Human leptospirosis: a twenty-nine-year serological study in São Paulo, Brazil

A retrospective study of 9,335 cases of human leptospirosis in the state of São Paulo, Brazil, diagnosed between 1969 and 1997 showed that the disease is endemic throughout the state. Middle-aged adults, with a range of 20-39 years, were most frequently infected (32.40%). The mean annual incidence was 0.53 per 100,000 population and the disease was more frequent in males (87.0%). Cases occurred mainly in January to April each year. A peak was observed in 1991 and 1996 which rainfall average was 159.9 and 160.3, respectively. These data emphasize the potential public health importance of leptospirosis in the state of São Paulo, Brazil.

Chagas disease in a community in Southeast Brazil: I. A serlogic follow-up study on a vectorcontrolled area

The prevalence of Trypanosoma cruzi infection was evaluated in Berilo, Minas Gerais (MG), Brazil, from January to July 1997. A serological survey using the indirect immunofluorescence test (IFT) in dried blood collected on filter-paper was performed in a sample of 2,261 individuals. The overall prevalence rate of T. cruzi infection was 18%, and reached 50% in individuals older than 30 years from rural areas. The percentage of seropositivity was 0.17% among individuals younger than 10 years old, suggesting that vectorial transmission is controlled in the area. A decrease in prevalence rates among people born after 1960 and 1970 was observed and this appears to be correlated with the beginning of control programs. A reduction in T. cruzi infection rates was observed when comparing our results with the rates estimated in a serologic study carried out in Berilo in 1983(11).

Clinical characteristics and evolution of syphilis in 24 HIV+ individuals in Rio de Janeiro, Brazil

A total of 24 patients with syphilis and HIV infection were treated from January 1997 to March 2003 at the Infectious Dermatology Outpatient Clinic of the Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. The caseload consisted of 20 males (83.3%) and four females (16.7%), with a mean age of 38.04 years and mean T CD4+ count of 389.5 cells/mL. Syphilis was diagnosed as secondary in 16 (62.5%) patients, late latent in eight (33.3%), and tertiary in one (4.2%). Manifestations of secondary syphilis were palmar and plantar erythematopapulous cutaneous lesions in nine (37.5%), papulous exanthema in four (16.7%), patchy alopecia in 3 (12.5%) and osteochondritis in one patient (4.2%). Tertiary syphilis was characterized by verrucous lesions. Neurosyphilis was diagnosed in four patients (16.7%), with headache as the only manifestation in two patients. Drugs used in treatment included benzathine penicillin, ceftriaxone, erythromycin, and crystalline penicillin. Cure was achieved in 18 patients (75%). Five patients (20.8%) were retreated, three of whom presented a history of re-exposure. This study confirms the importance of establishing the diagnosis of neurosyphilis in patients with HIV infection, in addition to performing follow-up on treatment for syphilis.

A conversa e o relato enquanto possibilidades do comum, apartir de we aim to be amateurs (Art & Language, 1997)

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Filosofia-Estética

Candida guilliermondii as the aetiology of candidosis

Candida guilliermondii is one of the components of human microbiota. This yeast has been infrequently associated with human infections, which may be related to its low pathogenicity. The aim of this study was to provide clinical and epidemiological data for patients infected with C. guilliermondii at Santa Casa Complexo Hospitalar, Brazil. From October 1997 to October 2003, C. guilliermondii was isolated from clinical samples from 11 patients. Three patients were excluded because the isolation of the yeast represented colonisation. Specimens from the eight patients included in the study corresponded to blood (n = 5), ascitis fluid (n = 2), and oesophagus biopsy (n = 1). Three patients (37.5%) had major immunosuppressed conditions, including solid organ transplantation, AIDS, and leukaemia. Previous use of antibiotics occurred in 87.5%. Main invasive medical procedures were central venous catheter (50.0%), abdominal surgery (25.0%), and peritoneal dialysis (50.0%). No susceptibility data was obtained. Although risk factors for candidaemia were similar amongst patients infected by with C. guilliermondii or other Candida species, mortality associated with C. guilliermondii was significantly lower.

Salmonella serovars isolated from humans in São Paulo State, Brazil, 1996-2003

Salmonellosis remains an important cause of diarrheal illness in humans in São Paulo State, Brazil. In this study were identified 3554 Salmonella isolates from human infections, during the period 1996-2003. Among 68 different serovars determined, S. Enteritidis was the most frequent one in gastrointestinal and extra-intestinal infections accounting for 67.4% of all isolates. S. Typhimurium and S. enterica subsp. enterica (4,5,12:i:-) were most frequently isolated from children aged < 1-4 year-old, in contrast, people with S. Enteritidis infections were most likely to be 20-50 year-old. In our geographic area the continued laboratorial surveillance of salmonellosis, including serotyping, has showed the trends in Salmonella serovars causing infections in humans throughout the time.

Intestinal parasitoses and environmental factors in a rural population of Argentina, 2002-2003

We evaluate the prevalence of intestinal parasites in 504 people and the degree of association between environmental variables and parasites found in population, soil and water in a rural area of Argentina during 2002-2003. A structured survey was used to evaluate the environmental variables and fecal-human, soil and water samples were analyzed. The prevalence of parasites was 45.4%. Most prevalent protozoa were Blastocystis hominis (27.2%) and Giardia lamblia (6.9%), while the most prevalent helminth was Ascaris lumbricoides (3.8%). The analyzed environmental variables showing association (p < 0.05) with presence of parasites in population were: cardboard-tin or wooden house, dirt floor, home or communal water pump, faucet outside the house or public faucet and cesspool or latrine. Parasite forms were found in 82.3% of the soil samples and in 84.2% of the water samples. In both samples we found parasites that were also found in people. In this study we have found deficient sanitary conditions associated with presence of parasites in population and we have evidenced that contaminated soil and water were the source of these parasites.

Epidemiological profile of malaria in the state of Tocantins, Brazil, from 2003 to 2008

This study describes the epidemiological profile of malaria in the State of Tocantins, in the period 2003-2008, investigates the association between the frequency of malaria and population growth, classifies the cases by 'autochthonous' and 'imported', reports the indices of the disease and analyses the distribution of the cases by Plasmodium species, age and gender. The retrospective study was based on secondary data, stored in SIVEP-malaria and analyzed using the software Epi-Info 3.5.1. and Bioestat 5.0. 19,004 samples were investigated for malaria, 19% of them were positive, 73.32% with Plasmodium vivax, 21.80% with Plasmodium falciparum, 4.79% with mixed infections and only 0.08% with Plasmodium malariae. Male individuals accounted for 76.95% and predominated in all years and age groups, especially in the 15 to 49 years old group. From the overall cases, 34.27% were autochthonous and 65.73% were imported (χ2 = 356.8, p = 0.0001). The frequency of malaria decreased significantly during the entire series (rp = 0.96, p = 0.002) and the number of municipalities with autochthonous transmission also diminished. It was found that malaria is predominantly imported, related to land activities, which confirms the need for effective measures to maintain vigilance throughout the state and enhance educational activities in order to guide the population towards early treatment-seeking.

Envenoming by coral snakes (Micrurus) in Argentina, during the period between 1979-2003

Envenomation by coral snakes (Micrurus sp.) is one of the most dangerous injuries in America and it is considered as a serious medical emergency, however bites by these snakes appear to be rare. We analyzed epidemiological data, clinical signs and antivenom use in Argentina during the period between 1979-2003. During this period of study 46 non-fatal Micrurus bites were reported. The majority of cases were men from 31 to 40 years old. Bites occurred primarily in spring and summer. Most cases were reported from the northeast and northwest provinces of the country. The bites were mostly located on hands or feet and occurred mostly during agricultural activities and so mainly involved farmers. Only four cases occurred as a result of handling snakes. The median time it took for antivenom to be administrated was 60 minutes after the bite, and the median number of vials applied was 2. Local pain was mentioned and edema was reported in 41% of patients. All patients recovered without sequelae. This study showed a low incidence of Micrurus bites and low severity of envenomation. However, although no deaths have been reported during the last 30 years, given the toxicity of the venom of Micrurus snakes, the risk of severe envenomation should be considered.

SURVEY OF SANDFLY FAUNA (DIPTERA: PSYCHODIDAE) IN UBERLÂNDIA, MINAS GERAIS STATE, BRAZIL, 2003-2004

We analyzed the sandflies around houses and domestic animal shelters located in residences close to forests in localities on the banks of the Araguari River, Uberlândia, MG, from February 2003 to November 2004. The phlebotomines were captured in the peridomiciliary area, where Shannon traps were utilized in the peridomicile and CDC traps in animal shelters. 2,783 specimens of sandflies were captured, 2,140 females (76.9%) and 643 males (23.1%), distributed between 17 species. The most abundant species was Nyssomyia neivai (88.1%), followed by Nyssomyia whitmani (3.1%). The presence of Lutzomyia longipalpis was also confirmed, it is the main vector of Leishmania (L.) infantum chagasi which causes visceral leishmaniasis. The presence of species involved in the transmission of leishmaniases in the municipality of Uberlândia is cause for concern. The presence of L. longipalpis indicates that its urbanization may not have been aleatory and instead occurred through the destruction of wild ecotopes. More studies of their occupation in anthropic environments need to be made.

Quando o presente é o passado e o presente: dois velhos lembram o passado no contexto de um lar

O texto aqui apresentado é produto de uma pesquisa' onde procurámos analisar por um lado, a experiência da velhice no contexto de um Lar, e, por outro, perceber como através da memória os residentes do Lar reconstroem a sua identidade, tendo em conta as particularidades do seu trajecto biográfico e as condicionantes da situação presente. Julganios que o conceito de experiência, cujo uso tem sido defendido na antropologia contemporânea (Turner e Bruner: 1986; Hastrup: 1995; Kleinman: 1996; Kleinman e Kleinman:1997; Willis: 2000; Throop: 2003), possa ser uma ferramenta importante na verificação compreensiva da articulação entre memória e identidade. O conceito de experiência a que nos reportamos está em sintonia com a definição proposta por Arthur Kleinman (1996) para uma 'etnografia da experiência'. Segundo este autor, a experiência não é um fenômeno subjectivo, antes um meio interpessoal de vivenciar as dinâmicas sociais e culturais, constitutivas dos processos e práticas experienciados no quotidiano (Kleinman, 1996: 97). Kleinman (1996) também refere que a prática etnográfica permite apenas aceder ao fluxo da experiência social em contextos limitados de espaço e de tempo, em determinados 'mundos morais locais', a que chama os 'microcontextos da experiência'. É o caso do contexto que foi analisado, o Lar. Aqui, a vida quotidiana é gerida segundo a trajectória de cada sujeito no espaço social e as especificidades culturais e históricas exercidas sobre esse mesmo 'microcontexto da experiência'

Evaluation of thermal remote sensing for detection of thermal anomalies as earthquake precursors: a case study for Malatya-Pütürge-Doganyol (Turkey) Earthquake, July 13, 2003

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Atlas sócio-demográfico de Moçambique (1997-2007) – uma abordagem SIG

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Estatística e Gestão de Informação.

Casuística da Consulta de Diabetes da Maternidade Dr. Alfredo da Costa no Ano de 1997

A Diabetes Mellitus é uma doença crónica que frequentemente complica a gravidez. Por outro lado, as perturbações do metabolismo glucídico podem ser exageradas pela gravidez, com as suas alterações endócrino-metabólicas. A vigilância da grávida diabética é complexa e deve envolver uma equipa multidisciplinar. Com o objectivo de avaliar as repercussões da diabetes no prognóstico da gravidez e vice-versa, os autores efectuaram a casuística da Consulta de Diabetes da Maternidade Dr. Alfredo da Costa durante o ano de 1997. Das 138 doentes que recorreram à consulta, 108 apresentavam Diabetes Gestacional/Intolerância à glicose oral (DG/IGO) e 30 Diabetes prévia à gravidez. Apenas 2 destas últimas tiveram uma consulta pré-concepcional. Cerca de 44% das mulheres com DG/IGO necessitaram de insulina em algum momento da gestação. A doença hipertensiva constituiu a complicação obstétrica mais frequente. A taxa de cesarianas (49%) situou-se acima da mencionada por outros estudos. Não se registaram mortes fetais in útero e a morbi/mortalidade neonatal foi semelhante à referida por outros autores. O dado mais importante que interessa salientar deste estudo reside no trabalho desta equipa multidisciplinar, sem o qual não se teria conseguido uma diminuição da morbilidade materna e peri-natal.

Invasão de ecossistemas por Acacia longifolia - caracterização da entomofauna associada e identificação de potenciais polinizadores

Dissertação para a obtenção do Grau de Mestre em Engenharia do Ambiente, perfil de Engenharia Ecológica