Antibody and cytokine seerum levels in patients subjected to anti-rabies prophylaxis with serum-vaccination

Rabies is considered a fatal disease once clinical symptoms have developed. The aim of this study was to evaluate epidemiological aspects and immune response in patients attacked by domestic and wild animals and subjected to post-exposure rabies treatment with equine serum and associated vaccine. Thirty-three patients were evaluated; they were between 13 and 65 years old, 75.8% were male and 24.2% female, and from the Botucatu neighborhood. Twenty healthy control individuals with the same age range were also studied. Specific antibodies to equine immunoglobulins and IFN-g, IL-2, IL-4, and IL-10 production were evaluated by ELISA. IgM, IgE, IgG and subclasses, and rabies virus antibodies serum levels were determined by nephelometry and seroneutralization methods, respectively. No anaphylactic or serum sickness allergic reactions were observed in patients after treatment. Anti-equine IgG levels were significantly higher than those of IgM after 14 and 28 days of treatment. Protective antibodies to rabies virus > 0.5 UI/ml were detected in 84.6% and 75% of patients at days 14 and 28, respectively. IFN-g, IL-2 and IL-10 levels in patients before and 48h after treatment were significantly higher than in controls suggesting that both Th1 and Th2 cells were activated in the patients. Serum IgM levels were higher at day 14, and IgG2 and IgE levels were higher at day 28 of treatment. These results suggest that post-exposure rabies treatment in humans induces significant alterations in patient immune response characterized by increased levels of cytokines, serum levels of specific rabies virus antibodies, and the equine serum components employed in the treatment

Antibody and cytokine serum levels in patients subjected to anti-rabies prophylaxis with serum-vaccination

Rabies is considered a fatal disease once clinical symptoms have developed. The aim of this study was to evaluate epidemiological aspects and immune response in patients attacked by domestic and wild animals and subjected to post-exposure rabies treatment with equine serum and associated vaccine. Thirty-three patients were evaluated; they were between 13 and 65 years old, 75.8% were male and 24.2% female, and from the Botucatu neighborhood. Twenty healthy control individuals with the same age range were also studied. Specific antibodies to equine immunoglobulins and IFN-gamma, IL-2, IL-4, and IL-10 production were evaluated by ELISA. IgM, IgE, IgG and subclasses, and rabies virus antibodies serum levels were determined by nephelometry and seroneutralization methods, respectively. No anaphylactic or serum sickness allergic reactions were observed in patients after treatment. Anti-equine IgG levels were significantly higher than those of IgM after 14 and 28 days of treatment. Protective antibodies to rabies virus > 0.5 UI/ml were detected in 84.6% and 75% of patients at days 14 and 28, respectively. IFN-gamma, IL-2 and IL-10 levels in patients before and 48h after treatment were significantly higher than in controls suggesting that both Th1 and Th2 cells were activated in the patients. Serum IgM levels were higher at day 14, and IgG2 and IgE levels were higher at day 28 of treatment. These results suggest that post-exposure rabies treatment in humans induces significant alterations in patient immune response characterized by increased levels of cytokines, serum levels of specific rabies virus antibodies, and the equine serum components employed in the treatment.

Evolution and prophylaxis of human rabies

Rabies is a viral acute encephalitis of progressive and fatal outcome, particular of hot-blooded animals, and accidentally affecting men. Since it is a zoonosis with different animal species acting as a reservoir in the nature, this disease is a great public health problem in several countries in development. Prophylactic treatments for human rabies started in 1885 with Louis Pasteur, and developed in order to provide higher protection and lower incidence of side effects. Today, treatments of pre and post-exposure to the virus are well established, with excellent results of protection for individuals exposed to animals potentially contaminated by the rabies virus. These treatments consist of utilising the vaccine isolatedly or in combination with equine immunoglobulin, what contributes, in an important way, to the decrease in the number of cases of rabies.(AU)

First Report of a Huanglongbing-Like Disease of Citrus in Sao Paulo State, Brazil and Association of a New Liberibacter Species, "Candidatus Liberibacter americanus", with the Disease.

Huanglongbing (HLB) (ex-greening) is one of the most serious diseases of citrus. The causal agent is a noncultured, sieve tube-restricted α-proteobacterium, "Candidatus Liberibacter africanus" in Africa and "Candidatus Liberibacter asiaticus" in Asia (2). The disease has never been reported from the American continent. However, Diaphorina citri, the Asian psyllid vector of HLB, is found in South, Central, and North America (Florida and Texas). Early in 2004, leaf and fruit symptoms resembling those of HLB were observed in several sweet orange orchards near the city of Araraquara, Sao Paulo State. Leaf mottling on small and large leaves was the major symptom. Shoots with affected leaves were yellowish. Fruits were small and lopsided, contained many aborted seeds, and appeared more severely affected than were plants infected with classic HLB. Forty-three symptomatic samples and twenty-five samples of symptomless sweet orange leaves from five farms were analyzed for the presence of the HLB-liberibacters using polymerase chain reaction (PCR) with two sets of HLB-specific primers for amplification of 16S rDNA (2,3) and ribosomal protein genes (1). None of the 43 symptomatic leaf samples gave a positive PCR amplification, while HLB-affected leaves from the Bordeaux HLB collection produced the characteristic amplicons with both sets of primers. The 43 symptomatic and the 25 symptomless leaf samples were then analyzed using PCR with universal primers for amplification of bacterial 16S rDNA (4). All symptomatic leaf samples, but none of the symptomless leaf samples, yielded the same 16S rDNA amplification product, indicating the presence of a bacterium in the symptomatic leaves. This was confirmed using the observation of a sieve tube restricted bacterium by electron microscopy. The 16S rDNA product was cloned, sequenced, and compared with those of "Ca. L. africanus" and "Ca. L. asiaticus". While the 16S rDNAs of these two liberibacter species have 97.5% sequence identity, the 16S rDNA sequence of the new bacterium shared only 93.7% identity with that of "Ca. L. asiaticus" and 93.9% with that of "Ca. L. africanus". The 16S rDNA sequence of the new bacterium had a secondary loop structure characteristic of the α subdivision of the proteobacteria and possessed all the oligonucleotide signatures characteristic of the liberibacters. For these reasons, the new bacterium is a liberibacter and is sufficiently different phylogenetically from known liberibacters to warrant a new species, "Candidatus Liberibacter americanus". Specific PCR primers for amplification of the 16S rDNA of the new species have been developed. They were able to detect "Ca. L. americanus" in 214 symptomatic leaf samples from 47 citrus farms in 35 municipalities, while the "old" species, "Ca. L. asiaticus", has been found only four times within the 47 farms. References: (1) A. Hocquellet et al. Mol. Cell. Probes, 13:373, 1999. (2) S. Jagoueix et al. Int. J. Syst. Bacteriol. 44:379, 1994. (3) S. Jagoueix et al. Mol. Cell. Probes 10:43, 1996. (4) W. G. Weisburg et al. J. Bacteriol. 173:697, 1991.

Evolution and prophylaxis of human rabies

Rabies is a viral acute encephalitis of progressive and fatal outcome, particular of hot-blooded animals, and accidentally affecting men. Since it is a zoonosis with different animal species acting as a reservoir in the nature, this disease is a great public health problem in several countries in development. Prophylactic treatments for human rabies started in 1885 with Louis Pasteur, and developed in order to provide higher protection and lower incidence of side effects. Today, treatments of pre and post-exposure to the virus are well established, with excellent results of protection for individuals exposed to animals potentially contaminated by the rabies virus. These treatments consist of utilising the vaccine isolatedly or in combination with equine immunoglobulin, what contributes, in an important way, to the decrease in the number of cases of rabies.

Saúde coletiva e direitos humanos: um diálogo possível e necessário / Public health and human rights: a possible and necessary dialogue

Aborda a história dos direitos humanos, na sua relaçäo com a saúde, em contraste, com a a história e a linguagem da saúde coletiva, mais desenvolvida e explorada no meio acadêmico. Visa oferecer informaçöes que venham otimizar o diálogo recém-inaugurado entre a saúde coletiva e os direitos humanos. (CACMS)

Evaluation of intradermal sensitivity test in patients submitted to heterologous serotherapy

This review deals with heterologous sera produced used in Brazil. The authors studied 64 patients. Of these, 35 had been attacked by domestic and wild animals and received antirabies serum; 20 had been bitten by venomous animals (snakes and scorpions) and were treated with specific antivenoms; and 9 had traumas and received antitetanic serum. All these patients were submitted to the intradermal sensitivity test before, and 30 days after receiving heterologous serotherapy. The following results obtained by the authors agree with those in literature: - The intradermal test using undiluted heterologous serum produced a more acute reaction than that using heterologous serum diluted 1:10; - The larger the volume of serum, the larger was the wheal directly after inoculation; - The antigenic concentration influenced the final local reaction; - The reading 30 minutes after inoculation was always higher than that 15 min after; - No systemic reaction was observed during the tests; - The use of promethazine as a prophylactic medication did not protect against the early reactions; - Tests performed 30 days after serotherapy showed a higher reactivity, probably due to sensitization; - The intradermal sensitivity test did not allow the authors to predict early reactions. After these observations, the authors do not recommend the intradermal sensitivity test for patients submitted to heterologous serotherapy. They, however, strongly recommend a careful observation during the infusion and clinical follow up in the first 24 hours.

Positional behavior of the white uakari (Cacajao calvus calvus).

The positional behavior and habitat use of a group of white uakaries (Cacajao calvus calvus) was observed for 6 weeks in the dry season at Lake Teiú, Brazil. Data are presented for feeding, traveling, and resting activities. The most common feeding posture is sit, followed by stand. Cacajao frequently exhibits locomotor behaviors while in feeding trees, using pronograde clamber and quadrupedal walk. The most frequently used locomotor behaviors in travel are quadrupedal walk, leap, and pronograde clamber. Quadrupedal run and drop also figure importantly in the behavioral repertoire. The most frequent resting posture was sit, followed by ventral lie. Compared to representative members of the other pitheciin genera, Pithecia and Chiropotes, Cacajao engages in more locomotion while feeding, and uses more pedal suspension. While traveling, pronograde clamber and drop are more frequently used by Cacajao. Multiple, deformable supports are used more by Cacajao than by the other pitheciins throughout all activities. Overall, the positional behavior of Cacajao is more similar to that of Chiropotes than of Pithecia. Cacajao's behavioral solutions to the problems of balance imposed by its greatly reduced tail are discussed.

[Historical interpretation and scientific transformation: the hermeneutical task of a critical theory of epidemiology]. / Interpretação histórica e transformação científica: a tarefa hermenêutica de uma teoria crítica da epidemiologia.

The objective of this work is to discuss the scope of historical issues in an epistemological approach to epidemiology. Considering the contributions to a practical comprehension of science made by Habermas's theory of communicative action and Gadamer's philosophical hermeneutics, this study attempts to explore the sense in which a historical point of view redirects the main epistemological questions of epidemiology. In contrast to strictly formal approaches, a historically enhanced epistemology seems to be a more prolific source of reasoning about the striving of epidemiology for scientific axioms. The relevance of historical theoretical improvements to epistemological methods themselves, with regard to emancipatory ideals, is particularly emphasized.

[Historical and philosophical elements for a critical analysis of epidemiology]. / Elementos históricos e filosóficos para a crítica da epidemiologia.

The historical and philosophical foundations of epidemiology are examined for the purpose of establishing objective bounds for a reflexive analysis as to the insertion of this science into today's health practices as a whole. With this in view, an epistemological approach, founded upon the Frankfurt School's criticism of modern rationality and some theoretical and methodological contributions from French School of historical epistemology, is attempted. Historical information was obtained from current specialized literature. The abstract notion of "environment" in the theoretical translation of "health's public space" is emphasized as the contradictory basis for the instrumental shaping of epidemiological knowledge. This abstract notion of environment has opened up increasing possibilities of knowledge of and practical intervention in sanitary phenomena, but has simultaneously restricted the objectivation of the properly public character of these phenomena.

[The problem of true knowledge in epidemiology]. / O problema do conhecimento verdadeiro na epidemiologia.

The philosophical basis of the validation of scientific knowledge, with a view to establishing a critical point of view as to the adoption of Popper's propositions in epidemiology is examined. The conservative character that results from the technical limitations implied in this adoption is a noteworthy aspect of the discussion, despite the evident increase in heuristic rationality and creativity that result.

[Prevalence of arterial hypertension in Piracicaba City]. / Prevalência da hipertensão arterial na cidade de Piracicaba.

PURPOSE: To analyse the prevalence of arterial hypertension (AH) in the population (15 years-old or above) as well as its relationship with some cardiac disease risk factors. METHODS: One thousand and nine hundred individuals (approximately 1.5% of the local population) were submitted to blood pressure sampling (Cochran technic). Age, gender, race, profession, social status, family history of AH, alcohol intake, cigarette and salt consumption were all analysed by means of proper questionnaires. RESULTS: Values of 140 X90 mmHg or above were present in 32.7%. Only 10% of these individuals were already receiving antihypertensive drugs. Social classes C and D had the main share (71%). Men and women had similar share (33% and 32%, respectively). The majority were above 51 years of age (58%) and blacks summed up 37% of the AH population. CONCLUSION: Prevalence (32.7%) of AH in Piracicaba far exceeded average international prevalence. This finding is addressed to higher presence of risk factors (stress, obesity, cigarette and alcohol habits, other diseases and family background).

Coat color and biochemical variation in Amazonian wild populations of Alouatta belzebul.

A comparative study of 13 blood genetic systems and pelage color variation was performed in four wild populations of Alouatta belzebul. The animals from the west bank of the Tocantins River showed less color variation than those from the east bank, as well as less than those from Tocantins Island. The blood genetic markers, however, revealed an opposite pattern of variation. A previously undescribed morphological variant (completely red) was observed in one specimen of the east bank, where pelage color of the local population varied from completely black to completely red. Levels of heterozygosity and inter- and intralocus variances for the blood systems are compared with those observed in five other species of New World primates.