Paracoccidioidomycosis in children in the state of Rio de Janeiro (Brazil): Geographic distribution and the study of a "reservarea"

Thirty six cases of acute disseminated paracoccidioidomycosis in 3 to 12 year-old children, natives of the state of Rio de Janeiro, were seen in the period 1981-1996. All patients were residents in the rural region of 15 counties, scattered on the Southwestern part of this state. The rural region of two neighboring counties, where 16 cases (44.4%) occurred, was visited. It exhibited the environmental conditions that are considered favorable to the survival of P. brasiliensis. The most important of these conditions, abundant watercourses and autochthonous forest, are distributed on well defined and limited areas, in which the dwellings are also localized. Probably, a careful epidemiological study of forthcoming cases of the disease in children may facilitate the search for the micro-niche of the fungus.

ELEVATED ALANINE AMINOTRANSFERASE (ALT) IN BLOOD DONORS: AN ASSESSMENT OF THE MAIN ASSOCIATED CONDITIONS AND ITS RELATIONSHIP TO THE DEVELOPMENT OF HEPATITIS C

The determination of aminotranferases levels is very useful in the diagnosis of hepatopathies. In recent years, an elevated serum ALT level in blood donors has been associated with an increased risk of post-transfusion hepatitis (PTH). The purpose of the study was to research the factors associated with elevated ALT levels in a cohort of voluntary blood donors and to evaluate the relationship between increased ALT levels and the development of hepatitis C (HCV) infection. 166 volunteer blood donors with elevated ALT at the time of their first donation were studied. All of the donors were questioned about previous hepatopathies, exposure to hepatitis, exposure to chemicals, use of medication or drugs, sexual behaviour, contact with blood or secretions and their intake of alcohol. Every three months, the serum levels of AST, ALT, alkaline phosphatase, gamma glutamyl transpeptidase, cholesterol, triglyceride and glycemia are assessed over a two year follow-up. The serum thyroid hormone levels as well as the presence of auto-antibodies were also measured. Abdominal ultrasound was performed in all patients with persistently elevated ALT or AST levels. A needle biopsy of liver was performed in 9 donors without definite diagnostic after medical investigation. The presence of anti-HCV antibodies in 116 donors were assayed again the first clinical evaluation. At the end of follow-up period (2 years later) 71 donors were tested again for the presence of anti-HCV antibodies. None of donors resulted positive for hepatitis B or hepatitis C markers during the follow-up. Of the 116 donors, 101 (87%) had persistently elevated ALT serum levels during the follow-up. Obesity and alcoholism were the principal conditions related to elevated ALT serum levels in 91/101 (90.1%) donors. Hypertriglyceridemia, hypercholesterolemia, hypothyroidism and diabetes mellitus also were associated with increased ALT levels. Only 1/101 (0.9%) had mild chronic active non A-G viral hepatitis and 3/101 (2.9%) had liver biopsy with non-specific reactive hepatitis. The determination of ALT levels was not useful to detect donors infected with HCV at donation in Brazil, including the initial seronegative anti-HCV phase.

Dimensionamento do Sistema Híbrido para Alimentação de Energia Elétrica da Escola Rural de Nangade (Cabo Delgado)

Os combustíveis fósseis, como o carvão, o petróleo e o gás, constituem fontes de energia que em breve se esgotarão e que são demasiado caras para serem desperdiçadas pelas centrais elétricas na produção de electricidade. Para além desse facto, existem outros argumentos (sobretudo económicos) que inviabilizam a utilização destas fontes de energia em algumas regiões, abrindo caminho a fontes de energia alternativas (e.g. solar, eólica, biomassa, mini-hídricas, geotérmicas, etc) e preferencialmente com contornos locais. No caso particular de Moçambique, tem-se verificado um interesse crescente por parte do governo e de várias ONGs na promoção do uso de energias alternativas para as zonas onde a energia convencional não chega e não chegará, devido aos custos muito elevados que esse processo acarretaria. Esta dissertação apresenta um estudo aprofundado do dimensionamento dum sistema híbrido de geração de energia elétrica envolvendo gerador FV e grupo eletrogéneo de emergência para a Escola Rural da Nangade, situada no Distrito de Nangade, na Província do Cabo Delgado. São também descritos os diversos componentes e as tecnologias associadas a um sistema deste género, com a inclusão de sistemas inteligentes de controlo de energia com a utilização de inversores bidireccionais (inversores de bateria e carregadores) para sistemas isolados. Os resultados são apresentados de forma a facilitar a aplicação e montagem deste tipo de sistemas in loco. Espera-se que esta dissertação possa servir de base no futuro próximo, para a implementação deste tipo de sistemas para permitir a melhoria da qualidade de ensino através de melhores infraestruturas, democratizando desta forma o acesso à educação para as crianças das zonas rurais das várias províncias de Moçambique. Como as energias renováveis são parte integrante do Sistema Elétrico Nacional, apresenta-se resumidamente, no anexo 17, o “Plano de Desenvolvimento na Área de Energia de Moçambique”.

Influence of commercially available polyimide and formation conditions on the performance and structure of asymmetric polyimide organic solvent nanofiltration membranes

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para a obtenção do grau de Mestre em Engenharia Química e Bioquímica

Cyclospora cayetanensis in sputum and stool samples

We report the observation of acid-fast Cyclospora cayetanensis oocysts in a sputum sample. The patient, a 60 year-old, HIV negative man, was successfully treated for pulmonary tuberculosis during 1997. On February 1998, he was admitted to our center due to loss of weight, cough with purulent expectoration, dysphonia and a radiological picture of pulmonary fibrosis. Bacilloscopic study of sputum (negative for acid-fast bacilli) stained with Ziehl-Neelsen technique showed large (8-10 µm) spherical, acid-fast Cyclospora cayetanensis oocysts. No other pathogens were isolated on cultures from this sample or from laryngeal biopsy. Serial parasitologic studies showed C. cayetanensis and also eggs of Trichuris trichiura, Ascaris lumbricoides and Hymenolepis nana and of Entamoeba coli cysts. The patient lives in the outskirts of Buenos Aires in a brick-made house with potable water and works as builder of sewers. He travelled in several occasions to the rural area of province of Tucumán which has poor sanitary conditions. C. cayetanensis is an emergent agent of diarrhea and as far as we know this is the first time the parasite is observed in respiratory samples.

Serologic survey for hantavirus infections among wild animals in rural areas of São Paulo State, Brazil

A serosurvey was conducted in wild animals captured close to two areas where hantavirus cardiopulmonary syndrome (HCPS) occurred in São Paulo State, Brazil. Serum samples from a total of 43 mammals were tested for antibodies reactive with Sin Nombre (SN) hantavirus using a strip immunoblot assay. RNAs from the blood clots of the positive samples were submitted to reverse transcriptase-polymerase chain reaction (RT-PCR). Two rodents of the genus Oligoryzomys were positive for hantavirus antibodies. These animals were captured in the Iguape region and represented 16.7% (2/12) of the sera from rodents and 100.0% (2/2) of the Oligoryzomys captured in that area. RT-PCR failed to amplify any viral cDNA. These results are in agreement with other data that suggest that members of this genus are important reservoirs of hantaviruses in Brazil.

Frequency of serum anti-cysticercus antibodies in the population of a rural Brazilian community (Cássia dos Coqueiros, SP) determined by ELISA and immunoblotting using Taenia crassiceps antigens

Considering the impact of cysticercosis on public health, especially the neurologic form of the disease, neurocysticercosis (NC), we studied the frequency of positivity of anti-Taenia solium cysticercus antibodies in serum samples from 1,863 inhabitants of Cássia dos Coqueiros, SP, a municipal district located 80 km from Ribeirão Preto, an area considered endemic for cysticercosis. The 1,863 samples were tested by enzyme linked immunosorbent assay (ELISA) using an antigenic extract from Taenia crassiceps vesicular fluid (Tcra). The reactive and inconclusive ELISA samples were tested by immunoblotting. Of the 459 samples submitted to immunoblotting, 40 were strongly immunoreactive to the immunodominant 18 and 14 kD peptides. Considering the use of immunoblotting as confirmatory due to its high specificity, the anti-cysticercus serum prevalence in this population was 2.1%.

Seroprevalence of Helicobacter pylori infection in chronic chagasic patients, and in the rural and urban population from Uberlândia, Minas Gerais, Brazil

As patients with chronic Chagas disease exhibit morphological and functional changes of the stomach (hypomotility and hypochlorhydria), malnutrition, immunological deficiency and high prevalence of peptic disease associated to Helicobater pylori infection, the purpose of this study was to evaluate if the prevalence of H. pylori infection in chronic chagasic is higher than in non-chagasic individuals in the urban and rural population from Uberlândia, MG, Brazil. Serological determination of IgG antibodies to H. pylori was performed using a second-generation ELISA. Thus, 598 people were evaluated: 128 chagasic (CG), 222 non-chagasic living in urban area (U-NCG) and 248 non-chagasic living in rural area (R-NCG). Regarding the age range from 21 to 50 years, the prevalence of H. pylori infection in the CG (85.1%) was significantly higher than in the U-NCG (56.3%, p < 0.01) and the R-NCG (67.4%, p < 0.05). In the patients over 50 years, the prevalence in the CG (86.4%) was similar to the U-NCG (78.8%) and R-NCG (86.1%). Similar results were also found between the U-NCG and R-NCG for all age ranges, with prevalence rates of 29.1% and 35.3% for the age range from 5 to 13 years, and 47.2% and 40% for that from 14 to 20 years, respectively. We conclude that chagasic patients showed a higher seroprevalence of H. pylori infection than non-chagasic individuals, in the age range from 21 to 50 years, and that the prevalence of this infection was similar in the studied urban and rural non-chagasic population.

Cultura tradicional e meio rural

pp. 99-119

Prevalence of human papillomavirus infection in rural villages of the Bolivian Amazon

Cervical cancer constitutes a major health problem in developing countries like Bolivia. The roles of certain genotypes of human papillomaviruses (HPVs) in the pathogenesis of cervical cancer is well established. The prevalence of HPV infection among sexually active women varies greatly. Information regarding HPV infection in Bolivia is very much scarce, specially in regions like the Amazonian lowland. We studied 135 healthy women living in four rural localities of the Bolivian Amazon. Presence of HPV in DNA extracted from cervical swabs was analyzed using a reverse line hybridization assay. The estimated overall HPV infection prevalence among the studied rural localities was 5.9% (ranging from 0-16.6%). These values were unexpectedly low considering Bolivia has a high incidence of cervical cancer. The fact that Amazonian people seem to be less exposed to HPV, makes it likely that some other risk factors including host lifestyle behaviors and genetic background may be involved in the development of cervical cancer in this population.

Intestinal parasites and commensals among individuals from a landless camping in the rural area of Uberlândia, Minas Gerais, Brazil

We evaluated the occurrence of intestinal parasites and commensals among children and adults from a landless camping in the rural area of Uberlândia, State of Minas Gerais, Brazil, from October to November 2001. Stool samples from 78 individuals were examined by both the Baermann-Moraes and Lutz methods. Fifty-one (65.4%; CI 54.8 - 76.0) individuals were found to be infected, 23 (45.1%) children and 28 (54.9%) adults, of whom 34 (66.7%) were mono-infected, 9 (17.6%) bi-infected, and 8 (15.7%) poly-infected. In conclusion, the high prevalence of intestinal parasites and commensals suggests that parasitological exams should be periodically carried out in addition to the sanitation education and health special care in this population.

Numerical analysis of the initial conditions in fractional systems

Fractional dynamics is a growing topic in theoretical and experimental scientific research. A classical problem is the initialization required by fractional operators. While the problem is clear from the mathematical point of view, it constitutes a challenge in applied sciences. This paper addresses the problem of initialization and its effect upon dynamical system simulation when adopting numerical approximations. The results are compatible with system dynamics and clarify the formulation of adequate values for the initial conditions in numerical simulations.

Impact of antihelminthic treatment on infection by Ascaris lumbricoides, Trichuris trichiura and hookworms in Covas, a rural community of Pernambuco, Brazil

This work aims to evaluate the impact of drug treatment on infection by Ascaris lumbricoides (Al), Trichuris trichiura (Tt) and hookworms (Hook) in a rural community from the sugar-cane zone of Pernambuco, Brazil. Four parasitological surveys were carried out from March 2001 to March 2002. Individual diagnosis was based on eight slides (four by the Kato-Katz method and four by the Hoffman method) per survey. Infected subjects were assigned to two groups for treatment with either albendazole (n = 62) or mebendazole (n = 57). Prevalence of infection fell significantly (p < 0.05) one month after treatment: Al (from 47.7% to 6.6%); Tt (from 45.7% to 31.8%) and Hook (from 47.7% to 24.5%). One year after treatment, infections by Tt and Hook remained significantly below pre-control levels. A substantial decrease in single-infection cases and multiple infections was found. Egg-negative rate was significant for Al (94.0%), Hook (68.3%) but not for Tt (45.5%), and did not differ significantly between subjects treated with mebendazole or albendazole. Egg counts fell significantly in the individuals remaining positive for Tt. It is recommended that antihelminthic treatment should be selective and given at yearly intervals preferably with albendazole, due to its cost-effectiveness.

Standing balance in individuals with Parkinson's disease during single and dual-task conditions

This study aimed to examine the differences in standing balance between individuals with Parkinson's disease (PD) and subjects without PD (control group), under single and dual-task conditions. A cross-sectional study was designed using a non-probabilistic sample of 110 individuals (50 participants with PD and 60 controls) aged 50 years old and over. The individuals with PD were in the early or middle stages of the disease (characterized by Hoehn and Yahr as stages 1-3). The standing balance was assessed by measuring the centre of pressure (CoP) displacement in single-task (eyes-open/eyes-closed) and dual-task (while performing two different verbal fluency tasks). No significant differences were found between the groups regarding sociodemographic variables. In general, the standing balance of the individuals with PD was worse than the controls, as the CoP displacement across tasks was significantly higher for the individuals with PD (p<0.01), both in anteroposterior and mediolateral directions. Moreover, there were significant differences in the CoP displacement based parameters between the conditions, mainly between the eyes-open condition and the remaining conditions. However, there was no significant interaction found between group and condition, which suggests that changes in the CoP displacement between tasks were not influenced by having PD. In conclusion, this study shows that, although individuals with PD had a worse overall standing balance than individuals without the disease, the impact of performing an additional task on the CoP displacement is similar for both groups.