Socioeconomic status and risk of HIV-1, syphilis and hepatitis B infection among sex workers in São Paulo State, Brazil. Instituto Adolfo Lutz Study Group.

OBJECTIVES: To determine how HIV risk behavior and the prevalences of sexually transmitted diseases vary according to socioeconomic status and city among sex workers in São Paulo State, Brazil. SUBJECTS AND METHODS: A cross-sectional study of 600 female sex workers (100 of a higher socioeconomic status and 100 of a lower socioeconomic status in each city) was conducted in the cities of São Paulo, Campinas and Santos. HIV risk behavior was assessed by questionnaire; serological tests were administered to assess prior exposure to HIV-1, syphilis and hepatitis B. RESULTS: Only statistically significant (P < 0.05) findings are reported here. Compared to those with a higher socioeconomic status, sex workers with a lower socioeconomic status worked longer hours each day (9.6 versus 7.9), had more clients per day (5.4 versus 2.6) and had fewer episodes of intercourse per client per encounter (1.1 versus 1.4). Levels of condom use for vaginal, anal and oral sex were significantly higher in Santos than in São Paulo or Campinas. Twenty-three per cent of the women said they feared violence if they insisted that their clients wear condoms; 74% voiced similar fears regarding their non-client sexual partners. Overall, 11% of sex workers were positive for exposure to HIV-1, 45% for syphilis and 39% for hepatitis B. Those with a lower socioeconomic status were more likely than those with a higher socioeconomic status to be infected with HIV-1 (17 versus 4%), syphilis (66 versus 24%) and hepatitis B (52 versus 26%), but there were no differences in prevalence rates by city. CONCLUSIONS: These data demonstrate substantial heterogeneity in HIV risk behavior and the prevalence of HIV-1 and other sexually transmitted diseases among sex workers in São Paulo State, many of which were related to differences in socioeconomic status. Interventions to prevent HIV transmission among sex workers must be tailored to the local environment and, in particular, to the socioeconomic status of these workers.

Esterase D assay in Brazilian retinoblastoma families.

The gene related to retinoblastoma (Rb gene) can be considered a model human tumor suppressor gene and was assigned to band 13q14, together with the esterase D (ESD) gene. We studied the ESD activity and phenotype in 40 retinoblastoma patients, 50 unaffected relatives, and 85 nonrelated healthy control individuals. ESD activity from patients is significantly different from that of relatives and control individuals, but there was no significant difference between ESD activity from unaffected relatives and control individuals. Twelve and one-half percent of patients and 4.2% of unaffected relatives with ESD1 phenotype showed a low ESD level. The results showed the importance of ESD studies in all retinoblastoma patients and their relatives.

Lack of sex and estrous cycle effects on the activity of three antioxidant enzymes in rats.

The activity of antioxidant enzymes was investigated in red blood cells of male and female Wistar rats 3-4 months of age. Superoxide dismutase (EC 1.15.1.1), catalase (EC 1.11.1.6), and glutathione peroxidase (EC 1.11.1.9) did not show any significant variation in the different phases of the estrous cycle. No differences were observed for the three enzymes related to the sex of young rats. The present data enable us to consider that sexual differences as well as the changes in estrous cycle do not interfere in erythrocyte antioxidant enzymatic defense of rats.

[Key aspects of sexual behavior and safer sex practice among men in the city of São Paulo]. / Alguns aspectos do comportamento sexual e prática de sexo seguro em homens do Município de São Paulo.

Heterosexual relations currently constitute the predominant route of HIV transmission to women in Brazil. Few studies have approached male sexual behavior taking women into account. This study included 597 men ages 21 to 50 in São Paulo city and explored several aspects pertaining to safer sex, such as sexual partners, knowledge of sexually transmitted diseases (STDs)/AIDS, risk perception, and protective practices aimed at AIDS prevention. The results showed that, similar to other countries, the proportion of men who have sex with men is low (5%), that younger men adopt more protective behavior than older men regarding multiple partners and condom use, that knowledge of AIDS is widespread (but that there is still a lack of knowledge concerning STDs in general), and that although risk perception increases protective behavior, presumption of the partner's behavior influences this perception, placing men and women in a vulnerable situation.

Nutritional evaluation of children with phenylketonuria.

CONTEXT: Dietary phenylalanine (PA) restriction is the most effective form for reducing its excess in the blood and is the only efficient method for treating phenylketonuria. The diet is complex and should be adapted to combine the patients' eating habits, growth and development. It depends basically on the use of industrialized products as substitutes free of PA for proteins that are not fully supplied. OBJECTIVE: To evaluate the nutritional status of children with phenylketonuria (PKU) by anthropometric measurements and food intake. DESIGN: Cross-sectional study. SETTING: Children with PKU attending the Association of Parents and Friends of Handicapped Children (Associação de Pais e Amigos dos Excepcionais - APAE) and normal children attending at municipal day care centers in São Paulo. PARTICIPANTS: 42 children with PKU and 31 normal children aged 1 to 12 of both sexes were assessed in two groups, under and over 7 years of age. MAIN MEASUREMENTS: Weight and height measurements. RESULTS: Children with PKU ingested calories, calcium, iron, zinc, and copper below the recommended values, whereas the protein intake was within the normal range. Food intake in the group of normal children was within normality rates. The height/weight Z-score means for children with PKU were 0.47 for those under 7 years and 1.86 for 7 year-olds and over; in normal children the means were 0.97 <7 years and 1.54 >/=7 years, with no statistically significant difference. The height/age Z-score means were significantly lower in the PKU children <7 years (-1.23) than in the normal controls (0.91). CONCLUSIONS: The data presented demonstrate the importance of nutritional surveillance in patients with PKU so as to support adequacy of nutrient intake and to guarantee growth within the relevant standards.

The effects of nutrients and secondary compounds of Coffea arabica on the behavior and development of Coccus viridis.

Phytochemicals may modify the food quality, reduce a plant's palatability to insects, or defend against pests. This work aimed to study 1) relationships between the nitrogen and potassium levels given to plants in nutritive solutions and the foliar phytochemical concentrations, 2) the effect of nutrients and secondary compounds of Coffea arabica on the behavior of Coccus viridis, and 3) tolerance of C. arabica to losses. Deficient, normal, and excessive nitrogen and potassium fertilization treatments were used. Each treatment had two plants (one infested and one noninfested plant). The contents of phytochemicals in the infested plants' leaves and their dry matter of roots, stems, and leaves as well as the total contents in noninfested plants, were determined. The adults and nymphs of C. viridis were counted for 60 d in all treatments. It was verified that elevated nitrogen and potassium levels in the nutritional solutions led to increased of nymphs and adults of C. viridis to the coffee plants over time. Potassium and nitrogen had both direct and indirect effects on C. viridis. The direct effect was because of the increase of the nitrogen content in the leaves. The indirect effect instead was because of reductions in the caffeine and chlorogenic acid contents in the leaves. This is the first study to show relationship nutrient levels of coffee phytochemicals in response to herbivory by scale insects. Caffeine and chlorogenic acid applied on coffee leaves stimulated the locomotory activity of the green scale, thus reducing their feeding compared with untreated leaves. The elevation of caffeine and chlorogenic acid levels in coffee leaves affect this generalist insect by stimulating the locomotion of crawlers.

Efficacy of social worker role in corneal donation in two different periods.

INTRODUCTION: The Brazilian National System of Transplantation and the Ministry of Health in Brazil establish procedures and effective actions for occupational health care so that there are increasing numbers of organ and tissue donations. OBJECTIVE: This study analyzes the performance of social workers at the Intrahospital Donation of Organs and Tissues for Transplantation, Clinical Hospital, State University of Campinas, Brazil (CIHDOTT). METHODS: We retrospectively analyzed the number of potential cornea donors, effective donations, family refusal, and the reasons for nonimplementation of the donations in 2009 (period studied with the presence of social workers) compared with 2006 (period studied without the presence of social workers). RESULTS: Data analysis revealed that in 2006 there were 141 potential cornea donors achieving 35 (25%) donations and 106 (75%) refusals. In 2009 there were 73 potential donors with 25 (34%) donations and 48 (66%) refusals. The causes of family refusal prevalent in both periods were similar: 65% from indecision and 25% from the family's wishes to maintain the patient's body intact. CONCLUSION: The performance of social workers in this case was satisfactory, achieving an increase in donations and reducing the number of patients awaiting corneal transplantation while promoting their quality of life.

Risk of health care professionals acquiring HIV infection in Latin America.

This study describes the professional risk of acquiring HIV infection while caring for AIDS patients at a teaching hospital in Brazil. Since 1985 we have tested health care professionals (HCP) for HIV-1 antibody after accidents with blood and body fluids from AIDS patients. The blood samples were tested twice using an ELISA FDA approved test and, if positive, we performed Western blot. Two hundred and forty seven health care professionals reported 338 accidents (50% were percutaneous and 22% were mucous membrane exposures to blood). A further 404 HCPs reported no occupational exposure but wanted to be tested. From 247 HCPs with at least one accident, we analyzed 115 with more than 6 months of follow up. None were HIV antibody positive. Nobody received zidovudine as a prophylaxis. Of the 404 HCPs with no accident, 6 (1.5%) were positive and had confirmed risk factors for HIV. Our results support other studies that report a low occupational risk (about 0.4%) of acquiring HIV infection.

Ethical, behavioral, and social aspects of HIV vaccine trials in developing countries.

ISSUE: Several investigators are preparing to conduct efficacy trials of human immunodeficiency virus (HIV) vaccines in the developing world. Failure to adequately address the unique ethical, behavioral, and social issues that surround vaccine testing in that setting will jeopardize the success of these trials and future acquired immunodeficiency syndrome (AIDS) research in the host nation. DESCRIPTION OF THE PROJECT: Twelve investigators from Africa, Asia, North America, and South America reviewed previous experience with HIV trials in developing countries and explored potential solutions to these issues. CONCLUSIONS: Host country scientists, government officials, and media must be actively involved in all aspects of the trials. Minimum prerequisites for conducting the trial include the following: (1) researching vaccines active against developing world HIV isolates; (2) establishing and maintaining an adequate technological infrastructure; (3) assessing the feasibility of recruitment in countries where the existence of HIV may be denied; (4) designing methods to obtain informed consent from each individual subject, rather than exclusively from family members or community elders; (5) creating locally appropriate instruments to measure risk behavior; (6) identifying a behavioral intervention for placebo and treatment groups; (7) making available laboratory methods to distinguish between natural HIV infection and vaccine-induced seropositivity; and (8) guaranteeing that an effective vaccine is available free of charge to the placebo group and at affordable prices to other host country residents.

Biologic instability of pancreatic cancer xenografts in the nude mouse.

Tumor transplants into nude mice (NM) may reveal abnormal biological behavior compared with the original tumor. Despite this, human tumor xenografts in NM have been widely used to study the biology of tumors and to establish diagnostic and therapeutic modalities. Clearly, precise differences in the biology of a given tumor in human and in NM cannot be assessed. We compared the growth kinetics, differentiation pattern and karyotype of an anaplastic Syrian hamster pancreatic cancer cell line in NM and in allogenic hamsters. As with the original tumor, transplants in hamsters grew fast, were anaplastic and expressed markers related to tumor malignancy like galectin 3, TGF-alpha and its receptor EGFR at high levels. However, tumors in the NM were well-differentiated adenocarcinomas, grew slower, had increased apoptotic rate and had a high expression of differentiation markers such as blood group A antigen, DU-PAN-2, carbonic anhydrase II, TGF-beta(2) and mucin. Karyotypically, the tumors in the NM acquired additional chromosomal damage. Our results demonstrate significant differences in the morphology and biology of tumors grown in NM and the allogenic host, and call for caution in extrapolating data obtained from xenografts to primary cancer.

Long-lasting effects of chronic ethanol administration on the activity of antioxidant enzymes.

The aim of this study was to investigate the long-lasting effects of prolonged administration of ethanol doses on oxidative processes of aged rats. We determined the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) in erythrocytes of rats 15, 20, and 24 months old treated with an average daily dose of 1.5 g/Kg of ethanol or saline administered intraperitoneally for 13 weeks and after a 2 month period of withdrawal from treatment. The activity of all three enzymes decreased significantly with aging in the controls, while no age-related changes were found among treated rats. These findings are important since they are the first to show a long-lasting toxic effect of low ethanol doses observed in association with the aging process.