Prevalência da doença de Chagas em gestantes da região sul do Rio Grande do Sul

Anticorpos antiTrypanosoma cruzi no cordão umbilical de 351 parturientes da Cidade de Pelotas, RS foram pesquisados a fim de investigar a prevalência da doença de Chagas em gestantes. Um (0,3%) caso foi identificado, não sendo detectada transmissão congênita. Salienta-se a importância da investigação da doença de Chagas em gestantes de zonas endêmicas ou provenientes destas.

A revolução de 1974-75: repercussão na imprensa internacional e memória(s)

O presente volume surgiu na sequência do seminário “Visões da Revolução: A Imprensa em Portugal, Espanha e Brasil” organizado no âmbito da atividade do Grupo de História Global do Trabalho e dos Conflitos Sociais e que contou com a participação de Luciana Soutelo, Rita Luís e Carla Luciana Silva e com o comentário de Ricardo Noronha e Raquel Varela em abril de 2012. Neste seminário procurou-se entender a imprensa escrita, e os meios de comunicação em geral, como um objeto historiográfico em si mesmo e não apenas como fonte. Entendendo, na esteira de Gramsci, os meios de comunicação como espaços de disputa da hegemonia. A imprensa atua como espaço de relações sociais, dando voz a determinados sujeitos e retirando o espaço de outros. Sendo parte de um aparelho de hegemonia, ela atua na sua dupla dimensão: a formação de consenso sobre determinadas ideias; o apoio ativo a medidas repressivas e coercitivas, fechando-se assim o círculo da hegemonia. Não se trata apenas de estratégias manipuladoras de opinião, mas de formas de estabelecimento de consensos, muitas vezes passivos, e que reproduzem uma lógica de dominação de classe. Assim, a imprensa não está longe de propiciar um retrato fidedigno da realidade: de mostrar posições, que muitas vezes são expressões de frações de classe organizadas.

Trends in antimicrobial resistance among clinical isolates of enterococci in a Brazilian tertiary hospital: a 4-year study

INTRODUCTION: In the past two decades members of the genus Enterococcus have emerged as important nosocomial pathogens worldwide. This study prospectively analyzed the distribution of species and trends in antimicrobial resistance among clinical isolates of enterococci in a Brazilian tertiary hospital from 2006-2009. METHODS: Enterococcal species were identified by conventional biochemical tests. The antimicrobial susceptibility profile was performed by disk diffusion in accordance with the Clinical and Laboratory Standards Institute (CLSI). A screening test for vancomycin was also performed. Minimal inhibitory concentration (MIC) for vancomycin was determined using the broth dilution method. Molecular assays were used to confirm speciation and genotype of vancomycin-resistant enterococci (VRE). RESULTS: A total of 324 non-repetitive enterococcal isolates were recovered, of which 87% were E. faecalis and 10.8% E. faecium. The incidence of E. faecium per 1,000 admissions increased significantly (p < 0.001) from 0.3 in 2006 to 2.3 in 2009. The VRE rate also increased over time from 2.5% to 15.5% (p < 0.001). All VRE expressed high-level resistance to vancomycin (MIC >256µg/ mL) and harbored vanA genes. The majority (89.5%) of VRE belonged to E. faecium species, which were characteristically resistant to ampicillin and quinolones. Overall, ampicillin resistance rate increased significantly from 2.5% to 21.4% from 2006-2009. Resistance rates for gentamicin, chloramphenicol, tetracycline, and erythromycin significantly decreased over time, although they remained high. Quinolones resistance rates were high and did not change significantly over time. CONCLUSIONS: The data obtained show a significant increasing trend in the incidence of E. faecium resistant to ampicillin and vancomycin.

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

INTRODUCTION: Hepatitis B infection constitutes an important cause of morbidity and mortality worldwide. In Brazil, however, the current epidemiological situation is not clear. Considering the importance of establishing this prevalence, the aim of this study was to determine the prevalence of HBV markers in voluntary adolescents, junior high (secondary school) students, in the City of Itajaí, State of Santa Catarina, Brazil. METHODS: A seroepidemiological, transverse study was conducted with 353 randomly chosen adolescents from elementary school in 2008. Blood samples were analyzed for HBsAg, anti-HBc and anti-HBs. All analyses were conducted by automated microparticle enzyme immunosorbent assay (Abbott®, AxSYM system, Deerfield, IL, USA), according to the manufacturer's instructions. RESULTS: The prevalence of HBsAg was 0.6% (CI 95% 0.1 - 2.0), that of anti-HBc was 1.1% (CI 95% 0.3 - 2.9) and that of detectable anti-HBs was 83.6% (CI 95% 79.3 - 87.3). Hepatitis B vaccination coverage was 97.5% (CI 95% 95.2 - 98.8). CONCLUSIONS: These results demonstrate the success of the vaccination program against hepatitis B in the region studied and indicate that prevention strategies must be maintained and, if possible, expanded to contribute to the establishment of positive prevalence rates in all age groups.

Dengue: clinical forms and risk groups in a high incidence city in the southeastern region of Brazil

INTRODUCTION: The article describes the epidemiologic profile of dengue cases in Vitória, the capital of Espírito Santo, Brazil, from 2000 to 2009, aimed at identifying risk groups regarding the incidence and severity of the disease. METHODS: Confirmed cases of dengue among city residents during ten years were classified as dengue fever, dengue hemorrhagic fever, dengue shock syndrome and dengue with complications, and analyzed according to sex, age, race-color and education. RESULTS: The proportion of dengue cases was highest among women aged 20 to 29 years-old and similar between whites and blacks. A gradual decrease occurred in the percentage of dengue cases in the population aged 15 years-old or more, in the historical series of 10 years, and a growing increase in individuals less than 15 years-old, showing statistical significance. The fatality rate ranged from zero to 0.3% for all forms of dengue and from 0.2% to 18.2% for severe forms. CONCLUSIONS: The profile of those affected by the disease in the municipality is similar to those affected in Brazil. The increasing number of cases in individuals under 15 years-old corroborates the results of recent studies in other Brazilian municipalities.

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

INTRODUCTION: We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. METHODS: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. RESULTS: The most frequent protozoan was Isospora belli (4.2%), followed by Giardia lamblia (3.5%), Entamoeba coli (2.8%), and Cryptosporidium parvum (0.3%). Ancylostoma duodenale (1.4%) was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load, and the characteristics of any particular parasite. CONCLUSIONS: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world.

Synthesis of Polymeric Nanoparticles for biomedical delivery applications

Polymeric nanoparticles (PNPs) have attracted considerable interest over the last few years due to their unique properties and behaviors provided by their small size. Such materials could be used in a wide range of applications such as diagnostics and drug delivery. Advantages of PNPs include controlled release, protection of drug molecules and its specific targeting, with concomitant increasing of the therapeutic index. In this work, novel sucrose and cholic acid based PNPs were prepared from different polymers, namely polyethylene glycol (PEG), poly(D,L-lactic-co-glycolic acid) (PLGA) and PLGA-co-PEG copolymer. In these PNP carriers, cholic acid will act as a drug incorporation site and the carbohydrate as targeting moiety. The uptake of nanoparticles into cells usually involves endocytotic processes, which depend primarily on their size and surface characteristics. These properties can be tuned by the nanoparticle preparation method. Therefore, the nanoprecipitation and the emulsion-solvent evaporation method were applied to prepare the PNPs. The influence of various parameters, such as concentration of the starting solution, evaporation method and solvent properties on the nanoparticle size, size distribution and morphology were studied. The PNPs were characterized by using atomic force microscopy (AFM), scanning electron microscopy (SEM) and dynamic light scattering (DLS) to assess their size distribution and morphology. The PNPs obtained by nanoprecipitation ranged in size between 90 nm and 130 nm with a very low polydispersity index (PDI < 0.3). On the other hand, the PNPs produced by the emulsion-solvent evaporation method revealed particle sizes around 300 nm with a high PDI value. More detailed information was found in AFM and SEM images, which demonstrated that all these PNPs were regularly spherical. ζ-potential measurements were satisfactory and evidenced the importance of sucrose moiety on the polymeric system, which was responsible for the obtained negative surface charge, providing colloidal stability. The results of this study show that sucrose and cholic acid based polymeric conjugates can be successfully used to prepare PNPs with tunable physicochemical characteristics. In addition, it provides novel information about the materials used and the methods applied. It is hoped that this work will be useful for the development of novel carbohydrate based nanoparticles for biomedical applications, specifically for targeted drug delivery.

A revolução de 1974-75: repercussão na imprensa internacional e memória(s)

O presente volume surgiu na sequência do seminário “Visões da Revolução: A Imprensa em Portugal, Espanha e Brasil” organizado no âmbito da atividade do Grupo de História Global do Trabalho e dos Conflitos Sociais e que contou com a participação de Luciana Soutelo, Rita Luís e Carla Luciana Silva e com o comentário de Ricardo Noronha e Raquel Varela em abril de 2012. Neste seminário procurou-se entender a imprensa escrita, e os meios de comunicação em geral, como um objeto historiográfico em si mesmo e não apenas como fonte. Entendendo, na esteira de Gramsci, os meios de comunicação como espaços de disputa da hegemonia. A imprensa atua como espaço de relações sociais, dando voz a determinados sujeitos e retirando o espaço de outros. Sendo parte de um aparelho de hegemonia, ela atua na sua dupla dimensão: a formação de consenso sobre determinadas ideias; o apoio ativo a medidas repressivas e coercitivas, fechando-se assim o círculo da hegemonia. Não se trata apenas de estratégias manipuladoras de opinião, mas de formas de estabelecimento de consensos, muitas vezes passivos, e que reproduzem uma lógica de dominação de classe. Assim, a imprensa não está longe de propiciar um retrato fidedigno da realidade: de mostrar posições, que muitas vezes são expressões de frações de classe organizadas. Posteriormente decidiu-se alargar o âmbito do debate de forma a incorporar outras prespectivas teóricas e centros produtores de visões sobre a revolução portuguesa de 1974-1975, fossem eles imprensa escrita, meios audiovisuais, editoras, materiais de educação, etc., para que fosse abordada tanto a repercussão coeva do processo revolucionário em meios de comunicação; como a sua memória e/ou o seu uso público em diferentes meios. O resultado deste alargamento é o presente volume.

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.

Descriptive study of HTLV infection in a population of pregnant women from the state of Pará, Northern Brazil

INTRODUCTION: In Brazil, studies have shown that HTLV seroprevalence among pregnant women varies from 0 to 1.8%. However, this seroprevalence was unknown in the State of Pará, Brazil. The present study describes, for the first time, the HTLV seroprevalence among pregnant women from the State of Pará, Northern Brazil. METHODS: 13,382 pregnant women were submitted to HTLV screening during prenatal care, and those with non-seronegative results to anti-HTLV were submitted to Western blot (WB) test to confirm and separate HTLV-1 and HTLV-2 carriers. RESULTS: HTLV seroprevalence in the population of pregnant women was 0.3%, and HTLV-1 was identified in 95.3% of patients. The demographic profile of HTLV carriers was as follows: women with age between 20 and 40 years old (78.4%); residing in the metropolitan region of Belém, Pará (67.6%); and with educational level of high school (56.8%). Other variables related to infection were as follows: beginning of sexual intercourse between the age of 12 and 18 years old (64.9%) and have being breastfed for more than 6 months (51.4%). Most of the women studied had at least two previous pregnancies (35.1%) and no abortion (70.3%). Coinfections (syphilis and HIV) were found in 10.8% (4/37) of these pregnant women. CONCLUSIONS: Seroprevalence of HTLV infection in pregnant women assisted in basic health units from the State of Pará, Northern Brazil, was 0.3% similar to those described in other Brazilian studies. The variables related to infection were important indicators in identifying pregnant women with a higher tendency to HTLV seropositivity, being a strategy for disease control and prevention, avoiding vertical transmission.

Enterobius vermicularis infection is well controlled among preschool children in nurseries of Taipei City, Taiwan

INTRODUCTION: Whether Enterobius vermicularis (pinworm) infections among preschool children in Taipei City had truly declined was investigated. METHODS: A total of 6,661 preschool children from 28 nurseries were randomly selected from 4 major geographic districts in Taipei City to examine the status of pinworm infection by using adhesive thin cellophane tape swab method. RESULTS: The overall prevalence of pinworm infection was 0.5% (30/6,661). Boys (0.6%; 21/3,524) had higher prevalence than girls (0.3%; 9/3,137) (p=0.06). Southern district (0.6%; 10/1,789) showed insignificantly higher prevalence than Western district (0.2%; 1/606) (p=0.22). CONCLUSIONS: Pinworm screening program remains necessary for some parts of Taipei City.

Prevalência de parasitas intestinais em crianças a frequentar a escola primária no Bairro Lucrécia, no Lubango, Angola, e sua relação com o estado nutricional e anemia

Introdução: Os parasitas intestinais são responsáveis por morbilidade em crianças de todo mundo, em especial nos países de baixa renda. Os estudos têm vindo a demonstrar o seu impacto negativo no estado nutricional e o seu contributo na etiologia da anemia. Pretendeu-se determinar a prevalência de parasitas intestinais em crianças dos 5 aos 12 anos de idade, a frequentar a escola primária no Bairro Lucrécia, no Lubango, Angola, e explorar a sua relação com o estado nutricional e anemia. Material e Métodos: Foi efectuado um estudo observacional, transversal e analítico, cuja colheita de dados se realizou entre Setembro e Outubro de 2010. A amostra foi constituída por 328 crianças. Realizou-se a detecção microscópica de parasitas intestinais e identificação molecular dos parasitas Entamoeba histolytica e Entamoeba dispar. O estado nutricional foi avaliado através dos z-scores do peso para a idade, da estatura para a idade e do IMC para a idade. A concentração de hemoglobina foi determinada através de um hemoglobinómetro portátil. Resultados: A prevalência de parasitas intestinais patogénicos foi de 44,2%, destacando-se Ascaris lumbricoides com 22,0%, Giardia lamblia com 20,1% e Hymenolepis nana com 8,8%. Na microscopia foi encontrada uma prevalência de Entamoeba histolytica/dispar de 13,7%, tendo sido posteriormente identificada, por diagnóstico molecular, uma prevalência de 13,1% para E. dispar e 0,3% para E. histolytica. A prevalência de baixo peso, subnutrição crónica e subnutrição aguda foi de, respectivamente, 36,1%, 41,5% e 30,2%. A probabilidade das crianças terem subnutrição crónica ou subnutrição aguda aumentou com o facto de terem 10 anos ou mais. As crianças co-infectadas por protozoários e helmintas apresentaram uma maior probabilidade de terem subnutrição crónica. A prevalência de anemia foi de 21,6%, encontrando-se a mesma significativamente associada à infecção por H. nana. A probabilidade das crianças estarem anémicas aumentou com o facto de terem menos de 10 anos. Adicionalmente nas crianças desparasitadas com albendazol ou mebendazol há 2 meses e meio ou menos verificou-se uma maior prevalência de infecção por G. lamblia (28,6%) em comparação com as desparasitadas há mais de 2 meses e meio (13,7%), tendo sido essa diferença estatisticamente significativa. Discussão e Conclusões: Emergiu deste estudo a importância da co-infecção com helmintas e protozoários no aumento da probabilidade das crianças terem subnutrição crónica e foi encontrada uma associação estatisticamente significativa entre a infecção por H. nana e a anemia. Será importante desenhar futuros estudos que investiguem o poder patogénico do H. nana e o modo como é efectuada a desparasitação com albendazol ou mebendazol, pois ao ser eficaz contra a infecção por A. lumbricoides, poderá aumentar a susceptibilidade à infecção por G. lamblia.

Desenvolvimento de novas ferramentas analíticas para a monitorização da actividade da Paraoxonase 1 em amostras de plasma humano

Segundo a Organização Mundial da Saúde (OMS), as doenças cardiovasculares (DCV) são a principal causa de morte nos países desenvolvidos. Há uma necessidade urgente de métodos eficazes para a detecção precoce de doenças cardiovasculares, devido à falta de factores de risco convencionais. Os níveis elevados de homocisteína (Hcy) no sangue, homocisteinemia, são um factor de risco independente bem estabelecido para DCV. De acordo com alguns autores, a conversão metabólica de Hcy no metabolito tóxico Hcy-Tl e subsequente N-homocisteinilação de proteínas induz a agregação e a formação de amiloide, contribuindo assim para a alterações próaterogénicas no sistema cardiovascular. A enzima associada à lipoproteína de alta densidade (HDL), paraoxonase 1 (PON1), é capaz de hidrolisar o metabolito tóxico Hcy-Tl de volta a Hcy no soro humano, como observado em estudos recentes que indicam o papel de patogénese em DCV da hPON1. As paraoxonases de soro (PON1, PON2 e PON3) são hidrolases dependentes de cálcio, que pertencem a uma família de enzimas que exibem propriedades antioxidantes e anti-inflamatórias. Foram identificadas três actividades catalíticas principais para PON1: (i) actividade paraoxonase, que corresponde à conversão hidrolítica de paraoxon em p-nitrofenol e a dietil fosfato, (ii) a actividade arilesterase que promove a hidrólise de ésteres aromáticos, e a (iii) actividade de lactonase, que catalisa a hidrólise de Hcy a Hcy-Tl, sendo considerada a actividade principal da PON1. Vários estudos têm relacionado estas actividades enzimáticas a diversas patologias, o que sugere a sua potencial utilidade no diagnóstico clínico. Neste trabalho pretende-se desenvolver um novo método electroquímico para a detecção fácil do substrato e produto resultantes da hidrólise enzimática de paraoxon pela hPON1. Utilizando uma célula electroquímica constituída por um eléctrodo de referência Ag /AgCl., um contra-eléctrodo de Pt e um electrodo de trabalho de carbono vítreo, o paraoxon e p-nitrofenol foram detectados simultaneamente por voltametria de onda quadrada, numa janela de potencial de [-0,3;-1,2] V. Os resultados dos ensaios com a enzima testada a pH 7,6 e 37°C, na presença de paraoxon e utilizando plasma humano como uma fonte de PON1 serão discutidos. Usando a mesma composição de célula electroquímica, Hcy e Hcy-Tl foram estudados utilizando diferentes interfaces e tipos de tratamento para testar a melhor maneira possível de detecção das duas espécies na mesma experiência electroquímica.

Occurrence of potentially pathogenic Vibrio in oysters (Crassostrea gigas) and waters from bivalve mollusk cultivations in the South Bay of Santa Catarina

Introduction This research aimed to identify and quantify potentially pathogenic Vibrio from different cultivations of bivalve shellfish in the State of Santa Catarina, Brazil, and water regions in the South Bay, as well as correlate the incidence of these microorganisms with the physicochemical parameters of marine waters. Methods Between October 2008 and March 2009, 60 oyster and seawater samples were collected from six regions of bivalve mollusk cultivation, and these samples were submitted for Vibrio counts. Results Twenty-nine (48.3%) oyster samples were revealed to be contaminated with one or more Vibrio species. The Vibrio parahaemolyticus and Vibrio vulnificus counts in the samples ranged from < 0.5 log10 Most Probable Number (MPN) g–1 to 2.3 log10 MPN g–1 oyster and from < 0.5 log10 MPN g–1 to 2.1 log10 MPN g–1 oyster, respectively. Of the 60 seawater samples analyzed, 44 (73.3%) showed signs of contamination with one or more vibrio species. The counts of V. parahaemolyticus and V. vulnificus in the samples ranged from < 0.3 log10 MPN·100mL–1 to 1.7 log10MPN·100mL–1 seawater and from < 0.3 log10 MPN·100mL–1 to 2.0 log10 MPN·100mL–1 seawater, respectively. A positive correlation between V. vulnificus counts and the seawater temperature as well as a negative correlation between the V. parahaemolyticus counts and salinity were observed. Conclusions The results suggest the need to implement strategies to prevent vibrio diseases from being transmitted by the consumption of contaminated bivalve shellfish.

The prevalence of hepatitis B virus infection markers and socio-demographic risk factors in HIV-infected patients in Southern Brazil

IntroductionHepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections are two of the world's most important infectious diseases. Our objective was to determine the hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) prevalences among adult HIV-infected patients and identify the associations between socio-demographic variables and these HBV infection markers.MethodsThis study was performed from October 2012 to March 2013. Three hundred HIV-seropositive patients were monitored by the Clinical Analysis Laboratory of Professor Polydoro Ernani de São Thiago University Hospital, Santa Catarina, Brazil. The blood tests included HBsAg, anti-HBc immunoglobulin M (IgM) and total anti-HBc. Patients reported their HIV viral loads and CD4+ T-cell counts using a questionnaire designed to collect sociodemographic data.ResultsThe mean patient age was 44.6 years, the mean CD4 T-cell count was 525/mm3, the mean time since beginning antiretroviral therapy was 7.6 years, and the mean time since HIV diagnosis was 9.6 years. The overall prevalences of HBsAg and total anti-HBc were 2.3% and 29.3%, respectively. Among the individuals analyzed, 0.3% were positive for HBsAg, 27.3% were positive for total anti-HBc, and 2.0% were positive either for HBsAg or total anti-HBc and were classified as chronically HBV-infected. Furthermore, 70.3% of the patients were classified as never having been infected. Male gender, age >40 years and Caucasian ethnicity were associated with an anti-HBc positive test.ConclusionsThe results showed an intermediate prevalence of HBsAg among the studied patients. Moreover, the associations between the anti-HBc marker and socio-demographic factors suggest a need for HBV immunization among these HIV-positive individuals, who are likely to have HIV/HBV coinfection.