Tendência da incidência e da mortalidade por Aids em mulheres na transição menopausal e pós-menopausa no Brasil, 1996-2005

Objetivo: Descrever a incidência e a mortalidade por Aids no Brasil e mulheres na fase menopausal e pós-menopausa. Métodos: Estudo retrospectivo de 1996 a 2005, utilizando dados secundários do Sistema de Informações de Saúde do DATASUS - Ministério da Saúde. Buscou-se por população residente em dados "Demográficos e Socioeconômicos, incidência no Sistema de Informação de Agravos de Notificação (SINAN) e mortalidade no Sistema de Informação sobre Mortalidade (SIM). Os coeficientes específicos de incidência e de mortalidade por Aids/100.000 mulheres foram calculados para cada década da faixa etária de 30 a 69 anos (30-39, 40-49, 50-59, 60-69), pois inclui a população de interesse; isto é, mulheres na transição menopausal e pós-menopausa, dos 35 aos 65 anos, Resultados: Houve aumento da incidência de Aids entre os anos de 1996 e 1998, a partir daí, observa-se tendência à ligeira queda até 2000 e posterior incremento até 2004. Em 2005, o coeficiente retorna a valores próximos dos encontrados em 1997. A mortalidade apresentou queda em todas as faixas etárias nos anos de 1996 e 1997, a partir de então, os coeficientes mantêm-se praticamente estáveis até 1999, exceto na faixa etária de 30 a 39 anos que continua estável até 2005. Já entre mulheres acima de 40 anos, o coeficiente de mortalidade apresentou aumento entre os anos 1999 a 2005. conclusão: Houve aumento no número de casos novos de Aids entre mulheres acima de 30 anos e o mesmo processo se repetiu com relação à mortalidade. O aumento e "envelhecimento" da epidemia entre brasileiras, sinalizam que medidas de promoção à saúde, prevenção da doença, diagnóstico precoce e tratamento efetivo devem ser oferecidos de maneira apropriada às mulheres de 30 a 69 anos, considerando as características pessoais, o contexto familiar e o papel social do sexo feminino nestas idades

Negligência e abandono de crianças e adolescentes: análises dos casos notificados em município do Paraná, Brasil

A negligência e abandono constituem-se uma das formas mais frequentes de maus tratos. No entanto, seu conhecimento ainda está em processo de construção. Objetivo: analisar as características da negligência/abandono contra menores de 15 anos residentes em Londrina, PR, cujo evento foi notificado aos Conselhos Tutelares e serviços de atendimento, em 2006. Método: Estudo transversal e descritivo, cujos dados foram processados pelo programa EPI Info. Resultados: Foram obtidos 308 casos, cuja notificação se deu, principalmente, por profissionais de saúde (67,2 por cento). As vítimas do sexo feminino predominaram (72,7 por cento) e maiores coeficientes foram aos 4 anos (13,8 e 5,0 por 1.000 no sexo feminino e masculino, respectivamente). Os agressores foram mãe (69,5 por cento) e madrasta (22,2 por cento). As quesões da maternidade, ou seja, presença de filho não natural (32,8 por cento) e a pouca idade da mãe (20,8 por cento) foram as características mais associadas. As vítimas sofreram o abuso por 1 a 2 anos antes da notificação (62,7 por cento). Conclusões: O estudo contribui para ampliar o conhecimento acerca da negligência e abandono praticada contra menores. É preciso que os órgãos competentes trabalhem para a detecção precoce, a fim de possibilitar tratamento e acompanhamento adequados que possam reduzir as importantes sequelas decorrentes

Agricultura e meio ambiente em Rio Verde (GO)

A modernização da agropcuária brasileira possibilitou aumento da produção através da expansão das monoculturas, como a soja. Alta demanda e bons preços no mercado internacional incentivaram o cultivo dessa oleaginosa, principalmente no Cerrado. Em que pese seus benefícios econômicos, a sojicultura realizada nestes moldes, com grandes aportes mecânicos e químicos e concentração fundiária, causa impactos ambientais e sociais. Desmatamento, poluição de cursos d´água, erosão, compactação de solos, intoxicação e concentração de terra são alguns desses problemas. Esta pesquisa objetivou verificar desmatamento, contaminação de cursos d´água por agrotóxico e intoxicação no município maior produtor de soja de Goiás, Rio Verde. Foram utilizados mapas de uso do solo de Rio Verde, dos anos 1975, 1989 e 2005, autos de infração emitidos por órgãos de fiscalização ambiental, resultado de análises de resíduos de agrotóxicos na água destinada ao abastecimento público e casos de intoxicação por agrotóxico. A presença e gravidade do desmatamento, que ocorreu entre 1975 e 2005, puderam ser detectadas pelos dados analisados. Já os dados sobre intoxicação, por possivelmente serem subnotificados, revelaram um problema de saúde pública. Concluiu-se a necessidade de ações pelo poder público de fiscalização ambiental em Rio Verde, de medidas que melhorem a notificação de casos de intoxicação, e da promoção de incentivos àqueles agricultores que respeitam as leis ambientais

Acidentes e doenças do trabalho notificadas, de motoristas profissionais do Estado de São Paulo

São descritos os acidentes do trabalho para motoristas profissionais residentes no Estado de São Paulo. Os dados tiveram origem em base específica elaborada nas CATs e processos notificados na Previdência Social do Estado de São Paulo, entre 1997 e 1999. Apresentam-se as características dos motoristas acidentados e dos acidentes do trabalho. São analisadas taxas de incidência, mortalidade e letalidade dos motoristas para o Estado, Região Metropolitana de São Paulo e Município de São Paulo

Violência sexual como questão de saúde pública: importância da busca ao agressor

Apesar de predominar junto à população a idéia de que a violência sexual é praticada por pessoas desconhecidas, na realidade a maioria desses crimes é praticada por pessoa identificável pela vítima. Além de conseqüências físicas e psicológicas, também há risco em adquirir o vírus HIV. Para prevenção deste, em situação de risco, há orientação para uso da quimioprofilaxia anti-retroviral. Esse uso, por 28 dias, pode trazer efeitos adversos com intensidades variáveis. O conhecimento da sorologia anti-HIV do agressor torna-se fundamental para manter, ou suspender, com segurança, essa indicação. Este estudo descritivo, realizado no Conjunto Hospitalar de Sorocaba, teve como objetivo identificar os agressores e suas respectivas sorologias. Foi realizado a partir de fichas de notificação e os prontuários no período de julho de 2003 a dezembro de 2005. Encontraram-se 920 vítimas de violência sexual, com idades entre oito meses e 77 anos, havendo predomínio do sexo feminino (86,5 por cento). Dentre os agressores, 76 por cento foram referidos como identificáveis. Indicou-se profilaxia anti-retroviral para 24,9 por cento das vítimas. Para 80 (33,2 por cento) agressores localizados, a busca foi realizada através de contato telefônico. Encontrou-se 52,5 por cento em seus domicílios, 45 por cento em Presídio/Delegacia e 2,5 por cento no Pronto Socorro. Um agressor (1,3 por cento) apresentou sorologia positiva para HIV. As buscas encerraram-se, em sua maioria, em até seis dias (80 por cento), possibilitando a suspensão da quimioprofilaxia em 30,6 por cento dos casos. Concluiu-se que a busca ao denunciado permitiu conhecer sua sorologia anti-HIV e suspender, para um terço das vítimas, o uso da quimioprofilaxia anti-retroviral, diminuindo, com isso, a possibilidade de efeitos adversos

Blood Meal-Derived Heme Decreases ROS Levels in the Midgut of Aedes aegypti and Allows Proliferation of Intestinal Microbiota

The presence of bacteria in the midgut of mosquitoes antagonizes infectious agents, such as Dengue and Plasmodium, acting as a negative factor in the vectorial competence of the mosquito. Therefore, knowledge of the molecular mechanisms involved in the control of midgut microbiota could help in the development of new tools to reduce transmission. We hypothesized that toxic reactive oxygen species (ROS) generated by epithelial cells control bacterial growth in the midgut of Aedes aegypti, the vector of Yellow fever and Dengue viruses. We show that ROS are continuously present in the midgut of sugar-fed (SF) mosquitoes and a blood-meal immediately decreased ROS through a mechanism involving heme-mediated activation of PKC. This event occurred in parallel with an expansion of gut bacteria. Treatment of sugar-fed mosquitoes with increased concentrations of heme led to a dose dependent decrease in ROS levels and a consequent increase in midgut endogenous bacteria. In addition, gene silencing of dual oxidase (Duox) reduced ROS levels and also increased gut flora. Using a model of bacterial oral infection in the gut, we show that the absence of ROS resulted in decreased mosquito resistance to infection, increased midgut epithelial damage, transcriptional modulation of immune-related genes and mortality. As heme is a pro-oxidant molecule released in large amounts upon hemoglobin degradation, oxidative killing of bacteria in the gut would represent a burden to the insect, thereby creating an extra oxidative challenge to the mosquito. We propose that a controlled decrease in ROS levels in the midgut of Aedes aegypti is an adaptation to compensate for the ingestion of heme.

Modeling the risk of malaria for travelers to areas with stable malaria transmission

Background: Malaria is an important threat to travelers visiting endemic regions. The risk of acquiring malaria is complex and a number of factors including transmission intensity, duration of exposure, season of the year and use of chemoprophylaxis have to be taken into account estimating risk. Materials and methods: A mathematical model was developed to estimate the risk of non-immune individual acquiring falciparum malaria when traveling to the Amazon region of Brazil. The risk of malaria infection to travelers was calculated as a function of duration of exposure and season of arrival. Results: The results suggest significant variation of risk for non-immune travelers depending on arrival season, duration of the visit and transmission intensity. The calculated risk for visitors staying longer than 4 months during peak transmission was 0.5% per visit. Conclusions: Risk estimates based on mathematical modeling based on accurate data can be a valuable tool in assessing risk/benefits and cost/benefits when deciding on the value of interventions for travelers to malaria endemic regions.

Structure of an Odorant-Binding Protein from the Mosquito Aedes aegypti Suggests a Binding Pocket Covered by a pH-Sensitive ""Lid""

Background: The yellow fever mosquito, Aedes aegypti, is the primary vector for the viruses that cause yellow fever, mostly in tropical regions of Africa and in parts of South America, and human dengue, which infects 100 million people yearly in the tropics and subtropics. A better understanding of the structural biology of olfactory proteins may pave the way for the development of environmentally-friendly mosquito attractants and repellents, which may ultimately contribute to reduction of mosquito biting and disease transmission. Methodology: Previously, we isolated and cloned a major, female-enriched odorant-binding protein (OBP) from the yellow fever mosquito, AaegOBP1, which was later inadvertently renamed AaegOBP39. We prepared recombinant samples of AaegOBP1 by using an expression system that allows proper formation of disulfide bridges and generates functional OBPs, which are indistinguishable from native OBPs. We crystallized AaegOBP1 and determined its three-dimensional structure at 1.85 angstrom resolution by molecular replacement based on the structure of the malaria mosquito OBP, AgamOBP1, the only mosquito OBP structure known to date. Conclusion: The structure of AaegOBP1 (= AaegOBP39) shares the common fold of insect OBPs with six alpha-helices knitted by three disulfide bonds. A long molecule of polyethylene glycol (PEG) was built into the electron-density maps identified in a long tunnel formed by a crystallographic dimer of AaegOBP1. Circular dichroism analysis indicated that delipidated AaegOBP1 undergoes a pH-dependent conformational change, which may lead to release of odorant at low pH (as in the environment in the vicinity of odorant receptors). A C-terminal loop covers the binding cavity and this ""lid"" may be opened by disruption of an array of acid-labile hydrogen bonds thus explaining reduced or no binding affinity at low pH.

Antiviral and antiparasite properties of an L-amino acid oxidase from the Snake Bothrops jararaca: Cloning and identification of a complete cDNA sequence (Retracted article. See vol. 80, pg. 288, 2010)

L-Amino acid oxidases (LAAOs, EC 1.4.3.2) are flavoenzymes that catalyze the stereospecific oxidative deamination of an L-amino acid substrate to the corresponding a-ketoacid with hydrogen peroxide and ammonia production. The present work describes the first report on the antiviral (Dengue virus) and antiprotozoal (trypanocidal and leishmanicide) activities of a Bothrops jararaca L-amino acid oxidase (BjarLAAO-I) and identify its cDNA sequence. Antiparasite effects were inhibited by catalase, suggesting that they are mediated by H(2)O(2) production. Cells infected with DENV-3 virus previously treated with BjarLAAO-I, showed a decrease in viral titer (13-83-fold) when compared with cells infected with untreated viruses. Untreated and treated promastigotes (T. cruzi and L. amazonensis) were observed by transmission electron microscopy with different degrees of damage. Its complete cDNA sequence, with 1452 bp, encoded an open reading frame of 484 amino acid residues with a theoretical molecular weight and pl of 54,771.8 and 5.7, respectively. The cDNA-deduced amino acid sequence of BjarLAAO shows high identity to LAAOs from other snake venoms. Further investigations will be focused on the related molecular and functional correlation of these enzymes. Such a study should provide valuable information for the therapeutic development of new generations of microbicidal drugs. (C) 2008 Elsevier Inc. All rights reserved.

The potential of virulent Wolbachia to modulate disease transmission by insects

A virulent strain of Wolbachia has recently been identified in Drosophila that drastically reduces adult lifespan. It has been proposed that this phenotype might be introduced into insect disease vector populations to reduce pathogen transmission. Here we model the requirements for spread of such an agent and the associated reduction in disease transmission. First, a simulation of mosquito population age structure was used to describe the age distribution of mosquitoes transmitting dengue virus. Second, given varying levels of cytoplasmic incompatibility and fecundity effect, the maximum possible longevity reduction that would allow Wolbachia to invade was obtained. Finally, the two models were combined to estimate the reduction in disease transmission according to different introduction frequencies. With strong CI and limited effect of fecundity, an introduction of Wolbachia with an initial frequency of 0.4 could result in a 60–80% reduction of transmitting mosquitoes. Greater reductions are possible at higher initial release rates.

Host age effect and expression of cytoplasmic incompatibility in field populations of Wolbachia-superinfected Aedes albopictus

The Asian tiger mosquito, Aedes albopictus (Skuse), is a known vector of dengue in South America and Southeast Asia. It is naturally superinfected with two strains of Wolbachia endosymbiont that are able to induce cytoplasmic incompatibility (CI). In this paper, we report the strength of CI expression in crosses involving field-caught males. CI expression was found to be very strong in all crosses between field males and laboratory-reared uninfected or wAlbA infected young females. In addition, crossing experiments with laboratory colonies showed that aged super- infected males could express strong CI when mated with young uninfected or wAlbA infected females. These results provide additional evidence that the CI properties of Wolbachia infecting Aedes albopictus are well suited for applied strategies that seek to utilise Wolbachia for host population modification.

Endemic and opportunistic infections in Brazilian solid organ transplant recipients

OBJECTIVE To evaluate the frequency and clinical features of endemic and other opportunistic infections in liver or kidney transplant recipients in four transplant centres in different geographical areas of Brazil. METHODS Retrospective analysis of medical and laboratory records of four transplant centres on endemic and other opportunistic infections in liver or kidney transplant recipients. Analyses were performed with spss statistical software. RESULTS From 2001 to 2006, 1046 kidney and 708 liver transplants were registered in all centres. The average age was 42 years. Among 82 (4.7%) cases with infections, the most frequent was tuberculosis (2.0%), followed by systemic protozoal infections (0.7%), toxoplasmosis (0.4%) and visceral leishmaniasis (0.3%). Systemic fungal infections occurred in 0.6%, of which 0.4% were cryptococcosis and 0.2% were histoplasmosis. Dengue was the only systemic viral infection and was registered in two cases (0.1%), of which one was classified as the classic form and the other as dengue haemorrhagic fever. Nocardiosis was described in one case (0.05%). The infectious agents most frequently associated with diarrhoea were Blastocystis sp., Schistosoma mansoni and Strongyloides stercoralis. CONCLUSIONS Opportunistic Infections in transplant patients have a wide spectrum and may vary from asymptomatic to severe infections with high mortality. A better understanding of the epidemiology of endemic pathogens and clinical manifestations can contribute to the establishment of an early diagnosis as well as correct treatment aimed at decreasing morbidity and mortality.

Eosinophilic pneumonitis induced by aerosol-administered diesel oil and pyrethrum to mice

Objective. To confirm the episode of eosinophilic pneumonitis that occurred in March 2001 in Manaus, Amazon, northern Brazil, as secondary to home aerosolization with 2% cypermethrin diluted in diesel compared with the more conventional 1% cypermethrin and soybean solution used in prophylaxis of dengue. Methods. Four groups of Swiss mice were kept in polycarbonate cages aerosolized with one of the following solutions: diesel, diesel and cypermethrin, soy oil and cypermethrin, and saline. Three and 6 days after exposure, resistance and compliance of the respiratory system and white cell kinetics in peripheral blood and lung tissue were analyzed. Results. The group exposed to diesel and cypermethrin showed higher respiratory system resistance (p < 0.001), lower compliance (p = 0.03), and increased eosinophils in blood (p = 0.03) and lung tissue (p = 0.005) compared with the other groups. There was an increase of neutrophils in the blood of all experimental groups on the third day after exposure (p < 0.001). Conclusions. We concluded that diesel associated with cypermethrin induced lung hyperresponsiveness in this experimental model and was associated with increased polymorphonuclear cells (eosinophils and neutrophils) in blood and lungs. This effect is strongest on the third day after exposure. These results are similar to the episode that occurred in Manaus in 2001 and suggest that diesel plus cypermethrin home aerosolization for arbovirosis prophylaxis should be revised.

Infectious diseases in paediatric pathology: experience from a developing country

Infectious and parasitic diseases have always challenged man. Although many of them are typically seen in some areas of the world and can be adequately managed by just improving socioeconomic status and sanitary conditions, they are still quite prevalent and may sometimes be seen outside their original geographical areas. Human migration due to different reasons, tourism, blood transfusion and solid organ transplantation has created new concerns for health professionals all over the world. If not for diagnostic purposes, at least these tropical and infectious diseases should be largely known because their epidemiology, pathogenesis, host/parasite interaction, inflammatory and reparative responses are quite interesting and teach us about human biology. Curiosity is inherent to pathology practice and so we are compelled to look for things other than tumours or degenerative diseases. This review focuses on infectious and parasitic diseases found in a developing country and brings up-to-date information on diseases caused by viruses (dengue, yellow fever), bacteria (typhoid fever, leprosy), parasites (Chagas` disease, cutaneous and visceral leishmaniasis, amoebiasis, Capillaria hepatica, schistosomiasis, cysticercosis) and caused by fungi (paracoccidioidomycosis, cryptococcosis, histoplasmosis) that may be useful for pathologists when facing somewhat strange cases from developing countries.

Poly(ethylene glycol) decorated poly(methylmethacrylate) nanoparticles for protein adsorption

Poly(ethylene glycol) decorated poly( methyl methacrylate) particles were synthesized by means of emulsion polymerization using poly(ethylene glycol) sorbitan monolaurate (Tween-20) as surfactant. PMMA/PEG particles presented mean diameter (195 +/- 15) nm, indicating narrow size distribution. The adsorption behavior of bovine serum albumin (BSA) and concanavalin A (ConA) onto PMMA/PEG particles was investigated by means of spectrophotometry. Adsorption isotherms obtained for BSA onto PMMA/PEG particles fitted well sigmoidal function, which is typical for multilayer adsorption. Con A adsorbed irreversibly onto PMMA/PEG particles. The efficiency of ConA covered particles to induce dengue virus quick agglutination was evaluated. (C) 2010 Elsevier B.V. All rights reserved.