Helicobacter pylori virulence factors as tools to study human migrations.

Helicobacter pylori is one of the most common infections worldwide. In most individuals it consists in a lifelong host-pathogen relationship without consequences, but in some subjects it is associated with peptic ulcer disease and gastric cancer. Polymorphism in genes that code bacterial virulence factors, cagA and vacA, are independently associated with the infection severe outcomes and are geographically diverse. In the last decade, accumulated knowledge allowed to characterize typical H. pylori strain patterns for all the major human populations; patterns that can be used to study the origin of specific human groups. Thus, the presence or absence of cagA, cagA EPIYA genotypes, and vacA subtypes can be used as tools to study not only the geographic origin of specific human populations, but also to identify markers of historical contact between different ethnicities. We report here a study including a set of native Amazon Amerindians that had supposedly been some, but little, contact with European Brazilian colonizer and/or African slaves. They harbor H. pylori strains in a mixed pattern with Asian and Iberian Peninsula characteristics. It is possible that this finding represents H. pylori recombination upon short contact between human groups. Alternatively, it could be due to a founder effect from a small cluster of Asian origin native Americans.

[Malaria and hematological aspects among residents to be impacted by reservoirs for the Santo Antônio and Jirau Hydroelectric Power Stations, Rondônia State, Brazil]. / Malária e aspectos hematológicos em moradores da área de influência dos futuros reservatórios das hidrelétricas de Santo Antônio e Jirau, Rondônia, Brasil.

In Rondônia State, Brazil, two new hydroelectric plants, Santo Antônio and Jirau, are scheduled for construction on the Madeira River, upriver from the State capital, Porto Velho. The current study analyzes malaria prevalence before the construction and provides information on the possible impacts of malaria burden related to the influx of thousands of persons attracted by direct and indirect employment opportunities. According to the findings, malaria is present throughout the region, with varying prevalence rates. The existence of potential asymptomatic malaria carriers among the local population may be epidemiologically relevant and should be considered in the malaria control programs organized by public authorities and companies responsible for building the power plants, aimed at early diagnosis and treatment, vector control, water supply, and infrastructure in the urban areas.

Alta soroprevalência de infecção pelos vírus das hepatites B e C na região do alto rio Madeira, Porto Velho, Rondônia, Brasil / High soroprevalence of hepatitis B and C markers in the upper Madeira river region, Porto Velho, Rondônia State, Brazil

Foi realizado um estudo de soroprevalência de marcadores sorológicos de hepatites B e C na população residente no alto rio Madeira, entre as localidades de Santo Antônio e Abunã, no Município de Porto Velho, Rondônia, local previsto para ser inundado pelas novas hidrelétricas do Madeira. A população local foi estimada em 5 mil pessoas, segundo o censo do Instituto Brasileiro de Geografia e Estatística, e uma amostra populacional de 10 por cento foi selecionada de modo aleatório. Coletaram-se 5 mL de sangue periférico por punção venosa em tubo seco e o soro foi conservado em freezer a -20° C. Os exames sorológicos tipo ELISA foram realizados seguindo a metodologia do fabricante, para os seguintes marcadores virais: Anti-HBc Total, HBsAg, Anti-HBs e Anti-HCV. Foram processadas 431 amostras, das quais foram obtidos os seguintes resultados: 192 positivas para Anti-HBc Total (44,5 por cento), 29 positivas para HBsAg (6,7 por cento), 230 positivas para Anti-HBsAg (53,4 por cento), 32 positivas para Anti-HCV (7,4 por cento). Concluímos que a região estudada estaria classificada, segundo a Organização Mundial da Saúde, como de prevalência intermediária para hepatite B, e alta para hepatite C. Se considerarmos a alta prevalência de pessoas imunes contra hepatite B (superior a 50 por cento), podemos concluir que, nas próximas décadas, o problema de saúde pública relacionado com a hepatite B tenderá a diminuir. A migração de milhares de novos habitantes para a região sem a devida atenção das autoridades sanitárias para prevenção, vacinação e educação em saúde da população, pode agravar a situação na região em relação a estas hepatites virais...

A seroprevalence study on the serologic markers of hepatitis types B and C on the inhabitants of the upper Madeira river, between the localities of Santo Antonio and Abunã, in the Municipality of Porto Velho, Rondônia State, was conducted. This locality will be flooded by two new hydropower plants yet to be built in the Madeira river. Local population was estimated in 5 thousand individuals, according to Instituto Brasileiro de Geografia e Estatística's (Brazilian Institute of Geography and Statistics) census. A sample of 10 per cent of the population was randomly selected. Five milliliters of peripheral venous blood were collected in Vacutainer® dry tubes, and the serum samples were maintained in a freezer at -20° C. ELISA serological tests (DiaSorin, Inc.) were performed according to the manufacturer's methodology for the following viral markers: total Anti-HBc, HBsAg, Anti-HBs and Anti-HCV After the processing of 431 samples, the results were: 192 (44.5 per cent) were positive for total Anti-HBc, 29 (6.7 per cent) were positive for HBsAg, 230 (53.4 per cent) were positive for Anti-HBs, and 32 (7.4 per cent) were positive for Anti-HCV We concluded that this region presented an intermediate and a high prevalence rate for hepatitis B and C, respectively, according to the World Health Organization. The high prevalence (more than 50 per cent) of individuals immune to hepatitis B leads us to the conclusion that in the next decades problems related to that type of hepatitis tend to decrease, whereas the incidence of hepatitis C will probably increase. Migration of thousands of new inhabitants drawn by the implementation of the new hydropower plants in this region has the potential of worsening the public health issues related to these viral hepatitis infections...

Malária e aspectos hematológicos em moradores da área de influência dos futuros reservatórios das hidrelétricas de Santo Antônio e Jirau, Rondônia, Brasil / Malaria and hematological aspects among residents to be impacted by reservoirs for the Santo Antônio and Jirau Hydroelectric Power Stations, Rondônia State, Brazil

Em Rondônia, prevê-se a construção de mais duas usinas hidrelétricas (UHE) no rio Madeira, a montante da cidade de Porto Velho, Rondônia, Brasil (de Santo Antônio e Jirau). O objetivo deste trabalho foi analisar a prevalência da malária antes do início da implantação das obras civis e fazer considerações sobre os impactos da doença com o ingresso de milhares de trabalhadores e agregados atraídos pelas oportunidades de emprego e comércio. Os resultados obtidos mostram que a malária se faz presente em toda região, em variados graus de prevalência. Além disso, a existência de potenciais portadores assintomáticos de malária entre a população nativa pode ter relevância epidemiológica e deve ser considerada nos programas de controle da malária, vinda tanto das autoridades públicas quanto das empresas responsáveis pela instalação das UHE, visando o diagnóstico e tratamento precoce, controle vetorial, abastecimento de água e aplicação de infra-estrutura nos centros urbanos.

In Rondônia State, Brazil, two new hydroelectric plants, Santo Antônio and Jirau, are scheduled for construction on the Madeira River, upriver from the State capital, Porto Velho. The current study analyzes malaria prevalence before the construction and provides information on the possible impacts of malaria burden related to the influx of thousands of persons attracted by direct and indirect employment opportunities. According to the findings, malaria is present throughout the region, with varying prevalence rates. The existence of potential asymptomatic malaria carriers among the local population may be epidemiologically relevant and should be considered in the malaria control programs organized by public authorities and companies responsible for building the power plants, aimed at early diagnosis and treatment, vector control, water supply, and infrastructure in the urban areas.

Enteropathogens associated with diarrheal disease in infants of poor urban areas of Porto Velho, Rondônia: a preliminary study

One hundred and thirty cases of diarrhea and 43 age-matched controls, 0 to 5 years old, were studied in a pediatric outpatient unit from a poor peri urban area of Porto Velho, Rondônia. Eighty percent of diarrheal cases were observed in the groups under 2 years of age. Rotavirus (19.2 percent) was the most frequent enteropathogen associated with diarrhea, followed by Shigella flexneri (6.15 percent) and S. sonnei (1.5 percent) and Salmonella sp. (6.9 percent). Four cases of E. coli enterotoxigenic infections (3.1 percent), E. coli enteropathogenic (EPEC)(2.3 percent) one case of E. coli enteroinvasive infection (0.8 percent) and one case of Yersinia enterocolitica (0.8 percent) were also identified. Mixed infections were frequent, associating rotavirus, EPEC and Salmonella sp. with Entamoeba histolytica and Giardia lamblia

Síndrome de Boerhaave: relato de caso e revisäo da literatura / Boerhaave syndrome: report of a case and literature review

Os autores apresentam um caso de rotura espontânea de esôfago - síndrome de Boerhaave - e discutem as dificuldades que esta entidade apresenta nos seus aspectos clínicos e as diferentes opçöes de tática operatória indicadas nos diversos momentos evolutivos da doença