Study of Health in Pomerode (SHIP-Brazil): aims, methodological issues and descriptive results / Estudo Vida e Saúde em Pomerode (SHIP-Brazil): objetivos, aspectos metodológicos e resultados descritivos

Background Few studies compared populations with similar genetic and culture background on different continents with standardized methods. Objective To describe methodological issues of the Study of Health in Pomerode - SHIP-Brazil and some characteristics of the participants of the baseline examination. Design and Setting Prospective, population-based cohort study of a representative sample of residents (aged 20 to 79 years) of Pomerode, Santa Catarina, Brazil. Methods Data for the baseline survey (from 2014 to 2018) were collected through interviews and medical examinations, including socio-demographic and lifestyle information, clinical and subclinical conditions, oral and mental health, among others. Biosamples (blood, urine, stool, and saliva) were collected and stored. Methods of data collection and quality control are described. Preliminary descriptive statistics were performed. Results The response rate was 67.6% (n=2,488 individuals). The Kappa test-retest of some variables varied from 0.54 to 1.0. German culture participants are older (46.5 vs 38.7 years), self-declared white (97.3% vs 82.1%), more frequently never smokers (71.4% vs 66.9%) but had higher risk of consuming alcohol (16.9% vs 13.4%) compared to participants with non-German background. Germans were taller (169 cm vs 166 cm), had greater abdominal circumference among men (101.9 cm vs 97.3 cm). Furthermore, they reported more multimorbidity (56.7% vs 43.6%) , had more arterial hypertension (30.7% vs 18.5%), but less depression (15.4% vs 19,1%) than non-Germans. Conclusions The interaction of genetic and social/environmental issues should be examined to understand the role of risk factors on clinical conditions observed.

Introdução Poucos estudos compararam populações com histórico genético e cultural semelhante em diferentes continentes com métodos padronizados. Objetivos Descrever questões metodológicas do estudo de "Vida e Saúde em Pomerode - SHIP-Brazil" e algumas características dos participantes do exame inicial do estudo. Desenho de estudo e local Estudo de coorte prospectivo de base populacional em amostra representativa de moradores (20 a 79 anos) de Pomerode, Santa Catarina. Métodos As informações para a linha de base (de 2014 a 2018) foram coletadas por meio de entrevistas e exames médicos, incluindo dados sociodemográficos, de estilo de vida, condições clínicas e subclínicas, saúde bucal e mental, entre outros. Amostras biológicas (sangue, urina, fezes e saliva) foram coletadas e armazenadas. A coleta de dados e o controle de qualidade foram descritos. Foram realizadas análises descritivas preliminares. Resultados A taxa de resposta foi de 67,6% (n=2.488 indivíduos). O Kappa teste-reteste de algumas variáveis variou  de 0,54 a 1,0. Os participantes de cultura alemã são mais velhos (46,5 vs 38,7 anos ), autodeclarados brancos (97,3% vs 82,1%), com menor número de fumantes (71,4% vs 66,9%), mas tiveram maior risco de consumir álcool (16,9% vs 13,4%), eram mais altos (169 cm vs 166 cm), tinham maior circunferência abdominal entre os homens (101,9 cm vs 97,3 cm) em comparação com participantes "não-alemães". Pessoas de cultura alemã relataram mais multimorbidade (56,7% vs 43,6%), apresentavam mais hipertensão arterial (30,7% vs 18,5%), mas menos depressão (15,4% vs 19,1%). Conclusões A interação genética e social/ambiental devem ser examinadas para melhor entender o papel desses fatores de risco nas condições clínicas observadas.

A Bioguided Approach for the Screening of Antibacterial Compounds Isolated From the Hydroalcoholic Extract of the Native Brazilian Bee's Propolis Using Mollicutes as a Model.

Nature is a vast source of medicinal substances, including propolis, which has been extensively investigated. Propolis is a resinous substance produced by bees from the exudates of plants that they collect and modify in their jaws; it is a rich and complex matrix with secondary metabolites of diverse botanical origins. The objective of this study was to apply an in vitro bioguided approach using as a model system the mollicutes with a sample of propolis from the Brazilian native bee Melipona quadrifasciata (mandaçaia) in order to identify potential new molecules with antimicrobial activity. A crude hydroalcoholic extract was obtained and submitted to liquid-liquid partitioning with solvents of different polarities, generating four different fractions: aqueous, dichloromethane, butanol, and ethyl acetate fractions. The antimollicute activity assays served as a basis for the bioguided fractionation. The dichloromethane fraction was the most promising, exhibiting a minimal inhibitory concentration (MIC) of 125 µg/mL against Mycoplasma pneumoniae. After purification by column liquid chromatography, a subfraction presenting MIC of 15.6 µg/mL against Mycoplasma genitalium was highlighted. The fractions were also tested against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Using gas chromatography coupled to a mass spectrometer (GC-MS), several volatile compounds were identified in the non-polar fractions of this propolis. However, the more purified molecules had no better antimollicute activity than their original subfraction. Apparently, the synergism among its compounds is largely responsible for the antibacterial activity of the propolis of this native Brazilian bee.

Anti-Hepatitis B Antibody Levels In Immunized Medical Students: Are They At Risk?

INTRODUCTION: Medical students have an occupational risk for hepatitis B (HB). This study sought to determine anti-HBs and anti-HBc IgG levels in vaccinated students, check their seroconversion, and correlate this with vaccination. METHODS: One hundred and forty-three students' blood samples and their vaccination schedules were analyzed. RESULTS: 65.7% were positive for anti-HBs; however, anti-HBs was absent in 34.3%. Only two samples were positive for anti-HBc IgG. CONCLUSIONS: More than 30% of students did not have minimum protective levels. Comparing HBV vaccination and anti-HBs reactivity, the majority of reactive individuals received their last dose within the past 16 years.

Anti-hepatitis B antibody levels In immunized medical students: are they at risk?

Abstract INTRODUCTION Medical students have an occupational risk for hepatitis B (HB). This study sought to determine anti-HBs and anti-HBc IgG levels in vaccinated students, check their seroconversion, and correlate this with vaccination. METHODS One hundred and forty-three students' blood samples and their vaccination schedules were analyzed. RESULTS: 65.7% were positive for anti-HBs; however, anti-HBs was absent in 34.3%. Only two samples were positive for anti-HBc IgG. CONCLUSIONS More than 30% of students did not have minimum protective levels. Comparing HBV vaccination and anti-HBs reactivity, the majority of reactive individuals received their last dose within the past 16 years.

Avaliação da qualidade e da estabilidade de amostras de soro humano para análise e armazenamento em biorrepositório / Evaluation of the quality and the stability of human samples for analysis and storage in biorepository

Objetivo: O Estudo das Condições de Vida e Saúde de Pomerode, SC (SHIP-Brasil), conduzido pela Universidade Regional de Blumenau, visa estratificar os fatores de risco e genéticos eventualmente existentes na gênese das mais variadas doenças. Para tal são necessários exames laboratoriais, antropométricos, genéticos e de imagem para a definição das mesmas e o acompanhamento de sua evolução. Este trabalho teve como objetivo avaliar a qualidade das amostras armazenadas no biorrepositório do estudo, que podem ser utilizadas para pesquisas de biomarcadores no futuro. Métodos: Foram avaliadas amostras de soro em jejum de 56 voluntários. Os analitos estudados foram glicose, colesterol total, creatinina e transaminase glutâmico-pirúvica (ALT), após 1, 2 e 3 anos de armazenamento a -80ºC. Os resultados foram analisados com o Teste t de Student e de acordo com o Erro Permitido Máximo para cada analito. Resultados: Não encontramos evidências de que as amostras do Estudo SHIP-Brasil possam perder a sua qualidade após serem armazenadas por longos períodos. Conclusão: Os Procedimentos Operacionais Padrão (POPs) estabelecidos estão adequados para o processamento e preservação das amostras.

High prevalence of HBV carriers among waste collectors in the largest landfill in Latin America

Hepatitis B virus (HBV) is a serious public health problem. Some professions are at an increased risk for HBV infection, such as recyclable waste collectors. In this study, the aim was to evaluate the prevalence of HBV carriers and vaccination coverage among waste collectors in the largest landfill in the Rio de Janeiro metropolitan area, as well as to determine the association between risk factors and HBV infection in the studied population. In this study 73 participants answered a questionnaire on their socio-demographic variables and occupational exposure to waste. All of the subjects in the study were tested for HBsAg and their vaccination cards were evaluated in order to assess their HBV vaccination status. The vaccination coverage among the individuals who had a vaccination card was 57.4%. The overall prevalence of HBsAg was 12.3%. The prevalence of HBsAg was significantly higher among men (p = 0.002). However, no statistical differences were found in the prevalence of HBsAg between individuals with a history of occupational accidents involving sharp edges and non-injured individuals (p = 0.267). The results of this study demonstrate the need to strengthen prevention measures and increase HBV vaccination among waste collectors.

Citocinas de resposta Th1 e Th2 e diabetes mellitus tipo 1 / Th1 and Th2 response cytokins in type 1 diabetes mellitus

O diabetes mellitus tipo 1 (DM1) é uma doença autoimune crônica, onde as células T autorreativas destroem as células beta pancreáticas levando à dependência de insulina exógena. Para o desenvolvimento do DM1 são necessárias numerosas interações entre as células do sistema imunológico, principalmente mediadas por citocinas de resposta T helper 1 (Th1) e T helper 2 (Th2). O presente estudo teve como objetivo analisar a relação das citocinas de resposta Th1 e Th2 no desenvolvimento do DM1 por meio de uma revisão de literatura, avaliando artigos científicos eletrônicos publicados entre os anos de 2001 e 2016, além de livros de imunologia aplicados à clínica. Diversos estudos na literatura demonstram que o perfil de secreção de citocinas durante o desenvolvimento do DM1 é de padrão Th1 onde temos como principais constituintes a IL-2 e o IFN-y. Já as citocinas de resposta Th2, compostas basicamente pela IL-4, IL-6 e IL-10, são responsáveis por bloquear a evolução do DM1. Através desses dados conclui-se que o entendimento dos aspectos imunológicos constitui a base para detecção e prevenção do DM1, sendo a disponibilidade de citocinas clonadas e purificadas uma nova perspectiva para terapias clínicas específicas para modular a resposta imune

Type 1 diabetes mellitus (DM1) is a chronic autoimmune disease, where as autoreactive T cells destroy as pancreatic beta cells leading to exogenous insulin dependence. For the development of DM1, interactions between immune system cells, mainly mediated by cytokines of T helper 1 (Th1) and T helper 2 (Th2) are required. The present study aimed to analyze the relationship of Th1 and Th2 response cytokines in the development of DM1, through a review of the literature, evaluating electronic scientific articles published between 2001 and 2016, as well as immunology books applied to the clinic. Several studies in the literature demonstrate that the cytokine secretion profile during the development of DM1 is of the Th1 pattern where we have as main constituent of IL-2 and IFN-γ. As Th2 response cytokines, composed mainly of IL-4, IL-6 and IL-10, they are responsible for blocking the progression of DM1. Through conclusive data, it is a point of view for the prevention of DM1. With the availability of cloned and purified cytokines a new perspective for specific clinical therapies to modulate the immune response

Mollicutes/HIV Coinfection and the Development of AIDS: Still Far from a Definitive Response.

Background. Mycoplasmas are known to cause various infections in humans, mainly in the respiratory and urogenital tracts. The different species are usually host-specific and cause diseases in well-defined sites. New species have been isolated, including those from HIV-infected persons. Summary. Its in vitro properties, combined with clinical findings, have led to the hypothesis that these microorganisms may act as cofactors of HIV in AIDS development. Even today this point of view is quite polemic among infectious disease specialists and many aspects remain to be clarified, in contrast to what happens, for instance, with HIV/Mycobacterium tuberculosis coinfection. Dozens of papers have been published covering aspects of Mollicutes/HIV coinfection, but they add little to no information about the putative contribution of Mollicutes to the evolution of AIDS. Very few researchers have devoted their efforts to trying to answer this question, which remains open. In this review, we discuss the evidences that may support this statement in the light of current knowledge in the field of mycoplasmology.

Antimicrobial (including antimollicutes), antioxidant and anticholinesterase activities of Brazilian and Spanish marine organisms – evaluation of extracts and pure compounds

Abstract This work describes the antimicrobial, antioxidant and anticholinesterase activities in vitro of organic extracts from fourteen seaweeds, eleven sponges, two ascidians, one bryozoan, and one sea anemone species collected along the Brazilian and Spanish coast, as well as the isolation of the diterpene (4R, 9S, 14S)-4α-acetoxy-9β,14α-dihydroxydolast-1(15),7-diene (1) and halogenated sesquiterpene elatol (2). The most promising antimicrobial results for cell wall bacteria were obtained by extracts from seaweeds Laurencia dendroidea and Sargassum vulgare var. nanun (MIC 250 μg/ml), and by the bryozoan Bugula neritina (MIC 62.5 μg/ml), both against Staphylococcus aureus. As for antimollicutes, extracts from seaweeds showed results better than the extracts from invertebrates. Almost all seaweeds assayed (92%) exhibited some antimicrobial activity against mollicutes strains (Mycoplasma hominis,Mycoplasma genitalium,Mycoplasma capricolum and Mycoplasma pneumoniae strain FH). From these seaweeds, A1 (Canistrocarpus cervicornis), A11 (Gracilaria sp.) and A4 (Lobophora variegata) showed the best results for M. pneumoniae strain FH (MIC 250 μg/ml). Furthermore, compounds 1 and 2 were also assayed against mollicutes strains M. hominis,M. genitalium,M. capricolum,M. pneumoniae strain 129 and M. pneumoniae strain FH, which showed MIC > 100 μg/ml. Antioxidant activities of extracts from these marine organisms were inactive, except for E7 (from sponge Ircinia sp.), which exhibited moderated antioxidant activities for two methods assayed (IC50 83.0 ± 0.1 μg/ml, and 52.0 ± 0.8 mg AA/g, respectively). Finally, for the anticholinesterase activity, all the 29 samples evaluated (100%) exhibited some level of activity, with IC50 < 1000 μg/ml. From these, seaweeds extracts were considered more promising than marine invertebrate extracts [A10 (IC50 14.4 ± 0.1 μg/ml), A16 (IC50 16.4 ± 0.4 μg/ml) and A8 (IC50 14.9 ± 0.5 μg/ml)]. The findings of this work are useful for further research aiming at isolation and characterization of active compounds.

Molecular epidemiology of heteroresistant vancomycin-intermediate Staphylococcus aureus in Brazil

ABSTRACTTo determine the epidemiological and molecular characteristics of 12 Staphylococcus aureus isolates presenting heteroresistance to vancomycin in laboratories of two cities in Santa Catarina, southern Brazil. Epidemiological data, including the city of isolation, health institution, and date of isolation were considered, as well as the associated clinical specimen. For molecular characterization, we analyzed the staphylococcal cassette chromosome types, the erm gene presence, and the genomic diversity of isolates using pulsed-field gel electrophoresis. The 12 isolates of S. aureus were previously confirmed as heteroresistance to vancomycin using the population analysis profile-area under curve. Regarding genetic variability, two clones were detected: the main one (clone A) composed of four isolates and the clones B, with two isolates. For clone A, two isolates presented identical band patterns and were related to the same hospital, with an interval of 57 days between their isolation. The other isolates of this clone showed no epidemiological link between them because they were isolated in different hospitals and had no temporal relationship. The other clone showed no detectable epidemiological relationship. The heteroresistance to vancomycin recovered in Santa Catarina State from 2009 to 2012 had, in general, heterogeneous genomic patterns based on pulsed-field gel electrophoresis results, which is in accordance with the fact that these isolates had little or no epidemiological relationship among them. Due to the characteristic phenotypic instability and often prolonged vancomycin therapy for selection, clonal spread is not as common as for other resistance mechanisms disseminated through horizontal gene transfer.

Molecular epidemiology of heteroresistant vancomycin-intermediate Staphylococcus aureus in Brazil.

To determine the epidemiological and molecular characteristics of 12 Staphylococcus aureus isolates presenting heteroresistance to vancomycin in laboratories of two cities in Santa Catarina, southern Brazil. Epidemiological data, including the city of isolation, health institution, and date of isolation were considered, as well as the associated clinical specimen. For molecular characterization, we analyzed the staphylococcal cassette chromosome types, the erm gene presence, and the genomic diversity of isolates using pulsed-field gel electrophoresis. The 12 isolates of S. aureus were previously confirmed as heteroresistance to vancomycin using the population analysis profile-area under curve. Regarding genetic variability, two clones were detected: the main one (clone A) composed of four isolates and the clones B, with two isolates. For clone A, two isolates presented identical band patterns and were related to the same hospital, with an interval of 57 days between their isolation. The other isolates of this clone showed no epidemiological link between them because they were isolated in different hospitals and had no temporal relationship. The other clone showed no detectable epidemiological relationship. The heteroresistance to vancomycin recovered in Santa Catarina State from 2009 to 2012 had, in general, heterogeneous genomic patterns based on pulsed-field gel electrophoresis results, which is in accordance with the fact that these isolates had little or no epidemiological relationship among them. Due to the characteristic phenotypic instability and often prolonged vancomycin therapy for selection, clonal spread is not as common as for other resistance mechanisms disseminated through horizontal gene transfer.

Evaluation of seasonal chemical composition, antibacterial, antioxidant and anticholinesterase activity of essential oil from Eugenia brasiliensis Lam.

This study describes the seasonal composition and the antibacterial, antioxidant and anticholinesterase activity of the essential oil from Eugenia brasiliensis leaves. Analysis by using GC allowed the identification of 40 compounds. It was observed that the monoterpenes varied more (42%) than the sesquiterpenes (14%), and that the monoterpene hydrocarbons suffered the greatest variation throughout the year (64%). Major compounds were spathulenol in the spring (16.02 ± 0.44%) and summer (18.17 ± 0.41%), τ-cadinol in the autumn (12.83 ± 0.03%) and α-pinene (15.94 ± 0.58%) in the winter. Essential oils were tested for their antibacterial activity, and the best result was obtained from the autumn oil, with MIC = 500 µg mL(- 1) against Staphylococcus saprophyticus and Pseudomonas aeruginosa. Antioxidant activity was evaluated using DPPH, lipid peroxidation and iron-reducing power assays, as well as the anticholinesterase activity. Both tests showed a weak performance of the essential oils.

Micoses superficiais em pacientes com Diabetes Mellitus atendidos em um ambulatório geral em Blumenau, SC / Superficial mycoses in patient with Diabetes Mellitus served in a general outpatient clinic in Blumenau, SC

O Diabetes Mellitus (DM) caracteriza-se por uma síndrome clínica de evolução crônica e degenerativa, decorrente de distúrbio na secreção e/ou ação da insulina no organismo, que determina um conjunto de alterações metabólicas, caracterizadas,principalmente, pela hiperglicemia. Os indivíduos portadores de DM são, em geral, indivíduos vulneráveis a uma série de complicações de natureza infecciosa, como os processos bacterianos, fúngicos e virais. As micoses mais frequentemente encontradas são causadas por fungos dermatófitos e leveduras do gênero Candida. O objetivo deste estudo foi analisar a frequência de infecção fúngica em portadores de DM atendidos em um ambulatório geral, em Blumenau, SC. Métodos: O diagnóstico laboratorial foi feito através de métodos tradicionais, incluindo exame micológico direto e cultura. Resultados: Constatou-se que, dentre os indivíduos avaliados, 36% apresentaram resultado positivo,sendo que, desses, 86% apresentaram lesão por Candida spp. e 14% por dermatófitos, o qual foi identificado como Trichophyton mentagrophytes na cultura. Conclusão: A maior frequência de Candida spp. pode estar relacionada à imunossupressão ocasionada pelo Diabetes Mellitus. Com este estudo, pode-se demonstrar a importância do diagnóstico laboratorial precoce das infecções fúngicas em indivíduos com Diabetes Mellitus...

Serologic survey on hantavirus in blood donors from the state of Santa Catarina, Brazil.

Emergent diseases such as Hantavirus Cardio-pulmonary Syndrome (HCPS) are able to create a significant impact on human populations due to their seriousness and high fatality rate. Santa Catarina, located in the South of Brazil, is the leading state for HCPS with 267 reported cases from 1999 to 2011. We present here a serological survey on hantavirus in blood donors from different cities of the state of Santa Catarina, with an IgG-ELISA using a recombinant nucleocapsid protein from Araraquara hantavirus as an antigen. In total, 314 donors from blood banks participated in the study, geographically covering the whole state. Among these, 14 individuals (4.4%) had antibodies to hantavirus: four of 50 (8% positivity) from Blumenau, four of 52 (7.6%) from Joinville, three of 50 (6%) from Florianópolis, two of 50 (4%) from Chapecó and one of 35 (2.8%) from Joaçaba. It is possible that hantaviruses are circulating across almost the whole state, with important epidemiological implications. Considering that the seropositive blood donors are healthy individuals, it is possible that hantaviruses may be causing unrecognized infections, which are either asymptomatic or clinically nonspecific, in addition to HCPS. It is also possible that more than one hantavirus type could be circulating in this region, causing mostly benign infections.

Immune memory response induced in vitro by recombinant hepatitis B surface antigen challenge 13-18 years after primary vaccination.

The question of whether booster doses are required to maintain long-term protection against hepatitis B virus (HBV) after primary vaccination remains to be determined. Thus, the aim of this study was to evaluate the immune memory responses to hepatitis B surface antigen (HBsAg) challenge in vaccinated individuals through an in vitro-specific stimulation assay. Peripheral blood mononuclear cells (4 × 10(6) cells/ml) were stimulated with 50 ng/ml of recombinant HBsAg. In vitro anamnestic antibody responses, as shown by detection of high avidity antibody in culture supernatants, were found 13-18 years after primary vaccination and were not correlated with serum antibodies (r = -0.177; P = 0.377). In addition, the findings from this study indicate that immune memory against hepatitis B was well preserved in 40.0% and 60.0% of vaccinees with anti-HBs levels less than 10 IU/L or lacking serum antibodies altogether, respectively. In conclusion, the data suggest the presence of immunological memory in vaccinated individuals, including those who showed anti-HBs <10 IU/L or undetectable antibody.

Serologic surve on hantavirus in blood donors from the state of santa Catarina, Braiil / Inquérito sorológico para hantavírus em doadores de sangue no Estado de Santa Catarina, Brasil

Emergent diseases such as Hantavirus Cardio-pulmonary Syndrome (HCPS) are able to create a significant impact on human populations due to their seriousness and high fatality rate. Santa Catarina, located in the South of Brazil, is the leading state for HCPS with 267 reported cases from 1999 to 2011. We present here a serological survey on hantavirus in blood donors from different cities of the state of Santa Catarina, with an IgG-ELISA using a recombinant nucleocapsid protein from Araraquara hantavirus as an antigen. In total, 314 donors from blood banks participated in the study, geographically covering the whole state. Among these, 14 individuals (4.4%) had antibodies to hantavirus: four of 50 (8% positivity) from Blumenau, four of 52 (7.6%) from Joinville, three of 50 (6%) from Florianópolis, two of 50 (4%) from Chapecó and one of 35 (2.8%) from Joaçaba. It is possible that hantaviruses are circulating across almost the whole state, with important epidemiological implications. Considering that the seropositive blood donors are healthy individuals, it is possible that hantaviruses may be causing unrecognized infections, which are either asymptomatic or clinically nonspecific, in addition to HCPS. It is also possible that more than one hantavirus type could be circulating in this region, causing mostly benign infections.

Doenças emergentes como a Síndrome Cárdio-Pulmonar por Hantavírus (SCPH) são capazes de promover um grande impacto nas populações humanas devido a sua severidade e alta letalidade. Santa Catarina, localizada ao Sul do Brasil, é o estado com o maior número de relatos de SCPH, com 267 casos desde 1999 a 2011. Apresentamos aqui um inquérito sorológico para hantavírus em doadores de sangue de diferentes cidades do Estado de Santa Catarina, usando um teste IgG-ELISA com proteína recombinante de nucleocapsídeo do hantavírus Araraquara como antígeno. No total, 314 doadores de banco de sangue participaram do estudo, cobrindo geograficamente todo o Estado. Dentre estes, 14 indivíduos (4,4%) apresentaram anticorpos para hantavírus: quatro de 50 (8% de positividade) provenientes de Blumenau, quatro de 52 (7,6%) de Joinville, três de 50 (6%) de Florianópolis, dois de 50 (4%) de Chapecó e um de 35 (2,8%) de Joaçaba. É possível que hantavírus estejam circulando praticamente em todo o Estado, com implicações epidemiológicas importantes. Considerando que os doadores de sangue soropositivos são indivíduos saudáveis, é possível que hantavírus possam estar causando infecções não diagnosticadas, sejam elas assintomáticas ou clinicamente inespecíficas, além da SCPH. É possível ainda que mais de um tipo de hantavírus possa estar circulando na região, causando infecções mais benignas.

Is prediffusion test an alternative to improve accuracy in screening hVISA strains and to detect susceptibility to glycopeptides/lipopeptides?

The characterization of heteroresistant vancomycin-intermediate Staphylococcus aureus strains (hVISA) is even more challenging, as no routine standardized laboratory methods are available. A total of 124 S. aureus isolates recovered from inpatients attended in hospitals of Santa Catarina State, Southern Brazil, were evaluated. The MIC of vancomycin, teicoplanin, and daptomycin was determined by Etest and prediffusion tests using NeoSensitabs® tablets. All isolates were susceptible to vancomycin (MICs: 0.5-3 µg/mL) by Etest. However, according to prediffusion test, 17 isolates presented reduced susceptibility to vancomycin, and of these, 12 were confirmed as hVISA using populational analysis. Considering daptomycin, prediffusion results were in agreement with susceptibility data (MICs), as all isolates were susceptible. Considering that characterizing hVISA is challenging and that MIC determination is not adequate to characterize this phenotype, prediffusion test was a viable alternative to screening hVISA and reduced susceptibility to vancomycin. It was simple and low cost, with accuracy comparable to other well-established methods.

In vitro lymphocyte stimulation by recombinant hepatitis B surface antigen: a tool to detect the persistence of cellular immunity after vaccination.

The study of the human immune response to hepatitis B virus (HBV) has been hampered by the lack of an adequate model to evaluate the hepatitis B surface antigen (HBsAg) specific cell response. Thus, this study was conducted to perform an in vitro analysis of the antigenic properties of recombinant HBsAg and demonstrate the influence of variables such as culture time, antigen concentration and cell density on lymphocyte proliferation. Peripheral blood mononuclear cells (PBMCs) were isolated from the venous blood of vaccinated individuals, and in vitro cellular immune responses were evaluated using an HBsAg-specific proliferation assay. Lymphoproliferative responses were detected in culture systems, despite the lack of serum antibodies. Optimal results were obtained when lymphocytes were stimulated at a seeding density of 4×10(6) cells/mL, with 50 ng/mL of recombinant HBsAg protein vaccine for 3 days. Data from the present study may contribute to the development of an adequate system to evaluate the cellular immune responses to HBsAg in vaccine recipients.

A new accurate, simple formula for LDL-cholesterol estimation based on directly measured blood lipids from a large cohort.

BACKGROUND: Low-density lipoprotein cholesterol (LDL-c) is the major measured parameter for cardiovascular risk assessment. The generally accepted formula (LDL-F) for estimating LDL-c developed by Friedewald and colleagues in 1972 using data from 448 individuals suffers from known inaccuracies at extremes of triglyceride (TG) and total cholesterol (TC) values. METHODS: We generated new formulas based on a large Brazilian database containing directly measured lipid values from 10,664 fasted individuals. This database LDL-c was measured by the LDL-C Select FS (DiaSys) system, a homogeneous method without centrifugation. The formulas were generated using linear and non-linear approaches, and the formula with the highest accuracy and simplicity for general clinical use was selected. RESULTS: The simple formula LDL-c = 3/4 (TC - HDL-c) provided an accurate estimate of LDL-c, a higher correlation with directly measured LDL (r = 0.93) compared with LDL-F (r = 0.87), and also a higher accuracy. CONCLUSIONS: The new formula outperformed several other LDL-c formulas over a wide range of TC, HDL-c and TG values. The validation and application of this formula in other populations is warranted.