Prevalência de hanseníase em São Luís–Maranhão entre os anos de2013 a 2015 / Prevalence of leprosy in São Luís-Maranhão from 2013 to 2015

Objetivo: analisar e representar, espacialmente, a evolução da distribuição geográfica dasocorrências de Hanseníase no Maranhão entre os anos de 2013 a 2015, utilizando técnicas degeoprocessamento. Método: realizou-se análise, utilizando mapas e tabelas temáticas, com base nosregistros do Sistema de Informação de Agravos de Notificação. Resultados: foram identificados 1.879casos, somados entre 219 bairros residenciais. Para o ano de 2013, o distrito mais afetado foi oTirirical; em 2014, aumentou a prevalência nos Distritos de Bequimão e Coroadinho e em 2015, houveuma redução de prevalências nos distritos de Tirirical Cohab, Coroadinho e Itaqui Bacanga.Conclusão: apesar de algumas localidades estudadas terem apresentado uma diminuição daprevalência entre 2013 e 2014, de 2014 a 2015 houve um aumento na quantidade de casos. O estudode prevalências possibilitou essa identificação de casos, podendo ser observada a imprescindibilidadede subsidiar estratégias de controle.

Objective: to analyze and spatially represent the evolution of the geographic distribution ofoccurrences of Leprosy in Maranhão between the years 2013 to 2015 using geoprocessing techniques.Method: the analysis was performed using maps and thematic tables, based on the records of theNotifiable Diseases Information System. Results: 1.879 cases were identified, among 219 residentialdistricts. For the year 2013, the district most affected was Tirirical; in 2014, increased prevalencein the Districts of Bequimão and Coroadinho and in 2015, there was a reduction of prevalences in thedistricts of Tirirical Cohab, Coroadinho and Itaqui Bacanga. Conclusion: although some localitiesstudied showed decrease in their prevalence between 2013 and 2014; there was increase in thenumber of cases from 2014 to 2015. The prevalence study made it possible to identify cases, and itis possible to observe the necessity of subsidizing control strategies.

The role of formulation and follicular pathway in voriconazole cutaneous delivery from liposomes and nanostructured lipid carriers.

In general, colloids provide increased cutaneous permeation of drugs. Still, skin interaction and main pathways for drug diffusion may vary depending on system and formulation characteristics. The knowledge of how different colloidal systems interact with biological membranes and the formulation impact on delivery is especially relevant for drugs that can be encapsulated in multiple nanosystems, as voriconazole (VOR). In here, we compared VOR release and permeation profile from liposomes (LP) and nanostructured lipid carriers (NLC) in aqueous colloidal dispersions and in gel formulations. Despite the controlled drug release provided by gel formulations, formulation only had a significant impact on drug skin accumulation from LP. The reduced mobility in gel formulations compromised follicle deposition and drug retention in the skin. Such a hypothesis was confirmed by permeation experiments evaluating follicle pathway influence. Follicular route also had an influence on delivery from NLC, which was only significant for total drug that reached the acceptor medium. These differences could be attributed to the mechanisms of colloid interaction with the skin and subsequent drug release. Follicle LP deposition and slow drug release leads to higher cutaneous amounts whilst NLC interaction with skin and fast drug release leads to fast drug diffusion and deeper penetration. By the low MIC50 values encountered against Trichophyton rubrum (∼ 0.001 µg/mL), permeated amounts could inhibit fungal growth, regardless the system. In conclusion, both LP and NLC seem to be valuable systems for cutaneous VOR delivery. Fluidic formulations could provide better efficiency for cutaneous drug delivery from LP.

Comparative study of different matrix/solvent systems for the analysis of crude lyophilized microalgal preparations using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

RATIONALE: Due to increases in greenhouse gas emissions, it is necessary to explore renewable sources of energy. Interesting alternatives are biofuels derived from microalgae. One challenge is the development of a detailed microalgae database compiling species identifications and characterizations that would facilitate microalgae selection for biomass production. Mass spectrometric (MS) analysis using a matrix-assisted laser desorption/ionization (MALDI) source is an advanced technique that enables advancement in this biological area. In this work a MALDI time-of-flight (TOF)MS method for the rapid identification of proteins in whole cells of selected microalgae species was studied. Furthermore, the efficiency of different matrix and solvent systems was tested. MS analyses were performed using an UltrafleXtreme MALDI-TOF mass spectrometer operating in linear positive ion mode. METHODS: Mass spectra were acquired in a mass range from 4000 to 20,000 Da with ions generated from Smartbeam laser irradiation using a frequency of 2000 Hz, a PIE 100 ns and a lens 7 kV. The voltage was 25 kV for the first ion source and 23 kV for the second. Each spectrum was generated by averaging of 10,000 laser shots and the laser irradiance was set at 95-100%. RESULTS: Similar mass spectra were obtained for all matrices (SA, HCCA, DHB and sDHB); however, the use of the sDHB matrix resulted in spectrum profiles with a greater amount number of proteins, a better signal/noise (S/N) ratio and higher intensities for the majority of microalgae analyzed. Trifluoroacetic acid (TFA) content was also studied and the best results in terms of S/N ratio, number of proteins and signal intensities were obtained with 0.1% TFA in the matrix solvent. The addition of isopropanol did not produce improvement in the quality of spectrum profiles. CONCLUSIONS: Therefore, the optimal matrix for the analysis of protein from intact microalgae cells is sDHB with TA50 as the matrix solvent and without isopropanol. These conditions allow the acquisition of high quality spectrum profiles.

Two women with cerebral venous thrombosis: oral contraceptives?

Two cases of cerebral venous thrombosis are reported. Patients were apparently healthy 39 and 28-year old females with non-specific presenting features. Image findings were characteristic of cerebral sinus thrombosis. The younger patient received progesterone to treat placental abruption eight years previously; she had cerebral venous thrombosis while using oral contraception. Both patients had used contraceptive pills for a long time. Oral hormonal contraceptives may increase the risk of vascular events, even in people without personal or family history of venous thrombosis. Modern imaging methods have contributed to early diagnosis, but the possibility of under diagnosis still persists. This report aims to increase the awareness of health-workers about cerebral venous thrombosis in women, an entity often misdiagnosed, under diagnosed and under-reported.

Testis stereology, seminiferous epithelium cycle length, and daily sperm production in the ocelot (Leopardus pardalis).

Similar to most wild felids, the ocelot (Leopardus pardalis) is an endangered species. However, knowledge regarding reproductive biology of the ocelot is very limited. Germ cell transplantation is an effective technique for investigating spermatogenesis and stem cell biology in mammals, and the morphologic characterization of germ cells and knowledge of cycle length are potential tools for tracking the development of transplanted germ cells. Our goal was to investigate basic aspects related to testis structure, particularly spermatogenesis, in the ocelot. Four adult males were used. After unilateral orchiectomy, testis samples were routinely prepared for histologic, stereologic, and autoradiographic analyses. Testis weight and the gonadosomatic index were 11+/-0.6g and 0.16+/-0.01%, respectively, whereas the volume density of seminiferous tubules and Leydig cells was 83.2+/-1.6% and 9.8+/-1.5%. Based on the acrosomic system, eight stages of spermatogenesis were characterized, and germ cell morphology was very similar to that of domestic cats. Each spermatogenic cycle lasted 12.5+/-0.4 d, and the entire spermatogenic process lasted 56.3+/-1.9 d. Individual Leydig cell volume was 2522mum(3), whereas the number of Leydig and Sertoli cells per gram of testis was 38+/-5x10(6) and 46+/-3x10(6). Approximately 4.5 spermatids were found per Sertoli cell, whereas daily sperm production per gram of testis was 18.3+/-1x10(6), slightly higher than values reported for other felids. The knowledge obtained in this study could be very useful to the preservation of the ocelot using domestic cat testes to generate and propagate the ocelot genome.

Sporadic cardiac myxomas and tumors from patients with Carney complex are not associated with activating mutations of the Gs alpha gene.

Cardiac myxomas are rare tumors that may be encountered sporadically or in the context of the Carney complex. The molecular basis for the development of cardiac myxomas and Carney complex tumors is unclear. Pathological myocardial function and myocardial hypertrophy have been associated with alterations in the heterotrimeric GTP-binding proteins. The postulated proto-oncogenic character of the gene encoding the alpha sub-unit of the stimulatory GTP-binding protein Gs alpha (gsp) in pituitary and thyroid tumors, the finding of identical somatic gsp mutations in the myocardium of patients with McCune-Albright syndrome, and the associated endocrine anomalies of the Carney complex prompted us to investigate the occurrence of activating missense mutations in the Gs alpha gene in 10 sporadically occurring atrial myxomas and in 8 tumors from 7 patients with Carney complex. No gsp mutations could be demonstrated by using the polymerase chain reaction and denaturing gradient gel electrophoresis complemented by direct DNA sequencing. Thus, activating Gs alpha mutations neither are associated with the development of atrial myxomas, nor can be demonstrated in other tumors from patients with Carney complex. The significance of these mutations in the myocardium of asymptomatic patients with McCune-Albright syndrome remains to be determined.

Transmission of tuberculosis to close contacts of patients with multidrug-resistant tuberculosis.

Multidrug-resistant tuberculosis (MDRTB) has emerged as a major public health problem worldwide. To determine the incidence and risk factors associated with tuberculosis among contacts of MDRTB index cases, we studied human immunodeficiency virus-seronegative close contacts of 64 culture-confirmed MDRTB patients in Rio de Janeiro, Brazil. Between March 1988 and July 1992, tuberculosis developed in 17 (7.8%) of 218 previously healthy close contacts of 64 MDRTB index cases (1.6 cases per 1,000-person-months of contact). Among strains of Mycobacterium tuberculosis isolated from 13 contacts of 12 index cases, six (46%) had susceptibility patterns identical to those of their index cases, four (31%) had different patterns of resistance, and three (23%) were susceptible to all drugs. Tuberculosis developed more frequently in male contacts (p < 0.05), persons > or = 15 yr of age (p < 0.05), nonwhites (p < 0.001), and persons not previously vaccinated with bacillus Calmette-Guerin (BCG) (p < 0.05). The association of BCG vaccination with decreased risk of disease was significant even when this variable was controlled (by Cox's regression analysis) for age, sex, race, purified protein derivative (PPD) status, and isoniazid prophylaxis. BCG vaccination appears to offer protection against tuberculosis during prolonged exposures to persons with MDRTB, which identifies a novel and specific indication of BCG use.

The proliferating cell nuclear antigen index in breast carcinomas does not correlate with mitotic index and estrogen receptor immunoreactivity.

To investigate the expression of a marker of cell proliferation (PCNA/Cyclin) and its putative relationship with histological grading, mitotic index and estrogen receptor immunoreactivity, we studied twenty-seven cases of invasive breast carcinoma in formalin-fixed, paraffin-embedded tissue sections. The PCNA and estrogen receptor were detected by the PC 10 and H 222 monoclonal antibodies respectively, using an avidin-biotin-peroxidase method. The median value of PCNA index was 20.9% with a range from 1.4 to 84.2%. We did not find any significant relationship between PCNA index and the histological grading, mitotic index and estrogen receptor immunoreactivity. We conclude that PCNA detected by the monoclonal antibody PC 10 in formalin-fixed material looks at present unreliable as a proliferation marker in breast carcinoma.

Consideraçöes sobre o câncer localmente avançado de mama (CLAM) acrescidas de identificaçäo dos receptores de estrogênios usando anticorpos monoclonais / Considerations of locally advanced cancer of the breast (LACB) increased of indentification of estrogen receptors by using monoclonal

Para investigar os resultados do tratamento do câncer localmente avançado de mama nós estudamos 49 pacientes, que foram submetidas à associaçäo de telecobaltoterapia convencional e quimioterapia dupla com ciclofosfamida e 5-fluoracil, combinadas com mastectomia radical nos casos operáveis. Obteve-se controle local do tumor em 86,7% dos casos. Näo houve recidivas logorregionais nas pacientes submetidas à cirurgia, índice que alcançou 21,7% nas inoperáveis que receberam só radioterapia e quimioterapia. O seguimento médio das pacientes falecidas foi de 29,5 meses e das sobreviventes, de 79,3 meses. O índice de respostas completas foi de 24,5%. O período médio livre de doença de 22,9 meses e índice global de sobrevida, entre três e cinco anos, de 32,7%. Os receptores de estrogênios foram identificados mediante método imuno-histoquímico (ER-ICA) usando anticorpo monoclonal antiestrogênio (RE, 22-SPy, Abbot). Näo houve diferenças de resultados entre as pacientes RE-positivas e RE-negativas, o que explica pelo adiantado estágio evolutivo dos tumores - no que tange aos índices de respostas completas, período livre de doença e sobrevida global. A presença de receptores de estrogênios correlacionou-se, significativamente, com alguns sinais histopatológicos das neoplasias: grau de diferenciaçäo, quantidade de elastose, ausência de infiltraçäo linfocitária e ausência de necrose

[Locally advanced cancer of the breast (LACB) and identification of estrogen receptors with monoclonal antibodies]. / Considerações sobre o câncer localmente avançado de mama (CLAM) acrescidas de identificação dos receptores de estrogênios usando anticorpos monoclonais.

The effects of therapy in locally advanced breast cancer submitted to combined conventional telecobalt therapy plus chemotherapy with cyclophosphamide and 5-fluorouracil were studied in 49 patients. Associated to radical mastectomy in operable cases. Local tumor control was achieved in 86.7%. There were no local recurrences in those submitted to surgery but they reached 21.7% in inoperable patients who received only radiation therapy and chemotherapy. The median follow-up time for dead patients was 29.5 months and for living patients 79.3 months. The index of complete responses was 24.5% and the median disease free interval was 22.9 months. The overall survival rate, between three and five years, was 32.7%. Estrogen receptors were identified by using immunohistochemical assay ER-ICA and monoclonal antibody H222-SP gamma, Abbott. There were no differences in the complete response index, disease free interval and survival rates, among ER-positive and ER-negative patients, explained by the far advanced stage of the disease. ER-positivity was significantly correlated with histological features of the tumors: cell differentiation, presence of elastosis, absence of lymphocytic infiltration and absence of tumor necrosis.

Detection of estrogen receptor in formalin-fixed and paraffin-embedded breast carcinoma: correlation with histological patterns.

The authors studied the expression of estrogen receptor (ER) in tissues of breast carcinomas which were previously fixed in formalin and paraffin-embedded. The ER expression was correlated with several histological findings, namely grade of differentiation, tumor necrosis, desmoplasia, lymphocytic infiltration and elastosis. The ER was detected in tissues using the avidin-biotin immunoperoxidase technique associated with the H222 monoclonal antibody from Abbott. All 39 biopsies were of infiltrating ductal carcinoma of breast and 16 of them expressed ER. The statistical analysis showed that the expression of ER was correlated with histological findings of good prognosis as well differentiated carcinomas, no tumor necrosis, absence or mild lymphocytic infiltration around the tumor cells and severe elastosis.

Decrescimo da populacao bacteriana eliminada por pacientes com tuberculose pulmonar tratados com esquema de curta duracao. / Decrease of bacterial population in patients with pulmonary tuberculosis treated with short-term chemotherapy

Foram estudados 10 pacientes tuberculosos, com baciloscopia e cultura positivas, tratados com esquema de curta duracao constituido de rifampicina, hidrazida e etambutol ou pirazinamida. A avaliacao da populacao bacteriana, antes e depois da quimioterapia foi feita por dois metodos quantitativos: baciloscopia direta do escarro, apos coloracao pelo descontaminacao pelo metodo de Petroff. A populacao bacteriana inicial variou entre 600.000 e 51.200.000 bacilos por ml e 45.450 e 1.511.250 colonias por ml de escarro. O decrescimo desta populacao nos dois subsequentes ao inicio do tratamento nao esta relacionada com a populacao inicial, seja ela alta ou baixa. Entretanto, pela baciloscopia, observa-se que o primeiro exame negativo e o ultimo positivo ocorreram mais precocemente no grupo de populacao baixa do que na alta. Nos primeiros 10 dias de tratamento verificou-se, em media, uma reducao na populacao bacteriana eliminada igual a 33% da inicial, atingindo 2,2% nos primeiros 30 dias a contagem de colonias, nos mesmos periodos, reduziu-se a 31,4% e 1% respectivamente. O percentual de colonicas sobre o numero total de bacilos, expressao da viabilidade bacilar, era de 3,6% antes da medicacao, caindo para 0,3% apos 30 dias de tratamento

Acao da pirazinamida e do etambutol sobre a populacao bacteriana eliminada por pacientes com tuberculose pulmonar tratada com esquema de curta duracao. / Action of the pyrazinamide and ethambutol on the bacterial population from patients with pulmonary tuberculosis treated with short-course chemotherapy

Dez pacientes tuberculosos com baciloscopia e cultura positivas foram divididos em dois grupos quanto ao esquema terapeutico: 1) rifampicina, hidrazida e etambutol; 2) rifampicina, hidrazida e pirazinamida. A avaliacao da populacao bacteriana, antes e depois da quimioterapia, foi feita por dois metodos quantitativos: baciloscopia direta para a determinacao do numero total de bacilos e a cultura para determinacao do numero de unidades viaveis, em dias alternados, ate a negativacao. Confrontando estes dois esquemas verificou-se que eles repercutem de maneira diversa sobre a populacao bacteriana, observada em periodos de dez dias. O esquema com etambutol provoca menor queda no numero total de bacilos nos dez primeiros dias de tratamento do que o da pirazinamida, baixando de 100% para 53,6% e 24,4%, respectivamente. Quanto ao numero de unidades viaveis a situacao e inversa, com 28,3% e 34,6% respectivamente. Nos demais periodos, a pirazinamida provocou menor queda no numero de unidades viaveis do que o etambutol. A negativacao do escarro foi mais precoce com o etambutol do que com a pirazinamida conforme e demonstrado pela analise estatistica. A ultima cultura positiva no grupo do etambutol ocorreu apos 24,8 dias, e com a pirazinamida apos 57,6 dias, em media. O reduzido numero de bacilos viaveis eliminado pelos pacientes submetidos a esses esquemas de tratamento permite inferir que a reintegracao social dos mesmos pode ser precoce, por nao oferecerem risco maior para os comunicantes