Altered resting-state functional connectivity in newborns with hypoxic ischemic encephalopathy assessed using high-density functional near-infrared spectroscopy.

Hypoxic-ischemic encephalopathy (HIE) results from a lack of oxygen to the brain during the perinatal period. HIE can lead to mortality and various acute and long-term morbidities. Improved bedside monitoring methods are needed to identify biomarkers of brain health. Functional near-infrared spectroscopy (fNIRS) can assess resting-state functional connectivity (RSFC) at the bedside. We acquired resting-state fNIRS data from 21 neonates with HIE (postmenstrual age [PMA] = 39.96), in 19 neonates the scans were acquired post-therapeutic hypothermia (TH), and from 20 term-born healthy newborns (PMA = 39.93). Twelve HIE neonates also underwent resting-state functional magnetic resonance imaging (fMRI) post-TH. RSFC was calculated as correlation coefficients amongst the time courses for fNIRS and fMRI data, respectively. The fNIRS and fMRI RSFC maps were comparable. RSFC patterns were then measured with graph theory metrics and compared between HIE infants and healthy controls. HIE newborns showed significantly increased clustering coefficients, network efficiency and modularity compared to controls. Using a support vector machine algorithm, RSFC features demonstrated good performance in classifying the HIE and healthy newborns in separate groups. Our results indicate the utility of fNIRS-connectivity patterns as potential biomarkers for HIE and fNIRS as a new bedside tool for newborns with HIE.

Intervenciones educativas para la prevención del VIH/sida en mujeres encarceladas / Educational Interventions for HIV/AIDS Prevention in Incarcerated Women

Introducción: La infección por el VIH es un grave problema de salud pública, en especial cuando se trata de mujeres encarceladas. En este escenario, las intervenciones educativas sobre el VIH son una estrategia importante para incentivar la prevención de esta infección. Objetivo: Analizar la evidencia científica sobre el uso de intervenciones educativas dirigidas a la prevención del VIH/sida en mujeres encarceladas. Métodos: Se realizó una revisión integradora de la literatura realizada mediante la búsqueda de artículos en las bases de datos Scopus, Cumulative Index to Nursing and Allied Health Literature, MEDical Literature Analysis and Retrieval System, Literatura Latinoamericana en Ciencias de la Salud y Web, sin restricción de idioma ni de tiempo. La pregunta de investigación se elaboró ​​a partir de la estrategia PICo Población (mujeres encarceladas); Interés (intervenciones educativas sobre el VIH/sida); Contexto (prevención). Conclusiones: En los 8 artículos analizados, se encontraron intervenciones educativas con enfoques en temas relacionados con la prevención del VIH, por medio de sesiones grupales, capacitación de habilidades, dramatizaciones, videos educativos y materiales impresos(AU)

Introduction: HIV infection is a serious public health concern, especially when it involves incarcerated women. In this scenario, HIV educational interventions are an important strategy to encourage the prevention of this infection. Objective: To analyze the scientific evidence on the use of educational interventions aimed at HIV/AIDS prevention in incarcerated women. Methods: An integrative literature review was carried out by searching articles in the databases of Scopus, Cumulative Index to Nursing and Allied Health Literature, MEDical Literature Analysis and Retrieval System, Latin American Literature in Health Sciences and Web, without language or period restrictions. The research question was elaborated from the PICo strategy: population (incarcerated women), interest (HIV/AIDS educational interventions), and context (prevention). Conclusions: In the 8 articles analyzed, educational interventions were found to have approaches on topics related to HIV prevention through group sessions, skills training, dramatizations, educational videos, and printed materials(AU)

Encuesta nacional de atención del paciente neurocrítico / National survey of neurocritical care patients / Pesquisa nacional de cuidados a pacientes neurocriticos

Antecedentes: los pacientes neurocríticos constituyen un subgrupo especial en la medicina intensiva. Estudios internacionales recientes han mostrado variabilidad en su monitorización y manejo terapéutico. Objetivo: conocer las características de la atención y manejo de los pacientes neurocríticos en Uruguay. Métodos: estudio prospectivo y descriptivo. Se realizó una encuesta telefónica basada en un cuestionario de estructuras y procesos en la asistencia del paciente neurocrítico. Fue diseñado por la comisión de neurocríticos de la SUMI. Se entrevistó a jefes o coordinadores de cada unidad de cuidado intensivo (UCI), de forma voluntaria y anónima. Resultados: se encuestaron 52 UCI (98% del país), 67% correspondieron al Interior y 65% al sector privado del país. 96% de las UCI reciben pacientes neurocríticos. Se cuenta con neurocirugía presencial en 46%. El estudio de neuroimagen más disponible es la tomografía computada (81%). Se realiza: monitorización de presión intracraneana en 65%, oximetría yugular en 27% y neuromonitorización no invasiva en 58%, siendo la ultrasonografía la más frecuente. Las estrategias más utilizadas para el tratamiento de la hipertensión intracraneana son: osmoterapia (salino hipertónico en 100%), propofol (85%), bloqueo muscular (78%) y descompresiva (75%). Reperfusión en ataque cerebrovascular: trombolisis (88%) y trombectomía mecánica (44%). Los fármacos antiepilépticos más utilizados son: midazolam (100%), levetiracetam y fenitoína (96%). Tratamiento del aneurisma cerebral: clipado quirúrgico (98%) y endovascular (66%). Protocolización en 96% y realización de ateneos clínicos en 61%. Conclusiones: se presenta el primer trabajo realizado en nuestro país sobre el tema. Se encontró variabilidad en la monitorización así como en la disponibilidad de neuroimagenología y especialidades neurointervencionistas. Este estudio proporciona una oportunidad para la investigación comparativa de efectividad.

Background: neurocritical care patients constitute a special subgroup in intensive care medicine. Recent international studies have shown variability in their monitoring and therapeutic handling. Objective. to learn about the handling and care characteristics of neurocritical patients in Uruguay. Method: prospective, descriptive study. A telephone survey was conducted based on a structure and processes questionnaire on neurocritical patients' care. It was designed by the Neurocritical Patients Comittee of the Uruguayan Society of Intensive Medicine (SUMI). Chiefs or coordinators of each intensive care units were interviewed, their participation being voluntary an anonymous. Results: 52 ICU in the country were interviewed, 67% were located in the provinces and 65% belonged to the private sector. 96% of intensive care units received neurocritical care patients. Routine neurosurgery was available in 46% of cases. Computerized technology was the most widely available imaging study (81%). The following procedures were conducted: intracranial pressure monitoring in 65% of patients, jugular venous oximetry in 27%, non-invasive neuromonitoring in 58%, ultrasound being the most frequently used. The most commonly used strategies to treat intracranial hypertension are: osmotherapy (hypertonic saline in 100%), propofol (85%), muscular blockade (78%) and decompressive craniectomy (75%). Reperfusion in cerebrovascular attack, thrombolisis (88%) and mechanical thrombectomy (44%). The most widely used antiepileptic drugs are: midazolam (100%), levetiracetam y phenytoin (96%). Cerebral aneurysm was treated with surgical clipping (98%) and endovascular treatment (66%). Protocols were followed in 96% and case conferences were organized in 61%. Conclusions: the study presents the first research conducted on this topic in our country and it found variability in terms of monitorization and availability of neuro-imagining and neurointerventionist special strategies. The study represents an opportunity for effectiveness comparative research.

Introdução: os pacientes neurocríticos constituem um subgrupo especial na medicina intensiva. Estudos internacionais recentes têm mostrado variabilidade em seu monitoramento e manejo terapêutico. Objetivo: conhecer as características de atendimento e manejo de pacientes neurocríticos no Uruguai. Métodos: estudo prospectivo e descritivo. Fez-se uma pesquisa telefônica utilizando um questionário sobre estruturas e processos do cuidado de pacientes neurocríticos. Foi projetado pela comissão de neurocríticos de la Sociedad Uruguaya de Medicina Intensiva. Os chefes ou coordenadores de cada unidade de terapia intensiva (UTI) foram entrevistados de forma voluntária e anônima. Resultados: pesquisaram-se 52 UTIs (98% do país), 67% do Interior e 65% do setor privado do país. 96% das UTIs recebem pacientes neurocríticos. A neurocirurgia no local está disponível em 46%. O estudo de neuroimagem mais disponível é a tomografia computadorizada (81%). Realiza-se monitorização da pressão intracraniana em 65%, oximetria jugular em 27% e neuromonitorização não invasiva em 58%, sendo a ultrassonografia a mais frequente. As estratégias mais utilizadas para o tratamento da hipertensão intracraniana são: osmoterapia (soro fisiológico 100% hipertônico), propofol (85%), bloqueio muscular (78%) e descompressão (75%). Faz-se reperfusão no ataque cerebrovascular por trombólise (88%) e trombectomia mecânica (44%). As drogas antiepilépticas mais utilizadas são: midazolam (100%), levetiracetam e fenitoína (96%). Tratamento do aneurisma cerebral: clipagem cirúrgica (98%) e endovascular (66%). Protocolização em 96% e reuniões clínicas em 61%. Conclusões: este é o primeiro trabalho realizado em nosso país sobre o tema. Foi encontrada variabilidade no monitoramento, bem como na disponibilidade de especialidades de neuroimagem e neurointervenção. Este estudo oferece uma oportunidade para a pesquisa comparativa de eficácia.

Rediscovery of the rare Phrynomedusa appendiculata (Lutz, 1925) (Anura: Phyllomedusidae) from the Atlantic Forest of southeastern Brazil.

The genus Phrynomedusa Miranda-Ribeiro, 1923 comprises rare and little known phyllomedusid species from southern Atlantic Forest, Brazil. Phrynomedusa appendiculata (Lutz, 1925) is known from three localities since its description and considered a lost species because it was last sighted 51 years ago. This pervasive lack of knowledge raised a significant concern about its threat status. Here, we present the rediscovery of P. appendiculata from a breeding population in the Atlantic Plateau forests of the state of So Paulo. This new record allowed the gathering of novel ecological, acoustic and morphological data for this species. Most of the novel data agreed with the variation historically reported for the species, but we found subtle divergences that we interpret as intraspecific variation. Moreover, this record also allowed a reassessment of geographic distribution of the species, and the first inference of its phylogenetic relationships based on molecular data (mitochondrial and nuclear DNA). The resulting phylogeny corroborated the generic placement and evolutionary distinctiveness of P. appendiculata, evidencing the species as sister to the clade P. marginata + P. dryade. Based on novel and historical data, we discuss some putative factors influencing the rarity of P. appendiculata and its congeners, and provide conservation perspectives. We expect that the novel data can support further assessments of threat status for this rare species, as well as initiatives aiming its conservation.

Impacts of a Pressure Challenge on Cerebral Critical Closing Pressure and Effective Cerebral Perfusion Pressure in Patients with Traumatic Brain Injury.

INTRODUCTION: Cerebral critical closing pressure (CrCP) comprises intracranial pressure (ICP) and arteriolar wall tension (WT). It is the arterial blood pressure (ABP) at which small vessels close and circulation stops. We hypothesized that the increase in WT secondary to a systemic hypertensive challenge would lead to an increase in CrCP and that the "effective" cerebral perfusion pressure (CPPeff; calculated as ABP - CrCP) would give more complete information than the "conventional" cerebral perfusion pressure (CPP; calculated as ABP - ICP). OBJECTIVE: This study aimed to compare CrCP, CPP, and CPPeff changes during a hypertensive challenge in patients with a severe traumatic brain injury. PATIENTS AND METHODS: Data on ABP, ICP, and cerebral blood flow velocity, measured by transcranial Doppler ultrasound, were acquired simultaneously for 30 min both basally and during a hypertensive challenge. An impedance-based CrCP model was used. RESULTS: The following values are expressed as median (interquartile range). There were 11 patients, aged 29 (14) years. CPP increased from 73 (17) to 102 (26) mmHg (P ≤ 0.001). ICP did not change. CrCP changed from 23 (11) to 27 (10) mmHg (P ≤ 0.001). WT increased from 7 (5) to 11 (7) mmHg (P ˂ 0.005). CPPeff changed less than CPP. CONCLUSION: The CPP change was greater than the CPPeff change, mainly because CrCP increased simultaneously with the WT increase as a result of the autoregulatory response. CPPeff provides information about the real driving force generating blood movement.

Transcranial Doppler Plateau Wave in a Patient with Pseudo-Chiari Malformation.

CASE REPORT: A 26-year-old woman presented a superior sagittal and transverse sinus thrombosis with venous infarction. Anticoagulation was started. Six months later headache and visual impairment developed, and intracranial hypertension was diagnosed-secondary pseudotumor cerebri. It was managed with a lumbo-peritoneal shunt (LPS) resulting in a positive initial evolution with initial symptoms resolution, but headache and visual impairment eventually reappeared. Magnetic Resonance Imaging revealed a Pseudo-Chiari malformation, leading to lumbo-peritoneal shunt removal (Friedman et al. Neurology 81:1159-1165, 2013; Moncho et al. Rev Neurol 56(12):623-634, 2013). As symptoms reappeared, a short period of continuous transcranial Doppler neuromonitoring, including a change of head of bed elevation, was performed. A sudden decrease in cerebral blood flow velocity with a dramatic increase in pulsatility index developed when head of bed was moved from 45° to horizontal position. Transcranial Doppler changes were compatible with a plateau wave of intracranial hypertension. A ventricle-peritoneal shunt was inserted, which resulted in symptomatology, imaging, and digital campimetry improvement.

Phylogenetic relationships of the poorly known treefrog Boana hobbsi (Cochran amp; Goin, 1970) (Anura: Hylidae), systematic implications and remarks on morphological variations and geographic distribution.

Boana hobbsi is a poorly known hylid frog currently placed within the Boana punctata group. Yet, morphological, ecological and bioacoustic traits do not support this placement, with no molecular data being available to date to test this hypothesis. Based on newly collected mitochondrial DNA sequences, morphological data review and field observations, we provide new insight into the phylogenetic relationships, morphological variations and geographic distribution of B. hobbsi. Our findings reveal that B. hobbsi is nested (with strong support) within the Boana benitezi group, recovering once more a polyphyletic Boana punctata group. Supported by this new genetic, morphological and ecological evidence, we propose a new taxonomic arrangement which includes B. hobbsi as a member of the Boana benitezi group. Furthermore, we emphasize the importance of conducting biological inventories in remote Amazonian areas, where many taxonomic and geographic knowledge gaps persist with regards to Amphibian diversity.

Comparison of ultrasonographic versus infrared pupillary assessment.

OBJECTIVES: To evaluate the correlation between ultrasonographic and infrared pupillary assessments in critically ill patients, including neurocritically ill patients. DESIGN: Prospective, observational study. SETTING: Tertiary teaching hospital intensive care unit (ICU) in Montevideo, Uruguay. PATIENTS: Twenty-six adults patients with age 18 or older admitted to the intensive care unit with and without neurologic pathology. A total of 212 pupillary measures were made between ultrasonographic pupillary assessment (UPA) and infrared pupillary assessment (IPA). INTERVENTIONS: This was a study that utilized non-invasive (minimal risk) ultrasonographic and infrared pupillary assessment in patients admitted to the ICU. Time between UPA and IPA in a single patient was consistently less than 3 min. MEASUREMENTS AND MAIN RESULTS: There was a strong positive association between UPA and IPA (right eye [OD]: r = de 0.926, p-value < 0.001; left eye [OS], r = 0.965, p-value < 0.001), also observed in the group of neurocritically ill patients (OD: r = 0.935, p-value < 0.001; OS: r = de 0.965, p-value < 0.001). Taking IPA as reference measure, the percent error for all subjects was 2.77% and 2.15% for OD and OS, respectively, and for neurocritically ill patients it was 3.21% and 2.44% for OD and OS, respectively. CONCLUSIONS: Ultrasonographic pupillary assessment is strongly correlated with infrared pupillary assessment in critically ill patients, including neurocritically ill patients. Ultrasonographic pupillary assessment is a quick, feasible, non-invasive method that allows accurate pupillary assessment, particularly neurologic function, in patients in whom a more precise measurement of the pupil is required or eye opening is not possible (e.g., periorbital edema due to traumatic brain injury).

TH17/Treg imbalance and IL-17A increase after severe aneurysmal subarachnoid hemorrhage.

To evaluate cerebrospinal fluid (CSF) and peripheral blood (PB) Treg, TH17 cells, TH1, TH2 and related cytokines in the acute phase of aSAH we assessed TH17, TH1, TH2, T regulatory cells and neutrophils in 39 aneurysmal subarachnoid hemorrhage (aSAH) patients and 56 controls. PB TH17 cells and TH17/Treg ratio were higher in CSF and PB of aSAH patients. Serum and CSF IL-17A levels were increased in aSAH. Serum IL-17A levels were associated with vasospasm and ICU mortality. Study results support the role of TH17/IL17 axis in aSAH pathogenesis, turning it into a potential clinical biomarker and a novel target for research.

Rediscovery of Osteocephalus vilarsi (Anura: Hylidae): an overlooked but widespread Amazonian spiny-backed treefrog.

Osteocephalus vilarsi (Melin, 1941) is an Amazonian treefrog species known for over 75 years from its holotype only. Due to a lack of published data on its morphological diagnostic characters and their variations, as well as the absence of molecular, acoustic and ecological data supporting its identity, a highly dynamic taxonomic history has led this species to be confused and even synonymised with other Osteocephalus species from distinct species groups. The molecular phylogenetic relationships of O. vilarsi were investigated based on recently collected specimens from eight Northwestern Brazilian localities in the state of Amazonas, leading to its removal from the Osteocephalus taurinus species group and placement in the Osteocephalus planiceps species group. Furthermore, detailed data on morphology and colour variation are provided, as well as advertisement call and tadpole descriptions. Finally, the currently known geographic range of O. vilarsi is considerably extended, first data on the natural history of the species are provided, and the possible ecological preference of O. vilarsi for Amazonian white-sand forests is discussed.

A new nurse frog of Allobates masniger-nidicola complex (Anura, Aromobatidae) from the east bank of Tapajós River, eastern Amazonia.

The small nurse frogs of the genus Allobates (Anura, Aromobatidae) represent one of the most challenging taxonomic issues of the Neotropics. During several amphibian surveys in the Middle Tapajós River region, state of Pará, Brazil, we collected phenotypic, ecological, and molecular data on species of this genus, leading to the identification of a new species included in the Allobates masniger-nidicola complex. The new species is characterized by a large body size (snout-vent length 19.2-21.7 mm in males and 19.3-22.0 mm in females), finger III not swollen in adult males; cryptic external coloration, with dorsum uniformly ochre; a dark brown lateral stripe and a pale cream ventrolateral stripe; limbs ranging from ochre to orange; throat and chest violaceous in males and yellowish in females. The advertisement call is usually arranged in bouts of four closely spaced notes, which we term 4-pulsed units of repetition (UR), 0.317 s long on average, followed by silent intervals, and an average dominant frequency of 4.163 kHz. The new species also has exotrophic tadpoles with a unique fin morphology, which begins after the body-tail insertion and is deeper posteriorly to half of the caudal length. Sequencing of the 16S and COI regions of the mitochondrial DNA show a genetic p-distance of approximately 6-10% compared to closely related congeners. We discuss the biogeography of the new species based on phylogenetic relationships of the species within the Allobates masniger-nidicola complex and the allopatric geographic distribution in relation to sister taxa. Functional characteristics and geographic restrictions make this species particularly sensitive to the increasing human impact in eastern Amazonia.

Temporal Variation in Species Abundance and Richness of Culicoides (Diptera: Ceratopogonidae) in a Tropical Equatorial Area.

The aim of this study was to investigate whether temperature, rainfall, and humidity influence the annual distribution of Culicoides Latreille 1809, species abundance and richness in rural areas on São Luís Island in the state of Maranhão, Brazil. Biting midges were collected in housing for domestic animals in the peridomestic areas of 10 homes. A CDC light trap was installed in each peridomestic area from 6:00 p.m. to 6:00 a.m. once a month for 12 mo. In total, 23,633 individuals belonging to 26 Culicoides species were captured. The most abundant species were Culicoides diabolicus Hoffman, 1925 (27.43%), C. ignacioi Forattini, 1957 (25.9%), C. flavivenulus Costa Lima, 1937 (15.53%), C. insignis Lutz, 1913 (10.66%), C. filariferus Hoffman, 1939 (6.21%), C. boliviensis Spinelli & Wirth, 1984 (6.07%), C. foxi Ortíz, 1950 (2.83%), and C. leopoldoi Ortíz, 1951 (2.54%). Species richness and abundance were greater during the rainy season (24 species; 88% of the individuals) than during the dry season (18 species; 12% of individuals). However, persistent rain on the days the midges were collected or in the preceding 24 h adversely affected abundance. Mean monthly maximum temperature and rainfall on the day of the collection adversely affected Culicoides abundance and richness.

Atividade sexual em pacientes pós-infarto agudo do miocárdio / Sexual activity in post-infarction patients acute myocardial

Objetivo: identificar as alterações de comportamento na atividade sexual de pacientes que tiveram infarto agudo do miocárdio. Método: estudo descritivo, de caráter transversal e abordagem quantitativa, realizado em um hospital público de grande porte e referência em cardiologia. A coleta de dados foi realizada por meio de entrevista direta, em local reservado, com aplicação de questionário estruturado pelos pesquisadores, tendo sido previamente executado um pré-teste para verificar sua adequabilidade. A análise estatística ocorreu através do software Assistat versão 7.7, sendo aprovado pelo CEP do HAM sob o n.º do CAAE: 65400117.3.0000.5197. Resultados: 50% dos pacientes referiram diminuição no interesse sexual e 60% presença de disfunção. Todos os pacientes apresentaram dúvidas sobre como retornar o desempenho de suas atividades sexuais, e contatou-se a completa ausência de orientações por parte dos profissionais de saúde. Conclusões: constata-se a necessidade de implementação de ações educativas pelos profissionais de saúde, principalmente pelo enfermeiro que reconhece seu papel nas ações educativas com os pacientes. Com isso, se faz necessário a abertura de espaços onde as necessidades de informação e o esclarecimento de dúvidas desses pacientes sejam sanados.(AU)

ABstRACt |Objective: to identify behavioral changes in the sexual activity of patients who had acute myocardial infarction. Method: descriptive, transversal study and quantitative approach, performed in a large public hospital and reference in cardiology. The data collection was done through a direct interview, in a reserved place, with application of a questionnaire structured by the researchers, having previously been performed a pre-test to verify its suitability. Statistical analysis was performed using the Assistat software version 7.7, and was approved by the CEP in HAM under the CAAE no.: 65400117.3.0000.5197. Results: 50% of patients reported decreased sexual interest and 60% had dysfunction. All patients had doubts about how to return the performance of their sexual activities, and contacted the complete absence of guidelines from health professionals. Conclusions: it is necessary to implement educational actions by health professionals, especially by nurses who recognize their role in educational actions with patients. With this, it is necessary to open spaces where the information needs and the clarification of doubts of these patients are remedied.

REsuMEN |Objetivo: identificar los cambios de comportamiento en la actividad sexual de pacientes que tuvieron infarto agudo de miocardio. Método: estudio descriptivo, de carácter transversal y abordaje cuantitativo, realizado en un hospital público de gran porte y referencia en cardiología. La recolección de datos fue realizada por medio de entrevista directa, en local reservado, con aplicación de cuestionario estructurado por los investigadores, habiendo sido previamente ejecutado un pre-test para verificar su adecuación. El análisis estadístico ocurrió a través del software Assistat versión 7.7, siendo aprobado por el CEP del HAM bajo el nº del CAAE: 65400117.3.0000.5197. Resultados: 50% de los pacientes refirieron disminución en el interés sexual y 60% presencia de disfunción. Todos los pacientes presentaron dudas sobre cómo retornar el desempeño de sus actividades sexuales, y se contactó con la completa ausencia de orientaciones por parte de los profesionales de salud. Conclusiones: se constata la necesidad de implementación de acciones educativas por los profesionales de salud, principalmente por el enfermero que reconoce su papel en las acciones educativas con los pacientes. Con ello, se hace necesario la apertura de espacios donde las necesidades de información y el aclaramiento de dudas de esos pacientes sean sanados.

Integrative overview of the herpetofauna from Serra da Mocidade, a granitic mountain range in northern Brazil.

The Brazilian mountain ranges from the Guiana Shield highlands are largely unexplored, with an understudied herpetofauna. Here the amphibian and reptile species diversity of the remote Serra da Mocidade mountain range, located in extreme northern Brazil, is reported upon, and biogeographical affinities and taxonomic highlights are discussed. A 22-days expedition to this mountain range was undertaken during which specimens were sampled at four distinct altitudinal levels (600, 960, 1,060 and 1,365 m above sea level) using six complementary methods. Specimens were identified through an integrated approach that considered morphological, bioacoustical, and molecular analyses. Fifty-one species (23 amphibians and 28 reptiles) were found, a comparable richness to other mountain ranges in the region. The recorded assemblage showed a mixed compositional influence from assemblages typical of other mountain ranges and lowland forest habitats in the region. Most of the taxa occupying the Serra da Mocidade mountain range are typical of the Guiana Shield or widely distributed in the Amazon. Extensions of known distribution ranges and candidate undescribed taxa are also recorded. This is the first herpetofaunal expedition that accessed the higher altitudinal levels of this mountain range, contributing to the basic knowledge of these groups in remote areas.

Immune cells subpopulations in cerebrospinal fluid and peripheral blood of patients with Aneurysmal Subarachnoid Hemorrhage.

BACKGROUND: There is growing evidence supporting the role of inflammation in aneurysmal subarachnoid hemorrhage (aSAH) pathophysiology and it is of great interest to elucidate which immune mechanisms are involved. METHODS: 12 aSAH patients and 28 healthy controls were enrolled prospectively. We assessed leukocytes subpopulations and their activation status by flow cytometry in cerebrospinal fluid (CSF) and peripheral blood (PB) of SAH patients at the same time and in PB of controls. RESULTS: Monocytes and neutrophils were activated in CSF of aSAH patients. The percentage of CD14(++)CD16(+) monocytes were higher in CSF than in PB of aSAH patients, and were also increased in PB of aSAH patients compared with controls. An enhanced expression of CD69 was shown in CSF neutrophils compared with PB in aSAH patients. PB of aSAH patients showed lower percentage of total lymphocytes compared with controls PB. Additionally, lymphocytes were activated in CSF and PB of aSAH patients. CD4(+) and CD8(+) T cells had a decreased expression on CD3 and higher levels of CD69 in CSF compared with PB in aSAH patients. Moreover, PB CD4(+) and CD8(+) T cells of aSAH patients were activated compared with controls. Additionally, CD28 expression was decreased on CSF T lymphocytes. CONCLUSIONS: Our data suggest an important recruitment of leukocytes to the site of injury in aSAH as well as an increased activation at this level. Overall, these results indicate that aSAH probably stimulates both the innate and adaptive immune responses.

Ecology of phlebotomines (Diptera, Psychodidae) in rural foci of leishmaniasis in tropical Brazil / Ecologia de flebotomíneos (Diptera, Psychodidae) em foco rural de leishmaniose no Brasil tropical

INTRODUCTION: This work aimed to study the community structure of sandflies, with regard to the richness, constancy, abundance, and monthly frequency of the species with a focus on the transmission of leishmaniasis. METHODS: The study was conducted in the rural villages of Bom Jardim and Santa Maria, situated on the edge of a tropical rain forest in the municipality of São Jose de Ribamar, Maranhão, Brazil. The phlebotomines were captured in the intradomiciles and peridomiciles of each village, with Centers for Disease Control (CDC) light traps set in 10 homes in each village, for 1 year, once a month, from 18h to 6h. RESULTS: We collected 1,378 individuals of 16 sandfly species. The capture success rate was higher in Bom Jardim (0.61 specimens/hour/trap) than that of Santa Maria (0.35/specimens/hour/trap). The sandflies were more abundant in the peridomiciles (86.1%) and in the rainy season (77%). Five species were considered constants (occurring in more than 50% of samples), 5 accessory (25%-50%), and 6 accidental (<25%). The most abundant species were Lutzomyia longipalpis (59.7%) and L whitmani (28%). The permutation analysis showed differences between the species composition of the villages and no separation between the intradomicile and peridomicile of each village. The species that most contributed to the dissimilarity between the light traps of the 2 villages were L. longipalpis, L. whitmani, and L. evandroi, contributing to 80.8% of the variation among groups. CONCLUSIONS: The high level of richness and abundance of species and the presence of competent vectors throughout the year and around houses justify the occurrence of leishmaniasis cases reported in the area.

INTRODUÇÃO: Este trabalho teve como objetivo estudar a estrutura da comunidade de flebotomíneos, dando a conhecer a riqueza, constância, abundância e a frequência mensal das espécies em foco de transmissão de leishmaniose. MÉTODOS: O estudo foi realizado nas localidades rurais de Bom Jardim e Santa Maria, situadas às margens de uma mata ombrófila infestada por esses insetos, no município de São José de Ribamar, Maranhão, Brasil. Os flebotomíneos foram capturados no intra e peridomicílio de cada vila, com 10 armadilhas luminosas tipo CDC em cada vila, durante um ano, uma vez por mês, das 18h às 6h. RESULTADOS: Foram capturados 1.378 indivíduos de dezesseis espécies e o esforço de captura foi maior em Bom Jardim (0,61 indivíduos/hora/armadilha) que em Santa Maria (0,35). Os flebotomíneos prevaleceram no peridomicílio (86,1%) e na estação chuvosa (77%). Cinco espécies foram consideradas constantes (ocorreram em mais de 50% das coletas), cinco acessórias (25% e 50%) e seis acidentais (< 25%). As espécies mais abundantes foram Lutzomyia longipalpis (59,7%) e Lutzomyia whitmani (28%). Estatisticamente, detectou-se uma diferença na composição das espécies entre os povoados. As espécies que mais contribuíram para a dissimilaridade entre as armadilhas das duas vilas foram Lutzomyia longipalpis, Lutzomyia whitmani e Lutzomyia evandroi, com 80,8% de variação entre os grupos. CONCLUSÕES: A elevada riqueza e abundância de flebotomíneos e a presença de vetores competentes ao longo do ano, justificam a ocorrência de casos de leishmanioses relatados na área.

Formigas (Hymenoptera: Formicidae) como vetores de bactérias em ambiente hospitalar na cidade de São Luis - Maranhão / Ants (Hymenoptera: Formicidae) as vectors of bacteria in a hospital environment in São Luís-MA City

Dentro do ambiente hospitalar, as formigas têm exercido um importante papel no carreamento de microrganismos patogênicos. Os objetivos deste estudo foram detectar as bactérias carreadas por formigas coletadas em uma Unidade Mista da cidade de São Luís-MA, traçar o perfil desusceptibilidade aos antibióticos e identificar o gênero dos insetos. As coletas foram realizadas de agosto a outubro de 2010 em seis setores do local estudado por meio de busca ativa com auxílio de swabs. A identificação das Enterobactérias foi realizada com o uso de kit. O antibiograma seguiu o método de difusão em disco e a identificação das formigas ocorreu através do uso de chave. Foram calculados o coeficiente de similaridade e o índice de intensidade média. O teste de Kruskal-Wallis foi utilizado para avaliar os perfis de susceptibilidade das cepas aos antimicrobianos. Foram coletadas 36 formigas e isoladas 21 bactérias. Os coeficientes e índices mais expressivos corresponderam aos dos gêneros Camponotus spp. e Solenopsis spp. A sensibilidade aos antibióticosmostrou-se estatisticamente significante em relação aos demais perfis. O presente estudo contribuiupara melhor elucidar a situação do estado do Maranhão no painel da veiculação de microrganismospatogênicos por formigas em ambiente hospitalar.