In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

INTRODUCTION: The goal was to develop an in-house serological method with high specificity and sensitivity for diagnosis and monitoring of Chagas disease morbidity. METHODS: With this purpose, the reactivities of anti-T. cruzi IgG and subclasses were tested in successive serum dilutions of patients from Berilo municipality, Jequitinhonha Valley, Minas Gerais, Brazil. The performance of the in-house ELISA was also evaluated in samples from other relevant infectious diseases, including HIV, hepatitis C (HCV), syphilis (SYP), visceral leishmaniasis (VL), and American tegumentary leishmaniasis (ATL), and noninfected controls (NI). Further analysis was performed to evaluate the applicability of this in-house methodology for monitoring Chagas disease morbidity into three groups of patients: indeterminate (IND), cardiac (CARD), and digestive/mixed (DIG/Mix), based on their clinical status. RESULTS: The analysis of total IgG reactivity at serum dilution 1:40 was an excellent approach to Chagas disease diagnosis (100% sensitivity and specificity). The analysis of IgG subclasses showed cross-reactivity, mainly with NI, VL, and ATL, at all selected serum dilutions. Based on the data analysis, the IND group displayed higher IgG3 levels and the DIG/Mix group presented higher levels of total IgG as compared with the IND and CARD groups. CONCLUSIONS: These findings demonstrated that methodology presents promising applicability in the analysis of anti-T. cruzi IgG reactivity for the differential diagnosis and evaluation of Chagas disease morbidity.

Evaluation of the Chagas Disease Control Program in Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil

Introduction Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil temporarily (2001-2005) interrupted epidemiological surveillance for Chagas disease. The objective of this work was to evaluate the Chagas Disease Control Program (CDCP) in Açucena and to offer suggestions for improving local epidemiological surveillance. Methods This study was conducted in three phases: I) a serological investigation of schoolchildren aged 5 to 15 years using an enzyme-linked immunosorbent assay (ELISA) test performed on blood collected on filter paper followed by ELISA, indirect immunofluorescence (IIF) and indirect hemaglutination (IHA) on venous blood for borderline cases and those in the gray zone of reactivity; II) vector evaluation using the data obtained by local health agents during 2006-2010; and III) examination by ELISA, IIF and IHA of serum samples from the inhabitants of houses where infected Triatoma vitticeps was found and evaluation of their knowledge about Chagas disease. Results Five individuals had inconclusive results in the ELISA screening but were seronegative for Chagas disease. The triatomine evaluation revealed the presence of three species: Triatoma vitticeps, Panstrongylus megistus and Panstrongylus diasi. Triatoma vitticeps was the most prevalent and widespread, with a higher (67%) index of Trypanosoma cruzi flagellates and evidence of colonization. Most of the inhabitants of the infested houses recognized triatomines and had basic knowledge about Chagas disease. Conclusions Although T. vitticeps is not clearly associated with Chagas disease transmission, these results highlight the importance of maintaining CDCP in endemic areas and the need for greater emphasis on epidemiological surveillance, especially in areas with important vectorial changes or that have been modified by human intervention.

Clinical and laboratory status of patients with chronic Chagas disease living in a vector-controlled area in Minas Gerais, Brazil, before and nine years after aetiological treatment

Twenty-eight Chagas disease patients (CD), 22 with the indeterminate clinical form (IND) and six with the cardiac or digestive form (CARD/DIG), were treated with benznidazole and underwent clinical and laboratorial analysis before (IND and CARD/DIG) and nine years after [patients after treatment (CDt), patients with the indeterminate clinical form at treatment onset (INDt) and with the cardiac or digestive form at treatment onset (CARD/DIGt)] treatment. The data demonstrate that 82.1% of CDt patients (23/28) remained clinically stable and 95.4% of the INDt (21/22) and 33.3% of the CARD/DIGt (2/6) patients showed unaltered physical and laboratorial examinations. The clinical evolution rate was 2%/year and was especially low in INDt patients (0.5%/year) relative to CARD/DIGt patients (7.4%/year). Positive haemoculture in treated patients was observed in 7.1% of the cases. None of the INDt (0/21) and 33.3% of the CARD/DIGt (2/6) patients displayed positive cultures. The PCR presented a positive rate significantly higher (85.2%, 23/27) than haemoculture and two samples from the same patient revealed the same result 57.7% of the patients. Conventional serology-ELISA on 16 paired samples remained positive in all individuals. Semi-quantitative ELISA highlighted significant decreases in reactivity, particularly in INDt relative to IND. Non-conventional serology-FC-ALTA-IgG, after treatment, showed positive results in all sera and 22 paired samples examined at seven and nine years after treatment, demonstrated significantly lower reactivity, particularly in INDt patients. This study was retrospective in nature, had a low number of samples and lacked an intrinsic control group, but the data corroborate other results found in the literature. The data also demonstrate that, even though a cure has not been detected in the none-treated patients, the benefits for clinical evolution were selectively observed in the group of INDt patients and did not occur for CARD/DIGt patients.

Use of the Kala-Azar Detect® and IT-LEISH® rapid tests for the diagnosis of visceral leishmaniasis in Brazil

The performances of two rapid tests and a standard serological test for the diagnosis of visceral leishmaniasis (VL) were compared using sera from 193 patients with VL and 85 controls. The Kala-Azar Detect®, IT-LEISH® and IFI-LH® assays showed sensitivities of 88.1%, 93.3% and 88.6%, respectively, and specificities of 90.6%, 96.5% and 80%, respectively. The sensitivity values were similar for both rapid tests, but the specificity and positive predictive values of IT-LEISH® were higher than the corresponding values for IFI-LH®. Both rapid tests showed satisfactory performances and can be used in primary health care settings; however, IT-LEISH® permits the use of whole blood, making this assay more suitable for bedside diagnosis.

A serological, parasitological and clinical evaluation of untreated Chagas disease patients and those treated with benznidazole before and thirteen years after intervention

The etiological treatment of Chagas disease is recommended for all patients with acute or recent chronic infection, but controversies remain regarding the benefit of chemotherapy and interpretations of the parasitological cure after etiological treatment. This study compares the laboratory and clinical evaluations of Chagas disease patients who were diagnosed 13 years earlier. Fifty-eight Chagas disease patients (29 treated with benznidazole and 29 untreated) were matched at the time of treatment based on several variables. Conventional serology revealed the absence of seroconversion in all patients. However, lower serological titres were verified in the treated group, primarily among patients who had the indeterminate form of the disease. Haemoculture performed 13 years after the intervention was positive for 6.9% and 27.6% of the treated and untreated patients, respectively. Polymerase chain reaction tests were positive for 44.8% and 13.8% of the treated and untreated patients, respectively. Patients who presented with the indeterminate form of the disease at the beginning of the study exhibited less clinical progression (17.4%) compared with the untreated group (56.5%). Therefore, this global analysis revealed that etiological treatment with benznidazole may benefit patients with respect to the clinical progression of Chagas disease and the prognosis, particularly when administered to patients with the indeterminate form of the disease.

Experimental benznidazole treatment of Trypanosoma cruzi II strains isolated from children of the Jequitinhonha Valley, Minas Gerais, Brazil, with Chagas disease

Trypanosoma cruzi strains from distinct geographic areas show differences in drug resistance and association between parasites genetic and treatment response has been observed. Considering that benznidazole (BZ) can reduce the parasite burden and tissues damage, even in not cured animals and individuals, the goal is to assess the drug response to BZ of T. cruzi II strains isolated from children of the Jequitinhonha Valley, state of Minas Gerais, Brazil, before treatment. Mice infected and treated with BZ in both phases of infection were compared with the untreated and evaluated by fresh blood examination, haemoculture, polymerase chain reaction, conventional (ELISA) and non-conventional (FC-ALTA) serologies. In mice treated in the acute phase, a significant decrease in parasitaemia was observed for all strains. Positive parasitological and/or serological tests in animals treated during the acute and chronic (95.1-100%) phases showed that most of the strains were BZ resistant. However, beneficial effect was demonstrated because significant reduction (p < 0.05%) and/or suppression of parasitaemia was observed in mice infected with all strains (acute phase), associated to reduction/elimination of inflammation and fibrosis for two/eight strains. BZ offered some benefit, even in not cured animals, what suggest that BZ use may be recommended at least for recent chronic infection of the studied region.

Filosofia schopenhaueriana e literatura machadiana: em torno do conto "Noite de almirante"

Trata-se neste artigo de mostrar como se dá a recepção de alguns elementos da filosofia schopenhaueriana, como a oposição entre intelecto e vontade, na literatura de Machado de Assis. Com efeito, examinado o conto "Noite de almirante", pode-se dizer que a personagem Genoveva faz as vezes da vontade, ao passo que Deolindo é guiado pelo intelecto.

Conjuros contra la locura: el alienista y el infarto del alma

La construcción del espacio en El alienista (1882) y El infarto del alma (1994) sugiere una fluidez transversal a los contrastes evidentes entre ambos libros. El cuento largo de Machado de Assis –irónico, desde su modernidad, respecto a las promesas de la Ilustración– y el testimonio/fotoensayo de Diamela Eltit y Paz Errázuriz – fragmentario e inquisidor de las homogeneizaciones reconfortantes de su fin de siglo–, narran la locura a través de una inmersión en espacios dúctiles. Tanto el orden colonial que pretende clasificarla como las exclusiones de una modernidad que convive con patrones unívocos de lo bello o deseable, adscriben un espacio a la locura. Sin embargo, surgen intersticios –desde lo arquitectónico y más allá de ello– que trastocan la noción de esta. El lector se inserta en un flujo de movimientos/interpretaciones y es incitado a participar de una actitud lúdica capaz de conjurar la locura. Las piezas de juego son innumerables –pasillos, nombres, viajes, sueños, ventanas, héroes, rincones– pero los resultados no se pueden clasificar como los objetos de estudio de la ciencia ilustrada. Tampoco medir como lo hacen las fórmulas de prestigio contemporáneas. Sólo está la libertad de jugar.

Um filete de vozes : a narrativa oral na formação do conto literário brasileiro

O objetivo deste trabalho é identificar a presença de características e marcas da narrativa oral, sobretudo dos contos populares, nas primeiras narrativas literárias produzidas por escritores brasileiros, no período compreendido entre 1838 e o início do século XX. A caracterização das narrativas orais e dos contos populares é feita baseando-se em Walter Ong, Nelly Novaes Coelho, Jorge B. Rivera, Robert Scholles & Robert Kellogg. As narrativas literárias analisadas, principalmente contos, são as seguintes: ‘Os três desejos’, de Firmino Rodrigues Silva; ‘Minhas aventuras numa viagem de ônibus’, de Martins Pena; ‘A dança dos ossos’, de Bernardo Guimarães; ‘O baile do judeu’, de Inglês de Souza; ‘Idéias de canário’, de Machado de Assis; ‘O testamento do Tio Pedro’, de Garcia Redondo; e ‘O hóspede’, de Lúcio de Mendonça.

Gestão de organizações sem fins lucrativos: uma avaliação de desempenho através do balanced scorecard

The methodology Balanced Scorecard (BSC) focuses on the major critical issues of modern organizations, whether with or without profit. The measurement of the effective performance of the latter is by evaluating the successful implementation of organizational strategy. The aim of this paper is to present the development of a system of performance measurement strategy for a nonprofit organization, whose object of study is the Associação de Apoio as Comunidades do Campo - AACC, in the context of the BSC methodology of Kaplan and Norton. The methodology of this case study is an exploratory, descriptive and qualitative, and diagnose the coherence of the Strategy Map in an organization, based strategic planning from 2010 to 2012. Initially conducted a literature review covering the main aspects of strategy maps and performance evaluation involving the translation of the BSC and strategy evaluation. The main results of the proposed approach refers to evaluation of overall scores for each dimension of the BSC methodology, financial, customer, internal processes, learning and growth. These results are able to help the organization evaluate and revise their strategy and, in general, to adopt management methods more accurately. Data collection is centered on interviews with semi-structured questionnaire. The findings highlight on balancing and alignment of strategic objectives, low causality map, strategic communication insufficient and fragmented. For interviewees organizational culture is the biggest impediment to structuring a management model based on indicators and strategic process should be initiated by non-financial indicators gradually. The performance indicators of the AACC/RN portray more meritocracy operational procedures of social projects in the context of the Strategic Map determined in a shortterm over the long term. However, there is evidence of improved performance management and strategic taken as a basis of planning as both the strategic map structured. Therefore, the nonprofits need to adopt a form of management that enables planning, setting objectives and targets that provide the continuity of its activities, and generating instruments that can measure the financial performance and non-financial, in order to develop strategic actions for growth and sustainability

A Esquizoanálise e a produção da subjetividade: considerações práticas e teóricas

O presente artigo discute algumas questões relativas à produção da subjetividade a partir do referencial esquizoanalítico de Deleuze e Guattari. Optamos por discorrer sobre o assunto procurando não nos prendermos, na medida do possível, em conceitos e jargões técnicos. Iniciamos com uma parte mais teórica, na qual colocamos em tela algumas das idéias centrais da Esquizoanálise e sua perspectiva de formação da subjetividade, que entendemos como sendo a argamassa de constituição do mundo, abrindo caminho para uma parte mais prática, na qual analisamos o conto O Espelho, de Machado de Assis, de acordo com a ética estética de valorização da vida que entendemos ser a Esquizoanálise.

À luz das inquietas sombras: a criatividade da melancolia na linguagem de Dom Casmurro

Qué se piensa aquí, esencialmente, está a mapear el itinerario de la melancolía creativa en el discurso de Dom Casmurro; es decir, aquél de el cual el valle narrativo de una sensación de la angustia a alçar él él las maneras de la representación en el discurso de Dom Casmurro. El árbol básico en el cual éste estimaba incurre en se basa en el acuerdo de eso que la actual melancolía en el texto del machadiano se puede analizar por las estratagemas de la lengua creativa en la intención de demostrar en él una especie del espacio virtual - el conducir de metáforas, de ironies y del exacerbamento de imágenes - por cuál se prepone el narrador construir su salvación . El propósito es analizar el uso de el proyecto del alegórico y el irónico previstos por el autor en la intención de descubrir pues tales procedimientos contribuyen para crear un texto ese desestabiliza el carácter malsano de la melancolía. Puede propagar lengua creativa de tal manera cuánto otras maneras de la representación de eso las marcas del arte utilizan. Más allá de este traz poético, la contribución de este trabajo también constituye: para componer una escena en la cual el teatralidade de la lengua de Dom Casmurro constituye drama y no tragedia. Después de la pista de los conceptos de los benjaminianas de la melancolía, alegoria, metalenguaje la ironía, vimos que éstos disalign de la voluntad que los estatutos se estabilizaron de las figuras del retórico para consistir mientras que las estrategias de los discursivas. Subyacente a este proceso es posible percibir el flash del rescate de la escritura melancholic, visto bajo luz del saturnine de una mirada que si desea alegórico, en la misma incandescencia de la risa del fáustico

A VRBS no Cosme Velho: análise da presença da literatura latina em Memórias póstumas de Brás Cubas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)