Clinical manifestations of head and neck cancer in pediatric patients, an analysis of 253 cases in a single Brazilian center.

BACKGROUND: Pediatric head and neck cancer (PHNC) is rare and its nonspecific clinical manifestations may often lead to delayed diagnosis. We aimed to describe the signs, symptoms, and clinicopathological characteristics of PHNC. MATERIAL AND METHODS: Medical records were retrospectively reviewed for all PHNC cases diagnosed from 1986 to 2016 affecting patients aged 19-years and younger from a tertiary referral center in Brazil. Demographic variables, anatomical site of primary tumors, histopathological diagnoses, signs and symptoms, and patterns of misdiagnosis were collected and interpreted by statistical and descriptive analysis. RESULTS: A total of 253 PHNC cases were included. The mean age was 9.3 years and male patients were more frequently affected (60.9%). Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common cancer types. The nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were the predominant anatomical sites. Tumor/swelling (68.4%), was the clinical finding often presented. The univariable analysis showed association between tumor histology and clinical variables such as sex (p=0.022), age (p<0.0001), anatomical location (p<0.0001) tumor/swelling (p=0.034), pain (p=0.031), systemic/general manifestations (p=0.004), nasal/breathing alterations (p=0.012), orbital/ocular alterations (p<0.0001). Misdiagnosis such as tonsillitis, otitis, and abscess were frequent. CONCLUSIONS: Although the clinical findings of PHNC are often unspecific, this study provided signs and symptoms with significant correlations between tumor histology. The suspicion of malignancy should be considered when the main signs and symptoms reported here appear and persist, in order to conduct a timely diagnosis.

Vaccination against hepatitis B with 4-double doses increases response rates and antibodies titers in HIV-infected adults.

BACKGROUND: Antibody responses to standard regimens of hepatitis B (HBV) vaccination are lower in HIV-infected subjects and the best hepatitis B vaccine schedule in this population is not known. OBJECTIVE: To assess the immunogenicity and to evaluate predictors of serologic response of a modified regimen of a HBV recombinant vaccine in a cohort of HIV-infected subjects. METHODS: HIV-infected subjects received 4 doses (40 µg) of a recombinant HBV vaccine at 0, 1, 2 and 6 months. Demographic information as well as CD4 cell count and plasma viral load were assessed at baseline. Protective and strong responses were defined as an anti-HBs titer ≥10 mIU/mL and ≥100 mIU/mL, respectively and were evaluated one month after the third and the fourth doses. RESULTS: 163 HIV-infected individuals were evaluated 67 (40%) were male and median age was 37 years. Median CD4 cell count was 385 cells/mm(3) and 113 (70%) had undetectable HIV-1 viral load. Protective antibody response was observed in 83 and 91% and a strong antibody response was observed in 62 and 80% of the subjects after 3 and 4 doses, respectively. In a multivariate logistic model undetectable HIV-1 viral load and higher CD4 cell counts were independent predictors of a strong antibody response after 4 doses. Patients with undetectable HIV viral load were almost 3 times more likely to have anti-HBs titers above 100 mIU/mL than those with detectable viral load. CONCLUSIONS: A 4-double-dose regimen of a recombinant HBV vaccine increased response rates and determined higher antibody titers which may translate in prolonged protection against HBV. Inclusion of a fourth dose of HBV vaccine for HIV-infected subjects should be considered in the public health setting.

Genetic parameters of libido in Brazilian Nellore bulls.

Genetic, environmental and phenotypic correlations between libido, testicular measurements, body weight and semen traits were estimated by multiple-trait-restricted maximum likelihood (MTDFREML) under animal models. Reproductive records, collected from 1992 to 1997, of 288 Nellore bulls were used. Estimates of heritability for libido unadjusted, adjusted for scrotal circumference and adjusted for body weight, were 0.34 +/- 0.10, 0.31 +/- 0.10, and 0.19 +/- 0.11, respectively. Genetic correlations between libido and body weight, scrotal circumference, testis length, testis width, testis volume and testis consistency were, respectively, 0.69, -0.43, -0.31, -0.16, 0.10, 0.87, and between libido and semen volume, sperm motility, vigor, gross motility, major, minor and total defects were, respectively, 0.71, 0.51, 0.12, 0.16, 0.31, 0.26 and 0.43. Results suggested that selection for libido would be effective and that it would lead to desirable correlated response for scrotal circumference, physical and morphological semen traits and undesirable correlated response in body weight.

Immune response to vaccine against influenza in smokers, non-smokers and, in individuals holding respiratory complications.

Levels of antibody against influenza virus were evaluated in serum pairing samples from individuals immunized against influenza by Hemagglutination Inhibition and Single Radial Hemolysis tests. For this purpose, groups of smokers, non-smokers and, of those holding respiratory complications, were formed. Results of serologic titrations pointed out to an increase in the level of antibodies for the smoker and non-smoker groups, with significant degrees of difference up to P < 0.001 difference between both averages after immunization. However, in the group of respiratory complications no significant differences (P > 0.05) were found out between the averages antibody levels for the subtype A (H1N1) and the Type B (vaccine components); an increase only at the level of antibodies was registered, with differences among the averages of the antibody levels, for the subtype A (H3N2) (vaccine component) at degrees of P < 0.01 and P < 0.001 on the titration of the SRH and HI tests, respectively. It can demonstrate that immunization against influenza presents a good protection for the smoker and non-smoker groups; however, in the group of respiratory complications it only occurred with the subtype A (H3N2), indicating that this subtype presents good antigenicity since it has induced better formation of antibodies, even in defective organisms.

Influenza eqüina: avaliaçäo da resposta imune humoral, através das reaçöes de inibiçäo da hemaglutinaçäo e de hemólise radial simples, em soro de animais vacinados com vacina comercial e experimental / Equine influenza: evaluation of the humoral immune response through the hemagglutination inhibition and single radial haemolysis, in vaccinated horses with commercial and experimental vaccines

Foram avaliadas, através de testes de inibiçäo da hemaglutinaçäo (HI) e da hemólise radial simples (HRS), as respostas de anticorpos contra influenza em 4 lotes de eqüinos adultos. O grupo do lote 01 recebeu a imunizaçäo com 2 doses de vacina contra influenza, preparada experimentalmente no Instituto Butantan. Nos lotes 02 e 03, regularmente imunizados contra a influenza, foram administradas doses de reforço anual com a vacina comercial e com a vacina experimental, respectivamente. O lote 04 foi o grupo controle da avaliaçäo. Os resultados dos testes demonstraram que as médias de títulos de HRS e IH do lote 01 apresentaram diferenças ao nível de p < 0,001, com significante aumento das médias de títulos detectados nos soros após a 2a. imunizaçäo. Näo foram observadas diferenças significantes entre as médias de títulos de anticorpos em soros obtidos antes e após a dose de reforço anual dos eqüinos dos lotes 02 e 03, atribuindo-se a persistência de nível de anticorpos protetores mantida após 1 ano da imunizaçäo regular com vacina comercial. A conversäo sorológica dos eqüinos do lote 01, à persistência dos títulos de anticorpos nos eqüinos dos lotes 02 e 03 e, ainda, os baixos títulos de anticorpos verificados nos eqüinos näo vacinados do lote 04 comprovam o resultado da resposta sorológica das duas vacinas, a experimental e a comercial, avaliadas neste trabalho

Preparation of human rabies vaccine in VERO cell culture using a microcarrier system.

1. The rabies virus (Pasteur PV strain) was propagated in VERO cells attached to microcarriers in a 3.7-1 bioreactor. Virus titers of about 10(6) LD50/ml were obtained regularly. 2. Ultrafiltration was efficient for concentrating the virus suspensions, and the sucrose gradient reduced the residual VERO cell DNA to acceptable levels (less than 50 pg/dose). The remaining cell DNA content was evaluated by dot-blot hybridization with a probe prepared with VERO cell DNA. 3. The final virus preparations were inactivated by B-propiolactone treatment, showed a potency higher than 2.5 IU/dose and protected mice experimentally infected intracerebrally with rabies virus (CVS-13.2). 4. This methodology for the production of a rabies vaccine for human use should be of interest to countries where high technology facilities are not available.

Preparation of human rabies vaccine in VERO cell culture using a microcarrier system

1. The rabies virus (Pasteur PV strain) was propagated in VERO cells attached to microcarriers in a 3.7-1 bioreactor. Virus titers of about 10(6) LD50/ml were obtained regularly. 2. Ultrafiltration was efficient for concentrating the virus suspensions, and the sucrose gradient reduced the residual VERO cell DNA to acceptable levels (less than 50 pg/dose). The remaining cell DNA content was evaluated by dot-blot hybridization with a probe prepared with VERO cell DNA. 3. The final virus preparations were inactivated by B-propiolactone treatment, showed a potency higher than 2.5 IU/dose and protected mice experimentally infected intracerebrally with rabies virus (CVS-13.2). 4. This methodology for the production of a rabies vaccine for human use should be of interest to countries where high technology facilities are not available

[Thermostability of rabies vaccine, type Fuenzalida & Palacios, for human use]. / Termoestabilidade da vacina contra a raiva, tipo Fuenzalida & Palacios, uso humano.

Ten lots of Fuenzalida & Palacios type antirabies vaccine for human use, produced at the Instituto Butantan (São Paulo, Brazil) were stored at temperatures of 45, 37, 28 and 2-8 degrees C. The potency of each lot was determined in samples taken at varied time intervals using the NIH method and lots presenting antigenic values > or = 0,3 were considered satisfactory for use. After 2 hours at 45 degrees C the antigenic value of one out of 10 lots tested was found to be less than the minimum required value. At 37 degrees C all lots maintained satisfactory antigenic values until the third day of storage, whilst at 28 and 2-8 degrees C the potency was fully maintained, respectively for 10 and 360 days. At the ideal temperature of 2-8 degrees C, 100% of the tested vaccines maintained the minimum required antigenicity for a longer period (16 months) than the expiration time of 6-12 months usually recommended for this type of biological produced in Latin American and Caribbean countries. Thus, the obtained data suggested that in countries still producing Fuenzalida & Palacios type vaccine, the expiration tim could be extended to 16 months, what could prevent the unnecessary discarding of products still in useful condition.

The preparation of cultured rabies virus and the production of antiserum for human use.

In this paper we describe a methodology for the preparation of the Pasteur strain of fixed rabies virus in BHK-21 clone 13 cells and also its use for the production of antisera in horses. The methodology showed here is simple, rapid, facilitates the attainment of high protective titers, and the antisera produced are of high quality.