Analysis of the gut microbiota in alopecia areata: identification of bacterial biomarkers.

BACKGROUND: Alopecia areata is a T-cell-mediated autoimmune disease with an unknown etiopathogenesis. Gut microbiota has been revealed as a key modulator of systemic immunity. OBJECTIVE: To determine whether patients affected by alopecia universalis present differences in gut bacteria composition compared with healthy controls and investigate possible bacterial biomarkers of the disease. METHODS: We conducted a cross-sectional study that involved 15 patients affected by alopecia universalis and 15 controls. Gut microbiome of the study subjects was analysed by sequencing the 16SrRNA of stool samples. We searched for bacterial biomarkers of alopecia universalis using the linear discriminant analysis effect size (LEFse) tool. RESULTS: In total, 30 study subjects (46.6% female; mean [SD] age, 40.1 [9.8] years) were enrolled. Neither alpha (Shannon diversity index 5.31 ± 0.43 vs. 5.03 ± 0.43, P 0.1) or beta diversity (ADONIS P value: 0.35) of gut microbiota showed statistically significant differences between cases and controls. In patients affected with alopecia, we found an enriched presence (LDA SCORE > 2) of Holdemania filiformis, Erysipelotrichacea, Lachnospiraceae, Parabacteroides johnsonii, Clostridiales vadin BB60 group, Bacteroides eggerthii and Parabacteroides distasonis. A predictive model based on the number of bacterial counts of Parabacteroides distasonis and Clostridiales vadin BB60 group correctly predicted disease status in 80% of patients (AUC 0.804 (0.633-0.976), P 0.004). CONCLUSION: Alopecia universalis does not seem to affect broadly gut microbiota structure. Bacterial biomarkers found associated with the disease (Holdemania filiformis, Erysipelotrichacea, Lachnospiraceae, Parabacteroides johnsonii, Eggerthellaceae, Clostridiales vadin BB60 group, Bacteroides eggerthii and Parabacteroides distasonis) should be further studied as they could be involved in its pathophysiology or be used as diagnostic tools.

Alopecia areata totalis and universalis: a multicenter review of 132 patients in Spain.

BACKGROUND: Alopecia areata totalis (AAT) and universalis (AAU) pose a therapeutic challenge. OBJECTIVE: To describe the clinical and epidemiological features, therapeutic response and prognostic factors in a large series of patients diagnosed with AAT and AAU. METHODS: This retrospective multicenter study included patients diagnosed with AAT/AAU with a minimum follow-up of 12 months. Response was assessed based on the regrowth of scalp hair. RESULTS: In all, 132 patients (92 women and 40 men) - 80 (61%) diagnosed with AAU and 52 (39%) diagnosed with AAT - were included. The median time between the presentation of alopecia areata (AA) and the development of extensive AA was 1 year and it was less than 4 years in 121 patients (91%). There was an initial response to treatment in 64% of patients, although only 14% presented a persistent response. Adverse side effects from the medications used were detected in 33% of patients. The prognostic factors associated with poor response were the presence of AAU and a positive family history of AA. CONCLUSIONS: Treatment of AAT and AAU is challenging. Although an initial regrowth may be achieved, the duration of response is usually short. There were no significant differences on the effectiveness or duration of response between the various systemic therapies.

[Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients]. / Punção aspirativa transbrônquica guiada por ecoendoscopia brônquica no diagnóstico e estadiamento de cancro do pulmão em 179 doentes.

BACKGROUND: Linear endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an important minimally invasive procedure for non-small cell lung cancer (NSCLC) staging. It is also a valid method for diagnosing extraluminal lesions adjacent to the tracheobronchial tree. AIM: To evaluate our EBUS-TBNA performance regarding diagnostic yield, safety and learning curve for lung cancer diagnosis and staging. MATERIAL AND METHODS: All patients undergoing EBUS-TBNA for lung cancer diagnosis or staging were included. They were divided into three different groups: paratracheal and parabronchial masses sent for diagnosis (Group 1); peripheral lung lesions with abnormal mediastinal lymph nodes sent for diagnosis and staging (Group 2); NSCLC patients sent for mediastinal staging (Group 3). The learning curve was assessed for yield, accuracy, procedure time, size and number of lesions punctured per patient. RESULTS: A total of 179 patients were included and 372 lesions were punctured. The overall yield and accuracy were 88% and 92.7%, respectively. In Group 1, EBUS-TBNA was performed in 48 patients and sensitivity was 86.1% and accuracy was 87.5%. For the 87 patients included in Group 2, yield was 86.7%, accuracy was 93.1% and cancer prevalence was 51.7%. The diagnostic yield and accuracy in Group 3 was 95% and 97.7% respectively. EBUS-TBNA practice led to an increase number of sites punctured per patient in a shorter time, without complications. CONCLUSION: EBUS-TBNA is an effective method for diagnosing and staging lung cancer patients. The procedure is clearly safe. Handling and performance improves with the number of procedures executed.

Synanthropy of mosquitoes and sand flies near the Aimorés hydroelectric power plant, Brazil.

The environmental changes resulting from the construction of hydroelectric dams may affect the fauna of insect vectors and consequently the epidemiology of the diseases they transmit. This work examined the mosquito and sand fly fauna in the area of the Aimorés hydroelectric power plant, analyzing the seasonal distribution and the degree of species synanthropy in different ecotopes. Between November, 2008 and September, 2009, entomological captures were performed with the help of HP light traps in the rural, urban, and forest areas of Aimorés, Ituêta, Resplendor, and Baixo Guandu counties. The fauna proved to be quite diversified. Twenty-two species of mosquitoes and 11 species of sand flies were found. Culex quinquefasciatus was predominant among mosquitoes (76.7%), while Lutzomyia intermedia prevailed among sand flies (34.5%). Some of the captured species have medical interest. Supported by the high degree of synanthropy, those species reinforce the need for epidemiological surveillance.

Characterization of the volatile fraction emitted by Pinus spp. by one- and two-dimensional chromatographic techniques with mass spectrometric detection.

The chemical composition of the needles of P. pinea, P. pinaster, P. halepensis, P. nigra, P. brutia, P. patula, P. radiata, P. taeda, P. elliotti, P. kesiya, P. sylvestris and P. eldarica was investigated. Headspace solid-phase microextraction and steam distillation extraction were used to collect the volatile fractions. Samples were analyzed using one-dimensional gas chromatography (1D-GC) and comprehensive two-dimensional gas chromatography (GCxGC) associated with a quadrupole and a time-of-flight mass detectors. Results showed that the analytical capabilities of 1D-GC are partially limited by the separation power of the columns. The higher sensibility and the absence of peak skewing of the time-of-flight mass analyzer, with the use of automated peak finding and deconvolution algorithms, allowed for the detection of trace components with qualitative full spectra and the extraction of true mass spectra from coeluting compounds, promoting their reliable identification and thus significantly improving results obtained by 1D-GC/MS, when using a quadrupole mass analyzer. The use of GC x GC resulted in enhanced separation efficiency and increased signal to noise ratio (sensitivity) of the analytes, maximizing mass spectra quality and improving compound detection and identification. This work shows the use of 1D-GC/ToFMS for the analysis of pine needles volatiles, achieving the detection of 177 compounds, that is more than twice the number previously identified by standard 1D-GC/MS. The analysis by GC x GC for the same sample allowed the detection of 212 compounds. The enantioselective GC x GC analysis performed for all the Pinus spp. under study achieved the detection of 422 different compounds. Cross-over phenomena according to operational conditions are highlighted and discussed.

Ocorrência de Amblyomma longirostre (Koch, 1844) em Chaetomys subspinosus (Olfers, 1818) oriundos da Mata Atlântica / Occurrence of Amblyomma longirostre (Koch, 1844) in Chaetomys subspinosus (Olfers, 1818) from Atlantic Forest

Chaetomys subspinosus (Olfers, 1818) or bristle-spined porcupine is a species of rodent restricted to the Atlantic Forest of the Eastern Coast of Brazil, vulnerable to extinction. Four specimens captured in the State of Espírito Santo, at the Biological Station of Santa Lúcia (EBSL) and at the State Park Paulo César Vinha (PEPCV), were examined for the presence of ectoparasites. One female and three males of Amblyomma longirostre were collected from a single C. subspinosus female in three independent captures carried out in 2004 at the EBSL. No ticks were found on bristle-spined specimens from the PEPCV. This constitutes the first report of A. longirostre infesting this rodent species in the State of Espírito Santo and reinforces that these mammals from the family Erethizontidae act as hosts for adults stages of this ixodic tick species.

[Correlation between homicide rates and economic indicators in São Paulo, Brazil, 1996]. / Relação entre homicídios e indicadores econômicos em São Paulo, Brasil, 1996.

Around 30% of the deaths due to violent causes in Brazil result from homicides. Violence has traditionally been related to larger social problems, such as poverty. Recently, however, a positive correlation has been observed between higher incomes and an increase in the homicide rate, so that some researchers have begun to consider inequality, rather than poverty, as an explanation for the epidemic of violence. The objective of this study was to investigate the correlation between urbanization, poverty, and economic inequality and homicide rates in the state of São Paulo, Brazil, in 1996. Information regarding population size, average monthly income of household heads, income distribution, and Gini index was obtained for each municipality, based on the demographic census. Homicide rates were calculated based on official data. Data were analyzed in terms of correlation and relative risk with 95% confidence intervals. Homicide rates rose in direct proportion to city population and ranged from 6.96 (per 100,000 inhabitants) in municipalities with a population smaller than 10,000 inhabitants, to 55.54 in municipalities with more than 1 million inhabitants. Relative risk ranged from 1.35 to 7.98. A significant correlation with population size was found only for incomes above 3.11 times the minimum wage and a Gini index greater than 0.50. There was a strong, direct, and significant correlation between homicide rates and the income ratio between the ninetieth and the twentieth percentiles of the population. It is necessary to probe more deeply into the macrosocial determinants of homicide rates in order to identify indicators of inequality that can generate meaningful data for developing public health strategies.

Soybean leghemoglobin targeted to potato chloroplasts influences growth and development of transgenic plants.

Potato tubers were transformed with a chimeric gene made by the fusion of the soybean leghemoglobin encoding gene (lba) with the chloroplastic targeting sequence from Rubisco. This construct was placed under the control of the strong constitutive 35S promoter and the 3' nontranslated region of Rubisco from pea. Leghemoglobin expression on kanamycin-resistant plants was monitored by RT-PCR. Furthermore, immunodetection of subcellular fractions of transgenic plants revealed that leghemoglobin was imported and correctively processed inside the organelle. In addition, analysis of transgenic plants revealed reduced growth and decreased tuber production compared with the untransformed plants. It is suggested that leghemoglobin expression in potato chloroplasts interferes with aerobic metabolism, leading to physiological and morphological changes.

[Vaccination coverage in the first year of life in 4 cities of the state of São Paulo, Brazil]. / Cobertura vacinal no primeiro ano de vida em quatro cidades do Estado de São Paulo, Brasil.

Immunization is an important disease prevention measure, and evaluating the effectiveness of immunization programs is crucial to ensuring their success. This study describes the results of a household survey in four cities in the state of São Paulo, Brazil: Francisco Morato, Guarulhos, Osasco, and São Paulo. The survey was done in order to estimate immunization coverage for the cohort of children born in 1996. The city of São Paulo was divided into five strata, according to socioeconomic and living conditions. The survey followed the methodology that the Pan American Health Organization recommends for immunization coverage surveys. The proportion of children who had received a complete set of the recommended vaccinations at the time of the interview, taking into account both oral reports and information recorded on the children's immunization cards, was above 90% for all the cities except Francisco Morato, which had the worst living conditions. In the city of São Paulo, the worst coverage was found in the lowest and highest strata. When only the doses received during the first year of life were considered, the coverage was not adequate to produce herd immunity. The use of private vaccination services was higher in the areas with better living conditions. The difference between the coverage calculated based on data from health services and the coverage calculated based on the survey was inversely proportional to living conditions. Our results suggest that surveys similar to the one described here should be carried out in other cities. Employees who provide vaccination services should be trained to correctly record vaccination data. In addition, it is important to make health professionals aware of the official immunization calendar, and to facilitate the public's access to health services.

Morphometric and phenetic studies of five geographical populations of Lutzomyia whitmani (Diptera: Psychodidae) in Brazil.

A morphometric survey examined adult specimens of Lutzomyia whitmani (Antunes & Coutinho) captured at 5 municipalities in southeastern and northeastern Brazil to compare the populations. The localities were Ilhéus (Bahia), Martinho Campos (Minas Gerais), Corte de Pedra (Bahia), Baturité (Ceará), and Amaraji (Pernambuco): all are known foci of American cutaneous leishmaniasis. Fifteen males and 15 females from each population were analyzed morphometrically for 42 and 37 characters, respectively. Statistical data alone were insufficient to discriminate among the 5 populations. Further analysis generated phenograms that indicated there were 2 spatial clusters: the 1st was composed of specimens from Ilhéus (Bahia) and Baturité (Ceará) and the 2nd of specimens from Martinho Campos (Minas Gerais), Corte de Pedra (Bahia), and Amaraji (Pernambuco). Although insufficient to define the taxonomic status of the populations studied, the results delineated the existence of biogeographical structuring within L. whitmani. Complementary studies on the susceptibility to Leishmania braziliensis infection in the 5 populations are in progress to clarify the relationship between the 2 biogeographical clusters and American cutaneous leishmaniasis transmission in those Brazilian regions.

[Time trends in death rates from homicides in the city of Sao Paulo, Brazil, 1979-1994]. / Tendencia temporal da mortalidade por homicidios na cidade de Sao Paulo, Brasil, 1979-1994.

To study homicide trends by gender and age, 1979-1994, São Paulo, Brazil, cubic polynomials were used to determine the best model for adjusting to time trends in homicide mortality rates by age and gender in the city of São Paulo, Brazil, 1979-1994. The model best adjusted to each group was selected considering the regression coefficient (Beta) , R2 value, residual analysis, and model's simplicity. The results show linear growth for total rates and rates by gender due to behavior of rates in the 20-29 and 30-39 year age groups. The reciprocal model adjusted best to rates for the 40-49 and 50-59 year age groups, while rates for adolescents followed the multiplicative model. There was no significant relationship between homicide rates and time for the remaining groups (under 10 and over 59 years). Rates for males were considerably higher in all age groups. The remarkably steady growth in homicide rates among adolescents and young adults is consistent with trends observed in other urban areas in developing and developed countries and denotes deteriorating living conditions and increased poverty.

Intra-urban differentials in death rates from homicide in the city of São Paulo, Brazil, 1988-1994.

The objective of this research was to analyze the relationship between socioeconomic statistics and homicide mortality rates in the city of São Paulo between 1988 and 1994. City districts were grouped into five geographic areas. A socioeconomic indicator (ISE) was constructed with census information combining average income of the family head, illiteracy rate for the population over 5 yr of age, average number of rooms and number of persons per household. The higher the score, the better the socioeconomic situation (possible values: 4 to 384). Deaths from homicide were grouped by residential areas, and the rates for these areas were calculated. The association between homicide rates and the socioeconomic situation was analyzed with Spearman correlation coefficients. Average ISE scores varied from 291 in the Central area (homicide rate = 27.96 deaths per 100000) to 119.9 in the East area (homicide rate = 40.38). The Spearman coefficient between ISEs and homicide rates was -0.98 (p < 0.05). Due to the heterogeneity inside the areas, the median ISE is a better indicator of the socioeconomic conditions yielding an rs = -1.0. Almost half the population resides in areas with the highest risk of homicide mortality (East and South). Taking the Central area as a reference, we found risks of 1.36 in the Western, 1.37 in the Northern, 1.44 in the Eastern and 2.67 in the Southern areas.

Technologic organization of malaria control in São Paulo, Brazil, 1930-1990.

Since the 1970s, when the world seemed on the threshold of malaria eradication, the incidence of the disease has increased in several countries. The upturn in cases raised a series of questions, and for some time malariologists and public health authorities scarcely understood what was happening. In an attempt to better comprehend the process, this article reviews the frequency of malaria cases in São Paulo, Brazil, between 1930 and 1990, examining the following factors in each of three 20-year time periods: the importance of malaria in the society, the conditions under which the disease occurred, the epidemiologic knowledge of the time, the technical instruments available to fight it, and the control strategies that were used. Through the construction of technological models based on these factors, it became clear that the occurrence of the disease, knowledge about it, and, consequently, the ways it was dealt with changed over time. In light of this research, the article discusses current options for the control of malaria.

[Technological organization of malaria control in São Paulo, Brazil, from 1930 to 1990]. / Organización tecnológica del control de la malaria en São Paulo, Brasil, de 1930 a 1990.

Since the 1970s, when malaria had seemed at the threshold of eradication, its incidence has increased in several countries of the world. This situation posed a series of questions, and for some time malariologists and public health authorities scarcely understood what was happening. In order to better comprehend the process, the author of this article studied the frequency of malaria cases in São Paulo, Brazil, from 1930 to 1990, attempting to examine the following factors in each of the periods studied: the importance of malaria in the society, the conditions under which the disease occurred, the epidemiologic knowledge of the time, the available technical instruments, and the control strategies that were used. Through the construction of technological models based on these factors, it became clear that the occurrence of the disease, knowledge about it, and, consequently, the ways it was dealt with changed over time. In light of this research, the paper discusses current options for the control of malaria.