Os Sistemas de Informação Geográfica e Detecção Remota na Determinação das Regiões de Risco por Malária na Guiné-Bissau

A malária é uma doença infecciosa complexa, que resulta do “vírus” plasmodium, e manifesta-se sob cinco tipos distintos de espécies protozoários (plasmodium vivax, plasmodium ovale, plasmodium falciparum, plasmodium malariae e plasmodium Knowlesi), atacando sobretudo os glóbulos vermelhos. Considerada a quinta maior causa de morte por doenças infecciosas em todo o mundo após doenças respiratórias, VIH/SIDA, doenças diarreicas e tuberculose, no continente africano, a malária é considerada a segunda causa do aumento da mortalidade, após VIH/SIDA. No caso particular da Guiné-Bissau, esta constitui a principal causa do incremento da morbilidade e da mortalidade naquele país, onde, em 2012 foram notificados 129.684 casos de paludismo, dos quais 370 resultaram em óbitos. Partindo da realidade acima constatada, em particular, da complexidade e o impacto global da doença associada a uma forte mortalidade e morbilidade, concluiu-se ser necessário abordar esta temática, utilizando os SIG e a DR no sentido de determinar as regiões de elevado risco. Entendeu-se serem necessárias novas abordagens e novas ferramentas de análise dos dados epidemiológicos e consequentemente novas metodologias que possibilitem a determinação de áreas de risco por malária. O presente estudo, pretende demonstrar o papel dos SIG e DR na determinação das regiões de risco por malária. A metodologia utilizada centrou-se numa abordagem quantitativa baseada na hierarquização das variáveis. Pretende-se, assim abordar os impactos da malária e simultaneamente demonstrar as potencialidades dos SIG e das ferramentas de Análise Espacial no estudo da disseminação da mesma na Guiné-Bissau.

PFO closure vs. medical therapy in cryptogenic stroke or transient ischemic attack: A systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: This study aims to assess whether patent foramen ovale (PFO) closure is superior to medical therapy in preventing recurrence of cryptogenic ischemic stroke or transient ischemic attack (TIA). METHODS: We searched PubMed for randomized trials which compared PFO closure with medical therapy in cryptogenic stroke/TIA using the items: "stroke or cerebrovascular accident or TIA" and "patent foramen ovale or paradoxical embolism" and "trial or study". RESULTS: Among 650 potentially eligible articles, 3 were included including 2303 patients. There was no statistically significant difference between PFO-closure and medical therapy in ischemic stroke recurrence (1.91% vs. 2.94% respectively, OR: 0.64, 95%CI: 0.37-1.10), TIA (2.08% vs. 2.42% respectively, OR: 0.87, 95%CI: 0.50-1.51) and death (0.60% vs. 0.86% respectively, OR: 0.71, 95%CI: 0.28-1.82). In subgroup analysis, there was significant reduction of ischemic strokes in the AMPLATZER PFO Occluder arm vs. medical therapy (1.4% vs. 3.04% respectively, OR: 0.46, 95%CI: 0.21-0.98, relative-risk-reduction: 53.2%, absolute-risk-reduction: 1.6%, number-needed-to-treat: 61.8) but not in the STARFlex device (2.7% vs. 2.8% with medical therapy, OR: 0.93, 95%CI: 0.45-2.11). Compared to medical therapy, the number of patients with new-onset atrial fibrillation (AF) was similar in the AMPLATZER PFO Occluder arm (0.72% vs. 1.28% respectively, OR: 1.81, 95%CI: 0.60-5.42) but higher in the STARFlex device (0.64% vs. 5.14% respectively, OR: 8.30, 95%CI: 2.47-27.84). CONCLUSIONS: This meta-analysis does not support PFO closure for secondary prevention with unselected devices in cryptogenic stroke/TIA. In subgroup analysis, selected closure devices may be superior to medical therapy without increasing the risk of new-onset AF, however. This observation should be confirmed in further trials using inclusion criteria for patients with high likelihood of PFO-related stroke recurrence.

Officium parvum beatae Mariae virginis.

Petit office de la Vierge noté. Le texte des hymnes est antérieur à la réforme d'Urbain VIII. F. 1 Titre. «Officia beatae Mariae virginis. Marevillae. Anno Domini MDCCLXXXII». F. 2-46 «Officium [parvum] b. Mariae virginis. Ad matutinum» (2-16v); par suite de lacune matérielle entre les ff. 10 et 11 il manque la première antienne et le Ps 95 du 3e nocturne. — Ad laudes (17-22v). Par suite d'une lacune matérielle entre les ff. 16 et 17, il manque les deux premières antiennes, le Ps 92 et le premier verset du Ps 99. — «Ad primam» (23-25). — «Ad tertiam» (25-27). — «Ad sextam» (27-29). — «Ad nonam» (29-31). — Ad vesperas (32-36v). Par suite d'une lacune matérielle entre les ff. 31 et 32, il manque la première antienne et le Ps 109. — «Tempore adventus antiphonae» (37-38v); «A nativitate ad purificationem» [antiphonae] (38v-40v). — «Ad completorium» (41-46) avec les antiennes finales. Hymnes signalées dans la table des incipit.

[La salle à manger de la maison gothique et le salon de la maison chinoise] : [dessin] / Jn Jques Le Queu inv. et delin.

Comprend : Géometral de la salle à manger de la maison gothique, côté de la porte d'ogive ; Géometral du salon de la maison chinoise, côté de la porte ovale du temple de la lumière

Le rôle des états prothrombotiques dans l’AVC du jeune adulte

Introduction: Au moins 30% des AVC ischémiques chez les jeunes demeurent inexpliqués malgré une investigation extensive. Le rôle de certains états prothrombotiques (ÉP) dans la thrombose artérielle reste incertain, possiblement à cause du petit nombre de patients, de populations hétérogènes ou d’ÉP analysés individuellement dans les études antérieures, alors que leur prévalence est basse. Méthodologie : Étude cas-témoins sur une cohorte rétrospective (2002-2011). Les patients âgés de ≤50ans lors d’un AVC ischémique furent identifiés sur une base de données hospitalière. Après exclusion des individus ayant une investigation étiologique incomplète, un syndrome antiphospholipide ou aucun ÉP testé, la cohorte fut divisée en groupes cas (AVC idiopathique) et témoins (étiologie identifiée). La prevalence de chaque ÉP fut comparée entre les groupe, ainsi que la présence de ≥2 ÉP (analyse primaire), sans et avec ajustement pour les facteurs de risque non-prothrombotiques (régression logistique). En analyse de sous-groupe, la présence de ≥1 ÉP fut comparée entre les cas avec versus sans foramen ovale perméable (FOP), entre les cas ou contrôles porteurs d’un FOP avec versus sans migraine, de même qu’entre les cas versus témoins de sexe féminin en incluant la contraception orale parmi les ÉP. Résultats : 502 jeunes avec AVC ischémique furent identifiés. Après exclusion de 108 patients, 184 cas et 210 témoins furent comparés, (âge moyen : 39,2 ans, 51% hommes). La prévalence des ÉP ne différait pas entre les cas et contrôles : déficits en protéine S (0,6%), protéine C (3,4%), antithrombine (1,2%), mutation de la prothrombine (2,5%), facteur V Leiden (4,6%), et anticardiolipines (titre 15-40 unités GPL ou MPL; 3,3%). La présence de ≥2 ÉP n’était pas associée à l’AVC idiopathique, avant (p=0,48) ou après ajustement (p=0,74). La présence de ≥1 ÉP ne différait pas entre les sous-groupes étudiés. Conclusion: Il n’y a pas d’association entre les ÉP, isolés ou en association, avec l’AVC ischémique idiopathique chez les jeunes, même en presence de FOP ou de migraine.

Seguimiento a largo plazo de pacientes sometidos a cierre percutáneo de foramen oval y comunicación interauricular

Objetivo: Describir los eventos ocurridos en el seguimiento a largo plazo de pacientes llevados a cierre percutáneo de FOP y CIA con dispositivo Amplatzer® Materiales y métodos: Estudio de seguimiento en donde se seleccionó una cohorte histórica de pacientes llevados a cierre percutáneo del FOP y CIA con dispositivo Amplatzer desde el año 2001 hasta el 2013, De los 92 (100%) pacientes intervenidos, se realizó seguimiento clínico a 55 (60%) pacientes, y 37 (40%) pacientes no se pudieron contactar, se revisaron registros médicos y se realizarón entrevistas telefónicas. Resultados: La edad promedio de los pacientes fue de 58 años, con una mediana de 62 años, el 73% de las intervenciones fueron realizadas en mujeres. Se realizaron 30 (55%) cierres percutáneos de CIA y 25 (45%) cierres de FOP, se presentaron dos complicaciones secundarias al procedimiento 3.6% (reacción alérgica y hematoma hepático), el diámetro del defecto septal fue 15 mm (DE 9),y una mediana de 16 mm, El tamaño del dispositivo implantado fue de 40 mm (DE 3.9 mm) (13 mm y 34 mm). El seguimiento registró un tiempo promedio de 44 meses (DE 28,6), (7-114 meses) con una mediana de 36 meses, no se registraron eventos, la probabilidad de supervivencia de este grupo de pacientes fue del 100% y la probabilidad de muerte fue del 0%.

Comparison of two methods for collecting free-living ticks in the Amazonian forest

In the present study, we compared 2 methods for collecting ixodid ticks on the verges of animal trails in a primary Amazon forest area in northern Brazil. (i) Dragging: This method was based on passing a 1-m(2) white flannel over the vegetation and checking the flannel for the presence of caught ticks every 5-10 m. (ii) Visual search: This method consisted of looking for guesting ticks on the tips of leaves of the vegetation bordering animal trails in the forest. A total of 103 adult ticks belonging to 4 Amblyomma species were collected by the visual search method on 5 collecting dates, while only 44 adult ticks belonging to 3 Amblyomma species were collected by dragging on 5 other collecting dates. These values were statistically different (Mann-Whitney Test, P = 0.0472). On the other hand, dragging was more efficient for subadult ticks, since no larva or nymph was collected by visual search, whereas 18 nymphs and 7 larvae were collected by dragging. The visual search method proved to be suitable for collecting adult ticks in the Amazon forest: however, field studies should include a second method, such as dragging in order to maximize the collection of subadult ticks. Indeed, these 2 methods can be performed by a single investigator at the same time, while he/she walks on an animal trail in the forest. (C) 2010 Elsevier GmbH. All rights reserved.

Antimicrobial activity in the tick Rhipicephalus (Boophilus) microplus eggs: Cellular localization and temporal expression of microplusin during oogenesis and embryogenesis

Arthropods display different mechanisms to protect themselves against infections, among which antimicrobial peptides (AMPs) play an important role, acting directly against invader pathogens. We have detected several factors with inhibitory activity against Candida albicans and Micrococcus luteus on the surface and in homogenate of eggs of the tick Rhipicephalus (Boophilus) microplus. One of the anti-M. luteus factors of the egg homogenate was isolated to homogeneity. Analysis by electrospray mass spectrometry (ESI-MS) revealed that it corresponds to microplusin, an AMP previously isolated from the cell-free hemolymph of X (B.) microplus. Reverse transcription (RT) quantitative polymerase chain reactions (qPCR) showed that the levels of microplusin mRNA gradually increase along ovary development, reaching an impressive highest value three days after the adult females have dropped from the calf and start oviposition. Interestingly, the level of microplusin mRNA is very low in recently laid eggs. An enhance of microplusin gene expression in eggs is observed only nine days after the onset of oviposition, achieving the highest level just before the larva hatching, when the level of expression decreases once again. Fluorescence microscopy analysis using an anti-microplusin serum revealed that microplusin is present among yolk granules of oocytes as well as in the connecting tube of ovaries. These results, together to our previous data. suggest that microplusin may be involved not only in protection of adult female hemocele, but also in protection of the female reproductive tract and embryos, what points this AMP as a considerable target for development of new methods to control R. (B.) microplus as well as the vector-borne pathogens. (c) 2009 Elsevier Ltd. All rights reserved.

A new tick Kunitz type inhibitor, Amblyomin-X, induces tumor cell death by modulating genes related to the cell cycle and targeting the ubiquitin-proteasome system

The aim of this study was to evaluate the anti-tumor activity of Amblyomin-X, a serine protease Kunitz-type inhibitor. Amblyomin-X induced tumor mass regression and decreased number of metastatic events in a B16F10 murine melanoma model. Alterations on expression of several genes related to cell cycle were observed when two tumor cell lines were treated with Amblyomin-X. PSMB2, which encodes a proteasome subunit, was differentially expressed, in agreement to inhibition of proteasomal activity in both cell lines. In conclusion, our results indicate that Amblyomin-X selectively acts on tumor cells by inducing apoptotic cell death, possibly by targeting the ubiquitin-proteasome system. (C) 2010 Elsevier Ltd. All rights reserved.

Diversidade e potencial zoonótico de parasitos de Didelphis albiventris Lund, 1841 (Marsupialia: Didelphidae)

Didelphis albiventris, gambá-de-orelha-branca, é um marsupial de hábitos crepusculares e noturnos que se alimenta de frutos, insetos, pequenos répteis e anfíbios, filhotes de aves e pequenos mamíferos. Com a destruição de seu “habitat” natural devido às queimadas e desmatamentos, esses animais têm-se aproximado, cada vez mais, das regiões peridomiciliar e domiciliar, onde procuram abrigo e alimentos. Com o objetivo de conhecer a diversidade de parasitos de D. albiventris e relatar os que apresentam potencial zoonótico, foram examinados 30 exemplares desta espécie, através de necropsia, para coleta de ectoparasitos da superfície externa do corpo e helmintos dos órgãos e conteúdos estomacal e intestinal. Os sifonápteros foram removidos da superfície externa dos animais, conservados em álcool etílico a 70°GL, clarificados em líquido de Nesbitt, desidratados em etanol, diafanizados em creosoto de Faya e montados em lâminas com bálsamo do Canadá para identificação. Os carrapatos foram removidos da superfície externa dos animais, conservados em álcool etílico a 70°GL e identificados ao estereomicroscópio, segundo chaves específicas de Aragão & Fonseca (1961) e Guimarães et al (2001). Os helmintos foram recolhidos com auxílio de estiletes e pinças, clarificados em lactofenol e montados entre lâminas e lamínulas com bálsamo do Canadá para identificação ao microscópio. Do total de animais examinados, 70% estavam infestados com pulgas das espécies Polygenis (Neopolygenis) atopus, Polygenis (Polygenis) rimatus, Polygenis (Polygenis) roberti roberti, Polygenis (Polygenis) sp., Craneopsylla minerva minerva e Ctenocephalides felis felis, todas essas registradas pela primeira vez sobre D. albiventris e, exceto C. felis felis, são também registradas pela primeira vez no estado do Rio Grande do Sul. Carrapatos foram encontrados em 43,33% dos animais examinados, representados pelas espécies Ixodes loricatus, Amblyomma aureolatum e Amblyomma sp, sendo A. aureolatum registrado pela primeira vez parasitando D. albiventris no Brasil. Os helmintos encontrados foram: Filo Nematoda - Capillaria spp. (esôfago, traquéia, faringe e pulmão), Didelphostrongylus hayesi (pulmão), Turgida turgida (estômago), Gnathostoma sp. (estômago e fígado), Travassostrongylus orloffi, Viannaia hamata e Trichuris minuta no intestino delgado e Trichuris didelphis, Cruzia tentaculata e Aspidodera raillieti no intestino grosso; Classe Trematoda – Echinostoma revolutum, Plagiorchis didelphidis, Rhopalias coronatus, R. baculifer, Brachylaema migrans e Didelphodiplostomum variabile, todos no intestino delgado; Classe Cestoda – exemplares da família Diphyllobotriidae, no intestino delgado; e Filo Acanthocephala – Hamanniella microcephala e Centrorhynchus sp., ambos no intestino delgado. Dos helmintos encontrados, os que apresentam potencial zoonótico segundo a literatura são T. turgida, Gnathostoma sp., Capillaria spp., B. migrans, E. revolutum e Família Diphyllobotriidae. Além disso, os sifonápteros e ixodídeos encontrados são potenciais vetores de patógenos que infectam humanos. D. albiventris, portanto, apresenta grande diversidade parasitária, incluindo espécies que podem potencialmente atingir o homem, alertando para a importância destes marsupiais na disseminação de doenças entre animais e humanos.

Atividade antimalárica de plantas medicinais da biorregião do Araripe-CE em modelo murino - Plasmodium berghei

Malaria, also popularly known as maleita , intermittent fever, paludism, impaludism, third fever or fourth fever, is an acute infectious febrile disease, which, in human beings, is caused by four species: Plasmodium falciparum, P. vivax, P. malariae and P. ovale. Malaria, one of the main infectious diseases in the world, is the most important parasitoses, with 250 million annual cases and more than 1 million deaths per year, mainly in children younger than live years of age. The prophylactic and therapeutic arsenal against malaria is quite restricted, since all the antimalarials currently in use have some limitation. Many plant species belonging to several families have been tested in vivo, using the murine experimental model Plasmodium berghei or in vitro against P. falciparum, and this search has been directed toward plants with antithermal, antimalarial or antiinflammatory properties used in popular Brazilian bolk medicine. Studies assessing the biological activity of medicinal plant essential oils have revealed activities of interest, such as insecticidal, spasmolytic and antiplasmodic action. It has also been scientifically established that around 60% of essential oils have antifungal properties and that 35% exhibit antibacterial properties. In our investigation, essential oils were obtained from the species Vanillosmopsis arborea, Lippia sidoides and Croton zethneri which are found in the bioregion of Araripe-Ceará. The chemical composition of these essential oils was partially characterized and the presence of monoterpenes and sesquiterpenes. The acute toxicity of these oils was assessed in healthy mice at different doses applied on a single day and on four consecutive days, and in vitro cytotoxicity in HeLa and Raw cell lines was determined at different concentrations. The in vivo tests obtained lethal dose values of 7,1 mg/Kg (doses administered on a single day) and 1,8 mg/Kg (doses administered over four days) for 50% of the animals. In the in vitro tests, the inhibitory concentration for 50% of cell growth in Hela cell lines was 588 μg/mL (essential oil from C. zethneri after 48 h), from 340-555 μg/mL (essential oil from L. sidoides, after 24 and 48 h). The essential oil from V. arborea showed no cytotoxicity and none of the essential oils were cytotoxic in Raw cell lines. These data suggest a moderate toxicity in the essential XVIII oils under study, a finding that does not impede their testing in in vivo antimalarial assays. Was shown the antimalarial activity of the essential oils in mice infected with P. berghei was assessed. The three species showed antimalarial activity from 36%-57% for the essential oil from the stem of V. arborea; from 32%-82% for the essential oil from the leaves of L. sidoides and from 40%-70% of reduction for the essential oil from the leaves of C. zethneri. This is the first study showing evidence of antimalarial activity with these species from northeast Brazil. Further studies to isolate the active ingredients of these oils are needed to determine if a single active ingredient accounts for the antimalarial activity or if a complex integration of all the compounds present occurs, a situation reflected in their biological activity

Avaliação da atividade antimalárica de extratos obtidos de algas marinhas no litoral do Rio Grande do Norte

Malaria is a major parasitic disease worldwide, accounting for about 500 million cases and causing 2 million to 3 million deaths annually. Four species are responsible for transmitting this disease to humans: Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale. The parasite resistance to antimalarial drugs and the usual limitations of the vector control implications are contributing to the spread of the disease. The most of significant advances in the search for new antimalarial drugs is based on natural components, the main ones being currently used antimalarial drugs derived from plants. Research on natural products of marine origin (particularly algae) show that some species possess antiplasmodial activity. Knowing that the coast of Rio Grande do Norte is home to several species of algae, the present study was to evaluate, for the first time, the antimalarial activity of ethanolic extracts of seaweed Spatoglossum schroederi, Gracilaria birdiae and Udotea flabellum against Plasmodium falciparum 3D7 strain tests and in vitro using the murine model (Plasmodium berghei) for evaluation in vivo. These species were ground, macerated with ethanol for 24 hours and the extracts concentrated in rotaevaporador (45 ° C ± 5 ° C). For in vitro tests, the extracts were diluted and tested at concentrations between 100 and 1.56 μg/ml (seven concentrations in triplicate), in order to obtain IC50 of each extract. The cytotoxicity tests with macrophages and BGM were performed using the MTT colorimetric assay. BGM macrophages and cells were distributed in 96 wells per plate (1x 105 to macrophages and 1x104 cells per well for BGM) and incubated for 24h at 37 ° C. The ethanol extracts were diluted and tested at concentrations of 100 to 1,56 μg/ml (seven concentrations in triplicate). After periods of 24 hours of incubation with the extracts, 100 μg of MTT was added to each well, and 3 hours elapsed, the supernatant was removed and added 200 μl of DMSO in each well. The absorbance of each well was obtained by reading on a spectrophotometer at 570 nm filter. To evaluate the acute toxicity in vivo, Swiss mice received a single dose (oral) 2000 mg/kg/animal of each extract tested. The parameters of acute toxicity were observed for 8 days. For in vivo tests, Swiss mice were inoculated with 1x105 erythrocytes infected with P. berghei. The treatment was given first to fourth day after infection with 0.2 ml of the extracts in doses of 1000 and 500 mg//g animal. The negative control group received 0.2 ml of 2% Tween-20, whereas the positive control group received sub-dose of chloroquine (5 mg/kg/animal). The assessment of antimalarial activity was done by suppressing suppressing the parasitemia at 5 and 7 days after infection. The growth inhibition of parasites was determined relative to negative control (% inhibition = parasitaemia in control - parasitemia in sample / parasitemia control x 100), the mortality of animals was monitored daily for 30 days The results showed that algae Spatoglossum schroederi and Udotea flabellum showed antimalarial activity in vitro, with reduced parasitemia of 70.54% and 54, respectively. The extracts of the three algae tested showed moderate to high cytotoxicity. Algae S. schroederi and U. flabellum were active against P. berghei only at doses of 500 mg / kg with reduction ranging from 54.58 to 52.65% for the fifth day and from 32.24 to 47.34% for the seventh day, respectively. No toxicity was observed in vivo at the dose tested, over the 8 days of observation. Although preliminary data, the bioactive components in those possible seaweed may be promising for the development of new anti-malarial drugs

Factors associated to Theileria equi in equids of two microregions from Rio de Janeiro, Brazil

Amostras de soro de 714 equídeos das microrregiões de Itaguaí e Serrana, Rio de Janeiro, Brasil, foram submetidas ao teste de imunofluorescência indireta (título 1:80) para Theileria equi. A prevalência entre as microrregiões e os fatores associados à soropositividade foram avaliados e a razão de prevalência (RP) calculada. A prevalência geral para T. equi foi de 81,09% (n = 579), com maior prevalência (p < 0,05) para microrregião de Itaguaí (85,43%), quando comparado a Serrana (76,92%). A região, altitude, nível da propriedade e origem dos equídeos foram associados (p < 0,05) com a soropositividade para T. equi. Equídeos criados na microrregião de Itaguaí (RP = 1,11; p = 0,003) e em altitudes abaixo de 500 m (RP = 1.10; p = 0,014) apresentaram maior chance de se tornarem soropositivos para T. equi. Além disso, quando são criados em propriedades de nível ruim (RP = 1,13; p = 0,018) e nascidos na propriedade (RP = 1,10; p = 0,008) apresentaram mais chance de terem contato com T. equi. As principais espécies de carrapatos encontradas parasitando os equídeos foram Amblyomma cajennense e Dermacentor (Anocentor) nitens. As microrregiões estudadas são endêmicas para theileriose equina e de estabilidade enzoótica para T. equi. Apenas os fatores relacionados à área de coleta das amostras de soro influenciaram a soropositividade dos equídeos para T. equi naquela região.

Brazilian spotted fever: A reemergent zoonosis

Brazilian spotted fever is caused by the bacterium Rickettsia rickettsii, which is the most pathogenic species of the spotted-fever rickettsiae group and is transmitted by the bite of infected ticks. Amblyomma cajennense is the most important tick species involved in the cycle of this zoonosis in Brazil as it presents low host specificity, great number of natural reservoirs and wide geographic distribution. It was first described in the state of São Paulo in 1929 and later in Rio de Janeiro, Minas Gerais and Bahia. The number of cases decreased in the 1940's with the development of new plague control techniques and antibiotics. In the last decades, the number of new cases has increased. The current review aimed at reporting some of the epidemiological and public health aspects of this reemergent disease with new foci, mainly in the southeastern region of Brazil.