Caracterização do zumbido em idosos e de possíveis transtornos relacionados

O envelhecimento populacional é uma realidade atual no Brasil, e com ele observa-se o aumento de doenças crônicodegenerativas. O zumbido surge como um sintoma muito prevalente e de alto impacto na qualidade de vida do paciente senil. OBJETIVO: Avaliar e qualificar o zumbido neste grupo. MATERIAL E MÉTODO: Questionário de pesquisa aplicado a 100 idosos em hospital terciário, aleatoriamente, com questões sobre características do zumbido; repercussão do zumbido na vida do paciente e antecedentes pessoais. RESULTADOS: 61% dos participantes eram do sexo feminino, a média de idade foi de 69,53 anos. Em relação às características do zumbido: não-pulsátil 76%, contínuo 54%, bilateral 57%, recente 62% e único 83%; à repercussão: 32,5% referiram alteração no emocional, 31,8% no sono, 22,5% na concentração e 13,2% na vida social; 39% classificaram o zumbido em moderado, 35% em intenso e 26% em leve; às comorbidades: relação com sintomas otoneurológicos e hipertensão arterial; aos achados audiométricos: curvas descendentes, sensorioneurais e simétricas foram prevalentes. CONCLUSÕES: O zumbido interfere na vida do idoso; não há correlação entre o grau da perda auditiva e o grau de insatisfação do paciente com o zumbido; e a presbiacusia foi o achado mais comum encontrado nas audiometrias.

Quebra de dormência de sementes da videira cv. niágara rosada sem estratificação

O objetivo deste trabalho foi verificar o efeito de três fatores na germinação de sementes de uva cv. niágara rosada: tratamentos físicos, tratamentos químicos e ambientes de germinação. Os tratamentos físicos consistiram de sementes com corte transversal na região mediana e de sementes com corte na micrópila. Os tratamentos químicos foram aplicados mediante imersão das sementes inteiras em solução aquosa de ácido giberélico (GA3) nas concentrações de 0 e 4000 mg L-1. Os ambientes avaliados foram in vitro e ex vitro. O experimento foi um fatorial do tipo 2 x 2 x 2 no delineamento em blocos ao acaso, com quatro repetições, sendo a parcela experimental constituída de um Gerbox®, contendo 25 sementes ou uma grade com 25 tubos de ensaio. Os parâmetros avaliados foram porcentagem e velocidade de germinação das sementes. Os resultados indicaram que o corte das sementes é imprescindível à germinação de sementes não estratificadas. A combinação entre cortes na micrópila, 4000 mg L-1 de GA3 e ambiente in vitro, proporcionou a germinação de 77% das sementes, sendo o ambiente in vitro significativamente superior ao ex vitro.

Carbohydrate assimilation profiles of Brazilian Candida dubliniensis isolates based on ID 32C system

The purpose of the present study was to evaluate the identification of 19 Brazilian C. dubliniensis based on the biochemical profile exhibited when tested by the commercial identification kit ID 32C (bioMerieux). Thirteen of the isolates were rigorously identified as C. dubliniensis and the remaining isolates (six) were considered as having a doubtful profile but the software also suggested that there was 83.6% of chances for them to be C. dubliniensis. As well as pointed by the literature the identification obtained by phenotypic tests should be considered presumptive for C. dubliniensis due to variability of this new species.

Optimization of the Sybr Green real time PCR for the detection of Human Herpes Virus type 6 (HHV-6)

HHV-6 is the etiological agent of Exanthem subitum which is considered the sixth most frequent disease in infancy. In immuno-compromised hosts, reactivation of latent HHV-6 infection may cause severe acute disease. We developed a Sybr Green Real Time PCR for HHV-6 and compared the results with nested conventional PCR. A 214 pb PCR derived fragment was cloned using pGEM-T easy from Promega system. Subsequently, serial dilutions were made in a pool of negative leucocytes from 10-6 ng/µL (equivalent to 2465.8 molecules/µL) to 10-9 (equivalent to 2.46 molecules/µL). Dilutions of the plasmid were amplified by Sybr Green Real Time PCR, using primers HHV3 (5' TTG TGC GGG TCC GTT CCC ATC ATA 3)'and HHV4 (5' TCG GGA TAG AAA AAC CTA ATC CCT 3') and by conventional nested PCR using primers HHV1 (outer): 5'CAA TGC TTT TCT AGC CGC CTC TTC 3'; HHV2 (outer): 5' ACA TCT ATA ATT TTA GAC GAT CCC 3'; HHV3 (inner) and HHV4 (inner) 3'. The detection threshold was determined by plasmid serial dilutions. Threshold for Sybr Green real time PCR was 24.6 molecules/µL and for the nested PCR was 2.46 molecules/µL. We chose the Real Time PCR for diagnosing and quantifying HHV-6 DNA from samples using the new Sybr Green chemistry due to its sensitivity and lower risk of contamination.

Rhinocerebral zygomycosis in a diabetic patient

Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.

Seroprevalence and risk factors associated with visceral leishmaniasis in dogs in Jaciara, State of Mato Grosso

Introduction Visceral leishmaniasis is a neglected disease. Jaciara, State of Mato Grosso has the most cases. This study aimed to determine the risk factors and seroprevalence of canine visceral leishmaniasis in urban and rural areas. Methods This cross-sectional study of domestic dogs used enzyme-linked immunosorbent assay and indirect immunofluorescence test. Results The prevalence was 54.7% among 345 analyzed samples. Short coat, age of 1-6 years, and living less than 100m from vegetation posed the highest infection risks. Conclusions Certain dog behaviors and characteristics, and their correlation with environmental conditions, were relevant in the high prevalence of canine leishmaniasis in Jaciara.

Fatores associados ao abandono de tratamento em saúde mental em uma unidade de nível secundário do Sistema Municipal de Saúde

A ocorrência de abandono de tratamento psiquiátrico de nível secundário é uma relevante questão clínica e econômica. Taxas de abandono em psiquiatria são mais altas que em outras especialidades médicas. Estudos publicados nos últimos 15 anos têm identificado diversos fatores estatisticamente associados ao não-comparecimento às consultas e/ou ao abandono de tratamento em saúde mental. OBJETIVO: Avaliar variáveis demográficas, psicopatológicas, de diagnóstico e tratamento enquanto possíveis preditores de abandono de tratamento em serviço especializado de saúde mental. MÉTODO: Estudo observacional, avaliando 896 pacientes encaminhados, no período de abril de 2004 a março de 2006, por Unidades Básicas de Saúde da área de abrangência do serviço especializado. RESULTADOS: Pacientes solteiros, com idade abaixo da média do grupo (39,2 anos) e desempregados abandonaram significantemente mais o tratamento. Duas variáveis relativas ao exame psicopatológico se associaram significantemente com abandono de tratamento (memória quanto ao passado recente e relação do humor com fatos reais, atuais). Pacientes adultos que receberam diagnóstico psiquiátrico de oligofrenia abandonaram significantemente menos e pacientes com diagnóstico relativo aos transtornos da infância e adolescência (F80-F98 da CID-10) também abandonaram significantemente mais o tratamento. O registro de comorbidade psiquiátrica e tratamento exclusivamente farmacológico se associaram a não abandono do tratamento. CONCLUSÃO: Os resultados confirmam achados de diferentes autores da evidência de características associadas a abandono ao tratamento. Tais achados sugerem que determinados subgrupos de pacientes necessitem de abordagens customizadas, a fim de influenciar positivamente sua adesão final ao tratamento indicado.

Estudo mesoscópico da valva mitral e do seu anel fibroso

OBJETIVO: Estudar o arranjo espacial dos elementos fibrosos que constituem os folhetos da valva mitral e do seu anel fibroso. MÉTODOS: Foram utilizados 20 corações adultos, de ambos os sexos, fixados em formol a 10%. Isolaram-se a valva mitral, juntamente com o anel fibroso, e uma pequena quantidade de tecido muscular ao seu redor. Parte desse material foi incluído em parafina, submetido a cortes seriados de 40µm de espessura e corados pelo tricrômio de Azan e pela resorcina-fucsina, e o restante das peças dissecadas sob lupa estereoscópica, com ajuda de delicadas pinças e agulhas, para se observar a disposição dos feixes miocárdicos ao nível do anel mitral. RESULTADOS: Observou-se que o anel fibroso mitral era constituído por feixes colágenos de trajetória semicircular, envolvendo de forma incompleta o óstio atrioventricular, uma vez que era ausente na região ântero-medial do óstio. Verificou-se que os feixes miocárdicos ventriculares inseriam-se de forma oblíqua, na borda externa do anel, sendo que na região ântero-medial assumiam uma trajetória semicircular. Os folhetos da valva mitral eram constituídos de feixes colágenos dispostos, paralelamente, no sentido do maior eixo da válvula, recobertos pelo endocárdio atrial e ventricular. Os feixes colágenos, presentes na base dos folhetos valvares, praticamente se continuavam com os do anel fibroso. Observou-se, em alguns casos, a existência de delgados feixes miocárdios atriais no folheto valvar anterior, que praticamente eram restritos à região central das válvulas. CONCLUSÃO: Os folhetos da valva mitral e seu anel fibroso possuem uma continuidade estrutural, que demonstra que estes elementos funcionam de forma integrada no fechamento do óstio atrioventricular esquerdo durante a sístole ventricular, no que seria auxiliado pela redução do diâmetro do anel fibroso, através da contração dos feixes miocárdicos semicirculares que nele se inserem.

Plasmodium coatneyi-infected rhesus monkeys: a primate modelfor human cerebral malaria

Although several animal models for human cerebral malaria have been proposed in the past, name have shown pathological findings that are similar to those seen in humans. In order to develop an animal model for human cerebral malaria, we studied the pathology of brains of Plasmodium coatneyi (primate malaria parasite)-infected rhesus monkeys. Our study demonstrated parazitized erythrocyte (PRBC) sequestration and cytoadherence of knobs on PRBC to endothelial cells in cerebral microvessels of these monkeys. This similar to the findings een in human cerebral malaria. Crebral microvessels with sequestred PRBC were shown by immunohistochemistry to possess CD36, TSP and ICAM-1. These proteins were not evident in cerebral microvessels of uninfected control monkeys. Our study indicates, for the first time, that rhesus monkeys infected with P. coatneyi can be used as a primate model to study human cerebral malaria.

Multicenter Brazilian Study of Oral Candida Species Isolated from Aids Patients

Oropharyngeal candidiasis continues to be considered the most common opportunistic disease in Aids patients. This study was designed to investigate species distribution, serotype and antifungal susceptibility profile among Candida spp. isolated from the oral cavity of Aids patients recruited from six Brazilian university centers. Oral swabs from 130 Aids patients were plated onto CHROMagar Candida medium and 142 isolates were recovered. Yeast isolates were identified by classical methods and serotyped using the Candida Check® system-Iatron. Antifungal susceptibility testing was performed according to the NCCLS microbroth assay. C. albicans was the most frequently isolated species (91%), and 70% of the isolates belonged to serotype A. We detected 12 episodes of co-infection (9%), including co-infection with both serotypes of C. albicans. Non-albicans species were isolated from 12 episodes, 50% of them exhibited DDS or resistance to azoles. Otherwise, only 8 out 130 isolates of C. albicans exhibited DDS or resistance to azoles. Brazilian Aids patients are infected mainly by C. albicans serotype A, most of them susceptible to all antifungal drugs.

Candida dubliniensis identification in Brazilian yeast stock collection

We investigated the presence of Candida dubliniensis among isolates previously identified as Candida albicans and maintained in a yeast stock collection from 1994 to 2000. All isolates were serotyped and further evaluated for antifungal susceptibility profile. After doing a screening test for C. dubliniensis isolates based on the capability of colonies to grow at 42°C, its final identification was obtained by randomly amplified polymorphic DNA (RAPD) analysis using three different primers. A total of 46 out of 548 screened isolates did not exhibit growth at 42°C and were further genotyped by RAPD. Eleven isolates were identified as C. dubliniensis with RAPD analysis. Regarding serotypes, 81.5% of C. albicans and all C. dubliniensis isolates belonged to serotype A. Of note, 9 out of 11 C. dubliniensis isolates were obtained from patients with acquired immunodeficiency syndrome (Aids) and all of them were susceptible to azoles and amphotericin B. We found 17 (3%) C. albicans isolates that were dose-dependent susceptibility or resistant to azoles. In conclusion, we found a low rate of C. dubliniensis isolates among stock cultures of yeasts previously identified as C. albicans. Most of these isolates were recovered from oral samples of Aids patients and exhibited high susceptibility to amphotericin B and azoles. C. albicans serotype A susceptible to all antifungal drugs is the major phenotype found in our stock culture.

Larvicidal Activity of essential oils from Brazilian plants against Aedes aegypti L.

Aedes aegypti L. is the major vector of dengue fever, an endemic disease in Brazil. In an effort to find effective and affordable ways to control this mosquito, the larvicidal activities of essential oils from nine plants widely found in the Northeast of Brazil were analyzed by measurement of their LC50. The essential oils were extracted by steam distillation and their chemical composition determined by GL-chromatography coupled to mass spectroscopy. The essential oils from Cymbopogon citratus and Lippia sidoides, reported in the literature to have larvicidal properties against A. aegypti, were used for activity comparison. The results show that Ocimum americanum and Ocimum gratissimum have LC50 of 67 ppm and 60 ppm respectively, compared to 63 ppm for L. sidoides and 69 ppm for C. citratus. These results suggest a potential utilization of the essential oil of these two Ocimum species for the control of A. aegypti.

Detection of IgG1 and IgG4 subtypes reactive against potato apyrase in schistosomiasis patients

In this paper, we showed for the first time that the conserved domains within Schistosoma mansoni ATP diphosphohydrolase isoforms, shared with potato apyrase, possess epitopes for the IgG1 and IgG4 subtypes, as 24 (80%) of the 30 schistosomiasis patients were seropositive for this vegetable protein. The analyses for each patient cured (n = 14) after treatment (AT) with praziquantel revealed variable IgG1 and IgG4 reactivity against potato apyrase. Different antigenic epitopes shared between the vegetable and parasite proteins could be involved in susceptibility or resistance to S. mansoni AT with praziquantel and these possibilities should be explored.

Antibody reactivity against potato apyrase, a protein that shares epitopes with Schistosoma mansoni ATP diphosphohydrolase isoforms, in acute and chronically infected mice, after chemotherapy and reinfection

Schistosoma mansoni ATP diphosphohydrolase isoforms and potato apyrase share conserved epitopes. By enzyme-linked immunosorbent assays, elevated levels of IgM, IgG2a and IgG1 antibody reactivity against potato apyrase were observed in S. mansoni-infected BALB/c mice during the acute phase of infection, while only IgM and IgG1 antibody reactivity levels maintained elevated during the chronic phase of infection. Antibody reactivity against potato apyrase was monitored over an 11-month period in chronically-infected mice treated with oxamniquine. Eleven months later, the level of seropositive IgM decreased significantly (~30%) compared to the level found in untreated, infected mice. The level of seropositive IgG1 decreased significantly four months after treatment (MAT) (61%) and remained at this level even after 11 months. The IgG2a reactivity against potato apyrase, although unchanged during chronic phase to 11 MAT, appeared elevated again in re-infected mice suggesting a response similar to that found during the acute phase. BALB/c mouse polyclonal anti-potato apyrase IgG reacted with soluble egg antigens probably due to the recognition of parasite ATP diphosphohydrolase. This study, for the first time, showed that the IgG2a antibody from S. mansoni-infected BALB mice cross-reacts with potato apyrase and the level of IgG2a in infected mice differentiates disease phases. The results also suggest that different conserved-epitopes contribute to the immune response in schistosomiasis.

Immunostimulatory property of a synthetic peptide belonging to the soluble ATP diphosphohydro-lase isoform (SmATPDase 2) and immunolocalisation of this protein in the Schistosoma mansoni egg

A peptide (SmB2LJ; r175-194) that belongs to a conserved domain from Schistosoma mansoni SmATPDase 2 and is shared with potato apyrase, as predicted by in silico analysis as antigenic, was synthesised and its immunostimulatory property was analysed. When inoculated in BALB/c mice, this peptide induced high levels of SmB2LJ-specific IgG1 and IgG2a subtypes, as detected by enzyme linked immunosorbent assay. In addition, dot blots were found to be positive for immune sera against potato apyrase and SmB2LJ. These results suggest that the conserved domain r175-194 from the S. mansoni SmATPDase 2 is antigenic. Western blots were performed and the anti-SmB2LJ antibody recognised in adult worm (soluble worm antigen preparation) or soluble egg antigen antigenic preparations two bands of approximately 63 and 55 kDa, molecular masses similar to those predicted for adult worm SmATPDase 2. This finding strongly suggests the expression of this same isoform in S. mansoni eggs. To assess localisation of SmATPDase 2, confocal fluorescence microscopy was performed using cryostat sections of infected mouse liver and polyclonal antiserum against SmB2LJ. Positive reactions were identified on the external surface from the miracidium in von Lichtenberg's envelope and, in the outer side of the egg-shell, showing that this soluble isoform is secreted from the S. mansoni eggs.