Ecology of phlebotomines (Diptera, Psychodidae) in rural foci of leishmaniasis in tropical Brazil

INTRODUCTION: This work aimed to study the community structure of sandflies, with regard to the richness, constancy, abundance, and monthly frequency of the species with a focus on the transmission of leishmaniasis. METHODS: The study was conducted in the rural villages of Bom Jardim and Santa Maria, situated on the edge of a tropical rain forest in the municipality of São Jose de Ribamar, Maranhão, Brazil. The phlebotomines were captured in the intradomiciles and peridomiciles of each village, with Centers for Disease Control (CDC) light traps set in 10 homes in each village, for 1 year, once a month, from 18h to 6h. RESULTS: We collected 1,378 individuals of 16 sandfly species. The capture success rate was higher in Bom Jardim (0.61 specimens/hour/trap) than that of Santa Maria (0.35/specimens/hour/trap). The sandflies were more abundant in the peridomiciles (86.1%) and in the rainy season (77%). Five species were considered constants (occurring in more than 50% of samples), 5 accessory (25%-50%), and 6 accidental (<25%). The most abundant species were Lutzomyia longipalpis (59.7%) and L whitmani (28%). The permutation analysis showed differences between the species composition of the villages and no separation between the intradomicile and peridomicile of each village. The species that most contributed to the dissimilarity between the light traps of the 2 villages were L. longipalpis, L. whitmani, and L. evandroi, contributing to 80.8% of the variation among groups. CONCLUSIONS: The high level of richness and abundance of species and the presence of competent vectors throughout the year and around houses justify the occurrence of leishmaniasis cases reported in the area.

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

IntroductionTo determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population.MethodsIgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease.ResultsAmong the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor.ConclusionsThe prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

The performance of four molecular methods for the laboratory diagnosis of congenital toxoplasmosis in amniotic fluid samples

Introduction Toxoplasmosis may be life-threatening in fetuses and in immune-deficient patients. Conventional laboratory diagnosis of toxoplasmosis is based on the presence of IgM and IgG anti-Toxoplasma gondii antibodies; however, molecular techniques have emerged as alternative tools due to their increased sensitivity. The aim of this study was to compare the performance of 4 PCR-based methods for the laboratory diagnosis of toxoplasmosis. One hundred pregnant women who seroconverted during pregnancy were included in the study. The definition of cases was based on a 12-month follow-up of the infants. Methods Amniotic fluid samples were submitted to DNA extraction and amplification by the following 4 Toxoplasma techniques performed with parasite B1 gene primers: conventional PCR, nested-PCR, multiplex-nested-PCR, and real-time PCR. Seven parameters were analyzed, sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and efficiency (Ef). Results Fifty-nine of the 100 infants had toxoplasmosis; 42 (71.2%) had IgM antibodies at birth but were asymptomatic, and the remaining 17 cases had non-detectable IgM antibodies but high IgG antibody titers that were associated with retinochoroiditis in 8 (13.5%) cases, abnormal cranial ultrasound in 5 (8.5%) cases, and signs/symptoms suggestive of infection in 4 (6.8%) cases. The conventional PCR assay detected 50 cases (9 false-negatives), nested-PCR detected 58 cases (1 false-negative and 4 false-positives), multiplex-nested-PCR detected 57 cases (2 false-negatives), and real-time-PCR detected 58 cases (1 false-negative). Conclusions The real-time PCR assay was the best-performing technique based on the parameters of Se (98.3%), Sp (100%), PPV (100%), NPV (97.6%), PLR (∞), NLR (0.017), and Ef (99%).

Laboratory diagnosis of amebiasis in a sample of students from southeastern Brazil and a comparison of microscopy with enzyme-linked immunosorbent assay for screening of infections with Entamoeba sp.

Introduction: Epidemiological studies on amebiasis have been reassessed since Entamoeba histolytica and E. dispar were first recognized as distinct species. Because the morphological similarity of these species renders microscopic diagnosis unreliable, additional tools are required to discriminate between Entamoeba species. The objectives of our study were to compare microscopy with ELISA kit (IVD®) results, to diagnose E. histolytica infection, and to determine the prevalence of amebiasis in a sample of students from southeastern Brazil. Methods: In this study, diagnosis was based on microscopy due to its capacity for revealing potential cysts/trophozoites and on two commercial kits for antigen detection in stool samples. Results: For 1,403 samples collected from students aged 6 to 14 years who were living in Divinópolis, Minas Gerais, Brazil, microscopy underestimated the number of individuals infected with E. histolytica/E. dispar (5.7% prevalence) compared with the ELISA kit (IVD®)-based diagnoses (15.7% for E. histolytica/E. dispar). A comparison of the ELISA (IVD®) and light microscopy results returned a 20% sensitivity, 97% specificity, low positive predictive value, and high negative predictive value for microscopy. An ELISA kit (TechLab®) that was specific for E. histolytica detected a 3.1% (43/1403) prevalence for E. histolytica infection. Conclusions: The ELISA kit (IVD®) can be used as an alternative screening tool. The high prevalence of E. histolytica infection detected in this study warrants the implementation of actions directed toward health promotion and preventive measures.

Evaluation of diagnostic tests for Wuchereria bancrofti infection in Brazilian schoolchildren

Introduction Since the launch of the Global Programme to Eliminate Lymphatic Filariasis, more than 70% of the endemic countries have implemented mass drug administration (MDA) to interrupt disease transmission. The monitoring of filarial infection in sentinel populations, particularly schoolchildren, is recommended to assess the impact of MDA. A key issue is choosing the appropriate tools for these initial assessments (to define the best intervention) and for monitoring transmission. Methods This study compared the pre-MDA performance of five diagnostic methods, namely, thick film test, Knott's technique, filtration, Og4C3-ELISA, and the AD12-ICT card test, in schoolchildren from Brazil. Venous and capillary blood samples were collected between 11 pm and 1 am. The microfilarial loads were analyzed with a negative binomial regression, and the prevalence and associated 95% confidence intervals were estimated for all methods. The accuracies of the AD12-ICT card and Og4C3-ELISA tests were assessed against the combination of parasitological test results. Results A total of 805 schoolchildren were examined. The overall and stratified prevalence by age group and gender detected by Og4C3-ELISA and AD12-ICT were markedly higher than the prevalence estimated by the parasitological methods. The sensitivity of the AD12-ICT card and Og4C3-ELISA tests was approximately 100%, and the positive likelihood ratios were above 6. The specificity of the Og4C3-ELISA was higher than that of the AD12-ICT at different prevalence levels. Conclusions The ICT card test should be the recommended tool for monitoring school-age populations living in areas with ongoing or completed MDA.

Ecoepidemiology and biology of Eratyrus mucronatus Stål, 1859 (Hemiptera: Reduviidae: Triatominae), a sylvatic vector of Chagas disease in the Brazilian Amazon

Introduction Eratyrus mucronatus Stål, 1859 is a wild triatomine vector of Trypanosoma cruzi Chagas, 1909. However, little is known regarding the biology and ecoepidemiology of this triatomine in the Brazilian Amazon. The present study describes the biology of E. mucronatus grown under laboratory conditions and the epidemiological aspects of its natural breeding sites. Methods Five colonies were monitored in the field for 3 years. Temperature and humidity measurements were taken in the mornings and afternoons at the natural breeding sites, and the behavior and distribution of the nymphs and adults were observed in the wild colony. We also monitored the life cycle under controlled laboratory conditions. Results Some factors that were considered decisive for the establishment of these colonies were present at all of the colonies studied in the field. These factors included an active termite nest, a vertebrate for repast, and dry and shaded substrates with temperatures of 24-28°C and with humidity of 80-90%. A generation was developed in 274 days under these microclimatic conditions in the laboratory. Conclusions The climatic variables described in the field indicate that these environmental parameters have a limiting effect on the dispersal and colonization of E. mucronatus to new environments. In addition, the long period of development to adulthood demonstrates that only one generation can develop per year even under the more favorable laboratory conditions.

Avaliação do potencial anti-inflamatório, antioxidante e antimicrobiano de extratos de segurelha, salsa e coentros

Recentemente tem-se observado um crescente interesse pelo uso de plantas aromáticas, devido às inúmeras propriedades benéficas que lhes têm sido associadas, e a sua aplicação em diversas indústrias, como a indústria alimentar e farmacêutica. Este estudo incidiu sob três ervas aromáticas utilizadas comummente em Portugal: coentros, salsa e segurelha. O objetivo do mesmo foi contribuir para um melhor conhecimento das propriedades bioativas das plantas estudadas, através da determinação do seu teor em compostos fenólicos totais e em flavonoides, e avaliação das suas atividades antioxidante, antimicrobiana e anti-inflamatória. A atividade antioxidante foi determinada através de diferentes tipos de ensaios, nomeadamente avaliação da capacidade redutora, com os ensaios FRAP e CUPRAC, avaliação da capacidade de sequestro do radical DPPH• e avaliação da capacidade de sequestro do radical anião superóxido. A atividade antimicrobiana foi determinada utilizando três estirpes microbianas, Staphylococcus aureus, Escherichia coli e Candida albicans. Por sua vez, a ação anti-inflamatória foi determinada através de ensaios in-vivo apenas para a segurelha, utilizando dois modelos, um para a inflamação aguda (modelo de edema da pata induzido pela carragenina) e outro para a inflamação crónica (modelo da colite ulcerativa). Os resultados demonstraram que todos os extratos de plantas aromáticas possuem atividade antioxidante, sendo que o extrato de segurelha foi aquele que apresentou um maior teor de compostos fenólicos e flavonoides, bem como o que demonstrou possuir uma maior atividade antioxidante relativamente aos restantes extratos estudados, o que sugere o envolvimento destes compostos neste tipo de atividade antioxidante. Entre o extrato de coentros e salsa, o extracto de coentros apresentou um teor em compostos fenólicos e uma actividade antioxidante significativamente superior relativamente ao extracto de salsa. O extrato de segurelha foi o único que apresentou ação antimicrobiana, o que poderá indicar que os compostos fenólicos se encontram também interligados com esta propriedade. A atividade anti-inflamatória foi determinada apenas para o extrato de segurelha, sendo que se observou que este possui efeitos benéficos para a inflamação aguda e crónica, o que poderá estar novamente relacionado com o seu teor em fenóis e flavonoides. O efeito anti-inflamatório observado com o extrato de segurelha no modelo de colite pode ser muito útil do ponto de vista de profilaxia pois o extrato foi administrado aos animais logo a seguir à indução da colite e os resultados demonstram haver uma diminuição significativa da extensão e violência dos sinais da inflamação crónica observados no grupo controlo positivo.

Pharmacokinetic/pharmacodynamic target attainment of intravenous β-lactam regimens against Gram-negative bacteria isolated in a Brazilian teaching hospital

ABSTRACTINTRODUCTION: Monte Carlo simulations have been used for selecting optimal antibiotic regimens for treatment of bacterial infections. The aim of this study was to assess the pharmacokinetic and pharmacodynamic target attainment of intravenous β-lactam regimens commonly used to treat bloodstream infections (BSIs) caused by Gram-negative rod-shaped organisms in a Brazilian teaching hospital.METHODS: In total, 5,000 patients were included in the Monte Carlo simulations of distinct antimicrobial regimens to estimate the likelihood of achieving free drug concentrations above the minimum inhibitory concentration (MIC; fT > MIC) for the requisite periods to clear distinct target organisms. Microbiological data were obtained from blood culture isolates harvested in our hospital from 2008 to 2010.RESULTS: In total, 614 bacterial isolates, including Escherichia coli, Enterobacterspp., Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, were analyzed Piperacillin/tazobactam failed to achieve a cumulative fraction of response (CFR) > 90% for any of the isolates. While standard dosing (short infusion) of β-lactams achieved target attainment for BSIs caused by E. coliand Enterobacterspp., pharmacodynamic target attainment against K. pneumoniaeisolates was only achieved with ceftazidime and meropenem (prolonged infusion). Lastly, only prolonged infusion of high-dose meropenem approached an ideal CFR against P. aeruginosa; however, no antimicrobial regimen achieved an ideal CFR against A. baumannii.CONCLUSIONS:These data reinforce the use of prolonged infusions of high-dose β-lactam antimicrobials as a reasonable strategy for the treatment of BSIs caused by multidrug resistant Gram-negative bacteria in Brazil.

C cells in the thyroid of pinealectomized rats

PURPOSE: To study quantitatively C cells in the thyroids of non-isogenic rats to determine the possible effects of pinealectomy on the number of these cells, and consequently on the synthesis and secretion of calcitonin. METHODS: Twenty male rats of an outbred strain (200-300 g) were used in the present study. One group of 10 animals was pinealectomized 50 days prior to sacrifice. Thyroid tissue was stained for calcitonin (Dako Corporation) at a 1:1500 dilution. The number of C cells observed was expressed as number of cells/cm². Data were analyzed statistically by Mann-Whitney test. RESULTS: The number of C cells in pinealectomized and normal animals ranged from 489 to 2084 per cm² and 227 to 1584 per cm², respectively, a difference that was statistically significant (P <0.05). CONCLUSIONS: These results showed consistent differences in the number of C cells after pinealectomy when compared to controls. We believe that pinealectomy increases the number of C cells in the rat thyroid.

Surgery information reduces anxiety in the pre-operative period

PURPOSE: Patients preparing to undergo surgery should not suffer needless anxiety. This study aimed to evaluate anxiety levels on the day before surgery as related to the information known by the patient regarding the diagnosis, surgical procedure, or anesthesia. METHOD: Patients reported their knowledge of diagnosis, surgery, and anesthesia. The Spielberger State-Trait Anxiety Inventory (STAI) was used to measure patient anxiety levels. RESULTS: One hundred and forty-nine patients were selected, and 82 females and 38 males were interviewed. Twenty-nine patients were excluded due to illiteracy. The state-anxiety levels were alike for males and females (36.10 ± 11.94 vs. 37.61 ± 8.76) (mean ± SD). Trait-anxiety levels were higher for women (42.55 ± 10.39 vs. 38.08 ± 12.25, P = 0.041). Patient education level did not influence the state-anxiety level but was inversely related to the trait-anxiety level. Knowledge of the diagnosis was clear for 91.7% of patients, of the surgery for 75.0%, and of anesthesia for 37.5%. Unfamiliarity with the surgical procedure raised state-anxiety levels (P = 0.021). A lower state-anxiety level was found among patients who did not know the diagnosis but knew about the surgery (P = 0.038). CONCLUSIONS: Increased knowledge of patients regarding the surgery they are about to undergo may reduce their state-anxiety levels.

New method for evaluation of cutaneous sensibility in diabetic feet: preliminary report

Diabetic neuropathy is an important complication of the disease, responsible for ulceration and amputation of the foot. Prevention of these problems is difficult mainly because there is no method to correctly access sensibility on the skin of the foot. The introduction of the Pressure-Specified Sensory Device (PSSD TM) in the last decade made possible the measurement of pressure thresholds sensed by the patient, such as touch, both static and in movement, on a continuous scale. This paper is the first in Brazil to report the use of this device to measure cutaneous sensibility in 3 areas of the foot: the hallux pulp, the calcaneus, and the dorsum, which are territories of the tibial and fibular nerves. METHOD: Non-diabetic patients were measured as controls, and 2 groups of diabetic patients - with and without ulcers - were compared. The PSSD TM was used to test the 3 areas described above. The following were evaluated: 1 PS (1-point static), 1 PD (1-point dynamic), 2 PS (2-points static), 2 PD (2-points dynamic). RESULTS: The diabetic group had poorer sensibility compared to controls and diabetics with ulcers had poorer sensibility when compared to diabetics without ulcers. The differences were statistically significant (P <.001). CONCLUSION: Due to the small number of patients compared, the results should be taken as a preliminary report.

COMPORTAMENTO FENOLÓGICO DA SUCUPIRA-PRETA (Diplotropis purpurea (Rich.) Amsh. var. coriacea Amsh.), NA RESERVA FLORESTAL DUCKE

Este trabalho analisa dados de 6 anos (1980-1985) de observações da fenologia de cinco indivíduos arbóreos da espécie Diplotropis purpures (Rich.) Amsh. var. coriacea Amsh., da família Leguminosae, subfamília Papilionoideae, localizados na Reserva Florestal Ducke. Determinou-se a época, duração e freqüência das fases reprodutivas, bem como o tipo de mudança foliar. A espécie apresentou a fase de floração na estação seca. A fase de frutificação foi observada no meio da estação seca e início da estação chuvosa. A duração média da fase de floração foi de 6 meses e a fase de frutificação 7 meses. Ao nível de espécie, o padrão de ocorrência da fase de floração e frutificação foi anual à irregular. Porém, ao nível de indivíduo, o padrão de comportamento foi irregular. Quanto ao tipo de mudança foliar, a espécie apresentou características de ser semi-caducifólia durante a floração, na época seca.

Distribuições diamétricas daFloresta Tropical úmida em uma área no município de Itacoatiara-AM

Foram estudadas as funções de distribuição Beta, Gama e Weibull em dez hectares de floresta tropical úmida de terra-firme da Madeireira Dois Mil, localizada no município de Itacoatiara, Amazonas, Brasil. Foram medidas todas as árvores com DAP 20 cm num total de 2.035 indivíduos. Para avaliar a função que melhor ajustou a distribuição de diâmetros nesta floresta foi utilizado o teste de Kolmogorov-Smirnov e a Análise gráfica dos resíduos. O menor valor de "D" do teste Kolmogorov-Smirnov foi encontrado para a função Weibull, seguido da função Beta e por último da função Gama. As funções Weibull e Beta foram significativas ao nível de 5% de probabilidade pelo teste de Kolmogorov-Smirnov, mas a Gama foi não significativa. Pela análise gráfica dos resíduos foi encontrado também melhor resultado para a função Weibull, pois não apresentou pontos discrepantes, ocorrendo para todas as classes uma variância uniforme dos pontos em torno da linha. Desta forma, a função Weibull foi a que apresentou melhor ajuste. A função Beta pode ser utilizada, porém para algumas classes podem ocorrer subestimativas. A função Gama não é recomendada.

Entre tempos e suspiros. Histórias de emigração em Vieira do Minho

(Excerto) A temática da emigração tem recebido considerável atenção, nas últimas décadas, por parte de investigadores das ciências sociais (Baganha, 1994; Gonçalves e Gonçalves, 1991; Leandro, 2004; Monteiro, 1994; Peixoto, 2004, 2007; Pires, 2003; Ribeiro, 1986; Rocha-Trindade, 1976, 1982, 1985, 1993; Wall, 1984, entre outros). Tal atenção explica-se pelo facto de a mobilidade e a deslocação das populações se terem constituído como assuntos de importância maior, quando se trata de planeamento da sociedade e da definição de políticas públicas. As migrações e as mobilidades mudam de forma ao longo do tempo, adquirindo constantemente outros contornos. Definem-se por outros pressupostos, confrontam-se com outros dilemas e constrangimentos. Não obstante, trata-se inegavelmente de um fenómeno que implica populações, políticas e processos de desenvolvimento, assim como contextos culturais, interesses e motivações individuais. Implica, também, questões de identidade individual e nacional.

Desbaste seletivo em povoamentos de Tectona grandis com diferentes idades

O efeito da intensidade do primeiro desbaste seletivo, após um ano, foi avaliado em dois povoamentos de teca sob espaçamento 3,0 x 3,0 m, e em duas diferentes idades. No povoamento com quatro anos de idade, o desbaste foi de 20%, 30% e 40%, em número de indivíduos, e no de cinco anos, de 30%, 40% e 50%, e as respectivas testemunhas (0%). Cada tratamento foi aplicado ao acaso, com oito repetições, contendo cada parcela 35 árvores, além da bordadura. Um ano após o desbaste aplicado no povoamento com quatro anos, as variáveis DAP, altura total (H) e as médias por árvore de área transversal () e de volume () não apresentaram diferenças significativas entre os tratamentos; o incremento corrente anual (ICA V) não foi afetado pelas intensidades. No povoamento desbastado aos cinco anos, o ICA V e H foram semelhantes em todos tratamentos. As intensidade de desbaste testadas não afetaram o crescimento em DAP, e , mas apresentaram diferenças significativas em relação à testemunha. O primeiro desbaste seletivo pode ser aplicado aos cinco anos de idade, em povoamentos de Tectona grandis com condições semelhantes, com qualquer das intensidades testadas.