Nutritional status of HIV-positive patients in Niterói, Rio de Janeiro, Brazil.

The objective of this cross-sectional study was to assess the nutritional status of HIV-positive patients in a hospital in the city of Niteroi, Rio de Janeiro, Brazil. We studied 235 patients (130 men and 105 women) from May 2009 to June 2010. The frequency of undernourishment among women was 7.6%; 26.7% of the women were overweight, and 16.2% were obese. Among men, the frequency of undernourishment was 3.8%; 25.4% of the men were overweight, and 6.9% were obese. A logistic regression was done to investigate the relationship between nutritional status and potential predisposing factors. Women were more frequently affected by obesity and undernourishment than men. However, only the difference in obesity was significant, and women had almost three times higher odds of being obese (OR 2.6; 95% CI 1.03-6.65). According to a nationwide survey done in Brazil during 2008-2009, 50.1% of the Brazilian healthy males were overweight, and 12.5% were obese; 48% of healthy females were overweight, and 16.9% were obese. Although the prevalence of undernourishment in HIV-positive patients is now lower than that observed in the beginning of the AIDS epidemic and excess weight is increasingly common among people living with HIV/AIDS, the proportion of excess weight was found lower and of undernourishment was higher in the present study than that found in the Brazilian population.

Neurodevelopmental Outcomes in Children Vertically Exposed to Chikungunya Virus: A Two Years Follow-up Study.

OBJECTIVES: To monitor by the first 24 months of life, children born to mothers with laboratory evidence of chikungunya virus (CHIKV) infection during pregnancy or up to 8 weeks before it, and to describe abnormalities in head circumference (HC), auditory and ophthalmological assessments and neuroimaging tests during the follow-up period. METHOD: This is a observational, descriptive, longitudinal and prospective study of children born to mothers who had a rash and a positive test for CHIKV during pregnancy or up to 8 weeks before it. They were admitted between November 2015 and May 2019 in the outpatient multidisciplinary clinic to investigate acute exanthematous disease. The exposed children were followed up by a multidisciplinary team and underwent periodic measurements of the HC. The Denver II test was applied, in addition to transfontanellar ultrasound (TU) to evaluate neurodevelopmental outcomes during the study period. Ophthalmological and auditory examinations, echocardiography and laboratory tests were also included. RESULTS: We included in the study 27 children vertically exposed to CHIKV. All children had a negative polymerase chain reaction test for the virus collected at the first outpatient visit (mean age of 16.8 days and standard deviation of 8 days). No clinical condition compatible with congenital infection at birth was reported. A change in HC characterized by macrocephaly and mild global delay development was observed in a 1-year-old child whose mother was infected in the peripartum, but with normal TU. Changes in the TU were observed in 2 other children with nonspecific subependymal cystic malformation that was not evident by the cranial computed tomography. The other children monitored showed normal results in the Denver II test, in the HC and TU. No changes were identified on ocular ophthalmoscopy or auditory brainstem response test. Two children had an increase in serum ferritin levels during the first year of life, with the others' inflammatory disease markers normal. CONCLUSIONS: Our study added knowledge about the neurodevelopment of children exposed to CHIKV during pregnancy by a longitudinal and prospective follow-up, throughout their first 24 months of life. We did not observe a negative impact of exposure to the virus on the neurological examination, global developmental test or measurements of the HC of these children.

Detection of human herpesvirus 6 and 7 DNA in saliva from healthy adults from Rio de Janeiro, Brazil.

In this study, we aimed to evaluate virus shedding in the saliva of healthy adults from the metropolitan region of the city of Rio de Janeiro, Brazil, in order to verify the prevalence of both human herpesviruses 6 and 7 (HHV-6, HHV-7). The studied group comprised 182 healthy individuals at Pedro Ernesto University Hospital, who were being seen for annual odontologic revisions. Saliva specimens were subjected to a multiplex polymerase chain reaction (PCR) to detect the presence of HHV-6A, HHV-6B and HHV-7. The total Roseolovirus DNA prevalence was 22.4%. The PCR detected a HHV-6 prevalence of 9.8%, with HHV-6A detected in 7.1% of the samples and HHV-6B in 2.7%. HHV-7 DNA was revealed in 12.6% of the studied cases. Multiple infections caused by HHV-6A and 7 were found in 2.1% of the samples. No statistical differences were observed regarding age, but for HHV-7 infection, an upward trend was observed in female patients. Compared to studies from other countries, low prevalence rates of herpesvirus DNA were detected in saliva from the healthy individuals in our sample. PCR methodology thus proved to be a useful tool for Roseolovirus detection and it is important to consider possible geographic and populations differences that could explain the comparatively low prevalence rates described here.

High-resolution computed tomography enhances the diagnosis and follow-up of influenza A (H1N1) virus-associated pneumonia.

INTRODUCTION: We present the findings on high-resolution computed tomography (HRCT) of influenza A (H1N1) virus-associated pneumonia of 140 patients with acute and post-acute pneumonia, totaling 189 exams in a retrospective observational study evaluating the importance of HRCT as a diagnostic imaging method in the acute phase and in the follow-up of pneumonia. METHODOLOGY: We performed a retrospective observational study evaluating the HRCT findings of 140 adult patients with confirmed diagnosis of influenza A (H1N1) pneumonia and without other associated infectious processes. Chest X-ray exams were also performed in these patients. RESULTS: The main HRCT findings of lung involvement were airspace consolidation (57 cases), ground-glass opacities (40 cases) and an association of both aspects (43 cases), with a predominantly bilateral and peripheral distribution. CONCLUSIONS: HRCT is able to distinguish small lesions, such as small areas of consolidation or ground glass opacities, with little increase in lung attenuation, when chest X-rays was normal, allowing a prompt diagnosis and treatment after imaging.

The genomic analysis of rubella virus detected from outbreak and sporadic cases in Rio de Janeiro state, Brazil.

BACKGROUND: The molecular epidemiology of rubella virus (RV) based on the analysis of the viral E1 gene sequences indicated the existence of two genotypes that differ from each other by 8 to 10% in their nucleotide sequences: genotype I is present in Europe, North America and Asia; and genotype II is present only in Asia. OBJECTIVES: The purpose of the study was to identify the RV genotypes circulating in Brazil. STUDY DESIGN: In this study, we analysed 86 clinical samples collected between 1996 and 1999 during a rubella outbreak and from sporadic cases of rubella in Rio de Janeiro State. For the molecular characterisation of RV strains we have used PCR/nested amplification and direct sequencing of a 513-nucleotide region of the E1 gene. RESULTS: The E1 gene sequences of 14 RVs were obtained and were assigned to two lineages, both within genotype I. The percentage divergence of nucleotide sequence ranged from 3.4 to 5.1% between these two lineages. These results were in agreement with the pattern of variation observed among the sequences obtained from other lineages of RV. CONCLUSIONS: This work demonstrated that two new lineages of RV circulated simultaneously between the years 1996 and 1999 in the state of Rio de Janeiro. These results provided new approaches for monitoring the progress of vaccination efforts in Brazil.

Detection of human herpesvirus 6 and 7 DNA in saliva from healthy adults from Rio de Janeiro, Brazil

In this study, we aimed to evaluate virus shedding in the saliva of healthy adults from the metropolitan region of the city of Rio de Janeiro, Brazil, in order to verify the prevalence of both human herpesviruses 6 and 7 (HHV-6, HHV-7). The studied group comprised 182 healthy individuals at Pedro Ernesto University Hospital, who were being seen for annual odontologic revisions. Saliva specimens were subjected to a multiplex polymerase chain reaction (PCR) to detect the presence of HHV-6A, HHV-6B and HHV-7. The total Roseolovirus DNA prevalence was 22.4 percent. The PCR detected a HHV-6 prevalence of 9.8 percent, with HHV-6A detected in 7.1 percent of the samples and HHV-6B in 2.7 percent. HHV-7 DNA was revealed in 12.6 percent of the studied cases. Multiple infections caused by HHV-6A and 7 were found in 2.1 percent of the samples. No statistical differences were observed regarding age, but for HHV-7 infection, an upward trend was observed in female patients. Compared to studies from other countries, low prevalence rates of herpesvirus DNA were detected in saliva from the healthy individuals in our sample. PCR methodology thus proved to be a useful tool for Roseolovirus detection and it is important to consider possible geographic and populations differences that could explain the comparatively low prevalence rates described here.

Aplastic crisis caused by parvovirus B19 in an adult patient with sickle-cell disease / Crise aplástica por parvovírus B19 em um paciente adulto com doença falciforme

Descreve-se um caso de crise aplástica devida ao parvovírus B19 num paciente adulto, manifestando-se por palidez, cansaço, lipotímias e dispnéia. A ausência de reticulócitos chamou a atençäo para o diagnóstico. Detectaram-se IgM e IgG anti-B19. Reticulocitopenia em pacientes com anemia hemolítica hereditária sugere infecçäo por B19

Serological findings during a measles outbreak occurring in a population with high vaccine coverage

No periodo de marco/1991 a abril/1992, foram escolhidas 112 amostras sanguineas para a deteccao de anticorpos da classe IgM de casos de sarampo notificados a Divisao de Epidemiologia da Fundacao Municipal de Saude de Niteroi, Estado do Rio de Janeiro. A positividade ultrapassou 90 por cento para os especimens escolhidos entre o 5º e o 29º dia apos o inicio da doenca. A partir do 30º dia foi observado um declinio na deteccao de IgM, embora positividade tenha sido constatada ate noventa dias do inicio dos sintomas. Historia de vacinacao previa estava presente em 48,9 por cento destes pacientes. Dos 22 casos restantes, em 5 a infeccao era devido a outros agentes (rubeola: 4 casos, dengue: 1 caso). Estes resultados demonstram que a sensibilidade do teste empregado para confirmacao de casos suspeitos de sarampo e elevada mesmo em pacientes vacinados.

Human parvovirus B19 infection: clinical and epidemiological study of 24 cases

No periodo de maio/94 a novembro/95, 24 casos de parvovirose humana foram atendidos no Servico de Doencas Infecciosas e Parasitarias do Hospital Universitario Antonio Pedro, Niteroi - RJ. Amostras sanguineas para a deteccao de IgM (ensaio imunoenzimatico por captura) foram positivas do primeiro ao vigesimo setimo dia apos o inicio do exantema. Os sinais e sintomas classicos do eritema infeccioso foram observados em 8 (33,3 por cento) dos casos e apenas em criancas. Oito pacientes (6 adultos e 2 criancas) apresentaram poliartropatia simetrica, vista mais frequentemente em mulheres. Os resultados deste trabalho demonstram que o diagnostico da parvovirose humana e dificil quando a doenca nao apresenta quadro clinico classico e, devido ao frequente envolvimento das articulacoes, tal infeccao deve ser considerada no diagnostico diferencial da artrite reumatoide na sua fase inicial

Increased pro-inflammatory cytokines (TNF-[alfa] and IL-6) and anti-inflammatory compounds (sTNFRp55 and sTNFRp75) in brazilian patients during exanthematic dengue fever

Pro-inflammatory cytokines, tumor necrosis factor (TNF-[alfa]), interleukin-6(IL-6) and interleukin-1ß (IL-1ß) as well as anti-inflammatory compounds, soluble TNF-Receptor p55 (sTNFRp55), sTNFRp75 and IL-1 receptor antagonist (sIL-1Ra), were investigated in 34 Brazilian cases of dengue fever (DF) originated from a study of exanthematic virosis. The presence of pro-inflammatory cytokines was detected in sera from these patients by ELISA. TNF-[alfa] and IL-6 levels were significantly higher than control subjects in 32 (por cento) and 52(por cento) patients, respectively. To our knowledge this was the first time a receptor antagonist and soluble receptors for cytokines were detected in sera obtained during exanthematic DF without hemorrhagic manifestations. Both sTNFRp55 and sTNFRp75 were consistently elevated in 42 (por cento) and 84 (por cento) patients, respectively. Most patients had IL-1ß levels not different from those of normal subjects, except for one case. Only 16 (por cento) patients had altered levels of IL-Ra. Previous studies in dengue hemorrhagic fever patients demonstrated production of these soluble factors; here we observed that they are found in absence of hemorrhagic manifestations. The possible role of these anti-inflammatory compounds in immune cell activation and in regulating cytokine-mediated pathogenesis during dengue infection is discussed.

Measles antibody prevalence after mass immunization campaign in Niteroi, state of Rio de Janeiro, Brazil

Tres meses apos a campanha de vacinacao em massa (cobertura: 100 por cento, faixa etaria: 9 meses a 14 anos) contra o sarampo, um inquerito soroepidemiologico foi realizado em estudantes de um a 19 anos de idade no municipio de Niteroi, estado do Rio de Janeiro. Amostras sanguineas foram testadas para deteccao de anticorpos especificos contra o sarampo por ensaio imunoenzimatico (EIE), e os casos negativos testados outra vez utilizando-se a reacao de inibicao da hemaglutinacao (IH) e a neutralizacao por reducao de placas (NP)...

Avaliaçäo da qualidade físico-química e microbiológica do leite pasteurizado proveniente de mini e micro-usinas de beneficiamento da regiäo de Ribeiräo Preto/SP / Physicochemical and microbiological quality evaluation of the pasteurized milk processed by mini and microprocessing lants of the area of Ribeiräo Preto, State of Säo Paulo - Brazil

Foram analisadas, de 1995 a 1998, 390 amostras de leite (123 tipo C, 86 tipo B, e 181 tipo Integral) provenientes de dezesseis mini e micro-usinas da regiäo de Ribeiräo Preto/SP. Dentre essas usinas, dez foram submetidas a um estudo longitudinal, ou seja, as amostras de leite foram analisadas durante 4 anos, sendo que cada ano correspdeu a um período. Os estabelecimentos foram fiscalizados por um médico veterinário do Serviço de Inspeçäo de Säo Paulo que, mediante os resultados das análises de leite, orientava os responsáveis pelas usinas. Dentre o total de amostras estudadas, observou-se que estavam em desacordo com os padröes físico-químicos e microbiológicos, estabelecidos pela legislaçäo em vigor, 15,5 por cento e 32,5 por cento do tipo C; 37,2 por cento e 32,6 por cento do leite tipo B e 30,9 por cento e 31,0 por cento do tipo Integral, respectivamente. Na avaliaçäo das dez mini e micro-usinas estudadas durante os 4 anos observou-se, quanto a qualidade microbiológica, que o leite tipo B apresentou uma melhora a partir do terceiro período de estudo; o de tipo Integral também no terceiro período e depois manteve níveis um pouco mais altos no decorrer do estudo. Os dados mostraram que a fiscalizaçäo e orientaçäo resultaram em uma maior adequaçäo nas condiçöes higiênico-sanitárias do leite. O mesmo näo foi observado em relaçäo às características físico-químicas. (AU)

The objective of this research was to investigate the physicochemical and microbiological quality of pasteurized milk processed by mini and microprocessing plants of the area of Ribeirão Preto, State of São Paulo, Brazil. The total of 390 samples of pasteurized milk types C,B and whole were analyzed for their physicochemical and microbiological conditions. Ten of this mini and microprocessing plants were submmited a longitudinal study, and their milk samples were analized during four years. These factories were supervised by a veterinary of the Agricultural Secretary of São Paulo State who guided each responsible for factory about the results of the milk analises. The microbiological analysis showed that 32.5% of 123 samples of type C milk, 32.6% of 86 samples of type B milk and 31.0% of 181 samples of whole milk did not comply with the legal standards established by the Brasilian legislation. By the physicochemical analysis 15.5%, 37.2% e 30.9%, respectively, did not comply with legal standards in Brazil. Salmonella were negative in all samples. The evaluation of ten mini and microprocessing plants showed that the microbiological quality of the type B milk has a improved in the last two years, the type C milk showed an improvement only in the second year of the study and the type whole milk showed a significant improvement in the third period of study. The results of this study showed that the inspection and guidance resulted in improvement of the sanitary-hygienic quality of these products. (AU)

Re-evaluation of the basic procedures involved in the storage of measles vaccine in puplic health units of the municipality of niterói, state of Rio de Janeiro, Brazil

Quatro anos após a primeira visita, dezessete unidades Sanitárias do Município de Niterói - RJ foram visitadas novamente e reavaliadas de acordo com as normas técnicas específicas estabelecidas pelo Programa Nacional de Imunizaçäo. Constatou-se que em 100 por cento das Unidades visitadas os cuidados com os refrigeradores e a arrumaçäo das vacinas no interior dos aparelhos eram adequados ou regulares mas quanto ao controle de temperatura dos refrigeradores este percentual caía para 64,7 por cento. De todos os itens avaliados, o mais problemático foi o apoio técnico imediato frente a situaçöes de emergência, considerado insuficiente em 94,1 por cento dos casos. Em 55,2 por cento das amostras vacinais recolhidas das unidades sanitárias, os títulos estavam abaixo da potência mínima preconizada para tal produto no momento da aplicaçäo. Verifica-se, deste modo, a necessidade de uma contínua avaliaçäo dos fatores que intervêm na cadeia de frio evitando-se, assim, que seja comprometida a qualidade das vacinas a serem utilizadas

Manifestaçöes clínicas associadas ao parvovírus humano B19, incluindo a anemia persistente na AIDS e em outras formas de imunodepressäo / Clinical problems related to human parvovírus B19, including protracted anemia in AIDS and other forms of immunodeficiency

A descoberta acidental do parvovírus humano B19 em 1974 levou ao esclarecimento da etiologia de algumas síndromes clínicas já desde há muito desconhecidas, e hoje comprovadamente associadas à infecçäo por este vírus. Com base na revisäo da literatura, säo descritas estas síndromes, bem como os eventos que permitiram associá-las ao parvovírus B19, na ordem aproximada em que ocorreram. A literatura brasileira foi também revista. O texto aborda também a infecçäo por pavovírus B19 no contexto de Aids e de outras formas de imunodepressäo

Manifestaçöes clínicas associadas ao herpesvirua humano tipo 6, incluindo aspectos da infecçäo na síndrome da imunodeficiência adquirida / Clinical features related to human herpesvirus type 6, including aspects of the infection in acquired immnunodeficience syndrome

O herpesvirus humano tipo 6 foi isolado em 1986 de pacientes com doenças linfoprolíferativas. Estudos posteriores demonstraram que o HHV-6 é frequentemente encontrado em seres humanos e que a infecçäo primária comumente ocorre nos primeiros anos de vida, algumas vezes causando uma doença benígna da infåncia denominada exantema súbito. Nesta revisäo, as síndromes relacionadas ao HHV-6 e a infecçäo em hospedeiros imunocomprometidos, incluindo a síndrome da imunodeficiência adquirida, säo descritas