Factors associated with immunization against hepatitis B among primary health care professionals.

Introduction: The hepatitis B virus is the cause of one of the major public health problems worldwide. The infection may affect the entire population equally; however, health care professionals are part of a group that is more vulnerable to the disease, since they are exposed to both occupational and daily hazards. Objectives: To investigate the prevalence and factors associated with the immunization of health care professionals against the hepatitis virus type B, in the city of Montes Claros, state of Minas Gerais, Brazil. Methods: This was a cross-sectional and quantitative study, conducted with primary health care professionals. Using a random cluster sampling, 209 medical professionals, nurses, and nursing technicians who were interested in participating in the research were selected. A structured questionnaire was applied, and blood sampling was performed for the analysis of hepatitis B surface antibody titers. Finally, a descriptive and bivariate statistical analysis was conducted. Results: Data have shown that 91.8% of the professionals had complete immunization against the hepatitis B virus, that is, they had taken the three recommended doses of the vaccine. However, 13.9% of the sample, even after vaccination, was non-reactive (titers < 10 IU/mL hepatitis B surface antibody). Most of the professionals (94.3%) had direct contact with needlesticks/sharps at work and none of the participants reported a previous infection by the virus. Conclusions: Although most participants had complete immunization, the total result of individuals who did not obtain seroconversion was eminent, so the importance of the hepatitis B surface antibody test must be disseminated in the context of public health.

Introdução: O vírus da hepatite B é o causador de um dos grandes problemas de saúde pública mundial. A infecção pode acometer toda a população de igual maneira; entretanto, os profissionais de saúde são parte de um grupo mais vulnerável à doença, visto que são expostos tanto ao risco ocupacional quanto ao risco cotidiano. Objetivos: Investigar a prevalência e os fatores associados à imunização de profissionais de saúde contra o vírus da hepatite viral tipo B na cidade de Montes Claros, Minas Gerais, Brasil. Métodos: Tratou-se de um estudo transversal e quantitativo, realizado com profissionais de saúde da atenção primária. Por amostragem aleatória por conglomerado, foram selecionados 209 profissionais médicos, enfermeiros e técnicos de enfermagem que tiveram interesse em participar da pesquisa. Foi aplicado um questionário estruturado, e foi realizada coleta de sangue para análise de títulos de anticorpo contra o antígeno de superfície da hepatite B. Por fim, a análise estatística descritiva e bivariada foi efetuada. Resultados: Os dados evidenciaram que 91,8% dos profissionais tinham imunização completa contra o vírus da hepatite B - ou seja, haviam tomado as três doses preconizadas da vacina. Entretanto, 13,9% da amostra, mesmo após a vacinação, se mostrou não reagente (títulos < 10 UI/mL de anticorpo contra o antígeno de superfície da hepatite B). A maioria (94,3%) dos profissionais tinha contato direto no trabalho com materiais perfurocortantes, e nenhum participante relatou infecção prévia pelo vírus. Conclusões: Apesar do fato de que a maioria dos participantes tinha imunização completa, o resultado total de indivíduos que não obtiveram soroconversão foi eminente, de modo que há de se divulgar a valia do exame de anticorpo contra o antígeno de superfície da hepatite B no contexto de saúde pública.

Fibular Nerve Repair by Lateral Sural Cutaneous Nerve Graft: Anatomic Feasibility Study and Clinical Results.

OBJECTIVE: The common fibular nerve (CFN) is the most frequently injured nerve in the lower limbs. Surgical management is necessary in approximately two thirds of patients and includes neurolysis, suture, graft repair, or nerve transfer. The distal sural nerve is the preferred donor for grafting, but it is not without complications and requires a second incision. We sought to study the surgical anatomy of the lateral sural cutaneous nerve (LSCN) with the aim of repairing CFN injuries through the same incision and as a potential source for grafting in other nerve injuries. METHODS: The popliteal fossa was dissected in 11 lower limbs of embalmed cadavers to study LSCN variations. Four patients with CFN injuries then underwent surgical repair by LSCN grafting using the same surgical approach. RESULTS: At the medial margin of the biceps femoris, the LSCN emerged from the CFN approximately 8.15 cm above the fibular head. The LSCN ran longitudinally to the long axis of the popliteal fossa, with an average of 3.2 cm medial to the fibular head. The mean LSCN length and diameter were 9.61 cm and 3.6 mm, respectively. The LSCN could be harvested in all patients for grafting. The mean graft length was 4.4 cm. Motor function was consistently recovered for foot eversion but was recovered to a lesser extent for dorsiflexion and toe extension. All patients recovered sensitive function (75% of S3). Hypoesthesia was recognized at the calf. CONCLUSIONS: LSCN harvest is a viable alternative for nerve grafting, especially for repairing short CFN injuries, thereby avoiding the need for a second incision.

Delayed Transfer of the Extensor Carpi Radialis Brevis Branch of the Radial Nerve to the Anterior Interosseous Nerve for Restoration of Thumb and Index Finger Flexion: Case Report.

High median nerve injuries (HMNIs) are rare lesions involving the upper extremities and affect the median nerve from its origin to the emergence of the anterior interosseous nerve (AIN). Proximal reconstruction has long been considered the gold standard in treating HMNI, but thumb and index flexion and pinch and grip weakness are consistently not recovered. We report the surgical results of a patient affected by an HMNI with partial spontaneous recovery after a gunshot wound. AIN function was successfully restored in a delayed fashion by transferring the radial nerve branch to the extensor carpi radialis brevis to the AIN.

Predictive Factors for Muscle Injury After Posterior Lumbar Spinal Surgery.

OBJECTIVE: The aims of this study were to evaluate the risk factors for muscle injury in patients undergoing posterior lumbar spinal surgery and the clearance of postoperative biochemical changes following lumbar fusion and secondarily to evaluate the timing for monitoring postoperative biochemical serum levels and potential clinical correlation. METHODS: The study prospectively enrolled 39 patients with degenerative disease of the lumbar spine. Biochemical markers (creatine phosphokinase [CPK], creatinine, and hemoglobin) were analyzed in 5 predefined stages. All relevant clinical data were collected. Rhabdomyolysis (RML) was defined as a postoperative 5-fold increase of the baseline CPK value. RESULTS: Patients from the lumbar fusion group had the highest postoperative CPK ratio. Overall, the rate of RML was 43.6%. CPK and creatinine activity reached their maximum on the first postoperative day in 69.2% and 87.5% of patients, respectively. Lumbar fusion (P = 0.005), surgical time >270 minutes (P = 0.028), and fall in hemoglobin levels >3 g/dL (P = 0.034) were identified as independent factors associated with higher risk of RML. CONCLUSIONS: The risk of RML increases with prolonged and invasive surgery with higher bleeding potential. Knowing the clearance of postoperative biochemical changes permits a standardized strategy with measurements in precise intervals, thereby avoiding unnecessary costs. The clinical significance is still undetermined.

Benznidazole affects expression of Th1, Th17 and Treg cytokines during acute experimental Trypanosoma cruzi infection.

BACKGROUND: The present study evaluated the effect of treatment with benznidazole on mRNA expression of IFN-γ, IL-17, IL-10, TGF-ß and FoxP3 in spleen and heart tissue of BALB/c mice in the acute phase of an experimental infection with Trypanosoma cruzi, strains JLP or Y. METHODS: The mRNA expression of cytokines and parasite load were assessed by q-PCR. Dependent groups were compared using Student's paired t-test and independent groups were compared using Student's unpaired t-test. RESULTS: Infection with the JLP or Y strains increased expression of IFN-γ in the heart and of IL-10 and IL-17 in the spleen and heart compared to uninfected animals. Treatment increased the expression of IFN-γ and decreased the expression of IL-17, IL-10, TGF- ß and Foxp3 in spleen and heart tissue compared to untreated infected animals. CONCLUSION: Benznidazole can induce Th1 profile in the initial of the acute phase. The treatment decreased the parasite load in both organs, although the number of parasites in Y-strain-infected mice remained high. The data suggest that benznidazole may modulate cytokine expression in infection and can be dependent of the strain. However, treatment was not fully effective in the infection provoked by Y strain, probably due to the characteristics of the strain itself.

Benznidazole affects expression of Th1, Th17 and Treg cytokines during acute experimental Trypanosoma cruzi infection

Background The present study evaluated the effect of treatment with benznidazole on mRNA expression of IFN-γ, IL-17, IL-10, TGF-β and FoxP3 in spleen and heart tissue of BALB/c mice in the acute phase of an experimental infection with Trypanosoma cruzi, strains JLP or Y. Methods The mRNA expression of cytokines and parasite load were assessed by q-PCR. Dependent groups were compared using Student's paired t-test and independent groups were compared using Student's unpaired t-test. Results Infection with the JLP or Y strains increased expression of IFN-γ in the heart and of IL-10 and IL-17 in the spleen and heart compared to uninfected animals. Treatment increased the expression of IFN-γ and decreased the expression of IL-17, IL-10, TGF- β and Foxp3 in spleen and heart tissue compared to untreated infected animals. Conclusion Benznidazole can induce Th1 profile in the initial of the acute phase. The treatment decreased the parasite load in both organs, although the number of parasites in Y-strain-infected mice remained high. The data suggest that benznidazole may modulate cytokine expression in infection and can be dependent of the strain. However, treatment was not fully effective in the infection provoked by Y strain, probably due to the characteristics of the strain itself.(AU)

Benznidazole affects expression of Th1, Th17 and Treg cytokines during acute experimental Trypanosoma cruzi infection

Abstract Background The present study evaluated the effect of treatment with benznidazole on mRNA expression of IFN-, IL-17, IL-10, TGF- and FoxP3 in spleen and heart tissue of BALB/c mice in the acute phase of an experimental infection with Trypanosoma cruzi, strains JLP or Y. Methods The mRNA expression of cytokines and parasite load were assessed by q-PCR. Dependent groups were compared using Student's paired t-test and independent groups were compared using Student's unpaired t-test. Results Infection with the JLP or Y strains increased expression of IFN- in the heart and of IL-10 and IL-17 in the spleen and heart compared to uninfected animals. Treatment increased the expression of IFN- and decreased the expression of IL-17, IL-10, TGF- and Foxp3 in spleen and heart tissue compared to untreated infected animals. Conclusion Benznidazole can induce Th1 profile in the initial of the acute phase. The treatment decreased the parasite load in both organs, although the number of parasites in Y-strain-infected mice remained high. The data suggest that benznidazole may modulate cytokine expression in infection and can be dependent of the strain. However, treatment was not fully effective in the infection provoked by Y strain, probably due to the characteristics of the strain itself.

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status.

BACKGROUND: Jorge Lobo's disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet. METHODS: DNA damage was assessed in the peripheral blood by the comet assay (tail intensity). RESULTS: The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet. CONCLUSION: These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay.

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status

Background Jorge Lobo's disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet.Methods DNA damage was assessed in the peripheral blood by the comet assay (tail intensity).Results The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet.Conclusion These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay.(AU)

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status

Background: Jorge Lobo’s disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet. Methods: DNA damage was assessed in the peripheral blood by the comet assay (tail intensity).Results: The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet. Conclusion: These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status

AbstractBackground Jorge Lobos disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet.Methods DNA damage was assessed in the peripheral blood by the comet assay (tail intensity).Results The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet.Conclusion These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay.

Analysis of the expression of toll-like receptors 2 and 4 and cytokine production during experimental Leishmania chagasi infection.

Toll-like receptors (TLRs) recognise pathogen-derived molecules and influence immunity to control parasite infections. This study aimed to evaluate the mRNA expression of TLRs 2 and 4, the expression and production of the cytokines interleukin (IL)-12, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-17, IL-10 and transforming growth factor (TGF)-ß and the production of nitric oxide (NO) in the spleen of mice infected with Leishmania chagasi. It also aimed to evaluate any correlations between mRNA expression TLR2 and 4 and cytokines and NO production. Infection resulted in increased TLR2-4, IL-17, TNF-α and TGF-ß mRNA expression during early infection, with decreased expression during late infection correlating with parasite load. IFN-γ and IL-12 mRNA expression decreased at the peak of parasitism. IL-10 mRNA expression increased throughout the entire time period analysed. Although TGF-ß, TNF-α and IL-17 were highly produced during the initial phase of infection, IFN-γ and IL-12 exhibited high production during the final phase of infection. IL-10 and NO showed increased production throughout the evaluated time period. In the acute phase of infection, there was a positive correlation between TLR2-4, TNF-α, IL-17, NO, IL-10 and TGF-ß expression and parasite load. During the chronic phase of infection, there was a positive correlation between TLR2-4, TNF-α, IL-17 and TGF-ß expression and parasite load. Our data suggest that infection by L. chagasi resulted in modulation of TLRs 2 and 4 and cytokines.

Analysis of the expression of toll-like receptors 2 and 4 and cytokine production during experimental Leishmania chagasi infection

Toll-like receptors (TLRs) recognise pathogen-derived molecules and influence immunity to control parasite infections. This study aimed to evaluate the mRNA expression of TLRs 2 and 4, the expression and production of the cytokines interleukin (IL)-12, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-17, IL-10 and transforming growth factor (TGF)-β and the production of nitric oxide (NO) in the spleen of mice infected with Leishmania chagasi. It also aimed to evaluate any correlations between mRNA expression TLR2 and 4 and cytokines and NO production. Infection resulted in increased TLR2-4, IL-17, TNF-α and TGF-β mRNA expression during early infection, with decreased expression during late infection correlating with parasite load. IFN-γ and IL-12 mRNA expression decreased at the peak of parasitism. IL-10 mRNA expression increased throughout the entire time period analysed. Although TGF-β, TNF-α and IL-17 were highly produced during the initial phase of infection, IFN-γ and IL-12 exhibited high production during the final phase of infection. IL-10 and NO showed increased production throughout the evaluated time period. In the acute phase of infection, there was a positive correlation between TLR2-4, TNF-α, IL-17, NO, IL-10 and TGF-β expression and parasite load. During the chronic phase of infection, there was a positive correlation between TLR2-4, TNF-α, IL-17 and TGF-β expression and parasite load. Our data suggest that infection by L. chagasi resulted in modulation of TLRs 2 and 4 and cytokines.

DNA damage and nitric oxide production in mice following infection with L. chagasi.

Leishmania chagasi, which causes visceral leishmaniasis in South America, is an obligate intracellular protozoan. Production of nitric oxide by macrophages during the inflammatory response is one of the main microbicidal mechanisms against this parasite. The goal of this study was to evaluate whether L. chagasi infection causes DNA damage in peripheral blood and spleen cells of Balb/c mice and whether such damage may be related to NO production. Balb/c mice were either infected with L. chagasi or maintained as controls. The single-cell gel electrophoresis (comet) assay was used to measure DNA damage in peripheral blood and spleen cells, and the Griess reaction was used to measure NO production in the spleen. L. chagasi infection induced DNA damage in peripheral blood and spleen cells of infected mice. Macrophages from the control group, challenged with L. chagasi, showed significantly (p<0.05) greater NO production, compared to non-challenged cells. Treatment of spleen cells with N(G)-monomethyl-l-arginine (LNMMA) caused a significant reduction of NO production and DNA damage (p<0.05). Our results indicate that L. chagasi induces DNA damage in the peripheral blood and spleen cells and that NO not only causes killing of the parasite but also induces DNA damage in adjacent cells.

Isoniazid acetylating phenotype in patients with paracoccidioidomycosis and its relationship with serum sulfadoxin levels, glucose-6-phosphate dehydrogenase and glutathione reductase activities

Os autores avaliaram o fenótipo acetilador da isoniazida, hematócrito, hemoglobina, atividade da glicose-6-fosfato desidrogenase, glutationa redutase e os níveis séricos de sulfadoxina de 39 doentes com paracoccidioidomicose, sendo 33 do sexo masculino e 6 do feminino, com idades compreendidas entre 17 e 58 anos. Vinte e um (53,84 por cento) doentes apresentaram fenótipo acetilador lento e 18(46,16 por cento) rápido. A atividade da glicose-6-fosfato desidrogenase (G6PD) esteve diminuída em 5(23,80 por cento) acetiladores lentos e 4(22,22 por cento) rápidos. A atividade da glutationa redutase esteve diminuida em 14 (66,66 por cento) acetiladores lentos e 12 (66,66 por cento) rápidos. Os níveis séricos de sulfadoxina livre e total foram maiores nos acetiladores lentos (p < 0,02). A análise dos resultados permite concluir que os níveis séricos de sulfadoxina relaciona-se com o fenótipo acetilador. Além disso, os níveis estiveram sempre acima de 50µg/ml, níveis estes considerados terapêuticos. Por outro lado, a deficiência de glutationa redutase pode estar relacionada com a má absorçäo intestinal de nutrientes, entre eles riboflavina, vitamina precursora de FAD