Showing papers by "Oswaldo Cruz Foundation published in 2002"
TL;DR: A historical introduction of drugs assayed against Chagas disease beginning in 1912 with the works of Mayer and Rocha Lima up to the experimental use of nitrofurazone, and a survey about new classes of synthetic and natural compounds studied after 1992/1993.
Abstract: In this "Critical Review" we made a historical introduction of drugs assayed against Chagas disease beginning in 1912 with the works of Mayer and Rocha Lima up to the experimental use of nitrofurazone. In the beginning of the 70s, nifurtimox and benznidazole were introduced for clinical treatment, but results showed a great variability and there is still a controversy about their use for chronic cases. After the introduction of these nitroheterocycles only a few compounds were assayed in chagasic patients. The great advances in vector control in the South Cone countries, and the demonstration of parasite in chronic patients indicated the urgency to discuss the etiologic treatment during this phase, reinforcing the need to find drugs with more efficacy and less toxicity. We also review potential targets in the parasite and present a survey about new classes of synthetic and natural compounds studied after 1992/1993, with which we intend to give to the reader a general view about experimental studies in the area of the chemotherapy of Chagas disease, complementing the previous papers of Brener (1979) and De Castro (1993).
822 citations
TL;DR: The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas.
Abstract: Discovered in 1909, Chagas disease was progressively shown to be widespread throughout Latin America, affecting millions of rural people with a high impact on morbidity and mortality. With no vaccine or specific treatment available for large-scale public health interventions, the main control strategy relies on prevention of transmission, principally by eliminating the domestic insect vectors and control of transmission by blood transfusion. Vector control activities began in the 1940s, initially by means of housing improvement and then through insecticide spraying following successful field trials in Brazil (Bambui Research Centre), with similar results soon reproduced in Sao Paulo, Argentina, Venezuela and Chile. But national control programmes only began to be implemented after the 1970s, when technical questions were overcome and the scientific demonstration of the high social impact of Chagas disease was used to encourage political determination in favour of national campaigns (mainly in Brazil). Similarly, large-scale screening of infected blood donors in Latin America only began in the 1980s following the emergence of AIDS. By the end of the last century it became clear that continuous control in contiguous endemic areas could lead to the elimination of the most highly domestic vector populations - especially Triatoma infestans and Rhodnius prolixus - as well as substantial reductions of other widespread species such as T. brasiliensis, T. sordida, and T. dimidiata, leading in turn to interruption of disease transmission to rural people. The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas. In economic terms, the cost-benefit relationship between intervention (insecticide spraying, serology in blood banks) and the reduction of Chagas disease (in terms of medical and social care and improved productivity) is highly positive. Effective control of Chagas disease is now seen as an attainable goal that depends primarily on maintaining political will, so that the major constraints involve problems associated with the decentralisation of public health services and the progressive political disinterest in Chagas disease. Counterbalancing this are the political and technical cooperation strategies such as the "Southern Cone Initiative" launched in 1991. This international approach, coordinated by PAHO, has been highly successful, already reaching elimination of Chagas disease transmission in Uruguay, Chile, and large parts of Brazil and Argentina. The Southern Cone Initiative also helped to stimulate control campaigns in other countries of the region (Paraguay, Bolivia, Peru) which have also reached tangible regional successes. This model of international activity has been shown to be feasible and effective, with similar initiatives developed since 1997 in the Andean Region and in Central America. At present, Mexico and the Amazon Region remain as the next major challenges. With consolidation of operational programmes in all endemic countries, the future focus will be on epidemiological surveillance and care of those people already infected. In political terms, the control of Chagas disease in Latin America can be considered, so far, as a victory for international scientific cooperation, but will require continuing political commitment for sustained success.
674 citations
TL;DR: O objetivo deste trabalho e analisar o perfil de morbidade referida, acesso e uso de servicos de saude em homens e mulheres no Brasil, segundo idade e regiao urbana e rural, mostram que as diferencas de genero na morbidade variam com a idade.
Abstract: O objetivo deste trabalho e analisar o perfil de morbidade referida, acesso e uso de servicos de saude em homens e mulheres no Brasil, segundo idade e regiao urbana e rural. Os dados da PNAD/98 mostram que as diferencas de genero na morbidade variam com a idade: desfavoraveis aos meninos ate os 10 anos e desfavoraveis as mulheres a partir dos 15 anos, aumentando ate os 64 anos e reduzindo apos esta idade. A alta prevalencia de atendimento indica que as barreiras de acesso dos que procuram servicos de saude sao pequenas. No entanto, o elevado percentual de nao procura face as necessidades percebidas sugere que as barreiras de acesso sao anteriores e dependem da oferta. A cobertura por planos de saude e bem maior na regiao urbana, mas nao ha diferencas de genero significantes nas regioes. As diferencas entre homens e mulheres nas taxas de uso curativo sao pequenas, se comparadas com as de uso preventivo, maiores para as mulheres, assim como as taxas de internacao, mesmo excluindo os partos. O financiamento das internacoes nao foi diferente entre homens e mulheres, ao contrario do financiamento de outros tipos de atendimento: maior cobertura por planos para mulheres na regiao urbana; na regiao rural, maior uso do SUS para as mulheres e maior desembolso de recursos proprios para os homens.
523 citations
TL;DR: The status of Chagas disease in Amazonian Brazil, including known reservoirs and vectors, and the genetic diversity of T. cruzi is reviewed, indicating that the disease may be emerging as a wider public health problem in the region.
293 citations
TL;DR: The cell parameters and the crystallite mean size behavior of both mineral phases reinforce the hypothesis that hydroxypyromorphite, PbHA, formation is the end of a process in which Pb(10-x)Ca(x)(PO4)6(OH)2 crystallites are continuously dissolved and recrystallized producing crystals with lower calcium content.
Abstract: The sorption of lead by synthetic hydroxyapatite (HA) from solutions containing Pb2+ initial concentrations up to 1770 mg L-1 was studied. X-ray diffractometry (XRD) associated with Rietveld methodology for refining the spectra pattern was used in order to characterize the mechanisms of lead uptake. It is shown that the dissolution of hydroxyapatite is followed by the formation of a solid solution, Pb(10-x)Cax(PO4)6(OH)2, with Pb ions mostly occupying Ca(II) sites. The Ca/Pb molar ratio of this solid solution decreases continuously until it reaches the structure of a pure hydroxypyromorphite. The cell parameters and the crystallite mean size behavior of both mineral phases reinforce the hypothesis that hydroxypyromorphite, PbHA, formation is the end of a process in which Pb(10-x)Cax(PO4)6(OH)2 crystallites are continuously dissolved and recrystallized producing crystals with lower calcium content. Combination of Inductively Coupled Plasma spectrometry (ICP), chemical analysis, and XRD results permitted th...
283 citations
TL;DR: The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil, and found that the 30-59-year and over-60-year age groups were the most affected.
Abstract: This study analyzes 3,181 deaths from paracoccidioidomycosis in Brazil, based on 16 years of sequential data (from 1980 to 1995). During this period paracoccidioidomycosis showed considerable magnitude and low visibility, representing the eighth most common cause of death from predominantly chronic or recurrent types of infectious and parasitic diseases. It also had the highest mortality rate among the systemic mycoses. The mean annual mortality rate was 1.45 per million inhabitants, indicating a downward long-term trend (reduction of 31.28%), while spatial distribution among the different regions and States of Brazil was non-homogenous. The South (with the highest regional rate) and the Southeast showed a downward trend, while the Central West had the second highest rate in the country. At least one-fifth of Brazilian municipalities (or 22.71% of the country's total area) reported deaths from paracoccidioidomycosis. Overall nationwide mortality per area was 3.73/10,000km2. The disease was endemic in non-metropolitan areas. The majority of deaths occurred in males (84.75%), and there was a sex ratio of 562 men/100 women. The 30-59-year and over-60-year age groups were the most affected. The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil.
260 citations
TL;DR: The use of health services by men and women in Brazil was dependent on family income and on the social status of the individual, indicating a pattern of social inequality.
Abstract: Estudo financiado pela Organizacao Pan-Americana da Saude atraves do Concurso Regional de Investigacion 1999 sobre “Genero y equidad en el acceso
a la atencion de la salud en las reformas de los sistemas de salud y seguridad social”. HDP/HDR/RGP/81/5.3.
246 citations
TL;DR: The high sensitivity of the approach enabled the detection of the parasite DNA in fecal samples containing as few as 2.4 eggs per gram of feces, which makes it 10 times more sensitive than the Kato-Katz examination.
Abstract: A novel method for the detection of Schistosoma mansoni in human samples that is based on the amplification of a highly repeated DNA sequence has been developed. By use of simple DNA extraction techniques and a rapid 2-step polymerase chain reaction (PCR), it was possible to amplify S. mansoni DNA in human fecal and serum samples. The high sensitivity of the approach enabled the detection of the parasite DNA in fecal samples containing as few as 2.4 eggs per gram of feces, which makes it 10 times more sensitive than the Kato-Katz examination. A detection limit of I fg of Schistosoma sp. DNA was determined when pure DNA was used as PCR template. The amplification reaction showed to be specific giving no cross-reaction with DNA from other helminths. The PCR assay developed in this study may constitute a valuable alternative for the diagnosis of the Schistosoma sp. infection.
207 citations
TL;DR: In this paper, a participacao de usuarios de a servico publico de saude, o Instituto de Pesquisa Clinica Evandro Chagas (IPCEC/Fiocruz), em uma associacao of pacientes, a Associacao Lutando para Viver (ALpViver) baseado em pesquisa qualitativa, com entrevistas semi-estruturadas e observacao participante.
Abstract: Este artigo discute alguns aspectos da participacao de usuarios de um servico publico de saude, o Instituto de Pesquisa Clinica Evandro Chagas (IPCEC/Fiocruz), em uma associacao de pacientes, a Associacao Lutando para Viver (ALpViver) Baseado em pesquisa qualitativa, com entrevistas semi-estruturadas e observacao participante, o trabalho analisa o papel dessa associacao, na visao de profissionais do hospital e pacientes, a partir dos conceitos de rede social, apoio social e empowerment A relevância deste estudo se da a partir da nocao de que a valorizacao de uma cultura participativa dentro das instituicoes de saude contribui para aumentar a autonomia e elevar a auto-estima dos usuarios, melhorando a qualidade de vida e de saude dos mesmos
204 citations
TL;DR: Reinterpretation of triatomine biogeography points to the origin of Triatominie in northern areas of South America, in Central America, or in the southern region of North America, thus supporting a monophyletic origin ofTriatominae.
192 citations
TL;DR: DL is an emerging clinical distinct form of leishmaniasis associated with agricultural activities and host immunological response and has lower levels of interferon-gamma and tumor necrosis factor-alpha production than patients with LCL.
Abstract: During the past decade, there has been an increase in the number of patients with disseminated leishmaniasis (DL), which is characterized by a large number of acneiform and papular skin lesions, with very few or no parasites in the skin tissue. The present report describes 42 cases of DL identified between 1992 and 1998 in an area where Leishmania braziliensis transmission is endemic; 8 of the patients were prospectively diagnosed. In a contrast to localized cutaneous leishmaniasis (LCL), acquisition of DL was associated with age >19 years (P<.05), male sex (P<.05), and agricultural occupation (P<.001). Patients with DL presented with 10-300 lesions that were a mixture of acneiform, papular, nodular, and ulcerated types. Twelve (29%) of 42 patients had mucosal involvement. Patients with DL had lower levels of interferon-gamma (P<.05) and tumor necrosis factor-alpha (P<.05) production, compared with patients with LCL. DL is an emerging clinical distinct form of leishmaniasis associated with agricultural activities and host immunological response.
TL;DR: The evitability approach of perinatal deaths in Brazil is highly recommended, as mortality rates are still very high and most of the deaths are considered avoidable.
Abstract: This is a literature review onperinatal mortality focusing its evitability. A Medline and Lilacs (Latin-America and Caribbean) search was conducted for the 90s. There are few research studies on this subject in Brazil due to the great number of underreported fetal deaths and the low quality information provided in death certificates. Different proposals for perinatal death classification are presented. Most are based on grouping the underlying causes of deaths in a functional system in order to facilitate the analysis. In the Wigglesworth classification system, one of the most recommended methods, deaths are related to the different stages of care for pregnant women and children, evidencing the possibilities of their prevention. The evitability approach of perinatal deaths in Brazil is highly recommended, as mortality rates are still very high and most of the deaths are considered avoidable. Premature deaths could be avoided improving the quality of health care. Besides improving the medical assistance, the organization of health care regarding pre-natal, birth and neonatal care must also be better developed to ensure access to qualified assistance.
TL;DR: This paper aims to review the applications of the polymerase chain reaction (PCR) for the detection and identification of trypanosomes in animals and recommends a multi-species-specific diagnostic protocol using a single PCR.
TL;DR: In this paper, the ellagitannin punicalagin was found to be active against methicillin-resistant Staphylococcus aureus strains and was identified by HPLC/UV and 1HNMR.
Abstract: The ethyl acetate extract of Punica granatum fruits was fractionated by chromatographic techniques to afford the ellagitannin punicalagin. The substance was found to be active against methicillin-resistant Staphylococcus aureus strains and was identified by HPLC/UV and 1HNMR. The antibacterial assays which guided the isolation of the tannin were conducted using the disc diffusion method. Minimum inhibitory concentration (MIC) was determined by the dilution method according to NCCLS (National Committee for Clinical Laboratory Standards) procedure.
TL;DR: The bulk of data discussed herein clearly points to the notion that the thymus gland is a target in malnutrition, including the cytokine/chemokine secretion as well as the positive and negative selection events driven by TCR/MHC-peptide interactions in malnutrition.
Abstract: Malnutrition, secondary to deficiency in uptake of proteins, metal elements or vitamins, consistently results in changes in the thymus gland. The organ undergoes a severe atrophy due to apoptosis-induced thymocyte depletion, particularly affecting the immature CD4(+) CD8(+) cells, as well as a decrease in cell proliferation. Such a feature is apparently linked to a hormonal imbalance, involving decrease of leptin and consequent raise of glucocorticoid hormone levels in the serum. Interestingly, this picture can be reversed after appropriate diet rehabilitation. The thymic microenvironment is also affected in malnutrition: morphological changes in thymic epithelial cells were found, together with a decrease of thymic hormone production by these cells. Additionally, intrathymic contents of extracellular proteins, such as fibronectin, laminin and collagens, are increased in the thymuses from malnourished children. Conjointly, the bulk of data discussed herein clearly points to the notion that the thymus gland is a target in malnutrition. Nevertheless, further relevant information regarding the physiology of the thymus, including the cytokine/chemokine secretion as well as the positive and negative selection events driven by TCR/MHC-peptide interactions in malnutrition, remains to be defined. These are questions that need to be answered in order to have a better understanding of the immunodeficiency seen in malnourished individuals.
TL;DR: O impact do uso de agrotoxicos sobre a saude humana and the impact of agrotoxico on this problem is a problem that tem merecido atencao da comunidade cientifica em todo o mundo, sobretudo nos paises em desenvolvimento as mentioned in this paper.
Abstract: O impacto do uso de agrotoxicos sobre a saude humana e um problema que tem merecido atencao da comunidade cientifica em todo o mundo, sobretudo nos paises em desenvolvimento O consumo de agrotoxicos na regiao sudeste do Brasil esta estimado em 12kg de agrotoxico/trabalhador/ano Em algumas areas agricolas do Estado do Rio de Janeiro, como na regiao da Microbacia do Corrego de Sao Lourenco, Nova Friburgo, o consumo de agrotoxico foi estimado em 56kg de agrotoxico/trabalhador/ano Elevados niveis de contaminacao humana e ambiental foram encontrados nesta regiao, como decorrencia do uso extensivo destes agentes quimicos A avaliacao do impacto sobre a saude humana implica o conhecimento e a visualizacao da importância/magnitude relativa de cada uma das vias de contaminacao Inumeros fatores, que, em geral, encontram-se inter-relacionados, contribuem para a situacao encontrada na Microbacia do Corrego de Sao Lourenco e a forma mais adequada de se avaliar toda a dimensao deste problema e o uso de uma abordagem integrada
TL;DR: Findings indicate the important role of endogenous IFN-γ and IRF-1 in the in vivo induction of the Trp-Kyn metabolic pathway during acute infection with Toxoplasma gondii.
Abstract: The induction of indoleamine 2,3-dioxygenase (INDO) expression and the tryptophan (Trp)-kynurenine (Kyn) metabolic pathway during in vivo infection with Toxoplasma gondii was investigated. Decreased levels of Trp and increased formation of Kyn were observed in the lungs, brain, and serum from mice infected with T. gondii. Maximal INDO mRNA expression and enzyme activity were detected in the lungs at 10 to 20 days postinfection. Further, the induction of INDO mRNA expression, Trp degradation and Kyn formation were completely absent in tissues from mice deficient in IFN-γ (IFN-γ−/−) or IFN regulatory factor -1 (IRF-1−/−). These findings indicate the important role of endogenous IFN-γ and IRF-1 in the in vivo induction of the Trp-Kyn metabolic pathway during acute infection with T. gondii. In contrast, expression of INDO mRNA and its activity was preserved in the tissues of TNF-receptor p55- or inducible nitric oxide synthase-deficient mice infected with T. gondii. Together with the results showing the extreme susceptibility of the IFN-γ−/− and the IRF-1−/− mice to infection with T. gondii, our results indicate a possible involvement of INDO and Trp degradation in host resistance to early infection with this parasite.
TL;DR: In this paper, a politica de reorganizacao da atencao basica a partir do processo recente de descentralizationacao do SUS no Brasil is discussed.
Abstract: O artigo discute a politica de reorganizacao da atencao basica a partir do processo recente de descentralizacao do SUS no Brasil. Enfatiza-se o papel indutor do governo central, que, atraves de um conjunto de medidas e programas especificos (PAB e PACS/PSF, principalmente), transfere para os municipios a responsabilidade com a atencao basica. Assim, e no nivel municipal que ocorre o processo de implementacao dessa politica, gerando efeitos de dificil avaliacao, dada a diversidade de contextos locais. A argumentacao central enfatiza a importância de se avaliarem processos e resultados intermediarios voltados para o desempenho institucional, que podem ser traduzidos em vontade politica e compromisso publico, capacidade de gestao e maior controle e participacao social, mais do que exatamente efeitos ou impactos mais diretos sobre a oferta de servicos. A conclusao e de que apesar de todas as dificuldades e obstaculos o processo tem implicado o fortalecimento da capacidade de gestao municipal no que diz respeito a organizacao da atencao basica em saude.
TL;DR: The relationship between macroinvertebrate assemblages, water chemistry variables and environmental degradation was examined using canonical correspondence analysis (CCA) in an Atlantic Forest region in Brazil as mentioned in this paper.
Abstract: Benthic macroinvertebrate assemblages, water chemistry variables and environmental degradation were investigated in an Atlantic Forest region in Brazil. Seven sites of the Guapimirim river basin were studied during three sampling periods based on the rain regime: end of wet season (May 1998), dry season (August 1998), and wet season (January 1999). Four substrates were collected at each site: sand, stony substrates, litter in pool areas and litter in riffle areas. Relationships between macroinvertebrate assemblages, water chemistry variables and environmental degradation were examined using canonical correspondence analysis (CCA). According to CCA, concentrations of dissolved oxygen and chloride, and the environmental degradation, measured by the Riparian Channel Environment index, exhibited the strongest relationship to macroinvertebrate assemblages. Overall, the loss of community diversity measured by the Shannon Index along the degradation gradient was observed. Some taxa were shown to be sensitive to water pollution, especially among Plecoptera, Trichoptera, Coleoptera and some Ephemeroptera, while others such as Simuliidae, Odonata and molluscs were tolerant to moderate levels of pollutants. The Chironomidae were the only group tolerant to a high level of pollutants and degradation.
TL;DR: In this article, a politica de informacao em saude como parte da agenda da reforma do setor saude in Brazil is presented, which poderiam de certa forma apontar for alguns caminhos no caso brasileiro.
Abstract: Partindo-se do suposto de que as estatisticas de saude devem compor um conjunto organizado de dados provenientes dos registros civil, da producao de servicos, das bases de dados de morbi-mortalidade, procura-se enfatizar a necessidade de coletar dados sobre saude e uso de servicos de saude, que so podem ser gerados por inqueritos populacionais periodicos, complementando dessa forma as deficiencias das informacoes para monitorar e avaliar as condicoes de saude e o desempenho do sistema de saude brasileiro. Faz-se uma apresentacao dos inqueritos desenvolvidos em alguns paises, seus enfoques principais e as limitacoes mais gerais. Finalmente, apresenta-se a producao mais recente de documentos e revisoes internacionais sobre os mecanismos que vem sendo utilizados em outros paises para a formulacao de uma politica de informacao em saude como parte da agenda da reforma do setor saude, que poderiam de certa forma apontar para alguns caminhos no caso brasileiro.
TL;DR: These studies indicate that lipid bodies formed after LPS stimulation and sepsis are sites for eicosanoid-forming enzymes and cytokine localization and may develop and function as structurally distinct, intracellular sites for paracrine eicOSanoid synthesis during inflammatory conditions.
Abstract: Lipid bodies are rapidly inducible, specialized cytoplasmic domains for eicosanoid-forming enzyme localization, which we hypothesize to have specific roles in enhanced inflammatory mediator production during pathological conditions, including sepsis. However, little is known about the origins, composition, or functions of lipid bodies in vivo. We show that lipid body numbers were increased in leukocytes from septic patients in comparison with healthy subjects. Analogously, the intrathoracic administration of LPS into mice induced a dose- and time-dependent increase in lipid body numbers. Pretreatment with anti-CD14 or anti-CD11b/CD18 mAb drastically inhibited LPS-induced lipid body formation. Moreover, LPS failed to form lipid bodies in C3H/HeJ ( TLR4 mutated) mice, demonstrating a requisite role for LPS receptors in lipid body formation. LPS-induced lipid body formation was also inhibited by the platelet-activating factor-receptor antagonists, suggesting a role for endogenous platelet-activating factor. The eicosanoid-forming enzymes, 5-lipoxygenase and cyclooxygenase-2, were immunolocalized within experimentally induced (LPS in mice) or naturally occurring (septic patients) lipid bodies. The proinflammatory cytokine involved in the pathogenesis of sepsis, TNF-α, was also shown to colocalize within lipid bodies. Prior stimulation of leukocytes to form lipid bodies enhanced the capacity of leukocytes to produce leukotriene B 4 and PGE 2 . In conclusion, our studies indicate that lipid bodies formed after LPS stimulation and sepsis are sites for eicosanoid-forming enzymes and cytokine localization and may develop and function as structurally distinct, intracellular sites for paracrine eicosanoid synthesis during inflammatory conditions.
TL;DR: A better knowledge of this complex biological circuitry will provide new clues for understanding thymus physiology and designing therapeutic strategies targeting developing T cells.
TL;DR: Efforts should be made to develop a more specific dipstick test for diagnosis of leishmaniasis, because they may ultimately prove more cost-effective than currently used diagnostic tests when used in mass-screening surveys.
Abstract: Current zoonotic visceral leishmaniasis (ZVL) control programs in Brazil include the culling of Leishmania infantum-infected reservoir dogs, a strategy that has failed to prevent a rise of canine and human ZVL cases over the past decade. One of the main reasons this strategy has failed is because of a long delay between sample collection, sample analysis, and control implementation. A rapid, sensitive, and specific diagnostic tool would be highly desirable, because it would allow control interventions to be implemented in situ. We compared an immunochromatographic dipstick test to enzyme-linked immunosorbent assay (ELISA) and PCR for detecting L. infantum infections in dogs from an area of ZVL endemicity in Brazil. The dipstick test was shown to have 61 to 75% specificity and 72 to 77% sensitivity, compared to 100% specificity for both ELISA and PCR and 71 to 88% and 51 to 64% sensitivity for ELISA and PCR, respectively. Of the field samples tested, 92 of 175 (53%), 65 of 175 (37%), and 47 of 175 (27%) were positive by dipstick, ELISA, and PCR, respectively. The positive and negative predictive values for the tested dipstick were 58 to 77% and 75%, respectively. Efforts should be made to develop a more specific dipstick test for diagnosis of leishmaniasis, because they may ultimately prove more cost-effective than currently used diagnostic tests when used in mass-screening surveys.
TL;DR: According to this study, prenatal care proved to be an effective compensatory policy for the prevention of prematurity and low birth weight, especially among adolescent mothers.
Abstract: Este trabalho tem como objetivo comparar as caracteristicas socio-economicas, a assistencia pre-natal e o estilo de vida de tres grupos de puerperas, um composto por adolescentes (< 20 anos) e os demais por mulheres de 20-34 anos, categorizadas segundo experiencia (ou nao) de gravidez na adolescencia. Foram entrevistadas 3.508 puerperas no pos-parto em maternidades municipais e federais do Municipio do Rio de Janeiro. A analise estatistica consistiu em utilizar testes qui-quadrado (chi2) para testar hipoteses de homogeneidade de proporcoes. Ao comparar os tres grupos, observou-se uma situacao mais desfavoravel entre as maes de 20-34 anos com historia de gravidez na adolescencia. Estas tem pior nivel de instrucao, mostram com maior frequencia habitos de fumo e uso de drogas ilicitas durante a gestacao e apresentam menor numero de consultas de atendimento pre-natal. A assistencia pre-natal se apresentou neste estudo como uma politica compensatoria eficiente para a prevencao da prematuridade e do baixo peso ao nascer, sobretudo entre as puerperas adolescentes.
TL;DR: This simultaneous appearance of anti-saliva humoral response and anti-L.
Abstract: Antibody responses to salivary gland sonicate (SGS) from Lutzomyia longipalpis were investigated using serum samples from individuals living in an area where visceral leishmaniasis is endemic. Individuals were classified into 2 groups, according to the alteration of their responses to Leishmania chagasi antigen over the course of 6 months. Group 1 included children who experienced anti–L. chagasi seroconversion from negative to positive; group 2 included children who experienced delayed-type hypersensitivity (DTH) response to L. chagasi antigen conversion from negative to positive. Individuals who experienced seroconversion againstL.chagasi antigens did not have increased anti-saliva antibody response, whereas those who developed a positive anti–L. chagasi DTH response had increased immunoglobulin (Ig) G, IgG1 and IgE anti-SGS antibody levels. Despite wide variation, serum samples from individuals in group 2 recognized more bands in SGS than did those from individuals in group 1. This simultaneous appearance of anti-saliva humoral response and anti–L. chagasi cell-mediated immunity supports the hypothesis that induction of immune response against SGS can facilitate induction of a protective
TL;DR: In this article, a modelo teorico de utilizacao de servos de saude proposto por Andersen serviu como marco de referencia da analise, permitindo que estimativas da demanda por servos of saude fossem feitas segundo niveis altos e baixos de capacitacao, necessidade e predisposicao for o consumo.
Abstract: Servicos de saude devem responder as demandas populacionais que resultam da conjugacao de fatores sociais, individuais e culturais. Para isso, faz-se necessario o conhecimento do padrao de consumo de servicos de saude. Neste artigo, quatro perfis de consumo de saude foram gerados a partir da aplicacao da tecnica do Grade of Membership (GoM). O modelo teorico de utilizacao de servicos de saude proposto por Andersen serviu como marco de referencia da analise, permitindo que estimativas da demanda por servicos de saude fossem feitas segundo niveis altos e baixos de capacitacao, necessidade e predisposicao para o consumo. Ressalta-se que especial atencao deve ser dada ao grupo de alta necessidade e predisposicao, e baixa capacitacao, que representa 14% da populacao brasileira acima de 14 anos de idade (exceto a regiao Norte) e e composto, predominantemente, por idosos que moram sozinhos e tem alta necessidade de servicos especializados.
TL;DR: In this paper, the degradation of the pesticide Diuron (Nortox, 3-(3,4-dichlorophenyl)-1,1-dimethylurea) was carried out under laboratory conditions to evaluate the potential use of this technology for in situ remediation.
TL;DR: A relationship exists between TNF-a and IL-10 promoter polymorphisms and the development of PB leprosy, and data indicate that Cytokines evidently play a critical role in triggering host-pathogen interactions.
Abstract: Single-nucleotide polymorphismswithin thegenescodingfortumornecrosisfactor(TNF)‐a and interleukin (IL)‐10 have been associated with several infectious diseases. To determine whether such polymorphisms are associated with leprosy, genotyping was performed at the 308 and 238 positions of the promoter of the TNF-a gene in 210 and 191 patients with multibacillary (MB) leprosy, respectively; 90 and 79 patients with paucibacillary (PB) leprosy; and 92 control subjects. For the 592 and 819 positions within the promoter of the IL-10 gene, 143 patients with MB leprosy, 79 patients with PB leprosy, and 62 control subjects were included in the analysis. TNF2 allele frequency was significantly higheramong controlsubjects than among all patients with leprosy or in the MB group ( and ). For the ILP ! .05 P ! .01 10 gene, the frequency of the homozygous 819TT genotype was significantly higher among patients than among control subjects. These data indicate that a relationship exists between TNF-a and IL-10 promoter polymorphisms and the development of PB leprosy. The more benign paucibacillary (PB) forms of leprosy— borderline tuberculoid (BT) and tuberculoid tuberculoid (TT) leprosy—are characterized by the predominance of a Th1-type immune response, the presence of well-formed granulomas at the site of the lesion, and control of mycobacterial replication. In contrast, in the multibacillary (MB) forms—borderline borderline (BB) and borderline lepromatous (BL) leprosy and lepromatous leprosy (LL)—no granuloma is seen, and high bacterial load and antibody levels are detected. Cytokines evidently play a critical role in triggering host-pathogen interactions. On one hand, greater tumor necrosis factor (TNF)–a production,
TL;DR: Results show that L-ESAT-6 is a potent M. leprae antigen that stimulates T-cell-dependent gamma interferon production in a large proportion of individuals exposed to M. tuberculosis and M. Leprae, which has implications for the use of ESAT- 6 as tool for diagnosis of leprosy and TB in areas where both diseases are endemic.
Abstract: In this paper we describe identification and characterization of Mycobacterium leprae ESAT-6 (L-ESAT-6), the homologue of M. tuberculosis ESAT-6 (T-ESAT-6). T-ESAT-6 is expressed by all pathogenic strains belonging to the M. tuberculosis complex but is absent from virtually all other mycobacterial species, and it is a promising antigen for immunodiagnosis of tuberculosis (TB). Therefore, we analyzed whether L-ESAT-6 is a similarly powerful tool for the study of leprosy by examining T-cell responses against L-ESAT-6 in leprosy patients, TB patients, and exposed or nonexposed healthy controls from areas where leprosy and TB are endemic and areas where they are not endemic. L-ESAT-6 was recognized by T cells from leprosy patients, TB patients, individuals who had contact with TB patients, and healthy individuals from an area where TB and leprosy are endemic but not by T cells from individuals who were not exposed to M. tuberculosis and M. leprae. Moreover, leprosy patients who were not responsive to M. leprae failed to respond to L-ESAT-6. A very similar pattern was obtained with T-ESAT-6. These results show that L-ESAT-6 is a potent M. leprae antigen that stimulates T-cell-dependent gamma interferon production in a large proportion of individuals exposed to M. leprae. Moreover, our results suggest that there is significant cross-reactivity between T-ESAT-6 and L-ESAT-6, which has implications for the use of ESAT-6 as tool for diagnosis of leprosy and TB in areas where both diseases are endemic.
TL;DR: The annual occurrence of viral respiratory infections in the coldest months is shown, with a significant annual variation in the frequency of RSV infection.
Abstract: Although acute respiratory infections (ARIs) are a major cause of child morbidity and mortality in Southern Brazil, little information is available on their seasonality and viral etiology. This study was conducted on children under 5 years of age with ARI to assess viral etiology in the State of Rio Grande do Sul, from 1990 to 1992. A total of 862 nasopharyngeal secretion (NPS) samples were tested using indirect immunofluorescence. The results showed that 316 (36.6%) NPS samples were positive: 26.2% for RSV, 6% for adenovirus, 1.7% for influenzaviruses, 1.5% for parainfluenzaviruses, and 1.2% for mixed infection. The mean viral prevalence rates in out-patient services, emergency wards, and in-patient hospital wards were 26.7%, 53% and 42.3%, respectively. Respiratory syncytial virus (RSV) and adenovirus accounted for 91.4 % of the viral diagnoses. RSV was more frequent in children under one year of age at the three levels of health care and was prevalent in infants under six months. Adenovirus was the most prevalent pathogen in hospitalized children, in 1992. Influenza A virus showed an increased prevalence with age among out-patient children. This study shows the annual occurence of viral respiratory infections in the coldest months, with a significant annual variation in the frequency of RSV infection.