Is Galleria mellonella model a good alternative to study virulence in Staphylococcus aureus from bovine mastitis?

Staphylococcus aureus is one of the agents of bovine mastitis of hardest control due to a complex pathogenesis comprising a variety of virulence factors, which ensures its persistence in the mammary gland, causing significant health and economic losses. Therefore, understanding the pathogenesis of this agent is imperative. Galleria mellonella has stood out as an invertebrate animal model for the study of infectious diseases that affect several hosts. This work aimed to evaluate G. mellonella larvae as an experimental model for the study of virulence phenotypes in an S. aureus population isolated from bovine mastitis. Thirty genetically divergent S. aureus strains were chosen based on PFGE analysis. After experimental infection, larvae survival rates, bacterial growth in hemolymph, melanization intensity of the dorsal vessel, and histological characteristics of the infected tissues were evaluated. The G. mellonella model showed a clear diversity in the S. aureus pathogenicity pattern, allowing the differentiation of strains with virulence phenotypes ranging from high to low degrees. Histological analysis confirmed that the strains tested were capable of inducing the formation of nodules and melanization spots in the dorsal vessels of the larvae in different magnitudes. The strains 16S-717, 19C-828, and 31S-1443 presented the highest virulence intensity among the bacteria tested and will be used further for the generation of S. aureus mutant populations to prospect genetic targets aimed to develop control strategies of bovine mastitis. Altogether, our results suggest that G. mellonella is an attractive and low-cost animal model for characterizing virulence phenotypes of large S. aureus populations.

Recovery of Brucella in raw milk Minas artisanal cheese approved for consumption by official inspection agency in Brazil: assessment of prevalence and risk factors through One Health integrated approaches.

BACKGROUND: Minas artisanal cheese (MAC) from the Serro region is a Brazilian intangible cultural heritage. Produced from raw milk, it may carry zoonotic pathogens such as Brucella. This study included a randomized survey for the prevalence of Brucella-positive MAC and its associated factors. METHODS: MAC samples (n=55), each one from a different rural family-based cheese-processing agroindustry, were analysed for Brucella by direct polymerase chain reaction (PCR) species-specific DNA detection and cultivation-based approaches. RESULTS: Among 55 MACs that were analysed, we found 17 Brucella DNA-positive samples (30.9% [95% confidence interval {CI} 18.7 to 43.1]) by PCR and, for the first time, from one MAC (1.8% [95% CI 0.5 to 9.7]), viable Brucella abortus was recovered by cultivation. Higher values for two variables, the number of lactating cows per herd (p=0.043) and daily milk production per herd (p=0.043), were each associated with Brucella-positive MAC, which concentrated in three high-risk and one low-risk spatial clusters. CONCLUSIONS: MAC may be a source of Brucella for humans, since the positive samples were from batches that were sold by cheesemakers. This should be of concern and encourage cooperation between the health and agriculture sectors in order to mitigate this public health risk through One Health integrated approaches.

First molecular detection of Coxiella burnetii in Brazilian artisanal cheese: a neglected food safety hazard in ready-to-eat raw-milk product.

BACKGROUND: Global publications on Q fever have increased after the 2007 epidemic in the Netherlands. However, the epidemiology of Q fever/coxiellosis in Brazil is still poorly understood. Accordingly, there have been few studies investigating the presence of Coxiella burnetii in dairy products around the world, especially in Brazil, where consumption of fresh cheese made from raw-milk is very high. OBJECTIVE: This study was a random survey to assess the prevalence of C. burnetii by PCR in traditional Minas artisanal cheese from the Serro microregion, Brazil, which is manufactured from bovine raw-milk. METHODS: DNA extracted from 53 cheese samples were analyzed by nested PCR with C. burnetii-specific primers and the products confirmed by DNA sequencing. RESULTS: Out of the 53 cheese samples five (9.43%) were C. burnetii DNA-positive, each coming from one of the respective randomly selected manufacturing agroindustries. Based on our results, it is estimated that 1.62 tons/day of ready-to-eat cheese made from raw-milk from a total of 16.2 tons produced daily in the study region are contaminated with C. burnetii. CONCLUSION: To our knowledge, this is the first report of highly heat-resistant zoonotic pathogen in raw-milk Brazilian artisanal cheese. This food safety hazard has been completely neglected in ready-to-eat raw-milk Brazilian artisanal cheese and could imply potential threats to consumers, since C. burnetii survives in artisanal cheese submitted to long ripening periods. Thus, this work established random and representative baseline prevalence of C. burnetii in this food product in Brazil. Further epidemiological studies, monitoring trends and setting control targets are warranted. Finally, these results point out the importance of including C. burnetii in animal and public health surveillance programs.

First molecular detection of Coxiella burnetii in Brazilian artisanal cheese: a neglected food safety hazard in ready-to-eat raw-milk product

ABSTRACT Background: Global publications on Q fever have increased after the 2007 epidemic in the Netherlands. However, the epidemiology of Q fever/coxiellosis in Brazil is still poorly understood. Accordingly, there have been few studies investigating the presence of Coxiella burnetii in dairy products around the world, especially in Brazil, where consumption of fresh cheese made from raw-milk is very high. Objective: This study was a random survey to assess the prevalence of C. burnetii by PCR in traditional Minas artisanal cheese from the Serro microregion, Brazil, which is manufactured from bovine raw-milk. Methods: DNA extracted from 53 cheese samples were analyzed by nested PCR with C. burnetii-specific primers and the products confirmed by DNA sequencing. Results: Out of the 53 cheese samples five (9.43%) were C. burnetii DNA-positive, each coming from one of the respective randomly selected manufacturing agroindustries.Based on our results, it is estimated that 1.62 tons/day of ready-to-eat cheese made from raw-milk from a total of 16.2 tons produced daily in the study region are contaminated with C. burnetii. Conclusion: To our knowledge, this is the first report of highly heat-resistant zoonotic pathogen in raw-milk Brazilian artisanal cheese. This food safety hazard has been completely neglected in ready-to-eat raw-milk Brazilian artisanal cheese and could imply potential threats to consumers, since C. burnetii survives in artisanal cheese submitted to long ripening periods. Thus, this work established random and representative baseline prevalence of C. burnetii in this food product in Brazil. Further epidemiological studies, monitoring trends and setting control targets are warranted. Finally, these results point out the importance of including C. burnetii in animal and public health surveillance programs.

Seroprevalence for equine infectious anaemia in Equidae seized in the municipality of Petrópolis, State of Rio de Janeiro, Brazil, 2015/2018 / Soroprevalência para anemia infecciosa equina em Equídeos apreendidos no município de Petrópolis, RJ, Brasil, 2015/2018

ABSTRACT: Equine infectious anaemia (EIA) is a globally distributed disease caused by a lentivirus. EIA is a notifiable disease that should be reported to the Official Veterinary Service (SVO). Outbreaks are controlled by sacrificing the EIA-positive animals. The study analysed the prevalence of EIA in 165 Equidae seized on public roads in the municipality of Petrópolis, Rio de Janeiro, Brazil, from 2015 to 2018. After the seizure and identification of the Equidae, blood was collected to diagnose EIA. A prevalence of 11.8% was observed among the Equidae seized, and the main risk factor was the region of seizure. A kernel-smoothed map showed areas with the highest density of EIA-positive Equidae in the centre and to the east of the study area. In this region, the chance of seizing an equine positive for EIA was greater (OR=3.6) relative to the remaining region. The implementation and maintenance of Equidae seizures and subsequent diagnostic testing for EIA in the municipality of Petrópolis were shown to have great importance for the control and prevention of the disease. Indicating the place of seizure on the identification cards of the animals enabled delineation of the locations in the municipality of Petrópolis, that had a higher risk of EIA-positive animals.

RESUMO: A anemia infecciosa equina (AIE) é uma doença globalmente distribuída causada por um lentivírus. AIE é uma doença de notificação obrigatória que deve ser relatada ao Serviço Veterinário Oficial (SVO), e os surtos são controlados pelo sacrifício dos animais positivos para AIE. O presente estudo analisou a prevalência de AIE em 165 equídeos apreendidos em vias públicas no município de Petrópolis, estado do Rio de Janeiro, Brasil, no período de 2015 a 2018. Após a apreensão e identificação dos equídeos seu sangue foi coletado para diagnosticar a AIE. Observou-se uma prevalência real de 11,8% entre os equídeos apreendidos, sendo que o principal fator de risco identificado foi a região de apreensão. O Mapa de Kernel mostrou que as áreas com maior densidade de equídeos positivos estavam no centro e leste da área de estudo. Nesta região, houve maior chance (OR = 3,6) de apreender um animal positivo para AIE em relação ao da outra região, composto pelos 34 locais restantes. A implementação e manutenção de apreensão de equídeos e posterior teste de diagnóstico para AIE no município de Petrópolis, RJ, mostrou-se de grande importância para o controle e prevenção da doença. A indicação do local da apreensão nos cartões de identificação dos animais possibilitou um delineamento dos locais no município de Petrópolis, RJ, que apresentavam maior risco de animais positivos para AIE.

[Seasonality of dengue reporting in state capitals in the Brazilian Amazon and impacts of El Niño/La Niña]. / Sazonalidade nas notificações de dengue das capitais da Amazônia e os impactos do El Niño/La Niña.

The dynamics of dengue transmission are multifactorial and involve socioeconomic, ecological, and environmental aspects, the latter being closely related to local climatic conditions that affect the vector's reproductive cycle. Climate depends in turn on tropical oceanic mechanisms such as phases of El Niño/La Niña over the Pacific. The study contributes to this discussion and reports on the correlations between the Multivariate ENSO Index (MEI) in the Pacific and the number of reported dengue cases in seven state capitals in the Brazilian Amazon from 2001 to 2012. The study also analyzes the seasonality pattern (quarterly mean values) in dengue cases throughout the region. Evidence that El Niño/La Niña causes a decrease versus increase in the local rainfall pattern is consistent with the lower versus higher number of reported dengue cases in most of the state capitals in the Amazon, a result proven by the statistically significant negative correlations seen in Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) and Palmas (Tocantins). The 12-years means (2001-2012) revealed the presence of pronounced seasonality in dengue incidence in the majority of the state capitals, with sharp peaks from January to March [Rio Branco (Acre), Manaus, Belém and Palmas] and from April to June (São Luís), corresponding to 50-70% of the annual total. State capitals farther north [Boa Vista (Roraima) and Macapá (Amapá)] showed dengue reporting in all quarters of the year, with no pronounced seasonality.

A dinâmica de transmissão da dengue é multifatorial e envolve aspectos socioeconômicos, ecológicos e ambientais, sendo este último intimamente relacionado às condições climáticas locais que interferem no ciclo reprodutivo dos vetores da doença. Por sua vez, o clima é dependente dos mecanismos oceânicos tropicais, a exemplo das fases de El Niño/La Niña sobre o Pacífico. O presente trabalho contribui com esta temática e reporta as correlações entre o índice MEI (Multivariate ENOS Index) do Pacífico e o número de casos notificados de dengue em sete capitais da Amazônia brasileira, no período de 2001 a 2012. Além disso, investiga-se o padrão de sazonalidade (médias trimestrais) dos casos de dengue ao longo da região. As evidências de que o fenômeno El Niño/La Niña provoca redução/aumento no padrão pluviométrico local é consistente com o número menor/maior de casos notificados de dengue na maior parte das capitais amazônicas, cujo resultado foi comprovado pelas correlações negativas estatisticamente significantes encontradas para Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) e Palmas (Tocantins). As médias dos 12 anos (2001/2012) revelaram a presença de sazonalidade pronunciada na incidência de dengue na maioria das capitais, com picos acentuados de janeiro a março [Rio Branco (Acre), Manaus, Belém e Palmas] e de abril a junho (São Luís), correspondendo em torno de 50% a 70% do total anual. As localidades mais ao norte [Boa Vista (Roraima) e Macapá (Amapá)] revelaram registro da dengue ao longo de todos os trimestres do ano, não apresentando sazonalidade acentuada.

La dinámica de transmisión del dengue es multifactorial e implica aspectos socioeconómicos, ecológicos y ambientales, estando estos últimos íntimamente relacionados con las condiciones climáticas locales que interfieren en el ciclo reproductivo de los vectores de la enfermedad. A su vez, el clima depende de los mecanismos oceánicos tropicales, como por ejemplo las fases de El Niño/La Niña sobre el Pacífico. El presente trabajo contribuye a esta temática e informa sobre las correlaciones entre el índice MEI (Multivariate ENOS Index) del Pacífico y el número de casos notificados de dengue en siete capitales de la Amazonia brasileña durante el período de 2001 a 2012. Además, se investiga el patrón de estacionalidad (medias trimestrales) de los casos de dengue a lo largo de la región. Las evidencias de que el fenómeno El Niño/La Niña provoca reducción/aumento en el patrón pluviométrico local es consistente con el número menor/mayor de casos notificados de dengue en la mayor parte de las capitales amazónicas, cuyo resultado se comprobó por las correlaciones negativas estadísticamente significativas encontradas en Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) y Palmas (Tocantins). Las medias de los doce años (2001/2012) revelaron la presencia de estacionalidad pronunciada en la incidencia de dengue en la mayoría de las capitales, con picos acentuados de enero a marzo [Rio Branco (Acre), Manaus, Belém y Palmas] y de abril a junio (São Luís), correspondiendo en torno del 50 al 70% del total anual. Las localidades más al norte [Boa Vista (Roraima) y Macapá (Amapá)] revelaron registro del dengue a lo largo de todos los trimestres del año, no presentando una estacionalidad acentuada.

Sazonalidade nas notificações de dengue das capitais da Amazônia e os impactos do El Niño/La Niña / Seasonality of dengue reporting in state capitals in the Brazilian Amazon and impacts of El Niño/La Niña / Estacionalidad en las notificaciones de dengue de las capitales de la Amazonia y los impactos de El Niño/La Niña

Resumo: A dinâmica de transmissão da dengue é multifatorial e envolve aspectos socioeconômicos, ecológicos e ambientais, sendo este último intimamente relacionado às condições climáticas locais que interferem no ciclo reprodutivo dos vetores da doença. Por sua vez, o clima é dependente dos mecanismos oceânicos tropicais, a exemplo das fases de El Niño/La Niña sobre o Pacífico. O presente trabalho contribui com esta temática e reporta as correlações entre o índice MEI (Multivariate ENOS Index) do Pacífico e o número de casos notificados de dengue em sete capitais da Amazônia brasileira, no período de 2001 a 2012. Além disso, investiga-se o padrão de sazonalidade (médias trimestrais) dos casos de dengue ao longo da região. As evidências de que o fenômeno El Niño/La Niña provoca redução/aumento no padrão pluviométrico local é consistente com o número menor/maior de casos notificados de dengue na maior parte das capitais amazônicas, cujo resultado foi comprovado pelas correlações negativas estatisticamente significantes encontradas para Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) e Palmas (Tocantins). As médias dos 12 anos (2001/2012) revelaram a presença de sazonalidade pronunciada na incidência de dengue na maioria das capitais, com picos acentuados de janeiro a março [Rio Branco (Acre), Manaus, Belém e Palmas] e de abril a junho (São Luís), correspondendo em torno de 50% a 70% do total anual. As localidades mais ao norte [Boa Vista (Roraima) e Macapá (Amapá)] revelaram registro da dengue ao longo de todos os trimestres do ano, não apresentando sazonalidade acentuada.

Abstract: The dynamics of dengue transmission are multifactorial and involve socioeconomic, ecological, and environmental aspects, the latter being closely related to local climatic conditions that affect the vector's reproductive cycle. Climate depends in turn on tropical oceanic mechanisms such as phases of El Niño/La Niña over the Pacific. The study contributes to this discussion and reports on the correlations between the Multivariate ENSO Index (MEI) in the Pacific and the number of reported dengue cases in seven state capitals in the Brazilian Amazon from 2001 to 2012. The study also analyzes the seasonality pattern (quarterly mean values) in dengue cases throughout the region. Evidence that El Niño/La Niña causes a decrease versus increase in the local rainfall pattern is consistent with the lower versus higher number of reported dengue cases in most of the state capitals in the Amazon, a result proven by the statistically significant negative correlations seen in Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) and Palmas (Tocantins). The 12-years means (2001-2012) revealed the presence of pronounced seasonality in dengue incidence in the majority of the state capitals, with sharp peaks from January to March [Rio Branco (Acre), Manaus, Belém and Palmas] and from April to June (São Luís), corresponding to 50-70% of the annual total. State capitals farther north [Boa Vista (Roraima) and Macapá (Amapá)] showed dengue reporting in all quarters of the year, with no pronounced seasonality.

Resumen: La dinámica de transmisión del dengue es multifactorial e implica aspectos socioeconómicos, ecológicos y ambientales, estando estos últimos íntimamente relacionados con las condiciones climáticas locales que interfieren en el ciclo reproductivo de los vectores de la enfermedad. A su vez, el clima depende de los mecanismos oceánicos tropicales, como por ejemplo las fases de El Niño/La Niña sobre el Pacífico. El presente trabajo contribuye a esta temática e informa sobre las correlaciones entre el índice MEI (Multivariate ENOS Index) del Pacífico y el número de casos notificados de dengue en siete capitales de la Amazonia brasileña durante el período de 2001 a 2012. Además, se investiga el patrón de estacionalidad (medias trimestrales) de los casos de dengue a lo largo de la región. Las evidencias de que el fenómeno El Niño/La Niña provoca reducción/aumento en el patrón pluviométrico local es consistente con el número menor/mayor de casos notificados de dengue en la mayor parte de las capitales amazónicas, cuyo resultado se comprobó por las correlaciones negativas estadísticamente significativas encontradas en Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) y Palmas (Tocantins). Las medias de los doce años (2001/2012) revelaron la presencia de estacionalidad pronunciada en la incidencia de dengue en la mayoría de las capitales, con picos acentuados de enero a marzo [Rio Branco (Acre), Manaus, Belém y Palmas] y de abril a junio (São Luís), correspondiendo en torno del 50 al 70% del total anual. Las localidades más al norte [Boa Vista (Roraima) y Macapá (Amapá)] revelaron registro del dengue a lo largo de todos los trimestres del año, no presentando una estacionalidad acentuada.

Presence of mecA-positive multidrug-resistant Staphylococcus epidermidis in bovine milk samples in Brazil.

Bacteria of the genus Staphylococcus are one of the major pathogens causing bovine mastitis. In recent decades, resistance of this genus to oxacillin (methicillin) has been a matter of concern due to the possibility of reducing the effectiveness of mastitis treatments and the transfer of resistance determinants to other bacteria. Oxacillin resistance was studied in 170 staphylococci from bovine milk samples, including 79 Staphylococcus aureus and 91 coagulase-negative staphylococci (CNS). The susceptibility profile of 10 antimicrobial agents used in veterinary practice was determined by the Etest method. In addition to the Etest, the phenotypic characterization of oxacillin resistance was tested using the cefoxitin disk diffusion test. All isolates were screened by PCR to detect the mecA gene in 2 different regions of the gene. The isolates with an oxacillin minimum inhibitory concentration ≥0.5 µg/mL or resistant to cefoxitin were identified by sequencing a 536-bp fragment of the 16S rRNA gene. This group of isolates was also evaluated for the presence of blaZ and mecC genes. Molecular analysis of the mecA gene was carried out by typing of the staphylococcal cassette chromosome mec (SCCmec). The relatedness of the mecA-positive isolates was evaluated by macrorestriction of chromosomal DNA followed by pulsed-field gel electrophoresis. With the exception of penicillin and oxacillin, 86% of the isolates showed susceptibility to cephalothin, gentamicin, erythromycin, sulfonamide, trimethoprim-sulfamethoxazole, and tetracycline. All S. aureus isolates were susceptible to oxacillin, whereas 47% (n=43) of the CNS isolates were resistant. The CNS isolates showed a higher resistance to cephalothin, erythromycin, tetracycline, and gentamicin in comparison with S. aureus. The mecA gene was only detected in 10 CNS isolates, identified as Staphylococcus epidermidis, and classified into 3 pulsotypes (A, B, and C) and 4 subtypes (A1, B1, B2, and B3). Among the isolates with an oxacillin resistance phenotype, 12 were positive for the blaZ gene, and 9 of them were mecA-positive. Two of the oxacillin-resistant isolates amplified the mecA homolog gene of Staphylococcus sciuri and none amplified mecC. Three SCCmec types, I, IV, and V, were found. Our results suggest that Staphylococcus epidermidis can be a reservoir for mecA for other Staphylococcus species. Studies investigating the molecular and phenotypic profile of antimicrobial resistance in staphylococcal species should be performed for controlling the spread of resistance and the selection of appropriate therapeutic measures.

Pain measurement as part of primary healthcare of adult patients with sickle cell disease.

OBJECTIVE: The aim of this exploratory, cross-sectional study was to evaluate pain in sickle cell disease patients and aspects related to primary healthcare. METHODS: Data were obtained through home interviews. The assessment instruments (body diagram, Numerical Pain Scale, McGill Pain Questionnaire) collected information on the underlying disease and on pain. Data were analyzed using the Statistical Package for Social Sciences program for Windows. Associations between the subgroups of sickle cell disease patients (hemoglobin SS, hemoglobin SC, sickle ß-thalassemia and others) and pain were analyzed using contingency tables and non-parametric tests of association (classic chi-square, Fisher's and Kruskal-Wallis) with a level of 5% (p-value < 0.05) being set for the rejection of the null hypothesis. RESULTS: Forty-seven over 18-year-old patients with sickle cell disease were evaluated. Most were black (78.7%) and female (59.6%) and the mean age was 30.1 years. The average number of bouts of pain annually was 7.02; pain was predominantly reported by individuals with sickle cell anemia (hemoglobin SS). The intensity of pain (Numeric Pain Scale) was 5.5 and the quantitative index (McGill) was 35.9. This study also shows that patients presented a high frequency of moderately painful crises in their own homes. CONCLUSION: According to these facts, it is essential that pain related to sickle cell disease is properly identified, quantified, characterized and treated at the three levels of healthcare. In primary healthcare, accurate measurement of pain combined with better care may decrease acute painful episodes and consequently minimize tissue damage, thus improving the patient's overall health.

Multiple sclerosis in South America: month of birth in different latitudes does not seem to interfere with the prevalence or progression of the disease.

OBJECTIVE: To assess whether the month of birth in different latitudes of South America might influence the presence or severity of multiple sclerosis (MS) later in life. METHODS: Neurologists in four South American countries working at MS units collected data on their patients' month of birth, gender, age, and disease progression. RESULTS: Analysis of data from 1207 MS patients and 1207 control subjects did not show any significant variation in the month of birth regarding the prevalence of MS in four latitude bands (0-10; 11-20; 21-30; and 31-40 degrees). There was no relationship between the month of birth and the severity of disease in each latitude band. CONCLUSION: The results from this study show that MS patients born to mothers who were pregnant at different Southern latitudes do not follow the seasonal pattern observed at high Northern latitudes.

Multiple sclerosis in South America: month of birth in different latitudes does not seem to interfere with the prevalence or progression of the disease / Esclerose multipla na America do Sul: mes de nascimento em diferentes latitudes nao parece interferir com a prevalencia ou progressao da doenca

Objective To assess whether the month of birth in different latitudes of South America might influence the presence or severity of multiple sclerosis (MS) later in life. Methods Neurologists in four South American countries working at MS units collected data on their patients' month of birth, gender, age, and disease progression. Results Analysis of data from 1207 MS patients and 1207 control subjects did not show any significant variation in the month of birth regarding the prevalence of MS in four latitude bands (0–10; 11–20; 21–30; and 31–40 degrees). There was no relationship between the month of birth and the severity of disease in each latitude band. Conclusion The results from this study show that MS patients born to mothers who were pregnant at different Southern latitudes do not follow the seasonal pattern observed at high Northern latitudes. .

Objetivo Avaliar se o mês de nascimento em diferentes latitudes da América do Sul pode influenciar a presença ou gravidade da esclerose múltipla (EM) na vida. Método Neurologistas de quatro países da América do Sul trabalhando em unidades de EM coletaram os dados de seus pacientes com referência ao mês de nascimento, gênero, idade e progressão da doença. Resultados A análise dos dados mostrou que, para 1207 pacientes com EM e 1207 controles, não havia diferença significativa no mês de nascimento com relação à prevalência de EM em quatro zonas de latitude (0–10; 11–20; 21–30; e 31–40 graus). Não houve relação entre o mês de nascimento e a gravidade da doença em nenhuma destas zonas. Conclusão Os resultados deste estudo mostram que pacientes com EM nascidos de mães grávidas em diferentes latitudes sul não seguem o padrão dos resultados sazonais encontrados nas latitudes norte. .

Força de pinça trípode e destreza manual em pacientes portadores de esclerose múltipla forma remitente-recorrente / Tripod pinch strength and manual dexterity of patientswith multiple sclerosis form relapsing-remitting

Esclerose múltipla é uma doença desmielinizante do sistemanervoso central, podendo provocar alterações de força e destrezamanual. A força do movimento de pinça trípode pode ser quantificadapor dinamômetro. A destreza manual pode ser quantificadaatravés do teste de Caixa e Blocos que consiste em uma caixa demadeira com 150 blocos. Este estudo objetivou descrever e analisara força muscular e destreza manual e verificar se há correlação entreelas, Expanded Disability Status Scale (EDSS) e idade. Realizamoso teste de caixa e blocos e a análise de força de pinça trípode em 18indivíduos da forma remitente-recorrente. Para o teste de caixa eblocos os resultados foram 35,38 blocos/min para a mão direita e36,66 blocos/min para a mão esquerda. A força de pinça foi de 6,86kgf para a mão direita e 6,54 kgf para a mão esquerda. Média deEDSS de 2,86 e idade 46,39 anos. Os pacientes analisados apresentaramalterações na destreza manual, mas não apresentaram alteraçãoda força de pinça. A idade não se correlaciona com as variáveis doestudo, e o EDSS somente com a destreza manual.

Multiple Sclerosis is a demyelinating disease of the centralnervous system and may cause changes in strength and manualdexterity. The strength of movement of the tripod pinch can bemeasured by dynamometer. Manual dexterity can be quantifiedthrough the Box and Blocks test that consists of a wooden boxwith 150 blocks. This study aimed to describe and analyze muscularstrength and manual dexterity and verifying correlation amongthem, Expanded Disability Status Scale (EDSS) and age. We carriedout the box and block test and analysis of tripod pinch strength in18 patients. The Box and Blocks test showed for the right hand anaverage of 35.38 packs / min and for the left hand 36.66 packs/min. The pinch strength was 6.86 kgf for the right hand and 6.54kgf for the left hand. EDSS average 2.86 and 46.39 years old. Thepatients studied showed changes in manual dexterity, but showed nochange in pinch strength. The age is not correlated with the studyvariables, and EDSS only with manual dexterity.

Sexuality and sickle cell anemia.

BACKGROUND: Sickle cell disease, the most common hereditary blood disease in the world, is the result of an atypical hemoglobin called S (Hb S) which, when homozygous (Hb SS) is the cause of sickle cell anemia. Changes of puberty, correlated with a delayed growth spurt, begin late in both male and female sickle cell anemia individuals with repercussions on sexuality and reproduction. The objectives of this exploratory and descriptive study were to characterize the development of sexuality in adults with sickle cell anemia by investigating the patient's perception of their sex life, as well as the information they had and needed on this subject. METHODS: Twenty male and female sickle cell anemia patients treated at the Hemocentro Regional de Uberaba (UFTM) with ages between 19 and 47 years old were enrolled. A socioeconomic questionnaire and a semi-structured interview on sexuality, reproduction and genetic counseling were applied. RESULTS: This study shows that the sickle cell anemia patients lacked information on sexuality especially about the risks of pregnancy and the possible inheritance of the disease by their children. Moreover, the sexual life of the patients was impaired due to pain as well as discrimination and negative feelings experienced in close relationships. CONCLUSION: The health care of sickle cell anemia patients should take into account not only the clinical aspects of the disease, but also psychosocial aspects by providing counseling on sexuality, reproduction and genetics, in order to give this population the possibility of a better quality of life.

Overproduction of polygalacturonase by Penicillium griseoroseum recombinant strains and functional analysis by targeted disruption of the pgg2 gene.

Inactivation of the pgg2 gene, a polygalacturonase-encoding gene from Penicillium griseoroseum, reduced the total activity of polygalacturonase (PG) by 90 % in wild-type P. griseoroseum, which indicates that the pgg2 gene is the major gene responsible for PG production in this species. To increase PG production, the coding region of the pgg2 gene was cloned under the control of the glyceraldehyde 3-phosphate dehydrogenase (gpd) promoter and the terminator region of the tryptophan synthase (trpC) gene from Aspergillus nidulans (pAN52pgg2 vector). This vector was then used to transform P. griseoroseum. The transformed strains were characterized according to PG production using glucose, sucrose, or sugar cane juice as the carbon sources. The recombinant P. griseoroseum T146 strain contained an additional copy of the pgg2 gene, which resulted in a 12-fold increase in PG activity when compared with that detected in the supernatant of the control PG63 strain. The proteins secreted by the recombinant strain T146 showed a strong band at 38 kDa, which corresponds to the molecular weight of PG of the P. griseoroseum. The results demonstrate the significant biotechnological potential of recombinant P. griseoroseum T146 for use in PG production.

Pain measurement as part of primary healthcare of adult patients with sickle cell disease

OBJECTIVE: The aim of this exploratory, cross-sectional study was to evaluate pain in sickle cell disease patients and aspects related to primary healthcare. METHODS: Data were obtained through home interviews. The assessment instruments (body diagram, Numerical Pain Scale, McGill Pain Questionnaire) collected information on the underlying disease and on pain. Data were analyzed using the Statistical Package for Social Sciences program for Windows. Associations between the subgroups of sickle cell disease patients (hemoglobin SS, hemoglobin SC, sickle β-thalassemia and others) and pain were analyzed using contingency tables and non-parametric tests of association (classic chi-square, Fisher's and Kruskal-Wallis) with a level of 5% (p-value < 0.05) being set for the rejection of the null hypothesis. RESULTS: Forty-seven over 18-year-old patients with sickle cell disease were evaluated. Most were black (78.7%) and female (59.6%) and the mean age was 30.1 years. The average number of bouts of pain annually was 7.02; pain was predominantly reported by individuals with sickle cell anemia (hemoglobin SS). The intensity of pain (Numeric Pain Scale) was 5.5 and the quantitative index (McGill) was 35.9. This study also shows that patients presented a high frequency of moderately painful crises in their own homes. CONCLUSION: According to these facts, it is essential that pain related to sickle cell disease is properly identified, quantified, characterized ...

Sexuality and sickle cell anemia

BACKGROUND: Sickle cell disease, the most common hereditary blood disease in the world, is the result of an atypical hemoglobin called S (Hb S) which, when homozygous (Hb SS) is the cause of sickle cell anemia. Changes of puberty, correlated with a delayed growth spurt, begin late in both male and female sickle cell anemia individuals with repercussions on sexuality and reproduction. The objectives of this exploratory and descriptive study were to characterize the development of sexuality in adults with sickle cell anemia by investigating the patient's perception of their sex life, as well as the information they had and needed on this subject. METHODS: Twenty male and female sickle cell anemia patients treated at the Hemocentro Regional de Uberaba (UFTM) with ages between 19 and 47 years old were enrolled. A socioeconomic questionnaire and a semi-structured interview on sexuality, reproduction and genetic counseling were applied. RESULTS: This study shows that the sickle cell anemia patients lacked information on sexuality especially about the risks of pregnancy and the possible inheritance of the disease by their children. Moreover, the sexual life of the patients was impaired due to pain as well as discrimination and negative feelings experienced in close relationships. CONCLUSION: The health care of sickle cell anemia patients should take into account not only the clinical aspects of the disease, but also psychosocial aspects by providing counseling on sexuality, reproduction and genetics, in order to give this population the possibility of a better quality of life.

Dor nas unidades de internação de um hospital universitário / Pain management at inpatient wards of a university hospital / Dolor en las unidades de ingreso de un hospital universitario

JUSTIFICATIVA E OBJETIVOS: Estudo exploratório-descritivo, transversal, com objetivo de determinar a prevalência, caracterização, localização, mensuração e discussão de medidas farmacológicas analgésicas em dor aguda em cinco unidades de internação de um hospital universitário. MÉTODO: Participaram 856 sujeitos, dos quais 272 com dor no momento. As informações relacionadas à dor foram obtidas através de entrevista estruturada junto ao leito. Usou-se a escala numérica de dor e diagrama corporal. RESULTADOS: A analgesia foi verificada no prontuário. A prevalência geral de dor foi de 31,8%, sendo intensa em 44,2% e a média de 6,6 na escala numérica de dor. O motivo principal foi traumatismo, o local mais frequente, o abdômen. O analgésico mais usado foi a dipirona em 76,1%, com/sem associação. Opioide forte foi prescrito em 4,4%. Para 27,5% não houve melhoria. CONCLUSÃO: Conclui-se que a dor é de alta prevalência, pouco avaliada, subtratada, com uso incorreto de analgésicos.

BACKGROUND AND OBJECTIVES: This is an exploratory, descriptive and transversal study aiming to determine the prevalence, characterization, location, and measurement and discuss pharmacological analgesic measures for acute pain management in five inpatient wards of a university hospital. METHOD: We enrolled 856 subjects in the study, of whom 272 were in pain at the time. Information related to pain was obtained using a bedside structured interview. Numeric pain scale and body diagram were used. RESULTS: Analgesia was assessed through medical records. The overall prevalence of pain was 31.8%, with severe pain in 44.2% and mean of 6.6 on numeric pain scale. The main reason was trauma and the most common site the abdomen. The most widely used analgesic was dipyrone (76.1%) with/without combination. Strong opioid was prescribed to 4.4%. For 27.5% there was no improvement. CONCLUSION: We conclude that pain is highly prevalent, poorly evaluated, undertreated, with inappropriate use of analgesics.

JUSTIFICATIVA Y OBJETIVOS: Estudio exploratorio, descriptivo y transversal, con el objetivo de determinar la prevalencia, la caracterización, la ubicación, la mensuración y la discusión de las medidas farmacológicas analgésicas en dolor agudo, en cinco unidades de ingreso de un hospital universitario. MÉTODO: Participaron 856 sujetos, de los cuales 272 tenían dolor en ese momento. Las informaciones relacionadas con el dolor se obtuvieron por medio de una entrevista estructurada con el paciente y junto a la cama de hospital. Se usó la escala numérica de dolor y el diagrama corporal. RESULTADOS: La analgesia fue verificada en la historia clínica del paciente. La prevalencia general de dolor fue de un 31,8% siendo intensa en un 44,2% y con un promedio de 6,6 en la escala numérica de dolor. El motivo principal fue el traumatismo y la región más frecuente fue el abdomen. El analgésico más usado fue la dipirona en un 76,1%, con/sin asociación. Se prescribió opioide fuerte en un 4,4%. Para el 27,5% no se registró mejoría. CONCLUSIONES: Llegamos a la conclusión de que el dolor es de alta prevalencia, poco evaluado, mal tratado, y con el uso incorrecto de analgésicos.

Pain management at inpatient wards of a university hospital.

BACKGROUND AND OBJECTIVES: This is an exploratory, descriptive and transversal study aiming to determine the prevalence, characterization, location, and measurement and discuss pharmacological analgesic measures for acute pain management in five inpatient wards of a university hospital. METHOD: We enrolled 856 subjects in the study, of whom 272 were in pain at the time. Information related to pain was obtained using a bedside structured interview. Numeric pain scale and body diagram were used. RESULTS: Analgesia was assessed through medical records. The overall prevalence of pain was 31.8%, with severe pain in 44.2% and mean of 6.6 on numeric pain scale. The main reason was trauma and the most common site the abdomen. The most widely used analgesic was dipyrone (76.1%) with/without combination. Strong opioid was prescribed to 4.4%. For 27.5% there was no improvement. CONCLUSION: We conclude that pain is highly prevalent, poorly evaluated, undertreated, with inappropriate use of analgesics.

A ocorrência de malária em quatro municípios do estado do Pará, de 1988 a 2005, e sua relação com o desmatamento / Occurrence of malaria in four cities in the state of Pará during 1988 to 2005 and its relationships with deforestation

O objetivo deste trabalho foi estudar a ocorrência de malária em quatro diferentes regiões representativas do estado do Pará, buscando suas possíveis relações com as taxas de desmatamento. Foi realizado um estudo retrospectivo, com dados secundários, no período de 1988 a 2005, através de casos de malária registrados em quatro municípios do Estado (Anajás, Itaituba, Santana do Araguaia e Viseu), como também das taxas de desmatamento fornecidas pelo PRODES-INPE. Aplicou-se a técnica dos Quantis para se estabelecer cinco categorias ou classes de incidência da malária para cada município, sendo gerado posteriormente um IPA representativo para o Estado. De 1988 até 1994, as curvas de incidência de malária acompanham os números de desmatamento. A partir de 1995, evidenciaram-se anos consecutivos com altos índices de ocorrência da doença logo após os períodos de altas taxas de desmatamento, como registrado nos anos de 1995, 2000 e 2004. Percebeu-se que após a época de intenso desmatamento, os casos de malária variaram entre alto e muito alto no seu padrão de incidência, apontando que o desmatamento pode ser um fator de incremento na frequência e aumento no número de pessoas infectadas no estado do Pará.

The purpose of this paper is to study occurrence of malaria in four different regions of the state of Pará and its possible relationships with deforestation rates. A retrospective study using secondary data from 1988 to 2005, using malaria incidence records reported in four cities in the state (Anajás, Itaituba, Santana do Araguaia and Viseu), as well as deforestation rates provided by the PRODES-INPE. The quantiles method was applied to establish five categories or classes of malaria incidence for each city, and a state IPA was generated with the contributions of these cities. From 1988 to 1994, the curves of incidence of malaria follow deforestation rates. From 1995, there are consecutive years of high incidence levels after years of high deforestation rates, as registered in 1995, 2000 and 2004. It was noticed that after periods of intense deforestation the occurrence of malaria presented an incidence pattern between high and very high, suggesting that deforestation may be a factor in maintaining and increasing the number of cases in the state of Pará.

Qualidade de vida de portadores de dor crônica atendidos em clínica multiprofissional / Calidad de vida y dolor crónico: una evaluación de pacientes tratados en una clínica de dolor multiprofesional / Quality of life in chronic pain sufferers: an evaluation of patients attended within a multi-professional pain clinic

Estudo descritivo, exploratório, com abordagem quantitativa, com objetivo de analisar a qualidade de vida dos portadores de dor crônica de uma clínica multiprofissional de dor de um hospital público de ensino de Minas Gerais. Para coleta dos dados utilizou-se o questionário Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), com a obtenção das médias dos escores de cada domínio. Para a análise foi realizada estatística descritiva. Foram entrevistados 31 pacientes. A maioria (61,3%) referiu dor em coluna e membros. O maior escore encontrado foi no domínio capacidade funcional (47,09), seguido de saúde mental (40,00). Os menores escores foram nos domínios limitações por aspectos físicos (27,41) e dor (28,06). Observaram-se escores menores entre os pacientes cadastrados há mais de dois anos na clínica multiprofissional de dor. Esses achados apontam para a necessidade de inserção de novas modalidades de tratamento considerando a complexidade da dor crônica.

This descriptive, exploratory study was performed using a quantitative approach, with the objective to analyze the quality of life of individuals with chronic pain undergoing treatment at a multidisciplinary pain clinic at a public teaching hospital in Minas Gerais. Data collection was performed using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) to obtain the mean score in each domain. Descriptive statistics were used for analysis. A total of 31 patients were interviewed. Most (61.3%) reported experiencing pain in the back and limbs. The highest identified score referred to the functional capacity domain (47.09), followed by mental health (40.00). The lowest scores referred to the domains of limitations due to physical aspects (27.41) and pain (28.06). Lower scores were observed among patients who had been attending the multidisciplinary pain clinic for over two years. These findings suggest a need to include new treatment modalities that consider the complexity of chronic pain.

Estudio descriptivo, exploratorio, de abordaje cuantitativo, objetivando analizar la calidad de vida de pacientes con dolor crónico atendidos por equipo multiprofesional del dolor de un hospital público de enseñanza de Minas Gerais. Datos recolectados mediante cuestionario Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), obteniéndose los puntajes promedio para cada dominio, analizados posteriormente utilizando estadística descriptiva. Fueron entrevistados 31 pacientes. La mayoría (61,3%) refería dolor en columna y miembros. El mayor puntaje encontrado correspondió al dominio capacidad funcional (47,09), seguido de salud mental (40,00). Los menores puntajes se observaron en los dominios limitaciones por aspectos físicos (27,41) y dolor (28,06). Se observaron puntajes menores entre pacientes atendidos durante más de dos años por el equipo multiprofesional de dolor. Estos hallazgos determinan la necesidad de inserción de nuevas modalidades de tratamiento, considerando la complejidad del dolor crónico.