Prevalence of neurocognitive disorders and depression in a Brazilian HIV population

AbstractINTRODUCTION:Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV) carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND), which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS) is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17), compare the IHDS performance with the performances on the Timed Gait Test (TGT), the Digit Symbol Coding Test (DS) and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL), and evaluate the association between the IHDS performance and clinical-demographic variables.METHODS:One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses.RESULTS:According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4) levels were significantly and independently associated with neurocognitive impairment.CONCLUSIONS:The prevalence of neurocognitive impairment according to the IHDS is high and associated with female gender, education level, and low CD4 levels.

Phenotypic and molecular characterization of CTX-M extended-spectrum beta-lactamase-producing Escherichia coli isolates in Shiraz, Iran

AbstractINTRODUCTIONThe aim of this study was to detect the prevalence of the extended-spectrum beta-lactamase (ESBL)-encoding CTX-M gene in Escherichia coliisolates.METHODS:Phenotypic screening of 376 E. coli isolates for ESBL was conducted using disk diffusion. ESBL-producing isolates were tested using PCR and specific primers. The blaCTX-M cluster was identified using the RFLP method, and its genotype was sequenced.RESULTS:From 202 ESBL-producing E. coli , 185 (91.5%) possessed CTX-M genes. CTX-M-1 subtypes were found in 98% of the isolates. The blaCTX-M gene was identical to CTX-M-15.CONCLUSIONS:A high prevalence of CTX-M-1-producing E. coli apparently exists in Shiraz, Iran.

Induction and nosocomial dissemination of carbapenem and polymyxin-resistant Klebsiella pneumoniae

INTRODUCTION:Polymyxins are antimicrobial agents capable of controlling carbapenemase-producing Klebsiella pneumoniae infection.METHODS: We report a cluster of four patients colonized or infected by polymyxin-resistant and Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae.RESULTS: Three patients were hospitalized in adjacent wards, and two were admitted to the intensive care unit. The index case maintained prolonged intestinal colonization by KPC-producing K. pneumoniae. Three patients received polymyxin B before the isolation of polymyxin-resistant K. pneumoniae.CONCLUSIONS: Colonization by KPC-producing K. pneumoniae and previous use of polymyxin B may be causally related to the development of polymyxin-resistant microorganisms.

Expression of annexin A1 in Leishmania-infected skin and its correlation with histopathological features

ABSTRACTINTRODUCTION:The aim of this study was quantify annexin A1 expression in macrophages and cluster of differentiation 4 (CD4) + and cluster of differentiation 8 (CD8)+ T cells from the skin of patients with cutaneous leishmaniasis (n=55) and correlate with histopathological aspects.METHODS:Infecting species were identified by polymerase chain reaction-restriction fragment length polymorphism, and expression of annexin A1 was analyzed by immunofluorescence.RESULTS:All patients (n = 55) were infected with Leishmania braziliensis . Annexin A1 was expressed more abundantly in CD163 + macrophages in infected skin (p < 0.0001) than in uninfected skin. In addition, macrophages in necrotic exudative reaction lesions expressed annexin A1 at higher levels than those observed in granulomatous (p < 0.01) and cellular lesions p < 0.05). This difference might be due to the need to clear both parasites and necrotic tissue from necrotic lesions. CD4 + cells in cellular lesions expressed annexin A1 more abundantly than did those in necrotic (p < 0.05) and granulomatous lesions (p < 0.01). Expression in CD8 + T cells followed the same trend. These differences might be due to the pervasiveness of lymphohistiocytic and plasmacytic infiltrate in cellular lesions.CONCLUSIONS:Annexin A1 is differentially expressed in CD163 + macrophages and T cells depending on the histopathological features of Leishmania -infected skin, which might affect cell activation.

Spatial and spatiotemporal occurrence of human visceral leishmaniasis in Adamantina, State of São Paulo, Brazil

Abstract: INTRODUCTION : Several municipalities of the Western region of the State of São Paulo have been affected by human visceral leishmaniasis (HVL), including the City of Adamantina, where the first autochthonous cases occurred in 2004. Therefore, this study aimed to describe the spatial and spatiotemporal occurrence of HVL in Adamantina. METHODS : Secondary data regarding the occurrence of HVL in Adamantina between 2004 and 2011 were used. Incidence, mortality, and case fatality rates were calculated. We used local empirical Bayesian incidence rates to represent the occurrence of the disease in the census sector of the city. The existence of spatial and spatiotemporal clusters of cases was evaluated using scan statistics. In situ observation was performed to assess the socioeconomic and environmental characteristics of the areas with medium and high incidences. RESULTS : Adamantina reported cases in 70% of its census sectors. No differences were observed between sexes. The group aged 0-4 years presented the highest incidence and mortality rates, and the group aged 40-59 years presented the highest fatality rate. We detected a spatiotemporal cluster, which coincided with the commencement of the endemic in the city. CONCLUSIONS : The individuals most affected by the disease were children. The disease was present in areas with better and worse socioeconomic conditions. The use of spatial analysis techniques was important to achieve the study objectives.

Molecular characterization of Mycobacterium tuberculosis isolates from Tehran, Iran by restriction fragment length polymorphism analysis and spoligotyping

Abstract: INTRODUCTION Characterization of Mycobacterium tuberculosis (MTB) isolates by DNA fingerprinting has contributed to tuberculosis (TB) control. The aim of this study was to determine the genetic diversity of MTB isolates from Tehran province in Iran. METHODS MTB isolates from 60 Iranian and 10 Afghan TB patients were fingerprinted by standard IS6110-restriction fragment length polymorphism (RFLP) analysis and spoligotyping. RESULTS The copy number of IS6110 ranged from 10-24 per isolate. The isolates were classified into 22 clusters showing ≥ 80% similarity by RFLP analysis. Fourteen multidrug-resistant (MDR) isolates were grouped into 4 IS6110-RFLP clusters, with 10 isolates [71% (95% CI: 45-89%)] in 1 cluster, suggesting a possible epidemiological linkage. Eighteen Iranian isolates showed ≥ 80% similarity with Afghan isolates. There were no strains with identical fingerprints. Spoligotyping of 70 isolates produced 23 distinct patterns. Sixty (85.7%) isolates were grouped into 13 clusters, while the remaining 10 isolates (14.2%) were not clustered. Ural (formerly Haarlem4) (n = 22, 31.4%) was the most common family followed by Central Asian strain (CAS) (n = 18, 25.7%) and T (n = 9, 12.8%) families. Only 1strain was characterized as having the Beijing genotype. Among 60 Iranian and 10 Afghan MTB isolates, 25% (95% CI: 16-37) and 70% (95% CI: 39-89) were categorized as Ural lineage, respectively. CONCLUSIONS A higher prevalence of Ural family MTB isolates among Afghan patients than among Iranian patients suggests the possible transmission of this lineage following the immigration of Afghans to Iran.

Two decades of tuberculosis in a city in Northeastern Brazil: advances and challenges in time and space

Abstract: INTRODUCTION This study presents two decades of epidemiological data on tuberculosis (TB), in order to understanding the disease profile and its spatiotemporal dynamics. METHODS This descriptive study was performed in the City of Olinda/Pernambuco, Brazil, from 1991-2010, and it analyzed new patients with TB living in the city. We used the χ²-test with a p-value <0.05 to identify differences in trends. Incidence and cluster distribution were identified using spatial scan statistics. RESULTS In total, 6202 new cases were recorded during the two decades. The highest incidence occurred in 1995 (110 cases/100,000 inhabitants), and the lowest occurred in 2009 (65 cases/100,000 inhabitants) (β=-1.44; R²=0.43; p=0.0018). The highest mortality occurred in 1998 (16 deaths/100,000 inhabitants), and the lowest occurred in 2008 (5 deaths/100,000 inhabitants) (β=-0.19; R²=0.17; p=0.07). There was a male predominance (65%), and ages ranged from 20-49 years (65%). There was a substantial increase in the number of patients that were cured after treatment (60% to 67%; p<0.001) as well as those tested for HIV (1.9% to 58.5%; p<0.001). During the first decade, clusters with p-values <0.05 included 29% of the total notified cases, and in the second decade, that percentage was 12%. CONCLUSIONS We observed a decreasing trend in incidence, which was significant, and mortality rates, which was not significant. The increased number of laboratory tests performed reflects advances in surveillance, and a reduction in the proportion of cases in primary clusters suggests, among other things, that the disease is spreading across the region.

Spatial distribution of disseminated histoplasmosis and AIDS co-infection in an endemic area of Northeastern Brazil

Abstract: INTRODUCTION: The spatial distribution of disseminated histoplasmosis (DH) and acquired immunodeficiency syndrome (AIDS) co-infection in adult residents of Fortaleza, Ceará, Brazil was evaluated. METHODS: Socio-demographic data for the DH/AIDS cases were obtained from a reference hospital, and socio-environmental indicators were obtained from an official Brazilian institute. Kernel analysis and local indicators of spatial autocorrelation (LISA) cluster maps were used to estimate the case density within the city. RESULTS: DH/AIDS cases were concentrated in the Northwestern and Southwestern peripheral areas of the city, related with low human development indices, but different from AIDS cases distribution. CONCLUSION: Risk factors other than AIDS infection must affect histoplasmosis development in this area.

Recensão: C. Cosmen Alonso; M. V. Herráez Ortega; M. P. Gómez-Calcerrada, (coord.), El intercambio artístico entre los reinos hispanos y las cortes europeas en la baja edad media

Recensão de: C. Cosmen Alonso; M. V. Herráez Ortega; M. P. Gómez-Calcerrada, (coord.). 2009. El intercambio artístico entre los reinos hispanos y las cortes europeas en la baja edad media. León: Universidad de León

Manipulus Rubiacearum - V. A revision of the genus Capirona.

The taxonomic histort of the genus Capirona is presented. Complete synonymies, descriptions, common names, distributions and discussions are given for Capirona and its two species C. descorticans and C. leiophloea. The generic distribution is the Amazon valley and eastern Guianas and coincides with that of the genus Hevea. C. descorticans is know from the western and southeastern Amazon valley; C. leiophloea is reported from the eastern Guianas and the northeastern Amazon valley. The zone of contact between the two species is along the southern edge oh the Amazon River and the lower drainage of the Rio Tapajoz in Pará, Brazil.

The larval development of palaemonid shrimps from the amazon region reared in the laboratory. V. The abbreviated development of Pseudopalaemon chryseus Kensley & Walker, 1982 (CRUSTACEA : DECAPODA: PALAEMONIDAE)

Larval development of the freshwater palaemonid shrip Pseudopalaemon chryseus Kensley & Walker, 1982 was studied in the laboratory from the offspring oof females collected in a lake of the lower Negro River system. Females carry few (14 to 43), large (1.86 + 0.13 x 1.29 + 0.06 mm), yolk-rich eggs. The species goes throught three larval stages without feeding and the main feature of its larval development is the presence of functional walking legs on hatching. Descriptions and illustrations of the three larval and first juvenile stages are presented.

“Del palazzo de’ cesari” genesi e riferimenti dell’attività di Filippo Juvarra per D. João V di Portogallo

Tal como os outros soberanos do Antigo Regime, D. João V procurava a legitimidade do Império Português a nível europeu, através dos grandes projetos arquitetónicos. O novo palácio real e a igreja patriarcal que Juavarra desenhou em 1719 para a cidade de Lisboa teve que representar e simbolizar o poder do rei. Um estudo pormenorizado sobre parte da arquitectura de Juvarra parece revelar uma estreita relação, não com a contemporânea Roma dos Papas, mas antes com a majestosa arquitectura da Roma Imperial. D. João V tinha o ensejo de ser considerado um imperador e a arquitectura de Juvarra demonstra-o claramente.

Recensão: Daniel Arasse, "Não se vê nada. Descrições"

Recensão de: Daniel Arasse, "Não se vê nada. Descrições", Trad. Rui Pires Cabral, Lisboa: Edição KKYM, col. Imago, 2015

Contribuição ao estudo das plantas medicinais no Estado de Alagoas V

O nosso trabalho é mais uma etapa, a quinta, do estudo sobre as plantas medicinais, ocorrentes no Estado de Alagoas. Várias excursões foram feitas, a fim de coletar espécies, utilizadas na medicina caseira. Os espécimens coletados foram preparados, identificados e incorporados ao Herbario "Professor Honorio Monteiro" (MUFAL) da Universidade Federal de Alagoas. O estudo das plantas medicinais, abrangendo famílias, nomes científicos e vulgares e a descrição sucinta para cada espécie, bem como o uso medicinal e a posologia, foi feito com auxílio de bibliografias especializadas no assunto. Foram estudadas as seguintes espécies, consideradas medicinais: Allium ascalonicum L. (cebola-branca); Astronium urundeuva (Fr. All.) Engl. (aroeira-do-sertão); Cecropia sp. (imbáuba); Coix lacryma-jobi L. (capim-de-contas); Daucus carota L. (cenoura); Eucalyptus citriodora Hook. (eucalípto); Eugenia jambosa L. (jambo-rosa); Eugenia malaccensis L. (jambo-roxo); Genipa americana L. (genipapo); Guazuma ulmifolia Lam. (mutamba); Helianthus annuusL. (girassol); Hedychium coronarium Koening (lírio-do-brejo); Imperata brasiliensis Trin. (capim-sapê); Jatropha curcas L. (pinhão-manso) Melocactus bahiensis (Brit. et Rose) Luetzelb. (coroa-de-frade), Monniera trifolia L. (alfavaca-de-cobra), Pithecollobium avaremotemo Mart. (bordão-de-velho); Polygonum persicaria L. (erva-de-bicho); Solidago microglossa DC. (erva-lanceta) e Syzygium jambolana DC. (azeitona).

Francisco Antônio de Almeida e a ópera italiana na corte de D. João V : La Spinalba

Relatório da aula teórico-prática apresentada à Faculdade de Ciências Sociais e Humanas da Universidade Nova de Lisboa para discussão na prova de habilitação prevista no artigo 589 do E. C. D. U.