Establishment and cryptic transmission of Zika virus in Brazil and the Americas.

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.

Prevalência de cefaleia em uma unidade de diálise / Prevalence of headache in a dialysis clinic

Introdução: De acordo com a Sociedade Internacional de Cefaleia, a cefaleia é uma dor localizada acima da linha orbitomeatal, classificada como primária e secundária. A cefaleia da diálise consiste em uma dor de cabeça inespecífica que ocorre no período da diálise, podendo persistir após o término da sessão. Apesar de ser um sintoma comum em pacientes submetidos à hemodiálise, a cefaleia decorrente da terapia dialítica é pobremente estudada. Não se tem a sua etiologia precisa, porém infere-se que a gênese da cefaleia seja multifatorial. Objetivo: Avaliar a prevalência da cefaleia em pacientes submetidos à hemodiálise. Além disso, classificar as cefaleias apresentadas pelos pacientes estudados, inclusive as que não são decorrentes da diálise. Métodos: Trata-se de um estudo constituído por pacientes submetidos à terapia dialítica em uma clínica, de uma cidade brasileira, no período de maio a agosto de 2014. Este foi composto por 152 pacientes. Resultados: Foram analisados 77 (50,7%) pacientes do sexo masculino e 75 (49,3%) do sexo feminino. Dos 61 pacientes (40,1%) que afirmaram apresentar episódios de cefaleia, os tipos mais prevalentes foram cefaleia do tipo tensional ­ CTT (41%) e cefaleia da diálise (37,7%), sendo outros tipos menos frequentes. Ou seja, 23 (15,1%) dos 152 pacientes foram diagnosticados com cefaleia da diálise, isolada ou associada a outros tipos de cefaleia. Conclusão: Diante da elevada prevalência de tal condição, elaborar planos de ação para melhoria da qualidade de vida desses pacientes é uma medida relevante.

Introduction: According to the International Society of Headache, headache is a pain located above the orbitomeatal line, classified as primary and secondary. The dialysis headache isclassified as secondary and consists of a nonspecific headache that occurs during the period of dialysis and may persist after the end of the session. Despite being a common symptom in patients undergoing hemodialysis, headache resulting from dialysis is poorly studied. It does not have a precise etiology, however it appears that the genesis of the headache is multifactorial. Background. Evaluate the prevalence of headache in patients submitted to hemodialysis. Besides classify headaches evidenced by patient studied, including those which are not decurrent from dialysis. Methods. It´s a study consists of patients who had dialysis performed at a clinic, in a brazilian city, from May to August, 2014. This was composed of 152 patients. Results. 77 (50,7%) patients were males and 75 (49,3%) were females. Of the 61 (40,1%) affirmed evince headache episodes, the most prevalence types were tension type headache ­ CTT (41%) and headache from dialysis (37,7%), and other less common types. So, 23 (15,1%) of 152 patients were diagnosed with headache from dialysis, irrespective of being or not being associated with other types of headache. Conclusion. Such high prevalence of this condition, draw up action plans to improve the quality of life of these patients is a relevant measure.

Aberrant signaling in T-cell acute lymphoblastic leukemia: biological and therapeutic implications.

T-cell acute lymphoblastic leukemia (T-ALL) is a biologically heterogeneous disease with respect to phenotype, gene expression profile and activation of particular intracellular signaling pathways. Despite very significant improvements, current therapeutic regimens still fail to cure a portion of the patients and frequently implicate the use of aggressive protocols with long-term side effects. In this review, we focused on how deregulation of critical signaling pathways, in particular Notch, PI3K/Akt, MAPK, Jak/STAT and TGF-beta, may contribute to T-ALL. Identifying the alterations that affect intracellular pathways that regulate cell cycle and apoptosis is essential to understanding the biology of this malignancy, to define more effective markers for the correct stratification of patients into appropriate therapeutic regimens and to identify novel targets for the development of specific, less detrimental therapies for T-ALL.

Aberrant signaling in T-cell acute lymphoblastic leukemia: biological and therapeutic implications

T-cell acute lymphoblastic leukemia (T-ALL) is a biologically heterogeneous disease with respect to phenotype, gene expression profile and activation of particular intracellular signaling pathways. Despite very significant improvements, current therapeutic regimens still fail to cure a portion of the patients and frequently implicate the use of aggressive protocols with long-term side effects. In this review, we focused on how deregulation of critical signaling pathways, in particular Notch, PI3K/Akt, MAPK, Jak/STAT and TGF-ß, may contribute to T-ALL. Identifying the alterations that affect intracellular pathways that regulate cell cycle and apoptosis is essential to understanding the biology of this malignancy, to define more effective markers for the correct stratification of patients into appropriate therapeutic regimens and to identify novel targets for the development of specific, less detrimental therapies for T-ALL.

Biochemical analysis of proteins and lipids found in parasitophorous vacuoles containing Leishmania amazonensis.

One fundamental step of Leishmania-macrophage interaction is the phase of parasite internalization through an endocytic process, with the formation of the parasitophorous vacuole (PV). The present study analyzed this process using two approaches. First, to investigate the host cell proteins which take part in this compartment, the macrophage surface was biotinilated and allowed to interact with both Leishmania forms, the PV was then isolated, and the biotinilated proteins were analyzed by Western blot. The results obtained showed that the isolated PV from macrophages infected for 60 min with infective promastigotes displayed high molecular weight proteins, 220 kDa and 180 kDa, contrary to the isolated PV obtained from amastigotes. The isolated PV from amastigotes, after 60 min interaction, displayed a faint, biotinilated protein profile, in contrast to the PV containing amastigote which, after 30 min interaction, displayed a strong protein profile in the range of 120 kDa and 40-60 kDa. The biotinilated protein profile may represent proteins distributed in the PV membrane and may also correspond to biotinilated proteins incorporated by the intracellular parasite, as observed by confocal microscopy. In a second approach, to investigate the PV phospholipid composition, macrophages were incubated with (32)P, allowed to interact with the parasites, and the isolated PV was then processed for phospholipid analysis by thin layer chromatography and scintillation counting. An increase in the levels of lysophosphatidylcholine was observed in infected macrophages. The isolated PV from infective promastigotes and amastigotes, after 60 min interaction, displayed high levels of phosphatidylcholine. Then the PV was ruptured and the intravacuolar parasite's (32)P phospholipid composition was analyzed by TLC; and labeling of the parasites was found, suggesting that phospholipids from the macrophage are transferred to the parasite. Taken together, the results obtained show that several proteins and phospholipids found in the plasma membrane of the macrophage are also found in the PV compartment.

Redistribution of plasma-membrane surface molecules during formation of the Leishmania amazonensis-containing parasitophorous vacuole.

Leishmania amazonensis presents two developmental stages that gain access to the host macrophage through phagocytosis. The protozoan resides in a membrane-bound compartment, the parasitophorous vacuole (PV), which can fuse with the endocytic system. For evaluation of the parasite/host-cell interaction process and of PV biogenesis, the two parasite forms or host-cell membrane whose surface had previously been labeled with specific probes for lipids, proteins, and sialoglycoconjugates were allowed to interact for periods varying from 5 to 15 min for adhesion and from 30 to 60 min for PV formation. The fate of fluorescent probes was followed by confocal laser scanning microscopy. In host cells previously labeled with PKH26, DTAF and FITC-thiosemicarbazide, which label membrane lipids, proteins, and sialoglycoconjugates, respectively, interaction with both protozoan forms revealed that adhesion to the macrophage was sufficient for labeling of the parasite surface. In addition, recently formed PVs displayed strongly labeled intravacuolar parasites, except for amastigote-macrophage interaction in a DTAF-labeled macrophage that displayed slight labeling of intravacuolar parasites, with the membrane lining the PV evidently being stained. Therefore, the vacuole modulation presents some particularities such that different host-cell membrane components may be selected, depending on the protozoan form involved. Thereafter, amastigotes labeled with the probes mentioned above displayed a diffuse labeling pattern after interaction with unlabeled macrophages, suggesting the spreading of Leishmania surface molecules during the initial parasite-invasion stages. In particular, intravacuolar DTAF-labeled amastigotes showed a delineating halo around the PV, with the intravacuolar parasite being partially labeled. Promastigotes could not be labeled with 5-(4,6-dichlorotriazinyl)aminofluorescein (DTAF) or with fluorescein-5-thiosemicarbazide, but promastigotes labeled with PKH26 lost the fluorescent probe during the invasion process such that slightly labeled promastigotes were seen inside the PV. These observations indicate the existence of a dynamic process of exchange of membrane-associated glycoproteins and lipids between the parasite and the host cell.

[Primary psoas abscess in a child. Case report and review of the literature]. / Abscesso primário do psoas em criança: relato de caso e revisão da literatura.

Primary psoas abscess is an uncommon disease. In children, clinical manifestations is often inspecific leading to diagnostic delay. The authors relate a primary pyogenic abscess of the psoas muscle in a 7-year-old girl with secondary septic arthritis of the hip. Confirmation of diagnosis was established by computerized tomography (CT) of the abdominal and pelvic areas. A review of the literature is presented about clinical manifestations, pathogenesis, differential diagnosis, etiology, diagnostic and therapeutic management of this infrequent entity.

Partial characterization of folate uptake in microvillous membrane vesicles isolated from human placenta.

The purpose of the present study was to determine biochemical parameters of folate uptake, and the putative contribution of the membrane-anchored folate receptor in microvillous membrane vesicles obtained from the syncytiotrophoblast of human term placenta. Uptake of [3H]-pteroylglutamic acid (PGA) by microvillous membrane vesicles was pH dependent with a maximum at pH 6.0, and attained equilibrium at 60 min of incubation. Uptake was higher in the presence on an inward pH gradient (pHout = 6.0; pHin = 7.5) than in the absence of the gradient (pHout = pHin = 6.0). The effect of changes in medium osmolality showed that both binding to the vesicular membrane and internalization contributed to the measured [3H]-PGA uptake. Equilibrium uptake experiments using [3H]-PGA concentrations within the physiological range of folate in blood serum showed that saturation was achieved at 30 nM and revealed a single class of binding sites with a Kd of 1.8 nM for [3H]-PGA. Cleavage of the glycosyl-phosphatidylinositol moiety of the folate receptor, which anchors the receptor to the membrane, with phosphatidylinositol-specific phospholipase C resulted in a reduction of about 80% in [3H]-PGA uptake. In conclusion, our results showed that the folate uptake in the maternally facing membrane of the human placenta presents a saturable component and is mediated by the folate receptor to ensure an adequate maternal-fetal folate transfer.

Partial characterization of folate uptake in microvillous membrane vesicles isolated from human placenta

The purpose of the present study was to determine biochemical parameters of folate uptake, and the putative contribution of the membrane-anchored folate receptor in microvillous membrane vesicles obtained from the syncytiotrophoblast of human term placenta. Uptake of [3H]-pteroylglutamic acid (PGA) by microvillous membrane vesicles was pH dependent with a maximum at pH 6.0, and attained equilibrium at 60 min of incubation. Uptake was higher in the presence of an inward pH gradient (pHout = 6.0; pHin = 7.5) than in the absence of the gradient (pHout = pHin = 6.0). The effect of changes in medium osmolality showed that both binding to the vesicular membrane and internalization contributed to the measured [3H]-PGA uptake. Equilibrium uptake experiments using [3H]-PGA concentrations within the physiological range of folate in blood serum showed that saturation was achieved at 30 nM and revealed a single class of binding sites with a Kd of 1.8 nM for [3H]-PGA. Cleavage of the glycosyl-phosphatidylinositol moiety of the folate receptor, which anchors the receptor to the membrane, with phosphatidylinositolspecific phospholipase C resulted in a reduction of about 80 per cent in [3H]-PGA uptake. In conclusion, our results showed that the folate uptake in the maternally facing membrane of the human placenta presents a saturable component and is mediated by the folate receptor to ensure an adequate maternal-fetal folate transfer.

[Survival curves of AIDS patients in Santos, Brazil]. / Curvas de sobrevivência de pacientes de AIDS em Santos, Brasil.

PIP: The probabilities of survival of patients carrying the AIDS virus are presented in the city of Santos, Brazil, where it is estimated that 1056 cases were reported in 1988, 1989, and 1990. Records of epidemiological investigations delivered by outpatient services or obtained by means of active search realized routinely in city hospitals were analyzed. Information on deaths were derived from the offices of the civil registry of Santos, Sao Vincente, and Guaruja, and from the notifications received. Losses (deaths registered in offices of other regions) were estimated at less than 2%, the proportion of incidence in the general population according to data of the Foundation SEADE. The patients were grouped by sex and stage of progression of the disease according to classification of cases (IV B, IV C, IV D, and IV E conform to the classification of the Centers for Disease control) [CDC, suspected cases (class IV A of CDC), and asymptomatic seropositive cases (classes I, II, and II of CDC).^ieng

[Epidemiological surveillance system for occupational accidents: experience in the northern area of the municipality of São Paulo (Brazil)]. / Sistema de vigilância epidemiológica para acidentes do trabalho: experiência na zona norte do município de São Paulo (Brasil).

The epidemiological approach to occupational accidents and diseases adopted in Brazil is inadequate for many reasons, among them being: 1) the fact that only employers may notify work accidents, thus permitting notorious undernotification of these occupational hazards; 2) the available information does not permit a better understanding of the causal relationship between work accidents and diseases; 3) the official policy exists only for purposes of insurance compensation. The official documents for occupational disease and accident registration are the CTA (Work accident report) and FTA (Casualty treatment card). The Worker's Health Program of SUDS-R-6 proposed, in October, 1988 a method for the codification, registration in a micro-computer data bank and analysis of this information, based on the records presently in use (CAT) for public health service planning and accident prevention purposes. The major interest was in identifying the most common types of accidents in the region and the work environments in which they most frequently occur. The target population were the workers who attended the health units lisenced to deal with work accidents and diseases, in the Northern region of S. Paulo City. The data presented below refer to the months of October, November and December, 1988, the first three months of the project. During that period a total of 2,339 accidents were registered. They were classified as: typical work accidents - 87%: commuting accidents which occurred between the home and the work-place--18% and work diseases (only 2 cases). The majority of workers (50%) were between 25 and 45 years of age, approximately 7% were under 18. Male workers represented 83.2% of accident cases.(ABSTRACT TRUNCATED AT 250 WORDS)

[Functional therapeutics: official subject in gynecology. New findings in gynecology. 22nd Brazilian Meeting on Gynecology and Obstetrics]. / 22 Jornada Brasileira de Ginecologia e Obstetricia, tema oficial de ginecologia; Aquisicoes Recents em Ginecologia: Terapeutica Funcional.

PIP: During the past 5 years, after a much longer period of studies and research, new methods of treatment for several gynecological disorders have been employed. Among such new methods the most important are: 1) the use of gonadotropin-releasing hormones as contraceptive agents, to diagnose cases of hypogonadism, or to cure amenorrhea. Gonadotropin-releasing hormones can be administered in several ways, provoke different reactions in different women, and are subject to several contraindications; 2) transphenoidal surgery for hypersecretory hypophysary tumors, or microsurgery of the hypophysis, which allows the identification of tumors smaller than 10mm, and which is used in the treatment of galactorrhea; 3) the use of ergot alkaloids derivates, such as bromocriptine or Lergotrile, to provoke menstruation and ovulation; 4) the clinical use of danazol in the treatment of endometriosis and in induction of ovulation; and 5) the treatment of primary dysmenorrhea by the use of synthetic inhibitors or by the use of prostaglandins.^ieng