Detection of human cytomegalovirus and Epstein-Barr virus in coronary atherosclerotic tissue

Previous studies indicated that patients with atherosclerosis are predominantly infected by human cytomegalovirus (HCMV), but rarely infected by type 1 Epstein-Barr virus (EBV-1). In this study, atheromas of 30 patients who underwent aortocoronary bypass surgery with coronary endartherectomy were tested for the presence of these two viruses. HCMV occurred in 93.3% of the samples and EBV-1 was present in 50% of them. Concurrent presence of both pathogens was detected in 43.3% of the samples.FAPES

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Detection and association of herpesviruses and periodontal pathogens in HIV positive patients with periodontal disease

Herpes vírus humanos são patógenos amplamente distribuídos na população mundial e, recentemente, tem se estudado um possível envolvimento desses vírus na etiologia da doença periodontal. Indivíduos HIV positivos (HIV+) têm mostrado uma maior prevalência desses vírus e, a imunossupressão induzida pelo HIV é conhecida por facilitar a reativação desses microorganismos. Desse modo, o presente estudo teve como objetivo determinar a presença dos vírus Herpes simples tipo 1 (HSV-1), Citomegalovírus (HCMV) e Epstein-Barr vírus tipo 1 (EBV-1), relacionando-os com a presença de bactérias periodontopatogênicas como: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis) e Tannerella forsythia (T. forsythia) em pacientes HIV+ com doença periodontal. Foram coletadas amostras de placa subgengival, saliva e sangue capilar de vinte e sete indivíduos HIV+ com periodontite crônica (HIV-p) e 23 indivíduos HIV+ com gengivite (HIV-g). A detecção das espécies bacterianas e dos herpes vírus foi realizada pela técnica de Reação em cadeia da polimerase (PCR) e Nested PCR, respectivamente. A análise estatística mostrou que para o grupo HIV-p, EBV-1 e T. forsythia apresentaram maior prevalência nas amostras de placa subgengival (70.4% e 51.8%, respectivamente) e saliva (81.5%, 40.7%, respectivamente) do que no sangue (22% e 0, respectivamente) (p<0.005 e p<0.0001, respectivamente). A bactéria P. gingivalis foi mais freqüente na placa subgengival (77.7%) em relação à saliva (25.9%) e sangue (25.9%) (p<0.0001). No grupo HIV-g, P. gingivalis e HCMV apresentaram maior freqüência na placa subgengival (95.6% e 91.3%, respectivamente) do que na saliva (21.8% e 65.2, respectivamente) e sangue (17.4% e 60.86%, respectivamente) (p<0.0001 e p=0.004, respectivamente). T.forsythia e EBV-1 foram detectados com maior freqüência na placa subgengival (47.8%, 78.3%, respectivamente) e saliva (52.2%, 52.2%, respectivamente) do que no sangue (8.7% e 13%, respectivamente) (p=0.004 e p<0.005, respectivamente). A.actinomycetemcomitans e HSV-1foram detectados com freqüências similares nas três amostras nos dois grupos. Não houve associação entre coinfecção de herpes vírus e patógenos periodontais e doença periodontal em pacientes HIV+ com doença periodontal. Na saliva de pacientes HIV+ houve associação entre EBV-1, e coinfecção viral por EBV-1 e HCMV com a doença periodontal.Herpesviruses are human pathogens widely distributed in the population and, recently, it has been studied a possible involvement of these viruses in the etiology of periodontal disease. HIV positive individuals (HIV+) have shown a higher prevalence of these viruses and the HIV-induced immunosuppression is known to facilitate the reactivation of these microorganisms. Thus, this study aimed to determine the presence of Herpes simplex virus type 1 (HSV-1), Cytomegalovirus (HCMV) and Epstein-Barr virus type 1 (EBV-1), relating to the presence of the periodontopathogens: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) in HIV+ individuals with periodontal disease. Samples were collected from subgingival plaque, saliva and capillary blood from twenty-seven HIV+ subjects with chronic periodontitis (HIV-p) and 23 HIV+ patients with gingivitis (HIV-g). The detection of bacterial species and herpesviruses were identified by Polymerase chain reaction (PCR) and nested PCR respectively. Statistical analysis showed that for HIV-p group, EBV-1 and T. forsythia presented higher detection in subgingival plaque (70.4% and 51.8%, respectively) and saliva (81.5%, 40.7%, respectively) than in blood (22%, 0, respectively) (p<0.005 e p<0.0001, respectively). P. gingivalis was more frequent in subgingival plaque (77.7%) than saliva (25.9%) and blood (25.9%) (p<0.0001). In the HIV-g, P. gingivalis and HCMV presented higher frequency in the subgingival plaque (95.6% and 91.3%, respectively) than in saliva (21.8% e 65.2, respectively) and blood (17.4% e 60.86%, respectively) (p<0.0001 e p=0.004). T.forsythia and EBV-1 were detected more frequently in the subgingival plaque (47.8%, 78.3%, respectively) and saliva (52.2%, 52.2%, respectively) than in blood (p=0.004 and p<0.005, respectively). A.actinomycetemcomitans and HSV-1 were detected with similar frequencies among the three samples in the two groups. There was no association between coinfection of herpesviruses and periodontal pathogens and periodontal disease in HIV patients with periodontal disease. In saliva of HIV patients there was no association between EBV-1, and viral coinfection by EBV-1and HCMV, with periodontal disease

Herpes viruses in periodontal compromised sites: comparison between HIV-positive and -negative patients

Aims: The objective of this study was to compare the frequency of herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in subgingival plaque, saliva and peripheral blood of HIV-positive and-negative patients with periodontal disease. Materials and Methods: Fifty HIV-positive subjects (23 with gingivitis, 27 with periodontitis) and 50 healthy HIV-negative patients with chronic periodontitis were included in the study. Parameters of probing depth (PD), clinical attachment level (CAL), gingival index and plaque index were recorded. The samples were processed for viral identification by the nested polymerase chain reaction technique. Results: HCMV was the most prevalent virus in HIV-positive (82%) and-negative patients (84%), and the detection in the three samples was similar (p > 0.05). HSV-1 was the least prevalent virus in both groups, being detected in similar frequencies in oral sites and in peripheral blood. EBV-1 was found more frequently in saliva and subgingival plaque of HIV-positive patients than in HIV-negative patients (p <= 0.05). Conclusions: EBV-1 was more frequently recovered in oral sites of HIV-positive patients than in HIV-negative patients.FAPESP[04/07147-8

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Resumos em andamento - Saúde Coletiva

Resumos em andamento - Saúde Coletiv

Resumos em andamento - Saúde Coletiva

Resumos em andamento - Saúde Coletiv

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved