Natural infection by Culex flavivirus in Culex quinquefasciatus mosquitoes captured in Cuiabá, Mato Grosso Mid-Western Brazil.

New species of insect-specific viruses (ISV) have been reported worldwide. In the present study, the complete genome of Culex flavivirus (CxFV) and partial sequences of other ISVs in Culex quinquefasciatus Say 1823 females (n = 3425) sampled in 200 urban areas census tracts of Cuiaba, state of Mato Grosso, were identified via reverse transcriptase-polymerase chain reaction for a NS5 region of flaviviruses, nucleotide and high-throughput sequencing, and viral isolation in C6/36 cells. CxFV was detected in 16 of 403 mosquito pools; sequences found in the study presented a high similarity with isolates from São Paulo, Brazil and other countries in Latin American that belong to genotype II, supporting the geographical influence on CxFV evolution. The monthly maximum likelihood estimation for CxFV ranged from 1.81 to 9.94 per 1000 mosquitoes. In addition to the CxFV complete genome, one pool contained an ORF1 sequence (756 bp) that belongs to a novel Negevirus from the Sandewavirus supergroup most similar to the Santana virus (77.1%) and another pool presented an RNA-dependent RNA polymerase sequence (1081 bp) of a novel Rhabdovirus most similar to Wuhan mosquito virus 9 (44%). After three passages in C6/36 cells, only CxFV was isolated from these co-infected pools. The importance of ISVs relies on their possible ability to interfere with arbovirus replication in competent vectors.

Evaluation of a IS6110-Taqman real-time PCR assay to detect Mycobacterium tuberculosis in sputum samples of patients with pulmonary TB.

AIM: Evaluate the IS6110-Taqman system performance in sputum samples from patients with pulmonary tuberculosis from health services in north-eastern Brazil as a diagnostic laboratory tool for pulmonary tuberculosis. METHODS AND RESULTS: 165 sputum samples from respiratory symptomatic patients were evaluated in the IS6110-TaqMan assay: 66 patients with pulmonary tuberculosis and 99 without TB. When the IS6110-TaqMan assay was evaluated using culture and/or clinical response to the specific treatment as the gold standard, IS6110-TaqMan assay obtained a sensitivity of 87.9% and specificity of 98%. The performance of IS6110-TaqMan assay was also evaluated with the sputum smear microscopy, resulting in a sensitivity of 79.7% and specificity 94.8%. CONCLUSIONS: The IS6110-TaqMan was rapid, sensitive and specific for the diagnosis of pulmonary TB. SIGNIFICANCE AND IMPACT OF THE STUDY: IS6110-TaqMan assay is a promising auxiliary tool for the diagnosis of pulmonary TB when used in conjunction with routine laboratory tests, clinical and epidemiological criteria of the patient, thus increasing the sensitivity and specificity of diagnosis.

Epidemiological, clinical and laboratory aspects of Angiostrongylus cantonensis infection: an integrative review.

This integrative literature review study analyzes the findings of the last 5 years of the parasite Angiostrongylus cantonensis. It is known that this nematode is found in the pulmonary arteries of rats, where it remains as a definitive host. From mice, the cycle spreads to animals, such as snails, which in contact with humans can trigger the disease. In humans, the parasite causes several neurological, abdominal manifestations and mainly meningitis. Based on the review of studies, its epidemiology shows worldwide distribution, although there are endemic cases for this parasite, such as asian countries. Laboratory findings generally showed altered CSF with turbidity, increased protein and eosinophilia, which generated meningeal signs in the patient, moreover MRI exams showed multiple alterations. Rare findings of the nematode in the eyeball, lung and signs of peritoneal inflammation were reported, which requires further studies to understand the whole pathophysiology. Finally, conservative treatment based on anthelmintics and anti-inflammatories brought good responses, although there are reports of deaths, which demonstrates the importance in the prevention and therapy of this disease.

Transition from glass- to gel-like states in clay at a liquid interface.

Colloidal clay in water suspensions are known to exhibit a multitude of bulk phases depending on initial colloidal concentration and ionic strength, and examples of this include repulsive Wigner colloidal glasses at low ionic strength and attractive gels at higher ionic strength due to screened electrostatic forces by the electrolyte. From confocal Raman microscopy combined with elasticity measurements, we infer that clay trapped at quasi two-dimensional interfaces between oil and water also exhibit confined glass-like or gel-like states. The results can be important for the preparation of particles stabilized colloidal emulsions or colloidal capsules, and a better understanding of this phenomenon may lead to new emulsion or encapsulation technologies.

Modeling of under-detection of cases in disease surveillance.

PURPOSE: Accurate epidemiological surveillance of leprosy is a matter of international public health concern. It often suffers, however, from potential problems of under-registration of reported cases, particularly in poorer and more socially deprived areas. Such problems also apply in the surveillance of many other communicable or transmissible diseases. We develop a Bayesian model for small-area disease rates that allows for censoring of case detection in suspect districts and can therefore be used to estimate under-reporting of cases in a given study region. METHODS: Such methods are applied to leprosy incidence in a municipality of Pernambuco State in North Eastern Brazil, using a social deprivation indicator as the basis for considering data from certain districts to be censored. The time period we consider was immediately prior to an extension of the coverage and efficacy of the control program and model predictions concerning under reporting can therefore be compared with more reliable data subsequently collected from the same region. RESULTS: The proposed method produces informative estimates of under detection of leprosy cases in the defined study region and these estimates compare well, both in size and in geographical location, with the numbers of cases subsequently detected. CONCLUSIONS: As illustrated by the application discussed in this article, the proposed model provides a general tool that may be used in spatial epidemiological surveillance situations where the available data is suspected to contain significant under-registrations of cases in certain geographical areas.

Distribution of microglial cells in the cerebral hemispheres of embryonic and neonatal chicks.

The distribution, morphology and morphometry of microglial cells in the chick cerebral hemispheres from embryonic day 4 (E4) to the first neonatal day (P1) were studied by histochemical labeling with a tomato (Lycopersicon esculentum) lectin. The histochemical analysis revealed lectin-reactive cells in the nervous parenchyma on day E4. Between E4 (5.7 +/- 1.35 mm length) and E17 (8.25 +/- 1.2 mm length), the lectin-reactive cells were identified as ameboid microglia and observed starting from the subventricular layer, distributed throughout the mantle layer and in the proximity of the blood vessels. After day E13, the lectin-reactive cells exhibited elongated forms with small branched processes, and were considered primitive ramified microglia. Later, between E18 (5.85 +/- 1.5 mm cell body length) and P1 (3.25 +/- 0.6 mm cell body length), cells with more elongated branched processes were observed, constituting the ramified microglia. Our findings provide additional information on the migration and differentiation of microglial cells, whose ramified form is observed at the end of embryonic development. The present paper focused on the arrangement of microglial cells in developing cerebral hemispheres of embryonic and neonatal chicks, which are little studied in the literature. Details of morphology, morphometry and spatial distribution of microglial cells contributed to the understanding of bird and mammal central nervous system ontogeny. Furthermore, the identification and localization of microglial cells during the normal development could be used as a morphological guide for embryonic brain injury researches.

Contralateral visual field representation in area 17 of the cerebral cortex of the agouti: a comparison between the cortical magnification factor and retinal ganglion cell distribution.

The cortical representation of the contralateral visual field in area 17 of the agouti's brain was studied by multiunit recording. The borders of area 17 were determined by electrophysiological, cytoarchitectonic and myeloarchitectonic criteria. The results were plotted in flat, bidimensional representations of the cerebral cortex to minimize perspective distortions. The V1 map, a first order topological transformation of the visual field, shows a magnified representation of the horizontal meridian that corresponds to a retinal specialization, the visual streak. The visual field representation has asymmetries that are not directly related to the topography of the retinal ganglion cell density. Whereas the ganglion cell density shows a plateau along the visual streak, the areal cortical magnification factor is higher in the region that corresponds to the intersection of the horizontal and vertical meridians. This suggests functional specializations that are not obvious when one considers the distribution of the whole ganglion cell population but which might be related to the distribution of specific ganglion cell classes.

Two-step inactivation of bee venom phospholipase A2 by scalaradial.

Scalaradial (SLD), a marine natural product isolated from the sponge (Cacospongia sp., possesses anti-inflammatory properties in vivo and in vitro (Pharmacologist 32: 168, 1990). In this study we characterize its effects against bee venom phospholipase A2 (PLA2; EC 3.1.1.4). SLD is a potent inactivator of bee venom PLA2 with an IC50 value of 0.07 microM. Inactivation of bee venom PLA2 occurred in a time-dependent, irreversible manner. The rate of inactivation followed first-order reaction kinetics and was dependent on the concentration of SLD. Kinetic analysis suggested a two-step mechanism of inactivation: an initial apparent noncovalent binding (Ki = 4.5 x 10(-5) M) followed by covalent modification. The rate of inactivation was reduced markedly in the presence of excess phosphatidylcholine, suggesting that modification of the enzyme occurs at or near the substrate binding site.

Heterogeneity of classic congenital muscular dystrophy with involvement of the central nervous system: report of five atypical cases.

A heterogeneous group of patients with congenital muscular dystrophy associated with clinical or radiologic central nervous system involvement other than the severe classic form with merosin deficiency, muscle-eye-brain disease, and Walker-Warburg syndrome is described. A probable hereditary or familial occurrence could be suggested in all patients. One merosin-positive patient presented severe motor incapacity and cerebral atrophy without any clinical manifestation of central nervous system involvement. A second patient, also merosin-positive, had moderate motor and mental handicap, and epilepsy with no changes in neuroimaging. A third patient, found to have partial merosin deficiency by muscle biopsy, manifested severe psychomotor retardation and cerebral atrophy with foci of abnormal white-matter signal on magnetic resonance imaging. Finally, two merosin-positive siblings with microcephaly, mental retardation, and an incapacitating progressive neuromuscular course, exhibited cataracts without defects of neuronal migration or brain malformation. This report emphasizes the broad clinical spectrum and heterogeneity of merosin-positive congenital muscular dystrophy with associated central nervous system involvement, and illustrates the importance of further studies on clinical, immunohistochemical, and genetic grounds for identifying new subsets of congenital muscular dystrophy.

Merosin-positive congenital muscular dystrophy in two siblings with cataract and slight mental retardation.

We report on two siblings that have been followed for 14 years, with merosin-positive congenital muscular dystrophy (CMD), cataract, retinitis pigmentosa, dysversion of the optic disc, but no cerebral anomalies, except for microcephaly and slight mental retardation (MR). The younger child had three generalized seizures easily controlled by anticonvulsant therapy. Both children presented hypotonia from birth, delayed psychomotor development, generalized muscular weakness, and atrophy and joint contractures of knees and ankles. The course of the disease, apparently static during the first 10 years of life, became progressive during the second decade with loss of deambulation by the age of 13. Creatine kinase was increased in both children. Bilateral cataract was diagnosed at 6-months of age. In spite of the occurrence of microcephaly, MR was slight and the siblings acquired reading and writing skills after the aged 10. Head magnetic resonance imaging showed normal results in both siblings. The classification of these cases within the broad spectrum of CMD is difficult since most of the known muscle-eye-brain syndromes generally show severe MR and brain anomalies. We consider these cases as corresponding to the rarer syndromes of merosin-positive CMD with associated features such as cataract and MR that were particularly emphasized during the 50th ENMC International Workshop on CMD [Dubowitz V. Workshop report: 50th ENMC International workshop on congenital muscular dystrophy. Neuromusc Disord 1997;7:539-547]. Further genetic, pathological, neuroradiological, and immunocytochemical studies will be necessary for better elucidation of the classification and pathogenesis of CMD.

Selective determination of cobalt using polyurethane foam and 2-(2-benzothiazolylazo)-2-p-cresol as a spectrophotometric reagent.

The present work describes a selective, rapid and economical method for the determination of cobalt using the 2-(2-benzothiazolylazo)-p-cresol (BTAC) as a spectrophotometric reagent associated with a solid extraction on polyurethane foam. The BTAC reacts with Co(II) in the presence of Triton-X100 surfactant forming a green complex with maximum absorption at 615 nm. The reaction is used for cobalt determination within a pH range of 6.50-7.50, with an apparent molar absorptivity of 1.62 x 10(4) L mol(-1) cm(-1). Beer's Law is obeyed for a concentration of at least 1.60 microg ml(-1). A selective procedure is proposed for cobalt determination in the presence of Fe(II), Hg(II), Zn(II) and Cu(II) up to milligram levels using masking agents. Polyurethane foam is used for the preconcentration and separation of cobalt from thiocyanate media and this procedure is applied to its determination in nickel salts and steel alloys.

Direct determination of gallium on polyurethane foam by X-ray fluorescence.

Gallium chloride is easily extracted from 6M HCl by comminuted polyether-type polyurethane foam. After the extraction step, the gallium absorbed by the PU foam can be quantitatively determined by X-ray fluorescence. A procedure for the direct determination of gallium absorbed by PU foam by XRFS is thus described. Gallium is determined at levels as low as 60 ng/ml (C(L)), with a calibration sensitivity of 424 cps ml/mug, within a linear range 0.1-2.30 mug/ml. The procedure investigated was successfully applied to determination of gallium in aluminum alloys, bauxite and industrial residue samples.

Prenatal and postnatal depression among low income Brazilian women.

Postnatal depression is a significant problem affecting 10-15% of mothers in many countries and has been the subject of an increasing number of publications. Prenatal depression has been studied less. The aims of the present investigation were: 1) to obtain information on the prevalence of prenatal and postnatal depression in low income Brazilian women by using an instrument already employed in several countries, i.e., the Edinburgh Postnatal Depression Scale (EPDS); 2) to evaluate the risk factors involved in prenatal and postnatal depression in Brazil. The study groups included 33 pregnant women interviewed at home during the second and third trimesters of pregnancy, and once a month during the first six months after delivery. Questions on life events and the mother's relationship with the baby were posed during each visit. Depressed pregnant women received less support from their partners than non-depressed pregnant women (36.4 vs 72.2%, P < 0.05; Fisher exact test). Black women predominated among pre- and postnatally depressed subjects. Postnatal depression was associated with lower parity (0.4 +/- 0.5 vs 1.1 +/- 1.0, P < 0.05; Student t-test). Thus, the period of pregnancy may be susceptible to socio-environmental factors that induce depression, such as the lack of affective support from the partner. The prevalence rate of 12% observed for depression in the third month postpartum is comparable to that of studies from other countries.

People's knowledge and practice about dengue, its vectors, and control means in Brasilia (DF), Brazil: its relevance with entomological factors.

In South America, the epidemiology and ecology of dengue fever are strongly associated with human habits because the vector Aedes aegypti is strictly urban. Thus, the evaluation of people's knowledge and practice (PKP) is of great importance to improve integrated control measures. A PKP evaluation has been done in a suburb of Brasilia. Thirty questions were submitted to 130 habitants about income level, education, sources of information, specific knowledge about dengue, vector biology, and control measures applied. Other questions were about the responsibility of dengue control and the opportunity of applying a fine to people who would not cooperate with the control measures. Level of PKP was fairly high, either for housekeepers, workers, or students. The mosquito bite was cited as source of infection by 60.8% of interviewed people but 22.3% had no knowledge about this topic. The most cited symptoms in association with dengue were fever (73.1%), headache (66.2%), and rash (35.4%). Knowledge about mosquito biology and control was also fairly accurate, as demonstrated by 96.9% of answers. Elimination of water containers was the most efficient means according to 73% of people. Such action should be done mainly by the citizen (75.3% of answers). Despite the good PKP, correlations existed only between the PKP about vector biology and presence of potential breeding containers in March, and between the PKP about the disease and potential breeding containers in April. In conclusion, global educational campaigns may have a real impact on the PKP but this did not result in effective control of the mosquito breeding containers by the people.

[Spatial analysis of Aedes aegypti larval distribution in the Ilha do Governador neighborhood of Rio de Janeiro, Brazil]. / Análise da distribuição espacial de larvas de Aedes aegypti na Ilha do Governador, Rio de Janeiro, Brasil.

This study aims to help expand knowledge on Aedes aegypti in Rio de Janeiro, based on spatial analysis of the mosquito's breeding sites in the neighborhood of Ilha do Governador, Rio de Janeiro, from June 1992 to July 1994. Use of spatial analysis techniques is proposed for vector surveillance and control. Information obtained from the number of dwellings per block that were used for the analysis. A smoothing method, a Gaussian Kernel, was used in the spatial distribution analysis. Breaks in National Health Foundation intervention activities were observed between cycles 4 and 5 and 5 and 6, respectively, followed by increases in vector density and vector-positive areas. Permanently positive areas, like slums and a military compound, display the persistence of favorable environmental conditions for oviposition and larval growth, indicating flaws in the vector control program. Although Kernel is an exploratory analytical method involving subjective interpretation, it provides easy and fast visualization of sites subject to different degrees of risk, unaffected by existing political and administrative territorial apportionment.

[Obstetric care during childbirth in Rio de Janeiro: hospital practices and user access]. / Assistência ao parto no Município do Rio de Janeiro: perfil das maternidades e o acesso da clientela.

The purpose of this paper is to identify and describe Rio de Janeiro maternity hospital profiles and the route between the mother's place of residence and the hospital. Data sources were: the State Live Birth Information System (1995) and the National Survey on Medical Care (1992). Two groups of maternity hospitals were identified using multivariate cluster analysis. Group A had an extremely high cesarean rate (81%), with mothers and neonates presenting good health conditions. Cesarean rates were lower in Group B, although still high (32%), and other variables reflected worse neonatal conditions. Cesarean rate was the indicator which best discriminated between the groups, followed by proportion of adolescent mothers and mothers with a high school education. The uneven spatial distribution of maternity hospitals, which were concentrated in the richest area of the city, was a factor in the long routes used by women to reach medical care for childbirth.

[Urban hospital markets: a methodological approach]. / Mercados hospitalares em área urbana: uma abordagem metodológica.

This study developed a method for the construction of hospital markets in a metropolitan area, focusing on users of the Unified Health System (SUS) with hip fractures and admitted to municipal hospitals in Rio de Janeiro in 1994-1995. The study used a spatial smoothing technique based on a Kernel (quartic) estimate for constructing areas of care for each hospital and subsequently for hospital markets. Areas of the city were presented where there was a market domain and a secondary domain for treating patients with hip fractures. Hospital market analysis can help health planners organize resources in the health care system.

[Spatial clusters detection of violent deaths in Porto Alegre, Rio Grande do Sul, Brazil, 1996]. / Detecção de aglomerados espaciais de óbitos por causas violentas em Porto Alegre, Rio Grande do Sul, Brasil, 1996.

Violence is of major importance in the health profile of Brazilian metropolitan areas and should be treated as a public health problem. Spatial analysis methods can be highly useful for the surveillance and prevention of violence. This paper analyzes the spatial distribution of victims' place of residence in relation to the main causes of violent death in Porto Alegre (1996) in order to identify vulnerable areas. For motor vehicle accidents, homicides, and suicide, the victim's place of residence was pinpointed using the municipal Geographic Information System. The point patterns of health events and population density were analyzed using a Kernel smoother, visually compared. Some areas with higher concentration of events are similar to population distribution but differ from each other in the remaining high concentration areas, thus indicating specific micro-areas at risk. Areas of higher homicide risk are mainly located on the periphery of the more urbanized area, with worse socioeconomic conditions. Motor vehicle accidents are concentrated in areas that are simultaneously commercial and residential and are traversed by streets with heavy traffic. Suicide deaths are more evenly distributed over the territory. Identification of risk areas provides meaningful information for developing preventive and health promotion measures focusing on the events for which health policies may play a central role.

[Spatial risk distribution: modeling infant mortality in Porto Alegre, Rio Grande do Sul State, Brazil]. / Distribuição espacial do risco: modelagem da mortalidade infantil em Porto Alegre, Rio Grande do Sul, Brasil.

Estimation and mapping of risk profiles are the main concerns of epidemiology. This paper analyzes spatial distribution of infant mortality cases as compared to live-born controls from Porto Alegre, Rio Grande do Sul. The modeling framework adopted in this research work is a spatial point process. Under this structure, a risk measure which continuously varies over the study region is defined and estimated using generalized additive model methods. This approach has the advantage of allowing for risk factors that are simple and easy to interpret. The procedure also allows the construction of tolerance contours which help identify areas of significantly high/low risk and an overall test for the null hypothesis of constant risk over the region. Application of this method to infant mortality data showed a highly significant spatial variation in risk for neonatal mortality data and non-significant results for post-neonatal mortality data.

[A survey of demand for medical care in three public health clinics in Rio de Janeiro, Brazil]. / Demanda ambulatorial em três serviços da rede pública do município do Rio de Janeiro, Brasil.

A sample survey was conducted in three public ambulatory medical care units in Rio de Janeiro in order to show the demographic and nosological aspects of the clientele as well as to evaluate the quality of clinic records. The sample included 2,029 patients registered in the health clinics and 3,980 consultants from October 1, 1990 to September 30, 1991. The diagnoses were coded according to the 9th revision of the International Classification of Dieases. Females accounted for about 60% of the sample, and more than a half were between 15 and 49 years of age. Children under 10 years old made up 28% of the total. About 38% of the patients came from the poor areas of the city: the "favelas". The case files were poorly filled out, frequently lacking useful information. The most frequent cause was classified in the XVIo chapter of the ICD - ill-defined causes, followed by respiratory, infectious, genitourinary and circulatory diseases. External causes predominated in one of the health clinics, which is an emergency service. There was a great demand for preventive measures, such as prenatal care and child care, even at the clinic that was traditionally devoted only to curative medicine. The most frequent specific diagnoses were upper respiratory tract infection, hypertension, gynecological problems, prenatal care, and skin diseases. There were no records for referrals to other health services. The poor quality of the medical records causes problems in terms of quality of health care. Use of such record-keeping systems, even while criticizing them, is essential to improve them.