Relationship between rainfall and temperature: observations on the cases of visceral leishmaniasis in São Luis Island, State of Maranhão, Brazil

INTRODUCTION: Visceral leishmaniasis is a serious public health problem that requires global control strategies, especially with respect to factors that may intervene in reducing the incidence of endemicity. In this work, rainfall density and temperature were correlated with the incidence of human cases in an area endemic for leishmaniasis in São Luis do Maranhão, Northeastern Brazil. METHODS: Notification of human cases by the National Health Foundation/Regional Coordination of Maranhão (FUNASA/COREMA) from 2002 to 2010 was used. Ecological data (mean temperature and rainfall density) were provided by the Meteorological Office of State. RESULTS: A significant association was verified between the number of VL cases and rainfall rate but not in the analysis concerning mean temperatures. CONCLUSIONS: These data suggest that the control actions in visceral leishmaniasis should be performed during rainy season in the State of Maranhão, which is in the first half of the year.

Produção de matrizes porosas 3D baseadas em réplicas invertidas de cristais coloidais

A Engenharia de Tecidos surge da necessidade recorrente de regenerar ou recriar órgãos e tecidos danificados devido a vários tipos de trauma. A carência de funcionalidades resultante pode ser resolvida através da implantação de substitutos bio-sintéticos. O presente trabalho consiste na produção de matrizes porosas 3D baseadas em réplicas invertidas de cristais coloidais com futura aplicação em substituintes ósseos sintéticos para fraturas de não-união. O substituinte ósseo consiste numa estrutura denominada Inverse colloidal crystal (ICC), em que a sua organização singular resulta numa homogénea proliferação celular e num aumento das propriedades mecânicas, quando comparada com outros substituintes. O primeiro passo para a obtenção desta estrutura é a produção de microesferas de poliestireno, por uma técnica baseada em microfluídica. Posteriormente as microesferas são empacotadas resultando numa estrutura coesa com ligações entre microesferas vizinhas. O preenchimento dos espaços vazios entre microesferas pelo biomaterial pretendido e posterior remoção das microesferas dá origem à estrutura porosa do ICC. ICCs poliméricos (ϕCs = 1,00) e compósitos (ϕCs = 0,86 e ϕHA = 0,14; ϕCs = 0,67 e ϕHA = 0,33; ϕCs = ϕHA = 0,50) são produzidos e as suas propriedades mecânicas são testadas através de ensaios de compressão e comparadas com outros substituintes sintéticos. Para avaliação do comportamento dos materiais em contacto com meio biológico, foram realizados testes de citotoxicidade que revelaram uma viabilidade celular acima dos 80% em todos os ICCs.

A Comédia Ulissipo de Jorge Ferreira de Vasconcelos

O trabalho que se segue consiste exactamente na identificação, estudo e edição do texto transmitido por estes testemunhos; tendo em conta que existem consideráveis diferenças entre os textos das duas edições, foi necessário proceder-se a uma edição crítica, cujos critérios serão adiante definidos. O facto de existirem edições do século seguinte, e divergentes entre si, sugere que tanto esta comédia como o seu Autor terão gozado de uma considerável fortuna junto do público: uma peça de teatro que continua a ser reeditada em Portugal e em Espanha muito tempo depois da sua primeira edição, era forçosamente importante. Nesse sentido, tudo o que nela se contém deve ser encarado como representativo da sua época e do gosto do público do tempo; por isso, tornou-se necessário elaborar e apresentar ao leitor um conjunto de índices – personalidades, topónimos, autores, entidades mitológicas – do mundo referencial existente na comédia. Este trabalho é, assim, constituído por duas grandes partes: na primeira, faz-se uma revisão crítica do estado dos conhecimentos sobre Jorge Ferreira de Vasconcelos e a sua obra, e desta comédia no conjunto da obra do Autor. Na segunda parte, procede-se à identificação da tradição impressa da obra e, naturalmente, ao estabelecimento do respectivo texto crítico. Um anexo, constituído pelos já referidos índices, completa o trabalho.

High prevalence of HTLV-1 and 2 viruses in pregnant women in São Luis, state of Maranhão, Brazil

INTRODUCTION: Human T cell lymphotropic virus type 1 (HTLV-1) is endemic in the Caribbean, Japan, South America and regions of Africa. HTLV-2 is present in Native American populations and associated with IV drug use in Europe and North America. In Brazil, it is estimated that 1.5 million people are infected with HTLV-1/2. The study objective was to determine HTLV-1/2 prevalence in pregnant women in the prenatal care from three public services in São Luis, State of Maranhão, Brazil, and to counsel seropositive women to reduce viral transmission. METHODS: A cross-sectional study was conducted from February to December 2008; women with age of 18 to 45 years, with low risk for sexually transmitted disease (STD) were invited to participate. Blood samples were collected in filter paper, and HTLV-1/2 immunoenzymatic test (ELISA) was performed as a screening test. Women with reactive results were submitted to peripheral venous blood collection for ELISA repetition, followed by Western blot (WB) and real-time PCR to confirm and discriminate the infection between virus types 1 and 2. RESULTS: Of the 2,044 women tested, seven (0.3%) were ELISA reactive and confirmed positive (four were HTLV-1, and three were HTLV-2). All positive women were oriented not to breastfeed their newborns. CONCLUSIONS: This study showed that the virus is present in high prevalence in that population. Further studies covering other segments of the population are necessary to better characterize the presence of HTLV-1/2 in Maranhão and to elicit measures to prevent its spread.

Circulation of the rabies virus in non-hematophagous bats in the city of Rio de Janeiro, Brazil, during 2001-2010

INTRODUCTION: Rabies is one of the most known lethal zoonosis, responsible for 55,000 human deaths per year. It is transmitted to humans mainly by the bite of domestic or wild animals infected with the virus. This paper shows the circulation of this virus in non-hematophagous bats in the City of Rio de Janeiro, Brazil. METHODS: A survey was performed on the number of bats that had been sent for diagnosis by the Seção de Virologia of the Instituto Municipal de Medicina Veterinária Jorge Vaitsman and were positive for rabies. The positive animals were identified, and the isolated viruses were sent for antigenic typification with indirect immunofluorescence. The results were compared with the antigenic panel of the Centers for Disease Control and Prevention. RESULTS: During 2001-2010, the laboratory received 555 non-hematophagous bats for rabies diagnosis, with 198 (35.7%) from Rio de Janeiro City. A total of 11 (5.5%) animals were positive for this disease. Antigenic typification revealed the predominance of variant 3 in 9 (81.8%) of the isolated viruses; 1 virus was classified as variant 4 and 1 variant was identified that segregated with the viruses in insectivorous bats. CONCLUSIONS: The data obtained in this study showed the presence of the rabies virus in synanthropic populations of non-hematophagous bats in the City of Rio de Janeiro. The circulation of this agent in these animals represents a serious risk to human and animal health and requires attention and control measures by the authorities.

Hepatitis D virus infection in the Western Brazilian Amazon - far from a vanishing disease

INTRODUCTION: A decline in hepatitis D virus (HDV) occurrence was described in Europe and Asia. We estimated HDV prevalence in the Brazilian Amazon following hepatitis B vaccination. METHODS: This is a cross-sectional survey of HDV measured by total antibodies to HDV (anti-HD T). RESULTS: HDV prevalence was 41.9% whiting HBsAg carries and was associated with age (PR = 1.96; 95% CI 1.12-3.42; p = 0.01), hepatitis B virus (HBV) infection (PR = 4.38; 95% CI 3.12-6.13; p < 0.001), and clinical hepatitis (PR =1.44; 95% CI 1.03-2.00; p = 0.03). Risk factors were related to HDV biology, clinical or demographic aspects such as underlying HBV infection, clinical hepatitis and age. CONCLUSIONS: Our study demonstrated that HDV infection continues to be an important health issue in the Brazilian Amazon and that the implementation of the HBV vaccination in rural Lábrea had little or no impact on the spread of HDV. This shows that HDV has not yet disappeared from HBV hyperendemic areas and reminding that it is far from being a vanishing disease in the Amazon basin.

O canto do cisne no retorno do Eu ao Ato da escrita. Estudo comparativo de testemunho de José Cardoso Pires e de José Luis Sampedro

Este trabalho com o título «O Canto do Cisne no Retorno do Eu ao Ato da Escrita» é um estudo comparativo que pretende investigar o fenómeno da criatividade literária na primeira pessoa, de um universo literário não convencional devidamente identificado, de acordo com a matriz dos testemunhos selecionados. O corpus principal do trabalho são dois livros de natureza biográfica, de dois escritores ibéricos, cujo propósito é testemunhar na primeira pessoa a experiência limite causada por grave fragilidade física. Não obstante o problema diagnosticado, os dois autores puderam, a seu tempo, pôr à prova a própria recuperação física e o estado de capacidade literária ao retomarem o ato da escrita para testemunharem com intimidade confessional a inevitabilidade do ato da escrita de escritores com percurso sério feito, no limite da precariedade da existência humana. A atividade literária dos autores é a sustentação indagativa para a fase adiantada de maturidade interpretativa revelada no corpus escolhido. José Cardoso Pires e José Luis Sampedro são dois “cisnes” que puderam e souberam “cantar” a conquista, ainda que temporária, sobre a morte, explicando com lucidez, cada um a seu modo, a sua experiência de finitude física, diria que em nome de todos os que, em situações análogas, gostariam de o ter feito; numa vontade exponenciada pela experiência do desconhecido, como o filósofo Paul Ricoeur que procurou testemunhar na sua escrita a experiência na primeira pessoa da finitude em estado de moribundo.A contribuição original deste trabalho para o conhecimento não se confina ao levantamento e análise comparativa dos testemunhos pessoais destes escritores de renome e de subida atividade sobre a necessidade vital e inventiva de escrever, nem tão pouco ao valor documental literário dos mesmos para a compreensão do fenómeno da atividade criativa, com e para as outras áreas do saber; remete também para o universo subsequente à receção das suas obras, às reações literárias e públicas envolventes, a depoimentos sobre o fenómeno do ato da escrita literária e à importância para o fenómeno da palavra escrita para a autopreservação física, intelectual, social e afetiva. A seleção do corpus de autores latinos contemporâneos foi feita de acordo com a contemporaneidade e a proximidade geocultural de ambos. Embora estes escritores não se conhecessem, a que tudo indica pessoalmente, tinham um importante amigo comum, José Saramago, com o qual partilhavam os mesmos ideais de justiça social. São dois altos representantes das literaturas portuguesa e espanhola conscientes da importância da cultura vizinha. Como o foram José Saramago e Miguel Unamuno.

Phenotypic detection of metallo-β-lactamases in Pseudomonas aeruginosa and Acinetobacter baumannii isolated from hospitalized patients in São Luis, State of Maranhão, Brazil

Introduction Acquired metallo-β-lactamases (MβL) are emerging determinants of resistance in Pseudomonas aeruginosa and Acinetobacter baumannii. The objectives of this study were to phenotypically detect MβL in imipenem-resistant P. aeruginosa and A. baumannii, to investigate the association between MβL-positive strains and hospitals, and to compare the resistance profiles of MβL-producing and non-MβL-producing strains. Methods The approximation disk and combined disk assay methods were used in this study. Results A total of 18 (38.3%) P. aeruginosa isolates and 1 (5.6%) A. baumannii isolate tested positive for the presence of MβL. Conclusions These results demonstrate the need for strict surveillance and for the adoption of preventive measures to reduce the spread of infection and potential outbreaks of disease caused by MβL-producing microorganisms.

Dengue infection in children and adolescents: Clinical profile in a reference hospital in northeast Brazil

Introduction This study aimed to describe the clinical spectrum of dengue in children and adolescents from a hyperendemic region who were admitted for hospitalization. Methods A retrospective study was conducted on patients diagnosed with dengue infection upon admission to a reference center in Fortaleza, Brazil. Results Of the 84 patients included, 42 underwent confirmatory testing. The main symptoms were fever, abdominal pain and vomiting. The median level of serum aspartate aminotransferase was 143.5±128mg/dL. Conclusions A peculiar clinical profile was evident among children and adolescents with dengue infection in a reference center in northeast Brazil, including gastrointestinal symptoms and liver involvement.

Diversity and dynamics of airborne fungi in São Luis, State of Maranhão, Brazil

Introduction: This study aimed to identify airborne fungi in São Luis, Maranhão, Brazil, to determine the prevalent genera and to correlate these genera with the area and season. Methods: In total, 1,510 colony-forming units (CFUs) of airborne fungi were isolated from the north, south, east and west sides and from the center of the city from January to December 2007. The samples were collected on Petri dishes that were exposed to the fungi by the gravitational method. Results: Twenty genera of fungi were isolated; the most common were Aspergillus (33.5%), Penicillium (18.8%), Cladosporium (14.2%), Curvularia (10.6%) and Fusarium (7.6%). The CFUs of the fungi were statistically significant (p < 0.0001). Fungal biological diversity was present all year, without any large seasonal variations but with slight increases in May, August and September. Conclusions: The fungal genera identified in this study were correlated with natural systems and could be useful when evaluating the impact of environmental changes on the region.

Factors associated with neural alterations and physical disabilities in patients with leprosy in São Luis, State of Maranhão, Brazil

Introduction Leprosy is a chronic infectious disease that is caused by Mycobacterium leprae. The objective of this study was to evaluate the risk factors that are associated with neural alterations and physical disabilities in leprosy patients at the time of diagnosis. Methods A prospective cross-sectional study was conducted on 155 leprosy patients who participated in a program that aimed to eliminate leprosy from São Luis, State of Maranhão. Results Patients who were 31-45 years of age, were older than 60 years of age or had a partner were more likely to have a disability. Patients with partners were 1.14 times more likely (p = 0.025) to have disabilities of the hands. The frequency of disabilities in the feet among the patients with different clinical forms of leprosy was statistically significant. Conclusions The identification of risk factors that are associated with neural alterations and physical disabilities in leprosy patients is important for diagnosing the disease because this approach enables physicians to plan and prioritize actions for the treatment and monitoring of patients.

High similarity of Trypanosoma cruzikDNA genetic profiles detected by LSSP-PCR within family groups in an endemic area of Chagas disease in Brazil

IntroductionDetermining the genetic similarities among Trypanosoma cruzi populations isolated from different hosts and vectors is very important to clarify the epidemiology of Chagas disease.MethodsAn epidemiological study was conducted in a Brazilian endemic area for Chagas disease, including 76 chronic chagasic individuals (96.1% with an indeterminate form; 46.1% with positive hemoculture).ResultsT. cruzi I (TcI) was isolated from one child and TcII was found in the remaining (97.1%) subjects. Low-stringency single-specific-primer-polymerase chain reaction (LSSP-PCR) showed high heterogeneity among TcII populations (46% of shared bands); however, high similarities (80-100%) among pairs of mothers/children, siblings, or cousins were detected.ConclusionsLSSP-PCR showed potential for identifying similar parasite populations among individuals with close kinship in epidemiological studies of Chagas disease.

Pulmonary tuberculosis in São Luis, State of Maranhão, Brazil: space and space-time risk clusters for death (2008-2012)

INTRODUCTION: The objective was to identify space and space-time risk clusters for the occurrence of deaths in a priority city for the control of tuberculosis (TB) in the Brazilian Northeast. METHODS: Ecological research was undertaken in the City of São Luis/Maranhão. Cases were considered that resulted in deaths in the population living in the urban region of the city with pulmonary TB as the basic cause, between 2008 and 2012. To detect space and space-time clusters of deaths due to pulmonary TB in the census sectors, the spatial analysis scan technique was used. RESULTS: In total, 221 deaths by TB occurred, 193 of which were due to pulmonary TB. Approximately 95% of the cases (n=183) were geocoded. Two significant spatial clusters were identified, the first of which showed a mortality rate of 5.8 deaths per 100,000 inhabitants per year and a high relative risk of 3.87. The second spatial cluster showed a mortality rate of 0.4 deaths per 100,000 inhabitants per year and a low relative risk of 0.10. A significant cluster was observed in the space-time analysis between 11/01/2008 and 04/30/2011, with a mortality rate of 8.10 deaths per 100,000 inhabitants per year and a high relative risk (3.0). CONCLUSIONS: The knowledge of priority sites for the occurrence of deaths can support public management to reduce inequities in the access to health services and permit an optimization of the resources and teams in the control of pulmonary TB, providing support for specific strategies focused on the most vulnerable populations.