A comparison of self-report and health care provider data to assess surveillance definitions of influenza-like illness in outpatients

Objective: Several surveillance definitions of influenza-like illness (ILI) have been proposed, based on the presence of symptoms. Symptom data can be obtained from patients, medical records, or both. Past research has found that agreements between health record data and self-report are variable depending on the specific symptom. Therefore, we aimed to explore the implications of using data on influenza symptoms extracted from medical records, similar data collected prospectively from outpatients, and the combined data from both sources as predictors of laboratory-confirmed influenza. Methods: Using data from the Hutterite Influenza Prevention Study, we calculated: 1) the sensitivity, specificity and predictive values of individual symptoms within surveillance definitions; 2) how frequently surveillance definitions correlated to laboratory-confirmed influenza; and 3) the predictive value of surveillance definitions. Results: Of the 176 participants with reports from participants and medical records, 142 (81%) were tested for influenza and 37 (26%) were PCR positive for influenza. Fever (alone) and fever combined with cough and/or sore throat were highly correlated with being PCR positive for influenza for all data sources. ILI surveillance definitions, based on symptom data from medical records only or from both medical records and self-report, were better predictors of laboratory-confirmed influenza with higher odds ratios and positive predictive values. Discussion: The choice of data source to determine ILI will depend on the patient population, outcome of interest, availability of data source, and use for clinical decision making, research, or surveillance. © Canadian Public Health Association, 2012.

Detection of avian influenza virus by fluorescent DNA barcode-based immunoassay with sensitivity comparable to PCR

In this paper, a coupling of fluorophore-DNA barcode and bead-based immunoassay for detecting avian influenza virus (AIV) with PCR-like sensitivity is reported. The assay is based on the use of sandwich immunoassay and fluorophore-tagged oligonucleotides as representative barcodes. The detection involves the sandwiching of the target AIV between magnetic immunoprobes and barcode-carrying immunoprobes. Because each barcode-carrying immunoprobe is functionalized with a multitude of fluorophore-DNA barcode strands, many DNA barcodes are released for each positive binding event resulting in amplification of the signal. Using an inactivated H16N3 AIV as a model, a linear response over five orders of magnitude was obtained, and the sensitivity of the detection was comparable to conventional RT-PCR. Moreover, the entire detection required less than 2 hr. The results indicate that the method has great potential as an alternative for surveillance of epidemic outbreaks caused by AIV, other viruses and microorganisms.

Detection of Avian Influenza Virus with PCR-Like Sensitivity by Fluorescent DNA Barcode-Based Immunoassay

In this paper, we report a coupling of fluorophore-DNA barcode and bead-based
immunoassay for the detection of Avian Influenza Virus (AIV), a potential pandemic threat for human health and enormous economic losses. The detection strategy is based on the use of sandwich immunoassay and fluorophore-tagged oligonucleotides as representatively fluorescent barcodes. Despite its simplicity the assay has sensitivity comparable to RT-PCR amplification, and possesses a great potential as a rapid and sensitive on-chip detection format.

Generation of replication-proficient influenza virus NS1 point mutants with interferon-hyperinducer phenotype

The NS1 protein of influenza A viruses is the dedicated viral interferon (IFN)-antagonist. Viruses lacking NS1 protein expression cannot multiply in normal cells but are viable in cells deficient in their ability to produce or respond to IFN. Here we report an unbiased mutagenesis approach to identify positions in the influenza A NS1 protein that modulate the IFN response upon infection. A random library of virus ribonucleoproteins containing circa 40 000 point mutants in NS1 were transferred to infectious virus and amplified in MDCK cells unable to respond to interferon. Viruses that activated the interferon (IFN) response were subsequently selected by their ability to induce expression of green-fluorescent protein (GFP) following infection of A549 cells bearing an IFN promoter-dependent GFP gene. Using this approach we isolated individual mutant viruses that replicate to high titers in IFN-compromised cells but, compared to wild type viruses, induced higher levels of IFN in IFN-competent cells and had a reduced capacity to counteract exogenous IFN. Most of these viruses contained not previously reported NS1 mutations within either the RNA-binding domain, the effector domain or the linker region between them. These results indicate that subtle alterations in NS1 can reduce its effectiveness as an IFN antagonist without affecting the intrinsic capacity of the virus to multiply. The general approach reported here may facilitate the generation of replication-proficient, IFN-inducing virus mutants, that potentially could be developed as attenuated vaccines against a variety of viruses.

An unbiased genetic screen reveals the polygenic nature of the influenza virus anti-interferon response

UNLABELLED: Influenza A viruses counteract the cellular innate immune response at several steps, including blocking RIG I-dependent activation of interferon (IFN) transcription, interferon (IFN)-dependent upregulation of IFN-stimulated genes (ISGs), and the activity of various ISG products; the multifunctional NS1 protein is responsible for most of these activities. To determine the importance of other viral genes in the interplay between the virus and the host IFN response, we characterized populations and selected mutants of wild-type viruses selected by passage through non-IFN-responsive cells. We reasoned that, by allowing replication to occur in the absence of the selection pressure exerted by IFN, the virus could mutate at positions that would normally be restricted and could thus find new optimal sequence solutions. Deep sequencing of selected virus populations and individual virus mutants indicated that nonsynonymous mutations occurred at many phylogenetically conserved positions in nearly all virus genes. Most individual mutants selected for further characterization induced IFN and ISGs and were unable to counteract the effects of exogenous IFN, yet only one contained a mutation in NS1. The relevance of these mutations for the virus phenotype was verified by reverse genetics. Of note, several virus mutants expressing intact NS1 proteins exhibited alterations in the M1/M2 proteins and accumulated large amounts of deleted genomic RNAs but nonetheless replicated to high titers. This suggests that the overproduction of IFN inducers by these viruses can override NS1-mediated IFN modulation. Altogether, the results suggest that influenza viruses replicating in IFN-competent cells have tuned their complete genomes to evade the cellular innate immune system and that serial replication in non-IFN-responsive cells allows the virus to relax from these constraints and find a new genome consensus within its sequence space.

IMPORTANCE: In natural virus infections, the production of interferons leads to an antiviral state in cells that effectively limits virus replication. The interferon response places considerable selection pressure on viruses, and they have evolved a variety of ways to evade it. Although the influenza virus NS1 protein is a powerful interferon antagonist, the contributions of other viral genes to interferon evasion have not been well characterized. Here, we examined the effects of alleviating the selection pressure exerted by interferon by serially passaging influenza viruses in cells unable to respond to interferon. Viruses that grew to high titers had mutations at many normally conserved positions in nearly all genes and were not restricted to the NS1 gene. Our results demonstrate that influenza viruses have fine-tuned their entire genomes to evade the interferon response, and by removing interferon-mediated constraints, viruses can mutate at genome positions normally restricted by the interferon response.

Modelação da qualidade do ar e da saúde humana: da mesoescala à dose

O actual, e crescente, padrão de consumo tem repercussões no ambiente que, inevitavelmente, se reflectem na saúde humana. A poluição atmosférica assume-se, na Europa, como um problema ambiental premente, por ter um elevado impacte na saúde dos cidadãos. Entre estes, há grupos particularmente vulneráveis, como os idosos, os doentes crónicos e as crianças. Vários estudos colocam em evidência a sensibilidade dos doentes asmáticos, em particular das crianças, à poluição atmosférica. No entanto, permanece por esclarecer o facto de a poluição atmosférica poder causar o aumento da prevalência desta doença, assim como a identificação dos principais poluentes atmosféricos responsáveis e os níveis de exposição seguros. O objectivo desta tese consiste no estudo da relação entre a poluição atmosférica e a saúde, contribuindo para o conhecimento nesta temática através do desenvolvimento de uma ferramenta e da sua aplicação a um caso de estudo concreto. Neste caso de estudo analisou-se a relação entre vários poluentes atmosféricos e o agravamento da sintomatologia em crianças asmáticas. Neste âmbito, foi desenvolvido o modelo doseAr, que possibilita o cálculo da exposição e da dose inalada, ao nível individual, de poluentes atmosféricos. Os resultados da aplicação do doseAr permitem a identificação dos microambientes onde a contribuição para a exposição e dose inalada de poluentes é mais relevante. Os microambientes interiores, em particular aqueles onde é desenvolvida actividade física exigente, são identificados como especialmente importantes. A relação entre a exposição e a dose inalada é claramente associada ao agravamento da asma nestas crianças, apesar dos níveis de poluição identificados serem baixos, face aos padrões de qualidade do ar existentes.

O azeite na alimentação humana

O azeite virgem é o sumo resultante da azeitona (fruto da Oliveira, Olea Europea L.) que conserva o sabor, aroma e todas as propriedades do fruto do qual tem origem, pelo que, possui características organolépticas particulares, colocando-o num lugar cimeiro entre as gorduras (Cenzano et al., 1988; March, 1994). É, além disso, a única gordura vegetal que pode ser consumida directamente, virgem e crua (Gonçalves Ferreira, 1994; March, 1994). O seu valor calórico é de 9 Kcal/g, a mesma proporção de qualquer outra gordura, animal ou vegetal (Gonçalves Ferreira, 1994; Peres, 1994).

Produção e purificação da proteína rica em gla (grp) humana recombinante

Dissertação de mest., Biologia Molecular e Microbiana, Faculdade de Ciências e Tecnologia, Univ. do Algarve, 2011

A ética como criação de qualidade de vida : o apreço pela vida como pilar de sustentação da acção humana

Relatório da Prática de Ensino Supervisionada, Mestrado em Ensino da Filosofia, Universidade de Lisboa, 2011

Lyophilisation of influenza, rabies and Marburg lentiviral pseudotype viruses for the development and distribution of a neutralisation-assay based diagnostic kit

Pseudotype viruses (PVs) are chimeric, replication-deficient virions that mimic wild-type virus entry mechanisms and can be safely employed in neutralisation assays, bypassing the need for high biosafety requirements and performing comparably to established serological assays. However, PV supernatant necessitates -80°C long-term storage and cold-chain maintenance during transport, which limits the scope of dissemination and application throughout resource-limited laboratories. We therefore investigated the effects of lyophilisation on influenza, rabies and Marburg PV stability, with a view to developing a pseudotype virus neutralisation assay (PVNA) based kit suitable for affordable global distribution. Infectivity of each PV was calculated after lyophilisation and immediate reconstitution, as well as subsequent to incubation of freeze-dried pellets at varying temperatures, humidities and timepoints. Integrity of glycoprotein structure following treatment was also assessed by employing lyophilised PVs in downstream PVNAs. In the presence of 0.5M sucrose-PBS cryoprotectant, each freeze-dried pseudotype was stably stored for 4 weeks at up to 37°C and could be neutralised to the same potency as unlyophilised PVs when employed in PVNAs. These results confirm the viability of a freeze-dried PVNA-based kit, which could significantly facilitate low-cost serology for a wide portfolio of emerging infectious viruses.

Departamento de Genética Humana do INSA e as suas atividades: apresentação no âmbito de uma visita de estudo do ensino secundário

Apresentação das actividades realizadas no Departamento de Genética Humana com particular destaque para a investigação desenvolvida pelo grupo de Toxicologia Genética. Introdução à visita dos alunos aos laboratórios de genética.

Validação do método de deteção de eritropoietina recombinante humana em urina humana por focalização isoelétrica

A eritropoietina (EPO) é uma substância que estimula a produção de eritrócitos, aumentando a oxigenação muscular, sendo segregada de forma natural pelo organismo e excretada na urina em baixas concentrações. Devido às suas propriedades e características, a EPO foi rapidamente introduzida no mundo do desporto, como substância ilícita, proporcionando vantagens no rendimento desportivo. No início de 2000 foi desenvolvido um método de deteção direta de EPO Recombinante (rHuEPO) em urina humana por Lasne, baseado na focalização isoelétrica (IEF) em gel de poliacrilamida, seguido de duplo blote, tendo este sido publicado e validado. Em 2002, a Agência Mundial Antidopagem (AMA) implementou este mesmo método, sendo atualmente um dos métodos oficiais utilizado pelos laboratórios acreditados pela AMA. Desta forma, o ponto de partida para a realização deste trabalho consistiu na necessidade de implementar e validar o método de referência de IEF para a deteção de rHuEPO em urina humana. O trabalho foi realizado no Laboratório de Análises e Dopagem (LAD) do Instituto do Desporto de Portugal (IDP), atual Instituto Português do Desporto e Juventude (IPDJ). O principal objetivo deste trabalho consistiu no estudo/investigação de diferentes parâmetros de validação (especificidade/seletividade; capacidade de identificação; limite de deteção; exatidão e repetibilidade), de acordo com o protocolado no Procedimento Geral interno do Laboratório de Análises de Dopagem de Lisboa (LAD). O referido método de triagem e confirmação revelou possuir características de desempenho conformes com os requisitos aplicáveis, pelo que é considerado validado e apto.

Conceções alternativas de alunos do 2.º ano de escolaridade sobre a reprodução humana

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º ciclo do Ensino Básico