[Premature Atherosclerosis in HIV-Infected Pediatric Patients: Literature Review and Clinical Approach]. / Aterosclerose Precoce na População Pediátrica Infetada pelo VIH: Revisão da Literatura e Abordagem Clínica.

Human immunodeficiency virus infected children and adolescents are a pediatric group with increased risk of premature cardiovascular disease. The virus itself, the antiretroviral therapy and the lifestyle establish a complex interplay of factors that promotes an accelerated atherosclerosis. This process is probably mediated by dyslipidaemia, dysregulation of glucose metabolism, lipodystrophy, inflammation, endothelial dysfunction and a prothrombotic state. The clinical approach to this population in terms of cardiovascular prevention is mainly based on efficient treatment of the infection, reduction of the modifiable risk factors and promotion of lifestyle changes.

As crianças e adolescentes infetados pelo vírus da imunodeficiência humana representam um grupo pediátrico com risco acrescido de doença cardiovascular precoce. O próprio vírus, a terapêutica antirretrovírica e os estilos de vida estabelecem um complexo conjunto interatuante de fatores que promove a aterosclerose acelerada. Este processo é provavelmente mediado por dislipidémia, alterações do metabolismo glicídico, inflamação crónica com disfunção endotelial e um estado pro-trombótico. A abordagem clínica desta população para prevenção cardiovascular é baseada sobretudo num tratamento eficaz da infeção, na redução dos fatores de risco modificáveis e na promoção de hábitos saudáveis.

HIV1-viral protein R (Vpr) mutations: associated phenotypes and relevance for clinical pathologies.

Over the last 30 years, research into HIV has advanced the knowledge of virus genetics and the development of efficient therapeutic strategies. HIV-1 viral protein R (Vpr) is a specialized and multifunctional protein that plays important roles at multiple stages of the HIV-1 viral life cycle. This protein interacts with a number of cellular and viral proteins and with multiple activities including nuclear transport of the pre-integration complex (PIC) to the nucleus, transcriptional activation, cell cycle arrest at G2/M transition phase and induction of cell death via apoptosis. Specifically, Vpr has been shown to control many host cell functions through a variety of biological processes and by interaction with several cellular pathways. The different functions of Vpr may enhance viral replication and impair the immune system in HIV-1 infected patients. Importantly, functional defects induced by mutations in the Vpr protein correlate with slow disease progression of HIV-infected patients. Vpr is also associated with other concomitant pathologies developed by these patients, which may lead it to be considered as a potential novel therapeutic target. This review will focus on HIV-1 Vpr, mainly on the importance of its structural mutations on the progression of HIV infection, associated phenotypes and relevance for clinical pathologies. Copyright © 2016 John Wiley & Sons, Ltd.

A high performance cost-effective digital complex correlator for an X-band polarimetry survey.

The detailed knowledge of the Milky Way radio emission is important to characterize galactic foregrounds masking extragalactic and cosmological signals. The update of the global sky models describing radio emissions over a very large spectral band requires high sensitivity experiments capable of observing large sky areas with long integration times. Here, we present the design of a new 10 GHz (X-band) polarimeter digital back-end to map the polarization components of the galactic synchrotron radiation field of the Northern Hemisphere sky. The design follows the digital processing trends in radio astronomy and implements a large bandwidth (1 GHz) digital complex cross-correlator to extract the Stokes parameters of the incoming synchrotron radiation field. The hardware constraints cover the implemented VLSI hardware description language code and the preliminary results. The implementation is based on the simultaneous digitized acquisition of the Cartesian components of the two linear receiver polarization channels. The design strategy involves a double data rate acquisition of the ADC interleaved parallel bus, and field programmable gate array device programming at the register transfer mode. The digital core of the back-end is capable of processing 32 Gbps and is built around an Altera field programmable gate array clocked at 250 MHz, 1 GSps analog to digital converters and a clock generator. The control of the field programmable gate array internal signal delays and a convenient use of its phase locked loops provide the timing requirements to achieve the target bandwidths and sensitivity. This solution is convenient for radio astronomy experiments requiring large bandwidth, high functionality, high volume availability and low cost. Of particular interest, this correlator was developed for the Galactic Emission Mapping project and is suitable for large sky area polarization continuum surveys. The solutions may also be adapted to be used at signal processing subsystem levels for large projects like the square kilometer array testbeds.

R77Q and Q3R HIV1-VPR mutations in an otherwise asymptomatic 5-year-old child with repeated ear infections.

INTRODUCTION: Viral protein R (Vpr) of human immunodeficiency virus type 1 (HIV-1) has been described as being involved in the progression of AIDS, and specific mutations are associated with long-term non-progressor patients. CASE PRESENTATION: We describe the case of a child with repeated ear infections who was otherwise healthy. The patient, a 5-year-old boy, was HIV-1 positive and the viral load at admission was 1 073 899 RNA copies ml-1 and 0 % CD4+ lymphocytes. A detailed study of the vpr gene sequence of the child revealed mutations leading to amino acid substitutions at positions 3 and 77. CONCLUSION: The case reported provides clinical support of previous findings that show that the R77Q and Q3R HIV-1 Vpr variants are associated with patients with delayed disease progression.

As atitudes sexuais, contraceptivas, o lócus de controle da saúde e a autoestima em estudantes do ensino superior / Sexual and contraceptives attitudes, the locus of health control and self-esteem among higher education students / Las actitudes sexuales, contraceptivas, el locus de control de La salud y la autoestima de los estudiantes de enseñanza superior

Analisar as relações entre as atitudes sexuais, contraceptivas, o lócus de controle da saúde e a autoestima nos estudantes de uma instituição de ensino superior privado. Métodos: Estudo descrito e correlacional, de abordagem quantitativa, realizado numa escola de ensino superior da região de Lisboa, com 152 estudantes do 1º e 4º anos dos cursos de licenciatura em Enfermagem, Fisioterapia, Cardiopneumologia e Radiologia. Utilizou-se como instrumento de pesquisa um questionário com as seguintes escalas de avaliação: ?atitudes sexuais?, ?atitudes contraceptivas?, ?lócus de controle da saúde? e ?autoestima?.Os dados obtidos foram submetidos à análise descritiva e inferencial. Resultados: A maioria dos estudantes (90,7%; n=138) já teve relações sexuais. As atitudes sexuais foram influenciadas pelo gênero (p=0,0035), e não pelo início da atividade sexual ou pelo ano de curso (p>0,05). As atitudes contraceptivas estavam relacionadas ao ano que os estudantes frequentavam (p=0,031) e ao gênero (p=0,029). O lócus de controle externo, em média, foi mais elevado nas raparigas (29,2) que nos rapazes (30,1). A autoestima aumentou com a idade dos estudantes (p=0,003). Conclusão: É necessário um investimento em educação sexual no ensino superior, pois os jovens vivem os seus dias inseridos no ambiente escolar, passando pouco tempo junto das famílias. A universidade deve assumir uma posição especial no desenvolvimento do conceito de sexualidade baseado na perspetiva holística do ser humano, promovendo a educação sexual como fundamental na construção da identidade humana e imprescindível na promoção da saúde...

To analyze the relationship between sexual and contraceptive attitudes, the locus of health control and self-esteem among students of a private institution of higher education. Methods: Descriptive and correlational study with a quantitative approach, performed in a higher education school in Lisbon, with 152 students, from the 1st to the4th year of undergraduate courses in Nursing, Physiotherapy, Cardiopneumology and Radiology. As research instrument, it was used a questionnaire with rating scales on ?sexual attitudes?, ?contraception attitudes?, ?locus of health control? and ?self-esteem?. The data obtained was analyzed using descriptive and inferential statistics. Results: The majority of students (90.7%) have already had sexual intercourse. Sexual attitudes were influenced by gender (p=0.0035), but not by the start of sexual activity or by the course?s year (p>0.05). Contraceptive attitudes were related to the year that students attended (p=0.031) and to gender (p=0.029). The external locus of control, on average, was higher among girls (29.2) than boys (30.1). The self-esteem increased with the student?s age (p=0.003). Conclusion: Investment in the area of sexual education is needed in the undergraduate programs, since the young people live their days in the school setting, spending little time with their families. The university should assume a special position in the development of the concept of sexuality based on the holistic perspective of the human being, promoting sexual education as essential in the construction of human identity and fundamental for health promotion...

Analizar las relaciones entre las actitudes sexuales, contraceptivas, el locus de control de la salud y la autoestima de los estudiantes de una institución privada de enseñanza superior. Métodos: Estudio descripto y de correlación, de abordaje cuantitativo realizado en una escuela de enseñanza superior de La región de Lisboa con 152 estudiantes del 1º y 4º años de los cursos de licenciatura en Enfermería, Fisioterapia, Cardioneumología y Radiología. Se utilizó como instrumento de investigación um cuestionario con las siguientes escalas de evaluación: ?actitudes sexuales?, ?actitudes contraceptivas?, ?locus de control de La salud? y ?autoestima?. Los datos obtenidos fueron sometidos al análisis descriptivo y de inferencia. Resultados: La mayoría de los estudiantes (90,7%; n=138) ya tuvieron relaciones sexuales. Las actitudes sexuales fueron influenciadas por el gênero (p=0,0035) y no por el inicio de la actividad sexual o por El año del curso (p>0,05). Las actitudes contraceptivas estuvieron relacionadas al año en el cual los estudiantes se encontraban (p= 0,031) y al género (p=0,029). El locus de control externo, em media, fue más elevado en las mujeres (29,2) que en los hombres (30,1). La autoestima aumentó con la edad de los estudiantes (p=0,003). Conclusión: Es necesario una inversión en educación sexual de la enseñanza superior pues los jóvenes viven sus días em el ambiente escolar quedándose poco tiempo junto a sus familias. La universidad debe asumir una posición especial en el desarrollo del concepto de sexualidad basado en la perspectiva holística del ser humano promoviendo la educación sexual como fundamental para la construcción de la identidad humana e imprescindible para la promoción de la salud...

[Serratia osteomyelitis and chronic granulomatous disease]. / Osteomielite por serratia e doença granulomatosa crónica.

Chronic Granulomatous Disease (CGD) is a primary immunodeficiency disorder characterized by recurrent purulent infections of the skin, lungs, and reticuloendothelial organs, primarily due to staphylococci, enteric bacteria, fungi, and occasionally mycobacteria. More than two thirds of all cases are X-linked and result from defects in the CYBB gene that encodes the gp91-phox subunit of NADPH oxidase. The authors present a case of a three month old child admitted with a metacarpic steomyelitis by Serratia marcescens. Studies confirmed an abnormal respiratory burst in activated neutrophils and absence of gp91-phox expression on patient and a brother (with previous Nocardia infection). Both hemizygous for a pathogenic mutation detected in exon 3 of CYBB gene (c.252 G>A, p.Ala84Ala), a variant that affects the splicing. At two years of age he is still on prophylaxis with cotrimoxazol and itraconazol, without relevant complications. CGD is rare but must be evocated in cases of uncommon or atypical infections.

Severe axillary lymphadenitis after BCG vaccination: alert for primary immunodeficiencies.

The bacilli Calmette-Guérin (BCG) vaccine is administered to all newborns in countries where tuberculosis is endemic. Immunocompromised hosts, namely patients with human immunodeficiency virus infection or primary immunodeficiencies, are especially prone to serious complications from this vaccine. We report three cases of BCG disease in children with primary immunodeficiencies: one with a partial recessive interferon-γ receptor 1 deficiency, who developed BCG dissemination; and two relatives with ZAP70 deficiency, a severe combined immunodeficiency, both of whom presented with regional and distant BCG disease. All had severe axillary lymphadenitis. These clinical cases underline the importance of considering the diagnosis of immunodeficiency in a child with severe axillary lymphadenitis after BCG vaccination and of disseminated BCG disease in an immunodeficient child in the appropriate clinical setting. Moreover, BCG vaccination should be delayed in every newborn with a family history of primary immunodeficiency until the condition has been ruled out.

Retrospective analysis of clinical yeast isolates in a hospital in the centre of Portugal: spectrum and revision of the identification procedures.

Abstract We conducted a four-year (2003-2006) retrospective study of yeasts recovered in a hospital laboratory in the centre of Portugal to evaluate the epidemiology of yeast infections. Clinical isolates and data were gathered from 751 patients corresponding to 906 episodes of yeast infection. The isolates were first identified using classical and commercial methods, routinely employed at the hospital laboratory. We then re-identified the same isolates using RFLP of the ITS 5.8S rRNA gene and sequence of the D1/D2 domain of the 26S rRNA gene. Candida parapsilosis isolates were re-identified using the Ban I digestion of the SADH gene. C. albicans was the most frequently isolated of the yeasts found in the analysed specimens, with an overall incidence of 69.6% and then in decreasing order, C. glabrata, C. tropicalis, C. parapsilosis and C. krusei. C. parapsilosis was most frequently recovered from younger patients, decreasing with age, while C. glabrata occurrence increased with age. We found an increased number of cases of fungemia per 100,000 people per year, reaching a maximum of 4.4 during 2006.

Identification and characterization of homeobox genes in Eucalyptus

Homeobox genes encode transcriptional factors, usually involved in molecular control of plant developmental patterns. They can be divided into several classes according to conserved sequences within the homeobox region and the presence of specific additional sequences. Based on these conserved sequences, we developed a search procedure to identify possible homeobox genes in the Eucalyptus Genome Sequencing Project Consortium (FORESTs) database. We were able to identify 50 Eucalyptus sequences (EST-contigs) containing the homeodomain sequence. Phylogenetic analysis was applied to this ESTs-contigs and 44 of them were found to have similarities with one of three well-known homeobox classes: Bell, Knox and HD-Zip, and their sub-classes. However, no EST-contig grouped with the fourth important homeobox class, the PHD-finger homeobox. On the other hand, two sequences have showed pronounced similarity to the Arabidopsis thaliana Wuschel gene, considered an "atypical" homeobox gene. Hierarchical clustering analysis of the expression pattern of these putative Eucalyptus homeobox genes revealed the presence of ten distinct expression groups. Combining phylogenetic analysis and expression patterns for some of the Eucalyptus genes revealed interesting aspects about some of the potential homeobox genes, which might lead to a better understanding of the Eucalyptus biology and to biotechnological applications

Effect of Urtica dioica agglutinin and Arabidopsis thaliana Chia4 chitinase on the protozoan Phytomonas françai.

The genus Phytomonas is responsible for many diseases in different crop plant species. The finding that chitin is an exposed cell surface polysaccharide in Phytomonas françai and the observation that chitinases can inhibit fungal growth raises expectations about the potential effect of plant chitinases on the P. françai cell membrane surface. The plant chitinases Urtica dioica agglutinin (UDA) and Arabidopsis thaliana Chia4 (ATCHIT4) proteins were over-expressed in bacteria and the interaction between these proteins and P. françai surface was analyzed by immunocytochemistry. We showed that UDA and ATCHIT4 proteins can interact with surface-exposed chitin from P. françai.

[Portugal and Europe are poliomyelitis free]. / Portugal e a Europa livres da poliomielite.

On the 21st of June 2002, in Copenhagen, the Regional Commission for the Certification of Poliomyelitis Eradication, declared the European Region of the World Health Organization (WHO) as polio-free. The last case (not imported) of poliomyelitis in Europe had occurred in November 1998. The health impact is enormous. In Portugal, the last case of poliomyelitis caused by the wild poliovirus, had occurred in December 1986. The path to eradication in Portugal had begun with a vaccination campaign in 1965/1966, with the oral polio vaccine (Sabin). High vaccination coverage has been maintained since then. The Portuguese program to eliminate poliomyelitis follows the strategic recommendations of WHO, with three components: vaccination; surveillance of acute placid paralysis (AFP); laboratory containment of wild polioviruses. Global eradication has not yet been achieved but is likely to happen till 2005. Keeping the high levels of motivation among Portuguese health workers is essential, in order not to loose what has been achieved. High vaccination coverage has to be maintained. Surveillance of AFP has to be improved and the prompt notification of cases by hospital clinicians, sending stool samples to the reference laboratory, is essential for the success of this activity. The laboratory containment programme is important to prevent the accidental reintroduction of poliomyelitis from laboratories.