Aspectos epidemiológicos da Febre do Oeste do Nilo Epidemiological aspects of West Nile Fever

Desde sua introdução na América do Norte em 1999, mais de 27.500 casos humanos da infecção por West Nile virus (WNV) foram reportados nos Estados Unidos da América (EUA), resultando em mais de 1000 casos fatais. Recentemente, a disseminação do vírus para o hemisfério sul foi confirmada com a detecção de animais infectados pelo WNV em território sul-americano. A soropositividade para WNV em eqüídeos na Colômbia e Venezuela e o isolamento do vírus nestes animais na Argentina, reiteram a necessidade da manutenção do sistema de vigilância enzoótica para WNV em território brasileiro. Aspectos pertinentes à infecção, patogenia e epidemiologia do WNV são discutidos neste artigo.<br>Since the West Nile virus (WNV) was introduced in North America in 1999, more than 27,500 cases were reported among humans in the US, resulting in more than 1,000 casualties. Recently, the dissemination of the WNV to the Southern Hemisphere was confirmed through the detection of seropositive animals. Positively-infected horses for WNV in Colombia, Venezuela and viral isolation in Argentina uphold the need to maintain the enzootic surveillance system in the Brazilian territory. Aspects related to infection, diagnosis and epidemiology of WNV are discussed in this article

Intravenous NPA for the treatment of infarcting myocardium early: InTIME-II, a double-blind comparison on of single-bolus lanoteplase vs accelerated alteplase for the treatment of patients with acute myocardial infarction

Aims to compare the efficacy and safety of lanoteplase, a single-bolus thrombolytic drug derived from alteplase tissue plasminogen activator, with the established accelerated alteplase regimen in patients presenting within 6 h of onset of ST elevation acute myocardial infarction. Methods and Results 15 078 patients were recruited from 855 hospitals worldwide and randomized in a 2:1 ratio to receive either lanoteplase 120 KU. kg-1 as a single intravenous bolus, or up to 100 mg accelerated alteplase given over 90 min. The primary end-point was all-cause mortality at 30 days and the hypothesis was that the two treatments would be equivalent. By 30 days, 6.61% of alteplase-treated patients and 6.75% lanoteplase-treated patients had died (relative risk 1.02). Total stroke occurred in 1.53% alteplase- and 1.87% lanoteplase-treated patients (ns); haemorrhagic stroke rates were 0.64% alteplase and 1.12% lanoteplase (P=0.004). The net clinical deficit of 30-day death or non-fatal disabling stroke was 7.0% and 7.2%, respectively. By 6 months, 8.8% of alteplase-treated patients and 8.7% of lanoteplase-treated patients had died. Conclusion Single-bolus weight-adjusted lanoteplase is an effective thrombolytic agent, equivalent to alteplase in terms of its impact on survival and with a comparable risk-benefit profile. The single-bolus regimen should shorten symptoms to treatment times and be especially convenient for emergency department or out-of-hospital administration. (C) 2000 The European Society of Cardiology