Epidemiological situation of bovine brucellosis in the State of Santa Catarina, Brazil

Realizou-se um estudo para caracterizar a situação epidemiológica da brucelose bovina no Estado de Santa Catarina. O Estado foi estratificado em cinco circuitos produtores. Em cada circuito produtor foram amostradas aleatoriamente cerca de 300 propriedades e, dentro dessas, foi escolhido, de forma aleatória, um número pré-estabelecido de animais, dos quais foi obtida uma amostra de sangue. No total foram amostrados 7801 animais, provenientes de 1586 propriedades. O protocolo de testes utilizado foi o da triagem com o teste do antígeno acidificado tamponado e o reteste dos positivos com o do 2-mercaptoetanol. O rebanho foi considerado positivo se pelo menos um animal foi reagente às duas provas sorológicas. As prevalências de focos e de animais infectados no Estado foram de 0,32% [0,10-0,69%] e 0,06% [0,0-0,17%], respectivamente. A prevalência de focos nos circuitos pecuários foram: circuito 1, 0,33% [0,0-0,99%]; circuito 2, 0,33% [0,0-1,0%]; circuito 3, 0,25% [0,0-0,75%]; circuito 4, 0,66% [0,08-1,84%] e circuito 5, 0,33% [0,0-1,0%]. _____________________________________________________________________________________________________ ABSTRACTA study to characterize the brucellosis epidemiological situation in the State of Santa Catarina was carried out. The State was divided into five regions. Three hundred herds were randomly sampled in each region and a pre-established number of animals were sampled in each of these herds. A total of 7,801 serum samples from 1,586 herds were collected. In each herd, it was applied an epidemiological questionnaire regarding herd features and also husbandry and sanitary practices that could be associated with risk of infection. The serum samples were screened for antibodies to Brucella spp. by the Rose-Bengal Test (RBT), and all RBT-positive sera re-tested by the 2-mercaptoethanol test (2-ME). The herd was considered positive if at least one animal was positive on both RBT and 2-ME tests. The prevalences of infected herds and animals in Santa Catarina State were, respectively: 0.32% [0.10-0.69%] and 0.06% [0.0-0.17%]. The prevalence of infected herds in the regions were: region 1, 0.33% [0.0-0.99%]; region 2, 0.33% [0.0-1.0%]; region 3, 0.25% [0.0-0.75%]; region 4, 0.66% [0.08-1.84%]; and region 5, 0.33% [0.0-1.00%]

Retinitis induction by human cytomegalovirus in imunossupressed rabbits

The search for new therapies to the HCMV retinitis made researchers look for an animal model for this infection. In anterior study we didn’t get a good level of imunossupression in rabbits with Azathiprina and Prednisona. In this way, we opt for use the Cyclophosphamide in five rabbits of New Zealand race, in which were injected HCMV in vitreous of both eyes, in different stages of imunossupression protocol. The observation period was 112 days, observing sistemics alterations (weight, blood count) and ocular alterations (trough binocular ophthalmoscopy and retinography ). After the animals sacrifice, it was researched HCMV antigens in vitreous and retina. It was found important weight loss, blood count not compatible with the imunossupression signs, retinians lesions and vitreous alterations not specifics (exsudate and vitreits with spontaneous involution ). It wasn’t detected HCMV antigens in vitreous and retina inprints from the sacrificed rabbits. In this way, it was concluded that also with this new imunossupression scheme, the HCMV causes not specific intra-ocular inflamation. Therefore, the HCMV inoculation in rabbits doesn’t determine an experimental model to HCMV retinitis.A procura por novos esquemas terapêuticos para a retinite por HCMV levou pesquisadores à busca de um modelo animal para o estudo desta infecção. Em estudo anterior, não conseguimos nível adequado de imunossupressão com associação de Azathioprina e Prednisona em coelhos. Assim, optamos por utilizar a Ciclofosfamida em cinco coelhos da raça New Zealand, e injetamos HCMV no vítreo de ambos os olhos de cada um deles, em diferentes etapas do protocolo de imunossupressão. O período de seguimento foi de até 112 dias, avaliando-se alterações sistêmicas (peso, hemograma) e alterações oculares (através de oftalmoscopia binocular indireta e retinografia). Após o sacrifício dos animais, pesquisaram-se antígenos de HCMV em vítreo e retina. Encontrou-se importante perda de peso, hemograma não compatível com os sinais de imunossupressão, lesões retinianas e alterações vítreas inespecíficas (exsudatos e vitreíte com involução espontânea). Não foram detectados antígenos de HCMV nos Inprints de retinas e vítreos dos coelhos sacrificados. Desse modo, concluiu-se que, também com esse novo esquema de imunossupressão, o HCMV causa inflamação intra-ocular inespecífica. Portanto, a inoculação do HCMV, em coelhos, não determina modelo experimental para a retinite pelo CMV

Results from the portuguese register

Objective Our aims were to evaluate the correlation between Juvenile Arthritis Disease Activity Score 27-joint reduced count (JADAS27) with erythrocyte sedimentation rate (ESR) and JADAS27 with C-reactive protein (CRP) scores and to test the agreement of both scores on classifying each disease activity state. We also aimed at verifying the correlation of the 2 scores across juvenile idiopathic arthritis (JIA) categories and to check the correlation between JADAS27-ESR and clinical JADAS27 (JADAS27 without ESR). Methods A nationwide cohort of patients with JIA registered in the Portuguese Register, Reuma.pt, was studied. JADAS27-CRP was adapted by replacing ESR with CRP level as the inflammatory marker. JADAS27-CRP was calculated similarly to JADAS27-ESR as the simple linear sum of its 4 components. Pearson's correlations and K statistics were used in the analyses. Results A total of 358 children had full data to calculate JADAS27; 65.4% were female and the mean ± SD disease duration was 11.8 ± 9.1 years. The correlation coefficient between JADAS27-ESR and JADAS27-CRP was 0.967 (P < 0.0001), although the correlation coefficient between ESR and CRP level was 0.335 (P < 0.0001). The strong correlation between JADAS27-ESR and JADAS27-CRP was maintained when compared within each JIA category. The agreement between JADAS27-ESR and JADAS27-CRP across the 4 activity states was very good, showing 91.1% of the observations in agreement; K = 0.867 (95% confidence interval 0.824-0.91). The correlation between JADAS27 with ESR and JADAS27 without ESR was high (r = 0.97, P < 0.0001). Conclusion JADAS27 based on CRP level correlated closely with JADAS27-ESR across all disease activity states and JIA categories, indicating that both measures can be used in clinical practice. Moreover, the correlation of JADAS27 with and without ESR was also high, suggesting that this tool might be useful even in the absence of laboratorial measures.publishersversionpublishe

Clinical and epidemiological characteristics of patients from Ribeirão Preto, SP, Brazil, with AIDS and oportunistic infections

Com o objetivo de conhecer e atualizar as características clínicas e epidemiológicas dos pacientes com aids e infecções oportunistas na região de Ribeirão Preto, foram revisados os prontuários médicos de 1019 pacientes com aids, do sub - grupo IVc (CDC), atendidos no HCFMRP, no período de janeiro de 1992 a agosto de 1996.Os seguintes itens foram analisados: data do primeiro atendimento, sexo, idade, cidade em que residia, via provável de aquisição do HIV, época do primeiro exame anti -HIV positivo, número de linfócitos CD4/mm3&nbsp;por ocasião do primeiro atendimento, data da primeira manifestação infecciosa após o início do seguimento, tipo e número de complicação(ões) infecciosa(s), data do óbito e tipo de infecção(ões) diagnosticada(s) nos pacientes que faleceram. Os resultados, quando comparados com os obtidos no período de 1987 a 1991, apontam para modificações importantes em algumas características dos pacientes no segundo período, como aumento da via de transmissão heterossexual do HIV, aumento da participação de mulheres na casuística, uma tendência de diagnóstico mais precoce da infecção pelo HIV e aumento da sobrevida dos pacientes. Por outro lado, os pacientes continuam sendo acometidos por ampla gama de processos infecciosos durante a evolução da aids, com destaque para a candidíase, as pneumonias bacterianas, a neurotoxoplasmose, a pneumonia por P.carinii, a sinusite, a diarréia e a neurocriptococose. Menção especial deve ser feita à tuberculose que acometeu cerca de 30% dos pacientes durante o período de seguimento. &nbsp; &nbsp;In order to up-to-date informations about the clinical and epidemiological characteristics of AIDS patients with opportunistic infections, from the Ribeirão Preto region, we revised 1019 medical records of individuals belonging to IVc AIDS sub-group attended in HCFMRP in the period from January 1992 to August 1996. The following parameters were analyzed: date of the first medical examination, sex, age, city of residence, probable form of acquisition of HIV, time of the first anti-HIV positive test, number of CD4+/mm3 lymphocytes at the beginning of the follow-up, date of the first infectious episodes after the beginning of the follow-up, type and number of infectious episodes, date of the death and the type of infectious processes diagnosed in the patients that died. The results point out for important modifications in some characteristics of the patients over the last five years. We noted, by comparing with the results obtained in the period of 1987 to 1991, an increase in the heterosexual transmission of HIV and an increase of the number of women with AIDS; a tendency of an early diagnosis of the HIV infection and an increase in patients’ survival. In the other hand patients continued presenting a wide range of infectious processes during the AIDS evolution with emphasis for candidiasis, for bacterial pneumonia, for neuro-toxoplasmosis, for pneumocystosis, for sinusitis, for diarrhoea, and for neuro-cryptococcosis. Special mention must be done for tuberculosis, which was diagnosed in 30% of the patients during the follow-up period

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

<p>Abstract</p> <p>Background</p> <p>Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.</p> <p>Methods</p> <p>This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.</p> <p>Discussion</p> <p>The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.</p> <p>Trial Registration</p> <p>Clinical Trials <a href="http://www.clinicaltrials.gov/ct2/show/NCT00970931">NCT00970931</a>.</p