Clusters of leprosy transmission and of late diagnosis in a highly endemic area in Brazil: focus on different spatial analysis approaches

Objective The Brazilian National Hansens Disease Control Program recently identified clusters with high disease transmission. Herein, we present different spatial analytical approaches to define highly vulnerable areas in one of these clusters. Method The study area included 373 municipalities in the four Brazilian states Maranha o, Para ', Tocantins and Piaui '. Spatial analysis was based on municipalities as the observation unit, considering the following disease indicators: (i) rate of new cases / 100 000 population, (ii) rate of cases < 15 years / 100 000 population, (iii) new cases with grade-2 disability / 100 000 population and (iv) proportion of new cases with grade-2 disabilities. We performed descriptive spatial analysis, local empirical Bayesian analysis and spatial scan statistic. Results A total of 254 (68.0%) municipalities were classified as hyperendemic (mean annual detection rates > 40 cases / 100 000 inhabitants). There was a concentration of municipalities with higher detection rates in Para ' and in the center of Maranha o. Spatial scan statistic identified 23 likely clusters of new leprosy case detection rates, most of them localized in these two states. These clusters included only 32% of the total population, but 55.4% of new leprosy cases. We also identified 16 significant clusters for the detection rate < 15 years and 11 likely clusters of new cases with grade-2. Several clusters of new cases with grade-2 / population overlap with those of new cases detection and detection of children < 15 years of age. The proportion of new cases with grade-2 did not reveal any significant clusters. Conclusions Several municipality clusters for high leprosy transmission and late diagnosis were identified in an endemic area using different statistical approaches. Spatial scan statistic is adequate to validate and confirm high-risk leprosy areas for transmission and late diagnosis, identified using descriptive spatial analysis and using local empirical Bayesian method. National and State leprosy control programs urgently need to intensify control actions in these highly vulnerable municipalities.

Human telomere disease due to disruption of the CCAAT box of the TERC promoter

Mutations in the coding region of telomerase complex genes can result in accelerated telomere attrition and human disease. Manifestations of telomere disease include the bone marrow failure syndromes dyskeratosis congenita and aplastic anemia, acute myeloid leukemia, liver cirrhosis, and pulmonary fibrosis. Here, we describe a mutation in the CCAAT box (GCAAT) of the TERC gene promoter in a family in which multiple members had typical features of telomeropathy. The genetic alteration in this critical regulatory sequence resulted in reduced reporter gene activity and absent binding of transcription factor NF-Y, likely responsible for reduced TERC levels, decreased telomerase activity, and short telomeres. This is the first description of a pathogenic mutation in the highly con-served CCAAT box and the first instance of a mutation in the promoter region of TERC producing a telomeropathy. We propose that current mutation-screening strategies should include gene promoter regions for the diagnosis of telomere diseases. This clinical trial was registered at www.clinicaltrials.gov as #NCT00071045. (Blood. 2012;119(13):3060-3063)

Two new species of Mezilaurus (Lauraceae) from Brazil

Ongoing taxonomic work on Mezilaurus has revealed two new species of the genus in Brazil, which are here described and illustrated. The first one, Mezilaurus glabriantha, from the state of Espirito Santo, represents the third endemic species known from the Brazilian Atlantic Forest, and Mezilaurus microphylla occurs in seasonally dry forests from the central Brazilian state of Tocantins. A key to distinguish the extra-Amazonian species of Mezilaurus from Brazil is provided.

Identification and characterization of drought/wet events homogeneous environments based on regional climate simulations

The objective of this study was to identify and characterize homogeneous environments based on the probability of drought/wet occurrence in the central-northern Brazil, considering Rondonia, Mato Grosso, Goias and Tocantins States. The drought index denominated the moisture anomaly Z-index (Z-index) was used. The input climate data for the drought index was generated by the regional climate model RegCM3 for the period from 1975 to 1989. As result of cluster analysis, it was identified 13 homogeneous environments. These environments were characterized based on the probability of drought/wet, relative density of drought/wet occurrence, annual rainfall variability and probability of drought occurrence during the rainy season (October to March). The Mato Grosso State had the highest number of homogeneous environments and the environment 11, located at southwest of this State had the highest probability of drought occurrence, 9%. The environment 10, located at the extreme east of Goias State, showed the lowest median for the total annual rainfall. The climatic event with the highest probability of occurrence in the study area is close to normal or normality moisture.

A trophic study of the sympatric Amazonian freshwater turtles Podocnemis unifilis and Podocnemis expansa (Testudines, Podocnemidae) using carbon and nitrogen stable isotope analyses

The Yellow-spotted River Turtle (Podocnemis unifilis Troschel, 1848) and the South American River Turtle (Podocnemis expansa (Schweigger, 1812)) are two turtles species that are widely distributed and have ecological, economic, and cultural importance in the Amazon basin. Although sympatric regarding most of their distribution, few studies have addressed the coexistence of these two species. To examine this, we analyzed the trophic level and the primary carbon source from the diets of both species in Baixo Araguaia, Tocantins, Brazil, using stable isotope analyses of carbon (delta C-13) and nitrogen (delta N-15). We also verified possible intraspecific variations (related to sex and body mass) in the trophic levels and primary carbon sources of their diets. Podocnemis unifilis had higher values of delta N-15 than P. expansa, averaging 7.59 parts per thousand and 5.06 parts per thousand, respectively, a difference which may indicate a possible trophic change owing to exploiting different food resources. No differences were found between the two species in relation to delta C-13 (mean values of -26.2 parts per thousand and -26.1 parts per thousand, respectively). The similarity between delta C-13 values suggests that the sources of their basal feeding are the same, consisting mainly of C-3 plants. There was no intraspecific variation in the values of delta C-13 and delta N-15.

Efeitos de altas temperaturas na germinação de sementes de capim-dourado (Syngonanthus nitens (Bong.) Ruhland, Eriocaulaceae): implicações para o manejo

Este estudo teve por objetivo investigar potenciais efeitos do fogo na germinação de sementes de capim-dourado (Syngonanthus nitens) (Bong.) Ruhland (Eriocaulaceae). Sementes coletadas na região do Jalapão, Tocantins, foram submetidas a choques de temperaturas de 60º, 100 ºC, 150 ºC e 200 ºC durante 1, 3 e 5 minutos. Foram feitas 5 réplicas, com 20 sementes para cada tratamento, e controle. As sementes foram dispostas em placas de Petri e em câmaras de germinação a 28 ºC, fotoperíodo 12h/12h, por 40 dias. As taxas de germinação das sementes foram analisadas por meio de ANOVA com teste de aleatorização. A maioria dos tratamentos resultou em altas taxas de germinação (>85%), exceto 200ºC/3' (50%) e 200ºC/5', que apresentou uma queda significativa (4,5%, P<0,05). Os resultados obtidos indicam que as sementes de S. nitens não são estimuladas nem mortas por altas temperaturas, exceto quando combinados temperatura e tempos de exposição extremos (200ºC/5'). A passagem do fogo é muito rápida durante queimadas nos campos úmidos, onde S. nitens ocorre e as temperaturas frequentemente não atingem os 150 ºC. Nessas condições, estes resultados indicam que as sementes de S. nitens potencialmente sobrevivem à passagem do fogo na maioria das queimadas. Esta informação é de utilidade imediata para o manejo desta espécie de alto valor comercial.

A New Species of Hypostomus (Siluriformes: Loricariidae) from the Upper Rio Paraguay Basin, Brazil

A new small Loricariidae, Hypostomus careopinnatus, is described from the Rio Taquari drainage, upper Rio Paraguay basin, Mato Grosso, Brazil. The new species can be easily distinguished from all congeners, except Hypostomus kids, by the absence of adipose fin. Hypostomus careopinnatus is distinguished from H. levis mainly by the presence of slender bifid teeth, with mesial cusp large and rounded, and lateral cusp small and pointed (vs. spoon-shaped teeth). The new species described herein completely lacks the adipose fin and also lacks the median pre-adipose plates in almost all specimens examined. The absence of adipose fin is probably an independent acquisition for Hypostomus careopinnatus and Hypostomus levis.

Cytogenetic and molecular analyses in troglobitic and epigean species of Pimelodella (Siluriformes: Heptapteridae) from Brazil

Samples from seven different locations of the genus Pimelodella were genetically examined, two caves (exclusively subterranean, upper Tocantins River and Sao Francisco River) and five epigean (from upper Parana River basin). Cytogenetic analyses revealed the same diploid number (2n=46) for all species besides similarities in both number and location of nucleolar organizer regions and C bands. FISH with 5S rDNA probes and CMA(3) staining indicated significant differences among the studied species. Application of PCR-RFLP in ATPase 6 and 8 mitochondrial genes allowed building a minimum evolution phenogram identifying the close evolutionary relationship among groups. Both chromosomal and molecular data were useful to infer the relationships among studied Pimelodella species.

Interphase Chromosome Flow-FISH

A 2-day method using flow cytometry and FISH for interphase cells was developed to detect monosomy 7 cells in myelodysplastic syndrome patients. The method, Interphase Chromosome Flow-FISH (IC Flow-FISH), involves fixation of leukocytes from blood, membrane permeabilization, hybridization of cellular DNA with peptide nucleic acid probes with cells intact, and analysis by flow cytometry. Hundreds to thousands of monosomy 7 cells were consistently detected from 10-20 mL of blood in patients with monosomy 7. Proportions of monosomy 7 cells detected in IC Flow-FISH were compared with results from conventional cytogenetics; identification of monosomy 7 populations was verified with FACS; and patient and donor cells were mixed to test for sensitivity. IC Flow-FISH allows for detecting monosomy 7 without requiring bone marrow procurement or the necessity of metaphase spreads, and wider applications to other chromosomal abnormalities are in development. (Blood. 2012; 120(15): e54-e59)

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

Identifying the areas to preserve passion fruit pollination service in Brazilian Tropical Savannas under climate change

The aim of this study was to identify future distribution areas and propose actions to preserve passion fruit pollination service under a scenario of future climate change. We used four species of Xylocopa bees that are important for passion fruit pollination in Brazilian Tropical Savannas. We also used the known forage plant species (33 species) that are associated with this same area, since passion fruit flowers provide only nectar for bees and only during their blossoming period. We used species distribution modeling to predict the potential areas of occurrence for each bee and plant based on the current day distribution and a future climate scenario (moderate projections of climate change to 2050). We used a geographic information system to classify the models and to analyze the future areas for both groups of species. The current day distribution map showed that Xylocopa and plant species occurred primarily in the southern and central-eastern areas of the Brazilian Tropical Savannas. In the north, Xylocopa species only occurred in a small area between the states of Maranhão and Piauí while forage plant species were only observed in the northern part of the Tocantins State. However, both future scenarios (bees and plants) showed a shift in distribution, with occurrence predominantly detected in the northern areas of Brazilian Tropical Savannas. Possible conservation areas and the use of appropriate agricultural practices were suggested to ensure the maintenance of the bee/plant focal species.

Identificação e caracterização de ambientes homogêneos de eventos de seca/umidade com base em simulações climáticas regionais

O objetivo deste trabalho foi identificar e caracterizar ambientes homogêneos com base na ocorrência de eventos de seca/umidade na Região Centro-Norte do Brasil, compreendendo os Estados de Rondônia, Mato Grosso, Goiás e Tocantins. Para esse fim, utilizou-se o índice quantitativo de seca denominado Anomalia de Umidade de Palmer (Z-index). Os dados climáticos de entrada utilizados por esse índice para quantificar os eventos de seca/umidade foram simulados pelo modelo regional climático RegCM3 ("Regional ClimateModel - version3"), para o período de 1975 a 1989. Por meio de análise de agrupamento foram identificados 13 ambientes homogêneos. Esses ambientes homogêneos foram caracterizados por meio da probabilidade de ocorrência de eventos de seca/umidade, densidade relativa destes eventos, variabilidade da precipitação pluvial anual e a probabilidade de ocorrência de seca na época das águas (outubro a maio). No Estado do Mato Grosso observou-se o maior número de ambientes homogêneos e na Região Sudoeste desse Estado, o ambiente 11, obteve a maior probabilidade de ocorrência de eventos extremamente seco, 9%. O ambiente 10, localizado no extremo leste de Goiás, teve a menor mediana para a precipitação pluvial anual. O evento climático com maior probabilidade de ocorrência na região de estudo é o próximo ao normal ou normalidade de umidade.

A new species of Anchoviella Fowler, 1911 (Clupeiformes: Engraulidae) from the Amazon basin, Brazil

Anchoviella juruasanga is described from the drainages of rios Negro, Madeira, Tapajós, Trombetas, Tocantins, and Jari, in the Amazon basin, Brazil. The new species is distinguished from its congeners by having a short upper jaw, with its posterior tip extending between the verticals through anterior and posterior margins of the pupil (vs. posterior tip of upper jaw extending beyond the vertical through posterior margin of the pupil). Anchoviella juruasanga is also distinct from other strictly freshwater Amazonian species of the genus by the distance from tip of snout to posterior end of upper jaw between 8 and 11% in standard length (vs. 14% or more in A. alleni, A. carrikeri, A. guianensis, and A. jamesi). The anal-fin origin slightly posterior to or at the vertical through the base of the last dorsal-fin ray further distinguishes the new species from A. alleni (anal-fin origin posterior to the vertical through the last anal-fin ray by at least 14% of head length) and A. jamesi (anal-fin origin anterior to the vertical through the last anal-fin ray). An identification key for the Amazonian species of Anchoviella, including marine and estuarine species known to occur in the lower portion of the basin, is presented.

Perfil clínico e epidemiológico e prevalência da coinfecção tuberculose/HIV em uma regional de saúde no Maranhão

OBJETIVO: Descrever o perfil clínico e epidemiológico e a prevalência da coinfecção tuberculose/HIV na Unidade Regional de Saúde do Tocantins, que envolve 14 municípios no estado do Maranhão. MÉTODOS: Estudo epidemiológico descritivo baseado em dados secundários das fichas individuais de tuberculose do Sistema Nacional de Informação de Agravos de Notificação. Foram incluídos todos os casos notificados de coinfecção tuberculose/HIV, por município de residência, no período entre janeiro de 2001 e dezembro de 2010. RESULTADOS: Foram notificados 1.746 casos de tuberculose no distrito. Dos pacientes testados para HIV, 100 eram coinfectados. equivalendo a uma prevalência de 39%. Dos coinfectados, 79% eram do sexo masculino, 42% eram de cor parda, 64% tinham idade entre 20 e 40 anos, 31% tinham até quatro anos de estudo, e 88% residiam em Imperatriz. A forma clínica predominante foi a pulmonar (87%), e 73% eram casos novos. Dos coinfectados, 27% apresentaram resultados positivos na baciloscopia de escarro e 89% tinham imagem sugestiva de tuberculose na radiografia do tórax. A cultura de escarro foi realizada em apenas 7% dos casos. CONCLUSÕES: Evidenciou-se que a situação clínica e epidemiológica da coinfecção tuberculose/HIV ainda é um grande problema de saúde pública no sudoeste do Maranhão e impõe uma maior articulação entre os programas de controle de tuberculose e de doenças sexualmente transmissíveis/AIDS. Além disso, são necessários o compromisso e o envolvimento político dos gestores e profissionais de saúde no planejamento de ações e serviços de saúde.

Neoproterozoic evolution of the basement of the South-American platform

Neoproterozoic geologic and geotectonic processes were of utmost importance in forming and structuring the basement framework of the South-American platform. Two large domains with distinct evolutionary histories are identified with respect to the Neoproterozoic era: the northwest-west (Amazonian craton and surroundings) and the central-southeast (the extra-Amazonian domain). In the first domain, Neoproterozoic events occurred only locally and were of secondary significance, and the geologic events, processes, and structures of the pre-Neoproterozoic (and syn-Brasiliano) cratonic block were much more influential. In the second, the extra-Amazonian domain, the final evolution, structures and forms are assigned to events related to the development of a complex net of Neoproterozoic mobile belts. These in turn resulted in strong reworking of the older pre-Neoproterozoic basement. In this domain, four distinct structural provinces circumscribe or are separated by relatively small pre- Neoproterozoic cratonic nuclei, namely the Pampean, Tocantins, Borborema and Mantiqueira provinces. These extra-Amazonian provinces were formed by a complex framework of orogenic branching systems following a diversified post-Mesoproterozoic paleogeographic scenario. This scenario included many types of basement inliers as well as a diversified organization of accretionary and collisional orogens. The basement inliers date from the Archean toMesoproterozoic periods and are different in nature. The escape tectonics that operated during the final consolidation stages of the provinces were important to and responsible for the final forms currently observed. These latest events, which occurred from the Late Ediacaran to the Early Ordovician, present serious obstacles to paleogeographic reconstructions. Two groups of orogenic collage systems are identified. The older system from the Tonian (>850 Ma) period is of restricted occurrence and is not fully understood due to strong reworking subsequent to Tonian times. The second group of orogenies is more extensive and more important. Its development began with diachronic taphrogenic processes in the Early Cryogenian period (ca. 850e750 Ma) and preceded a complex scenario of continental, transitional and oceanic basins. Subsequent orogenies (post 800 Ma) were also created by diachronic processes that ended in the Early Ordovician. More than one orogeny (plate interaction) can be identified either in space or in time in every province. The orogenic processes were not necessarily synchronous in different parts of the orogenic system, even within the same province. This particular group of orogenic collage events is known as the “Brasiliano”. All of the structural provinces of the extra-Amazonian domain exhibit final events that are marked by extrusion processes, are represented by long lineaments, and are fundamental to unraveling the structural history of the Phanerozoic sedimentary basins.