores-hospedeiras" para o Cryptococcus neoformans var. gattii.

Hepatitis B and C prevalences among blood donors in the south region of Brazil

The prevalence of hepatitis B and C infection has been determined in a seroepidemiological survey among blood donors from the south of Brazil (Florianópolis, State of Santa Catarina). These markers has also been correlated with the levels of alanine aminotransferase (ALT), a surrogate marker to prevent post-transfusion hepatitis. Sera from 5000 donors were randomly collected in the period of April to November 1991. The prevalences of HBsAg, anti-HBs and anti-HBc were respectively 0.78, 7.02 and 13.98. The anti-HCV prevalence after confirmation testing with line immunoassay (LIA), was 1.14. Normal values of ALT ( < = 32 U/ml) were found in 59.78, values slightly above the mean (ALT between 32-70 U/ml) in 37.74 and high values of ALT ( > = 70 U/ml) in 2.48. The positivity of anti-HCV antibodies increased with the elevation of ALT levels. This correlation was not observed in relation to HBsAg. There exists a diversity in the recognition of HCV epitopes among HCV positive donors. Via the confirmation test used, we could observe that 94.7 of donors recognize the structural core antigen. Besides that, we observed that 5.26 of the HCV reactive sera recognized only epitopes located in the NS4 and/or NS5 region, indicating the importance of these epitopes for the improvement of assays.

Prevalence of hepatitis B and C virus infection among leprosy patients in a leprosy-endemic region of central Brazil

Leprosy and hepatitis B virus (HBV) are highly endemic in some regions of the state of Mato Grosso, in central Brazil. The association of leprosy with HBV and hepatitis C virus (HCV) was assessed using a seroprevalence study and 191 leprosy outpatients were included. Demographic data and the clinical classification of leprosy were recorded. Evidence of previous HBV infection was present in 53 patients (27.7%, 95% confidence interval: 21.9-34.5) and two (1%) were HBsAg positive. Five (2.6%) had antibodies to HCV. The prevalence of previous exposure to HBV was higher than expected for an adult population in central Brazil. In contrast, the prevalence of anti-HCV antibodies was not much higher regarding the age range of participants. HBV markers were associated with a higher number of sex partners and the use of injections without proper sterilisation of the syringes. The number of HBV carriers was small, suggesting that there was no increased likelihood of chronification among these patients.

Immunization aganist hepatitis B in children from endemic zone: evaluation of the antibody response against the DNA recombinant vaccine (Engerix B-20 mcg)

A previous seroepidemiological study in the rural zone of Vargem Alta (ES) SouthEast of Brazil, showed a prevalence of up to 9% of hepatitis B surface antigen (HBsAg) in some areas. One hundred susceptible children aging 1 to 5 years old were selected and immunized with a recombinant DNA hepatitis B vaccine (Smith-Kline 20 mcg) using the 0-1-6 months vaccination schedule. Blood samples were collected at the time of the first vaccine dose (month 0) in order to confirm susceptible individuals and 1,3,6 and 8 months after the first dose , to evaluate the antibody response. Our results showed that two and five months after the second dose, 79% and 88% of children seroconverted respectively, reaching 97% after the third dose. The levels of anti-HBs were calculated in milli International Units/ml (mIU/ml) and demonstrated the markedly increase of protective levels of antibodies after the third dose. These data showed a good immunogenicity of the DNA recombinant hepatitis B vaccine when administered in children of endemic areas.

High prevalence of hepatitis C infection among Brazilian hemodialysis patients in Rio de Janeiro: a one-year follow-up study

Nearly 400 hemodialysis patients treated at 5 different hemodialysis units in Rio de Janeiro were tested for one year for the presence of hepatitis C and B markers. During the same period, samples were also obtained from 35 continuous ambulatory peritoneal dialysis (CAPD) patients and from 242 health care workers. Depending on the hemodialysis unit studied, anti-HCV prevalence rates ranging from 47% to 82% (mean 65%) were detected. CAPD patients showed a lower prevalence of 17%. The prevalence of antibodies against hepatitis C virus (anti-HCV) among health care workers was 2.9%. We observed a hepatitis C attack rate of 11.5% per year in the anti-HCV-negative hemodialysis patient population. An average of 9.4% of the hemodialysis patients were chronic carriers of hepatitis B virus (HBV) (range 1.8% - 20.4%), while 48.9% showed markers of previous HBV infection. The HBV attack rate was 4.5% per year (range 0% - 6%). These results indicate an alarming high prevalence of anti-HCV among hemodialysis patients of this studied region.

Necrotizing enteritis associated with Clostridium perfringensType B in chinchillas (Chinchilla lanigera)

Four 3-4 month-old chinchillas (Chinchilla lanigera) from a commercial flock of 395 chinchillas, were found dead with evidence of previous diarrhea and prolapsed rectum. A fifth 8 month-old chinchilla died 8 hours after being found recumbent, apathetic, diarrheic and with a prolapsed rectum. Two chinchillas were necropsied and observed gross lesions consisted of extensive hemorrhagic enteritis, mild pulmonary edema and enlarged and yellow liver; this latter finding was particularly prominent in the chinchilla presenting longer clinical course. Histologically there was necrotizing enteritis associated with abundant bacterial rods aggregates in the intestinal surface epithelium and within the lamina propria. In the lungs there were small amounts of pink proteinaceous material (edema) in the interstitium and marked vacuolar hepatocellullar degeneration (lipidosis) in the liver. Anaerobic cultures from the intestinal contents of one of the affected chinchillas yielded Clostridium perfringens. Genotyping of this C. perfringens isolate was achieved by multiplex polymerase chain reaction (mPCR) as C. perfringenstype B due to detection of alpha, beta and epsilon-toxin genes. These findings suggest C. perfringens type B as an important cause of sudden or acute death in chinchillas.

Effect of hepatitis C serology on C-reactive protein in a cohort of Brazilian hemodialysis patients

Hepatitis C (HCV) is not an uncommon feature in hemodialysis (HD) patients and may be a cause of systemic inflammation. Plasma cytokine interleukin-6 (IL-6) is mainly produced by circulating and peripheral cells and induces the hepatic synthesis of C-reactive protein (CRP), which is the main acute phase reactant. The aim of this study was to investigate the influence of HCV on two markers of systemic inflammation, serum CRP and IL-6, in HD patients. The study included 118 HD patients (47% males, age 47 �� 13 years, 9% diabetics) who had been treated by standard HD for at least 6 months. The patients were divided into two groups depending on the presence (HCV+) or absence (HCV-) of serum antibodies against HCV. Serum albumin (S-Alb), plasma high sensitivity CRP (hsCRP), IL-6, and alanine aminotransferase (ALT) were measured and the values were compared with those for 22 healthy controls. Median hsCRP and IL-6 values and hsCRP/IL-6 ratio were: 3.5 vs 2.1 mg/l, P < 0.05; 4.3 vs 0.9 pg/ml, P < 0.0001, and 0.8 vs 2.7, P < 0.0001, for patients and controls, respectively. Age, gender, S-Alb, IL-6 and hsCRP did not differ between the HCV+ and HCV- patients. However, HCV+ patients had higher ALT (29 ± 21 vs 21 ± 25 IU/l) and had been on HD for a longer time (6.1 ± 3.0 vs 4.0 �� 2.0 years, P < 0.0001). Moreover, HCV+ patients had a significantly lower median hsCRP/IL-6 ratio (0.7 vs 0.9, P < 0.05) compared to the HCV- group. The lower hsCRP/IL-6 ratio in HCV+ patients than in HCV- patients suggests that hsCRP may be a less useful marker of inflammation in HCV+ patients and that a different cut-off value for hsCRP for this population of patients on HD may be required to define inflammation.

Alternagin-C, a disintegrin-like protein from the venom of Bothrops alternatus, modulates alpha2ß1 integrin-mediated cell adhesion, migration and proliferation

The alpha2ß1 integrin is a major collagen receptor that plays an essential role in the adhesion of normal and tumor cells to the extracellular matrix. Alternagin-C (ALT-C), a disintegrin-like protein purified from the venom of the Brazilian snake Bothrops alternatus, competitively interacts with the alpha2��1 integrin, thereby inhibiting collagen binding. When immobilized in plate wells, ALT-C supports the adhesion of fibroblasts as well as of human vein endothelial cells (HUVEC) and does not detach cells previously bound to collagen I. ALT-C is a strong inducer of HUVEC proliferation in vitro. Gene expression analysis was done using an Affimetrix HU-95A probe array with probe sets of ~10,000 human genes. In human fibroblasts growing on collagen-coated plates, ALT-C up-regulates the expression of several growth factors including vascular endothelial growth factor, as well as some cell cycle control genes. Up-regulation of the vascular endothelial growth factor gene and other growth factors could explain the positive effect on HUVEC proliferation. ALT-C also strongly activates protein kinase B phosphorylation, a signaling event involved in endothelial cell survival and angiogenesis. In human neutrophils, ALT-C has a potent chemotactic effect modulated by the intracellular signaling cascade characteristic of integrin-activated pathways. Thus, ALT-C acts as a survival factor, promoting adhesion, migration and endothelial cell proliferation after binding to alpha2��1 integrin on the cell surface. The biological activities of ALT-C may be helpful as a therapeutic strategy in tissue regeneration as well as in the design of new therapeutic agents targeting alpha2ß1 integrin.

Espécies vegetais para cobertura do solo: influ��ncia sobre plantas daninhas e a produtividade do algodoeiro em sistema plantio direto

Este trabalho objetivou avaliar a produç��o, a persistência e os efeitos de coberturas vegetais sobre as plantas daninhas e a produtividade do algodoeiro em sistema plantio direto. Os tratamentos consistiram das espécies de cobertura: milheto (Pennisetum glaucum (L.) R. Brown), Brachiaria ruziziensis Germain &amp; Evrard, sorgo forrageiro (Sorghum bicolor L. Moench), capim-p��-de-galinha (Eleusine coracana L. Gaerth), Crotalaria juncea L., Crotalaria spectabilis Roth, aveia-preta (Avena strigosa Schreb.), nabo forrageiro (Raphanus sativus L.), P. glaucum + C. juncea, P. glaucum + C. spectabilis, B. ruziziensis + C. juncea, B. ruziziensis + C. spectabilis, S. bicolor + C. juncea, S. bicolor + C. spectabilis, E. coracana + C. juncea, E. coracana + C. spectabilis, A. strigosa + R. sativus, P. glaucum + R. sativus e pousio. As esp��cies foram semeadas no final do verão, após a colheita de soja, e o algodoeiro BRS 269-Buriti, nove meses após. O delineamento experimental foi em blocos ao acaso, com quatro repetições. As espécies B. ruziziensis, B. ruziziensis + C. juncea, B. ruziziensis + C. spectabilis e P. glaucum + R. sativus produziram mais de 6,8 t ha-1 de biomassa seca. A palhada produzida pela B. ruziziensis garantiu boa cobertura do solo durante o ciclo do algodoeiro. A biomassa seca de B. ruziziensis, B. ruziziensis + C. juncea e B. ruziziensis + C. spectabilis reduziu a infestaç��o de plantas daninhas até a época de semeadura do algodão e durante os estádios iniciais de seu desenvolvimento. Palhas de R. sativus e A. strigosa, solteiras e consorciadas, interferiram negativamente na produtividade do algodoeiro.

Hospitaliza��ões por condiç��es cardiovasculares sensíveis �� atenç��o primária em municípios goianos

OBJETIVO: Analisar taxas de hospitalizaç��o por condiç��es cardiovasculares sensíveis �� atenç��o primária. MÉTODOS: Estudo ecol��gico com 237 municípios do Estado de Goi��s, de 2000 a 2008, utilizando dados do Sistema de Informação Hospitalar e Sistema de Informa��ão da Atenç��o Básica. As taxas de hospitaliza��ão foram calculadas pela proporç��o entre o número de hospitalizaç��es por condições cardiovasculares e a popula��ão acima de 40 anos. Foram avaliadas em tri��nios: A (2000-2002), B (2003-2005) e C (2006-2008), segundo sexo, faixa etária, porte populacional, pertencimento à regi��o metropolitana, macrorregião de saúde, dist��ncia da capital, ��ndice de Condiç��es de Vida e Saúde e cobertura de Estratégia Sa��de da Família. A cobertura populacional potencial da Saúde da Fam��lia foi calculada conforme diretrizes do Ministério da Saúde. A variabilidade das taxas foi avaliada segundo teste t e ANOVA. RESULTADOS: Ocorreram 253.254 interna��ões (17,2% do total) por condições cardiovasculares sens��veis à atenção prim��ria. As taxas de hospitaliza��ão diminu��ram entre os tri��nios: A (213,5, dp = 104,6), B (199,7, dp = 96,3) e C (150,2, dp = 76,1), com diferença entre os per��odos A-C e B-C (p < 0,001). Porte populacional municipal n��o influenciou o comportamento das taxas. Munic��pios pr��ximos à capital e aqueles da regi��o metropolitana apresentaram maiores taxas (p < 0,001). Em todos os percentis do Índice de Condições de Vida e Sa��de, houve reduç��o das taxas (p < 0,001), exceto no percentil 1. Redução foi também observada em todas as macrorregiões, exceto na regi��o nordeste do estado. A redu��ão das taxas ocorreu independentemente da cobertura da Sa��de da Família. CONCLUSÕES: As taxas de hospitaliza��ão por condições cardiovasculares sens��veis à atenção prim��ria diminu��ram nesses munic��pios, independentemente da cobertura da Saúde da Família.

Treatment of relapsing chronic infections of the respiratory tract: a comparative study of the effectiveness of non specific immunotherapy with the immunoadjuvant p40 and of vaccinotherapy

The treatment of relapsing chronic infections (RCI) encounters many difficulties. In the present study, the use of the immuno adjuvant P40 either alone or in association with vaccinotherapy for the treatment of RCI turned out to be very effective, whereas vaccinotherapy alone was not. It is hypothesized that cell-mediated immunity may play a major role in controlling RCI, since the clinical improvement of the patients kept up with the positivation of previously negative skin tests carried out with either the specific infecting agent or with recall-anti gens.

Cryptococcus neoformans strains isolated from church towers in Rio de Janeiro City, RJ, Brazil

Cryptococcosis has been a significant cause of morbidity and mortality in patients with Aids. Many reservoirs of the agent Cryptococcus neoformans have been reported, but the ecology of this yeast must be elucidated in order to establish surveillance programs and to prevent infections. The objective of this study was to evaluate the presence of C. neoformans in Rio de Janeiro City, RJ, Brazil. Ten churches were selected for sampling and detection of the yeast collecting pigeon dropping, air samples from church towers and neighboring areas during one year. The data demonstrated that C. neoformans has been present in every church selected and was present in 37.8% of 219 pigeon dropping samples. As well as, the yeast was isolated from soil, insects, eggs, pigeon nests and feathers. Fifteen air samples (4.9%) were positive. The growth on C.G.B. medium showed that all strains belonged to C. neoformans var. neoformans, with 98.8% of the strains belonging to serotype A.

Primary liver AIDS-related lympoma

Non-Hodgkin's lymphomas (NHL) are the second most frequent malignancies in AIDS patients. The majority of NHL associated with AIDS involves extranodal sites, especially the digestive tract and the central nervous system. Primary liver lymphoma (PLL) is an uncommon neoplasm among these patients. Ultrasonography and computed tomography scans may be helpful in the diagnosis of focal hepatic lymphoma. Image-guided fine-needle biopsy with histopathology of the liver lesions is the gold standard for the diagnosis of hepatic lymphoma. We report a case of PLL as the initial manifestation of AIDS in a patient without any previous infection by hepatitis C or B virus, presented as multiple and large hepatic masses.

Survey of chicken abattoir for the presence of Campylobacter jejuni and Campylobacter coli

The genus Campylobacter is of great importance to public health because it includes several species that may cause diarrhea. These species may be found in water, food and in the intestinal tract of chickens. This study investigated the presence of Campylobacter jejuni and Campylobacter coli in chicken abattoirs in São Paulo State, Brazil. A total of 288 samples of feces, feathers, scald water, evisceration water, chiller water, and the rinse water of eviscerated, not eviscerated and chilled carcasses were collected in six chicken abattoirs. Polymerase Chain Reaction (PCR) was performed in Campylobacter spp.-positive isolates using the gene HIP, specific for hippuricase enzyme from Campylobacter jejuni and aspartokinase gene, specific to detect Campylobacter coli. The percentage of positive isolates of Campylobacter jejuni was 4.9% (14/288). Isolation was greater in feces samples (22%, 8/36). One sample was positive for the species C. coli. In conclusion, the results indicate that it is necessary to improve quality control for Campylobacter spp. in chicken abattoirs.