Epidemiology of neurocysticercosis in Brazil

A revision of literature was done with the objective of tracing an epidemiologic profile of neurocysticercosis (NCC) in Brazil. The prevalence was 0.12-9% in autopsies. The frequency was 0.03-7.5% in clinical series and 0.68-5.2% in seroepidemiological studies. The disease corresponds to 0.08-2.5% of admissions to general hospitals. Patient origin was rural in 30 63% of cases. The most involved age range (64-100%) was 11 to 60 years, with a predominance (22-67%) between 21 and 40 years. The male sex was the most affected (51-80%). In the severe forms there was a predominance of urban origin (53-62%) and of the female sex (53-75%). The period of hospitalization ranges from 1 to 254 days and 33 to 50% of patients suffer 1.7 ± 1.4 admissions. The clinical picture was variable, with a predominance of epileptic syndrome (22-92%) and intracranial hypertension (19-89%). Psychiatric manifestations were associated in 9-23% of patients. Lethality was 0.29% in terms of all diseases in general and 4.8-25.9% in terms of neurologic diseases. The asymptomatic form was detected in 6% of patients in clinical serie and in 48.5% of case from autopsies The racemose form and ventricular localization also was observed as asymptomatic form. Among the patients with cutaneous cysticercosis 65% of them showed neurologic manifestations.

Protein deficiency and nutritional recovery modulate insulin secretion and the early steps of insulin action in rats

Maternal malnutrition was shown to affect early growth and leads to permanent alterations in insulin secretion and sensitivity of offspring. In addition, epidemiological studies showed an association between low birth weight and glucose intolerance in adult life. To understand these interactions better, we investigated the insulin secretion by isolated islets and the early events related to insulin action in the hind-limb muscle of adult rats fed a diet of 17% protein (control) or 6% protein [low (LP) protein] during fetal life, suckling and after weaning, and in rats receiving 6% protein during fetal life and suckling followed by a 17% protein diet after weaning (recovered). The basal and maximal insulin secretion by islets from rats fed LP diet and the basal release by islets from recovered rats were significantly lower than that of control rats. The dose-response curves to glucose of islets from LP and recovered groups were shifted to the right compared to control islets, with the half-maximal response (EC 50) occurring at 16.9 ± 1.3, 12.4 ± 0.5 and 8.4 ± 0.1 mmol/L, respectively. The levels of insulin receptor, as well as insulin receptor substrate-1 and phosphorylation and the association between insulin receptor substrate-1 and phosphatidylinositol 3-kinase were greater in rats fed a LP diet than in control rats. In recovered rats, these variables were not significantly different from those of the other two groups. These results suggest that glucose homeostasis is maintained in LP and recovered rats by an increased sensitivity to insulin as a result of alterations in the early steps of the insulin signal transduction pathway.

Is chronic hypoxemia in patients with chronic obstructive pulmonary disease associated with more marked nutritional deficiency?: A study of the fat-free mass evaluated by anthropometry and bioelectrical impedance methods

In order to determine wheter blood gases abnormalities, specially hypoxemia, are associated with more marked changes in fat-free mass in patients with chronic obstructive pulmonary disease (CPOD), nutritional assessment was performed on 16 normoxemic (PaO 2 > 55 mm Hg) and 16 hypoxemic (PaO 2 < 55 mm Hg) COPD patients in stable clinical condition. Body weight was expressed as percentage of the ideal body weight. Fat-free mass was estimated by anthropometry (FFM-Anthr) and by bioelectrical impedance (FFM- BI). Handgrip-strength was assessed as a measure of peripheral skeletal muscle strength. Patients were age-matched and presented similar degree of airway obstruction. Malnutrition, defined as body weight less than 90% of the ideal, was observed in 19% of the normoxemic patients and in 25% of the hypoxemic patients (p>0,05). FFM values in hypoxemic patients, estimated by both methods, were not different from those observed in normoxemic patients. No significant difference was observed on handgrip values between the two groups. No correlation was found between nutritional indices and pulmonary function and gases exchange parameters. FFM correlated positively with values of peripheral muscle function in normoxemic and hypoxemic patients. These data add further evidence to the hypothesis that hypoxemia is not a primary cause of the nutritional deficiency observed in COPD patients.

Piranha Attacks on Humans in Southeast Brazil: Epidemiology, Natural History, and Clinical Treatment, with Description of a Bite Outbreak

There are many tales describing ferocious schools of piranha attacking humans, but there are few scientific data supporting such behavior. The very few documented instances of humans attacked and eaten by piranha schools include 3 that occurred after death by other causes (eg, heart failure and drowning). These predaceous fishes, however, do occasionally injure bathers and swimmers in lakes and rivers. The characteristic profile of most injuries is a single bite per victim, generally related to the fish defending its brood. This paper describes an outbreak of piranha bites in a dammed river portion in southeast Brazil. The outbreak was caused by the speckled piranha, Serrasalmus spilopleura, a widespread species which benefits from the growing tendency of damming rivers all over Brazil. This article focuses on the epidemiological and clinical aspects of the injuries, as well as on piranha biology, to gain a better understanding of the natural history of bite outbreaks.

Nutritional support and outcome in hospitalized dogs and cats

This study investigated the effect of assisted nutritional support on the outcome and time of hospitalization (TH) of dogs and cats. The study compared two groups of 400 hospitalized animals. The animals in group 1 did not receive assisted nutritional support because they were hospitalized before the clinical nutrition service was implemented; animals in group 2 were nutritionally managed. Animals in group 1 received a low-cost diet with no consumption control. Group 2 animals had their maintenance energy requirement (MER) calculated, received a high-protein and high-energy super-premium diet, had their caloric intake (CI) monitored, and received enteral and parenteral nutritional support when necessary. The statistical analysis of the results included the standard T test (group 1 versus group 2) and chisquare and Spearman's correlation to evaluate group 2 (CI and outcome, body condition score (BCS) and outcome, BCS and CI). For group 2, favorable outcome (FO), defined as the percent responding to therapy and dis-charged from the hospital, was 83%, and the TH was 8.59 days. These values were lower (P < .001) for group 1 (63.2% FO and TH of 5.7 days). For group 2, 65.5% of the animals received voluntary consumption (93.1% outcome), 14.5% received enterai support (67.9% FO), 6.5% received parenteral support (68% FO), and 6.17% did not eat (38.5% FO), demonstrating an association between the type of nutritional support and outcome (P < .01). Group 2 animals that received 0% to 33% of their MER had 62.9% FO, and those receiving more than 67% had 94.3% FO, which shows that lower mortality rates are associated with higher CI (P < .001). TH was higher for animals with higher CI (P < .001). The BCS did not correlate with Cl (P > .05) but did correlate with outcome (P < .01). FO was 68.7% for animals with low BCS, 85.7% for animals with ideal BCS, and 86.6% for overweight animals. Nutritional support could allow for longer therapies, thus increasing the TH and FO rate.

Nutritional and social hierarchy establishment of the primitively eusocial wasp Mischocyttarus cassununga (Hymenoptera, Vespidae, Mischocyttarini) and related aspects

The results on the nutritional influence in the social hierarchy establishment among females from six colonies of Mischocyttarus cassununga show that: - there was no caste determination in the pre-imaginal period concerning ingested food quantities, however, in relation to qualification (proteins and carbohydrate) the Mann-Whitney test applied showed variation among colonies: in two colonics (colony 3, p=0.0209; colony 4, p=0.0090) the larvae which ingested a higher quantity of solid food became adults of hierarchically higher position, however in two other colonies, colony 1 (p=0.6744) and colony 2 (p=0.3367) this difference was not statistically significant; in two experimentally manipulated colonies the caste determination was observed in the imaginal phase (it was verified that the larger the food quantity consumed, the higher the assumed hierarchical position by the individuals); - adult individuals of hierarchically higher position in two colonies ingested a greater amount of solid than liquid food (Mann-Whitney; p ≤ 0.05), however in the other three colonies there was no difference. It can be seen that for all colonies (2, 3, 4, 5 and 6) the high tendency to solid food ingestion occurs. In colony 1, this data was not collected because the observation purpose was different); - inside the colony hierarchy, the older individuals were the ones that occupied higher hierarchical positions; - more than one inseminated female per colony was found in the two experimentally manipulated colonies ; - ovarian development is greater in inseminated females; - the average height of the 3rd tergite was greater for inseminated females, indicating an adaptation to accommodate larger ovary development (t-Student test; p ≤ 0.05).

Clinical and nutritional profile of individuals with Chagas disease

Chagas disease (CD), caused by the protozoan Trypanossoma cruzi, affects approximately 18 million individuals in the Americas, 5 million of which five in Brazil. Most chronic sufferers have either the indeterminate form of the disease, without organic compromise, or the cardiac or digestive forms. Despite the importance of this disease, there is no information on the effect of nutrition on CD evolution. We evaluated the clinical-nutritional profile of individuals with CD treated at the Tropical Diseases Nutrition Out-Patient Clinic of the Botucatu School of Medicine, UNESP.A retrospective cohort study was performed between 2002 and 2006, on 66 patients with serum and parasitological diagnosis of CD. Epidemiological, clinical, nutritional, and biochemical data were collected, including gender, age, skin color, smoking, alcoholism, physical activity, weight, stature, body mass index, abdominal circumference, glycemia, and lipid profile. Fifty-three percent were mate and 47% female; 96% were white skinned. Mean age was 49.6±6.36 years. The predominant form was indeterminate in 71 %; smoking and drinking were recorded in 23% and 17%, respectively. Sedentariness predominated in 83%, and 55% presented increased abdominal circumference. Most, 94%, were overweight or obese. The biochemical exam revealed hyperglycemia in 12% and dyslipidemia in 74%. These findings suggest that the Chagas population presents co-morbidities and risk factors for developing chronic non-transmissible diseases, including cardiovascular diseases, making CD evolution even worse. © 2007 by The Brazilian Journal of Infectious Diseases and Contexto Publishing. All rights reserved.

Importance of xenarthrans in the eco-epidemiology of Paracoccidioides brasiliensis

Background. Several pathogens that cause important zoonotic diseases have been frequently associated with armadillos and other xenarthrans. This mammal group typically has evolved on the South American continent and many of its extant species are seriously threatened with extinction. Natural infection of armadillos with Paracoccidioides brasiliensis in hyperendemic areas has provided a valuable opportunity for understanding the role of this mammal in the eco-epidemiology of Paracoccidioidomycosis (PCM), one of the most important systemic mycoses in Latin America. Findings. This study aimed to detect P. brasiliensis in different xenarthran species (Dasypus novemcinctus, Cabassous spp., Euphractus sexcinctus, Tamandua tetradactyla and Myrmecophaga tridactyla), by molecular and mycological approaches, in samples obtained by one of the following strategies: i) from road-killed animals (n = 6); ii) from naturally dead animals (n = 8); iii) from animals that died in captivity (n = 9); and iv) from living animals captured from the wild (n = 2). Specific P. brasiliensis DNA was detected in several organs among 7/20 nine-banded armadillos (D. novemcinctus) and in 2/2 anteaters (M. tridactyla). The fungus was also cultured in tissue samples from one of two armadillos captured from the wild. Conclusion. Members of the Xenarthra Order, especially armadillos, have some characteristics, including a weak cellular immune response and low body temperature, which make them suitable models for studying host-pathogen interaction. P. brasiliensis infection in wild animals, from PCM endemic areas, may be more common than initially postulated and reinforces the use of these animals as sentinels for the pathogen in the environment. © 2009 Bagagli et al; licensee BioMed Central Ltd.

Late-onset sepsis: Epidemiology, evaluation, and outcome

Late-onset neonatal sepsis is a common serious problem in preterm infants in neonatal intensive care units. Diagnosis can be difficult because clinical manifestations are not specific and none of the available laboratory tests can be considered an ideal marker. For this reason, a combination of markers has been proposed. Complete blood count and acute-phase reactants evaluated together help in diagnosis. C-reactive protein is a specific but late marker, and procalcitonin has proven accurate, although it is little studied in newborns. Blood, cerebrospinal fluid, and urine cultures always should be obtained when late-onset sepsis is suspected. Blood culture, the gold standard in diagnosis, is highly sensitive but needs up to 48 hours to detect microbial growth. Various cytokines have been investigated as early markers of infection, but results are not uniform. Other diagnostic tests that offer promise include: neutrophil surface markers, granulocyte colony-stimulating factor, toll-like receptors, and nuclear factor kappa B. The greatest hope for quick and accurate diagnosis lies in molecular biology, using real time polymerase chain reaction combined withDNAmicroarray. Sepsis and meningitis may affect both the short- and long-term prognosis for newborns. Mortality in neonatal meningitis has been reduced in recent years, but short-term complications and later neurocognitive sequelae remain. Late-onset sepsis significantly increases preterm infant mortality and the risk of cerebral lesions and neurosensory sequelae, including developmental difficulties and cerebral palsy. Early diagnosis of late-onset sepsis contributes to improved neonatal prognosis, but the outcome remains far from satisfactory. © 2010 by the American Academy of Pediatrics.

Epidemiology of vampire bat-transmitted rabies virus in Goiaαs, central Brazil: Re-evaluation based on G-L intergenic region

Background. Vampire bat related rabies harms both livestock industry and public health sector in central Brazil. The geographical distributions of vampire bat-transmitted rabies virus variants are delimited by mountain chains. These findings were elucidated by analyzing a high conserved nucleoprotein gene. This study aims to elucidate the detailed epidemiological characters of vampire bat-transmitted rabies virus by phylogenetic methods based on 619-nt sequence including unconserved G-L intergenic region. Findings. The vampire bat-transmitted rabies virus isolates divided into 8 phylogenetic lineages in the previous nucleoprotein gene analysis were divided into 10 phylogenetic lineages with significant bootstrap values. The distributions of most variants were reconfirmed to be delimited by mountain chains. Furthermore, variants in undulating areas have narrow distributions and are apparently separated by mountain ridges. Conclusions. This study demonstrates that the 619-nt sequence including G-L intergenic region is more useful for a state-level phylogenetic analysis of rabies virus than the partial nucleoprotein gene, and simultaneously that the distribution of vampire bat-transmitted RABV variants tends to be separated not only by mountain chains but also by mountain ridges, thus suggesting that the diversity of vampire bat-transmitted RABV variants was delimited by geographical undulations. © 2010 Itou et al; licensee BioMed Central Ltd.

Dry matter yield and nutritional value of Marandu grass under nitrogen fertilization and irrigation in cerrado in São Paulo

The aim of this study was to evaluate dry matter yield and nutritional value of palisade grass (Brachiaria brizantha cv. Marandu) using nitrogen doses and sprinkler irrigation in two periods of the year, aiming at reducing seasonality of forage production. It was used a randomized block design in a split-plot scheme, with five doses of nitrogen (0, 50, 100, 150, and 200 kg/ha/cut), and the sub-plots were defined by the seasons of the year (wet and dry season), with and without irrigation. During the wet season, in the plots with and without irrigation, doses of 175 and 161 kg/ha/cut promoted the highest dry matter yields. During the dry season, 171 kg ha -1N with irrigation resulted in the highest dry matter yield. During the same season, there was no response to N fertilization in the lack of irrigation. Average contents of CP were 10% with and without irrigation. Contents of neutral detergent fiber decreased with nitrogen doses, while acid detergent fiber was not affected by fertilization. Plots under irrigation reached the maximal acid detergent fiber content at N dose of 60 kg ha -1. Irrigation promotes increase of 15% increase in dry matter yield and it increases contents of neutral detergent fiber. © 2010 Sociedade Brasileira de Zootecnia.

Food intake and nutritional status of hospitalised older people

Background and aims. Disease is influenced by the nutritional status of the individual. We have assessed the relationship between nutritional status and food intake among recently hospitalised older people. Methods. A cross-sectional study was undertaken with 240 older people in a hospital that provides care for the public and private healthcare systems. Nutritional status was classified by the MNA (Mini Nutritional Assessment) into: malnourished, risk of malnutrition and without malnutrition. Food intake was estimated by the reported food intake during a typical day. The Kruskal-Wallis test was used to compare the medians and the correlation coefficient of Spearman to verify the relationship between the consumption of energy, protein and vitamin C and MNA scores. Results. 33.8% were classified as adequate regarding nutritional status; 37.1% were classified as being at risk of malnutrition and 29.1% were classified as malnourished. The malnourished individuals reported significantly less energy and nutrient intake than those at risk of malnutrition or those without malnutrition (P=0.001). Not all nutrient intake, just some (iron, cholesterol and fibre), were lower in malnourished people. Conclusions and implications for practice. Deterioration of the nutritional status of older people is accompanied by a reduction in energy and some nutrient intake. The investigation of food intake in older people could provide important information about nutritional risk. © 2010 Blackwell Publishing Ltd.

Relevance of Chinese goose (Anser cygnoides) in experimental epidemiology of Newcastle disease

This study aimed to characterize the true epidemiological role played by the Chinese goose (Anser cygnoides) as a potential source of infection by the Newcastle disease virus (NDV). For this, Specific-Pathogen-Free chicks (SPF) were used and were housed with Chinese geese that had been inoculated with a pathogenic strain (velogenic viscerotropic, strain São João do Meriti) of NDV (DIE50=108.15/0.1 mL) pathogenic to chickens, by the ocular-nasal route. Each group was composed of 6 SPF Leghorn chicks and 3 geese. At 6 days (Group I) and 14 days (Group II) after inoculation of the Chinese geese with NDV, SPF chicks were put into direct contact with each goose group. Cloacal swabs were collected from both species (Chinese geese and SPF chicks) 6, 10 and 20 days after challenge to genome viral excretion by Reverse Transcription Polymerase Chain Reaction (RT-PCR). Chinese geese did not demonstrate any clinical signs of Newcastle disease (ND). They were refractory to the clinical disease with the NDV. However, NDV genome was detected 20 days after challenge. Therefore, NDV carrier status was demonstrated by Chinese geese. Moreover, 100% of SPF chicks housed with the infected Chinese geese had died by 6 (Group I) and 14 days (Group II) after challenge. Thus, the transmission of the pathogenic virus from the Chinese geese to cohabiting SPF chicks was evident within 20 days of the experimental infection. This reveals the epidemiological importance of Chinese geese as a potential transmitter of NDV infection to other commercial birds that could be raised in close proximity.

Relevance of lovebirds (Agapornis roseicollis Selby, 1836) in experimental epidemiology of Newcastle disease

Studies were made to clarify the role that was played by the lovebirds (Agapornis roseicollis) in the epidemiological plan, under the perspective of its being a potential source of infection of Newcastle Disease Virus (NDV). The study used Specific-Pathogen-Free chicks (SPF) that were housed with lovebirds inoculated with a pathogenic strain (velogenic viscerotropic) of NDV pathogenic to chickens, by the ocular-nasal via. Each group was composed of six SPF chicks and four lovebirds. After five days of the inoculation of the lovebirds with NDV, SPF chicks were put together with each group of lovebirds. Cloacae swabs were collected after 9, 14 and 21 days post-challenge in both species (lovebirds and SPF chicks) for genome viral excretion by Reverse Transcription Polymerase Chain Reaction (RT-PCR). Lovebirds did not demonstrate any clinical signs of NDV. They were refractory to the clinical disease with the NDV. However, NDV genome was detected 9 and 21 days after challenge. This study shows that lovebirds can be carriers NDV. Moreover, 100% of SPF chicks allocated with the infected lovebirds demonstrated clinical signs and lesions suggestive of NDV. In these birds, NDV genome was detected 9, 14 and 21 days after challenge. Thus, the transmission of the pathogenic virus from the lovebirds to SPF chicks that were housed together was evident until 21 days of the experimental infection. This study reveals the importance of lovebirds from the epidemiological point of view as potential source of infection of the NDV to other avian species that could be raised near this species. © Asian Network for Scientific Information, 2012.