Relato de nematóides da família Anisakidae em bacalhau comercializado em Ribeirão Preto, SP

A anisaquíase é uma parasitose gastrointestinal dos seres humanos, resultante da ingestão acidental de larvas infectantes de nematóides da família Anisakidae. Foram analisadas 11 amostras de bacalhau sendo que 64% estavam em desacordo com a legislação em vigor por conter nematóides da família Anisakidae e, portanto, impróprias para o consumo.

Avaliação da contaminação de hortas produtoras de verduras após a implantação do sistema de fiscalização em Ribeirão Preto, SP

O estudo avaliou a contaminação microbiológica e parasitológica de 88 hortas produtoras de verduras, das quais 47 haviam sido investigadas anteriormente. A taxa de contaminação foi de 38,3% nas hortas previamente investigadas e de 43,9% nas novas hortas. A segurança alimentar requer um contínuo e eficiente sistema de vigilância sanitária das hortas.

Prevalência, fatores de risco e caracterização genética dos vírus linfotrópico de células T humana tipo 1 e 2 em pacientes infectados pelo vírus da imunodeficiência humana tipo 1 nas Cidades de Ribeirão Preto e São Paulo

O objetivo deste estudo foi definir a prevalência dos vírus linfotrópico de células T humana tipo 1 e 2 em pacientes positivos para o vírus da imunodeficiência humana tipo 1 no Estado de São Paulo, Brasil. Avaliamos 319 indivíduos atendidos em clínicas de Ribeirão Preto e Capital. Os pacientes foram entrevistados e testados sorologicamente. Foram seqüenciadas as regiões tax e long terminal repeat para diferenciação e determinação do subtipo. A soroprevalência geral foi de 7,5% (24/319) e esteve associada somente com uso de drogas injetáveis e ao vírus da hepatite tipo C (p<0, 001). O genoma viral foi detectado em 13 das 24 amostras, sendo 12 caracterizadas como HTLV-2 subtipo 2c e uma como 1a. Nossos dados mostraram que o uso de drogas injetáveis é um importante fator de risco para a transmissão de HTLV-2 em populações infectadas pelo vírus da imunodeficiência humana tipo 1.

Hepatitis B virus genotyping among chronic hepatitis B patients with resistance to treatment with lamivudine in the City of Ribeirão Preto, State of São Paulo

INTRODUCTION: Lamivudine is a nucleoside analogue that is used clinically for treating chronic hepatitis B infection. However, the main problem with prolonged use of lamivudine is the development of viral resistance to the treatment. Mutations in the YMDD motif of the hepatitis B virus DNA polymerase gene have been associated with resistance to drug therapy. So far, there have not been many studies in Brazil reporting on genotype-dependent development of resistance to lamivudine. Thus, the aim of the present study was to determine the possible correlation between a certain genotype and increased development of resistance to lamivudine among chronic hepatitis B patients. METHODS: HBV DNA in samples from 50 patients under lamivudine treatment was amplified by means of conventional PCR. Samples were collected at Hospital das Clínicas, FMRP-USP. The products were then sequenced and phylogenetic analysis was performed. RESULTS: Phylogenetic analysis revealed that 29 (58%) patients were infected with genotype D, 20 (40%) with genotype A and one (2%) with genotype F. Mutations in the YMDD motif occurred in 20% of the patients with genotype A and 27.6% of the patients with genotype D. CONCLUSIONS: Despite the small number of samples, our results indicated that mutations in the YMDD motif were 1.38 times more frequent in genotype D than in genotype A.

Diagnosis of hantavirus infection in humans and rodents in Ribeirão Preto, State of São Paulo, Brazil

INTRODUCTION: Hantavirus pulmonary and cardiovascular syndrome (HPCS) is an emerging serious disease in the Americas. Hantaviruses (Bunyaviridae) are the causative agents of this syndrome and are mainly transmitted through inhalation of aerosols containing the excreta of wild rodents. In the Ribeirão Preto region (state of São Paulo, Brazil), HPCS has been reported since 1998, caused by the Araraquara virus (ARAV), for which Necromys lasiurus is the rodent reservoir. This study aimed to show diagnostic results relating to infection in humans and rodents, obtained at the Virology Research Center of the Ribeirão Preto School of Medicine, University of São Paulo, between 2005 and 2008. METHODS: HPCS was diagnosed by means of ELISA and/or RT-PCR in 11 (21.2%) out of 52 suspected cases, and 54.4% of these were fatal. Furthermore, 595 wild rodents (Necromys lasiurus, Akodon sp, Calomys tener and Oligoryzomys sp) were caught between 2005 and 2008. RESULTS: Fifteen (2.5%) of these rodents presented antibodies for hantavirus, as follows: Necromys lasiurus (4%), Calomys tener (1.9%) and Akodon sp (1.5%). Nucleotide sequences obtained through RT-PCR from one HPCS patient and one Calomys tener rodent were compared with hantavirus sequences from GenBank, which showed that both were homologous with ARAV. CONCLUSIONS: This work corroborates previous studies showing that ARAV is the hantavirus causing HPCS in the Ribeirão Preto region. It also shows that rodents infected with hantavirus represent a constant risk of transmission of this virus to man.

Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infection in men attending STD clinics in Brazil

INTRODUCTION: The study aimed to assess the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections and identify demographic, behavioral and clinical factors correlated withsuch infections in men attending six sexually transmitted disease clinics in Brazil. METHODS: Multicentric, cross-sectional study performed among men attending STD clinics in Brazil. The study included STD clinics in six cities distributed throughout the five geographic regions of Brazil in 2005. Patients provided 20 ml of first catch urine for testing for NG and CT by DNA-PCR. RESULTS: A total of 767 (92.9%) men were included in the study. The mean age was 26.5 (SD 8.3) years-old. Prevalence of Chlamydia infection was 13.1% (95%CI 10.7%-15.5%) and gonorrhea was 18.4% (95%CI 15.7%-21.1%). Coinfection prevalence was 4.4% (95%CI 2.95%-5.85%) in men who sought attendance in STI clinics. Factors identified as associated with C. trachomatis were younger age (15-24) [OR=1.4 (95%CI 1.01-1.91)], present urethral discharge [OR=4.8 (95%CI 1.52-15.05)], genital warts [OR=3.0 (95%CI 1.49-5.92)] and previous history of urethral discharge [OR=2.4 (95%CI 1.11-5.18)]. Variables associated with gonorrhea were younger age (15 to 24) [OR=1.5 (95%CI 1.09-2.05)], presence of urethral discharge [OR=9.9 (95%CI 5.53-17.79)], genital warts [OR=18.3 (95%CI 8.03-41.60)] and ulcer present upon clinical examination [OR=4.9 (95%CI 1.06-22.73)]. CONCLUSIONS: These findings have important implications for education and prevention actions directed toward men at risk of HIV/STD. A venue-based approach to offer routine screening for young men in STD clinics should be stimulated.

Perfil clínico-epidemiológico dos casos de tétano acidental ocorridos em Ribeirão Preto, Estado de São Paulo, no período de 1990 a 2009

INTRODUÇÃO: O tétano continua sendo um grave problema de saúde pública nos países em desenvolvimento. No Brasil, apesar dos avanços tecnológicos, não houve um decréscimo significativo da taxa de letalidade nos últimos anos. Nesta casuística, foram analisados dados clínicos e epidemiológicos dos pacientes diagnosticados em Ribeirão Preto, nas últimas duas décadas. MÉTODOS: Este é um estudo retrospectivo que analisou dados dos pacientes internados por tétano acidental no Hospital das Clínicas de Ribeirão Preto, entre 1990 e 2009. O diagnóstico do tétano foi realizado segundo critérios do Ministério da Saúde do Brasil. RESULTADOS: Onze (47,8%), casos positivos, dos 23 suspeitos de tétano, foram incluídos neste estudo. Não houve mortes, mas dois (18,2%) pacientes apresentaram déficit neurológico permanente. O indicador prognóstico Tetanus Severity Score variou entre 0 a 8 pontos. A mediana da permanência hospitalar foi de 17 dias, variando de 6 a 98 dias. A ausência de óbitos pode ser explicada pelo diagnóstico clinico precoce da doença com instituição imediata de terapia. CONCLUSÕES: Ribeirão Preto é uma área onde o tétano não é um relevante problema de saúde pública.

Designing and implementing a performance measurement system in Auto Ribeiro, Lda.

In any business it is very important to measure the performance and it helps to select key information to make better decisions on time. This research focuses on the design and implementation of a performance measurement system in a Portuguese medium size firm operating in the specialized health care transformation vehicles industry. From the evidence that outputs from Auto Ribeiro’s current information system is misaligned with the company’s objectives and strategy, this research tries to solve this business problem through the development of a Balanced Scorecard analysis, although there are some issues, which deserve further development.

Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

INTRODUCTION: The purpose of this ecological study was to evaluate the urban spatial and temporal distribution of tuberculosis (TB) in Ribeirão Preto, State of São Paulo, southeast Brazil, between 2006 and 2009 and to evaluate its relationship with factors of social vulnerability such as income and education level. METHODS: We evaluated data from TBWeb, an electronic notification system for TB cases. Measures of social vulnerability were obtained from the SEADE Foundation, and information about the number of inhabitants, education and income of the households were obtained from Brazilian Institute of Geography and Statistics. Statistical analyses were conducted by a Bayesian regression model assuming a Poisson distribution for the observed new cases of TB in each area. A conditional autoregressive structure was used for the spatial covariance structure. RESULTS: The Bayesian model confirmed the spatial heterogeneity of TB distribution in Ribeirão Preto, identifying areas with elevated risk and the effects of social vulnerability on the disease. We demonstrated that the rate of TB was correlated with the measures of income, education and social vulnerability. However, we observed areas with low vulnerability and high education and income, but with high estimated TB rates. CONCLUSIONS: The study identified areas with different risks for TB, given that the public health system deals with the characteristics of each region individually and prioritizes those that present a higher propensity to risk of TB. Complex relationships may exist between TB incidence and a wide range of environmental and intrinsic factors, which need to be studied in future research.

Late diagnosis and HIV infection in children attending a service of specialized care for pediatric AIDS in Brazil

Introduction: This study describes the frequency of late diagnosis and HIV among children attending a pediatric AIDS clinic. Methods: Cross-sectional study in children exposed to HIV from 2005-2008. A questionnaire was given that included questions on demographics and clinical information. Results: Two-hundred twenty-one (97.8%) children were exposed to HIV during pregnancy/childbirth. A total of 193 (87.3%) children had late enrolment in the service and late access to HIV serology. The frequency of HIV was 21.3% (95% confidence interval [CI] 15.9%-26.7%). Protective factors were earlier diagnosis [odds ratio (OR)=0.17 (0.08-0.37)] and receiving complete prophylaxis [OR=0.29 (0.09-0.97)]; being born by vaginal delivery was a risk factor [OR=4.45 (1.47-13.47)]. Conclusions: There was a high frequency of late diagnosis in this patient cohort. Earlier diagnosis is an important measure for controlling HIV among children.

Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet

Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized. PURPOSE: In this study, the effect of a diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa. METHODS: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20th postoperative day). Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300) connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa. RESULTS: The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the without-glutamine diet group, though not significantly different from with standard-diet group. CONCLUSIONS: In rats with experimentally produced short-bowel syndrome, glutamine-enrichment of an isonitrogenous test diet was associated with an improved adaptation response by the intestinal mucosa but not reduced weight loss. However, the adaptation response in the group receiving the glutamine-enriched diet was not improved over that for the group fed regular chow.

Mechanical analysis of asphalt mixtures produced with waste plastic modified binders

This work compares the viscoelastic properties of an asphalt binder (70/100 pen) modified with different waste plastics and the mechanical properties of the resultant asphalt mixtures. Two different plastic wastes were used, namely recycled HDPE and EVA. Three different polymer modified binders were produced with these plastic wastes: i) 5% HDPE modified binder (P5); ii) 5% EVA modified binder (E5) and; iii) a modified binder with 4% of EVA and 2% HDPE (E4P2). Asphalt mixtures were produced with these modified binders, and their mechanical properties were analysed and compared with a conventional mixture produced with a 30/50 pen bitumen. It was possible to conclude that these recycled polymers are able to improve the mechanical performance of the asphalt mixtures used in road paving.

Efeitos de um evento de friagem nas condições meteorológicas na Amazônia: um estudo de caso

A influência do fenômeno da friagem nas variáveis meteorológicas e nos fluxos de energia e CO2 , foi realizada numa área de floresta próxima à região de Ji-Paraná, Rondônia, durante o mês de junho de 2001. A friagem ocasionou uma diminuição de 35% no valor da temperatura do ar. Notou-se uma redução de 75 W.m-2, na radiação solar incidente, associada à nebulosidade presente em decorrência da penetração da massa de ar fria. Conseqüentemente, tanto o fluxo de calor sensível (H) quanto o de calor latente (LE), apresentaram uma diminuição no seu valor médio diário, apresentando uma diferença em relação aos dias normais de 8 e 34%, respectivamente. A concentração de CO2 permaneceu constante, sem apresentar o aumento comum durante a noite, devido à condição de vento forte típica da friagem. Em situação normal o fluxo médio durante o dia de CO2 (-2,44 mmol m-2 s-1) foi menor que durante os dias de friagem (-5,78 mmol m-2 s-1); enquanto que os fluxos médios noturnos foram +1,77mmol m-2 s-1 e +2,83mmol m-2 s-1 durante situações de dias normais e de friagem, respectivamente.

Updating of the hierarchical rock mass rating (HRMR) system and a new subsystem developed for weathered granite formations

The RMR system is still very much applied in rock mechanics engineering context. It is based on the evaluation of six weights to obtain a final rating. To obtain the final rating a considerable amount of information is needed concerning the rock mass which can be difficult to obtain in some projects or project stages at least with accuracy. In 2007 an alternative classification scheme based on the RMR, the Hierarchical Rock Mass Rating (HRMR) was presented. The main feature of this system was the adaptation to the level of knowledge existent about the rock mass to obtain the classification of the rock mass since it followed a decision tree approach. However, the HRMR was only valid for hard rock granites with low fracturing degrees. In this work, the database was enlarged with approximately 40% more cases considering other types of granite rock masses including weathered granites and based on this increased database the system was updated. Granite formations existent in the north of Portugal including Porto city are predominantly granites. Some years ago a light rail infrastructure was built in the city of Porto and surrounding municipalities whi h involved considerable challenges due to the high heterogeneity levels of the granite formations and the difficulties involved in their geomechanical characterization. In this work it is intended to provide also a contribution to improve the characterization of these formations with special emphasis to the weathered horizons. A specific subsystem applicable to the weathered formations was developed. The results of the validation of these systems are presented and show acceptable performances in identifying the correct class using less information than with the RMR system.