Carcinoma hepatocelular e as infecções pelos vírus das hepatites B e C na Amazônia Oriental: estudo clínico-sorológico e de biologia molecular

Com o objetivo de contribuir para um melhor conhecimento do eventual envolvimento das infecções pelos vírus das hepatites B e C, na etiopatogenia do carcinoma hapatocelular (CHC) na Amazônia Oriental, estudaram-se 36 pacientes internados em três hospitais públicos em Belém (PA), de janeiro de 1992 a março de 1999. Os critérios de inclusão adotados foram: o clínico, associado à imagenologia compatível, níveis séricos de alfafetoproteína (AFP) acima de 400ng/ml e/ou histopatologia compatível. Foram avaliados os aspectos clínicos, exames bioquímicos e hematológicos, imagenologia, histopatologia, níveis séricos de AFP e exames sorológicos das hepatites B e C. A presença dos ácidos nucléicos virais, o HBV-DNA e o HCV-RNA, foi avaliada a partir da detecção no soro pela reação em cadeia da polimerase. Observou-se um predomínio do sexo masculino (p<0.01), com reação M/F de 6,2: 1. Média e medianas gerais de idade foram, respectivamente, 50,8 e 53,0 anos, com amplitude de 6-81 anos. A maioria dos pacientes (52,7%) era procedente da zona rural, sendo a profissão de lavrador a mais freqüente (p<0,01). Etilismo foi encontrado em 33,3% dos casos. Dor abdominal e hepatomegalia, presentes em 94,4% dos casos, foram os sintomas e sinais mais freqüentes. Observou-se a presença de cirrose em 83,3% dos casos, sendo 80% enquadrados nas classes B e C (child-pugh). Cinqüenta por cento apresentaram complicações durante o diagnóstico, sendo as mais freqüentes a encefalopatia hepática e a hemorragia digestiva alta, relacionadas à doença hepática crônica de base. Marcadores sorológicos de infecção pelo HBV e pelo HCV foram encontrados em, respectivamente, 88,9% e 8,3% da casuística. Em 11,1% não se encontrou marcador sorológico. O HbsAg foi encontrado em 58, 3%. Anti-HBc foi encontrado em 86%, estando associado ao anti- HBs em 25%. Entre os HbsAg positivos: o anti- Hbe foi encontrado em 85%; o antiHBc IgM em 57,1%; e o anti-HD não foi detectado. O HBV- DNA foi encontrado em 37,7% do total de casos e em 65% dos HbsAG positivos. O HCV-RNA foi encontrado em 8,5% da amostra estudada e em 100% dos casos anti-HCV positivos. Não foi observada positividade para o HBV-DNA e para o HCV-RNA em soros de pacientes HbsAG ou anti- HCV negativos. A AFP esteve acima da normalidade em 88,9% dos casos, estando acima de 400 ng/ml em 75% e em 27,8% a titulações foi superior a 70.000 ng/ml. A ultrassonografia abdominal mostrou tumores com múltiplos nódulos em 63,9% e, nódulo único em 36,1% dos casos. O tipo histológico predominante foi carcinoma bem diferenciado do tipo trabecular (p<0,05). Os casos HbsAg positivos apresentaram menor média de idade e níveis de AFP mais elevados (p<0,01). A maioria dos pacientes se encontravam em fase avançada de doenças com uma taxa de óbito durante o diagnóstico de 38,9%. Conclui-se que, na Amazônia Oriental, a infecção pelo HBV parece exercer importância na etiologia do CHC, ressaltando-se a necessidade de incrementação de medidas preventivas, como vacinação e programa de detecção precoce do tumor em populações de risco. São necessários estudos adicionais controlados ou direcionados, para os possíveis co-fatores de importância na região, o que pode contribuir para um melhor entendimento dos mecanismos envolvidos na hepatocarcinogênese.

Formação de biofilmes e resistência a antifúngico e biocidas em Candida parapsilosis e C. orthopsilosis isoladas de águas usadas para hemodiálise

Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR

Eficiência reprodutiva de camundongos endogâmicos balb/c em diferentes idades de acasalamento, com ou sem enriquecimento ambiental

Pós-graduação em Zootecnia - FMVZ

Tratamento térmico, radiação ultravioleta (UV-C), quitosana e cera na prevenção de injúrias pelo frio em mangas ‘Tommy Atkins’ e ‘Palmer’

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluation of the therapeutic response of hepatitis C in coinfected patients (HIV/HCV): a study of cases from a hospital for chronic liver diseases in the Eastern Brazilian Amazon

INTRODUCTION: The aim of this study was to evaluate the therapeutic response of hepatitis C in patients coinfected with human immunodeficiency virus (HIV-1). METHODS: A retrospective study of 20 patients coinfected with HIV-1/HCV who were treated in the outpatient liver clinic at the Sacred House of Mercy Foundation Hospital of Pará (Fundação Santa Casa de Misericórdia do Pará - FSCMPA) from April 2004 to June 2009. Patients were treated with 180µg PEG interferon-α2a in combination with ribavirin (1,000 to 1,250mg/day) for 48 weeks. The end point was the sustained virological response (SVR) rate (HCV RNA negative 24 weeks after completing treatment). RESULTS: The mean age of the patients was 40±9.5 years, of which 89% (n=17) were male, and the HCV genotypes were genotype 1 (55%, n=11/20), genotype 2 (10%, n=2/20) and genotype 3 (35%, n=7/20). The mean CD4+ lymphocyte count was 507.8, and the liver fibrosis stages were (METAVIR) F1 (25%), F2 (55%), F3 (10%) and F4 (10%). The early virological response (EVR) was 60%, the end-of-treatment virological response (EOTVR) was 45% and the SVR was 45%. CONCLUSIONS: The median HCV viral load was high, and in 85% of cases in which highly active antiretroviral therapy (HAART) was used, none of the patients with F3-F4 fibrosis responded to treatment. Of the twenty patients treated, 45% achieved SVR and 45% achieved EOTVR. Studies that include cases from a wider region are needed to better evaluate these findings.

Hepatitis B and C virus infection among Brazilian Amazon riparians

INTRODUÇÃO: As hepatites virais constituem um importante problema de saúde pública no mundo. No Brasil existem poucos estudos sobre esta questão, especialmente entre as comunidades ribeirinhas. O objetivo deste estudo foi determinar a soroprevalência das hepatites B e C virais na comunidade ribeirinha da Ilha do Pacuí, no Estado do Pará, Brasil, e investigar os principais fatores de risco principal a que está comunidade está exposta. MÉTODOS: O presente estudo avaliou amostras de sangue de 181 voluntários que responderam a um questionário epidemiológico. Análises de marcadores sorológicos foram testados com kits comerciais de ELISA para detecção de HBsAg, anti-HBc total, anti-HBs e anti-VHC. Nos pacientes reagentes para VHC, RT-PCR e um line probe assay foi realizado para identificar o genótipo viral. RESULTADOS: Na análise dos marcadores sorológicos para hepatite B, observou-se taxas de 1,1% para anti-HBc total e 19,3% para anti-HBs, o marcador sorológico HBsAg não foi encontrado nesta população. Para a hepatite C foi encontrada um soroprevalência de 8,8%, destes 62,5% tinham RNA viral. Entre os fatores de risco estudados se destacaram: a não-utilização de preservativos, o compartilhamento de instrumentos cortantes, uso de drogas ilícitas e relatos de doença na família com VHB ou VHC. CONCLUSÕES: Observamos que a cobertura de vacinação contra o VHB é baixa e uma alta prevalência da hepatite C nesta comunidade.

Estoques e fluxos de carbono em plantações florestais jovens de Acacia mangium e Schizolobium parahyba var. Amazonicum na Amazônia Oriental

Plantações florestais são consideradas como alternativas de uso da terra para mitigação dos efeitos das mudanças climáticas, devido ao potencial de sequestro de carbono em espécies arbóreas. No entanto, há poucas informações sobre estoques e fluxos de carbono em espécies comumente usadas em plantações florestais, sobretudo na Amazônia. O objetivo deste estudo foi determinar o estoque de carbono na fitomassa e o efluxo de dióxido de carbono do solo em plantios de Acacia mangium Willd e Schizolobium parahyba var. amazonicum em diferentes espaçamentos. O estudo foi conduzido em Dom Eliseu, Pará, cujo clima apresenta temperatura média anual em torno de 25 ºC e precipitação anual de 2250 a 2500 mm; o solo predominante é Latossolo amarelo distrófico típico A moderado textura muito argilosa. Neste estudo foram selecionadas duas espécies (A. mangium e S. parahyba) em dois espaçamentos (4,0 m x 2,0 m e 4,0 m x 3,0 m), com duas repetições, totalizando 4 tratamentos e 8 parcelas, estudadas por um período de um ano, dos 2,5 aos 3,5 anos de idade. As parcelas mediram 48 m x 60 m. Mediram-se altura total, diâmetro à altura do peito, fluxo de CO₂ do solo, e estimou-se o estoque de carbono na fitomassa acima do nível do solo. O efluxo de CO₂ do solo nos plantios de A. mangium tiveram uma média global de 5,61 ± 1,30 Mg C ha^-1 ano^-1, e, em S. parahyba, a média global foi 7,07 ± 1,50 Mg C ha^-1 ano^-1. O acúmulo anual de carbono na fitomassa acima do solo nos plantios de A. mangium foi 16,41 ± 1,16 e 14,03 ± 0,82 Mg C ha^-1 ano^-1, no 4,0 x 2,0 m e 4,0 x 3,0 m, respectivamente. Em S. parahyba o acúmulo anual global foi 8,93 ± 1,87 Mg C ha^-1 ano^-1. O plantio de A. mangium acumulou mais carbono na fitomassa acima do solo em relação a S. parahyba, com efluxos anuais de CO₂ menores em relação ao plantio de S. parahyba em ambos espaçamentos. Dessa forma, plantios de A. mangium, no espaçamento 4,0 x 2,0 m, são recomendados para projetos de sequestro de carbono. Entre os espaçamentos de plantio testados para S. parahyba, 4,0 x 3,0 m seria recomendado devido a mesma eficiência no sequestro de carbono em relação a 4,0 x 2,0 m, porém com menor requerimento de mudas. A continuidade no monitoramento nessas plantações florestais é fundamental para que conclusões mais definitivas sejam feitas a respeito da dinâmica do carbono.

Influência dos genótipos / haplótipos das posições polimórficas -786T > C, 894G > T e Íntron 4b / a do gene NOS3 sobre o sistema cardiovascular e a atividade das enzimas antioxidantes em adultos submetidos ao treinamento físico aeróbio

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Peginterferon plus ribavirin and sustained virological response rate in HCV-related advanced fibrosis: a real life study

Background: Tolerance and response to antiviral HCV treatment is poor in advanced fibrosis. The aim of this study was to assess SVR rate and its predictive factors in HCV advanced fibrosis patients treated in real life with full dose PEG-IFN plus RBV and to evaluate the adverse events related to treatment. Methods: A multicentric, retrospective study was conducted at six university hospitals. METAVIR F3 and F4 HCV monoinfected patients who were treated with PEG-IFN and RBV had their data analyzed. A stepwise logistic regression analysis was performed to identify the variables independently related to SVR. Adverse events were recorded during treatment. Results: 308 patients were included, 75% genotype 1 and 23% genotype 3. METAVIR F3 was present in 39% and F4 in 61% of patients. The median Child Pugh score for F4 patients was 5 (5–9). The global SVR rate was 34%, 11% were relapsers and 55% were nonresponders. SVR rates were similar between patients treated with PEG-IFN alfa 2a or alfa 2b (p = 0.24). SVR rates according to Child–Pugh score were 26% (Child A) and 18% (Child B). The independent factors related to SVR in F4 patients were genotype 3, RVR and fewer Child Pugh score points. Treatment interruption occurred in 31% patients and death occurred in 1.9%, all with liver cirrhosis. Conclusion: Treatment of HCV in patients with advanced fibrosis should not be postponed. However, a very careful evaluation of cirrhotic patients must be performed before treatment is indicated and careful monitoring is required during treatment.

Perfil imunofenotípico e nível de citocinas plásmáticas em portadores de hepatite C crônica com diferentes graus de comprometimento hepático

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

From west to east: Environmental influences on the rate and pathways of Polynesian colonization

The prime movers behind the prehistoric colonization of Remote Oceania, and in particular the large c. 2000-year temporal gap (i.e. long pause') seen between West and East Polynesia, has long been major point of interest in the Pacific. To address these events and the processes that may have led to the known chronological disparity of these diasporas, we present results from two different, but equally powerful, analytical tools which are used to examine Polynesian seafaring capabilities and trajectories. The first is a statistical model known as Seascape, which simulates voyages, while the second uses ease of eastward travel estimates based on land distribution and wind pattern analysis. These analyses were done with the goal of determining the potential role of environmental factors in the colonization process, particularly as they relate to the long pause. We show that the eastern boundary of West Polynesia, the limit of the initial colonization pulse, is marked by a discontinuity in land distribution, where the distances travelers would have to cross in order to reach islands further to the east become significantly larger. At the same time, in West Polynesia, the frequency and intensity of winds favorable to eastward displacement decrease continuously from west to east. As far as winds are concerned, eastward travel in West Polynesia is favored in the northern and southern areas and much more difficult across the central portion. Favorable winds have a clear seasonality, and eastward displacement along the northern area is much easier under El Nino conditions. Voyaging simulations show that intentional eastward voyages departing from Tonga and Samoa, when undertaken with vessels capable of sailing efficiently against the wind, afford a viable route toward several island groups in East Polynesia, with trips starting in Samoa having a higher probability of success.

Auditory stimulation with music influences the geometric indices of heart rate variability in response to the postural change maneuver

It is poor in the literature the behavior of the geometric indices of heart rate variability (HRV) during the musical auditory stimulation. The objective is to investigate the acute effects of classic musical auditory stimulation on the geometric indexes of HRV in women in response to the postural change maneuver (PCM). We evaluated 11 healthy women between 18 and 25 years old. We analyzed the following indices: Triangular index, Triangular interpolation of RR intervals and Poincar plot (standard deviation of the instantaneous variability of the beat-to beat heart rate [SD1], standard deviation of long-term continuous RR interval variability and Ratio between the short - and long-term variations of RR intervals [SD1/SD2] ratio). HRV was recorded at seated rest for 10 min. The women quickly stood up from a seated position in up to 3 s and remained standing still for 15 min. HRV was recorded at the following periods: Rest, 0-5 min, 5-10 min and 10-15 min during standing. In the second protocol, the subject was exposed to auditory musical stimulation (Pachelbel-Canon in D) for 10 min at seated position before standing position. Shapiro-Wilk to verify normality of data and ANOVA for repeated measures followed by the Bonferroni test for parametric variables and Friedmans followed by the Dunns posttest for non-parametric distributions. In the first protocol, all indices were reduced at 10-15 min after the volunteers stood up. In the protocol musical auditory stimulation, the SD1 index was reduced at 5-10 min after the volunteers stood up compared with the music period. The SD1/SD2 ratio was decreased at control and music period compared with 5-10 min after the volunteers stood up. Musical auditory stimulation attenuates the cardiac autonomic responses to the PCM.

Effect of follicle age on conception rate in beef heifers

The objective of this study was to determine the effect of age of the ovulatory follicle on fertility in beef heifers. Ovulation was synchronized with the 5 d CO-Synch + controlled intravaginal drug release (CIDR) program in heifers in Montana (MT; n = 162, Hereford and Angus Crossbred) and Ohio (OH; n = 170, Angus Crossbred). All heifers received estradiol benzoate (EB; 1 mg/500 kg BW, [i.m.]) 6 d after the final GnRH of the synchronization program to induce follicular atresia and emergence of a new follicular wave (NFW) followed by prostaglandin F2 alpha (PGF(2 alpha); 25 mg, i.m.) administration either 5 d (young follicle [YF]; n = 158) or 9 d (mature follicle [MF]; n = 174) after EB. Estrous detection was performed for 5 d after PGF(2 alpha) with AI approximately 12 h after onset of estrus. Ovarian ultrasonography (MT location only) was performed in YF and MF at EB, 5 d after EB, PGF(2 alpha), and AI. Heifers in MT (n = 20) and OH (n = 18) that were not presynchronized or did not initiate a NFW were excluded from further analyses, resulting in 142 and 152 heifers in MT and OH, respectively. Heifers from the MF treatment in MT that initiated a second NFW after EB but before PGF(2 alpha) (MF2; n = 14) were excluded from the primary analysis. In the secondary analysis, the MF2 group was compared to MF and YF treatments in MT. Estrous response was similar (90%; 252/280) between treatments and locations. Proestrus interval (from PGF(2 alpha) to estrus) and age of the ovulatory follicle at AI were similar for MF heifers between locations (54.6 +/- 1.7 h and 8.3 +/- 0.07 h) but were greater (P < 0.01) for YF heifers in OH (78.5 +/- 1.4 h and 5.3 +/- 0.06 h) than MT (67.4 +/- 1.6 h and 4.8 +/- 0.06 h; treatment x location, P < 0.01). However, conception rate did not differ for MF (63.8%; 74/116) and YF (67.0%; 91/136) treatments. In the MT heifers, follicle size and follicle age atAI in the YF treatment (10.4 +/- 0.15 mm and 4.8 +/- 0.06 d, respectively) was less (P < 0.01) than in the MF treatment (11.0 +/- 0.18 mm and 8.3 +/- 0.11 d, respectively), but conception rate to AI did not differ between treatments in MT. In the MF2 group proestrus interval was greater (P < 0.01); hence, diameter of the ovulatory follicle and age were similar to that for the YF treatment. Conception rate to AI did not differ between MF2, MF, and YF (61.5, 63.3, and 64.7%, respectively) in MT. In conclusion, manipulation of age of the nonpersistent ovulatory follicle at spontaneous ovulation did not influence conception rate.

Effect of progesterone concentrations, follicle diameter, timing of artificial insemination, and ovulatory stimulus on pregnancy rate to synchronized artificial insemination in postpubertal Nellore heifers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The effect of follicle age on pregnancy rate in beef cows

The effect of the age of the ovulatory follicle on fertility in beef cows was investigated. Multiparous (n = 171) and primiparous (n = 129) postpartum beef cows in 2 groups (G1 and G2) received estradiol benzoate (EB; 1 mg/500 kg BW, intramuscular [i.m.]) 5.5 d (G1; n = 162) and 6.5 d (G2; n = 138) after the final GnRH of a synchronization program (5d CO-Synch + CIDR) to induce emergence of a new follicular wave (NFW), followed by prostaglandin F2 alpha (PGF2 alpha; 25 mg, i.m.) administration either 5.5 d (young follicle, YF; n = 155) or 9.5 d (mature follicle, MF; n = 145) after EB. Estrous detection coupled with AI 12 h later (estrus-AI) was performed for 60 h (MF) and 84 h (YF) after PGF(2 alpha); cows not detected in estrus within this period received timed AI (TAI) coupled with GnRH at 72 and 96 h, respectively. Within the first 72 h after PGF(2 alpha), more (P < 0.01) cows in the MF (76.3%) than YF treatment (47.7%) exhibited estrus, but through 96 h, the proportion detected in estrus (P < 0.05) and interval from PGF(2 alpha) to estrus (P < 0.01) were greater in the YF than MF treatment (88.6% vs. 76.3%, 78.9 +/- 0.8 vs. 57.5 +/- 1.6 h, respectively). Age of the ovulatory follicle at AI was greater (P < 0.01) in the MF (9.32 +/- 0.04 d) than YF (6.26 +/- 0.02 d) treatment, but follicle diameter at AI and pregnancy rates did not differ between MF (13.1 +/- 0.2 mm; 72.0%) and YF (12.9 +/- 0.1 mm; 67.1%) treatments. Regardless of treatment, the diameter of the ovulatory follicle at AI and pregnancy rate were greater (P < 0.01) with estrus-AI (13.1 +/- 0.1 mm; 75.0%) than TAI (12.6 +/- 0.2 mm; 55.4%). Cows in the MF treatment that initiated a second NFW after EB but before PGF(2 alpha) (MF2; n = 47) were induced to ovulate with GnRH and TAI at 72h, when ovulatory follicles were 4 d old and 10.2 +/- 0.2 mm in diameter. Pregnancy rate for TAI (51.1%) in MF2 did not differ from TAI pregnancy rate (55.4%) across the MF and YF treatments. In summary, the age of the ovulatory follicle affected interval to estrus and AI but did not influence pregnancy rate in suckled beef cows.