Distribuição geográfica de agravos nutricionais entre escolares na cidade de Piracicaba-SP, Brasil

The objective was to map the prevalence of nutritional disorders in children attending the 1st to 4th grade of 12 public elementary schools located in the 5 administrative regions of Piracicaba, SP, each with its own socioeconomic profi le, from 2003 to 2006. A total of 16,068 children, divided into 8,133 (50.6%) girls and 7,935 (49.4%) boys, aged 7 to 11 years, were weighed and measured. Their nutritional status indicators heightfor-age (H/A), weight-for-age (W/A), and body mass index-for-age (BMI/A) were compared with those of the NCHS/CDC 2000 reference population and classifi ed according to the z-score cut-off points recommended by the World Health Organization. During that period, the Western Region, which has the lowest socioeconomic indicators, had the lowest z-score medians of the three anthropometric indicators assessed (p<0.0001) and was the only region to have a higher-than-expected stunting prevalence (3.0% with Z < -2). Excess weight prevalence was higher than expected in all regions. The Central Region, which has the highest socioeconomic indicators, had the highest excess weight prevalence (6.0% with Z > 2). Time had a positive effect on the stunted children, reducing the stunting rates in the regions with the lowest socioeconomic indicators. In conclusion, the three nutritional status indicators showed results suitable to the social and economic characteristics of each region. Although nutritional disorders have particular characteristics, they are a problem to the entire population.

Nebraska Adolescents' HIV/Aids Attitudes, Knowledge and Related Practices: 1989

This Prevention Center Paper (No. 22) describes the HIV/AIDS related knowledge, attitudes and practices of a random sample of 1240 Nebraska adolescents in grades 9-12. The data were gathered in 1989. Data were gathered by staff of Health Education, Inc., a Nebraska-based nonprofit research and development corporation, as part of a contract with the Nebraska Department of Education. The Nebraska Department of Education has a major HIV /AIDS cooperative agreement with the U.S. Centers for Disease Control (CDC) in Atlanta, Georgia. Schools were selected at random from each of the six classifications of Nebraska schools established by the Nebraska Department of Education. Two to three classrooms for each grade 9-12 were then randomly selected within each sampled school. All students in the classes on the day of the survey voluntarily completed CDC's HIV / AIDS adolescent survey. All responses were anonymous. Classroom teachers and school administrators 'were not involved in the data collection in any way. A data collection protocol was followed to ensure validity in this self-report survey. This report is divided into four parts: Part 1 deals with students' acceptance of HIV/AIDS instruction and of people with HIV / AIDS. Part 2 describes students' access to HIV / AIDS information: Part 3 is about students ' knowledge of HIV / AIDS, and Part 4 discusses Nebraska adolescents' practices that increase the risk of HIV/AIDS.

Pre- and Posttransplant Monitoring of Alloantibodies by Complement-Dependent Cytotoxicity and Luminex Methodologies in Liver Transplantation

Background. This study evaluated the influence of circulating anti-HLA antibodies on outcomes of 97 liver allografts from deceased donors. Methods. Human leukocyte antigen (HLA) antibody screening was performed by both complement-dependent cytotoxicity (CDC) and multiparameter Luminex microsphere-based assays (Luminex assay). Results. The agreements between T- and B- cell CDC and Luminex assays were 67% and 77% for pre- and posttransplant specimens, respectively. Graft dysfunction was not associated with either positive pretransplant CDC or Luminex panel-reactive antibody (PRA) values. Likewise, positive posttransplant T- or B- cell CDC PRA values were not associated with graft dysfunction. In contrast, posttransplant Luminex PRA values were significantly higher among patients with graft dysfunction compared with subjects with good outcomes (P = .017). Conclusion. Posttransplant monitoring of HLA antibodies with Luminex methodology allowed identification of patients at high-risk for poor graft outcomes.

Nutritional transition of school children from low income families of a northeastern urban area, Brazil

Background: Evaluating child growth is, in practice, performed by measuring the development of a child's weight, height, and body composition in comparison to averages observed among a reference population. Objective: To describe the nutritional status of children of low income families who live in urban region in northeastern Brazil. Methods: This study is a population case series with a transversal and observational design. The study population consisted of 257 children, aged 5 to 10 years, who were enrolled in a public school to children of low income families. We used the cutoff point for short stature of -2 Z scores for age, and underweight, overweight, and obese were classified as the 5th, 85th, and 95th percentiles, respectively, of the body mass index (BMI) for age, with both classifications in accordance with the Center for Disease Control and Prevention (CDC 2000). Comparisons by gender were performed for the measures of the central tendency and the frequency of diagnoses, in addition to the tendency of the evolution of BMI by age. Results: The prevalence of short stature was 3.5% (95% CI: 1.9-6.5). In the evaluation of BMI for age, the prevalences found for underweight, overweight, and obese were 5.8% (95% CI: 3.6-9.4), 4.7% (95% CI: 2.7-8.0), and 2.3% (95% CI: 1.1-5.0), respectively. We found a significant trend in the reduction of BMI with the increase in age. Conclusions: According to CDC references, the prevalences of underweight and short stature were higher than expected and for the overweight and obesity were lower than expected, indicating that the nutritional transition had still not reached, as commonly is described, these low income children from the urban outskirts of the Northeast region.

Natural infection in anopheline species and its implications for autochthonous malaria in the Atlantic forest in Brazil

Abstract Background A descriptive study was carried out in an area of the Atlantic Forest with autochthonous malaria in the Parelheiros subdistrict on the periphery of the municipality of São Paulo to identify anopheline fauna and anophelines naturally infected with Plasmodium as well as to discuss their role in this peculiar epidemiological context. Methods Entomological captures were made from May 2009 to April 2011 using Shannon traps and automatic CDC traps in four areas chosen for their different patterns of human presence and incidences of malaria (anthropic zone 1, anthropic zone 2, transition zone and sylvatic zone). Natural Plasmodium infection was detected by nested PCR based on amplification of the 18S rRNA gene. Results In total, 6,073 anophelines were collected from May 2009 to April 2011, and six species were identified in the four zones. Anopheles cruzii was the predominant species in the three environments but was more abundant in the sylvatic zone. Anopheles (Kerteszia) cruzii specimens from the anthropic and sylvatic zones were positive for P. vivax and P. malariae. An. (Ker.) bellator, An. (Nys.) triannulatus, An. (Nys.) strodei, An. (Nys.) lutzi and An. (Ano) maculipes were found in small numbers. Of these, An. (Nys.) triannulatus and An. (Nys.) lutzi, which were collected in the anthropic zone, were naturally infected with P. vivax while An. (Nys.) triannulatus from the anthropic zones and An. (Nys.) strodei from the transition zone were positive for P. malariae. Conclusion These results confirm that Anopheles (Kerteszia) cruzii plays an important role as a major Plasmodium vector. However, the finding of other naturally infected species may indicate that secondary vectors are also involved in the transmission of malaria in the study areas. These findings can be expected to help in the implementation of new measures to control autochthonous malaria in areas of the Atlantic Forest.

Epidemiological aspects of American cutaneous leishmaniasis and phlebotomine sandfly population, in the municipality of Monte Negro, State of Rondônia, Brazil

INTRODUCTION: This work was carried out on the purpose of identifying the species of phlebotomine sandflies in the municipality of Monte Negro, state of Rondonia, Brazil, that may have been transmitting the American cutaneous leishmaniasis (ACL), and concisely describe epidemiological aspects of disease. METHODS: The epidemiologic and socioeconomical indicators were obtained from government institutions and the local Municipal Secretary of Health. Phlebotomine sandflies were captured using CDC light traps between July 2006 to July 2008. The total of 1,240 of female sandflies were examined by PCR method directed to k-DNA. RESULTS: There has been a significant decrease in the incidence of ACL of about 50% over the last ten years in the municipality. A total of 1,935 specimens of 53 sandfly species were captured, three of the genus Brumptomyia genus and 50 of the genus Lutzomyia. The predominant species was Lutzomyia acanthopharynx, Lutzomyia whitmani, Lutzomyia geniculata and Lutzomyia davisi. None were positive for Leishmania sp. CONCLUSIONS: Four sandflies species were found in the State of Rondonia for the first time: Brumptomyia brumpti, Lutzomyia tarapacaensis, Lutzomyia melloi and Lutzomyia lenti. The presence of Lutzomyia longipalpis, was also captured. Socioeconomical improvement of Brazilian economy and the increase of environmental surveillance in the last 15 years collaborated in the decrease of people exposed to vectors, reducing the incidence of ACL.

Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. Medscape, LLC designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at http://www.medscape.com/cme/eidExternal Web Site Icon; (4) view/print certificate. Learning Objectives Upon completion of this activity, participants will be able to: Describe the mechanism of infection for adiaspiromycosis. Identify the age group most susceptible to ocular adiaspiromycosis. Describe presenting symptoms associated with ocular adiaspiromycosis. Describe the frequency of ocular lesions associated with adiaspiromycosis. Identify risk factors for ocular adiaspiromycosis.

Genetic characterization and molecular identification of the bloodmeal sources of the potential bluetongue vector Culicoides obsoletus in the Canary Islands, Spain

[EN] Background: Culicoides (Diptera: Ceratopogonidae) biting midges are vectors for a diversity of pathogens including bluetongue virus (BTV) that generate important economic losses. BTV has expanded its range in recent decades, probably due to the expansion of its main vector and the presence of other autochthonous competent vectors. Although the Canary Islands are still free of bluetongue disease (BTD), Spain and Europe have had to face up to a spread of bluetongue with disastrous consequences. Therefore, it is essential to identify the distribution of biting midges and understand their feeding patterns in areas susceptible to BTD. To that end, we captured biting midges on two farms in the Canary Islands (i) to identify the midge species in question and characterize their COI barcoding region and (ii) to ascertain the source of their bloodmeals using molecular tools.Methods: Biting midges were captured using CDC traps baited with a 4-W blacklight (UV) bulb on Gran Canaria and on Tenerife. Biting midges were quantified and identified according to their wing patterns. A 688 bp segment of the mitochondrial COI gene of 20 biting midges (11 from Gran Canaria and 9 from Tenerife) were PCR amplified using the primers LCO1490 and HCO2198. Moreover, after selected all available females showing any rest of blood in their abdomen, a nested-PCR approach was used to amplify a fragment of the COI gene from vertebrate DNA contained in bloodmeals. The origin of bloodmeals was identified by comparison with the nucleotide-nucleotide basic alignment search tool (BLAST). Results: The morphological identification of 491 female biting midges revealed the presence of a single morphospecies belonging to the Obsoletus group. When sequencing the barcoding region of the 20 females used to check genetic variability, we identified two haplotypes differing in a single base. Comparison analysis using the nucleotide-nucleotide basic alignment search tool (BLAST) showed that both haplotypes belong to Culicoides obsoletus, a potential BTV vector. As well, using molecular tools we identified the feeding sources of 136 biting midges and were able to confirm that C. obsoletus females feed on goats and sheep on both islands.Conclusions: These results confirm that the feeding pattern of C. obsoletus is a potentially important factor in BTV transmission to susceptible hosts in case of introduction into the archipelago. Consequently, in the Canary Islands it is essential to maintain vigilance of Culicoides-transmitted viruses such as BTV and the novel Schmallenberg virus.

L'analisi di rischio nel trasporto stradale di merci pericolose: due software a confronto

Confronto tra due software specifici per l'analisi di rischio nel trasporto stradale di merci pericolose (TRAT GIS 4.1 e QRAM 3.6) mediante applicazione a un caso di studio semplice e al caso reale di Casalecchio di Reno, comune della provincia di Bologna.

I rifiuti da apparecchiature elettriche ed elettroniche (RAEE) - Aspetti tecnico-gestionali e ambientali

I RAEE (Rifiuti da Apparecchiature Elettriche ed Elettroniche) costituiscono un problema prioritario a livello europeo per quanto riguarda la loro raccolta, stoccaggio, trattamento, recupero e smaltimento, essenzialmente per i seguenti tre motivi: Il primo riguarda le sostanze pericolose contenute nei RAEE. Tali sostanze, nel caso non siano trattate in modo opportuno, possono provocare danni alla salute dell’uomo e all’ambiente. Il secondo è relativo alla vertiginosa crescita relativa al volume di RAEE prodotti annualmente. La crescita è dovuta alla continua e inesorabile commercializzazione di prodotti elettronici nuovi (è sufficiente pensare alle televisioni, ai cellulari, ai computer, …) e con caratteristiche performanti sempre migliori oltre all’accorciamento del ciclo di vita di queste apparecchiature elettriche ed elettroniche (che sempre più spesso vengono sostituiti non a causa del loro malfunzionamento, ma per il limitato livello di performance garantito). Il terzo (ed ultimo) motivo è legato all’ambito economico in quanto, un corretto trattamento dei RAEE, può portare al recupero di materie prime secondarie (alluminio, ferro, acciaio, plastiche, …) da utilizzare per la realizzazione di nuove apparecchiature. Queste materie prime secondarie possono anche essere vendute generando profitti considerevoli in ragione del valore di mercato di esse che risulta essere in costante crescita. Questo meccanismo ha portato a sviluppare un vasto quadro normativo che regolamenta tutto l’ambito dei RAEE dalla raccolta fino al recupero di materiali o al loro smaltimento in discarica. È importante inoltre sottolineare come lo smaltimento in discarica sia da considerarsi come una sorta di ‘ultima spiaggia’, in quanto è una pratica piuttosto inquinante. Per soddisfare le richieste della direttiva l’obiettivo dev’essere quello di commercializzare prodotti che garantiscano un minor impatto ambientale concentrandosi sul processo produttivo, sull’utilizzo di materiali ‘environmentally friendly’ e sulla gestione consona del fine vita. La Direttiva a livello europeo (emanata nel 2002) ha imposto ai Paesi la raccolta differenziata dei RAEE e ha definito anche un obiettivo di raccolta per tutti i suoi Stati Membri, ovvero 4 kg di RAEE raccolti annualmente da ogni abitante. Come riportato di seguito diversi paesi hanno raggiunto l’obiettivo sopra menzionato (l’Italia vi è riuscita nel 2010), ma esistono anche casi di paesi che devono necessariamente migliorare il proprio sistema di raccolta e gestione dei RAEE. Più precisamente in Italia la gestione dei RAEE è regolamentata dal Decreto Legislativo 151/2005 discusso approfonditamente in seguito ed entrato in funzione a partire dal 1° Gennaio 2008. Il sistema italiano è basato sulla ‘multi consortilità’, ovvero esistono diversi Sistemi Collettivi che sono responsabili della gestione dei RAEE per conto dei produttori che aderiscono ad essi. Un altro punto chiave è la responsabilità dei produttori, che si devono impegnare a realizzare prodotti durevoli e che possano essere recuperati o riciclati facilmente. I produttori sono coordinati dal Centro di Coordinamento RAEE (CDC RAEE) che applica e fa rispettare le regole in modo da rendere uniforme la gestione dei RAEE su tutto il territorio italiano. Il documento che segue sarà strutturato in quattro parti. La prima parte è relativa all’inquadramento normativo della tematica dei RAEE sia a livello europeo (con l’analisi della direttiva ROHS 2 sulle sostanze pericolose contenute nei RAEE e la Direttiva RAEE), sia a livello italiano (con un’ampia discussione sul Decreto Legislativo 151/2005 e Accordi di Programma realizzati fra i soggetti coinvolti). La seconda parte tratta invece il sistema di gestione dei RAEE descrivendo tutte le fasi principali come la raccolta, il trasporto e raggruppamento, il trattamento preliminare, lo smontaggio, il riciclaggio e il recupero, il ricondizionamento, il reimpiego e la riparazione. La terza definisce una panoramica delle principali metodologie di smaltimento dei 5 raggruppamenti di RAEE (R1, R2, R3, R4, R5). La quarta ed ultima parte riporta i risultati a livello italiano, europeo ed extra-europeo nella raccolta dei RAEE, avvalendosi dei report annuali redatti dai principali sistemi di gestione dei vari paesi considerati.

Vergleichende Untersuchungen zur funktionellen Wechselwirkung von T-Helferzellen, regulatorischen T-Zellen und dendritischen Zellen

Dendritische Zellen (DC) verbinden angeborene und adaptive Immunität. Abhängig vom Aktivierungsgrad vermitteln sie Toleranz oder Immunität. Hier wurden konventionelle DC (kDC) und plasmazytoide DC (pDC) hinsichtlich ihrer T-Zellstimulation in An- und Abwesenheit regulatorischer T Zellen (Treg) verglichen. Als starke T-Zellstimulatoren induzieren aktivierte kDC Treg-Proliferation. Proliferierende Treg sind nicht suppressiv, weshalb T-Effektorzellen nach kDC-Stimulation in Treg-Anwesenheit proliferieren. Demgegenüber vermitteln aktivierte pDC nur schwache T-Zellstimulation, die aber ausreicht T-Effektorzellproliferation auszulösen. Aktivierte pDC brechen aber nicht die Anergie von Treg und induzieren daher nicht ihre Proliferation. Trotz der geringen T-Zellstimulation sind pDC in der Lage Proliferation und Expansion von T-Effektorzellen in Treg-Gegenwart zu bewirken. Dies konnte auf ein insuffizientes pDC-vermitteltes T-Zellrezeptorsignal für Treg zurückgeführt werden, das keine funktionelle pDC-vermittelte Treg-Aktivierung bewirkt.rnUnter homöostatischen Bedingung vermitteln DC Toleranz, so induzieren unreife kDC Treg in der Peripherie. Hierbei ist eine ICOS-vermittelte Kostimulation essentiell für die Induktion des IL-10-Rezeptors auf T-Zellen. Ein gleichzeitiges starkes CD28-Signal überkommt den ICOS-vermittelten Effekt und wirkt der IL-10R-Expression entgegen. Daher führt nur die Stimulation mit unreifen kDC zu IL-10-sensitiven T-Zellen in denen dann ein anergischer Phänotyp etabliert wird, der Teil des Differenzierungsprozesses zur induzierten Treg ist. Die ICOS/ICOS-L-Interaktion ist somit zentral für die Aufrechterhaltung peripherer Toleranz.rn

The incidence and health economic burden of ischemic amputation in Minnesota, 2005-2008

Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery disease (PAD), is associated with high rates of myocardial infarction, stroke, and amputation, and has a high health economic cost. The objective of this study was to estimate the incidence of lower limb amputation, the most serious consequence of CLI, and to create a surveillance methodology for the incidence of ischemic amputation in Minnesota.

Safety and efficacy of allogeneic cell therapy in infarcted rats transplanted with mismatched cardiosphere-derived cells

Cardiosphere-derived cells (CDCs) are an attractive cell type for tissue regeneration, and autologous CDCs are being tested clinically. However, autologous therapy necessitates patient-specific tissue harvesting and cell processing, with delays to therapy and possible variations in cell potency. The use of allogeneic CDCs, if safe and effective, would obviate such limitations. We compared syngeneic and allogeneic CDC transplantation in rats from immunologically-mismatched inbred strains.

Efficacy of a strategy to prevent neonatal early-onset group B streptococcal (GBS) sepsis

BACKGROUND: Existing guidelines recommend different strategies to prevent early-onset neonatal GBS sepsis. In 1997, using our own data on incidence and risk factors, we established a new prevention strategy which includes GBS screening at 36 weeks' gestation and intrapartum antibiotic prophylaxis (IAP) in women with positive or unknown GBS colonization with at least one risk factor. The present study evaluates the efficacy of the new prevention strategy. METHODS: Retrospective study of the incidence of early-onset GBS sepsis among all live births at the University Women's Hospital Basel between 1997 and 2002. Additional analysis of delivery and post partum period of all GBS sepsis cases, including GBS screening, risk factors during labor (prematurity, rupture of membranes (ROM) <12 h, intrapartum signs of infection), and IAP. Comparison of this group's characteristics G2 (9,385 live births, using the new strategy) with the previous group, G1 (1984-1993, 16,126 live births, without GBS screening or routine IAP) was performed. RESULTS: The incidence of early-onset GBS sepsis was reduced from 1/1000 (G1) to 0.53/1000 (G2). We observed a significant reduction of overall intrapartum risk factors in cases of GBS sepsis. CONCLUSION: This study suggests that our new prevention strategy is effective in reducing the incidence of early-onset GBS sepsis in neonates. In comparison, implementation of the CDC's prevention strategy might have prevented 2 additional cases in 9385 live births. However, this would have required treating a much larger number of pregnant women with IAP with consequential increasing costs, side effects and complications.

Assessment of recent HIV-1 infection by a line immunoassay for HIV-1/2 confirmation

BACKGROUND: Knowledge of the number of recent HIV infections is important for epidemiologic surveillance. Over the past decade approaches have been developed to estimate this number by testing HIV-seropositive specimens with assays that discriminate the lower concentration and avidity of HIV antibodies in early infection. We have investigated whether this "recency" information can also be gained from an HIV confirmatory assay. METHODS AND FINDINGS: The ability of a line immunoassay (INNO-LIA HIV I/II Score, Innogenetics) to distinguish recent from older HIV-1 infection was evaluated in comparison with the Calypte HIV-1 BED Incidence enzyme immunoassay (BED-EIA). Both tests were conducted prospectively in all HIV infections newly diagnosed in Switzerland from July 2005 to June 2006. Clinical and laboratory information indicative of recent or older infection was obtained from physicians at the time of HIV diagnosis and used as the reference standard. BED-EIA and various recency algorithms utilizing the antibody reaction to INNO-LIA's five HIV-1 antigen bands were evaluated by logistic regression analysis. A total of 765 HIV-1 infections, 748 (97.8%) with complete test results, were newly diagnosed during the study. A negative or indeterminate HIV antibody assay at diagnosis, symptoms of primary HIV infection, or a negative HIV test during the past 12 mo classified 195 infections (26.1%) as recent (< or = 12 mo). Symptoms of CDC stages B or C classified 161 infections as older (21.5%), and 392 patients with no symptoms remained unclassified. BED-EIA ruled 65% of the 195 recent infections as recent and 80% of the 161 older infections as older. Two INNO-LIA algorithms showed 50% and 40% sensitivity combined with 95% and 99% specificity, respectively. Estimation of recent infection in the entire study population, based on actual results of the three tests and adjusted for a test's sensitivity and specificity, yielded 37% for BED-EIA compared to 35% and 33% for the two INNO-LIA algorithms. Window-based estimation with BED-EIA yielded 41% (95% confidence interval 36%-46%). CONCLUSIONS: Recency information can be extracted from INNO-LIA-based confirmatory testing at no additional costs. This method should improve epidemiologic surveillance in countries that routinely use INNO-LIA for HIV confirmation.