Leishmaniose tegumentar americana no Litoral Norte Paulista, período 1993 a 2005

A leishmaniose tegumentar americana adquiriu caráter epidêmico no Litoral Norte Paulista, desde a década de 1990. A partir de dados secundários, realizou-se estudo descritivo da doença no período de 1993 a 2005 nos quatro municípios que compõem a região e analisou-se a freqüência dos flebotomíneos capturados nos locais prováveis de transmissão. Foram notificados 689 casos autóctones de leishmaniose tegumentar, com casos isolados e agrupados, determinando uma distribuição espacial heterogênea, com sincronismo na manifestação e ciclicidade, em intervalo de seis a oito anos. Todas as faixas etárias foram acometidas, com ligeiro predomínio do sexo masculino, sem associação com uma ocupação. Capturou-se 2.758 flebotomíneos e a espécie Nyssomyia intermedia predominou (80,4%), no peri e intradomicílio. A doença apresentou perfil de transmissão peri e intradomiciliar, entre o periurbano e a mata, e no interior da mata. Neste caso, a transmissão estaria mais relacionada com os focos enzoóticos.

Association between osteoporosis and rheumatoid arthritis in women: a cross-sectional study

CONTEXT AND OBJECTIVES: Osteoporosis has frequently been observed in patients with rheumatoid arthritis. The present study was undertaken in order to evaluate factors associated with osteoporosis among women with rheumatoid arthritis. DESIGN AND SETTING: Cross-sectional study, carried out in a public hospital in São Paulo. METHODS: The participants were 83 women with rheumatoid arthritis (53.7 ± 10.0 years old). Bone mineral density (BMD) and body composition were measured by dual energy X-ray absorptiometry. The patients were divided into three groups according to BMD: group 1, normal BMD (n = 24); group 2, osteopenia (n = 38); and group 3, osteoporosis (n = 21). Tests were performed to compare differences in means and correlations, with adjustments for age, duration of disease and cumulative corticosteroid. The relationships between clinical factors, physical activity score, dietary intake, body composition and biochemical parameters were analyzed using linear regression models. RESULTS: Mean calcium, vitamin D and omega-6 intakes were lower than the recommendations. Associations were found between BMD and age, disease duration, parathyroid hormone concentration and fat intake. The linear regression model showed that being older, with more years of disease and lower weight were negatively correlated with BMD [Total femur = 0.552 + 0.06 (weight) + 0.019 (total physical activity) - 0.05 (age) - 0.003 (disease duration); R² = 48.1; P < 0.001]. CONCLUSION: The present study indicates that nutritional factors and body composition are associated with bone mass in women with rheumatoid arthritis.

Associação entre excesso de peso e hábito de fumar, Santarém, PA, 2007

OBJETIVO: Estudar associação entre excesso de peso e hábito de fumar. METODOLOGIA: Estudo transversal desenvolvido por telefone numa amostra probabilística de adultos (Santarém /PA), em 2007. Variável desfecho foi excesso de peso, explanatória hábito de fumar e de confusão idade, escolaridade, união conjugal, estado nutricional prévio, abuso de bebidas alcoólicas, atividade física no lazer e padrão alimentar. Associação entre excesso de peso e demais variáveis foi investigada pelo teste do qui-quadrado e regressão de Poisson para o cálculo das razões de prevalência de excesso de peso conforme hábito de fumar, considerando-se três níveis de hierarquia: características sociodemográficas, estado nutricional prévio e padrão comportamental. RESULTADOS: Verificou-se 40,6% de excesso de peso e 16,4% de fumantes. As variáveis associadas ao excesso de peso foram: maior idade, menor escolaridade, união conjugal estável, excesso de peso aos 20 anos e hábito de não consumo de refrigerante para ambos os sexos; não ativo no lazer para homens e hábito de fumar (atual e passado) para mulheres. As razões de prevalência de excesso de peso não apresentaram associação com hábito de fumar para homens, porém para mulheres houve tendência de maior prevalência de excesso de peso para fumantes atuais, chegando a 2,56 vezes mais do que para nunca fumantes e ex-fumantes. CONCLUSÃO: Este estudo constatou que a prevalência de excesso de peso foi maior para mulheres fumantes, comparativamente às ex-fumantes e nunca fumantes. Para os homens não se observou nenhuma associação entre excesso de peso e tabagismo.

Association of the borer Spermophthorus apuleiae (Coleoptera; Curculionidae; Scolytinae) with the "pau-ferro" tree Caesalpinia ferrea (Leguminosae)

The weevil subfamily Scolytinae includes beetles which may feed on the bark, trunk or roots of both live and dead trees and are sometimes considered forest and silvicultural pests. Less frequently, some species feed on seeds and may be cause economic losses when associated to plant cultivars. Spermophthorus apuleiae Costa-Lima is a Neotropical Scolytinae formerly recorded to be "associated" with seeds of Caesalpinia ferrea var. leiostachya Benth, a Brazilian tree popularly known in Portuguese as "pau-ferro". Hitherto, it was not clear whether these beetles actually feed on the seeds of that plant. In order to investigate the ability of S. apuleiae to feed on seeds of "pau-ferro", observations were done and colonies of these beetles were established. Both in the field and in captivity the beetles were not observed feeding on the seeds. Even when beetles were exposed to seeds as the only source of food they were incapable of boring or eating the seeds and died. Our data therefore suggest that S. apuleiae is a frugivorous species which peculiarly does not eat seeds of "pau-ferro".

Serosurvey of antibodies against spotted fever group Rickettsia spp. in horse farms in Northern Paraná, Brazil

Brazilian spotted fever (BSF) is an emerging disease most likely caused by Rickettsia rickettsii. The objective of the present study was to estimate the seroprevalence of BSF rickettsia infections in equines from six horse farms located in Londrina County, Paraná, Southern Brazil. Six owners of horse farms situated in Cambé, Santa Fé, Guaraci and Londrina municipalities participated in the study. All farms were located in areas where BSF has not been reported. A total of 273 horses were sampled and their sera were tested by indirect Immunofluorescence assay (IFA) using R. rickettsii and R. parkeri antigens. Titers equal to and greater than 64 were considered positive. Of 273 sera tested, 15 (5.5%) reacted to R. rickettsii and 5 (1.8%) to R. parkeri. Five out of the six farms studied revealed seropositive animals and seropositivity rate ranged from 0 to 13%. The titers ranged from 64 to 512, and four samples had a titer of 512. Nine animals reacted to R. rickettsii with titers four-fold higher than those for R. parkeri. These results suggest that horses in Northern Paraná may have been exposed to rickettsiae identical or closely related to R. rickettsii.

Exposure of free-ranging wild carnivores, horses and domestic dogs to Leptospira spp in the northern Pantanal, Brazil

Leptospirosis is a zoonotic disease affecting most mammals and is distributed throughout the world. Several species of domestic and wild animals may act as reservoirs for this disease. The purpose of this study was to assess the exposure of free-ranging wild carnivores, horses and domestic dogs on a private reserve located in the northern Pantanal (Brazil) and the surrounding areas to Leptospira spp from 2002-2006, 75 free-ranging wild carnivores were captured in the Pantanal and serum samples were collected. In addition, samples from 103 domestic dogs and 23 horses in the region were collected. Serum samples were tested for the presence of Leptospira antibodies using the microscopic agglutination test. Thirty-two wild carnivores (42.7%) were considered positive with titres > 100, and 18 domestic dogs (17.5%) and 20 horses (74.1%) were also found to be positive. Our study showed that horses, dogs and several species of free-ranging wild carnivores have been exposed to Leptospira spp in the Pantanal, suggesting that the peculiar characteristics of this biome, such as high temperatures and an extended period of flooding, may favour bacterial persistence and transmission. In this region, wild carnivores and horses seem to be important hosts for the epidemiology of Leptospira species.

Dietary calcium intake and overweight: an epidemiologic view

OBJECTIVE: We evaluated the relation between overweight and calcium intake in adults living in the municipality of São Paulo, Brazil. METHODS: This was a cross-sectional population-based study on a sample of 1459 adults that was obtained by multistage cluster sampling. Dietary intake was measured by the 24-h recall method. Poisson's and linear regression analyses were performed to evaluate the relation between overweight and quartiles of calcium intake adjusted for energy. RESULTS: The prevalence of overweight was 43.1% and the average adjusted calcium intake was 448.6 mg. In the linear regression analyses, the regression coefficient for adjusted calcium was significant and negative (P = 0.019, beta(1) = -0.0001). Although evaluated by quartiles, the prevalence ratio for overweight in the first quartile of calcium intake was 1.24 (95% confidence interval 1.00-1.54) and that in the second quartile was 1.24 (95% confidence interval 1.03-1.49). CONCLUSION: In the present study, calcium intake showed a significant negative association with body mass index

Practice of walking and its association with perceived environment among elderly Brazilians living in a region of low socioeconomic level

Background: The aim of this study was analyze associations between the practice of walking and environmental perception among elderly Brazilians in a region of low socioeconomic level. Methods: A cross-sectional study was conducted among 385 elderly people aged 60 years and over. To evaluate walking, the International Physical Activity Questionnaire (IPAQ), long version (leisure and transport modules) was used. The environment was evaluated by means of the Neighborhood Environmental Walkability Scale (NEWS) (adapted Brazilian version). For the statistical analysis, multiple logistic regression models were created separately for men and women. The practice of at least 150 minutes a week of walking was the dependent variable, and the variables of environmental perception were the independent variables. All the models were controlled for schooling level and age. Results: The proportion of elderly people active in walking was 56.9% for the men and 26.4% for the women. The perception of the presence of soccer fields (OR = 4.12) and their proximity, within ten minutes' walk from home (OR = 3.43), were associated with the practice of walking among the men. The perception of the presence of public squares (OR = 4.70) and the proximity of primary healthcare units, within ten minutes' walk from home (OR = 3.71), were associated with the practice of walking among the women. An association with adequate perception of vehicle traffic remained at the threshold of significance for the women. Conclusion: Accessibility of leisure structures such as football fields and public squares and of health services such as primary healthcare units were important environmental variables associated with the practice of walking among elderly people living in a region of low socioeconomic level in Brazil. These variables need to be taken into consideration when aiming to promote the practice of walking among elderly people living in similar regions.

Association Between Physical Activity in Parks and Perceived Environment: A Study With Adolescents

Background: The purpose of this study was to analyze the relationship between adolescents' physical activity practice and their perception about the environment of urban parks. Methods: A school-based representative sample (n = 1,718; boys = 40.4%) of teenagers of Curitiba, Southern region of Brazil. A questionnaire was employed to identify perceived parks environmental features as well as physical activity practice in the parks (PAP), habitual physical activity (HPA) and demographics. The relationship between PAP and parks environments was analyzed through multivariate logistic regression controlling for age and socioeconomic status, HPA and parks distance. Results: After controlling for confounders PAP was associated with lack of space to be physically active, activities to choose from and equipments for both boys and girls, (odds ratio (OR)-ranging from 1.5 to 1.8). Among boys, having people of same age (OR = 1.5) and accessibility (OR = 2.0) showed association with PAP only in crude analysis. However, among girls, to be bulled or teased (OR = 1.4) and accessibility (OR = 1.7) were associated with PAP after confounding control. Conclusions: The results showed that specific attributes in parks may be considered and offered to increase the likelihood of physical activity practice among adolescents in such locations.

No evidence for an association between the-36A > C phospholamban gene polymorphism and a worse prognosis in heart failure

Background: In Brazil, heart failure leads to approximately 25,000 deaths per year. Abnormal calcium handling is a hallmark of heart failure and changes in genes encoding for proteins involved in the re-uptake of calcium might harbor mutations leading to inherited cardiomyopathies. Phospholamban (PLN) plays a prime role in cardiac contractility and relaxation and mutations in the gene encoding PLN have been associated with dilated cardiomyopathy. In this study, our objective was to determine the presence of the -36A>C alteration in PLN gene in a Brazilian population of individuals with HF and to test whether this alteration is associated with heart failure or with a worse prognosis of patients with HF. Methods: We genotyped a cohort of 881 patients with HF and 1259 individuals from a cohort of individuals from the general population for the alteration -36A>C in the PLN gene. Allele and genotype frequencies were compared between groups (patients and control). In addition, frequencies or mean values of different phenotypes associated with cardiovascular disease were compared between genotypic groups. Finally, patients were prospectively followed-up for death incidence and genotypes for the -36A>C were compared regarding mortality incidence in HF patients. Results: No significant association was found between the study polymorphism and HF in our population. In addition, no association between PLN -36A>C polymorphism and demographic, clinical and functional characteristics and mortality incidence in this sample of HF patients was observed. Conclusion: Our data do not support a role for the PLN -36A>C alteration in modulating the heart failure phenotype, including its clinical course, in humans.

Association between neuromuscular tests and kumite performance on the Brazilian Karate National Team

The aim of this study was to verify the relationship of strength and power with performance on an international level karate team during official kumite simulations. Fourteen male black belt karate athletes were submitted to anthropometric data collection and then performed the following tests on two different days: vertical jump test, bench press and squat maximum dynamic strength (1RM) tests. We also tested power production for both exercises at 30 and 60% 1RM and performed a kumite match simulation. Blood samples were obtained at rest and immediately after the kumite matches to measure blood lactate concentration. Karate players were separated by performance (winners vs. defeated) on the kumite matches. We found no significant differences between winners and defeated for strength, vertical jump height, anthropometric data and blood lactate concentration. Interestingly, winners were more powerful in the bench press and squat exercises at 30% 1RM. Maximum strength was correlated with absolute (30% 1RM r = 0.92; 60% 1RM r = 0.63) and relative power (30% 1RM r = 0.74; 60% 1RM r = 0.11, p > 0.05) for the bench press exercise. We concluded that international level karate players' kumite match performance are influenced by higher levels of upper and lower limbs power production.

Prevalence of Human T-Cell Lymphotropic Virus (HTLV-1/2) in Individuals from Public Health Centers in Mozambique

The prevalence of human T-cell lymphotropic viruses types 1 and 2 (HTLV-1/2) in Mozambique is not known. The present study examined blood samples from 208, 226, and 318 individuals from Northern, Central, and Southern Mozambique, respectively, of all socioeconomic and demographic strata attending public health centers in Mozambique for HTLV-1/2-specific antibodies. Serum samples were assessed for HIV- and HTLV-1/2-specific antibodies by using enzyme immunoassays, and infections with HTLV-1 and -2 were confirmed by using Western blot. An overall HTLV-1/2 prevalence of 2.3% (2.9% in female and 1.1% in male subjects) was observed, and the prevalence of infection increased with age. Regional variation in the prevalence of HIV and HTLV-1/2 was observed; 32.2%, 65.5%, and 44% of individuals tested HIV positive in Northern, Central, and Southern Mozambique, respectively, and 2.4%, 3.9%, and 0.9% tested HTLV-1/2 positive in the same regions. HTLV-1 infection was confirmed in these individuals. No association between HTLV-1 infection and socio-demographic variables or HIV status was detected, although the low number of HTLV-1-positive cases did not allow robust statistical analyses. The results obtained suggest different risk factors and epidemiologic correlates of HIV and HTLV-1 transmission in Mozambique. Furthermore, our results suggested that North and Central Mozambique should be considered endemic regions for HTLV-1 infection. As no cases of HTLV-2 were detected, HTLV-2 appears to have not been introduced into Mozambique.

ASSOCIATION OF A MYOSIN MOTOR WITH MEMBRANE-BOUNDED PIGMENT GRANULES IN FRESHWATER SHRIMP CHROMATOPHORES: EVIDENCE FROM THE NITELLA ACTIN-CABLE ASSAY

We have adapted an actin-mosin motility assay to examine the interactions in vitro between actin cables isolated from the giant internodal cells of the freshwater alga, Nitella, and pigment granules extracted from red ovarian chromatophores of the freshwater palaemonid shrimp, Macrobrachium olfersi. The chromatophore pigment mass consists of large (0.5-1.0-mu m diameter) membrane-bounded granules, and small (140-nm diameter), a membranous granules, both structurally continuous with the abundant smooth endoplasmic reticulum. Our previous immunocytochemical studies show a myosin motor to be stably associated with the pigment mass; however, to which granule type or membrane the myosin motor is attached is unclear. Here, we show that sodium vanadate, a myosin ATPase inhibitor, markedly increases the affinity of isolated, large, membrane-bounded granules for Nitella actin cables to which they become permanently attached. This interaction does not occur in granule preparations containing ATP with uninhibited, active myosin without vanadate. We propose that a stable state of elevated affinity is established between the granule-located myosin motor and the Nitella actin cables, resulting from a vanadate-inhibited acto-myosin-ADP complex. This finding provides further evidence for a myosin motor positioned on the surface of the membrane-bounded pigment granules in shrimp ovarian chromatophores.

First Description of a Cluster of Acute/Subacute Paracoccidioidomycosis Cases and Its Association with a Climatic Anomaly

Background: Identifying clusters of acute paracoccidioidomycosis cases could potentially help in identifying the environmental factors that influence the incidence of this mycosis. However, unlike other endemic mycoses, there are no published reports of clusters of paracoccidioidomycosis. Methodology/Principal Findings: A retrospective cluster detection test was applied to verify if an excess of acute form (AF) paracoccidioidomycosis cases in time and/or space occurred in Botucatu, an endemic area in Sao Paulo State. The scan-test SaTScan v7.0.3 was set to find clusters for the maximum temporal period of 1 year. The temporal test indicated a significant cluster in 1985 (P<0.005). This cluster comprised 10 cases, although 2.19 were expected for this year in this area. Age and clinical presentation of these cases were typical of AF paracccidioidomycosis. The space-time test confirmed the temporal cluster in 1985 and showed the localities where the risk was higher in that year. The cluster suggests that some particularities took place in the antecedent years in those localities. Analysis of climate variables showed that soil water storage was atypically high in 1982/83 (similar to 2.11/2.5 SD above mean), and the absolute air humidity in 1984, the year preceding the cluster, was much higher than normal (similar to 1.6 SD above mean), conditions that may have favored, respectively, antecedent fungal growth in the soil and conidia liberation in 1984, the probable year of exposure. These climatic anomalies in this area was due to the 1982/83 El Nino event, the strongest in the last 50 years. Conclusions/Significance: We describe the first cluster of AF paracoccidioidomycosis, which was potentially linked to a climatic anomaly caused by the 1982/83 El Nino Southern Oscillation. This finding is important because it may help to clarify the conditions that favor Paracoccidioides brasiliensis survival and growth in the environment and that enhance human exposure, thus allowing the development of preventive measures.

Association of alpha1a-adrenergic receptor polymorphism and blood pressure phenotypes in the Brazilian population

Background: The alpha1A-adrenergic receptor (alpha(1A)-AR) regulates the cardiac and peripheral vascular system through sympathetic activation. Due to its important role in the regulation of vascular tone and blood pressure, we aimed to investigate the association between the Arg347Cys polymorphism in the alpha(1A)-AR gene and blood pressure phenotypes, in a large sample of Brazilians from an urban population. Methods: A total of 1568 individuals were randomly selected from the general population of the Vitoria City metropolitan area. Genetic analysis of the Arg347Cys polymorphism was conducted by polymerase chain reaction/restriction fragment length polymorphism. We have compared cardiovascular risk variables and genotypes using ANOVA, and Chi-square test for univariate comparisons and logistic regression for multivariate comparisons. Results: Association analysis indicated a significant difference between genotype groups with respect to diastolic blood pressure (p = 0.04), but not systolic blood pressure (p = 0.12). In addition, presence of the Cys/Cys genotype was marginally associated with hypertension in our population (p = 0.06). Significant interaction effects were observed between the studied genetic variant, age and physical activity. Presence of the Cys/Cys genotype was associated with hypertension only in individuals with regular physical activity (odds ratio = 1.86; p = 0.03) or younger than 45 years (odds ratio = 1.27; p = 0.04). Conclusion: Physical activity and age may potentially play a role by disclosing the effects of the Cys allele on blood pressure. According to our data it is possible that the Arg347Cys polymorphism can be used as a biomarker to disease risk in a selected group of individuals.