Tratamento da Co-Infecção do Vírus da Hepatite B e C. Resposta Excedida

Os vírus da hepatite B (VHB) e da hepatite C (VHC) constituem a causa mais frequente de doença hepática crónica. A partilha de vias de transmissão contribui para o risco de coinfecção VHB-VHC. Nos doentes co-infectados com o VHB e VHC verifica-se uma progressão mais rápida para a cirrose hepática e existe um risco aumentado para o carcinoma hepatocelular. A terapêutica da co-infecção VHB/VHC é empírica, consistindo na indicada para a infecção exclusiva pelo VHC, o qual, na maioria dos casos, é o vírus dominante. A utilização do tratamento padrão para a hepatite C, nomeadamente interferão alfa peguilado e ribavirina, não mostra diferenças significativas na resposta virológica sustentada ao VHC comparativamente com a dos monoinfectados pelo VHC. É incerto o benefício da associação de análogos dos nucleós(t)idos. A acção terapêutica pode modificar a interacção entre os dois vírus e, designadamente, exacerbar a doença por reactivação do VHB. Os autores apresentam o caso clínico de uma doente com co-infecção VHB-VHC, sem reconhecimento de vírus dominante, em que a resposta à terapêutica instituída superou a expectativa da evidência científica disponível.

Conceção de um tutorial de Iniciação ao co-projeto de Hardware/software

A crescente evolução dos dispositivos contendo circuitos integrados, em especial os FPGAs (Field Programmable Logic Arrays) e atualmente os System on a chip (SoCs) baseados em FPGAs, juntamente com a evolução das ferramentas, tem deixado um espaço entre o lançamento e a produção de materiais didáticos que auxiliem os engenheiros no Co- Projecto de hardware/software a partir dessas tecnologias. Com o intuito de auxiliar na redução desse intervalo temporal, o presente trabalho apresenta o desenvolvimento de documentos (tutoriais) direcionados a duas tecnologias recentes: a ferramenta de desenvolvimento de hardware/software VIVADO; e o SoC Zynq-7000, Z-7010, ambos desenvolvidos pela Xilinx. Os documentos produzidos são baseados num projeto básico totalmente implementado em lógica programável e do mesmo projeto implementado através do processador programável embarcado, para que seja possível avaliar o fluxo de projeto da ferramenta para um projeto totalmente implementado em hardware e o fluxo de projeto para o mesmo projeto implementado numa estrutura de harware/software.

ELEVATED TRANS-MAMMARY TRANSMISSION OF Toxocara canis LARVAE IN BALB/c MICE

Toxocariasis is a widespread zoonosis and is considered an important worldwide public health problem. The aim of this study was to investigate the frequency of trans-mammary Toxocara canis infection in newborn BALB/c mice nursed by females experimentally infected with 1,200 eggs after delivery. After 50 days of age, the presence of larvae in different organs of the offspring was investigated. Trans-mammary infection was confirmed in 73.9% of the mice that had been nursed by infected females. These data show a high trans-mammary transmission of T. canis and confirm the significance of this transmission route in paratenic hosts.

PRETERM BIRTH AND FETAL GROWTH RESTRICTION IN HIV-INFECTED BRAZILIAN PREGNANT WOMEN

Introduction: Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below, between or beyond the ±1.28 z/GA score, the usual clinical cut-off to demarcate the 10th and 90th percentiles. Results: PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%, 13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were: PTB: 5.9 versus 27.5%, LBW: 14.7% versus 25.0%, SGA BW: 17.6% versus 15.0%, BL: 6.0% versus 30.0%, HC: 9.0% versus 17.9%, and AC: 13.3% versus 21.2%; only SGA BL attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA cases. A concomitant presence of, at least, two SGA dimensions in the same fetus was frequent. Conclusions: The proportions of preterm birth and low birth weight were higher than the local and Brazilian prevalence and a trend was observed for higher proportions of SGA fetal dimensions than the expected population distribution in this small casuistry of newborn from the HIV-infected, low income, antiretroviral users, and publicly assisted pregnant women. A trend for higher prevalence of PTB, LBW and SGA fetal dimensions was also observed in infants born to mothers with AIDS compared to HIV-infected mothers without AIDS.

SAINT LOUIS ENCEPHALITIS VIRUS IN MATO GROSSO, CENTRAL-WESTERN BRAZIL

The dengue virus (DENV), which is frequently involved in large epidemics, and the yellow fever virus (YFV), which is responsible for sporadic sylvatic outbreaks, are considered the most important flaviviruses circulating in Brazil. Because of that, laboratorial diagnosis of acute undifferentiated febrile illness during epidemic periods is frequently directed towards these viruses, which may eventually hinder the detection of other circulating flaviviruses, including the Saint Louis encephalitis virus (SLEV), which is widely dispersed across the Americas. The aim of this study was to conduct a molecular investigation of 11 flaviviruses using 604 serum samples obtained from patients during a large dengue fever outbreak in the state of Mato Grosso (MT) between 2011 and 2012. Simultaneously, 3,433 female Culex spp. collected with Nasci aspirators in the city of Cuiabá, MT, in 2013, and allocated to 409 pools containing 1-10 mosquitoes, were also tested by multiplex semi-nested reverse transcription PCR for the same flaviviruses. SLEV was detected in three patients co-infected with DENV-4 from the cities of Cuiabá and Várzea Grande. One of them was a triple co-infection with DENV-1. None of them mentioned recent travel or access to sylvatic/rural regions, indicating that transmission might have occurred within the metropolitan area. Regarding mosquito samples, one pool containing one Culex quinquefasciatus female was positive for SLEV, with a minimum infection rate (MIR) of 0.29 per 1000 specimens of this species. Phylogenetic analysis indicates both human and mosquito SLEV cluster, with isolates from genotype V-A obtained from animals in the Amazon region, in the state of Pará. This is the first report of SLEV molecular identification in MT.

FIRST REPORT OF ACUTE CHAGAS DISEASE BY VECTOR TRANSMISSION IN RIO DE JANEIRO STATE, BRAZIL

SUMMARY Chagas disease (CD) is an endemic anthropozoonosis from Latin America of which the main means of transmission is the contact of skin lesions or mucosa with the feces of triatomine bugs infected by Trypanosoma cruzi. In this article, we describe the first acute CD case acquired by vector transmission in the Rio de Janeiro State and confirmed by parasitological, serological and PCR tests. The patient presented acute cardiomyopathy and pericardial effusion without cardiac tamponade. Together with fever and malaise, a 3 cm wide erythematous, non-pruritic, papule compatible with a "chagoma" was found on his left wrist. This case report draws attention to the possible transmission of CD by non-domiciled native vectors in non-endemic areas. Therefore, acute CD should be included in the diagnostic workout of febrile diseases and acute myopericarditis in Rio de Janeiro.

Comparison of Methods and Co-Registration Maps of EEG and fMRI in Occipital Lobe Epilepsy

Clinically childhood occipital lobe epilepsy (OLE) manifests itself with distinct syndromes. The traditional EEG recordings have not been able to overcome the difficulty in correlating the ictal clinical symptoms to the onset in particular areas of the occipital lobes. To understand these syndromes it is important to map with more precision the epileptogenic cortical regions in OLE. Experimentally, we studied three idiopathic childhood OLE patients with EEG source analysis and with the simultaneous acquisition of EEG and fMRI, to map the BOLD effect associated with EEG spikes. The spatial overlap between the EEG and BOLD results was not very good, but the fMRI suggested localizations more consistent with the ictal clinical manifestations of each type of epileptic syndrome. Since our first results show that by associating the BOLD effect with interictal spikes the epileptogenic areas are mapped to localizations different from those calculated from EEG sources and that by using different EEG/fMRI processing methods our results differ to some extent, it is very important to compare the different methods of processing the localization of activation and develop a good methodology for obtaining co-registration maps of high resolution EEG with BOLD localizations.

ACUTE TOXOPLASMOSIS IN A BREASTFED INFANT WITH POSSIBLE TRANSMISSION BY WATER

Toxoplasma gondii transmission via breastfeeding has been discussed; however, no cases have been confirmed to date. This article describes a case of acute toxoplasmosis diagnosed in a mother and her six-month-old breastfed infant. The study accounts for the possibility of breast milk transmission and directs both clinicians and pediatricians to the hypothesis that both patients acquired toxoplasmosis via water ingestion.

Participação pública em processos controversos de decisão ambiental – Caso de estudo da co-incineração em Souselas

Dissertação para obtenção do Grau de Mestre em Engenharia do Ambiente, Perfil de Ordenamento do Território e Impactes Ambientais

VISCERAL LEISHMANIASIS IN PETROLINA, STATE OFPERNAMBUCO, BRAZIL, 2007-2013

Visceral leishmaniasis is a life-threatening disease of great public health relevance in Brazil. The municipality of Petrolina is an endemic area in the State of Pernambuco, Brazil. This study was designed to assess the recent expansion of VL in the municipality ofPetrolina, Pernambuco. Patients data were obtained from the Brazilian National Information System for Notifiable Diseases (SINAN). A total of 111 records from 2007 to 2013 were investigated, of which 69 were residents in Petrolina. The disease has predominantly affected 1-4 year old children (34.8%). Most of the patients were males (59.4%). Co-infection with human immunodeficiency virus occurred in 14.5% of the cases. The criterion most frequently used was the clinical and epidemiological confirmation (59.4%), with clinical cure in 78.3% of cases and one fatal outcome. Visceral leishmaniasis is endemic in Petrolina with transmission levels varying from moderate to high. The present study has shown the precariousness of the use of diagnostic tests in primary healthcare units, and this misuse has interfered with the diagnosis and treatment of cases.

Diferença de susceptibilidade à infecção com T. Cruzi entre espécies de triatomíneos alimentados em cão, tatu e camundongo infectados

Diversas espécies de triatomíneos foram alimentadas em cão, tatu e camundongos infectados pelo T. cruzi, para verificação de suas susceptibilidades. Em cão T. infestans e P. megistus se infectaram melhor. Em tatus T. iníestans e T. brasiliensis acusaram melhores índices de infecção, enquanto em camundongos as espécies de Rhodnius e T. brasiliensis foram as melhores infectadas. A positividade dos xenos não pareceu obrigatoriamente relacionada com a riqueza da parasitemia evidenciada através da hemoscopia direta. A positividade dos xenos em camundongos variou de 26 a 96%. Quando a mesma espécie de triatomineos foi usada em tipos diversos de animais, pareceu haver uma tendência para apresentarem diferentes taxas de infecções, de acordo com o animal empregado. Dessa forma, a susceptibilidade dos triatomíneos poderia estar dependente dos fatores: cepa do tripanosoma, espécie e fase do triatomíneo e o tipo do animal infectante.

Studying the impact of co-authorship with external researchers:the case of research community in Portugal using social network analysis.

Project work presented as a partial requirement to obtain a Master Degree in Information Management

Estudo da formação de depósitos e aglomeração de cinzas durante a combustão de biomassa em leito fluidizado e co-combustão com carvão para minimizar a sua ocorrência

Dissertação para obtenção do Grau de Doutor em Energia e Bioenergia